How to Build a Surgical Preference Card: Step-by-Step Guide for OR Professionals
Ever felt like you were in the middle of a surgical case and the room suddenly turned into a game of charades, with everyone guessing what comes next? If so, you’ve experienced the pain of a poorly made (or nonexistent) surgical preference card.
Let’s be real: a solid preference card isn’t just a “nice to have”—it’s the secret sauce for operating room efficiency, surgeon satisfaction, and fewer “where’s that thing?” moments. As a Surgical First Assist and founder of Beyond Assisting, I’ve seen (and rewritten) enough cards to know exactly what works. In this post, I’ll break down the step-by-step process for building the perfect surgical preference card, share common mistakes, and offer some pro tips you won’t find in a textbook.
What Is a Surgical Preference Card and Why Does It Matter?
A surgical preference card is a living document that outlines a surgeon’s specific requirements for a procedure. This includes everything from instrument selection and room setup to draping technique and suture choice. When done right, a preference card is like a cheat sheet for the whole OR team—making the surgery smoother, faster, and safer.
Step 1: Start with the Basics
Every card should include the following essentials:
Surgeon’s Name
Procedure Name
Patient Positioning
Draping Preferences
Required Instruments and Supplies
Suture Types and Sizes
Implants/Devices Needed
Special Requests or Notes
Coach’s tip:
Don’t skip over the “obvious” stuff. One surgeon’s “standard” is another’s “what the heck is this?”
Step 2: Get Input From the Source (a.k.a., The Surgeon)
You’d be surprised how many preference cards are made based on guesswork or outdated habits. Schedule a quick chat with the surgeon—yes, even if you have to catch them between cases. Ask about their quirks, must-haves, and pet peeves. Record the conversation (with permission) or take detailed notes.
Pro questions to ask:
“Walk me through your setup—what’s non-negotiable?”
“Any particular instrument brands or sizes?”
“What’s your backup plan if a primary item isn’t available?”
Step 3: Map Out the Sequence
A great preference card isn’t just a checklist—it’s a roadmap. List items in the order they’ll be used, from incision to closure. This helps everyone anticipate what’s next and keeps the case flowing smoothly.
Example:
Position patient (supine, arm board)
Prep and drape (chlorhexidine, split drape)
Skin incision (10 blade)
Hemostasis (Bovie, tonsil)
Closure (3-0 Vicryl, skin glue)
Step 4: Include Visuals and Diagrams
Not everyone learns best by reading. If your facility allows, add images or diagrams of draping, instrument tray setup, or room layout. The Beyond Assisting app is an awesome tool for this—upload annotated images so everyone, from the newest scrub tech to the most tenured nurse, is on the same page.
Step 5: Make It Dynamic and Easy to Update
Surgical techniques and surgeon preferences change—sometimes daily, sometimes mid-case (yes, I’m looking at you, Dr. Never-the-Same-Twice). Use a digital format like your facility’s EHR to keep cards up-to-date. Assign someone (that’s you, OR coordinator!) to review and revise cards quarterly or after major feedback.
Step 6: Cross-Check for Completeness
Before rolling out your shiny new preference card, walk through a mock setup with the team. Ask:
Is anything missing?
Are there duplicates?
Does the flow make sense?
Catch the mistakes here, not when the patient’s prepped and draped.
Step 7: Share and Educate
Don’t just upload the card and call it a day. Host a quick in-service or huddle to introduce the new format. Show how to access it, update it, and where to find those critical surgeon notes (like “never use silk suture” or “prefers music off”).
Common Mistakes (and How to Avoid Them)
Outdated info: Schedule regular reviews.
Assuming one size fits all: Customize for each surgeon and procedure.
Missing backup plans: Always list alternatives for key supplies and devices.
Poor formatting: Use bullet points, bold headings, and clear sections for readability.
Coach’s witty aside:
If your card still says “pager” instead of “cell phone,” it’s time for a rewrite.
Pro Tips for Maximum Efficiency
Color-code by procedure or specialty (e.g., blue for ortho, green for gen surg)
Include a “last updated” field to keep everyone accountable
Solicit feedback—the best cards are team efforts