Abstract Aim This project aimed to redesign the existing handwritten Kardex system to improve clarity, standardisation, and safety in surgical theatres. Secondary objectives were to reduce equipment waste, improve multidisciplinary communication, and explore the educational value of involving medical students in quality improvement initiatives. Methods A review of the original Kardex identified issues including illegibility, inconsistency, and missing information. A low-cost, standardised, pictorial Kardex was developed using accessible software, incorporating diagrams of patient and staff positioning, instrument layout, and clear distinction between essential and optional kits. It was introduced within oesophago-gastric theatres and evaluated via an initial survey of 50 multidisciplinary staff members. Following positive feedback, the template was adapted for other specialties with support from medical students. Results 75% of staff reported the new Kardex as an improvement, while 78% felt it offered better standardisation and ease of use. Qualitative feedback highlighted improved clarity, reduced confusion, enhanced communication, and more efficient setup. The classification of equipment reduced unnecessary kit opening, supporting sustainability goals. Medical students reported significant educational and professional benefits, including skill development in quality improvement, teamwork, and operational understanding. Medical student involvement also enabled rapid, sustainable expansion of the system across multiple specialties and into a second NHS Trust. Conclusions A simple, low-cost redesign of the Kardex significantly improved theatre efficiency, organisation, and communication. The project demonstrates that practical system change can enhance patient safety, reduce waste, and simultaneously serve as a powerful educational platform, to make a sustainable model for future standardisation in surgical settings.
Lawrence et al. (Sun,) studied this question.