Health care building energy efficiency design model shifts

Hospital, health care insights

• Hospitals, health care facilities and related medical buildings are changing to meet the needs of resiliency, new outpatient facility demands and energy efficiency.
• New technologies and forward-looking energy options are under consideration.

Respondents

• Tanner Burke, PE, Senior Fire Protection Engineer, ACS Group, Austin, Texas
• Derek Cornell, Senior Associate, Certus Consulting Engineers, Dallas, Texas
• Beth Gorney, PE, Assistant Project Manager, Dewberry, Raleigh, North Carolina
• Sierra Spitulski, PE, LEED AP BD+C, Associate Principal/Studio Leader/Mechanical Engineer/Project Manager, P2S Inc., Long Beach, California
• Kristie Tiller, PE, LEED AP, Associate, Team Leader, Lockwood Andrews & Newnam Inc. (LAN), Dallas, Texas.

Tanner Burke, PE, Senior Fire Protection Engineer, ACS Group, Austin, Texas; Derek Cornell, Senior Associate, Certus Consulting Engineers, Dallas, Texas; Beth Gorney, PE, Assistant Project Manager, Dewberry, Raleigh, North Carolina; Sierra Spitulski, PE, LEED AP BD+C, Associate Principal/Studio Leader/Mechanical Engineer/Project Manager, P2S Inc., Long Beach, California; Kristie Tiller, PE, LEED AP, Associate, Team Leader, Lockwood Andrews & Newnam Inc. (LAN), Dallas, Texas.

What level of performance are you being asked to achieve, such as WELL Building Standards, U.S. Green Building Council LEED certification, net zero energy, RESET Standard or other guidelines?

Kristie Tiller: While sustainable building design has been around for a long time and building codes and standards have increased over the years to reach the highest levels, sustainability in health care facilities is important, but not at the expense of the health and safety of the patients being served. Don’t misunderstand — health care institutions are held to the same standards (if not higher) as all facilities, but while a standard office building may be able to easily achieve a U.S. Green Building Council LEED Certification, it is more difficult for a hospital to achieve the same.

Health care design is much more specific and less forgiving than most other facilities given the nature of its operation and more energy efficient solutions are not always appropriate to best serve the spaces and environments for which we are designing. Our first duty as engineers is to protect the safety and well-being of the community and that solution may not always be the most energy efficient one. We provide facility condition assessment services to help ensure we are completely aware of all systems in a facility, how they operate together and the longevity/condition of those systems. We also have several LEED and other energy-specific specialists in our firm to ensure that we are knowledgeable of the most energy efficient solutions in the industry and we strive to always provide our clients with the best solutions tailored specifically for their facilities.

What unusual systems or features are being requested to make hospital projects more energy efficient?

Derek Cornell: We are currently working on a project that involves the application of a power transfer technology with a proven record to decrease the inefficiencies in a typical power distribution system. The technology enhances the electrical efficiency by cycling and cleaning the power thereby lowering the total electrical energy consumption. In addition, by applying the efficient use of the power loads, power factor correction is also simultaneously achieved.

Sierra Spitulski: We work with health care providers, builders and designers to create reliable, energy-efficient facilities that safeguard their patient’s health and comfort while simultaneously reducing operating costs. Lately, we’ve been leveraging current code exemptions to decrease airflows in specific areas of the hospital during unoccupied hours through strategic zone level controls, finding creative ways to decarbonize such as rejecting boiler fuel heat to raise the temperatures of the domestic hot and heating hot water systems, in addition to more obvious decarbonization efforts such as heat recovery chillers and electric boilers.

P2S provided mechanical, electrical, plumbing, low-voltage and lighting design services for the adaptive reuse of the 505,000 SF facility with all new central utility plant systems integrated into the building. The utility systems included a new highly efficient water-cooled chilled water plant, heating and domestic hot water condensing boilers, fan array air handling systems, emergency generator system, fiber and copper utility services and all the utility distribution through the facility. P2S also provided support for construction and LEED Gold application for the project. Courtesy: P2S Inc.

What types of sustainable features or concerns might you encounter for these buildings that you wouldn’t on other projects?

Tanner Burke: Because hospitals typically require essential electrical systems to service critical electrical loads of the facility, we are seeing more microgrids proposed. These can include the use of energy storage systems which present unique fire hazards. While our recommendation has been to locate these in a safe area away from the hospital, spatial constraints have dictated locating them interior to the building. If this is the case, there needs to be careful evaluation regarding the fire detection, fire suppression, ventilation, explosion control and separation measures that should be taken to avoid compromising the safety of patients and staff.

Sierra Spitulski: Simultaneous heating and cooling is not advantageous to energy efficiency efforts, but it’s almost completely unavoidable in a hospital due to necessary dehumidification of sensitive spaces, including operating rooms that have much lower room temperature requirements. Understanding this challenge from the beginning of the design process can allow for a more targeted engineering approach. Our health care team understands every phase of the master planning process and they will thoroughly evaluate facilities to create an ideal master plan that fits all needs.

What are some of the challenges or issues when designing for water use in such facilities, particularly buildings with high water needs?

Sierra Spitulski: Hospitals are not places for lowest-flow fixtures, due to the need for cleanliness: handwashing, janitorial services, housekeeping, laundry, cooking, sterilization. All of the processes use a ton of water, especially in kitchens and equipment sterilization. When designing to optimize or reduce water usage, it’s important to consider end-use and contamination control.

What value-add items are you adding these kinds of facilities to make the buildings perform at a higher and more efficient level?

Sierra Spitulski: We work with health care providers, builders and designers to create reliable, energy-efficient facilities that safeguard their patient’s health and comfort while simultaneously reducing operating costs. Lately, we’ve been leveraging current code exemptions to decrease airflows in specific areas of the hospital during unoccupied hours through strategic zone level controls, finding creative ways to decarbonize such as rejecting boiler fuel heat to raise the temperatures of the domestic hot and heating hot water systems, in addition to more obvious decarbonization efforts such as heat recovery chillers and electric boilers.

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