Changes: The Latest Revisions To The ICAEL Pediatric Standards
| from
the April 2007 issue |
|
Serving
as the basis for the accreditation program, The ICAEL Standards
are an extensive document defining the minimal requirements
for echocardiography laboratories to provide high quality care.
The Standards are used by laboratories as both a guideline
and the foundation to create and achieve realisting quality
care goals. Every two years, these documents are reviewed by
the ICAEL Board of Directors and revised as needed. As an adjunct
to the Adult Standards published in 2006, the ICAEL is
pleased to release the 2007 Pediatric Standards.
This
article will provide an overview of the key revisions made to
the 2007 ICAEL Pediatric Standards. Please visit www.icael.org
to download and review the new Standards in their entirety.
In
numerous statements throughout each document, the Standards
were strengthened, with the word "should" being replaced
by "must." This revision changes these guidelines
from recommendations to requirements.
PART I
Summary Of Revisions To The Organization Standards
MEDICAL
DIRECTOR
The
pediatric Medical Director Required Training and Experience
portion was revised to read as follows:
The
pediatric Medical Director must meet one of the following
criteria:
A)
Advanced level of expertise: high level of expertise in all
aspects of pediatric echocardiography. Physicians with this
level of training are expected to be able to perform independently
and to interpret echocardiograms in patients with all forms
of congenital and acquired pediatric heart disease, and to
supervise and train others. In addition to the core requirement
of 150 studies, each advanced level physician should perform
and interpret at least 200 additional pediatric transthoracic
echocardiograms and review, or perform and interpret, another
200 pediatric echocardiograms. At least 50 should be done
in infants one year of age or younger. Each trainee should
perform a significant number of echocardiograms independently
(one-third to one-half of the exams), with subsequent review
and critique of the examination by the responsible staff pediatric
cardiologist-echocardiographer.
B)
Three years of echocardiography practice experience with at
least 1800 echocardiogram/Doppler examination interpretations
in children and patients with congenital heart disease.
Comment:
It is recognized that some pediatric echocardiography laboratories,
particularly those that perform a majority of studies on adults,
will not achieve the above numbers. However, the individual
pediatric Medical Director must possess the outlined experience,
while it is not necessary that it be obtained at a single
institution.
An
additional requirement appears as item D under Medical Director
Responsibilities:
D)
The pediatric Medical Director must be an active participant
in the interpretation of studies performed in the lab.
TECHNICAL DIRECTOR
The
revised Technical Director Required Training and Experience
Standards state that the Technical Director must hold an
appropriate credential:
1.2
The Technical Director must be a qualified sonographer.
Note:
In a laboratory with no sonographers, the Medical Director
serves as Technical Director. In this case, in addition to
submitting the Medical Director forms, the Medical Director
must also submit all forms and representative cases required
for the Technical Director. If the laboratory is a combined
adult/pediatric laboratory, the Technical Director may be
the same.
1.2.1
Technical Director Required Training and Experience:
A)
The Technical Director must have an appropriate credential
in echocardiography from the American Registry of Diagnostic
Medical Sonography (ARDMS) or Cardiovascular Credentialing
International (CCI). A credential in pediatric echocardiography
is preferred if the Technical Director will be performing
pediatric echocardiograms.
B)
In a laboratory with no sonographers, the physician Technical
Director must have either advanced or core echocardiography
training as defined by Task
Force 2: Pediatric Training Guidelines for Noninvasive Cardiac
Imaging1
or an appropriate sonographer credential from the ARDMS
or CCI.
MEDICAL STAFF
The
pediatric Medical Staff Required Training and Experience section
was revised to read as follows:
The
pediatric Medical staff must meet one of the following criteria:
A)
Advanced level of expertise: high level of expertise in all
aspects of pediatric echocardiography. Physicians with this
level of training are expected to be able to perform independently
and to interpret echocardiograms in patients with all forms
of congenital and acquired pediatric heart disease, and to
supervise and train others. In addition to the core requirement
of 150 studies, each advanced level physician should perform
and interpret at least 200 additional pediatric transthoracic
echocardiograms and review, or perform and interpret, another
200 pediatric echocardiograms. At least 50 should be done
in infants one year of age or younger. Each trainee should
perform a significant number of echocardiograms independently
(one-third to one-half of the exams), with subsequent review
and critique of the examination by the responsible staff pediatric
cardiologist-echocardiographer.
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