Hospitals are among the biggest energy consumers in the country when considering how they are run and the number of people who use them. They are open 24 hours a day and have sophisticated energy needs, such as code mandated air change rates and temperatures along with specialized HVAC systems. Yet of all the challenges facing the nation's health care system, one of the most prevalent -- yet solvable -- is its overwhelming energy consumption.
Heat recovery-chiller systems aim to capture energy that would otherwise be wasted to the atmosphere. It is possible to capture the rejected heat from the condenser and use it to produce hot water for use in the hospital, therefore overall system efficiencies can be significantly increased. In addition, heat recovered from the building can be used to offset wasteful reheat, which can contribute to over 60% of a large hospitals natural gas energy bill.
Recovering heat by using heat recovery chiller systems can drastically reduce fossil fuel use. In addition to the environmental benefits, this has advantages for building management in the form of lower operating costs.
Learning Objective:
• Discuss the various energy consuming “processes” for a typical large hospital.
• Explain what reheat is and why it’s a “necessary evil” for most large hospitals.
• Demonstrate the basics of chiller heat-recovery (HR), how the HR chiller is sized and how it can be both easily and economically integrated into the overall central plant design.
• Explore the life-cycle economics of chiller HR with in real-world operational scenarios, analyzed using various electricity and natural gas utility rate structures.
• Show the “green” contributions of chiller HR through a reduction in greenhouse gas emissions.
• Talk about HR chiller maintenance, life expectancy, and other cost-of-ownership concerns.
The Advanced Energy Design Guide for Large Hospitals is an ASHRAE publication designed to provide strategies and recommendations for achieving 50% energy savings over the minimum code requirements of ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings. The Guide provides user-friendly, how-to design guidance and efficiency recommendations for large hospitals, showing how reliable technologies and design philosophies can be used to reduce energy use. In essence, the guide provides design teams a methodology for achieving energy savings goals that are financially feasible, operationally workable, and otherwise readily achievable.
This seminar is intended as a “primer” for those healthcare design and facility professionals who may not have had time yet to review the ASHRAE Design Guide and its recommendations in detail. It will cover various HVAC technologies and systems that have been demonstrated to produce substantial energy savings, and will qualify the financial aspects of those savings to a typical hospital facility. Many of the recommendations in the guide can be applied equally to new construction as well as add-on/retrofit or energy upgrade projects.
Presentation Objectives:
1. Define the “how” and “why” of energy consumption in a typical large hospital facility in (Your City). Identify avenues where the facility professional can invest limited financial resources in order to achieve the greatest energy savings and the quickest ROI.
2. Describe some of the inefficiencies inherent in various hospital environmental processes and learn how to mitigate the energy penalties through improved HVAC system design.
3. Understand the energy and operational benefits associated with various HVAC system types, such as chiller heat-recovery, airside energy-recovery, dedicated outdoor air delivery systems, chilled beams, fan arrays, desiccant dehumidification, condensing boilers, pressure independent control valves, etc.
HVAC systems in hospitals provide a broad range of services in support of a population who are uniquely vulnerable to an elevated risk of health, fire and safety hazard. Operated 24 hours/day, 7 days/week, the often unique environmental conditions associated with these facilities, and the critical performance, reliability and maintainability of the HVAC systems necessary for their success, demand a specialized set of engineering practices and design criteria.
Air-handling units (AHU’s) in hospitals provide a variety of functions that may include comfort conditioning, maintaining air quality, reducing airborne infections, odor control, and smoke ventilation, while directly contributing to the temperature, humidity, air movement, ventilation and filtration within these facilities. Additionally, they must operate as efficiently as possible in order to eliminate the burden of excessive energy costs which diminish a hospitals financial bottom line. The proper design, selection, installation and operation of these significant system components is key to a HVAC system that contributes positively to the complex dynamics of patient wellbeing and outcome. Much of the information in this presentation comes from various ASHRAE and ASHE publications, including the ASHRAE HVAC Design Manual for Hospitals and Clinics and the ASHE Mechanical Systems Handbook for Health Care Facilities.
Learning Objective:
• Discuss design, configuration and componentry unique to AHU’s serving the healthcare environment.
• Discuss reliability and redundancy in hospital AHU’s, as well as how to incorporate this cost effectively into the system design.
• Demonstrate how the criticality of space environmental requirements can impact the cooling, dehumidification and humidification strategies employed in a hospital air-handling system, and how to properly select units that will perform accordingly.
• Present various hospital filtration requirements, types and efficiencies, along with design strategies that help ensure AHU components, ductwork and final filters remain dry, and effective.
• Show the associated energy use contributed by air-handlers (including reheat and fan energy) along with design strategies that help curb hospital energy costs.
Many rooms within hospitals require special design considerations because of intensified infection concerns, high air change rates, special equipment, unique procedures, high internal loads and the presence of immunocompromised patients. ANSI/ASHRAE/ASHE Standard 170, Ventilation of Health Care Facilities is considered the cornerstone of healthcare ventilation design. This standard defines minimum design requirements, but due to the wide diversity of patient population and variations in their vulnerability and sensitivity, it may not guarantee an environment that will satisfactorily provide comfort and control of airborne contagions and other elements of concern.
This presentation will cover various aspects of HVAC system and ventilation design that when properly applied can help ensure an environment that is favorable to both occupant comfort and enhanced patient care. Along with Standard 170, comprehensive design assistance and best practice techniques as outlined in the ASHRAE HVAC Design Manual for Hospitals and Clinics will also be introduced.
Presentation Objectives:
• Review some of the minimum HVAC standards and code requirements for a hospital facility.
• Explain how these code requirements align with the “real-word” expectations of patients, doctors and staff.
• Discuss the various aspects of how temperature, relative humidly, pressurization, ventilation and filtration should interact to help create a comfortable and healthy environment.
• Introduce HVAC system design “best-practices” that (along with code requirements) may help contribute to a level of improved occupant comfort as well as an enhanced environment for patient care.
In the U.S., a new healthcare-delivery model is emerging and large centrally located urban hospitals are giving way to smaller community-based facilities intended to attract patients by being more accessible. ASHRAE has supported this movement through publication of “Advanced Energy Design Guide for Small Hospitals and Healthcare Facilities: 30% Energy Savings.” One of the guide’s recommendations to reduce operational costs and greenhouse-gas emissions is to utilize air-cooled chillers.
Technological innovations, combined with advances in manufacturing practices, have resulted in considerable improvements in air-cooled-chiller performance, particularly in terms of efficiency, sound, and footprint. This presentation will cover the recent evolution in air-cooled chillers and discuss the various improvements helping drive the air-cooled advantage. It will detail the first-cost and life-cycle cost differences between air-and-water cooled chillers and will speak to the “delivered-system” as a whole, pointing out that concentrating on chiller efficiency alone may not produce the most favorable chiller plant.
Presentation Objectives:
1. Define the differences between "todays" high-efficiency air-cooled and water cooled chiller products.
2. Describe how air-cooled chillers have evolved over the past several-years to become life-cycle advantageous when compared to traditionally more efficient water-cooled systems.
3. Provide an overview of the various first-cost and life-cycle considerations that must be taken into account when comparing air-cooled verses water-cooled chilled water systems.
4. Understand the substantial impact both cooling tower water consumption and water treatment play in defining the total life-cycle operational costs involved when comparing water-cooled verses air-cooled chiller plants.
Many rooms within hospitals require special design considerations because of intensified infection concerns, high air-change rates, special equipment, unique procedures, high internal air-conditioning loads and the presence of immunocompromised patients. In no other healthcare space does the design of the Heating-Ventilating and Air-Conditioning (HVAC) system take on more importance than in an Operating Room (OR), where its sole purposes is to minimize infection, maintain staff comfort and contribute to improving the environment of patient care.
Learning Objectives:
• Discuss how minimum code requirements for temperature and relative humidly align with the “real-word” expectations of the OR surgeon and staff.
• Learn why Doc’s and Nurses are so rarely comfortable in the OR, even in modern (and expensive) healthcare facilities.
• Understand what Doc’s and Nurses really mean when they say “make it colder” in the OR.
• Realize the roll both temperature and relative humidity (in combination) play in maintaining both comfortable and healthy OR environments.
• Come to appreciate the struggle Hospital Facility Professionals face when tasked to provide Doc’s and Nurses with comfortable (cool & dry) OR conditions. Learn the limits of existing hospital HVAC systems in producing the desired results.
• Recognize new and emerging HVAC technologies that can maintain precise OR comfort control while also helping minimize the risk of Surgical Site Infections (SSI) and Hospital Acquired Infections (HAIs), which together contribute greatly to increased healthcare costs and reductions in hospital productivity and profitability.
Healthcare facilities in the United States account for 4.8% of the total area of all commercial buildings yet are responsible for 10.3% of their total energy consumption. If the healthcare sector were a country, it would be the fifth-largest emitter of greenhouse gasses on the planet. As well, the number of healthcare facilities has increased by 22% since 2003, leading to a 21% rise in energy consumption which has placed a sustainability target on the back of every hospital in the country.
The American Society for Health Care Engineering (ASHE) defines decarbonization as the reduction of greenhouse gas (GHG) (CO2) emissions resulting from human activity, with the eventual goal of eliminating them. In practice, getting to zero net emissions requires shifting from fossil fuels to alternative low-carbon energy sources. The scale of the current climate crisis means that full decarbonization of the economy rather than partial reduction of emissions is now the goal. Instead of just using fossil fuels more efficiently, this requires ceasing using them at all. This in turn requires moving to zero carbon energy vectors, notably via electrification of end-uses previously not served by electricity.
Energy efficiency has delivered the largest share of historic greenhouse gas mitigation and is an anticipated path for hospitals to follow into the immediate future. ASHE has suggested facility managers begin their decarbonization journey by implementing measures that will deliver the biggest bang for the buck. This presentation will define the current situation faced by facility managers and suggest some simple cost-effective strategies that can produce immediate energy and GHG reductions for any healthcare operation.
Learning Objective:
1. Understand what greenhouse gas reduction involves and exactly what hospital facilities are tasked to deliver.
2. Provide references to industry resources which can be used to help create a road map to success.
3. Explain the various contributors of hospital GHG emissions including direct, indirect, and other source emissions that must be addressed.
4. Define hospital “energy use intensity” (EUI) and show exactly which process within the facility consume the most energy, and why.
5. Outline three opportunities within a hospital that can deliver the largest energy-source reduction and understand practical ways to implement solutions with little or no first-cost consequence.
6. Clarify a simple and effective way to communicate the financial benefit of any energy-efficiency initiative to the CFO, in a manner that will garner a positive response.