Common Misconceptions about CUAP

1. US programs are assumed and not a big deal anymore. The exploding use of US makes it a prime focus for review in health care systems from competence of providers, to machines safety, infection control, quality assurance, and accountability. The public is aware of the technological advances in US and expects a safe US program.
2. We don’t bill for US so we don’t need CUAP. If you are using US for any diagnostic, procedural guidance, or treatment reason, US is part of your emergency care. Meeting national EM guidelines is expected, regardless of billing.
3. CUAP is only for large academic programs. CUAP was designed for all emergency departments, ranging from the small critical-access hospital to the large tertiary care center. The US program criteria are the same for all, regardless of size, location, or educational mission.
4. We don’t perform all 12 US applications mentioned in the ACEP Ultrasound Guidelines. Even if your program performs just one application, such as procedural guidance or focused assessment with sonography in trauma (FAST), you still should address issues of quality, safety, and training. CUAP can help you achieve this standard.
5. Our ED director is our US director. We realize that, in small groups or emergency departments, roles may be shared. We want the US director to understand the issues associated with US use in the emergency department.
6. Our images/reports are not digital. While most emergency departments have changed to digital images and reports in the electronic medical record, we recognize that there are settings and situations that utilize different media.
7. We don’t use endocavitary probes or transesophageal echo (TEE) in our practice. Most EM US use is surface use, and even that use has safety requirements. Internal probe use like endovaginal US or TEE is not mandatory for CUAP accreditation. We encourage any emergency department to pursue endovaginal pregnancy US or TEE cardiac imaging as your program matures.
8. We don’t have a high-level disinfection (HLD) program. The vast majority of emergency ultrasound exams that use external transducers do not need a HLD program. However, US performed within body cavities (endocavitary or TEE) does rerquirer an appropriate HLD program.
9. Our practice is spread across several hospitals. We recognize that some groups staff multiple hospitals and yet function under the same US leadership and policies. These types of programs are offered discounts for their additional facilities.
10. We don’t have enough money for accreditation. The cost of accreditation for an emergency departments is very reasonable and has not increased since inception.
11. US fellowship programs don’t need CUAP because they will have separate accreditation. All fellowship programs need to train fellows in a safe, high-quality system. That is the mission of CUAP. While US fellowship programs may not be required by the American Board of Emergency Medicine to be CUAP accredited, any EM fellowship program that has made the effort to achieve CUAP accreditation has also demonstrated a sincere interest in promoting their program’s focus on quality, safety, and training.
12. Our hospital does not care about US accreditation. A safe, high-quality practice that meets nationally-recognized standards is always noticed by hospital system administration, and can make your US program and your ED appreciated, respected, and protected.
13. CUAP application is going to take too long. Once you have your checklist of program policies and descriptions ready, it only takes an hour to finish the application. You need to get the policies approved locally, but we make it as simple as possible with templates and sample documents. There is no cost to start the application process on the CUAP website, and you finish the application as you gather, complete, and upload the required forms and policies. Payment is the last step of submission.