The Perks of Paperless Preference Cards

Healthcare IT

By: Jay Jadlowski, Joni Turner

Published: 4/3/2019

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Digital platforms take the stress out of knowing you'll have the supplies you need when and where you'll need them.


You sorted, stacked and sifted. Crossed out, erased and added. It took several months and several bottles of Advil, but your facility's preference cards are finally up to date. They note every supply and every instrument every one of your surgeons wants for every procedure they perform. Congrats on a job well done! Now sit back and relax. It'll be at least a couple days until one of your docs changes his mind about the prep he prefers or the laparoscope he likes.

You're probably well aware that trying to maintain paper preference cards is often an exercise in futility, and that inaccurate and out-of-date information can grind the surgical schedule to a halt and put patients in harm's way. Why go through all that trouble and subject yourself to all that worry when a digital preference card system can do all the heavy lifting? Our health system recently implemented the technology, which has improved the way we manage supplies and the care we provide.

When we enter a surgery into the system, it automatically generates a preference card based on the scheduled procedure and the surgeon who'll perform it. The card includes a pick list of the supplies, equipment and instruments needed for the case. Staff in the supply storage area print out the preference card the day before the scheduled surgery. They pick needed supplies, scan bar codes on each supply and place the items on case carts, which are wheeled to the OR on the day of surgery. As we pick and scan supplies, the system automatically deducts them from the general inventory count.

We place a hard copy of the preference cards on the case cart to inform the OR staff about which supplies they should open and which should remain unopened until needed. We return unopened supplies on the case carts to the supply storage area and scan them back into inventory.

It's a simple and straightforward way to ensure supplies are on hand where and when they're needed. Here are several other benefits we've realized since going with paperless procedure cards:

  • Easy to update. Our health system hosts 30,000 procedures a year performed by hundreds of surgeons at 5 facilities, so we need to make changes to preferences cards on a daily basis. It's a huge undertaking, one we hired a dedicated staff member to handle. Christine Nordstrom, RN, is responsible for managing change requests and ensuring preference cards are current and consistent throughout the system.

Ms. Nordstrom doesn't have an informatics background, but she does work closely with our hospital's IT team. She has worked in the OR, however, and that experience pays big dividends in her ability to understand and manage the preference cards and the constant updates that need to be made.

QUICK REFERENCE Digital preference cards let you standardize your procedure list, update supply requests on the fly and take advantage of an inventory management system.   |  Dan Johnson, Methodist Health System

Preference card update requests are emailed to Ms. Nordstrom, who makes the updates and communicates the changes across the health system as needed. If, for example, our value analysis committee wants to trial new gloves, the preference cards for procedures involved in the trial have to be changed. If a surgeon wants to use a different kind of suture, his preference cards throughout the health system must be updated to reflect the request.

  • Tighter inventory control. We use the preference card platform to run reports that show how many items are returned to storage after being picked for procedures. Our goal as a health system is to return less than 20% of picked items. We're returning 15% of supplies in 2 of our smaller surgical departments and 30% in our larger hospital, so there's room for improvement. Knowing which items are often returned has improved the efficiency of the supply-picking process; staff don't waste time putting unneeded items on case carts.
  • Added efficiencies. Our platform lets us categorize supplies and specify their specific storage locations. That means preference cards note supplies by category — instruments, sutures and dressings, for example — ?and identify the storage bins where they can be found. That intuitive format is easy for staff to follow as they walk the aisles of the storage area to pick supplies.
  • Customizable notes. The electronic preference cards also include areas where staff can document and save notes about supply needs for specific procedures or requests from individual surgeons, including comprehensive details about room set-ups, patient positioning preferences, skin prepping instructions and preferred glove sizes.

We can even flag equipment that's used on a limited basis, such as C-arms, and have the system provide real-time updates of how many scheduled procedures require the equipment. Having access to the information is invaluable. We can confirm the equipment will be available when it's needed and know ahead of time if we'll need to adjust the schedule to ensure each surgical team has the equipment they need.

Always improving

Electronic procedure card systems aren't foolproof. We noticed that inputting non-standardized procedure names resulted in incorrect supplies and instruments ending up in ORs. That issue drove us to move toward creating a standardized list of procedure names and change our procedural documentation to the standardized nomenclature. Using standardized procedure names is especially important if your procedure card program is part of an integrated medical record because the terminology you use will automatically populate in the patient's chart, the operative report and the surgeon's daily progress notes.

We're also planning to link procedures in the system with their corresponding CPT codes. That way a surgeon can schedule cases by searching for procedure-specific CPT codes and filling out an electronic form, on which he can include his preferred dates and times and requests for special equipment.

Working with electronic procedure cards has proven to be very beneficial for our team. The technology has made our supply management processes more efficient, updates are made more easily and staff throughout the health system are on the same page with respect to supply needs and requests. When it comes to providing top-notch surgical care, that's important. We also pride ourselves on being the regional leader in innovative practices and this technology keeps us ahead of the game. OSM

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