1.The impact on patients’ time-to-theatre following colour coding classification in emergency operation theatre, Sarawak General Hospital
Khaw Soon Keong ; Teo Shu Ching ; Mohamad Adam Bujang
The Medical Journal of Malaysia 2020;75(4):379-384
Introduction: A proper prioritisation system of emergency
cases allows appropriate timing of surgery and efficient
allocation of resources and staff expertise. The aim of this
study was to determine the impact of colour coding
classification on Time-to- theatre (TTT) of patients in
comparison with the normal practice.
Method: Categorisation was a surgical judgment call after
thorough clinical assessment. There were 4 levels of urgency
with their respective TTT; Red (2 hours), Yellow (8 hours),
Green (24 hours), Blue (72 hours). Caesarean cases were
excluded in colour coding due to pre - existing classification.
The data for mean TTT was collected 4 weeks before the
implementation (Stage 1), and another 4 weeks after
implementation (Stage II). As there was a violation in the
assumption for parametric test, Mann Whitney U test was used
to compare the means between these two groups. Using
logarithmic (Ln) transformation for TTT, Analysis of
Covariance (ANCOVA) was conducted for multivariate
analysis to adjust the effect of various departments. The mean
TTT for each colour coding classification was also calculated.
Results: The mean TTT was reduced from 13 hours 48 min to
10 hours, although more cases were completed in Stage II (428
vs 481 cases). Based on Mann-Whitney U test, the difference in
TTT for Stage I (Median=6.0, /IQR=18.9) and Stage II
(Median=4.2, IQR=11.5) was significantly different (p=0.023).
The result remained significant (p=0.039) even after controlled
for various department in the analysis. The mean/median TTT
after colour coding was Red- 2h 24min/1h, Yellow- 8h
26min/3h 45 min, Green- 15h 8min/8h 15min, and Blue- 13h
46min/13h 5min.
Conclusion: Colour coding classification in emergency
Operation (OT) was effective in reducing TTT of patients for
non-caesarean section cases.