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Area of Refuge in a Hospital

by Brad Keyes, CHSP, on Oct 28, 2020 1:00:51 AM

Q: We ask staff this question when we do Environmental Rounding: "Can you identify the closest area of refuge?" The answer we have used is "shelter-in-place," but I believe this may be misleading. Can you please provide a more accurate answer?

A: According to section 3.3.22 of the 2012 Life Safety Code, an Area of Refuge is one of the following two things:

  1. An area that is a story in a building where the building is protected throughout by an approved, supervised automatic sprinkler system and has at least two accessible rooms or spaces separated from each other by smoke-resistant partitions (i.e. corridor walls).

  2. An area of refuge is a space located in the path of travel leading to a public way that is protected from the effects of a fire, either by means of separation from other spaces in the same building or by virtue of location, thereby permitting a delay in egress travel from any level.
In the past, most hospitals have relied on item #1 above to meet the Area of Refuge requirement. Rooms and spaces could be found on most stories of hospitals that were separated from each other by corridor walls. Each smoke compartment could easily qualify as an Area of Refuge simply by having two accessible rooms separated by corridor walls. There has been no requirement by any of the accreditation organizations (AOs) to mark the Life Safety drawings with the Areas of Refuge. But, many hospitals are not fully protected with sprinklers, so they automatically do not qualify for option #1. In healthcare occupancies, section requires compliance with section 7.2.12 for areas of refuge used as part of a required accessible means of egress. That means if the hospital cannot meet the requirements for item #1 above (accessible rooms separated by corridors in a fully sprinklered building), then they have to comply with the more rigid section 7.2.12, that has the following requirements:

  • Each elevator landing must be provided with a two-way communication system for communication with the fire command center or a central control point approved by the AHJ.
  • Directions on use of the two-way communication system, instructions for summoning help, and written identification of the location must be posted.
  • Audible and visual signals must be included in the two-way communication system.
  • Accessibility requirements regarding exits and elevator access
  • Illuminated signs identifying AREA OF REFUGE
  • Two-way communication system at the AREA OF REFUGE

The problem is, this does not seem to fit the mold of healthcare occupancy, where there is adequate staff to attend to the needs of the patients. Most patients cannot egress on their own, let alone travel to the AREA OF REFUGE. I don’t recall ever seeing a finding from an accreditation survey or a CMS state agency survey involving the AREA OF REFUGE in a healthcare occupancy. In a business occupancy…? Yes, but that is an entirely different animal because the expectation is the occupants can egress themselves and there may not be anyone around to assist them.

Personally, I would suggest you stop using the words ‘AREA OF REFUGE’ in your rounding, and just encourage your staff to egress into the adjoining smoke compartment.

Topics:Life Safety Code

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