5 Mistakes Code Black Teams Make

Code Black training Resolution Education Australia

Last updated: May 2026

A code black in a hospital occurs when someone is putting themselves or others in harm’s way and their behaviour needs to be de-escalated — often because the person is armed and lives are at risk, requiring immediate contact with emergency services such as police. A code grey indicates threatening behaviour that is not yet violent or physically destructive, handled by the organisation’s internal response team.

What Are the 5 Biggest Mistakes Code Black Teams Make?

  1. The team doesn’t practise drills — organisations test their systems but fail to drill the response, leaving teams underprepared when a real incident occurs.
  2. Team members’ roles are unclear — without defined roles, multiple responders arrive with no coordinated plan.
  3. Code black incidents aren’t reviewed — without post-incident debrief, the same gaps and risks repeat.
  4. Other staff lack awareness — frontline staff don’t know who is coming or what will happen when the code black button is pressed.
  5. No focus on preventative de-escalation — teams rely on physical response rather than verbal techniques that can prevent escalation entirely.

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 hospital 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 and training options that Resolution Education provides.

This article is for: healthcare managers, nursing unit managers, WHS officers, team leaders, and anyone responsible for occupational violence response in hospitals, aged care facilities, emergency services, and community health organisations across Australia.

This may not apply if: your organisation already has a fully embedded code black and code grey program with regular drills, documented role assignments, and structured post-incident review processes in place.

Table of Contents

What Are the Hospital Codes?

Hospital colour codes are a standardised alert system used by healthcare organisations to communicate the type and urgency of an emergency to all staff instantly. 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 the Difference Between a Code Black Team and 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.

What Are the Other Hospital Colour Codes?

Australian hospitals use a range of colour codes to communicate different types of emergencies to staff quickly and clearly. 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. Does Your Code Black Team Practise Drills — or Just Test the System?

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. Are Your Code Black Team Members’ Roles Clearly Defined?

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:

Communicator The lead team member on the restraint team, and first point of communication with the consumer.
Left Arm* The team member in charge of securing the left arm of the consumer.
Right Arm* The team member in charge of securing the right arm of the consumer.
Guide/Observer The team member approaching from the back, helping to coordinate the Left and Right Arm, to help move the consumer during the restraint; observing what is happening, contacting police and escalating the situation if needed.
Clinical Staff The team member to administer medication and check the well-being of the consumer.
Controller  The team member to handle doors and other people/consumers in the area.

* Only required if doing restraints.

3. Does Your Organisation Review Code Black Incidents After They Occur?

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. Do All Staff Know What Happens When the Code Black Button Is Pressed?

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. Is Your Code Black Team Trained in Preventative De-escalation — Not Just Physical Response?

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.

Resolution Education’s training is built on the A.D.P. Framework — Awareness, De-escalation, and Protection — which outlines the necessary skills and steps needed to prevent and respond to difficult situations effectively.

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

Key Takeaways: Improving Code Black Team Effectiveness

  • Drill regularly — testing the alarm system is not the same as drilling the response. Run scenario-based drills every couple of months.
  • Define every role before an incident happens — each code black team member must know exactly what to do before a real event, not during it.
  • Review every incident — post-incident review is where safety cultures are built. Identify patterns, give feedback, and update procedures accordingly.
  • Inform all staff — frontline employees who know what to expect when code black is called are safer, more confident, and better able to assist.
  • Lead with verbal de-escalation — the best outcome is one where physical intervention is never needed. Resolution Education’s A.D.P. Framework trains teams to de-escalate first.

Other Names Used for Code Black and Code Grey in Healthcare

Across Australian healthcare settings, code black and code grey may also be referred to using the following terms:

    • Personal threat
    • Code Response
    • Behavioural emergency
    • Critical incident
    • Behavioural disturbance
    • Acute behavioural disturbance
    • OVA response

Our Expert Take on Code Black Training in Australian Healthcare

“In over 28 years of delivering occupational violence and aggression training across Australia and New Zealand, the most consistent gap we see in healthcare organisations is not a lack of intention — it’s a lack of follow-through. Teams are trained once and then never drilled. Incidents happen and are filed without debrief. The code black button gets pressed and staff don’t know who is coming or what will happen next. The good news is that all of these are fixable, and fixing them has a direct, measurable impact on safety outcomes for both staff and patients.”

— Resolution Education Australia Training Team

What Our Clients Say About Resolution Education Training

“The trainer was great. Would love to have further training with them in the future. Gives me confidence and clarification on when to act / respond to an incident or circumstance.”

— Aileen Forde

Resolution Education delivers code black and code grey training for healthcare workers across Brisbane, Sydney, Melbourne, Adelaide, Perth, and throughout regional and remote Australia. Contact us today to discuss a program tailored to your team’s specific risk profile.

Written by the training team at Resolution Education Australia — specialists in occupational violence and aggression (OVA) training, code black training, and workplace conflict resolution, with 28 years of experience in adult training and education delivering practical, hands-on training to healthcare organisations, aged care facilities, and community services providers across Australia.


Frequently Asked Questions

What is the difference between code black and code grey in a healthcare emergency?

A code black typically involves a person who is putting themselves or others in serious danger and may be armed, requiring immediate escalation to emergency services to de-escalate the situation. In contrast, a code grey involves threatening behaviour that is not yet violent or destructive, with security personnel and trained teams working to calm or remove the individual without needing outside emergency support.

How often should code black teams conduct practice drills?

It is generally advised that code black teams conduct formal practice drills at least annually, though many high-risk healthcare and clinical environments benefit from biannual or quarterly refreshers.

Best practice includes:

  • Full team simulations at least once per year
  • Short refresher drills or scenario walkthroughs every 3–6 months
  • Post-incident reviews immediately after any real Code Black event
  • Additional training whenever there are staff changes, procedural updates, or identified skill gaps

 

What proactive approach should teams take to prevent code black situations?

Instead of relying solely on physical interventions, teams should be trained in verbal de-escalation techniques, situational awareness, and preventative strategies. Focusing on reducing the escalation of conflict can decrease the number of physical altercations, improving overall workplace safety.

Why is it important to include situational awareness training as part of a code black program?

Situational awareness helps team members recognise early warning signs of aggression or escalation, so they can intervene sooner using appropriate strategies, improving safety and potentially preventing full-blown emergencies.

Aside from healthcare facilities, what other workplaces might benefit from code black or de-escalation training?

Any workplace where staff may encounter aggression or violence — such as retail, hospitality, community services, aged care, or customer service environments — can benefit from tailored training to safely manage critical incidents and reduce risk.


 

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