A shift in thinking - A healthy hospital that saves money

---

At the recent Hospital and Healthcare week I caught up with Professional Engineer Rick Rome (WSP/PB + ccrd). After his presentation, US Case Study: A Comparison of Two Hospitals Methods of Success, Rick and I discussed his passion for creating healthy hospitals that are both financially and environmentally sustainable.

---

 
Rick has been involved in many large scale international hospital builds and expansions. He has seen both new and existing facilities realise significant cost savings through energy efficiency and in many cases it’s just about a shift in thinking.
“I know it’s somewhat ironic coming from the firm that has done two out of the three LEED platinum hospitals in the world, but I think too many times people involved in hospital infrastructure get lost in the paperwork and forget why they are doing this. The real reasons are that we are trying to create environments that promote patient wellness and help the caregivers operate more efficiently and we want to do this in a way that saves money,” he said.
He continued, “The one real statistic that always jumps out is ‘one dollar saved on energy could mean between 25 to 35 dollars of revenue that the facility doesn’t have to produce. This requires a long-term view and an understanding that by saving energy you are actually doing things that will allow you to be a better health care provider.”
According to Rick, energy efficiencies do not only apply to new builds. Significant cost savings and environmental gains can be made in existing facilities. One of the chief factors in determining life cycle performance and sustainability of a building design is the building’s overall energy consumption.
“Right now,” he explained, “we are working with a major health system in Toledo, Ohio and we have performed energy usage evaluations on ten of their hospitals and we compare the results with what a hospital should be doing.”
“Firstly, we identify the ‘low hanging fruit’ or the areas where they can achieve tangible savings within a six month to two year period. And these factors are usually controls-oriented and involve adjusting set-points,” he said.
Rick continued, “Say for example a hospital has an air handling unit with a discharge air temperature set-point of 9 degrees C. This can be adjusted up to 13 degrees C for a significant portion of its operating time. Running the cooling coils in these units causes significant electrical usage and cost. Many facilities set their discharge air temperature to one point and walk away. Rooms do not always need to be cooled all day to the same degree and through the use of simple software, cost savings can be realised quickly by using simple reset algorithms,” he said.
Rick delivered his presentation to a rapt audience at the Hospital and Healthcare Week conference and I asked him how he chose the material for his presentation.
“We were the design engineers for the greenfield site Dell Children’s hospital and the expansion of Phoenix Children’s hospital in the US,” he said.
“I decided to focus on these projects in my presentation because they chose different routes to demonstrate the advantages of sustainability. Dell Hospital was a new build with a large donation base that set out to show the world how the first LEED Platinum hospital could be accomplished while the Phoenix Children’s Hospital used sustainability by putting energy efficiencies in place because they ‘have to’ in order to survive in the new world.”
He went on to provide an example of how energy efficiencies were introduced to Phoenix hospital.
“Even in Phoenix Arizona, which has a very high ambient temperature during the day, there is heating required in the hospital environment. We introduced a heat pump chiller for the primary cooling equipment which then rejects the heat from the building into the heating water system which provides domestic hot water for the patients and kitchen.
It is a great heat recovery method that reduces the natural gas consumption of the facility and lowers the carbon footprint. And since we are not evaporating water thru cooling towers to reject the waste heat to the atmosphere, we saved over 24,000,000 litres of water per year. A win-win situation. It saved Phoenix Children’s over $500,000 US the first year alone,” he said.
I asked Rick how important he feels the certification process is for green buildings.
“The one thing to consider with putting sustainable practices in place in a facility is to understand that the certification process is only the beginning,” he said.
“When systems are installed in a hospital or aged care facility, you need to keep operating those systems in the manner they were designed to achieve results. In the end it is not about the piece of paper; it’s about saving energy and keeping your operating costs down so you can spend more money on a new MRI,” he explained.
Rick firmly believes that if procurement methods are capital cost driven they do not allow facilities to think long term.
“If it’s all about getting it built for the lowest dollar,” he said “this can have an adverse effect on hospitals’ viability into the future.”
Rick advises that the hospitals he sees who take a close look at how their energy is being managed and take simple steps to ensure they are working as efficiently as possible, are not only seeing financial returns within six months to three years but more importantly, they are future-proofing their hospitals against the challenges of an increasingly competitive marketplace.

---

“The one real statistic that always jumps out is ‘one dollar saved on energy could mean between 25 to 35 dollars of revenue that the facility doesn’t have to produce.”

---

 

FAST FACTS

• Energy efficiencies do not only apply to new builds. Significant cost savings and environmental gains can be made in existing facilities.


• One of the chief factors in determining life cycle performance and sustainability of a building design is the building’s overall energy consumption.


• The certification process is only the beginning. It is not about the piece of paper; it’s about saving energy and keeping your operating costs down


• Hospitals taking simple steps towards energy efficiency will see returns in 6 months to 3 years and future proof themselves against the challenges of a competitive market.

 


Summary of systems recommendations report

 
 
 

System Improved
Budget Cost Estimate
Potential Energy Savings (Per Year)

Building Management System
 $                  72,000
 $                34,000

Heating/Chilled Water Systems
 $              3,75,000
 $            1,10,000

Steam System
 $                  30,000
 $                  8,000

Air Handling Systems
 $              2,00,000
 $                35,000

Total
 $              6,77,000
 $            1,87,000

Simple Payback
3.6
years

 
Rick Rome
Executive Vice President, WSP/PB + ccrd
Mr Rick Rome serves as Executive Vice President of WSP/PB + ccrd and is director of the USA Healthcare Market Sector for the company. Additionally, he co-chairs the WSP/ PB Global Healthcare Committee and is active in healthcare project designs around the world including the UK, the Middle East and Asia.
Mr Rome has been the Principal in Charge of over 1,000,000 square meters of healthcare facility designs over the past seven years including the King Fahad Cancer/Proton Beam Therapy Centre in Riyadh, the LEED Platinum awarded Dell Children’s Hospital in Austin, Texas and the renowned Phoenix Children’s Hospital in Phoenix, Arizona