Lower costs and improve nursing satisfaction in the OR

Many hospitals, ASCs and IDNs face a similar question: What is the best way to optimize inventory and reduce waste in the Operating Room? According to the American College of Surgeons, an estimated two million pounds of supplies—valued at close to $15 million—are wasted every year in the surgical setting. A critical and often overlooked component in controlling waste and improving nurse and staff efficiency in the OR is maintaining accurate preference cards.

Preference cards are instructions detailing the equipment, tools, supplies, and room setup that a surgeon uses for a specific procedure. Preference cards help ensure that when a surgeon begins a procedure, all the supplies and instruments are in the room, easily accessible, and ready for the procedure.

Typically, all attending surgeons have preference cards on file at the facilities where they have surgical privileges. Preference cards function as workflow blueprints, outlining all of the steps and requirements of a procedure. However, a cascade of problems can arise when the preference cards are incorrect, outdated or call for products that are not on contract.

When that happens, nurses can easily spend 20% or more of their time searching for or sorting surgical supplies—leading to case delays, decreased physician satisfaction and a potential negative impact on patient safety.
A preference card should list the following surgeon requirements:

  • Glove type and size
  • Necessary equipment, supplies and instruments
  • Types and quantities of sutures and dressings
  • Specific patient positioning needed during the procedure

Procedural information that was originally documented on physical cards is typically electronic today. While digitalization has provided valuable connections between the preference cards, documentation and inventory, the cards still become outdated over time.

Surgical staff have limited time outside of surgery, and there is rarely a dedicated resource to manage preference cards. As a result, they often are left with little time to review preference cards for off-contract supplies or to remove extra products from supply areas.

Surgical cases can account for up to 50% of a health system’s revenue, and wasted time and supplies can easily cut into those margins. Missing materials cause surgeon frustration, lead to inefficiencies and delays in cases, and disrupt OR utilization. However, surplus items that are not used are either thrown away or have to be restocked in inventory—often leading to waste without any immediate consequence. Ensuring that all incorrect items on a preference card are routinely modified can positively impact patient safety as well as the health system’s bottom line.

How to optimize your preference cards with limited staff resources

Working with HealthTrust members over the years, we have learned that the best way for facilities to decrease supply waste, improve nurse efficiency in preparing for cases, and improve overall satisfaction is through a process that periodically reviews preference cards for accuracy and optimization. Our Advisory Services team can work independently in facilities that are understaffed or bolster existing teams in performing this process collaboratively.

When health systems have engaged HealthTrust to review their preference cards, we have identified, on average, that 14% of the items needed a change to the quantity or to the open/hold status. Even more surprisingly, another 16% of the items could be removed due to low or no use.

Our collaboration with a health system requires very little staff involvement because we are able to identify priority procedures based on volume and impact. From there, we analyze the cards against utilization data and contract supplies. Then, we make recommendations for each card to add, remove or change items. Once the updates are made, the health system can quickly begin to see the benefits in reduced waste and improved productivity. This means supplies are more organized and staff time can be refocused on patient care versus re-stocking unused items or keeping track of non-contracted supplies.

Accurate preference cards ensure that the right tools are in the right place, at the right time, for the right case. Their optimization is one of the best ways to increase OR utilization and reduce waste for health systems or facilities with an active surgical service lines.


To learn more about a preference card audit, email the Advisory Services team at solutions@healthtrustpg.com.

Drew Preslar

Drew Preslar, MBA, is Assistant Vice President for Supply Chain Advisory Solutions with HealthTrust, where he is responsible for managing and developing client relationships while leading teams in the delivery of supply chain transformation engagements. Preslar has more 15 years of experience working in healthcare systems, delivering operational improvements, cost reductions and process redesigns within Supply Chain, Surgical Services and Pharmacy Operations. Preslar earned an MBA from the Fuqua School of Business and an undergraduate degree from Duke University.

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