Hospital standards for high-risk surgeries save lives

ANN ARBOR, Mich. -- If all hospitals met the quality standards for five high-risk surgeries set by a national coalition, it would save nearly 8,000 lives each year, according to a new study from the University of Michigan Health System.

Open heart surgery alone would result in about 4,000 fewer deaths, and procedures such as angioplasty would see another 3,000 fewer deaths if all patients were treated at hospitals meeting these standards, according to the study. Results are published in the June issue of the journal Surgery.

The coalition, the Leapfrog Group, established evidence-based quality standards for five surgical procedures that hospitals must meet to be on the group's preferred list. The Leapfrog Group is a coalition of 150 large public and private employers representing more than 40 million people and aimed at improving health care quality.

Based on research showing better outcomes at hospitals that perform certain surgeries more often, the group initially set its standards to reflect surgical volumes only. New standards, revised in 2003, consider additional measures of quality, such as mortality rates. Researchers at UMHS evaluated whether patients would fare better after surgery if they were treated exclusively at hospitals that met these new criteria.

"Patients deciding where to undergo elective but high-risk surgery can substantially improve their odds of survival by selecting a hospital that meets Leapfrog safety standards," says John Birkmeyer, M.D., George D. Zuidema Professor of Surgery at the U-M Medical School and chair of the Michigan Surgical Collaborative for Outcomes Research and Evaluation. Birkmeyer conducted the study along with Justin Dimick, M.D., a UMHS surgical resident.

Leapfrog has set standards for five procedures: pancreatic surgery, esophageal surgery, open heart surgery, percutaneous coronary interventions (such as angioplasty) and abdom


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