Health-care facilities are mastering the art and science of systems integration
Forward-thinking health-care facilities see patients as their No. 1 priority; therefore, their facility-automation systems should support a “patients-first” agenda. Integrating building systems with critical patient-care and caregiver-support systems can have a positive effect not only on patients and their care, but hospitals and their financial health.
Technical integration enables systems to exchange information and act on requests, improving data quality and decision making. Physical connections among systems facilitate network sharing, often reducing installation and lifetime-maintenance costs. The benefits of information sharing become a reality when data are shared on a network.
With technical integration, product or system features are combined to achieve solutions that bring value and serve a variety of technology-based agendas, such as indoor-air quality (IAQ). A critical element that must be controlled to ensure a patient's quality of care, health-care-facility IAQ is regulated by a hospital-accreditation body. Therefore, air-handling data must be captured and reported to ensure compliance. No matter how cutting-edge a discrete system might be, more important is what happens to the data and the solutions such systems provide.
For example, to affect energy-savings strategies in a hospital, information from myriad sources (and systems) needs to be acted on via knowledge-based technologies or human intervention. Decision-making is not static; data must be collected and processed through effective graphics and reports so facilities personnel or automated alarm-management and escalation routines can react appropriately to critical failures.
The two basic building-automation goals are system (and, therefore, facility) knowledge and facility control (Figure 1). With system knowledge obtained from building automation, facility managers are able to make decisions that can have positive impacts, such as reduced energy costs, the enabling of proactive maintenance, and the tracking of system activity and defects, on facility operations.
Integrated control lets building managers approach facility management with a “hands-off” mentality. A facility can operate itself optimally and efficiently, alerting facility management and staff when conditions requiring intervention occur.
Building-automation tools can be broken down as follows (Figure 2):
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These basic components yield useful outputs, such as reports on system information and activity; graphics that provide a user-friendly interface, revealing current system and facility conditions; alarms that instantly notify personnel about abnormal conditions; and trends that provide historical data for troubleshooting, data analysis, and compliance.
Integrating components provides these benefits:
When data are collected from all relevant systems and put on a single database, reports can be created using a single report package.
A facility can be run more efficiently with a single application interface that leverages interface options, such as graphics, alarms, trends, paging, and Internet access, for all facility systems.
Supplying tools and interaction among systems that provide precise control based on actual and anticipated conditions and reducing opportunities for the systems to misbehave results in increased comfort.
Sharing data among systems maximizes the use of assets, such as personal computers, cables/wires, sensors, applications, etc., so investments in one system's capabilities can be leveraged to the advantage of all of the systems in a facility.
Intersystem control can be used to increase productivity by allowing the various systems in a facility to share and act on information freely. Training on a single system allows a higher level of proficiency.
Recent experience has proved that health-care facilities are taking advantage of integration to achieve the previously mentioned benefits. Banner Estrella Medical Center, a 214-bed nonprofit community hospital in the west valley of Phoenix, is the first acute-care health-care facility to serve the rapidly growing communities in its region. Designed by the health-care team at Syska Hennessy Group, the first portion of the 50-acre campus opened in 2004 with a 180-bed acute-care hospital tower, diagnostic and treatment center, and central-plant facility.
Typically, a major hospital project requires five to seven years to design and construct. However, the contracting team — working closely with the project's architect; mechanical, electrical, and plumbing consultancy; and owners — was able to compress the schedule significantly, requiring only two-and-a-half years from initial concept to completion of construction. Regular meetings were held with the project team, architect, client, and contractors to resolve design issues, perform maintainability and constructability analyses, and, most importantly, coordinate technology interfaces to establish systems-integration criteria and goals. The hospital required partners that could make real contributions to the design/build process and had the capability to fully integrate its building-automation system (BAS) with fire-alarm and life-safety systems, thus reducing first costs and eliminating scope gaps with multiple subcontractors.
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Using an open BACnet-enabled BAS, more than 20,000 pieces of equipment and devices — including the fire-alarm system, emergency generators, central-plant chillers, medical-gas system, and patient-isolation-room differential-pressure monitors — were integrated. The fire-alarm system has state-of-the-art sensing technology that guarantees no false alarms. The implemented smoke-detector technology senses different types of compounds in the air, ensuring actual smoke, rather than dust, is recognized and false alarms are eliminated.
Because the BAS was fully integrated with the fire-alarm system, the facility team was able to use graphical floor plans to view and identify alarm locations. Also, utilizing floor plans with HVAC equipment layouts allowed the team to identify where equipment was located after construction was completed.
The BAS is programmed to alarm and generate a work order when any equipment goes into fault. The system's remote paging and notification software allows the hospital's operating staff to receive alarms and monitoring points via cell phone, pager, and e-mail when corrective maintenance is required.
Additionally, the BAS automatically analyzes and trends utility data regularly. By knowing historical data, facility managers can track costs and troubleshoot anything abnormal, such as power spikes, during a given period. The resulting documentation is critical for proving compliance and, in some cases, for protecting data needed for clinical projects.
The hospital can operate the facility's 800,000 sq ft of space from a single workstation platform, monitoring and controlling utility data; the air-conditioning, heating, and fire-alarm systems; and the central plant. This allows the owner to limit maintenance staff, thus reducing ongoing operational costs.
The integrated fire-alarm system and BAS also allow the owner to maintain and track two critical building systems from a single location. Connectivity to critical systems gives operators instant access to important information. For example, if a power generator goes down, operators can check fuel levels in backup generators immediately. Or, for a critical environment, operators can take pressure readings online, keeping the hospital in compliance and preventing labor-intensive smoke-test readings.
Using trending capabilities, the hospital can reduce maintenance schedules for equipment with a history of clean operation and increase maintenance of equipment with a history of corrective maintenance. Reporting and trending also provide the necessary documentation for compliance and accreditation issues. For example, the hospital can provide historical data on freezer temperatures.
Because Banner Estrella Medical Center is located in a desert environment, special attention is placed on additional cooling requirements, along outside equipment's exposure to the elements. The hospital's central-plant facility was located out of the way of future hospital-expansion areas, creating control challenges because the location was not directly adjacent to the first-phase hospital tower and diagnostic and treatment buildings. To solve this dilemma, a utility tunnel connected the central plant to the buildings. Medium-voltage distribution systems were designed to provide longer-distance electrical service while reducing voltage loss, and a high-temperature, high-pressure water system replaced traditional steam pipes, providing a lower-cost delivery alternative with smaller pipes and less energy loss.
With 480,000 sq ft of space, Dell Children's Medical Center of Central Texas is the largest children's hospital in central Texas. Part of the Seton Family of Hospitals, the 32-acre campus opened in June 2007 and includes child-focused facilities, such as a healing garden, a therapy pool, operating rooms, diagnostic facilities, an emergency-treatment center, and outpatient rehabilitation facilities.
From the project's conceptual beginnings in 2004, Seton's engineers brought together contractors and a technology supplier to collaborate on an intensive system integration to achieve a high-performance facility. For Seton, a high-performance facility required best-in-class energy efficiency. The hospital's efficiency measures save enough power to fuel about 1,800 homes in Austin, Texas.
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Achieving Leadership in Energy and Environmental Design (LEED) certification was a priority and an overall driver of the facility's design and engineering. Tight building-automation control and comprehensive system integration contributed to the medical center's status as the world's first health-care facility to achieve LEED Platinum certification. In 2004, LEED certification for any building was considered new territory; for a health-care provider to consider it was unprecedented.
A BAS was used to integrate numerous third-party devices, such as emergency-power transfer switches, domestic-water booster pumps, hot-water generators, an underfloor air-distribution system, computer-room air conditioners, and a therapy-pool air-conditioning unit, that utilized the BACnet and Modbus protocols.
BAS integration provides the information necessary to monitor equipment properly and make complex decisions driving energy savings and efficiencies. Using BACnet to integrate variable-frequency drives and underfloor HVAC systems provides the system control necessary to drive down energy costs based on demand-control strategies.
Similar to the Banner Estrella Medical Center, Dell's BAS is configured to alarm in the event any equipment or condition, such as critical air-handler-unit fans, switchgear, or operating/isolation-room conditions, are out of tolerance. Remote-paging and notification software allows operators to receive alarms and monitoring points via cell phone and pager.
The BAS also automatically trends utility data regularly. Facility managers can use historical data to track costs and troubleshoot equipment operating in abnormal ranges. Reporting and trending capabilities can provide historical data on isolation-room pressures and operating-room temperatures and humidity readings.
This medical center also can operate from a single workstation platform to monitor and control utility data, the air-conditioning and heating system, and the utility-distribution plant, allowing Seton to limit the number of maintenance workers.
It is clear that building systems and their integration with critical patient-care and caregiver support systems play an increasingly strong role in the health-care environment, contributing to better patient and financial outcomes. Delivered by highly integrated systems, improved information and data gathering is key to proper decision making.
The senior product manager of integrated systems for Siemens Industry Inc., Chris Hollinger joined the company in 1995. He is responsible for the development of integrated building applications, standard-protocol solutions, and integration solutions. He holds bachelor's and master's degrees from the University of Illinois at Urbana/Champaign. A member of BACnet International and active in the BACnet Testing Laboratories and BACnet International marketing committee, he has authored several articles and case studies on integrated building systems and the use of standard protocols.