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Related Concept Videos

Healthcare Associated Infections II: Preventive Measures01:22

Healthcare Associated Infections II: Preventive Measures

Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Methods of Documentation VI: Case Management Model

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Minimum Procedural Volume Thresholds for Surgical Privileging: A Mixed-Methods Validation and Risk Management

Nantana Suppapitnarm1, Suthorn Bavonratanavech2,3, Wanicha Panyakhamlerd4

  • 1Medical Affairs Division, Bangkok Dusit Medical Services PCL, Bangkok, Thailand.

Risk Management and Healthcare Policy
|June 23, 2026
PubMed
Summary
This summary is machine-generated.

Establishing minimum annual procedural volumes and surgical pairing standards for Orthopedics and Obstetrics-Gynecology (OB-GYN) significantly reduces clinical incident rates. Adherence to these safety benchmarks enhances surgical competency and patient safety.

Keywords:
clinical privilegingdelphi techniqueobstetrics and gynecologyorthopedic surgerypatient safetyphysician competency

Related Experiment Videos

Area of Science:

  • Medical quality and safety research.
  • Surgical outcomes analysis.
  • Healthcare policy development.

Background:

  • Ensuring surgical competency is crucial for patient safety.
  • Lack of standardized procedural volume thresholds can impact clinical outcomes.
  • Proactive risk management requires evidence-based benchmarks.

Purpose of the Study:

  • To establish evidence-based annual procedural volume thresholds for Orthopedics and Obstetrics-Gynecology (OB-GYN).
  • To define surgical pairing standards for complex procedures.
  • To validate these benchmarks against clinical incident rates.

Main Methods:

  • A sequential mixed-methods design was employed.
  • Phase 1: Delphi technique with 36 senior experts to determine consensus on minimum volumes and co-surgeon requirements.
  • Phase 2: Retrospective analysis of clinical incidents (2022-2024) to validate thresholds using statistical tests.

Main Results:

  • Consensus reached on safety thresholds: 10 cases/year for high-volume procedures (e.g., cesarean delivery, ACL reconstruction), 6 for proximal humerus fractures, and 5 for rotator cuff repair.
  • Surgeons meeting thresholds showed significantly lower incident rates for cesarean delivery (p < 0.001), proximal humerus fractures (p = 0.027), and rotator cuff repair (p < 0.001).
  • Sustained multi-year compliance strongly correlated with lower incident rates (p < 0.001); high-complexity procedures require mandatory co-surgeons.

Conclusions:

  • Minimum annual procedural volume is a key indicator of surgical competency and patient safety.
  • Established thresholds and team-based models offer a data-driven framework for clinical privileging.
  • These findings provide hospital administrators with an objective policy tool for proactive risk management.