A Healthcare Owner's Perspective on Commissioning

Presented at the National Conference on Building Commissioning: April 19-21, 2006, by Christopher Brennan, State University New York, Stony Brook

Stony Brook University Hospital (SBUH) has been among the largest proponents and procurers of commissioning services among regional healthcare institutions in terms of their scope, magnitude and financial investment in commissioning. Established in 1980 in Stony Brook, Long Island, this 504-bed tertiary care facility is part of the State University of New York system. In 2001 the institution embarked on a $300 million, 400,000-square-foot modernization of SBUH facilities, for which rigorous commissioning services would be a requirement of the construction manager.

SBUH has gone through many projects over the past few years and we have noticed a trend that occurs within construction. The delivery of the space does not meet the high standards of quality and timely delivery that we require. As much as we are a hospital and are concerned about the well being of people we are a business as well. The untimely or improper turn over of a facility can severely impact the hospital’s cash flow, as well its reputation. Making sure that the project is turned over at the completion date allows the hospital to see patients and schedule procedures, therefore generating revenue.

Commissioning is not merely about energy savings anymore. We look at it as a documented quality assurance program that will allow us to delivery a project on time and on budget. A hospital is a mission-critical facility, and if something goes wrong the consequences and impacts are felt in unimaginable ways. That is why we must make sure that issues are resolved before beds are filled and procedures are performed.

I strongly believe that the commissioning authority must work directly for the owner and have no direct involvement in the actual design or construction of the project. This gives you objectivity on the part of the authority and removes any question of loyalty of the services. The authority must be firmly aligned with the owner and, in essence, become the owner advocate in order to be most effective. I look for a firm that is primarily a commissioning firm and does not rely on providing design services as their primary source of income. We want to hire commissioning providers who commission building[s], not ones that just design them. What is equally important is that the field personnel have operating experience, as there is a nuance to operators knowing how systems must look, sound and feel. Firms that hire former facilities personnel who have operated and maintained hospitals and other facilities bring a set of skills to the table that an engineer who has only design experience lacks.

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