No two surgeons operate in the same way. The supplies one surgeon needs to perform a procedure, for example, might be very different from those of a colleague. And in a facility that performs hundreds of surgeries a week, those details add up, meaning the OR team needs a reliable way to keep everything straight.

This is where physician preference cards come in.

Preference cards are an integral part of an efficient OR. They keep the team informed on which supplies are needed from stock so surgeons have exactly what they need when they need it. The cards ensure not only that staff and surgeons are satisfied; they also minimize waste, both in materials and spending. When only the necessary supplies are used and accounted for, patients can be accurately billed. And perhaps most importantly, up-to-date preference cards ensure a quicker, safer procedure with minimal anesthesia time for the patient.

But surgeon preferences change, and preference cards often fail to change with them. Poorly kept cards result in excess supply stock, increased patient costs, prolonged anesthesia times, reduced safety from staff leaving the OR to retrieve missing items, lost charges and unnecessary waste from pulling incorrect supplies and equipment.

“When preference cards aren’t maintained well, efficiency in the OR is at risk and that can lead to not only surgeon and staff dissatisfaction – resulting in high turnover rates – but also a negative impact on the OR’s bottom line,” said Sherri Mason, senior consultant, clinical advisory solutions for Vizient.

To avoid unnecessary delays and reap the benefits of accurate preference cards, Mason offers the following tips.

Downsize and digitize

A useful first step in addressing the status of preference cards is to assess what you already have and downsize by eliminating what you no longer need. With so many cases happening each day, along with constantly changing supply needs, ORs can easily become overloaded with outdated cards.

While some hospitals still prefer a physical Rolodex system for their paper cards, they may find it easier to keep them current and accounted for by transferring to an electronic format. This allows for a centralized, easily updated preference card system.

It may be as simple as ensuring that the tools you already have are doing all the work they can. Start by checking to see if your EHR system has an electronic database related to preference cards or if an electronic preference card change management system is part of your OR information system. If neither of these is an option, then a third-party system would be of benefit.

Align inventory

Preference cards don’t just affect nurses and surgeons. They affect the entire hospital supply chain.

“Inefficiencies in the OR are passed on to other departments who also suffer increased waste, disorganization and higher costs,” said Mason. “From scheduling to sterile processing to materials management, OR delays impact workflows and processes in those departments as well.”

If items are pulled from the inventory but not used, they must be manually returned to stock, which is a labor-intensive and time-consuming process. If the items are unused but opened – meaning they’re no longer sterile – then the hospital loses supplies. And if items end up getting used that weren’t listed on the preference card, the patient might never get billed and the hospital loses money.

It’s also important for items listed on preference cards to match the hospital’s item master file. That way, staff can easily pick the items needed for surgery, track inventory and bill accurately. That means more time for patient care.

Assign responsibility

It’s easy enough to set a goal of updating preference cards, but unless hospitals have staff assigned and accountable for the task, it risks falling by the wayside.

To develop an effective process for addressing incomplete or out-of-date preference cards, hospitals should consider assembling a project team that consists of these roles:

  • A project manager to oversee the work;
  • At least two OR nurses or surgical techs who can observe procedures, interview surgeons, and document waste to ensure the preference cards are as accurate as possible;
  • A process improvement manager who can map supply chain flow across facilities;
  • A data analyst who can input and collate data collected through observation in order to track the project’s progress.

“Once the project is complete, the hospital or health system might find it useful to retain at least one staff member dedicated to keeping them current for continued success,” added Mason.

Collaborate with surgeons

As health systems more fully integrate value-based care into daily processes, physicians are starting to understand the importance of cost. Still, busy surgeons might think it’s tedious or even a waste of time to help staff update their preference cards. But a streamlined, efficient process that invites feedback from surgeons can benefit everyone in the OR.

Mason suggests having staff observe and determine what they believe are the most effective edits to preference cards. They can then schedule one-on-one meetings with surgeons to review those edits. This makes the best use of surgeons’ time, and also allows them to have a say in their operating room procedures.

“Updating preference cards can be a daunting task. But it can lead to higher patient satisfaction and substantial savings for hospitals,” Mason concluded.

By keeping surgeon and procedure-specific cards updated – and implementing a process to make sure they stay that way – OR teams are able to more efficiently prepare for cases and keep the department running smoothly. The stakes are too high to risk getting caught holding a bad hand.

For more information on how Vizient clinical advisory solutions can help you evaluate and restructure your OR processes, contact us today.

Published: September 11, 2018