Bruce Eichler, MBA, AIC
Senior Claims Consultant
Steve Johnson, COSS, CHSP, COEE
Senior Risk Consultant
How often do you think about the mechanisms that allow doors to operate? If you are the typical visitor to a healthcare facility, the answer is not often if at all. This month’s claim study examines what happens when a door closure system fails and causes injury to a visitor.
External door systems are used by staff and visitors around the clock in many facilities. The typical door closure system found on commercial buildings is operated by a manual hydraulic system. Hydraulic systems in and of themselves are both heavy and heavy-duty. They are built to maintain control of commercial entry doors where the door weight can exceed 100 pounds. However, the door closure system is attached at the top of the door, making it easy for staff or visitors entering or exiting a building to overlook.
So it was both unfortunate and unexpected when a hydraulic system became detached from an external door and swung down, striking the back of a visitor’s head as she exited the facility. It was reasonable to expect a resulting impact injury to her head and soft tissue injury to her neck from the incident. While the visitor did not sustain long-lasting or permanent injury, she did file a claim based upon the injuries received.
While the reasons for this particular system failure will never be known, the case highlights the importance of performing routine checkups of all door closure systems at your healthcare facility.
Door closure systems can present many hazards if they become loose or are improperly adjusted. If they become loose, closure systems can disconnect from the door and hit someone such as in this situation. If the closure is not adjusted properly, the door can be too hard to open or close too quickly, causing the door to hit someone before they pass through the door opening.
Door pressure gauges can be used to check the force required to open a door. Interior doors should require no more than 5 pounds of force to open, and exterior doors should require between 8.5 and 10 pounds of force. A door’s closing swing speed should be no more than 5 seconds when measured at the open 90-degree position to 12 degrees from the latch.
Your facility’s Environment of Care Plan should include routine door inspections and establish a regular maintenance schedule for facility entries and exits. Doors inspections must also take place during safety rounds conducted at least quarterly by facility maintenance staff. Check all door hardware to ensure it is secure and functioning properly. The LHA Trust Funds has created an Environment of Care Safety Rounds Checklist that includes external door closure systems and is intended for use during facility Safety Rounds. View the checklist here.
Staff or visitor complaints related to concerns about a door should be followed up on in a timely fashion through the work order system. Sometimes complaints that are submitted regarding doors closing too quickly or doors that are difficult to push open may indicate a safety issue exists. By conducting regular door inspections and responding to work orders promptly, your facility can reduce the risk of injury and ensure safety for all.