How Evacuation Training, Exercises and Drills Can Save Lives

How Evacuation Training, Exercises and Drills Can Save Lives

Education and knowledge are critical to survival.

On September 11, 2001, Rick Rescorla, the security director for the Morgan Stanley offices in the World Trade Center buildings, was seated in his office on the 44th floor of Two World Trade Center. He had roughly 3,700 employees in those buildings who occupied over 22 floors of space. When he saw the first plane hit the north tower of the World Trade Center, he immediately ordered the evacuation of his staff in the south tower despite orders to the contrary. He even called for the evacuation of around 1,000 employees in WTC 5, a nine-story building near the Twin Towers.

He is credited for saving almost all of his people that day. Unfortunately, Rescorla died that terrible day and was last seen going back up the stairwell to ensure that everyone was evacuated, just as the second plane hit the north tower.

While many tell the story of his heroism in the face of danger, leading his staff down the stairs in a calm and orderly manner, their survival and success was developed before that fateful day. It was developed with the rigorous evacuation training, exercises and drills he demanded. Rescorla met resistance in scheduling these “non-productive” events, but he did it anyway. Proper planning prevents panic.

The OSHA Act of 1970, states that employers provide a work environment "free from recognized hazards that are causing or are likely to cause death or serious physical harm." In my role of leading emergency management for my organization, we took an “All Hazards Approach” to planning for emergencies. The essence of this is to create a common response plan as much as possible, regardless of the hazard. There should be no sense of competition concerning which hazard is more impactful. Fires and active shooters both kill. The biggest lessons learned from employees is that they want to feel and be “safe,” not only from fires, but from violence and other risks. Knowing what to do helps achieve that. Training, exercises, and drills make it happen. 

The Difference Between Procedures and Plans  

One important distinction is the difference between procedures and plans. Early in my career, we encountered an emergency that had the potential to require the evacuation of over 600 patients. We had a procedure in place at that time which stated that for this particular hazard, plan and execute an evacuation. Evacuating a hospital should be the last resort as there can be greater harm to patients during an evacuation. While we prepared for the potential to evacuate, we took steps to mitigate the harm until the hazard was eliminated. And in the end, we avoided the need for evacuation.

In the subsequent Department of Public Health review of the incident, they were pleased with our response, except for the fact that we were cited for not following our procedure. The lesson we were taught was to develop plans that allow for critical thinking and “just in time” decisions. I was tasked with converting our procedures into more general plans, not proscriptive procedures.

In emergency management, our plans were developed to address four phases: mitigation, preparedness, response, and recovery. To provide a holistic approach for safety and to adhere to the all-hazards concept, our occupational safety staff (responsible for fire safety) and emergency management staff worked together. We developed plans to address evacuation measures regardless of the hazard.

These plans need to be presented to new employees as a part of their on-boarding process. OSHA will want a new employee to be prepared on day one and rightfully so.

“I am a new employee,” should not be an excuse. In a healthcare environment, patients’ lives depend on caregivers providing assistance and direction on day one. In an education setting, students as little as five years old are the responsibility of a teacher. Many times, these children will look to their teacher to save them, even on day one. In higher education schools the student population turns over a brand-new group of freshmen every year. Along with the usual hijinks, someone will likely pull a fire alarm pull station. It should be an automatic response to evacuate the classroom, not assess if it is a false alarm or real. The path to the rally location should be known on day one.

I was recently in a hotel when I heard the fire alarm annunciation and saw the strobes get activated. I started down the path to the exit when hotel staff stopped me to advise me that the fire alarm technician was working on the system. It is so important that these service events be articulated by multi-modal means with signs and audible notification to ensure people do not build in assessment time in their response. When an alarm is activated, always assume it is real and follow the procedures. People can die because they assume a false alarm and do not act in time.

Thankfully, and mostly due to NFPA guidance; most buildings evacuation stairwells are mandated by municipal codes that are similar and require pretty much the same evacuation paths. As adults we should be able to recognize where the emergency stairwells are located and the paths to these. As a part of my “Run, Hide, Fight,” training, I emphasized preparation. Be prepared to hide or evacuate. Know where the emergency exits are located. When you sit down at a meeting, a concert or any other gathering, take the time to identify your emergency exit strategy.

How to Conduct Exercises and Drills  

Once people have been trained on an evacuation plan, it is time to exercise and drill. In most occupancies, the fire alarm activation is a single stage condition requiring evacuation. These types of drills are conducive to unannounced exercises. I believe the drills that merely check the box for compliance without feedback or analysis are a waste of time. A concept or mantra we embraced at my organization is that we wanted to be more than compliant, we wanted to be ready for any emergency.

The drills that provide trained observers along the exit path provide the best opportunity for immediate feedback to the participants and will help participants be better prepared for a real emergency. We created a group of interested volunteers into a committee that would be trained to be observers. Train observers to look for the proper behavior. Ensure participants are calm, are not causing bottlenecks or lugging unnecessary belongings with them. Observers should be easily identified with hi-vis vests or the like. They should have two-way radios to help communicate status. We staged them at the stairwell doors on each floor. When it was believed that all participants had evacuated, we would ask them to check the usual hiding spots such as special offices, bathrooms and sometimes even closets for non-participants.

In a healthcare setting, the fire alarm activation is a two-stage response. The first stage should be annunciated as a code red. That puts nursing and organizational staff into a mode of education for visitors and preparing patients for horizontal evacuation. Hospitals are built with smoke and fire compartments. If the code red is affecting the immediate area, staff should be trained to move patients and visitors in a horizontal path to the next compartment, awaiting further instruction.

While we held unannounced routine fire drills, we would also introduce and announce a scheduled, limited real life patent evacuation drill using patient slides for non-ambulatory patients down stairwells. We put real people on the slides, ensuring that all safety measures are followed. Experienced observers would assist in evaluating and teaching staff on the use of the equipment. Horizontal evacuation is not easy and these drills were important to staff.

Routine fire drills are usually required by local codes, regulations or authorities having jurisdiction. Minimally, every employee should be required to review fire and evacuation plans annually. Their understanding of the plans can be demonstrated with test scores on quizzes. Each employee should be required to participate in an annual drill.

Drills and exercised are opportunities to use what you have learned in a class setting and further that with actual hands-on practice. Don’t be afraid to fail. It happens to everyone. It is best to fail and learn in practice than in the real scenario. Remember that no doctor or nurse touches a patient without having enough practice and exercise beforehand. 

This article originally appeared in the April 2022 issue of Occupational Health & Safety.

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