Case Study: Bringing Buildings to Life

How Strategic Equipment Activation Translates Construction into Clinical Readiness

By Dawn Rose, VP of Activation Planning, HBS

As hospitals near completion, organizations often focus on construction milestones and grand openings, yet true operational readiness is determined by what happens after the last wall is built. One of the most critical and often underestimated phases is equipment activation.

Hospital equipment activation refers to the strategic planning and execution of delivering, installing, testing, and integrating medical technology—from large imaging modalities like MRI and CT scanners to mobile devices and IT-integrated clinical systems. It is not simply logistics. It is a precision-driven process that connects capital investments to clinical readiness.

This case study explores what strategic equipment activation involves, why it matters to health system leaders and stakeholders, and how one overlooked MRI connection became a defining lesson in readiness.

What Is Equipment Activation?

Equipment activation is the final operational readiness phase before a hospital becomes fully functional. It ensures all medical equipment is delivered, installed, tested, integrated, and aligned with clinical and IT workflows.

Key components typically include:

• Large, fixed equipment: MRI, CT, X-ray, linear accelerators

• Mobile and modular equipment: Monitors, infusion pumps, ultrasound units

• Clinical support tools: Anesthesia machines, ventilators, crash carts

• Technology interfaces: PACS, EMR connectivity, nurse call systems

While these assets vary in complexity, every item must be accounted for within a coordinated activation plan. Effective activation connects physical installation with clinical usability—ensuring care teams have what they need and are prepared to use it on day one.

Why Strategic Activation Matters

Poorly executed activation can result in:

• Delayed openings and missed revenue targets

• Patient safety risks from untested or partially integrated equipment

• IT integration failures that disrupt workflows

• Erosion of trust among clinicians, leadership, and external stakeholders

By contrast, a disciplined activation approach supports:

• A smooth transition from construction to care delivery

• On-time, on-budget installation of all equipment

• Compliance with regulatory and accreditation standards

• A high-functioning care environment from day one

For health system leaders, these outcomes directly impact revenue cycle timing, patient safety, and organizational credibility.

The Strategic Blueprint: Five Phases of Equipment Activation

High-performing health systems follow a structured, phased approach to manage the complexity of activation. The following five-phase framework reflects leading practices used to translate construction into operational performance.

1. Planning and Procurement

(12–18 months before opening)

• Develop a comprehensive Equipment Master List (EML) aligned with clinical goals

• Engage clinicians to define needs and preferences

• Finalize vendor selections, delivery schedules, and installation requirements

• Coordinate site readiness (floor loading, shielding, power supply, utilities)

2. Logistics and Staging

(6–12 months before opening)

• Sequence deliveries to align with construction completion

• Implement just-in-time delivery to reduce onsite storage constraints

• Create department-specific staging and kitting plans

• Coordinate rigging and specialty installation teams for large modalities

3. Installation and Commissioning

(3–6 months before opening)

• Install and test major equipment (MRI, CT, surgical robotics)

• Conduct Site Acceptance Testing (SAT)

• Validate vendor performance against scope of work

• Prepare for regulatory and radiation safety inspections

4. Integration and Readiness

(1–3 months before opening)

• Connect devices to hospital networks and systems (PACS, EMR)

• Simulate clinical use cases for high-risk workflows

• Train end users and support staff

• Finalize go-live checklists and readiness assessments

5. Go-Live and Stabilization

(Opening day + 90 days)

• Support clinical teams with in-use troubleshooting

• Monitor early equipment performance

• Maintain open communication with vendors for service needs

• Capture lessons learned for future facility activations

Case Study: The MRI That Was “Installed”—But Not Ready

During a recent hospital activation, a new MRI scanner was delivered, rigged into place, and signed off as “installed.” From a construction standpoint, the milestone was complete.

However, during system testing, a critical issue surfaced: the MRI was not connected to the hospital’s Picture Archiving and Communication System (PACS).

While the scanner was physically installed, it was not operationally ready for clinical use. Without PACS connectivity, images could not be stored, shared, or viewed—rendering the machine clinically unusable.

How the Issue Was Resolved

• A cross-functional triage team was assembled, including IT, the equipment vendor, and hospital project leadership

• Interface reconfiguration addressed the communication gap between the MRI and the PACS network

• End-to-end testing simulated a full patient imaging workflow to confirm readiness

Through structured readiness governance and coordinated testing, remediation was completed quickly, preserving the planned go-live timeline.

Early identification prevented weeks of delayed radiology services, protected revenue timing, and reinforced the importance of workflow-level validation—not just physical installation.

What External Stakeholders Should Watch

For boards, investors, and executive leadership, strategic equipment activation is a visible indicator of organizational readiness and operational reliability. Key performance metrics include:

• On-time delivery rate by modality type

• Installation success rate (first-time-right metrics)

• Integration readiness (equipment-to-IT system connectivity)

• Go-live performance (equipment uptime in the first 30 days)

• Staff training completion (percent of trained users per department)

• Zero Harm benchmarks (no safety or quality incidents during ramp-up)

These indicators help leadership teams assess whether capital investments are translating

into sustainable operational performance—not just construction milestones.

Strategic Activation as a Differentiator

In an environment of tight margins, workforce constraints, and rapid technology change, equipment activation has become a strategic differentiator.

A well-executed activation supports:

• Operational confidence among clinicians

• Trust among patients, boards, and the broader community

• Financial efficiency by avoiding rework, delays, and lost revenue

• Scalability for future expansions and technology refresh cycles

The difference between “on paper” and fully operational is determined during activation. From MRI suites to crash carts, every asset plays a role in delivering safe, reliable care.

About HBS

At HBS, we partner with healthcare organizations to lead hospital equipment activation—from early planning and procurement through final commissioning and go-live support.

Our activation methodologies help health systems:

• Deliver large-scale equipment activations on time and on budget

• Align installation schedules with clinical and IT workflows

• Reduce risk by identifying integration and readiness gaps early

• Launch new facilities with confidence, safety, and operational stability

Planning a new facility or major expansion? HBS works with health systems to ensure equipment activation supports safe, on-time, and financially sound go-lives.

Learn more about our Activation Planning services at hbsinc.com.