The ASHE Health Facility Commissioning Guidelines defines “commissioning” as a process intended to assure that all building systems in a facility, including sustainable building technologies, are installed and perform in accordance with the design intent, that the design intent is consistent with the owner’s project requirements, and that operations and maintenance staff are adequately prepared to operate and maintain the completed facility.

Hospital Planning

Unlike most other buildings, health facilities are complex buildings incorporating multiple clinical disciplines. They need to be planned and designed to accommodate various functions that have to strictly follow laid down operational policies. It is not just the building but other asset classes such as MEP and HVAC services that follow strict design norms, not to mention the medical devices that can often cost as much as or more than the building itself. Establishing the facilities under these circumstances is just half the task. Hospitals, by and large are complex, expensive to operate and maintain. It is therefore essential to synchronize the commissioning and hand over in a seamless manner so as to minimise any problems in future. 


The commissioning team would prepare a project implementation plan / program based on the objectives of the project promoters, the nature of the hospital, time lines for commission the facility, the various assets and services that need to be incorporated, the building plans, etc.

Elaborating, in most cases, the major categories of systems to be commissioned would be:

1. Building envelope
2. Safety systems
3. MEP systems
4. HVAC systems
5. Medical Gas Pipeline System (MGPS)
6. Nurse Call System (NCS)
7. Pneumatic Tube System (PTS)
8. Fire protection and alarm systems
9. Information technology
10. Vertical transport
11. Material handling
12. Interiors including lighting, furniture and finishes
13. Landscape
14. Exterior lighting

Hospital Project Tools

Thus commissioning involves almost every single aspect of the healthcare provision process.

Cost of healthcare delivery is increasing year on year and hospitals are continuously under pressure to reduce operational expenses as the management continuously explores techniques to improve the bottom line. Amongst other ways and means, the hospital experts could add value to this exercise from the outset itself, viz. the commissioning process.

The commissioning process for hospital buildings should ensure that the facility operates as per its design philosophy and plan. This approach applies to both new facilities as well as existing ones that are undergoing expansion.

Taking medical devices as an example, it is essential to verify that all relevant space, utility and environmental requirements are met. Many of these are very sensitive to these parameters and are also governed by certain statutory requirements such as AERB, NABH, etc. Hence, whilst one plans and provides for installation of medical devices, it is necessary to also ensure that their maintenance envelope in the room is adequately designed as many larger equipment such as CT, MRI, Xray, etc. have to be maintained and repaired at site.

It is equally important to plan for the future. This not only means provisioning for adding more devices in future but even replacing some of the major installations in times to come and as technology evolves. Planning for replacement of a CT or MRI, for instance would mean planning pathways for them to be brought into their prescribed installation room and catering for any specific installation requirements of the new technology.

In summation, commissioning of a healthcare facility can be defined as the process of not only bringing healthcare facilities to an operational status in a timely, effective and efficient manner but also verifying the plans that will ensure seamless expansion and renovation in future.

Dhanraj Chandriani
Managing Director
Technecon Healthcare Pvt. Ltd.