aeee hospital webinar for caho
TRANSCRIPT
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ENERGYEFFICIENCYINHEALTHCARE
SECTOR
AWebinarbyCAHOandAEEE
Dr.SatishKumarJune22,2016
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Motivation
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Green isBecominganImperativeforHospitals
HealthcareBusiness
CompetitivenessAnd Quality
EnergyCosts&EnergySecurity
Regulation
HighQualityPatientCare
Carbon/Emissions
Differentiation
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0.9bedper1000populationin2014~11Lakhbeds
Privatesector’ssharein totalnumberofhospitalsandhospitalbedsisestimatedat74percentand40percent
Annualenergyconsumptionperbedvariesfrom4,000kWh– 16,000kWhand Annualenergyconsumptionperm2 varies75kWh– 320kWh
Totalnational levelelectricityconsumption~9,40,000GWhTotalcommercialsectorconsumption~1,03,000GWh (11%)Totalhealthcaresectorenergyconsumption– 5,000GWh – 10,000GWh (5%- 10%)
Total built-upareainhealthcaresectorconsidering11lakhbeds– 30- 50millionm2
Expectedriseinnumberofbedsinnext5years– 50,000equivalentto2millionm2
WHAT’SITWORTH?WHYBOTHER?
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EnergyManagementinHospitals
EXISTINGBUILDINGS
NEWCONSTRUCTION
O&M/FacilityManagement
PROCUREMENTOFEQUIPMENT&SERVICES
BUILDINGDESIGN
AlignEnergyEfficiencywiththeCriticalFunctionofHealthCareFacilities
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EnergyEfficientFacilityManagementinHospitals
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OverarchingGoalsofHospitalFacilityAdministrators
Ensurequalitypatientcareandminimizehealthrisks
Securereliableenergyandutilitysupplies
Managebuildingservicesandindoorenvironmentalservices
Guaranteeperformanceandcost
MeasurableandEnforceableServiceLevelAgreements(SLAs)
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GetBasicsRightBeforeAttemptingAmbitiousProjects
KnowYourFacility- MeterYourBuildingandSystem
BenchmarkYourHospitalBuildingandSystems
SetKPIsforFacilityStaff(EPI,PlugPower,HVAC,etc.)
ConductAction-OrientedEnergyAudit– UseFacility/SystemDatatoGetBest BangforyourBuck
IdentifyECMswithROI;Develop ImplementationPlan
MeasureandVerify
ApplyforBEEStarorGreenBuildingRating
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SPECIALNEEDSINCRITICALENVIRONMENTSHAVINGENERGYIMPLICATIONS
AirConditioning Lighting&Electrical UninterruptedPowerSupply
Cogeneration Refrigeration MedialVacuumSystems
Cleanrooms Sterilization Steam
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KPIDrivenEnergyManagement:FromISO50001toCapex Investments
EnergyEfficiencyProjectExecution
EnergyAssessment/Advisory
EnergyManagementSystem
MeteringInfrastructure
ISO50001
Capex/Opex baseddecisionandAssuredROI(M&V)
AuditsandDiagnosticsatafractionofcost
Enterprisemanagementandreporting
DataDrivenDecisionMakingandActions
CreateaCultureofEM
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ISO50001ENERGYMANAGEMENT
Initiated&SupportedByTopManagement
SinglePersoninCharge
Drivenbyanenergypolicy
Reviews->Baselines->KPIs->Plans
Train->Communicate->Document->DriveOperations,Design&Procurement
Measure->Audit->Report
Review
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Count Building Type Floor Area, (m2)
Annual Energy
Consumption (kWh)
Energy Performance
Index(kWh/m2/year)
OFFICE BUILDINGS
145 One shift Building 16,716 20,92,364 149
55 Three shifts Building 31,226 88,82,824 349
88 Public Sector Building 15,799 18,38,331 115
224 Private Sector Building 28,335 44,98,942 258
10 Green Buildings 8,382 15,89,508 141
HOSPITALS
128 Multi-specialty Hospitals 8721 24,53,060 378
22 Government Hospitals 19,859 13,65,066 88
HOTELS
89 Luxury Hotels – 4&5 Star 19,136 48,65,711 279
BEE-ECO-IIIBENCHMARKINGSTUDYAVERAGESFORDIFFERENTCOMMERCIALBUILDINGS
Source:BEEECOIIIbenchmarkingstudy
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BEEStarLabelforHospitals
Rank 0 4 12 24 40 60
EPI(kWh/m2) 0 153 192 229 269 318
EPI(kWh/bed) 0 7661 9616 11445 13425 15900
INR/sq ft/month 0 8 10 12 15 17
INR/bed/month 0 4469 5609 6676 7831 9275
≤< ≤< ≤< ≤< ≤<
Source:StakeholderworkshoponStarRatingofHospitals, BEE
Averagehospital:Yearly:~230kWh/sq.mor~11500kWh/bedMonthly:Rs.~12/sq.ft.orRs.~6680/bed
EnergycostsforBEE5-Starratedhospital:Monthly:Rs.~8/sq.ft.orRs.~4500/bed
Collected samplecharacteristics
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MAJORCONTRIBUTORSOFELECTRICITYCONSUMPTION- CBERDSTUDY
67IndianhospitalsanalysiscarriedbyCBERD
Source;Exploratory DataAnalysisofIndianHospitalBenchmarkingDataset:KeyFindingsandRecommendations, 2014,CBERD
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CBERDSTUDY- 67INDIANHOSPITALSANALYSIS
Source;Exploratory DataAnalysisofIndianHospitalBenchmarkingDataset:KeyFindingsandRecommendations, 2014,CBERD
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STRATEGIESFOREnergyEfficientProcurementinHEALTHCARESECTOR
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MedicalEquipmentCategories
ComputerTomography (CT)Magnetic ResonanceImaging (MRI)Molecular Imaging (MI)PET&PET/CT ImagingMammographyUltrasound
OperationTheaterEquipmentIntensiveCareUnitEquipmentCatheterization LaboratoryEquipmentCentralSterilizationEquipmentPatientMonitoringSolutions
Hospital InformationSystemWorkstationsComputers
Laser CameraFilmProcessors
PrintersTelevision/Screens
Diagnostic andImagingEquipment LifeSavingEquipment Hospital ITEquipment
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PROCUREMENTOFEQUIPMENT
EnergyConsumptionofsomeofthemedicalequipment
EQUIPMENT HIGH MEDIUM LOW
MRI High
CT High
CATHLAB High
PET &PETCT High
OTEquipment High
CSSD(Centralsterilizationsupplydept.) High
X-RAY(Radiography&Fluoroscopy) Medium
ICCUEquipment Medium
Mammography Medium
Ultrasound Low
HealthcareITworkstations Low
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PLUGLOADENERGYCONSUMPTION
InUSinstalledbaseofMRImachinesisestimatedtohaveincreasedbyover40%injustthreeyearsfrom7000in2005to9400in2008(Zogg etal.2009)
TIAX(2010)estimatesthestandbypowerdrawofMRImachineas14kWandevenanoffmodepowerdrawashighas7kW
TIAXestimatesabout40%savingsinannualenergyconsumptionfromMRImachines
Source:MiscellaneousEnergyLoadsinBuildingsbySameerKwatra,JenniferAmann,andHarveySachsJune2013
MRIPowerConsumptionpattern–Europeanstudy
Source:COCIRSelf-regulatoryInitiativeforMedicalImagingEquipmentStatusReport 2013
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PROCUREMENTOFEEEQUIPMENT
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PROCUREMENTOFEEEQUIPMENT
Evolving technology- ShiftingtodigitalX-raytechnology,DigitalX-raytechnologyeliminatestheneedforfilmprocessinganduseslessenergythanconventionalanalogsystems
Giventheintermittentuseofmedicalimagingservices,efficientpowermanagementshouldoffersubstantialenergysavings, equipmenttobedesignedtoconsumelessenergyonstandbymode
Energyefficiencyratingsystemsformedicalequipment- helpingtocreateamarketformoreefficientproductsbyprovidingthebuyerswithmoreinformationandgivingmanufacturersanincentivetodifferentiate
Futureresearchandproductdevelopmentwithafocusonenergyefficiencyarelikelytorevealadditionalopportunitiestoreduceenergyuse.
TheEUprojectlaunchedin2011todefinegreencriteriaforpublicprocurementofmedicaldeviceshasconcludedandpublishedinJuly2014
Someopportunitiesinclude:
InUS,clinics couldsaveover$2000peryearperunitandhospitals couldsaveover$6000perunitwith thepurchaseofmoreefficient equipment (EPA2013).
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HospitalBuildingDesign
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EnergyEfficientDesignFundamentals
DoubleGlazingreducesnoiseandcoolingloads
Designedwindowopeningstotakeinenoughlightandventilationforpatientbutreducingontheheatintake
Integration of renewable energy. e.g. Solar thermal panels
Warm air exists at high level due to natural “stack effect”
Well insulated building fabric
Thermal mass in exposed concrete floors/ ceiling
Warm air rises naturally up the atrium, drawing cooler air in from outside
Trees can provide shade in summer and shelter from the wind and rain in exposed areas
Overhanging eves to provide solar shade
Terracedgreenspaces
Verticalfinstothesouth
Recessedwindowsonsouth
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HospitalLayoutandFormEvolution
BetterCirculation,AccessibilityandExpandability:EuropeanHospitalLeadingtheWay
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RoleofEnvironmentinTheraupatic CareofPatients
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BuildingDesignFundamentalsExecutiveLevel
• ReviewStandards• ReduceLosses• EliminateWastage
1.BeLean:HalvetheDemand
• Buyefficientequipment/technology• Optimise systemefficiency• OperateandmaintainthesystemwithKPIs
2.BeMean:DoubletheEfficiency
• Withon-siterenewables,ifpossible• Withgreenprocurement,wherepossible• Withvalidatedoffsets,wherepossible
3.BeGreen:HalvetheCarbon
Potentialtoreduceenergyconsumptionto1/8th ofbusinessasusualBUTyouneedtoalltheabovestepsandintherightorder
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Credits
• BureauofEnergyEfficiency• CenterforBuildingEnergyResearchandDevelopmentProgram• Dalkia EnergyServicesLtd.• USAIDECO-IIIProgram• GeneralElectricIndia• SchneiderElectricIndiaPvt.Ltd.• UsableBuildingTrust
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REFERENCES
• http://www.cees.ingersollrand.com/CEES_documents/2013.ACEEE.MiscEnergyLoadsinBuildings.pdf
• https://hightech.lbl.gov/sites/all/files/documents/HealthcareRoadmap_2009.pdf
• http://www.who.int/medical_devices/publications/en/MD_Regulations.pdf
• http://www.cocir.org/fileadmin/6_Initiatives_SRI/SRI_Status_Report/COCIR_SRI_Status_Report_2014_-_10092015.pdf
• http://dhae.com/wp-content/uploads/2014/03/Targeting100_FullReport_063010.pdf
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DiscussionsandQuestions