Standardized Templates for Thoracic Anesthesia Practitioners: A Quality Improvement Needs Assessment to Support Onboarding and Protocol Adherence

Background Onboarding in anesthesiology varies widely across institutions and often emphasizes logistics over clinical workflow integration, contributing to cognitive load and inconsistent early practice. These challenges may be amplified in thoracic anesthesia, where complex perioperative management requires specialized skills and coordinated workflows. Although structured perioperative pathways, such as Enhanced Recovery After Surgery (ERAS) protocols, improve outcomes when consistently implemented, adherence depends on reliable, accessible clinical guidance. This quality improvement needs assessment evaluated thoracic anesthesia practitioners' perceptions of standardized, workflow-integrated templates to support onboarding and protocol adherence. Methods A pre-implementation needs assessment was conducted among anesthesia residents, fellows, and faculty to evaluate the perceived usefulness of standardized template systems for thoracic cases, with a primary focus on the ERAS protocol. The survey assessed anticipated effects on confidence and clinical focus (e.g., shifting effort from learning local norms to patient optimization and patient-centered care) and identified perceived barriers and concerns to implementation. Results Most respondents were staff anesthesiologists. Exposure to thoracic anesthesia varied. Most participants reported prior experience with ERAS protocols. Participants perceived that access to a standardized thoracic ERAS protocol would increase confidence in managing cases and facilitate more rapid integration into new clinical environments. Respondents also reported that standardized protocols would support greater focus on patient optimization rather than determining local standards of care. Reported concerns included potential reductions in clinical flexibility and the need for regular protocol updates, while integration within the electronic health record was identified as the preferred mode of access. Conclusion Respondents perceived standardized thoracic ERAS protocols as useful for improving confidence, integration, and clinical focus, with EHR integration preferred. Concerns centered on flexibility and protocol updates. Findings support implementation feasibility and inform a post-implementation evaluation.