The history of anti-barricade door systems

Julian Hall, Sales Director at Kingsway Group shares the history of the anti-barricade doorset and how the various issues which are so important to providing safe psychiatric care environments have been addressed as these systems have developed and been honed over the last ten years.

Since the first doorset project undertaken by Kingsway Group in 2011 significant change and progress has been made in how anti-barricade door systems operate and as thought leaders in mental health door solutions we’d like to share this journey which has been a result of collaborative input from NHS project managers, clinical directors, service users, architects, contractors and most importantly the service users themselves.

I hope that you find this article informative and interesting and one thing we know for certain is that the voyage of development has not yet finished and that Kingsway Group will continue their quest of providing the safest solutions to provide healing mental health environments.

Kingsway Group | Blog | The history of anti-barricade door solutions for mental health environments

Pivot type anti-barricade doors

Background

The centre hung pivot system had been used for many decades in all types of buildings and comprised of a top bracket and a bottom strap on the door which located with a floor mounted spindle plate, this held the door and allowed movement in either direction.

For installation the contractor would screw the bottom spindle plate to the floor and then sit the door on top so the bottom strap on the door was located, the top of the door was then moved into position and by turning a screw the top pivot could be wound out and lock into the top of the door.

Positives

Pivot hung doors had been widely used in all scenarios where a double acting door was required from domestic homes through to general hospitals and public buildings so were a known solution that general contractors were accustomed to and were readily available, in essence the pivot system provided a simple and cost-effective double action solution but when implemented in mental health hospital environments had serious flaws.

Negatives

Ligature risk – due to the pivot system being site installed and relying on a single metal pin into the top of the door this would often result in the pin being accessible as a potential ligature tie-off point.

Pivot pins broke - under force which doors receive in mental health hospital environments the pivot pins would break out of the side of the door which led to unsightly metal re-enforcing plates being fitted or the door replaced altogether leading to critical mental health bedrooms being out of action while the repairs were carried.

Lack of patient privacy – due to the scalloped back edge of the door to allow double action there would be a sight line into the patient bedroom from the corridor which was a privacy and dignity issue and not acceptable to hospital inspectors.

Floor mounted components – the bottom spindle plate of the pivot system was floor mounted which gave contractors issues when underfloor heating was used and also caused project co-ordination issues with different trades setting the spindle plates and then the carpentry teams hanging the doors only to find the two did not line up.

Anti-ligature door closer issues – the only option available if a door closer was required was to recessed a double action door closer into the top of the door, this was hidden when the door was closed so went some way to providing an anti-ligature solution but as soon as the door was opened the fixed overhead arm was present as a serious ligature risk.

Continuous double action hinge type anti-barricade door systems

Background

To develop a full-length continuous hinge was the obvious next step in addressing some of the inherent issues with the pivot door system and from the early 2000’s there was some use of a continuous geared type double action hinge which was developed in the US to provide a robust solution but this was not designed specifically with mental health environments in mind so still had issues with gaps between parts; sharp edges and ligature risk when used with a self-closing device. 

This led to the development of the world’s first knuckle type double action hinge called SwingHinge which is a patented product that comprises of two rounded metal extrusions which couple together with a stainless steel pin through the middle and uses brass washers on every knuckle which results in product that can open to 105° in either direction.

 

Positives

Full length of the door – having the hinge running the full length of the door eliminated the privacy gap issue created by the pivot system.

Multiple fixing points – continuous hinges such as the SwingHinge have multiple fixing points from the hinge into the frame and the door which provides a much more robust system.

Integration with door closer – the double action butt hinge type continuous hinge can be connected to a recessed transom closer in the head of the door frame, for the first time it was possible to install a complete pre-hung double action door with the concealed overhead closer that was fully 3rd party certificated.

Reduced ligature points – the continuous hinge removed the exposed ligature risk of the pivot pin at the top of the door and down the closing side.

Electrical wire integration – the continuous hinge allows for wiring to be safely provided to the door to power items such at access control and ligature alarm systems

 

Negatives

Staff in ‘red zone’ when attending a barricade situation – the continuous hinge anti-barricade system relies on a removable door stop attached to the opening side of the frame which the staff unlock in an emergency situation and open the door outwards and potentially are standing in the opening path of the door in some situations resulted in staff injury. 

Kingsway Group conducted a clinical survey to ask qualified nursing staff if they felt vulnerable when standing on the opening side of the door in a barricade situation and the overwhelming 80% of respondents asking for a solution that would allow them to stand in the barricade ‘green-zone’ on the hinge side of the door led to the development of the next generation of anti-barricade systems called Switch.

Kingsway Group | Blog | The history of anti-barricade door solutions for mental health environments
Kingsway Group | Blog | The history of anti-barricade door solutions for mental health environments

Switchable double action anti-barricade door system

Background:

Kingsway Group were given the design challenge by the clinical team of a large NHS Trust to provide a solution for their new build hospital project that eliminated the potential staff injury risk of a patient opening a door while the nurse was opening the anti-barricade stop.  Kingsway Group’s engineering department decided to start from first principles and clearly understand what was required, their findings were as follows:

The door needed to be opened inwards by the patient in normal operation.
The door needed to be opened outwards by staff in an emergency barricade situation.
The staff did not want to be standing on the opening edge of the door during the barricade.
The door needed to have a robust frame and also a self-closing device.

The revolutionary development milestone was achieved when it was decided to have the hinge retractable which enabled the use of a standard single rebated door frame, the hinges profiles where drawn up and Switch was born!

Positives:

All of the excellent positive features of the Swing continuous double action hinge were retained.

Increased staff safety – staff could now stand away from the opening door edge in the barricade ‘green zone’ which eliminates the risk of being hit by the opening door or having to put your hands on the door frame on the opening side.

Rebated door frame – having a solid rebated frame section on the closing side increases robustness and allows for an acoustic seal to be fitted for noise reduction.

Simplified operation of barricade mechanism – no retracting or moving parts on the opening side of the door which reduces chance of confusion and provides a simplified system.

Conclusion:

The system used for provide a double action anti-barricade door has seen excellent developments over the last ten years and Kingsway Group are committed to continuing their research of further enhancements in safer and less institutional anti-ligature products for mental health inpatient environments.

 

Get in touch with Kingsway Group to discuss your anti-barricade requirements:

sales@kingswaygroup.co.uk | 01322 610470 or contact the author direct at julian.hall@kingswaygroup.co.uk

November 28th 2018Posted by Julian Hall
Kingsway

Kingsway Group
Teardrop Centre,
London Road,
Swanley,
Kent BR8 8TS
United Kingdom

T: +44 (0)1322 610 470
E: sales@kingswaygroup.co.uk

Registered in England & Wales.
Company No. 08012701