Session: Cracking the Code: Innovative Hacks for Preference Card Management and C-Suite Support

Editor's Note

Outdated and inaccurate preference cards cost hospitals millions of dollars in delayed surgeries wasted supplies—but with the right strategy, they can become a powerful tool for efficiency and cost reduction.

This was among the main takeaways of a 2025 OR Business Management Conference presentation from Jason Goodwin, MPH, MSN, BSN, president of Innovative Cultures Consulting, and Hannah Shufeldt, DNP, MSHCM, RN, CNOR, director of procedural services at Sarah Bush Lincoln Health System. They emphasized that preference cards impact nearly every aspect of perioperative operations, from supply chain management and labor costs to patient safety and OR efficiency. In fact, research shows that up to 80% of preference cards contain outdated information at any given time, and 26% of sterile single-use supplies go unused by the end of surgeries. The result is often extended turnover times, increased anesthesia durations, and supply chain confusion.

Turning preference cards into a dynamic, strategic asset rather than a static document can help combat these issues, the presenters argued. Implementing a structured review process, such as quarterly audits and real-time updates, ensures that preference cards remain accurate and useful. Engaging surgeons by demonstrating how optimized preference cards can increase OR throughput and reduce wasted supplies is another critical strategy. Simple low-tech interventions, such as red and green bins for items marked as “always needed” versus “use if necessary,” can also minimize waste without requiring major system overhauls.

Integration with scheduling and inventory management systems further enhances preference card accuracy, reducing supply shortages and last-minute substitutions that disrupt workflow. As an example, the presenters cited a case study demonstrating how linking preference cards to inventory data helped eliminate unnecessary overnight orders, saving costs and improving stock reliability. Another success story involved assigning a dedicated preference card manager to oversee updates, ensuring prompt implementation of changes and reducing frustration among surgeons.

Whatever the chosen approach to addressing preference card inefficiencies, change tends to require buy-in from stakeholders beyond the OR, such as supply chain managers and executive leadership, presenters said.  Framing preference card optimization as a revenue growth strategy—demonstrating its impact on case volume, patient access, and cost control—can help perioperative managers can secure the resources they need.