What are the requirements with regards to locking doors within a required means of egress?

Any examples are for illustrative purposes only.

Doors in means of egress are required to be opened without the “use of a tool or key from the egress side”.  Occupant movement cannot be restricted during an emergency; however, locking certain doors may be necessary for the safety of the patient in certain situations.

When a healthcare facility determines that doors must be locked to protect patients the locking configuration must comply with one of the following:

• Delayed-egress locking system as defined by NFPA 101-2012: 7.2.1.6.1
• Access-controlled egress door assemblies as defined in NFPA 101-2012: 7.2.1.6.2
• Elevator lobby exit access door locking compliant with NFPA 101-2012: 7.2.1.6.3

Each of these allowable exceptions are unique and have specific required features. Mixing and matching of these features is not compliant. 

Where the clinical needs of the patients require specialized security measures or where patients pose a security risk, door-locking arrangements without delayed egress is permitted, provided that staff can readily unlock such doors at all times. Psychiatric units, Alzheimer units, and dementia units are examples of areas with patients who might have clinical needs that justify door locking to prevent elopement.
NFPA 101-2012: 18/19.2.2.2.5.1. and 18/19.2.2.2.6

Pediatric units, maternity units, and emergency departments are examples of areas where patients might have special needs that justify door locking.  Patients that require additional protective measures to ensure safety and security are allowed to have door locking arrangements provided that all of 5 criteria of NFPA 101-2012: 18/19.2.2.2.5.2 are met, in summary these are:

1. Staff can readily unlock all doors at all times
2. A total (complete) smoke detection system is provided throughout the locked space, compliant with NFPA 101-2012: 9.6.2.9, or locked doors can be remotely unlocked at an approved, constantly attended location within the locked space.
3. The building is protected throughout by an approved, supervised sprinkler system in accordance with NFPA 101-2012: 18/19.2.2.2.5.2
4. Locks are electrical and fail safe to release upon loss of power
5. The locks release by independent activation of each:

Additional Resources:
LS.02.01.20
NFPA 101-2012: 18/19.2.2.2.4; 19.2.2.2.5