Emergency Preparedness

Hospital Staff Needs to Drill on Security Codes

Security practitioners at some healthcare facilities report a disturbing issue: Many employees don’t know or can’t remember the various security-related color codes connected to their work. While they certainly know Code Blue for a patient in medical distress or Code Pink for an actual or attempted infant abduction, they may not use or remember the weapons or evacuations codes.

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Several primary issues may arise to compound this problem, including the presence of visiting nurses picking up work shifts who are not regular employees of the hospital; different codes being used by different facilities with no uniform national standard; and the rarity of some of the issues covered, like bomb threats, where staff has had little or no training as to its responses.

Nurses coming from different hospitals or other care facilities are usually given an employee identification (ID) badge with the color codes on the back. Nurses may not have the time or inclination to study these, thinking that they are the same as other facilities where they have worked. From facility to facility, the color codes are different. Code Black may be a bomb threat at one hospital or a person with a weapon in another. Code Gray is a weather emergency in some hospitals, a power failure in others. Code Purple could be a hostage situation at one facility or an armed person at another. This suggests the need for a national standard for healthcare-related emergency color codes and standardized public address (PA) system announcements that correspond with those color codes.

Healthcare professionals are used to attending dozens of in-service training classes that cover subjects from patient care to knowing hospital policies and procedures. Adding more security-related training classes becomes a challenge to fit them all in over a 1-year period, especially with staff turnover, hectic work schedules, and no time to stop for training in the most stressful critical care units, like the emergency department, the intensive units, and the pediatrics ICU floors.

And while training is a necessity and hard to schedule, the use of drills may become driven only by either a serious event or a series of small incidents rather than by creating a proactive staff security training culture. Healthcare facilities that wait to be driven by security incidents can raise their liability for protecting staff and patients. Security directors and mangers in healthcare environments face challenges to even get in front of the staff, which can number in the hundreds at some locations, to talk about security situations, effective responses, and the continuous need for vigilance and awareness. Creating a standardized color-code response, training on the security-related codes on a regular basis, and realizing that new employees and staff turnover will create a never-ending cycle to repeat the process will help bring more assured, stable, and predictable responses to rare or catastrophic events.