We have read with great interest González-Romero et al.’s paper1 describing how important it is to train the intensive care unit (ICU) personnel when it comes to acquiring knowledge on self-protection in the hospital setting. Following in the footsteps of your reflections and based on our own experience, we would like to stress how important it is for the organization the right management of both material and human resources in the ICU setting in order to answer effectively to all sort of emergencies and eventualities, and eventually ensure the safety and health of patients, workers, and visitors.

A recent study shows that in Swedish public hospitals there is a high risk for patients in the case of a fire and ICU evacuation.2 Also, certain situations that have already been reported in other hospitals3,4 show us how little the healthcare personnel know about how to deal with urgent situations due to the lack of proper learning and training.

Decisive leadership during the implementation and disclosure phase of the self-protection plan (SPP) is of paramount importance; also, the commitment from the healthcare personnel involved that should take an active role in the development and planning of the proceedings to be followed when this or that contingency occurs. Planning and executing disclosure and implementation activities, including information and training, and conducting audits and inspections guarantee the right implantation and follow-up of the SPP.

This contribution exposes the real risk of all hospital ICUs within the Spanish National Healthcare System and, in order to ensure the effectiveness of the SPP in time, it is necessary to review the technical resources, enable CME initiatives for the healthcare personnel, and verify how operative the plan is through periodic drills.

Healthcare organizations should go beyond the mere observance of the applicable legislation and orient themselves towards a proactive system model in order to implement safety measures comprehensively by developing management systems5 that deal with proceedings and processes that guarantee protection when it comes to the safety and health of users and healthcare professionals.