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Psychiatric facilities must not only help support beneficial activities and therapies, they also must ensure the safety of staff and patients. A specialist in medical and psychiatric facility design offers his advice on hidden hazards, interior doors, vestibules, windows, and other elements of design.
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A new method to transmit fire-alarm signals, effective immediately, has been approved by the Joint Commission. The method, which can be used in all health care organizations with buildings classified as health care occupancies, is explained in the following paragraphs.
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Any product that causes a fire to grow large is deficient in fire safety performance. A large fire in any building represents a serious hazard. Multiple-death fires almost always are linked to fires that grow quickly to a large size. Interior finishes have large, continuous surfaces over which fire can spread. They are regulated to slow initial fire growth, and must be qualified for use on the basis of fire tests. To obtain meaningful results, specimens must be representative of actual installation. Variables--such as the substrate, the adhesive, and product thickness and density--can affect product performance. The tunnel test may not adequately evaluate some products, such as foam plastics or textile wall coverings, thermoplastic materials, or materials of minimal mass. Where questions exist, products should be evaluated on a full-scale basis. Curtains and draperies are examples of products that ignite easily and spread flames readily. The present method for testing curtains and draperies evaluates one fabric at a time. Although a fabric tested alone may perform well, fabrics that meet test standards individually sometimes perform poorly when tested in combination. Contents and furnishings constitute the major fuels in many fires. Contents may involve paper products and other lightweight materials that are easily ignited and capable of fast fire growth. Similarly, a small source may ignite many items of furniture that are capable of sustained fire growth. Upholstered furniture can reach peak burning rates in less than 5 minutes. Furnishings have been associated with many multiple-death fires.(ABSTRACT TRUNCATED AT 250 WORDS)
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Executive managers can ensure the most efficient management of the physical assets of their psychiatric hospital by involving the facility management staff in all phases of all planning and implementation. This paper stresses how maintaining expert in-house staff and equipping them with comprehensive computer-based tools results in the efficient use of available space and in good management of both capital and operating expenses. As the hospital liaison with outside design firms and regulatory agencies, the facility management staff can effectively communicate the facility's requirements and represent its interests.
Safety in the psychiatric setting involves many aspects of facility design, renovation, operations, training, and administrative control. Through the application of a systematic hazard-control program, risks may be identified and action taken to reduce or eliminate the potential for accidental or self-inflicted injuries. This paper addresses specific aspects of the hazard-control process and its application at The Sheppard and Enoch Pratt Hospital, Baltimore, Maryland.