Healthcare facility commissioning – the transition of clinical services

Abstract

A public multi-disciplinary primary-level hospital delivers clinical services to both in and out patients within its catchment area. A multi-disciplinary hospital is a healthcare facility of which the commissioning or transition into operations is a complex process that can last several months. This paper treats a hospital’s clinical services using a systems perspective on healthcare services delivery within the context of the systems hierarchy level definitions used in South Africa to relate the inward and outward commissioning of a hospital to the concepts of systems engineering and services science. A hospital can be viewed as a system of systems containing several tangible and intangible elements identified through the clinical services blueprint that during commissioning can be related to useful systems engineering ideas from large-scale infrastructure projects. The relationship between the clinical services blueprint and the Systems Breakdown Structure (SBS) is very important and must be coordinated with the Work Breakdown Structure (WBS) and Organizational Breakdown Structure (OBS) during commissioning. The concepts put forward in this paper should enable hospital project and commissioning managers to gain insights into the integration of systems from a holistic perspective during design to achieve an integrated and optimized commissioning schedule to achieve overall operational readiness.