Every day, thousands of surgeries are scheduled and performed across the country. Have you ever wondered:
- How do staff know the unique surgeon preferences for each procedure?
- How does the perioperative team know what supplies to open and when to hold items until needed?
- How is the department efficiently organized to support pulling the supplies and equipment needed for those surgeries?
- How are inventory levels properly managed to avoid waste?
- What’s the recipe for a successful surgery?
Most electronic health record (EHR) systems integrate surgical instructions — commonly called doctor preference cards (DPCs) — to document equipment, instruments and single-use supplies needed for a specific procedure. These cards can also be referred to as physician preference lists, procedure cards, resource cards, pick lists, or simply cards — like a recipe card.
Without a dedicated maintenance process, these preference cards can actually be detrimental to healthcare organizations — cases can be delayed, the wrong items might be chosen, or unnecessary supplies could be opened and unused.
Lowering costs and reducing waste
Almost 30 percent of items pulled before surgery go unused.1 What a waste! To prevent such loss, DPCs should be kept up-to-date and list all the items necessary for a procedure.
Another opportunity to reduce costs is to identify variation between surgeon preferences for supplies used for the same procedures. Healthcare systems often allow for a considerable amount of physician preference in clinical decisions, including requested items for surgery — which can cause significant complexity and cost variance. Some of this variation can be addressed through a DPC analysis, but physician engagement and willingness to adopt change is drastically improved when the variation review includes a correlation to quality and outcome measures with direct cost transparency.
Patient safety during surgery directly correlates with having the right supplies, instruments, equipment and medications available at the right time. This preparedness enables the surgical team to focus on the patient rather than searching for needed items. The risk of complications, longer anesthesia times, case delays or even cancelations rises when needed supplies are not available.
Furthermore, a department with poorly maintained DPCs is at risk of high turnover if staff lack proper tools and resources.
When a DPC process is optimal, the entire surgical team is free to focus on what’s most important — patient safety.
Impact to operational efficiencies
Accurate DPCs support operational efficiencies through the entire process — from scheduling to billing.
With up-to-date DPCs and accurate scheduling, inventory is more likely to be optimized.2 When a DPC pick list is referenced, staff can confidently pull surgical case carts prior to each case, ensuring the right supplies are ready for use. As a result, procedure cancelations, delayed on-time starts, lengthy turnover times and costly waste are avoided. Eliminating this type of waste not only saves money but improves teamwork and employee satisfaction.
Collaboration among all members of the surgical team, supply chain specialists, surgeons and anesthesiologists leads to successful surgical outcomes, and DPCs are a key tool for collaboration. Don’t neglect them! An improved process for maintaining DPCs will enhance operational and financial benefits, improve surgeon satisfaction, support a culture of safety within the OR, and promote the competency of all surgical services staff for the department.
At Olive, we know that DPC accuracy and optimization are crucial to identifying and reducing unwarranted clinical variation in surgery. By optimizing workflows that promote staff engagement, one of our clients identified over $2.5 million worth of supplies that were unnecessary during the initial phase of preference card clean-up. They found $1.3 million more in the second year by implementing a defined process. Imagine what Olive can do for you.
- Preference Card Management: Improving Clinical Efficiency and Patient Care; research study and CME provided by Cardinal Health (2012)
- Schmidt, R. N., Posteraro, R. H., & Lopez, M. (2019). Reducing Waste in the Operating Room through Inventory-Based Supply Chain Optimization. Journal of Business & Behavioral Sciences, 31(1), 74–83. Retrieved from https://search-ebscohost-com.chamberlainuniversity.idm.oclc.org/login.aspx?direct=true&db=bth&AN=137227632&site=eds-live&scope=site