Reid Jerry
ARRT, 1255 Northland Drive, St Paul, MN 55120-1155, USA.
Radiol Technol. 2010 May-Jun;81(5):499-501.
The certification model addresses quality and safety by directly targeting the qualifications of individuals. The practice accreditation model takes a more global approach to quality and safety and addresses the qualifications of individuals and standards for additional components of the quality chain. Although both certification and practice accreditation fundamentally are voluntary, the programs may become mandatory when enforcement mechanisms are linked to the programs via state or federal legislation or via private reimbursement policies, effectively resulting in mandatory standards. The CARE bill takes a certification approach to quality and safety by focusing on the qualifications of the individual. MIPPA takes an accreditation approach by focusing on the practice. MQSA is somewhat of a hybrid in that it takes an accreditation approach, but spells out standards for the individual that the accreditor must follow. If the practice accreditation standards require that all technologists employed in the practice be certified in the modalities performed, then the practice accreditation model and the certification model become functionally equivalent in terms of personnel qualifications. To the extent that practice accreditation models are less prescriptive regarding personnel standards, the certification model results in more stringent standards.
认证模式通过直接针对个人资质来解决质量和安全问题。实践认证模式对质量和安全采取更全面的方法，涉及个人资质以及质量链其他组成部分的标准。尽管认证和实践认证从根本上来说都是自愿的，但当通过州或联邦立法或通过私人报销政策将执行机制与这些项目联系起来时，这些项目可能会变成强制性的，从而有效地产生强制性标准。《医疗质量与可负担医疗法案》（CARE bill）通过关注个人资质来对质量和安全采取认证方法。《医保改善与保护法案》（MIPPA）通过关注实践来采取认证方法。《乳腺X线摄影质量标准法案》（MQSA）在某种程度上是一种混合模式，因为它采取认证方法，但详细说明了认证机构必须遵循的个人标准。如果实践认证标准要求在该实践中工作的所有技术人员都要获得所从事模式的认证，那么就人员资质而言，实践认证模式和认证模式在功能上就变得等效。在实践认证模式对人员标准规定较少的情况下，认证模式会产生更严格的标准。
