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Retro-Commissioning and Healthcare Facilities

Updated: May 8, 2023

The priority for the operators of healthcare facilities is undoubtedly patient care and safety. When building systems are not functioning the way they should be, this affects both the safety and care of patients and staff.  Systems may not be operating as intended due to aging equipment, problems from design or construction, or because spaces have been repurposed and the systems were not updated.  Retro-Commissioning can help keep the building systems running as needed to maintain a healthy and comfortable environment for its occupants.

Retro-Commissioning is not only a process to improve the efficiency and operation of an existing building’s systems but also a process to confirm the intended resiliency of systems is adequate. Systems reviewed include primarily mechanical and electrical systems such as heating, ventilation and air conditioning, building automation, domestic water systems and standby power systems. Proactive retro commissioning will provide the most benefit by finding potential issues before they pose a problem.  This will help reduce illness, complaints from occupants, and help keep within the owner’s budget as problems uncovered during a regulatory investigation can lead to unexpected costs.

There are two types of issues that may be identified during the commissioning process – ones that can be easily remedied by adjusting a setpoint or ones that require more intervention such as a major repair. The retro commissioning process should result in a report that will include identified issues and recommendations on how to correct them.

Some of the challenges faced with commissioning include getting the right players involved, obtaining access to the building systems and the ability to manipulate them for functional testing, and data acquisition.

  1. Facility operations and staff will be the best resources into known problems. They are the ones involved with day to day operations and often hear from the occupants when there are issues with comfort.

  2. Obtaining access will require coordination of schedules between facility staff, commissioning engineers and the building owner to organize appropriate down times for the commissioning process. This may result in working during off hours.

  3. The ability to obtain appropriate data may be difficult in older systems still operating with pneumatics and systems that have not installed all data points or mapped them to the graphical user interface. In some cases, analog dials will indicate temperature or pressure on major equipment working with pneumatics, but it should be verified that the dials are calibrated and working properly before trusting any reading obtained. There may be the capability to add points for data collection when DDC systems are present. Mapping available data points from manufacturer microprocessor based controls may be another option.

Some of the many benefits of retro-commissioning include improved facilities maintenance, maintaining regulatory compliance, energy use, patient satisfaction, and reliable capital planning.

  1. Maintaining sensor calibration and proper operation can be difficult since issues with these devices are not as obvious as they are in recognizing dirty filters or broken fan belts. The commissioning process includes examination of all sensors and devices so any issues that need correction will be recognized.

  2. There are often regulatory organizations in place that will ensure standards are maintained within healthcare facilities and regular inspections occur to determine compliance. Proactive retro commissioning can detect and address issues ahead of scheduled inspections to avoid facilities staff having to deal with the repercussions of noncompliance.

  3. It is important to be able to trust systems that operate on standby power are going to respond in an emergency. Simulated outages to demonstrate resiliency give owners the confidence they need that systems will perform in their time of need.

  4. Retro commissioning can uncover systems that are not operating efficiently and save on energy use.

  5. Satisfied customers often return to businesses to seek their services. Retro commissioning can examine data on hospital acquired infections or other claims related to building systems to draw common denominators and come up with a list of issues that need to be remedied.

  6. The commissioning report can identify issues that need to be addressed both in the immediate and long term. This report can help the staff involved with capital planning to balance spending on existing and new facilities and come up with a strategic plan.

Retro-commissioning is a valuable tool for any building to maintain its desired operation. In healthcare facilities its benefits are even more important due to the safety of patients and staff and the strict regulations for system operations that need to be maintained.  Using the retro commissioning process proactively will act as a means for identifying issues before they put occupant safety or comfort at risk or turn into costly repairs due to regulatory compliance issues.

Stay tuned for the full guide, coming soon!


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