Energy Savings in Health Care

1. Energy Savings in Health Care 2012 ASHE Conference Recap of the following sessions • VA Medical Center Low Cost / High Impact Energy Program Successes • How Public Competition Spur Energy Savings in Health Care • Excellence in Healthcare Facility Management: Defining World Class Care

2. VA Medical Center Low Cost / High Impact Energy Program Successes John Stenger (Director of Healthcare Engineering, U.S. Department of Veterans Affairs) Robert Anselmi (Network Energy Manager, U.S. Department of Veterans Affairs) William Hudson (Manager, U.S. Department of Veterans Affairs) Janes Larson (Network Energy Manager, U.S. Department of Veterans Affairs)

3. How Public Competition Spur Energy Savings in Health Care Clark Reed (Director of Healthcare Facilities Division for ENERGY STAR, U.S. Environmental Protection Agency) Gary Byrum (Director Project Management, HCP Inc.) John D`Angelo (Senior Director, Cleveland Clinic) Jeffrey Hunt (Senior energy Consultant, Ridgecrest Energy Advisors St. Mark’s Medical Center

4. Excellence in Healthcare Facility Management: Defining World Class Care Michael Hatton (System Executive, Memorial Hermann Hospital) Lona Canada (Corporate Manager of Healthcare Business Development, Trane

5. Getting Started • Know where your at • EPA Energy Star Energy Performance Rating (Priority focus on use over Award) • Building #1 – 76 • Building #2 – 50 • Building #3 – 73 • Building #4 – 46 • Building #5 – 26 • Building #6 – 21 • Building #7 – 69

6. Getting Started • Know where your at

7. Getting Started • Know where your at

8. Getting Started • Know where your at

9. Getting Started • Tap the power of people • Engage Senior Leaders • Energy use as part of the decision making for new and renovation projects • Support for conservation projects • Support best practices • Support operational changes • Support commissioning • Support retro-commissioning

10. Getting Started • Tap the power of people 2. Energy Team • Engage Employees • Nurse – to – Nurse • Doctor – to – Doctor • Ect • What does energy do for patient outcome • Employee day – to – day action • Use steps – vice – elevators (energy + health) • Turn off lights in bathrooms, storerooms ect when departing

11. Getting Started • Tap the power of people • Energy Team d) Bench mark • Collect data • Set goals • IAW the V.A. Medical Center’s low cost / high impact program they determined the following break down of BTU’s • Facility – 28% • Boilers, Chillers, Pumps & Air Handlers – 72% • Keep an eye out for innovation

12. Getting Started • Tap the power of people • Energy Team • Award Submission “Tips” • Share energy benchmarking journey • Key milestones • Success / Failures • ENERGY STAR Ranking / Improvements • Monthly / Annual BTU / SF Comparisons by Facility • HVAC Hot / Cold Trend Graph

13. Getting Started • Tap the power of people • Energy Team j) Team Education (Success will slip away) • Staff Turnover • “Hogging” the Knowledge • Basic education (HVAC & Building Science) • What is Not working • Recognize failures as a learning tool on the path for improvement • Continuous process monitoring • Expect What You Inspect

14. Facility Management • Experiences and Recommendations Not in any order of priority • Reporting to Administration use $$$ not BTU’s • Real time tracking of power use • How to quantify the cost of your utilities • Cost of steam – Fuel, Water, Chemicals, power (pumps) & maintenance. • Cost of chilled water – Power (chillers & pumps), water, Chemicals & maintenance

15. Facility Management • Experiences and Recommendations Not in any order of priority 4. Where are your utilities going? a. What can you control? b. What can't you control? 5. Sufficient dead ban between heat & cooling to prevent system cycling 6. Prevent heating & cooling at the same time 7. Replace T-12 bulbs

16. Facility Management • Experiences and Recommendations Not in any order of priority 8 Replace incadesant fixtures 9 Replace EXIT signs with LEC’s (.2 watts) 10. Chillers with VFD’s 11. Boiler Plant Automation 12. Steam Pressure – What pressure is required? 13. Test and Balance air & water flow

17. Facility Management • Experiences and Recommendations Not in any order of priority 14. Test and correct Building efficiency a. Make up air b. Set Backs c. Minimize re-heat d. Employee / Tenant behavior e. Operating Room Temperatures

18. Facility Management • Experiences and Recommendations Not in any order of priority • Look at system / process changes IE; Radiology went from film processing to large heat generating computers to process films. Did the A/C get up graded with this change? • Facilities tends to fix the problem rather then finding the problem. IE; Cracked Duct – Fix duct but why did it fail? System controls not working because …

19. Facility Management • Experiences and Recommendations Not in any order of priority 17.Be proactive • Be Positively Critical • Ask Why not • Ask Who • Investigate – Dig deep • Look at the whole picture • Think in system terms

20. Facility Management • Experiences and Recommendations Not in any order of priority 19. Be Patient • Don’t react • Plan ahead • Review • Work the problem • Know your budget

21. Facility Management Make a Difference Make it Better