[From compliance with volume standards to learning from healthcare outcomes]

The authors provide an update of an article about volume standards that was published in this journal in 2013. A systematic literature review uncovered trends in volume-outcomes research (2014-2021): studies focused on outcomes after concentration of care in the Netherlands, attempted to define volume thresholds and assessed whether experience in a specific operation can influence outcomes in similar procedures. Available research still does not shed much light on the mechanisms underlying the volume-outcome relationship. Nevertheless, professional associations look beyond volume and include multiple indicators of quality of care in their national quality standards. Professionals have also increasingly collaborated in regional networks where they share, compare and learn from outcomes. Three preconditions to enhance these efforts in "learning networks" are: the availability of reliable information about treatments and outcomes, adequate knowledge and support in selecting meaningful interventions, and lastly, an ambitious, collective goal which garners support from financiers and government bodies.