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Effect of a Preoperative Communication Checklist on Operative Efficiency in Burn Surgery: A Quality Improvement
Robertson Orson1, Bettarelli Douglas1, Bandaru Vishal1
1Department of Surgery, Texas Tech University Health Sciences Center, School of Medicine, 3601 Fourth Street, MS6207, Lubbock, Texas, 79430, USA.
Introduction:
Preoperative communication checklists are used to improve surgical safety and team coordination. We evaluated whether introduction of a preoperative communication checklist was associated with reduced operative duration in a burn operating room.
Methods:
We conducted a quality improvement study comparing operative outcomes before and after introduction of a preoperative communication checklist in a burn unit. Cases from August 19, 2020, to August 20, 2022, were included, with checklist introduction occurring in August 20, 2021. Adult patients undergoing excisional debridement procedures were analyzed. The primary outcome was operative duration. Mixed-effects models were used to assess the association between checklist use and operative duration while adjusting for surgeon, procedure type, and square area excised.
Results:
A total of 139 patients undergoing 281 operations were included (143 pre-checklist, 138 post-checklist). Mean operative duration decreased from 107.8 minutes pre-checklist to 96.0 minutes post-checklist. In adjusted analysis, checklist use was associated with a 17.99-minute reduction in operative duration (p<0.001). Procedures involving autograft, ReCell, and biodegradable temporizing matrix were associated with increased operative time, as was greater square area excised. In interaction models, the overall reduction was not statistically significant; however, ReCell procedures demonstrated a significant reduction of 30.49 minutes (p=0.003) following checklist introduction.
Conclusion:
Introduction of a preoperative communication checklist was associated with decreased operative duration. The greatest effect was observed in ReCell procedures, suggesting that improved preoperative coordination may enhance efficiency in complex workflows. Preoperative checklists represent a scalable quality improvement strategy to optimize operative efficiency and resource utilization in burn care.
