Signalling fire safety plans in hospitals

Following the devastation of the Grenfell Tower fire, Mark Hughes, a member of the IOSH Health and Social Care Group, considers how signage can play a part in the safe evacuation of large numbers of people

There are many causes of fires but, in places where there are many people, the risks are far greater. The logistics of evacuating large numbers of people, and the possibility of panic spreading among them, add to the difficulties. But the use of clear, well-displayed signage goes a long way to helping with this.

The devastating danger posed by fire in large, multi-occupancy buildings was brought into terrifying reality last summer with the disaster of Grenfell Tower. The inquiry continues, and no doubt there will be lessons learned into what health and safety professionals and others can do to minimise the risk of similar tragedies. While Grenfell hit the headlines because of the huge loss of life, there have been other fires in large buildings, including some in the health service.

Hospital signage
In June 2017, fire broke out in Royal Stoke Hospital, with many patients having to be evacuated. On this occasion no one was hurt, and the fire was contained. This could in part be due to the hospital’s health and safety programme and a clear, well-communicated evacuation plan.

Clear and effective signage plays a part in ensuring safety plans are easier to follow. By ensuring visitors can quickly understand and follow the exit strategy, panic can be minimised, and evacuation carried out in a more efficient and safe manner.

However, there are many things to consider relating to signs, to ensure they are effective. We must ask when signs become so overwhelming they lose their efficacy and how many signs are too many.
Wherever you look in hospitals there is a sign telling you to do this, not to do that, or wash that in this way - all in different styles and formats; some printed, some handmade. There are so many, we run the risk of ignoring them and walking by without taking much notice.

We can refer to this as getting sign blindness. Signs have their use, when used effectively and meaningfully. If we look at it from a health, safety and fire perspective there are obvious requirements for signs. For example, to warn of dangers such as X-Ray equipment and areas, or to warn of potential hazards like wet floors.

Hazard and warning signs are available off-the-shelf and come in the mandatory or advisory colours and styles. These have been designed to be uniform and therefore easily recognisable. For example, a hazardous substance can be distinguished immediately and dealt with accordingly.

Patient safety
When it comes to the safety of patients, signage, especially emergency signs, is important. When arriving at hospital, there is always slight trepidation. The buildings are usually large and unfamiliar with many departments and people. Also, hospitals are different from any other organisation; patients may be in the hospital as in-patients, intensive care patients, new born babies, and they may have special mobility or access requirements. Therefore, the signage needs to be clear to ensure patients and visitors know what to do in the event of an emergency and how to get out.

If we don’t get the emergency signage right, including suitable and sufficient emergency lighting, it can have catastrophic effects. So when it comes to emergencies, signage is important and a legal requirement. However, it is only a small element in any emergency planning. We must consider other key elements, including training, to make sure staff know what to do and can assist and evacuate patients.

Other points to consider include the standardisation of signage, ensuring they are controlled and ensuring the signs are limited to essential information to avoid overload. This includes nominating someone responsible within each department and trust wide to monitor the amount of signs and having specific areas on internal walls by outpatient clinics or along the corridor for general signs can help keep with this.

Additionally, temporary signs should still be made to a specific standard, such as infection control isolation areas, but once the problem has been removed so should the sign. Clear signs should also be in place taking you to the right car park for the specific department you are visiting, including clear car parking fees. Signage should also direct visitors to the various departments. Generally, outpatients are split into various specifics, and the common approach is to colour code them. These are often directional signs (in colour) along the wall or floor, so it’s a case of follow the red or green etc lines to the relevant clinic. Directional signs can also be used to help find the way out of a building – which could be crucial in the event of an emergency evacuation, whilst walkways should be clearly illuminated with clear exit signage.

Signs are a great way to warn the many thousands of people who come through hospital doors every day of some of the risks and specific precautions that need to be taken, but it is important that significant health and safety mitigations are not compromised by being buried in the plethora of other information.

Mark Hughes is a Chartered Member of IOSH, having started his health and safety career working at one of Norfolk’s many food processing factories before joining the NHS. After eight years at the Norfolk and Norwich University Hospital NHS Trust, he moved on to Kingston Hospital to manage health and safety, and is now the head of Risk at the Royal Berkshire NHS Trust.

IOSH is the chartered body for health and safety professionals. With over 46,000 members in 130 countries, we’re the world’s largest professional health and safety organisation. We set standards, and support, develop and connect our members with resources, guidance, events and training. We’re the voice of the profession, and campaign on issues that affect millions of working people.

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