In addition, the vast majority of rural hospitals did not perform these high-risk procedures, and those that did were less likely than other hospitals to meet the volume standard for patient safety.

"If a hospital and/or surgeon is not able to perform the designated minimum number of surgeries per year, as established in literature, to be able to do so safely, the surgeon should have a conversation with the patient about other facilities where they may be able to seek care," said Mobley. "Most importantly, if a hospital cannot ensure that they will perform an established minimum number of designated procedures, it should not electively perform those surgeries. Likewise, the hospital should not grant privileges to surgeons who do not perform a minimum volume of a specific surgery each year."

She adds that hospitals must "implement an appropriateness policy to assess whether a high-risk procedure is necessary and ensure patients are not receiving surgeries they may not need. For cancer surgeries, this includes having a multidisciplinary tumor board prospectively review cases. For other procedures, hospitals should develop appropriateness criteria based on published evidence and surgeon input. Finally, hospitals should have a policy to help patients find another hospital and/or surgeon if they do not have adequate volumes to perform the procedure safely."

Leapfrog has publicly reported since 2018 on the ability of hospitals to meet minimum volume standards for safety of eight high-risk procedures.

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