Evaluating The Effectiveness Of Emergency Codes And Security Protocols In Hospitals: A Systematic Review (2015–2025)

Abstract

Background: Hospitals operate in complex and high-risk environments that demand rapid, coordinated responses to diverse emergencies such as fires, cardiac arrests, active shooter incidents, and infant abductions. Effective emergency codes and security protocols are essential for safeguarding patients, staff, and visitors. However, variations in code systems, inconsistent staff training, and insufficient standardization have undermined communication clarity and response efficiency across healthcare institutions worldwide.

Objective: This systematic review aimed to evaluate the effectiveness of hospital emergency codes—both color-coded and plain-language systems—and security protocols implemented between 2015 and 2025. It also sought to identify their impact on response time, staff preparedness, violence prevention, and patient safety outcomes.

Methods: Following PRISMA 2020 guidelines, five electronic databases (PubMed, Scopus, Web of Science, CINAHL, and Google Scholar) were systematically searched for English-language studies published from 2015 to 2025. Twenty-six empirical studies met the inclusion criteria. Data were extracted and appraised using the Joanna Briggs Institute and CASP tools, with narrative synthesis applied due to methodological heterogeneity.

Results: Evidence indicates that transitioning from traditional color codes to plain-language alerts markedly improved communication accuracy and reduced staff confusion by 25–40%. Simulation-based and interprofessional training significantly enhanced staff readiness, confidence, and decision-making under stress. Implementation of structured violence-prevention standards—such as those introduced by The Joint Commission (2023)—led to measurable declines in workplace-violence incidents and greater staff perception of safety. Key barriers included resistance to change, inadequate funding for continuous training, and absence of standardized evaluation metrics.

Conclusions: Between 2015 and 2025, hospitals adopting standardized, plain-language emergency codes and comprehensive security protocols demonstrated superior preparedness and safety outcomes. Continuous simulation training, interdisciplinary coordination, and policy-driven standardization emerged as critical success factors. Future research should develop validated outcome measures and explore cost-effectiveness and cross-national harmonization of hospital emergency communication systems.