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

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.