Improving Hospital Energy Efficiency

Hospitals use energy…lots of energy. Inpatient hospitals in the U.S. comprise close to 2.5 billion square feet of floorspace and have an annual energy bill totaling upwards of $9 billion dollars. Representing just 2.7% of the total commercial floorspace, hospitals disproportionately consume 7.9% of all the energy used in U.S. commercial buildings. While energy is vital to providing quality healthcare, hospitals use so much energy in so many different ways that inefficiencies are inevitable. The question for hospital facilities managers is “how large are the inefficiencies and what to do about them”. Fortunately, new techniques and technologies make it easier than ever to evaluate hospital energy efficiency. Hospitals: Most Floorspace & Complexity In terms of floorspace, hospitals are the largest of all commercial building types. They are also the most complex combining restaurant, fast food, hotel, laundry, office, warehouse, car parking, outpatient healthcare, data center, public safety and many other types of facilities. Despite the complexity of energy use in hospitals, the only way to improve efficiency is by measuring energy usage. While it’s possible to measure the energy efficiency of individual systems and compare them to similar systems, evaluating overall hospital energy efficiency is challenging. Frequent changes, upgrades and interaction of various systems add to the challenge. New cooking and refrigeration systems, for example, may be more energy efficient than the ones they replace, but will they help or hurt the hospital’s overall energy usage? How does the addition of a parking garage affect the solar load and energy usage? Ultimately, facility managers need to understand, in a macro sense, whether their hospitals are using energy efficiently, or not. Today, there is a simple, effective and free way to evaluate overall hospital energy efficiency and get clues where changes may be needed. ENERGY STAR – Not Just for Appliances A growing number of commercial building facilities managers, including those in charge of hospitals, are using energy efficiency-related tools provided by the U.S. Environmental Protections Agency (EPA). Perhaps the best-known EPA energy efficiency program, ENERGY STAR, began in 1992 promoting energy efficiency for computer hardware and later appliances and lighting. The ENERGY STAR Portfolio Manager (“Portfolio Manager”), is a free, web-based energy tracking and management tool for buildings released in 2000. Portfolio Manager enables the easy comparison of a hospital’s energy usage with a large population of similar building types. An upgraded version of Portfolio Manager released in 2013 included energy use benchmarking tools. As of 2014, nearly 5,000 hospitals, representing some 2.5 billion square feet, were utilizing Portfolio Manager to monitor and improve their energy usage. About Portfolio Manager Using the ENERGY STAR Portfolio Manager starts by simply going online and entering some basic data about a hospital into the program: hospital type, address, gross floor area, number of staffed beds, number of full time equivalent (FTE) workers, number of MRI machines and 12 months of utility bills. Portfolio Manager also includes a wide range of options to refine the definition of the hospital and its services: separate buildings, parking garages, data centers, medical buildings and much more. Not limited to inpatient hospitals, Portfolio Manager manages other types of healthcare facilities, including:

• Ambulatory Surgical Centers,
• Outpatient Rehabilitation/Physical Therapy Facilities,
• Residential Care Facilities,
• Urgent Care/Clinic/Other Outpatient Facilities, and
• Senior Care Community Facilities.

Hospital ENERGY STAR Scores One of the outputs of Portfolio Manager is called the “ENERGY STAR score”. Each hospital in Portfolio Manager receives an ENERGY STAR score between 1 and 100. The ENERGY STAR score is intended to be a fair assessment of energy performance of a hospital relative to other hospitals of similar size, ancillary services, climate and weather. An ENERGY STAR score of 50 means the hospital has energy usage efficiency better than half of the hospitals and worse than half of the hospitals in the database. Hospitals with exemplary overall energy efficiency will have ENERGY STAR scores of 70 and higher. Calculation of an ENERGY STAR score for a particular hospital begins with a statistical analysis of like hospitals in the EPA’s national database of hospitals. The analysis identifies and normalizes those activities significantly affecting energy usage of hospitals such as multiple MRIs or large data centers and then predicts the optimum energy usage of the hospital of interest. The optimum energy usage prediction is compared to actual energy usage of the specific hospital to yield a 1 to 100 percentile ranking of energy efficiency relative to other hospitals in the database. Data for hospitals is collected by the American Society for Healthcare Engineering (ASHE) which is a personal membership society of the American Hospital Association (AHA). For hospital facilities managers, a small investment of time putting data into Portfolio Manager delivers a good estimation of overall energy efficiency relative to other hospitals. Putting more information and detail into Portfolio Manager yields even more accurate results, but there is another way to measure energy efficiency. Benchmarking & Energy Use Intensity Benchmarking hospital energy usage is another powerful feature of Portfolio Manager. Where the ENERGY STAR score is relative to other hospitals, benchmarking is specific to an individual hospital. As monthly utility bills come in and facilities and operations evolve over time, benchmarking makes it easy to monitor changes in a hospital’s energy usage. To facilitate benchmarking, Portfolio Manager automatically calculates what is called the “energy use intensity” (EUI) for each hospital. EUI is specific for a hospital and is calculated by dividing the hospital’s total annual energy consumption (e.g. kBtu) by the gross hospital floorspace (square feet). Measured in kBtu/sq. ft., Portfolio Manager makes it easy to compare EUI with that of other hospitals. Ways to Improve Energy Efficiency With more knowledge about their hospitals’ energy efficiency, it is easier for facilities managers to determine if and what type of performance improvement measures (PIMs) are in order. Some PIMs may be handled by in-house staff such as lighting or thermostat upgrades. Larger and more complex PIMs generally require outside help for engineering, installation and startup such as with a combined cooling-heating-power system. For larger energy PIMs, hospitals should consider all options including design, build, operate & maintain (DBOM), project financing, federal, state and local energy efficiency incentives, energy purchase agreements and even demand response alternatives. Energy service and product providers with the resources to bring all of these options to the table would make can often deliver large PIMs on a more efficiently and cost effectively. Contact Equans MEP to discuss a review of your facility’s energy efficiency options.