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Complex Adult and Pediatric Surgery

Three decades of research have consistently demonstrated that patients that have their high-risk surgery at a hospital and by a surgeon that have more experience with the procedure have better outcomes, including lower mortality rates, lower complication rates, and a shorter length of stay than for patients who have their surgery done at a hospital or by a surgeon with less experience.

Based on the research by Dartmouth-Hitchcock Medical Center, Michigan Medicine, and Johns Hopkins Medicine, as well as guidance from Leapfrog’s national expert panel, Leapfrog has identified eleven 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 privileging are shown in the table below.

Procedure Minimum hospital volume standard Minimum annual 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
Carotid endarterectomy 20 10
Open aortic procedure 10 7
Mitral valve repair and replacement 40 20
Total knee replacement surgery 50 25
Total hip replacement surgery 50 25
Congenital heart surgery for infants (Norwood procedure) 8 5

Hospital and Surgeon Volume fact sheet

Hospital and Surgeon Volume bibliography