Sustainability 101

HESNI Quarter 1 Meeting

March 9th, 2017

Meet the Presenters

u  Ryan Ollie, CEM, CMVP, EIT

u  Manager of Energy Solutions, Advocate Health Care

u  HESNI Energy & Sustainability Liaison

u  Katie Wickman, MS, RN, CIC

u  Manager of Sustainability, Advocate Health Care

u  Michael Smucker

u  General Manager of Environmental Services, Aramark/Advocate Health Care

Agenda

u  Introduction u  What is Sustainability?

u  Main Areas of Sustainability in Healthcare u  Green Buildings

u  Waste Reduction Strategies

u  Green Purchasing

u  Green Cleaning

u  What is Energy Management? u  Growing Popularity in Healthcare u  Energy Utilization u  Benchmarking

u  Operational/Capital Examples u  Utility Incentives/Rebates

u  Questions/Comments

What is Sustainability?

u  “Sustainability is based on a simple principle: Everything that we need for our survival and well-being depends, either directly or indirectly, on our natural environment.”

u  “To pursue sustainability is to create and maintain the conditions under which humans and nature can exist in productive harmony to support present and future generations.”

- US Environmental Protection Agency

Sustainability in Health Care

Images from Practice Greenhealth (practicegreenhealth.org)

Green Buildings

u  Energy & water efficiency

u  Sustainable building materials

u  Low/no hazardous materials (lead, mercury, VOCs, others)

u  Local or sustainable products (sustainably-harvested wood, etc)

u  Designing for health

u  Maximizing daylighting, connecting to nature, spaces for respite

u  Designing for sustainable operations

u  Utility rooms, collection areas for recycle streams, cafeteria design, food waste prevention & management, etc

u  LEED (Leadership in Energy & Environmental Design)

Building sustainable spaces – and building for sustainable operations.

u  Greening existing buildings…

It’s complicated.

Green Operations - Waste Reduction Strategies

REDUCE

Green Operations - Waste Reduction Strategies

u  Regulated medical waste

u  Fluid management systems

u  Proper segregation

u  Reformulating OR packs

u  Materials management

u  Reusable service ware

u  Cafeteria

u  Break rooms

u  Food waste prevention

u  Going “paperless”

u  Using only what you need

REUSE

Green Operations - Waste Reduction Strategies

u  Reprocessing

u  Surgical devices

u  Medical devices

u  Furniture/equipment management

u  Redeployment

u  Donation

u  Donation

u  Food

u  Supplies (expired, etc)

u  Decommissioned equipment

RECYCLE

Green Operations - Waste Reduction Strategies

u  Co-mingled

u  Confidential paper

u  Batteries

u  Blue wrap

u  Electronics

u  Scrap metal

u  Construction debris

u  Bulbs & ballasts

u  Toner / cartridges

u  Composting

Green Purchasing What we buy matters – our purchasing dollars make a difference in our facilities and can help transform the market.

u  Considerations

u  Product content (recycled content, sustainably-sourced materials)

u  Chemicals (mercury, fire retardants, PVC, DEHP, etc)

u  Packaging

u  End of life (take back, reuse, reprocess, recycle)

u  Local/regional products

Green Purchasing What we buy matters – our purchasing dollars make a difference in our facilities and can help transform the market.

u  Key products & services

u  Furniture/interiors/flooring (flame retardants, PVC, environmental certification)

u  Medical products (PVC/DEHP, recyclability, reprocessing)

u  Environmental services (green cleaners, recycling services)

u  Food (meat raised without antibiotics, local/certified sustainable, recyclable/compostable service ware, healthy beverages)

u  Electronics (EPEAT certified, recycling)

Healthier Hospitals

u  Free program of Practice Greenhealth

u  Challenges & resources u  6 challenge areas:

u Engaged Leadership u Healthier Food u Leaner Energy u Less Waste u Safer Chemicals u Smarter Purchasing

u  1800+ hospitals enrolled (HH/PGH)

Green Cleaning

Green Cleaning Products u  HH Standard- Inventory cleaning

products and purchase 90% Green Seal or UL ECOLOGO certified cleaning products in the following categories:

u  Carpet

u  Window

u  All purpose

u  Bathroom

u  General floor care*

*Does not include strippers or finishes

78.00%

80.00%

82.00%

84.00%

86.00%

88.00%

90.00%

92.00%

94.00%

System Average

Green Cleaning Compliance

2014 2015 2016

Business Case for Green Cleaning

u  Chemical selection to HH criteria with cost impact

u  Overall cost reduction as compliance increased

$0

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

Chemical Costs per Year

Chemical Costs

2014 2015 2016

Microfiber

u  Effective at capturing microbes

u  Prevents cross-contamination

u  Reduces chemical and water use more effectively

Interiors

u  Special selection of interior surfaces

u  Upholstery selection of furniture

u  Paint

u  No finish flooring

u  Labor saving

Health Impacts of Green Cleaning

u  By switching to safe and effective alternatives, hospitals can create a

u  healthier environment for patients, staff members and communities.

u  Lower disposal costs and limits liability.

u  Industry is driving a marketplace shift by creating the demand, and suppliers are responding.

What is Energy Management?

“Energy management is the process of monitoring, controlling, and conserving energy in a building or organization.”

- BizEE Software Ltd

Growing Popularity in Healthcare

u  Healthcare providers are being asked to do more with less

u  Hospitals consume an enormous amount of energy

u  Managing energy consumption with efficiency in mind is becoming more of a focus in healthcare facility operations

Energy Utilization Index (EUI)

u  A popular way of analyzing energy consumption is by calculating the EUI

u  EUI [kBTU/SF] = (Total BTU’s of Electricity & Natural Gas)/(Total SF x 1000)

u  1 kWh = 3,412 BTU’s

u  1 Therm = 100,000 BTU’s

Continued

u  This method allows facilities staff to compare energy usage across different buildings of various size on per unit basis

u  Normalize for weather and occupancy

Versus

Energy Benchmarking

u  “A mechanism to measure energy performance of a single building over time, relative to other similar buildings, or to modeled simulations of a reference building built to a specific standard (such as an energy code).”

- US Department of Energy

ENERGY STAR Portfolio Manager

u  Free web-based tool created by the Environmental Protection Agency

u  Helps facility management staff and partners track and compare energy usage across a portfolio of properties

u  Specific building categories for general medical/surgical and medical office properties

Continued

u  Various high-level and detailed reports in the tool helps users showcase performance

u  Uses a proprietary scoring method to rank buildings from 1 to 100

Continued

u  Score of ≥ 75 allows building to receive nationally recognized ENERGY STAR certification

u  Only 58 hospitals nationwide received the certification in 2016

Energy to Care

u  ASHE’s Energy to Care (E2C) program is a free benchmarking and awards program for health care facilities

Continued

u  If you are already utilizing ENERGY STAR Portfolio Manager, it allows you to easily import all of your energy data into the tool

u  You can also manually enter data into the tool

u  Many powerful features to help track and analyze energy usage behavior

Continued u  Various awards and challenges are offered to participating members

u  HESNI is currently competing in the E2C Chapter Challenge against other chapters across the country

Operational Energy Efficiency

u  Preventative maintenance is the first line of defense for energy efficiency improvements.

u  Often requires little to no investment

u  Preserves the life of existing equipment

u  Examples:

u  Ensure heating/cooling coils are cleaned and maintained to reduce the fan HP needed to overcome resistance caused by plugged coils

u  Regularly replace dirty air filters for the same reason

Energy Efficiency Checklist

u  Advocate created an energy efficiency operational checklist

u  Helps standardize proven procedures

u  Proactive approach (preventative maintenance)

Energy Efficiency Capital Project Example

u  Where to use recovered heat?

u  Boiler feed water

u  Boiler make-up water

u  Domestic hot water

34

Boiler Flue Stack Economizers

35

De-aeratorVentHeatRecovery

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Utility Incentives (Rebates)

•  ComEd, Nicor, North Shore/Peoples Gas, and Ameren have state requirements for energy efficiency incentive/rebate programs

•  Prescriptive

•  Custom

•  New Construction

•  Retro-Commissioning (Cx)

•  Monitor-Based Cx

•  Data Centers

•  This is money that everyone pays on their utility bill

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Questions/Comments

Sources

u  http://greenpsf.com/pub/pages/benchmark

u  http://www.scoop.co.nz/stories/GE0909/S00010/biggest-hospital-building-just-what-the-dr-ordered.htm

u  https://chemical-materials.elsevier.com/chemical-manufacturing-excellence/sustainability-instrumentation-process-control/

u  https://mcdmag.com/2013/11/efficiency-radar-todays-trends-what-the-future-holds-for-healthcare-energy-management/#.WHehOVXR-M-

u  http://www.insidegreenecounty.com/Being-Healthy-in-Greene-County-34

u  http://www.energytocare.com/

u  https://www.energystar.gov/buildings/facility-owners-and-managers/existing-buildings/use-portfolio-manager

u  http://cmsmechanical.com/recent-news/energy-management-gains-ground-globally/

u  http://www.metropolitanind.com/blog/category/green_solutions/