Understand Where Energy Is Used To Maximize Benefits Of Healthcare Efficiency Efforts

Understanding both performance and where energy is being used is also the first step to identifying low- and no-cost strategies for improving efficiency — strategies that can show upper managers how much can be done with no or little money, and therefore how much more can be done with a little bit more.

"When matching performance to demand, you have to understand the use of the facility," says Della Barba. As one example, he says, hospitals are thought of as 24/7 facilities, but only about 30 percent of the facility is actually 24/7. The rest is supplemental services, labs, office space, clinics, etc. Therefore working with the people who occupy those spaces, and understanding how those spaces use energy, can reap huge rewards. For instance, says Della Barba, it's pretty easy to change setpoints, start and stop times, and lighting levels in space that isn't being used. "Talk with doctors and nurses," he says. "Find out what times they really use the facilities. This way, they really feel like contributors; that they're helping put money towards the bottom line in other ways than just patient care."

King says most people understand the importance of turning off the lights, but it's more important for facility managers to help them understand how the building behaves and why it's been designed to behave that way. It's another strategy that helps non-facility personnel have a stake in the building's performance. What's more, the understanding and support of non-facility folks can be an immense augmentation to a facility manager's credibility when it's time to make a case.

One misconception about energy efficiency, says Della Barba, is that if a facility is relatively new, there is little opportunity for improvement. Indeed, he says, in his experience, "most of the opportunities for optimization are in new facilities, four to five years old with sophisticated automation systems." There is always a lot of opportunity in controls, he says — especially if setpoints have been overridden for any number of reasons: equipment failures, emergency repairs, or retrofits, for example. Re-optimizing controls can make a huge impact on efficiency, he says.

Remove The Competition

Another strategy Della Barba says he's seen be successful is simply to remove yourself from the competition for funds. Of course, this is easier said than done, but Della Barba relays the story of one facility manager who was able to make several energy efficiency improvements based on suggestions from a retrocommissioning effort. The contract was structured such that payments could be spread out, and then essentially made out of the operational savings from the improvements. Della Barba says the facility manager was delighted: "Competing for money in a hospital is difficult. But with this program, he shaped it so we could delay payments to match up with the realization of savings." This effectively took the facilities team out of the competition for funds because it was using money it already had, essentially.

If it's not possible to remove the competition, however, at least ensure you're making your case on as level a playing field as possible. King suggests one way to do this is to present energy efficiency not in a project-by-project, piecemeal fashion, but as a long-term strategy inseparable from the objectives of the business. "Use energy efficiency as a way to help the organization's goals," he says. Two main goals for Kaiser Permanente, he says, are affordable healthcare and being responsible to the environment. Energy efficiency as a long-term goal does both. "Nail down the organization's commitment, and that will guide your energy strategy," he says. "It's extremely helpful to establish a goal."

With the idea of long-term efficiency goals firmly in mind, Kaiser Permanente has begun investing heavily in renewable energy. The organization, to date, has installed solar in 13 locations in California and the Northwest, generating 17 million kWh of electricity annually.

"We've been pretty aggressive with our alternative energy strategy, because alternative energy has been largely unexplored in healthcare," says King. "We use purchase models like power purchasing agreements so there's no up-front capital." The alternative energy strategy, then, both helps the organization's long-term energy strategy, as well as removing these upgrades from the competition for funds because of the way they're financed, an important lesson for all facility managers, says King.

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