Hospital Commissioning & Operational Readiness: From Construction to Care
- Raj Sehgal
- 2 days ago
- 3 min read
Constructing a hospital is a visible milestone—a symbol of hope, health, and progress. But the real test of a hospital’s success begins after the cement dries and the walls rise.
Hospital commissioning & activation of services, sometimes under-prioritised , is the engine behind a facility’s seamless launch and long-term efficiency.
In a healthcare landscape where competition is high, patients are more informed and regulatory scrutiny is rising, skipping or rushing this crucial phase can cost more than just time and money—it can cost lives.
What Is Hospital Commissioning
Hospital commissioning is the systematic process of transitioning a newly built facility into a fully functional, patient-ready hospital. It ensures that people, processes, policies, and infrastructure are aligned and optimised before admitting the first patient.
It’s not just about flipping a switch—it’s about ensuring that every aspect, from oxygen lines to the HR manual, is tested, aligned, and integrated into a well-oiled system.
Why Hospital Commissioning is important
Across India, many healthcare promoters and hospital owners believe the hard work ends with construction. But this misconception often leads to:
Operational disarray due to untrained staff and untested protocols
Regulatory delays from incomplete documentation or missed NOCs
Patient safety risks from poorly calibrated medical equipment
Low ROI from uncoordinated departments and delayed soft launches
Common Commissioning Gaps:
Issue | Impact |
Late recruitment | Understaffed departments on opening day |
Missing SOPs | Inconsistent care and admin errors |
Ignored I.T setup | No EMR/HIS integration ready at go-live |
Untrained soft service vendors | Housekeeping, security chaos on day one |
No mock drills | Panic during real emergencies |

An Illustrative Commissioning Checklist
Here’s an actionable checklist tailored for Indian hospitals, especially mid-size and tertiary care centers.
1. Human Resource & Training
Finalise org. structure, reporting hierarchy
Start recruitment 3–6 months before launch
Design onboarding & training modules
Provide department-wise orientation and mock duties
Implement dress code and uniform distribution
2. Infrastructure & Equipment Readiness
Commission and calibrate all biomedical equipment
Set up non-clinical departments: laundry, CSSD etc
Install wayfinding signage, emergency exits, and fire safety devices
Inspect utilities: backup generators, HVAC, IT networks
3. Medical & Non-Medical Procurement
Lock BOQs and initiate procurement cycles early
Pre-test critical machines (OT tables, imaging devices)
Create asset registers and tagging for all items
Tie up with biomedical waste vendors and ensure documentation
4. Policies, SOPs, and Accreditation Alignment
Develop department-wise SOPs for both clinical & administrative workflows
Draft HR policies: hiring, grievance redressal, code of conduct
Ensure NABH pre-assessment readiness if applicable
Set up infection control protocols and IPC committees
5. Licensing and Compliance Essentials
Secure:
Fire NOC
Pollution Control Board clearance
AERB license (for radiology)
Clinical Establishment License
Bio-waste disposal agreement
Pharmacy Licence
Other relevant approvals & licences
Display certificates prominently at reception and admin offices
6. IT Infrastructure and Hospital Software
Install HIS and integrate with billing, lab, pharmacy
Implement PACS and EMR (for secondary/tertiary care setups)
Test Wi-Fi zones, biometrics, and digital queue systems
Setup of server rooms, data storage policies, and cybersecurity protocols
7. Branding, Marketing & Community Engagement
Develop a brand kit: logo, tagline, signage standards
Launch teaser campaigns for soft opening
Build a responsive website with SEO content
Register Google My Business, and social media handles
Host a community medical camp or soft launch event
8. Operational Dry Runs
Test all equipment & machines
Simulate emergency scenarios: cardiac arrest, fire, casualty surge
Run full cycle: patient registration → consultation → diagnostics → billing
Test elevators, fire alarms, intercoms, and ambulances
Involve local doctors and managers in feedback sessions
9. Vendor Contracts & AMC Finalization
Sign MOUs for laundry, security, cafeteria, ambulance
Secure AMC contracts for lifts, HVAC, RO plants, power backups
Confirm pathology/radiology outsource tie-ups if not in-house
Top Tips to Make Your Commissioning Foolproof
Start Early: Begin commissioning when 70% of construction is complete
Use a PERT/Gantt Chart: Track procurement, recruitment, and readiness milestones
Hire a Specialist: A commissioning consultant saves time, costs, and chaos.
Document Everything: From SOP sign-offs to AMC logs—record every step
Don’t Ignore Soft Services: Cleanliness, reception, and staff etiquette are your first impression
Commissioning Is Not an Add-On—It’s the Backbone
You can build the most beautiful hospital in the city, but if your operations aren’t ready, it’s like opening a five-star hotel with no staff or electricity.
In today’s hyper-competitive healthcare space, where online reviews and word-of-mouth drive patient choices, launching strong is no longer optional—it’s survival.
Hospital commissioning is often underrated, yet mission-critical phase of launching a healthcare facility. In India, where the demand for quality care is exploding, operational readiness can be your biggest competitive advantage.
Whether you're launching a 50-bed secondary care center or a 500-bed tertiary hospital, remember: commissioning isn't just the final step—it's the first step to long-term success.
Your hospital’s reputation is built in its first 30 days. Get that right.
Drop an email to us if you are looking for any management support in this critical phase of commissioning !
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