Major health systems move to ban low-volume surgeries at member hospitals

Three major academic health systems — Dartmouth-Hitchcock Medical Center in Lebanon, N.H., Baltimore-based Johns Hopkins Medicine and Ann Arbor-based University of Michigan — plan to bar member hospitals from performing certain low-volume procedures.


According to U.S. News & World Report, this move comes following a story released Monday showing that when hospitals or surgeons perform a low volume of cases of a certain procedure, it puts patients at a higher risk of harm or even death than if surgeons and hospitals have more experience.

The standards will apply to up to 20 hospitals within the three systems. Boston-based Partners HealthCare is also considering instituting the standards, which were written by John Birkmeyer, MD, a surgeon and chief academic officer at Dartmouth-Hitchcock, and Peter Pronovost, MD, PhD, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins University, in consultation with surgeons.

"Low-volume hobbyists are bad for patients and we have to stop them," Dr. Birkmeyer, told U.S. News.

Currently, the three systems have agreed on 10 procedures that tend to be riskier when not performed at experienced hospitals by experienced surgeons. Those include bariatric surgery, lung cancer surgery, esophagus surgery and joint replacement.

While executive leadership and the boards of Dartmouth-Hitchcock and Johns Hopkins have agreed on these standards, the medical executive committee at each hospital must also buy-in, which could be difficult, Dr. Pronovost told U.S. News. "There are going to be strong critics of this. We just have to be ready for that."

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