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April 12, 2026American Journal of Medical Quality0 citationsOpen Access

Disproportionate Use of Security Response Codes on Black Patients in a Quaternary Academic Center

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EMEmily MitchellRWRavneet Kaur WaraichSGSophie Goldman

Key Points

  • The aim is to explore the demographics and utilization of security emergency response codes in an academic hospital setting, particularly focusing on racial disparities.
  • Conducted a retrospective chart review of adult emergency department and inpatient encounters from January 2022 to July 2023.
  • Calculated age-adjusted standardized event ratios for different racial categories.
  • Compared utilization of security emergency response codes across racial groups using standardized rate ratios.
  • SERCs were recorded in 411 encounters across 60,957 eligible cases, with a higher frequency observed in Black patients.
  • The standardized event ratio for Black individuals was 1.66, notably higher than white individuals (0.98) and individuals of other racial groups (0.82).
  • The standardized rate ratio indicates a 70% higher event rate for Black patients compared to white patients and a 202% higher rate compared to other racial groups.

Abstract

Hospitals use security emergency response codes (SERCs) to manage security threats. This study explored the demographics of SERCs in an academic hospital setting in the Pacific Northwest. A retrospective chart review of all adult emergency department and inpatient encounters between January 2022 and July 2023 was performed. Age-adjusted standardized event ratios were calculated for each racial category and compared using a standardized rate ratio (SRR). Among the 60 957 eligible encounters over the study period, 411 SERCs occurred across 273 (0.45%) encounters. Compared with the demographics of all hospital encounters, SERCs occurred more frequently with patients who were male (n = 2313, 76.2%), English-speaking (n = 402, 97.8%), and younger (18-70 years old, n = 331, 80.6%). A total of 348 SERCs occurred among white individuals, 34 among Black individuals, and 29 among individuals of other racial groups. The age-adjusted standardized event ratio was 1.66 for Black individuals, 0.98 for white individuals, and 0.82 for individuals of other racial groups. The SRR (Black vs white) was 1.70 (95% CI, 1.20-2.40; P = 0.003), indicating a 70% higher standardized event rate among Black individuals compared with White individuals. The SRR (Black vs other racial groups) was 2.02, indicating a 202% higher standardized event rate among Black individuals compared with individuals of other racial groups. This study demonstrates disparities in the frequency of SERC utilization against Black patients. Further investigation into the etiologies leading to SERCs and improved mechanisms of SERC tracking should be undertaken.

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Cite This Study

Mitchell et al. (2026) studied this question.

synapsesocial.com/papers/69db38534fe01fead37c69e8https://doi.org/10.1097/jmq.0000000000000305
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