A Detailed Look at What Items Are Typically Found on the Surgeon's Preference Card

September 30, 2025 •

4 min read

Inaccurate surgical preference cards are linked to higher direct costs, wasted materials, and potentially dangerous procedural delays. Understanding what items are typically found on the surgeon's preference card is therefore critical for ensuring a safe, streamlined, and efficient operating room environment for both patients and staff.

Quick Summary

A surgeon's preference card is a personalized checklist or blueprint outlining a surgeon's specific needs for a particular procedure, including all instruments, equipment, and supplies.

Key Points

Detailed Blueprint: The preference card is a customized guide that outlines all the specific tools, supplies, and setup for a surgeon's particular procedure.
Wide Scope: Items covered include core instruments, specialized equipment, disposable supplies like sutures, and medications used in the sterile field.
Logistical Instructions: Beyond equipment, the card specifies important procedural details such as patient positioning and the overall layout of the operating room.
Efficiency Driver: An accurate preference card helps streamline OR setup, reduce wasted supplies, and improve turnover times between cases.
Patient Safety: Outdated or inaccurate cards can lead to dangerous procedural delays and increased complications by causing the surgical team to scramble for missing items.
Economic Impact: Optimized preference cards reduce unnecessary supply costs by ensuring only required items are pulled and opened.
Evolving Document: Effective cards must be regularly reviewed and updated to reflect changes in surgical techniques, equipment, and surgeon preferences.

A surgeon's preference card serves as a comprehensive, procedure-specific guide used by operating room (OR) staff to prepare for a surgery. The card helps standardize the setup for a particular surgeon and procedure, ensuring that everything needed is sterile, accessible, and ready to go before the operation begins. While older systems relied on paper or index cards, modern hospitals increasingly use electronic preference cards integrated into their health IT systems. The following details the typical items found on this essential document.

Core Surgical Instruments and Supplies

This section forms the foundation of the preference card, detailing the physical tools required for the operation. Accuracy here is paramount, as missing or incorrect items can cause significant delays.

Instruments and Surgical Trays

Surgeons develop specific preferences for the instruments they use, which are meticulously listed. For some procedures, this may involve standard trays of general surgical instruments, while others require specialized sets. The card lists all trays and instruments by name and, where applicable, size and quantity.

Standard Instrument Trays: Common trays include general surgery, vascular, or orthopedic instrument sets.
Specialty Instruments: These are unique tools for a specific technique or procedure, such as endoscopes, drills, or specialized retractors.
Implants and Prostheses: For procedures requiring implants, the card specifies the type, size, and manufacturer of the device, ensuring the correct item is available.

Disposable Supplies and Consumables

Consumables are a major component of surgical costs, and precise listing on the preference card helps control waste.

Sutures: The card specifies the type, size, and quantity of every suture needed for closing different layers of tissue.
Dressings: A list of required dressings, tapes, and sponges is included for wound care post-procedure.
Drapes and Gowns: The card details the specific type and size of surgical drapes and gowns preferred by the surgeon.
Gloves: Personal preferences for glove type (e.g., latex, synthetic) and size for the surgeon and other scrubbed-in staff are listed.

Equipment, Setup, and Procedural Details

This category goes beyond basic tools to include the necessary technology and logistical setup required for the surgery to proceed smoothly.

Equipment and Settings

Specialized equipment needs and their specific settings are documented to ensure consistent performance.

Cautery Machines: The card specifies the type of electrocautery device and the desired settings for cutting and coagulation.
Suction Devices: Details on suction equipment and catheter sizes are included.
Operating Room Tables: The type of operating table or special attachments needed for the procedure are listed.

Medications and Solutions

While anesthesia staff manages medication administration, the preference card outlines the surgeon's preferences for solutions and medications used within the sterile field.

Irrigation Solutions: The type and temperature of solutions for rinsing the surgical site.
Hemostatic Agents: The card may list specific brand preferences for agents used to control bleeding.
Antibiotics: Antibiotic solutions for wound irrigation can also be specified.

Patient Positioning and Room Setup

Proper patient positioning is essential for surgical access and patient safety. This section details how the patient and OR equipment should be arranged.

Patient Position: The card states the exact position, such as supine, prone, or lateral, and any specific supports required.
Equipment Placement: The optimal placement of the back table, Mayo stand, and other sterile equipment is noted.
Anesthesia Considerations: The card can include notes for the anesthesiologist regarding critical positioning or special precautions.

A Comparison of Inaccurate vs. Accurate Preference Cards


Aspect	Accurate Preference Card	Inaccurate Preference Card
Efficiency	Ensures all needed items are ready, facilitating a smooth start and preventing delays.	Causes procedural delays and disrupts OR flow while staff searches for missing items.
Patient Safety	Reduces the time the patient is under anesthesia and minimizes the risk of complications.	Increases the risk of complications and unnecessary anesthesia time due to delays.
Cost	Minimizes waste by ensuring only necessary supplies are opened and used.	Leads to significant waste as unnecessary supplies are often opened and discarded.
Inventory Management	Provides accurate consumption data, leading to optimized inventory levels and reduced stockouts or surpluses.	Results in suboptimal inventory, requiring constant adjustment and potentially leading to overstocking or shortages.
Staff Satisfaction	Improves morale and communication among the surgical team, who can be confident in the setup.	Creates frustration and stress for staff, who must troubleshoot issues and find missing items on the fly.

The Critical Importance of Ongoing Optimization

With surgical techniques and technology evolving, maintaining accurate preference cards is an ongoing process. Regular review and updates are crucial to ensure that the cards reflect a surgeon's current practice. Some hospitals employ data analytics and technology to automate card updates based on actual usage, providing significant financial and operational benefits.

Benefits of Optimization

Reduced Waste: Optimizing cards based on real usage patterns ensures hospitals aren't stocking unnecessary or outdated products, directly lowering costs.
Enhanced Financial Performance: Accurate inventory management and cost-per-case analysis are improved, which is critical for a health system's financial health.
Improved Patient Outcomes: Fewer delays and a well-prepared team lead to a safer, more predictable surgical experience for the patient.
Better Training: Updated cards provide accurate information for new surgical staff, making training more effective and reducing room turnover time.

For more information on the significance of preference card management, see the Association of periOperative Registered Nurses (AORN) resources on the topic.

Conclusion

The surgeon's preference card is a powerful tool that extends far beyond a simple list of supplies. It is a vital component of operating room efficiency, patient safety, and hospital management. By detailing everything from specific instruments and equipment settings to patient positioning and surgical techniques, the card provides a blueprint that ensures consistency and precision. Regular, proactive optimization of these cards, especially through modern digital systems, is essential for reducing waste, lowering costs, and ultimately providing the best possible care for patients.

Frequently Asked Questions

The primary purpose of a surgeon's preference card is to provide a detailed, procedure-specific checklist for the operating room staff. It ensures that all necessary instruments, supplies, and equipment are correctly prepared and available before the surgery begins, streamlining the process and improving efficiency.

The preference card is used by a variety of OR staff, including surgical technicians who gather the instruments, circulating nurses who manage supplies and documentation, and the surgeon themselves to confirm the setup.

An inaccurate or outdated preference card can lead to costly and dangerous consequences. It can cause procedural delays, waste unused and opened supplies, and increase the risk of complications for the patient due to interruptions.

No, preference cards are specific to individual surgeons and their unique techniques or preferences. While some items may be standardized across a hospital, the card reflects a specific surgeon's chosen instruments, sutures, and procedural steps for a given case.

While preference cards are common for standard procedures like a laparoscopic cholecystectomy, they can also be used for more general categories, such as 'Excision of Lesion.' In these cases, the card provides a baseline list that can be adjusted for specific patient needs.

Digital preference cards are integrated into a hospital's electronic health record (EHR) system, making them easier to update, access, and analyze. Unlike manual paper cards, they provide real-time data, improve communication, and support more efficient inventory management.

'Open' items on a preference card are supplies that are opened and prepared for use at the beginning of the case. 'Hold' or 'PRN' (as needed) items are also prepared but left unopened, ready to be used only if required during the procedure, which helps reduce waste.