Berglund has decades of experience managing critical utility shutdowns in hospital buildings around the country. We have distilled this experience into an 8-step process that repeatedly guides our team to success in these risky operations.
This process has proven successful across a range of projects, including significant renovations at the University of Chicago Medical Center, Weiss Memorial Hospital, and BayCare Health System. Done correctly, this process helps our healthcare clients find the correct balance between maximizing the value in improvements while minimizing disruption and mitigating risk.
Step 1: Identify the shutdowns
Projects that span patient rooms, public spaces, and infrastructure often require multiple shutdowns to complete our work. First, we identify and log all major shutdowns during preconstruction.
Step 2: Identify the risks and mitigation strategies
Our team works through the risks in preconstruction to develop effective strategies to minimize the disruption to the hospital. At the University of Chicago’s Medical Center, our team identified an Air Handling Unit that needed refurbishment but serviced patient care areas. Our risk assessment concluded that we needed to maintain a maximum air exchange per hour and that there was a potential for dislodging particles in existing ductwork, putting patients at risk. We started by rating the likelihood and impact. Then, we determined the mitigation strategy, which slowed the AHU to a minimal level, keeping some pressure in the ducts to avoid dislodging the ductwork. Additionally, we used the Infection Control team to help determine additional strategies.
Step 3: Investigate and validate
Our team, the design engineer, and the hospital’s plant operations survey the systems to be shutdown to verify the extent and footprint of the work areas that would be impacted by the shutdown. This often includes extensive field investigation in hard-to-access areas such as labs, operating rooms, and, most recently, in areas with COVID-19 patients.
Step 4: Create a Method of Procedure
After the investigation phase, we work with trade partners responsible for system shutdowns. They compile the information gathered to draft Method of Procedure forms. The form is a step-by-step guideline for completing each the shutdown. It lists each task to be completed, responsible parties, risk mitigation strategies, and estimated durations. These plans remove the guesswork, reduce human error, and plan for the “what-ifs” that may occur.
Step 5: Notify impacted user groups
Next, we notify all affected user groups. This includes staff, patients, and visitors. These notifications take place at least two weeks prior to any shutdown. When a shutdown is considered “major” due to impacts on life safety systems, these notifications must take place even earlier. This also ensures the team can properly vet concerns and implement any temporary risk mitigation measures.
Step 6: Perform a go/no-go meeting
Within 24 hours of any planned shutdown, we schedule Go / No-Go meetings. All involved parties attend this meeting to review the Method of Procedure in detail and confirm all necessary steps are completed to move forward with the shutdown. Upon confirmation, we implement a notice to proceed.
Step 7: Execute the work
We follow our plan in detail. After each step, we mark it complete before moving forward. A Berglund supervisor is always with our trade partners to ensure adherence to the plan, and we address any issues that may arise during the shutdown. An emergency phone tree consisting of other project team members and stakeholders is available should additional assistance or resources be needed. Upon completion, correspondence is sent out to all impacted parties to alert them that the impacted system is back in operation.
Step 8: Debrief and identify any lessons learned
Finally, a post shutdown debrief is completed by our team and any lessons learned are discussed. The notes are loaded into our shutdown log for reference for continuous improvement on future scopes of work.
We know that our healthcare partners rely on these critical systems to provide optimal care. By following this process, we ensure our projects stay within our target value cost and, most importantly, keep the health system safe and secure for patients.
About the Author
Ted provides oversight of our healthcare portfolio, maintains healthcare client and design partner relations, and manages our project management and support staff. Ted focuses his efforts on process improvement, emerging healthcare construction trends, and most importantly, client satisfaction.
Director of Healthcare