IAC Standards & Guidelines For Dental CT Accreditation (2018)
The IAC Standards and Guidelines forDental CT 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 – Dental or Medical Director(s)4STANDARD – Dental or Medical Staff6STANDARD – Technical Staff7STANDARD – Medical Physicist or Qualified Expert9STANDARD – Support Services9Section 2A: Facility . 10STANDARD – Examination Areas10Section 3A: Examination Reports and Records . 11STANDARD – Records11STANDARD – Examination Interpretation and Reports11Section 3A: Examination Reports and Records Guidelines . 13Section 4A: Dental Practice Safety . 14STANDARD – Dental Practice Safety14Section 4A: Dental Practice Safety Guidelines . 15Section 5A: Administrative . 16STANDARD – Patient Confidentiality16STANDARD – Patient or Other Customer Complaints16STANDARD – Primary Source Verification16STANDARD – Indications16STANDARD – Ordering Process and Scheduling16Section 6A: Multiple Sites (Fixed and/or Mobile) . 17STANDARD – Multiple Sites17Section 6A: Multiple Sites (Fixed and/or Mobile) Guidelines . 17Part B: Instrumentation and Procedures . 18Section 1B: Instrumentation and Equipment. 18STANDARD – Instrumentation18Section 1B: Instrumentation and Equipment. 19Section 2B: Equipment Quality Assurance . 20STANDARD – Quality Assurance (QA)20Section 2B: Equipment Quality Assurance Guidelines . 22Section 3B: Elements and Components of CT Examination Performance . 23STANDARD – Elements of CT Examination Performance23Section 4B: Procedure Volumes . 24STANDARD – Procedure Volumes24Section 4B: Procedure Volumes Guidelines. 24Part C: Quality Improvement . 25Section 1C: Quality Improvement (QI) Program . 25STANDARD – QI Program25Section 1C: Quality Improvement Program Guidelines . 25Section 2C: Quality Improvement Measures . 26STANDARD – QI Measures26Section 2C: Quality Improvement Measures Guidelines. 27Section 3C: Quality Improvement Meetings . 28STANDARD – QI Meetings28Section 4C: Quality Improvement Documentation. 29STANDARD – QI Documentation29Bibliography . 30Medical Physicist or Qualified Expert Guidance Document . 31Medical Physicist or Qualified Expert Assessment Requirements . 33The IAC Standards and Guidelines for Dental CT Accreditation (Published 9/1/2015, Revised 9/12/2018) 2018 Intersocietal Accreditation Commission. All Rights Reserved.2
IntroductionThe IAC Standards and Guidelines for Dental CT Accreditation list the requirements and recommendations for thedental practice and/or dental specialty practice performing diagnostic and/or treatment planning maxillofacialcomputed tomography (CT) examinations using a cone beam CT system. For any practice using a conventional CTsystem, accreditation may be obtained through the non-dental IAC CT program atintersocietal.org/ct/seeking/ct standards.htm.These accreditation Standards and Guidelines are the minimum standards for accreditation of dental CT practices.Standards are the minimum requirements to which an accredited practice is held accountable. Guidelines aredescriptions, examples, or recommendations that elaborate on the Standards. Guidelines are not required, but canassist with interpretation of the Standards.Standards are printed in regular typeface in outline form. Guidelines are printed in italic typeface in narrative form.These Standards became effective on September 1, 2015, with minor revisions published on September 12,2018. Facilities applying for accreditation must comply with this version of the Standards.In addition to all standards listed below, the facility, including all staff, must comply at all times with all federal,state and local laws and regulations, including but not limited to laws relating to licensed scope of practice, facilityoperations and billing requirements.The IAC Standards and Guidelines for Dental CT Accreditation (Published 9/1/2015, Revised 9/12/2018) 2018 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»3
Part A:OrganizationSection 1A: Personnel and SupervisionSTANDARD – Dental or Medical Director(s)1.1AThe Dental or Medical Director must be a dentist or specialty dentist, board certified (or board eligible withintwo years of completion of training) in a dental specialty recognized by the American Dental Association(ADA) or the Royal College of Dentists of Canada; or a physician, certified by the American Board ofMedical Specialties (ABMS), American Osteopathic Association, Royal College of Physicians and Surgeonsof Canada or Le College des Medicins du Quebec in a relevant specialty. The Dental or Medical Directormust have a license in good standing from the state or province in which the practice is located.1.1.1ADental or Medical Director Required Training and Experience:The Dental or Medical Director must meet at least one of the following criteria:1.1.1.1AFormal Trainingi.Completion of residency in a dental specialty that included advancedradiology /imaging training as part of the curriculum approved by the ADACommission on Dental Accreditation (CODA) or the Commission onDental Accreditation of Canada (CDAC), with a letter of verification fromthe program director of the educational institution.ORii.Board certified by an ADA recognized dental specialty certifying board thatincludes advanced radiology/imaging training and is recognized by CODAor CDAC.ORiii.Board certified (or board eligible within two years of completion oftraining) in a medical specialty recognized by the American Board ofMedical Specialties (ABMS), American Osteopathic Association (AOA),Royal College of Physicians and Surgeons of Canada or Le College desMedicins du Quebec and completion of a minimum of a four-month formaltraining program in CT with radiation safety training as part of thecurriculum and/or at least one year (full-time equivalent) of CT experiencewith independent interpretation of at least 150 maxillofacial CT studies.OR1.1.1.2AInformal Trainingi.Documented interpretation of at least 150 mentored* maxillofacial CTexaminations.ANDThe IAC Standards and Guidelines for Dental CT Accreditation (Published 9/1/2015, Revised 9/12/2018) 2018 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»4
ii.Attendance in at least 20 hours of CT training with a letter of verificationfrom the program director of the educational institution. Such trainingshould be certified for ADA Continuing Education Recognition Program(CERP), Academy of General Dentistry (AGD) Program Approval forContinuing Education (PACE) and/or Category I continuing education (CE)credit. The 20 hours of CT training must include at least three hours ofrelevant radiation safety instruction.*The case load recommendation may include studies from established teaching files orelectronic online CE courses that include a post test or course competency.OR1.1.1.3AEstablished Practicei.A dentist, specialty dentist or physician who has been interpreting CTstudies for at least three years.ANDii.Has acquired 50 hours ADA CERP, AGD PACE and/or Category I CE (atleast 15 hours of the CE must be CT-related training and include at leastthree hours of relevant radiation safety.ANDiii.1.1.2ADental or Medical Director Responsibilities:1.1.2.1AThe Dental or Medical Director is responsible for all clinical services provided andfor the determination of the quality and appropriateness of care provided.i.ii.iii.1.1.3AHas interpreted a minimum of 150 documented maxillofacial CTexaminations over the course of their career.The Dental or Medical Director may supervise the entire operation of thedental practice or may delegate specific operations to associate Dental orMedical Director(s) or dental or medical staff.The Dental or Medical Director is responsible for assuring compliance ofthe Dental or medical staff and technical staff to the Standards outlined inthis document and the supervision of their work.The Dental or Medical Director must be an active participant in theinterpretation of CT examinations performed in the practice. If notgenerating final reports, the Dental or Medical Director must providedocumentation of review and acceptance of reports, or amendment offindings as appropriate.Continuing Education (CE) Requirements for Reaccreditation:1.1.3.1AThe Dental or Medical Director must document at least 15 hours of ADA CERP,AGD PACE and/or Category I CE in dental/maxillofacial CT that have beenacquired within the past three years.1.1.3.2AA minimum of three hours of the documented 15 hours of CE must be related toradiation safety.1.1.3.3AYearly accumulated CE must be kept on file and available to the IAC CT, whenrequested.The IAC Standards and Guidelines for Dental CT Accreditation (Published 9/1/2015, Revised 9/12/2018) 2018 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»5
Comment: If the Dental or Medical Director has completed training or certification, as specifiedunder 1.1.1.1A in the past three years, the CE requirement will be considered fulfilled.STANDARD – Dental or Medical Staff1.2AThe dental or medical staff must be a dentist or specialty dentist, board certified (or board eligible within twoyears of completion of training) in a dental specialty recognized by the American Dental Association (ADA)or by the Royal College of Dentists of Canada; or a physician certified in a relevant specialty recognized bythe American Board of Medical Specialties (ABMS), American Osteopathic Association (AOA), RoyalCollege of Physicians and Surgeons of Canada or Le College des Medicins du Quebec. The dental or medicalstaff must have a license in good standing from the state or province in which the practice is located.1.2.1ADental or Medical Staff Required Training and Experience:The dental or medical staff must meet at least one of the following criteria:1.2.1.1AFormal Trainingi.Completion of a residency in a dental specialty that included advancedradiology/imaging training and radiation safety as part of the curriculumapproved by ADA Commission on Dental Accreditation (CODA) orCommission on Dental Accreditation of Canada (CDAC) with a letter ofverification from the program director of the educational institution.ORii.Board certified by an ADA-recognized dental specialty certifying board thatincludes advanced radiology/imaging training and radiation safety and isrecognized by CODA or CDAC.ORiii.Board certified (or board eligible within two years of completion oftraining) in a medical specialty recognized by the American Board ofMedical Specialties (ABMS), American Osteopathic Association (AOA),Royal College of Physicians and Surgeons of Canada or Le College desMedicins du Quebec and completion of a minimum of a four-month formaltraining program in CT with radiation safety training as part of thecurriculum and/or at least one year (full-time equivalent) of CT experiencewith independent interpretation of at least 150 maxillofacial CT studies.OR1.2.1.2AInformal Trainingi.Documented interpretation of at least 150 mentored* maxillofacial CTexaminations.ANDii.Attendance in at least 20 hours of CT training with a letter of verification from theprogram director of the educational institution. Such training should be certifiedfor ADA CERP, AGD PACE and/or Category I CE. The 20 hours of CT trainingmust include at least three hours of relevant radiation safety instruction.*The case load recommendation may include studies from established teaching files orelectronic online CE courses that include a post test or course competency.The IAC Standards and Guidelines for Dental CT Accreditation (Published 9/1/2015, Revised 9/12/2018) 2018 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»6
OR1.2.1.3AEstablished Practicei.A dentist, specialty dentist or physician who has been interpreting CTstudies for at least three years.ANDii.Has acquired 50 hours ADA CERP, AGD PACE, and/or Category I CE (atleast 15 hours of the CE must be CT-related and include at least three hoursof relevant radiation safety instruction.ANDiii.1.2.2ADental or Medical Staff Responsibilities:1.2.2.1A1.2.3AHas interpreted a minimum of 150 documented maxillofacial CTexaminations over the course of their career.The dental or medical staff interprets diagnostic and/or treatment planning CTexaminations in compliance with the requirements established by the Dental orMedical Director.Continuing Education (CE) Requirements for Reaccreditation:1.2.3.1AThe dental or medical staff must document at least 15 hours of ADA CERP, AGDPACE and/or Category I CE in maxillofacial CT that have been acquired withinthe past three years.1.2.3.2AA minimum of three hours of the documented 15 hours of CE must be related toradiation safety.1.2.3.3AYearly accumulated CE must be kept on file and available to the IAC CT, whenrequested.Comment: If the dental or medical staff member has completed training or certification, asspecified under 1.2.1.1A in the past three years, the CME requirement will be considered fulfilled.STANDARD – Technical Staff1.3AThe technical staff must meet the specific state or province requirements where the practice is located toperform dental radiographic procedures, have appropriate training and technical certification as notedbelow and documented experience in the use of a cone beam CT scanner for the performance of dental /maxillofacial CT imaging.1.3.1ATechnical Staff Required Training and Experience:Technical staff must meet at least one of the following criteria:1.3.1.1AA dentist or specialty dentist, board certified (or board eligible within two years ofcompletion of training) in a dental specialty recognized by the American DentalAssociation (ADA) or by the Royal College of Dentists of Canada; or a licensedphysician certified by the American Board of Medical Specialties (ABMS), AmericanOsteopathic Association (AOA), Royal College of Physicians and Surgeons of Canadaor Le College des Medicins du Quebec in a relevant specialty as well as a licensein good standing from the state or province in which the practice is located.The IAC Standards and Guidelines for Dental CT Accreditation (Published 9/1/2015, Revised 9/12/2018) 2018 Intersocietal Accreditation Commission. All Rights Reserved.Return to Table of Contents»7
OR1.3.1.2AA dental assistant or dental hygienist state license or state certification, orauthorization by the state radiation control/protection department, and incompliance with the state dental board regulations.OR1.3.1.3AIn states with no licensure for dental assistants or dental hygienists, a DentalAssistant National Board (DANB) certification, a Certified Dental Assistant(CDA) certification or Certified Orthodontic Assistant (COA) certification, withcertification of training and education from an accredited educational program(e.g., CODA).OR1.3.1.4AA radiologic technologist with certification by the American Registry ofRadiologic Technologists (ARRT) or the Canadian Association of MedicalRadiation Technologists (CAMRT) (i.e., RT).AND for the pathways 1.3.1.1A, 1.3.1.2A and 1.3.1.3A:1.3.1.5AAt least three hours of documented, specific training in radiation safety relevant toCT testing.AND for all pathways listed above (1.3.1.1A, 1.3.1.2A, 1.3.1.3A and 1.3.1.4A):1.3.1.6A1.3.2A1.3.3AReceived at least four hours of documented, equipment specific training in theoperation of each CT scanning system employed. The training may be provided bythe manufacturer or by a technical staff member with documentation of trainingprovided by the manufacturer.Technical Staff Responsibilities:1.3.2.1AThe technical staff member(s) reports to the Dental or Medical Director.1.3.2.2AThe technical staff member(s) assumes the responsibilities specified by the Dentalor Medical Director and, in general, is responsible for the performance of clinicalCT examinations and other tasks assigned.Continuing Education (CE) Requirements for Reaccreditation:1.3.3.1AThe technical staff member(s) must document at least 15 hours of ADA CERP,AGD PACE, Category 1 or Category A CE which must be relevant todental/maxillofacial CT that have been acquired within the past three years.1.3.3.2AA minimum of three hours of the documented 15 hours of CE must be related toradiation safety.1.3.3.3AYearly accumulated CE must be kept on file and available to the IAC CT, whenrequested.Comment: If the technical staff member has completed training or certification, as specified un
Commission on Dental Accreditation (CODA) or the Commission on Dental Accreditation of Canada (CDAC), with a letter of verification from the program director of the educational institution. OR ii. Board certified by an ADA recognized dental specialty certifying board that includes advanced radiology/imaging training and is recognized by CODA or .
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