How, When and Where a Life Safety Consultant Can Save Your Healthcare Project

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How, When and Where a Life Safety Consultant Can Save Your Healthcare Project

By Megan Headley

For healthcare facility managers (FM) who are able to get involved early on in the construction of facility additions or new construction, one of the biggest areas where they can contribute is by bringing a life safety partner onto the team.

Eric Babcock, director of the New York-Armonk Office for Jensen Hughes, noted in an August blog from the IFMA Health Care Institute that too often healthcare projects go through the early design stages of new facilities or additions without bringing in a code, life safety or any other healthcare specific consultant to review the plans. Often these experts are brought in after a problem is found, at which point the project costs begin to skyrocket.

Brad Keyes, CHSP, owner and senior consultant with Keyes Life Safety Compliance LLC, agrees that a consultant should be brought on as soon as possible on a project. Unfortunately, he agrees, this is not typically the case. “In fact, it is rather rare that a life safety expert gets the opportunity to conduct a peer review of a new design. This can be attributed to tight budgets and the thought process that the design professional will create a design that is compliant with all applicable codes and standards,” he says.

Help Meeting Every Criteria

One reason it’s critical to involve these parties early is that healthcare design is incredibly complicated in terms of compliance, having to meet not just local and national building codes but also meeting compliance with healthcare-specific regulations and authorities having jurisdiction (AHJ).

“From the design perspective, especially for new facilities but also renovations, we find that the architects usually know the building code pretty well but they don’t know the Life Safety Code (LSC) as well,” says Sharon S. Gilyeat, PE, principal at Koffel Associates Inc. “So they’ll tend to comply with the building code thinking that they’re going to comply with the LSC and that is not always the case. In some cases the LSC has additional requirements that they are not meeting.”

Keyes also finds that design professionals don’t always understand just how many AHJs exist in the healthcare arena.

“Typically, the design professional will seek the advice and approval from the state agency in charge of healthcare licensing, but fail to understand that the healthcare institution has to comply with other AHJs, such as CMS, accreditation organization, state fire marshal, local fire inspector and the organization’s liability insurance carrier. The life safety expert usually has the pulse of the interpretations made by many of these other authorities that often times the design professional fails to seek,” he says.

Nicholas E. Gabriele, CFPS, vice president of Russell Phillips & Associates LLC, notes that his company’s longstanding clients get this. Whether it’s a small ED expansion, or a new tower being built, these clients are more willing to bring in the expert early in the design phase—because have found that it does in fact pay to have a life safety consultant on the team to do plan reviews and identify problems early on.

“For new clients, typically we don’t get called until there’s some kind of a conflict between the healthcare authority having jurisdiction and the design and then we’re brought in after well into the construction phase,” Gabriele says.

And these conflicts can be incredibly challenging to solve after the fact.

Challenges with Interfaces

One area where these experts consistently identify issues is in the interface between new and existing facilities. This can lead to challenges with integrating fire and smoke barrier compartmentalization, as well as other fire safety components, but seems to prove particularly challenging in coordinating egress.

“Healthcare facilities are [often] very landlocked, and they’re constantly adding on and adding around the existing infrastructure. As a result the biggest compromise that is made is egress,” Gilyeat says. “Often [designers] are not taking enough time to look at the existing egress and existing building and making sure that they haven’t compromised stair discharge, in particular.”

Gilyeat describes one extreme example. She recalls examining one building several years ago where she went up and down the stairs only to find that the staircase didn’t discharge anywhere. “They put a link in on the first floor and never went back to see how the stair got out,” she says.

Gabriele agrees that the interface between new and existing is often lost on design professionals, adding that this may be because their focus is on the new design rather than the standing project.

“That’s pretty common, with exiting issues,” he says. “An example of that would be a stair tower that today exits through the exterior of the building and we build a new addition up against that building and now [the existing stair] enters back into another building.”

Gilyeat adds that compliance also poses a problem here.

“We’ve seen that architects will often use a concept of a horizontal exit—a two-hour separation that has additional egress benefits. But when they try to do it they don’t always make sure the building is in overall compliance to allow them to use that concept. I have seen so many times where that’s been done poorly or totally wrong, where we have stairs discharging to the interior of the building so they can’t use that concept,” she says.

The Problem with Suites

For new construction, suites seem to pose frequent problems for designers as well.

“It’s very common where suite design doesn’t necessarily meet the LSC and although it meets building codes we end up with issues with the AHJ,” Gabriele says.

Keyes agrees. “It appears that many design professionals do not understand the concept of suites,” he finds. They either design a suite that is too large for the application, or they fail to specify positive latching hardware on the corridor entrance doors to suites.”

Minimize Rework

With any construction project, time is money and rework is money. Building a relationship with a life safety consultant at the earliest possible moment—the design of a new facility or addition—has the potential to save a health system money, keep facilities in compliance with all AHJs, and lead to a relationship that could potentially keep the Facilities Department out of compliance trouble over the long run.

About the Author

Megan Headley is a freelance writer with 10 years of experience writing about the built environment. She can be reached at, or connect with her at

Date: November 5, 2015