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- Surgical volumes are the number of times a hospital has done a specific surgical procedure in a defined time period.
- Hospitals that do more of a specific surgical procedure tend to have better outcomes for their patients than hospitals that do less of them.
- Patients should ask their surgeon how many times the surgeon and the hospital have done their specific surgical procedure in the last two years.
What is this measure?
For a number of surgical procedures, studies have shown a strong relationship exists between the number of times a hospital performs a specific surgical procedure and the outcomes for those patients, including death and complication rates. In May 2015, Johns Hopkins Health System, along with Dartmouth-Hitchcock Medical Center and University of Michigan, pledged that their hospitals would meet annual volume thresholds for 10 surgical procedures. The 10 procedures identified by this group of hospitals are those that have the strongest link between hospital volume and patient mortality. Many of the surgeries listed below consist of multiple types of surgeries. For example, some examples of the surgeries that fall in the Complex Aortic Surgery category are thoracic aortic surgery, valve surgery and aortic aneurysm surgery.
Better than target
Worse than target
|Number of Surgeries|
|Volume Target||The Johns Hopkins Hospital|
(Average of FY15-16)
Johns Hopkins Bayview Medical Center
|Academic Division Volume**|
(Average of FY15-16)
|Bariatric surgery for weight loss||40||Procedure not done electively at this hospital||296||296|
|Carotid artery stenting||10||8||10||18|
|Complex abdominal aortic aneurysm repair||20||147||30||177|
|Hip replacement ***||50||10||299||309|
|Knee replacement ***||50||8||394||402|
|Mitral valve repair||20||104||Procedure not done electively at this hospital||104|
|Rectal cancer surgery||15||75||15||90|
Why is it important?
Patients who need to undergo a surgical procedure should understand both the experience of their surgeon and the experience of the hospital where the surgery will be done. For many surgical procedures, there is a strong link between how many times the hospital has done the procedure and the outcomes for those patients. Hospitals that do more of a procedure tend to have lower death rates and complication rates for their patients.
We urge our patients to ask their surgeon how many times the surgeon and the hospital have done their specific surgical procedure in the last two years.
What is Johns Hopkins Medicine doing to continue to improve?
The Surgical Volume Pledge reinforces the need for the Johns Hopkins Health System to review where surgical procedures are being done and what level of volume each hospital is doing, and to consider opportunities to shift procedures from lower-volume hospitals to higher-volume hospitals.
Johns Hopkins Medicine recognizes that traveling to a hospital farther away from home can be inconvenient for the patient, the patient’s family and their loved ones, but Johns Hopkins Medicine strongly believes that the end goal of providing the best and safest care for our patients is a trade-off that is worth taking.