There are some building types and/or organizations that are nearly always undergoing some sort of facility upgrade, modification, and/or expansion to accommodate evolving needs. Health care facilities are the first to come to mind, with renovations required due to new technologies, new services, changing patient demographics, growing populations, and/or simply aging infrastructure. Other examples of organizations with ever-changing facility needs include colleges and universities, high-technology industries, and museums.
Because of the constant churn of projects at these organizations, they were the first to embrace commissioning 20-25 years ago as a means to successfully and efficiently achieve their project goals. They simply didn’t have time to “work out the kinks” over a few months or years on one project because they were already working on the next project.