A quick project snapshot

• Tell me about the project that brought you here today, including building type and the trigger (new build, clinical expansion, occupancy change, renovation) Options: New building, Clinical expansion / new program, Renovation with occupancy change, Infrastructure upgrade, Other
• Which clinical program and core spaces drive the plumbing, medical gas, and fire protection scope (examples: acute care with ORs, NICU, outpatient clinic, research lab)? Options: Acute care hospital (ORs/ICU), Behavioral health, Outpatient clinic/ambulatory, Research lab, Long term care, Other
• Describe existing site or building constraints we should know now, such as basement utilities, limited ceiling space, or gaps in as-built documentation
• Who will be the primary decision-maker for selecting the plumbing/fire protection subconsultant and who is the day-to-day contact for design questions Options: Project architect (principal), Project architect (project manager), Director of Facilities / Hospital engineering, Owner's representative, Construction manager, Other
• Approximate count of beds, procedure rooms, or specialized suites that determine medical gas and fixture counts Options: Less than 25, 25–75, 76–150, 151–300, More than 300, Unknown / TBD
• On previous projects like this, how involved has the owner/facilities team been during design and coordination Options: Very involved, weekly reviews, Periodic involvement, milestone reviews, Minimal involvement until construction, Owner not engaged

Compliance is the driver, not an afterthought

• If a single compliance miss forced a rework that delayed turnover, where would that break most often — medical gas classification, backflow placement, sprinkler hydraulics, or AHJ interpretation? Options: Medical gas classification/locations, Backflow preventer or water service sequencing, Sprinkler hydraulic demand or occupancy classification, Local health department / sterile processing constraints, Other
• Which authority having jurisdiction or local agency will be the final reviewer for plumbing, medical gas, and fire protection approvals Options: Local building department, County/city health department, State AHJ, Multiple AHJs (multi-jurisdiction), Insurer review required, Unknown / TBD
• Describe any known local amendments, insurer mandates, or health department rules that deviate from the model codes and affect layout, equipment, or inspection sequencing
• Typical frequency of infection control risk assessments, Joint Commission documentation, or clinical engineering reviews required for design milestones Options: At schematic only, At 50% and 100% design, Monthly during design, Only at permit stage, Not required / unknown
• Name the person or role who must sign off on any design variance or alternate that affects code compliance or patient safety Options: Owner's Facilities Director, Project architect, Clinical engineering lead, Hospital safety / infection control, Authority having jurisdiction, Other

Where coordination usually reveals the hidden costs

• Where do clashes between plumbing, structural, and mechanical most often get discovered on your projects — in design review, during submittals, or in the field? Options: During design coordination, During submittal review, Contractor clash detection on site, During construction when routing changes occur, Other
• Walk me through the last time a pipe routing conflict required a change order: what caused it, whose documents missed it, and how much delay or cost resulted
• Identify the role or team that currently owns BIM clash resolution and model federation on your projects Options: Lead MEP coordinator, Architect BIM manager, General contractor BIM team, Owner's BIM/CA lead, No clear owner, Other
• Typical cadence for model coordination sessions during design that you expect (for example weekly, biweekly, or milestone-only) Options: Weekly, Biweekly, Monthly, Milestone-only (30/60/90%), None planned
• If the owner declines to include the plumbing and fire protection engineer in weekly coordination sessions, would you still proceed with the current procurement strategy or pause to change routing? Options: Proceed with current procurement, Pause and require inclusion, Proceed but increase contingency, Unsure

Schedule pressure exposes hidden assumptions

• What single schedule risk — permit delay, late model access, owner changes, or materials lead time — would force you to delay construction? Options: Permit approval delay, Late or restricted model access, Owner-directed scope change, Long lead product delivery, Other
• Estimate your target dates for 30 percent, 60 percent, 90 percent design and issuance for bid
• List the milestones that currently trigger payment, contractor bid release, or formal acceptance in your procurement schedule Options: 30% design, 60% design, 90% design / issued for permit, Issued for construction, As-built turnover
• Target turnaround after a milestone handoff for contractors to receive coordinated BIM deliverables and submittal-ready documents Options: Same week, Within 2 weeks, 2–4 weeks, More than 4 weeks
• Would your team be able to meet the BIM LOD expectations and RFI targets if the schedule compresses by more than 20 percent? Options: Yes, with existing team, Yes, with added resources, No, would need schedule relief, Unsure

When the plan hits the site, these things break first

• Point to the single unresolved site or existing system issue that has derailed projects like this in the past Options: Unknown underground utilities, As-built drawings missing or inaccurate, Insufficient ceiling/shaft space, Conflicting owner equipment, Other
• Tell me about the last time RFIs exceeded acceptable targets on a similar project, what category the RFIs fell into, and who bore the cost
• Permitting delays typically change contingency budgets by which magnitude on projects like this Options: Less than 2% of construction cost, 2–5%, 5–10%, More than 10%, Unknown
• Name the role that makes the call to accept an underground reroute or other field-necessitated piping change during construction Options: Owner's Facilities Director, Project architect, General contractor superintendent, Design engineer, Other
• Would an unresolved AHJ objection to the medical gas scheme or sprinkler design stop the project from moving forward? Options: Yes, stop work, No, work continues with redesign plan, Depends on severity, Unsure

The other paths you're weighing

• What would have to be true about your current approach for you to keep the incumbent or continue without an outside specialist instead of changing to a specialized plumbing and fire protection firm Options: Proven low RFI history, Documented healthcare experience, Integrated BIM coordination already in place, Lower cost with acceptable risk, Other
• Provide the names of external firms or internal teams you are actively comparing for plumbing and fire protection services
• Length of time the incumbent or in-house team has been on the project and whether they have delivered similar bed-count or clinical program types Options: New to project, On project <6 months, 6–12 months, More than 12 months, No incumbent
• Is anyone internally proposing to deliver plumbing or fire protection design without an external partner Options: Yes, full internal delivery, Yes, with external QA, No, external partner required, Undecided
• Pick the priority between lower fees with higher RFI risk, and higher fees with fewer RFIs and tighter BIM coordination Options: Lower fees, accept higher RFIs, Higher fees, fewer RFIs and tighter coordination, Balance cost and coordination equally, Undecided

Practical readiness and gating items

• Point to any prerequisites that, if unmet, would prevent us from starting design on your schedule Options: Model access not granted, Key approvals missing, Owner funding not confirmed, Named subcontractor requirement, None
• Do you have an existing BIM execution plan and will you share it or require us to provide one Options: Owner provides BIM execution plan, We must supply a BIM execution plan, No formal plan exists, Unknown
• Identify who owns the building model, who can grant federated model access, and any platform constraints we should know
• Current state of as-built drawings, pipe rack elevations, and medical gas riser documentation Options: Complete and up to date, Partial and requires cleanup, Mostly missing, Unknown
• Are there contractual, insurer, or funder requirements that mandate specific reviews, named products, or preapproved subcontractors Options: Yes, insurer or funder mandates, Yes, owner-preferred vendors, No mandated requirements, Unknown
• Can this engagement proceed if model access and key documentation cannot be granted within two weeks of notice to proceed Options: Yes, with adjusted schedule, No, cannot proceed, Maybe, with written agreement on milestones, Unsure

Acceptance triggers and the next steps

• Name the single acceptance trigger that would make you sign and lock the engagement immediately (for example an approved timeline, insurer sign-off, or sample BIM deliverable) Options: Accepted fee and schedule, Sample coordinated BIM model approval, Insurer or AHJ pre-approval, Owner mandate to proceed, Other
• Specify the deliverable or milestone you require to release the first payment or authorize construction procurement Options: 30% design milestone, 60% design milestone, 90% design / permit set, Issued for construction, Other
• Expected delivery timeframe for a sealed set and coordinated BIM from your notice to proceed Options: 4–6 weeks, 6–10 weeks, 10–16 weeks, Longer than 16 weeks
• Assuming a short pilot proves a measurable drop in RFIs and coordination rework, what specific barrier would still stop you from signing that week Options: Funding not approved, Contract terms unresolved, Stakeholder alignment missing, No barrier, would sign, Other
• Preferred routing and reviewers for plumbing and fire protection submittals to ensure timely review (for example route through architect, CM, or directly to owner/facilities) Options: Route through architect first, Route through construction manager, Route to owner/facilities for parallel review, Route to a central submittal portal only, Other

• Integrated Design Experience Session

• Confirm the current state and cost to your project
• You confirm that the demonstrated model excerpts eliminate the routing conflicts and AHJ/insurer concerns you described.
• Deliver two coordinated model excerpts tied to your clinical spaces and a draft acceptance criteria sheet before the follow-up decision meeting.
• Map regulatory, insurer, and constructability constraints
• You agree on measurable acceptance criteria (BIM LOD, RFI targets, document lock triggers) that define construction-ready deliverables.
• Provide the latest floor plans, AHJ code amendments, and any insurer checklist or comments you have received.
• Prove coordinated model decisions with project-specific excerpts
• Run a quick clash report snapshot on the provided model and share the findings in advance of the follow-up session.
• You identify any remaining risks that would prevent adopting the proposed coordination approach.
• Confirm which stakeholders will attend weekly model coordination sessions and who can sign off on acceptance criteria.
• Confirm measurable acceptance criteria
• Validate this maps to your needs
• Agree next-step evidence and timeline

• Integrated Design Experience Session
• Integrated Design Experience Deck
• Integrated Design Solution Brief

• meeting
• slides
• document

• Schematic plumbing and fire protection drawings
• Design-development plumbing & fire drawings and equipment schedules
• Construction documents and specifications for plumbing and fire
• BIM coordination model (plumbing & fire) with clash reports
• Hydraulic calculations for sprinkler and standpipe systems
• Domestic water, sanitary waste, and storm drainage piping design
• Medical gas piping design, manifold sizing, and NFPA 99 compliance package
• Backflow prevention location details and sterile-processing plumbing integration
• Prefabrication isometrics for critical piping runs
• Shop drawing review and submittal coordination for plumbing & fire
• Witness testing, commissioning, and certification for medical gas and backflow devices
• Permit submittal package and AHJ response support
• As-built record drawings and O&M manuals for plumbing and fire

Schematic plumbing and fire protection drawings

• Do you require floor-level schematic riser diagrams for domestic water, sanitary, storm, and sprinkler zoning? Options: Yes, No
• Which clinical areas (e.g., operating rooms, sterile processing, imaging) must be shown at schematic routing level? Options: Operating rooms, Sterile processing, Radiology, ICU, Patient rooms, Other
• How many building levels and separate mechanical zones should be included in the schematic riser diagrams? Options: 1-3, 4-8, 9+
• Who on your team will provide the architectural floor plan and equipment lists required to develop schematic plumbing and sprinkler layouts? Options: Architect, Owner/Facilities, Contractor, Not yet assigned
• When must schematic drawings be delivered to align with the project schematic design milestone? Options: Within 2 weeks, 2-4 weeks, 4-6 weeks, Custom
• Where should schematic-level medical gas source locations and proposed manifold rooms be shown relative to the clinical program diagrams?

Design-development plumbing & fire drawings and equipment schedules

• Provide the expected Level of Development for plumbing and sprinkler elements at design development (for example LOD 300 routing, LOD 350 fabrication intent). Options: LOD 300, LOD 350, LOD 400, Mixed by element
• List the major equipment schedules required (water heaters, boilers, pumps, backflow preventers, fire pumps, medical gas receivers) and indicate any manufacturer constraints.
• Describe the extent of equipment selection versus performance-spec approach for pumps, backflow devices, and fire pumps. Options: Owner-selected manufacturers, Performance spec - contractor selects, Mixed
• Are there existing basis-of-design documents or hospital utility standards we must follow for fixture counts and medical gas outlet types? Options: Yes - provide, No, Partial - provide key pages
• What is the target sheet set count and discipline split (for example plumbing 12 sheets, fire 8 sheets) for design-development deliverables?
• Confirm whether equipment schedules must include maintenance access clearances and manufacturer O&M references for coordination with sterile-processing and mechanical spaces. Options: Yes, No

Construction documents and specifications for plumbing and fire

• Specify the required drawing scale and annotation standards for construction-ready plumbing and sprinkler plans (for example 1/8 in = 1 ft, 1/4 in = 1 ft, or metric equivalents). Options: 1/8 in = 1 ft, 1/4 in = 1 ft, 1:100 (metric), Other
• Identify which project specification format to use for plumbing and fire sections and any required Division 01 cross-references. Options: MasterSpec, In-house spec, Owner provided, Other
• Will you require performance criteria and explicit acceptance tolerances for installation such as sprinkler coverage and pressure loss tolerances to be included in the specifications? Options: Yes, No, Need discussion
• Include any contract administration deliverables expected with the construction documents such as bid addenda, ASIs, or stamped addendum sketches? Options: Yes - include, No, Only after award
• Would you like prescriptive coordination notes for site utilities (meter locations, backflow vaults) included on civil and plumbing plans? Options: Yes, No, As requested
• Is the acceptance criterion for construction-ready documents to be defined as stamped, coordinated, and complete for permit or bidding with no outstanding coordination RFIs above an agreed threshold? Options: Yes, No - provide alternative acceptance criteria

BIM coordination model (plumbing & fire) with clash reports

• Please indicate the required BIM Level of Development at each delivery: LOD 300, 350, or 400 for plumbing and sprinkler elements. Options: LOD 300, LOD 350, LOD 400, Mixed by element
• Attach or indicate whether you will provide a federated architectural and mechanical model for coordination or require we federate models from discipline submittals. Options: Owner provides federated model, Owner provides separate models, We federate from submittals, Not provided yet
• State the expected clash report cadence such as weekly model coordination with 48-hour issue routing and any acceptable open clash threshold before permit submission. Options: Weekly, <50 open clashes, Biweekly, <100, Weekly, <25, Custom
• Estimate the number of trades that will participate in coordination for plumbing and sprinkler clash resolution (for example mechanical, electrical, structural, specialty medical gas). Options: 2-3 trades, 4-5 trades, 6+ trades
• Indicate whether you require discipline-specific coordinated model deliverables (plumbing model separated from fire model) or a single combined plumbing and fire model. Options: Separate models, Combined plumbing & fire model, Both
• Select the evidence that will validate BIM acceptance such as a federated model plus clash report with all high-priority clashes resolved and model LOD sign-off. Options: Federated model + clash report, Clash-free model export, Owner review sign-off, Other

Hydraulic calculations for sprinkler and standpipe systems

• Name the applicable hazard classifications and occupancy types that drive hydraulic calculations for sprinkler design, for example operating rooms, ICU, or general medical wards.
• Share the required design criteria for sprinkler calculations including design area, density in gpm per square foot, and available water supply pressure at the meter or dedicated fire service.
• Outline whether a fire pump is anticipated and if so whether the pump curve, fuel supply, and jockey pump requirements will be provided. Options: Fire pump TBD, Fire pump required - provide curve, No fire pump, To be determined
• Supply the existing municipal water service hydrant flow test report or indicate if we must coordinate hydrant flow testing with the AHJ. Options: Flow test provided, We will coordinate flow test, No flow test available
• Detail any standpipe class requirements (Class I, II, III) and whether hose stations or preaction systems are required per the AHJ or insurer. Options: Class I, Class II, Class III, Preaction required, Unknown
• Explain the expected deliverable for calculations such as a signed and sealed hydraulic calculation report suitable for permit submittal showing node-by-node results and summary tables. Options: Signed sealed report, Unsigned draft only, Both draft and sealed

Domestic water, sanitary waste, and storm drainage piping design

• Recommend the preferred method for sizing domestic water mains and risers (fixture unit counts versus measured peak demand) aligned to hospital standards. Options: Fixture unit sizing, Measured peak demand, Hybrid
• Account for special waste streams such as laboratory acid waste, radiology contrast waste, or chemical neutralization that require separate piping or neutralization systems. Options: Yes - list streams, No special streams, To be determined
• Report any existing site grading or storm sewer constraints that affect roof leader routing and underground storm piping layout.
• Mark whether grease interceptors, oil-water separators, or special traps are required for kitchens or service areas and provide expected capacities. Options: Grease interceptor required, Oil-water separator required, None required, Unknown
• Suggest preferred material schedules for sanitary, storm, and domestic piping such as cast iron, PVC, HDPE, or copper based on infection-control and maintenance needs.
• Clarify whether existing utility abandonment or temporary bypass pumping for sanitary or storm systems during construction is within scope. Options: Included, Excluded, Needs discussion

Medical gas piping design, manifold sizing, and NFPA 99 compliance package

• Record the medical gas systems required such as oxygen, medical air, suction/vacuum, nitrous oxide, and medical CO2 and indicate any special services like waste anesthetic gas disposal.
• Note the required supply reliability classification per NFPA 99 for critical clinical spaces to size manifolds and source redundancy. Options: Class I, Class II, Class III, Unknown
• Choose whether manifold design should assume a centralized gas room with duplex receivers or decentralized manifolds in each mechanical room. Options: Centralized manifold, Decentralized manifolds, Hybrid
• Do you require alarm and monitoring point lists compatible with your building automation system and medical gas alarm panel schedules? Options: Yes, No, Provide BAS protocol
• Which NFPA 99 edition and any local hospital code amendments must the medical gas compliance package reference? Options: Specify NFPA 99 edition, Local amendments provided, Unknown
• How will acceptance of medical gas design be verified: AHJ plan review approval, third-party certification, or onsite witness testing sign-off? Options: AHJ approval, Third-party certification, Onsite witness testing, Combination

Backflow prevention location details and sterile-processing plumbing integration

• When must backflow preventer assemblies be coordinated with sterile-processing layouts to avoid contamination risks and maintenance access conflicts? Options: During design development, During construction documents, After permit
• Where on site are domestic and irrigation backflow devices preferred to be located per AHJ and owner's maintenance access (for example meter vault, interior mechanical room, exterior yard)? Options: Meter vault, Interior mechanical room, Exterior fenced yard, Other
• Provide any sterile-processing instrument water quality requirements such as filtered water or hard water treatment that affect inlet piping and backflow location.
• List the required utilities and plumbing penetrations through sterile-processing clean zones that must comply with infection control risk assessment procedures.
• Describe the preferred maintenance access clearances around backflow assemblies and sterilization equipment for routine testing and repair. Options: Allow 3 ft clearance, Allow 4 ft clearance, As per manufacturer, Specify
• Are annual backflow testing and certification witnesses to be scheduled and documented in the O&M manual? Options: Yes, No, Owner arranges

Prefabrication isometrics for critical piping runs

• What piping runs are candidates for prefabrication isometrics such as operating room corridor risers, medical gas mains, or long horizontal sprinkler mains? Options: OR corridors, Medical gas mains, Sprinkler mains, Domestic risers, Other
• Confirm whether shop fabrication tolerances and site connection details must conform to a provided modular prefabrication standard. Options: Yes - provide standard, No standard provided, We will agree during shop drawing review
• Specify the required file formats and naming conventions for isometric deliverables intended for off-site fabrication. Options: IFC, Revit/CAD with PDF, Native CAD with PDF, Other
• Identify whether hanger details, splice connections, and pressure test procedures are required on isometrics for MEP prefabrication. Options: Include hangers and splices, Include pressure test procedures, Basic routing only
• Will the contractor assume responsibility for prefabrication logistics and QA or do you require the designer to provide prefabrication QA checklists? Options: Contractor handles, Designer provides QA checklist, Shared responsibility
• Include the expected milestone for isometric deliverables such as prior to procurement or prior to fabrication in the project schedule. Options: Pre-procurement, Pre-fabrication, After procurement

Shop drawing review and submittal coordination for plumbing & fire

• Would you prefer a three-step submittal review (designer review, coordinated comment set, return to contractor) or a simplified two-step process? Options: Three-step standard, Two-step expedited, Hybrid
• Is a maximum review turnaround time required for shop drawings such as 10 business days and should it be tracked per submittal? Options: 10 business days, 15 business days, As negotiated
• Please indicate whether annotated coordination markups must be returned in native model files or as PDF overlays for contractor use. Options: Native model files, PDF overlays, Both
• Attach any prefabrication or vendor submittal standards we must enforce during review such as pipe hanger schedules or manufacturer submittal forms.
• State the number of anticipated shop drawing submittals for plumbing and fire per bid package for budget purposes. Options: 1-3, 4-6, 7+
• Estimate the expected RFI threshold during the shop drawing phase that would trigger a scope review, for example more than 5 RFIs per 100 sheets. Options: <5 per 100 sheets, 5-10 per 100 sheets, >10 per 100 sheets

• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Fee Schedule & Payment Terms
• BIM Coordination & Model Exchange Agreement
• Deliverables Acceptance & Handover Criteria
• Change Order Agreement
• Insurance & Indemnity Exhibit
• Confidentiality & Non-Disclosure Agreement (NDA)
• Design Review & Approval Routing Agreement
• Regulatory Compliance Addendum — Healthcare (HIPAA BAA conditional)

• Go-live Closeout Health Check
• First Measurement, RFI and Change-Order Review
• Acceptance Gate, Closeout Acceptance and AHJ Sign-off
• Quarterly Ongoing Support Review

• If legacy files remain active, produce a retirement or archiving plan and schedule.
• Publish a root-cause log for open RFIs with suggested corrective actions and targeted resolution dates.
• Submit an updated as-built gap list showing missing elements relative to the agreed BIM LOD.
• Update the change-order register with descriptions, cumulative value, and next steps to reduce future change risk.
• Restate acceptance criteria and numeric targets
• Produce a documented acceptance decision by the buyer's authorized signatory, or a remediation plan with named verification dates.
• Close the loop on any outstanding AHJ conditions or critical as-built gaps that block acceptance.
• Confirm the shared maintenance channel and the expected response timeline for post-acceptance issues.
• Deliver the final as-built model package and supporting as-built report or log.
• If acceptance is conditional, publish the remediation plan with milestones and the final verification date.
• Provide the documented acceptance or conditional acceptance statement for archival alongside project records.
• AHJ status and any jurisdictional follow-ups
• Confirm ongoing metric trends for as-built completeness, open RFI count, and average RFI resolution time are within acceptable ranges against Outcome & Compliance Discovery targets.
• Ensure the maintenance request queue and enhancement backlog are prioritized and have realistic resolution timelines.
• Verify archival status of legacy design files or incumbent systems when applicable to prevent dual-system use.
• Publish the quarterly metrics dashboard with trend lines and a short commentary on variances.
• Update the maintenance and enhancement backlog with target resolution windows and required inputs.
• Reconfirm acceptance criteria and owners
• All closeout owners and decision roles are confirmed against the acceptance criteria recorded in Outcome & Compliance Discovery.
• Current AHJ approval status and next inspection dates are documented and shared.
• A prioritized short list of immediate closeout actions with target dates is agreed.
• Publish an AHJ approvals tracker with expected clearance dates and outstanding comments.
• Deliver an as-built model delivery checklist showing file list, LOD, and access instructions.
• Produce an initial RFI/punchlist log with remediation actions and target dates.
• Present first-period metrics
• Determine whether open RFI count and average RFI resolution time are trending toward the targets recorded in Outcome & Compliance Discovery.
• Identify the top 3 root causes driving change-order value and agree corrective actions with dates.
• Agree a revised acceptance timeline if required and record the remediation checkpoints.
• Present outcome data versus each criterion
• Metrics trend review
• AHJ submission and approval status
• Diagnose primary root causes
• Document pass or fail per criterion
• As-built model delivery plan
• Shared channel maintenance and enhancements log
• AHJ approvals and outstanding jurisdictional items
• Formal acceptance decision or bounded remediation plan
• Early RFI and punchlist triage
• As-built model completeness review
• Preventive updates to as-built model and documentation
• Agree corrective actions and timeline
• Legacy file and incumbent system archival check
• Coordination channel and maintenance request setup
• Agree post-acceptance support and escalation path
• Agree immediate remediation actions