Interventions to improve emergent response in hospitals

As a city hospital and research center, Boston Children's Hospital is a complex environment that requires a seamless, coordinated response in the event of a fire emergency. Although BCH met all regulatory requirements, a multidisciplinary team was formed to evaluate and improve fire response in order to ensure patients, families and employees would be safe in the event of a fire. As a secondary goal, false alarms were identified as desensitizing distractions that needed to be reduced. This interdisciplinary team led a rapid results initiative to: identify root causes of activations, reduce false alarms and improve coordinated response. A Root Cause Analysis Taskforce evaluated causes of historic alarms (2008-2011) and developed interventions for the most prevalent root causes (~60%). A Local Preparation Taskforce developed a Fire Coordinator role, responsible for training and drilling a coordinated team response, based on local risk assessment. This task force identified and trained over 300 Fire Coordinators in 2012. A Drill Taskforce developed a measurement tool to assess coordinated response effectiveness. This tool was used to test pre- and post- interventions. In 2012, we saw a 53% reduction in false alarms for the most prevalent root causes, compared to 2011. Comparison of drill results pre- and post- Fire Coordinator implementation showed a 36% increase in staff performance. This multidisciplinary initiative improved coordinated staff response during fire emergencies, as well as reduced false alarm activations that can distract from real emergencies. The three task forces continue to identify root causes and opportunities for performance improvement.