320 The Reimagined Kardex System: An Ecological, Economical, and Standardised Approach

Abstract Aim The NHS’s current surgical Kardex system relies on handwritten notes, lacking standardisation across hospitals. This, combined with staff fluctuations in both elective and emergency surgery, leads to confusion, errors, and inefficiencies. We aimed to introduce a low-tech, inexpensive modification to address issues like patient positioning, theatre instrument layout, essential versus potential kits, and consultant variations—all summarised on a single page. The goal was to create a consistent, adaptable Kardex system across theatres, which could be replicated internationally. Method A revised Kardex layout was developed and trialled in our Oesophagogastric theatres. The new design incorporated a pictorial and tabular layout, clarifying patient, instrument, and staff positioning. It identified essential kits and potential kits on standby to reduce waste and showcased variations among surgeons for a procedure. Built with Excel and PowerPoint, the Kardex was evaluated through a feedback survey across several operating theatres. The survey assessed design simplicity, standardisation, ease of use, confidence in setup, and waste reduction. Results Of 40 healthcare professionals surveyed:75% favoured the new Kardex system.78% believed standardisation would benefit their department.78% found the layout easy to understand.68% saw potential for increased sustainability.78% believed the layout could save costs. Conclusions The new Kardex layout received positive feedback, improving clarity and confidence among staff. It reduced waste, highlighted consultant variations, and showed promise for standardisation. This low-cost solution has potential for broader implementation and international adaptation, enhancing surgical efficiency and sustainability.