Study Finds Many Hospitals Have Insufficient Volumes for High-risk Surgeries

Many hospitals and surgeons continue to perform high-risk procedures without sufficient patient volumes to ensure patient safety.

A new report from The Leapfrog Group suggests that most hospitals and surgeons in 2019 continued to perform high-risk elective surgeries without sufficient volumes to ensure patient safety.

The report, Safety In Numbers: Hospital Performance on Leapfrog’s Surgical Volume Standard Based on Results of the 2019 Leapfrog Hospital Survey, also found that a higher percentage of hospitals met Leapfrog's minimum volume standards in 2019 than 2018.

"The good news is we are seeing progress on surgical safety," said Leah Binder, president and CEO of The Leapfrog Group.

"The bad news is the vast majority of hospitals performing these high-risk procedures are not meeting clear volume standards for safety," she said. "This is very disturbing, as a mountain of studies show us that patient risk of complications or death is dramatically higher in low-volume operating rooms."

The report surveyed more than 2,100 hospitals representing 70% of the nation's hospitals beds on eight high-risk procedures.

Esophageal resection for cancer and pancreatic resection for cancer were the two procedures where the fewest hospitals met the volume standard for patient safety – less than 3% and 8% respectively.

Almost half (48%) of hospitals were most likely to meet the safety standard for bariatric surgery.

While many rural hospitals elected not to perform high-risk procedures, those that did were not likely to meet the volume standards, the report found.

The survey found that 70% of hospitals have protocols to ensure appropriateness for cancer procedures. For other high-risk procedures, hospital compliance to ensuring appropriateness ranged from 32%-60%, depending on the procedure.