Defining a vein center as a facility where venous evaluation and management and/ or treatment procedures are performed, the Intersocietal Accreditation Commission (IAC) accredits facilities with the capability to provide at least two of the four following procedures: sclerotherapy, ambulatory phlebectomy, saphenous vein ablation and/or non-operative management of chronic venous insufficiency with ulceration.
At a minimum, a qualified medical director (MD or DO), appropriate equipment to perform the procedures and utilization of venous duplex ultrasound diagnostic testing in an IAC or American College of Radiology (ACR) accredited facility are required.
Accreditation through IAC Vein Center provides facilities with a pathway to voluntarily demonstrate their commitment to quality patient care to patients, referring physicians and insurance carriers. By participating in the accreditation process, vein centers assess every aspect of their daily operation and its impact on the quality of health care provided to patients. While completing the application, facilities often identify and correct potential problems, revising policies and validating their quality assurance programs. Participating facilities utilize accreditation as the foundation to create and achieve realistic quality care goals.
The process of applying for accreditation takes time and requires proper planning, organization, attention to detail and utilization of all available resources. Facilities wishing to participate in the IAC Vein Center accreditation process are encouraged to first review the IAC Standards for Vein Center Accreditation: Superficial Venous Evaluation and Management. As the basis of the accreditation program, the standards are an extensive document defining the minimum requirements for vein centers to provide quality patient care. The standards represent the collaborative effort of each specialty group represented on the IAC Vein Center Board of Directors, and are designed to be utilized by facilities to conduct a selfevaluation to ensure compliance. The published standards are available free-of-charge, for review and download.
Overview of the Standards
The Organization section of the IAC Standards for Vein Center Accreditation: Superficial Venous Evaluation and Management is devoted to the administrative aspects of the vein center, with guidelines related to personnel and supervision, physical facilities and administrative aspects. Within the Process section, standards specific to procedure overview are provided, including details of the requirement for a written protocol inclusive of indications, contraindications, pretreatment evaluation and reporting outcomes.
Procedures required prior to performance of the procedure, during the performance of the procedure and following the performance of the procedure, are specified for sclerotherapy, ambulatory phlebectomy, endovenous thermal ablation (EVTA) and management of chronic venous insufficiency (CEAP C5-C6). In addition, the standards discuss the procedure volumes sufficient to maintain proficiency in procedure performance. The facility must have performed at least 75 superficial venous procedures over the preceding one-year period in at least two of the four categories. In addition, there must be a minimum of 25 cases per category in at least two of the four categories for the facility to be considered eligible for accreditation.
A section devoted to guidelines for facilities performing fluoroscopy contains guidelines for personnel, the medical physicist, examination areas, equipment and instrumentation, quality control and contrast. The Quality Improvement (QI) section defines the requirements for the QI program, QI measures and QI meetings. Serving the vein center as the accompanying guide throughout the accreditation process, the standards are to be used as a reference when completing the online accreditation application.
Completion of the Accreditation Application
Facilities seeking accreditation through the IAC prepare and submit their applications using IAC online accreditation. To create a vein center account, visitors to the IAC Vein Center website can click “Learn More Now” under the online accreditation login on any page of intersocietal.org/ vein. The online accreditation application format offers those completing the application many benefits. Online help is included throughout the application, with most questions having direct links to the related standards.
The progress of the application’s completeness can be visually tracked, and required attachments are easily uploaded in multiple file formats. Related to data accessibility, the online accreditation format enables applicant facility staff members the ability to retain data and work on their application consistently between accreditation cycles. In addition, the data is accessible from any Internet-based computer, by multiple users from work or home. Upon completion of the application, the data is submitted securely to the IAC in adherence to Secure Sockets Layer (SSL) certification and with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliance.
Applications are accepted by the IAC at any time; there are no specific deadlines. The application elicits key responses that allow reviewers to objectively judge whether or not substantial compliance to the standards is met by the applicant vein center. Representative case studies are evaluated as part of each application and carry a significant weight in the final decision. Once the application is submitted via online accreditation, three venous treatment cases from the submitted procedure log are randomly selected by the IAC for review. The medical director of the applicant vein center is notified of which procedures have been selected and given instructions for submission. Pre-procedure documentation, procedure documentation, post-procedure documentation and follow-up documentation are required.
Numerous resources are available to facilities seeking accreditation. The IAC offers customer service-oriented clinical and administration personnel trained to guide participating vein centers through the accreditation process via phone, live chat or email. Presented by clinical staff, complimentary, live IAC webinars are routinely offered as a means to inform and educate facilities about accreditationrelated topics. In addition, recorded webcasts are also offered free-of-charge and available for viewing at any time. The IAC Vein Center website provides sample documents and reports that facilities may download and customize to reflect their current practices. In addition, a simple, convenient online checklist of items facilities must have for accreditation is made available.
Participation in a Site Visit
As part of the IAC Vein Center accreditation process, each participating facility undergoes a site visit within one year of the date their decision is rendered. The cost of the site visit is covered within the application fee of $6,000. A mutually agreed upon date is determined in advance of the site visit. The objective of the site visit is to ensure the facility’s compliance with the standards by observing operations and reviewing supporting documentation. Each one-day visit includes a tour of the facility and an introductory meeting with the vein center’s medical director. In addition, the site visitors conduct a comprehensive review of records, patient charts and patient procedures. While conducting the site visit, it is important for the site visitors to be able to observe two or three venous ablation procedures, two or three phlebectomy procedures (if performed), two or three sclerotherapy injection patients (if performed) and a new patient workup/venous duplex examination. At the conclusion of the site visit, an exit summation is provided, during which the findings are shared with the medical director.
Once submitted, each application undergoes a comprehensive in-house evaluation for completeness and is then assigned for clinical review. Each submitted application is assigned to two clinical reviewers. The overall evaluation process is one of peer review conducted by trained reviewers who are active in the practice of venous evaluation and management and/or treatment procedures. The review process is accomplished and a decision communicated within 10-12 weeks from the date the application is submitted to the IAC by the participating facility. The accreditation process strives to recognize substantial compliance with the standards when determining the vein center’s accreditation status, and therefore the IAC affords due consideration to each applicant facility’s plans and progress toward achieving compliance. These plans may impact the accreditation decision.
One of the following accreditation decisions is rendered to each applicant facility:
- One-year grant: Accreditation is granted for a period of 12 months for those facilities that are in substantial compliance with all standards. If compliance is demonstrated at the time of site visit, the facility will be granted full accreditation for the remainder of the three-year cycle. If compliance cannot be demonstrated within the specified time frame, the accreditation decision will be delayed.
- Delay: A delayed decision means that there are deficiencies or a lack of compliance to the IAC Vein Center standards that must be addressed by the facility before it can be granted IAC Vein Center accreditation. Facilities receiving a delayed accreditation decision notification have up to 12 months to provide the additionally requested documentation demonstrating adherence to the standards as outlined in the accreditation notification letter. Those facilities have a maximum of only three additional material submissions to demonstrate compliance. If continued non-compliance is documented after review of the three resubmissions, the application will be denied and the facility will be required to resubmit a complete accreditation application and application fees.
One of the most valuable aspects of the process is the application review findings document provided to each participating facility. This electronic report summarizes the strengths and weaknesses of the vein center, as identified during the detailed peer review process. Facilities are encouraged to utilize this critique as a tool for continued improvement. When applying for reaccreditation, the vein center is required to demonstrate that they have addressed the issues raised in the application review findings, as part of their commitment to continuous improvement.
Tools for Promoting Accreditation
Accredited vein centers receive a certificate package containing several tools to utilize for promoting their achievement to patients, referring physicians and insurers. The facility is encouraged to display their accreditation certificates in a prominent area within their vein center. Accredited facilities can download the IAC Seal of Accreditation for use in final reports, on their website and in any other marketing efforts. A press release announcing the facility’s accreditation is also provided.
The IAC offers a service whereby it sends the personalized press release on behalf of the accredited vein center to 10 local media outlets, as identified by the accredited vein center. Accreditation decals imprinted with the Seal of Accreditation for prominent display within their accredited facility are also provided. Lapel pins and embroidered patches that can be worn proudly by staff members on medical scrubs and lab coats are available. To further communicate the significance of vein center accreditation, patient information brochures can be purchased in bulk for a nominal fee for display in the patient waiting areas.
Medical professionals providing venous evaluation and management and/or treatment procedures are being held to high levels of accountability— by patients, by peers, and by insurers. The IAC Vein Center accreditation program offers a means by which vein centers can evaluate and demonstrate the level of patient care they provide and document their commitment to quality. To learn more about the IAC Vein Center accreditation program, visit www.intersocietal.org/vein or call 800-838-2110.