Clinical Audit and Practice Accreditation

Abstract

In countries with a high level of health care, exposure to ionizing radiation from medical imaging, on average, equals to 80 % of that from natural sources. However, the dose to the patients for various procedures varies widely between facilities. The risk from ionizing radiation and the variability emphasizes the need for a systematic evaluation of radiologic facilities to improve the quality and safety of the care provided.

This chapter discusses the elements of both clinical audit and accreditation. It highlights the differences in the two types of assessment of radiologic facilities. There is an emphasis on the importance of some form of practice validation in assuring that the quality and safety of care in diagnostic imaging is optimized.

A description of the governmental regulatory environment in Europe as compared to the United States is provided. In the European Union, there is mandate for clinical audits although each country can determine the process for such audits. In the United States, there are differing mandates, e.g. federal mandates that are implemented by the Food and Drug Administration (FDA) for mammography and the Centers for Medicare and Medicaid Services (CMS) for outpatient MRI, CT, Nuclear Medicine and PET. However, much of diagnostic imaging remains unregulated.