Amanda Akers

Managing Physician Preference Cards: Why it’s so Difficult

Preference cards are a reference tool used to inform operating room setup before a surgical procedure. They contain instructions outlining each physician’s preferences and requirements for each particular procedure: the pick list of disposable supplies, instruments and tools, and room setup specifications. When used correctly, they can boost OR efficiency and ensure patient safety.

The problem of unclean physician preference cards is pervasive. Thanks in part to the systemic weaknesses the COVID-19 pandemic highlighted, hospitals across the U.S. are finally facing a difficult truth: unclean preference cards obstruct OR performance and are a source of continuous frustration for OR staff. Moreover, inaccurate preference cards cost the hospital’s bottom line, as they result in massive supply waste and return costs. Studies show that cleaning up preference cards, in fact, would have direct positive effect on a hospital’s margins.

The solution to the problem of unclean preference cards, therefore, may seem obvious. Clean up the preference cards, and the problems evaporate. Re-train the staff so there is a process in place to keep the cards clean. Hire a consultant, perhaps, to create a new process. Naturally, however, if the solution were that straightforward, the problem would not be so persistent, and many hospitals would have acted long ago. The fact remains that preference cards are a complicated piece of the puzzle, and simply instructing OR staff that they must be kept clean is not enough.

Education Alone is Insufficient for Changing Preference Card Practices

Since unclean preference cards result in such costly waste, the education of OR staff as to the cost of this waste may seem like a tempting solution to the problem. Studies show, in fact, that OR staff are probably not aware of the cost of the supplies that are unused and discarded after a surgery. If they were conscious of the extent to which supply waste costs the hospital, potentially even driving up healthcare costs for patients, perhaps they would be willing to put greater effort into maintaining preference cards.

But further studies demonstrate that education alone is not enough to prompt OR staff to change their practice. It would be precipitous to assume that OR staff could or should be able to successfully maintain preference cards merely by paying more mind to the task. The fact is that the complexities of manual preference card maintenance simply outstrip the desire to succeed at it.

Incentives Impede Manual Preference Card Maintenance

Cleaning and maintaining preference cards by manual process is tedious, time-consuming work that is all too susceptible to human error. To ensure the ongoing accuracy of preference cards, the nurses and physicians who use these cards must devote significant time and energy to the task. In most cases, the likelihood of their having such an amount of spare time is minimal. Because requests for preference card changes are frequently recorded haphazardly on typed or handwritten notes or via word-of-mouth, the likelihood of error makes the job even more difficult.

In fact, the nature of the OR means that incentives can actually impede manual preference card maintenance. If an item on a preference card is not needed during a surgery, it may be discarded, returned to inventory, or require re-serialization. This practice is detrimental to the hospital’s supply chain and inventory management, but it does not affect the immediate surgery or the doctors and nurses while they perform it. On the other hand, if an item is needed and mistakenly removed from a preference card, the surgery must pause while the item is fetched, which is both frustrating for the OR staff and potentially dangerous for the patent. With limited time to spend manually maintaining preference cards, therefore, the nurses who select the items needed for a surgery are far more likely to err on the side of allowing supplies to go to waste rather than risk disrupting the surgery.

Physician Preference Card Maintenance Requires Data & Automation

The fact is that manual management of physician preference cards is simply no longer a workable solution. What hospitals need is a new system, not the reinforcement of an old one. Physicians and nurses have a difficult time maintaining preference cards not due to lack of understanding or determination, but because preference card management is complex. To be effective – that is, to provide the information needed in a timely fashion – it requires reliable, accessible data that offers guidance as to how a card should be built or maintained. Additionally, in order to ensure supply chain accuracy, preference card data must be linked to inventory data. Finally, hospitals must have access to data that enables them to standardize their preference cards and supply inventory based on hospital best practices.

Physician preference cards are key to OR efficiency, supply chain optimization, and physician and nurse job satisfaction. Overhauling the system rather than attempting to service the existing one may seem intimidating, but targeted software can eliminate the guesswork. If you’d like to know more about PrefTech’s AI-driven software solution for preference card management, schedule a demo with us today.