34 www. refrigerationandaircon. co. za RACA Journal I February 2026
LABORATORIES voices
Unlike commercial buildings that can tolerate brief interruptions for maintenance, hospitals operate continuously, with no allowance for downtime. Any HVAC failure in an operating theatre or ICU can have life-or-death consequences, requiring redundant systems, standby power integration and technicians who are permanently on call.
Each section of a hospital functions as a unique microenvironment, with specific temperature and humidity requirements tailored to its purpose. Operating rooms are kept between 18 ° C and 22 ° C with a relative humidity of 40 – 60 % to inhibit bacterial growth and ensure surgeon comfort. Pharmacies, server rooms and general wards each have their own setpoints dictated by regulatory and operational needs.
Compounding this complexity is the stringent documentation and compliance regime that governs hospital facilities. Every filter change, pressure reading and maintenance activity must be recorded and available for audit by health authorities. HVAC systems are further intertwined with other essential infrastructure, including medical gas and vacuum systems, RO water purification and emergency electrical supplies – all of which interact to sustain life-critical operations.
THE SCALE AND INFRASTRUCTURE At the private hospital, the HVAC plant was extensive. The central chilled water system consisted of two primary chillers and a heat pump, forming the heart of both the cooling and hot-water generation loops. Eighteen large air handling units( AHUs) served theatres, wards, isolation rooms and specialist zones. These AHUs incorporated multiple stages of filtration, cooling and heating coils, and in some cases, humidifiers.
A further 134 fan coil units provided room-level control, while more than 40 independent split and VRV / VRF systems served ancillary and administrative spaces. Numerous specialised areas required dedicated systems, including surgical theatres, ICUs, CSSD( Central Sterile Services Department), isolation wards, pharmacies and IT rooms equipped with close-control CRAC( Computer Room Air Conditioner) units.
To maintain oversight of this vast infrastructure, I personally developed a comprehensive asset database – a digital register ensuring that no component was overlooked in the maintenance cycle. This database became a cornerstone of the hospital’ s maintenance transformation, allowing for precise scheduling and traceability across every system.
ROUTINE AND PREVENTIVE MAINTENANCE Hospital HVAC maintenance follows a highly structured rhythm, balancing planned preventive work with rapid response capability for unexpected faults. Each day begins with a full physical
34 www. refrigerationandaircon. co. za RACA Journal I February 2026