Opening a New Hospital: A Case Study Healthcare Commissioning and the Authority Having Jurisdiction

Transcription

1 Opening a New Hospital: A Case Study Healthcare Commissioning and the Authority Having Jurisdiction Matthew Tunnard, PE, CCP, LEED AP, Senior Engineer Horizon Engineering Associates, LLP

2 AIA Quality Assurance The Building Commissioning Association is a Registered Provider with The American Institute of Architects Continuing Education Systems (AIA/CES). Credit(s) earned on completion of this program will be reported to AIA/CES for AIA members. Certificates of the Completion for both AIA members and non-aia members are available upon request. This program is registered with AIA/CES for continuing professional education. As such, it does not include content that may be deemed or construed to be an approval or endorsement by the AIA of any material of construction or any method or manner of handling, using, distributing, or dealing in any material or product. Questions related to specific materials, methods, and services will be addressed at the conclusion of this presentation. 2

3 Learning Objectives At the end of this session participants will be able to: 1. Explain how commissioning can help ensure smooth certification from the AHJ 2. Describe the commissioning authority s role in the building walk through 3. Identify the critical elements of healthcare facilities that require special attention 4. Specify scope for levels of effort for the Cx authority to meet expectations 3

4 Agenda for Session Project Background Cx Scope of Work Healthcare specific AHJ and turnover Walkthroughs Occupancy Calls for service, energy efficiency Lessons Learned How to specify

5 Bibliography Evan Mills Building Commissioning: A Golden Opportunity for Reducing Energy Costs and Greenhouse-gas Emission Misc. Photos University of Michigan

6 Acknowledgements University of Michigan Mary L. Krasny Mary Pinegar-Koster Frank Marcinkiewicz Phil Shaughnessy

7 C.S. Mott Children s Hospital & Von Voigtlander Women s Hospital

8 C.S. Mott Children s Hospital & Von Voigtlander Women s Hospital

9 Project Background 1.1 Million Sqft Hospital and Medical Office Building (MOB) Pediatric and Women s care specialty hospital $750 million total project budget LEED Silver Certified Combination of self generated utilities and fed from central plant

10 Project Background 29 - Air Handlers, 9 Stair Pressurization Units, 2 Energy Recovery Units Feeds VAV system with Reheat. 4 pipe Fan Coil Unit for process loads Entire Hospital is HEPA Filtered

11 Project Background Ton Chillers with 4 Cooling Towers Electric Centrifugal Chillers Ability to utilize free cooling Primary/ Secondary loop

12 Project Background Heating Hot Water 3 Steam to Water Heat Exchangers Steam supplied from Central Plant Domestic Hot Water 2- Heat Exchangers 3- Booster pumps for each hot and cold water

13 Project Background 4 2 Mega Watt Diesel Generator Paralleling gear with load shedding Transfer switches Substations

14 Project Background 16 Operating Rooms Regional Infection Control Unit (RICU) Radiology with 3 MRI s Emergency Department Bone Marrow Transplant Unit (BMT)

15 Project Background Labor, Delivery, Recovery, Post-Partum (LDRP) Neonatal Intensive Care Unit (NICU) Pediatric Cardiothoracic Intensive Care Unit (PCTU ) Pediatric Intensive Care Unit (PICU)

16 Owner Expectations Reduced Energy Cost High reliability Low occupant complaints Reduce construction issues Change orders Time delays

17 Cx Scope of Work HVAC 100% testing of all equipment including VAVs Electrical Distribution, 100% check to panel level Plumbing, 100% supply side, 10% fixture check Medical Gas Witness blow down of system Work with inspector and certifier to witness necessary tests

18 Cx Scope of Work Security, 100% verification of all devices Infant Abduction, 100% verification of all devices Fire Alarm Verification of all interaction with other systems Security, HVAC, Infant Abduction

19 Cx Scope of Work Fire Protection Work with mechanical inspector to witness any tests. Coordinate all tests and certifications of fire pump Witness testing of Pre-Action systems Pre-testing of Helipad Foam system Pneumatic Tube Review installation and test final system

20 Cx Scope of Work Healthcare Specific Performance Tests Operating Rooms Designed with 25 air changes per hour HEPA filtered Must be positive pressure to adjacent spaces Transplant rooms must be able to raise temp from 55F to 95F in 15 minutes

21 Cx Scope of Work Healthcare Specific Operating Room

22 Cx Scope of Work Healthcare Specific Bone Marrow Transplant Area Severely Immuno-compromised patients Area needs to provide a clean space with minimum amount of contamination Patient rooms are positive pressure HEPA Filtered Room pressure monitors on all rooms

23 Cx Scope of Work Healthcare Specific Neonatal Intensive Care Unit (NICU) Area that cares for premature and high risk infants Immuno-compromised patients Need space for family Adjustable lighting levels from minimum to clinical care Precise temperature control

24 Cx Scope of Work Healthcare Specific NICU

25 Cx Scope of Work Healthcare Specific Labor, Delivery, Recovery, Post-partum Rooms where women prepare, deliver, and recover from giving birth Need area for family, comfortable room (can spend days here) Need to incorporate proper lighting and HVAC controls

26 Cx Scope of Work Healthcare Specific LDRP

27 Cx Scope of Work Healthcare Specific Regional Infection Control Unit (RICU) Floor that can be turned into an isolation area for an outbreak of an infectious disease. (ex: SARS, Ebola) Normal operation is standard patient floor RICU operation turns the entire area negative pressure to adjacent spaces with no HVAC return air. Need interlocks on entrance doors and with Fire Alarm In RICU mode, 100% OA

28 Cx Scope of Work Healthcare Specific Isolation Rooms Room Pressure Monitors Radiology Wall protection and magnetic protection Cafeteria and Kitchen Kitchen hoods, sanitation

29 Responsibilities in Building Performance Designers Overall responsible for design and meeting code Authorities Having Jurisdiction Responsible for ensuring building meets code, not performance Cx Authority Responsible for ensuring building meets design performance

30 AHJ and Turnover Authorities Having Jurisdiction on the Project UM Mechanical Inspector UM Electrical Inspector UM Fire Marshall for all business occupancy State of Michigan Fire Marshall for hospital State of Michigan Department of Health for hospital and kitchen

31 AHJ and Turnover Cx interface with AHJ on different issues During construction Mechanical - Med Gas Blow Down, Duct work installation, Generator Stack Sealing Electrical Equipment clearance Fire Marshall Pre-testing of all fire systems Health Department HVAC and lighting systems

32 AHJ and Turnover Generator Stack Testing

33 AHJ and Turnover Walkthroughs Mechanical Plumbing Hot water at fixtures Mechanical Duct Cleaning Pressurization Equipment Clearance

34 AHJ and Turnover Walkthroughs UM Fire Marshall Business Occupancy Fire Alarm Pre-test Audible levels Fire Door Latching Stair Pressurization Exit Signs

35 AHJ and Turnover Walkthrough State Fire Marshall Healthcare Occupancy Fire Alarm Pre-test Audible levels Fire Door Latching Stair Pressurization Exit Signage Space Pressurization Interface with Infant Abduction and RICU

36 AHJ and Turnover Walkthrough Health Department Space Pressurization Lighting Sequence of Operations Staff Notification of Issues/Alarms RICU Operation

37 Issues During AHJ Walkthrough State Fire Marshall Stair Pressurization Provide a certified report as Special Inspector FA Pre-testing Ensure that all pre-testing occurred Made sure the final testing went very quickly

38 Issues During AHJ Walkthrough State Fire Marshall Testing of Release of exit doors in RICU and with Infant Abduction Helipad Foam System Audible Level Testing Smoke Capture Test in Kitchen Fire/Smoke Damper Inspections Provided a report showing all dampers

39 Issues During AHJ Walkthrough

40 Issues During AHJ Walkthrough State Health Department Positive Pressure Rooms BMT rooms control reset Negative pressure rooms Issues with Balancing, Rebalance Lighting levels in OR Sequence of Operations RICU

41 Occupancy During Construction over 3,500 deficiencies identified and corrected Power Loss tests found numerous issues that would affect operation Fire Damper inspections found numerous issues Testing of controls systems

42 Occupancy Pediatric Emergency Room

43 Occupancy Areas where Cx helped project Driving controls schedule Managing LEED concerns Temp Heating and Cooling Pre-testing of systems for AHJ Getting all deficiencies completed before occupancy

44 Occupancy Building Opening Calls for Service Patients were moved from the old hospital over a period of 12 hours During opening month about 10 calls for service Building occupants were very happy with the building Patients and family were overwhelmed by the upgrade

45 Occupancy Peds ICU

46 Occupancy Energy Efficiency Found numerous issues where the sequence of operation did not match the design Found areas where the design sequences didn t work as anticipated Found numerous valves and dampers that leaked by

47 Lessons Learned Commissioning was integral to completing the project on time Construction Scheduling made functional testing very difficult Floor completion did not match up with MEP systems Controls contractor needed more hand holding Fell behind schedule Integrated Power Loss Testing for durations was critical to finding issues

48 Lessons Learned How to specify Owner needs to determine the level of effort Cost is directly related to increased scope Owner needs to identify systems they want checked Systems such as Med Gas, Nurse Call, Fire Alarm, etc MEP is standard

49 Lessons Learned How to specify Get commissioning involved early Can help with construction scheduling Owner to set clear requirements for successful outcome (OPR) Owner needs to identify a partner not just based on cost, Cx is a professional service

50 Matthew Tunnard, PE, CCP, LEED AP Senior Engineer Horizon Engineering Associates, LLP