Code White Simulation Learning Framework

Strengthening Safety Through Collaboration & Compassion

In acute psychiatry, safety and compassion are inseparable. Every Code White response reflects not only how we protect, but how we care — for our patients, for one another, and for the integrity of our therapeutic environment.

The Code White Simulation Learning Framework represents our shared commitment to continuous learning, teamwork, and trauma-informed practice. Through scenario-based training, reflective debriefing, and the application of Nonviolent Crisis Intervention (NVCI) principles, we strengthen our ability to recognize early signs of escalation, respond with professionalism and empathy, and recover together as a unified team.

Our goal is not perfection, but progress — to foster a culture where staff feel confident, supported, and psychologically safe while navigating the complexities of mental health care. This work ensures that patient care remains both safe and deeply human.

A Collaborative Initiative Across Western Nova Scotia

The Acute Inpatient Unit at Valley Regional Hospital has initiated an innovative and collaborative approach to Code White preparedness in partnership with Nova Scotia Health Security Services and Paladin Security, including both mental health officers and tactical officers. This initiative reflects a shared understanding that effective crisis response in mental health settings requires strong interdisciplinary coordination, mutual respect, and consistent training.

Following its success at Valley Regional Hospital, this framework has now been shared with the Inpatient Mental Health Unit at South Shore Regional Hospital in Bridgewater and is being introduced to the Inpatient Mental Health Unit at Yarmouth Regional Hospital in May, supporting a broader, zone-wide approach to safety and preparedness.

Purpose & Overview

This approach supports the delivery, evaluation, and continuous improvement of Code White simulation learning and tabletop exercises within acute inpatient psychiatry. Its objectives are to:

• Strengthen team confidence and role clarity
• Reinforce early intervention and trauma-informed care principles
• Ensure safe, consistent, and policy-aligned responses
• Promote reflective learning and continuous improvement

Building a Culture of Safety and Support

At its core, this initiative is about more than simulation — it is about culture. By creating structured opportunities to practice, reflect, and learn together, teams are better equipped to respond effectively while maintaining therapeutic relationships and personal safety.

Equally important is the emphasis on psychological safety for staff. The simulation learning encourages open dialogue, shared learning, and a just-culture approach to performance, ensuring that every team member feels supported in their professional growth.

Acknowledgements

This work would not be possible without the dedication and collaboration of many contributors. Sincere appreciation is extended to the clinical nurse educators, frontline nursing and interdisciplinary staff, psychiatry teams, and senior leadership with the Nova Scotia Health Mental Health and Addictions Program, as well as Security Leadership, Paladin Security leadership and officers, Occupational Health & Safety, the Nova Scotia Nurses’ Union, and most importantly, the patients and families whose experiences continue to shape and inform this work.

Through collaboration, innovation, and a shared commitment to compassionate care, this initiative helps to strengthen both safety and trust across inpatient mental health services in Western Nova Scotia.