December 07, 2021

Spotlight on Accreditation

In this issue, we talk about the ACR® Accreditation program with Margaret M. Szabunio, MD, FACR, FAAWR, Chair of the ACR Committee of Accreditation Chairs in the Commission of Quality and Safety and Chair of the ACR Committee on Mammography Accreditation, and Chief of the Division of Women's Radiology at UK HealthCare — the hospitals and clinics of the University of Kentucky in Lexington.

Q. Tell us about the ACR Accreditation program and its importance to improving quality and safety.

A. The ACR offers accreditation programs in CT, MRI, breast MRI, nuclear medicine and PET as mandated under the Medicare Improvements for Patients and Providers Act (MIPPA) as well as for modalities mandated under the Mammography Quality Standards Act (MQSA). The overarching goal of the ACR Accreditation program is to ensure consistency in radiological practice by adhering to established industry standards for every modality. We aim to ensure we have reproducibility of what we do and continually strive to reduce medical errors, which is one of the top causes of death in the United States. With the ACR Accreditation program, we want to make sure that we, as physicians, are meeting certain standards, and also that the images we produce in our institutions are complying with standards. The ultimate beneficiaries of ACR Accreditation's rigorous standards are our patients.

Q. Why is the ACR Accreditation program the gold standard for quality and safety?

A. ACR Accreditation is the oldest and most experienced radiological imaging and radiation oncology accreditation body with more than three decades of experience. By displaying the gold seals of ACR Accreditation, facilities can demonstrate to their patients, payers and referring providers that they are committed to providing the safest and best quality care possible. We are a gold standard because we are raising the bar for radiology and radiation oncology practices to achieve a higher level of consistent imaging quality. The ACR Accreditation review program includes physicians, physicists and technology experts in radiology and radiation oncology. What we’re trying to do is to make sure that we, as representatives of the ACR, are all looking at images and scoring examinations in the same way. In order to do that, we require education for the reviewers to reduce subjectivity and make the assessments as objective as possible. So we all can be proud of giving out an ACR Certificate of Accreditation — meaning that we all believe in and follow the same standards.

Q. What initiatives are currently underway to update and strengthen the ACR Accreditation program?

A. The ACR Accreditation program is constantly evolving to help facilities keep up with the latest quality and safety guidelines and deliver the best care possible. Prior to the pandemic, the ACR would perform on-site surveys to validate compliance with regulations and safety standards. Those visits have been one of our best tools to communicate with facilities and personnel and allow them to ask questions. We have enabled the Radiation Oncology Accreditation and Diagnostic Imaging Center of Excellence programs to perform virtual site visits to ensure continuous operation of these important programs. In addition, the FDA has allowed virtual site visits under limited circumstances for mammography facilities. The ACR will soon release an updated accreditation database to include many enhancements. We are also participating in the ACR Learning Network, which seeks to improve diagnostic excellence in imaging with a focus on cancer diagnosis. Four initial improvement collaboratives are supported by a standard process for improvement. What we learn from those collaborations will inform the ACR Accreditation program going forward.

Q. What are some steps that radiologists should take now to improve their quality and safety?

A. The ACR has many quality improvement programs such as Image Gently® and Image Wisely®. We should all participate in those programs. “Take the Pledge” to Image Wisely and get resources and information on radiation safety in adult medical imaging. Image Gently is working to increase awareness of the opportunities to promote radiation protection when imaging children.

Please consider becoming a designated Center of Excellence in the following domains: Breast Imaging Center of Excellence, Diagnostic Imaging Center of Excellence, Lung Cancer Screening Center and Prostate Cancer MRI Center. If all practices strive for these, it is very worthwhile because it ensures proper imaging and the best possible interpretation of images because all the radiologists and technologists are doing whatever they need to do to stay at the current level of knowledge and raise the bar.

Finally, I am very passionate about the education of residents and fellows, our next generation of radiologists, and we want them to be more successful than we are. It is important for all of us not to lose sight of this perspective: that we are not just looking at images or interpreting images or doing biopsies. There's a human behind the images — there is a person with feelings and fears — and I always tried to teach my residents and fellows how important it is to remember that.

In the Spotlight

Margaret M. Szabunio, MD, FACR, FAAWR, is Chief of the Division of Women's Radiology and Professor of Radiology, Surgery and Biomedical Engineering at UK HealthCare, the hospitals and clinics of the University of Kentucky in Lexington, KY. She is also Chair of the ACR Committee of Accreditation Chairs in the Commission of Quality and Safety and Chair of the ACR Committee on Mammography Accreditation.

Dr. Szabunio completed medical school at Drexel University College of Medicine (formerly Hahnemann University Medical School) in Philadelphia, followed by a radiology residency and fellowship at Long Island Jewish Medical Center in New York.

Her clinical goal is early detection of breast cancer using new and emerging technologies. She is board certified by the American Board of Radiology.