Establish Energy Use Benchmarks in Health Care

Imagine you instituted a hospitalwide energy efficiency initiative and spent the next two years fighting and scratching for every kWh saved. Just recently, you finally hit your goal of a 10 percent reduction in energy use, and you're working on your next 10 percent-reduction goal.

Then one day you're informed the hospital has just received a charitable donation, which it is using to purchase a brand new state-of-the-art magnetic resonance imaging (MRI) machine and a computed tomography (CT) scanner, and to build out some vacant shell space to start a new clinic. Within six months, most of your hard-fought energy-use reductions will be wiped out, and you will find yourself re-benchmarking and basically starting over.

Such is life for the health care facility executive — the only constant in health care facilities is change. But that doesn't mean facility executives should throw up their hands in defeat. Despite their notoriety as energy hogs — hospitals have an energy intensity about two-and-a-half times that of normal commercial office facilities, according to the Hospital Energy Alliance (HEA) — health care facilities also offer many opportunities for energy efficiency. Given the disparate sources of a building's energy use, facility executives need to employ a combination of creativity, craft and diplomacy to make a lasting impact on their energy spend.

To know where you're going, you first have to mark your start. "Many hospitals don't have good benchmarking data and can't compare themselves against their own buildings or their peers," says Dru Crawley, team leader, commercial building research and development for the Department of Energy's Building Technologies Program, and head of HEA. "There is a lot of generic information out there on HVAC and lighting energy use, and we don't yet have a good handle on how medical equipment uses energy."

So, first, find out where the starting line actually is. "The first step is just getting utility bills and finding out where the trends are," says Corey Zarecki, efficiency improvement leader at Gundersen-Lutheran, a multispecialty, 6,000-employee health care organization headquartered in LaCrosse, Wis. Zarecki says his organization started about a year and a half ago by collecting three years worth of energy-use data. "We realized very quickly that we need even more information," he says. "So we're putting meters everywhere."

The Hospital Corporation of America (HCA) is also in the midst of a massive initiative to get a handle on its energy costs and look for opportunities to reduce. With 163 hospitals all over the country, and a few in England as well, HCA is the largest private health care organization in the world. HCA is working on an extensive benchmarking and retrocommissioning plan to identify how its hospitals use energy and where capital dollars can be invested to get the most bang for the buck.

"Understanding how hospitals use energy is important in developing a plan to reduce energy use," says Brian Weldy, vice president of engineering and facility management for HCA. Weldy says he estimates that building system loads make up about 70 percent of a hospital's total electricity use, while medical equipment and plug loads use about 30 percent. "Each individual hospital's energy consumption portfolio varies and there are discrepancies between published sources, but a 70/30 split is a good rule of thumb," he says.

The first stage of the retrocommissioning process, says Weldy, is looking at each building's central energy plant and identifying opportunities to recalibrate and optimize systems such as the chillers, boilers and the associated distribution systems. That no-cost strategy alone is expected to save between 5 and 7 percent on energy, says Weldy. From there, the organization will continue by examining everything from its air handlers to its building automation systems for energy-saving opportunities. "If a building is already well-calibrated, then we'll start looking at capital investments as the next step," he says. "It's sort of reverse thinking, but we're trying to spread out the money as evenly as possible over all 163 facilities."

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