Emergency Department Wayfinding, Signage, Lighting and Security Requirements

On and after January 1, 2024, hospitals with emergency departments must adhere to the wayfinding, signage, and security requirements in 105 CMR 130.127 and in guidelines of the Department. (A) Signage and Wayfinding. (1) Public entrances to the emergency department shall be clearly marked from external approaches and shall be identified by exterior signage and visible from public thoroughfares. Signs identifying the emergency department shall read "EMERGENCY" in all caps in red on a white background or white on a red background and public entrances to emergency departments when applicable, shall be distinguishable from the emergency department ambulance entrance. (2) Emergency department patient drop off and entry areas and hospital perimeter doors, which include, but may not be limited to, doors that are locked at night, main entrance doors, emergency department entrance doors, ambulance entrances and any door a patient may typically use to enter the hospital, shall be well lit and include directions to the emergency department. Emergency patient vehicle drop off and external and internal entry areas shall be lit to be distinguishable from other entrances. (3) Exterior hospital entry points shall be clearly identified from all major exterior routes including roadways, public transportation stops, and vehicular parking. (4) Exterior hospital emergency department identification and directional signs shall be sufficiently lit to allow drivers and pedestrians to see signage after dark and during inclement weather. Hospitals must place directional signs leading to the emergency department in such a manner as to ensure visual continuity in accordance with guidance from the Department. (5) Exterior wayfinding shall clearly define the access pathways from public thoroughfares to the hospital main entrance and emergency department entrance. (B) Security and Communications. (1) Hospitals with an emergency department shall maintain lighted communications technology, such as two-waylive audio-visual communication technology, with duress alarm features across the grounds of the hospital facility, which shall at a minimum contain communication devices at the hospital main entrances, emergency department entrance, ambulance entrances, and any exterior door a patient may typically use, and in strategic locations around hospital grounds to communicate with on-duty personnel. Such technology shall be accessible to people with low vision, hearing loss, difficulties with speech and cognitive processing. The system shall include emergency duress button stations that are well marked and lit, and not dependent solely on audio communication. (2) Hospital security desks and emergency department front desks shall be staffed 24 hours per day, seven days per week, or the hospital shall have a phone number posted at these locations that can connect patients with hospital personnel who can provide immediate assistance. (3) Hospitals shall have written policies and procedures for the video/audio monitoring 24 hours per day, of exterior entrances and emergency department patient drop off and entry areas with security technology that includes the ability to record and play back recordings, and the ability to store recording footage for up to 14 days. (4) Hospitals shall have written policies and procedures to ensure that patients on hospital grounds seeking emergency medical care who cannot physically access the emergency department are quickly located and are immediately given appropriate care. (5) Hospitals shall ensure that all staff and securityhave appropriate staff training, including on disability and disability access at the emergency department and how to communicate with, accommodate, and provide support for such individuals, as well as staff responsibilities when patients or companions have difficultylocating and entering an emergencydepartment. (6) Hospital emergency departments shall have a unique street address for navigational purposes unless the emergency department shares the address with the currently used patient access point and the address for the emergency department shall be listed on the hospital homepage.