How are hospitals being designed differently to achieve energy efficiency?

Hospitals and health care facilities are changing and their energy efficiency and sustainability systems must transform with them

By Consulting-Specifying Engineer December 9, 2021
Courtesy: Moses Engineering


  • Mark Chrisman, PE, PhD, Healthcare Practice Director, Principal, Henderson Engineers, Lenexa, Kansas 
  • Mike Fialkowski, PE, RCDD, LEED AP, Technology Services Market Leader, Affiliated Engineers Inc, Madison, Wisconsin 
  • Zach Frasier, PE, Mechanical Engineer, Moses Engineering, Gainesville, Florida 
  • Steve Lutz, PE, LEED AP, Associate Director, Harris, St. Paul, Minnesota 

Mark Chrisman, PE, PhD, Healthcare Practice Director, Principal, Henderson Engineers, Lenexa, Kansas
Mike Fialkowski, PE, RCDD, LEED AP, Technology Services Market Leader, Affiliated Engineers Inc, Madison, Wisconsin
Zach Frasier, PE, Mechanical Engineer, Moses Engineering, Gainesville, Florida
Steve Lutz, PE, LEED AP, Associate Director, Harris, St. Paul, Minnesota

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

Mark Chrisman: The efficiency conversation is evolving as health care systems connect continued use of fossil fuels with negative health outcomes. Leading health care systems are initially looking at how to transition to all-electric hospital campuses and then how to optimize the somewhat limited all-electric system options. Heat recovery chillers, heat pump water heating and control systems all play a big role in the electrification of hospitals. 

House HVAC system reconfiguration for the TAII reconfiguration. Moses Engineering evaluated the existing HVAC system and determined that the facility systems could be reconfigured from a recirculating to a single pass air system. The exposed ductwork shown above provided supplemental ventilation air to the house AHUs to achieve the intended reconfiguration. Courtesy: Moses Engineering

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

Mark Chrisman: Reaching required hot water temperatures to avoid legionella becomes a concern when working with some all-electric water heating systems. However, when all-electric systems are deployed and combustion-based heating systems are eliminated, the associated pollutants and on-site greenhouse gas emissions are eliminated as well. The risk of contaminating indoor spaces with on-site combustion fumes disappears. 

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

Mark Chrisman: A common concern is that low water use flush fixtures won’t be able to effectively manage and evacuate contents thus leading to additional flushes and maintenance issues. The strategy of using recycled water for nonpotable end uses is also a challenge for hospital settings due to health codes that prohibit anything but potable water from entering hospitals and health care facilities.