Energy Efficiency in Hospitals

Dr Mahesh R
Associate Professor
Dept of Hospital Administration
AIIMS, New Delhi- 110029
Protocol

 Energy consumption in Hospitals

 Major Electricity end-users in Hospitals
 Energy saving approaches
 Hospital Indoor Climate requirements
 Benchmarking
 Case Study- Hospital Dietetic Services
Energy Consumption in Hospitals

 Electricity

 Major electricity consumers in a hospital are

cooling/heating equipment, lighting, air
compressors, water pumps, fans and ventilation.
 Other applications include laundry equipment;
kitchen and canteen equipment; ovens and geysers
and medical equipment including autoclaves
 Office facilities such as computers and photocopiers,
utilities such as lifts, refrigerators, water coolers, etc.
 Heat Stream is used in the form of steam and
hot water.
 Steam is used in the kitchens and for
humidification in HVAC and sterilization
process. In addition steam is used to
transport heat over longer distances.
 Oil/Gas-fired boilers are used to generate
steam and hot water.
 Compressed air - two main categories, namely medical
air and technical air.
 Medical compressed air refers to the direct treatment
and care of patients.
 Examples include breathing apparatus and surgical
tools driven by the compressed air. The medical
compressed air is subjected to very high standards for
availability and quality.
 The technical compressed air is used for HVAC control
systems, workshop applications or keeping containers
under pressure.
 Cold Stream mainly takes the form of chilled
water and is used for in-door climate control
systems, for cooling and drying the
ventilation air. In many cases cold stream is
generated centrally by means of compression
coolers. In combination with cogeneration,
absorption-cooling machines are used to
supplement compression coolers.
Major Electricity End-Users in Hospitals

 HVAC System
 In many large and centrally air-conditioned hospitals,
HVAC systems may consume 40% of total electricity
consumption. Air Conditioning and Ventilation system
in hospitals is required for:
 Maintaining the requisite indoor temperature, air
distribution and humidity levels for thermal comfort.
 Maintaining indoor air quality, particularly in areas requiring
prevention of infection
 Building envelope design plays a very important role in the
determination of HVAC capacity in the hospital.
 Lighting
 Lighting is a major electricity consumer next only to HVAC
systems. Requirement of lights in a hospital varies widely
depending upon the activity, time of day and the occupancy
level.
 The complexity can be well understood from the simple fact
that National Building Code (NBC) 2005 recommends
Illuminance level varying from one lux for night lighting in
some areas to 750 lux in operation theaters for general
requirements.
 At times special lights are used with illumance of 10,000-
50,000 lux in operation theaters.
 Water Pumps
 Water is consumed in different sections of
the hospitals for various requirements. In
most hospitals, water pumping systems may
account for 5-15% of total electricity
consumption and offer scope for reducing
energy consumption.
Energy Saving Approaches
-Three basic approaches

 Switching off — All energy-consuming equipment

should be switched off when not in use. This can
be done manually by hospital staff or
automatically with special devices.
 Maintenance — A number of energy efficiency
measures can be carried out as part of routine
maintenance procedures at no extra cost.
 Refurbishment — Energy saving measures can be
extremely cost-effective when planning for
refurbishment in the hospital.
Indoor Climate Requirement

 Mainly accomplished by regulations for

thermal insulation, ventilation, lighting, and
indoor temperature levels
Thermal Insulation

 The thermal properties of the building envelope are very

important, as a well air conditioned hospital often requires a
temperature level of 21-22°C throughout the year, but is limited
to a maximum of around 26°C during the warmer months.
 In several European countries’ regulations are usually in the form
of mandatory maximum levels for U-values (coefficients of
thermal transmittance) for the entire building envelope, including
walls, foundations, roof and windows.
 In India, this is being currently attempted by Energy Conservation
Building Code (May 2007) particularly for new buildings, having a
connected electricity load of 500 kW or more or a contract
demand of 600 kVA or more.
Ventilation
 It is not always the heat generated that decides the
ventilation and cooling/heating rates (as is normal
for commercial buildings, such as offices), but the
hygiene considerations.
 As indoor air is contaminated by occupants (some of
them may be patients) and activities in the hospital,
it must be renewed in order to eliminate
contaminants, odours and pollutants.
 In many European Countries, room ventilation levels
typically range from 35-140 m3 per person/hour
depending on the function of the room (e.g. general or
intensive-care).
 Operating theatres are usually among the rooms having
the highest demands, with ventilation rates around 30-
55 m3/square meter/hour.
 In India, National Building Code (2005) recommends 6-8
air changes per hour in hospital wards, and 15-25 air
changes per hour in sterilizing departments of the
hospitals.
Lighting

 Daylight is, by far the most desirable type of illumination for

the human comfort. Design of areas used by patients should
always provide for windows. Their size, orientation and position
in rooms must provide sufficient lighting levels, and should give
a view of the outside surroundings and the sky. This adds to a
patient’s feeling of contact with the outside world, which is
important, psychologically, in healing.
 Often in conflict with the above benefits are the unwanted
effects of glare and overheating due to solar radiation. These, if
not avoided, result in considerable discomfort for the patients,
and an increased need for cooling energy. For this reason
sunshades and blinds should be fitted to the affected windows.
 Maximum utilization of daylight is best provided
by having sun shades and blinds automatically
controlled by sensors triggered by sunshine and
wind, but manual controls should always be
available for individual adjustment. Hospitals also
usually have a substantial number of windowless
rooms, in which daylight is, of course, not a
practical solution. In these cases, artificial lighting,
which is energy efficient, must be employed to
maintain comfort levels.
Temperature

 To maintain comfort levels for patients, a typical

temperature for patients’ rooms and recovery rooms is
24-26°C during summer months. This value could be
maintained at 21-23°C during the colder part of the year.
 When temperature discomfort is identified, it is usually
more efficient to localize the sources of discomfort and
treat these, rather than to increase or decrease the
room temperature. This can be done, for example, by
covering cold walls, erecting screens against cold drafts
from windows, window frames and badly positioned air
vents, and minimizing isolation by installing sunshades.
Indoor Air Humidity

 Indoor air should neither be too dry (which causes

dehydration) nor too humid (which causes
perspiration and increases the risk of fungal
growth). The comfort range covers, relative
humidity of 45-55%, at temperatures of 24-26°C
normally required in patients and recovery rooms.
 Strict hygrometric controls are often only applied
in rooms where conditions are more critical, i.e. in
operation theatres, intensive-care wards, etc.
Benchmarking Indicators

 Two indicators most commonly used

internationally for benchmarking in hospitals
are :
 a)  Annual energy consumption per square
meter of the hospital’s building area
 b)  Annual energy consumption per inpatient
bed in the hospital

(Leonardo Energy, 2008)

Energy Consumption in Hospital
Kitchen: Opportunities for saving

Dr Mahesh R
Associate Professor
Dept of Hospital Administration
AIIMS, New Delhi- 110029
Format

 Introduction
 Importance
 Who …
 What…
Introduction

 Kitchen’s in Hospitality and Institutional

facilities are intense energy users putting
food service among the biggest energy
consumers
Energy consumption by end use in
food service facility

Source: U.S. Energy Source Information

 Kitchen’s are Energy Intensive!

Shaping Restaurants to Be Models of Efficiency

By LAURA NOVAK May 17, 2006

If Hospital Kitchen’s were automobiles, they would be

“

Hummers.”
 Organisations /Agencies

 Bureau of Energy Efficiency

 Government of India under the provisions of
Energy Conservation Act -2001

 Energy Star
 Voluntary climate protection partnership with the
U.S. Environmental Protection Agency (EPA)
Energy Efficiency Star grading agencies
Objectives
 Strategic approach to energy management,
promoting energy efficient products and practices
 Tools and resources to help save money and
protect the environment
 Reduce greenhouse gas emissions and other
pollutants caused by the inefficient use of energy
AND
 Make it easy to identify energy-efficient products
that offer savings on energy bills without sacrificing
performance, features, and comfort.
 Bureau of Energy Efficiency has endorsed
designs of >15 appliances used for household
purposes for Energy Star ratings

 Energy Star – US based voluntary agency has

60+ product categories to its credit
 Product Categories Covered

Lighting Home Envelope

Residential light Home sealing
Fixtures & insulation
CFLs BEE Roof products
LEDs Windows/Doors

Heating & Commercial Home

Cooling Office Food Service Appliances Electronics
Central AC Equipment Refrigerators Clothes washers Battery chargers
& ASHPs Computers Freezers Dishwashers Telephony
LCHVAC Monitors Fryers Refrigerators Televisions
Boilers Printers Steamers Dehumidifiers Audio/Video
Furnaces Copiers Griddles Air cleaners equipment
Ceiling fans Scanners Ovens Water coolers
Room AC Fax machines Ice Machines Water heaters
Ventilating fans Servers Dishwashers
Why should Hospital Kitchen’s care about
Energy efficiency star gradings?

 These kitchen appliances saves end-users energy,

water, and money
 Energy efficiency is becoming more important in
foodservice environments

 Demonstrates commitment to environment

 Guards against rising energy rates
 These qualified equipment has a lower total cost of
ownership over time
 Overview of Energy Efficiency STAR
grading- Qualified Products & Savings

Case Study- Energy Star

(Voluntary Climate Protection Agency)
ENERGY STAR Guiding Principles

 Guiding principles:
 Cost effective for the end user
 Significant unit/national energy savings
 Performance is maintained or enhanced
 Efficiency performance is measured and verified
with industry accepted test method
 Third-party certification procedures bolster
the integrity of the program and ensure
energy-efficient performance
Eligible Energy efficiency star - Qualified
Commercial Food Service Equipments

Refrigerators and Hot Food Holding Dishwashers Ovens

Freezers Cabinets

Griddles Fryers Steam Ice Machines

Cookers
Average Annual Cost Saving

$55 - $70(refrigerators); $655 $190 (electric);

$175 - $320 (freezers) $720 $360 (gas)

Refrigerators and Hot Food Holding Dishwashers Ovens

Freezers Cabinets

$190 (electric); $100 (electric); $470 $1,100 - $1,200

$175 (gas) (gas) (electric or gas) $130

Griddles Fryers Steam Ice Machines

Cookers
• Actual energy savings may vary based on equipment use and other factors.
• 2011 EPA savings figures
Average Lifetime Cost Savings

12 year life 12 year life 12 year life

$500 – 650 (refrigerators); $ 6,150 20 year life $1,800 (electric);
$1,650 – $3,000 (freezers) $5,850 – $9,750 $3,400 (gas)

Refrigerators and Hot Food Holding Dishwashers Ovens

Freezers Cabinets

12 year life 12 year life 12 year life

$1,800 (electric); $950 (electric); $4,400 $10,350 (electric); 8 year life
$1,650 (gas) (gas) $11,500 (gas) $900

Griddles Fryers Steam Ice Machines

Cookers
• Actual energy savings may vary based on equipment use and other factors.
• Lifecycle cost savings based on a 4% discount rate
Additional Benefits of Energy efficiency Star
graded Kitchen Equipment

 Shorter cook times

 Improved production rates
 Reduced load on the HVAC system (from heat
loss)
 Improved recovery times
 Lower maintenance costs
 Reduced noise levels
 Specific Benefits with
Energy Efficiency Star Graded
Kitchen appliances
Overview of Improved Efficiency with
Energy efficiency Star graded appliances
Product Type % Improved Efficiency*
Dishwashers 25%
(+ 25% more water efficient)
Fryers 30%
Griddles 10-25%
Hot Food Holding 65%
Cabinets
Ice Machines 15%
(+10% more water efficient)
Ovens 10-25%
Refrigerators 30%
and Freezers
Steamers 60%

*Approximated values
Commercial Dishwashers
• Approximately 25% more energy efficient &
25% more water efficient than standard models
 Examplesof technical approaches to
reduce energy & water consumption:
 Improved tank insulation
 Improved nozzles and rinse arm designs
 Auxiliary pre-rinse section
 Additional equipment benefits:
 Quiet operation
 Auto mode capabilities
 Water heater/building energy savings
 Heat recovery
Commercial Fryers

• Approximately 30% more energy efficient than

standard models
 Examplesof technical approaches to reduce
energy consumption:
 Advanced gas heat exchanger designs
 Advanced electrical heat transfer technologies
 Thermostats with improved accuracy
 Frypot insulation (electric only)

 Additional equipment benefits:

 Continuous production capacity & higher pound-per-hour
production rates
 Quicker comparable recovery process
 Improved oil conservation and management, improved ease of cleaning
Commercial Griddles

 Approximately 10-25% more energy efficient

than standard models
 Examples of technical approaches to reduce
energy consumption:
 Strategic placement of thermocouples
 Double sided griddles
 Use of highly conductive or reflective plate materials
 Improved thermostatic controls
 Sub-griddle insulation (electric only)
 Additional equipment benefits:
 Improved cooking performance
 High production capacity
 Improved/more even heat distribution
 Easier to clean
Commercial Hot Food Holding
Cabinets
• Approximately 65% more energy efficient
than standard models
 Examplesof technical approaches to
reduce energy consumption:
 Improved insulation
 Temperature and humidity controls
 Magnetic door gaskets
 Dutch doors
 Additional equipment benefits:
 Better temperature uniformity from top to bottom
Commercial Ice Machines
 Approximately 15% more energy efficient
& 10% more water efficient than standard
models
 Examples of technical approaches to
reduce energy & water consumption:
 Improved cold-compartment insulation
 Higher efficiency compressors, fan motors and fan blades
 Reduced harvest meltage and evaporator thermal cycling
 Additional Equipment Benefits
 Quicker ice harvesting
 Less frequent compressor start up and shutdown cycles → less maintenance
 Commercial Ovens

• Approximately 10-25% more energy efficient

than standard models
 Examplesof technical approaches to
reduce energy consumption:
 Direct-fired gas burners
 Infrared burners
 Improved insulation
 Quality control features
 Improved gaskets
 Additional Equipment Benefits:
 Faster & more uniform cooking process
 High production capacity
Commercial Refrigeration

• Approximately 30% more energy efficient than

standard models
 Examples of technical approaches to
reduce energy consumption:
 High-efficiency compressors and improved coil design
 ECM (Electronically Commutated Motor) evaporator and
condenser fan motors
 Improved fan blade designs
 Hot gas anti-sweat heaters for defrost
 Improved insulation and gaskets
 Efficient interior lighting
 Additional Equipment Benefits:
 Uniform cabinet temperatures
Commercial Steam Cookers
• Approximately 60% more energy efficient than
standard models
 Examplesof technical approaches to
reduce energy consumption:
 “Connectionless” steamers
 Closed-system design
 Improved insulation
 Low-temp standby/idle modes
 Improved gaskets
 Additional Equipment Benefits:
 90% reduction in water consumption
 Shorter cook times
 Higher production rates
Tips for Hospital Kitchen Operators
How to strategically save ENERGY?

 Operations & Maintenance

 Employee’s Behaviour

 Lighting

 Vacancy Sensors and Controls

Operations & Maintenance

 O&M = “low-hanging fruit” for energy savings

 Performing regular maintenance on:
 Walk-in refrigerators: clean coils, add refrigerant, fix
gaskets
 Heating, cooling, and ventilation (HVAC): regular tune ups
by Air conditioning engineers and schedule filter changes
 Cooking and sanitation equipment: have a professional
tune up and recalibrate the equipment
 Fix water leaks immediately
 Consider an energy audit

Source: PG&E Food Service Technology Center

Employee Behavior

 Creating an environment and to imbibe the culture

of a “start-up/shut-down schedule”
 Most equipment only needs 15 min. to preheat
 Turn off lights and burners when not in use!
 Cut idle time for support equipment

 Toasters  Coffee Warmers

 Warming drawers  Plate warmers
 Holding cabinets  Steam tables

 Walk-in refrigeration: instructions to -do not prop

open doors
Source: PG&E Food Service Technology Center
Lighting

 Installing Energy efficiency Star grading

agency qualified lighting can save users
money
 LED and CFL lighting use about 75% less energy
than incandescent lighting and produces less heat
→ saving money on HVAC expenses
 These lighting lasts longer and can also improve
the visual experience
Vacancy Sensors & Lighting Controls
 Use occupancy sensors to turn off lights when they
are not needed
 Cost: $25 (Rs 1500) to $80 (Rs 4800) (ultrasonic or
infrared)
 Place in work area, diet counseling rooms,
bathrooms, storerooms, and walk-in refrigerators
 Restrooms: save 30 to 75%
 Storage areas: 45 to 65%
 Offices (private): 25 to 50%

Source: ENERGY STAR Small Business Guide:

Putting Energy Into Profits
Dietetics : AIIMS
Sl No Type of Diet Quantity/Annum
1 Normal Diet 376773
2 Therapeutic Diet 161470
3 Semisolid Diet 57057
4 Enteral feeds 38839
5 Private ward Diet 90899

Total 725038
Energy Consumption

 Electrical component
 an average of 700 kwH is consumed approximately per
day
 Includes light fittings, various types of fans, Air
conditioners, Geysers, Chapati making machine, and Cold
Storage
 Gas Consumption

Type bill/month
LPG 5,07010
PNG 3,24840
Acknowledgements
• PG&E Food Service Technology Center
– www.fishnick.com
• National Restaurant Association’s Conserve Initiative
– http://conserve.restaurant.org/
• ENERGY STAR Small Business partnership program
– www.energystar.gov/restaurants
• ENERGY STAR Training Center
– www.energystar.gov/training
 Department of Dietetics, AIIMS
 Engineering Services Department, AIIMS
 Dr M B Suja, Resident Administrator, AIIMS
Thank you