Workshop A Energy Savings Champions Best Practices & Case - - PDF document

Workshop A

Energy Savings Champions Best Practices & Case Studies in Energy Reduction & Energy Efficiency in Award-Winning Hospitals and Medical Facilities Tuesday, February 19, 2019 10:45 a.m. to Noon

Biographical Information

Nolan Rutschilling, Energy Program Director, Ohio Hospital Association 155 E Broad St. Suite 301, Columbus OH 43215 614.384.9145 Nolan.rutschilling@ohiohospitals.org Nolan Rutschilling leads the OHA Energy & Sustainability Program to ensure all members have access to the resources, financial incentives and educational programs necessary to make informed decisions around energy and the environmental impact of their facilities. Nolan has a background focused on alternative transportation fuels such as natural gas, propane, and electric vehicles where he wrote grants, held consumer education events regarding electric vehicles, and managed electric vehicle charging infrastructure projects. Rutschilling assisted the City of Columbus in designing the electrification portion of the application for the Smart City Challenge, a competition started by the US Department of Energy and the Vulcan Foundation to encourage mid-sized cities to pursue strategies reducing their carbon footprint and electrify the transportation sector. Rutschilling began employment at the Ohio Hospital Association in 2017. Nolan serves as Vice President of The Ohio State University School of Environment and Natural Resources Alumni Society. Originally from Cincinnati, he is a LEED Green Associate and earned a bachelor’s degree in environmental policy and decision making from Ohio State University. Marty Lanning, Partner, Energent Solutions 1550 Old Henderson Road, Suite 175, Columbus OH 43220 614.360.2245 FAX: 614.360.0650 mlanning@energentsolutions.com Marty Lanning is a Partner at Energent Solutions in Columbus, Ohio. Energent helps clients to optimize energy usage to create tangible cost savings and a compelling environmental story for their brand. Over the last several years, the firm worked with 1

• ut of 5 Energy Star certified hospitals in the country, including the 2017 American Society

for Health Care Engineering Energy Champion - the top award in the country for hospital energy management.

• Mr. Lanning is a Certified Measurement & Verification Professional and a LEED

Accredited Professional. He holds a BSBA in Finance from The Ohio State University and an MBA from the University of North Carolina at Chapel Hill.

Biographical Information

Nick Bagnolo, CHFM, Vice President, Construction & Facilities Sisters of Charity Health System Mercy Medical Center, 1320 Mercy Drive NW, Canton, Ohio 44708 (330) 489-1367 Fax (330) 430-6962 nbagnolo@sistersofcharityhealth.org Bagnolo, began his career at Massillon Community Hospital in 1987, came to Mercy in 1997, where he has administered building and boiler plant maintenance, construction, property management, environmental services and laundry, safety and security, food service, courier and valet services, telecommunications and clinical engineering. Bagnolo has been instrumental in helping to develop Mercy’s facilities master plan— including the new I.C.U. and current emergency department construction—he has also directed several other major additions and renovations for the surgery, heart and cancer centers, radiology and offsite health centers. With more than 32 years of experience in health care facilities management, Bagnolo is responsible for overseeing construction projects and their related approvals and design and financial management at all SCHS facilities in Ohio including Mercy Medical Center,

• St. Vincent Charity Medical Center, Regina Heath Center, and Light of Hearts Villa.

As the Vice President of Construction Management Services he is the party primarily responsible for the successful completion of SCHS’ entity construction projects. The Vice President leads the delivery of multiple construction projects to the SCHS entities. The Vice President is responsible for managing the master facilities plan implementation through the design, construction and close-out phases of the recommended and approved projects. As Administrative Director of Support Services, he has direct responsibility for the Facilities and Engineering Department which includes managing planning, construction, maintenance, and code/regulatory compliance responsibilities. He also provides

• versight of the balance of the Support Services including: Clinical Engineering,

Telecommunications, Environmental Services, Food Service, Safety & Security, and Courier/Transport/Valet departments. A graduate of St. Thomas Aquinas High School in Louisville, Bagnolo earned his bachelor

• f science in construction technology from the University of Akron. He is a Certified

Healthcare Facility Manager. He and his wife live in North Canton.

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OHA Energy & Sustainability Program February 2019

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• Hospitals are the 2nd

largest employer in Ohio

• Hospitals are the

largest employer in 77

• f 88 counties in Ohio
• Ohio is the 7th most

populous state in the country

OHA Energy & Sustainability Program February 2019

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Advocacy

Operating Cost Optimization

Energy Efficiency Education Energy Procurement Benchmarking Audits | RCx Rebates Reduced greenhouse gas (GHG) impact from Ohio hospitals Increased Hospital Resilience Enhanced Regulatory Compliance

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Energy & Sustainability Program Goals

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Agencies Regulating Hospitals: The Communication Challenge

MACs QIOs

Joint Commission

FDA

State

• Survey &

Certification

• Courts
• Attorneys

General

• Medicaid
• Board of Health
• Medical Boards
• Local

Governments

• Licensure
• Health Care

Authority

• Department of

Labor and Industries

• Public Disclosure

Commission

• Office of the

Insurance Commissioner

Payer

• Medicare
• Medicare

Advantage

• Medicaid
• CHIPs
• TRICARE (DoD)
• Uncompensated

Care Pool

• Employer‐

Sponsored Insurance

• Patient Self‐Pay
• Worker’s

Compensation

• Other Public

Insurance

• Other Private

Insurance DME Regional Contractors Regional Offices IRS DOL EPA FTC HHS/ HRS A HHS/ NIOSH NRC FCC Regional Home Health Intermediaries DEA FAA OPOs SEC OSHA DOJ Treasury FBI DOT

Source: Adapted from Washington State Hospital Association, (2001). How Regulations Are Overwhelming Washington Hospitals, and American Hospital Association and PricewaterhouseCoopers, (2001). Patients or Paperwork? The Regulatory Burden Facing America’s Hospitals.

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Begin with the End in Mind

• Get buy‐in from C‐Suite
• Create an “efficiency snowball”

– Start with “Low Cost, No Cost” – Use savings to pay for small capital projects – Use savings to pay for large capital projects

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Create Action Plan Create Action Plan Implement Action Plan Implement Action Plan Evaluate Progress Evaluate Progress Recognize Achievement Recognize Achievement Make Commitment Assess Performance & Set Goals

Goals

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• Collaboration
• Access to data
• Technical Expertise

Copying from Many is Research

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Rebates

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Rolling Edge

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HOSPITAL CASE STUDIES & ENERGY STAR

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12

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5 10 Years ‐25% ‐20% ‐15% ‐10% ‐5%

+5%

Costs

Audit Easy Actions Undertaken (obvious energy waste) Program Falters Savings lost due to lack

• f systems

Audit again

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5 10 Years ‐25% ‐20% ‐15% ‐10% ‐5%

+5%

Costs

EM Program Initiated Technical Development Extra savings from

• perations and process

improvements New Plant Cut energy waste

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• No matter your ENERGY STAR score,

there are always cost-effective energy saving opportunities, if we only look

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Ohio . . . Cradle of ENERGY STAR hospitals

• Current ENERGY STAR hospitals in

Ohio:

1. Mercy Medical Center 2. Summa St. Thomas 3. Adena Greenfield 4. Good Samaritan (TriHealth) 5. Firelands South 6. ProMedica Bay Park 7. Barnesville 8.

• St. Rita’s Health Partners

9. The Ohio State University Hospital East

• 10. Southern Ohio Medical Center
• 11. Mercy Tiffin
• 12. Avon Hospital
• 13. Summa Akron City

Current ENERGY STAR certified hospital 2018 John Chapman Award hospital 2018 Melvin Creeley Environmental Leadership Award hospitals

We’re #2!

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How to Leverage the Energy Cup

Gain CEO Attention

• Speak dollars not BTUs

Table accessed in the “Goals” tab We’re paying this much compared to the

• Median. But if we

improved to ES = 75, we’d pay much less.

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Long Large $ Now Plan / Life Cycle

Payback Period / ROI Focus / Delivery Effort / Funding Required

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ENERGY STAR:

Bright Light in a Green Initiative

23rd Annual Ohio Energy Management Conference February 19, 2019

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Case Study: ENERGY STAR

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Mercy Becomes ENERGY STAR Facility in 2009

National Mark of Energy Excellence

• Second hospital in Ohio and

87th nationwide to achieve ENERGY STAR.

• Only 1 of 3 hospitals

nationwide to earn 10 consecutive Energy Star Awards

• Most recent rating was 87 on

an energy efficiency scale of zero to 100.

• Passed rigorous application

and on‐site review.

U.S. Congressman John Boccieri (right) and Mercy president and CEO hold the ENERGY STAR plaque, presented to Mercy last August.

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Achieving ENERGY STAR

• Culmination of a lengthy process.
• Requires employee commitment and

know‐how combined with administrative support and funding.

• Driven by a long‐term facilities master

plan.

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Evolution of Mercy Facilities

• Currently 1,000,000+

square feet – a blend

• f old and new
• Construction of A and

C wings in the 1950s

• Main Building and

Mercy Hall in 1980s

• Surgery Center in the

1990s

• ICU completed in

2009

• ED addition 2013

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Mercy Campus Today

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Journey to Energy Efficiency

• Identified deficiencies

– Cooling plant – Emergency generator capacity – Electrical distribution capacity – Redundancy

• In 1993 Mercy added:

– 3,600‐ton cooling plant with three 1200 centrifugal chillers. – Redundant switch gear with tie breaker – Additional electrical distribution capacity – Landis & Gyr (Siemens) Building Automation System (BAS)

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Journey to Energy Efficiency

• We continue to grow and adapt our BAS, using it to

control:

– Air handling units – temp set points, set‐back programming, trending and more. – Operating rooms – verification of air exchange rates and pressurization. – Isolation/negative pressure rooms, including monitoring

• f alarms.

– Chiller plant – use of free cooling option and adjusting chilled water temperature based on current dew point. – Electric demand in real time – automated load shedding to reduce chiller plant exertion.

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Journey to Energy Efficiency

• Other key energy savings

enhancements include:

– Installation of variable frequency drives (VFD) on air handling units and pumps. – Retrofitting of old T‐12 fluorescent light fixture with T‐8s and T‐5s initially, now moving to LED technology. – Installation of motion and timer switches in nonessential areas following completion of lighting survey. – Power factor correction, presently at 96%.

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Water Conservation

• Used about 50 million

gallons of water in 2018 on main campus

• Installed waterless medical

vacuum pumps to annually save:

– Three million gallons of water – $7,200 in utility costs

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2018 Energy Cost Savings

Utilities Amount Saved Electricity $735,000 Natural gas $153,300 Water $ 87,500 Total savings $975,800

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Five‐step ENERGY STAR Process

• Retro‐commission your
• perations.
• Conduct a lighting evaluation.
• Achieve supplemental load

reductions.

• Upgrade air handling systems.
• Right‐size the building’s chiller.