Improving Preanesthetic Assessment and Documentation in Cardiac Surgery: A Quality Improvement Audit

Abstract Background: Cardiac surgery patients present significant anesthetic challenges due to high comorbidity burdens and limited cardiopulmonary reserves. Effective preanesthesia checkups (PACs), especially focused on airway assessment, are critical to minimizing perioperative risk. Objectives: This hybrid open-label clinical audit aimed to assess and improve the quality of PAC documentation in cardiac surgical patients using global quality index (GQI)-aligned tools. Secondary aims included improving difficult airway prediction and reducing PAC-related complications. Materials and Methods: Conducted at a tertiary cardiac center, the audit was divided into three phases: (1) baseline retrospective audit of PAC records ( n = 150); (2) implementation of GQI-aligned checklist and training modules; and (3) prospective postintervention audit ( n = 150). Key variables included demographic details, airway indicators, comorbidities, and informed consent documentation. Data were analyzed using descriptive statistics, and appropriate test had been applied as appropriate. Results: The baseline audit ( n = 150) revealed significant documentation gaps for key metrics like height (24% compliance) and weight (64% compliance). Following the implementation of a structured checklist and training, the postintervention audit ( n = 150) demonstrated a significant improvement in documentation, with compliance for both height and weight reaching 100% ( P < 0.001). The proportion of PACs conducted in the outpatient setting increased, which was associated with improved intraoperative preparedness and has the potential to reduce anesthesia-related complications. Conclusions: A structured audit framework significantly improved the quality of PAC documentation and clinical readiness in high-risk cardiac patients. Continuous training, periodic reaudits, and GQI alignment are recommended to sustain improvements as part of practice in future.