A small fire breaks out in a hospital's outpatient wing. Immediately, the fire alarm system kicks into action. The hospital engineering staff is alerted to the activated device location, the fire department is called, and an audible chime strobe informs the public. Meanwhile, in the ambulatory care's private mode area, nurses are notified via the chime strobe and an alarming device on the nurse call system. Now, emergency egress can calmly take place in the affected areas. Of course, such a potentially disastrous scenario would only proceed so smoothly if a code-compliant fire alarm/voice evacuation system had been carefully specified and installed -- and a well-trained facility staff was manning the system.

"Hospitals are very unique, complicated buildings, and our systems are the most complicated within a hospital because we have to interface with so many other systems," explains Kurt Brinkman, principal of the Oakland, Calif.-based Intrepid Electronic Systems, whose company recently installed integrated fire alarm/mass notification systems at the renovated VA Palo Alto Health Care System campus and the new John Muir Medical Center in Walnut Creek, Calif.

Part of this complexity is created by the fact that the systems designer and supplier must closely coordinate with so many different trades, not to mention they must deal with stringent hospital code requirements mandating specs like device placement and communication protocols.

The need for a large-capacity system that can be easily reconfigured and expanded led Intrepid to use a Notifier NFS-2 3030 system controlled by an ONYXWorks workstation for both hospital projects.

For the VA project, the team phased out the existing central system and phased in the new technology, while keeping the fire alarm system operational. Thanks to the new system's architecture, five control panels were sufficient to replace the existing 36.

Mass notification can easily be communicated across the campus in the form of audio, LED strobes, computers, phones, and mobile devices. In sync with code requirements, the system was specifically programmed to encapsulate varying signals to different facility areas to prevent unnecessary panic amongst bed-ridden patients, for example.

Integrated with the HVAC, security, and elevator systems, the VA's new fire alarm installation can also shut off damper and fans for smoke control, operate the elevators, and override the security system to unlock doors for enhanced egress.

On the John Muir project, similar features were incorporated, except the mass notification was scaled down to a chime system without speakers, and open-plenum wire was specified instead of conduit. All together, the new 250,000-sq-ft, $400-million hospital incorporated more than 1,100 fire/smoke dampers, approximately 1,400 ceiling smoke detectors, 300 horns/strobes, 50 manual pull stations, 50 duct smoke detectors, two control panels, and one network station.

Because the fire alarm system is usually the last to go in, working closely with the owner and subcontractors is essential in commissioning the system. "For the VA, it was a lot easier because it was design-build, and we were responsible for all the trade coordination," explains Brinkman. "We understood the other supplier's requirements, so we were forced to look at the issues up-front. This way, my guys were able to go out and clarify all the connections to our systems."

Coordinating inspections and system design reviews can be time-consuming but necessary. "It's a huge challenge, especially in the state of California," confirms Brinkman. "There were three different State of California Office of Statewide Health Planning and Development (OSHPD) inspectors involved with John Muir, and it took more than 60 days just to get our drawings through the OSHPD plan check process."

When inspectors from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) came through, Intrepid's process of bar coding every device at the VA helped the inspection process, notes Veitch. "Utilizing inspection reports software, JCAHO reviewers were then able to ascertain when each device was last scanned and inspected," he says.

Brinkman also points out that one-third of the manpower required for a new hospital is engineering, and the review process is extensive. As such, the blueprints are constantly being worked on all the way through the project, which requires a significant time investment. In terms of proactively preparing for such realities, Brinkman advises building system suppliers to become NICET-certified (National Institute for Certification in Engineering Technologies) electricians. Through the certification process, electricians study up on the building and fire codes. Then, by the time the top certification rank (Level IV) is achieved, his or her code knowledge is typically equivalent to that of a fire protection engineer. In addition, Brinkman recommends becoming active in associations, such as the National Fire Protection Association (NFPA) and the Automatic Fire Alarm Association, which can be a great resource of information on code and design issues coming up in health care projects.

Another important aspect of effective fire protection installations is commissioning. Although currently not mandated, NFPA 3: Recommended Practice on Commissioning and Integrated Testing of Fire Protection and Life Safety Systems code prioritizes it as a best practice.

"Commissioning building systems typically involves testing 10% of the components, but with fire protection systems, that's unacceptable and doesn't really serve the owner well. It has to be 100%," explains David L. Boswell, SET, regional director, Hughes Associates, Lafayette, Colo., whose firm served as the third-party commissioning agent for the VA's fire protection upgrade.

Another piece of the puzzle is training the end-user to operate the system. A big believer in education, Brinkman's firm typically gives as much training as required, particularly in the first year, which includes system testing. "The worse time to figure out how to use something is during an emergency," he says. "I can't tell you how many times these systems go off, and the user doesn't know how to silence the alarms."

With the VA installation, for instance, Intrepid spent 200 plus hours working with the hospital staff to fully understand the system operation. These "field factory training classes," plus the issuance of training certificates to participants, were actually required by the VA. Furthermore, Intrepid had to train the VA Police Department, which necessitated six different training classes to cover the department's various shifts supporting its 24/7 operations.

"Even now, we're doing a refresher training course for another week to get up-to-date on some updates to the system," says Veitch. "As the first responders, [in non-emergency situations], my facility engineering staff has to be able to make minor repairs, so the training has really helped."

In the grand scheme of things, today's fire protection/mass notification technology is more advanced than ever. However, for hospitals to truly take advantage of this functionality, a new installation must incorporate solid operator training, knowledge, and patience with the code compliance process. Finally, a well-coordinated project process where the fire systems dealer is brought onboard as early as possible can ensure a well-designed fire protection solution and timely installation.