Building Commissioning Critical for Modern Facilities
Atlanta Hospital News - Atlanta, Georgia (July 2008)

More than ever before, building commissioning is a vital component of any new hospital construction or expansion. Gone are the days of the hospital that simply houses advanced technology. Modern healthcare facilities incorporate high-end technologies throughout.

Building commissioning provides a comprehensive approach to quality assurance for a hospital’s entire infrastructure. Such systems may include heating and air conditioning, plumbing, bio-containment, electrical, safety equipment and security systems. Commissioning ensures a new facility begins its life cycle at optimal productivity with all systems operating as intended.

For maximum effectiveness, a commissioning firm should be brought in at the outset of a project. The earlier commissioning is incorporated, the better the cost-benefit ratio. It is far easier and more cost-effective to make changes on paper during the design phase than on site once construction is underway.

The commissioning firm will initially conduct pre-construction analysis of all design documents. Such analysis will help ensure that systems are appropriate and sufficient to meet the owner’s requirements. Periodic on-site reviews are then conducted throughout the system installation process. These inspections ensure that installations are being done to specification as designed. Once the facility nears completion, systems testing and optimization can begin.

Firms such as Boyken International can take the commissioning process even further by providing training to a facility’s maintenance and operations personnel. Beyond handing over an optimized facility, it stands to reason that those responsible for the ongoing operations of that facility be versed in the management of its systems.

The reality for facility owners is that building costs continue to climb, both from a materials and labor standpoint during construction as well as from an operating standpoint. Building systems have become more complex, and must often integrate with other advanced systems. There are also more stringent regulatory requirements that must be taken into account.

The cost for building commissioning is easily offset in a number of ways, including the increased value of the building as an asset. Properly functioning facilities with reliable equipment kept in good condition are worth more than their uncommissioned counterparts. The equipment also will hold its value longer.

When facilities are properly commissioned, operating expenses are reduced because systems function properly. They use less energy and require less maintenance. Equally, if not more important, is the fact that properly commissioned systems experience less downtime. Consider the loss of sustainable power supplies for diagnostic equipment or the failure of HVAC systems in patient bed areas. Beyond repair costs, the loss of revenue compounds the problem.

Properly operating systems also impact patient and employee satisfaction levels. From a patient perspective, having commissioned environmental control systems means improved air quality and overall comfort. From the staff and physician standpoint, creating a comfortable, reliable working environment impacts not only satisfaction levels, but also productivity.

As the demand for healthcare facilities continues to climb, many organizations will look to expand existing facilities. This creates additional challenges in that not only will new systems need to be commissioned; they must effectively integrate with existing infrastructure. Commissioning becomes even more critical when multiple generations of systems are called upon to work together.

Some facility owners are now looking to retro-commissioning as a means of bringing existing facilities up to better performance standards. The process is much the same as new building commissioning in that it creates a systematic process for investigating, analyzing and optimizing the performance of older systems.

There are a number of variables that can negatively impact a facility’s infrastructure over time that would justify retro-commissioning. For example, a facility and its systems may not have been properly maintained. Failure to perform regular maintenance or the use of retrofitted parts that don’t meet design specifications will degrade performance and reduce efficiencies.

A facility’s physical requirements may have changed over time. As medical equipment has advanced and been replaced, the original systems designed to support that technology may not meet today’s requirements. Areas originally designed as storage or clinical areas may be converted to patient areas, which likely have different demands of various systems.

Further, there will always be those systems that were never properly configured from the outset. While they may be performing as designed, if they were not optimized for the particular facility there are likely inefficiencies that can be corrected.

Whether for new construction, renovation or expansion of older facilities, smart owners and operators are realizing there are major benefits to be gained from building commissioning. It has truly become an integral component of facility building and management.