Abstract：
BACKGROUND: Refinement of surgical preference cards may reduce waste from surgery. This study aimed to characterize surgeon perceptions and practices regarding preference card maintenance, identify barriers to updating preference cards, and explore whether opinions on environmental stewardship relate to preference card maintenance.
METHODS: This was a mixed methods survey performed at a single tertiary academic medical center. Surgeons completed questions on accuracy, frequency of updates, and perceived environmental impact of their preference cards. Responses were compared between early career and mid-to late-career surgeons using Kruskal-Wallis, chi-squared, and Fisher\'s exact tests.
RESULTS: The response rate was 46.4% (n = 89/192). Among respondents, 46.1% (n = 41/89) rarely or never updated preference cards. Nearly all (98.9%, n = 87/88) said some of their cases had unused items on their cards. Most (87.6%, n = 78/89) made updates via verbal requests. Unfamiliar processes (83.7%, n = 72/86) and effort required (64.0%, n = 55/86) were viewed as barriers to card maintenance. Most agreed that more frequent updates would reduce waste (80.5%, n = 70/87), but respondents did not feel knowledgeable about the environmental impact of items on their cards (62.1%, n = 54/87). Mid-to late-career surgeons were less likely to update their cards annually or more often compared to early career surgeons (18.9%, n = 7/37 vs. 57.1%, n = 24/42, p < 0.001). No other responses varied significantly between early career and mid-to late-career surgeons.
CONCLUSIONS: Surgeons acknowledged the utility of preference card maintenance in environmental stewardship, but unfamiliar systems and perceived effort hindered preference card review. Greater attention to preference card maintenance would promote environmentally sustainable practices in surgery.
METHODS: This was a mixed methods survey performed at a single tertiary academic medical center. Surgeons completed questions on accuracy, frequency of updates, and perceived environmental impact of their preference cards. Responses were compared between early career and mid-to late-career surgeons using Kruskal-Wallis, chi-squared, and Fisher\'s exact tests.
RESULTS: The response rate was 46.4% (n = 89/192). Among respondents, 46.1% (n = 41/89) rarely or never updated preference cards. Nearly all (98.9%, n = 87/88) said some of their cases had unused items on their cards. Most (87.6%, n = 78/89) made updates via verbal requests. Unfamiliar processes (83.7%, n = 72/86) and effort required (64.0%, n = 55/86) were viewed as barriers to card maintenance. Most agreed that more frequent updates would reduce waste (80.5%, n = 70/87), but respondents did not feel knowledgeable about the environmental impact of items on their cards (62.1%, n = 54/87). Mid-to late-career surgeons were less likely to update their cards annually or more often compared to early career surgeons (18.9%, n = 7/37 vs. 57.1%, n = 24/42, p < 0.001). No other responses varied significantly between early career and mid-to late-career surgeons.
CONCLUSIONS: Surgeons acknowledged the utility of preference card maintenance in environmental stewardship, but unfamiliar systems and perceived effort hindered preference card review. Greater attention to preference card maintenance would promote environmentally sustainable practices in surgery.
摘要：
背景：手术偏好卡的细化可以减少手术的浪费。这项研究旨在描述外科医生对偏好卡维护的看法和做法，识别更新偏好卡的障碍，并探讨有关环境管理的意见是否与偏好卡维护有关。
方法：这是一项在一个三级学术医疗中心进行的混合方法调查。外科医生完成了关于准确性的问题，更新的频率，以及他们偏好卡对环境的影响。使用Kruskal-Wallis比较了职业生涯早期和职业生涯中后期外科医生的反应，卡方，和费希尔的精确测试。
结果：有效率为46.4%（n=89/192）。在受访者中，46.1％（n=41/89）很少或从未更新过偏好卡。几乎全部（98.9%，n=87/88）说，他们的某些箱子上有未使用的物品。大多数（87.6%，n=78/89)通过口头请求进行更新。不熟悉的流程(83.7%，n=72/86)和所需努力(64.0%，n=55/86)被视为卡维护的障碍。大多数人同意更频繁的更新将减少浪费(80.5%，n=70/87），但受访者对卡片上物品对环境的影响并不了解(62.1%，n=54/87）。与早期职业外科医生相比，职业中后期外科医生不太可能每年或更频繁地更新他们的卡片(18.9%，n=7/37vs.57.1%,n=24/42,p<0.001)。在职业生涯早期和职业生涯中期到后期的外科医生之间，其他反应没有显着差异。
结论：外科医生承认偏好卡维护在环境管理中的效用，但是不熟悉的系统和感知的努力阻碍了偏好卡的审查。更加关注偏好卡的维护将促进外科手术中的环境可持续做法。
方法：这是一项在一个三级学术医疗中心进行的混合方法调查。外科医生完成了关于准确性的问题，更新的频率，以及他们偏好卡对环境的影响。使用Kruskal-Wallis比较了职业生涯早期和职业生涯中后期外科医生的反应，卡方，和费希尔的精确测试。
结果：有效率为46.4%（n=89/192）。在受访者中，46.1％（n=41/89）很少或从未更新过偏好卡。几乎全部（98.9%，n=87/88）说，他们的某些箱子上有未使用的物品。大多数（87.6%，n=78/89)通过口头请求进行更新。不熟悉的流程(83.7%，n=72/86)和所需努力(64.0%，n=55/86)被视为卡维护的障碍。大多数人同意更频繁的更新将减少浪费(80.5%，n=70/87），但受访者对卡片上物品对环境的影响并不了解(62.1%，n=54/87）。与早期职业外科医生相比，职业中后期外科医生不太可能每年或更频繁地更新他们的卡片(18.9%，n=7/37vs.57.1%,n=24/42,p<0.001)。在职业生涯早期和职业生涯中期到后期的外科医生之间，其他反应没有显着差异。
结论：外科医生承认偏好卡维护在环境管理中的效用，但是不熟悉的系统和感知的努力阻碍了偏好卡的审查。更加关注偏好卡的维护将促进外科手术中的环境可持续做法。
