HOSPITAL PROJECT

COMMISSIONING & HANDING OVER

Dr. Maarof Sudin

Planning Division
Ministry of Health, Malaysia
October 2016
 Health Facilities in Malaysia
• Health facilities are complex buildings

• Designed to accommodate various functions

• Designed to follow certain operational

policies

• Various disciplines involved

• Basically to provide curative care to patients

• Cost - large sum of money

• Expensive to operate & maintain

• Important to do commissioning and take over

• in the correct manner
• so that future problems are
minimized.
 Hospital Development in Malaysia

• Done by :
– PWD as designer and/or
supervisor
( for bigger projects)

– MOH’s Engineering Services

Division
( for Smaller Projects or Special
Projects)

• Strive for functionality &

sustainability
 Project Implementation in Malaysia
• Conventional
– Design, built & equipped by
different parties
– Eg. design by PWD, built by private
contractors & equipment
procurement by MOH

• Design & Built

– Design & built by private
contractors
– Equipment procurement by MOH

• Turnkey
– Design, built & equipped by one
party eg. private contractor
– Package Deal
 Macro & Micro-Planning
Malaysia advocates both macro &
micro-planning

• Macro-planning is important to
decide on the building blocks
that include
– Zoning according to spatial
relationships
– Segregation and
compartmentalization for
security and administrative
controls
– Master planning to address
expansion, phasing and future
needs

• Micro planning using loaded

room data sheets
– With end-user involvement to
include preferences and local
requirements
 Site Requirements
Critical success factor

Land and site issues must

be settled and finalized
before project can be
considered
• Site must be free from
encumbrances
• Vacant possession of site
• Boundaries must be
delineated
 Funding
Critical success factor

• Adequate funding
– Complete or phased
implementation

• Planned and timely cash flow

– To match progress and
payment
– Capital contribution
– Infrastructure contribution
 Equipment
Critical success factor

• Important to include the cost and availability

of consumables and fuel during
commissioning and acceptance phase

• Important to have competent personnel from

both the vendor and end-user to ensure
successful testing and commissioning of
major equipment

• Important to have reliable electricity supply

during the testing of major or sensitive
equipment

• Important to make provision for proper

storage of major and sensitive equipment
pending T&C and taking over

• Important to define and sort out third party

rights, responsibility and licensing especially
with regards to ICT
 Commissioning Plan

Critical success factor

• Must be considered
from Day one of the
project
 Health Facility Project- Implementation Process
Approved Projects

SON & Medical Brief/Design Brief

Architectural Drawings/Design Development

Tender

Construction

Testing & Commissioning & Handing Over

DLP / Operation & Maintenance

Evaluation
 Commissioning

• Commissioning is a quality process

• A process to ensure building’s

systems operate as per intent of the
design scope

• Functional Testing – building system

operate & function as designed

• A systematic and documented process

• building systems perform interactively
• to design intent and user needs
Benefits of Commissioning

-Ensure system works the way it is supposed to

-Coordinates, functionally test

and fine tune systems before handing over

-Smooth transition to M&O

-Fill the gap between

construction & operation

-Reduced utility consumption and operational costs

-Reduced occupant complaint

Commissioning Responsibility

-Contractor

-Consultants

-Owner/User – verification
P&D, Engineering Div, Users,
Support services provider
 Testing & Commissioning
– Two main components
» Functional component (individual / may not be real)
» Operational component (actual/integrated)

– Five project phases

» Facility program phase
» Design phase
» Construction phase
» Acceptance phase
» Post-acceptance phase
 T & C – 5 PROJECT PHASES
1. Facility Programme / Scope Phase
-Identify and set-up T&C Team and their
Working Group of Professionals

-Identify roles & responsibility

-Set-up commissioning plan

-Define issues based on experience and

ways to avoid/overcome
2. Design Phase 3. Construction Phase
-Identify systems appropriate for commissioning -Interaction with the construction team

-Define commissioning specifications -Review relevant system submission by contractors

-Interaction with design and construction team -Familiarization to system

-Develop test documents -Develop contractor’s commissioning requirements

ie contractor checklists
-Develop T&C schedules
-Get ready for Functional Testing

4. Acceptance / Occupancy & Operation 5. Post Acceptance /

Continuous Commissioning Phase
-Doing Functional Testing
-Monitoring of systems in operation
-Field verify the operation of each commissioned system
-Issues/Problem identification before warranty expires
-Function,Standards,Safety etc.
-Monitor system maintenance
-Training review

- Operation and Manual verification

END-USER’S ROLE IN :
- HOSPITAL DEVELOPMENT

- T&C

- PROJECT HANDING OVER

 Hospital Development

• Main Success Factors:

– Teamwork
– Communication
– Professionalism
– Clear Direction Towards
Common Goal

• Team Players:
– Project Manager/Director
(PWD/MOH Engineering
Division)
– Developer / Builder
– Owner (MOH and End-
Users)
 End-User’s Role in Hospital
Development
• End-user’s role and contribution
is fully acknowledged by MOH
Malaysia

• Recognized as important partner

in hospital design and
development

• This is to ensure end-user’s and

local needs are considered in the
design and development of the
facility
 End-User’s Role in Hospital
Development
WHY ?:
• MOH (with P&D)
– Capital funding and Project Administration
– Set building and design norms and practice
guidelines
– But does not have capacity to monitor
closely all projects

• Role of state or local health office

– Coordination and administration

• End-user
– Responsible to run facility once completed
and in operation
– Vested interest in ensuring facility built and
commissioned to high standards
– Sense of ownership
 End-User’s Role in Hospital
Development
WHEN?
• Through-out development period

• As early as possible
- Planning and conceptual stage
- Design stage
- Construction stage
- Commissioning
- Post acceptance stage

• Especially towards handing-over stage

• Take-over and ‘live’ systems testing

• Defects Liability Period (DLP)

• Post Occupancy Evaluation (POE)

 End-User’s Role in Hospital
Development
• HOW?

– Carefully Planned and

Organized

– Identification and
appointment of core
team and key
contributors

– Clearly defined Roles

and Responsibilities

– Empowerment
 Organization of End-User’s Team
• Core Team Organization (preferably
full time)

– Team Leader (Ideally future

hospital director)
• Senior Staff member
• Leadership qualities
• Decision making capability

– Permanent Team Members

(hospital ‘main’ departments)
• Nursing staff
• Administrative staff
• Engineering personnel

– Co-opted Members (When

required)
Empowerment of End-User/Core Team
• Delegation of overall
responsibility

• Early involvement
– Incorporate user needs
– Familiarize with project scope,
design, process & contract
– Develop/foster relationships with
other team members

• Training eg. T&C briefing etc.

• Adequately resourced

• Decision support – open line of

communication with MOH
(P&D) for major decisions
 Core Team’s Roles and
Responsibilities
• Main Role 1 – Early

– MOH Permanent
Representative for project

– Coordinate end-user
inputs
• Service planning
• Design development
• T&C planning
 Core Team’s Roles and
Responsibilities
Main Role 2 :

– Prepare hospital operational

policies & procedures

– Identification & procurement

of equipment

– Identifying staffing needs and

recruitment

– Ensuring smooth transition of

facility
• T&C and building hand-
over
• Prepare to take-over
• Coordinate and transfer
equipment and services
from existing facilities if
required
 Core Team’s Roles and
Responsibilities
Main Role 3 :

– Ensure smooth transition of

facility
• T&C and building hand-over
• Prepare to take-over

– Prepare for Opening and

beginning operation at the new
premise
• Determine Opening Sequence
and phased opening if desired
• System/equipment shakedown

– Coordinate activities during DLP

 Activities Towards Practical
Completion
• Contractor established commissioning
programme

• T&C by contractor completed

• Documentation: Compilation and distribution

– For reference and verification

• Training & briefing for commissioning team

• Joint inspection (PWD,MOH/Core Team)

– Identify and document defects (Snag list)
– Verify T&C report / witness T&C

• Rectification of defects by contractor

• Joint inventory checking (PWD, MOH/Core

Team)
– Document defects / outstanding equipment
– Seal room/department
Room to room inspection
Equipment T&C by the contractor OVERALL T&C PROCESS
Produce defect lists report (snag lists)

Rectification works done

based on defects lists

Room to room inspection

Equipment T&C by the contractor & JKR
Produce defect lists report

Rectification works done

based on defects lists

Room to room inspection &

equipment T&C by MOH
Produce defect lists report

Rectification works done

based on defects lists

Room to room equipment inventory

counting by the contractor

Room to room equipment inventory

counting by MOH

Seal room

Handing Over
 1. Equipment/System Testing & Commissioning

Process :
MOH /Core Team Checklists
1. T&C by contractor
1. Request for T&C schedule
2. Schedule agreement with MOH
2. Rectification by contractor partners
3. Ensure contractor has done
3. T&C Verification by JKR / MOH their internal T&C by checking
their reports
(Engineering Division / Radicare / 4. Know system/equipment and
Users/Core Team) parameters to be tested & their
standards
5. If in doubt, request for re-testing
4. Rectification by contractor
through JKR
6. Document ALL comments in the
5. Acceptance by JKR / MOH T&C forms
(Engineering Division / Radicare /
Users/Core Team)
 2. Room To Room Inspection
Process :
1. Inspection by contractor
2. Rectification by contractor
3. Inspection by JKR / MOH Defects
List (major & minor)
(Users/Core Team/Planning &
Development Division)
4. Rectification by contractor (all
defects major or minor)
5. Acceptance by JKR / MOH
(Users/Core Team/Planning &
Development Division)
MOH /Core Team Checklists
1. Request for Inspection schedule
2. Schedule agreement – realistic,
convenient
3. Ensure contractor has done their
own inspection
4. Sufficient team members from
contractor to support inspection
teams
5. Floor plans ready for references.
Room data sheet pasted in each
room
6. If in doubt, request for re-testing
through JKR
7. Document ALL comments /defects
and submit to JKR officially
 3.
Process :
1. Distribution, inspection and
counting by contractor
2. Rectification by contractor
3. Inventory checking & counting by
JKR / MOH
(Users/Core Team/Planning &
Development Division)
4. Rectification by contractor
5. Acceptance by JKR / MOH
(Users/Core Team/Planning &
Development Division)
6 Seal Room
Inventory Checking
MOH /Core Team Checklists
1. Request for inspection schedule
2. Schedule agreement with users
3. Ensure contractor has done their internal
checking and counting
4. Equipment lists available for each team
5. Ensure contractor have representative in each
team
6. Ensure equipment are distributed as agreed by
all parties
7. Check each equipment quantity, brand and the
required accessories
8. What you see is what you get. Do not make
assumption
9. Document ALL comments in the T&C forms
10. Do not seal room/department which is not fully
equipped
Reference Document Required
For Testing & Commissioning

1:100 floor plans (fully loaded)

Room inventory equipment list

Specification and catalogues of equipment

As-build drawings

Relevant checklists

Other relevant documents

AVOIDING PITFALLS
Pitfalls in commissioning a facility can be avoided be taking
the following measures:

Establish the commissioning team and the working groups

as early as possible

Plan and schedule all activities carefully and realistically

Avoid taking any shortcuts in the T&C process

Ensure documentation of T&C records are done properly

Maintain motivation and cooperation among members

Of the T&C team
Tips On Doing T&C
-Do not proceed T&C if the contractor/consultant has not done their part

-Do not proceed T&C if ‘T&C team’ is not complete

-Do not proceed T&C if T&C forms and other relevant documents
specified earlier are incomplete

-Document/record all findings and do not accept

contractor’s reasoning/excuse

-You should satisfy yourself and not the contractor

-Take your time to do the T&C

-Get clarifications if required from the relevant supervisory officer

eg. P&D dev., JKR, Engineering div. etc.
Issues/Problems In T&C
-Poor documentation of commissioning specification
in the project document
- standards/parameters
- references

-Lack of experience of the commissioning team

-insufficient team members-engineers etc
-unsure of processes
-unsure of standards & requirements,policies

-Roles & responsibility of team (including contractor) not clear

-Poor commissioning plan – sequence, duration

-Reliability to the contractors system performance report

-Poor documentation of the defects

-Taking ‘short-cut’ – not comprehensive

 Activities Towards Practical
Completion
• Pre-Handing Over Meeting (PWD)
– Connection and commissioning
– Licenses, certifications and
documentation
– Defects Liability Period (DLP)
maintenance management process
– Training sessions
– As constructed information
– Handing over of keys
– Security transition
– Sealing of rooms and equipment

- HANDING OVER CHECKLIST -

 Activities Towards Practical
Completion
• Preparation to Take-Over
Hospital by Core Team

• Ensure clear demarcation of

responsibilities

• Security
– Handing over key
process (master key
system)
– Ready to takeover
building security
 Activities Towards Practical
Completion
• Utilities
– Meter reading (water,
electricity, gas etc)
– Arrangement to fill-up
gas tanks (medical gas,
LPG)

• Outsource services
– Privatized support
services eg.
Engineering, Biomedical
etc.
– Kitchen
 Issuance of CPC
• Building fulfill
– Contract requirements
– All statutory requirements
– Reasonably suitable for
habitation
– No major defects

SOLE PREOGRATIVE OF PROJECT MANAGER (PWD) with or

without consultation with OWNER (MOH/Core Team)
 Defects Liability Period (DLP)

• Starts from the issuance of CPC

• Duration : 2 years (for new

Public Hospital Buildings in
Malaysia)

• Scope
– Making good minor omission
and defects outstanding during
handover
– Rectifying defects identified
during DLP
– System & equipment
maintenance
 Defects Liability Period (DLP)
• System & Equipment
Shakedown / Life Testing

– Portion of the building

– Complex equipment system

– Simulate hospital operation

before hospital opening

– Ensure patient safety & prevent

possible malpractice suits

– Eg. medical gases, power

back-up system etc.
 Defects Liability Period (DLP)
Management

• Documentation of new defects

• Management of rectification works

– Defects reporting mechanism/procedures
– Rectification/repair works verification
procedures
– Onsite supervisors

• Monitoring of maintenance activities

– Update records

• Regular meetings with PWD

– Monitoring
– Resolve issues

BY END OF DLP, BUILDING SHOULD BE FULLY

OPERATIONAL AND ALL DEFECTS AND
OMMISSIONS SHOULD HAVE BEEN FULLY
ADDRESSED.
 ISSUES / CHALLENGES
1. The quality of T&C done
- Lack of
guidelines/standards
- Process not integrated
- System unable to meet
functional needs
- Professionalism /
Transparency

2. System/Equipment not
properly maintained
- Subcontractor / Supplier
not paid by Main
Contractor

3. Gap between CPC and

building takeover by MOH
- ‘Shortened’ DLP &
Equipment Warranty
- Utility Payment
 ISSUES / CHALLENGES
4. Tendency to delayed rectification works
towards the end of DLP
- Poor monitoring
- Limited enforcement
- Hesitant to take action / 3rd party

5. Personnel and authority

- Important to clearly designate and
delineate those with authority to
approve and sign off on behalf of
MOH
- Coordination and working as a
cohesive team is important with
good communication throughout
the project and acceptance phase

6. Independent T&C Consultant

- Accreditation body
- Training
- Licensing
TERIMA KASIH