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Evidence Based Hospital Referral

Millions of Americans undergo elective surgery every year. For many procedures, patients should be able to expect low risks no matter where they choose to have surgery. With heart surgery, for example, studies have found more than three-fold differences in surgical mortality rates across hospitals.

Leapfrog asks for information on 5 high risk conditions or procedures:

  1. Abdominal aortic aneurysm repair
  2. Pancreatic Resection
  3. Esophagectomy
  4. Aortic valve replacement
  5. High-risk deliveries, as classified by one or more of the following:
    a. Expected birthweight <1500 grams
    b. Gestational age <32 weeks, or
    c. Pre-natal diagnosis or major congential abnormality


Under the advisement of national experts in quality improvement, The Leapfrog Group adopted EBHR as one of its Safety Standards.  Procedures, conditions, and safety criteria were initially selected after review of published research in the field and consultation with leading experts in surgery and neonatal intensive care. These have since been reviewed and revised, incorporating even more current data and input from the hospital and physician communities. 

Hospitals fully meeting the EBHR Standards will meet a combination of outcome, process and volume criteria. For more information on Leapfrog’s EBHR requirements, see our fact sheet