Fire Safety In Hospitals - Causes, Hazardous Materials, Planning, And Management Essay.

An investigation commission was immediately formed by the Government to conduct detailed investigations to identify the causes of the fire, to check on fire safety of hospitals around the country, and the necessity of upgrading hospital buildings to prevent a repeat of similar tragedy in future. 

Question 1:
From review of literature

a)  Elaborate how a fire can break out.

b)  Identify the fire hazardous materials which are commonly found in hospitals. 

Question 2:
a) Examine the planning for fire protection and fire safety design of hospitals, and installation of fire detection and alarm devices which need  to be installed in hospitals .

b) Formulate a framework for fire safety management in hospitals to prevent future fires from happening.                             

How a Fire Can Break Out: Literature Review

Qn. 1 (a) Elaborate how a fire can break out from literature review:

Recent studies have focused on finding out how fires break out. Some of the researches done to explain the root causes of fire include:

According to the Indian Express (2017), faulty electrical systems can potentially cause fire. The online journal outlines how fire raged down part of a private hospital in India. According to the reporter, this was as a result of a short circuit that happened in the first floor of the building. Firstly, smoke was detected, and then fire followed. Furthermore, in such situation, more damage can occur especially if there are no effective evacuation and rescue systems. Jackman (1983) agrees with the notion; pointing at both the faulty and the misused electrical equipment as another source of fire outbreaks.  When the operating levels of such equipment are exceeded, they are likely to blow up in flames and cause fire. He also opines that most fires occur in the wards followed closely by kitchens, store rooms, lavatories and other areas like offices. According to Jackman (1983), fires occurring in the wards are due to the smoking materials which can set fire on the furnishings. This happens when one carelessly throws away such materials. Additionally, overheating of food cooking fat in the kitchens can also cause fire. The laboratory chemicals are as well potential fire risks. Notably, there are some dangerous explosives being used in the laboratory. Improper storage of such chemicals can potentially cause fire.

(b) Identify fire hazardous materials which are commonly found in hospitals

1. Fire hazardous materials include;
2. Office wastes including all used surgical instruments and papers
   leaking gas from faulty gas cylinders
3. Improperly stored generator fuel and oil
4. Carelessly stored laundry materials e.g clothes scattering
5. Overheated electrical appliances
6. Improperly stored laboratory chemicals
7. Smoking materials e.g cigarettes
8. Paper wastes scattered by patient’s visitors
9. Faulty Electric systems and Appliances

The faulty and overworked sockets prevalent in the building have the potential to cause fire (Elitefire, 2015). Normally the electrical systems are designed to operate in a particular level, arrived at after some design consideration. Exceeding the limits by applying more loads especially during renovations and expansion of the hospital building can be disastrous. Additionally, the faulty sockets and loose wire connections pose serious threat to the lives of the occupants, especially the patients whose mobility can be affected as a result of their health conditions. Most fire accidents occur due to explosion caused by electric sparks that result from loose connection. Besides, some electric devices like the transformers require effective cooling. Should this be overlooked, potentially, the heat that is given off is enough to ignite the place.

(x) Specialized Medical and surgical equipments: According to the EliteFire ( 2015), Laser and electro-surgical equipments provide a genuine ignition hazard. Laser emit light energy which carries with it some heat energy.

2. (a) Examine:

(i) Planning for fire protection

Effective planning for fire safety should involve the following:

1. The working condition of the fire fighting equipments should be ascertained on a regularly basis as per the set requirements
2. There should be up-to-date training of staff as per the legal requirements on fire protection
3. Safe handling of hazardous materials during use, transit and storage
4. Performing regular audits to assess the extent of fire preparedness
5. Dispose off all wastes safely and recycle some
6. Ear mark the fire assembly points, evacuation routes and exit points and effectively communicate the same to all occupants.

(ii) Fire safety design of hospitals

Modern hospital facilities have become more complex. The approach for effective design must adopt an integrated systems design; where various systems are examined both at individual and wholesome levels. Therefore, design of fire systems must integrate virtually all systems in a building with near seamless interaction. Moreover, an optimum balance should be reached by various stakeholders. For instance, the intended performance of the building services should not be sacrificed as a result of preoccupation with the building safety.

Identifying Fire Hazardous Materials Commonly Found in Hospitals

(iii) The installation of fire detection and alarm devices

Proper installation of the above is undeniably the first step towards mitigating the accidental fires. In fact, according to technical training (2014), ‘…the installation must ensure that false alarms are infrequent and that a real fire would be detected quickly without damage to property or loss of life’

Hence the following general installation guidelines should be followed:

• The systems should harmoniously integrate with other systems when installed, for instance, should functionally harmonize with the electrical system.
• It should reliably work after installation such that quality workmanship and relevant design be considered before installation.
• It should ensure response of the alarms and detection devices are beyond reproach such that effective and fast response can be achieved.
• The installation location selected should be secured and tamper-proof to avoid incidences of ‘fake fire alarms’
• However, it should be easily accessible to the authorized users hence the strategic locations should be carefully considered by the safety team
• The communication systems of the devices must be effective preferably automatic with manual back-up incase of failure of the former
• Should be user-friendly when being operated manually
• The alarm devices sound being produced must be loud enough to alert persons from all corners of the building and the sound being produced must be a familiar signal to all occupants such they instantly perceive it as a warning for fire break out
• It should also ensure they are insensitive to other uses apart from the intended purpose, that is, to detect and raise alarm  or alert the occupants on the impending danger due to the fire outbreak
• And lastly, the installation process must strictly follow the standard professional procedure as annexed in the installation manual provided and ensure systems maintainability afterwards.

(b) Formulate a framework for fire safety management in hospitals to prevent future fires

Most investigation reports of fire outbreaks have always ended with a chain of causes enlisted and a dozen recommendations cited. Such reports, if examined closely, have often pointed out to the overall system failure to prevent or minimize the risks. Although there are several mitigation measures, the following discussion will attempt to provide a workable framework for managing fire safety with a focus on proactive mitigation:  

The Framework

Fire Safety Policy Team

Firstly, a team among the hospital staff shall be selected to form a Fire safety Policy team. It shall be composed of selected representatives from across all the hospital departments including housekeeping with its team leader being the Hospital Superintendant. Regular trainings shall be thoroughly conducted. Each member of the committee shall under rigorous tests to ascertain their comprehension. Notably, both theory and practical tests shall be issued. The module materials shall be in tandem with the policy and legal requirements of the Malaysian Authority on Management of National Disasters. Mainly, the team’s responsibility shall be to provide policy guidelines on fire assessment, continuous development and implementation of proactive measures and professional training of the fire marshals among others.

One of the roles of the team, as mentioned above, shall be to continuously develop proactive measures on fire mitigation.

The major areas that it shall focus its energy include:

1. Fire Marshals management

The Fire marshals shall be highly recognized as the engine that drives the fire safety policy implementation. They shall be trained on a regular basis, at least once a year. Their main responsibilities shall include:

Performing weekly inspection on the fire safety and evacuation systems. A standardized checklist for all fire and evacuation equipments shall be provided. The inspection report shall be submitted to the Policy team.

Drawing the attention of the Fire safety policy team on any anomalies that arise however small they may be. Standard procedures on correcting such anomalies shall be formulated by the team pursuant to the hospital fire safety policy and Malaysian legal provision on Fire Safety.

On emergency situation, providing rescue assistance by evacuating the patients and visitors and being responsible for fire fighting.

Advising the occupants on the safest routes to follow when a fire emergency occurs. Hence, they must be very familiar with all escape routes in the building.

Performing regular fire drills under the guidance and direction of the safety policy team and

Observing the standardized professional procedures on fire safety drilling, evacuation and systems maintenance.

And any other duty as shall be deemed necessary.

The overall Fire management team(OFMT) shall be composed of:

Planning for Fire Protection and Fire Safety Design of Hospitals

All members of the Fire Safety policy team

All marshals across all departments

2 Secretaries

Patron (who shall be a representative of the National Government)

The OFMT shall meet on semi-annually to review the performance as far as Fire Safety management is concerned.

Lastly, the OFMT shall have its structure as illustrate:

2. Fire systems installation and Maintenance management

By fire systems, we mean all the devices and associated services installed in the hospital premise to detect, monitor, analyze and mitigate fires that break out in any part of the hospital. These include: the smoke detectors, Alarm system, Fire extinguishers, Security systems like CCTV cameras, fire safety, fire fighting gears, visual aids among others.

All these systems shall, on regular occasion, be inspected and maintained by the maintenance department under the guidance of the fire marshals.

The fire marshals shall ensure proper handling of all hazardous materials during transit and storage. Reference shall be made to the legislation on handling hazardous materials

Any fire risk, based on the marshals’ judgment, shall be acted upon to minimize the risk.

Monthly reports on the operational state of these systems shall be submitted to the Safety -Policy team and any recommendation acted upon appropriately.

3. Rescue and Evacuation systems

There shall be a well defined procedure for evacuating and rescuing all patients and visitors.

New workers shall be taken through the Hospital safety orientation before resumption of duty

The Security personnel shall exhaustively do check up in and around the building at all times. New persons getting access to the hospital shall thoroughly be checked and cleared by the security before proceeding into the hospital building.

The entry and exit routes of the hospital shall clearly be marked. It is the responsibility of the fire marshals to ensure that all hospitals workers are familiar with the routes.

All lifts and escalators shall be in a perfect operational state at all times.

During emergency situation, the marshals shall comb through all parts of the building to ensure everyone is rescued.

The visuals aids shall strategically be placed in all parts of the hospital premise. They will be according to the Malaysian standards. An example of the visual aids is the one indicating ‘Fire assembly point’

During evacuation, the marshals shall ensure that the patients are least subjected to stress as their health condition is fragile.

The systems shall be reviewed from time to time by the Fire Policy Team.

4. Building designs including future expansion plans

During design of the building, there shall be provisions included in the designs to exhaustively support the Fire mitigation measures. It shall be upon the engineers to figure out how building services design can be integrated into the Hospital Fire protection Policy.

-During drafting or review of the fire policy, future expansion plans shall be considered and accommodated in the policy.

5. Contingency planning

-There shall be alternative mitigation measures instituted in the policy. For instance, during power outage and generator also not working, and accidentally, fire occurs, how shall the alarm be raised?

-Therefore, it is upon the Safety Policy Team to figure out all possible contingencies and appropriately design a mitigation policy on the same.

Therefore, the above framework provides a clear strategy to proactively deal with all fire risks at the onset. However, it may not be a perfect document hence continuous and regular review is highly recommended.

References

Online journal. (2017). The New Indian Express. Telangana State. Retrieved from  https://www.newindianexpress.com/states/telangana/2017/jan/03/fire-breaks-out-in-vijayawada-hospital-1555711.html

Jackman, F.P. (1983). Fire Safety in Hospital Design.Department of health. Retrieved from: https://www.lenus.ie/hse/bitstream/10147/555656/1/firesafetyhospitaldesign.pdf

EliteFire. (2015). Common Fire hazards for the Health care Industry. London City. Retrieved from: https://www.elitefire.co.uk/common-fire-hazards-healthcare-industry/

Fire Safety.(No date).Fire Safety management and Fire Emergency plan. United Kingdom. Retrieved from:

https://www.ddfire.gov.uk/sites/default/files/attachments/fire-emergency-plan.doc

Fire Emergency Evacuation Plan and the Fire Procedure. Retrieved from: https://www.firesafe.org.uk/fire-emergency-evacuation-plan-or-fire-procedure/

(2014). Technical training Solutions. Waterside court. https://www.technicaltrainingsolutions.co.uk/courses/fire-alarm-installation-course.html