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O R I G I N A L A R T I C L E ู† ูู„ ู…ูˆ ู‰ ู ู… ู… ู‰ ูƒู… ู… ู† ู‰ ู ู…ูƒ ู ู‰ : ู ู‰ ูˆ ู‡ ุซ ู‡ ุจ ู ู‰ ู…ู‡ ู„ู…ู„ ู… ู‰ ูู… ู„ ู ู…ูƒ ู… ู ู… CH Chiu Anna Lee PT Chui ่ถ™ไฟŠ้›„ๆŽ็…ฅๅคๅพๅฏถๅ ‚ ู… ููƒ ููƒู‰ู‡ ู… ู‰ ูƒู… ู… ู† ู…ูƒ ู… ู ู… ู‰ ู…ูˆ ู… ู‰ ู… ู…ู„ ุด Objective. ูู… ู…ูˆ ู„ ู ู‰ ู ู…ูƒ ููƒ. ู„ ู ู‰ ูƒู… - Design.ู‡ ุซ ู‡ ุจ ู ู‰ ูˆ ู‡ ู‰ูˆูƒูู…ุด Setting ู‰ ู ู…ูƒ ููƒ ู…ู‡ ู… ู‰ ูƒู… ู… ู† ู„ ูƒู… ู… ูู…ูˆ ู‡ ู‰ ู ู… ุฏ Patients ู… ู‰ ูƒู… ู… ู… ู…ๅฑž ูขู ู ูฉ ู…ู‚ ู…ูƒู…ุก ูฃูก ูขู ู ูฉ ู ูุช ูก ู†.ู„ู…ๅฑž ู…ู‰ ู… ู…ู‡ ู† ูู„ ู…ูˆ ู…ู‡ ู… ู‰ ูƒู… ู… ู„ู… ู„ู…ูˆูƒ ู† ู‰ ู ู…ูƒ ู Main outcome measures. ูู… ู‡ ู‰ู„ ู… ูƒ ู…ูˆ ู„ ู ู ู„ู…ู„ ู…ู‰ ูˆูƒู‰ูˆๅฑž ู„ู… ู…ูƒ ููƒ ู… ู…ๅฑž ูคูงูฆ ู„ู… ู„ู…ูˆูƒ ู… ููƒ ูฆูขูฃูค ู†ุฏ Results -ูง.ู  ู† ู ู… ู‰ ู…ูƒ ู…ู„ู…ุญ ูƒ ูฉูฅ ู ูˆ ู‰ๅฑž ูง.ูฆ ู† ู…ูƒ ู… ู ู… ู‰ ู…ู‰ ู ู‰ ู„ู… ูƒูƒ ู‰ ู ู…ูƒ ููƒ ู† ู…ู‚ ู…ูˆู‡ู‰ูˆ ู…ูˆุด. ูจ.ูฃ ( ูขู  ูฉูค= ) ู… ู„ู…ูƒ ููƒู‰ู‡ ู ู… ู…ู‡ ูŠู ู† ู„ู… ู„ู…ูˆูƒ ูƒู‰ู„ู…ู ูˆ ูŠู ( ูกูฃ ูฆูค= ) ู… ู„ู…ูƒ ููƒู‰ู‡ ูŠู ู…ู‡ ูƒู‰ูƒู ูˆ ู‰ู„ ููƒ ูŠู -ู ู„ ู ( ูจ ูฃูจ= ) ู…ู‡ ูๅฑž ู‰ ู ู…ูƒ ููƒ ู† ู‡ู… ููƒ ูƒ ู…ูˆุด.( ูฆ ูขูฉ= ) ( ูกู ) ู…ู‰ ู ( ูกูง) - ๅฑž ู‚ ู„ู…ๅฑž ู† ( ูงูฃ) ู‰ ู‰ูƒูู† ู… ู„ ู… ู‰ ู‡ ู‰ ู ู… ู… ู‚ู ู‰ู ู ุฎ.( ูก) ู…ู‡ ู„ ู ูู… ูƒ ู…ูˆ ูๅฑž ู…ู‡ ู‰ ู… ู…ูˆ ู† ู… ู…ู‡ ู ู… ู…ู‡ ู„ู… ู.(ูฃูกู = ) ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ู‰ ู… ููƒู…ุญู‰ ู‡ู‰ ูๅฑž ู… ู‰ ู‡ ู‰ ู ู… ู… ู‚ู ู‰ู ู ู† ู„ู„ ู…ูˆ -ู .ูกูง ู ู… ู‰ ู…ูƒ ู…ู„ู…ุญ ูƒ ูฉูฅ ู .ูขูฆ = ู‰ ู ู„ู„ ) ูƒู‰ู„ู…ู ูˆ -ู .ูกูฆ ู .ูฃูฆ ) ู…ู‡ ู… (ู .ูคูฆ-ู .ูกูฃ ู .ูขูฅ ) ู‡ ู‡ ู (ู .ูฃูฉ (ู .ูขูฉ-ู .ูกูก ู .ูกูจ ) ู‡ ูƒู…ู ู‡ (ู .ูจูง-ู .ูฃูก ู .ูฅูฃ ) ูƒู‰ ูู‰ู„ู…ู (ู .ูงู .(ู .ูฆู -ู .ู ู  ู .ูกู  ) ู‰ ู…ู„ ู„ ู (ู .ูคูก-ู .ู ูง ู .ูกูฉ ) ู‡ ููˆ ูˆ ู ูˆูƒ ูƒูู† ู‰ ู‰ูƒูู† ู… ู„ ู‰ู ู… ู…ๅฑž ู‰ ู ู…ูƒ ููƒ ู… ู Conclusions ู‡ ู‰ ููˆ ู† ู„ู„ ู…ูˆุด.ู… ู‚ู ู‰ู ู ู‡ ู‰ู…ู‚ ู… ู‰ ู‡ ู‰ ู ู… ููƒู‰ู‡ ู…ู…ๅฑž ู…ู‚ ู„ู…ู‰ ู ู… ู‚ู ู‰ู ู ู… ู‰ ู‡ ู‰ ู ู…. ู…ู‰ ูู‰ูƒู… Key words Appointments and schedules; Efficiency, organizational; Operating rooms; Quality improvement; Surgical procedures, elective Hong Kong Med J 2012;18:5-10 Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong CH Chiu, MPhil A Lee, PhD, MPH PT Chui, MB, BS, FANZCA Correspondence to: Prof Anna Lee Email: annalee@cuhk.edu.hk New knowledge added by this study. ูง.ูฆ ูๅฑž ู…ู‡ ู„ู…ู„ ู… ู‰ ู† ูู„ ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ู…ูƒ ู… ู ู… ู‰ ู…ูˆุด ุท ู‡ ู‰ ู ู… ู ูˆ ู‰ๅฑž ู… ู‚ู ู‰ู ู ู… ู‰ ู‡ ู‰ ู ู… ู… ู„ ู‰ู ู… ู…ๅฑž ู‰ ู ู…ูƒ ููƒ ู… ู ุท. ู…ู‰ ูู‰ูƒู… ููƒู‰ู‡ ู… ู…ู†ู†ู‰ู„ ู…ู…ๅฑž ู…ู‚ Implications for clinical practice or policy ููƒู‰ู‡ ู† ู‰ ู ู…ูƒ ููƒ ูู„-ู… ู ู…ูƒ ู„ู… ู„ู…ู„ู…ู… ู… ู ู…ู‰ู‡ู… ู ู… ู… ู‰ ู‰ ู ุฑ ุท. ู… ู„ู…ูƒ ู… ูู… ูƒู…ู„ ููƒู…ุญู‰ ู‡ู‰ ู ู… ู‰ ู ู ู… ู… ู‰ ู ู… ู… ู„ู… ู ู‡ู… ู‰ ู ู† ู‰ ู ู… ู… ุฉ ุท. ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู…ู‡ ู„ู…ู„ ู… ู‰ุชุญ ูู„-ู… ู ู† ู… ู ู…ูˆ Introduction ูƒ ู…ู‰ูƒู…ุญู†ู… ู… ูู…ูˆ ู‡ ู‰ ู ู… ู… ูู… ูƒู…ู„ ู…ู‡ ู… ู‰ ูƒู… ู… ู† ู‰ ู ู…ูƒ ููƒ ู„ู… ู ู‰ูƒู‰ ู ุต ู…ู‰ ู… ูƒ ู‰ ู ู… ู ู…ู‰ ู…ู‡ ู„ู… ู…ูƒ ู.ู„ู… ู‰ ู‰ ู‰ ู… ู‰ ู… ูู…ูˆ ู‡ ู‰ ู ู… ู†ู‰ ู†ู†ู ู„ู…ูˆ ู‰ ู‰ ู‰ู„ ู„ ู ู‰ ูƒูู† ู‰ ู ู…ู‰ ู ู„ู… ูู… ูƒู…ู„ ู„ูู… ู†ู†ู ู„ ู ูู‰ูƒู‰ ูˆ ู…ู‰ ู ู‡ ู‰ูˆูƒ ู - ูƒ ู„ ู‚ ู„ ู ู‰ ูู‡ู‰ ู… ู‰ ู„ู… ู ๅฑž ู‰ ู… ู‰ ู ู…ูƒ ููƒ ู… ู ูก.ู… ู.ู… ูƒ ููƒู‰ ู‰ ูƒ ู ู… ู…ูˆ ูƒู…ู†ู†ู ูู‰ ู… ููƒ ู„ ู ู… ููƒ ู…ู‰ ู ู„ู… ู ู…ู„ ู„ูู… ู† ูู„ ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ู… ู ู…ูˆ ู‡ ู‰ ู… ู… ู‰ ู‰ ู…ู‰ ูƒู…ุญู†ู‰ู„ ู…ูˆ ู† ู… ุฏ - - ๅฑž ู… ู ู…ู„ู ู‰ ูƒูู† ู„ู… ู ู… - ู…ู‰ ู : ู… ู‰ู‡ ูู… ู† ู…ู‡ ู ู…ูˆ ู‰ ู…ู‡ Hong Kong Med J Vol 18 No 1 # February 2012 # www.hkmj.org 5

# Chiu et al # ้ฆ™ๆธฏไธ€ๆ‰€้†ซ้™ขๆ–ผๆ‰‹่ก“็•ถๅคฉๅ–ๆถˆ้ธๆ“‡ๆ€งๆ‰‹่ก“็š„ๆฏ”็Ž‡ๅŠๅŽŸๅ›  ็›ฎ็š„ๆŽข่จŽๅ–ๆถˆ้ธๆ“‡ๆ€งๆ‰‹่ก“็š„ๆฏ”็Ž‡ๅŠๅŽŸๅ›  ่จญ่จˆๆฉซๆ–ท้ข็ ”็ฉถ ๅฎ‰ๆŽ’้ฆ™ๆธฏไธ€ๆ‰€ๆ•™ๅญธ้†ซ้™ข ๆ‚ฃ่€…ๅ›ž้กง็ ”็ฉถ 2009 ๅนด 1 ๆœˆ 1 ๆ—ฅ่‡ณ 12 ๆœˆ 31 ๆ—ฅๆœŸ้–“, ๅ–ๆถˆ้ธๆ“‡ๆ€งๆ‰‹่ก“็š„ๆ‰‹่ก“ๅฎค็ด€้Œ„ ไธป่ฆ็ตๆžœๆธฌ้‡ๆ–ผๆ‰‹่ก“็•ถๅคฉๅ–ๆถˆ้ธๆ“‡ๆ€งๆ‰‹่ก“็š„ๆฏ”็Ž‡ๅŠๅŽŸๅ›  ็ตๆžœ็ ”็ฉถๆœŸ้–“ๅ…ฑๆœ‰ 6 2 3 4 ้ …ๅทฒ้ ็ด„ๆ‰‹่ก“, ๅ…ถไธญ 4 7 6 ้ … (7.6%) ๆœ€็ต‚่ขซๅ–ๆถˆ (95% ็ฝฎไฟกๅ€้–“ :7.0-8.3%) ๆœ€ๅคš่ขซๅ–ๆถˆๆ‰‹่ก“็š„็ฏ„็–‡ๆœ‰ๅคงๅž‹ๆ™ฎ้€šๅค–็ง‘ๆ‰‹่ก“ (94 ไพ‹,20%) ๅคงๅž‹ๆณŒๅฐฟๆ‰‹่ก“(64 ไพ‹,13%) ๅคงๅž‹้ชจ็ง‘ๆ‰‹่ก“ (38 ไพ‹,8%) ่ถ…ๅคงๅž‹ๅฟƒ่ƒธๅค–็ง‘ๆ‰‹่ก“(29 ไพ‹,6%) ๅ–ๆถˆๆ‰‹่ก“ๆœ€ๆ™ฎ้็š„ๅŽŸๅ› ๆ˜ฏ่ˆ‡ๅ ดๅœฐๆœ‰้—œ (73%), ๅ…ถๆฌกๆ˜ฏๆชขๆŸฅ (17%) ็—…ไบบๆœฌ่บซ(10%) ๅค–็ง‘้†ซ็”Ÿ (1%) ๅ–ๆถˆๆ‰‹่ก“ๆœ€ไธป่ฆๅŽŸๅ› ๆ˜ฏ็”ฑๆ–ผไน‹ๅ‰็š„ๆ‰‹่ก“้€พๆ™‚, ๅฐŽ่‡ดๆฒ’ๆœ‰ๆ‰‹่ก“ๅฎคๆ™‚้–“ (310 ไพ‹ ) ่ˆ‡ๆ™ฎ้€šๅค–็ง‘ๆ‰‹่ก“ๆฏ”่ผƒ, ไปฅไธ‹ๅ„ๅฐˆ็ง‘ๅ› ๆฒ’ๆœ‰ๆ‰‹่ก“ๅฎคๆ™‚้–“่€Œ้ ˆๅ–ๆถˆๆ‰‹่ก“็š„ๆฉŸๆœƒ็Ž‡ๆ˜Ž้กฏ่ผƒไฝŽ : ้ชจ็ง‘ ( ๆฏ”ๆ•ธๆฏ” =0.26;95% ็ฝฎไฟกๅ€้–“ :0.17-0.39) ่€ณ้ผปๅ–‰็ง‘(0.25;0.13-0.46) ่…ฆๅค–็ง‘(0.36;0.16-0.70) ๅ…’็ง‘(0.53; 0.31-0.87) ๅฉฆ็ง‘(0.18;0.11-0.29) ็œผ็ง‘(0.19; 0.07-0.41) ็‰™็ง‘(0.10;0.00-0.60) ็ต่ซ–ๅ–ๆถˆๆ‰‹่ก“็š„ไธป่ฆๅŽŸๅ› ๆ˜ฏๅŸบๆ–ผๅ ดๅœฐๅ•้กŒ, ไพ‹ๅฆ‚ๆฒ’ๆœ‰ๆ‰‹่ก“ๅฎคๆ™‚้–“ ๅ„ๅฐˆ็ง‘ๆ‰‹่ก“ๆฒ’ๆœ‰ๆ‰‹่ก“ๅฎคๆ™‚้–“็š„ๅฏ่ƒฝๆ€ง้ƒฝๆœ‰ๅทฎ็•ฐ ู‰ ู ู ู… ู… ู‰ ู ู… ู… ู„ู… ู ู‡ู… ู‰ ู„ ู ู„ู… ู‰ ูู‡ ู… ู‰ ู…ูˆ ู… ู ู‰ ู… ู…ู„ ู… ู† ู…ู‡ ุณ. ู… ู‰ ู‰ู‚ู ู‰ู…ูˆ ู„ ู ู… ู„ู…ูƒ ู ู† ู… ู„ู…ู„ู…ู… ูกูก.ู… ู‚ู ู‰ู ู ู… ู‰ ู… ูู…ูˆ ู…ูˆ ู‰ ู… ู„ู…ูƒ ู…ูˆ ู…ุญ ู† ูู… ู…ูˆ ู„ ู ู…ูƒ ู… ู ู… ู‰ ู…ูˆ ู… ู… ๅฑž ุจ ู‰ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ููƒู‰ู‡ ู… ู‰ ูƒู… ู… ูู„-ู… ู ู‰ูˆ ู† ู… ู‰ ูƒู…ูŠู‚ ู…ูˆุด. ๅฑž ู‰ู ู… ู‡ ุซ ู‡ ุจ ๅฑž ู…ู‰ ู ูˆ ู‰ ๅฑž ู… ู… ู ู ู… ู…ูˆ ู… ู‰ ู… ู…ู„ ู ๅฑž ู„ ู„ู… ู ู ๅฑž ููˆ ูู… ู ูƒู…ุญู‰ูƒู… ู‰ ูˆู‡ู‰ ู‰ ู‡ ู‰ู„ู‰. ู… ู… ู‰ Methods ู… ู… ู‰ูˆ ู‰ ุช ู…ูˆ ู† ู ู ู‡ ู‰ ู‰ู ู‚ ู… ู†ุก ู… ู ู…ู‰ ู‰ ู…ุด ๅฑž ู…ุฎ ู„ ู ู‰ ู… ู‰ ุต ู… ููƒ ููƒู‰ู‡ ู…ู… ู‰ ูƒู‰ูˆ ูˆูƒ ูู… ู…ุฒ ููƒู‰ ู‰ ู…ูƒ ู‰ ุฐ ู…ูˆ ู† ู„ู… ูƒู… ูƒ ู… ู… ๅฑž ู ูู„ ู‰ ู ู…ูƒ ููƒ ูฃูก ู ูุช ูก) ูขู ู ูฉ ูู… ู…ูˆ ู† ู ู‰ ุจ ู… ูุท ู† ู ู‰ ุจ ู… ูุท ู† ู…ูƒ ู‰ ุฐ ู…ูˆุด.(ู… ู‰ ูƒ ู‰ ู…ู‚ ู…ูƒู…ุก ู„ู… ููƒ ู ู… ู ๅฑž ูˆูƒู‰ูˆ ๅฑž ู† ู… ูู…ูˆ ู‡ ู‰ ู ู… ูกูก ููˆ ู‰ู‡ู…ู‚ ู‰ ู‡ ู‰ ู ู… ู… ู‰ ูƒู…. ู…ู‡ ูƒ ู…ู‡ ู… ู… ู†.ูˆ ูกูฆ:ูฃู  ู‚ ู„ู…ูˆ ู‰ ู…ุญ ู…ู‚ ู„ู… ู‰ ู… ู… ู ู„ ู ูˆ ู ูจ:ู ู  ู ู„ู…ู‰ ูƒูƒ ู… ู ู… ูู…ูˆ ูƒ ู…ู‡ ู… ู… ูˆ ู‚ ู… ู… ู…ูˆ ุฉ ู‰ ู„ู… ู† ู… ู‰ ู… ู„ู…ูƒ ูƒ ู…ู‡ ู… ู… ๅฑž ู… ู. ู… ููƒ ู… ู‰ ูƒู… ู… ู‡ ู‰ ู…ูƒ ููƒ ู‚ ู… ูู…ูˆ ู… ู‰ ูƒู… ู… ู ู„ู… ู ู… ู… ู ู… ููƒ ููƒู‰ู‡ ูŠู -ู ู„ ู ูŠูุญ ู…ูˆ ู† ู‰ ู… ูƒ ๅฑž ู ู‰ ู…ูˆ ูู… ูˆ ูกูฆ:ู ู  ู‚ู ู ู„ู… ู…ูƒ ููƒ ู… ู ู… ู.ูˆ ูกูฆ:ูฃู  ู‚ ู‰ ู… ู‚ู ูู… ููˆ ู… ู„ู…ูƒ ู‡ ู‰ู„ ู… ูƒ ู…ูˆ ู†ู‰.ูˆ ูกูง:ู ู  ู‚ ู„ู… ู… ูƒ ู‡ ู‰ู…ู‚ ู† ูƒู… ู„ ู ู‰ ูƒู… - ูƒ ู… ู‰ ูƒู… ู… ู ู ๅฑž ู‰ูˆุด ู…ูƒ ู…) ู… ู„ู…ูƒ ููƒู‰ู‡ ู… ู‰ ูƒู… ู… ู† ู… ู ู† ู… ู‰ ู… ู„ู‰ู„ ููˆ ู… ู„ู…ูƒ ุฐ.( ู… ู„ู…ูƒ ูƒู‰ ู… ู‚ ู… ุฏ.ู„ู…ู„ ูƒ ู… ู… ู… ๅฑž ู‰ ู…ูˆ ู…ู ู ู ู† ู…ูƒ ู… ู… ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู‚ู ู ูู„ ู…ูˆ ู„ู… ูƒู… ูƒ ูˆ ู ู…ูˆ ู† ู‡ ู‰ ู ู… ู„ู… ู„ู…ูˆูƒ ู…ูˆ ู† ู…ู‡ ู… ู‰ ูƒู… ู… ู† ู…ู‰ ู ู„ ู ู‚ ู‡ ู… ููƒ ู… ูู…ูˆ ู‡ ู‰ ู ู… ู‰ ู ู ู„ู… ู…ุญู…ู„ ู ๅฑž ู… ููƒ ู„ู… ู…ูƒ ููƒ ุก. ู„ ูƒู… ููƒู‰ู„ู… ู…ูˆ ู„ู… ู…ูƒ ููƒ ู ๅฑž ููˆ ู…ู‡ ู… ู‰ ูƒู… ู… ู„ู… ู„ู…ูˆูƒ ู‰ ู‰ ู ู… ู…ูˆ ู† ู… ูู… ู… ู…ูˆ ู… ู†ู ู…ู‡ ู† ูู„ ู‰ ู ู…ูƒ ููƒ ู ู…ูˆุท. ูู„ ู‰ ู… ู…ูˆ ูˆ ูกูค:ู ู  ู ู‰ู ู…ูˆ ู„ู… ู‰ ู†ู†ู ู… ูู…ูˆ ู… ู‰ ู ู ู„ู… ูƒูƒ ู… ูู…ูˆ ู‡ ู‰ ู ู… ู…ูˆ ู‰ ู‰ ู ู…ูƒ ููƒ ู…ูˆ ู† ูู… ู…ู‚ ู…ูˆ ู„ู…ู„ ูƒ ู‰ ู ูู„ ู„ู… ูƒู… ูƒ ู…ูˆุด. ู‚ ู‡ ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู† ู…ู‚ ู… ููƒ ู„ู… ู„ู…ูˆูƒ ู† ู† ู…ู„ ู‰ ู‡ู ู…ูˆุด. ูู‰ูƒู… ููƒู‰ู‡ ู…ูˆ ู„ ู ูู… ( ูƒ ู… ูˆ ู‡ู…) ู„ุง ู‰ุญููŠ ู ู„ู…ู…ุญู‰ ู ูƒ ู ๅฑž ู…ู‡ ู…ูˆ ู‡ู…) ู„ุง ูŠูุญููŠ ( ู‰ู ู… ูู‰ ู…ูˆ ู ู‰ ู‡ ู‰ ู‡ู…) ู„ุงู… ูู‰ู„ู… ู… ุฉููŠ ู ุตููŠ ู„ ู (ู… ู ู…ูˆ ู† ู‰ ูƒู… ู… ู ูˆ ู… ู ู‚ ู„ู… ู…ุญู…ู„ ู ( ู†ู ู‡ ู ู‚ ู… ู ู ูƒ ู‡ู…) ู„ุง ูŠู ู† ูู…ุฒ ูกูข.ู… ู…»ูุง ู… ู… ุง ู‡ ุซ ู‡ ุจ ู…ูˆ ู† ู… ู‡ ู‰ู‡ ู…ู‚ ู ู„ู… ู‰ ู‡ ูƒู… ู… ู… ๅฑž ู‰ ู ู…ูƒ ููƒ ู‰ ู ู…ูƒ ููƒ ู… ู‡ ู‰ ู„ ู ( ู‰ู„ ู… ุก) ู…ู‰ ู‡ู… ููƒ ู‰. ู‡ู… ููƒ ู… ููˆ ู… ู„ู… ู‡ู‰ ู ู…ู‚ ู„ ูƒ ู„ู… ู ูƒ ููƒ ู ๅฑž ู… ู ู‰ ู ู…ูƒ ููƒ ู ู… ู…ูˆุด ู…ูˆ ู‚ ู„ู…ู„ู‰ ู‰ู„ ู‰ ู ู…ูƒ ููƒ ู† ู…ู‚ ู ู…ูˆ ู† ู‰ ู ู…ูƒ ููƒ ู…ูˆุด. ู… ููƒ ู„ู… ู„ู…ูˆูƒ ู† ู…ู‚ ู ูู… ู ู„ู… ู… ู ๅฑž ู…ู‰ ูู‰ูƒู… ููƒู‰ู‡ ู‚ ู… ู ู‡ ู‰ ู ู… ู„ู…ู‚ ู ู‰ ูˆ ู† ู‰ ู‰ู‚ู ู‰ู ู ู„ู… ู‰ ู„ ู ู ู† ู…ุฒ ูข.ู†ู†ู ู† ูƒู ู„ ู ู… ู‰ -ู„ ู-ู… ู†ู…ู‚ ู„ ู ูค ูฅ ู…ู‰ู„ ูˆ ูƒ ูฃ ูู‰ ู„ู… ูƒ ู ู‡ ู‰ ู… ู… ู‰ ู† ูƒู ู‰ ู…ูˆ ู‡ ู‰ ู‰ ู ู… ู…ู‰ู„ ู… ู†ู ู… ู‰ ูƒ ู… ููˆ ูฆ-ูจ ู… ู‰ ู ู ู… ู… ู‰ ู ู… ู… ู… ููƒ ู† ู… ู ู…ูˆ ู‰ ู‰ ูƒ ู„ู… ููƒู…ุญู‰ ู‡ู‰ ู„ู…ู„ ู…ู‰ ู‰ ูƒ ู„ ู‰ ู…ูˆุด. ู…ู‡ ู† ูู„ ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู ๅฑž ู… ู‰ ู ู ู… ู… ู‰ ู ู… ู… ู„ู… ู ู‡ู… ู‰ ู ู† ู‰ ู…ูˆ ู‰ ู‰ ูƒ ู„ู… ู… ู‚ู ู ูˆ ู‰ ๅฑž ู„ู… ูู‰ูƒ ู ู† ู…ู‡ ู† ูู„ ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู† ู…ูƒ ู… ู ู… ู„ู… ูู‰ูƒ ู ู ู… ู… ๅฑž ู… ู… ู…ูˆุด. ูง ูฅ ูง ูข ู‚ู ููˆ ู…ู‡ ู† ู„ู… ู ู… ู… ู…ู‚ ู‡ ู‰ู…ู‚ ู…ู‰ ู ูˆ ู‰ ๅฑž ู…ู‰ ู - ู… ู‰ ู ู… ู… ูˆูƒ ู‡ ู‰ ู‡ ู…ู„ ู… ูˆ -ู… ููƒ ู‰ ู… ุก ูฉ. ู‰ ู ูƒ/ ู… ู… ู ูƒู‰ ู‰ ูƒ ู…ู‡ ู† ูู„ ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู† ู„ ูƒ ู… ู„ ู‰ูˆูƒ ููˆ ู„ู… ๅฑž ูˆ ู‰ ู ู ู… ู… ู ู…ู„ู ู‰ ู… ู„ - ู… ู‰ ู ู… ู… -ูู‰ ู…ูˆ ู…ู ู ู ู‡ ู‰ู„ ู… ู ู‰ู…ูˆ ู… ููˆ ู… ู‰ ู… ู… ู‰ ู…ู… ูˆ ู… ู… ๅฑž ูƒู‰ ู‰ ูƒ ู…ู‰ ู ูˆูƒ ู‡ ู‰ ู‡ ู…ู„ ู… ูˆ ููˆ ู„ู… ู…ูƒ ููƒ ู‰ ู ู… ู…ูƒ ู…ู„ู…ุญ ูƒ ูฉูฅ ูฃ.ูกูจ =]ุฒุฏ[ ู‰ ู ู„ู„ ) ู‰ ู ูƒ ู.(ูง.ูฆูฃ-ูก.ูฃูข ูกู  ]ุฉ [ ู ู… ู‰ ู… ู ู… ููƒ ู…ู‡ ู… ู‰ ูƒู… ู… ู‡ ุซ ู‡ ุจ ุฉ ู ู„ู‰ ู‰ู„ ู‰ ู‚ ู… ู‰ ู ู… ู… ู„ู… ๅฑž ู„ ู ู„ู… ู‚ ๅฑž ู‰ู…ูˆ ู… ู†ู ูˆ ๅฑž ูู… ูู‰ูƒู… ููƒู‰ู‡ ู ู…ูƒ ู ูˆู‡ ูˆ ููˆ ู…ูˆ ู ู‰ ู… ูู…ูˆ ู‡ ู‰ ู ู… 6 Hong Kong Med J Vol 18 No 1 # February 2012 # www.hkmj.org

# Elective surgery cancellations # ู…ูƒ ู…ู„ู…ุญ ู‡ ู‰ ู„ ูˆ ู… ู‰ุท ู…ูˆ ู‚ ุฉ ูฉูฅ ู„ ู ู ู… ุด) ูข.ูก.ูข ู… ู ๅฑž ู† ู‰ ู ุก ู ู… ุฉ ู„ู… ู ูƒ ู„ ู (ุซุต ููˆ ุณ ู† ู‰ ู… ู‰ ุต ู…ู… ๅฑž ู…ู‚ ู‰ ูู‰ูƒ ู ู…ูˆุด. ู‰ ู ู ู„ู… ู ู‰ูˆ ู‡ ู‰ ู…ู‡ ู† ู…ู„ ู‰ ู‡ู ู„ ู ู…ู‰ ู‡ู… ููƒ ู‰ ู ู…ูƒ ููƒ ุฒุฏ ู…ูˆุด. ู‰ ู ู ู„ู… ู ู‰ูˆ ู‡ ู‰ ู„ู… ู‰ ู ู… ู ๅฑž ู† ู„ ูˆู‰ ู… ู‰ ู…ูˆ ู† ู„ู… ู ู‰ ู… ู… ู… ๅฑž ุฉ ูฉูฅ ู„ ู ู…ู‰ ูู‰ูƒู… ู† ู… ู‰ ู ู…ูˆ ู† ู… ู‰ ู… ูู…ูˆ ู‰ูˆ ู‡ ู‰ ( ู…ู‡ ู ู… ู…ู‡) ู‡ ู…ูƒ ู… ู…ู†ู… ู ู‰ูู‡ู ู…ูˆ ู‡ ู‰ ู„ู… ูƒ ู„ ูƒ ู… ู… ๅฑž ู… ู ุก. ู‰ ู ู ู„ู… ู ๅฑž ู„ ู‰ุท) ู…ูƒ ู…ู‰ูƒุณ ูู‰ูƒ ุณ ู…ูˆ ู† ู…ู‡ู ูƒูุฐ ููƒู‰ ู‰ ู ุณ ู† ู… ู… ู…ูˆุด.(ุณุต ]ุฌุฉ[ ู‡ููƒู‰ูˆ ูƒ ุฉ ุณุณุฐุณ ูกูฅ.ู  ู‰ ู…. ู .ู ูฅ ฺคุฐ ู ู… ู ๅฑž ู…ูƒ ููƒู…ุญู‰ ู‡ู‰ Results ู† ูู… ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ูคูงูฆ ู…ูˆ ู†ุฏ ู…ูˆุด.(ูก ู… ู‚ูุด) ูคูฆูค ู‰ ู„ู… ู… ูƒ ู„ ู ๅฑž ู‰ ู ู…ูƒ ููƒ ู‰ ู‰ูƒูู† ู ๅฑž ู‰ ู ู…ูƒ ููƒ ู† ู‡ู… ููƒ ูƒ ู„ ู ( ูกู ) ู…ู‰ ู ( ูกูง) - ๅฑž ู‚ ู„ู… ๅฑž ู† ( ูงูฃ) ู ู… ู„ ู‰ ู ู…ูƒ ููƒ ู… ู… ๅฑž ู… ู…ูˆุด.( ูก) ู…ู‡ ู… ููƒ ูƒ ู…ู‡ ู… ู… ู… ูƒู ู… ู‰ุฎ.ู†ู†ู ูู‰ ู…ูˆ ู…ู ู ู† ูƒู ูˆ ู‚ ู…ูˆ ๅฑž ู… ููƒ ู… ู‰ ูƒู… ู… ู… ู…ูƒ ู…ู„ู…ูƒู… ู… ู…ูˆุด.(ูก ู… ู‚ูุด) ู„ู…ู‰ ูƒูƒ ู… ู… ๅฑž ู… ูู…ูˆ ูƒ ู…ู‡ ู… ู… ู† ู‰ ู‚ู‰ ู‰ู„ ู…ูˆ ู‰ ู…ูƒ ู… ู…ู†ู†ู‰ู„ ููƒู…ุญู‰ ู‡ู‰ ู… ู… ๅฑž ู…ู‰ ูู‰ูƒู… ููƒู‰ู‡ ู…ู… ๅฑž ู…ู‚ ู…ู‰ ู‡ู… ููƒ ู‰ ู ู…ูƒ ููƒ ู„ู… ู† ู… ู… ููƒ ููƒู‰ู‡ ู… ู‰ ูƒู… ู… ูฅูงูฅูจ ู… ู… ๅฑž ู… ู…ูˆุด ูขูฉูจ) ู… ููƒ ูคูงูฆ ูขู ู ูฉ ู‡ ู‰ ู„ ูู‰ ู…ูˆ ู…ู ู ู„ู… ู‰ ู… ููˆ ] ู‰ ูู‰ ู…ู„ ู„ ูู„ ู [ ูู… ู… ู ู…ู† ูกูงูจ ู„ ู ู… ู ู† ู… ู†ู… ู…ูˆุด.ู„ู… ู…ูƒ ููƒ ู… ู… ๅฑž ( ูู… ]ูขูฃ[ ูฅูข ู† ู…ู‡ู ู† ู…ูƒ ู… ู ู… ู‰ ู…ูˆ ู„ู… ู‚ ู… ู„ู…ูƒ ูฆูขูฃูค ู…ูˆ ู… ุณ.( ูจ.ูฃ-ูง.ู  ุฉ ูฉูฅ) ูง.ูฆ ู ๅฑž ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู… ู ู‰ ู ู…ูƒ ููƒ ู… ู‚ู‰ ู…ูƒ ู… ู… ู… ๅฑž ู…ู‰ ูู‰ูƒู… ู„ู… ูƒูƒ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ( ูกูง) ูจูก ู ุฉ.(ูก ู‡ู‰ุก) ูŠู ู† ( ูฆูฅ) ูฃู ูจ ู… ู„ู…ูƒ ูŠู -ู ู† ู… ู„ู…ูƒ ู… ูู‰ู„ู… ู… ู‰ ู† ( ูกูง) ูงูฉ ู… ู„ู…ูƒ ู ู ๅฑž ู… ู…ูˆุด. ู… ู„ู…ูƒ ู‰ ู† ( ูข) ูจ ู„ ู ูู‰ูƒู… ููƒู‰ู‡ ู…ู… ๅฑž ู…ู‚ ู‰ ูู‰ูƒ ู ููƒู…ุญู‰ ู‡ู‰ ู„ู… ูƒูƒ ู…ูˆู‡ู‰ูˆ ู…ูˆ ( ู .ู ู ูก ฺคุฐ) ู… ู ู‰ ู ู…ูƒ ููƒ ู„ ู ู… ู„ู…ูƒ ููƒู‰ู‡ ู ู… ู…ู‡ ูŠู ู‡ ู‰ ููˆ ู… ูˆ ู‰ ูฆูค= ) ู… ู„ู…ูƒ ููƒู‰ู‡ ูŠู ู„ ู ( ูขู  ูฉูค= ) ู„ ู ( ูจ ูฃูจ= ) ู…ู‡ ูƒู‰ู„ู…ู ูˆ ูŠู ( ูกูฃ.( ูฆ ูขูฉ= ) ู…ู‡ ูƒู‰ูƒู ูˆ ู‰ู„ ููƒ ูŠู -ู Cancellation rate (%) 18 16 14 12 10 8 6 4 2 0 General Orthopaedics Urology Otolaryngology Cardiothoracic Neurosurgery Paediatrics Plastic & reconstruction Gynaecology Ophthalmology Dentistry FIG 1. Case cancellation rates by surgical specialties The mean cancellation rate for all specialties combined was 7.6% (95% confidence interval [CI], 7.0-8.3%). Error bars indicate 95% CI TABLE 1. Frequency of cancellations according to category (n=476) Categories Cancellation reasons* No. Patient Patient refused or gave no consent 22 Preoperative instructions not followed or patient not instructed adequately 7 Patient cancelled and had procedure performed elsewhere 1 Patient was a no-show, no contact from patient 15 Subtotal 45 (10%) Work-up Anaesthesia work-up needed 23 Abnormal test 3 Change in medical status 41 Change in treatment plan 10 Subtotal 77 (17%) Facility Equipment broken or not available 1 No intensive care unit beds 14 No operating time 310 Emergency case 9 Weather/natural disaster 3 Subtotal 337 (73%) Surgeon Surgery staff not available 5 (1%) ู… ููƒ ูกูข ู‰ ู„ู…ู„ู‰ ูู… ู„ู… ู‰ู ู…ู„ ุฎ Hong Kong Med J Vol 18 No 1 # February 2012 # www.hkmj.org 7

# Chiu et al # TABLE 2. The likelihood of no available operating time (odds ratio and 95% confidence interval) by surgical specialty * Surgical specialty Scheduled No. (%) of cancelled cases Odds ratio (95% confidence interval) P value General (reference) 1102 110 (10.0) 1.00 - Orthopaedics 1147 32 (2.8) 0.26 (0.17-0.39) <0.001 Urology 521 45 (8.6) 0.85 (0.58-1.24) 1.000 Otolaryngology 478 13 (2.7) 0.25 (0.13-0.46) <0.001 Cardiothoracic surgery 426 36 (8.5) 0.83 (0.54-1.25) 1.000 Neurosurgery 262 10 (3.8) 0.36 (0.16-0.70) 0.005 Paediatrics 362 20 (5.5) 0.53 (0.31-0.87) 0.067 Plastic and reconstruction surgery 227 14 (6.2) 0.59 (0.31-1.06) 0.593 Gynaecology 1116 22 (2.0) 0.18 (0.11-0.29) <0.001 Ophthalmology 338 7 (2.1) 0.19 (0.07-0.41) <0.001 Dentistry 89 1 (1.1) 0.10 (0.00-0.60) 0.007 ู„ู…ู„ ูƒ ู‰ ูู… ู…ูˆ ู… ู„ ู‰ ู ู…ูƒ ููƒ ู… ู ูกูฆูฆ ุถ ูู‰ูƒู… ู…ูƒ ู… ู…ู†ู… ู…ูˆ ูˆ ู‰ ๅฑž ู‰ ู ูƒ ู… ู‰ ู† ู„ู… ูƒู… ูƒ-ู‰ ู…ู† ู„ู… ู ู… - ู…ู‰ ู ู… ู…ๅฑž ู… ู…ูˆุด.( ู .ู ู ูก ฺคุฐ ูข ู‡ู‰ุก) ู‡ ู‡ ู ู‰ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ูู… ู‡ ุก. ู… ู„ู…ูƒ ู ู…ู„ ู„ ู ู…ู‡ ู… ู ู‰ ู… ู… ู ู…ู‡ ู† ู„ู… ู„ู…ูˆูƒ ู… ู„ ู‰ูˆูƒ ู‰ ู ู…ูƒ ููƒ ู† ูู… ู‰ู ู…ูˆ ูๅฑž ู‰ ูƒู…ู† ู‰ ูƒู ู† ู‰ ู‚ู‰ ู‰ู„ ู…ูˆุด.( ูข ูจ= ) - ๅฑž ู„ู… ู ู… ู‡ ู‰ู„ ูƒูƒู ู ู„ู‰ู„ ู‡ู… ููƒ ู„ู… ูู‚ ู‰ ู ู…ูƒ ููƒ.( ู .ูขูฃ =ุฐ) ู…ู‡ ู† ู…ู„ ู‰ ู‡ู ู…ูˆ ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ูู… ูƒ ู…ูˆุด ู… ู… ู„ ู… ู‰ ู‡ ู‰ ู ู… ู… ู‚ู ู‰ู ู ูๅฑž ููƒู…ุญู‰ ู‡ู‰ ู„ู…ู‰ ู ูˆูƒู‰ูˆๅฑž ู…ู‡ ู‰ ู… ู† ู ู… ู…ู‡ ู„ู… ู.( ู .ู ู ูก ฺคุฐ) ู…ู‰ ูู‰ูƒู… ู…ู…ๅฑž ู…ู‚ ู… ู…ๅฑž ู… ู‰ ู‡ ู‰ ู ู… ู… ู‚ู ู‰ู ู ู† ู„ู„ ู…ูˆ ู…ู‡ ู‡ ู‡ ู ูƒู‰ู„ู…ู ูˆ ู‰ ู…ๅฑž ููƒู…ุญู‰ ู‡ู‰ ู„ ู ู‡ ููˆ ูˆ ู‡ ูƒู…ู ู‡ ู…ู‡ ู….(ูข ู… ู‚ูุด) ู‰ ู…ู„ 100 80 60 % 40 20 0 General Orthopaedics Urology Otolaryngology Cardiothoracic Patient Work-up Neurosurgery Paediatrics Plastic & reconstruction Gynaecology Facility Surgeon Ophthalmology Dentistry FIG 2. Type of case cancellation reasons by surgical specialties (see Appendix for definitions) Discussion ูู„ ู…ูˆ ู… ู ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู… ู‰ ูƒู… ู… ู…ูˆุด ู… ูู…ูˆ ู‡ ู‰ ู ู… ู† ููƒู‰ู„ ู‰ ู ู‰ ู…ู‡ ู† ู…ูˆ ู… ูƒ ู‰ ู… ู…ูˆ ูˆู‡ ูˆ ุก ูกูฃ. ูƒ ู…ู‰ูƒู…ุญู†ู… ู‡ ู‰ ู…ุญู…ู„ ู…ูˆ ๅฑž ู… ู ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู… ู‚ู ู…ูƒูƒู ู ู… ู…ู‡ ู‰ ูฅ ููˆ ู… ู… ูู…ูˆ ู‡ ู‰ ู ู… ู…ู‰ูƒู…ุญู†ู… ูู‰ ู ุก ู… ูุท ูˆ ุณ ๅฑž ู…ุฎ ุฉ ูกูฃ.ู„ู…ู„ ู… ูƒู… ู‰ ู ู…ูƒ ููƒ ู…ู‰ ู ู„ู… ู‚ ู† ู ูˆูƒ ู…ู‚ ู…ูˆ ููˆ ู… ู ๅฑž ( ูู… ู ู†) ู…ู‡ ู† ูู„ ู…ูˆ ู ๅฑž ู‰ ู‰ู„ ูƒ ููƒู‰ู„ู… ู ู… ู„ ู‰ ู ู…ูƒ ููƒ ูข ู‡ ู‰ู„ ู… ู ู…ู‰ ู ู† ู„ ู ูก ููˆ ู… ู ู… ุฏ. ู .ูฅ ูกูค ููˆ ู… ู ๅฑž ู‰ ู…ู‡ ู† ูู„ ู…ูˆ ู‡ ู‰ูˆูƒู ู ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ู…ูƒ ู… ู ู… ู‰ ู… ู… ู‰ ู ู… ู‰ ู… ููˆ ู…ู‡ู‡ ูขู ู ูฉ ู‰ ูจ ู…ูƒ ู ู† ู… ู… ูู‰ ู ุก ู‡ ู‰ ุต. ู…ู‰ูƒู…ุญู†ู… ู‰ ู ๅฑž ู… ู ู…ู„ู ู‰ ู… ู„ ู… ู ู‰ ู ู…ูƒ ููƒ ููƒู‰ู„ ู‰ ู… ู ู .ูข ู‚ ู… ู‚ู ู…ูƒูƒู ู ูก.ูข ๅฑž ู† - ๅฑž ู ๅฑž ู…ู‡ ู† ูู„ ู…ูˆ ู‡ ู‰ู„ ู… ู ู…ู‰ ู ู†.ู… ู‚ู ู…ูƒูƒู ูƒ ู‡ู… ููƒ ู…ูˆ ู ๅฑž ู‰ ู‰ูƒูุก ู… ููƒ ููƒู‰ู‡ ู… ู‰ ูƒู… ู… ู† ู‰ ู ู…ูƒ ููƒ ู† ู„ู… ูƒูƒู ู‡ู… ููƒ ู‰ูˆ ู…ู„ ูู… ูƒ ู…ูˆุด.ูขู ู ูฉ ู‰ ู… ู… ู„ (ูฃูกู = ) ู… ู‰ ู‡ ู‰ ู ู… ู ๅฑž ู‰ ู‰ูƒูู† ู… ู…ูˆ ๅฑž ู…ู‰ ูู‰ูƒู… ุฉ. ู…ู‡ ู‰ ู… ู† ู‰ ู‰ ู ู…ูƒ ููƒ ู† ูู… ูƒ ู ู… ู… ๅฑž ูƒูู† ู„ู… ู‚- ู… ู ู‰ ู… ู‰ ู… ู… ๅฑž ู‰ ู…ูˆ ููˆ ู…ู‚ ู ู… ู„ ู‡ ู‰ู…ู‚ ู… ููƒ ู…ูˆ ู ู† ู„ ูˆู‰ ู… ู‰ ู…ูˆ ู… ูู… ูƒ ู‰ ู„ู… ู…ูƒ ููƒ ู…ู‚ ู„ ูƒ ู… ููƒ ููˆ ู‰ ู…ูˆ ู‡ ู‰ ููƒ ู… ู‰ูˆ ๅฑž ู‚ ู„ู…ู„ ูƒ ูƒ ู…ู‚ ู… ู‰ ู… ู… ๅฑž ู…ูˆ ู†ู‰ ูˆ ูกูฆ:ู ู  ู ู‡ ู‰ ู‚- ู… ููˆ ู„ู… ู ู‰ ู… ู„ ู‰ ู… ุก.ูˆ ูกูง:ู ู  ู… ู… ู‰ ู‡ ู‰ ู‰ู ๅฑž ู… ู„ ( ูฅู ) ูƒ ู ๅฑž ู‰ ู ูู… ููƒู‰ู‡ ู…ูˆ ููˆ ู‰ ู…ูƒ ู… ู ู„ู‰ ู ู„ ู ูกูฅ.ู‡ ู‰ ๅฑž ู„ ููˆ ู ๅฑž ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู† ู… ู ู…ูˆ ู…ูƒ ู„ู… ู…ู‰ู‡ู… ู ุณ ู ู… ู‰ ู„ู… ููƒ ู ู…ูˆ ู‡ ู‰ ู… ู… ููƒ ู… ู„ ูุญ. ูƒ ู…ู‰ูƒู…ุญู†ู… ู‡ ู‰ ู ู… ู ู… ู… ู‰ ู…ูˆ ู† ู ู… ู‰ - ู… ู‰ ู… ู ูˆูƒ ู ู… ู‰ ู… ูู‰ ู…ูˆ ู…ู ู ู† - ู… ูู„ ู…ูˆ ู† ู… ููƒ ู…ุญ 8 Hong Kong Med J Vol 18 No 1 # February 2012 # www.hkmj.org

# Elective surgery cancellations # ู‡ ู‰ ู‚ ู ู… ู‰ ู„ู… ู ู‰ ู… ู…ูˆ ู„ ูƒู… ู„ู‰ู„ ู…ุท ูˆูƒูู… ู† ู…ู‡ ู… ู‰ ูƒู… ู… ู† ู… ู ู… ู‰ ู ูƒู ู„ ู ูˆๅฑž ู… ูˆ ููˆ ู„ู…ๅฑž ูˆ ู„ ู‰ ู… ุก. ู…ู‡ ู ู‚ ู‰ ู ู… ู† ู„ู…ู„ู…ู… ู… ู‰ ู…ูˆ ู„ู… ู ู‰ ู… ู…ู„ ู‰ ู ู…ูƒ ููƒ ู ู„ููˆ ู… ู‰ ูกู  ููˆ ู… ู† ู…ู‡ู ู… ู - ู… ูˆๅฑž ู… ูˆ ู† ูฆ ู„ู… ู ูƒ ูกูก ู† ู… ู ู‰ูˆ ู…ูˆ ู…ูˆุท ูขูก.( ู .ู ู ูก ฺคุฐ) ู„ู…ู„ู…ู… ู… ู‰ ู…ูˆ ู„ู… ู ู‰ ู… ู… ู‰ ู… ู‰ ู‰ ู‰ ู„ู…ู‰ ู ู…ู‚ ููƒ ู‰ ู ู… ู‚ ู„ู… ู ู‰ ู… ู„ุง ู…ู‡ ูˆูƒูู… ู… ู ูƒ ู„ ู…ูˆ ู† ู ู‡ ู‰ๅฑž ู ู„ ู† ู… ู‰ ู…ูˆ ู ู… ู‰ ู… ู„ู…ูƒ ู† ูˆ ู‡ ู…. ู… ู ู… ู‰ ู ูƒู ู…ูˆ ู‰ูู‡ู ู‰ ู‡ ู‰ ู ู… ู…ูˆ ููˆ ู„ู… ู…ู‡ู‡ ู… ู… ู‚ู ู…ูˆ ู… ู‰ ู…ุก ู‰ ู ู…ูƒู… ู… ู ู…ู‰ู‡ู… ู ู… ู… ู‰- ู‰ ู ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู… ู‚ู‰ ู…ูƒ ู…ู‰ ูู‰ูƒู… ู… ูˆ -ู… ูƒ ู…ูˆ ู… ู‰ ู‰ ู ู ูƒูู† ู‰ ู‰ูƒูู† ู… ู„ ู‰ ู ู… ู… ุฉ. ู‰ ู‡ ู‰ ู ู… ููƒู‰ู‡ ู† ู‰ ู… ู‰ ู ู ู… ู… ู‰ ู ู… ู… ู„ู… ู ู‡ู… ู‰ ู ู† ุชุญ ูู„-ู… ู ู† ู… ู ู…ูˆ ู… ูู… ูƒู…ู„ ููƒู…ุญู‰ ู‡ู‰ ู ๅฑž ู…ูƒู…ุฒ ูขูค. ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู…ู‡ ู„ู…ู„ ู… ู‰ ู‡ ู‰ ู„ ูู… ูˆูƒูู… ู† ู…ูƒ ู ู† ู… ู…ูˆ ู‡ ู‰ ู…ุญู…ู„ ูƒ ู…ู‰ูƒู…ุญู†ู… ู„ู… ู‰ู‚ ูƒ ู…ู† ูƒ ู‰ ู‡ ู‰ ู ู… ููƒู‰ู‡ ู… ู‡ ู‰ ู‰ ู‰ ู‰ ู‰ ู ู‰ ู‰ ู… ูู…ูˆ ู‡ ู‰ ู‰ ู‰ ู ) ูขูฅ. ู‰ ู‰ ูƒ ู„ ู… ู‰ ู„ ู ( ู‰ ู ู…ูƒ ููƒ ู…ูƒ ู…ูˆ ู„ ู ู‡ ู„ ูˆ ู… ู‰ูˆ ู‡ ู‰ ู ู† ู‰ ููƒู‰ ู‰ ู…ูˆุด ู„ูู… ู ู ูู„ ู… ู‰ ู„ู… ูƒู… ูƒ ู… ู‰ ูƒู… ู… ู„ ู ูขูฅ ู‰ ู‡ ู‰ ู‰ูๅฑž ู† ู… ู…ู‡ู ู ู… ู…ู‚ ู…ูˆ ู… ู ู… ุก. ู‰ ููƒ ู ู…ูƒ ู… ู… ู‰ ูƒู…ูŠู‚ -ู… ููƒ ู„ู… ู ู… - ู‰ ู‡ูู‰ู„ (ุฐ ูค ุฐ) ู…ูƒ ู ู† ู…ุฐ ู† ูุฐ ูขู ูกู -ูขู ู ูฉ ู‰ ู„ู…ูƒ ู„ ู‰ ู…ูƒู… ูๅฑž ู…ู„ ู‰ ู‰ูˆ ู‰ๅฑž ู ู‰ ูˆ ูˆูƒูู… ู† ู…ูƒ ู ู† ู… ู…ูˆ ู… ูู… ู…ู„ ู‰ูˆ ุฉ ูขูฆ. ู… ูƒ ููƒู‰ูˆ ู ู‡ ู…ู‡ ู… ู… ู…ูˆ ู† ู… ู„ ู ู‰ ู‰ ูƒ ู„ ู… ู… ู‰ ู…ูƒ ู‰ ู… ู ู… ู…ูˆ ุฐ ูค ุฐ ู…ูˆ ู‰ ู ู… ู… ู‰ ู† ูู… ู…ุญ ู‰ ุฉ. ู‰ ู ูู… ู…ูˆ ู‰ ู‰ ูƒ ู„ู… ู ูˆ ู‰ๅฑž ู„ู… ูู‰ูƒ ู ูๅฑž ู…ู„ ู… ููƒ ู‰ ูƒ ูƒ ุฉ. ูง ูขูฆ ู† ู…ู„ ู‰ ู… ู… ู ู† ูˆ ู‡ ู… ู‡ ู‰ ู ู… ู… ู„ ู‰ู ู… ู…ๅฑž ู‰ ู ู…ูƒ ููƒ ู…ู…ๅฑž ู…ู‚ ู‡ ู‰ ู ู… ู ู…ูˆ ูˆ ู‰ๅฑž ู… ู‚ู ู‰ู ู ู‡ ู‰ู…ู‚ ู… ู‰. ู…ู‰ ูู‰ูƒู… ููƒู‰ู‡ ู…ู‚ ููƒ ููƒ ู… ููƒ ู„ ู ู…ู‰ ู† ู‰ ูƒู… ูƒ ู„ ู ู‡ ู‰ ู ู… ู‰ ู… ูู… ูƒ ู‰ ูˆ ู‰ ๅฑž ู… ู ู ู‰ ู„ู… ู† ู… ููƒู‰ ู‰ูˆ ู„ู… ู‰ ู… ูƒ ู„ู… ู ูกูฆ ูกูง. ูƒ ู…ู‰ูƒู…ุญู†ู… ู‡ ู‰ ู‚ ู… ู ูู„ ู… ู…ู‡ู ู ู… ูู…ูˆ ู‡ ู‰ ู ู… ูู‰ ู…ูˆ ู…ู ู ู…ู‡ ู‡ ู‰ ู ู‚ ู„ู… ู‰ ู‰ ู‰ ู…ู‚ ููƒ ู‡ ู‰ ู„ ู ูƒูƒู ู‰ ูƒูู† ู‰ ู‰ูƒูู† ู„ ู ู…ู‰ ู ู… ู‰ ู† ู ู…ูˆ ู… ู ู‰ ู… ู„ ูˆ ู… ููƒู‰ ู‰ ู ููƒ ู… ู… ู ู ู… ู…ูˆุด.ู… ู„ู…ูƒ ูˆูƒูู… ู„ู… ููƒ ู ูƒ ู…ู‰ูƒู…ุญู†ู… ู…ูˆ ู‡ ู‰ ู‰ ู† ูู… ู ู ู„ู…ู„ ูู‡ู… ู…ู‚ ูขูก-ูกูฆ. ู… ูู…ูˆ ู‡ ู‰ ู ู… ู† ู… ู… ู‡ ูˆ ู‰ ๅฑž ู…ู‰ ูู‰ูƒู… ู… ู„ ุฉ ู„ ู ู‡ ู…ู‡ ู ู… ู…ู‡) ู… ููƒ ู… ูƒ ู…ูˆ ููˆ ู… ู‰ ู… ู… ู… ๅฑž (ูƒู‰ูƒู ูˆ ู‰ู„ ููƒ ู„ู… ู‚ ู† ู… ู‰ ู… ูู…ูˆ ู‡ ู‰ ู ู… ู…ู‰ูƒู…ุญู† ู‰ ู… ููˆ ูู… ู„ู… ู„ู…ูˆูƒ ู…ู…ู‚ ู„ููˆ ู…ูˆ ูˆู‡ ูˆ ู… ู… ู… ููƒ ูขูข ู„ ู„ุง ู ู… ู„ ู…ู…ุญ ูˆูƒุณ ู‰ ุก. ู‰ ู…ูˆ ู‡ ู‰ ู„ ู ๅฑž ู„ ู ูจ ู… ู ๅฑž ู… ู ู‰ ู ู…ูƒ ููƒ ูƒู‰ูƒู ูˆ ู‰ู„ ููƒ ู„ ู ู… ู‰ ู‡ ู‰ ู ู… ) ูƒูู† ู‰ ู‰ูƒูู† ู… ู„ ู‰ู ู‡ ู‡ ู ู… ู… ๅฑž ุจ.(ู„ู…ู‚ ู… ู‰ ู ู… ู‡ ู‰ ู ู… ู…ู‰ูƒู…ุญู† ู‰ ู… ู„ ู… ู ู‰ ู ู…ูƒ ููƒ ู… ููƒ ู… ู„ ู…ู…ุญ ูˆูƒุณ ู„ู… ู ูƒ ( ูข.ูง) ๅฑž ู ๅฑž ู… ู‰ ู… ูู…ูˆ ู…ูˆ ู‰ ู…ูƒ ู… ู…ู†ู†ู‰ู„ ู… ู„ ู…ู‚ ู ู‰ูˆุด.( ูขูก) ูขูข ู„ ู„ุง ู ููƒู‰ู‡ ู‡ ู ู… ูƒ ู† ู…ู‚ ู„ ู ู‰ ู ู„ ู‡ ู‰ ู‚ ููƒู‰ู‡ ูƒู‰ ู‰ ู… ูƒู ููˆูƒ ู…ู‰ ู ู… ู„ู…ูƒ. ู…ู‰ู‡ ู„ ูˆ ู… ู„ ู…ูˆ ู„ ู ู… - ๅฑž ู… ู ู…ู„ู ู‰ ู„ู… ู ู… ู‰ ู ู…ูƒ ููƒ ุก ูˆูƒูู… ู‚ู ( ู„ุง ูู… ููŠ ู…ูˆ ) ู ูู„ ู… ู‰ ู ู ู… ู‰ ู ู ู…ูˆุด.ู‡ ู‰ ู…ู„ู‰ ูƒ ูˆ ๅฑž ู… ู ู‰ ู ู…ูƒ ููƒ ู… ู…ูƒ ู ู‰ ูˆ ู† ู…ู‰ ู‰ ู… ูƒ ู…ูˆ ูƒู…ู…ุฎู… ู ูู„ ู ู… ู‰ ุก.ู… ู‰ ู ู† ู‰ ู„ ู ู‡ ู‰ู‡ูู‡ ู… ู…ู‚ ููƒ ู„ ู ู…ูˆ ููˆ ู…ูˆ ู ู ูู„ ู… ู‰ ู ู ู…ูˆ ู… ู…ู‡ู ู ู… ู‰ ูƒู…ู†ู†ู… ู ู…ู‚ ู… ู‰ ู… ู… ู ู… ู ู‰ ู ู…ูƒ ููƒ ู… ู ู… ุก. ู†ู†ู… ู… ู… ู‰ ู‰ ู ู…ู„ู‰ ู‡ ู„ู… ู„ู…ูˆูƒ ู… ู‰ูƒ ู ูˆ ู‰ ๅฑž ู… ู ู„ ูู… ูฅูฃ ูุชู… ู…ูˆ ู‚ ู„ู… ู…ูƒ ููƒ ู ๅฑž ูƒ ู ู ูƒู‰ ู‡ูู‰ู„ ู… ููˆ ู„ ูƒ ู ู‡ ู‰ู„ ููƒ ูˆูƒู… ู ู… ููƒู…ู‚ ู‰ ู…ูˆ ู…ู ู ู‡ ู‰ู„ ููƒ ู…ูˆ ูˆู‡ ูˆ ) ุชู…ู… ู‰ ู‰ ู„ู…ู‡ ู ู ู…ู‚ ู† ู…ูƒ ู… ู… ู…ูˆ ู…ู„ ูƒ ู… ู ๅฑž ู‰ูˆุด.( ู… ู ู…ู„ ู…ู‰ ู - ู‰ ู„ู… ู‰ ู‰ ู„ู… ู ู‰ ู„ ู ู‰ ู†ู†ู… ูู‰ู„ ููƒู‰ ู…. ู… ู… ู ูƒู‰ ู…ูˆ ู…ู ู-ู… ู† ู‡ ู‰ู„ ููƒ ู… ู‚ู‰ ูˆู‡ู‰ ูˆู‡ู‰ูˆ ู… ู†ู… ู…ูˆ ู‰ ู‰ ูƒ ู…ู„ ู‰ูˆุด ููƒู‰ ู ูƒ ูˆ ู‰ ๅฑž ู…ูƒ ูู„ ูƒูƒู ู‰ ู… ู… ู‰ ู† ูู… ู ูขูฃ. ู… ู‰ูƒ ู‰ ู… ู… ู‰- ู‰ ู ุชู… ู…»ู‰ูุซุชู… ู ๅฑž ู‰ ููˆ ู ๅฑž ู„ ู‰ูˆ ู† ู‰ ู ู‰ ู‰ ู‰ู ู…ูˆุด ู‰ ู ู…ูƒ ููƒ ู† ูู… ู…ูˆ ูˆู‡ ูˆ ู… ู‰ ูƒู… ู…. ู… ููƒ ู…ูˆ ู† ูฉูค ู‰ ู… ู ู…ู„ู ู„ู… ู… ูƒ ู„ ู… ู… ๅฑž Acknowledgements ู„ู… ู† ู ๅฑž ู… ู ู‰ูˆ ู‰ ู„ู…ู‚ู‰ ูƒ ู…ู„ ๅฑž ู…ูˆุด ู…ูˆ ู† ู‰ ุต ูƒู‰ ุฐ ู ู… ู…ูˆ ู† ู ู‡ ู ู‚ ู ุง ูˆูƒ ูู… ู…ุฒ ู…ูˆ ู„ ู ุฒุกุณุซุจ ู† ู… ู… ุง :ู…ูƒ ู… ู…ู†ู… ูƒู…ูŠ ุฐ) ู ู‰ูˆ ุฒุกุณุซุจ ู…ูˆ ู† ู‰ูƒ ู† ูˆ ุก ุก ููˆ ู…ุท.( ูฃ -ุฒุฐุฐ- ูคู ู ูฃ ุซุจุต. ู‰ ูƒ ู ู…ูˆ ู† ู‰ ู… ูู… ู ู‡ ู‰ ๅฑž ู…ู‰ ู… References 1. Tait AR, Voepel-Lewis T, Munro HM, Gutstein HB, Reynolds PI. Cancellation of pediatric outpatient surgery: economic and emotional implications for patients and their families. J Clin Anesth 1997;9:213-9. 2. Argo JL, Vick CC, Graham LA, Itani KM, Bishop MJ, Hawn MT. Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement. Am J Surg 2009;198:600-6. 3. Macpherson DS, Lofgren RP. Outpatient internal medicine preoperative evaluation: a randomized clinical trial. Med Care 1994;32:498-507. 4. Conway JB, Goldberg J, Chung F. Preadmission anaesthesia consultation clinic. Can J Anaesth 1992;39:1051-7. 5. Ferschl MB, Tung A, Sweitzer B, Huo D, Glick DB. Preoperative clinic visits reduce operating room cancellations and delays. Anesthesiology 2005;103:855-9. Hong Kong Med J Vol 18 No 1 # February 2012 # www.hkmj.org 9

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