Why will all good hospitals eventually have color coded uniform programs for their nurses?

Answer: Color Coded Uniform Programs have a direct impact on HCAHP scores.

Could this actually be true?  Is it possible that how we dress at work effects how we perform?  How could having each functional unit of patient facing employees wear coordinating uniforms actually result in a lower HCAHP score?  How do we get real answers to this question?

Up to this point, all that had ever been done was a simple study where patients were shown a series of photos to which they reported their first impressions.  They were shown images of nurses wearing non-matching uniforms vs. nurses wearing coordinated uniforms.  The balance of those tests revealed exactly what you would expect.  A coordinated looking group of employees looks more professional.

Recently, a few very smart people at the University of Northern Colorado set out to find some real answers to these questions that were based in statistically significant data.  Catherine Dingley, PhD, RN, FNP, University of Northern Colorado; Kathy Boyle, PhD, RN and Denise Johnson, BS; Denver Health Medical Center, set out to do just that.

The study was performed at the Denver Health Medical Center, a 477 bed urban public safety net hospital in the Denver metro area.  At DHMC they had the opportunity to study and compare the before and after of a full-blown color coded uniform program.

The last 2 sentences in their published study sum up their results nicely:

Nurses’ dress and appearance significantly affected patient and family perceptions and could potentially affect their response and satisfaction with care as well. In addition, staff engagement and participation in decision-making are vital to successful implementation of organizational change such as color-coded uniforms.

So a few Ph.D's did a study and got some results that line up with the common sense idea that teams that look more professional give a better impression to their patients and their patients' families.  Ok, that make sense.  But how does this improve an HCAHP score?

HCAHP scores are all about patient impressions.  Service is in the eye of the beholder.  Quality is in the eye of the beholder.  Are HCAHP scores really that important if they are just tied to perception?  Ask anyone in the administration of a hospital network and they'll tell you that HCAHP scores are everything.  They are tied to funding and funding is tied to providing good quality care.

Let's abandon the academic approach for just a minute and get down into some micro-views of this topic.  In a recent interview we conducted with Kati Kleber, author of the awesome book Becoming Nursey, we got some first-hand insight into how a color coded uniform program helps in a practical way. (BTW - Becoming Nursey is available on Amazon here!)

Kati said that there were way too many times when one of her patients had coded and she needed to pull a team together almost instantly.  She quite literally didn't have time to run out into a hallway and start checking people's badges.  It would be nice if the teams everyone worked on were always totally consistent, but that's just not the world we live in.  

Having people in uniforms according to their job function could not be more important than during these moments of incredible lifesaving action.

Ok, now let's back off of the micro-view and pan out to take a look at a broad, indirect effect of color coded uniforms.  Take a look at these two photos and think for a second what effects a coordinated uniform program has on its employees and how they think of themselves and their team.

Both sets of employees are qualified, brilliant, life-saving machines.  There's no question, right?  Now think about what Kati Kleber said about having to pull together a team in an instant.  Does having our clothing, which is actually a tactical garment this case by the way, help fill a function of our job make us feel more professional about ourselves and our team?  

We have started asking all of our clients this question and we're getting the same response every time.  Nurses fight it at first because they don't want to be told what to wear but very quickly they appreciate the functionality of having coordinated uniforms.  

Coordinated uniforms are something that the administration, the nurses, and most importantly the patients can all appreciate.  

And, it's not just conjecture, there's actual data to back it up.  I always say, "In God we trust, all others bring data".  So, the next time someone brings up the issue of color coded uniforms, be sure to tell them that they work to everyone's benefit and you can prove it!