9/13/2011. Mark Hanicits, Director of Facilities and Safety, MetroSouth Medical Center. Terry Malloy P.E., Cxa, Project Manager, Teng & Associates

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Mark Hanicits, Director of Facilities and Safety, MetroSouth Medical Center September 21 st, 2011 4:15pm 5:15pm Terry

, Cxa, Project Manager, Teng & Associates Energy consumption (BTU/SF) in most hospitals and related buildings is

Through Retro-Commissioning and thorough energy analysis, the high energy use can be reduced, often through simple

Proper scheduling, and fine-tuned adjustments can provide large energy savings.

1 Mark Hanicits, Director of Facilities and Safety, MetroSouth Medical Center September 21 st, :15pm 5:15pm Terry Malloy P.E., Cxa, Project Manager, Teng & Associates Energy consumption (BTU/SF) in most hospitals and related buildings is significantly higher than almost any other building type. Through Retro-Commissioning and thorough energy analysis, the high energy use can be reduced, often through simple operational changes and appropriate use of the EMS. Proper scheduling, and fine-tuned adjustments can provide large energy savings. Through operational changes and some minor HVAC balancing work, MetroSouth Medical Center reduced electrical consumption by 5%. 1. What is Retrocommissioning (Rcx) and why is it important to your facility? 2. How much energy are you currently using, how should it be analyzed, and where is it going? 3. The basic steps to Implementing an Rcx project/program. 4. Results of some projects and recommendations to follow 1

2 The What Retrocommissioning is simply the Commissioning of a building that was never Commissioned in the first place. Commissioning i i is cooperative and proactive process that includes design review, installation verification, proper system start-ups, functional performance tests, O&M training, and complete documentation of all building systems being commissioned. The Why Poor or Varying Comfort Conditions High Energy Use and/or Increasing Usage Trend Building Usage has Changed Warranting Operating Changes The Building Systems were never (properly) Commissioned in the First Place In a nutshell GET IT RIGHT IN THE FIRST PLACE The How The RCx provider will conduct a facility assessment to diagnose problems and make recommendations for minor low-cost adjustments that can be made immediately, as well as recommendations for more substantial improvement opportunities. This will include an assessment of cost, savings, and payback. Where applicable, the RCx study may involve an assessment of energy savings opportunities eligible for incentives through grants and rebates. Better operation, maintenance and reliability Improved indoor air quality and occupant productivity Lower energy and operations costs To have the building systems operate in the best and most efficient way possible 2

3 In 2010 the U.S. consumed over 100 quads of energy, representing 20% of total global consumption. Of this, the buildings sector accounted for almost 40%. Total building energy consumption in 2010 was about 50% higher than consumption in Space heating and water heating were the dominant end uses, consuming close to half of all energy in the buildings sector. BUILDING ENERGY USE BY FUEL TYPE Electricity 54% Natural Gas 37% Hospitals have unique and intensive energy use requirements. In addition to the need for lighting, cooling and heating 24 hours a day, hospitals demand extensive energy for ventilation, sterilization, laundry and food preparation. Energy Use in healthcare-related facilities is higher than most other building types. Hospitals in the U.S. spend about $6 billion annually for energy. Renewables 2% Other Fuels 7% Hospital Energy Use Hospital Energy vs. Other Buildings Hospitals Commercial Offices Schools KBTU/SF KWH/SF $/SF Often your utility provider(s) can assist with this process. Sophisticated software is not needed, but simply a thoughtful and methodical analysis of 12 to 24 monthly bills will reveal a plethora of information. The analysis should establish the following: Time when peak kw occurs Months of largest kwh, and smallest kwh Month when least heating/cooling takes place Oct.?? Calculate baseline consumption based on above. Subtract baseline usage from peak heating and cooling months to get an approximation of that usage. CBECS Data 2007 averages for zone 2 facilities 3

4 Water Heating 25% Lighting 15% Cooking 11% With a typical profit margin of 4%, every dollar saved is the equivalent of $25 dollars of revenue. Refrigeration 15 2% Ventilation 3% Office 10 Equipment 6% 5 Heating 25% Miscellaneous 13% 0 Energy Savings Equivalent Revenue Director of Facilities PATIENT S AND STAFF NEEDS CODE COMPLIANCE A Retrocommissioning Program consists of three phases 1.Planning/Investigation ENERGY SAVINGS 2.Implementation 3. Verification 4

1. Evaluate function, sequencing and scheduling of major systems. 2.

Plan critical items for investigation and verification phases. 5.

Detailed investigation by RSP - Functional testing - Collect trend logs or data logs - Revise

Diagnostic & Calculation Plans - present findings 4.

RSP provides technical support to implementation team 1.

5 1. Evaluate function, sequencing and scheduling of major systems. 2. Interview facilities Operation Staff. 3. Set up Building Automation System trends. 4. Plan critical items for investigation and verification phases. 5. Identify sufficient measures to achieve target. 6. Planning Phase milestone decisions. 1. Detailed investigation by RSP - Functional testing - Collect trend logs or data logs - Revise energy savings estimate - Define scope of work for candidate measure 2. Bi-Weekly Meetings 3. Diagnostic & Calculation Plans - present findings 4. Customer is responsible to implement measures 5. RSP provides technical support to implementation team 1. Inspect RCMs for installed equipment and controls modifications. 2. Execute Measurement & Verification Plan (M&V) from Diagnostic and Calculation l Plan. 3. Set up trends depending on measure. 4. Conduct functional tests depending on measure. 5. Revise calculations as necessary. 5

MetroSouth Medical Center MetroSouth Medical Center (formerly St. Francis), is located on a 16-acre campus in Blue Island, Illinois.

MetroSouth th Medical Center has 335 licensed beds and consists of a six story main building with over 800,000 square feet and a

Total % of Annual (kwh) Cost ($) Usage Nov-10 1,336,684 105,379 7.8% Oct -10 1,384,928 109,359 8.1% Sep-10 1,672,639 122,790 9.

8% Apr-10 1,322,280 133,549 7.7% Mar-10 1,095,698 111,910 6.4% Feb-10 1,102,532 112,643 6.4% Jan-10 1,195,486 117,394 7.

94 Lighting 20% Cooling 17% Miscellaneous 14% ELECTRIC USE BREAKDOWN (mwh) Fans/Pumps 27% Kitchen 9% Process Equipment 13% The ComEd

6 MetroSouth Medical Center MetroSouth Medical Center (formerly St. Francis), is located on a 16-acre campus in Blue Island, Illinois. The facility was constructed and opened in MetroSouth th Medical Center has 335 licensed beds and consists of a six story main building with over 800,000 square feet and a Medical Office Building with over 50,000 square feet. Electric usage and related costs Month Electric Usage Elect. Total % of Annual (kwh) Cost ($) Usage Nov-10 1,336, , % Oct -10 1,384, , % Sep-10 1,672, , % Aug-10 1,748, , % Jul-10 1,840, , % Jun-10 1,665, , % May-10 1,507, , % Apr-10 1,322, , % Mar-10 1,095, , % Feb-10 1,102, , % Jan-10 1,195, , % Dec-09 1,288, , % Total 17,160,357 $1,555, % Per SF/yr $1.94 Lighting 20% Cooling 17% Miscellaneous 14% ELECTRIC USE BREAKDOWN (mwh) Fans/Pumps 27% Kitchen 9% Process Equipment 13% The ComEd Smart Ideas Retrocommissioning Program is Rate Payer-funded and provides free Rcx services to its customers who meet the following requirements: Have a peak load > 500 kw Have > 150,000 SF of conditioned space Will commit to spending at least $10 - $20,000 on recommended Rcx measures which have a bundled payback of 1.5 yrs. or less 6

7 Retrocommissioning Conservation Measures (RCMs) The program provides an opportunity for staff members to work closely with expert energy engineers, and gain insights as to how to operate their Building Systems in the most efficient ways. CHW secondary loop Calculate and balance operating time for (2) 75 hp chilled water pumps. Calculate and reduce temperature set point. Energy Savings - 55,971 kwh/year Cost Savings - $7,622/year Simple Payback Period 1 year Space Temperature AHU-C Calculate and reset cooling space temperature set point for summer use (5F on average). Energy Savings - 33,309 kwh/year Cost Savings - $2,665/year Simple Payback Period 3 months 7

Supply Air Reductions (AHU-C) Calculate and reduce fan speed

Energy savings - 70,292 kwh/year Electric Cost Savings -

6 Inspect dampers for excessive airflow.

$879/year Simple Payback Period - 1 month Parking Garage

8 Supply Air Reductions (AHU-C) Calculate and reduce fan speed by VFD in turn reducing space cooling requirements. Energy savings - 70,292 kwh/year Electric Cost Savings - $8,226/year Simple Payback 2 months Dampers on AHU 2 and AHU 6 Inspect dampers for excessive airflow. Energy Savings - 8,859 kwh/year Electric Cost Savings - $706/year Simple Payback Period years Chilled Water Calculate, balance and reduce chiller loads. Energy Savings - 10,985 kwh/year Electric Cost Savings - $879/year Simple Payback Period - 1 month Parking Garage Lights Calculate and assess lighting needs. Evaluate hours of operation in the parking garage. Energy Savings - 129,210 kwh/year Electric Cost Savings - $10,337/year Simple Payback 1 month 8

Preheat on S-19 Air Handler Scheduling Calculate and re-set usage cycling during

Energy Savings - 75,981 kwh/year Electric Cost Savings - $6,078/year Simple Payback

2 months Measure Description Balance CHW secondary loop Reset space temperature AHU-C

Scheduling AHU-5, 7, & A Scheduling AHU-15 & 16 Scheduling AHU-22 Parking garage

Scheduling Cath Lab AHU-11A Annual Electric 55,971 33,309 70,292 8,859 10,985 182,025

210 93,111 75,981 16,903 16,521 Annual Electric Energy Cost Savings $7,622 $2,665

9 Preheat on S-19 Air Handler Scheduling Calculate and re-set usage cycling during cooling season. Energy Savings - 75,981 kwh/year Electric Cost Savings - $6,078/year Simple Payback Period 2 months Calculate energy usage and set schedule accordingly. AHU 5, 7, 11,11A, 15, 16, 22, & 40. Energy Savings - 340,532 kwh/year Cost Savings - $27,243/year Simple Payback Period - 2 months Measure Description Balance CHW secondary loop Reset space temperature AHU-C Supply Air reduction AHU-C Fix dampers AHU-1, 2, & 6 Implement CHW temp reset Scheduling AHU-5, 7, & A Scheduling AHU-15 & 16 Scheduling AHU-22 Parking garage lights Scheduling AHU-40 Shut off preheat AHU-S19 Scheduling Cath Lab AHU-11 Scheduling Cath Lab AHU-11A Annual Electric 55,971 33,309 70,292 8,859 10, ,025 13,282 18, ,111 75,981 16,903 16,521 Annual Electric Energy Cost Savings $7,622 $2,665 $8,226 $706 $879 $14,562 $1,063 $1,495 $10,337 $7,449 $6,078 $1,352 $1,322 Implementation Costs $8,000 $640 $1,280 $1,280 $320 $480 $320 $160 $1,000 $160 $1,000 $160 $160 Simple Payback (years) Energy Saving Opportunities! Total 725,139 $63,759 14,

10 HVAC Operations VAV boxes minimum position set too high (> 50%) causing excess fan energy use and overcooling of space, reheats turn on needlessly. - Reset boxes to allow for minimum airflow. Outside Air dampers not fully opening or out of sync with others. - Periodically check all dampers for correct operation and insure linkages are not slipping. AHU heating coil not fully closed (summer). - Check operation of heating coils before starting cooling operations and/or manually valve off. HVAC Operations Electrical closets and switchgear rooms often have oversized ventilation systems and operating hours. - Control with thermostat and occ. sensor. Return/Relief dampers out of sync causing excess OA to be used and excess supply fan energy. - Periodically check all dampers for correct operation and insure linkages are not slipping. AHU running when space is unoccupied. - Control with BAS or time clock. HVAC Operations BAS often under utilized nothing more than time clock. - Use key features such as OAT setback, Return Water Temperature setback, and optimum start. - Add GUI to make system more user friendly and/or update to non-proprietary front end. Heating & Steam Systems Boilers oversized for light and summer loads. - Install smaller boilers for light duty. Reheat coils working more than necessary especially electric reheats. - Adjust main supply air temperatures appropriately to meet loads, monitor electric reheats and when possible discontinue. Steam and condensate leaks. - Monitor makeup water usage and inspect condensate tanks for excess steam venting. 10

11 Lighting The most common problem is over-lit spaces, especially hallways. Often have 3 or 4 tube fixtures with 70 foot candles. - Remove 1or 2 tubes and related ballast; hallways do not need more than foot candles. Lights left on in unoccupied spaces especially infrequently used bathrooms. - Install dual sensing occupancy sensors. Parking lots and garages lights on during daylight hours and often over-lit. - Check photocells for proper operation and size fixtures to maintain 5-10 foot-candles. Zone garages appropriately so areas receiving adequate daylight remain off. Probably the two most common problems are: Space temperatures overly cold (60F) bad for patient and excessive energy use. - Set temps at 70F see AORN study AHU supplying unnecessary excess air during unoccupied times. - Install occupancy sensors to set VAV boxes to minimums when unoccupied. From the Association of Operating Room Nurses 2010 Congress comes a report on the findings from a study to ascertain the Best Practices for Preventing Hypothermia During Surgery. The Surgical Care Improvement Project (SCIP) is a national quality partnership p of organizations interested in improving surgical patient outcomes by significantly reducing potential complications. Research was conducted with a multidisciplinary team using Johns Hopkins EBP Nursing Model and a literature review. Findings suggest that hypothermia increases post-operative complications (surgical site infections, length of hospital stay, need for blood transfusions, morbid cardiac events). Recommendations: Monitor patient temperatures pre-operatively, intraoperatively, and post-operatively. 1.Use head and feet coverings. 2.Use forced air warming blankets during surgery. 3.Keep ambient room temperature (OR Suite) at 21C to 24C. 11

12 Questions and Answers Contact Information: Terry Malloy, Teng & Assoc

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