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Technology Report

April, 2009

Siemens Industry, Inc. Page 1 of 12

Green Healthcare Facilities

Steps Toward Sustainability

Healthcare facilities account for 9% of all commercial

energy consumption in America, according to the

DOE.

As shown in Figure 1, inpatient healthcare

facilities are the second largest energy consumer

and u

se on average 250,000 Btu per sq ft.

Figure 1

. Energy Usage by Building Type.

Motivation to Go Green

The motivation for healthcare facilities to incorporate

sustainable green design, construction and

operating practices is that improved indoor

environmental quality improves the health of

patients, professionals, staff and visitors.

More than 20 healthcare facilities have achieved the

U.S. Green Building Council’s LEED for New

Construction (LEED-NC) certification; however, it is

acknowledged that the LEED-NC rating system was

designed for commercial buildings and presents

challenges to healthcare facilities.

1. Joyce Hackenbrach, Healthcare Facilities Account for 9% of

Energy Consumption, Managed Healthcare Executive,

December 1, 2008

2. Carol Fem, Champion Both Infection Control and Energy

Conservation, Healthcare Building Ideas, April 5, 2008, pp

68-74

Green Guide for Health Care

(GGHC)

The Green Guide for Health Care (GGHC)

is a

voluntary, self-certifying tool for sustainable design,

construction, and operations. Modeled, with

permission, on the U.S. Green Building Council’s

Leadership in Energy and Environmental Design

(LEED

) building rating systems and tailored to

address specific healthcare regulatory requirements

that control many aspects of acute care hospitals’

physical environment and facility operations.

The GGHC was developed with guidance from the

Green Healthcare Construction Statement written by

the American Society of Healthcare Engineers

(ASHE).

USGBC and GGHC

U.S. Green Building Council (USGBC) and the

Green Guide for Health Care (GGHC) signed a

memorandum of understanding in September of

2007.

The LEED for Healthcare rating system was

developed as a collaborative effort between the

Green Guide for Health Care (GGHC) and USGBC.

GGHC helped streamline development by aligning

the organizational structure, conducting public

comment periods and a pilot program that included

more than 100 healthcare facilities.

LEED for Healthcare will be released in 2009.

3. For more information, see the Green Guide for Health Care

(GGHC) Web site at: www.gghc.org

Document No. 1

49-822

Summary of content (12 pages)

PAGE 1
Technology Report April, 2009 Green Healthcare Facilities Steps Toward Sustainability Healthcare facilities account for 9% of all commercial energy consumption in America, according to the DOE. 1 As shown in Figure 1, inpatient healthcare facilities are the second largest energy consumer and use on average 250,000 Btu per sq ft. 2 Green Guide for Health Care (GGHC) The Green Guide for Health Care (GGHC) 3 is a voluntary, self-certifying tool for sustainable design, construction, and operations.
PAGE 2
Innovation and Design Process The GGHC created the Innovation and Design Process (ID) to provide design teams and projects with the opportunity to achieve additional points for exceptional performance above credit goals set by the GGHC and innovation for green building goals or strategies. Sustainable Sites Hospitals store and manage chemicals in both underground tanks and other outdoor facilities. By minimizing potential leaks and spills, hospitals can protect the surrounding community.
PAGE 3
A water use study, published in 2002, showed that hospitals typically have the following broad breakdown of water use as shown in Figure 3. 6 Figure 3. Water Usage in Healthcare Facilities. Rain Water Usage The GGHC, WE1 requires using captured rainwater, recycled water, recycled greywater for non-potable uses for irrigation. Rainwater systems have significantly fewer code requirements than greywater systems. Using rainwater reduces the load on municipal water utilities.
PAGE 4
Symbols L BAS Rainwater Control Panel Level Sensor Flow Sensor Pump L From Gutters and Drains L Water Treatment Subsystem Rainwater Collecting Tank Greywater Storage Tank Greywater Supply Figure 4. Rain Water Collection Processes are Coordinated by the Building Automation System. Pumps deliver the greywater for such uses as landscape irrigation and cooling towers.
PAGE 5
single room, central systems are more complex to design, install and operate. Long term water efficiency depends on regular maintenance by specialists trained on the equipment. This is a good approach for organizations that can realistically commit to maintaining performance. For smaller users, a trade-off in efficiency is often made so that a simpler system can be installed.
PAGE 6
Table 1. Commissioning Tasks for Pressurization in Healthcare Facilities. Fundamental Commissioning (Prerequisite 1) General Patient Rooms Enhanced Commissioning (EA Credit 3) Describe acceptance tests in the contract documents. Include commissioning team members during all phases. Verify airflow rates at high and low values of cooling and ventilation rate. Commissioning team reviews design, include voice of user and safety. Verify pressurization throughout operating range.
PAGE 7
The following mandatory controls are required for HVAC system energy efficiency: Eliminate Simultaneous Heating and Cooling        Elimination of simultaneous heating and cooling (section 6.5.2) requires controls that serve zones, hydronic systems and dehumidification process to be sequenced to prevent reheating, recooling or mixing of mechanically cooled or heated fluids or air. Zone isolation (6.4.3.2.4) Shutoff Damper Control (6.4.3.3.3) Low-leakage Dampers (6.4.3.3.
PAGE 8
The following ASHRAE 90.1-2004 prescriptive provisions are recommended for healthcare facility ventilations systems:     (6.5.1) Air handling units that provide cooling must provide either an air or water economizer. Air Economizer options are based on ASHRAE climate zones. (6.5.3.2) VAV fan with motors 10 hp or larger have one of the following: variable-speed drive, vane-axial fan with variable-pitch blades or other controls and devices that will reduce fan motor demand. (6.5.3.2.
PAGE 9
mechanically ventilated spaces ensures adequate ventilation rates are maintained. CO2 sensors should be installed in all densely populated occupied spaces (occupant density is greater than 25 people per 1,000 sq ft) such as: conference rooms, patient waiting areas, etc. CO2 monitoring locations should be located three feet to six feet above the floor. CO2 and airflow measurements should be monitored, controlled and trended by the Building Automation System (BAS). Figure 5.
PAGE 10
Existing Healthcare Facilities Operations and maintenance protocols are critical to ensuring the health and environmental performance of healthcare facilities. The Green Guide for Health Care (GGHC) developed a specific set of credits to support a healthcare facilities continuous improvement program for sustainable operations.   Many of the Facility Management credits found in the GGHC mirror those found in the LEED for Existing Buildings: Operations & Maintenance.
PAGE 11
Ongoing Commissioning  The GGHC Operations rating systems awards a separate point (FM3.3) provided that the following items are implemented.     Implement ongoing commissioning program that includes planning, system testing, performance verification, corrective action response, ongoing measurement and documentation to proactively address operating problems. Create written plan that summarizes the commissioning cycle for the building by equipment or building system group.
PAGE 12
Emission Reduction Reporting The GGHC Operations rating systems awards a separate point (FM5.4) provided that the following items have been documented. Emissions reductions must be tracked and recorded, including those obtained for energy efficiency improvements, renewable energy and other building emission reduction actions. Figure 8 shows an example of a Emissions Summary Report generated from historical building operating data by the building automation system. Figure 8. Example Emissions Report.