Accurate Inventory and Preference Card Assignment Improves Operating Room Efficiency: A Quality Improvement Initiative

Introduction: Operating room (OR) delays are both costly to the hospital and potentially preventable. Inaccurate preference card assignment and surgical instrument tray availability were found to be factors contributing to OR delays at our institution. We performed a cross-discipline quality improvement project to decrease the common cause variability caused by preference card inaccuracy and instrument tray availability.

Methods: We addressed OR delays due to preference card inaccuracy and instrument tray availability using a plan-do-study-act (PDSA) model. An apparent cause analysis was performed to identify contributing factors to limited tray availability. Scope inventory audits were performed for rigid endoscopes and laparoscopes used by pediatric surgery, neurosurgery, and otorhinolaryngology which revealed inaccurate preference cards and a lack of instrumentation. Additional inventory was purchased for instruments exceeding a maximum utilization of 100%.

Results: Maximum utilization for the General Surgery Pediatric Laparoscope, ENT Endoscopic Sinus Instruments & ENT Sinus Scopes, and ENT Clip Appliers Long & Short Tray decreased from 133% to 80%, 200% to 133%, 150% to 133%, and 200% to 100%, respectively.

Conclusion : This study highlights a strategy to improve surgical instrument tray availability associated with preference card inaccuracy. This approach can provide more accurate turnover needs for specific instrument and scope trays to prevent procedural delays and save the institution on processing costs.