The latest statistics released by The Joint Commission show the top cited standard in accredited hospitals involves fire protection problems. And it is likely that many of these deficiencies stem from low-hanging fruit that surveyors can easily grab, including items improperly stored in exit corridors.
The 2000 edition of the National Fire Protection Association's Life Safety Code—which The Joint Commission and CMS both enforce—forms the foundation of hospital corridor requirements through minimum widths, says Frederick Bradley, PE, a fire protection engineer and owner of FCB Engineering in Alpharetta, GA.
Exit corridors offer a fundamental fire protection feature in medical centers, allowing staff members the room to move patients to safe areas if a fire alarm goes off on a unit.
Stopwatch is set for 30 minutes
Items left in exit corridors—such as housekeeping carts—technically impede minimum width requirements and are code deficiencies. Not all aisles in hospitals count as exit corridors, so consult with your facilities director or safety officer for further information.
As with all Life Safety Code concerns, it's up to authorities to interpret and apply the requirements.
In an August 2004 regional memorandum to state survey agencies and fire authorities, CMS states that wheeled items "in use" can't be left unattended in egress corridors for more than 30 minutes, and the agency specifically mentions linen carts, medication carts, and janitor equipment.
Attended carts are those that are being used actively by an individual; an unattended cart is one that is not in use. Other similar items that would be affected by the 30-minute limit include food service carts and computers-on-wheels.
The CMS memo further states that:
- Infection control isolation carts can remain in corridors indefinitely as long as they are outside an active isolation patient's room
- Crash carts can always remain in corridors so that staff members can quickly get to them in an emergency
An online FAQ from The Joint Commission, which carries the same weight as an accreditation standard, reiterates the points of the CMS memo.
CEOs may need to step in
A hospital's success in dealing with corridor clutter could rest upon administrators' shoulders, says Brad Keyes, CHSP, a safety consultant for The Greeley Company, a division of HCPro, Inc., in Marblehead, MA.
"If your staff feels there's no way to solve corridor clutter, then a change in culture is in order," says Keyes, who is a former life safety surveyor for The Joint Commission.
When Keyes was a safety officer at Rockford (IL) Memorial Hospital, workers didn't always listen to him about keeping corridor widths clear until he started showing them a letter signed by the hospital executives supporting the life safety provisions.
In Bradley's opinion, a best practice is to limit in-use carts in a typical unit corridor to a crash cart and perhaps one or two other carts. "The food service cart should only be in the corridor during meal times," Bradley says.