What is the difference between IRT and ESS IRT

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The E.S.S is the main feeder.
We are adding 4 277/480vpanels from 3 different systems in a main electrical room. I am going to assume this is what is meant, then we have 4 120 208 panels and transformers. I will assume that is the second IRT.

Next question is there is a grounding effectiveness test as well as a ground rod test. These seem to be the same thing when looking at the procedure for doing both.

Am I wrong?
 
Next question is there is a grounding effectiveness test as well as a ground rod test. These seem to be the same thing when looking at the procedure for doing both.

Am I wrong?
They are not the same thing, and I don't know where ground rod testing would come to play in hospital commissioning.

The receptacles and electrical equipment in patient vicinities have to have an impedance of no more that .1 ohm, it takes a special analyzer or apparatus to do the testing, here is an illustration and values that must be achieved.

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