Sustainable Healthcare

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Sustainable Healthcare
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Sponsored by
CENTER FOR MAXIMUM POTENTIAL BUILDING SYSTEMS
The Corporate Realty, Design Management
Institute
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The GGHC builds on LEED by addressing the
particular structural, usage, and regulatory
challenges of healthcare buildings and by
emphasizing the environmental and public health
issues that comprise an important part of what it
means for a healthcare institution to address
sustainable construction. Unlike LEED,the GGHC
is structured as a self-certifying system.
What are Green Healthcare Facilities?
buildings that are environmentally responsible,
profitable, and healthy places to live, work and
heal.
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The Green Guidelines for Healthcare Construction
seek to reward organizations that strive to
engage in environmental stewardship, and that
lead the healthcare industry toward high
performance healing environments
sustainable
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Section PreReqs - Points 1 Integrated
Design and Operations 4 - 0 2 Sustainable
Sites 1 - 20 3 Water Efficiency 1 - 12 4
Energy Atmosphere 3 - 22 5 Materials
Resources 2 - 25 6 Indoor Environmental
Quality 4 - 23 7 Innovation 0 - 4
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LEED for Healthcare Application Guide

• Volunteer committee at work to develop
  application guide that will support healthcare
  facilities registered under LEED-New
  Construction.

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Green Guidelines for Healthcare
Construction www.gghc.org Download the draft
now Register for version 1.0 Pilot - September, 04
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US Population by Broad Age Groups
Source US Census Bureau
Demographics Drive Demand
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Acute Care Admissions To Increase 41
65 account for 40 Admissions49 Beds
65 account for 51 Admissions59 Beds
Source Solucient
Demographics Drive Demand
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46 More Hospital Beds Are Needed
Source Solucient
Demographics Drive Demand
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Yet Capital Spending Is Not Keeping Up

• Between 1997 and 2001
• Inpatient Admissions Rose 7.7
• Outpatient Visits Increased 19.6
• Capital Spending Increased Only 5
• 41 of Medical Institutions Are Not Spending
  Enough to Keep Ahead of Asset Depreciation

Source Hospital Financial Managers Association
Source IFMA HCC CRDMI Survey
Demographics Drive Demand
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Healthcare Impact on Energy

• The Big Numbers
• 3 - Buildings
• 4 - Floor Space
• 8 - Energy Consumption
• Energy Consumption/SF
• Inpatient 179,400 Btu
• Outpatient 79,000 Btu
• Energy Intensity/SF
• Thermal 5.6 kWh
• Lighting 11.5 kWh

Data Source DOE
Environmental Impact
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Medical Waste

• Hospitals produce 2 million tons of solid waste a
  year
• 15 pounds per patient daily
• 85 is paper, plastic, food and other materials
• 57 Ton Disposal Fee
• 15 has infectious potential
• 450 Ton Disposal Fee
• 4th largest source of mercury discharge into
  environment
• Mercury is highly toxic
• Medical waste incineration is a major source from
  mercury-containing devices and histopathological
  wastes
• Lamps are another source

Environmental Impact
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Saving Energy Equals Millions in Revenue
Sustainable Economics
Equivalent revenue of 50,000 in annual energy
savings (annual savings divided by net margin)
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Which Earned More Money?
Sustainable Economics
100,000 Invested 1/97 - Amounts shown exclude
return of initial investment
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Lighting For Sustainability

• 75 of healthcare floor space is illuminated 100
  of time
• Design lighting to occupant task - IESNA
  suggestions
• Nurse Station 53 FC
• Patient Room 30 FC
• Task Lighting 50 FC
• Ambient Lighting 25 FC- Offices with Computers
• Maximize fixture, lamp and ballast efficiency
• Use automatic controls
• Optimize maintenance and disposal practices

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Environmentally Responsible Lighting

• 1 - 1970s
• 2 x 4 Fixture, (4) T1234 Lamp8 x 8 Layout,
  24,656 Lamps, 2.9 W/sf
• 2 - Mid 1980s
• 2 x 4 Fixture, (2) T1234 Lamp8 x 8 Layout,
  12,328 Lamps, 1.7 W/sf
• 3 - Mid 1990s
• 2 x 4 Fixture, (3) T8 Lamp8 x 8 Layout,
  18,492 Lamps, 1.4 W/sf
• 4 - Low Mercury Alternative
• 2 x 4 Fixture, (3) T8PLC Lamp8 x 8 Layout,
  18,492 Lamps, 1.4 W/sf
• 5 - Save Energy Low Mercury
• 2 x 4 Fixture, (2) T8PLC Lamp8 x 10 Layout,
  9,862 Lamps, 0.8 W/sf

Total Grams of Mercury
355,000 SF. Building
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Change Lamps At Right Time And Save
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Typical Hospital Building Envelope

• Building Era lt1980 gt1980
• Percent Glass 25 25
• Shading Coefficient .71 .66
• Window U-Value 0.57 0.51
• Window R-Value 1.79 1.96
• Wall R-Value 0.3 6.9
• Roof R-Value 12.3 11.5
• Roof Material Built Up
• On a Sunny Day 95 F
• Dark Roof 180 F
• Window 120 F
• Interior Space 75 F

Source DOE - ORNL
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White Roofs Are Cool

• Nearly half of US population lives or works in a
  heat island
• Dark roofs cause 38 of heat island effect
• On a Sunny Day 95 F
• Dark Roof 180 F
• White Roof 110 F
• Energy Star Roof Criteria
• ? 65 Initial Reflectance
• ? 50 Reflectivity after 3-yrs.
• Roofs are 5-10 of building cost, yet account for
  60-80 of litigation

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White Roofs Are Cool Money Makers
Source DOE - ORNL
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Auditing Operations Maintenance

• Things to Look At
• Lighting
• Building Envelope
• Controls
• Testing, Adjusting Balancing
• Air Handlers, Fan Coils, Baseboard Units
• Heating Cooling System
• Security Systems Procedures
• Housekeeping
• Roads Grounds
• Typical Savings 5-15 Better Performance

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Be Healthy, Clean Safely, Save Money

• Clean for health first and appearance second
• Evaluate products and buy least toxic product
  available
• Selected disinfectants based on purpose and
  efficacy
• Clean, then disinfect
• Educate workers on proper cleaning methods and
  use of hazardous cleaning products
• Take advantage janitorial pollution prevention
  projects

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Is This Your Healthcare Facility?

• Dust Microbial Contamination
• 70 Airborne, 63 Not Visible
• 100 Microns of Dust on Coil Cuts Cooling Capacity
  10
• 20-30 increase in annual energy costs
• Sick Building Syndrome
• Productivity Absenteeism
• Legionnaires Disease
• 50,000 to 100,000 Cases/Year 15 Death Rate - CDC

Indoor Air Quality
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Ultraviolet Germicidal Irradiation - UVGI

• The germicidal wavelengths are located around 254
  nanometers in the UV-C band
• Controls fungi in HVAC systems to reduce or
  eliminate mold-related allergies
• Prevents the development of Legionella and other
  bacteria provides a recognized control strategy
  for tuberculosis
• Predictably reduces the spread of cold and flu
  viruses and other airborne-transmitted diseases

Indoor Air Quality
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Childrens Hospital - SUNY Buffalo

• Neonatal Intensive Care Unit
• Serial bacterial and fungal cultures on HVAC
  system and tracheal aspirate (TA) from intubated
  infants
• Microbes isolated from HVAC system were identical
  to those in NICU and TA
• Pseudomonas, Klebsiella,
• Bacillus and Serratia
• After UVGI was installed total microbial load
  markedly decreased

Source Dr. C. Leach, Dr. R. Ryan
Indoor Air Quality
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Economics of UVGI

• Energy Reduction 112,075 kWh/yr.
• Cost of Electricity 0.1168 kWh
• Energy Cost Savings 13,090
• Maintenance Cost Savings 500
• Total Annual Cost Savings 13,590
• UVGI System Installed Cost 10,000
• UVGI Lamp Annual Replacement 1,350
• Simple Payback .74 Years
• Return on Investment 136

Indoor Air Quality
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How Much Water Do Hospitals Use?
200 Bed Hospital - 18,200,000 Gallons per
Year 300 Bed Hospital - 33,500,000 Gallons per
Year
Water Efficiency
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Where To Save Water and Money Too

• Toilets, sinks, showers
• Film Processors
• Sterilizers - Tempering
• Reverse Osmosis Filter (RO)
• Medical Air/Vacuum
• Lab Equipment Cooling
• Kitchen Equipment
• Water Cooled Ice Machines
• Laundry
• Landscaping
• Cooling Tower Blowdown
• Boiler Blowdown - Tempering

Water2.15 per1000 Gallons
Sewer3.19 per1000 Gallons
Water Efficiency
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