Commissioning Isn’t Just for Manufacturing Anymore

Submitted by Kishore Warrier, Director of Commissioning & Compliance (Hauppauge, NY)

Kishore (right) on the job

With the focus on LEED design and energy savings in recent years, the process of commissioning—with its assurance that facilities, utilities, and, especially, energy systems are functioning properly and meeting user and owner needs—is in higher demand than ever. As the Director of Commissioning and Compliance at Stantec, I spent the majority of my career working for the pharmaceutical industry. But now we’re seeing commissioning becoming ever more relevant in areas such as healthcare, office and retail, hospitality, and education.

While the term “commissioning” is sometimes used differently from sector to sector, and even from client to client, understanding commissioning within the pharmaceutical industry makes it clear how specialized this kind of work is. Obviously, manufacturing drugs requires a highly rigorous process to assure their consistent quality and safety. Commissioning in this context often includes qualification and validation, sometimes interchangeable terms, referring to a robust analysis process where qualification documents or protocols, often written by our group, are subject to regulatory agency review. Qualification involves an extended period of time, either to assure that previous testing results are still valid or to determine that new equipment is performing consistently over time.

The complex mechanical systems of pharmaceutical
facilities require diligent commissioning 

Similarly, commissioning across different business sectors provides owners with the means to test facilities, utilities and equipment to ensure that they function as designed and as expected. While not as rigorously documented as in the pharmaceutical sector, commissioning here also includes the development of a master plan defining the scope of work and a check list for monitoring the facility and its equipment, particularly in terms of energy usage.

Commissioning is performed for new buildings and for older ones, ranging from assessing proposed systems to providing field investigations for existing facilities. Especially significant are the building controls, those systems that run and monitor HVAC and utilities for temperature, humidity and air flow, which must operate at optimum efficiency. As such, commissioning engineers are often involved right at the start of a project—developing a commissioning master plan and providing a thorough design review, helping clients mitigate risk before problems arise. In other cases, we provide management and oversight once the facility, its utilities and equipment are constructed.

This interface and coordination of engineering and construction disciplines is challenging and very satisfying, especially since we work closely with clients to gain a thorough understanding of their products/services, processes, stakeholders and users. It’s a special kind of work and requires a particular type of person. I appreciate spending a majority of time in the field, at the client’s site, rather than sitting at a desk in the office. And since we serve clients with facilities across the country, the job requires extensive travel, which I really enjoy.

While this isn’t the profession I went to school for (I studied economics, actually), it’s been extremely rewarding and exciting. And as sustainability becomes even more ingrained in the building and construction process, I see my job and what commissioning can do for clients only growing.

When Gender Makes a Difference in Transportation Design

Submitted by Marsha Anderson Bomar, Senior Principal (Duluth, GA)

Can alternative design solutions avoid
this scenario?

The first national city planning conference in the US was entitled City Planning and the Problem of Congestion. Though it sounds like something you might attend this year, it was actually held in 1909. The themes included crowding in urban areas, blight, immigrants arriving in large numbers, and the shortage of affordable housing.

There was just one woman among the presenters: Mary Kingsbury Simkhovitch, who founded a settlement house in lower Manhattan. In addition to her comments on social issues, she spoke about the connection between social and physical mobility. Her focus was on improving transit to allow families to live in places where women would have economic opportunity and children would be able to thrive.

As planners, modellers, designers, and engineers, we recognize that what we do requires both art and science. The body of knowledge for our professional work provides the framework for most every task we tackle. But along the way we are called on to use judgement outside of the formulae to arrive at accurate, meaningful outcomes.

Stratifying the population in some manner to derive solutions is not new. You may look at income levels or age distribution to inform a decision. In the last ten years or so there has been a more deliberate examination of when gender makes a difference in the judgement calls.

So, when does gender matter? Let’s take a look at a few areas open for exploration.

At times, design is centered on physical factors. The average woman is shorter and weighs less than the average man. When car manufacturers were designing airbags, front and side, using male crash dummies, women were left at risk. A female crash dummy was later adopted and designs were changed. Now, for example, side curtain airbags are long enough so that most women will not hit their heads on the window glass in a T-bone crash. Other adjustments and recommendations have come forth for pregnant women.

But other design issues can be informed by behavior and culture. Streetscape projects are a great tool for enhancing a community but when pavers with wide spacing are used, many women are challenged to walk on these sidewalks while wearing high-heeled shoes. Tree wells that are open grates or the ventilation grates for subterranean spaces or trains that are incorporated into a sidewalk are even more difficult to traverse. Have alternatives been explored?

A recent University of Honduras study showed that male and female students have different bicycling behaviors. Male students were more likely to ride and even ride longer distances independent of where the bicycling occurred (on road or off road). Female students felt less safe riding in an on-road bicycle lane or where there was no designated lane and so rode less or rode shorter distances. This is a transportation issue, as well as a health issue.

Marsha Anderson Bomar

Today many transit properties are using cameras and alarms to reduce the number of personnel needed in stations and trains. Some initial studies show that, in general, men feel safe with these technology-based solutions while women still strongly prefer having people on the platform and in the cars. While in the short term this use of technology may save some money, how will it impact transit ridership over time?

Household surveys tell us that women continue to do the majority of child-related car trips, which often means getting to many different places over the course of a work week. Could this be a factor when assessing who is willing to pay additional fees for access to increasingly popular HOT lanes? How might it impact their marketing?

With more women entering the transportation engineering field, we’ll continue to take a careful look at how our presence can inform truly universal design.

To explore the findings of the most recent conferences sponsored by TRB and the Women’s Issues committee, visit the website http://www.trb.org/ and search for women’s issues.

Cycling for life

Submitted by Mike Jones, Planner & Project Manager (Windsor, ON)

Almost four years ago, on August 27, 2008, I survived a heart attack.

I was driving home from working in Sarnia for the day when I began experiencing severe chest pain. When the pain didn’t subside, I pulled over and stood in traffic to flag down help. A vehicle soon stopped. When I told the driver I thought I was having a heart attack, he responded: “Get in!”

The driver took me to a local hospital where the doctors confirmed it: I had suffered a heart attack. Luckily, doctors were able to stabilize me and I was transferred to Hotel-Dieu Grace (HDG) Hospital in Windsor via helicopter. It was HDG’s catheterization lab that identified I had an 85-percent blockage in a lower left artery in my heart. Doctors had to operate, placing a stent in my heart in order to “open up” the blocked artery.

Since that day, I’ve made a great recovery. But, also since that day, I’ve thought about how I could repay the talented team at Hotel-Dieu Grace. How could I thank them for saving my life?

So, with this desire to give back and to say “Thanks,” I approached our team at Stantec with my idea: I would ride my bicycle from Dawson City, Yukon, to Windsor, Ontario. That’s more than 5,600 kilometers (~3,480 miles). I’m banking on taking three-and-a-half months to complete it, with the goal of traveling 100 kilometers (~61 miles), five days a week.

My goal for this odyssey is to raise awareness of Windsor-Essex’s dreadful record when it comes to coronary disease. The journey will also be a way to raise fund to support the new cardiac catheterization lab that is set to be constructed at HDG.

Stantec has provided me with incredibly generous support, giving me the necessary time off work to complete my journey and even donating a great touring bike, trailer, and the cost of my initial trip to the start line in Dawson City. But, given Stantec’s commitment to community and to the health and wellness of employees, I’m really not surprised.

Mike Jones begins his cross-Canada journey on Sunday, May 13. Check out @Stantec’s Twitter feed for weekly updates from the road! To make a donation to his cause, visit www.support-hdgh.org/donatenow/general.aspx and click: I am supporting: Cross Canada Bicycle Tour.

Q&A – Bill Rostenberg, Hospitals of Tomorrow

Given the uncertain future of America’s healthcare system, administrators, doctors, and patients alike are all are asking the same question: “What will the hospitals of tomorrow look like?” A healthcare architect of nearly 30 years, Stantec’s Bill Rostenberg is regularly asked to comment on this very topic. Ranked No. 1 on the list of the “25 Most Influential People in Health Facility Design” by Healthcare Design Magazine, he offers here some insights on the state of the industry.
 

The open design of the University of British Colombia’s
Djavad Mowafaghian Centre for Brain Health in
Vancouver aims to reduce barriers between
clinicians and researchers for better collaboration.


What’s changed most dramatically in the healthcare arena in the past 10 years?
Now more than ever, hospital and healthcare owners are being faced with considerable changes. Now there is less reimbursement available, and facility owners have an increased liability to achieve patient satisfaction. The Hospital Consumer Assessment of Healthcare Providers and Systems is a national standardized patient survey that actually results in satisfaction “scorecards” for healthcare facilities. Those scores now directly impact the reimbursement process. If a patient acquires an infection in a facility because of an environmental issue, it can affect those scores and ultimately impact their reimbursement. This is a healthy motivator for changing the process.

Does that change the philosophy of how hospitals look, feel, and deliver care?
Definitely. Facilities are becoming more accountable for the continuity of the patient experience—before, during, and after treatment. An increasingly large emphasis is—and will be—on seamless care, meaning fewer hand-offs between different healthcare practitioners and more comprehensive responsibility. Post-surgery, patients typically go home and then see a different practitioner in an outpatient site who doesn’t have the same sense of ownership or familiarity with the patient’s history. Facilities will take shape in a way that better allows for continuity of the facility and care. Those issues go hand in hand.

Technology is increasingly becoming a key feature
of today's hospitals.

How do the physical structures accommodate that idea of seamless care?
We’re already seeing a steady erosion of departmental boundaries in the physical layout of hospitals. The multidisciplinary, collaborative, interventional medicine ideology is alive and present. Information technology will also play a large role with the continuity of communication between disciplines. For example, the use of electronic medical records and picture records allows for better collaboration between practitioners. To receive facility funding, mandates for enhanced IT features are actually becoming more prevalent. Physical design strategies are key in removing discipline boundaries, but IT support definitely makes this happen.

Bill Rostenberg is a senior principal
and architect based in San Francisco.

How will designers change their approach to meet changing industry, patient needs?

First of all, we will need to recognize the need for seamless care. The greatest cost is wasted and greatest harm is done when the hand-off between providers is not handled appropriately. Many consider the idea of decentralized care, or “healthcare enterprise,” as a potential solution. Not every issue needs to be treated in a traditional healthcare facility. Patients can be treated through the use of micro-clinics or smaller ambulatory facilities where the care is needed, but not necessarily all of the clinical equipment. Many other consumer, retail and service-related industries have evolved to connect with the public in different, alternative settings. If the patient’s needs can be met using automated services, even certain web-based tools might be an appropriate reality. There are multiple ways to treat individual needs, and both designers and owners will undoubtedly be looking to develop facilities to accommodate that idea.