One of the main goals of hospital commissioning is to provide the owner a “certainty of outcome” that the project will meet the owner’s expectations for the completed facility. To provide this certainty, expectations must be defined and monitored throughout the design and construction process.
Thus, for health facility commissioning to have the best return on investment, it should begin early in the conceptual design phase and extend through the warranty period so it can provide guidance before design decisions are finalized and during the construction phase as systems are procured and installed.
When this is not possible, however, commissioning can still be a valuable tool introduced during the construction phase of a project.
Defining the process
The commissioning process must begin with the owner’s project requirements (OPR) document. This defines what the owner expects to receive in the completed facility. It defines the facility’s key elements and expectations for performance, capacity, redundancy, maintainability, quality of systems and materials, life expectancy of systems and project costs.
The OPR will be used as the standard for system installation and performance for the design and construction process. The completed design, installed construction product and performance of systems will all be measured against the requirements as defined in the OPR. The OPR will evolve as the project is developed. Criteria defined in it will be impacted by changes in project budget, scope and schedule. It must be maintained as a living document throughout the project.
To define the most cost-effective commissioning process for a project, the commissioning team must consider all the elements associated with commissioning and then determine which elements are most important for the project. A simple concept of commissioning is that it is a process that applies various tasks to a group of systems. However, the extent of these tasks and systems can be exhaustive.
Commissioning tasks
Commissioning tasks can be broken into subsections of the design phase, construction phase, acceptance phase and post-occupancy phase. Within each of these phases, a checklist of tasks is developed and completed. Design phase tasks can range from assistance in development of the OPR to reviewing project design concepts (sometimes called the basis of design, or BoD, documents) to preparing a design phase commissioning plan or specification.
As the project moves from the design phase to the construction phase, the tasks tend to become more labor intensive and team oriented. Some construction phase tasks include preparing project-specific installation checklists and functional performance test procedures, reviewing drawings and testing procedures, monitoring the development of operations and maintenance activities, and preparing for the training that will be used to instruct the owner about maintenance and operation of the health care facility.
Once the construction is completed, commissioning is tasked with testing individual pieces of equipment, individual systems and system integration with other systems, testing at part load and full capacity, testing on normal power and while transitioning to and from emergency power, and testing alarms and safeties.
The training process is planned throughout the construction phase of a project and implemented concurrently with the functional testing process. The operations and maintenance procedures (O&Ms) should be reviewed and completed before training begins and used as a resource during training. Finally, during the post-occupancy phase, tasks will include opposed season functional testing and end-of-warranty reviews.
Systems to be commissioned
Similar to the list of tasks, the list of systems that could be commissioned can be lengthy as well. The elements that comprise these systems are numerous and not all are equally critical to facility performance. The key to being cost-effective is to identify the systems critical to the facility and minimize duplicating the code officials’ efforts. It is also important to utilize sampling techniques of smaller, less mission-critical equipment and less complex elements.
Within the mechanical system, the most important and cost-effective systems to commission include chilled water systems, heating systems, steam systems, air-handling units, critical zone controls such as terminal boxes in operating rooms, critical exhaust systems and controls on all modes, alarms and sequences. After these systems have been commissioned, the less-critical equipment, such as the zone controls, exhaust fans and computer room air conditioning units, can be sampled.
Tasks in place for the plumbing, medical gas and fire protection operations tend to be streamlined in comparison to the mechanical systems. The most important elements to commission within this system are the fuel oil, domestic booster pumps, domestic hot water, water softeners and natural gas. Other elements to be considered for sampling include sump pumps, fixtures, meters and heat trace. Systems closely reviewed by others, such as medical gas and fire protection, may not be commissioned if the budget is tight.
Elements of electrical systems that are at distribution level and higher should be commissioned. These include normal power, emergency power/uninterruptible power supplies, the coordination study, monitoring systems and all prototypical sequences of the fire alarm system and integration with other systems. If the project budget is limited, consider sampling elements like transformers and lighting-type panel boards.
Depending on the type of project and the budget, other systems that may be evaluated for commissioning include the building envelope, elevators, pneumatic tube system, sterilization equipment, roofs, kitchen equipment, IT, nurse call/code blue, security and paging/intercom.
Limited systems or tasks
Often project budgets do not allow for all the tasks or systems listed above to be performed or commissioned. The commissioning team must determine what elements of commissioning will offer the most help in making the project successful.
The commissioning agent can assist in helping to identify a scope that optimizes the effectiveness of the process. The key elements most often are related to past experience for the owner. If incomplete contract documents have been a historical problem, plan reviews may be critical to the design process. If problems with the mechanical systems on previous projects have been the most costly due to energy concerns or failure to meet the demands of the staff, a priority on commissioning the mechanical systems may be necessary.
Commissioning tasks may need to be limited to documenting installation and function of only the mechanical systems, or mechanical and major electrical, or mechanical and emergency power. Simply put, the process scope can be defined by the owner to meet the immediate needs.
The most cost-effective commissioning process is the one that is the most proactive. It is better to catch a construction installation problem before systems are completely installed and placed into operation than to discover a problem after systems are operational and the facility is occupied. In addition, it is beneficial to know that the operations and maintenance staff has been trained and given all the appropriate materials and record documents before an operational emergency arises.
Integrating into a project
Often, commissioning may not be considered until after the project design or construction has started. It is critical to determine a method of integrating commissioning into the existing project process while minimizing cost to the other team members. In this case, it is important to remember that commissioning is simply documenting the project’s completion. It is also documenting that the owner has received all contracted services and that these services have met the owner’s expectations.
The most cost-effective way to integrate commissioning into an ongoing project is to define the process so that the commissioning agent works in parallel with the project team. For example, if no OPR has been developed, the commissioning agent can perform an interview with the owner’s personnel and develop an OPR that defines their expectations. He or she can review the contract documents developed and report to the owner any discrepancies noted. This doesn’t impact the design team’s cost; it simply advises the owner whether the criteria are reflected in the design.
The commissioning agent can perform a design review at any time during the project. Identifying potential problems with maintainability or functionality prior to occupancy but after the design is complete or systems are installed is not ideal but still valuable. It will be more costly than if commissioning had been integrated sooner, but will still provide benefits. If the owner chooses to omit developing an OPR, the focus moves to documenting compliance with the completed contract documents.
The commissioning agent can develop and execute a commissioning plan at any point in the process. The plan can be developed to document installation of systems through the creation of an executing installation checklist. Deviations noted by the commissioning agent are not “commissioning issues,” they are a failure to meet contract requirements. Commissioning that begins after a project starts can still include monitoring the equipment startup process, the owner training process, the development of operation and maintenance materials by developing checklists that document the criteria specified in the contract documents and monitoring the execution of the process to ensure all specified criteria are followed.
Similarly, functional test procedures can be developed from the contract documents and shop drawings. At that point, there may be some additional scope for the construction team because they will need to demonstrate the system operation to the commissioning agent. But this cost will be minimal because the contract documents should already require the construction team to demonstrate functionality of the systems to the owner prior to completion.
Part of project delivery
Health care organizations must have a facility delivered to them that is maintainable, functional and energy efficient. Management must be trained on the systems and have well-developed O&M data, systems manuals and accurate record documents prior to occupancy.
The commissioning process can be tailored to meet the needs of the organization or the individual project. In either case, the most important consideration is that commissioning becomes part of the project delivery system. n
Steven R. Ross, P.E., LEED AP, CxA, is director of commissioning services for SSRCx, a wholly owned subsidiary of Smith Seckman Reid, an engineering design and facility consulting firm headquartered in Nashville, Tenn. He can be reached via e-mail at rross@ssr-inc.com.
This article first appeared in the March 2008 issue of HFM.
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