Hospitals use more energy per square foot than almost any other type of building—the only establishments that perform worse are fast-food joints. So architects, designers, and energy professionals are starting to think seriously about how to reduce hospitals’ energy footprint. And the health care industry is realizing that, as sustainable health care design expert Robin Guenther says, “We will not have healthy people on a sick planet.”
New York City’s Pratt Center for Community Development has been gathering leaders like Guenther through its Green Healthcare Forum to discuss how the industry can contribute to a sustainable environment. The opportunity is huge: Hospitals account for 8 percent of the energy consumed by commercial buildings, but occupy just 4 percent of commercial floorspace across the country. Ongoing research from the University of Washington’s Integrated Design Lab has shown that hospitals could reduce energy use by more than 60 percent at a premium of only 1 to 3 percent over current costs.
In Guenther's formulations, these high-performance buildings will be a step towards a key medical principle—first, do no harm. The goal, she says, should be to work toward buildings that not only do no harm (net-zero energy buildings) but toward hospital facilities that heal the environment and people through regenerative designs.
To start, they need to use less energy. Hospitals do run a fleet of electricity-sucking specialty gadgets, but, like most buildings, cooling and heating spaces and water take the largest amount of energy. Hospitals must pay extra attention to the quality and circulation of air, and they operate around the clock.
Researchers and administrators who have looked into hospital energy use have found that the systems they use can be terribly inefficient. One problem in hospitals is the need to re-heat air after it’s been cooled down to keep temperatures at a comfortable level. Central systems cool air to the lowest temperature needed for a large building, but when that air reaches more temperate rooms, it needs to be heated back up to a reasonable temperature. Hospitals also heat water to a high germ-killing temperature before sending it lukewarm (and bacteria-friendly) to taps around the hospital. That might not be the best system from keeping hospital workers’ hands germ-free.
Changing how hospitals work, though, presents a particular challenge. They’re risk-averse: They need to keep sick patients from being exposed to additional health hazards and comply with lots of regulations. They’re also sensitive to the demands of patients: When you’re sick and you feel too hot, you want the room to cool down now.
There are opportunities to start ramping down energy use at hospitals. Panelists at the Pratt event said hospitals are increasingly looking at lifecycle costs for energy system rather than just the upfront charge. Hospitals produce huge amounts of heat, so power systems that capture that energy—cogeneration plants, for instance—can dial down energy use. There are also efficiencies to be found in the ventilation and conditioning of air.
But the panel also agreed that, ultimately, hospitals will focus on energy use most when it’s presented as a means to an end—building resilient systems that will enable the industry to take better care of patients.