Tag Archives: Public Address Systems

Cracking the Code of State-of-the-Art Hospital Communication

A patient is rapidly transported into the ER.  He was stabilized by the paramedics on the way to the hospital and is immediately placed in the ICU.  The staff efficiently transfers him from the gurney to his bed and hooks him back up to the heart and respiratory monitors.  Then something goes wrong.  The patient’s heart stops.  The attending ER nurse rushes to her station, picks up her phone, and calls for a “code blue” response.

There’s only one problem, no one heard it because the emergency notification system was not designed properly.

In today’s world of high tech medicine, it’s easy to get overwhelmed with the advancements technology is bringing to our hospitals.  It really is an amazing time and something to behold.  However, the need to communicate effectively and efficiently is still at the core of providing essential care.

There are really two main parts to effective and efficient communication.  The first part is to make sure that all of the staff is speaking the same language.  Hospitals use a “color code” system to communicate different events within their facility and to trigger the proper response.  In the past many codes varied from facility to facility making that communication system inefficient and confusing at times.  To give a relevant true story:

“A hospital per diem nurse, employed by two different hospitals, began her shift to find that one of her patients had gone into cardiac arrest. She responded quickly by picking up the phone and announcing “code blue”. Within minutes she was surrounded by security guards and police officers with weapons in hand. To her dismay, the nurse was informed that code blue is a security alert in this facility. In her other place of employment, it means cardiac arrest. The correct team was quickly brought to the bedside and the patient recovered.”

This story illustrates two things.

First, it shows the need for some standardization in the color code system at least regionally for hospitals.  Hospitals in Washington, Oregon, and California are working on standardizing these codes for more effective communication and to minimize confusion for staff that may work in multiple facilities.

Second, even though the nurse gave the wrong code in the above example, something went right. 

The emergency notification and code announcement system worked.  The proper response for that hospital was implemented based on the code the nurse gave. This can only happen if the notification and code announcement system is designed properly.  So what are the core features of a state-of-the-art system?


In order to be able to initiate a color code alert you first need a way to access the system.  Having multiple, convenient handsets or paging devices at nurse’s stations and other key areas assure the hospital staff will have the ability to communicate a color code and initiate a response.


Once a code is initiated, there must be some way to communicate it to the rest of the staff for proper response.  The delivery system usually consists of public address (PA) speakers and sometimes may even include a method of alerting staff on personal mobile devices as well.


A system that includes PA speakers must have the proper coverage.  The coverage is determined by the ceiling heights, area needing to be covered, and coverage pattern of the speakers.


Even if everything above is all in place, the system is worthless if the staff cannot understand the codes being communicated.  Intelligibility is key and may be one of the trickier parts of the puzzle.  The Speech Transmission Index (STI) helps rate the intelligibility of speech delivered.  In a hospital environment, there is little opportunity to redesign the space or add acoustic treatments to the hard, sanitary surfaces.  For this reason having equipment that can be adjusted for background noise levels and audio frequency responses is dually important.

At the end of the day, hospitals rely on efficient and effective communication to provide exceptional care and ultimately save lives.  First get all the staff on the same page, then make sure you have a state-of-the-art emergency notification and code announcement system.

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#1:  http://www.hasc.org/resource/hospital-emergency-codes

#2:  http://www.wsha.org/files/82/codeseducationslides.ppt

#3:  http://en.wikipedia.org/wiki/Speech_transmission_index


Bob Higginbotham

About Bob Higginbotham

Bob Higginbotham, CTS-I, CTS-D, is the Avidex National Manager of Healthcare AV. Bob has spent his 30 year career in leadership positions in the AV industry including extensive design and build work in healthcare facilities. He owned and operated a successful AV business in Texas with multiple offices in several cities where he managed a staff of over 100 employees. Bob has served as a technical consultant for a major AV manufacturer, led the technical sales team for a national video conferencing provider and provided technology auditing services for several private education facilities. He has a unique working knowledge of audiovisual technology as well as multiple certifications in audio engineering, acoustics, AV design, CQT system commissioning and video transmission systems. Bob holds a BA in communications and has recently served as board chair for a large private school. He brings his years of technical knowledge and leadership experience to Avidex where he leads the national healthcare AV team. Contact Bob at bobh@avidexav.com