Making hospital-level surgical volume data public

Hospitals could help patients make more informed decisions by releasing data on how many of surgical procedures are performed in the facilities.

Peter Pronovost, MD, PhD, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, wrote in U.S. News and World Report about one example where current quality data failed a surgical patient. He chose where to have esophageal surgery based on a hospital’s safety ratings, but without knowing, had switched from a facility more experienced with the procedure to one where it had only been done once in the previous year.

“Initially, the surgery seemed to go well,” Pronovost wrote. “But two days later, the man developed a rapid heart rate, shortness of breath and dangerously low blood pressure. A breathing tube had to be inserted. The cause was a leak where the surgeon had sutured the esophagus. After a long stay, the patient was transferred to a different hospital, where he later died.”

Part of the solution John Hopkins advocated for was a “volume pledge” to perform a certain number of higher-risk procedures. Provonost argued that pledge alone ignores a potentially life-saving, patient-centered reform: making surgical volume data public.

“When patients are considering a surgeon and a hospital for a procedure, they are entitled to know how many the surgeon and hospital have performed. Armed with this data, and in dialogue with their surgeon, family and others, they can make informed decisions,” Provonost wrote.

For more on the challenges to making surgical volume data public, and how John Hopkins has already done so at several hospitals, click on the link below: