Retrofitting aging health care facilities requires patience

Health care organizations are turning to renovation and expansion of their existing facilities, many dating back to the 1960s, but it isn’t an easy process.

If you work in health care, the issues are all too familiar. Changing laws, advanced technologies, aging populations and aging facilities are plaguing the increasingly cost-conscious industry today.

Unfortunately, funding for capital improvements are not the types of investments that move the needle quickly enough to affect the bottom line. This hampers the design and construction of health care facilities to meet only immediate needs, with little planning toward the future. Additionally, new construction often means interruptions in service and disruption in revenue.

For these reasons and more, health care organizations are turning to renovation and expansion of their existing facilities, many dating back to the 1960s.

With most expanding and modernization projects, the mechanical scope of work often involves replacing and relocating boilers, pumps, chillers, and heat exchangers, and then optimizing both the layout for operation and schedule for construction. Each comes with its unique challenges and solutions, including code compliance and space.

Working toward solutions to the problems through comprehensive review of national and local codes, in conjunction with sound engineering practices, and through the evaluation of cost implications, will dictate the success of the design and aging infrastructure as a whole.

Preparing for retrofit challenges

Four rules of thumb worth following ahead of retrofit work:

  1. Understand the history of the systems. Research their evolution from original installation to current state, and know the engineering decisions of the past. This knowledge will help their expansion, particularly if they were made on sound engineering practice.
  2. Know the operation of all systems and their relationships. This will help in making recommendations for improvement.
  3. Work with engineers across all disciplines to create solutions that work in the best interest of the owner. Revisit the code.
  4. Don’t assume that all prior installations were or are code compliant. Sometimes the AHJ overlooks something. Revisiting the application portions of the code can help in shaping the interpretation and application.

Russell Ashcroft, principal engineer, Southland Industries. This article originally appeared on Southland’s blog, In the Room.