TITLE: Fire Drill Policy
DATE ISSUED: 5/2015 SECTION: All Staff
Transformations Surgery Center (TSC) will conduct quarterly fire drills to comply with the
National Fire Protection Association’s Life Safety Code, enhance emergency preparedness for fire
emergency and standardize a uniform set of guidelines for the preparation of fire emergencies.
ξ At least quarterly Transformations Surgery Center will conduct a practical fire drill at unexpected
times to ensure staff readiness for fire emergencies. The drill will be documented, evaluated and
used as a tool to improve life safety for all occupants.
ξ Prior to the fire drill:
o Review with staff the TSC Fire Response Policy and job action sheets.
o Identify those who will not be able to participate. Have staff participating in the fire drill
sign the Fire Drill Signup Sheet (see Attachment A).
o If appropriate, ask for employee volunteers to represent patients during the drill to practice
the moving of mobility impaired occupants.
o Call Facilities to have the fire alarm monitoring account put “on test” (refer to the Fire
Alarm Testing Policy) for the drill period.
o Have the Fire Drill Evaluation Form (see Attachment A) and timer ready.
ξ Fire Drill
o Coordinate the fire alarm system activation with Facilities.
o When beginning the drill, record the time. You may use a watch or clock.
o Observe employee response. Pay attention to job specific duties noted in the Fire Response
ξ Fire Drill Evaluation
o During the drill, evaluate staff performance using the Fire Drill Evaluation Form. Be sure
to record the time it took for staff to respond and evacuate outside or to areas on the safe
side of the smoke barrier.
o After the drill, have Facilities take the fire alarm monitoring account “off test” and confirm
with alarm monitoring when signal was received and system restored.
o After completing the evaluation, review with staff the results of the fire drill.
o Review any deficiencies with the Safety & Security Manager as well as plans for
o Share the final drill outcome and corrective action with all staff.
Fire Drill Sign-up Sheet
Participants Job Title
FIRE DRILL EVALUATION FORM
Complete as much information as possible on the evaluation form. Record the time it took staff to evacuate to the designated
assembly area (Drill Response Time). Average the scores and record at the bottom of form. Review results with staff and submit
completed form to the Safety & Security Manager.
Location: Date: Time:
Drill Conductor: Drill Response Time:
IN TERMS OF PARTICIPATION, WORST IS DEFINED AS LESS THAN HALF, PARTIAL IS AT LEAST
HALF AND BEST IS NEARLY ALL.
Were any persons rescued from the immediate fire
Was the fire alarm pull station tripped or overhead code
Were doors around the immediate fire area closed?
Was the location of fire identified/ shared with arriving
Did occupants evacuate to the outside designated area
(about 150-200 feet)?
Did critical care patients move to the safe side of the
Was evacuation done in a timely manner?
Were any hall doors wedged opened?
Were exit lights visible?
Were exit routes free of obstructions?
Was radio communication clear?
Were there any participants not accounted for?
Total Average Score = _______
What problems were encountered?
Did fire alarm monitoring receive the alarm signal? YES_______ NO_______
Time signal was received ____________
At what time was the fire alarm monitoring system restored?