Code Lavender is a code used in hospitals and other healthcare facilities to signal a need for immediate help in managing disruptive or aggressive patient behavior. It is becoming an increasingly common practice as healthcare workers face growing rates of workplace violence and aggression from patients and visitors.
What is the purpose of code lavender?
Code Lavender serves several important purposes in healthcare settings:
- It is a discreet way to summon security and additional staff to help de-escalate a tense or dangerous situation with a disruptive patient or visitor.
- It alerts staff to a developing situation that requires immediate backup and intervention before things get out of hand.
- It provides stressed healthcare workers with reassurance that support is on the way.
- It gives staff a collective strategy for safely managing aggressive behavior and reducing risk of injury.
Many hospitals and clinics have instituted rapid response teams that are summoned via Code Lavender to contain disruptive situations. These teams usually consist of security guards, behavioral health specialists, social workers, and senior medical staff who are trained in crisis intervention and de-escalation techniques.
How does code lavender work?
There are a few common ways that Code Lavender can be activated in a healthcare facility:
- The staff member in the room with an escalating patient calls the emergency line and says “Code Lavender” to dispatch the response team.
- The staff member pushes the Code Lavender button on their security alarm transmitter, which triggers a page.
- The staff member calls the emergency operator and gives the code word “Lavender” to mobilize support while avoiding raising alarm from the disruptive person.
Once Code Lavender is initiated, the rapid response team immediately comes to the location to intervene in the situation. They focus on safe containment and aiming to prevent violence or harm to staff and patients. The team uses evidence-based techniques like active listening, empathy, clear limit-setting, negotiation, distraction, and de-escalation questions to try to calm the disruptive person.
| Who activates Code Lavender | How it is activated | Who responds |
|---|---|---|
| Healthcare staff in room with escalating patient situation | Call emergency line and say “Code Lavender” / Push Lavender alarm button / Call operator with “Lavender” codeword | Specially trained rapid response team – security, behavioral health, social work, senior medical staff |
If they are unable to contain the situation safely, the team will clear the area and call for police support. The goal is to resolve the incident without injuries or need for arrests/restraints if possible.
Why is it called code lavender?
The term “Code Lavender” is believed to have first originated at Chicago’s Mercy Hospital in the 1990s. It was chosen specifically because “lavender” is thought to be a calming, pleasant word associated with relaxation. Hearing the term immediately triggers a mental connection to de-escalation and winding down tension.
Other hospitals creating their own Code Lavender-type systems have adopted similar calm, nature-inspired code names like Code Comfort, Code Tranquility, Code Silver (for silver-lining), and Code Purple. The code name itself serves as a subtle cue to staff to breathe deeply and approach the situation with empathy and care.
Code Lavender Color Meaning
The lavender flower is also associated with wisdom, grace, calm, and healing. In color psychology:
- Lavender represents balance, soothing energy, spirituality, and tranquility.
- The purple shade is thought to slow down heartbeat and lower blood pressure.
- Lavender is strongly connected to reduced anxiety and peaceful sleep in aromatherapy.
Knowing these calming attributes of lavender, it makes sense hospitals chose it as the code word to de-escalate agitation and restore peacefulness in a crisis situation.
What are the benefits of using code lavender?
Adopting a Code Lavender protocol has shown many benefits for hospitals and clinics, including:
- Safer work environment – Gives staff a discrete way to call for aid and prevent violence/harm.
- Reduced staff injuries – Trained teams are skilled at safely diffusing aggressive behavior.
- Increased preparedness – Designated responders regularly drill and refine techniques.
- Earlier intervention – Issues are addressed before escalating to critical levels.
- Decreased restraint use – Emphasis is on verbal de-escalation over physical interventions.
- Improved care quality – Disruptions are resolved so staff can focus on delivering good care.
- Higher patient satisfaction – Conflicts are handled professionally and humanely.
- Lower staff burnout – Employees feel supported in volatile situations.
Implementation of Code Lavender aligns with hospitals’ goals to deliver safe, therapeutic, and patient-centered care. Assisting staff during behavioral emergencies promotes morale, resilience, and retention.
Decreased workplace violence
Code Lavender is especially critical to combat increasing rates of violence against healthcare workers. A recent study found:
- 44% of nurses reported being physically assaulted at work.
- 68% reported frequent verbal abuse from patients.
- Only 30% felt their workplace responded adequately to safety concerns.
Code Lavender protocols demonstrate an organization’s commitment to reducing unacceptable abusive and aggressive behaviors. Backing up staff during conflicts can curtail violence-related turnover and absences.
Improved patient outcomes
Getting disruptive situations under control quickly also benefits patients. Unmanaged behavioral emergencies can impede delivery of appropriate medical care. Other patients can experience distress when witnessing acts of aggression in healthcare settings. Code Lavender promotes a therapeutic environment to optimize care and healing.
What types of situations warrant code lavender?
Code Lavender is intended for use during any behavioral emergency involving threatening, frightening, or violent words or actions. Specific situations where Code Lavender may be activated include patients or visitors who are:
- Yelling, screaming, or verbally abusive
- Throwing objects
- Making physical threats
- Striking or attacking staff
- Under the influence of drugs/alcohol
- Delusional or hallucinating
- Self-harming
Code Lavender calls are appropriate anytime staff feel unsafe and require urgent assistance to regain control. It mobilizes help to prevent disruptive situations from escalating into more dangerous territory.
Calling a Code Lavender
However, Code Lavender should only be activated as needed for serious incidents. Calling a Code too frequently can dilute its impact and effectiveness. Healthcare workers are trained to distinguish routine non-compliant behavior from truly aggressive or threatening actions necessitating Code Lavender response.
Many facilities set behavioral emergency policies guiding when to call a Code Lavender based on the level of escalation. This helps staff make objective decisions in tense situations. For example, codes may be categorized as:
| Level 1 | Level 2 | Level 3 |
|---|---|---|
| Situational anxiety or non-directed verbal outbursts | Escalating agitation and verbal aggression | Imminent or actual violence/danger to others |
| Standard de-escalation techniques | Call for Code Lavender team | Emergency lockdown procedures |
Code Lavender is specifically called for Level 2-3 disturbances involving heightened risk of harm that require rapid intervention.
How should staff respond to code lavender?
When Code Lavender is announced, staff not directly involved with the escalating patient should:
- Pause any non-urgent tasks and prepare to assist if called upon by the Code Lavender team.
- Redirect other patients and visitors away from the area where the code is occurring.
- Clear hallways and paths so response teams can access the site.
- Monitor exit points to ensure safety as the incident is addressed.
- Provide information to Code staff as requested about the patient/location.
- Reassure and update other patients and visitors that the situation is under control.
- Resume regular duties once the Code Lavender response is complete.
Staff are instructed not to rush to the scene or intervene in a Code Lavender event unless directly called. Only the trained rapid response team should manage the emergency due to their expertise in safe crisis containment.
After Code Lavender
After the incident is resolved, there should be debriefing, counseling, and follow-up support offered to any staff who were involved in or impacted by the event. Code Lavender response protocols should be reviewed to identify any opportunities for improvement or additional training needs.
How are staff trained on code lavender response?
For Code Lavender policies to be effective, thorough and ongoing staff training is crucial. Recommended education includes:
- All staff: Awareness of Code Lavender procedures, their role, who activates/responds, and proper response.
- Direct patient care staff: Identifying escalating behavior, when to call a Code, and basic de-escalation techniques.
- Code Lavender team members: In-depth crisis intervention and de-escalation training specific to their role.
- Leadership: How to support, implement, monitor, and reinforce the Code Lavender program.
Training should utilize role-plays and simulations of realistic Code Lavender scenarios. Refresher courses help keep protocols sharp. Proper training ensures smooth and effective responses when disruptive events occur.
Staff training methods
Recommended techniques for teaching Code Lavender response include:
- Classroom/online instruction about policies, procedures, responsibilities
- Discussion of case studies and example situations
- Role-play practice and walkthroughs
- Simulations with actors to rehearse live responses
- Observational learning (watching others model techniques)
- Ongoing refreshers, skills practice, and drills
The more hands-on application involved through role-plays, simulations, and drills, the better prepared staff will be if an actual Code Lavender arises. Training helps ingrain appropriate responses until they become second nature.
| Training Method | Description |
|---|---|
| Classroom/online learning | Lectures and materials teaching Code Lavender policies, procedures, responsibilities |
| Case study discussion | Review examples of situations that warrant Code Lavender response |
| Role-plays | Practice and walk through Code Lavender protocols |
| Simulations | Use actors to create realistic practice scenarios |
| Observation | Watch others model proper Code Lavender responses |
| Refreshers & drills | Regularly rehearse skills to reinforce learning |
Examples of how code lavender has been implemented
Many types of healthcare settings have adopted Code Lavender systems to improve staff and patient safety during behavioral emergencies. Here are a few examples:
Hospitals
- Yale-New Haven Hospital uses Code Lavender to mobilize specially trained personnel called Treat, Address, Carry through, and Handle (TACH) teams.
- Nebraska Medicine has Code Lavenders for threats of self-harm called White Lavenders and threats of external violence called Purple Lavenders.
- Tampa General Hospital dispatches Code Lavender responders trained in trauma-informed de-escalation.
Outpatient medical clinics
- Scripps Health Clinic implemented Code Lavender with posters reminding staff what to listen for, say, and do during escalating situations.
- FamilyCare Health centers use Code Lavender buttons or lavender wristbands to silently signal need for aid.
- Children’s Hospital of Orange County’s clinics trained “Safety Champions” as Code Lavender responders.
Behavioral health settings
- Montefiore’s children’s psychiatric ER uses Code Lavender to get additional staff to manage agitation and aggression.
- Menninger Clinic has a Threat Management Team mobilized via Code Lavender that provides stabilization techniques.
- Seattle Children’s Autism Center classifies levels of escalation to guide Code Lavender response.
Long-term care facilities
- Enlivant senior care facilities train all staff to utilize Code Lavender for any unpredictable resident behavior.
- Asbury Communities senior living uses Code Lavender to support staff managing dementia-related behavioral issues.
These examples demonstrate how Code Lavender can be customized across different healthcare settings while achieving the same goals of preventing harm and restoring safety when disruptive events occur.
Conclusion
Code Lavender is an increasingly prevalent practice in healthcare facilities for addressing disruptive or aggressive behavior while protecting staff and patients from harm. Implementing Code Lavender requires training staff on recognizing escalating situations, activating the alert, and properly responding as the incident is handled by specialized teams.
When used correctly, Code Lavender allows early intervention to de-escalate conflicts through safe crisis containment protocols. This system benefits healthcare organizations by reducing workplace violence, improving care quality, supporting staff wellbeing, and creating a more therapeutic environment.
The calming purple hue and associations with lavender promote a holistic approach emphasizing de-escalation over restraints or arrests. Overall, Code Lavender protocols enable healthcare staff to deliver safer care with lower risk of adverse events.