Healthcare Business News
Muskogee (Okla.) Community Hospital opened in March 2009.
Muskogee (Okla.) Community Hospital opened in March 2009.

Shining examples

More hospitals work to earn the Energy Star logo as they advance the greening of their facilities

By Andis Robeznieks
Posted: October 31, 2011 - 12:01 am ET

You've gotten used to seeing it on your refrigerator and on your computer printer for years now. According to some experts, you'll soon be seeing the Environmental Protection Agency's Energy Star logo more and more on hospitals.

Started in 1992 as a way to identify and promote energy-efficient products, consumers first saw the Energy Star logo on computers, printers and fax machines. According to the EPA, in 2010, the Energy Star program helped reduce the nation's greenhouse gas emissions by 170 metric tons (the same as produced by 33 million vehicles) and helped lower U.S. utility bills by about $18 billion.

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It remains to be seen what can be done with the healthcare industry's utility bill, estimated to be about $8.8 billion a year. A recent EPA publication touts how the Cleveland Clinic recently used the program to lower its gas and electricity bills by 5% and 8% and saved nearly $4.2 million over a 12-month period. In terms of emissions, the EPA said the reductions were the equivalent of taking 5,280 cars off the road. In terms of finances, the savings equaled the cost of hiring of 64 more nurses.

The program measures 12 months of energy-use data and, to qualify for Energy Star certification, a hospital needs to achieve a score of at least 75 on a one-to-100 scale—which means it is more energy efficient than 75% of its peers. And though few hospitals have gone through Energy Star certification, officials say the program's “portfolio manager” benchmarking tools are widely used to track improvements and to identify the most cost-effective energy efficiency projects a hospital may want to tackle next.

Energy Star is often compared to the U.S. Green Building Council's Leadership in Energy and Environmental Design program, or LEED. But LEED, in addition to energy conservation, also measures the use of environmentally sustainable materials as well as the use of recycled materials in construction.

Meeting the challenge

In an e-mail, Clark Reed, the EPA's national healthcare manager, says that while only 134 hospitals have earned Energy Star certification, more than 85% of acute-care hospital space has been benchmarked through portfolio manager.

“Improving the energy efficiency of healthcare facilities can be challenging because of the complex and vital services and systems they provide, such as life support and infection control,” Reed says in the e-mail. “Medical equipment also can be very intensive, and combined with typical operating hours—frequently 24 hours a day, seven days a week—hospitals can consume a great deal of energy.”

A new one-to-100 scale is due to be released Nov. 7. Changes to the old scale include counting staffed beds instead of licensed beds and factoring in the number of MRI machines a hospital operates.

Peter Belisle, president of energy and sustainability services for real estate services firm Jones Lang LaSalle, says healthcare is behind other industries in terms of energy conservation but is catching up.

“If you think about healthcare in general and compare it to other sectors, the healthcare space has been late to the game—not just sustainability but also energy reduction—especially in acute care,” Belisle says. “We finished almost $1 billion in healthcare work in the last 24 months; none of them were pursuing LEED or Energy Star.”

Belisle notes, however, that those were projects started between 2004 and 2006. He says there is a different way of thinking now, and he believes pursuit of Energy Star certification will “go up dramatically,” and not just in hospital construction, but with medical equipment as well.

“The train has left the station,” Belisle says. “I think we're going to see a lot of movement in the next 24 months.”

He explains that the sustainability and energy-efficiency forces have “moved into the mainstream” and pressure is coming from multiple sources, such as large philanthropic benefactors and physician groups, for hospitals to be part of this movement. “It's not just return on investment,” Belisle says.

That said, ROI is always on healthcare administrators' minds. According to the EPA, for every dollar a not-for-profit healthcare organization saves on energy, it has the same effect on operating margins as a $20 increase in revenue for a hospital or $10 for a medical office building.

“Any dollars we save by energy efficiency are dollars we can spend on something else—whether you use it for betterment of the patients, betterment of employees, or to add another coat of paint someday,” says Mark Roberts, president of 45-bed Muskogee (Okla.) Community Hospital. “It's just simple business sense: Saving money is easier than earning money.”

The photo above shows trenches for installation of the Muskogee (Okla.) Community Hospital's extensive geothermal heating and cooling system.
The photo above shows trenches for installation of the Muskogee (Okla.) Community Hospital's extensive geothermal heating and cooling system.
Last year, Muskogee became the first hospital to earn Energy Star design recognition, and the environmental centerpiece of the physician-owned hospital is a geothermal heating and cooling system that uses 35 miles of pipe to act “as a radiator” among the underground network of 280 wells 300 feet deep.

The system is located under parking lots and landscaped areas and, according to Roberts, helped the facility to become the first for-profit hospital to be certified “Gold” on the LEED recognition scale (which goes from basic certification to silver, gold and platinum).

But it's not the hospital's only distinguishing environmental factor. Special ultraviolet lighting fixtures are used to fight infection by sterilizing the air. In the process, it also eliminates bacteria and mold growth on cooling elements that helps extend the life of the equipment and improves its efficiency. Roberts says a build-up of just 13/1,000ths of an inch can reduce its efficiency by up to a third.

“Any program that makes you aware of how you can save energy and cuts costs is a good thing, and Energy Star does a good job of that,” he says. “Energy has become so expensive, and it seems like it's just getting more expensive, so I'm pleased with the program.”

A popular trend

Greater energy efficiency was “a significant goal from the outset” at the new Issaquah (Wash.) campus of Swedish Medical Center.
Greater energy efficiency was “a significant goal from the outset” at the new Issaquah (Wash.) campus of Swedish Medical Center.
Patrick Chambers, a project executive with the Hammes Co. in Denver, says Energy Star can help provide a strategy for achieving energy reduction targets.

Chambers says pursuing Energy Star and LEED certification is becoming a popular trend, and Hammes is involved with Energy Star on multiple levels—either as the developer or owner of healthcare properties or as the project manager for its clients.

Hammes has just finished a medical office building and the new Issaquah (Wash.) campus of Swedish Medical Center outside of Seattle, where Chambers says energy efficiency was “a significant goal from the outset.”

“They set aggressive targets,” he says, explaining how a typical hospital may consume 200 to 210 kBTUs per square foot, but the goal at Issaquah was 150 kBTUs. “We're in the process of verifying if we met those goals.”

Phillip Risner, network engineer and senior project manager for the Seton Healthcare Family in Central Texas, says all of the 10 Seton hospitals participate in the program—including one high-profile facility that has failed to achieve Energy Star certification.

Seton's Dell Children's Medical Center of Central Texas in Austin made history by becoming the first hospital to be certified LEED platinum. But, according to Energy Star, it doesn't make the cut.

Dell opened in 2007, and has reduced its energy use by about 15% since then, Risner says. But some of the innovations the facility implemented, such as capturing and using “waste” heat from a local energy plant, don't score any points on the Energy Star scale.

“We're doubling our efficiency, but it's not reflected in our score,” Risner says, explaining that—if certain changes were made to the Energy Star scale—Dell Children's would have a score in the 80 to 85 range. “That's my take on it.”

Instead, it only received a well-above-average-but-still-way-short-of-certification score of 58. “Our (LEED) platinum rating was primarily the result of the way we got our energy,” Risner says. “And we have consistently been very close to the energy we thought we'd be consuming.”

He adds that Dell Children's is constantly improving its lighting systems and accompanying occupancy sensors that dim or shut off lights in empty rooms.

One system that is finally working as designed adjusts the amount of electric lighting to get brighter or dimmer depending on the amount of natural daylight coming in.

“It never worked from day one,” Risner says. “We finally got it fixed a couple of months ago.”

Because Dell Children's is about three times as large as the facility it replaced, Risner is reluctant to make comparisons between the old and new facilities in terms of energy used and dollars saved. Instead, he just says, “We believe we are 20% better than a good office building.”

He adds that Seton is part of the 75-hospital Ascension Health network and all of its facilities participate in Energy Star—whether or not they pursue certification. “Environmental stewardship is important to the leadership of both Seton and Ascension,” Risner says. “The dollar savings are part of that, but being good environmental stewards is also important.”

Gundersen Lutheran in LaCrosse, Wis., is another health system known for energy innovation—including a project that captures and uses waste methane from a local brewery—that also hasn't pursued Energy Star certification.

“We like the EPA's Energy Star program, but it hasn't been a priority for us,” says Gundersen spokesman Chris Stauffer. “We've done our own baseline testing. We already have our own measurements. We just need to improve.”

Improvements to Gundersen's energy portfolio planned for the near future include installing a wind turbine and generating energy from landfill gasses, Stauffer says, adding that Energy Star is a good place to start for organizations that are about to launch an energy-efficiency program.

But “they don't account for everything” in its rating scale, Stauffer says, and there is also the concern that some organizations may grow complacent after achieving certification.

Jumping hurdles

Belisle says it also is becoming more common for hospitals to be designed to LEED or Energy Star specifications, but then owners don't pursue certification because of the documentation work required for LEED or because of the expense of getting third-party verification for Energy Star.

On the American Society for Healthcare Engineering website, however, the group notes that certification from respected programs like Energy Star helps set legitimate environmental stewardship efforts apart from cynical “greenwashing” attempts of organizations that spend more on public-relations efforts to create a reputation as an efficient-energy user rather than working on actually reducing their consumption of electrical power.

Belisle adds that, in terms of marketing and fundraising, LEED or Energy Star certification help “tell the story” of why a hospital looks like it does and sets it apart from those who are putting up another “windowless concrete building.”

“There is so much room for improvement,” he says.

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