309 - Empowered by Innovation: A Staff-driven Approach to Managing Surgical Preference Cards
Description: In today’s operating room, it is impossible to be an expert on every surgical preference. While in the room, there is pressure to have instruments and supplies ready to go for the case. One way to combat staff anxiety is to have clear, precise preference cards for staff to follow. At Memorial Sloan Kettering Cancer Center (MSKCC), each specialty service leader is responsible for creating and updating team surgical preference cards. Over the years these preference cards have been copied and stored in a central, hospital-based intranet location for staff access. These cards provide detailed information about the surgery, pertinent surgeon preferences, positioning, equipment, instruments, supplies, medication, specimen handling, and research protocols. Aside from maintaining the digital preference cards, each service leader is responsible for checking the surgical pick list. This pick list is a digital platform in the electronic documentation system which identifies equipment, positioning, instruments, supplies, and medication required for a procedure (CPT) code. When checking the cases for their specialty, each service leader can make changes to the pick list. This interface generates a list of required instruments and supplies, which support staff print to build the case cart for a case. In addition to preference cards found on the hospital-based intranet shared drive and the pick lists, preference card forms exist which drive the electronic logs and pick lists. These preference card forms are the master copy residing in the electronic scheduling system. All pick lists can be changed for each case ad hoc, but the system preference card form must be updated for a change to become permanent. In the past, a designated service leader made permanent changes to preference cards. In order to make a change, each service leader needed to submit a form detailing the change to the one service leader that had been given security clearance and informatics training to make these permanent changes. Sometimes these changes happened immediately, other times it took weeks, all depending on the outstanding workload. In 2017, to offset the workload, leadership approved the training of two additional service leaders. A plan was devised to educate the two service leaders to ensure changes that were made remained consistent with the approved format and guaranteed supplies, equipment, and implants for each pick list was ordered. This immediately improved the time in which permanent changes occurred. In 2019, leadership decided all service leaders could make permanent changes to the electronic preference card forms. Super-users used a power point to train remaining service leaders in both individual and group settings. Reference manuals were created when a super-user was not available. All service leaders now have autonomy and commitment to maintain their specialty preference card forms. It has been a definite staff satisfier.