On target

A trend appears to be gaining momentum in which health facility professionals are replacing conventional infrastructure systems with products and technology formerly considered out of reach.

If you'd like to explore innovative, progressive energy-efficient and sustainable technology and systems, options ranging from fuel cells to solar energy to rain harvesting are available that can reap long-term financial and environmental benefits.

It appears that a growing number of hospital executives are open to purchasing alternative energy-saving options, according to the 2011 Hospital Energy Management Survey conducted by Health Facilities Management and the American Society for Healthcare Engineering, which appeared in last year's July issue.

The survey found that 7 percent had upgraded or replaced conventional systems with such technology as cogeneration, fuel cells, photovoltaic (PV) systems or other solar thermal systems in the previous two years. Another 14 percent of the respondents said they plan to upgrade or replace conventional energy systems with alternative technology in the next two years, a significant increase.

Not all renewable or energy-efficient products make sense for every hospital, as sources interviewed for this story attest. But, depending on the fit, options that once may have been pipe dreams are becoming realistic, thanks to cost reductions and financial incentives frequently available at the federal or state level or from local utilities.

Brighter days for solar?

A common misconception is that alternative energy sources like solar or wind are going to totally replace power purchased on the grid. Instead, hospitals need to look at renewable energy sources or less conventional systems as part of their energy portfolio, says Burke Kascha-Hare, director of business development, REC Solar Inc., San Luis Obispo, Calif.

"I think the perception of solar as high tech or as being an off-grid power generator over the last decade has been shed," he says. "When solar is used on large, energy-consuming facilities such as hospitals, it's helpful to integrate it as an energy-efficiency device rather than a power generator."

REC Solar is a solar power integrator that provides turnkey services, including site feasibility, system design, material procurement, system installation and monitoring and maintenance. REC has been awarded contracts to design and install photovoltaic solar systems at about 15 Depart­ment of Veterans Affairs (VA) hospitals and outpatient clinics across the United States.

The VA's goal is to increase renewable energy consumption to 15 percent of electricity usage by 2013, he says. The VA installations by REC Solar range in size from 100 kilowatt (kW) to a 4.5-mega­watt system at the Southern Arizona VA Health Care System in Tucson that is nearly complete, he says.

While PV solar energy is scalable to each hospital's needs and budget, it is not the silver bullet of energy solutions be­cause none exists, he ex­plains.

"A solar photovoltaic system, depending on the space available, potentially could offset 40 to 50 percent of the total power consumed by a facility. But it's not going to create a situation where you're going to take the whole hospital off the grid," says Kascha-Hare.

Taking such steps as changing out inefficient lighting and windows and installing upgraded rooftop units are all useful actions that can reduce energy consumption by 30 to 40 percent, he says. "But how are you going to get over the remaining 60 percent? Well, that's where solar can reduce that energy consumption even further," Kascha-Hare says.

Generating power

Yusef Orest, project developer, Juhl Wind Inc., Woodstock, Minn., has headed up the design, construction and installation of two wind power turbines supplied by Carpinteria, Calif.-based Clipper Windpower LLC for Gundersen Lutheran Health System in La Crosse, Wis., at a site near Winona, Minn.

Gundersen's goal is to be energy-independent by 2014 and it is on track to meet that objective by implementing an array of energy-saving and generating measures, hospital officials say. It plans to sell the power generated by the turbines back to the local utility to offset power consumed by the health care system.

Orest says wind energy is not for all health care organi­zations, but those in medium-sized towns such as La Crosse or in rural areas need to give it a hard look as an option to add to their energy portfolio.

Most wind energy projects have a payback of about 10 years, depending on the size of the project, but facilities will experience a reduction in energy costs from Day 1 by selling power generated back to the grid, Orest says.

Two turbines at a site in Minnesota started operating in December and offset about 6.5 percent of the hospital's energy consumption. A second double turbine site in Wisconsin will offset about 5.5 percent when it starts working in April, says Jeff Rich, executive director, GL Envision, a wholly owned subsidiary of Gundersen Lutheran Health System.

Fuel cells offer on-site power generation that is a clean alternative to the central grid, says Neal Montany, director of stationary fuel cell business, UTC Power, South Windsor, Conn. A fuel cell is an electrochemical device that is fueled by hydrogen derived from standard natural gas to produce electricity, heat and water.

"Each PureCell system is capable of producing 400 kW of continuous, reliable, clean electric power while generating 1.7 million Btu per hour of usable heat byproduct. This heat can be used for space heating, hot water and for driving an absorption chiller to provide cooling, which greatly increases the fuel cell's efficiency," he says. "Fuel cells operate without combustion, so they are virtually pollution-free."

St. Helena Hospital, a 181-bed community hospital located in Napa Valley, Calif., recently installed a PureCell system to provide 60 percent of the hospital's electricity needs and 50 percent of its space heating and domestic hot water requirements, Montany explains. By generating most of its power on-site with a fuel cell, St. Helena is able to prevent the release of more than 530 metric tons of carbon dioxide annually.

Fuel cells require a big-time investment, though, with a unit ranging from $2 million to $2.5 million, says Montany. UTC Power offers finance options that require no out-of-pocket expenses up front and there are incentives for fuel cells offered by several states. Fuel cell installations are also eligible for a federal incentive tax credit, Montany says.

True green technology

Biomass energy systems, which burn organic material to generate energy for heat, cooling and electricity, are another option for hospitals to consider.

The Chillicothe (Ohio) VA Medical Center is constructing a new central energy plant that will include a biomass boiler system to provide the 1 million-square-foot facility's entire water heating and steam generation needs.

Steven Benson, chief of facilities management at the medical center, says that by burning wood chips rather than natural gas, the biomass unit is expected to save $600,000 to $900,00 annually in fuel costs.

Gundersen Lutheran is looking at biomass-based, fuel-fired boiler systems to further reduce operating costs and dependence on fossil fuels. AFS Energy Systems, Lemoyne, Pa., and Global Energy Solutions Inc., Naper­ville, Ill., a representative of Hurst Boiler & Welding Company Inc., are among
several companies vying for Gundersen's business.

Doug Fisher, chief operations officer, AFS Energy Systems, says because biomass burns organic material, it is a true green technology and it also offers a quick payback. "Most customers save enough energy to pay for their investment in 18 months to four years," he says.

James Alwin of Global Energy Solutions says biomass-based systems can generate steam for facility heating and on-site processes like laundry operations and sterilization. More recently, biomass systems are being considered for on-site electric power generation. The system requires replenishing and storage of the organic fuel source, which usually is trucked to the site.

Reusing precious water

Water is evolving quickly into a precious resource, especially in certain regions of the United States. To address this growing need, Aquanomix, Davidson, N.C., designs water management systems engineered to manage harvested rainwater, storm water, gray water, pro­cess water and foundation water for reuse as cooling tower, toilet and irrigation makeup.

"With the demand for fresh water reaching new heights as the world population grows, we must confront the challenges that lie ahead," says Robert O'Donnell, president and a partner, Aquanomix.

"Hospitals will need to consider the question of using reclaimed water streams for their non-potable water needs. With continued pressure from the Environmental Protection Agency on Clean Water Act enforcement, there will be an additional push to capture these storm water outflows, treat and reuse on-site," he says.

The Aquanomix system is capable of capturing, measuring, treating and delivering this non-potable water source to its point of use through an advanced control system that performs input/output commands, runs on-board diagnostics and integrates with most building automation
systems.

Capturing water requires storage or detention capability that usually is handled through an above- or below- ground cistern, O'Donnell explains. The water is conveyed from the roof surface and stored in the cistern.

The Aquanomix system controls a pumping station that is located in or near the cistern when there is a demand for the water. The water then is sent to the Aquanomix controls platform, where it is cleaned and disinfected prior to use. This ensures that the water quality is suitable for its intended application.

In many instances, payback is less than five years on the system when water is used for cooling tower makeup and irrigation needs.

Reducing air changes

Displacement ventilation also offers a host of advantages for hospitals, including reduced energy use and the potential to improve air quality in patient care areas. The system introduces cool air directly into the occupied zone of a room at low velocity.

"The resulting room airflow pattern, with cool, fresh air initially at the floor, rising and warming in thermal plumes, picking up pollutants along the way and collecting at a high level where it is exhausted or returned, is what makes displacement ventilation such an effective air distribution system," says Julian Rimmer, P.Eng., LEED AP, senior product manager, sustainable technologies, Price Industries Inc., Atlanta. It allows for a reduction in the room design cooling capacity of the supply air.

The company offers the Puraflo in-wall displacement diffusers designed for use in patient areas, hallways, waiting rooms, exam rooms, nursing stations and other common spaces where air quality demands are high. The diffuser discharges cool supply air evenly across the removable perforated face at low velocity, with minimal turbulence or induction of room air.

Displacement ventilation offers a means of improving the air quality in these spaces and with lower air change rates. This, in turn, saves energy and reduces operating costs for the health care system, says Rimmer.

Reducing air changes in the operating room (OR) is the purpose of the Healthcare Environment Optimization software from Johnson Controls Inc., Milwaukee. The product integrates a hospital's building automation system with surgery scheduling to optimize air exchange rates and energy use with projected annual savings of up to $10,000 in each OR.

"Typically, a high volume of air is being moved through the OR around-the-clock, even when the room is vacant," says Richard Smith, director for health care, Johnson Controls. "This wastes energy and valuable dollars, but with Healthcare Environment Optimization, we can now control the airflow in an efficient and safe manner."

Developed through a collaboration with HDR, an architecture, engineering and consulting firm in Omaha, Healthcare Environment Optimization translates and routes data from surgery scheduling to the automation system and determines which of the two HVAC system modes should be used: surgery or setback.

When the system is in surgery mode, the HVAC system achieves a minimum number of air changes every hour per industry or local authority standards. In setback mode, most regulatory entities state that air changes may be reduced to 25 percent of suggested values when the operating room is unoccupied.

Jeff Ferenc is senior editor for Health Facilities Management magazine.