Interactions and connections of safe egress factors in hospital designs

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Abstract

Purpose – This study examines fire safety design in hospitals, aiming to identify and understand the factors that influence its effectiveness through control and evacuation while addressing challenges related to patient mobility. Design/methodology/approach – The study employs a qualitative narrative approach, systematically reviewing 130 relevant articles and research papers. Conducting a systematic literature review identified 10 key factors of safe egress in hospitals that affect patient evacuation. Then, through semi-structured interviews, 25 field experts confirmed those findings and added two more key factors. Findings – This study found patient mobility rate and conditions as the most crucial key factor influencing safe egress apart from the other 12 factors which are occupant types, occupant behaviour, exit characteristics, interior layout, fire spread and fire cells, building fire-rated materials, required safe egress time/available safe egress time, fire detection and suppression systems, signs and evacuation elevators, building model simulation and staff training. Research limitations/implications – This study’s limitations include the non-inclusion of the most recent fire incident reports due to their unavailability to the public. Additionally, reliance on secondary data sources in some areas introduces the potential for inaccuracies. The scope of the literature review was also limited by language (English only). The robustness of the methodology followed mitigates the limitations of the study. Practical implications – This study assists field professionals – including architects, fire engineers, consultants, medical staff and firefighters – as well as the general public, by providing critical design information to ensure the safe evacuation of all hospital occupants, particularly patients, thus participating in achieving the United Nation’s goals of creating safe environments and fostering sustainable, resilient infrastructure while ensuring the safety of people of all ages. Moreover, the new factor of patient mobility conditions is an addition to the body of knowledge that would interest academics. Originality/value – The novelty of the study identified patient mobility conditions as the key influencer for safe fire egress at hospitals while discussing the interrelations between the 12 critical factors.

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APA

Fahmi, M., Purushothaman, M. B., Rotimi, F. E., & GhaffarianHoseini, A. (2026). Interactions and connections of safe egress factors in hospital designs. Smart and Sustainable Built Environment, 15(4), 1590–1623. https://doi.org/10.1108/SASBE-06-2025-0307

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