Following a regional natural disaster, our hospital experienced an influx of patients who presented unique challenges. Patients formerly managed by the local charity system instead were processed through our emergency department, nearly tripling our uninsured population from 4% to 11 %. Concurrent with this demographic shift, our emergency department and hospital witnessed an upsurge in patients and families who displayed agitated and/or combative behavior. The community suffered from a decrease in available nurses, security personnel, and virtually all other categories of workers. The staff, especially the hospital medicine staff, which managed 60% of the inpatient population, was challenged to find effective ways to deal with disruptive behaviors displayed by patients and their families.
The goals of the present study were to roll out Crisis Prevention and Intervention Certification training and to initiate a code green to support hospital staff when faced with agitated, combative, or disruptive behavior.
An 8‐hour crisis prevention and intervention class that counted toward required contact hours was offered to all interested staff. An annual refresher course, 4 hours long, was also offered. A new code, code green, was devised. When a code green is called over the overhead paging system, all available personnel who have been trained in crisis intervention proceed quickly to the area of the code to help diffuse the situation. They respond to threats of a physical, verbal, or nonverbal nature. Only anecdotal outcome data are available at present. Patient care coordinators have reported that patients who are agitated respond very positively to the arrival of several male personnel who interact with the patient in a calming manner.
Widespread training of staff in crisis management techniques and the initiation of a special code for assistance with combative patients helped our organization cope with a sudden shift in patient demographics following a natural disaster in our area. The innovative efforts of the organization helped to retain staff during a particularly challenging time.
S. Deitelzweig, None; F. C. Wharton, None.
To cite this abstract:Deitelzweig S, Wharton F. Implementation of Code Green. Abstract published at Hospital Medicine 2007, May 23-25, Dallas, Texas Abstract 77. Journal of Hospital Medicine. 2007; 2 (suppl 2). https://www.shmabstracts.com/abstract/implementation-of-code-green/. Accessed April 10, 2020.