Having recently been appointed to serve on the Commissioning Program Business Partners Task Force for the American Society for Healthcare Engineering (ASHE), I'm looking forward to learning about and contributing to the efforts to win funding for commissioning, particularly in existing buildings. More and more hospitals require clear business cases for every funding decision—purchasing another MRI, invest in better HVAC controls, or hire a nurse assistant. Because of this, facility engineers are finding themselves in the C-Suite, presenting their financial case in competition with clinical, food service, and other managers.
Convincing Hospital C-Suites to Fund Commissioning and Retro-Commissioning Projects
The goals of the task force are to convince members of hospital C-Suites to fund commissioning and retro-commissioning of their HVAC systems. During my appointment on the task force, I'll be responsible for developing a model to educate key stakeholders on ASHE's Healthcare Commissioning program, and gaining buy-in and support from business partners. Doctors might become "partners" in a pitch to make HVAC improvements to lower the temperature and humidity in the operating room suite.
Commissioning is the process of assuring that all components of the HVAC system meet operational requirements by routinely conducting energy accounting, troubleshooting, testing, balancing, start-up, condition assessment, and review of setpoints and sequences in light of changes in use, codes, or even staff. With 37 years of hands-on engineering experience, I'm an avid proponent of retro-commissioning—also known as energy auditing, troubleshooting, tuning, and now commissioning. I have presented to hundreds of hospital engineers, administrators, and even boards of directors about the return on investment using this approach.
Commissioning Can Equal Cost Savings for Hospitals
As hospitals tighten their budgets, there is a considerable need to reduce energy costs. The typical hospital spends $4-7 per square foot, per year on energy—with large hospitals over one-million square feet in size. Further, HVAC accounts for about 67 percent of a hospital's total energy bill. A 15 percent reduction in HVAC use can result in a saving of $500,000 per year in a large hospital. Most hospitals run on very thin margins. At a two percent margin, it will take $25,000,000 in sales to earn the $500,000.
But commissioning isn't just about energy savings. In hospitals, a good HVAC system must meet rigid temperature, humidity, and air quality requirements, thereby mitigating the air borne spread of infections; as well as be reliable, easy to maintain, and energy efficient. As with tuning a car, controls commissioning improves performance and mileage.