5 Ways to Improve Code Silver Procedures

What is a Code Silver in a Hospital?

In the healthcare sector, there are many color-coded incidents that staff use to communicate emergencies with each other. They can be announced over speakers or pagers and tell staff what to prepare for. A Code Silver call is significant in relation to active threats involving weapons. 

A Code Silver is called when staff require emergency assistance because a person poses an active shooter threat or is armed and endangering others in the organization (staff, volunteers, patients, visitors, etc.). Incidents may involve a person with a firearm or other weapon threatening to harm themselves or others. This code is typically activated in response to an active shooter situation or a credible threat of gun violence.

What is Code Silver in an emergency?

In an emergency setting, Code Silver has the same meaning – an armed threat is underway, and the Code Silver team must be deployed to secure the area and coordinate with law enforcement. If another emergency occurs at the same time, the team should have procedures for handling it.

What is Code Silver in surgery?

The security threat is the same when a Code Silver is called while a surgery is occurring, but in this case the threat may be coming from a patient, a visitor, or another outside party while the surgery is occurring/in the theater. Surgery staff will call the Code Silver team to help with the situation so that they can continue with their work or evacuate safely as needed.

What’s the Code Silver team?

Healthcare organizations create Code Silver teams whose responsibility is to answer these Code Silver calls. This means that in the event of an emergency, they, along with security personnel and law enforcement, are called on immediately to manage the situation, secure areas, and facilitate evacuations or lockdowns.

However, there are some ways these Code Silver teams falter which results in a lack of efficiency and a decrease in the level of safety. That is why Code Silver training is becoming so popular.

What are other hospital color codes?
Other color codes include:

Code Red for fire,
Code Blue for medical emergencies,
Code Yellow for missing patients, and
Code Orange for hazardous spills.

Remember that some codes can differ between hospitals, so staff should always be updated on procedures. Outlined in this article are common mistakes these teams make, how to avoid them and how to improve your Code Silver procedures overall.

How can organizations improve their Code Silver procedures?

Tip #1: Increase Code Silver awareness among all staff

One of the key aspects of effective Code Silver systems is that every employee — whether they are a part of the Code Silver team or not — recognizes exactly when and how to call a Code Silver as well as who will be responding if they do. 

If an organization does not provide this necessary information, it creates confusion among employees around boundaries and what constitutes an emergency, a lack of trust in the workplace support system, and an increased risk of danger to staff and members of the public. 

It is important that organizations take the time to clearly define within their team what a Code Silver is and when to call one.

Suggestion: It is recommended that companies create a work environment where there is a consistent understanding of boundaries, the steps taken when a Code Silver is called and each person’s role to play in a Code Silver procedure.

Tip #2: Practice drills with Code Silver teams

Practicing drills builds confidence and competence when dealing with emergencies. Many organizations have Code Silver systems in place, but they fail to drill employees on them. This is an issue because it means their Code Silver teams lack the knowledge and skill to carry out the emergency protocols effectively. When teams are provided with scheduled practice drills, there is time for immediate corrective instruction in a low-risk setting, reinforcement of new learning, and procedural fluency. Therefore, team members are better equipped to safely handle a Code Silver call in their workplace.

Suggestion: Try to take your Code Silver team out every couple of months to practice different drills, increase confidence, and improve any weak areas in the procedures.

Tip #3: Ensure clarity around Code Silver team roles

When a Code Silver is called, members of the Code Silver team should be well-trained on their part in the procedure. Issues arise when there is confusion about each team member’s role and responsibility, resulting in a lack of structure in the procedure and a delay in response time. This creates a level of danger that could be prevented with clarity around roles.                     

Resolution Education’s Code Silver Training allows for up to six roles in a Code Silver scenario, depending on the healthcare facility:

1. Communicator: The lead team member on the team and the first point of communication with law enforcement or to coordinate lockdowns.
2. Securer Left: The team member in charge of securing the left perimeter or access point.
3. Securer Right: The team member in charge of securing the right perimeter or access point.
4. Guide/Observer: The team member monitoring from a safe position helps coordinate movements during lockdown or observes what is happening and contacts authorities to escalate the situation if needed.
5. Controller: The team member tasked with handling doors, barriers, and directing other people in the area to safe zones.
6. Clinical Staff: The team member required to provide medical support or assess the well-being of those affected.

Only required if physical securing is part of the protocol.

Suggestion: Take a moment to clearly define the roles that each Code Silver team member is responsible for and communicate these roles with all staff.

Tip #4: Review all Code Silver incidents

A significant aspect of effective Code Silver procedures is reviewing incidents after they take place. Many organizations do not allow time to review incidents even though it helps determine trends and identify patterns. Not only does this prevent incidents from reoccurring, but it creates an opportunity to assess and adapt responses and adjust roles where necessary.

Suggestion: To ensure the greatest safety within your organization, take time to review incidents with the Code Silver team and adjust procedures accordingly.

Tip #5: Focus on de-escalation and prevention

Focusing on de-escalation and prevention strategies can help reduce the severity of Code Silver incidents. Many organizations are not aware of the benefits of using verbal techniques to de-escalate a potential threat before it escalates to violence, or implementing preventive measures like threat assessments. All Code Silver team members can be trained on these de-escalation strategies, which will minimize the need for lockdowns or evacuations and therefore reduce the level of danger for all involved.

Suggestion: Take time to up-skill staff on effective de-escalation and threat recognition strategies. This will ensure a reduced number of escalations and greater safety in the workplace.

If you need help training your staff and Code Silver teams, as well as creating drills for practicing incidents, fill out the form below. At Resolution Education, we would be happy to outline training programs that meet your specific needs.