Accreditation of endocrine surgery units

  • Thomas J. MusholtEmail author
  • Robert Bränström
  • Reto Martin Kaderli
  • Nuria Muñoz Pérez
  • Marco Raffaelli
  • Michael J. Stechman
  • on behalf of ESES
Review Article



A key measure to maintain and improve the quality of healthcare is the formal accreditation of provider units. The European Society of Endocrine Surgeons (ESES) therefore proposes a system of accreditation for endocrine surgical centers in Europe to supplement existing measures that promote high standards in the practice in endocrine surgery.


A working group analyzed the current healthcare situation in the field of endocrine surgery in Europe. Two surveys were distributed to ESES members to acquire information about the structure, staffing, caseload, specifications, and technology available to endocrine surgery units. Further data were sought on tracer diagnoses for quality standards, training provision, and research activity. Existing accreditation models related to endocrine surgery were included in the analysis.


The analysis of existing accreditation models, available evidence, and survey results suggests that a majority of ESES members aspire to a two-level model (termed competence and reference centers), sub-divided into those providing neck endocrine surgery and those providing endocrine surgery. Criteria for minimum caseload, number and certification of staff, unit structure, on-site collaborating disciplines, research activities, and training capacity for competence center accreditation are proposed. Lastly, quality indicators for distinct tracer diagnoses are defined.


Differing healthcare structures, existing accreditation models, training models, and varied case volumes across Europe are barriers to the conception and implementation of a pan-European accreditation model. However, there is consensus on accepted standards required for accrediting an ESES competence center. These will serve as a basis for first-stage accreditation of endocrine surgery units.


Accreditation Endocrine surgery Quality control 



We thank ESES for the opportunity to develop the proposal.

Authors’ contributions

Study conception and design: Thomas J. Musholt. Acquisition of data: Robert Bränström. Analysis and interpretation of data: Thomas J. Musholt, Robert Bränström, Reto Martin Kaderli, Nuria Muñoz Pérez, Marco Raffaelli, Michael Stechman. Drafting of manuscript: Thomas J. Musholt, Robert Bränström, Reto Martin Kaderli, Nuria Muñoz Pérez, Marco Raffaelli, Michael Stechman. Critical revision of manuscript: Thomas J. Musholt, Robert Bränström, Reto Martin Kaderli, Nuria Muñoz Pérez, Marco Raffaelli, Michael Stechman.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Section of Endocrine Surgery, Department of General, Visceral and Transplant SurgeryUniversity Medicine of the Johannes Gutenberg-University MainzMainzGermany
  2. 2.Endocrine and Sarcoma Surgery Unit, Department of Molecular Medicine and Surgery, Karolinska InstitutetKarolinska University HospitalStockholmSweden
  3. 3.Department of Visceral Surgery and Medicine, Bern University HospitalUniversity of BernBernGermany
  4. 4.Cirugía General, Sección de Cirugía EndocrinaHospital Universitario Virgen de las NievesGranadaSpain
  5. 5.Istituto di Semeiotica ChirurgicaUniversità Cattolica del Sacro CuoreRomeItaly
  6. 6.Department of Endocrine SurgeryUniversity Hospital of WalesCardiffUK

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