Low volume hospitals are hospitals that are not performing a specific type of surgery very often and are there fore likely not as good at the procedure as larger, busier hospitals. The relationship between low procedure volume and worse outcomes for patients has been well documented since the 1970’s.
It makes sense that the more times you perform a procedure, you will become better at it. If you’re only performing a shoulder replacement surgery 3 times a year, you will not be able to do it as well as someone who performs it 150 times per year. This is just how humans work, we are able to perfect something with practice. The aim of the new initiative is to prevent deaths and complications that occur at the hands of less-practiced providers. For three decades, researchers have known the hazards of having surgery at hospitals that only care for a few similar patients each year.
Now, Dartmouth-Hitchcock Medical Center, Johns Hopkins Medicine, and the University of Michigan Health System are taking steps to put this into practice by limiting specific surgeries to certain hospitals where the outcome is better. There is no financial incentive to do this, but these groups are doing this because it offers a better patient outcome.
In healthcare, it’s typically been hard to “always do the right thing” because of financial incentives aren’t always aligned with patient wellbeing. Doing the right thing for patients should be a an easy decision, but that isn’t always the case.
It is encouraging to see health systems putting patient wellbeing first and trying to provide the best services that they can, not the services that are easiest and most convenient.