“Paging Dr. Strong” and Other Confusing Hospital Emergency Codes

Hearing “Paging Dr. Strong” on the intercom system does not necessarily mean the operator is summoning an actual Dr. Strong. Some facilities use that code to call in the security guards to deal with misbehaving patients or visitors. Code Silver in one hospital may refer to “missing person” and in another “somebody with a gun.” These codes might be standardized across a hospital or a hospital system, but there is little standardization across regions or states. Some hospitals list the dozen or so codes on the back of staff identification cards, but those too, vary from hospital to hospital.

In May of 2014, the Hospital Association of Southern California’s (HASC) Security and Safety Committee revised the Healthcare Emergency Codes to improve the overall experience of individuals working in healthcare organizations. The committee included safety, security, licensing and accreditation experts from member hospitals in the region.

They recognized the lack of consistency among the variation of codes across hospitals which can become particularly confusing to staff who work across multiple healthcare organizations. The standardized set of codes can be used by all healthcare organizations to improve the safety and communication of hospital staff, but also for patients and visitors. The HASC guidelines are available online.

The North Carolina Hospital Association has made an effort to switch from color codes to “plain language” to avoid confusion. By the end of 2016, North Carolina hospitals are encouraged to switch to plain language. While hospitals will have flexibility to choose language that everybody understands, they will not have to be confined to a specified set of codes, except for code red, code blue and code pink, resuscitation, medical emergency, and child abduction, respectively.

Switching to standardized or plain language codes may improve the safety and reduce the harm for patients and visitors, and improve the communication among individuals working in a hospital.


HASC Standardized Emergency Codes: Health Care Emergency Codes. A Guide for Code Standardization. 4th ed. 2014.

Garloch, Karen. “Attention, please: plain language replaces color-coded alerts at some hospitals.” The Charlotte Observer. 27 January 2016.