MEP Design Process and Coordination in Healthcare Facilities

By Gary Walton, Managing Director, JPW Consulting Group

The 2017 Building Healthcare Innovation & Design Show is a showcase of the best of the region’s health consultants, contributors and partners, and JPW Consulting Group is pleased to be part of such a distinguished event.

The design and coordination of healthcare buildings is by its very nature, particularly challenging. Many factors require careful consideration and coordination: the nature of the facility, the extent, standard and type of MEP services, as well as the specialist systems to be accommodated within the development.

More than being high volume high traffic edifices, hospital buildings represent lives. They are among the most heavily serviced types of building. Operating 24/7, these facilities incur high operational and maintenance costs. It is therefore of paramount importance that scrupulous attention be given to the planning and integration of services within the overall building.

In this regard, MEP services and special systems are critical to ensure facilities function as intended over the life cycle of the development. The following article addresses these points as well key issues in the design and coordination process for healthcare facilities.

Client Brief

To the outside observer, it may seem as if all healthcare facilities are exactly the same. This however could not be further from the truth. Given that there are significant differences in the types of healthcare facilities, it stands to reason that requirements for their optimum functioning will vary too. Briefs generally do not detail the required MEP services or specialist systems. It therefore falls to the MEP Consultant to determine the level of services to be provided for the development. Indeed, it is essential to consider MEP services at the outset of the project design as well as confirm the services brief inclusive of standards and codes to be applied.

From inception, a client and developer must establish a realistic budget for the planned healthcare facility. MEP services and specialist systems are a fundamental component for any facility and typically amounts to more than 40% of the project’s construction costs. In this equation, the importance of a solid brief cannot be stressed enough. For example, whether staff accommodation forms part of the design brief or not.

The facility life cycle must be considered in the overall budget. Undertaking a value assessment at the design stage will avoid ‘Value Engineering’ during contract stage which often leads to disruption and reduced engineering and life cycle standards. Early design team involvement is always advised with client and stakeholders. This is a necessary factor to ensure project goals, and that the best return on investment can be realised.

Design Standards & Codes

Right from the start, we advise no compromise on standards and procedures. It is essential to define the standards and codes to be applied, and agree on this with client prior to the design stage.

It is entirely possible that a client may not be as well versed in design standards. It is then the duty of the MEP Engineering Consultant to ‘Back Brief’ the client to ensure there is absolutely no misunderstanding regarding the standards and codes to be applied.

Primary and recognised design codes are North American, Australian, UK and local Emirate codes. To ensure both consistency and accountability it is recommended that the selected standards and codes are not mixed and a common international standard is used for the overall project design.

Key Design Considerations for Your Project

  • Design Team Coordination

The benefit of early involvement between the design team and client should not be over estimated. Without a single doubt, this is the essential ingredient that will ensure project goals are attained and that the best return on investment is realised. Moreover, early team coordination ensures that the building, architecture, structural, MEP services and medical equipment facilities are in harmony.

  • The Importance of MEP Engineer’s Hospital Experience

Technical knowledge of hospital design is an important consideration for clients in selecting their MEP Engineering Consultant partner. Expert development knowledge of design standards and codes, combined with prerequisite experience, is imperative for process and coordination with other team members.

  • Completeness of Design

Designs that are fully complete and coordinated prior to tender and construction stages will mitigate risk to the project budget and construction period.

  • Quality specifications

Compromise is never a good idea. Especially on project specifications and design drawings that are detailed, clear, and precise specific to the project. A robust, coordinated design will go a long way to assuage dispute during the contract stage of the project.

  • Retaining Design Team through Construction Process

It is advantageous to retain a design team as Engineer of Record to ensure project specifications and client requirements are achieved.

  • MEP Space Requirements / Planning

The building designer and architect must work closely with the MEP consultant engineer to establish the principles of MEP plant space and distribution. These will directly impact on the building design. For example, the extent of horizontal ceiling mounted equipment will determine the depth of ceiling voids which will directly impact the slab-to-slab floor heights and consequently the overall height of the building.

MEP and specialist systems must be integrated in a manner that they can be maintained with minimum disruption to normal activities or to patients. Design stage thinking and deliberations such as the optimum sizing and location of plant rooms, services zones and risers can pay real dividends. Not only will this kind of diligence reduce construction costs, but will also result in beneficial financial impact on operations and maintenance.

  • Patient Safety

The safety of staff and patients is beyond compromise for any healthcare facility. To this end, building MEP services play a critical role.

  • Providing positive, negative and neutral air pressure regimes associated with operating theatres, intensive care, isolation rooms and the hospital in general to mitigate agas
  • Design of water systems to avoid Legionella
  • Design of water quality and temperature to serve dialysis equipment and processes
  • Electrical power quality including measures against Harmonics and EMC
  • Selection of integrated bedhead trunking systems combining power, data, medical gases and lighting are readily available and provide a concealed solution for dealing with multiple services. And importantly, to ensure ease of cleaning to reduce the risk of infection
  • Medical Equipment / Systems Interface

Service types and connections required for medical equipment require absolute coordination to ensure the correct level of service is provided at the point of connection.

  • Sustainability (Estidama) and LEED

The UAE promotes sustainable and building efficiency designs. The Estidama & LEED targets should be established at the outset of the project.

  • Testing Commissioning Periods

All commissioning should include critical Cause & Effect of systems by undertaking ‘Black Out’ tests. This is a complex issue and the time required to undertake these critical tests should not be underestimated. All record documents and maintenance manuals should be complete, recorded and approved before the facility officially opens for business.

Sensible allowances should be incorporated into the master development programme for commissioning and evaluating all service installations. Very often this line item is reduced, compressed or eliminated entirely masking the inefficiencies accumulated during the construction phase. Not only will this lead to a compromised and potentially unsatisfactory operation of systems, but invariably lead to a re-commissioning with certain associated disruption at a future date. 

  • Technological Advancements

Designing for adaptability at the outset does not need to cost a great deal. Simply ensuring that plant areas are accessible, service routes are safeguarded and risers can be modified or expanded easily will go a long way to make future modifications relatively straightforward.

Moreover, advances in lighting and wireless technology may, in any event, reduce rather than increase riser sizes and containment systems. For example, television systems are playing a much greater role in service integration. Smart TV has the capability to incorporate patient controlled applications including air conditioning, lighting, blinds, patient information, nurse calls, etc.

MEP Consultant Overview

Healthcare MEP systems account in excess of 40 percent of budget - a significant investment that affects operating costs in both the short and long term. MEP systems are a crucial consideration and owners and stakeholders must be prepared to juggle budget, quality, performance, changes, and maintenance, to ensure its inclusion in the project plan.

With projects increasing in complexity, MEP Consultants are ideally experienced and positioned to assist with mechanical and electrical design, as well as preconstruction and construction issues. JPW Consulting Group offer independent support and analysis to ensure project stakeholders receive expert guidance and oversight for key building systems - including coordination and integration. Without this, MEP systems are likely to fail or not operate as intended.

With years of industry experience, we can help guide both clients and project teams to make cost effective and sound engineering solutions that are practical for overall building functionality. These decisions greatly secure both the capital expense and life cycle costs associated with building assets.

With focused expertise in the field, we understand the challenges that engineering companies face in the UAE. With both Dubai and Abu Dhabi adopting sustainable building codes, our team offers a thorough understanding of how these codes affect building project designs, timelines, service life of equipment and project budgets.