IAC Standards & Guidelines For MRI . - Intersocietal
The IAC Standards and Guidelinesfor MRI Accreditation
Table of ContentsAll entries in Table of Contents are linked to the corresponding sections.Introduction . 3Part A: Organization . 4Section 1A: Personnel and Supervision . 4STANDARD – Medical Director . 4STANDARD – Technical Director . 6STANDARD – Medical Staff . 7STANDARD – Technical Staff . 9STANDARD – Support Services . 11STANDARD – Medical Physicist . 11Section 2A: Facility . 12STANDARD – Examination Areas. 12STANDARD – Interpretation Areas . 12STANDARD – Storage Space . 12Section 3A: Examination Reports and Records . 13STANDARD – Records . 13STANDARD – Examination Interpretation and Reports . 13Section 3A: Examination Reports and Records Guidelines . 15Section 4A: Facility Safety . 16STANDARD – Patient and Facility Safety . 16Section 4A: Facility Safety Guidelines. 18Section 5A: Administrative . 19STANDARD – Patient Confidentiality . 19STANDARD – Patient or Other Customer Complaints . 19STANDARD – Primary Source Verification . 19Section 5A: Administrative Guidelines . 19Section 6A: Multiple Sites (Fixed and/or Mobile) . 20STANDARD – Multiple Sites . 20Section 6A: Multiple Sites (Fixed and/or Mobile) Guidelines . 20Part B: Examinations and Procedures . 21Section 1B: Instrumentation and Equipment . 21STANDARD – Instrumentation. 21STANDARD – Equipment Quality Control . 21STANDARD – Quality Control Documentation. 23Section 1B: Instrumentation and Equipment Guidelines. 24Section 2B: Protocols . 25STANDARD – Procedure Volumes . 25STANDARD – Indications . 25STANDARD – Techniques . 25Section 2B: Protocols Guidelines . 26Part C: Quality Improvement . 27Section 1C: Quality Improvement Program . 27STANDARD – QI Program. 27Section 2C: Quality Improvement Measures . 28STANDARD – QI Measures . 28Section 2C: Quality Improvement Measures Guidelines . 29Section 3C: Quality Improvement Meetings . 30STANDARD – QI Meetings. 30Section 4C: Quality Improvement Documentation. 31STANDARD – QI Documentation . 31Appendix A . 32Bibliography. 33IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.2
IntroductionThe Intersocietal Accreditation Commission (IAC) accredits facilities specific to magnetic resonance imaging (MRI).IAC accreditation is a means by which facilities can evaluate and demonstrate the level of patient care they provide.An MRI facility (i.e., imaging center, physician office and hospital) is a unit under the overall direction of a MedicalDirector with a Technical Director who is appointed and responsible for direct supervision of the technical staffmembers and the daily operations of the facility.The intent of the accreditation process is two-fold. It is designed to recognize facilities that provide quality MRIservices. It is also designed to be used as an educational tool to improve the overall quality of the facility.The following are the specific areas of MRI for which accreditation may be obtained: cardiovascular MRIbreast MRIbody MRI [chest (non-cardiac), abdomen, pelvis, extremity]musculoskeletal MRIneurological MRIMRAThese accreditation Standards and Guidelines are the minimum standards for accreditation of MRI facilities. Standardsare the minimum requirements to which an accredited facility is held accountable. Guidelines are descriptions,examples, or recommendations that elaborate on the Standards. Guidelines are not required, but can assist withinterpretation of the Standards.Standards are printed in regular typeface in outline form. Guidelines are printed in italic typeface in narrative form.Standards that are highlighted are content changes that were made as part of the May 15, 2020 revision.These Standards will become effective on November 15, 2020. Facilities applying for accreditation afterNovember 15, 2020 must comply with these new highlighted Standards.In addition to all Standards listed below, the facility, including all staff, must comply at all times with all federal, stateand local laws and regulations, including but not limited to laws relating to licensed scope of practice, facilityoperations and billing requirements.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»3
Part A:OrganizationSection 1A: Personnel and SupervisionSTANDARD – Medical Director1.1AThe Medical Director must be a licensed physician and certified by an American Board of MedicalSpecialties (ABMS) recognized board in a relevant specialty or board certified in a relevant specialtyrecognized by the American Osteopathic Association, Royal College of Physicians and Surgeons of Canadaor Le College des Medicins du Quebec.1.1.1AMedical Director Required Training and ExperienceThe Medical Director must demonstrate an appropriate level of training and experience bymeeting one or more of the following:1.1.1.1AEstablished Practice – A physician who has worked in an MRI facility for at leastfive years, has acquired 150 hours of Category I CME relevant to MRI to includecourses specifically designed to provide knowledge of the techniques, safety,limitations, accuracy and methods of interpretation and clinical applications specificto the anatomic area and has interpreted a minimum of 1,000 MRI examinations.OR1.1.1.2AFormal Training Program – Completion of a residency or fellowship that includesappropriate didactic and clinical MRI facility experience as an integral part of theprogram and a minimum number of cases interpreted specific to the anatomic areaas indicated:i.ii.iii.iv.v.vi.body – 300 casescardiovascular – 300 casesmusculoskeletal – 300 casesneurological – 300 casesMRA – 150 casesbreast – 150 casesComment: The formal training experience is to be documented by a letter from thedirector of the training program verifying the areas of MRI expertise and theextent of the training experience.OR1.1.1.3AInformal Trainingi.Didactic: Appropriate background for proper qualifications to interpret MRIfacility studies can be achieved through accredited postgraduate continuingmedical education (CME). A minimum of 150 hours of AMA Category ICME credits must be acquired within a three-year period. These hours mustbe met with courses specifically designed to provide knowledge of thetechniques, safety, limitations, accuracy and methods of interpretation of MRIexaminations and clinical applications specific to the anatomic area.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»4
ii.Documentation of the CME courses, with a listing of the content, must besubmitted.Practical Experience: In addition to the formal didactic education outlinedabove, the individual must acquire a minimum of six months of supervisedpractical experience observing or participating in MRI procedures,preferably in an accredited facility. The practical experience must includeall areas of MRI for which the facility is applying. This experience is to bedocumented with a letter from the Medical Director of the facility where thepractical experience was obtained.For those examinations the Medical Director will interpret, experience ininterpreting the following minimum number of MRI or MRA studies, whileunder supervision, must be documented:1.1.1.4A body – 300 cases cardiovascular – 300 casesmusculoskeletal – 300 casesneurological – 300 cases MRA – 150 casesbreast – 150 casesNeuroimaging Subspecialtyi.Current Neuroimaging subspecialty certification by the United Council forNeurologic Subspecialties (UCNS).ORii.1.1.2ACurrent certification in MRI by the American Society of Neuroimaging(ASN).Medical Director ResponsibilitiesThe Medical Director responsibilities include but are not limited to:1.1.3A1.1.2.1Aall clinical MRI services provided and for the determination of the quality ofimaging provided related to the MRI services;1.1.2.2Asupervising the entire operation of the facility or delegating specific operations tofacility staff members;1.1.2.3Aselecting and approving medical staff members and supervising their work; and1.1.2.4Aassuring compliance of the medical and technical staff to the Standards outlinedwithin this document.Continuing Medical Education (CME) Requirements1.1.3.1AThe Medical Director must show evidence of maintaining current knowledge byparticipation in CME courses that are relevant to MRI. A minimum of 15 hours ofAMA Category I CME is required every three years. It is recommended that aminimum of 1 CME hour include MRI safety instruction.Comment: To be relevant to MRI, the course content must address the principles,instrumentation, techniques and/or interpretation of MRI specific to the anatomic area.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»5
1.1.3.2AYearly accumulated CME must be kept on file and available to IAC whenrequested.Comment: If the Medical Director has completed formal training as specified under 1.1.1.2A inthe last three years, the CME requirement will be considered fulfilled. Correlation conferencesor other internal meetings are not to be counted as part of this requirement.STANDARD – Technical Director1.2AA qualified Technical Director (i.e., supervisor, chief technologist, manager, etc.) is designated for thefacility.1.2.1ATechnical Director Required Training and ExperienceThe Technical Director must have appropriate training, technical certification and documentedexperience in the field of MRI. The Technical Director must meet one of the following criteria:1.2.1.1AAmerican Registry of Radiologic Technologists (ARRT) or the CanadianAssociation of Medical Radiation Technologists (CAMRT) certification in MRI(RT (MR)).OR1.2.1.2AAn appropriate credential from a nationally recognized credentialing organizationin another medical imaging specialty (i.e., NMTCB, ARDMS, ARRT orARMRIT).ANDOne year (12 months) of full-time (35 hours/week) equivalent experience as anMRI technologist performing a minimum of 100 examinations.OR1.2.1.3AFor personnel operating scanners capable of performing only peripheral jointimaging, all of the following criteria must be met:i.ii.iii.iv.medical practitioner state license or state certification acceptable to IACMRI (i.e., basic operator, LMRT, RE);three months clinical experience performing examinations;performance of at least 125 MRI examinations; andcertificate from MRI vendor documenting a minimum of 56 hours ofuninterrupted (but not necessarily contiguous) training. No more than 16 ofthe 56 hours may be acquired through self-study that includes successfulcompletion of structured education that is Recognized ContinuingEducation Evaluation Mechanism (RCEEM) approved. The vendor’straining on the device must include: MRI safety;basic anatomy; basic MRI physics; slice orientation; andsequence and protocol development.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»6
1.2.2ATechnical Director Responsibilities1.2.2.1AThe Technical Director reports directly to either the facility administrator or theMedical Director. Responsibilities include, but are not limited to, and may bedelegated to other staff:i.ii.iii.iv.v.vi.vii.viii.1.2.3Aall facility duties delegated by the facility administrator and/or MedicalDirector;supervision of the technical and ancillary staff;Comment: The Technical Director must provide oversight of the technicalstaff.the delegation, when warranted, of specific responsibilities to the technicalstaff and/or the ancillary staff;daily technical operation of the MRI facility (i.e., staff scheduling, patientscheduling, record-keeping, etc.);operation and maintenance of MRI imaging equipment;the compliance of the technical and ancillary staff to the Standards outlinedwithin this document;working with the Medical Director, medical staff and technical staff toensure quality patient care; andtechnical training.Continuing Education (CE) Requirements1.2.3.1AThe Technical Director must document at least 15 hours of Category I AMA orRCEEM approved MRI-related CE over a period of three years. It isrecommended that a minimum of 1 CE hour include MRI safety instruction.Comment: To be relevant to MRI, the course content must address the principles,instrumentation, techniques and/or interpretation of MRI specific to the anatomicarea.1.2.3.2AYearly accumulated CE must be kept on file and available to IAC when requested.Comment: If the Technical Director has successfully acquired an appropriate MRI credentialwithin the past three years, the CE requirement will be considered fulfilled.STANDARD – Medical Staff1.3AAll members of the medical staff must be licensed physicians and American Board of Medical Specialties(ABMS) board certified in a relevant specialty or board certified in a relevant specialty recognized by theAmerican Osteopathic Association, Royal College of Physicians and Surgeons of Canada or Le College desMedicins du Quebec.1.3.1AMedical Staff Required Training and ExperienceThe medical staff must demonstrate an appropriate level of training and experience by meetingone or more of the following:1.3.1.1AEstablished Practice – A physician who has worked in a MRI facility for at leastthree years, has acquired 150 hours of Category I CME relevant to MRI to includecourses specifically designed to provide knowledge of the techniques, safety,limitations, accuracy and methods of interpretation and clinical applicationsspecific to the anatomic area and has interpreted a minimum of 500 MRI facilityexaminations.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»7
OR1.3.1.2AFormal Training Program – Completion of a residency or fellowship that includesappropriate didactic and clinical MRI facility experience as an integral part of theprogram and interpreted a minimum of 150 cases specific to the anatomic area:i.ii.iii.iv.v.vi.body – 150 casescardiovascular – 150 casesmusculoskeletal – 150 casesneurological – 150 casesbreast – 150 casesMRA – 150 casesComment: The formal training experience is to be documented by a letter from thedirector of the training program verifying the areas of MRI expertise and theextent of the training experience.OR1.3.1.3AInformal Trainingi.ii.Didactic – Appropriate background for proper qualifications to interpretMRI facility studies can be achieved through accredited postgraduatecontinuing medical education (CME). A minimum of 150 hours of AMACategory I CME credits must be acquired within a three-year period. Thesehours must be met with courses specifically designed to provide knowledgeof the techniques, safety, limitations, accuracy and methods ofinterpretation of MRI examinations and clinical applications specific to theanatomic area. Documentation of the CME courses, with a listing of thecontent, must be submitted.Practical Experience – In addition to the formal didactic education outlinedabove, the individual must acquire a minimum of six months of supervisedpractical experience observing or participating in MRI procedures,preferably in an accredited facility. The practical experience must includeall areas of MRI for which the facility is applying. This experience is to bedocumented with a letter from the Medical Director of the facility where thepractical experience was obtained.For those examinations the medical staff member will interpret, experiencein interpreting the following minimum number of MRI or MRA studies,while under supervision, must be documented: 1.3.1.4Abody – 150 casescardiovascular – 150 cases musculoskeletal – 150 cases neurological – 150 casesbreast – 150 casesMRA – 150 casesNeuroimaging Subspecialtyi.Current Neuroimaging subspecialty certification by the United Council forNeurologic Subspecialties (UCNS).ORIAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»8
ii.Current certification in MRI by the American Society of Neuroimaging(ASN).Comment: ASN and UCNS certification is accepted for physicians who onlyinterpret brain and spine examinations.1.3.2AMedical Staff ResponsibilitiesMedical staff responsibilities include but are not limited to:1.3.3A1.3.2.1Athe medical staff reports to the Medical Director; and1.3.2.2Athe medical staff interprets and/or performs clinical MRI studies in accordancewith privileges approved by the Medical Director.Continuing Medical Education (CME) Requirements1.3.3.1AThe medical staff members must obtain a minimum of 15 hours of AMA CategoryI CME every three years. The medical staff must show evidence of maintainingcurrent knowledge by participation in CME courses that are relevant to MRI. It isrecommended that a minimum of 1 CME hour include MRI safety instruction.Comment: To be relevant to MRI, the course content must address the principles,instrumentation, techniques and/or interpretation of MRI specific to the anatomicarea.1.3.3.2AYearly accumulated CME must be kept on file and available to IAC whenrequested.Comment: If the medical staff member has completed formal training as specified under1.3.1.2A in the past three years, the CME requirement will be considered fulfilled. Correlationconferences or other internal meetings are not to be counted as part of this requirement.STANDARD – Technical Staff1.4AThe technical staff must have appropriate training, technical certification and/or documented experience inthe field of MRI.1.4.1ATechnical Staff Required Training and ExperienceAll members of the technical staff must meet one or more of the following criteria:1.4.1.1AAmerican Registry of Radiologic Technologists (ARRT) or the CanadianAssociation of Medical Radiation Technologists (CAMRT) certification in MRI(RT (MR)).OR1.4.1.2ASuccessful completion of a MRI training program, which includes verified didacticand supervised clinical experience in MRI. These programs must be accredited bythe Joint Review Committee on Education in Radiologic Technology (JRCERT)or accredited by the Canadian Medical Association Committee on ConjointAccreditation (CMA-CCA).ORIAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»9
1.4.1.3ACompletion of six months full-time supervised (35 hours/week) postgraduateclinical MRI experience plus one of the following:i.ii.iii.an appropriate credential from a nationally recognized credentialingorganization in another medical imaging specialty (i.e., NMTCB, ARDMS,ARRT or ARMRIT);completion of a formal two-year program or equivalent in another medicalimaging profession (see 1.4.1.2A); orcompletion of a bachelor’s degree in another medical imaging specialty.OR1.4.1.4AFor personnel operating scanners capable of performing only peripheral jointimaging, all of the following criteria must be met:i.ii.medical practitioner state license or state or national certification acceptableto IAC MRI (i.e., CMA, basic operator, LMRT, RE);certificate from MR vendor documenting a minimum of 56 hours ofuninterrupted (but not necessarily contiguous) training;Comment: No more than 16 of the 56 hours may be acquired through selfstudy that includes successful completion of structured education that isRCEEM approved. The vendor’s training on the device should include:iii.iv. MRI safety;basic anatomy;basic MRI physics; slice orientation; andsequence and protocol development.three months clinical experience performing examinations; andperformance of at least 125 MRI examinations.OR1.4.1.5AFor personnel operating a MRI scanner full time prior to and consistently since2013, without meeting any of the above required training and experience criteria(1.4.1.1A, 1.4.1.2A, 1.4.1.3A, 1.4.1.4A), the following must be provided:i.ii.1.4.2Aa letter from the current Medical Director or Technical Director verifyingthe training, experience and competency prior to and consistently since2013, specific to the testing area for which they are applying;if less than five years at the current position, a letter from the previousMedical or Technical Directors prior to and consistently since 2013,verifying training, experience and competency specific to the testing areafor which they are applying.Technical Staff ResponsibilitiesTechnical staff responsibilities include but are not limited to:1.4.2.1Areports to the Technical Director; and1.4.2.2Aassumes the responsibilities specified by the Technical Director and, in general, isresponsible for the performance of clinical examinations and other tasks assigned.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»10
1.4.3AContinuing Education (CE) Requirements1.4.3.1AThe technical staff must document at least 15 hours of Category I AMA orRCEEM approved MRI-related continuing education over a period of three years.It is recommended that a minimum of one CE hour include MRI safety instruction.Comment: To be relevant to MRI, the course content must address the principles,instrumentation, techniques and/or interpretation of MRI specific to the anatomicarea.1.4.3.2AYearly accumulated CE must be kept on file and available to IAC when requested.Comment: If the technical staff member has successfully acquired an appropriate MRIcredential within the past three years, the CE requirement will be considered fulfilled.STANDARD – Support Services1.5AAncillary personnel (i.e., clerical, nursing, transport, etc.), if necessary for safe and efficient patient care,must be provided.1.5.1AClerical and administrative support is sufficient to ensure efficient operation and recordkeeping.1.5.2ASupervision: The Medical Director must ensure that support services are appropriate and in thebest interest of patient care.STANDARD – Medical Physicist1.6AThe medical physicist must be certified by the American Board of Radiology in Diagnostic Medical (orDiagnostic Radiologic) Physics, by the American Board of Medical Physics in Diagnostic Medical Physicsor MRI Physics, or by the Canadian College of Physicists in Medicine in MRI Physics. In states wheremedical physicists are licensed, a full license to practice Diagnostic or MRI Medical Physics is acceptable.1.6.1AOther personnel, deemed by the medical physicist as competent to perform the assigned tasks,are permitted to assist the medical physicist in data collection. The medical physicist mustapprove all work performed by assistants and must sign the final report.1.6.2AThe medical physicist must document at least 15 hours of Category I AMA Continuing MedicalEducation (CME) or Commission on Accreditation of Medical Physicists Educational Programs(CAMPEP) continuing education related to medical physics and/or medical imaging over aperiod of three years.1.6.2.1AA minimum of three hours of the documented 15 hours of CE must be related toMRI safety.1.6.2.2AYearly accumulated CE must be kept on file and available to IAC MRI, whenrequested.IAC Standards and Guidelines for MRI Accreditation (Published May 15, 2020) 2020 Intersocieta
May 15, 2020 · RCEEM approved MRI-related CE over a period of three years. It is recommended that a minimum of 1 CE hour include MRI safety instruction. Comment: To be relevant to MRI, the course content must address the principles, instrumentation, techniques and/or interpretation of MRI specific to the anatomic area.
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Annual Report 2018 REPORT Contents The Provost 2 The Fellowship 5 Tutorial21 Undergraduates37 Graduates42 Chapel46 Choir 52 Research 60 Library and Archives 64 Bursary67 Staff 71 Development75 Major Promotions, Appointments or Awards 103 Appointments & Honours 104 Obituaries107 Information for Non-Resident Members 319. The University has been the subject of press attention in relation to the .
