Facility Care - design, build, and renovation of healthcare facilties

The term “Going Green” has been get-ting a lot of airplay and is the buzzphrase of today. A look at the biggerpicture of practical steps that can betaken to improve facility mainte-nance and the financial/safety rationale foradopting them can help facility managersturn this phrase into reality.

The Leadership in Energy andEnvironmental Design Green BuildingRating System is a third-party nationallyaccepted certification program. It is used asa benchmark for evaluating the design, con-struction and operation of high-perform-ance green buildings. LEED is often used asa qualifying criterion for a growing array ofstate and local government initiatives. Whatmany facility managers may not realize isthat it is an easy list of steps worth adoptingeven if LEED certification is not beingpursed.

Facility managers that haven’t alreadylooked into upgrading faucets and toilets,using energy-efficient lighting, and upgrad-ing systems that manage energy should con-sider doing so. But remember to take usageinto account when making any changes thatwill impact staff performance and comfort.This is a fertile and well-documented domainfor green improvements.

The importance of the HVAC systems togoing green is often understated although itplays two important roles: as a major sourceof power consumption and as the primarydriver of a facility’s indoor air quality. A 1999 Department of Energy survey showed coolingalone accounts for 28 percent of office build-ing energy use.

A recent nationwide independent study ofoffice building workers found that one inthree employees had accepted or left a jobdue to building amenities and conditions.More than two-thirds reported that their pro-ductivity and motivation were impacted byoffice building conditions. Extreme tempera-ture variation was reported as being the sin-gle biggest worker complaint, along with per-sistent odors and unclean air.

Employee turnover, reduced productivity,the liability of sick building syndrome andother health conditions come with big dollarsigns. IAQ issues were twice as common inpeople concerned about becoming sick. Theimplications for healthcare facilities are stark.“Minimum” standards, however, are indica-tive of a level of compliance that is far fromideal and much less than occupants shouldaccept. Green air, therefore, is about recog-nizing the financial advantages to pursuing amore proactive and environmentally friendlyHVAC system.

The process starts with an HVAC systemrehab and a regular maintenance program,i.e., restoring equipment and ductwork totheir original operating specifications. Thenext step is system retro-commissioning.

Air temperature, volume and filtration arethe three primary drivers of a facility’s IAQ.As an HVAC system ages, these drivers areimpacted by mechanical inefficiencies due tocomponent wear and tear and by the buildupof material within the system. Although sys-tem replacement is an eventual necessity, itcan often be deferred with cleaning andrehab, thus increasing the life cycle of thesystem and restoring IAQ.

Hopefully problems with motors and beltsare fixed as they occur, filters are changed inaccordance with manufacturer’s recommenda-tions, and components are replaced as neces-sary. Generally, maintenance tends to focus onroutine mechanical problems and ignore issuesbeyond filter replacement. As a result, atmos-pheric deposits, rust, organic growth and allthe other particulate matter that gets suckedinto the HVAC system tend to occlude it.

A major challenge of system rehab isremoving this organic and inorganic matter.Heat exchange and airflow are dependentupon keeping transfer surfaces, includingducting, free of grime and obstructions. Itdoes not matter, however, if a HVAC systemis providing good air volume if it also is beingcontaminated within the ductwork. TheNational Institute for Occupational Safetyand Health has concluded that 52 percent ofall sick building syndrome-related com-plaints were the result of inadequate ventila-tion and dirty, contaminated air-conditioningsystems.

STEPS TO GREEN

Green air means improving a facility’s IAQ and energy consumption as much as possible. There are clear financial, health and public relations reasons for doing this. The steps are straightforward:

Restore the HVAC system to as close to spec as possible.
Institute a regular maintenance program to keep it there.
Look for further opportunities to improve performance

Servicing systems regularly reduces a facility’s IAQ problems relating to molds, dirt, spores, etc., that build up within the system. HVAC systems rarely break down out of the blue; they degrade as small issues become larger ones. Regular maintenance, therefore, is a more costeffective approach to long-term reliability.

Such maintenance has many benefits. It will provide higher average IAQ over the life of a system. Instead of big declines in air quality and large-scale repairs, small declines in air quality are continually addressed with small-scale servicing. The overall level of maintenance effort is the same, but better performance is maintained over the given period of time.

Regular maintenance also decreases energy consumption. The HVAC system becomes less energy-efficient as performance suffers. Maintaining the system keeps it closer to peak efficiency in the same way as IAQ maintenance. IAQ Maintenance keeps the HVAC system in a constant state of readiness for inspection and can help qualify a facility for federal, state and local financial incentives. It avoids costly emergency repairs; reduces the number of IAQ complaints; reduces infection/ health condition liability; makes budgeting easier; and, when using outsourced labor, creates administrative efficiencies.

California’s energy efficiency and marketing outreach campaign, Flex Your Power, has identified regular maintenance, cleaning coils, changing belts and filters, fixing duct leaks, and cleaning ductwork as tasks that should be performed. This kind of normal maintenance activity can, for example, save up to 30 percent of fan energy and 10 percent of space conditioning energy use.

Retro-commissioning, or existing building commissioning, is a relatively new equipment performance and energy-efficiency measure. It is particularly effective when applied to the complex infrastructure systems found in healthcare facilities. The process consistently delivers improvements to equipment performance along with utility savings of 20 percent or more and paybacks within 12 months or less, without the need for expensive retrofits and equipment change-outs. These characteristics have encouraged many utility companies to offer attractive incentives to organizations that agree to complete retrocommissioning projects in their facilities.

Energy savings, equipment performance and indoor comfort improvements are available with retro-commissioning because most existing buildings in the Untied States were not formally or independently commissioned when they were constructed or have not been recommissioned since occupancy. Given this reality, combined with the years of adjustment, renovation and retrofit that takes place in all buildings, many facilities no longer function efficiently or effectively.

The significant improvements in equipment performance and efficiency that result from retro-commissioning have been welldocumented during the past few years. In fact, the evidence has become so compelling that the U.S. Green Building Council made the process integral to the Energy and Atmosphere section of its LEED EB rating system from the beginning. In many states utility companies are anxious to provide the funding necessary to complete a retro-commissioning investigation.

Opportunities to return building systems to design intent to improve equipment operation, energy efficiency and indoor environmental conditions are common across all building types. However, in the healthcare environment, due primarily to the need for around-the-clock operations and the complexity of systems, the opportunity is particularly attractive. In addition, growing populations and the rising cost of oil have put increasing pressure on energy resources, pushing up prices. Intolerance of hospitalassociated infection and IAQ-driven health issues also are at an all-time high. Combined, these make it a shrewd investment in the health of a facility to focus on maintaining and improving an HVAC system rather than just waiting for it to break.
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