A positive diagnosis: How hospitals are reducing energy consumption

Rocky Mountain Institute

A positive diagnosis: How hospitals are reducing energy consumption

Hospital photo by VILevi via Shutterstock

With the media attention paid to the rollout of the Affordable Care Act (aka Obamacare), it's easy to miss a related, if seemingly mundane, development: the recent release of the U.S. Department of Energy's "Advanced Energy Retrofit Guide for Healthcare Facilities." Of all the challenges facing the nation's health care system, one of the most pervasive -- yet solvable -- is its overwhelming energy consumption. U.S. health care facilities spend $8.8 billion per year on energy.

Connecticut's Greenwich Hospital was one facility contributing to that colossal number. On the U.S. government's 1-100 rating scale for Energy Star, Greenwich Hospital scored a disappointing score of 47, falling far short of the 75 required to garner an Energy Star designation. The hospital implemented a deep energy retrofit and the results [PDF] speak for themselves: Greenwich saved more than 1.7 million kWh and $303,000 of electricity per year, nearly doubled its Energy Star rating to 88, and reduced its overall energy consumption by 35 percent with a less-than-six-month payback on the effort.

According to the "Advanced Energy Retrofit Guide," there are ample opportunities such as this that can lead to savings of more than 30 percent in hospital energy costs. Health care retrofits provide numerous other benefits as well, ranging from improved equipment longevity to decreased patient recovery times to a more attractive brand. Because the value of retrofits isn't limited to just energy savings, demand should be strong.

Co-written by the Rocky Mountain Institute, the National Renewable Energy Laboratory's "Advanced Energy Retrofit Guide for Healthcare Facilities" is part of the "Advanced Energy Retrofit Guides" series, which provides retrofit guidance specific to various commercial property types. The health care guide reveals the significant impact retrofits in this industry can have on energy savings and patient care. 

Energy use in health care facilities

Health care facilities are among the most energy-intensive facilities in the U.S. According to the 2003 Commercial Building Energy Consumption Survey (CBECS), the average hospital spends $675,000 on energy costs annually, exceeding the per-building energy costs of other building types by a factor of 10. The energy use intensity for hospitals is approximately 250 kBtu per square foot, ranking just behind the food-service sector. To put that in context, the energy use intensity of hospitals is nearly three times that of a typical office building.

The energy cost savings potential in health care facilities ranges from 10 to 32 percent, according to an analysis completed of "typical" facilities in five climate zones. The "Advanced Energy Retrofit Guide for Healthcare Facilities" analysis breaks this savings potential into two steps: 

1. Fix what isn't working correctly. This is known as "existing building commissioning," or EBCx. EBCx consists of developing a detailed understanding of a building's systems and operations, followed by targeted upgrades and changes to optimize those systems. These upgrades can include improvements in operation and controls for the building envelope, lighting, plug loads, space heating and cooling, ventilation and water heating. Limiting these improvements to those that are both widely applicable and cost-effective, the "Advanced Energy Retrofit Guide for Healthcare Facilities" shows that EBCx can reduce energy costs 6 to 12 percent within a set of sample facilities. 

2. Upgrade multiple systems. Beyond commissioning the existing system, building retrofits that replace equipment and components offer even more opportunities for health care facilities looking to reduce their energy consumption. Although individual retrofits can produce significant savings on their own, complementary benefits can be gained by upgrading multiple systems. As noted in the report, "if lighting and HVAC systems are replaced, the HVAC system designer can take into account the reduced cooling load achieved by the lighting retrofit, resulting in a smaller cooling system."

Although retrofits can require significant capital investments, these projects become financially attractive if timed to coincide with other deadlines or requirements. For example, purchasing an energy-efficient furnace becomes much more financially attractive if the hospital's furnace is scheduled to be replaced anyway. Considering only simple and cost-effective measures, the "Advanced Energy Retrofit Guide for Healthcare Facilities" presents a recommended retrofit package within sample facilities that reduces energy costs up to 21 percent in addition to the EBCx savings.

Retrofit benefits

Well-planned and executed retrofits can create significantly more value than the energy cost savings. Analogous to the simple maintenance activities you can do with your car, the simple, low-cost efforts of EBCx not only make expensive equipment run more efficiently, but also increase the equipment's life.

Retrofits that improve the air quality of the hospital or introduce daylight into patient rooms, for example, can deliver even greater values in both cost and quality of care. The Lawrence Berkeley National Laboratory documented that air quality improvements can reduce the transmission of airborne illnesses within hospitals. In addition, multiple recent studies have found a decreased length of stay for patients in rooms with daylight compared to artificial lighting. The Economics of Biophilia report [PDF] by Terrapin Bright Green indicated that if all patients in the U.S. recovering from major surgeries had access to daylight, the reduced time at the hospital would amount to an annual savings of $93 million (and who doesn't want to go home from the hospital sooner?). 

Attractively daylit and well-ventilated hospitals with a low-carbon footprint additionally may attract skilled doctors and nurses seeking a more comfortable and productive workplace. Moreover, we live in an era of patient empowerment, one in which they can choose where and by whom they'll be treated. In this era, "green" hospitals may become one deciding factor alongside traditional factors, such as the reputation and track record of the physician doing the procedure.

For example, Gundersen Health System has developed an entire program branded "Envision" that demonstrates its commitment to a clean energy future and 100 percent energy independence. Last year, health care giant Kaiser Permanente committed to a 30 percent carbon emissions reduction by 2030; this year, Kaiser announced that it will seek LEED certification for all new hospitals and major construction projects. Such audacious commitments tend to shape public perceptions about an organization's brand.

While the health care industry currently wastes an enormous amount on energy costs, it appears that the demand for cost-effective energy savings is growing. The "Advanced Energy Retrofit Guide for Healthcare Facilities" will help meet that demand and accelerate the trend.

Hospital photo by VILevi via Shutterstock