Hospitals Urged to Post Surgical Volume Data

Hospitals should make surgical volume data routinely available as a means of informing patients and families about potential risks and benefits, according to healthcare quality expert Peter Pronovost, MD, in a recent posting on thehealthcareblog.com. He notes that three major health systems—Johns Hopkins, the University of Michigan and Dartmouth-Hitchcock Medical Center—have agreed to a “Volume Pledge” requiring surgeons and hospitals to meet volume thresholds for ten procedures. Pronovost says an impetus for the pledge was a 2015 report in U.S. News & World Report that found that hospitals with extremely low volume for knee-replacement had twice the national average risk of death from the surgery. The same report found risk that was 77 percent higher for hip-replacement patients at low volume hospitals. The data now available on a Johns Hopkins website show volume targets for ten surgeries including hip and knee replacement, lung resection, abdominal aortic aneurysm repair and carotid artery stenting. Frequency statistics from two Hopkins facilities posted alongside the targets show actual volume above and below the target numbers. According to Pronovost: “the benefit to patients is not in selecting the hospital that has done 20 cases of a procedure versus another that’s done 19. It is in avoiding, if possible, hospitals that rarely do it at all.” The Pronovost essay, which originally appeared in U.S News & World Report, is available at www.thehealthcareblog.com. The Hopkins data are available at www.hopkinsmedicine.org.