A Prescription for Decarbonizing Health Care Facilities

Eric Granzow, Mechanical/Electrical

July 29, 2021

As states and cities adopt new regulations in a race toward net-zero emissions, decarbonization of the built environment has emerged as a buzz topic. However, certain industrial sectors face much higher hurdles in the collective effort to address climate change – perhaps none more than health care.

As hospitals, ambulatory surgical centers, and clinics feel pressure to reduce their carbon footprints, they still must meet long-established facility standards for power resiliency, sterilization, water quality, and indoor air temperature and humidity. These demands result in a baseline energy requirement for hospitals that far surpasses offices, hotels, schools, and apartment buildings, according to a 2017 report by the Urban Green Council in New York City. Now consider that some jurisdictions have enacted policies that will prohibit the supply of natural gas to new construction sites, and the urgency heightens for the health care industry to reduce baseline energy consumption as it works to sever its reliance on fossil fuels.

Despite these challenges, a host of strategies exist to incorporate carbon-free energy into health care facilities. Though the potential to decarbonize a facility is greatest when planning for new construction, significant gains can also be made by conversions of existing buildings and campuses.

Substantial energy cost savings represent another benefit of shrinking a hospital system’s carbon footprint. Depending upon the scope a conversion project, monthly utility bills can be reduced by 25-percent to 50-percent. In some cases, facility administrators have reported higher-than-expected savings that cut years from predicted payback timelines. Additionally, industry leaders find that it fits the larger mission of health care to adopt technologies that reduce air pollution and slow the pace of global warming.

Let’s consider a typical hospital that provides inpatient and outpatient services to better understand how carbon-reduction strategies can make a positive difference. The hospital campus likely consists of a medical office building that has doctors’ offices and exam rooms for outpatient treatment, an ambulatory surgical center where scheduled outpatient procedures are conducted, and the main hospital, which houses inpatient treatment and support along with an emergency department. Each building serves purposes that have differing utility needs for maintaining temperature, humidity, ventilation, power, and processes.

Essentially, hospital campuses function as small cities that provide for basic needs and amenities on-site – sterilization, cooking, laundry, even the hot water for the venti latte at the Starbucks kiosk. Currently, many hospital systems rely on natural gas to power these functions, so replacement approaches must be found. As for electricity, it will be essential for hospitals to satisfy more of their demand with power produced by wind, solar, hydro, and other non-carbon generating methods.

Options exist to make strategic transitions, but they must be considered and discussed as early as possible. At the first planning meeting, specialty consultants would ideally be engaged to present a full range of choices so hospital leaders can identify the solutions that best fit their organizations.

Geothermal systems represent one method of heating and cooling that requires early planning. A proven option to natural gas-powered systems, geothermal requires space for cooling ponds or wells. The space requirements must be accounted for before site decisions are made that would remove geothermal as an option, whether the project involves greenfield construction or modification of an existing campus. In other words, decide that the field next to your ambulatory tower would be perfect for a cooling pond before it’s paved over for a parking lot.

Other technologies in the net-zero consultant’s toolbox include heat recovery chillers, thermal storage systems, microgrids, and heat pump water heaters to name a few. At least one hospital has adopted a biogas system that captures methane from agricultural waste generated by nearby farms. To move hospitals away from fossil fuels, alternative approaches and innovative thinking will be necessary. Olsson’s team of planners, engineers, and industry-leading experts can advise and assist at every stage of master planning, concept development, site acquisition, design, construction, testing, commissioning, and management.

Hospitals are critical to our health, safety, and quality of life. They are sources of pride and centers of excellence in our communities. And they have consistently adapted to change and embraced technological innovation. All of this bodes very well for their prospects of meeting the decarbonization challenge.

Eric Granzow, PE, LEED AP, HFDP, CEM, brings more than two decades of experience designing health care facilities to be safer and more energy efficient. He is a certified Heathcare Facility Design Professional and is a member of the ASHRAE standing standard project committee on ventilation of health care facilities. Reach Eric at 309.269.8767 or egranzow@olsson.com