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|
|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|
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.