Building safe, effective health care facilities: Fire and life safety

It’s hard to think of an engineering project with higher standards than a hospital or health care facility—successfully designed and installed systems can literally be a matter of life and death. Here, engineers with experience in the field offer advice on how to deliver such projects with a clean bill of health.


J. Patrick Banse, PE, LEED AP, Senior Mechanical Engineer, Smith Seckman Reid, HoustonDaniel L. Doyle, PE, LEED AP O+M, Chairman, Grumman/Butkus Associates, Evanston, Ill.Robert Jones Jr., PE, LEED AP, Associate Director of Electrical, JBA Consulting Engineers, Las VegasCraig Kos, PE, LEED AP, Vice President, ESD Inc., ChicagoEssi Najafi, Senior Vice President/Principal, Global Engineering Solutions, Rockville, Md.Paul J. Orzewicz, PE, Mechanical Engineer, Project Manager, RMF Engineering Inc., BaltimoreDavid A. Smith, PE, EDAC, Principal, National Director of Health Care, KJWW Engineering Consultants, Madison, Wis.


  • J. Patrick Banse, PE, LEED AP, Senior Mechanical Engineer, Smith Seckman Reid, Houston
  • Daniel L. Doyle, PE, LEED AP O+M, Chairman, Grumman/Butkus Associates, Evanston, Ill.
  • Robert Jones Jr., PE, LEED AP, Associate Director of Electrical, JBA Consulting Engineers, Las Vegas
  • Craig Kos, PE, LEED AP, Vice President, ESD Inc., Chicago
  • Essi Najafi, Senior Vice President/Principal, Global Engineering Solutions, Rockville, Md.
  • Paul J. Orzewicz, PE, Mechanical Engineer, Project Manager, RMF Engineering Inc., Baltimore
  • David A. Smith, PE, EDAC, Principal, National Director of Health Care, KJWW Engineering Consultants, Madison, Wis. 

CSE: What unique fire suppression or life safety systems have you specified or designed in a hospital?

Najafi: When a health care facility has a large data center, it requires a cross zoned pre-action sprinkler system. This system should also incorporate a VESDA early warning constant air sampling smoke detection system.

CSE: How have the costs and complexity of fire protection systems changed in recent years?

Smith: The cost of fire protection systems has actually decreased due to the quality and acceptance of plastic piping systems.

CSE: What type of unique smoke control solutions have you designed in these buildings? What were the challenges/solutions?

Banse: Hospitals and related health care facilities pose many challenges to fire and smoke control as they relate to patient and staff safety. These facilities have mandatory requirements to be protected with an automatic fire sprinkler system, which is extremely beneficial in containing fires to the compartment of fire origin. Maintaining the integrity of fire and smoke partitions with fire-safe and sealed openings and properly placed fire smoke dampers allows for horizontal movement of patients to areas of safe refuge, as general evacuation is not an option as it is in other occupancy types.

Orzewicz: Recently, I was involved in a renovation of a six-story patient bed tower that required the central air handling units (AHUs) to remain operational in the event of a fire. However, this was not the typical smoke control mode where only a portion of the building needed to remain pressurized; instead the entire building needed to remain under control by the BAS for patient comfort. To achieve this, the AHUs go to 100% outside mode and an extensive network of isolation dampers (controlled through the BAS and fire alarm system) automatically rebalances each floor to a negative pressure with a positive pressure air lock outside each floor’s entrance lobby. 

Najafi: One area where creative solutions are required for smoke control is large bay spaces and specifically atriums. On several projects we’ve taken what was previously an open-air courtyard and converted it to a glass-enclosed atrium which required smoke evacuation systems.

CSE: What unique egress challenges do hospitals pose?

Banse: Maintaining proper means of egress, exits, and exit access is a challenge; however, proper design and selection of HVAC systems and controls allows for the isolation of smoke to the compartment of fire origin by either the shutting down of air systems and closing of fire smoke dampers or by exhausting of air in adjacent spaces to maintain clear egress paths. Isolation of duct systems that communicate with egress paths to minimize smoke migration is also effective.

Najafi: One of the challenges with egress for health care environments is not only the large quantity of people needing to evacuate at one time, but in many cases that the people being evacuated have limited mobility, which can present significant challenges.

CSE: Describe a recent project in which a mass notification system (MNS) or emergency communication system (ECS) was specified. Describe the challenges and solutions.

Najafi: Providing MNS for one building is typically not difficult, but providing the system throughout a campus presents unique challenges. Outlining exact requirements of the system requires close coordination with the campus technical staff in addition to close coordination of the underground pathways throughout the campus. 

Smith: Intelligibility of the voice systems can be difficult due to the fact that the system is usually designed before the interior designer selects finishes, which can greatly affect the acoustics of the space.

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