5 Mistakes Code Black Teams Make

It is vital for healthcare organisations to maintain specially-trained code grey and code black teams that are up-to-date on company safety procedures and policies. These teams help to reduce risks created by agitated people within the organisation and therefore ensure the wellbeing of everyone involved.

Unfortunately, not all hopsital teams receive the proper code grey training, code black training or follow the best procedures to reduce the occurrence of altercations and deal with them effectively. When the effectiveness of the code grey and black teams’ procedures is reduced, the level of safety across the organisation decreases.

In this post, we’ll discuss common mistakes to help you improve your code black team procedures. 

What are the Hospital Codes?

In the healthcare sector, altercations can be labelled as code grey or code black scenarios. There are also several other potential codes identified by different colours. Note that different organisations may define their colour codes differently, so it’s important to clarify the codes you will be using and know what to do in the event of one being called. 

What is a Code Black in a hospital?

A code black occurs when someone in the hospital is putting themselves or others in harm’s way and their behaviour needs to be de-escalated. When a code black occurs, it’s essential to contact emergency services such as police to help de-escalate the situation. Often, code black means the person is armed and lives are at risk. Code black can also refer to a threat coming from someone from outside the facility, while code grey can be a threat from a patient. Below, we’ll talk more about what a code black means for the hospital and how to handle one best. 

What is a Code Grey in a hospital?

 A code grey indicates that someone poses a security risk to those in the organisation (staff, volunteers, patients, etc.). They are displaying threatening behaviour, but have not yet been violent or physically destructive. Typically, they are unarmed. If someone is armed, it would be a code black that requires security personnel and emergency services. Code grey requires immediate attention from the hospital’s code grey team, who will de-escalate the aggressive, combative or threatening person and/or remove them. 

What happens when code grey is called?

When a code grey is called, the security personnel within the hospital and the code grey team will be called upon to de-escalate the situation. They will assist hospital staff and patients who may be at risk, and possibly remove the aggressor from the building. Emergency services may not need to be called unless it escalates into a code black. 

How is a code grey handled in a hospital?

In the event of a code grey, no matter if you’re in the code grey team, a staff member, a patient or a visitor, try to remain calm and follow instructions as well as you can. Keeping yourself safe and following guidelines helps the situation to be resolved more smoothly. Stay distanced from the aggressor, especially if they are threatening violence. The code grey team will handle the situation as per the organisation’s protocols and their training.

What is a code black team vs a code grey team?

Because these two scenarios are different, it is important for a healthcare organisation to have both a code grey and code black team trained in dealing with each type of scenario. For everyone’s safety, it’s important that the code black team is trained on proper procedures, has drills regularly, and understands the implications of their actions. 

Here are some other codes that a hospital may have plans and a team for:

What is a Code Brown in a hospital?

Code brown refers to an external emergency that may impact the hospital, for example, a natural disaster.

What is a Code Yellow in a hospital?

Code yellow means there is an emergency within the hospital, such as a missing patient. Staff must be called upon to locate the missing patient or deal with the hospital emergency to ensure no one is at risk of harm. Similarly, code amber may be used if a child or infant is missing.

What is a Code Orange in a hospital?

Code orange means evacuation is needed, alerting the staff to assume plans to remove themselves and patients, as well as visitors, from the building.

What is a Code Red in a hospital?

Code red means there is a fire or potential for a fire in the hospital, or smoke. Evacuation procedures may be necessary, as well as fire alarms, alerting emergency services, or calling upon the hospital’s fire team or code red team.

What is a Code Purple in a hospital?

Code purple alerts those in a hospital that there has been a bomb threat.

What is a Code Blue in a hospital?

Code blue refers to a medical emergency, usually one that is life-threatening and requires assistance, like a cardiac arrest.

What is a Code Pink in a hospital?

Sometimes, code pink is used for emergencies regarding babies, for example when someone is going into labour unexpectedly, having issues with the birth, or a newborn baby’s life is at risk.

What are the 5 biggest mistakes code black teams make?

1. The team doesn’t practise drills

Many organisations test their code black systems but fail to drill them. This is an issue because it means the code black team will be out of practice. When a code black occurs, they will lack the necessary skills to deal with the situation. To avoid this mistake, take your code black team out for a few hours every couple of months to practise different code black drills, review previous incidents and set up better ways to respond to code black scenarios.

2. The team members’ roles are unclear

A code black is called, and the next thing you know, 10 people turn up. Do these people know how to work as a team to effectively deal with the situation? 

It is important that clearly defined roles are set up so each team member knows exactly what to do and how to work together – for everyone’s safety. This ensures the scenario is dealt with quickly and effectively. Resolution Education’s Code Black Training includes up to six roles for a code black team, depending on the healthcare facility:

* Only required if doing restraints.

3. Code black incidents aren’t reviewed

It is important to review every code black post-incident to see what could improve, how it was handled, and to give feedback on the roles. This means that every time an incident occurs, the code black team’s procedures and skills are improved, increasing safety every time. Also, by reviewing incidents, the team can identify patterns and see how the organisation might prevent future incidents before they occur. 

4. Other staff lack awareness

All staff should be aware of the code black team, including who will be coming to support them if they press the code black button. Why? So they will know exactly what will occur and how the situation will play out, increasing their ability to help in the situation and giving them peace-of-mind to continue with the work they need to do. When staff know their safety is paramount and risk is reduced, they can more effectively do their jobs and feel better in the workplace. 

5. They don’t focus on preventative de-escalation

It’s always better to not need a code black team at all – preferably, your organisation will be free of confrontation. But if there is a confrontation, there are ways to de-escalate using verbal techniques to prevent a physical altercation. It is always best to train your code black team on verbal de-escalation as a preferred method over physical techniques. Being able to rely on reducing the amount of physical incidents means that the safety and peace-of-mind of the entire organisation can be increased. 

Need help training your code black team and creating drills for incidents? We’re excited to work with you.