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Nurses used these estimates to revise 309 preference cards across eight surgical services corresponding to, respectively, 1777 and 3106 procedures in the pre- and post-intervention periods. The average direct cost of supplies per case decreased by 8.38% ($352, SD $6622) for the intervention group and increased by 13.21% ($405, SD $14706) for the control group (P .001). The DID analysis showed significant cost reductions only in the intervention group during the intervention period (P .001). The optimization of preference cards