Healthy hospital success: Automation and controls

With hospital projects, it is imperative that engineers get everything exactly right—after all, the lives of patients treated in the health care building may depend on it. Building automation systems and controls are key to a building’s success.


Richard Heim, PE, LEED AP Mechanical Project Engineer RMF Engineering Inc., Baltimore. Courtesy: RMF Engineering Inc. Tim Koch, PE, LEED AP Electrical Engineer HDR Inc., Omaha, Neb. Courtesy: HDR Inc. Nolan Rome, PE, LEED AP Senior Vice President ccrd, a WSP | Parsons Brinckerhoff Co., Phoenix. Courtesy: WSP | Parsons Brinckerhoff Co.

Raymond Schultz, PE Project Engineer, CannonDesign, Grand Island, N.Y. Courtesy: CannonDesign Kunal G. Shah, PE, LEED AP, RCDD President, PBS Engineers Glendora, Calif. Courtesy: PBS Engineers Glendora Tommy Spears, PE, Vice President of Design Solutions, TME, Little Rock, Ark. Courtesy: TME


Richard Heim, PE, LEED AP, Mechanical Project Engineer, RMF Engineering Inc., Baltimore

Tim Koch, PE, LEED AP, Electrical Engineer, HDR Inc., Omaha, Neb.

Nolan Rome, PE, LEED AP, Senior Vice President, ccrd, a WSP | Parsons Brinckerhoff Co., Phoenix

Raymond Schultz, PE, Project Engineer, CannonDesign, Grand Island, N.Y.

Kunal G. Shah, PE, LEED AP, RCDD, President, PBS Engineers, Glendora, Calif.

Tommy Spears, PE, Vice President of Design Solutions, TME, Little Rock, Ark.



Figure 2: The new Parkland Hospital in Dallas is a $1.27 billion health care facility built to replace a 60-year-old facility. The project consisted of an acute care hospital, outpatient center, office center, parking for 6,000 vehicles, central plant, anCSE: When working on monitoring and control systems in hospitals, what factors do you consider?

Schultz: Building automation systems (BAS) need to be expandable and versatile. They need to easily integrate with a facility's low-voltage systems (nurse call, security, lighting controls, etc.). Initially, the integration may not be implemented, but it is important to provide an adaptable control system. Potential BAS providers need to offer strong local representation with quick responses and a willingness to train building operators and make adjustments. It's beneficial to show room-temperature sensors within design-development documents so the health care staff using the facility understand which rooms will have temperature adjustability. Where an existing direct-digital-control (DDC) system is established, it is best to expand the system's capabilities. But cost can be a real challenge for a proprietary system. The design team can identify an alternative manufacturer to act as a control measure for the cost. In some cases, the alternative manufacturer provides a more cost-effective solution and secures the project.

Koch: When designing the monitoring and control systems in hospitals, we consider several factors. The first and foremost factor is owner input. Do they have an existing controls system that they are familiar with? Are there certain equipment-control sequences they have used that are a facility standard? The best controls system can be significantly under-used or compromised if the owner of the system cannot effectively use it or changes the system due to complexity.

Spears: IT security protocols are the No. 1 consideration when working with monitoring and control systems in a hospital. It is essential that contractors, engineers, and hospital staff have access to the systems remotely to use them to their full potential. IT staff must understand this need and find a way to accomplish it without violating HIPAA rules or creating a weak point in security that would allow the system to be hacked. Integrating the various systems within the facility is also an important aspect of monitoring and controls protocol. For example, if the occupancy and work order systems are not integrated, it is more difficult for maintenance staff to know the best time to complete the work orders in a particular room or area.

Rome: The main consideration is the goals of the hospital facility staff and keeping in mind that end users will monitor and maintain the systems being controlled. Will the end user have any continuing education beyond the initial original equipment manufacturer (OEM) training provided with the project? Are there energy goals? What makes it usable and future-proof for troubleshooting and analyzing systems use? We can design very intricate and complex systems, but the user has to be able to understand and use them properly. It is extremely important that we tailor our designs to the capability of the owner/user.

Shah: For monitoring and controls, it is important to consider expandability and compatibility. In many cases, the intent is to have an open-system infrastructure that can allow multiple inputs of systems and allow the facilities manager to be able to manage the overall function of the hospital. With the size of hospitals and the critical infrastructure associated, it is important for facilities managers to have real-time data on their components. Further, the system needs to be dynamic and flexible to accept various systems. Thus, it is important to have an open-architecture controls protocol backbone. This allows the HVAC, electrical, and plumbing systems to all seamlessly communicate and report their statuses to the facilities manager.

Heim: Information is incredibly important, especially in hospitals where people's lives are dependent upon the accuracy of the information being shared. With that said, it is critical that the monitoring and control systems be reliable and informative. It is also critical to have alarms and troubleshooting monitoring points to give the hospital engineering staff the tools needed to solve problems.

CSE: What are some common problems you encounter with BAS in hospitals?

Heim: Frequently, we find issues with integrating manufacturer-provided controls with the BAS. Some specialty HVAC equipment comes with integrated sequences and controls, and often it becomes a challenge to fully integrate with the BAS. Inevitably, there is a discrepancy between what the BAS is able to control/monitor versus what function the packaged equipment controls can perform. Another control issue is finding control devices out of calibration. We've seen this affect system operation, oftentimes leading to a significant waste of energy.

Shah: Some recent challenges we have seen with BAS in hospitals deal with renovation of equipment within existing facilities. In some cases, the equipment and the associated BAS is proprietary to the equipment, thus making it difficult for the facility's management to effectively monitor and manage the hospital. When making upgrade recommendations, an open architecture like BACnet is typically specified to allow for future expansion and compatibility. In some cases, the proprietary systems can be modified to allow for some compatibility, but there are costs associated. Thus, we see the frustration many facilities managers face when they have multiple systems that have different interfaces to manage their critical systems.

Spears: The biggest issue we encounter with BAS, regardless of facility type, is naming conventions. Most facilities do not have pre-established standards for naming various pieces of equipment within the facility that are tied into the BAS. From a maintenance perspective, this issue creates a tremendous amount of additional work to ensure that each piece of equipment is programmed and controlled properly based on its location and function within the facility. For hospital facilities, specifically, the main issue we encounter is communicating effectively with the IT department, as discussed above to ensure that all of the necessary personnel have the access they need to monitor systems within the facility.

Rome: A common problem we see in hospitals is vetting through the full commissioning process within the construction schedule. In our experience, owners who are using seasonal commissioning the year after a project opens and who are reviewing energy metrics regularly will see fewer issues from the system, and more will more-accurately execute the sequences.

CSE: What types of system integration and/or interoperability issues have you overcome, and how did you do so?

Koch: Integration is more than simply having common communication platforms/protocols. It extends to confirming the integration outcome is clearly communicated and followed through to the commissioning phase. A plan also needs to be in place when either integration partner upgrades their software to confirm the desired integration outcome is still accomplished.

Rome: We recently integrated the lighting controls system and the owner's financial patient-tracking system into the BAS. The important focus was importing the occupancy of a space from the financial-tracking system.

Spears: Many integration issues are related to the disconnect that occurs between systems when campuses with multiple facilities have multiple BAS from different manufacturers. To overcome this issue recently encountered on a large campus in Alabama, we not only integrated the systems into a single platform, but also developed instrumentation, controls, and electronics standards for systems lists, controls diagrams, network controls, utility meter applications, etc. TME also found creative solutions, including pulse reader calibration and tie-ins, to integrate various utility meters into the comprehensive campus BAS. This issue is particularly complicated because these is not a general solution that will fit all facilities on a given campus, due to the variety of technology used for different meters and the various utility companies providing those meters.

Heim: Full system integration has been one of the challenges we have faced recently. Our solution has been to provide explicit direction in the documents identifying BAS contractor responsibilities and HVAC equipment contractor responsibilities. Not only is it important to describe their responsibilities on what needs to be provided, but it is equally important to describe how they will interact and what needs to be monitored/controlled. As with many things, time spent thinking this through early on in the project has often paid off in the end.

CSE: In your hospital projects, have you worked to incorporate the Internet of Things (IoT), the Industrial Internet of Things (IIoT), or Industry 4.0? Are other countries more, less, or equally advanced when compared to U.S. projects?

Shah: Many of our projects call for designs to allow for the building to be interconnected. Many devices are considered "smart" and need infrastructure to unleash their true potential. This ranges from hospital-specific equipment, like computerize tomography (CT) scanners and X-rays, to actual electrical-distribution equipment with smart metering and sensors to allow the facility to understand the actual demand usage. This demand on the data and communication network forces the designs to implement robust infrastructure to support the connectivity of these devices. Rack space, bandwidth, and propagation of wireless signals are key factors in the success of the interconnectivity.

Rome: We are integrating Industry 4.0 concepts into our automation-management systems on a more limited basis at this point. Again, it relates back to what the owner's staff can deal with at this point. As they become more sophisticated, we turn it up a notch on what we integrate into the designs. As for other countries, the U.S. projects are definitely more progressive than most of the world. Again, this relates to what the facility engineering staff is prepared to deal with. It is not that the technology is not available in other parts of the world, there is just an evolution of education that has to be introduced gradually or it is overwhelming and is "turned off" by the staff.

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