Most Hospitals Fall Far Short on Leapfrog Surgery Volume Standards

Frank Diamond

For the first time in its annual survey, the Leapfrog group looked at the number of surgeries hospitals and surgeons perform for a particular condition. A large body of research shows that the fewer surgeries a hospital or surgeon performs, the greater the chance of errors, complications, and deaths.

Overall, the Leapfrog results are not a pretty sight.

The survey of about 2,000 hospitals nationwide found that “the vast majority of participating hospitals do not meet” Leapfrog’s minimum hospital or surgeon volume standards for safety. “Rural hospitals are particularly challenged in meeting the standards,” Leapfrog said in a press release when the report was released in July.

To fully meet the standard for, say, bariatric surgery, 50 procedures must be performed at a hospital each year annually and a surgeon must perform at least 20 of the procedures. 

Both hospital and surgeon standards must be met in order to meet Leapfrog’s standard.

Abdominal aortic aneurysm repair and esophageal resection for cancer were the two procedures where the fewest hospitals and surgeons met the volume standard (less than 3% meeting the combined hospital and surgeon standard set by Leapfrog).

The volume standards were developed under the guidance of Leapfrog’s National Expert Panel, which consulted published research and evidence to establish the minimum volume for each of the eight procedures.

Leapfrog volume standards for 8 high-risk procedures
Procedure Hospital standard for number of procedures Surgeon standard for number of procedures
Bariatric surgery for weight loss 50 20
Carotid endarterectomy 20 10
Esophageal resection for cancer 20 7
Lung resection for cancer 40 15
Mitral valve repair and replacement 40 20
Open abdominal aortic aneurysm repair 15 10
Pancreatic resection for cancer 20 10
Rectal cancer surgery 16 6
Source: “Safety in Numbers: The Leapfrog Group’s Report on High-Risk Surgeries Performed at American Hospitals,” July 2019

Small percentage of hospitals meet Leapfrog volume standards

The results were best for bariatric surgery for weight loss, but even for that procedure fewer than half (38%) of hospitals met the Leapfrog standard that combines hospital and surgeon volume.

Source: “Safety in Numbers: The Leapfrog Group’s Report on High-Risk Surgeries Performed at American Hospitals,” July 2019

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