Safety management is a very important aspect of planning in every form of infrastructure. Safety management as a whole include aspects of not only fire safety, but also security measures in terms of safety from other unsafe encounters like thefts, pilferages, extortion, riots, natural calamities, etc. Safety measures should be so designed to ensure safety of all services renderers, service recipients, infrastructure (property, other fixed assets), etc. However lets focus on one major aspect of safety management & i.e. Fire safety.
Fire can cause irreparable losses, particularly to any hospital. Hospitals are infrastructures with a high density of life in terms of patients, doctors, staff, etc. Therefore utmost care needs to be taken and precautions followed to imbibe good safety measures & practices amongst planners, employees & healthcare workers in any hospital.
The hospital as an infrastructure has many heat dissipating equipments, combustible gasses /fuel, chemicals, a lot of electrical wiring, etc. that stand as prone to hazardous incidents, if proper precautions not taken while planning the infrastructure.
Adequate measures need to be considered, designed and practiced to ensure safety to all. Indicators like architectural designs, interior designs, electrical wiring, appropriate equipment planning and proper waste management are considered while planning such safety measures.
Architect & Layout Planner:
While planning the layout, care should be taken to design the building such that there is sufficient open space around the building to minimize fire spread possibilities from or to neighboring structures. Also there should be enough space for movement and parking of fire fighting vehicles, ambulances, etc in the premises.
The design & construction of every building structure should incorporate features of prevention of fire & fire loss:
Considering the type & density of occupancy, lobbies, staircases, aisles, etc should be sufficiently wide to ensure easy movement of traffic at all times and at the same time to permit easy and orderly evacuation during emergencies.
- The design of the building structure should be so planned that it allows pressurized exclusion of smoke in case of fire or any smoke leak.
- Adequate emergency rescue aids and suitable refuge area should be incorporated in the design. The critical areas should be well protected with such measures and extra precautionary measures should be implemented in such critical areas, for e.g.: use of fireproof doors.
- Ideally a heavy-duty elevator especially for use of fire fighting personnel only & used in case of emergency only should be incorporated.
In addition to the above the planner also needs to incorporate the following:
- The building should be so designed that it can resist damages due to earthquakes to a fair extent.
- Safe & easy means of access should be provided to and in every place of work /occupancy. This should enable access to all including the disabled to move easily.
- In case of an emergency safe and rapid egress should be provided for all occupants.
- The floor should be so designed that they are free from obstructions, slip-resistant & even. Openings in floors should be securely fenced or covered
- Staircases, ramps & aisles should be provided with substantial handrails and other suitable support means to prevent slipping, wherever necessary.
- Easy access for the servicing and maintenance of plant, machinery and buildings should also be incorporated in a design.
- The "National Building Code of India, 1980 issued by the Indian Standards Institution serves as an excellent references to safety management for infrastructures.
- The Tariff Advisory Committee Of the General Insurance Industry &The Metropolitan City Government Authorities recognize fire hazards with large buildings and have developed rules and regulations for fire protection & fire fighting requirements in large buildings.
- Architects, layout planners, interior designers & construction authorities need to follow these rules and regulations diligently.
Interior Designer & Electrical and Engineering (Plant & Machinery) Planner:
The interior designer needs to keep in mind to incorporate the environment safety measures, the clean green ambience & comfort levels for the occupants of the infrastructure especially the patients here. Indicators like adequate natural light, fresh air and color therapy need to be considered in such designs. The designs should be such that there is minimal use of combustible materials. The designs should use plenty of good quality fire retardant material for furnishing & decoration purposes. Appropriate waste management systems also need to be designed to prevent accidents due to hazardous waste.
- For electrical wiring designs and plant & machinery designs:
- The electrical wiring could be enclosed in metal/ heavy gauge screwed conduits.
- The cable passing from one floor to the other should be suggestively sealed off effectively to minimize fire-spread possibilities.
- A master control switch for each floor should be located at the ground floor for easy switching off of systems in case of emergency.
- It is highly advisable to use individual air conditioning or space heating systems for each floor in large buildings. However in case of centralized systems that we generally use in hospital infrastructures; care should be taken to provide appropriate automatic fire dampers for each
- floor in the common ducting system.
- Proper cooling facilities to dissipate heat should be provided for over heated equipments/ plants/ machinery.
- Boilers, Plant rooms, Freezers, manholes and similar confined spaces should have effective means to ensure safe access & exits.
- All equipments should be bonded and earthed properly to dissipate the static charges to the earth.
- Incorporate totally enclosed switchgear systems/ miniature circuit breakers instead of ordinary fuses.
- Always an emergency power supply arrangements need to be designed & incorporated in case of total system switch-offs during emergency.
- Appropriate fire fighting equipments, fire detection, smoke & heat detection alarms should be incorporated in the design.
- The fire fighting equipments should be planned as per quality standards & norms.
Safety Practices:
- Finally after taking adequate precautionary measures in the conceptual & design stage itself there is a need to implement safety measures & protocols in the infrastructure:
- Prepare a guideline manual to be followed by all the staff for prevention & precautions against fire & related accidents.
- A manual stating actions/steps to be taken in case of emergencies should be effectively designed and followed stringently by all.
- The staff should be trained to handle such emergencies & chaotic situations.
- The organization should call for regular safety audits & drills so as to train the staff effectively.
- The fire audit survey should be conducted as per standard norms and the changes if any should be implemented diligently.
- Appropriate delegations of tasks should be implemented for safety management protocols.
- Preferably a head/supervisor should be designated to look into the safety measures of any infrastructure.
The above stated indicators & guidelines are only some of the vital tools & protocols considered for fire safety management. There are many more protective measures & safety norms to be implemented & practiced for proper safety management. For e.g.: Implementation of electrical wiring as per ISI standards, etc.
To conclude, safety for all is a responsibility of all. It is not only the staff of the hospital but also the occupants. However it becomes more important for the healthcare service renderers to follow all precautionary measures for effective safety management of self & the infrastructure, especially the patients. We have come across so many instances where in there have been casualties in terms of injuries & loss of life of patients in a hospital in the advent of fire & inadequate measures taken thereof or as a result of untimely help. Hence it is of high importance that the staff is well trained and equipped with knowledge & preliminary equipments to handle such calamities. Further it becomes necessary for every planner to take all the precautions & consider all safety management protocols and incorporate them in the design of the infrastructure especially for an hospital infrastructure; where care, safety & well being of mankind is of utmost importance.
