# Longitudinal impact of Intersocietal Accreditation Commission vein treatment center accreditation on practice patterns, safety metrics, and patient outcomes

## TL;DR

This study shows that accreditation improves vein treatment quality and safety, especially for centers that initially lacked compliance.

## Contribution

The study demonstrates that IAC accreditation leads to improved practice patterns and outcomes, particularly in noncompliant centers.

## Key findings

- Accredited centers showed improved compliance and safer practices over time.
- Initially noncompliant centers improved their practice patterns after accreditation.
- Accreditation was linked to better patient outcomes and lower complication rates.

## Abstract

With health care rapidly expanding and patient accessibility needs increasing, there has been an influx of providers often lacking formal training in venous disease management. The aim of this study was to determine if centers that participate in an accreditation program exhibit increased quality, safety outcomes, and overall practice standards.

Of 325 accredited vein centers, 287 underwent reaccreditation within 3 years. Fifty-nine of them were compliant with Intersocietal Accreditation Commission (IAC) standards at the time of initial accreditation. Fifty-nine IAC-accredited centers participated in the American Vein and Lymphatic Society Pro Vein registry and had patient-level data. Sixteen were initially compliant with IAC standards (group 1; 4977 patients) and 43 had deficiencies (group 2; 11,179 patients). A stratified before-and-after design was used to analyze center-level and patient-level data (demographics, body mass index, and disease severity scores [Clinical-Etiological-Anatomical-Pathophysiological and revised Venous Clinical Severity Score (VCSS)]. Primary outcomes included compliance with IAC standards, treatment results (eg, VCSS changes, complications, endothermal heat-induced thrombosis >2), and interventional practice patterns, such as intervention rate and Utilization Index.

Of the 287 IAC-accredited vein centers who pursued reaccreditation, 59 were compliant initially and at reaccreditation. The remaining centers (n = 229) had multiple deficiencies, with safety issues persisting in some centers at reaccreditation. Before accreditation, group 2 centers treated younger, lower body mass index patients with less severe disease, and group 1 centers saw more advanced cases. Over time, group 2 centers began treating more severe cases. Group 1 had higher intervention rates and lower use indices before accreditation. Post-treatment complication and endothermal heat-induced thrombosis rates were low and similar across both groups. Group 1 showed a greater VCSS score change after treatment, partly owing to higher baseline scores. Over time, group 2 showed a decrease in Utilization Index, without a post-treatment decrease in the revised VCSS change aligning with group 1, indicating improved practice patterns after accreditation.

IAC accreditation plays a meaningful role in standardizing and improving the quality of outpatient venous care. It promotes safer procedural environments, encourages more selective use of interventions, and is associated with improved clinical outcomes—particularly among initially noncompliant centers. These findings support the expansion of accreditation programs and underscore their importance in maintaining high standards of care in an increasingly heterogeneous field.