Run Surgeon Preference Card Annual Audit — Free

Audit Scope and Card Identification

Surgeon name and service line match the audited preference card

Record the surgeon, specialty, and preference card identifier being audited.

Audit period covers a full 12-month review cycle critical (required)

Confirm the audit period includes a complete annual cycle.

Yes No N/A

Current preference card version is documented

Capture the current card version, revision date, or last update reference.

Cases included in the audit sample are identified

Enter the number of cases reviewed for this surgeon preference card.

Reference source for case data and supply pulls is documented

Identify the system, report, or log used to compare actual usage against the card.

Card Accuracy vs Actual Case Usage

Listed instruments and supplies match actual case usage critical (required)

Verify the preference card reflects items actually used in the reviewed cases.

Yes No N/A

Items on the card that were not used are identified

Confirm unused items were reviewed for potential removal or conditional use.

Yes No N/A

Frequently used items missing from the card are identified critical (required)

Confirm omissions were captured for card revision.

Yes No N/A

Supply pull quantities align with documented case needs

Compare pulled quantities to actual utilization and note variances.

Yes No N/A

No obsolete, expired, or discontinued items remain on the card critical (required)

Verify the card does not reference items no longer stocked or approved.

Yes No N/A

Discrepancy Review and Standardization Opportunities

All discrepancies between card, case record, and supply pulls are documented critical (required)

Capture each discrepancy with item name, case reference, and variance type.

Yes No N/A

Discrepancies are categorized by type

Select all applicable discrepancy categories.

Note (optional)

Waste or overpull trends are identified

Review whether the card contributes to excess supply pulls or avoidable waste.

Yes No N/A

Standardization opportunities are documented

Note opportunities to align similar cards, reduce variation, or simplify setup.

Yes No N/A

High-impact discrepancies are escalated for review critical (required)

Confirm significant variances were escalated to perioperative leadership, materials management, or the surgeon as appropriate.

Yes No N/A

Revision Approval and Follow-Up

Recommended preference card changes are listed critical (required)

Document specific additions, removals, quantity changes, or note updates needed.

Responsible owner for card revision is assigned critical (required)

Identify the person or role responsible for updating the preference card.

Target completion date for revision is documented

Record the due date for completing the card update and communicating changes.

Follow-up validation plan is defined

Confirm there is a plan to verify the updated card after implementation.

Yes No N/A

Audit findings reviewed and approved critical (required)

Inspector or reviewer signs to confirm the audit findings and follow-up actions.

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Run: Surgeon Preference Card Annual Audit

Audit Scope and Card Identification

Card Accuracy vs Actual Case Usage

Discrepancy Review and Standardization Opportunities

Revision Approval and Follow-Up

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