SIR Position Statement Addresses Maintenance of Privileges

November 15, 2011—The Society of Interventional Radiology (SIR) announced the release of a position statement on the maintenance of credentials for image-guided interventions that lays out guidelines for the continuation of noncoronary percutaneous artery interventional procedure privileges in the hospital setting, stating that outcomes are a more important measure of quality than procedure volume alone. The statement was published in the Journal of Vascular and Interventional Radiology (2011;22:1353–1354). For physicians to be granted medical staff membership and clinical privileges, a hospital's credentials committee obtains critically important information for review and traditionally relies on ongoing procedure volumes among individual physicians to gauge continuing competence, stated the SIR.

“This statement is an important step as the SIR guides the safe and efficacious delivery of services and informed clinical decision-making,” commented SIR President Timothy P. Murphy, MD. “Interventional radiology is a highly diverse specialty with a large number of procedures under the umbrella of image-guided interventions. All of these procedures use similar, overlapping skill sets. Credentialing criteria that parse out volumes of specific procedures without consideration of the global skill set and overlap in skills among image-guided procedures may be biased against interventional radiologists and may not serve the best interests of patients.”

Dr. Murphy added, “SIR believes that the volume of specific procedures is less important in determining quality than patient outcomes. The education, experience and skills required to perform image-guided interventions are extensive, and many interventional radiologists have the training and education to provide these services by obtaining subspecialty certification in vascular and interventional radiology from the American Board of Radiology (ABR).”

ABR criteria include the successful passage of a board exam that incorporates knowledge of clinical medicine, imaging and image-guided procedures, the completion of advanced educational modules and successful passage of test questions that measure comprehension, the documentation of performance of a large volume of image-guided procedures, the demonstration that the practitioner is engaged in continuous practice quality improvement, and accredited fellowship training.

“Within ABR criteria, there are also expectations with regard to analyzing a wide range of imaging modalities including fluoroscopy, radiography, computed tomography, ultrasound, and magnetic resonance, and determining what laboratory or physiological testing is needed; how to integrate this information into a comprehensive assessment of the appropriateness of image-guided therapy; and how best to use this information to plan the specific image-guided procedures,” advised Dr. Murphy.

The position statement notes that interventional radiologists who have met these training and experience requirements for board certification in vascular and interventional radiology are engaged regularly during their clinical practice in the performance of image-guided interventional procedures throughout many organ systems in the body and are capable of using a wide variety of interventional devices, including needles, guidewires, catheters, balloon catheters, drainage catheters, and embolic devices, and are expected to perform clinical assessments of patients for whom image-guided intervention may be an option.