Fire drills are a problem — Here’s how to ace them
Joint Commission: Every employee, every quarter
Did you receive a poor score regarding fire drills during your last accreditation survey? If so, you weren’t alone. The Joint Commission on Accreditation of Healthcare Organizations reports that 13.7% of facilities surveyed between January and July 1997 received a score of 3, 4, or 5 for Environment of Care standard 2.10: Expectations for fire drills. The Accreditation Association for Ambulatory Health Care (AAAHC) also reports that facilities have problems complying with fire drill requirements.
The Joint Commission requires that fire drills be conducted every quarter on every shift and involve every employee. "And some may be a walk-through," says Ann Kobs, sentinel event specialist for the Department of Standards at the Joint Commission. "That works fine."
The Joint Commission doesn’t require freestanding centers that have less than four people incapacitated at any given point and time to conduct fire drills, Kobs says.
In comparison, AAAHC requires at least one fire drill a year in which the fire department is notified so that the alarms can be pulled, says Gerald G. Pousho, MD, medical director at Washington Outpatient Surgery Center in Freemont, CA, and AAAHC surveyor.
Also, there should be a policy that clearly states who gives the order for evacuation, and at what point that order is given, Pousho says.
What would your physicians do in a fire?
Two of Pousho’s favorite questions to ask a same-day surgery employees are: Where is the nearest fire alarm pull box? And where is the nearest fire extinguisher? Kobs says surveyors like to ask physicians what they would do in the event of a fire.
"The answers we’ve received have been very enlightening," she says. "One was, ’I’d call my secretary.’ The second one was, Run like hell.’"
All joking aside, many physicians aren’t oriented about what to do in the event of a fire, Kobs points out.
Want to earn extra points with your surveyor? Schedule one employee inservice every year in which the fire extinguishers are demonstrated, Pousho says.
"That tells me they’re serious about them," he says. "Not only do employees know where they are, but thy know how to use them. That’s a good sign."
In regard to another environment of care standard that requires sterilizers to be monitored, neither the Joint Commission nor AAAHC tell you how to monitor them or how often.
Instead, use direction from associations such as the Association for the Advancement of Instrumentation in Arlington, VA; Association for Professionals in Infection Control and Epidemiology in Washington, DC; and the Association of Operating Room Nurses in Denver, Kobs suggests. Also, read your manufacturer’s instructions, she adds.
The number of tests on the sterilizer depends on the volume of the surgery program, Pousho says. "If a surgery center is only doing two or three procedures a week that require a sterile technique, then monitoring can be more infrequent."
"But if it’s a high-volume program, I’d expect monitoring of the sterilization technique to be at more frequent intervals," he says.
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