Many hospital facilities receive a plethora of “too hot/too cold” complaints from staff. Maintenance personnel may have no choice but to apply band-aid solutions to rapidly address user dissatisfaction. But by not addressing the root cause at a systemic level, complaints will ultimately escalate. At that point, a common knee-jerk reaction is to replace a major equipment system.

Instead, we recommend that facilities “roll up their sleeves” and invest in unearthing the root cause. Often the solution involves fixing rather than replacing components. This delays or eliminates the need for major equipment purchases, conserving capital outlay.

This approach considers overall system operational performance:

1. Collect symptoms. Discuss user expectations, past problems, and suspected causes with the facilities department.
2. Review as-built plans and specifications. Plans provide valuable insight into system type, components, capacity, performance, and assembly method. The sequence of operation within the specifications conveys the design intent.
3. Perform a factual review. Visit the site to document the condition of equipment and components. Establish which parts function and which don’t. Test operating conditions with a contractor who has the proper test equipment and knows how to take the appropriate readings. This analysis reveals surprising facts about system operation.

Haskell engineers recently applied this approach at a large community hospital. Surgical staff complained of persistently uncomfortable temperature and humidity levels in the ORs. The problem had escalated such that the administration planned to replace the HVAC system in three ORs. That tactic carried a $125,000 price tag. For $30,000 including design fees, we helped the hospital eliminate the problem.

The three operating rooms were associated with one Air Handling Unit (AHU). During onsite investigations we reviewed cooling coil control sequences and performed functional testing. We verified the operation of control hardware components. We examined whether cooling coils could maintain a 44-46 degree air discharge temperature set point for the AHU. We determined that two different cooling coil circuits controlled the AHU. Because they were two different brands, they were not communicating effectively to the AHU.

We recommended only one new purchase: a controller to start and stop the existing air cooled chiller. The remaining recommendations consisted of modifications and repairs to existing equipment. We demonstrated that the system could maintain the desired air discharge temperature by:

• Performing testing and balancing
• Modifying control sequences
• Recalibrating control valves, sensors, and air flow stations

Not only was the solution less expensive, but it took less time to implement than a replacement would have. Our solution minimized down time of important revenue-generating space. A less intensive construction effort minimized inconvenience to staff.

Capital for infrastructure is increasingly difficult to come by. We must get the largest bang for the buck. Faster and cheaper, with staff satisfaction? Yes, you can have all three!