Don’t Fail Me Now! Criticality & Risk in Healthcare Facilities & Utilities Systems

Posted by Bryan Haag on Monday, July 17, 2023

Operating Room Surgeons

The reliability of mechanical systems and central utilities like heating, electrical, and wastewater is not an ancillary issue on a hospital campus. Surprisingly, these systems and their risk of failure can be significantly under-valued among healthcare portfolio assets, and the very thing that should make them a priority might cause them to be inadvertently neglected: patient bed availability.

What’s behind your walls? Evaluating critical systems

Facility assessments and the resulting metrics and recommended projects often focus only on assets that can be seen, such as lighting and plumbing fixtures, individual mechanical heating and cooling units, window and door replacements, and architectural finishes. In the healthcare setting, these assets can be addressed through a cyclical process of relocating beds and renovating contained spaces. While this approach to renovation can be a practical way to limit interruption to patient care, the approach itself has a life cycle. Eventually, non-visible systems, such as building mechanicals and campus boilers and chillers, which can’t be taken out of service in a single floor renovation, will break down. Hospital administrators and facilities managers must have a strategy in place to address these systems that lie behind the walls and beneath the surface.

When you are undertaking a Facility Condition Assessment (FCA), be sure to understand the scope of the assessment at the outset. Some questions you should consider:

  • Will your non-visible system values be included in the analysis?
  • Do you have central heating and cooling systems or other central utilities that serve multiple facilities, and if so, will a Utility Condition Assessment (UCA) be performed by professionals who understand the complexities of those systems?
  • How will the replacement values and deficiencies of those campus systems be reported in relation to the individual buildings that those systems serve, as these figures can significantly impact your FCI ratings?

What’s behind your metrics? Pairing assessment with thorough analysis

Countless competing budget demands make it challenging to prioritize unseen assets in unknown conditions over obvious ROI items like medical equipment, a renovated OR, or technology upgrades, especially if addressing those hidden assets involves a costly full-system shutdown. Gauging the value of such an investment of time and finances requires accurate data to identify and communicate the benefits versus the risks and costs of a failure.

A Facility Condition Index (FCI) is a valuable benchmark metric for understanding the ratio of the backlog of deferred maintenance projects to the current replacement value of the asset. A comprehensive Facility Condition Assessment should determine both visible and non-visible systems' asset values alongside estimated project costs and should evaluate that data using an ‘FCI by system’ metric to allow the condition of each system within each building to be understood and analyzed at a campus level. Likewise, a Utility Condition Index or ‘UCI’ should be calculated to put a comparable value to the campus’s central utilities systems. Since metrics live in a vacuum, and have little value without proper context, those key findings should be paired with deeper analyses of how that data actually correlates to the day-to-day operations and maintenance practices of the healthcare campus. By quantifying the condition of visible and non-visible building mechanical and campus utility systems and by evaluating those factors alongside the costs of remediation vs. replacement, each system’s risk and value can be understood and communicated among key stakeholders using data-based reports, so that informed, confident decisions can be made.

Be sure that your Facility and Utility Condition Assessments don’t just end with static reports that leave you to put all the pieces together. Your professional engineering consultant should provide an analysis of the findings and a consultation of what those findings actually mean in the context of your current operation – an operation with which they should be thoroughly familiar, having asked the right questions while they engaged with both your facilities management leadership and your operators through on-site evaluations and interviews.

If you need help, have questions, or aren’t sure where to begin, reach out – we’d be happy to talk with you!


Categories: Buildings & Campus

Tagged: Facility Condition Assessment (FCA)  |  Facility Planning & Management

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