Evacuation to an Adjoining Building

Q: Our fire plan says if there were ever a fire in our hospital, we would evacuate our patients horizontally to the other side of the smoke barrier. It then goes on to say that if further evacuation is ever required, patients would be taken down a stair located on the other side of the smoke barrier. Once in the stair, patients would be taken to at least 2 floors below the fire floor. Some floors in our hospital connect with another building. My question is: Instead of moving patients down the stairs in the hospital, can we move patients horizontally into another building separated by a 2 or 3 hour fire rating? People have different opinions on this. Some say it’s a good idea to move into a different building because you don’t want to move patients down the stairs, while others say you should always stay in the building and evacuate using the building’s stairs because once you’re in the stair, you’re in a 2-hour fire rated enclosure anyway. Does NFPA reference/requirement on this? If not, what would you recommend?

A: I’m not aware of any reference in the NFPA codes or standards that discusses the virtues of evacuating into another building, but I know it is done in many other hospital organizations. I think it is always best to continue to evacuate horizontally if you can, rather than vertically down a set of stairs. If you’ve ever been involved in a training event where simulated patients were used to evacuate down the stairs, you will quickly agree that should be the last resort.

For those individuals who say you should stay in your own building and evacuate down the stairs, I would respond saying why? What advantage is there? Yes, the stairwell does provide a certain level of safety from the fire (i.e. a 2-hour barrier), but so does the 2-hour occupancy separation (or 2-hour building separation) that an adjoining building offers. For those who say you should never take inpatients into a non-healthcare occupancy, I say poppycock! (My English grandfather used to use that word a lot). A fire event is an emergency and during an emergency you do what is best for the patient.

Change your policies if they say you don’t evacuate horizontally into an adjoining building, but rather down the stairs. You do what you have to do during an emergency. It is assumed that the evacuation of an inpatient into an adjoining building that is not healthcare occupancy would be for a short period of time. The patient may still require a certain level of care that may not be provided in an ambulatory healthcare occupancy or a business occupancy. In those cases, the patient should continue be evacuated to a location where they can be cared for.

And don’t forget the elevators. While elevators are not permitted as a required means of egress, they can be a secondary means of egress, provided the elevator is not actively involved in the fire. Find an elevator away from the fire (even if it is in an adjoining building) and use the elevator to evacuate patients.

Brad Keyes
Brad Keyes, CHSP

Brad is a former advisor to Healthcare Facilities Accreditation Program (HFAP) and former Joint Commission LS surveyor. He guides clients through  organizational assessment; management training; ongoing coaching of task groups; and extensive one-on-one coaching of facility leaders. He analyzes and develops leadership effectiveness and efficiency in work processes, focusing on assessing an organization’s preparedness for a survey, evaluating processes in achieving preparedness, and guiding organizations toward compliance. 

As a presenter at national seminars, regional conferences, and audio conferences, Brad teaches the Keyes Life Safety Boot Camp series to various groups and organizations. He is the author or co-author of many HCPro books, including the best-selling  Analyzing the Hospital Life Safety Survey, now in its 3rd edition. Brad has also authored a variety of articles in numerous publications addressing features of life safety and fire protection, as well as white papers and articles on the Building Maintenance Program. Currently serving as the contributing editor of the monthly HCPro newsletter Healthcare Life Safety Compliance  gives Brad further insight into the industry’s trends and best practices.