Dale Woodin, CHFM, FASHE
Executive Director, American Society for Healthcare Engineering

Oh, for the good old days. As we fast approach Labor Day weekend it seems like a distant memory that only one year ago we were shocked that gas was hovering around $3.00 ar gallon. After a rough summer of sticker shock at the pump we are now delighted when we find a station at less then $4.00 a gallon.

We all get it, energy costs are up – a lot – over the past few years. The real question is – what are we all doing about it?  Johnson Controls, the American Society for Healthcare Engineering (ASHE)’s Knowledge Exchange Partner, recently asked that exact question. Working with ASHE through a double-blind survey process, Johnson Controls gathered data from nearly 1,500 energy management decision makers including 335 from healthcare facilities. 
The 2008 Energy Efficiency Indicator provided an interesting comparison of healthcare and other industries’ priorities and concerns related to energy management, including:

• Healthcare companies spend a smaller proportion of their total expenses on energy, suggesting that perhaps they are run more efficiently than other companies.
  
• Companies across all industries expect energy prices to rise in the coming year but healthcare companies are particularly likely to believe this.
  
• Healthcare companies are more likely than those in other industries to expect to make energy efficiency improvements using capital and operating expenditures
  
• The healthcare industry is somewhat less optimistic about the impact of energy efficiency investments on energy use:
  
• Healthcare companies have even less interest in green building certification than companies in other industries. That is not to say that energy efficiency is not a design priority for those projects, because in the vast majority of cases it is. Companies simply don’t seem to be interested in achieving certification.
  
• Across all industries, while the environment is a motivation for achieving energy efficiency, the primary driver is saving money. This is even more the case in the healthcare industry.
  

I found these observations surprising and counterintuitive. Often our discussions about energy efficiency begin with, “Healthcare is different.” Certainly that is true when you consider the 24/7 nature of our business, our emphasis on patient comfort regardless of our climatic region, and the stringent ventilation requirements to reduce the potential for airborne infection. 
For those reasons healthcare has not been subject to the same building energy model codes and standards applied to other industries. So based on the “healthcare is different” argument you would think we would be lagging other industries in our current energy efficiency and our capital spending to improve efficiency. 

But the truth is the healthcare industry is moving forward aggressively to help hospitals and clinics reduce energy and focus on patient outcomes. ASHE and ASHRAE have joined together to co-sponsor the proposed Standard 189.2, Design, Construction and Operation of High-Performance Green Healthcare Facilities. Under the leadership of Richard Moeller, Senior ASHE, principal of CDi Engineers, the technical committee will comprehensively address the design and operational challenges that are unique to healthcare facilities and develop a standard which will guide future design and operations. 

Although this guidance will be extremely valuable on the operations side it will really pay dividends on the design side. Often the design specifications for energy efficient equipment, systems, and controls are the first victims of value engineering. Consequently the efforts to lower the first cost come at great expense to the life cycle cost. 

As much as this new standard promises to assist us in embedding energy efficiency in new construction, energy benchmarking remains the key first step to operational efficiency. EPA’s Portfolio Manager allows each facility manager to benchmark against a national pool of data of healthcare facilities. The insights gained from benchmarking ultimately will lead to better decision making on energy management. 
The Johnson Controls survey shows we are actually ahead of many other industries in our energy management systems. And we should be. Because our successes are not measured in dollars and cents; they are measured in each patient’s comfort in the physical environment which we create.

Dale Woodin, CHFM, FASHE is Executive Director of the American Society for Healthcare Engineering (ASHE). ASHE is one of the personal membership groups of the American Hospital Association (AHA). ASHE represents a diverse network of more than 9,200 members dedicated to optimizing the healthcare physical environment. For information on ASHE go to www.ashe.org.