8/18/2019 Ranking book

1/9

Fire Sa fet y Journal, 7 (1984 ) 145 - 153 145

T h e D e v e l o p m e n t o f a P o i n t s S c h e m e t o A s s es s F ir e S a f e t y i n H o s p it a ls

PAUL ST OL L ARD

De par tme nt o f F ire Saf e ty Engineering, Univers i ty o f Edinburgh , The K ing s Buildings , Edinbu rgh EH 9 3JL

(U.K.)

SUMMARY

The improvement of fire safety standards

m existing buildings requires a systematic

evaluation of both the present deficiencies

and the options for improvement. A points

scheme offered a simple and repeatable

method of performing such an analysis of the

patient areas within hospitals, and the Depart-

ment of Fire Safety Engineering at the Uni-

versity of Edinburgh was sponsored by the

Department of Health and Social Security

(DHSS) to produce such a scheme. The

authority of a points scheme derives from the

experience of those producing it and the use

of the Delphi technique to produce this

scheme is described.

INTRODUCTION

Fire safety in hospitals is a very sensitive

topic; sensitive both morally and politically,

as the very existence of hospitals controlled

by a national system suggests tha t the nation,

through government, has taken the respon-

sibility to care for people who are ill in some

way. If patients or st aff are to be injured by

some exte rnal agency, such as fire, then this

is a direct reflection on the quality of the

managem ent of the total health care system.

The need to develop an evaluation scheme

came after attempts to apply to hospitals the

relevant parts of the Fire Precautions Act

(1971). A trial survey of 365 hospitals was

carried out around 1976 and 45 were selected

for a detailed fire safety appraisal by the fire

prevention officers of the local authorities'

fire services. These detai led surveys include d

recommendations for improving the hospitals

to some acceptable standard and they were

costed for the DHSS by in depe ndent consul-

tants. As a result of these surveys, it was con-

sidered that the costs would be prohibitive if

improvements were to be made throughout

the National Health Service, and as hospitals

have a good record with respect to fire loss, it

was decided to develop an evaluation scheme

which would identi fy those areas of greatest

risk. This would enable the available money

to be spent to the best advantage.

An evaluation scheme for he alth buildings

was already being developed in the U.S.A.

[1] and it was hoped that this might serve as

the basis for the DHSS evaluation scheme.

Tests of the U.S. system, conducted in the

Edinburgh hospitals, revealed that none of

these hospitals would comply with U.S.

standards. The reasons behind these poor

results related to the differences in the spatial

design of hospitals in the U.S.A. and U.K.,

and the unsuitabil i ty of many of the detailed

definitions in the American evaluation system

for British buildings. However, it was obvious

that there was some virtue in the concepts

of a flexible rating system which compares

existing buildings in a consistent manner

against an accepted standard.

Having accepted th e need for an evaluation

scheme designed to assess the patient areas

within hospitals, five developmental problems

were identified.

(A) The selection of a 'norm' against which

assessment can be made.

(B) The identification of the safety factors

contributing to the norm.

(C) The calculation of the relative values of

the sa fety factors.

(D) The development of a method of sur-

veying the patient areas to provide factual in-

formation.

(E) The form ulati on of a succinct way to

present the results and make comparisons.

To solve these five problems, a group of

specialists was invited by the DHSS to assist

in the prepa ration o f a scheme which would

0379-7112/ 84/$3.00 © Elsevmr Sequoia/Pr inted in The Nether lands

8/18/2019 Ranking book

2/9

146

simplify the implementation of the Fire

Precautions Act (1971) and facilitate the

evaluation of relative levels of fire safety in

existing hospitals.

The group was led by members of the De-

partment of Fire Safety Engineering at

Edinburgh University and used the Delp hi

technique to achieve an agreed system. In this

technique, experts from a variety of related

fields are assembled and their opinions to

various questions recorded. The divergences in

opinion are then repeatedly discussed until

common agreement is reached as to the solu-

tion. In determining the basis for the evalua-

tion scheme and th e details of its application,

the Delp hi met hod was used and the valid-

ity of the scheme lies in the membership of

the Delp hi group. The ironical name

Delp hi is taken from the ancient Greek

oracle at Delphi which was famous for the

ambig uity of its answers.

(A) THE SELECTION OF A 'NORM' AGAINST

WHICH ASSESSMENT CAN BE MADE

The American evaluation scheme took the

NFPA Life Safety Code [2] as the standard

against which fire saf ety was to be assessed.

Unfor tunat ely, in the U.K. there is no docu-

ment whose provisions can be expected to

apply equally to all geographical locations and

to all types of hospitals. The application of

the standards contained in the Building Regu-

lations may be possible, but those for England

and Wales contained no requirements relating

to escape routes in hospitals. The only docu-

men t in existence was the draft of The Fire

Precautions Act 1971 -- A Guide to Fire Pre-

cautions in Hospitals (1976 /79) , and it was

agreed that this should serve as the norm, for

if hospitals were to be designated under the

Act, then this, or a similar docum ent, would

form the basis of all advice on the upgrading

of existing buildings. This doc ume nt has now

been published by the Home Office in a

slightly revised for m [3].

(B) THE IDENTIFICATION OF SAFETY FACTORS

CONTRIBUTING TO THE NORM

Having accepted the Draft Guide as the

standard for assessment, seventeen factors

within it were identified. These covered the

principal areas of fire safety in hospitals, and

the Delphi group were asked to grade each of

these between 0 and 5 on the basis of impor-

tance, and to list any they felt had been

excluded. Against each factor were listed the

elements within the Draft Guide which collec-

tively described the 'perfect' attainment of

the factor. For example, detection/warning

systems is described in terms of call poin ts

and powe r supplies ; while comp artm enta -

ti on is described in terms of fire resistance ,

prot ect ed areas and self-closing doors .

The seventeen factors were:

fire resistance of floors

fire resistance o f walls

compartmentat ion

surface flame spread

travel distance

corridors

staircases

inter-room access

lifts

direct external access

fire/smoke spread

signs

emergency lighting

detection/warning systems

firefighting equipment

staff training

evacuat ion drills.

To these the Delphi group added an addi-

tional three, and regrouped others. The three

new ones (staff; patients and visitors; fire

brigade) were only implicit in the Draft Guide

but were felt to be significant enough to be

made explicit in the revised list.

Having identified twenty components of

fire safety, it was essential to determine their

relative importance, but before this could be

done it was necessary to determine impor-

tance for what? . To this end the Delphi

group was next asked to consider a hierarchy

of fire safety:

Level 1 • Fire Safety Policy

Course or general plan of action adopted by a

government, party or person, to achieve

security against fire and its effects.

Level 2: Fire Safety Objectives

Specific goals to be achieved.

Level 3: Fire Safety Tactics

Independent fire safety alternatives, each of

which contributes wholly or partly to the

fulfilmen t of the fire safety objectives.

8/18/2019 Ranking book

3/9

L e v e l 4 . F i re S a f e t y C o m p o n e n t s

M a j o r p a r t s o f f i r e s a f e t y a s d e f i n e d i n c o n -

v e n t i o n a l f ir e c o d e s a n d s t a n d a r d s . T h e t w e n t y

c o m p o n e n t s a l re a d y a g re e d b y t h e D e lp h i

g r o u p .

L e v el 5 S u b c o m p o n e n t s

E s s en t ia l p a rt s o f c o m p o n e n t s w h i c h c a n b e

r e a d il y i d e n t i f ie d . S o m e o f t h e s e h a d a l r e a d y

b e e n i d e n t i f i e d i n t h e D e l p h i g r o u p ' s l i s t o f

a d d i t i o n a l f a c t o r s .

M u c h d i sc u s si o n t o o k p l a ce o n t h e m e a n i n g

o f t h e o b j e c t i v e s , an d o n t h e d i v is i o n a n d

d e f i n i t i o n s o f t h e t a c t i c s . T h i s r e s u l t e d i n

a g r e e m e n t o n t h e f o l l o w i n g f o u r o b j e c t i v e s

a n d f i v e t a c t i c s i n t h e h i e r a r c h y :

F i r e S a f e t y O b j e c t w e s ( L e v e l 2 ):

( 1 ) L i fe s a fe t y . P r es e r v a t io n a n d p r o t e c t i o n o f

l if e f r o m t h e h a z a r d s o f f la m e , h e a t a n d

s m o k e .

( 2 ) M i s s io n c o n t i n u i t y . M a i n t e n a n c e o f t h e

s u p p l y o f h e a l t h c a r e w i t h m i n i m a l d i s r u p t i o n .

( 3 ) P r o p e r t y p r o t e c t i o n . A v o i d a n c e o f th e

d i v e r s i o n o f f u n d s t o r e p l a c e e s s e n t ia l e q u i p -

m e n t a n d / o r f a c i l i t i e s .

( 4 ) O t h e r c o n s e q u e n c e s . A v o i d a n c e o f m e n t a l

a n g u i s h , u n n e c e s s a r y t i m e - c o n s u m i n g i n -

q u i r i e s , a n d p o s t - f i r e p u b l i c a n x i e t y .

F i re S a f e t y T a c t i c s (L eve l 3 )

( 1 ) I g n i t i o n p r e v e n t i o n . P r e v e n t i n g t h e i n i t i a -

t i o n o f d e s t r u c t i v e a n d u n c o n t r o l l e d b u r n i n g .

( 2 ) F i re c o n t r o l . R e t a r d i n g t h e d e v e l o p m e n t

a n d / o r m o v e m e n t o f fi re a n d f ir e p r o d u c t s .

( 3 ) R e f u g e . A n y p o r t i o n o f a b u i l d i n g r e l a -

t i v e ly s a f e f r o m f i re d a n g e r i n t o w h i c h p e o p l e

c a n m o v e . A s p a c e n o t i n v o l v e d i n f i r e a n d

n o t a f f e c t e d b y s m o k e , t o x i c g a s e s , o r o t h e r -

w i s e h a z a r d o u s t o h u m a n l if e a n d s a f e t y .

( 4 ) E g r es s . C o n t i n u o u s p a t h o f tr a v e l f r o m

a n y p o i n t i n a b u i l d i n g t o t h e o u t s i d e a t

g r o u n d l e v e l .

TABLE 2

Contributory values of tactics to objectives

147

( 5 ) R e s c u e . S a v i n g o f p e r s o n s i n d a n g e r d u e t o

f i r e o r a c c i d e n t . A s s i s t a n c e g i v e n t o p e r s o n s i n

d a n g e r w h o c a n n o t h e l p t h e m s e l v e s .

T h e t w e n t y c o m p o n e n t s a l r e a d y i d e n t i f i e d

f o r m t h e n e x t l e v e l ( L e v e l 4 ) a n d a r e t h e

m a j o r i n d e p e n d e n t p a r t s o f f ir e s a f e t y . E a c h

c o n t r i b u t e s t o a d i f f e r e n t d e g r e e t o e a c h o f

t h e f i v e t a c ti c s , an d t h r o u g h t h e m t o t h e

o b j e c t i v e s a n d t h e o v e r a l l p o l i c y . I n d i v i d u a l

e le m e n t s o f ea ch o f t h e t w e n t y c o m p o n e n t s

c a n b e i d e n ti f ie d a s s u b c o m p o n e n t s a n d t h e s e

f o r m a f i f t h le v e l o f t h e h i e r a r c h y . I n t h e

a s s es s m e n t o f e a c h c o m p o n e n t t h e s e s u b c o m -

p o n e n t s f o r m e d a c h e c k l i s t a n d a r e i n c l u d e d

o n t h e w o r k s h e e t s .

(C) THE CALCULATION OF THE RELAT IVE

VALUES OF THE SAFETY FACTORS

F o l l o w i n g a g r e e m e n t o n t h e t w e n t y c o m -

p o n e n t s a n d o n t h e ir r e l a ti o n s h i p t o t h e h ie r-

a r c h y o f f i r e s a f e t y , i t w a s a g r e e d t o u s e

m a t r i c e s t o e s ta b l is h t h e c o n t r i b u t i o n o f e ac h

c o m p o n e n t t o o v e r a ll f ir e s a f e t y p o l ic y . T h e

D e l p h i g r o u p w a s t h e r e f o r e a s k e d t o g i v e

v a l u e s t o a n o b j e c t i v e s - t o - p o l i c y v e c t o r , a

t a c ti c s - to - o b j e c t i v e s m a t r i x a n d a c o m p o -

n e n t s - t o - t a c t i c s m a t r i x . T h e m a t r i c e s a g r e e d

b y t h e D e l p h i g r o u p a r e s h o w n i n T a b l e s 1 - 3

a n d , b y t h e m u l t i p l ic a t i o n o f t h e s e m a t r i c es , a

v e c t o r f o r th e c o n t r i b u t i o n o f c o m p o n e n t s t o

o v e ra l l p o l i c y w a s p r o d u c e d . E a c h n u m b e r i n

TABLE 1

Contribut ory values of objective to policy

Life safety 0.94

Mission contin uity 0.78

Property protec tion 0.50

Other consequences 0.44

Igniti on preve ntio n 0.96 0.84 0.84 0.54

Fire cont rol 0.82 0.78 0 88 0.58

Refuge 0.74 0.46 0.14 0.54

Egress 0.74 0.26 0.04 0.54

Rescue 0 56 0.26 0.06 0.50

Life Mission Proper ty Other

safety continuity protection consequences

8/18/2019 Ranking book

4/9

1 4 8

T A B L E 3

C o n t r i b u t o r y v a lu e s o f c o m p o n e n t s t o t a c t i c s

I g m t l o n F i r e R e f u g e E g r e ss R e s c u e

p r e v e n t i o n c o n t r o l

1 S t a f f 0 . 9 8

2 P a t i e n t s a n d v i s i to r s 0 . 8 8

3 F a c t o r s a f f e c t in g s m o k e m o v e m e n t 0 0 4

4 P r o t e c t e d a r e a s 0 . 1 2

5 D u c t s , s h a f t s a n d c a v i t i es 0 3 4

6 H a z a r d p r o t e c t i o n 0 . 6 6

7 I n t e r i o r f i n i s h 0 5 0

8 F u r n i s h i n g s 0 . 9 6

9 A c c e s s t o p r o t e c t e d a r e a s 0 0 4

1 0 D i r e c t e x t e r n a l e g re s s 0 . 0 0

1 1 T r a v e l d i s t a n c e 0 . 0 2

1 2 S t a i r c a s e s 0 . 1 4

1 3 C o r r i d o r s 0 . 1 2

1 4 L i f t s 0 . 1 4

1 5 C o m m u n i c a t i o n s y s te m s 0 . 12

1 6 S i g n s a n d f i r e n o t i c e s 0 . 2 4

1 7 M a n u a l f i r ef i g h ti n g e q u i p m e n t 0 . 0 4

1 8 E s c a p e l i g h t i n g 0 . 0 2

1 9 A u t o m a t i c s u p p r e s s i o n 0 . 0 8

2 0 F i r e b r i g a d e 0 0 4

0 . 9 0 0 7 2 0 8 6 0 8 6

0 . 3 0 0 7 0 0 8 0 0 6 8

0 . 8 2 0 8 0 0 8 6 0 7 8

0 . 6 6 0 9 6 0 . 6 8 0 7 6

0 7 2 0 . 5 0 0 . 3 8 0 1 4

0 . 8 8 0 5 6 0 6 0 0 6 2

0 7 2 0 . 4 2 0 4 4 0 . 2 8

0 . 8 6 0 2 4 0 . 2 2 0 2 0

0 . 4 8 0 . 8 2 0 . 7 2 0 5 2

0 4 4 0 . 5 0 0 . 8 8 0 . 8 6

0 . 4 2 0 . 7 8 0 9 2 0 . 7 6

0 5 8 0 . 5 8 0 8 8 0 . 7 2

0 . 5 8 0 . 6 8 0 8 2 0 . 7 2

0 . 4 8 0 3 8 0 5 2 0 4 0

0 . 9 2 0 5 2 0 5 2 0 . 3 8

0 . 2 2 0 6 0 0 . 7 8 0 4 2

0 9 0 0 2 8 0 1 4 0 1 0

0 . 4 0 0 6 2 0 8 2 0 6 0

0 . 8 2 0 3 0 0 1 0 0 1 0

0 . 9 0 0 3 0 0 . 3 4 0 7 8

T A B L E 4

V a l u e s o f c o m p o n e n t s . C o l u m n 1 : r e la t iv e v a lu e s b y m a t r i x m u l t i p l i c a t i o n

C o l u m n 2 r e vi s ed v al u es o f c o m p o n e n t s a f t e r c o n s i d e r i n g i n t e r a c t io n s .

1 2

1 S t a f f 0 . 0 8 6 6 0 . 0 8 8 9

2 P a t i e n t s a n d v i s it o r s 0 . 0 6 4 6 0 . 0 6 4 3

3 F a c t o r s a f f e c t in g s m o k e m o v e m e n t 0 . 0 5 8 6 0 . 0 6 5 6

4 P r o t e c t e d a r e as 0 . 0 5 6 5 0 . 0 5 5 5

5 D u c t s , s h a f t s a n d c a v i t ie s 0 0 4 4 3 0 . 0 4 0 0

6 H a z a r d p r o t e c t i o n 0 . 0 6 7 6 0 . 0 6 4 9

7 I n t e r i o r f i n i s h 0 . 0 5 0 0 0 . 0 4 9 7

8 F u r n i s h i n g s 0 . 0 5 9 2 0 . 0 6 2 5

9 A c c e ss t o p r o t e c t e d a r ea s 0 . 0 4 4 8 0 . 0 4 0 7

1 0 D i r e c t e x t e r n a l e g r es s 0 0 4 3 6 0 . 0 4 1 2

1 1 T r a v e l d i s t a n c e 0 . 0 4 7 8 0 0 4 8 8

1 2 S t a i r c a se s 0 . 0 5 0 9 0 . 0 4 8 8

1 3 C o r r i d o r s 0 . 0 5 1 1 0 0 5 0 9

1 4 L i f ts 0 . 0 3 5 6 0 . 0 3 4 2

1 5 C o m m u n i c a t i o n s s y s t e m s 0 . 0 4 8 7 0 0 5 0 6

1 6 S i g n s a n d f i re n o t i c e s 0 0 4 0 1 0 . 0 4 0 6

1 7 M a n u a l f i r ef i g h ti n g e q u i p m e n t 0 . 0 3 2 8 0 . 0 3 0 2

1 8 E s c a p e l i g h t i n g 0 . 0 4 1 1 0 0 4 6 2

1 9 A u t o m a t i c s u p p r e s s i o n 0 . 0 3 1 6 0 . 0 3 2 9

2 0 F i r e b r i g a d e 0 . 0 4 4 5 0 0 4 3 5

1 . 0 0 0 0 1 . 0 0 0 0

t h i s v e c t o r w a s t h e n c o n s i d e r e d a s a d e c i m a l

f r a c t i o n o f t h e w h o l e , t o g i v e a s e t o f r e l a t i v e

v a l u e s f o r t h e c o n t r i b u t i o n o f c o m p o n e n t s

( s e e T a b l e 4 , c o l u m n 1 ) .

I n a d d i t i o n , t h e g r o u p w a s a s k e d t o c o n -

s i d e r i f a n y p a i r o f c o m p o n e n t s i n t e r a c t e d

a n d i f s u c h i n t e r a c t i o n s w e r e a n e n h a n c e m e n t

o f t h e p u r p o s e o f t h e tw o c o m p o n e n t s

8/18/2019 Ranking book

5/9

T

A

B

L

E

 

5

C

o

b

o

y

v

u

o

c

m

p

n

e

o

m

a

x

C

o

m

p

B

0

9

 

0

0

9

 

O

 

E

 

0

~

 

~

 

~

 

.

~

 

-

~

~

~

~

~

~

~

~

~

~

~

~

~

o 0

9

 

0

E

 

0

9

 

O

 

7

e

S

a

P

e

a

v

o

0

8

F

o

a

n

s

m

o

0

7

m

o

m

e

P

o

e

e

a

0

5

0

4

D

u

s

a

c

e

H

a

d

p

o

e

o

I

n

e

o

n

F

n

n

0

4

A

c

o

p

o

e

e

a

D

i

e

e

n

e

T

d

a

0

6

0

7

S

a

0

6

0

7

C

o

d

0

6

L

0

5

0

5

0

6

C

o

m

m

u

c

o

s

e

m

s

0

9

0

6

0

7

S

g

a

n

c

M

a

g

n

0

7

e

p

m

e

E

g

n

0

7

A

u

o

m

a

c

s

o

F

b

g

0

8

0

6

0

7

0

5

0

4

0

6

0

6

0

6

0

7

0

6

0

6

0

4

0

7

0

5

0

0

6

0

8

0

7

0

7

0

3

0

8

0

6

0

0

8

0

4

0

6

0

0

0

4

0

6

0

7

0

8

0

6

0

8

0

0

6

0

6

0

4

0

0

3

0

4

0

4

0

4

0

3

0

4

0

4

0

6

0

7

0

2

0

5

0

6

0

5

0

6

0

5

0

5

0

4

0

4

0

5

0

4

0

4

0

6

0

5

0

7

0

5

0

5

0

5

0

8

0

7

0

6

0

6

0

5

0

4

0

6

0

6

0

4

0

6

0

2

0

6

0

5

0

4

0

6

0

6

0

5

0

2

0

5

0

7

0

5

0

5

0

7

0

5

0

6

0

5

0

5

0

8

0

5

0

4

0

5

0

3

0

4

¢

O

8/18/2019 Ranking book

6/9

1 5 0

concern ed. A matri x expressing these interac-

tions (Table 5) was developed and used to

modify the com ponent contr ibution vector to

give a new set of values (see Table 4, column

2).

It is imp ort ant to n ote t hat m all calcula-

tions of interactions, each component was

assumed to be making the maximum possible

contribution to fire safety. The assessment of

how far shor t of tha t maximum contr ibution

com pon ent s actually fell, required the devel-

opmen t o f a survey method.

(D) THE DEVELOPMENT OF A METHOD

OF SURVEYING THE PATIENT AREAS TO

PROVIDE FACTUAL INFORMATION

In parallel with the development of the

theoretical basis of the evaluation scheme,

tho ugh t was given to the design of the survey

docu ment s themselves. To facilitate a survey,

the patient areas of each hospital must be

considered as one or mor e survey volumes; an

individual survey vol ume being a self-contain ed

and physically defined area which will nor-

mally comprise a single nursing unit.

The surveyor is asked to make an assess-

ment of each survey volume by considering

the deficiency in each of the tw enty compo-

nents and selecting the approp riate grade on a

six-point scale; 0, 1, 2, 3, 4, 5. This grade

indicates the deficiency of the component

compared to the ideal outlined in the Draft

Guide to the Fire Precautions Act (0 repre-

sents 100% deficiency, 1 --80% deficiency,

and so on, to 5 which indicates no deficiency).

This 0 - 5 grading gives a level of accuracy of

+0.5 on each of twenty components (i.e.

-+10% on the total score). A 0 - 10 grading

would obviously give an increase in the level

of ac curac y to +- 5%, but it assumes th at the

surv eyor has been able to assess the building

with this level of precision. It is felt unlikely

that such a level would always be obta inable

so a 0 - 10 grading would only introduce a

false appearance of accuracy. However,

should a surveyor feel that he can be more

specific than a 0 - 5 assessment, he is quite at

liberty to introduce halves into the system

without affecting the required calculations.

Field trials of the survey were conducted

during 1981 on twenty-eight different survey

volumes from seven Regional Health Aut hor-

ites in England. The surveys were condu cted

either by representatives of the Regional

Works Officers or by t he local Fire Preventi on

Officers in the hospitals concerned. Survey

volumes varied from Victorian built Nightin-

gale wards to hospitals built during the last 15

years. The results were carefully analysed to

determine any ambiguities in the worksheets

and to test that this form of assessment was

viable.

Various modifications to the form and lay-

out of the worksheets were subsequently

agreed by the Delphi group and this modified

version was then used in a series of repeatabil-

ity tests. This was to ensure that different

people assessing the same survey area would

award the same values to each component.

Eight survey volumes taken from three hos-

pitals in the South Lothian District Health

Authority (Edinburgh) were used, four being

evaluated by four pairs of assessors and four

by two pairs of assessors. The results for each

survey volume were then carefully compared

to highlight any problems in the interpreta-

tion o f the worksheets.

The worksheets were then modified and

two of the eight survey volumes were re-

assessed by four local Fire Prevention Officers

(three from the three hospitals concerned and

one from North Lothian District Health

Authority). Each of these four surveyed the

same two survey volumes and the results

obtained showed a marked improvement in

repeatability.

The results of the second series of repeat-

ability tests and the revised draft of the work-

sheets used, were presented to the final Delphi

group meeting and as a result of the discus-

sions at this meeting, a definite set of work-

sheets were drawn up as part of the proposed

Health Technical Memorandum.

Four forms of assessing the components

had proved satisfactory under trial and are

used in the final set of worksheets. The first

form relies on initially assigning an approxi-

mate grade to the dominant subcomponent

(e.g. for 'staff', this is the staff-to-patient

ratio), and then m odif ying this depending up-

on the assessor's evaluation of t he remaining

subcomponents. If they are all average then

the initial approximate grade is unchanged,

but if the y are bett er than average it might be

raised by one or two points, while, if the y are

worse than average, it could fall one or two

8/18/2019 Ranking book

7/9

points. Components assessed in this manner

are 'staff' , 'patients and visitors', 'factors

affecting smoke movement', 'staircases',

'escape lighting', 'au tomat ic suppression' and

'fire brigade',

The second type of assessment is by simple

addition of values awarded to relevant sub-

com pone nts (e.g. for 'pr otect ed areas', values

are assigned to floors and to walls). Compo-

nents assessed in this manner are 'protected

areas', 'ducts', 'shafts and cavities', 'hazard

protection' and 'interior finish'.

The third type of assessment is by simple

comparison of the condition in the survey

volume with a list on the worksheet from

which the appropriate grade can be read.

Components assessed in this fashion are

'furnishings', 'access to protected areas',

'direct external egress' and 'travel distance'.

The final form of assessment used in the

worksheets is based upon a comparison of

each subcomponent with an established mea-

sure of adequacy derived from the Draft

Guide to the Fire Precautions Act, though it

is expe cte d t hat the assessor will also be famil-

iar with the other DHSS recommendations

and standards relevant to the com ponent. If

the component is found to be completely

adequate in every respect, it is rated as grade

5, but the further it is from the measure of

adequacy, the lower the grade, until if it is

totally in adequate then it is rated as grade 0.

The components which use this form of

assessment are 'corridors', ' l ifts' , 'commun ica-

tions systems', signs and fire notices', and

'manual firefighting equipment'.

( E ) T H E F O R M U L A T I O N O F A S U C C I N C T W A Y

T O P R E S E N T T H E R E S U L T S A N D M A K E C O M -

P A R I S O N S

The grades for each of the components in a

survey volume need to be combined together

to achieve an overall score which reflects the

relative importance of each component and

the interactions between them. The method

used for making such an overall assessment of

a survey volume is determ ined by the accuracy

of the survey data available. The simplest

method is based on the multiplication of the

grade for each compo nent by the percentage

contribution of that comp onen t to the overall

fire safety policy. This percentage contribu-

1 5 1

tion must include some assessment of the

interactions and so is based on the revised

values of the components (see Table 4,

column 2). This method assumes that the

components with which the comp onent under

consideration interacts have all been rated as

grade 5, rather than considering their actual

grades. The degree of inaccuracy introduced

by this simplification is fairly small and the

coarseness of the survey (between 0 and 5 at

integer intervals) suggests that any more

intricate or detailed mathemati cal use of the

survey grades would be inappropriate and

would o nly give a misleading sense of accura cy.

By this method, a single score of between 0

and 500 is calculated for each survey volume

which measures how far short of the require-

ments o f the Draft Guide to the Fire Precau-

tions Act the survey volume falls. It is this

met hod which is used in the proposed Health

Technical Memo rand um and Table 6 shows a

completed example of the summary sheet

provided using this metho d.

However, if a finer sys tem o f grading was

to be developed for the survey volume, it

would be worthwhile to calculate the score

for the volume by a direct application of the

mathem atical manipulation. This is modifie d

by the grades for every interacting com pon ent

and gives a score between 0 and 1192. A com-

parison of the overall scores obtained by these

two methods (for 32 sets of survey grades)

from the repeatability tests showed that the

use of the simpler metho d resulted in only a

small decrease in accuracy.

Having determined a figure which measures

safety against a common standard for an

individual survey volume, it is possible to

compare them with each other to determine

which are most in need of improvement. To

provide an approximat e indicati on of the level

that could be termed 'acceptable', the Delphi

group was asked to place each of the eight

survey volumes used for the repeatability tests

into one of the following four categories:

Good

Acceptable

Unacceptable

Definitely unacceptable.

Their estimates of 'acceptability' were made

within the con text of the current state of the

National Health Service in the United King-

dom; the term 'acceptable' does not imply

perfect fire safety.

8/18/2019 Ranking book

8/9

1 5 2

T A B L E 6

S a m p l e s u m m a r y s h e e t

H e a lt h A u t h o r i t y '

B u i l d i n g : V i c t o r i a H o s p i t a l

S u r v e y V o l u m e ' W a r d 1

D a t e o f S u r v e y : 1 / 4 / 8 3

S u r v e y o r ' A . N . O t h e r

N u m b e r o f B e d s p a c e s: 3 0

C o m p o n e n t

0 1 S t a f f

0 2 P a t i e n t s a n d v i s i t o r s

0 3 F a c t o r s a f f e ct i n g s m o k e m o v e m e n t

0 4 P r o t e c t e d a r e a s

0 5 D u c t s , s h a f t s a n d c a v i t i e s

0 6 H a z a r d p r o t e c t i o n

0 7 I n t e r i o r f i n is h

0 8 F u r n i s h i n g s

0 9 A c c e ss to p r o t e c t e d a r e as

1 0 D i r e c t e x t e r n a l e g r e ss

1 1 T r a v e l d i s t a n c e

1 2 S t a i r c a s e s

1 3 C o r r i d o r s

1 4 L i f t s

1 5 C o m m u n m a t i o n s s y s t e m s

1 6 S i g n s a n d f i r e n o t i c e s

1 7 M a n u a l f i r e fi g h t i n g e q u i p m e n t

1 8 E s c a p e l i g h t i n g

1 9 A u t o m a t m s u p p r e s s i o n

2 0 F i r e b r i g a d e

A d d i t i o n a l c o m m e n t s :

G r a d e * P e r c e n t a g e

c o n t r i b u t i o n

0 1 2 @ 4 5 × 9 = 2 7

0 1 ~ 3 4 5 x 6 = 1 2

0 1 2 ~ 4 5 X 7 = 21

0 1 2 3 4 ~ X 6 = 3 0

0 1 2 3 @ 5 X 4 = 1 6

0 1 2 3 4 ~ X 7 = 3 5

0 1 2 ~ 4 5 × 5 = 1 5

0 1 2 @ 4 5 × 6 = 1 8

0 1 2 3 @ 5 × 4 = 1 6

0 1 2 3 ~ 5 X 4 = 1 6

0 1 2 ~ 4 5 × 5 = 1 5

0 1 2 3 4 ~ X 5 = 2 5

0 1 2 3 4 ~ × 5 = 2 5

0 1 2 3 4 ~ X 3 = 1 5

0 1 ~ 3 4 5 X 5 = 1 0

0 1 2 ~ 4 5 X 4 = 1 2

0 1 2 3 ~ 5 X 3 = 1 2

0 1 ~ 3 4 5 X 5 = 1 0

@ 1 2 3 4 5 X 3 = 0

0 1 2 3 4 ~ X 4 = 2 0

T o t a l s c o r e ( o u t o f 5 0 0 ) = 3 5 0

* G r a d e s g i v e n b y a s s e s s o r a r e e n c i r c l e d

B y c o m p a r i n g t h e i r e s t i m a t e s w i t h t h e

s c o r e s f r o m t h e r e p e a t a b i l i t y t e s t s , i t w a s p o s -

s i b l e t o s e t t h e l e v e l o f a c c e p t a b i l i t y a t 7 0 % ,

w i t h s c o r e s g r e a t e r t h a n t h i s b e i n g c o n s i d e r e d

a s a c c e p t a b l e . A s c o r e o f 7 0 % o r l e s s w a s c o n -

s i d e r e d i n d i c a t i v e o f a n u n a c c e p t a b l e l e v e l o f

f i r e s a f e t y a n d a s c o r e o f 5 6 % o r l e s s w a s

d e f i n i t e l y u n a c c e p t a b l e . O n l y a s c o r e o f o v e r

9 0 % c o u l d b e c o n s i d e r e d ' g o o d ' a s o n l y t h i s

r e p r e s e n t s c o m p l i a n c e w i t h t h e ' n o r m ' ( t h e

D r a f t G u i d e ) .

T h r e e o f t h e c o m p o n e n t s ( ' s t a f f ' , ' p a t i e n t s

a n d v i s i t o r s ' , a n d ' f i re b r i g a d e ' ) w e r e n o t d e a l t

w i t h e x p l i c i t l y w i t h i n t h e D r a f t G u i d e , a n d a s

t h e e v a l u a t i o n s c h e m e o n l y c o m p a r e s s u r v e y

v o l u m e s w i t h t h i s n o r m , i t w a s u n f a i r t o

p e n a l i s e s u r v e y v o l u m e s w h i c h f a i l i n t h e s e

c o m p o n e n t s . T h e r e f o r e a s u r v e y v o l u m e h a d

t o b e g r a d e d a s 5 f o r e a c h o f t h e o t h e r c o m -

p o n e n t s , b u t n e e d o n l y b e g r a d e d a s 2 . 5 o n

t h e s e t h r e e . I n t h i s w a y , p a r t i c u l a r l y h i g h

s c o r e s f o r ' s t a f f ' , ' p a t i e n t s a n d v i s i t o r s ' o r

' f i r e b r i g a d e ' c o u l d c o m p e n s a t e i n s o m e m e a -

s u r e f o r a d e f i c i e n c y i n o t h e r c o m p o n e n t s .

W h e n d e t e r m i n i n g i n w h i c h c a t e g o r y a s u r -

v e y v o l u m e s h o u l d b e p l a c e d , i t i s i m p o r t a n t

t o b e a r i n m i n d t h e c o a r s e n e s s o f t h e g r a d i n g

s y s t e m w i t h i n w h i c h t h e s u r v e y w i l l h a v e b e e n

c o n d u c t e d ( t h e 0 - 5 g r a d i n g g i v i n g a n a c c u -

r a c y o f + 0 . 5 o n e a c h c o m p o n e n t ) . T h e

r e p e a t a b i l i t y s t u d i e s i n d i c a t e d a m a r g i n o f

e r r o r o f a b o u t 5 % , a n d s o s c o r e s o f 5 1 - 6 1 % ,

6 5 - 7 5 % a n d 8 5 - 9 5 % m u s t b e r e g a r d e d a s

i n d i c a t i v e o f b o r d e r l i n e s i t u a t i o n s . T h e s c a l e

o f a c c e p t a b i l i t y i s i l l u s t r a t e d i n F i g . 1 .

W h e n c o n s i d e r i n g t h e i m p r o v e m e n t s n e c e s-

s a r y t o a s u r v e y v o l u m e w h i c h i s ' d e f i n i t e l y

u n a c c e p t a b l e ' , i t c a n b e s e e n t h a t i t i s i n s u f -

f i c i e n t t o s i m p l y r a i s e i t a b o v e 5 6 % a n d s o

i n t o t h e u n a c c e p t a b l e c a t e g o r y . A n y p l a n n e d

i m p r o v e m e n t s m u s t e n s u r e t h a t i t w o u l d s c o r e

a b o v e 7 0 % a n d s o f a ll i n t o t h e ' a c c e p t a b l e '

z o n e . A f t e r t h e c o m p l e t i o n o f o n e o r al l

a s s e s s m e n t s o f s u r v e y v o l u m e s , i t w i l l b e p o s -

8/18/2019 Ranking book

9/9

4 5 ( ~

3 5 q

2 8 0

0

Fig.

. . . . . . . . . . . . . . . . . . . 1 0 0 . . . . . . . . . . . . . . . . . . . 5 0 0

G O O D

. . . . . . . . . 9 0 . . . . . . . . . . 4 5 0

A C C E P T A B L E

70%

UNACCEPTABLE

56%

. . . . . . . . . .

D E F I N I T E L Y U N A C C E P T A B L E

. . . . . . . . . . . . . . . . . . . . O ~ o . . . . . . . . . . . . . . . . . . .

Scale of acceptability.

3 5 0

2 8 0

0

s ib le t o i d e n t i f y t h e c o m p o n e n t s w i t h in o n e

v o l u m e , o r v o l u m e s , w i t h i n a b u i l d i n g w h i c h

n e e d i m p r o v e m e n t s o t h a t t h e i r s co r e s w i ll

b e c o m e ' a c c e p t a b l e ' . I t is p o s s i b l e a ls o t o

i d e n t if y t h o s e c o m p o n e n t s w h o s e im p r o v e -

m e n t w o u l d g iv e t h e b e s t o v e r a ll i n c re a s e i n

t h e s u r v e y s c o r e b y c o n s i d e r i n g t h e i r p e r c e n t -

a g e c o n t r i b u t i o n s t o f i r e s a f e t y . T h e g r a d e s

o b t a in e d b y t h e t w e n t y c o m p o n e n t s i n d ic a te

t h o s e w h i c h a r e p a r t i c u l a rl y d e f i c ie n t , a n d t h e

r e la t i v e v a l u es a t ta c h e d t o e a c h c o m p o n e n t

s h o w w h i c h w i l l o f f e r t h e g r e a t e s t p o t e n t i a l

f o r i n c r e a s e i n f i r e s a f e t y . F o r e x a m p l e , a

o n e - p o i n t i n c r e a s e i n t h e g r a d e f o r ' s t a f f ' i s

e q u i v a l e n t t o a t h r e e - p o i n t i n c r e a s e i n t h e

g r a d e f o r ' m a n u a l f i r e f i g h t i n g ' .

CONCLUSIONS

T h e p r i m e o b j e c t i v e o f t h is e v a l u a t i o n

s c h e m e w a s t o g i v e l o c a l as s e s s o r s a s y s t e m a t i c

t e c h n i q u e w h i c h is s i m p l e to o p e r a t e , s o th a t

t h e l ev e l o f fi r e s a f e t y e x i s t in g i n a n y s u r v e y

v o l u m e c a n b e a ss e ss e d a n d c o m p a r e d w i t h a

l ev e l o f a c c e p t a b i l i t y . T h e h i g h e s t s t a n d a r d o f

f ir e s a f e ty t h a t c o u l d b e e x p e c t e d w o u l d b e

c o m p l e t e c o m p l i a n c e w i t h t h e D r a f t G u i d e ,

t hi s r e p r e se n t in g w h a t c o u l d b e e x p e c t e d b y

t h e a p p l i c a t i o n o f t h e F i r e P r e c a u t i o n s A c t

( 1 9 7 1 ) t o e x i s t in g h o s p i t a l b u i l d in g s . T h e

153

e v a l u at io n s c h e m e o f f e r s a u n i f o r m m e t h o d

o f a s s es s in g f i r e s a f e t y r e l a t iv e t o t h i s s t a n d a r d .

I f a d o p t e d i t w o u l d e n a b l e H e a l th A u t h o r i t ie s

t o e a s i ly i d e n t i f y t h o s e h o s p i t a l s w h e r e a lo w

s t a n d a r d e x i st s , a n d b e r e a s o n a b l y s u r e t h a t

a n a c c e p t a b l e s t a n d a r d h a s b e e n a c h i e v e d

a f te r i m p r o v e m e n t s h a v e b e e n c o m p l e t e d .

T h e a u t h o r i t y o f th e s c h e m e li es i n t h e

a b i li ty o f t h e m e m b e r s o f th e D e l p h i g r o u p

w h o b e t w e e n t h e m e v a lu a t ed t h e d i f fe r e n t

o b j e c t iv e s , t a c t ic s a n d c o m p o n e n t s , a n d

e s t a b l is h e d w h a t t h e y r e g a r d e d a s t h e ' a c c e p t-

a b l e ' le v el o f fi re s a f e t y . A n y p o i n t s s c h e m e

c a n o n l y b e a s g o o d a s t h e m a t e r ia l o n w h i c h

i t w a s b a s e d , e i t h e r s t a t is t i c a l r e s e a r c h o r , a s

i n th i s c a s e , t h e e x p e r i e n c e o f t h e s p e c i a l is t s

i n v o l v e d .

I t is h o p e d t h a t t h e t w e n t y w o r k s h e e t s

m e n t i o n e d i n t h i s a r t i c l e , a l o n g w i t h a n

e x p l a n a t o r y d e s c r i p t i o n o f t h e s c h e m e , w i ll

b e p u b l i s h e d i n t h e f o r m o f a H e a l t h T e c h -

n ic al M e m o r a n d u m o n b e h a l f o f t h e D e p a r t -

m e n t o f H e a l t h a n d S o c i a l S e c u r i t y , b y H e r

M a j e s t y ' s S t a t i o n e r y O f f i c e , d u r i n g 1 9 8 3 .

A f u l l r e p o r t o f t h e p r o j e c t , i n c l u d i n g a ll

s u r v e y d a t a , is a v a i l a b le f o r c i r c u l a t i o n f r o m

t h e D e p a r t m e n t o f F i re S a f e t y E n g in e e r in g ,

E d i n b u r g h U n i v e r s i t y .

ACKNOWLEDGEMENTS

T h e s p o n s o r s h i p a n d f i n a n c i a l s u p p o r t o f

t h e D e p a r t m e n t o f H e a l t h a n d S o c ia l S e c u r i ty

h a v e b e e n i n v a lu a b l e . T h a n k s a r e al s o d u e t o

D r E ri c M a r c h a n t ( H e a d o f th e D e p a r t m e n t

o f F i r e S a f e t y E n g i n e e r in g a t t h e U n i v e r s i t y

o f E d i n b u r g h ) w h o d i r e c t e d t h e o v e r a ll p r o -

j e c t, D r J o h n M W a t ts , J r. , w h o w o r k e d o n

t h e m a t r i c e s , a n d t o a ll t h e m e m b e r s o f t h e

D e l p h i g r o u p .

REFERENCES

1 Rep ort NBS IR 78-1555-1, National Bureau of

Standards, 1978.

2 Code for Saf ety to Life fr om Fire in Buildings

and Structures, NFPA 101-1973, National Fire

Protection Association, Batterymarch Park,

Quincy, MA 02269, 1973.

3 Draft Guide to Fire Precautions in Hospitals,

Home Office/Scottish Home and Health Depart-

ment, 50 Queen Anne's Gate, London SWlN

9AT, 1982.