Top 5 Joint Commission Compliance Issues
The American Society for Healthcare Engineering (ASHE) this month is releasing a new handbook to serve as a guide for healthcare facility commissioning.
For anyone not immediately familiar with commissioning, it’s essentially a process through which an assessment can be made as to whether building systems are operating as intended.
ASHE’s Health Facility Commissioning Handbook provides details to help implement the commissioning process on new construction projects as well as at existing facilities.
“The guidelines tailored the commissioning process specifically to healthcare to ensure hospitals—complex facilities operating 24/7 and serving patients with a wide variety of needs—will function as they should, both in the short term and the long term. Additionally, commissioning can help hospitals save resources, which is especially critical given the rising cost of healthcare,” a release from ASHE states.
Earlier this month at the ASHE PDC Summit in Phoenix, the session “A Case Study in Collaboration and Commissioning” was presented, outlining how The University of Arkansas for Medical Sciences (UAMS) undertook a project to develop a case study with students on the commissioning process and its related outcomes.
For the project, the ASHE commissioning process was followed.
Phillip Dunston, PhD, associate professor, says the first step in the commissioning process is developing a team that includes the:
- Commissioning authority;
- Architect; and
Like IPD, the commissioning team should be formed early, Dunston notes; however, this is done with no specific contract in mind. Then, in the pre-design phase, the owner must consider exactly what it is that it wants commissioned and how the team should be structured.
During the design phase, he stresses the importance of getting off on the right foot and explaining how the process should be carried out. Moving on to construction, Dunston says the process then becomes more complex, with issues fed into a log and inspections and balancing carried out.Finally, in the transition to operational sustainability, he says training and documentation is handed over to the facility management staff, as post-occupancy and the warranty phase provides time to review and benchmark performance.
For this particular case study to be carried out at UAMS, the application of these principles will be during a 30,000-square-foot renovation, which includes an increase in PACU beds-to-OR ratio and the addition of support spaces, describes Rob Smetana, a student from Purdue University taking part in the project.
Additional goals for the project include a return on investment on the building systems and use of BIM models by the staff.
Construction began in January and is expected to be completed March 26, 2013, carried out in four phases. So far, the group has some observations to offer for lessons learned in applying the commissioning guidelines to date, including the need to identify a “quarterback” and “receivers” to carry out the process, not to move too quickly into schematic design but instead get the owner’s project requirements and then move into the basis of design, and ensure a good owner training program that is established up front.
As for why students were involved in the project to begin with, Ed Tinsley, PE, LEED AP, HFDP, CHFM, managing principal, TME Inc., said it’s having a new, fresh perspective that was so attractive to the process, and valuable.
“The ASHE process is a sea change different than the traditional commissioning process,” he said, adding that normally designs aren’t reviewed to offer suggestions but rather just to determine if a project is commissionable.
In this case, the students offer a fresh perspective to ask questions other professionals may not have thought of. “They’re seeing this process as commissioning. They didn’t know it before,” he says.