JAMA Forum: Back to the Future: Volume as a Quality Metric

Interesting thoughts — Could Volume be a default quality metric — because we choose not measure quality more meaningfully ? Interesting arguement — but not very convincing


Image: Aubrey LaMedica/Harvard T.H. Chan School of Public Health Ashish K. Jha, MD, MPH (Image: Aubrey LaMedica/Harvard T.H. Chan School of Public Health)

Recently, a group of leading academic institutions asked all hospitals to pledge to minimize the number of patients who undergo certain surgeries performed by surgeons and hospitals who seldom do those procedures. The “Take the Volume Pledge” campaign, initiated by 2 of the most respected experts on quality and safety in the nation, John Birkmeyer, MD, of Dartmouth-Hitchcock health system, and Peter Pronovost, MD, PhD, of Johns Hopkins Medicine, makes a lot of clinical sense. We know that when patients receive these surgeries at low-volume institutions or in the hands of low-volume surgeons, they tend to fare worse.

What’s remarkable isn’t that these leaders asked hospitals to focus on volume as a way to improve patient outcomes, but that they are doing it in 2015. And herein lies a story of volume as a quality…

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