Commissioning is key to return on investment

Throughout its life cycle, a modern health care facility will be met with changing occupancies, additional regulatory requirements, opportunities to upgrade technologies and efficiencies, and constantly evolving patient care, education and research missions.

To stay abreast of developments in the industry, health care organizations must carefully maintain and constantly refresh their facilities. When owners identify the need for a change, they engage professional designers and contractors to develop their concepts into structures, which the health care organization then owns and operates to meet the needs of its business.

Despite many changes in the approach to health care design and construction, a health care organization's desire to achieve a suitable return on investment (ROI) from its facility projects has remained a relatively low priority for most project teams.

A major obstacle to turning this situation around has been the continuation of interdisciplinary silos that long have existed throughout the facility life-cycle continuum — from project inception through operation and maintenance of a completed facility. These silos interfere with collaboration among project participants that could improve the project team's ability to optimize the health care physical environment.

In July 2010, ASHE introduced a new publication, titled the Health Facility Commissioning Guidelines (see the "ASHE Insight" column below for more details). The ASHE health facility commissioning process that was introduced in these guidelines is designed to provide the project-delivery team with a robust set of tools to help improve initial project-commissioning collaboration, continuing commissioning behaviors and retrocommissioning tactics.

The guidelines will assist health facility professionals in their efforts to optimize the health care physical environment while achieving the ROI their organizations desire.

The introduction of this broader, more collaborative commissioning process may be met with some resistance, but change must happen to ensure a health care organization's best interests are met in all phases of the facility life cycle. Without project commissioning and a team focus on the full life-cycle cost, the desired ROI is not guaranteed and generally not obtained.

This month's 2011 International Summit & Exhibition on Health Facility Planning, Design & Construction in Tampa, Fla., features a special half-day briefing that will provide information on how to incorporate the features of health facility commissioning described in the Guidelines into different facility projects.

The authors will provide information to increase your understanding of the importance of commissioning in terms of executive leadership support, preparation, cost-effectiveness, long-term impact, benefits and team support.

It is time to broaden the scope of standard operating procedures in health care facility project management to make commissioning a normal part of every health facility project, regardless of project size or cost.

This month's column was written by Mark Kenneday, CHFM, SASHE, vice chancellor, campus operations, University of Arkansas for Medical Sciences, Little Rock, Ark., who is an ASHE board member.

ASHE Insight

Resources available

ASHE offers a number of valuable resources at special prices to professionals in the health care industry.

They include the following:

• Health Facility Commissioning Guidelines. Written by health care professionals, this resource helps optimize construction or renovation delivery. It enables project teams to deliver cost-effective and efficient health care facilities that yield the desired return on investment. The guidelines can help ensure a suc­cessful transition from construction completion to a sustainable, high-performance operation.
• Guidelines for Design and Construction of Health Care Facilities. The 2010 guidelines cover minimum program, space and design needs for all clinical and support areas of hospitals, nursing facilities, freestanding psychiatric facilities, outpatient and rehabilitation facilities, and long-term care facilities. It also includes new material on acoustics, patient handling and movement, patient safety, bariatric patient care, cancer treatment and emergency services.

For information on purchasing either of these valuable references, click here.