Credentials of Professionals Performing Echocardiography

Abstract

We examined the IAC-Echocardiography applications database to describe the board certification of physicians and registration of sonographers and explored how staff credentials affected initial laboratory accreditation decision. Deidentified IAC-Echocardiography applications from January 2012 to December 2013 were reviewed, including size and setting of echocardiography laboratories, National Board of Echocardiography (NBE) testamur status of physicians, and registered credential status of sonographers. Multivariate logistic regression models evaluated associations between echocardiography laboratory characteristics and accreditation and deficiencies in peer-reviewed domains (staff, imaging protocols, image quality, reporting, and quality assurance) of accreditation. During the study period, 1921 echocardiography laboratories representing 10 602 physicians and 6841 sonographers applied for IAC-Echocardiography accreditation; 26.9% of physicians were NBE testamurs and 79.5% of sonographers were registered. NBE status of medical directors did not reach statistical significance for accreditation success (AOR 1.15 [0.93-1.42]), but number of registered sonographers per applicant did (AOR 1.13 [1.04-1.23]). NBE testamur medical directors were associated with fewer deficiencies in image quality (AOR 0.61 [0.48-0.79]) and reports (AOR 0.72 [0.56-0.92]). Applicants whose technical director was a physician rather than a sonographer were more likely to have deficiencies in image quality (AOR 1.84 [1.06-3.21]). Registered sonographers were associated with fewer deficiencies in the domains of staff credentials (AOR 0.84 [0.78-0.92]), reporting (AOR 0.88 [0.81-0.96]), and quality assurance (AOR 0.91 [0.84-0.98]). Registration status of sonographers, but not NBE testamur status of physicians, was positively associated with accreditation decisions. The overall interaction between individual certification and laboratory accreditation suggests a complementary role for both.