As Regional Leader for The Leapfrog Group, an independent national health care watchdog organization, we are sharing the just-released report, Safety In Numbers: Hospital Performance on Leapfrog’s Surgical Volume Standard Based on Results of the 2019 Leapfrog Hospital Survey. The report analyzes whether hospitals are performing a sufficient volume of high-risk surgeries to perform the procedures safely — and whether the hospital grants privileges only to surgeons meeting the Leapfrog minimum volume standard. Surgeons may achieve the minimum surgeon volume standard by performing the procedure at multiple hospitals. The report also records whether hospitals actively monitor surgeries to assure that each elective surgery is necessary.

Highlights from the 2019 report include:

• The majority of hospitals are still electively performing high-risk procedures without the adequate, ongoing experience to do so.
• There has been improvement: a higher percentage of hospitals are meeting Leapfrog’s minimum volume standards in 2019 than 2018.
• A sizeable percentage of hospitals have implemented protocols to monitor for appropriateness, potentially protecting patients from unnecessary or inappropriate surgeries.

Safety In Numbers uses final hospital data from the 2019 Leapfrog Hospital Survey. In New Jersey, all but two hospitals voluntarily answered this portion of the Leapfrog Hospital Survey. We thank New Jersey hospitals for acknowledging the importance of transparency and participating in the Survey.

The eight surgeries included in the survey were identified by Leapfrog’s National Inpatient Surgery Expert Panel as procedures for which there is a strong volume-outcome relationship. The Expert Panel relied on published research and evidence to advise on minimum hospital and surgeon volume standards for each procedure.

Overall, New Jersey hospital data align with national data in that while we’ve improved, a majority of hospitals do not meet the standard for surgical volume or the privileging process for these surgeries. On the positive side, a majority of Garden State hospitals do have protocols in place to ensure surgical appropriateness for six of the eight high-risk procedures. For two procedures, carotid endarterectomy and open aortic procedures, a majority of New Jersey hospitals did not meet the standard for surgical appropriateness.

Having this information is important to patients deciding where to have their surgeries. We urge all hospitals to continue their commitment to transparency on quality measures and encourage our employer, purchaser, and health plan members to use and share this important resource. Abundant evidence suggests that for certain procedures, patients can save their lives by choosing a hospital that protects against unnecessary surgery, and by choosing a surgeon with adequate, ongoing experience performing that surgery.