Based on the research by Dartmouth-Hitchcock Medical Center, Michigan Medicine, and Johns Hopkins Medicine, as well as guidance from Leapfrog’s National Surgical Volume Expert Panel, Leapfrog has identified eight high-risk procedures for which there is a strong volume-outcome relationship.
The procedures with their corresponding minimum hospital volumes and minimum surgeon volumes for credentialing are shown in the table below.
Minimum hospital volume standard
Minimum surgeon volume standard
|Bariatric surgery for weight loss||50||20|
|Esophageal resection for cancer||20||7|
|Lung resection for cancer||40||15|
|Pancreatic resection for cancer||20||10|
|Rectal cancer surgery||16||6|
|Open abdominal aortic aneurysm repair||15||10|
|Mitral valve repair and replacement||40||20|
For each procedure, hospitals are asked to report on their total hospital volume over a 12-month period or their annual average over a 24-month period. To achieve Leapfrog’s Surgical Volume Standard for a procedure, a hospital must meet the established minimum volume for the listed high-risk procedures that the hospital electively performs.
Additionally, Leapfrog asks hospitals about whether their privileging process for surgeons requires that the surgeon meet or exceed the minimum surgeon volume standards established for each of the eight high-risk procedures.
This new structural measure challenges hospitals and health systems across the country to hold themselves accountable for minimum surgical volume standards known to improve the odds of a safer surgery for their patients.