Preference Cards: An (expensive) artifact of the OR

A 2011 study estimated that $5 billion of waste each year in the US healthcare industry can be directly attributed to inaccurate preference cards.  That figure may seem astounding, and it should. But the unfortunate truth is that it’s entirely true.

Preference cards are the ‘playbook’ for any given surgery.  They contain the list of supplies, types of instruments, and instructions to the OR team for what is needed to carry out an operation.  The problem is that most management systems used by hospitals and surgery centers maintain preference cards in a format that is siloed from the actual process in the operating room.

That creates a number of issues.  Typically, a generic, hard-copy preference card is used for a given type of surgery.  In general, when a surgeon joins a hospital or surgery center, a preference card for each operation is inherited from another surgeon in that specialty.  Within the standard system, the surgeons and OR team do not have direct access to the preference card. That prevents the ability to customize the needs for a surgery to that specific patient.  Moreover, it does not allow for an opportunity to update the preference card with changes that the surgeon or OR team would like to make for the future.

The end result is a preference card that is outdated and inaccurate.  Since that is a well-known fact among all members of the OR team, there is a lack of trust in the contents of any preference card.  That leads to a well-intentioned effort among the team to have available a surplus of materials that may be needed for an operation, and lack of clarity around the surgical plan.  Supplies that are opened, but unused and therefore discarded contribute significantly to unnecessary expenses. In the era of value-based care, that is reflected in a shrinking margin for hospital systems and surgery centers.

In fact, it has been found that optimizing the preference card system alone could save between $50 to $150 per surgery.  Those numbers escalate quickly, and lead us back to that astronomical figure of $5 billion in waste annually. Streamlining the process and enabling direct interaction with the surgical preference card through modern technology could save hospitals and surgery centers a substantial amount of money going forward.

Sources:

PNC Healthcare, GHX quantitative research study. August 2011.

Perry S. Preference Cards as a Ticket to Savings. Journal of Healthcare Contracting. October 2013.

Gitelis M, et al. American Journal of Surgery (2015) 209: 488-92.

Avansino JR, et al. Journal of Pediatric Surgery (2013) 48: 1843-49.