A Basic Guide to Life Safety in Health Care Facilities

Jun 28 2023

By: Jeff Schmidt

Lobby/check in area at Eastowne Medical Center.

Safety is a critical component in the design of any health care facility.  

Life safety requirements are designed to provide a reasonable degree of safety from fire and emergencies for all occupants of a facility. All health care settings must keep their life safety plans up to date to help prevent fires and the spread of fires throughout their facilities. Although life safety design cannot guarantee that fires will not occur, it can help ensure the users can exit the building as safely as possible during a fire.  

What Makes Life Safety Unique in Hospitals Compared to Other Facilities?

Unlike office buildings or apartment complexes, hospitals can defend-in-place in the event of a fire. Since many patients inside a hospital are incapable of self-preservation, the design of a hospital allows users to safely move away from the fire without having to leave the hospital if it is not necessary.  

The walls and doors inside of a hospital have specific ratings designed to prevent the passage of smoke and fire, enabling providers to move their patients to a different smoke compartment until emergency responders arrive. Hospitals are divided into different smoke compartments and in the event of a fire, users can safely move through different smoke compartments or evacuate the building until the fire has been extinguished. 

“In a typical office building, people will exit directly outside of the building in the event of a fire. Since some patients inside of hospitals are incapable of leaving by themselves during an event, it is important that we design hospitals so that users can defend-in-place until the fire has been put out.”
— Jeff Schmidt, MHAworks Project Manager

Common Violations in Health Care Settings

A few common life safety violations found in health care settings include:

1. Obstruction of Corridors and Doorways

One of the most common life safety violations in health care settings is obstruction of corridors and doorways. Leaving things in walkways and doorways such as boxes or carts can obstruct the pathway and make it difficult for people to exit in the event of an emergency. Being cognoscente about what items are in the corridors and finding better solutions to store these items will help solve this issue.  

2. Improper Closure of Doorways

Leaving doors propped open is another common life safety violation found in health care settings. If a door is left open, it allows a fire to further spread throughout the facility. Reminding staff to keep doors shut after opening them and avoid propping the doors will help slow the spread of fire if it occurs.  

3. Improper Storage of Combustible Items

Storage rooms in hospitals are designed to safely hold the equipment designated to each storage room. Combustible materials such as bed sheets, personal protective equipment (PPE), paper hospital gowns, and other flammable materials need to be stored in spaces with high wall and door ratings. Storing these materials in rooms that are not designated storage rooms, such as unused offices, poses a fire hazard because the rooms are not designed with highly rated materials.  

Nurses station.

Our Assessment Process

Our firm has performed life safety assessments and maintained life safety drawings for many of North Carolina’s major health systems and private practices. Below is our typical assessment process: 

1. Collect Previous Drawings and Building Plans

The first step for any life safety assessment is to collect any previous drawings and building plans that have already been developed for the facility. Designers can learn a lot about a building from these existing documents and can use them as the foundation for their assessment.  

2. Field Investigation to Verify Building Layout

Once previous plans have been acquired, the team will walk through the facility to verify that the layout identified in the plans matches the current layout of the facility. Any updates to the layout of the building, such as changes of room number and names, renovations, and additions to the space will be noted and added to the new drawings.  

3. Note Current Conditions

During the assessment, designers will look at all fire safety aspects of the facility including the wall ratings, exit signs, and fire extinguishers to ensure that each of these features are up to building code. Any code violations will be noted for the final plans.  

4. Produce New Plans

Updated life safety plans will include information on all life safety features inside the building including:

  • Exit passageway corridors  
  • Distance between exits  
  • Travel distances 
  • Common paths of travel 
  • Suites 
  • Wall ratings
  • Exit access corridors
  • Smoke compartments 
  • Occupancy types 
  • On grade building exit locations  
  • Vertical exits and occupancy load  
  • Horizontal exits 
  • Hazardous storage
  • Elevators 

How Often Should Life Safety Plans be Updated?

Life safety plans are “living documents,” meaning they should be constantly updated as the facility is renovated, reconfigured, or expanded upon. Any update to the facility should be added to the life safety plans as soon as construction is completed. 

The Advantages of Hiring a Qualified Architect

Hiring an architectural firm with extensive experience designing health care facilities and conducting building assessments is the best way to ensure that facilities are safe and up to code. An experienced firm will be well-versed in current building codes, spotting deficiencies, and producing smart design solutions that are cost-effective, minimally disruptive to patient care, and take the entire building and its systems into account.  

Why is it Important to Use the Same Architectural Firm to Complete Assessments and Keep Life Safety Drawings?

Using the same architectural firm to complete assessments and maintain life safety drawings is a wise practice if possible. This firm will not only know building codes and regulations but will be an expert in the facility’s layout.  

“Using the same architect has a host of positive benefits. For some of our long-term clients, we [the architect] know their building so well that we could navigate it in our sleep.”
Jeff Schmidt

Project Spotlights

Mission Health System Life Safety Compliance

Asheville’s Mission Hospital hired MHAworks to conduct field surveys of the current conditions of the main hospital buildings and the St. Joseph’s campus and to update Mission’s life safety plan to match current standards. 

MHAworks partnered with McKim & Creed to conduct surveys of more than 2 million total square feet of Mission’s campus. The survey considered all the interior building elements designed to protect and evacuate the building in the event of an emergency including exit signs, fire alarm pull stations, extinguisher cabinets, fire hose cabinets, fire department valves, door ratings, and building exit widths. After the surveys were completed, new smoke and heat detectors were installed, and the design team crafted new plans and drawings for multiple buildings on Mission’s campus. 

UNC Hospitals Assessments, Base Plans, and Life Safety Plans

Over the last 35 years, it has been MHAworks’ job to assess, document, and renovate UNC Hospitals’ complex facilities. To date, we have completed more than 1,500 projects on campus. We have provided overall studies including space management plans, plumbing fixture count documentation, occupancy documentation, suites documentation, exit signage documentation, and room numbering documentation. We also maintain base plans, life safety, occupancy, and plumbing fixture drawings for the entire UNC Hospitals’ campus.  

Projects for UNC Health always consist of a thorough site review of walls, doors, and ceilings, and mechanical, electrical and plumbing (MEP) systems and life safety. During design, careful consideration is given to how to phase the project. Since almost every project involves continued occupancy of the space, the design must incorporate a comprehensive approach as to how the walls can be modified and how the MEP systems can be modified while occupied spaces stay in operation. Life safety standards must be maintained throughout renovation. Many program functions have been required by code to be maintained throughout the renovation. Many program functions have been required by code to be maintained and therefore must be temporarily relocated while various projects are under construction.