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This paper aims to evaluate the level of compliance of fire safety with the legal requirements in Malaysia government hospital buildings by evaluating via fire risk management.

Five government hospitals were selected. These five hospitals were selected due to the location of Penang, which is one of the fast-growing states in Malaysia (Salleh, 2019; Ebekozien, 2019). This state is the second most densely populated state after Wilayah Persekutuan Kuala Lumpur, with an average distribution of 1,490 persons per square km. This higher population caused the higher demand on the health-care services by the public (DOSM, 2016). The observation and building audit processes are as described. Hundreds of photos were taken for qualitative analysis, and all fire safety elements were measured for the descriptive analysis for each hospital. The framework of audit elements is created based on the Life Safety Code: NFPA 101 (2018), UBBL 1984: Part VII (Fire Requirements) and Part VIIII (Fire Alarms, Fire Detection, Fire Extinguishment and Fire Fighting Access). The cross-sectional descriptive evaluation is conducted in the case studies building in accordance with Life Safety Code of NFPA, also known as NFPA 101. To conduct the study, the information needed to assess the fire safety status was extracted from the CFSES software based on the NFPA 101 standard and prepared and compiled by the researcher as a checklist. In the next stage, gathered information was analysed using Computerised Fire Safety Evaluation System (CFSES) software. This method was developed based on the NFPA 101 standard and evaluated the fire risk from four dimensions of containment, extinguishment, people movement and general safety. This software gives the risk assessment results in three areas of fire control, exits and general safety. To assess the fire risk of the commercial buildings after entering the background information (height, age, number of stories, etc.) in the software, the software first calculates the score that the building should obtain in the three aspects of fire control, exit routes and general safety (minimum score required).

The utmost zones in the case studies (44.3%) occupied by limited mobility are located at low-rise buildings or at the first floor to third floor of the hospital buildings. Hospitals managements lacked in creating the maximum exit route and egress the occupants to disclosed the building during evacuation, it correlates to the patients' mobility positions strategy to assign their categories that fell on effortless mobilisation. Surveyed hospitals were built with the non-combustible materials, even though four of the case studies were built before 1984. Hospitals were equipped with hazard separations and vertical smoke pores, and in most of the zones, sprinkler system is installed only in the corridors, equipped with communication system and system of communication with fire and relief organisations and has a fire detection and alarm system throughout the building. Results of fire risk assessment on four groups of elements were tested via CFSES revealed from 122 zones of surveyed hospitals; 102 or 84% of zones give the highest failed rate to comply the NFPA 101 requirements in terms of people movement in the building. The high-occupied Penang General Hospital contributed as the highest case study for not complying with the minimum requirements in all dimensions: people movement elements (41 zones), fire containment (31 zones), fire extinguisher (31 zones) and general safety (20). Fire extinguishment (62 zones) recorded the highest numbers of zones that complied with NFPA 101 (2013). The overall results of the fire risk assessment suggested that in terms of the fire control, egress and general safety aspects, the fire risk assessment score was unacceptable (failed) in all hospital buildings studied, and in the three areas mentioned, the general safety, egress/exit routes and fire control were in a worse status in terms of the score obtained in the software. None of the surveyed hospital received the minimum safety score in the three areas mentioned. The involvement of Emergency Response Team is crucial to overcome this egress or fire exit requirement and parameters.

Several limitations exist in this research that cannot be controlled. Firstly, the occupancy rates only determined during peak hour. Accessibility into hospital compound permitted only during daytime. Secondly, the fire safety audits and fire safety risk management in this research are not being conducted by a professional architect or engineer and as a result must be relied on the direct inspection checklist to create valid results. Thirdly, this research has some limitations which need to be noted but does not affect the robustness of the study’s findings. This study focuses only on five selected public hospitals in one state of the northern region of Malaysia and excluded data gathering from all other parts of Malaysia. The perception of hospital operators regarding fire safety issues from different state hospitals may allow comparisons.

The findings of this paper should make a key practical contribution to the body of knowledge. In practice, the proposed framework should expand the knowledge of public hospital fire safety management plan concerning the level of fire safety compliance with the requirements in government hospital buildings and develop a fire safety management plan framework for government hospital buildings.

This paper develops an early framework component related to the occupants’ safety which gives the basis for future research in hospital fire safety settings as it imparts early investigation into the consequence of investigating the phenomenon from the operators’ perspective as an attempt to improve public health-care fire safety performance in hospitals.

This paper has created a few measurement tools that can be applied among public hospital buildings stakeholders to perform the fire safety audit and risk management and rate the performance of Fire Safety Management in public hospitals.

Globally, several studies have shown that hospital building is charged with multiple inherent risks because a large number of users are vulnerable in tragic events. Thus, the need for the fire safety management plan (FSMP) has been proved as an instrument to mitigate fire and related risks in healthcare facilities. In Malaysia, FSMP regarding public healthcare building is yet to be explored in-depth. Therefore, this paper explores the information necessary to develop the FSMP framework for public hospital buildings.

The paper’s objectives were accomplished via a combination of five face-to-face interviews and observations of five selected public hospitals in Pulau Pinang, Malaysia. The five key participants were across the five public hospitals and collated data analysed through thematic analysis with the assistance of MAXQDA 2018.

Findings show that fire safety stakeholders practice system, fire safety action plan and fire risk management were the three main variables that promote fire safety programme and will improve FSMP for Malaysia’s public hospital buildings.

This paper’s data collection is limited to Penang, Malaysia, and a qualitative research approach was used, but this does not deteriorate the strength of the findings. Future studies are needed to consider validating findings from this paper via a quantitative approach.

The suggested framework can be employed by Malaysia’s public hospital authorities as a guideline to mitigate fire hazards in the country’s healthcare facilities.

This paper is encouraging hospital operators and other key stakeholders to improve on their FSMP for healthcare buildings across Malaysia as part of the study implications.