You may feel your facility is above par when it comes to fire safety standards. But is it? The Joint Commission recently released its annual “Most challenging requirements for the first half of 2014.” In the hospital section, two of the five requirements most frequently identified as “not compliant” in surveys completed in the first half of this year, had to do with fire safety. Fifty-two percent of surveyed hospitals were shown to be not compliant in maintaining the “integrity of the means of egress” (i.e., blocked doors, too many pieces of equipment in hallways, etc.) and 50 percent were not compliant in maintaining “fire safety equipment and fire safety building features.” These are serious infractions that severely compromise the safety of everyone in the hospital.
A study released by the New York City Fire Department reported that between 2004 and 2006, healthcare provider facilities nationally averaged 6,400 fires a year, with those open 24 hours a day accounting for 89% of the incidents. The fires caused five civilian deaths, injuries to 175 people and about $34 million in annual property loss.
That is a high price to pay, given the ability to avoid both the injuries and the loss of property through various mitigation strategies. The bulk of the estimated 550-650 surgical fires per year are entirely preventable, according to an interview with Mark Bruley, vice president of accident and forensic investigation at the patient-safety organization ECRI Institute.
Knowing what to do in the event of a fire in a healthcare environment can save numerous lives and prevent the destruction of millions of dollars of equipment. Additionally, prevention can reduce insurance claim costs, insurance premium costs and exposure to unwanted lawsuits.
Fire drills are a critical component of fire risk mitigation; however, due to the difficulty of holding fire drills in a healthcare setting, they are a rare occurrence. In a facility, a comprehensive approach is required—one that works within the confines and limitations of healthcare. Structuring your staff training, reviewing policies, performing internal audits and, yes, conducting fire drills, all are crucial practices for fire risk management and reduction.
The Role of Management of Change
Hospital buildings are designed to isolate and contain fires, so that people can remain inside the building for the duration of a fire. Fire-proof zones and rooms are crucial to maintain, as the lack of patient mobility makes evacuation extremely difficult and time consuming. The consequences of compromising fireproof walls and areas can be extremely dire. According to Modern Healthcare, information technology departments cause most fire barrier breaches when running new wires and cables. Comprehensive management of change procedures are crucial to eliminating this source of risk, followed by routine inspections and audits.
Learning from the Past
Hartford Hospital in Connecticut was the site of the deadliest hospital fire in America since 1960, when 16 people perished after smoldering cigarette ash went down a trash chute, causing a multi-story flame pillar. This tragic incident and the subsequent investigations led to the majority of current hospital fire codes and regulations.
State-wide changes stemming from the Hartford fire are the banning of trash chutes and the implementation of fire sprinkler systems. Minimizing mobile equipment which sits in hallways or may be left in front of escape routes are also policy-based changes. Design-based fire risk mitigation regulations include a maximum dead-end corridor length of 30’ and fire zones requiring at minimum a horizontal and a separate vertical exit. Similar standards now exist throughout the country.
Current Fire Safety Challenges
Oxygen, rubbing alcohol for surface preparation and electro-cautery devices used in surgery combine to create all of the elements needed for surgical flash fires. Reductions in the use of oxygen and changes in method of oxygen delivery effectively mitigate this risk.
The widespread use of magnetics, particularly in imaging, create firefighting complications. Virtually all regular fire extinguishers are metal and the force of an operating MRI would pull the fire extinguisher across the room with great force. Accurately and appropriately placing appropriate fire-fighting equipment throughout the facility is essential for fire safety in the healthcare setting.
Fire Safety Training
Hospital staff, volunteers and professional visitors need to know what to do in case of a fire. Fire safety training is essential to ensuring that everyone will competently perform what’s required of them. In some cases, that may be nothing more than safely removing themselves from the facility, allowing trained staff and firefighters to focus on the safety of the patients.
Through Reptrax University, part of the ReptraxTM vendor credentialing service, professional visitors can learn the types of fire hazards commonly encountered in the healthcare environment, the information necessary to prevent fire and the steps to take in case of fire. Other groups within the hospital from medical staff to volunteers can have their training monitored through IntelliCentrics , the first all-in-one credentialing and privileging service.
With the proper fire safety protocols and training, your facility can create a safer and more secure environment for patients and staff. It’s been over 50 years since the Hartford Hospital fire, let’s work together to ensure that the tragedy is the last of its kind.