The widespread use of fire suppression sprinklers has had a tremendous impact on making American hospitals safer over recent decades. Yet, even now, some consider the installation of fire suppression sprinklers as a type of optional insurance policy in health care facilities. While we estimate that a great majority of our nation's hospitals are sprinklered, many are only partially sprinklered — leaving some areas vulnerable.

There are several reasons behind the lingering resistance to fully sprinkler hospitals.

Of course, money is a concern. We haven't set aside the capital to retrofit non-sprinklered hospital buildings or non-sprinklered areas of hospitals. Sprinkler installation can be value-engineered quickly out of modernization projects.

The Centers for Medicare & Medicaid Services (CMS) and local building officials also have not strictly required us to fully sprinkler our hospitals. Concerns over potential water damage in certain areas — operating rooms, information technology centers and rooms containing medical records — are another reason we sometimes pause at the thought of fully sprinklering our facilities.

But the time is coming when fully sprinklering our facilities will be required. In 2009, the International Code Council (ICC) adopted a change that would retroactively require all hospitals to be fully sprinklered. The evidence supporting this change is indisputable — when fully operational fire suppression systems are installed, there is no loss of life. It's important to remember that this change was accompanied with many trade-offs and allowances that benefit hospitals, such as using defend-in-place practices that allow hospitals to keep patients in their rooms during an emergency or fire alarm instead of instituting full facility evacuations.

The ICC's building and fire codes are adopted in most states or municipalities across the country. The new editions of these codes clearly expect every area of hospitals to be covered by some type of fire suppression system.

While no time frame for fully sprinklering health care facilities has been set, some authorities would argue that the changes need to be made immediately. Unsprinklered or partially sprinklered hospitals should seriously consider funding projects that would complete their sprinkler system coverage.

The ICC is not the only code-writing organization moving toward fully sprinklered facilities. CMS also is considering updating its adopted regulations, which would require hospitals to be fully sprinklered within nine years of adoption.

If your hospital is not already fully protected, sprinkler installation should be on your radar. Delaying full sprinklering of your health care facility is only delaying the inevitable. Retrofitting can be expensive, and in some aging facilities it can be nearly impossible, but having a good plan now could help prevent a citation by regulating authorities while providing optimal safety levels.

ByChad Beebe, AIA, SASHE, director of codes and standards at ASHE.

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