Wednesday, March 8, 2017

Code What? Improving Hospital Communication in an Emergency

By Scott Robins, MD
Chair, Texas Hospital Association Hospital Physician Executive Council
Division Chief Medical Officer, Medical City Healthcare

Anyone who has ever been in a hospital has probably heard over the public address system the cryptic words, “Code Pink” or “Code Black” or, more commonly, “Code Blue.” These color-based alert codes are intended to notify hospital staff and physicians and sometimes the public to an emergency of some kind.

The color-based alert codes typically are unique to each hospital. This means they lack standardization across facilities. When an emergency occurs and time is of the essence, this variation can create confusion and delay or uncertainty in response. This is particularly true for physicians who work in multiple hospitals and for new employees who have come from different hospitals.
The Texas Hospital Association has a solution.

It recommends that hospitals use standardized, plain-language emergency alerts instead of the color-based codes. The alerts are intended to allow hospitals to personalize the information to their facilities and provide site-specific details.

For example, instead of announcing “Code Pink” for a missing person alert, a hospital could instead announce “Security Alert. Missing female child, age 2. Last seen first-floor lobby.” Hospitals could choose to add additional information as warranted, such as instructions on contacting hospital security.
The intent of using plain-language alerts is to:

  • Promote the safety of patients, visitors, physicians, and hospital staff;
  • Reduce errors;
  • Increase transparency of communications and safety protocols; 
  • Align with national safety recommendations; and
  • Reduce confusion for staff or physicians who work in more than one facility. 

The initiative is completely voluntary, but THA hopes that every Texas hospital adopts all of the standardized, plain-language codes as part of the industry’s work to improve and provide higher quality, safer care.

Complete information about the initiative is available on

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