LEBANON — Alert, alert: the familiar “code red” emergency announcements broadcast over Dartmouth Hitchcock Medical Center’s public address system and long familiar to viewers of TV hospital dramas is now 10-7 (“out of service”).

Effective today, DHMC will drop the color codes over the hospital’s PA system that alert staff and visitors of facility emergencies and instead adopt a “plain language” format in order to make them more easily understood among staff, patients and visitors.

“We’ve been looking at how employees and the public become aware of situations at the hospital that they may need respond to,” said Catherine Garfield-Lagare, administrative director of Dartmouth Health Children’s and member of the committee that reviewed the emergency code system. “Plain language has become recognized, especially in health care, as very important.”

The changes mean the color coded emergency alerts like “code red” that are well known to viewers of Grey’s Anatomy, and which DHMC and other hospitals have used for decades on their PA system will be replaced with briefly worded descriptions of the nature of the specific emergency — several which, perhaps not surprisingly, reflect the social pathology of our time.

Under the new system, Code Red becomes “facility alert, fire;” Code Amber becomes “security alert: infant/child abduction;” Code Purple becomes “facility alert: mass casualty” and Code Black becomes “security alert: bomb threat.”

Also, a new category has been introduced: “security alert: missing person,” to be used to alert about adult patients who may have wandered off or gone missing while on the DHMC premises.

(DHMC four years ago “retired” Code Silver, previously used to denote an active shooter or uncontrolled person situation, and replaced it with the alert “security alert: active shooter” or “security alert: disruptive person”).

Garfield-Lagare said a review of DH’s audio broadcast system began a year ago in conjunction with the New Hampshire Hospital Association’s and Granite State Health Care Coalition’s call for all hospitals in the state to adopt a universal plain language emergency announcement format to replace the traditional color code system.

“The majority of hospitals in the state have gotten on board with this program and we are doing it at Dartmouth Health across our entire system, all of our clinic locations,” Garfield-Lagare said.

Contrary to popular belief, emergency codes used by police and hospitals are not uniform nationally and can vary even by locality, although there is general conformity among the most-used codes.

Still, Garfield-Legare said that the color codes of some New Hampshire hospitals differed among each other and that presents a challenge for employees, patients and visitors alike.

“Code red is pretty consistent for ‘fire, facility alert,’ but not everyone was using code amber. Sometimes it was code pink,” she said, adding, especially as staff shuttles among locations in the DH system, “it is important for employees who are moving from one facility to another to have consistency.”

Two codes, however, are not switching over to the plain language format: code blue and code white, signaling “clinical emergencies” and broadcast to hospital staff on their pagers, will remain unchanged.

“Those codes don’t go out over the public address system and staff know what they mean,” Garfield-Legare said.

The use of direct, plain language to alert about emergency situations may unnerve some people, Garfield-Legare acknowledged. But she said the benefits of transparency outweigh the risks in panic, she said.

“We considered this as did the state group working on it,” Garfield-Legare said. But, she explained, it would “not be fair to our patients to not understand what’s going on if they see people running.”

More important, plain language as to the nature of the emergency might make people more attentive to instructions about where to go and what to do “rather than asking ‘what does that color mean?’ ” Garfield-Legare explained.

Contact John Lippman at jlippman@vnews.com or 603-727-3219.

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