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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
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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.
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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
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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
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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
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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.
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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 -
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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.