A commissioning checklist for biomedical teams and project managers installing capital equipment, current as of September 2026. It gives no electrical work instructions and no clinical guidance, and it makes no claim about any universal installation standard.
Commissioning is the stage where a purchase becomes an asset, and it is the stage most often compressed because everyone is waiting for the equipment to be usable. That compression is expensive. A device that is installed before the room is ready, or accepted before its performance is verified, transfers risk from the project to the department that will live with the equipment for the next decade.
Before install: site readiness
Site readiness is a list of conditions that must be true before the delivery date is confirmed, not a set of tasks to complete on the day the crate arrives. The list is short but each item blocks the installation if it is missing: the space is prepared and clear, the utilities the equipment needs are available and at the right point, access routes can accommodate the largest component, and the people who need to be present have been scheduled.
- Room dimensions, floor loading and clearance verified against the equipment’s footprint.
- Electrical supply, gas, water, drainage and ventilation confirmed as required.
- Delivery route, lift capacity and door widths checked against the largest component.
- Installation, clinical and biomedical representatives scheduled with dates and contacts.
- Consumables, accessories and any required fixtures on site before installation begins.
Utilities and environment checks
Utilities are verified rather than assumed. The verification is a comparison between what the equipment documentation requires and what the room actually provides ¡ª supply type, capacity, connection point, and any conditioning the equipment needs. Environmental requirements deserve the same treatment: temperature, humidity, ventilation and any floor or mounting conditions the manufacturer specifies.
Where a requirement cannot be met as documented, resolve it before installation rather than around it. An installation adapted to an inadequate utility is an installation whose warranty position is unclear, and manufacturers are entitled to ask whether their stated conditions were provided.
Installation steps
| Stage | What happens | What to record |
|---|---|---|
| Delivery and inspection | Crate and contents inspected against the packing list before installation begins | Damage notes, photographs, signed delivery document |
| Positioning and assembly | Equipment positioned, levelled and assembled as the manufacturer specifies | Photographs of the installed configuration |
| Connection | Utilities connected by the parties authorised to do so | Who made each connection, and when |
| Initial power-up | Manufacturer’s start-up procedure followed | Start-up outcome and any fault indications |
Functional commissioning
Commissioning is not the same as installation. Installation places and connects the equipment; commissioning demonstrates that it performs as specified in its intended configuration. That demonstration should follow the manufacturer’s procedure, record measured values where the procedure produces them, and be performed by people qualified to interpret the results.
Two details are worth insisting on. First, test the configuration the department will actually use, including the accessories and interfaces that go with it, rather than a bare console. Second, record what was tested along with what was not ¡ª an unchecked function is a question for the acceptance plan, not an omission to be discovered later.
Common commissioning failures
Four patterns account for most of the problems seen at this stage. The room is not ready when the equipment arrives, so installation is improvised around missing utilities or inadequate access. The commissioning test is performed on a bare unit, so the configuration the department will use is never verified. Training is delivered to whoever happens to be available, and the record of it is a signature sheet with no defined competency. And the outstanding items are closed verbally, so nobody can say later what was accepted and on what basis.
Each of those failures has the same cause: compressing a stage that has its own requirements because the equipment is expected to be working by the end of the week. The remedy is not a longer schedule for its own sake ¡ª it is deciding in advance which stage may be compressed and which may not.
Training and handover
Handover is a document event as well as a conversation. It should transfer three things: the commissioning record, the operating and maintenance documentation for the configuration supplied, and a named route for service and support. Training should be scheduled with the people who will use and maintain the equipment, and attendance recorded ¡ª for equipment with a defined operator training requirement, that record is part of the compliance position.
Where training is delivered at installation only, plan how new staff will be trained afterwards. This is the point at which many installations quietly fail: the original team is competent and everyone who joins later learns from them rather than from the manufacturer’s material.
Post-install review checklist
- Confirm the installed configuration against the order, including accessories and options.
- File the commissioning record with measured values and the procedure followed.
- Confirm that the safety testing applicable to the device class has been completed.
- Record training attendance and the route for later training.
- Confirm the service and support pathway in writing, with contact details.
- Enter the equipment in the asset register with model, serial and installation date.
- Schedule the first preventive maintenance visit and record who owns the schedule.
- Close out any outstanding item with an owner and a date ¡ª not with a note that it will be sorted out.
Questions managers ask
Who should sign off commissioning?
The people accountable for the equipment performing as intended: typically biomedical for the technical verification and the department for fitness for its intended use. Where a manufacturer’s engineer performs part of the work, their report becomes part of the record rather than a substitute for it.
Can installation and commissioning happen on the same day?
Often, for simple equipment. For capital equipment with utilities, accessories and training, separating them reduces the pressure to declare success before the verification is complete ¡ª which is the main cause of incomplete records.
What if outstanding items remain at handover?
Record them with an owner and a date, and decide explicitly whether the equipment may be used before they are closed. An unrecorded outstanding item becomes an unowned one.
Treat commissioning as a project with records, not a morning of activity. If you are installing equipment and want the documentation that should arrive with it, ask HHG for the records on a specific item. Related reading: lifecycle management for medical equipment and why rapid delivery plans fail.