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For years, Chicago area hospitals have implemented various projects to conserve energy, resulting in nearly $3 million in program incentives, $3 million in utility savings, and 241,000,000 kBtus conserved. To quicken the pace of improvements and energy reductions, more comprehensive approaches are now needed. Five major initiatives stand out as solutions that hospitals across the country could benefit from. Read More...

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Facilities Manager Peer Exchange Meeting

June 22, 2012

Participating Hospitals

  • Advocate Health Care & Advocate Illinois Masonic Medical Center (IMMC) – Meeting Host
  • Jesse Brown VA Medical Center
  • Mt. Sinai Hospital & Schwab Rehabilitation Institute
  • Mercy Hospital & Medical Center
  • Saint Bernard Hospital
  • Saint Joseph Hospital/Presence Health Care (Provena Health – Resurrection Health Care)
  • Shriners Hospital for Children - Chicago
  • 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).

Energy Management Approach

  • Advocate discussed their use of Energy Star’s Guidelines for Energy Management Overview.
  • Steps in the process are:
    • Step 1: Make Commitment
    • Step 2: Assess Performance
    • Step 3: Set Goals
    • Step 4: Create Action Plan
    • Step 5: Implement Action Plan
    • Step 6: Evaluate Progress
    • Step 7: Recognize Achievements

Examples of Advocate's Implementation of Energy Star Guidelines

  • Make Commitment: As stated in their 2011 Environmental Stewardship Report, Advocate's sustainability initiatives are: Mission Driven, Bottom Line Driven, Board Endorsed, Church Supported and Clinically Relevant. They have tangible senior leadership commitment that includes allocation of infrastructure funds to support energy efficiency. NOTE: Leaner Energy is on pages 8 & 9.
  • Assess Performance: Baseline data along with quarterly updates are entered into EPA's Energy Star Portfolio Manager.
  • Set Goals: Goals have been set and have become more aggressive over time as experience and capability have increased.
  • Set Goals: Advocate's goal is a 20% energy reduction by 2015 relative to 2008 levels. Currently they are more than halfway to reaching the goal.
    • Advocate’s energy costs = $29 million/year.  The system comprised of 10 acute care hospitals and 2 integrated children’s hospitals; 10 campuses; 250 sites of care in IL.
    • Advocate IMMC is a Level 1 trauma center with 408 licensed/330 staffed beds; 18 buildings built between 1908 – 2004; 1.6 million SF.  2008 baseline ES rating = 80; current ES rating = 99.
  • Implement Action Plan: Having an energy champion at each facility is important to move the facility forward.
  • Implement Action Plan: Culture change is important. DOE estimates that energy awareness could reduce energy consumption by 6-10%.
  • Implement Action Plan: Each hospital has an active Green Team that meets regularly and the System Environmental Team meets monthly.
  • Evaluate Progress: Energy Star scores are evaluated quarterly and operating budget line items are shared with staff at all levels. Ideas are solicited from all staff re: improvements. This increases staff engagement and participation.
  • Recognize Achievements: Facilities staff performance evaluations include individual contributions to energy efficiency.
  • Recognize Achievements: Advocate recognizes achievements with annual stewardship awards.

Demonstrating Progress / Making the Case for Energy Efficiency

  • Energy Usage Intensity (EUI) or BTUs/SF is a consistent metric to show improvement.  This metric along with dollar savings are reported to senior leadership.
  • IMMC’s EUI is approximately 160,000 BTUs/SF.  
  • Average EUI across all 12 Advocate hospitals is 240,000 BTUs/SF
  • US Hospital EUI Average = 260,000 BTUs/SF.  
  • European Hospital EUI Average = 150,000 BTUs/SF

Changes to Energy Star Portfolio Manager

  • The changes in scoring that EPA implemented in November 2011 included changing from number of licensed to staffed beds and reporting the number of FTEs and MRIs. If you haven’t yet adjusted your scores using the new methodology, you must do so in order to be able to benchmark with other facilities.
  • EPA is currently developing a new streamlined PM tool that they will launch in June 2013.  They host periodic online live demos.  Access slides & a recording from the most recent demo on 6/28/12.

Note: If you would like assistance setting up or managing your PM account, contact Peter Locke at peterlocke@terralocke.com or 773.551.0761.

Implementing Energy Conservation Measures

  • As a first step, check out Advocate's Energy Management Operations Checklist.  Over the course of several years, they have developed a 200 item checklist of no/low cost fixes has enabled them to save millions of dollars.  It includes chiller plant operations, boiler plant operations, HVAC systems, building envelope, lighting, cooling towers and exhaust systems.
  • Retro commissioning (RCx) helps you to determine if your systems are operating properly.  Both ComEd and Peoples Gas have programs that will pay for these assessments. Many paybacks are 1.5 years or less and the resulting cost savings are an ongoing benefit. The program has some requirements such as:
    • Have a peak demand of 500 kW or greater.
    • Commit to spending $15-30K in improvements to receive incentives/rebates. 
    • Note:  Even facilities using pneumatic controls can participate; trade ally conducting the assessment will use data loggers. 
  • Calculate life cycle costs of equipment vs. just first costs.  
  • Invest in a building automation system (BAS). Use this technology to augment human performance.
  • Have a system override approach. Advocate does not allow overrides except in very limited and controlled cases. For example, in the ORs, nursing staff is allowed to regulate temperature between 68 and 72.  IMMC nurses have educated/influenced surgeons about enhanced patient recovery in this range vs. colder temps.  This range maintains better patient body temperatures that resulted in 69% improved pneumonia treatment in 2008, 84% in Q1 2009, 100% in rest of 2009.  They also saved $74,000 since they greatly reduced the need for Bair Hugger patient warmers.

NOTE: For additional ideas and information, reference York Chan's presentation to USGBC: Hospital Energy Efficiency as a Culture

Next Facilities Manager Peer Exchange meeting

  • Date: Friday, July 20, 2012
  • Time: 11:30 – 1:00 (lunch will be provided)
  • Location:  Mt. Sinai Hospital – California Avenue at 15th Street
  • Conference Room: Glasser A
  • Discussion Topics
    • LED lighting
    • Each hospital spends 5 - 7 minutes describing retrofit efforts underway.
    • Additional Topics TBD by you

Future meetings topics:

  • Please review Topic List, indicate topics of most interest to you, note topics for which you would like to be the discussion starter and return to Debra Krause.
  • Please let Debra know if you would like to host a future meeting and state the topic.
  • If you have any suggestions re: Peer Exchange meetings, online information sharing, etc.; we welcome your input.
  • If you would like to take the lead on a specific topic; but, don’t have a meeting space that would accommodate 20-30 people; Advocate Illinois Masonic has offered to provide their state of the art training room.

Note: If you would like assistance with launching or supporting a Green Team, contact Debra Krause at dkrause@practicegreenhealth.org or 773.505.0150.