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Dont design me something I cant build

and
dont build me something I cant maintain

AGENDA:
Bio - 2 Minutes
Examples of few active projects - 3 minutes

Cost of deadly downtime 5 minute


MEP maintainability & accessibility issues on
few projects-10 minutes
Solutions - 5 minutes
Questions

Dont design me something I cant build


and
dont build me something I cant maintain

MAHMOOD AKTHER
MEP Consultant / Function Manager
makhter23@yahoo.com ; sakhter@zfp.com

25+ Years of Global design and construction management experience in Building


design and Urban Planning - Healthcare and Data Centers in the USA and MENA region
Location served: USA ( ~ 40 States), Cairo, Philippines, Dubai and Saudi Arabia
Overall Healthcare facilities and Tier III + Data Centers engineered : ~ 7500 Bed /
2 Million sft of Raised Floor
Largest Healthcare facility engineered 4000 Bed Medical City

Education: The Wharton School of Business, USA


University of Wisconsin, Madison, USA
Present : Head of MEP / Technology Engineering at www.zfp.com
an A/E firm of 2400 personnel

Dont design me something I cant build


and
dont build me something I cant maintain

Dont design me something I cant build


and
dont build me something I cant maintain

4000 BED (8 Million m2)


MEDICAL CITY

1
.

Dont design me something I cant build


and
dont build me something I cant maintain

1000 BED MEDICAL CITY Housing 1.1 Million m2

Dont design me something I cant build


and
dont build me something I cant maintain

WORK

HOME

Dont design me something I cant build


and
dont build me something I cant maintain

Specialty Hospital

Dont design me something I cant build


and
dont build me something I cant maintain

Physician Offices,
Private Wards, ICU & Operating Theaters

Dont design me something I cant build


and
dont build me something I cant maintain

Dont design me something I cant build


and
dont build me something I cant maintain

DEADLY DOWNTIME COSTS:


USA hospitals pay an estimated $1.6B each year
The highest cost for a single event was more than $1.7 million
500 Bed Hospital spends more than $5M in a year in unplanned outages
Almost two out of five (40 percent) global healthcare organizations have experienced an unplanned
outage in the past 12 months at a cost of $400,000 per incident.
On average, healthcare organizations have lost 57 hours to unplanned downtime over
the past 12 months.
Security Breaches: Nearly one in five (19 percent) global healthcare organizations
have suffered at a cost of $800,000 per incident.
Data Loss: Nearly one in three (28 percent) global healthcare organizations has
experienced data loss in the past 12 months at a total cost of nearly $ 1 Million per incident
Unplanned data center downtime cost healthcare organizations $600,000 per incident
in 2013
To be sure, the cost of an unplanned outage goes behind finances IT affects life.

Dont design me something I cant build


and
dont build me something I cant maintain

MEP Mechanical (Patient Comfort, Cooling, Ventilation)


Electrical (Power, Lighting, Patient safety/Comfort)
Plumbing (Water supply, Sterilization and Hygiene) and
Technology (Privacy, Safety, Fire, Cameras and Access control, EMR..) etc.
MEP is the largest block of cost that determines project schedule and success
MEP systems are greater than 45% of the overall construction cost
MEP determines Patient Satisfaction, Physicians preference to use the location and the
Patient cost
Hospital ranking from Cancer to Urology Centers are determined by its structures,
process and outcomes - uptime, accuracy of records, On Time services !

Dont design me something I cant build


and
dont build me something I cant maintain

Few examples of Deadly downtime

Dont design me something I cant build


and
dont build me something I cant maintain

Typical Layout
Roof Mechanical Room

Dont design me something I cant build


and
dont build me something I cant maintain

1
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Dont design me something I cant build


and
dont build me something I cant maintain

Roof Mounted Chillers


prime source of cooling
1
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Dont design me something I cant build


and
dont build me something I cant maintain

Car Radiators
Chillers Primary
source of cooling

Chillers are also surrounded by


car radiators - to minimize ambient
temperature for chillers to perform

Dont design me something I cant build


and
dont build me something I cant maintain

Chillers are housed


with Temporary Roof
to minimize direct sun

Dont design me something I cant build


and
dont build me something I cant maintain

150,000 m2 FACILITY
Construction cost $ 400 million

A view of overall Temporary Structure

Dont design me something I cant build


and
dont build me something I cant maintain

Car Radiators

Water Pipe

Radiators are water cooled to minimize air temperature


Surrounding chillers
The temporary structure of roof and wall surrounding chillers
designed for temporary use are permanent for many years!!
The above were provided by the owner to minimize chiller
compressors getting burnt out

Dont design me something I cant build


and
dont build me something I cant maintain

Car Radiators

Dont design me something I cant build


and
dont build me something I cant maintain

Air coolers are provided


to blow cold air to chillers

Dont design me something I cant build


and
dont build me something I cant maintain

Air coolers are provided


to blow cold air to chillers

Dont design me something I cant build


and
dont build me something I cant maintain

Cable tray open to outside is non weather proof and non


accessible from floor

Cable tray on floor are non weather proof and cables get wet in
rain creating hazardous conditions

Dont design me something I cant build


and
dont build me something I cant maintain

Potential source of Electrocution,


Non Enclose breaker

Dont design me something I cant build


and
dont build me something I cant maintain

Disconnect switch for a


main control panel not accessible

Dont design me something I cant build


and
dont build me something I cant maintain

Passage thru the corridor not


available to cross over

Dont design me something I cant build


and
dont build me something I cant maintain

Passage thru the corridor not


available to cross over

Dont design me something I cant build


and
dont build me something I cant maintain

15kV Oil filled transformer


requires pit to drain-Non
code/ EPA compliance

Dont design me something I cant build


and
dont build me something I cant maintain

Centrifugal Chillers 5000 tons Each

Dont design me something I cant build


and
dont build me something I cant maintain

The leakage result of lack of


maintenance-Reason no access

Dont design me something I cant build


and
dont build me something I cant maintain

HVAC unit and Electrical Panels are


exposed to water-Non Code Compliance
& Potential source of Electrocution

Dont design me something I cant build


and
dont build me something I cant maintain

Critical valves not accessible-Cat walk not


available-Higher downtime increased
operating expense.

Dont design me something I cant build


and
dont build me something I cant maintain

Expansion Joints not accessible-Increased


downtime, Higher operating expense

Dont design me something I cant build


and
dont build me something I cant maintain

No access for maintenance-Higher downtime, Increased


operating expense

Dont design me something I cant build


and
dont build me something I cant maintain

Lack of Maintenance shall only result


in big replacement costs

Dont design me something I cant build


and
dont build me something I cant maintain

Solution : It works
It starts with Change in developer/ owner approach when selecting the A/E
The cost of proactive solutions are tiny when compared to downtime , loss of brand name along
with increased capital and operating cost not counting loss of patient comfort and selection of
physician preferred location
Health care is a niche and not a commodity
Engineering Health Care is a skill profession - functions follow form and not the other way round
Don't treat engineering health care as a commodity
Hire team of engineers who have successful health care experiences - they are not the cheapest!
Life matters and so does engineering MEP systems for OR, ICU, ER , Trauma centers - it saves life
or otherwise

Contract engineers directly and monitor if the team sold are indeed assigned to the project
Hire MEP contractor separate from the General contractor

Dont design me something I cant build


and
dont build me something I cant maintain

Solution : It works
Request prove of systems/ equipments accessibility and maintainability - 3D / BIM model of utility
rooms and above ceiling are required
Request design evaluation by Commissioning agents and hospital operators

Dont design me something I cant build


and
dont build me something I cant maintain

Dont design me something I cant build


and
dont build me something I cant maintain

THANK YOU
MAHMOOD AKTHER
MEP Consultant / Function Manager
makhter23@yahoo.com ; sakhter@zfp.com

+ 966 55 318 4135, +1 312 968 9888