Facility Managers Play Crucial Role in Healthcare Commissioning
The FM must be involved in each phase of design, construction, and commissioning, from developing owner's project requirements to creation of a systems manual.
Building commissioning (BCx) is a structured, quality assurance process intended to ensure that a completed building meets the owner’s requirements. That’s especially true of healthcare facilities. It is so critical to the successful operation of every healthcare facility that the American Society for Healthcare Engineering (ASHE) has written the Health Facility Commissioning Guidelines and the Health Facility Commissioning Handbook as resources for implementing commissioning in healthcare projects. However, these documents are only truly meaningful if they are used in conjunction with input from the facility management team. Indeed, facility managers are crucial to a successful commissioning process.
Let’s start by defining the building commissioning process and demonstrating how the facility management team can contribute to each phase. Then we’ll look at some specific examples of how the experience and expertise of the facility management team can really make a difference in the final product by participating in the commissioning process.
FMs Role in Each Phase
Commissioning should be part of the overall business plan for every new healthcare facility, as well as facilities being considered for expansion or remodeling. Common targets of commissioning include the building envelope, mechanical, electrical and plumbing (MEP) systems, medical gases, fire and safety systems, refrigeration, and elevator systems. But keep in mind that commissioning is a process, not just a single event, task list, test, or inspection. It occurs throughout the building life cycle and is broken into four phases: pre-design, design, construction, and operation.
In the pre-design phase, a workshop is held to determine the owner’s project requirements. The attendees typically include the owner’s project manager, building occupants, the facility manager, operations and maintenance personnel, the commissioning authority (CxA), the designers (architects and engineers), and the construction project manager. Collectively, this is the commissioning team, and they work together to meet the common goal of producing a building that meets the owner’s project requirements. The purpose of the workshop is to decide in advance how the owner defines a successful building. If these targets are missed, the building is a failure, even if it’s completed under budget and on time.
The discussion of the owner’s requirements should cover the requirements of the facility management team. Their input at this meeting is critical, because their experience and expertise can be reflected in the owner’s project requirements that the designers will be required to address.
Once the owner’s project requirements are agreed upon and documented in a commissioning plan, the design phase can begin. The designers of record take the owner’s project requirements and run with them. The designers capture their design inputs, calculations, and decisions in a document known as the basis of design. While the owner’s project requirements lay out what needs to be done, the basis of design describes how the needs are going to be met. The CxA reviews the basis of design as well as the drawings and specifications produced by the designers of record to make sure they meet the owner’s project requirements. This design review is another opportunity to gather more input from the facility management team. For example, if the design team is specifying a system or manufacturer that the facility management team doesn’t particularly like, they can communicate their preference to the designer of record through the CxA. That way, they won’t have to just take whatever they’re handed.
With a finalized design, the process moves into the construction phase. The CxA reviews equipment submittals to ensure that they meet the owner’s project requirements and incorporates the specific equipment data into installation checklists. The facility management team can contribute their experience to the commissioning process here by helping the CxA develop the checklists. Consider all the irritating issues the facility management team has to deal with over the life of the building that could have been remedied during installation, and make sure they’re addressed in the checklists.
The construction phase also includes quality assurance inspections to verify that the checklists are being completed accurately. This is also when commissioning team meetings occur to keep communication channels open. While it’s not mandatory, attendance at these meetings by the facility management team would provide them with insights into the systems being installed. And they can meet the craftspeople installing them, building a rapport with the people they may be calling on during the warranty phase.
When the components of the systems are installed and started up, functional performance testing can begin. This concluding part of the construction phase is where the systems are tested as a whole, verifying that the components operate together to meet the owner’s project requirements. Again, this a great opportunity for the facility management group to contribute their expertise and learn about their new systems.
After functional testing, the building can be handed over to the owner’s staff with confidence, knowing that the building systems are performing as designed, and the operation phase of commissioning begins. And this, of course, is where the facility management team takes center stage.
First, the CxA will need the facility management team’s help to produce a systems manual. More than just the O&M manuals for each piece of equipment, the systems manual is the O&M manual for the building. It includes the information necessary to operate each commissioned system, including the sequence of operations, set points, schedules, and other instructions specific to the building.
As part of the operation phase, the CxA facilitates training for the facility management staff on the new equipment and systems. The training is performed by the people who know the equipment best, the manufacturers’ representatives. The training is usually recorded for future reference and use in training new facilities management staff. Feedback on the training is collected from the participants to ensure quality. Finally, the CxA will work closely with the facility management team to monitor the systems, address any warranty issues that may arise, and complete any functional testing that may have been deferred due to seasonal conditions.