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 |
| 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 |