Observations from the ACR CT Accreditation Program: Areas of Success and Areas for Improvement James A. Brink, MD February 24, 2011 Background •  Three accrediting organizations are recognized by CMS to fulfill the MIPPA requirements for accreditation by 1/1/12: – ACR: American College of Radiology – ICACTL: Intersocietal Commission for Accreditation of CT Laboratories – TJC: The Joint Commission (through its ambulatory health care program) Background •  Number of accredited sites: – ACR: 4200 – ICACTL: 250 – TJC: unknown* * subset of TJC Ambulatory Health Care Requirements •  ACR: – Objective dose assessment: • Phantom-based – Adult Head – Adult Abdomen – Pediatric Abdomen (5 yr) Requirements •  ACR: – Subjective dose assessment: • Patient-based – Are mAs, kVp, pitch appropriate for exam, body habitus? Requirements •  ICACTL: – Does not assess dose, but has three standards that reflect awareness of dose: • 4.1.1 All CT laboratory professionals must have an understanding of the radiation exposure involved in CT to advise patients undergoing CT imaging Requirements •  ICACTL: • 4.1.2 Radiation dose for CT acquisition should be set at the lowest values that are consistent with satisfactory image quality for the study ordered. Requirements •  ICACTL: • 4.1.6 The laboratory should comply with the currently published ALARA recommendations for personnel and subscribe to dose optimization for patients… Requirements •  TJC: – Does not assess dose – Policies / standards are not readily available Success #1 •  ACR CT Accreditation Program has focused attention on radiation dose monitoring and control since 2002