Management Essentials

Use Color Coding Like a “Top Gun” Would

By Farrell “Toby” Tyson, MD, FACS

If you have ever watched the movie Top Gun, or any Navy recruitment television commercial, you will notice scenes involving the carefully choreographed workings of an aircraft carrier deck. At first it seems like one is viewing a hornet's nest that has just been kicked with men and equipment moving all over the deck. Over time, one realizes that is actually a well-orchestrated symphony where everyone knows their place and jobs. This is readily accomplished through the use of color coding. If you look closely, every member of the deck crew has a different colored helmet and uniform indicating their role, from fire safety to ordnance. This allows for quick recognition of job, function and proper placement of personnel.

Color Me Impressed

At a recent conference, I had the pleasure of speaking with Dr. Cynthia Matossian of Matossian Eye Associates. We were discussing ways to streamline our practices when she brought up the use of color coordination in her practice. What first came to mind was the way we use different colored labels to identify which charts are glaucoma, retina or diabetic patients. We have also used different colored charts to identify patients who are in studies, collections or are refractive surgery patients. Dr. Matossian expounded on this by explaining her use of different colored charts also for co-managed patients and VIPs.

Dr. Matossian reminded me to not limit my use of colors to just charting. Colors can be beneficial not only to staff but also to patients. At Dr. Matossian's practice, staff uniforms use color to help differentiate roles and responsibilities. This helps patients quickly identify who is a tech or nurse vs. a check in/out person. This saves your staff time, as patients' questions are self-directed to the appropriate person. Different colored scrubs can also be used in the ASC — where facial features are often obscured by masks — to differentiate between surgical personnel and guests. In our ASC, all visiting guests must wear an assigned color scrub so that miscommunication between staff and guests is minimized.

Appointment or case scheduling can benefit from color coding. This allows for a quick glance at the schedule with immediate recognition of what the caseload entails. Individuals process color association quicker than they do reading. On a primal level, we know that red is hot and blue is cold, but reading is an arduously learned skill. We see the red stop sign but seldom actually read it.

Color coding can also be integrated into the interior design of an office to facilitate patient flow. At Matossian Eye, the lower portion of the walls are painted different colors in different hallways. This allows for simple directional instruction that patients can understand and follow when confronted with the maze of an ophthalmology practice. Several practices have implemented the use of colored lights or flags to send simple signals to doctors and techs on the flow and location of staff in the examination rooms.

Expand Your Palette

One area that has not taken off is the use of color coding in the ophthalmic instrument tray. Almost all our instruments are either silver or blue. If the manufacturers would start using different colors of anodization on their instruments based on use, our (presbyopic) scrub techs would have an easier time handing us the correct instrument. A Connor Wand and a Lester Manipulator look almost identical to a 50-year-old; if one were red and one blue, it would be simple to grasp the appropriate instrument. Several practices have leapfrogged the manufacturers by using colored tape around the handles of their instruments, or applying nail polish. Both methods break down with time and may contribute to TASS.

Just as in our patient population, where color deficiencies can be passed from one generation to the next, the same is true with use of color coding policy (or lack thereof) in a practice. Once implemented, your color coding policy must be monitored and maintained. It usually takes at least four months for a procedure to become a habit. Once your “color” vision is successfully implemented you will find your practice taking flight as effortlessly as an F-14 Tomcat in Top Gun. OM

Farrell C. Tyson, MD, FACS, is a refractive cataract/glaucoma eye surgeon at the Cape Coral Eye Center in Florida. He may be reached at tysonfc@hotmail.com.