Fire hazards are a global concern, as a fire can result in substantial amounts of property damage, injuries, and deaths. In recent times a quick glance through media reports will tell us of the many fire incidents that broke out, engulfed properties and claimed human lives. “Breaking News” in the form of major fire incidents in theatres, markets and residential complexes strike us with terrible regularity where horrifying images jolt the consciousness of the nation and expose our general indifference to safety and the poor safety standards prevalent in all sectors in India. It also establishes that hospitals in India are no safe heavens and are vulnerable to the scourge fire hazards. While human attention is usually focused on immediate incidents, most cities show the same sad patterns where fire preparedness is concerned and recurring incidents only validate this sorry reality.
Fire safety and protection is important in any building or profession but more so in the case of hospitals due to the vulnerable patients and the sheer number of footfalls it sees in a day, be it the inflow of patients or people living and working in hospitals. It is particularly challenging and life-threatening in the case of hospitals because of the difficulties and increased risks associated with evacuating the patients many of whom may be highly dependent and vulnerable and have their mobility impaired by illness, disability or treatment. Unlike any other institution, hospitals are responsible for patient safety from a fire as the patients are unable to evacuate themselves. Additionally, hospitals are full of electrical equipment, ample oxygen supplies from cylinders, volatile chemicals and other combustible gasses that make it conducive for a fire to break out, that can easily spread and emit deadly fumes into the air endangering the life of all concerned.
At Apollo Hospitals Bhubaneswar, in our commitment to placing a premium of patient and public safety we have gone to great lengths to bolster our level of preparedness toward fire prevention and safety management. We believe “Ignorance is no defence.” And that attitude is reflected in our uncompromising attitude to all the provisions of the fire safety regulations. Ignorance of safety measures is inexcusable, therefore utmost care is taken and precautions followed to imbibe good safety measures and practices amongst employees and healthcare workers in the hospital. To that end, our strategies towards prevention and mitigation of fire risks begin with compliance and enforcement of all regulatory norms, Fire Safety Certificates, State Fire NOCs etc.
At Apollo, we have a well thought out fire safety system in place for optimal protection against fire hazards. Opening up escape routes and extinguishing the fire in its initial phase is the key fire protection objective as the overwhelming panic-stricken crowds can cause a stampede trying to find a way to safety. When confronted with a threat or danger like fire the first instinct is to look for an exit or take the “flight” response. The fight-or-flight response is also known as the acute stress response which is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. Panic and confusion are the greatest hazards of fire and they can be avoided or countered only by sufficient preparedness in case of a fire emergency. For panic-stricken people in the premises, we have well-defined fires exit routes throughout that are easy to find:-
- Signages, one set of which are put up closer to the ground label to aid visibility as the dense smoke has a tendency to go up -direct towards the fire exits
- The texts in the signages are illuminated with radium to glow in the dark and are in bilingual so that everyone understands
- Each floor has specific fire exit floor plans displayed for ready reference during an emergency.
- Every room of the hospital has a room specific plan worked out in case anybody wants to locate the escape from that particular room. A red circle stating “you are here” and arrows showing the escape route helps to locate the exit routes.
- To help evacuate critical and immobile patients in case of a fire emergency we have in place portable stretchers to transport patients by the staircases at every strategic location of the building
- Fire exit doors that are painted in vibrant red open automatically to the side of the exit whenever the fire code is activated in case of emergency.
- There are 3 fire exit doors on each floor and 22 Fire exit doors in total and these doors are never blocked
- Fire Lifts that are distinguished from the other lifts with clearly highlighted bilingual signages offer another option for a quick exit in case of an emergency
The other important instinct in the face of threat is “fight” response. And fire fighting requires fire fighting equipment to ensure fire safety. The importance of fire fighting equipment and accessories is indispensable one to ensure maximum protection against fire. The hospital has a wide range of fire detection systems and automatic fire extinguishing technologies at its disposal for fire protection. The hospital has as part of its fire safety equipment:-
- 72 MCPs (Manual Call Points) of Fire Alarm systems that are placed within reach at strategic locations with clear instructions on how to operate them in case of an emergency.
- Sufficient numbers of Fire extinguishers are provided for a ‘first attack’ fire fighting measure on clearly identified locations.
- Extinguishers, prominently labelled with the extinguishing agent are placed according to their principle use taking into account possible sources of fire. They are wall mounted and are at an accessible height. An inspection record for every extinguisher is maintained once in two months.
- Fire smoke detectors that can immediately detect fires in their initial phase make the system more rigid in detecting/ controlling fire hazards – allowing time for rescue and evacuation measures to be implemented
- Time is essential in the control of fire. Automatic sprinkler systems are one of the most reliable methods available for controlling fires. We have sprinkler systems that detect fires, activate an alarm and spray water automatically to provide reliable, round-the-clock protection.
- Fire hydrant systems are installed in buildings and Fire hose reels are provided for use by staff as a ‘first attack’ fire fighting measure to complete the range of fire protection equipment for public areas. They are checked for operational readiness at frequent intervals.
- PPE Boxes are placed at strategic locations and required personal protective clothing are made available with serviceable safety device and specific hazard related equipment, for quick gearing up of staff during an emergency.
- Emergency Lights are put in required places like the patient room, corridors etc. During the facility rounds, we take cognizance of any open or loose hanging wires and they are fixed.
- All fire-prone areas are well taken care of and are under regular surveillance. These areas are protected with boundary coverage. “Restricted Entry” board is put up and “No Smoking” signages are displayed.
A system is as strong as its weakest link. So just putting a system in place won’t make it effective. To make it more compact and responsive Preventive maintenances are scheduled and the calendar is adhered to stringently. Fire panel in place is checked as per the plan. Fire detection system is reviewed once in three months and fire fighting system is reviewed monthly. Documentation is maintained for reference and records. Fire Safety Officer is appointed and a dedicated team is put in charge to monitor the safety measures in place for functional readiness and to ensure there are no loose ends and they are effective during an emergency. Fire Education display boards informing on the steps one should take in such emergencies are put in identified locations. It also details the operating procedure for fire extinguishers. Staff IDs have the exact contents of the educational displays as an aid during fire emergencies. The emergency codes are displayed on every land phone in the hospital for easy recall by the staff in case such code is required to be raised.
Beyond the procurement of Hi-tec fire safety equipment; there is a need to develop holistic fire prevention and detecting solutions as per the organization’s unique needs. At Apollo Hospitals Bhubaneswar, we have invested in building enhanced patient and employee safety measures. We have in our system OT -5 Isolation panel Alarm installed to monitor the insulation level of OT power distribution. RAW & UPS Power Mark has been put in all ICU, indicating Raw or UPS supply in power outlets. We have in place Down comer with 20,000-liter water containing capacity which is placed at the top of the building and can be used for fire extinguishing during any fire emergency. Water tanks (TANK-1 & TANK- 2) each having capacity of 75,000 liters dedicated to fire safety. Two main hydrant pumps with two jockey pump and 1 DG Set specifically placed for fire disaster management.
As a people, we have a ‘chalta hey’ attitude to most things in life. This casual attitude is reflected in most spheres of everyday life as public memory is short. Every disaster is followed by a big hue and cry and then it is business as usual. The country has no shortage of incidents so a casualty is nothing more than a statistic and the general apathy. This ‘chalta hey’ and business as usual attitude can have no place in a hospital with regard to fire safety due to the high density of life in terms of patients, doctors, staff, etc.
Self Preservation is a natural instinct and we tap into it to make our staff sensitive to fire safety issues. Apollo’s heightened sensitivity and responsibility to safety issues are reflected in the training modalities of the hospital, starting from the induction sessions for the new joiners. We have on the job training and group training to educate our staff about their role during such emergencies. Monthly mock drills as practical training help identify potential risk zones. The focus is also on assessing the staff response TAT, their awareness and response to an emergency situation. Gaps are identified and refurbished. Internal regular audits supplemented by external audits further make our preparedness more robust.
As an NABH Accreditated Hospital, our fire systems have been examined for adherence to safety standards and have been found to be satisfactory. These have been also appreciated by the concerned state Offices.
The best form of protection from fire is its prevention. So it is incumbent to develop a collaborative approach between the healthcare organization and fire regulatory agencies of the state. Fire has an uncanny ability to surprise us by bringing to the fore vulnerabilities of systems, structure, and processes. So it is imperative that structural resilience is backed by the operational resilience of the hospital where each individual acts as a unit of safety and prevention and effectively minimizes the risk of hazards by making the fire safety system all pervasive.
We should forever remember that every big fire starts from small one, therefore, nothing should be considered insignificant within hospital premise because of its potential to cause unprecedented damages in terms of life, limb, and property. Hence no effort should be spared to secure safety from these hazards. We have put in our best efforts to establish a reasonable degree of safety for fire emergencies at Apollo Hospitals which is borne out by a decade of uninterrupted health care services for the public good and continue to be firm and relentless as eternal vigilance is the price of freedom from fire hazards.
By Ms Swetapadma Dash
DGM- QMS & Research
Apollo Hospitals Bhubaneswar