Alabama hospitals are being asked by the Alabama Hospital Association (AlaHA) to voluntarily begin using standardized, color-coded wristbands to identify patients at risk of allergies (red) and falls (yellow) and patients who with a do not resuscitate — DNR — status (purple). The recommended conversion date is January 1, 2009. While this idea seems simple, significant thought and planning have gone into it. "This program was actually modeled after something Arizona had done," said Rosemary Blackmon, executive vice president/COO of AlaHA. "Arizona did extensive research on different colors and on what different colors mean, along with how many colors they should use. In other words, if you do too many colors, do you start confusing people? So they felt like three colors were a good starting point." AlaHA, after much discussion, decided to adopt the same three colors that Arizona chose. About 20 other states have adopted those same three colors, although some have added more. These color-coded wristbands are another component to help hospitals ensure patient safety. "In hospitals right now, when somebody comes in and has an allergy, that is noted on their chart," Blackmon said. "A lot of times, they'll put signage on the door or somewhere if the patient is a fall risk. So, this is really another step to say, stop and check the chart." According to Blackmon, another reason for standardization is that nurses don't always work at only one hospital. "It just makes sense for the colors to all mean the same thing. There was an incident in Pennsylvania where a nurse had misread something and almost did something that would not have been good for the patient. We're just trying to reduce the risk of something like that happening." AlaHA has created tool kits to assist hospitals in implementing the new wristbands. First, hospitals will have to take steps to train their staff and deplete their existing supplies or do away with them. After this, the kits give the hospitals all the tools they will need to begin using the wristbands, including staff education materials, draft policies and procedures, and a patient brochure in English and Spanish that hospitals can download and use when talking to patients and their families to explain why they are using the wristbands. Many area hospitals plan to implement the color-coded wristbands, including Shelby Baptist Medical Center. The hospital decided to work toward early implementation of the program after its director of risk/compliance, Claire Owens, CPHRM, CHC, read an article from the American Society for Healthcare Risk Management about color coding. "It was something unique to healthcare, which can impact patient care, and it's cost-effective. So, I thought, this is great. We need to jump on this." After reading the article, Owens began her research to determine the color strategy that would work best for Shelby Baptist, including looking at programs planned by Arizona (which the Alabama plan is based on) and Pennsylvania. The AlaHA wristband campaign "came at a great time for us because of our new bed tower project (which is planned to be completed in October 2009). We were implementing color-coded signage for the bed tower as part of the interiors. We said, 'Let's figure this out and incorporate it into this construction project.'" Shelby will begin implementing the change this fall, having received final approval for the colors they will use — in addition to the red, yellow, and purple wristbands — for their chart stickers and door signage. "The color designation for fall prevention is yellow. So, we're going to do a whole fall patient safety awareness campaign this fall, and try to tie that together," Owen said. "Historically, orange has been our (fall risk) color at Shelby. We really want to put a focus on that one to make sure everybody understands that yellow is now the indicator color." Shelby plans to roll out the two remaining color-coded wristbands in January 2009, following AlaHA's guidelines. According to Owens, this roll-out should be simple since red has historically been used for allergies at the hospital, and no color designation has been assigned to DNR patients until now. Not every color will necessarily have a wristband. Some will be used for door signage, but the colors will be consistent. "AlaHA has done a great job with the tool kit that they put together," Owens said. "I hope it's something that's going to be very easy for facilities in Alabama to adopt and implement."