Health care is one of the top five energy consuming building categories (8% of the total usage) in the United States, where it consumed about half of the energy consumed by all commercial buildings in 2012 (EIA, 2018).

Executive Summary

Introduction and Background

Healthcare facilities end up consuming huge amounts of energy due to the technologically advanced machinery and equipment, certain temperature regulations (regardless of outside climate) of a huge space. Health care is one of the top five energy consuming building categories (8% of the total usage) in the United States, where it consumed about half of the energy consumed by all commercial buildings in 2012 (EIA, 2018). Large hospitals that are bigger than 200,000 sq ft. generally run twenty-four hours a day, and every day of the year that require many energy intensive activities such as the use of motorized equipment (it was reported that around 31% to 75% of the total energy is consumed by electrical motors in quite a few places around of the world (R.Saidur, 2010)) , heating or cooling, laundry, lab equipment, sterilization along with ventilation systems that all cumulate to a big amount of energy being used. These large hospitals account for less 1% of all commercial buildings yet consumed 4.3% of the total energy used by the commercial sector in 2003 (EIA, 2012). A survey done in 2015 to track hospital’s carbon footprint with 137 participating facilities shows that an average U.S. hospital pays around three dollars per square footage for energy (Kaften, 2017). 

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In 2007, it was reported that a large hospital uses about 485 trillion Btu of energy (EIA, 2012). The study showed natural gas as the most prevalent fuel used (about 208 trillion Btu) for space heating, cooling, water heating and cooking. 92% of all the hospitals surveyed used electricity to power air conditioning equipment. Moreover, fuel oil was used for electricity generation in these hospitals for emergency back-up generation as they need a secure and reliable source of electricity (EIA, 2012). Another substantial source of energy usage in these hospitals is lighting. This is because of how hospitals are open twenty-four hours a day along with the lights in the facility. In five different areas of the United States, 12 to 20% of large hospitals’ total energy usage was due to lighting (EIA, 2018).

This is an important area of concern not only because of environmental issues involved but also because of the sheer cost involved in this kind of major energy consumption. In the United States more than 6.5 billion dollars is spent on energy by health care facilities every year (Chambers, 2011), with an average individual hospital spending around 680,000 dollars per year. As many hospitals are non-profit organizations, if energy costs continue to exist at this rate – hospitals won’t be able to afford other costs or improvements particularly those that have smaller amounts of funding, such as those not affiliated with universities. Therefore, many hospitals have begun to research and implement different measures to reduce energy consumption and cost.

Discussion of the Issue:

Many large hospitals all over the country have already started implementing small, simple practices to reduce energy consumption. This has been driven by hospital management, which sees the need to reduce energy costs in order to allocate funds to patient care rather than energy costs. A method to reduce energy costs is to fix any equipment that does not operate at maximum facility.

This practice is known as ‘existing building commissioning’ which includes weather stripping windows and doors for protection against extreme climates, installing low flow water fixtures, setting lights on a time system (so they are turned off when not in use) and repairing and installing new cooling and heating systems. These steps were taken with maximum efficiency in mind so that the building is using the least amount of energy without wasting any. Without these, the hospital was using more energy and spending more money than truly necessary. Evidence from EIA shows following ‘existing building commissioning’ may reduce 20% of the energy costs. Moreover, in a report by the EIA shows different energy management and conservation plans employed in hospitals to save energy – 99% of the building in the study have regular HVAC maintenance and repair scheduled, 93% of them use daylighting or lighting conservation features, 90% use CFLs, 40% use LEDs, 76% have economizer cycle and 88% have and multi-layer glass windows (EIA, 2012).

In Massachusetts General Hospital (MGH) lighting and other electric loads like plugs used 21% of the building site energy and has a site EUI of 86.2 KBtu/ftyr which is the site energy use intensity  (Michael Sheppy, 2014). Lighting is the second highest consumer in MGH while in SUNY UMU lighting is the third highest consumer of energy with a site EUI of 28.9. One of the ways this can be improved is by completely replacing their lightbulbs to LEDs which makes it very efficient and reduces a substantial amount of energy needed for lighting. Cleveland Clinic, which is a twenty-four billion square foot hospital in Ohio, replaced around a thousand light bulbs and found that in conjunction with existing building commissioning saved around 825,000 dollars per year by reducing the energy usage by 135,000 MMBtu (RetroFit, 2017). Another way hospitals can benefit from energy savings is by installing LED exit signs as they would only use 44 kWh energy per year and use less than a third of the energy consumed by fluorescents (140 kWh) and around seven times less than incandescent (US Department of Energy , n.d.). Therefore, for typical six hundred bed hospital, replacing around three hundred 36W exit signs with 5W LED signs would result an annual savings of about fifteen thousand dollars. Assuming each sign costed around 57 dollars each, then the total cost for this would be 17,100 dollars and has a payback time of about 1.15 years (US Department of Energy , n.d.). This is a pretty quick turn-around time which proving it to be a pretty good investment.

Another effectively and substantially save energy is by repairing and replacing air conditioning and heating systems, including water heating systems. Considering, heating and cooling systems are one of the largest sources of energy consumption in large hospitals, it’s another area most people focus on. Repairing or upgrading these systems to make them more efficient can reduce a lot energy usage. In a case study on the University of Minnesota Medical Center, in 2013 the current hot water heating system was replaced with an “on and off” model, which automatically turned off the system when no hot water was needed or used. Also, the hospital repaired ventilation system and leaked valves for heat control. This contributed to a total energy savings of about $180,000 a year. Danbury Hospital, Connecticut hospital installed additional insulation to reduce their reliance on electric heating systems, upgraded their air conditioning and water heating systems, and also reduced their need for a separate heating power plant by combining it with their already existing general power plant. This reduced their energy use by approximate 100,000 MMBtu per year, and saved the hospital almost 3 million dollars annually (US Department of Energy, 2013). 

Besides upgrading and replacing existing equipment, some hospitals have chosen to turn to renewable energy sources, including solar and wind power, driven by energy cost savings. The Kaiser Permanente health system, which operates hospitals and medical facilities at several locations, is a major example of this. Kaiser Permanente has started using solar and even wind power over the past several years to provide energy for its hospitals. An example of this is at Santa Clara, California’s Kaiser Permanente hospital. In 2011 several large solar panels, 110 MW of solar (Donge, 2015), were installed on the roof of the hospital. These solar panels will provide about 8.5 percent of the daily energy consumption of the hospital; this is one of the highest amounts of solar power a hospital uses in the United States (Burger, 2018). Kaiser Permanente is also looking to incorporate wind power in addition to increasing its investment in solar power. In early 2015, the health care system purchased 43 megawatts (Donge, 2015) of wind power from the renewable energy project developer, NextEra Energy Resources, as well as several hundred megawatts of solar power. Several off site wind turbines were used to generate power for Kaiser hospitals. This should generate enough power to cover 40 percent of the 1.6 terawatt hours of energy used by Kaiser Permanente in a year in conjunction with solar power. Moreover, Sunnybrook Health Sciences Center is another hospital that strives to become environmentally friendly. The facility recognized that hospital operating rooms are a source of greenhouse gas emissions due to the large amounts of anesthesia being used. The use of anesthesia can result in volatile ethers being released into the environment, which contributes significantly to global warming (Hina Gadani, 2011). The anesthetic agents used today are volatile halogenated ethers and nitrous oxide (the carrier gas) is an aggressive greenhouse gas. The department of anesthesiology worked with environmental engineers to develop a system for capturing excess gas in operating rooms. This gas is then sent to a plant where new anesthetic gas can be incorporated. This has prevented more than 474 tons of carbon dioxide equivalent amount into the environment.

Bibliography

Chambers, N. (2011, August 17). Green Healthcare Could Save Billions of Dollars.

EIA. (2012). Energy Characteristics and Energy Consumed in Large Hospital Buildings in the United States in 2007. Retrieved from https://www.eia.gov/consumption/commercial/reports/2007/large-hospital.php

EIA. (2018, September 28). Energy Use in Commercial Buildings . Retrieved from https://www.eia.gov/energyexplained/index.php?page=us_energy_commercial

Kaften, C. (2017, February 22). Average U.S. Hospital Pays $3/Square Foot for Energy. Retrieved from Energy Manager Today : https://www.energymanagertoday.com/average-u-s-hospital-pays-3-per-square-foot-energy-0167446/

Michael Sheppy, S. P. (2014). Healthcare Energy End-Use Monitoring. Retrieved from National Renewable Energy Laboratory (NREL): https://www.energy.gov/sites/prod/files/2014/09/f18/61064.pdf

R.Saidur, M. S. (2010). An end-use energy analysis in a Malaysian public hospital. Energy, Volume 35, Issue 12 , Pages 4780-4785.

RetroFit. (2017). Project Case Study: Cleveland Clinic. Retrieved from https://rmi.org/wp-content/uploads/2017/04/Pathways-to-Zero_Cleveland-Clinic-Retrofit_Case-Study_2012.pdf

US Department of Energy . (n.d.). Energy-Efficient Hospital Lighting Strategies Pay Off Quickly. Retrieved from https://www1.eere.energy.gov/buildings/publications/pdfs/alliances/hea_lighting_fs.pdf