NFPA Journal - January/February 2018 - 59

the end of construction projects for information technology (IT)
departments to run cables through, but these uncapped sleeves
can result in through penetrations that compromise fire-rated
walls. Coordination must occur between the IT and facilities
and engineering departments, as well as with the contractor,
to ensure sleeves are appropriately capped and sealed.
Visibility of exit signage
NFPA 101 requires that exit signage be installed in readily
visible locations. Obstructions to exit signage can occur where
pendant lighting or furniture have been installed without consideration to the visibility of the signs, and the installation of
those features must be coordinated to avoid obstruction of exit
signage sight lines.
Hand-rub dispenser installation
NFPA 101 prohibits the installation of alcohol-based hand-rub
dispensers above ignition sources and within one inch horizontally or one inch below an ignition source. Alcohol-based hand
rub dispensers are often found installed directly above electrical
outlets and other ignition sources. The location of these dispensers should be coordinated with the electrical plans and reviewed
after installation to ensure they are not located too close to
ignition sources.

TO ADDRESS THE GOAL OF MINIMIZING REGULATORY
RISK AND MAINTENANCE COSTS THROUGH THE
CODE-COMPLIANCE APPROACH AND DESIGN ON
THE BAYSTATE PROJECT, THE FOLLOWING MEASURES
WERE INCORPORATED:
Maximize use of patient-care suites in the design.
In NFPA 101, suites allow for a reduction in the required clear
width in corridors from 96 inches to 36 inches where serving
fewer than 50 people, and 44 inches where serving an occupant
load of greater than 50 people. On accreditation surveys, hospitals are frequently cited for carts projecting into the required
clear width. Additionally, positive latching hardware is not
required on doors within the suites.
Minimize the amount of fire-rated wall when performing a
renovation or addition project.
In NFPA 101, smoke compartments are limited to a maximum
of 22,500 square feet. A common architectural strategy with
projects in existing buildings is to create a new smoke compartment in the work area so as not to create renovations in existing
areas of the building. While this strategy can insulate the project
from issues in the existing building, it also greatly increases the
amount of fire-rated wall, which requires additional costs for
fire-stopping and opening protectives. To address this issue,
incorporate the end area with the existing smoke compartment strategy and make revisions as necessary to minimize the
amount of fire-rated wall.
Include security staff in the design process
Required egress routes may overlap with security risks, which
is why it is important to include the facility's security staff as
part of the design collaboration. Strategies to separate these
routes were identified through design rather than expensive
locking door hardware that often doesn't meet the needs of the
security team.

was involved in the planning process,
they were able to identify a more costeffective smoke damper design. This
resulted in more than $100,000 in savings, as well as ongoing savings in time
and money needed to maintain and test
the dampers. The insights gained from
this type of innovation can also improve
code language so that everyone can benefit from this type of success.

5
DEVELOP A HYPOTHESIS

In the EBD process, hypotheses help
guide data collection and provide guidance for analyzing and interpreting the
data.
The BMC project team hypothesized
that the design and location of the
care team stations could be optimized
to improve interdisciplinary communication, which in turn could lead to
improvements in staff satisfaction,
patient satisfaction, safety, and outcomes.
The team also hypothesized that equipment in the patient room design in Phase
1 could be developed further to provide a
safer, more ergonomic space to improve
the healing environment. For example,
the Phase 1 location of the computer at
the headwall was in conflict with the
staff's ability to access the button for code
blue, which requires immediate action
by additional care team members. This
potential problem was improved in the
Phase 4 headwall mock-up by relocating
the code blue button, allowing staff direct
access to the button without inferring
with the wall-mounted computer.

6
COLLECT BASELINE
PERFORMANCE MEASURES

In this step, the design team assesses
current processes at a macro level and
defines the project metrics that will be
used to measure outcomes.
Prior to designing the Phase 4 South
Wing patient tower, the team collected
baseline performance measures based
on patient surveys in the Phase 1 West
N F PA . O R G / J O U R N A L * NFPA JOURNAL

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Table of Contents for the Digital Edition of NFPA Journal - January/February 2018