School of PE Blog

Fire protection systems and egress requirements are an important consideration for all types of building projects, but they are especially important for healthcare projects. In healthcare facilities, occupants of the building may be unable to egress the building without assistance from another person. Additionally, the importance of maintaining operations of a healthcare facility is often much greater than for other building occupancy types since patients rely on the continued functionality and operation of building systems for their health and safety. Therefore, project team members should understand the design requirements for the facility's fire protection systems, both active and passive, as well as egress requirements for this type of project. Proper ongoing maintenance of the building's fire protection systems and the education of staff for the prevention of fire hazards is also necessary once the building construction has been complete.

In designing fire protection systems, it is important to understand and follow the codes and standards which have been adopted in the particular jurisdiction in which the project is located. These may include the International Building Code, the International Fire Code, and the NFPA standards. When determining requirements related to life safety, it is necessary to determine the occupancy classification by code. The IBC, which is the model building code for most jurisdictions in the United States, provides a description of each occupancy type in Chapter 3 of the code. Depending on the specific uses with a particular healthcare project, the building occupancy may be determined. Some uses, such as outpatient offices where occupants are capable of self-preservation, may be classified as Business occupancy. Business classification also includes outpatient clinics as well as ambulatory care facilities (which have their own set of particular requirements within Chapter 4 of the code). Within the Institutional Group are sub-groups, specifically I-1, I-2, I-3, and I-4. Group I-1 includes uses such as 24-hour assisted living facilities, alcohol and drug centers, and social rehabilitation facilities. The individuals within these settings would need to be either capable of responding to an emergency on their own or with limited assistance. Group I-2, by contrast, includes 24-hour medical facilities where occupants are not capable of self-preservation during an emergency. This would include hospitals, nursing homes, and psychiatric hospitals. Groups I-3 and I-4 are less related to discussions of healthcare, being related to security facilities such as prisons and daycare facilities, respectively. It should be noted that NFPA classifications differ somewhat and should be reviewed when the NFPA standard must be followed. The IBC I-1 and I-2 occupancy classifications correspond with the NFPA occupancy classifications of Residential Board & Care and Healthcare, respectively.

In terms of allowable construction types, it should be noted that I-2 occupancy buildings are most typically built of non-combustible structures, that is to say Types I or II because I-2 buildings of the other construction types (even being sprinklered) would be limited to a single story in height. If a healthcare use were classified as Business, there would be significantly less restriction as far as building height and area is concerned.

While an exhaustive study of the code requirements related to fire protection for healthcare is not possible in this discussion, there are a number of general points which are useful to keep in mind. For I-2 occupancies, which include hospitals, it is necessary that corridors, independent of any fire rating requirements that may apply, be built as smoke partitions. There are exceptions for certain types of spaces, but this is the general requirement. In addition to these smoke partitions, there are requirements to provide smoke barriers which divide the building into smoke compartments. A door which is located within a smoke barrier and connecting two parts of a corridor is required to have hold-opens such that they would automatically close in the event that smoke is detected. The IBC defines the requirements for determining these smoke compartments, which include area limitations and other factors. Each smoke compartment is also required by code to contain a refuge area. In addition to walls and doors which resist the passage of smoke, consideration must also be given to the horizontal assemblies which separate spaces so that these may also resist the passage of smoke as required by the code. An important consideration when designing for smoke compartments and separations is to ensure that any wall and floor penetrations (whether for cables, pipes, or other elements) within a barrier are sealed with appropriate firestopping. It is also important not to compromise the effectiveness of the barrier after the completion of construction with any subsequent work within the building.

It should be noted that there are also egress requirements specific to I-2 occupancies, which are listed in Chapter 4 of the IBC. Additionally, egress components such as stairways are often larger for I-2 occupancies because of the way that their widths are required to be calculated (i.e., multiplying the calculated occupant load by a larger factor than for other occupancy types - see Section 1005 of the IBC). Compared to Business occupancies, I-2 occupancies have a significantly lower threshold for the maximum number of occupants that can be in a space with only a single exit - 10 compared to 49. It is therefore common that a room of any size will have at least two exits. The travel distance to the exit access in an I-2 occupancy is also less than most other occupancy types, with 200 feet being the maximum distance allowed. In terms of egress, the need for lighting on emergency power should also be noted.

Group I occupancies are required to have manual fire alarms, as well as automatic smoke detectors; both of which must connect to an occupant notification system. In terms of active fire protection systems, Group I occupancies are required by IBC to have an automatic sprinkler system. There are only a few exceptions to this requirement, and they relate to specific circumstances in I-1 and I-4 occupancies.

Ambulatory care facilities can be understood as those which provide medical care to an individual for a period of time less than 24 hours, with these patients being considered incapable of self-preservation (whether because of a medical procedure or for other reasons). Like I-2 occupancies, ambulatory care facilities also have requirements for the use of smoke compartmentalization through smoke barriers. It is also required to separate spaces where occupants are incapable of self-preservation with fire partitions, which are to have a fire rating of at least 1 hour. Refuge areas must be provided within each smoke compartment of the building. Safety evacuation plans must also be developed for this project type so that an appropriate emergency response can be enacted for the facility. Further information on the requirements for the emergency response are found in the International Fire Code. Fire alarms and automatic sprinkler systems are also a necessity for ambulatory care facilities. In the NFPA, these types of facilities are classified as Ambulatory Health Care occupancy. NFPA has similar requirements to the IBC for this occupancy, but there are some differences, as the IBC treats this occupancy type as a subset of Business occupancy type (with special requirements), and the NFPA has a separate occupancy classification with its own set of requirements.

These are just some aspects of note for fire protection that should be considered in healthcare design projects. Familiarity with code requirements is especially important for this project type given both the importance of fire protection systems for these buildings as well as the level of detail and nuances of the codes and standards which must be understood for proper design of a building and its systems.