Audit your preference cards. Verify with your staff and sur-
geons that your cards are up to date and accurate. Ask things
like, "This $1,500 item you used last time, is that something we need
to order every time?" In some cases, staff might have added a rarely
used device to the preference card. And then, lo and behold, you're
ordering — maybe even overnighting — these items and then ship-
ping them right back, incurring restocking and shipping fees, because
you didn't need it after all. Have these conversations and make the
necessary changes. You'll want to audit on a regular basis — say, once
a year.
Oversight. Who's in charge of updating and managing your pref-
erence cards? If you can dedicate one person to this task —
someone to whom everyone consults on changes and provides updat-
ed information for revising cards — you'll operate much more
smoothly. Beware the nurses and scrub techs who like to have things
on hand that aren't usually necessary, but would make them "the
hero" if the surgeon actually needs them. Or they order them just in
case, so they don't need to leave the OR and chase them down.
Don't update preference cards in the OR. It's usually pretty hec-
tic in the OR. Nurses trying to change cards on the fly often are
sloppy or make mistakes. Whoever's in charge of updating the cards
should do so in a setting away from the OR and, really, away from as
many distractions as possible. This is serious work that requires con-
centration.
Provide forms for OR staff. Place blank forms in ORs that nurs-
es can fill out when they feel a card needs updating. This form
should include such basic info as date, name of person submitting
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