FacilityCare September 2009 : Page 22

Managing Energy Use By Laura Rygielski Preston and Paul Wheeler regulatory requirements, downward pressure on reimbursement rates and rising costs, the current healthcare climate demands improv- ing the quality of healthcare service while keeping operating expenses down. Environment of Care compliance and H process documentation are becoming increas- ingly complicated and rigorous, which drives mandatory investment in operational improve- ments and process monitoring. At the same time, cost-reduction pressure makes further capital investment and additional human resources harder to secure. Every industry, including healthcare, faces the prospect of ris- ing or wildly fluctuating costs for fuel, services, material and employee expenses. In this challenging environment, health- care facility managers must do all they can to ensure that their operations stay healthy financially and operationally despite the chal- lenging economic and operational times. Technologies that provide opportunities to manage and control energy use while still maintaining environments that support care- givers and patients can help in this endeavor. Environment of Care Standards Must Be Met Indoor air quality (IAQ) has a significant effect on patient care and health outcomes. Maintaining healthy air quality is critical to achieving healthcare-setting accreditation by the country’s primary accrediting body for healthcare facilities, The Joint Commission. The Joint Commission defines specific Environment of Care standards and requires 22 | FACILITYCARE facilitycare.com ospitals and other healthcare facilities are working in an unprecedented economic and operating environment. Caught in a perfect storm of increasing detailed emergency plans and backup sys- tems be at the ready in case of building sys- tems failure. Filtration, air exchange rates, positive/neg- ative pressure relationships, temperature, humidity and other redundancies must all be designed into the building. The heating, ven- tilation and air-conditioning systems that control this environment must be operated and maintained to ensure that the proper temperature levels, airflow relationships and outdoor air ventilation rates that support a healthy healing environment remain compli- ant with mandated standards. Ongoing investment in equipment, con- trols and systems improvements, including calibration, maintenance and operations, is required to ensure healthful conditions with- out wasting large amounts of energy. Managing Energy Use Presents Challenges and Opportunities Improving existing building systems in a hospital can be complicated. A single health- care facility normally contains several differ- ent types of occupancies, which presents sig- nificant challenges. Occupancy types may include office and administrative, outpatient clinics, urgent care, operating rooms, laboratories, and criti- cal care environments. Each function has a different set of regulatory requirements relat- ed to air quality, ventilation, temperature, humidity, pressure relationships to related areas, exhaust, lighting levels/controls, etc. Energy is essential for delivering quality healthcare. It constitutes approximately 45 percent of a typical healthcare facility’s oper- ating costs, according to the Consortium for Energy Efficiency, Inc. It is also one of the largest controllable factors in healthcare cost; so, clearly there is an opportunity to drive significant cost reduction if improvements are managed correctly. One opportunity facility managers can take advantage of is reducing the minimum total airflow in administrative offices, dining areas, common areas and many outpatient therapy areas during unoccupied periods. According to The Joint Commission, most local codes allow minimum total airflow in these areas to be reduced to 25 percent of occupied airflow rate requirements, as long as directional control and pressure relationships are maintained and fully occupied status can immediately be re-established when occu- pancy status changes. Of course, taking advantage of this oppor- tunity requires the appropriate application of technology. Variable air volume equipment and electronic controls can ensure that the pressure and airflow relationships between occupancies and the responsiveness of the air-conditioning system to changes in occu- pancy status are recognized and responded to appropriately. Getting Started – Assess Current Performance The energy efficiency of a building is deter- mined by the energy efficiency of the build- ing’s design elements – materials, equipment and controls. The energy assumptions used to design healthcare buildings and systems have changed over time, as have the point-of- use specifications. The energy-efficiency ratings of equipment have changed, as have the requirements for ventilation and the ability to control building conditions. Lighting levels can be adjusted based on outdoor conditions. Fresh air venti- lation and exhaust can be controlled much SEPTEMBER 2009

Managing Energy Use

Laura Rygielski Preston

Hospitals and other healthcare facilities are working in an unprecedented economic and operating environment. Caught in a perfect storm of increasing regulatory requirements, downward pressure on reimbursement rates and rising costs, the current healthcare climate demands improving the quality of healthcare service while keeping operating expenses down. Environment of Care compliance and process documentation are becoming increasingly complicated and rigorous, which drives mandatory investment in operational improvements and process monitoring. At the same time, cost-reduction pressure makes further capital investment and additional human resources harder to secure. Every industry, including healthcare, faces the prospect of rising or wildly fluctuating costs for fuel, services, material and employee expenses. In this challenging environment, healthcare facility managers must do all they can to ensure that their operations stay healthy financially and operationally despite the challenging economic and operational times. Technologies that provide opportunities to manage and control energy use while still maintaining environments that support caregivers and patients can help in this endeavor. Environment of Care Standards Must Be Met Indoor air quality (IAQ) has a significant effect on patient care and health outcomes. Maintaining healthy air quality is critical to achieving healthcare-setting accreditation by the country’s primary accrediting body for healthcare facilities, The Joint Commission. The Joint Commission defines specific Environment of Care standards and requires detailed emergency plans and backup systems be at the ready in case of building systems failure. Filtration, air exchange rates, positive/negative pressure relationships, temperature, humidity and other redundancies must all be designed into the building. The heating, ventilation and air-conditioning systems that control this environment must be operated and maintained to ensure that the proper temperature levels, airflow relationships and outdoor air ventilation rates that support a healthy healing environment remain compliant with mandated standards. Ongoing investment in equipment, controls and systems improvements, including calibration, maintenance and operations, is required to ensure healthful conditions without wasting large amounts of energy. Managing Energy Use Presents Challenges and Opportunities Improving existing building systems in a hospital can be complicated. A single healthcare facility normally contains several different types of occupancies, which presents significant challenges. Occupancy types may include office and administrative, outpatient clinics, urgent care, operating rooms, laboratories, and critical care environments. Each function has a different set of regulatory requirements related to air quality, ventilation, temperature, humidity, pressure relationships to related areas, exhaust, lighting levels/controls, etc. Energy is essential for delivering quality healthcare. It constitutes approximately 45 percent of a typical healthcare facility’s operating costs, according to the Consortium for Energy Efficiency, Inc. It is also one of the largest controllable factors in healthcare cost; so, clearly there is an opportunity to drive significant cost reduction if improvements are managed correctly. One opportunity facility managers can take advantage of is reducing the minimum total airflow in administrative offices, dining areas, common areas and many outpatient therapy areas during unoccupied periods. According to The Joint Commission, most local codes allow minimum total airflow in these areas to be reduced to 25 percent of occupied airflow rate requirements, as long as directional control and pressure relationships are maintained and fully occupied status can immediately be re-established when occupancy status changes. Of course, taking advantage of this opportunity requires the appropriate application of technology. Variable air volume equipment and electronic controls can ensure that the pressure and airflow relationships between occupancies and the responsiveness of the air-conditioning system to changes in occupancy status are recognized and responded to appropriately. Getting Started – Assess Current Performance The energy efficiency of a building is determined by the energy efficiency of the building’s design elements – materials, equipment and controls. The energy assumptions used to design healthcare buildings and systems have changed over time, as have the point-ofuse specifications. The energy-efficiency ratings of equipment have changed, as have the requirements for ventilation and the ability to control building conditions. Lighting levels can be adjusted based on outdoor conditions. Fresh air ventilation and exhaust can be controlled much more accurately. Noise control and acoustics design are now considered by most people to be standard building features. In order to optimize energy efficiency, the first question to ask is whether building systems and controls are operating as designed and whether they are designed to be easily modified, monitored and controlled in order to meet changes in operating requirements in response to regulatory agency mandates. If the system’s designs are not flexible and a retrofit is warranted, incorporating highefficiency equipment and adding controls improvements and monitoring into a system’s renovations plan brings a low-cost side benefit to improved regulatory compliance. If systems are adequately flexible to meet changing regulatory requirements, enterprise- level controls systems can provide improved visibility into systems performance by providing easy-to-use trend information. Assessing utilities consumption requires measuring and comparing performance to a standard. Building systems can only perform as well as they are designed. So, one way to add accountability to a building’s utilities consumption is to track current building performance versus engineering modeling data as a benchmark. Energy performance models are required during the design of modern buildings, and the data generated is used to make engineering and financial cost trade-off decisions. Once buildings and systems are installed, the target data is used to commission the buildings and systems, ensuring the proper installation and calibration of all building components. Recommissioning is a way to readjust the baseline data to current occupancy and operating conditions. Recommissioning can involve modifications to building elements such as windows, window treatments or shading; lighting changes or adjustments; and HVAC adjustments to rebalance and optimize the energy efficiency of the building to a new baseline. This new baseline data can then be used to measure ongoing energy performance and utility consumption. Benchmarking with comparable facilities is another way to obtain comparable energy performance data to check your building’s performance against others with a similar function, design or age. Benchmarking of energy performance is common across all industries, whether healthcare, commercial office buildings, retail, special purpose or high technology. Utilities benchmarking should be more than simple cost comparison. The value of benchmarking is in the comparison of processes and practices in order to learn new ways to adapt your building to more efficient technologies. Managing Energy Use to Deliver Results Remote monitoring and intelligent service applications are maturing technologies that can be used to assist building owners and operators in managing their energy use and optimizing and benchmarking utilities costs. Remote monitoring can be used to optimize equipment and controls functionality at a systems level by remotely detecting substandard performance and either modifying the controls parameters or dispatching appropriate service technicians to implement repairs. The benefits of remote technology in energy optimization can result in 15 to 20 percent improvement in energy use and as much as a 30 percent reduction in service technician field time, according to Jerry McFarlane, director of Trane National Service business group. Five things determine building energy efficiency: design, proper commissioning, ongoing operation practices, timely repair and maintenance practices, and disciplined adjustment/modification. This last determinant of building energy efficiency is best done using controls. Controls are key to making a building work better. Many controls available on the market today are engineered to be userfriendly and help building owners achieve their desired temperature, humidity and ventilation better than any other building system, no matter what the building’s purpose. Controls range from Web-based, enterprisewide, integrated controls systems that can provide flexibility and reduced operating expenses to widely compatible field controllers for building renovations with more basic functionality. Controls that can optimize a system’s performance throughout the life of a building are available on the market today. Instrumentation, building sensors, electronic controls, focused efficiency improvement and effective conservation practices are all a part of an effective energy management program that will enable effective oversight and management of energy consumption. Access to data – whether it is baseline, comparative or remotely acquired – is essential. Managing energy use begins and ends with a vision for the building, business or organization – a vision for the way the building will be used, the efficiency of the systems that will be used to support occupant’s needs, how the building systems will be operated and maintained, how energy use will be measured and reported, and a plan for what has to be done when performance does not meet specifications. Once the vision is deployed, the performance must be managed; otherwise, nothing will happen and the energy efficiency will drift upward. Effective metering and remote monitoring strategies are effective solutions for achieving quality control and ensuring that energy improvements will “hold the gains” as time goes by.

Previous Page Next Page

Publication List