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Research Study Shows How Hospitals Can Reduce Energy Use by Up to 60 Percent With Little Additional Capital Cost

Design Strategies Offer Hospitals an Improved Environmental Footprint and Healthier Workplace for Staff and Patients

SEATTLE — A new study presented at the CleanMed conference in Baltimore shows how hospitals, which account for four percent of all energy consumed in the U.S., can achieve a 60 percent reduction in energy utility use by redesigning the way they use energy. A newly constructed, code-compliant hospital can expect to save around $730,000 a year, according to the report.


All sectors of the medical industry are tackling issues of sustainability as care providers continue to be asked to do more with less. This week at CleanMed, over 800 healthcare industry professionals – including climate experts and top healthcare executives from some of the nation’s largest hospitals – have gathered to address the critical environmental issues facing the health care sector. This study represents one of the latest findings in the ongoing push to green America’s hospitals and build healthier communities.

The most salient outcome of this study is the identification of a process that brings together architectural, mechanical and central plant systems to deliver significant efficiencies. These strategies include heat recovery, daylighting, and thermal energy storage, which when integrated at the very beginning, can reduce up to 60 percent of a new hospital’s energy use. This approach has been modeled for energy use as well as cost of construction and can be implemented for less than three percent of the total project’s cost, a fee that is expected to be recouped through energy savings and utility incentives within the first five-to-eight years of a building’s life.

The study, titled, “Targeting 100! Envisioning the high performance hospital: implications for a new, low energy, high performance prototype,” is the result of the close collaboration of the University of Washington’s Integrated Design Lab and NBBJ, one of the nation’s leading healthcare architectural firms. The study was primarily funded by the Northwest Energy Efficiency Alliance (NEEA) through its BetterBricks initiative. NEEA advocates for changes to energy-related business practices in Northwest buildings. In addition to these parties, the research team also included engineers, general contractors, utilities, hospital CEOs and facilities managers.

Tackling energy reduction in hospitals, which use about 2.5 times the amount of energy as a similar-sized commercial building, is challenging due to a 24-hour operating schedule, health related guidelines and extra commitments on air filtration/circulation and humidity. A complete reassessment of the architectural systems, building mechanical systems and central plant systems was conducted in order to find a code-compliant path that could achieve the highest quality, lowest energy hospital design for the lowest additional capital cost.

“The goal of this research report is to provide hospital executives, architects and engineers with the latest tools available for moving energy efficiency goals forward toward the ultimate goal of carbon neutral hospitals. We also wanted to offer evidence that high energy efficiency goals do not require substantially increased capital commitments,” said Duncan Griffin, NBBJ’s healthcare energy specialist and one of the lead researchers on the study. “The research shows we can integrate these strategies into most new and renovated hospital projects with little cost implications, which eliminates the need for our clients to decide between reducing CO2 emissions and buying an MRI.”

In addition, the study allows hospitals to address the growing demand to reduce their environmental impact and to provide their staff with a healthy workplace, something Geoffrey Glass, director of facility & technology services at Providence St. Peter Hospital in Olympia, Wash., says is a recruiting tool for physicians.

“Physicians get the connection between the environment and health. Doctors want to work in facilities that are achieving these kinds of energy and health performance goals,” said Glass. “This research study sets specific, cost effective and achievable design principles for successfully reducing operational costs and carbon footprints. This report should be required reading for anyone planning to build or renovate a hospital in the future.”

Through a three-year process of energy simulations, iterative hourly load testing, prototyping, cost analysis and peer review, the research team refined a series of energy-reduction design solutions that include strategies like solar and daylight shading controls, in-room environment tempering, vacancy air control, outdoor air supply and heat recovery, heat recovery systems, thermal energy storage and wall and window values.

The biggest breakthrough was addressing the re-heating of centrally-cooled air. It is the largest contributor to wasted energy in a hospital, representing around 40 percent of annual heating energy usage.

“Many of these concepts require departures from standard design and operations practices in hospitals, but they are not necessarily new design ideas, just new to hospital design. What makes the strategies novel is the way they are bundled together using an integrated design process,” says Joel Loveland, director of the Integrated Design Lab at the UW. “The key is to bring design, engineering, utility and ownership teams together as early as the conception phase of the project. When everyone is around the table, from the very beginning, we can start to see the bigger picture of how everything connects and we can then leverage those connections in a way that decreases energy and avoids added risk for the lowest capital cost.”

In terms of carbon dioxide emissions, one average-sized hospital emits approximately 18,000 tons of CO2 annually, so a 60 percent reduction in energy of the same hospital would save approximately 7,800 tons of carbon from entering the atmosphere every year, which is equivalent to taking over 1,300 passenger cars off the road or planting over 300,000 trees.

The study was presented at the CleanMed Conference in Baltimore on May 11, 2010. To read an executive summary of Targeting 100!, click here. The full report, with completed cost estimations, will be available the first week in June. For Energy in Healthcare Fact Sheet, click here.

Study Background:

The study was initiated in 2007 when NBBJ formed a research team of architects, engineers, contractors and hospital owners dedicated to discovering design solutions that would reduce a “typical” hospital’s energy use by half and eventually down to zero. NBBJ joined efforts with UW’s IDL and NEEA’s BetterBricks initiative, which were running a parallel effort related to testing the validity of high performance hospital designs. Solarc Architecture and Engineering and Mahlum Architects also contributed to this study.

Previous research conducted by the UW’s IDL of Scandinavian hospitals showed that a hospital could achieve an EUI of 100 and still provide patients and staff with an exceptional work and healing environment. This study shows that hospitals in the U.S. can also target an EUI of 100 and achieve similar successful outcomes while fully complying with codes.

What does Targeting 100! mean?

Most Northwest hospitals have a total energy use of 270 KBtu per square foot a year. This is called the Energy Use Index (EUI) and is normally reported in units of KBtu/sf./year. Design strategies researched in this study seek to deliver an EUI of 100, the lowest EUI possible, while still fully complying with ASHRAE Standards and regional building codes. Targeting an EUI of 100 will significantly reduce energy and effectively put dollars back into hospitals’ operating budgets.

By conducting a detailed costing of a prototype, the study team found a hospital designed to target an EUI of 100 added up to two percent to the total design and construction upfront costs, when utility incentives were included; three percent if incentives were not included. Payback of these incremental costs would occur within five and eight years respectively.

About NBBJ

NBBJ is a global architecture, planning and design firm with offices in the United Kingdom, North America, the Middle East and China. Its healthcare practice is consistently ranked among top five in the world by Modern Healthcare and the firm has collaborated on six of the top 10 US News and World Report Honor Roll Hospitals, including the Cleveland Clinic and Massachusetts General Hospital. In addition to architects, NBBJ’s healthcare practice is comprised of nurses, MBA’s, economists, energy experts and policy advisors who bring a more complete understanding of how to deliver better health outcomes through design. NBBJ is firmly dedicated to designing sustainable, healthy and performance-driven hospitals and has instituted its own in-house R&D initiative to achieve these goals.

About the Integrated Design Lab at the University of Washington

The Integrated Design Lab (IDL) is an extension of the University of Washington’s College of Built Environments, Department of Architecture. The work of the IDL in the Pacific Northwest is chiefly sponsored by the Northwest Energy Efficiency Alliance’s (NEEA) BetterBricks initiative. The IDL’s mission is to provide regional design team’s access to the best building performance knowledge available, project-by-project support, and education and training on how to design, construct and operate the healthiest, most productive and energy efficient buildings in North America. For more information about the lab, visit http://www.integrateddesignlab.com/Seattle/index.html.

About BetterBricks

BetterBricks is the commercial building initiative of the Northwest Energy Efficiency Alliance, which is supported by local electric utilities. Through the BetterBricks initiative, NEEA advocates for changes to energy-related business practices in Northwest buildings. In this era of heightened appreciation for the impact climate change is having on our environment and our economy, energy efficiency is a crucial component in addressing these issues. On www.BetterBricks.com, find information, tools, training and resources to help buildings make a difference to the bottom line and the environment.

Research Team Quotes

Heather Burpee, lead researcher for Targeting 100!, UW IDL

Seattle, Wash.

“The Targeting 100! research has shown that there are synergistic opportunities for both energy and cost savings in healthcare projects. In other parts of the world we have seen hospitals with remarkable energy efficiency in action coupled with vast opportunities for interior environmental qualities such as daylight and view. Now we know it is possible to attain these goals here and that it costs very little up-front to implement if integrated early.”

Geoffrey Glass, director of facility & technology services, Providence St. Peter

Olympia, Wash.

“Physicians get the connection between the environment and health. Doctors want to work in facilities that are achieving these kinds of energy and health performance goals. This research study sets specific, cost effective and achievable design principles for successfully reducing operational costs and carbon footprints. This report should be required reading for anyone planning to build or renovate a hospital in the future.”

Duncan Griffin, NBBJ healthcare energy specialist/NBBJ’s lead researcher on Targeting 100!

Seattle, Wash.

“The goal of this research report is to provide hospital owners, architects and engineers with the latest tools available for moving energy efficiency goals forward toward the ultimate goal of carbon neutral hospitals. We also wanted to offer evidence that high energy efficiency goals do not require substantially increased project capital commitments. The research shows we can integrate these strategies into most new and renovated hospital projects with little cost implications, which eliminates the need for our clients to decide between reducing CO2 emissions and buying an MRI.”

Mike Hatten, principal, Solarc Architecture and Engineering, involved with the research study

Eugene, Ore.

“With the BetterBricks program’s concept of integrated design, we need to have our primary focus on loads rather than systems. In hospitals, the heating and cooling loads imposed by the systems on themselves are significantly greater than the loads imposed by the building. Once we understood this, it became obvious that alternative system concepts, such as de-coupled systems, were both a load reduction strategy and an efficient system strategy.”

John Jennings, design and construction market manager, NEEA’s BetterBricks initiative

Portland, Ore.

“This is really more than a ‘study.’ It is a real-world design project resulting in full prototype schematics for comparison that can serve as examples for other hospitals around the country.”

Joel Loveland, director of the Integrated Design Lab, University of Washington

Seattle, Wash.

“Many of these concepts require departures from standard design and operations practices in hospitals, but they are not necessarily new design ideas, just new to hospital design. What makes the strategies novel is the way they are bundled together using an integrated design process. The key is to bring design, engineering, utility and ownership teams together as early as the conception phase of the project. When everyone is around the table, from the very beginning, we can start to see the bigger picture of how everything connects and we can then leverage those connections in a way that decreases energy and avoids added risk for the lowest capital cost.”

Jennifer Stout, healthcare market manager, NEEA’s BetterBricks initiative

Portland, Ore.

“A hospital would have to bring in a whopping $18.5 million in revenue each year to get that same $730,000 as net income if the hospital were operating at a four percent margin. But resource cost savings go directly to the bottom line.”

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Posted May 17, 2010

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