Could There Be Any Value to Accrediting Carotid Stent Programs?

An Interview With Barry T. Katzen, MD

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VASCULAR DISEASE MANAGEMENT 2024;21(2):E14-E15

Interventional radiologist Barry T. Katzen, MD, founder and chief medical executive emeritus of the Miami Cardiac & Vascular Institute and member of the Editorial Board for the Journal of Critical Limb Ischemia, presented several sessions at ISET 2024. Vascular Disease Management spoke with Dr. Katzen about his session on accrediting carotid stent programs, why it’s important, and the steps that physicians, administration, and accrediting bodies can take to make it a reality. 

Dr. Katzen, why do you think carotid stent programs should be accredited?  

Carotid stenting has recently been improved, and the Centers for Medicare & Medicaid Services (CMS) have issued guidelines on carotid stenting that include the need for documentation, quality improvement processes, and measuring outcomes. I believe that there is a role for some external oversight or accreditation for carotid stenting programs. Accreditation is a big part of ensuring quality in a variety of programs. 

The Intersocietal Accreditation Commission (IAC) is involved in accrediting many services in many hospitals. These include noninvasive vascular labs, echocardiography programs, and other types of programs in about 14,000 entities throughout the United States. One of the reasons why accreditation may be important is to bring in a third party to ensure quality data. Publications have shown that when you compare the outcomes in institutions or entities that have gone through the accreditation process with entities that have not, there is a demonstrable difference in quality and improvement in outcomes. 

What steps are involved in getting a carotid stent program accredited? 

The actual first step is, internally, for the physicians and administration to make a commitment to ensure that they have a quality program. They need to develop the commitment to having a measurable, quality program. That means metrics, outcomes, documentation, and having a process in place for quality improvement when opportunities are identified. 

The second step would be to look at possible accrediting organizations or bodies that are externally oriented. It might be a professional society, or it could be other organizations. In this particular case, the IAC, which is an organization supported by all the major medical societies, has essentially developed an entire process that could be used as a boilerplate for institutions to be able to begin the accreditation process.

What is the most important takeaway that you wanted attendees to get from your presentation? 

During this presentation at ISET, I wanted attendees to really understand an important fact: When you look at outcomes and the quality of programs that go through the accreditation process and compare them with CMS programs that have not gone through an accreditation process, there is a measurable difference in the quality of things such as the percentage of time that measurements are done correctly, or how severe the stenosis is, and documentation of whether there has been a stroke or not. These are very important metrics in quality for carotid artery stenting in carotid therapy. Once one recognizes that there is a benefit to the accreditation process, the next step is developing a commitment to actually deploy some sort of accreditation process for these programs.

For more information on getting a carotid stenting program accredited, visit the IAC at https://intersocietal.org/programs/carotid-stenting.