Surgical Preference Cards: Patient Risk, Material Waste, and General Dissatisfaction

By November 9, 2020 News

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: Patient Risk, Material Waste, and General Dissatisfaction

By Tod Knight
Partner & CTO at Alitek Solutions

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.

Having the correct supplies available for a surgical procedure is crucial, so you would expect these cards to be treated very carefully to ensure they are accurate, up-to-date and meticulously used. Even though these cards are very important to providing safe, efficient surgeries, most cards are out-of-date and inaccurate at most surgical facilities and hospitals.

There are many reasons for this state of affairs, not the least of which is a bit of apathy and a widespread unwillingness to change, even when almost everyone agrees the processes are broken. There is also an ongoing push-pull of whose responsibility it is to keep cards up-to-date and accurate, the hospital or the physician?

If your facility does not have any issues with your preference card processes and your surgeons and staff are quite satisfied with how your cards are managed, you are in a very exclusive group! You are much better positioned to provide safe procedures with less waste and inefficiencies than most facilities.

But if you have any doubts about the efficiency and safety of your preference card management processes, you should consider the risks and costs and decide whether you want to stay the course or get some help to realize improved safety, savings, and satisfaction. 

Why preference card systems fail

Preference card systems are not typically very user-friendly, but they are adequate for creating and updating cards, if the right person knows (or remembers) to login and make the changes.

However, most systems do not manage the workflow required to ensure that surgeon’s requests to change cards are handled timely and efficiently so that cards are kept up-to-date.

Most facilities use error-prone, manual, paper-based processes that lack transparency, accountability or reporting. This leads to cards becoming, and remaining, inaccurate and out-of-date. Without an automated workflow, nurses and techs tend to focus more on providing healthcare, not tracking paper and doing data entry.

When most of your preference cards are inaccurate and out-of-date, your staff won’t trust or use them. This causes a ripple effect that has dramatic and widespread costs and risks.

What are the costs and risks?

High levels of waste and inefficiency that can be almost 50% of your O.R. equipment and supplies value!

Staff will pull extra quantities of supplies, and may even pull additional items that are not on the card, “just to be safe”. Waste alone can measure in the millions of dollars at larger facilities.

Over 25% of items pulled prior to surgery go unused. Disposable items get disposed or re-stocked if they are not opened. Reusable items must be re-sterilized and re-stocked. None of the unused items are available for others to use and may even trigger automatic re-ordering of new stock!

Patient safety suffers dramatically, which also increases costs

Not having preferred items increases the risk of complications. Do you want the surgeon to wait for an item and delay the procedure (keeping the patient under anesthesia longer) or use the unfamiliar or inappropriate instrument and risk causing injury? Neither option sounds very good, does it?

Intraoperative medication errors are often a direct result of inaccurate preference cards. Get ready for expensive litigation and significant judgements for the harm or death these errors can cause.

Inaccurate preference cards contribute to hospital & physician liability. Out-of-date preference cards have been the culprit of causing prolonged anesthesia times, medication errors, incorrect surgical instruments being used, and extended recovery times. Judgements against hospitals and physicians in these cases are often quite substantial.

Out-of-date preference cards frustrate physicians and O.R. staff

Surgeons are generally dissatisfied about how their preference cards are maintained and used. A minority of particularly satisfied surgeons (such as cardiac or neurosurgeons) have dedicated teams who are intimately familiar with their preferences. However, most surgeons don’t have a dedicated team and work with frequently changing techs and nurses who don’t trust the cards and don’t know the surgeon’s preferences.

Many perioperative nurses are concerned about the accuracy of surgical preference cards. When staff don’t trust preference cards, they will often keep private notes about surgeon preferences. This can lead to as many errors as relying on the inaccurate cards. This also creates more work and dissatisfaction.

Now are you ready to fix how your preference cards are managed?

Organizations that try to automate their current, broken processes, or simply throw more, already overworked staff at the problem, typically end up with the same results: patient risk, waste, and dissatisfaction. 

Alitek can help you improve and automate your preference card processes as well as other, labor-intensive, fax-and-paper-based workflows such as prior authorizationsreferrals, and healthcare assessments.

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