Scrub Colors and Safety: Rethinking Role Identification in Critical Events

Christine E. Sanchez (chrsanchez@pa.gov) is a research scientist on the Data Science & Research team at the Patient Safety Authority. She is responsible for utilizing patient safety data, combined with relevant literature, to develop strategies aimed at improving patient safety in Pennsylvania.

Color-coding and color differentiation have been used in healthcare to facilitate the identification of healthcare personnel^1–3 and support patient safety.^4–7 Color-coding assigns a specific meaning to a given color,^8,9 such as using red to signal “stop” or assigning scrub colors to specific staff roles. In contrast, color differentiation uses color to signal differences between items or bring attention to something without assigning a fixed meaning,10 for example, using a colored sticker to bring attention to a warning label.

Although color-coding and color differentiation can support rapid recognition, these strategies have limitations from a human factors perspective.^11–13 Color can be a useful cue; however, relying on color alone is insufficient and can introduce confusion, particularly in environments where lighting, stress, visual overload, or individual differences in color perception affect how colors are interpreted.¹² Because color cues require individuals to notice, process, and correctly interpret each color, they are considered a low-leverage risk mitigation strategy and vulnerable to human error.¹³ These vulnerabilities become evident when color cues fail to support accurate role identification in fast-paced environments, especially when cues must be remembered or transferred across contexts.¹¹