Health & Wellness

Health care workers struggle to recall emergency codes

A small group of diverse medical professionals stand in the hallway for a brief meeting. They are each wearing scrubs and focused on the conversation.
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Workers only matched code words to corresponding emergencies 44% of the time

A new study by University of Georgia researchers reveals that many health care workers cannot accurately identify emergency codes.

Researchers tested the ability of health care staff to identify their facilities’ codes. Having this knowledge front of mind is critical for responding quickly and appropriately to emergencies.

“Health care facilities have traditionally relied upon code-based notifications to quickly and efficiently alert employees to ongoing emergencies within or affecting the facility,” said co-author Morgan Taylor, a doctoral student with UGA’s College of Public Health.

Not all hospitals use color codes, but those that do, use separate code words for each emergency.

For example, a “code blue” call is often used to alert all hospital staff that a patient’s heart has unexpectedly stopped or that they’ve stopped breathing, and they need to be resuscitated.

However, there is no universal standard to assign certain codes to specific emergencies. Prior research in this area has shown significant variation among different hospital emergency code systems across the United States and internationally.

Taylor and her co-authors focused on the ability of clinical and non-clinical employees in five Georgia health care facilities to correctly identify their facility’s emergency codes.

They also assessed employees’ opinions of emergency alert systems and determined individual factors that enabled more accurate identification of emergency codes.

The study surveyed 304 employees, testing them on codes for 14 emergencies. On average, participants could identify the correct emergency codes 44% of the time. Codes for fire, infant abduction and cardiac arrest were the most well known.

“The results of our study suggest a prompt response to such incidents is likely to be poor, as most employees were unaware of the meanings or actions of these notifications,” said Taylor.

On top of that, many participants reported that the codes were only introduced at orientation, and they had little training on them.

“Codes are often confusing because we do not use or practice them regularly. It is unreasonable to assume that staff will retain the knowledge they receive during orientation, disaster simulations, or once-a-year in-service reminders,” said Curt Harris, director of the Institute for Disaster Management and lead investigator of the study.

“It is also unreasonable to assume that just because the meaning of the color code is on the back of their badges, an appropriate and prompt response will ensue,” he said.

There is evidence to suggest that transitioning from color codes to plain language reduces employee confusion and training time. Employees in the current study expressed concerns that a plain language system would cause extreme panic and fear for visitors and patients.

However, those concerns are contradictory to current research, said Taylor.

“We know plain language communications reduce bystander panic and confusion. Our study highlights the continued need for effective training and education that helps translate this research into practice,” she said.

The paper, “Breaking the Code: Considerations for Effectively Disseminating Mass Notifications in Healthcare Settings,” was published in the International Journal of Environmental Research and Public Health.

Co-authors include James Zerylnick, Kelli McCarthy and Curtis Fease from UGA’s Institute for Disaster Management