In the Fall of 2007, the Florida Society for Healthcare Risk Management and Patient Safety (FSHRMPS), a professional membership group of the Florida Hospital Association (FHA), asked the Florida Hospital Association to spearhead a project to recommend standardized colors for wristbands used in Florida hospitals. This initiative stems from a near-miss incident several years ago that highlighted the risks when hospitals use different colors to communicate the same alert. It has generated a response nationwide; to date, the majority of states have standardization projects implemented or underway.

In March, FHA staff convened a work group of representatives from the following:

• Florida Society for Healthcare Risk Management and Patient Safety
• Florida Academy of Healthcare Attorneys
• Florida Association of Children's Hospitals
• Florida Association of Homes & Services for the Aging
• Florida Health Care Association
• Florida Organization of Nurse Executives
• Florida Society of Health System Pharmacists
• Florida Society for Healthcare Education & Training
• Florida Society for Healthcare Security, Safety & Emergency Management Professionals
• Florida Society of Hospital Physician Executives
• Florida Society for Rehabilitation

The Work Group reviewed patient safety advisories published by the Pennsylvania Patient Safety Reporting System and the Institute for Safe Medication Practices that described reported incidents involving confusion over the meaning of color-coded wristbands. One involved a near miss incident in Pennsylvania in 2005 that nearly resulted in the death of a patient when the patient's wristband was improperly understood to signify DNR. The second resulted in the use of latex-containing vials and syringes on a patient identified as allergic to latex because the testing staff did not know the significance of the patient's colored wristband.

The Work Group reviewed the findings of an FHA survey on current practices in Florida hospitals with respect to the use of colored wristbands and observed significant variation in both the nature of the alerts and colors used as indicators. The Work Group heard information regarding activities in other states that have recommended standardized colors and have developed materials to assist facilities in their implementation.

After consideration and discussion of all of the information, the Work Group voted to request approval from their organizations of the following standard colors for use on a voluntary basis by inpatient healthcare facilities in Florida:

• Red - Allergy
• Yellow - Falls
• Purple - DNR

During its June meeting, the Florida Hospital Association Board of Trustees adopted a policy on June 13, 2008, that encourages all Florida hospitals to adopt standardized colors for patient alert wristbands. The other stakeholder groups have endorsed the project as well. This combined action of the FHA Board of Trustees and its partners has cleared the way for a statewide effort to encourage consistency in practices of Florida hospitals, thereby reducing the risks to patients.