Susana Perese, BS, RVT, FASE

The following is an interview with Susana Perese, BS, RVT, FASE by Fadi Shamoun, MD, FASE. Susana currently serves as a sonographer representative on the Council on Vascular Ultrasound and as the Council’s representative to the Intersocietal Accreditation Commission’s Vascular Testing Board.

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  What is the Intersocietal accreditation commission (IAC)? And what is your role?

The Intersocietal Accreditation Commission (IAC) provides accreditation programs for vascular testing, echocardiography, nuclear/positron emission tomography, magnetic resonance imaging, diagnostic computed tomography, dental computed tomography, carotid stenting and vein treatment and management. The IAC is a nonprofit organization supported by the various sponsoring organizations, while operating independently of their activities. ASE is one of those sponsoring organizations. I currently am on the Vascular Testing board as a representative from the ASE Vascular Council. In this role and capacity I provide input to proposed changes, reviews and comments that make the standards and guidelines what they are today.

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  What are the standards and guidelines for vascular testing accreditation?

Serving as the basis for the accreditation program, the IAC Standards and Guidelines for Vascular Testing Accreditation is an extensive document that defines the minimal requirements for vascular testing facilities to provide high quality care. The standards are used by facilities as both a guideline and the foundation to create and achieve realistic quality care goals. At our facility we use the standards and guidelines as the measure of quality by which we perform and interpret our examinations. This standardization allows all staff to perform examinations equivalently so that the patient and physicians always get the same technical result. This is crucial in our world of ultrasonography given that much of what we do is sonographer dependent.

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  Does compliance with the IAC guidelines and standards reflect on reimbursement of vascular testing procedures?

Although reimbursement is currently not tied nationally to accreditation, over the past few years, several states have adopted payment policies for the reimbursement of vascular testing procedures, requiring either credentialing of individuals performing examinations or accreditation of the facility.

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  Do you require credentialing of individuals performing the examinations or accreditation of the facility?

By January 2017, IAC will require that all technical staff in IAC accredited vascular laboratories must have obtained an appropriate credential in vascular testing. In our facility noncredentialed staff are aware and are making efforts to achieve this requirement. To me, having the vascular testing credential represents one’s personal commitment towards quality patient care that is recognized via professional standards.

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  What is the role of Council on Vascular Ultrasound at the American Society of Echocardiography? And what is your role?

The ASE Council on Vascular Ultrasound was founded in 2007 and is dedicated to representing and advancing quality in vascular ultrasound imaging. Vascular ultrasound has most definitely expanded within the cardiology field. Members of this council provides support, guidance and a forum for ASE members to learn and/or expand their knowledge and practice of vascular ultrasound. The council is rather active within ASE to include providing quarterly articles in JASE, guideline documents and white papers, annual vascular travel grants, and sponsors a dedicated vascular track session at the annual ASE Scientific Session conference. It has been an honor to serve on the ASE Vascular Ultrasound Council and represent this organization at IAC.

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  How do you manage quality assurance in your laboratory?

On a monthly basis, we gather logs from radiology and surgery departments. We pull up reports for patients that were seen for equivalent procedures within our established timeframe (e.g., carotid procedures done within 6 months of each other). We then compare our findings with theirs. Any discrepant cases are reviewed with the designated medical staff member as well as all technical staff. Cases of interest and/or significant variances are presented at our Q&A meetings. Staff, both technical and medical, really enjoy the meetings as it is an opportunity to dialogue about what can be done differently, how well the staff handled a case and most importantly the opportunity to interact and learn from each other.

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  Are there ways to streamline accreditation in both vascular and echocardiography?

Yes. During the process of establishing policies, templates, and standards for accreditation for modality, one inadvertently streamlines the process for the next modality. After all, quality processes are quality processes, so when you set up things right from the beginning every other modality just simply falls into place.

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  How can sonographers get involved with the Vascular Council?

Membership in ASE’s councils is a complimentary member benefit. You can join the Council by checking the Vascular Council box on your membership application or by selecting it in your online membership profile.