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 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 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