Emergency Ultrasound

Ask the Expert: ACEP Clinical Ultrasound Accreditation Program (CUAP)

Robert M. Bramante, MD, RDMS, FACEP
Vivek S. Tayal, MD, FACEP, Secretary, CUAP Board of Governors

What is CUAP?

The Clinical Ultrasound Accreditation Program is a program dedicated to quality and safety created by the ACEP Emergency Ultrasound Section and ACEP staff.

Initially presented to the ACEP Board in 2008 subsequent to the approval of the ACEP 2008 Emergency Ultrasound Guidelines, the CUAP was thought to be a response to payors and other specialties trying to exclude clinicians from reimbursement for point-of-care ultrasound examinations. CUAP has now evolved into a comprehensive program to demonstrate to the public and others that Emergency Medicine and other clinicians performing ultrasound examinations are dedicated to high standards of quality and safety.

Who should apply for CUAP?

Every emergency US program!

CUAP accreditation is an appropriate goal for US programs that are developed and mature with credentialing, quality assurance/improvement, reporting, and safety protocols. We hope that every emergency medicine department and possibly every clinical, point-of-care US program will consider participating. Participation in the CUAP shows that the EM and the clinical US community understands that the demonstration of quality and safety, based on specialty specific peer review programs, is important. It shows that these departments are willing to be judged from the outside. And it creates a community of leaders who will continue to raise the level of ultrasonography at their institution from a play toy used infrequently without supervision or standards, to a well-developed system of performance, review, acknowledgement, improvement, notification, and built-in safety of machines and probe use. We hope that over time, all EDs and others will aspire to be part of our quality program.

Why should I spend money on an accreditation?

Ultrasound is different than other procedures. Every specialty or other organization wants to claim ultrasound as their procedure, but CUAP is the only one that looks at the point-of-care setting. As every physician who performs ultrasound knows, there is a difference in the operations of an ultrasound program in an ED and one in a radiology suite.

Have I gone through the CUAP accreditation?


What are the things that you gained from the accreditation process or final accreditation?

I strengthened my program, even after having built an US program over 19 years. I had to create some missing policies and formalize job descriptions, I had to figure out who had been credentialed during an era of change at my institution. The good news is that I had a fair amount already in place, but needed administrative work.

Final accreditation has helped me with requests for ultrasound machines, support for IT initiatives, support for cleaning protocols, and the prominence of the ultrasound program within the larger healthcare regional system. It has reinforced the cleaning and safety guidelines that we have in place with my partners in my department. Honestly, in the real world, administrators and health systems like external accreditation.

Will it help you with payors?

That remains to be seen, but I am hopeful. I think in this value based era where insurers and payors are looking for quality programs, having an ultrasound accreditation from a prominent clinical ultrasound organization like ACEP is helpful.

What is the future of CUAP?

We hope to incorporate new advances in the CUAP after the first year of the roll-out, and perhaps incorporate QI projects that would help our members. We look forward to hearing from the US section and the general ACEP membership on their desires for future features or goals.

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