Joint Commission Official: Don't Put Patients in Egress Halls When ED Overcrowds

Scott Wallask, for HealthLeaders Media , June 25, 2009

An important point: The task force indicated the policy doesn't apply to ED surges caused by disasters that resulted in a large influx of victims to a facility.

The thinking is that such events are hard to fully plan for and the immediate need of medical services may temporarily trump exit corridor requirements in the Life Safety Code.

Hospital moves with state approval

The Joint Commission's stance comes as a surprise to Dennis Irish, spokesperson for Saint Vincent Hospital in Worcester, MA, especially given that the Massachusetts Department of Health and the state fire marshal have communicated about how patient boarding in hallways can work within fire safety requirements. The Department of Health ruled in January 2009 that hospitals in Massachusetts can't divert ambulances to other healthcare facilities to avoid ED overcrowding.

Saint Vincent's policy is to put boarded patients in wheeled chairs—not gurneys—in the hallways on rare occasions when the ED is in danger of being overpopulated, Irish said.

"It's a last resort," he added.

In a letter to local fire chiefs posted online, the Massachusetts fire marshal highlighted the Department of Health's new overcrowding policy. The letter further asked chiefs to work closely with hospitals in their communities to understand healthcare egress strategies in the event that patients are boarded in corridors.

Scott Wallask is senior managing editor for the Hospital Safety Center. He can be reached at

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