Emergency Preparedness — Planning and Management

Breaking the Code: Considerations for Effectively Disseminating Mass Notifications in Healthcare Settings

“…However, due to factors such as age, education, culture, and geographic area, individuals often associate specific colors with specific images that may not be universal [ 17 , 18 , 19 ]. This likely explains why colors that have less culturally engrained meanings, such as black, silver, purple, or orange, are used for a broader range of emergencies, while colors such as red and pink are nearly universally used for fire and pediatric incidents [ 14 , 16 , 20 ]. In fact, surveys of hospital emergency codes in California [ 12 ], Colorado [ 21 ], Florida [ 22 ], Oregon [ 13 ], and Puerto Rico [ 23 ] have indicated there is significant variation among different hospital emergency code systems.…”

“…To minimize these concerns, hospital associations from 25 of the 50 states in the U.S. have recommended the introduction of a standardized set of emergency codes [ 39 ]. There is little question that standardized codes would result in reduced training time, misunderstandings, and a more efficient overall response [ 20 ]. However, little progress has been made in implementing these recommendations, largely due to a lack of consensus.…”

“…There is little agreement among those recommending a standardized set of emergency codes. For example, the California Hospital Association’s system has 11 color codes, which some healthcare professionals feel is excessive [ 12 , 20 ]. Some recommendations explicitly state facilities should not use codes similar to types used by other organizations, such as Code Amber for a missing child, while other systems use Code Amber for missing child [ 13 , 20 ].…”

“…For example, the California Hospital Association’s system has 11 color codes, which some healthcare professionals feel is excessive [ 12 , 20 ]. Some recommendations explicitly state facilities should not use codes similar to types used by other organizations, such as Code Amber for a missing child, while other systems use Code Amber for missing child [ 13 , 20 ]. Yet others have argued that the three basic codes of red (for fire), blue (for medical emergency), and pink (for infant abduction) should be supplemented by individual facility codes [ 20 ].…”

“…Some recommendations explicitly state facilities should not use codes similar to types used by other organizations, such as Code Amber for a missing child, while other systems use Code Amber for missing child [ 13 , 20 ]. Yet others have argued that the three basic codes of red (for fire), blue (for medical emergency), and pink (for infant abduction) should be supplemented by individual facility codes [ 20 ]. Even the recommendations published by TJC do not align with any of the previously discussed systems [ 11 ].…”