VA Lexington KOM.pdf

Non-Confidential Information and Basic Personal Data

Elekta Linac System—Kickoff Meeting VA – Lexington, KY TBD, 2026

• Introductions and sign-in sheet

• Project teams

• Roles and responsibilities

• Critical success factors

• Project scope of supply/project charter

• Implementation process

• Project timeline

• Vault construction review

• Elekta site inspections overview

• Linac system delivery and installation

Meeting Agenda

Roles and Responsibilities

Roles and responsibilities

• Complete project charter, project plan, communication plan

• Scheduling resources

• Conduct kickoff meeting

• Review invoicing plan

• Identify core team

• Review kickoff materials and complete required documentation

• Building access credentials for installation team

• Ensure invoices are reviewed and paid according to purchase and license agreement

• Confirm contract deliverables are delivered

• Confirm site prep completed to Elekta standards

• Confirm rigging path for delivery

• Vault construction is 100% complete prior to final inspection, according to Elekta specifications

• Provide network/physics information prior to progress inspection

• Deliver and rig-in machine • Ensure staging area is clear and free of obstacles

• Ensure Elekta personnel have access to space

• Install Linac and components

• Acceptance testing with physics

• Conduct radiation leakage survey

• Acceptance testing-last 3 days

• Connect MOSAIQ to Linac and update MAC file • Complete connectivity checklist(s) provided by Elekta

• Add sequencer(s)

• Provide IT support as needed

• Perform beam modeling, if purchased • Collect beam data

• Perform beam modeling and quality assurance testing

• Deliver end-user training

• Provide on-site Go Live support

• Complete pre-training checklist

• Assist with scheduling and coordination of end-user training

• Provide Super User and IT support, as needed

• Conduct project close meeting

• Transition customer to support

• Participate in project close meeting

Elekta Customer

Install

Connect to

MOSAIQ

Commission

Close

Inspect

Deliver

Plan and Kickoff

Train and Go Live

Scope of supply: Accessories

Standard

• PDU (shipped to site during construction)

• CITB (shipped to site during construction)

• SF6 and dry nitrogen gases (for Linac install and service)

Optional items (based on contract inclusions)

• CCTV

• Patient intercom system

• Green lasers

• Coded shadow tray

• Open air graticule

• Hook and Latch Graticule

• Requesting service:

• Online: Customer portal; https://community.elekta.com/

• Online self-service center: Access information, tools and resources / Manage your Elekta account & products / Open a non-priority case / Access learning resources / FCO mgmt. & more!

• Speak to representative: Call 855-693-5358 (855-MY-ELEKTA)

• For urgent case please contact the call center and take advantage of Elekta’s remote support team.

• Why opening a case is critical:

• Downtime clock starts when a case is opened / Visibility for the Elekta service team

• Escalation pathway: service region slide (RSM, Sr RSM, Head of Service, Support Manager)

• SLA review

• Entitlements review: Agreed hours, response time, parts coverage, tech refresh (what is covered), etc

• 'Shared Service’ or 'Block of Hours' a review of how these are accessed and consumed

• Afterhours billing rates: Rate sheet

• Holiday coverage

• Planned Maintenance: expectations and scheduling

• MSR: discuss plan for first MSR check in and potential cadence for future meetings

• Local Service Team: Introductions if possible

Service overview https://community.elekta.com/

• Control room chairs

• 10 gal distilled water for filling phantoms and Linac internal cooling loop

• Landline phone in control room

• Live network with IP info—1 static IP

• 24/7 access to vault

Supplied by customer for Linac installation

Project timeline: Linac treatment system

Site design finalized, contractor selected, permits pulled

• Elekta Vault Construction/ Renovation Completed

• Toolbox delivery to site— 2–3 days before Linac delivery; will need to be received by customer and placed in secure location i.e.: Linac vault

• Linac System Delivery—1 day

Vault construction /renovation

• Site Inspections (4)

− Pit Inspection—Generally five weeks prior to delivery, or as soon as concrete is placed

− Progress Inspection—Generally three weeks prior to delivery

− Final inspection—Generally one week prior to delivery − Transition to Installation performed if needed—will review punch list items remaining from final inspection

Clinical Start/1st Patient Treatment—Wednesday of Phase 1 training

1 2 3

456 Installation

• 5 weeks

• Customer Acceptance— Last three days of Linac installation and final invoicing due

• MOSAIQ Connectivity to Elekta Linac—3 days

• Commissioning—2 weeks

• Training—8 to 10 days

One week prior to machine delivery: all site prep requirements must be 100% complete. Go or No Go for Installation (Pass/Fail)

Mobilization of installation activities takes place after the final inspection (toolboxes ship, final arrangements made by riggers and logistics company delivering the equipment, Engineer makes final travel plans)

The Elekta SC will return to site 2 days prior to machine delivery and will confirm completion of any punch list items from final inspection Elekta rigging and installation teams take ownership of the vault the day prior to machine delivery for drilling and vault prep Elekta SC will act as an intermediary/liaison between contractor and Elekta install team for vault access and remaining construction tasks SC will remain onsite until push-in is complete and Hardware Team agrees the remaining construction items are complete or an adequate plan in place

Elekta site inspection overview

Vault slab inspection

All electrical and mechanical rough-ins should be complete, vault door installed, fascia wall roughed in, all laser and camera mounts roughed in

Check Linac table pit and vault slab levelness—pass/fail

Progress inspection Final site inspection Transition to installation

• Kickoff meeting

• Linac enters product cycle

• Linac shipment

• Pre-construction meeting

• Vault construction

• Pit / vault slab inspection

• Progress site inspection

• Final site inspection

• Delivery and rigging of Linac

• Completion of acceptance testing

• Linac service handoff

• Commissioning

• MOSAIQ installation

• Elekta Linac training

• Additional Elekta training (if applicable):

BodyFIX, ABC, Fraxion, etc.

Milestones

Critical success factors

• Project ownership and buy-in—mutual responsibility

• Primary client contact

• General contractor

• IT infrastructure

• Meeting project milestones on time

• Maintaining continuous communication

Failure of the site inspections will result in the installation being pushed to the next available dates, typically 3–4 months later It is very important to stay on schedule!

• Once the Linac acceptance has been completed, the main point of contact on the customers side will receive an email from Experience@elekta.com which contains several questions about the overall project.

• Elekta uses this feedback for process improvement as well as employee evaluation. There is a specific question asking about your experience with your Project Manager which is especially helpful.

• We would ask that you please take the time to respond to this survey. The Project Manager will also follow up with the POC to ensure they received the survey and have no issues accessing it.

Elekta Customer Survey mailto:Experience@elekta.com

The Elekta Linac installation process

Patient treatment, safety, and comfort

A complex system—used in treating serious diseases

• Shielding survey

• Area survey

• Neutron test above 10Mv

• Acceptance of Linac

• Commissioning

• Beam modeling or validation

• MOSAIQ installation acceptance

Physicist involvement

Shielding design and calculations

Shielding design and calculations

The physics pipe location and size is up to the physicist

All shielding design is done by the site physicist of record

All vault penetrations are to be approved by the physicist

• All Elekta items should be incorporated into architectural plans

• Elekta drawings are not for permitting purposes, only for reference

• Use the architectural blue lines

We have two sets of plans— whose plans do we use?

What does Elekta expect?

Observance of tolerances on plans

Elekta is required to calibrate the machine to .3 mm

We require from you 1/16” (2 mm) accuracy

Center of Excellence

Critical dimensions

• All critical dimensions are marked with an asterisk *

• Noted in the NOTES block on each sheet

Absolutely the most difficult part of the job

Critical dimensions +/- 1/16” (2 mm) throughout

The table pit establishes isocenter!

Option #2 Pre-manufactured “leave in place” pit frame

• Frame to be level and square to 1/16” (2 mm)

• 9.25” depth from finished floor

• Not centered on isocenter G/T direction

• Leave steel pit edge proud of concrete by floor covering thickness

Option #1 Field formed with 2”x 2” steel around pit edge

Vault renovation

Vault floor flatness is critical around table pit out 3’

Floor level +/- 2 mm (1/16”) inside and around pit

3/16-inch clearance from finished floor

• Correct location of table pit

• Pit depth = 235 mm

• Raceway location and layout correct

• Vault slab flatness

• Framing for fascia wall

Pit and vault slab inspection Confirm table pit and floor raceway meets all Elekta specifications

Example of long raceway

How do I meet tolerance?

• > 4500 PSI

• > 9” monolithic slab

• No layering

• 9.25” depth and flat to 1/16”

Typical laser location examples ¼” thick aluminum plates on ½” spacers mounted solid to concrete

Fascia wall construction

• Wall must be 48-1/16” from isocenter and parallel

• Opening must be 13’-1.5” centered x 101” tall

• Solid wood header

• 9’ min clearance behind fascia opening

• Both service doors require a set of safety switches

• Minimum door opening 24”

• Doors must open out into treatment room

• NO CLOSURES on service doors allowed

Pre-install deliveries

Toolbox

PDU

Elekta to supply

• PDU

• CITB

• Installers tools

• Gases

• Input: 480 @ 40-amp 3P

• Output: 415 & 220

• Wire size is critical

• 8–10-week lead time

• 2 ea 2-in knockouts in back

• CITB—Client Interface Terminal Box

• Interface from building to Linac

• 4-week lead time minimum (ordered by Site Coordinator)

• Needs two 120-vac circuits

• All connections by electrician

• Fully tested on final inspection

Client interface terminal box (CITB) Supplied by Elekta and wired by Site Electrician

• Qty 6 required

• Beam Off / Motion Stop Positive locking switches

• Wired in series, Run back to Client Interface Panel

Additional electrical items NOT supplied by Elekta

• Fascia Door Switches supplied by Electrician

• Need 2 separate contacts per door!

Elekta requirements for chilled water monitoring

(100 micron)

Pressure gauges 15–60 psi

Temp gauges 59–70⁰

8–14 GPM

Optional chiller switchover panel Water connections, 4 feet to left of ISO center, with temp loop

• Auto city water backup switchover panel

• Chiller controlled

• Filter and gauges included

• External power required

• Still requires external solenoids

• 120vac—Water solenoids 2 ea N.C. and 1 ea N.O. / All spring return

Final water connections by Elekta

• Vault slab / Pit inspection. Check location of pit and fascia wall. Answer questions from subcontractors.

• Progress inspection and Site check. Substantial completion—mechanical and electrical rough in complete. Camera and laser structures in place. Fascia wall constructed.

• Final site check—Vault and Control room 100% complete, dust free, all utilities operational. Permanent power and chiller fully operational. Hard surface of Staging area.

• If the site passes final site check, equipment will be delivered the following week.

• If site check fails, a later date for installation will be determined by the Elekta Project Manager.

Site inspections and expectations To avoid missing customer delivery dates, Elekta Site Coordinators conduct site checks

The Project Manager will hold a call with the Customer, Contractor, and Site Coordinator while we are onsite for any inspection. This will help to review construction progress and determine if there are any deviations from the construction timeline.

Additional contractor expectations

• Finished floor protection in vault (if applicable)

• Water connections on 3rd day of install

• Power connections on 3rd day of install

• Fascia wall trim to cover gap

• Trim table pit floorboards to fit and cover

• Laser Door Holes (if applicable)

NOTE: Elekta is responsible for disposal of crates and packing from Linac delivery

Cabinet

Final inspection—vault condition

How does Elekta get it into the room?

Linac Delivery Day

Delivery and Rigging

Linac Delivery Day Prep-staging area

• 50 crates

• Weather considerations

• Trash removal

Loading the gantry onto the carrier chassis

Door dimensions are critical

The gantry drum is lifted into place

Beam arm is 11’ 7” long— check pathway

Table base anchored in pit

Add table to base unit

Install tabletop

Fit and finishes after Elekta delivery

The fascia panels are supported by a tubular frame, installed by Elekta

Add floor finishes to table pit cover

Add floor covering to boards and center dial

Trim Elekta-supplied floorboards to fit

Typical laser enclosure and mounting plate (Hole to be drilled in door after laser is installed)

Elekta treatment system

• Toolbox delivery—Confirm main contact and address − After final site inspection, dolly incl, 2500 lbs, must be secured

• Equipment rigging and crate disposal − Morning of the delivery

• Installation of Linac

• Installation of MOSAIQ connectivity to Linac

• Acceptance documentation to client physics

• Applications training

• Warranty and service support

− Acceptance is a trigger of warranty and support

Reminder: Elekta responsibility

• ELEKTA Ready Vault − Site inspection expectations − Site inspection checklist − Electrical and mechanical engineering support at installation start

• Distilled water, control room chair, phone

• IT hardware for MOSAIQ system (scheduling workstations, etc.)

• IT network infrastructure

− LAN or Citrix, must be at least 3 MB, dedicated network speed

• Physics acceptance and commissioning (estimated up to 4 weeks)

• IntelliMax network security solutions preparations

• Radiation survey

Reminder: Client responsibility

Next steps

• Staging area/Rigging path review

• Establish communication plan

• Finalize Elekta timeline

• Review invoicing terms and expectations

Thank you