Surgical Preference Cards

REDEFINED

By: Ashwin Kulkarni

Published: April 3, 2020

Undoubtedly, communication is key to a successful team. We’ve learned this since we were children, from calling for the soccer ball from a teammate when open to score a goal to providing constructive feedback in a group science project when testing a hypothesis. These team-building experiences have trained us for the moments we encounter every day as a surgical team in the OR, where our operations provide patients with the ability to walk, reduce the risk of stroke or possibly even save a life. For a successful procedure, we must communicate with our team effectively and efficiently.

This all seems like common sense. Yet, the extent to which communication and incivility affects OR outcomes – and still does to this day – may surprise you. A 2015 CBS report found over 7,000 malpractice cases between 2009 and 2013 where surgical team communication failures harmed patients. Within these cases alone, over 2,000 patients died and over $1.7 billion were paid in malpractice fees.

Daniel Katz, associate professor of anesthesiology and perioperative and pain medicine at the Icahn School of Medicine, wanted to study OR communication further. In a 2019 study, he and his colleagues simulated scenarios of occult hemorrhage, randomly assigning 76 anesthesiology residents to a “normal” or “rude” OR environment and graded their behavior on several metrics including vigilance, diagnostic ability, communication and patient management. 

The results, as he labelled them, were “startling.” Residents in the “rude” environment graded lower on every performance metric, with just 64% of residents operating at their expected level compared with 91% in the control group. The “rude” group residents did not call for more blood to the OR, administer IV fluids or discuss differential diagnosis with the head surgeon. Though Dr. Katz mentioned that the study is limited to a simulated environment, he does support the conclusion that “behavior in the workplace can affect the performance of those around them.”

There are many reasons why incivility in the OR may arise. One of these include outdated hand-written surgical preference cards. These surgical blueprints or modern EHR-generated list of materials – documenting needed instruments, medicine and much more – often are not updated. This leads to significant cost increases and lapses in communication within the surgical team staff: nurses, assistants and physicians altogether. Having software that can easily update these cards would improve OR organization so that surgeons can go into the OR knowing that their preferred setup, instruments and medicines are present as required. Above all, this would decrease frustration within the OR during a procedure, which can significantly compromise patient safety and increase malpractice costs.

At OR Link, we view improving surgical preference cards as a responsibility. We have designed the digital surgical preference card to improve staff communication and improve the safety of the patients we serve. We believe our software would go a long way towards making the already-stressful job of the surgical team easier and less frustrating within the OR.