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We describe our process for quality improvement (QI) for a 3-year accreditation cycle in echocardiography by the Intersocietal Accreditation Commission (IAC) for a large group practice. Echocardiographic laboratory accreditation by the IAC was introduced in 1996, which is not required but could impact reimbursement. To ensure high-quality patient care and community recognition as a facility committed to providing high-quality echocardiographic services, we applied for IAC accreditation in 2010. Currently, there is little published data regarding the IAC process to meet echocardiography standards. We describe our approach for developing a multicampus QI process for echocardiographic laboratory accreditation during the 3-year cycle of accreditation by the IAC. We developed a quarterly review assessing (1) the variability of the interpretations, (2) the quality of the examinations, (3) a correlation of echocardiographic studies with other imaging modalities, (4) the timely completion of reports, (5) procedure volume, (6) maintenance of Continuing Medical Education credits by faculty, and (7) meeting Appropriate Use Criteria. We developed and implemented a multicampus process for QI during the 3-year accreditation cycle by the IAC for Echocardiography. We documented both the process and the achievement of those metrics by the Echocardiography Laboratories at the Ochsner Medical Institutions. We found the QI process using IAC standards to be a continuous educational experience for our Echocardiography Laboratory physicians and staff. We offer our process as an example and guide for other echocardiography laboratories who wish to apply for such accreditation or reaccreditation., (© 2016, Wiley Periodicals, Inc.)

Background: Serum hemoglobin (H) level is a well-known predictor of all-cause mortality in patients undergoing percutaneous coronary interventions but has not been studied in patients undergoing peripheral vascular interventions (PVI). We sought to determine the prognostic significance of serum H in patients undergoing PVI., Methods: We identified 346 consecutive patients undergoing PVI who had a documented a baseline and a postprocedural serum H level over a 33-month period. A multivariate analysis of predictors of 9-month mortality was performed., Results: Of 346 patients identified, there were 28 deaths (8.1%) over a 9-month follow-up period. Periprocedural H change was not associated with death [OR: 1.12 (95% CI: 0.71-1.79), P = NS]. In a multivariate model independent predictors of all-cause mortality were clinical bleeding [OR: 10.7 (95% CI: 0.012-0.769), P = 0.026], emergency intervention [OR: 4.5 (95% CI: 0.07-0.71), P = 0.011], ejection fraction [OR: 1.02 (95% CI: 1.01-1.05), P = 0.020], and preprocedural H [OR: 1.56 (95% CI: 1.19-2.04) P = 0.001]., Conclusion: In patients undergoing PVI, preprocedural H was a significant predictor of 9-month all-cause mortality. The highest mortality rate was seen in patients with a preprocedural H level ≤ 10 g/dl. Preprocedural H level can be used in clinical practice to risk stratify patients being considered for PVI. Further investigation is needed to assess if optimization of H level preprocedure improves midterm mortality., (Copyright © 2011 Wiley-Liss, Inc.)