{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:43:17Z","timestamp":1790264597692,"version":"4.1.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Emergency surgery is associated with night-time procedures and disruption of elective surgery. An analysis was undertaken of the effect of classifying emergency operations uniformly with a three-tier urgency colour code and the use of dedicated daytime operating rooms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Observed changes from 2001 to 2012 in the number, timing and ability to meet the urgency-designated colour code deadline were retrieved from the computer-based operating theatre organization system for all emergency operations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The number of emergency operations performed annually ranged from 3330 to 4341, with an increasing trend. The proportion of night-time emergency operations decreased from 27\u00b74 per cent (2563 of 9347) before to 23\u00b75 per cent (7731 of 32 959) after introduction of the colour coding system in 2004 (\u03c72 = 61\u00b794, 1 d.f., P &amp;lt; 0\u00b7001). In 2007, owing to long preoperative delays in patients with acute appendicitis and acute cholecystitis, colour codes for these patients were upgraded from \u2018orange\u2019 to \u2018red\u2019 and from \u2018yellow\u2019 to \u2018orange\u2019 respectively. The proportion of patients operated on with a red code before and after this change increased from 45\u00b72 per cent (5831 of 12 907 operations) to 62\u00b77 per cent (13 020 of 20 778 operations; \u03c72 = 986\u00b799, 1 d.f., P &amp;lt; 0\u00b7001). In 2012, the office-hours raw utilization time for the principal emergency operation theatre was 85\u00b74 per cent.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The structural separation of elective and emergency surgery, the use of dedicated daytime operating theatres and the implementation of a universal classification of emergency operations reduced night-time surgery, improved the efficiency of operating theatre utilization during daytime, shortened preoperative delay in patients requiring urgent surgery, and enabled monitoring and corrective actions for providing emergency surgery services.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.9325","type":"journal-article","created":{"date-parts":[[2013,11,24]],"date-time":"2013-11-24T14:50:37Z","timestamp":1385304637000},"page":"e134-e140","source":"Crossref","is-referenced-by-count":53,"title":["A traffic-light coding system to organize emergency surgery across surgical disciplines"],"prefix":"10.1093","volume":"101","author":[{"given":"A","family":"Lepp\u00e4niemi","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery, Meilahti Hospital, University of Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Jousela","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Meilahti Hospital, University of Helsinki ,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2014,1,1]]},"reference":[{"key":"2024092904570308500_bjs9325-bib-0001","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/S0002-9610(02)01362-4","article-title":"Efficiency of the operating room suite","volume":"185","author":"Weinbroum","year":"2003","journal-title":"Am J Surg"},{"key":"2024092904570308500_bjs9325-bib-0002","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.1445-2197.2008.04790.x","article-title":"Acute-care surgical service: a change in culture","volume":"79","author":"Parasyn","year":"2009","journal-title":"ANZ J Surg"},{"key":"2024092904570308500_bjs9325-bib-0003","first-page":"62","article-title":"Emergency surgery: half a day does make a difference","volume":"81","author":"Lovett","year":"1999","journal-title":"Ann R Coll Surg Engl"},{"key":"2024092904570308500_bjs9325-bib-0004","first-page":"27","article-title":"The efficiency of management of emergency surgery in a district general hospital \u2013 a prospective study","volume":"72","author":"Flook","year":"1990","journal-title":"Ann R Coll Surg Engl"},{"key":"2024092904570308500_bjs9325-bib-0005","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/003693300104600207","article-title":"Separating elective and emergency surgical care (the emergency team)","volume":"46","author":"Addison","year":"2001","journal-title":"Scott Med J"},{"key":"2024092904570308500_bjs9325-bib-0006","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.jamcollsurg.2009.06.368","article-title":"Initial implementation of an acute care surgery model: implications for timeliness of care","volume":"209","author":"Britt","year":"2009","journal-title":"J Am Coll Surg"},{"key":"2024092904570308500_bjs9325-bib-0007","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1023\/A:1009941214632","article-title":"Optimal sequencing of urgent cases. Scheduling cases using operating room information systems","volume":"15","author":"Dexter","year":"1999","journal-title":"J Clin Monit Comput"},{"key":"2024092904570308500_bjs9325-bib-0008","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/1749-7922-2-29","article-title":"We still need to operate at night!","volume":"2","author":"Faiz","year":"2007","journal-title":"World J Emerg Surg"},{"key":"2024092904570308500_bjs9325-bib-0009","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1111\/j.1399-6576.2008.01618.x","article-title":"Operating room management; why, how and by whom?","volume":"52","author":"Marjamaa","year":"2008","journal-title":"Acta Anaesthesiol Scand"},{"key":"2024092904570308500_bjs9325-bib-0010","first-page":"87","article-title":"Dedicated orthopedic trauma theatres: effect on morbidity and mortality in a single trauma centre","volume":"52","author":"Lemos","year":"2009","journal-title":"Can J Surg"},{"key":"2024092904570308500_bjs9325-bib-0011","doi-asserted-by":"crossref","first-page":"1262","DOI":"10.1213\/ane.0b013e31819775cd","article-title":"Typical savings from each minute reduction in tardy first case of the day starts","volume":"108","author":"Dexter","year":"2009","journal-title":"Anesth Analg"},{"key":"2024092904570308500_bjs9325-bib-0012","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1097\/01.sla.0000231726.53487.dd","article-title":"Is it safe to delay appendectomy in adults with acute appendicitis?","volume":"244","author":"Ditillo","year":"2006","journal-title":"Ann Surg"},{"key":"2024092904570308500_bjs9325-bib-0013","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1097\/SLA.0b013e318228d31c","article-title":"Population-based analysis of 4113 patients with acute cholecystitis: defining the optimal time-point for laparoscopic cholecystectomy","volume":"254","author":"Banz","year":"2011","journal-title":"Ann Surg"},{"key":"2024092904570308500_bjs9325-bib-0014","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1213\/ane.0b013e318184e919","article-title":"A simulation model for determining the optimal size of emergency teams on call in the operating room at night","volume":"107","author":"van Oostrum","year":"2008","journal-title":"Anesth Analg"},{"key":"2024092904570308500_bjs9325-bib-0015","first-page":"313","article-title":"What is the safety of nonemergent operative procedures performed at night? 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