Basic commissioning efforts focus on documentation, testing and training associated with individual systems. But when it comes to hospitals, the old adage that "the whole is greater than the sum of its parts" is particularly applicable. Demonstrating the generator starts and comes on line in less than 10 seconds does not guarantee the associated HVAC, Fire Alarm and Security, etc. will respond properly when called upon to function under adverse conditions . It's this increased level of certainty the Owner is striving to achieve.

Integrated Systems Testing picks up where traditional Commissioning leaves off. The process involves testing how individual systems that are vital to the ongoing operation of a hospital function as an integrated set of systems under adverse conditions. For example, if one of three generators does not start, do the HVAC systems respond appropriately? If the elevators are responding to a code blue call and an elevator re-call signal is received due to activation of a lobby smoke detector, is the appropriate response made?

Through the process of Integrated Systems Testing the hospital staff can develop a deeper understanding of their systems. The data collected and experience obtained can be used to develop a better emergency response plan that sets guidelines for the appropriate actions to be taken by staff during emergency situations.

This presentation will focus on Integrated Systems Testing as it relates to an emergency situation such as the loss of normal power.

1. The first step is to perform an in-depth failure mode analysis and use the data collected to develop a list of failure modes that will be investigated.

a. Review utility power sources.
i. How many Utility Feeders serve the facility?
ii. Are they from separate sub-stations?
iii. Is there an alternate feed?
iv. Does it have an Automatic Throw-over switch?

b. Review Essential Power System configuration.
i. Is there more than one generator?
ii. Are they paralleled?
iii. Is there Load Shedding Capability?
iv. Is there Cogeneration capability?
v. What types of Automatic Transfer Switches are utilized?
vi. Is there an Uninterruptable Power Supply (UPS)?

c. Review Switchboard configuration.
i. Are they single ended or double ended?
ii. If double-ended, are they equipped with a manual or automatic tie?
iii. The second step is to develop a detailed outline of how each system to be tested should respond under the various failure modes.

a. Life Safety loads.
i. All outages less than 10 seconds.
ii. Automatic connection to back-up.

b. Critical Loads.
i. All outages less than 10 seconds.
ii. Automatic connection to back-up.

c. Equipment Loads.
i. Delayed Automatic Connection.
ii. Load Shed Priority.

d. Optional Equipment Loads.
a. Delayed Manual Connection.
b. Load Shed Priority.

3. The third step is to develop a testing plan that will allow the responses to be observed and documented including:

a. What systems are to be tested?
i. Lighting
ii. Red Outlets
iii. Nurse Call
iv. OR Suites
v. Smoke Doors
vi. Security
vii. Electronic Patient Records
viii. Smoke Dampers
ix. Heating
x. Cooling
xi. Isolation Exhaust
xii. Lab Exhaust
xiii. Ventilation
xiv. Gas and Vacuum
xv. Smoke Management
xvi. BAS
xvii. Vertical Transportation

b. Under what conditions?

c. What are the anticipated results?

4. The Integrated Systems Testing for the new 1,000,000 square foot Prentice Women's Hospital will be used as an example of the information that can be collected from the test. Details of complications encountered during the planning and implementation of the test will be provided. Sample forms for documenting testing results will be shared. Details of the protocol developed will be analyzed and results will be shared.