Surgical Preference Cards – Why are they so difficult to keep up to date?

By April 6, 2021May 3rd, 2021News

A surgical preference card contains the list of instruments, equipment, and supplies that a surgeon needs to efficiently perform a particular procedure safely. The preference card is the surgeon’s personalized “recipe” for that procedure, customized to their needs.

Surgical Preference Cards – Why are they so difficult to keep up to date?

By Tod Knight

Partner & CTO at Alitek Solutions

Surgical preference cards contain the list of instruments, equipment, and supplies a surgeon needs to perform surgical procedures safely and efficiently. These cards are the surgeon’s personalized “recipe” for a procedure, customized to their needs and preferences.

Although preference cards are essential to providing safe, efficient surgeries, most cards are out-of-date, and inaccurate at most hospitals and other surgical facilities.

Inaccurate and out-of-date preference cards increase patient riskcause substantial waste, and lead to widespread surgeon & staff dissatisfactionOur first article on preference cards discusses these negative impacts in more detail.

“But we have a preference card system!”


Your organization made a substantial investment in your existing preference card system so you might wonder how your cards can be out-of-date. Unfortunately, those systems are designed to update and store electronic preference cards, but they lack features for managing your cards to ensure they are updated in a timely fashion and kept up-to-date over time, while providing visibility into the process.

Updating cards is different from managing your cards. Since your preference card system does not help you manage your cards, you are on your own, and your cards will tend to remain out-of-date.

“Why is it so difficult?”


Several things contribute to this ongoing, widespread mismanagement of preference cards:

  • “That’s how it has always been done.” Preference cards are still managed much the same way today as they have been for decades. Even though technology has replaced paper for updating & storing cards, the processes that are used for requesting changes, routing and assigning the requests, tracking the requests, and eventually updating the system are based on printing the cards and manually passing them around!
  • No one likes to change. Using a cumbersome, broken, paper-based process often seems easier than learning something new (even if users get frustrated and spend even more time when the process breaks down).
  • Hospital surgical facilities are designed foremost for performing safe surgeries and getting patients in-and-out efficiently. Workspace for performing paperwork is at a premium, if it is even convenient to the surgical suites. Staff have few options for processing or storing paper, so they are faced with carrying it around until they can hand it off to the correct person (once they find them).
  • Surgical staff have frequently changing work assignments. Typically, a small number of trained, trusted staff are responsible for actually updating cards in the preference card system, while a surgeon can ask practically any surgical staff to change a card. The staff must know (or find) the right person to give change requests. This might be different people for different specialties (pulmonary, general, ontological, etc..) and this too is an ever-changing assignment.
  • Most scanning technology is ill-suited for use in surgical facilities. Document scanners typically need to be connected to a computer and are often complicated to use, with a myriad of buttons, settings, and choices to makeTheir footprint and power & network requirements constrain where they can be located. Mobile devices are not widely deployed in many hospitals and using a phone or tablet to “scan” multi-page preference cards is cumbersome, at best.

With all of these challenges, it is no surprise that so many hospitals’ manual, paper-based processes are inefficient and error-prone. But this is not through the staff’s lack of commitment or desire to do the right thing; it is simply because the cards are stacked against them (pun intended).

“So, what’s a hospital to do?”


First, let’s review a couple things to avoid:

1. “Let’s just scan the requests to have cards updated and email them.” At least there will be an electronic “record” of some sort, right?

This approach requires a diligent staff member to find a scanner, figure out how to scan the card (one-to-several pages of paper), find a computer to access email and load the scanned card, and finally try to remember who to send the email to with the card attached.

There’s typically no way to know when the process has broken down, because the email is in limbo in someone’s inbox! This approach might seem “better” than paper, but it is simply trading one set of problems for another without really improving anything.

2. “Let’s allow anyone who gets asked to update a preference card to make the update directly in the preference card system.” No waiting. No routing. Just make the change. What could go wrong?

Most preference card systems are complicated to use and require special knowledge to update cards correctly. It is unlikely that all the staff who may use the system will be sufficiently trained, so there will be a significant number of mistakes made (and frustrated staff).

Using this approach, you will find that when everyone has the ability to update cards, but no one has the training or accountability for ensuring the accuracy of updates, everybody is quickly dissatisfied because the cards become even less reliable. This is pretty much the opposite of what you want.

Let’s review some features and capabilities you need to better manage your preference cards in a way that will be welcomed and embraced by your staff so your cards can be up-to-date:

  • Scanned change-requests – it is very unlikely that you can get away from paper completely any time soon, so you should strive to get marked-up cards scanned asap. The scanner should be readily accessible and easy-to-use. Quit carrying paper around.
  • Secure, online access – electronic card change-requests should be easily and securely accessible by authorized personnel.
  • Automated workflows – the system should know where to route requests instead of users having to know or decide. Workflows should adapt to changing roles and responsibilities.
  • Notifications – interested parties involved in the process should get notified when items are ready for their attention or when requests have been completed.
  • Transparency and tracking – secure, online access should provide visibility into the status of requests, who requests are assigned to, and metrics for measuring performance.

An easy-to-use, automated process with transparency and accountability will assure everyone involved that cards are being kept up to date on a timely basis. Staff will be able to trust the reliability and accuracy of cards, so they will use them consistently. Surgeons will be happy when their cards are fulfilled correctly. This in turn will lead to reduced risk, waste and dissatisfaction. Over time, ALL of your cards will become, and remain, up to date, further improving safety, savings and satisfaction.

If this sounds like a great idea, but you are afraid that it would be complicated, time consuming, and expensive to implement, you are partially right.

Assembling, configuring and deploying the technology to support the features described above IS complicated, and ensuring that the end result is secure and supportable takes additional planning and effort.

Good news! We have already done the heavy lifting to develop SurgCard, a SaaS that can be implemented quickly and for a surprisingly low price, especially considering the complexity and robustness of the solution.

Reduced material waste will save you more each month than the cost to use SurgCard. Keeping just one surgery from being postponed due to an out-of-date card can pay for a year of SurgCard.

SurgCard will help you save FAR MORE than you will spend.

Surgeons will be happier, staff will be more efficient, patients will be safer, and you will realize a substantial ROI when you manage your preference cards to keep them up-to-date.

Are you ready to start managing your preference cards?


Please look for and read the next, and final installment in this series of articles to find out more about SurgCard and how you can quickly get on the path to improving patient safety, reducing risk & waste, and improving your staff and surgeon satisfaction.

If you can’t wait and you would like to know more now, contact us at [email protected] and we will be happy to discuss SurgCard with you.

We can also help you improve and automate other, labor-intensive, fax-and-paper-based workflows such as prior authorizations, referrals, and healthcare assessments.

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About Alitek

Alitek is a leader in information based digital transformations. We help organizations improve business outcomes, increase efficiency, and reduce risk, through better management of information. Our experienced team works with you to build a unique strategic plan based on your specific needs, no matter the size of your company.