Physician Engagement in Improving Operative Supply Chain Efficiency Through Review of Surgeon Preference Cards

J Minim Invasive Gynecol. 2017 Nov-Dec;24(7):1116-1120. doi: 10.1016/j.jmig.2017.06.018. Epub 2017 Jun 29.


Study objective: To reduce operative costs involved in the purchase, packing, and transport of unnecessary supplies by improving the accuracy of surgeon preference cards.

Study design: Quality improvement study (Canadian Task Force classification II-3).

Setting: Gynecologic surgery suite of an academic medical center.

Participants: Twenty-one specialized and generalist gynecologic surgeons.

Interventions: The preference cards of up to the 5 most frequently performed procedures per surgeon were selected. A total of 81 cards were distributed to 21 surgeons for review. Changes to the cards were communicated to the operating room charge nurse and finalized.

Measurements and main results: Fourteen surgeons returned a total of 48 reviewed cards, 39 of which had changes. A total of 109 disposable supplies were removed from these cards, at a total cost savings of $767.67. The cost per card was reduced by $16 on average for disposables alone. Three reusable instrument trays were also eliminated from the cards, resulting in savings of approximately $925 in processing costs over a 3-month period. Twenty-two items were requested by surgeons to be available on request but were not routinely placed in the room at the start of each case, at a total cost of $6,293.54. The rate of return of unused instruments to storage decreased after our intervention, from 10.1 to 9.6 instruments per case.

Conclusions: Surgeon preference cards serve as the basis for economic decision making regarding the purchase, storing, packing, and transport of operative instruments and supplies. A one-time surgeon review of cards resulted in a decrease in the number of disposable and reusable instruments that must be stocked, transported, counted in the operating room, or returned, potentially translating into cost savings. Surgeon involvement in preference card management may reduce waste and provide ongoing cost savings.

Keywords: Cost; Instruments; Operating room supplies; Supply chain.

MeSH terms

  • Adult
  • Consumer Behavior* / economics
  • Consumer Behavior* / statistics & numerical data
  • Cost Savings
  • Disposable Equipment / economics*
  • Disposable Equipment / statistics & numerical data
  • Disposable Equipment / supply & distribution
  • Female
  • Humans
  • Male
  • Medical Order Entry Systems / economics
  • Medical Order Entry Systems / statistics & numerical data
  • Middle Aged
  • Operating Rooms / economics
  • Physician's Role*
  • Quality Improvement* / economics
  • Resource Allocation / economics
  • Resource Allocation / statistics & numerical data
  • Retrospective Studies
  • Surgeons* / economics
  • Surgeons* / standards
  • Surgeons* / statistics & numerical data
  • Surgical Instruments / economics*
  • Surgical Instruments / statistics & numerical data
  • Surgical Instruments / supply & distribution
  • Workforce