Majority of U.S. hospitals do not meet minimum volume standard for high-risk surgeries

The majority of U.S. hospitals are not meeting minimum hospital or surgeon volume standards when it comes to performing high-risk surgical procedures, according to a new report from The Leapfrog Group. With guidance from scientific advisers at the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, Leapfrog experts examined data from about 1,300 hospitals that voluntarily submitted their data to Leapfrog and had performed at least one high-risk procedure in 2018. They looked at eight high-risk procedures including bariatric surgery, three heart surgery procedures and four cancer procedures. Of the eight high-risk procedures, the report found fewer than 3% of hospitals met a minimum volume standard when it came to the number of open abdominal aortic aneurysm repairs or esophageal resections for cancer they performed. For five of the eight procedures, no rural hospitals are fully meeting Leapfrog’s volume standard. The report found most of those hospitals also did not have criteria for gauging the appropriateness of those high-risk procedures for patients to prevent the overuse of such procedures, the report found. They found about 75% of those hospitals did not have appropriateness criteria for procedures they performed. "This is deeply concerning and its enough of a problem that we believe hospitals should put in place at least a minimum policy to try and assure patients undergoing these serious surgeries are in fact needing them," said Leah Binder, president and CEO of Leapfrog. Binder said it has been well-established in research that volume of procedures performed is associated with better outcomes, saying no surgeon or hospital should only perform one or two of these procedures a year.