Facilities Manager Peer Exchange Meeting

August 17, 2012

Participating Hospitals

• Advocate Health Care & Advocate Illinois Masonic Medical Center
• La Rabida Children's Hospital
• Lurie Children's
• Northwestern Memorial Hospital
• Rush University Medical Center
• Saint Bernard Hospital
• Shriners Hospital for Children - Chicago
• Swedish Covenant
• University of Chicago Medical Center

NOTE: If you would like to learn more about any of the following peer exchange discussion topics, please contact the CGHI team and we will connect you with the appropriate hospital(s).

Group Initiative Discussion

The following group initiatives were discussed and next steps determined.

CGHI website access and content

• The CGHI website is: www.chicagogreenhc.org Sections of the website are password protected for information that is shared privately among facility management peers. We ask that you do not share the login or password with vendors. If you do not have this information, please contact the CGHI team and we will send it to you.
• The website has been created to meet your needs. Please let us know what additions/changes you would like to see so that it will work best for you.
• The CGHI website will be updated to include sector statistics, LED lighting tracking, and beta test opportunities. Login credentials will be required to access the LED and beta test opportunity information.

LED implementation tracking

• The group would like to track and share experiences with LED lighting.The CGHI team will work with group members to consolidate this information and post to the private/password section of the CGHI site.

City codes that hospitals would like to see revised

• Although there are various opportunities to update City of Chicago code (exit signs, recessed lighting, etc.), at this time the group did not prioritize engaging on this topic.

Hospitals as beta testers of new vendor products

• The group is interested in beta testing various products and sharing the results. The CGHI team, with the support of Facility Managers, will identify and list on the CGHI website those opportunities as well as specifics required to beta test those products.

Water and Sewer Rate References

• City of Chicago Water Fee Exemption and Fee Increase Overview
• City of Chicago Certification Application for Water and Sewer Charge Exemption
• City of Chicago code regarding the water fee exemption and rate increase

Water Conservation Opportunities for Healthcare Facilities

Daryll Dylla, Manager, HVAC/Power Plant at Advocate Illinois Masonic Medical Center (IMMC) initiated a plan to conserve water based upon several factors.  Drought conditions have lowered the level of Lake Michigan by 11 inches compared to 2011; the City of Chicago will begin charging hospitals for water usage; MWRD is planning to increase rates; and, conserving water is the right thing to do for our eco system.  Daryll enlisted Grumman/Butkus Associates to design a condensate capture and reuse system for their cooling tower.

Presentation: Dan Doyle, President, Grumman/Butkus Associates gave a water conservation presentation covering the following topics:

Why water conservation should be a priority

• Hospitals have a wide range of water-using equipment; so, volume of water usage is high.
• It is relatively easy to improve water efficiency.
• The opportunity to save money is excellent and continuous since the Chicago’s plan is to keep increasing water fees for the next several years.  Additional savings include lowered use of water treatment chemicals and reduced volume of effluent going into the sewage system.
• As the population increases, so do chemical and biological contamination of water sources.
• Aquifers are being depleted with no effective recharge.
• The U. S. water supply and distribution system is aging; most of Chicago’s water system was installed before World War I.
• Water and energy are tightly linked; energy production uses large amounts of water.

Create a Water Management Plans

• Audit current water use
• Benchmark current usage
• Identify water conservation opportunities (WCO)
• Determine cost of WCOs and potential ROI of each
• Develop a phase plan that fits budget
• Implement the plan
• Measure and document success

Benchmark your Water Consumption

Use any of the following water benchmarking tool options.

• U.S. EPA's - Water Consumption
• G/BA's Hospital Energy and Water Benchmarking Survey - includes consumption and cost
• WATERMARK! - new tool by Mazzetti Nash Lipsey Burch

Water Efficiency Opportunities

High water consumption and cost effective efficiency opportunities include:

• Taps, toilets, urinals, and shower heads
• Cooling towers including non-chemical water treatment devices
• Boilers/Steam Systems
• Water efficient irrigation
• Single-pass cooling equipment
• Sterilizing systems
• In House Laundry
• Food Preparation

Additional Discussion Topics

• The water quality required for each use can also be included, as well as information about the local climate, such as monthly averages for evapotranspiration rate, relative humidity, temperature, and precipitation.
• Estimate consumption of all end-use equipment and systems.
• Compare to metered data.
• Investigate discrepancies to find source of imbalance between water purchases vs. water usage.
• If the two are in balance, the next step is to look for opportunities for greater efficiency in each major usage category and determine whether water from one process can be used elsewhere cost effectively.
• The two most useful water sources for healthcare facility buildings are air-conditioning condensate recovery and rainwater harvesting.
• GOAL:   Minimize the use of potable water for process applications.

Source: Practice Greenhealth Green Guide for Health Care Series - Water Conservation Strategies

Additional Discussion Topics

• ASHRAE 188P: Various members believed that this pending legislation will unnecessarily mandate additional Legionella testing and increase costs. Contact the CGHI team if you want to get involved legislatively.
• ASHRAE 170:air exchange, temperature parameters and humidity in operating rooms.
• Faucet aerators: Should they be used? The group did not have a collective opinion. Faucet aerators are used in some hospitals and not permitted by other hospital's infection control department due to concern with infection/legionella.
• There has been significant debate and research regarding faucet types and links to infections, such as Legionella. More information is available here.
• Single Pass Cooling: Although banned in Chicago since 1984, installations still exist (medical equipment and condensers) and a good solution for it is a process cooling loop.
• Steam System Leaks: It is necessary to check for and repair leaks in steam systems

Advocate's Cooling Coil Condensate Recovery System

After the discussion, the group toured Advocate's cooling coil condensate recovery system, pictured below. The system:

• Recovers condensate from four air-handling systems to use a cooling tower make-up
• Recovered 127,800 gallons between July 9-August 9. Estimated annual savings is 450,563 gallons with four coils connected. When all ten coils are connected they will save over one million gallons of water per year which will decrease water purchase by 25%.
• Reduced the use of chemicals which increased concentration ratio and further increased savings
• Leveraged a combined mechanical and pulse meter to accurately measure captured condensate

Advocate's Magnetic Chiller

Completely unscheduled, York Chan took a few of us to see Advocate's new Daikin McQuay Magnitude Frictionless Centrifugal Chiller which is more energy efficient, takes up less space, uses no oil, and requires less maintenance. Vendor Information

Next Facilities Manager Peer Exchange meeting

• Date: Friday, September 21, 2012
• Time: 11:30 - 1:30; 90 minute tour followed by 30 minute discussion in conference room with food and beverages.
• Location: Rush University Medical Center
• The tour will include Rush's Central Energy Plant (boilers, chillers, generators, etc.), new loading dock area with Automatic Guided Vehicles, the Tower (ComEd vault, electrical distribution system, main mechanical room, etc.) and more more.