Rave blog Post

Breaking Down Hospital Emergency Codes

Most of us are familiar with what hospital emergency codes are due to the success of TV shows such as The Resident, Grey’s Anatomy, and E.R. What you may not know is that hospital emergency color codes can mean different things in different hospitals, and nowadays they are not used as often as you might think.

Hospital emergency codes were originally introduced in healthcare facilities to discreetly alert staff to emergency events over public address systems. The motive behind using different colors to represent different types of emergencies was to prevent situations in which emergency responses were obstructed by alarmed patients and visitors.

Unfortunately, different healthcare facilities often used different colors to represent different types of emergency situations, or had no color assigned to specific types of incidents. 

This had tragic consequences in September 1999 when an armed assailant entered the West Anaheim Medical Center in California and killed a nurse's assistant, a pharmacist, and a hospital maintenance worker.

An investigation into the event found that, after the first shots had been fired, a “Code Gray” alert was issued indicating a violent patient. Consequently, rather than shelter in place and await the arrival of law enforcement, male personnel raced to the unit to subdue the violent patient – resulting in the unnecessary deaths of the pharmacist and hospital maintenance worker.

Healthcare Association Introduces Standardized Codes

Following the tragic event, the Hospital Association of Southern California (HASC) conducted a survey among California healthcare facilities to establish what codes were being used and what their purpose was in order to standardize hospital emergency codes and eliminate gaps in the coding system to prevent a repeat of the West Anaheim Medical Center tragedy.

The survey found that, although over 90% of hospitals used “Code Red” to indicate a fire and “Code Blue” to indicate a medical emergency, there was little cohesion elsewhere in the color-coding system. Among more than two hundred healthcare facilities that responded to the survey, there were 47 different codes to indicate an infant abduction and 61 different codes for a violent person.

In 2000, the HASC produced a list of standardized hospital emergency codes based on the eleven most common or significant security events and the colors most used by healthcare facilities across California to indicate these events. Although not adopted by every healthcare facility in the region, a survey in 2002 found 89% of healthcare facilities were using the standardized format.

Not All Areas Enjoy High Code Adoption Rates

Following the success of the HASC´s code standardization, other regional healthcare agencies attempted to standardize hospital emergency codes. However, a 2016 analysis of the codes being used found that, not only had only seventeen healthcare agencies standardized codes, regional discrepancies existed between which colors indicated which type of event.

Therefore, although Code Red, Code Blue, and Code Orange indicated the same type of threat among the states that had implemented hospital emergency codes, Code White could mean a pediatric medical emergency in California, an internal or external disaster in New Hampshire, a violent person in Louisiana, and an external disaster in Wisconsin.

It isn't only the case that different hospitals were using different colors to indicate different types of emergency. In some healthcare facilities – including those in states with standardized color codes – different types of emergency were assigned different numbers or “doctor codes”. For example, in some hospitals in Vermont, Code Blue was replaced with Code 99; while throughout the Kaiser Permanente hospital system in California, “Dr. Pyro on 3” indicated a fire on the third floor.

Hospital Emergency Codes Used Less as Technology Improves

Although many of the standardized hospital emergency color code systems developed over the past two decades still exist, they are rarely used – except on TV. Initially, public address announcements were replaced with multicolor LED displays, then by pagers to facilitate discrete plain English alerts, and – more recently - by mobile phone alerts due to the greater versatility of mobile technology.

The use of mobile phone alerts enables healthcare facilities to add hyperlinks to the end of alert messages. Adding hyperlinks helps avoid confusion about the appropriate response by directing staff to dedicated emergency preparedness web pages developed in advance to cover each type of emergency. The web pages can also be prepared for different roles within emergency types.

A further advantage of using mobile phone technology to communicate hospital emergencies is that alerts can be targeted to only those for whom they are relevant. This minimizes business disruption and enables patients and visitors to opt-in to receive alerts, which can be tailored to the minimum amount of information necessary (i.e., the emergency notifications do not include hyperlinks).

[INFO SHEET]: Opt-In to Alerts with Rave Keywords

To find out more about the versatility of mobile phone alerts, do not hesitate to get in touch. Our team of safety experts will be happy to explain more about setting up emergency alert templates with and without hyperlinks, database segmentation, and the “text to opt-in” capabilities of Rave Alert. Our team will also be happy to organize a free demo of Rave Alert in action tailored to your organization's specific requirements.

HealthCare User Group q1 2021 CTA

Mary Kate McGrath
Mary Kate McGrath

Mary Kate is a content specialist and social media manager for the Rave Mobile Safety team. She writes about public safety for the state & local and education spheres.

Denver Health and Hospital Authority

Learn more about a how  Denver Health selected Rave for its reliability, sending messages and administrative capability, along with the ability to have templated alerts and role-based access controls for various departments.


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