As healthcare systems face rising operating costs and the pressure of meeting carbon reduction mandates, facility leaders are increasingly seeking ways to improve building performance without major capital investment.

Retro-commissioning (RCx) offers a strategic, cost-effective path forward. Focused on optimizing existing systems, RCx identifies and resolves operational issues to improve energy performance, enhance reliability, and reduce environmental impact.

What is Retro-Commissioning?

Retro-commissioning is a hands-on process that fine-tunes a facility’s operational systems, particularly HVAC and electrical equipment. Unlike commissioning, which applies to new construction, RCx is designed for existing buildings—making it especially valuable for hospitals, ambulatory surgery centers (ASCs), and other healthcare environments where uptime and operational precision are critical.

The process begins with a facility walkthrough, where engineers collaborate with hospital staff to pinpoint key inefficiencies or operational concerns. Once identified, a targeted action plan is developed, often focusing on areas such as air handling units; temperature, humidity, and pressure regulation, and building automation controls. Field testing and data analysis then refine the proposed optimizations, ensuring that any recommended changes align with the facility’s operational needs and budget. Finally, adjustments are implemented, and staff receive training to maintain efficiency improvements over time.

Addressing Common Efficiency Challenges

Healthcare buildings often operate around the clock, making energy use particularly intensive.

Many common inefficiencies go unnoticed for years—like air handling systems that simultaneously heat and cool, or operating rooms that maintain full airflow and temperature even when unoccupied. Through RCx, operating rooms can be optimized for unoccupied periods to adjust airflow and temperature to reduce energy consumption while maintaining pressurization requirements.

Smaller surgical centers may struggle with humidity control due to the limitations of direct expansion (DX) HVAC systems. Additionally, unsealed gaps in a building’s envelope contribute to problems related to uncontrolled air infiltration, while emergency power misconfigurations can put patients, staff, and visitors at risk during outages.

Why Retro-Commissioning is a Game-Changer

Traditionally, healthcare facilities have prioritized system reliability over efficiency, a stance that made sense in an environment where patient safety is paramount. However, changing financial and regulatory landscapes are pushing executives to rethink this balance.

Retro-commissioning offers a way to bridge the gap—retaining reliability while introducing smart, targeted improvements that reduce costs and carbon footprints. The advantages are particularly pronounced in healthcare, where the cost of energy per square foot is higher than in most other building types.

Beyond financial benefits, RCx helps healthcare facilities meet sustainability goals by reducing carbon emissions and enhancing energy efficiency. With stringent air quality requirements and high operational costs, even small improvements can yield significant long-term benefits.

A Smarter Approach to Healthcare Facility Optimization

As hospitals and healthcare facilities navigate a rapidly evolving landscape, retro-commissioning is emerging as a crucial tool for maintaining efficiency and sustainability.

By proactively optimizing building performance, healthcare leaders can reduce costs, improve reliability, and meet environmental standards. For organizations looking to enhance their operations, investing in RCx is a step toward a more efficient and resilient future.