Hospitals account for the top-heavy amount of energy demand and joint emissions due to their 24/7 operation and embedment of sophisticated equipment pertaining to the advent of technology. This represents approximately 6% of total energy consumption in the utility building sector with Heating, Ventilation, and Air Conditioning (HVAC) systems being the major consumer of electrical energy. While refraining from the use of such products or services becomes a way to save energy, it can also be done by utilizing various energy conservation measures over their conventional counterparts. Energy conservation refers to the minimization of energy consumption with more efficient equipment and appliances as well as their sensible utilization. This involves a number of factors affecting energy consumption such as high maintenance of machinery and the high load of the patient-to-doctor ratio in India which is 1596: 1 in comparison to the regulated 1000: 1 prescribed by WHO.

For healthcare quality systems with a capacity higher than 2,100 liters/second and a minimum outdoor air supply of 70%, it is recommended by the Energy Conservation Building Code (ECBC) to use technology with a minimum of 50% effectiveness from air-to-air heat recovery. However, a recent report by the Confederation of Indian Industry (CII) states that almost 60% of the Health Care Services and hospitals do not even meet the minimum criteria of the Energy Performance Index (EPI) which is 200 kWh/sq.m/year. Indian hospitals have the potential to conserve 42% of the energy consumption by implementing energy-efficient measures. This calls for a dire need to address the parameters contributing to the heavy energy consumption along with their conservative and preventive measures.

Identifying the high-end energy use of healthcare facilities:

As hospitals in India are increasingly becoming global destinations for patient care, there has been a corresponding growth in the infrastructure supporting the different end energy use. Share of different consumption is based on the divergent factors related to occupancy, service, and climatic zone in which a hospital is located.

Fig: Energy Breakdown in Indian Hospitals

HVAC and lighting applications, in general, constitute about 75% of the electricity consumption in a hospital. Their technical systems must be designed and adjusted to meet the requirements of a controlled indoor environment.

Improving energy efficiency with cost-effective strategies.

An economic savings potential of a healthcare facility is between 10 and 20% of current energy use with best practices. Any energy efficiency opportunities for a healthcare organizer would, thus, be able to find energy savings with the following possible solutions:

• Implement on-site power generation, such as externally mounted solar panels or wind turbine
• Swap out older hospital equipment for energy-efficient models.
• Installing combined heat and power (CHP) systems.
• Reducing the use of HVAC systems with occupancy-based interoperation to set back cooling when not required.
• Balancing air and water systems of HVAC that are out of balance and repairing the variable-air-volume boxes that are not working properly to reduce excessive air-change rates
• Replacing lighting with LED or other energy-saving light bulbs. A smart lighting system can reduce hours of lighting operation and intensity with 24 to 38% energy savings.

• Installation of occupancy-driven wireless thermostats which would aid in saving 5-10% of the costs incurred
• Advanced rooftop unit (RTU) controls for cutting the HVAC energy use by 20-40%.
• For retrofitting of the building, the existing windows can be fitted with CO2 demand-controlled ventilation (DCV) sensors. This technology coupled with room occupancy sensors would be able to adjust the ventilation accordingly.
• Continuous monitoring of the hospital building’s energy system can lead to 10 to 15% in their annual energy bills.

Discovering new build opportunities with the Green Hospital:

With all the challenges that come with retrofitting a hospital, the best time to upgrade a building’s energy efficiency is during its construction. In recent years, there has been an emerging subset of green design that has been revolutionizing hospital design with sustainable technologies, energy-saving systems, and recyclable or renewable resources and materials. Green hospital buildings usually cost the same amount to build but can save a great deal on energy costs long-term with:

• Natural Light hubs and interior courtyards bring natural light throughout the building.
• Energy Star reflective roof, with a high R-value (R-30). A reflective roof or insulation in the roof and exterior walls minimizes heat gain in the building and the accompanying energy usage. It is recommended to use minimum R-30 roof insulation for minimizing the annual heating and cooling cost
• Green roofs have the ability to reduce the urban heat island effect, improve stormwater mitigation and absorb pollutants through air filtration. This results in lower maintenance costs and higher energy savings than a traditional roof.
• Energy-efficient glazing: Low E (emittance) glass containing an invisible metal coating sandwiched between the layers of glazing and, thereby, causing the glass to be reflective. This keeps the building warmer in the winter and cooler in the summer.

Despite the challenges, today’s health care institutions are finding new ways to incorporate green design strategies into new construction so as to speed up the healing of their patient and the planet. Small steps like an energy audit or moving to a greener cleaning protocol would break down such obstacles for greater innovations. This would require high-cost energy categories to be monitored with an integrated Hospital Safety Management program to identify the areas of potential savings. The resulting energy-saving measures would eventually allow us to consider the entire life cycle cost of improvements rather than seeking the lowest initial cost in the safety of the healthcare facility.

Enroll with Certification in Hospital Safety Management for further information.