Getting Healthcare Facilities Ready for Operations on Day 1

Case Study | Arkansas Children’s Northwest with Bernhard TME

Bernhard TME is a full-service design and energy engineering service firm with more than 200 employees in eight offices across the nation. They have completed more than 4,500 projects at over 1,000 facilities in the United States. Founded on the core belief in Owner Advocacy, the firm focuses on providing innovative, customized solutions that help clients save energy and improve operations. Their expert staff bring an informed and holistic approach to solving their client’s challenges.

In 2015, Bernhard TME began work on the Arkansas Children’s Northwest (ACNW) project, a pediatric hospital campus located in Springdale, Arkansas. The 235,000-ft. satellite facility was created to provide quality care for children in Northwest Arkansas, with 24 inpatient beds, 30 emergency patient beds, five operating rooms, and 30 outpatient clinic rooms. With a goal of delivering complete and verified BIM data to the facilities managers (FM) before the first day of operation, February 27, 2018, Bernhard TME developed a delivery method that focused on facilities maintenance and embraced whole project data delivery using BIM Assure by Invicara.

In this case study, we will explore the challenges faced by the project team at ACNW, and how BIM Assure helped provide detailed and thorough data models at handover with Mark Mergenschroer, Principal and BIM Application Specialist at Bernhard TME.

With BIM Assure we were able to get high quality data for the CMMS with much less effort.

Challenges

A key challenge facing healthcare facilities is regulatory compliance. ACNW needed to comply with Joint Commission record keeping and preventative maintenance procedures. The ACNW team knew they would have a Joint Commission survey within 90 days of the start of operations. The challenges were to:

  • Implement the building’s computerized maintenance management system (CMMS) by Day 1 of operations.
  • Confirm Joint Commission compliance with data collected and verified during the construction and commissioning processes.

Actually, the surveyors arrived 21 days before opening, finding the facility fully compliant. “It’s not uncommon for healthcare facilities to take six months or more after closeout to have their FM software up and running,” said Mark. “BIM Assure played an important role in helping Bernhard TME get ACNW ready months before operations.”

Other common issues that the facilities team wanted to avoid were:

  • Paper deliverables
  • Large PDFs
  • Inaccurate or incomplete asset data
  • Inaccurate or incomplete as-builts
  • Time consuming subcontractor and maintenance staff efforts at data handoff
  • Maintenance documentation management prior to occupancy

In addition, the ACNW owners had a handful of concerns that they wanted Bernhard TME to address in the workflow. Their concerns included:

  • Time-consuming, manual data entry by facility personnel
  • Facility personnel task overload during transition to operations
  • Inaccurate and incomplete Operations and Maintenance (O&M) manuals provided during construction
  • O&M manuals not ready for the CMMS at building opening

Process

Bernhard TME set a goal to provide the ACNW FM team with complete and verified data before the first day of operations. For most projects, data is given to owners six to eight months after opening, and it can take up to one year after handover to sort through the data.

The Approach

Bernhard TME wanted to keep the approach simple. Mark notes, “We wanted to do this project differently. We were focused on doing BIM correctly from the start, but also wanted to make it easy for all of our team members to implement.”

With the approval of the owners to try a new and innovative method, Bernhard TME developed a workflow that started data collaboration efforts and validation during the design stage, and decided to use BIM Assure to manage design, construction, and commissioning data. BIM Assure helps check, validate, and add data to models, and acts as a platform for both BIM specialists and team members that aren’t BIM users to collaborate on data requirements. Bernhard TME knew they could use BIM Assure to validate data throughout the project for handover. “Validation of the data was huge,” Mark emphasizes, “We needed a way to report back to owners that the data was correct, validated, and met the rules of documentation. Creating a process that the owners could understand was key before we began.”

Data Specifications

To improve communication and provide clear data expectations, Bernhard TME created a 30+ page data spec, which, after input from the general contractor, commissioning agent, subcontractors, and owners, grew to a 70+ page document, outlining individual responsibilities for every piece of equipment. “We had 92 different equipment types,” says Mark, “and we spelled out exactly who would gather that data for us.”

Anytime we did have data issues, we were able to use BIM Assure analyses and reports to find the error and fix the issues. BIM Assure turned a painful, time-consuming process into a click of a button.

Equipment Asset Information

How did Bernhard TME decide which assets needed information? “We looked for what would be needed for Joint Commission review. We worked directly with the ACNW facility team to determine the assets needed for preventative maintenance and preventative maintenance records,” Mark explains.

Bernhard TME began by gathering and verifying six data basics for each piece of equipment, including:

  1. Equipment ID
  2. Category
  3. Equipment type
  4. Location
  5. Manufacturer
  6. Model number

Why was it necessary to gather this information so early in the project? “While we didn’t need the manufacturer and the model number at that stage, but we knew we wanted to gather the information as quickly as possible so we could create asset tags later on,” explains Mark.
To ensure that accurate data was being collected, the Bernhard TME team ran validation reports and evaluated the findings before pushing any data into the CMMS. Mark says, “One thing we did not want to do was to push bad data in the CMMS. Any time we did have data issues, we were able to use BIM Assure analyses and reports to find the error and fix the issues before entering it into the CMMS.”

Data Collection and Consolidation

Part of the project scope was to create an “as-constructed data model,” so Bernhard TME had to aggregate all the FM data in a single Revit model.

However, not everyone on the project team was using Revit. “We had people using 3D CAD and even spreadsheets to capture the data,” noted Mark. He looked at several different tools to merge and aggregate the data for the CMMS. For this, Mark needed to collect and merge:

  • Field verification data
  • Commissioning documents
  • Design documents
  • Submittals
  • Revit models
  • Models from other BIM tools

Bernhard TME set up the CMMS using the ACNW specifications nomenclature to sync data with Revit . “We were able to keep track of our data in a relatively simple way,” Mark points out. The team developed:

  • An “as-constructed” data model
  • A data collection tool using Revit
  • Asset documentation

The Bernhard TME team would then sync all the information from the CMMS with Revit and review the final as-constructed model and related data in BIM Assure.

Lessons Learned

As with all its projects, Bernhard TME developed lessons learned throughout the process. For instance, while the entire project team was involved in the development of the plan, following the plan was sometimes difficult. The team understood all the rules, but often times found themselves perceiving unwritten rules that may have worked in opposition to the workflow. For example, typically firms don’t have to deliver their data until closeout instead of at substantial completion. Mark notes, “There doesn’t have to be a rule that you have wait to hand over everything until closeout – an AEC firm can deliver their information earlier and get paid earlier.”

Arkansas Children's Northwest Hospital

The team was enthusiastic to take ownership of the process, but occasionally had difficulty understanding the whole process and seeing the true end goal. Consistency was key, but manual data validation would have been difficult and time-consuming, which is where BIM Assure was used to facilitate. “Everyone has different strengths and weaknesses,” Mark says, “but when it comes to data coordination, everybody has to be all in.”

2700

validated and working assets added to CMMS

60GB

of verified facility data handed over

Results

In May 2017, Bernhard TME trained the ACNW team, starting with a kick off meeting to increase understanding and engagement. Bernhard TME developed a test environment with 20 assets so that the project team could become familiar with the process. Part of the maintenance staff began by taking pictures of the assets and hanging the asset tags with associated barcodes. “The team learned the building by using their CMMS software,” says Mark. “While we were still putting data into the CMMS, we wanted them to become familiar with the system early enough in the process that if something were to go wrong, we could fix it without a great loss.”

Additionally, Mark and the team created seven model views of the facility, accessible on iPhones and iPads, all of which are color coded, and blend together design and construction data. With a maintenance staff of 12, and only three computer terminals, everything else at ACNW is run on iPads. Keeping this in mind, Mark developed a method for increased accessibility to the equipment data after building opening. Mark and the team created asset tags with barcodes that could be scanned to provide asset data that had been collected. FMs and building operators can use an iPad or iPhone to scan and view data, training data, warranty information, and models on all documented equipment within the facility.

As of November 2017, there were over 1,800 pieces of validated data in CMMS, all tied to 3D geometry. A total of over 2,700 validated assets were added to the CMMS and working by Day 1 of operations, with 500 preventative maintenance tickets submitted and over 1700 work orders issued with correct location data all before opening. As part of the process, Bernhard TME has also handed ACNW almost 60 gigabytes of verified data for their facility.

Moving Forward

As an industry, Mark notes that “big picture data is typically given to owners during handover. That was one of our initial challenges with ACNW,” he explains. “Determining what data we needed, and how we were going to obtain and validate that data for handover in a simple way was what we aimed to accomplish.”

Does the process developed during this project have an impact on how Mark and Bernhard TME will initiate workflows in the future? “Absolutely,” Mark says. “Anyone can hand over data. But we need a way of recording that we have done some quality checks, and processes, because once bad data gets into a system, it just multiplies. That’s where BIM Assure comes in.”

For more information on Bernhard TME, visit bernhard.com.

For more information on BIM Assure, visit invicara.com/bim-assure.

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