Damian Skelton keeps an equally sharp eye on hallway lightbulbs and 1,300-ton air-conditioning chillers.
Skelton oversees facilities at Baptist Hospital and Saint Thomas Hospital in Nashville, Tenn., both members of St. Louis-based Ascension Health. Skelton knows that both big and small aspects of his domain expend energy — and hold the potential to conserve it.
Skelton said Baptist Hospital has reduced its energy use by 20 percent since 2008. That makes it Exhibit A in Ascension Health's embrace of a national campaign, called the Better Buildings Challenge, to cut energy consumption by that same ambitious amount in all commercial buildings.
Ascension Health is one of only two hospital systems, and the only ministry member, among the 40 participants in the U.S. Department of Energy's challenge. The range of partners includes Kohl's Department Stores, Walgreens, Michigan State University and the city of Denver. Each has pledged to cut energy use by 20 percent by the year 2020.
The government estimates that business buildings of all sorts consume about 20 percent of the nation's electricity, natural gas and other energy sources. It also says about 30 percent of all that power is wasted, mainly by poor habits and inefficiencies.
Ascension Health signed up with the Better Buildings Challenge in December to further its own effort, begun in 2008, to reduce energy use systemwide by 5 percent every three years by 2020, said Dan Scher, director of its Facilities Resource Group. Scher said Ascension Health has cut its consumption by 5.6 percent since 2008, translating into $10.1 million in savings.
"We are a Catholic ministry committed to caring for God's creation," Scher said. "What began as an energy-savings program has grown into a systemwide environmental stewardship program."
Scher said six of Ascension Health's 68 hospitals have reduced energy use by at least 10 percent each since 2008. Dell Children's Medical Central of Central Texas in Austin leads with a 21.4 percent reduction.
Dell Children's opened in summer 2007 and was designed as a "green" hospital. Taking nothing from its achievement, Scher said, some of Dell Children's energy savings since 2008 relate to the quick efficiencies gained by fine-tuning a new system.
Tuning mature systems
The older buildings and power systems at Baptist Hospital in Nashville are more typical of the facilities — and representative of the challenges — in meeting energy efficiency targets across the Ascension Health system.
Scher said Skelton and his crew at Baptist Hospital have combined relatively minor capital improvements with a system of monitoring and managing energy use each day. Those efforts have saved $1.2 million since 2008, even with rising energy costs, Scher said. Baptist Hospital is licensed for 683 patient beds and Saint Thomas, three miles away, has 541. Skelton said his crew is working on similar improvements and efficiencies at Saint Thomas.
The two hospitals are part of Saint Thomas Health, which includes three other hospitals in middle Tennessee.
Skelton said Baptist Hospital zeroed in on its lighting, replacing all T12 fluorescent bulbs with the narrower but more efficient T8 bulbs. Scher said a $3 million investment throughout Ascension Health in T8 bulbs was projected to net about $2 million in annual savings of electricity.
Energy audit
Skelton said Baptist Hospital also did an inventory of all exterior lighting, finding places where outside signs stayed lit all day. Workers simply turned them off permanently or installed timers. "You just cannot do much better than 'off' when it comes to energy savings," he said.
Skelton said one of Baptist Hospital's best moves was to hire Greg Foreman as its energy manager. Foreman spent six months digging into the daily use and costs of the power-plant operations. With heating and cooling often accounting for as much as two-thirds of a hospital's energy bill, there is real money to be saved.
Skelton said Foreman posted daily weather forecasts in the engineering department so employees could plan their use of such electricity-inhaling machines as the big, 1,300-ton chillers that produce cool water for air conditioning. The cool water is pumped into coils. Large blowers force air through the coils, cooling the air and sending it throughout the hospital. That process transfers heat to the water, which gets pumped back to the chillers. Carefully monitoring the temperature of the chilled water, which usually is kept at 42 degrees, allows the crew to keep the hospital comfortable while running fewer chillers — and using a lot less electricity.
Skelton said Baptist Hospital ordered a study, known as a "retro-commissioning," to examine how the air-conditioning system's many components actually work compared to what they were designed to do. He said that in part allows his crew to do a better job of drawing fresh air into the hospital. The air-conditioning system is designed to run a blend of fresh air and inside air through the cooling coils, and operators can vary the mixture by adjusting outside and inside vents. But components that aren't working correctly — or aren't being watched — can draw in too much fresh air on a hot day, forcing the entire system to work much harder, Skelton said.
He said consulting engineers also helped Baptist Hospital reconfigure the pipes and valves that direct cool water from chillers to coils and back. That, and installation of bypass valves and variable frequency drives on the main pumps, allow Baptist Hospital to turn off eight zone pumps, markedly reducing electricity use.
Skelton said the hospital did that work during a $1.9 million project to link the chillers to its emergency-power system, which activates when utility service is lost.
For similar projects at all Ascension Health hospitals, Scher said the health system created a "Facility Infrastructure Pool" for capital spending in 2010 that allows hospitals to present proposals for major needs, including energy-saving projects. Skelton said that frees maintenance departments from having "to compete with plans for a new cath lab or an MRI."
Scher said the pool offered $50 million this fiscal year and may have $40 million the coming year. "We know that health care has a lot of challenges and that capital is tight, but this pool of resources allows us to refresh the aging infrastructure in our facilities portfolio so that we can continue to provide an appropriate environment for care," he said.
Systemwide energy-saving efforts include:
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Carefully monitoring steam traps, which remove cooled water from steam-heating systems without wasting steam.
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Installing temperature controls in operating rooms to more efficiently heat or cool them when not in use, such as on weekends. Scher said four hospitals already have completed this retrofit.
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Installing variable-speed drives on electrical motors, from fans to air-conditioning chillers.
Employee buy-in
Scher said Ascension Health has begun working to get all 113,000 of its employees involved in saving energy. It has discussed the issue in articles in internal publications and recently published its first environmental stewardship report, a 25-page missive detailing such things as plans for recycling, reuse, better water management and improvements in food services.
"It is absolutely critical that everyone become involved in this bold goal," Scher said.
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