As health care quality, cost containment, and infectious disease containment gain more of the spotlight, the role of mechanical systems and IAQ will likewise gain importance. These case studies point to the ways in which HVAC and IAQ play critical roles in today’s health care trends.
On the energy side, Boston Medical Center and Johnson Controls were recently honored by the New England Chapter of the Association of Energy Engineers (AEE) for the Best Energy Project - Medical Facilities, based on significant energy savings from the infrastructure renewal and energy conservation improvements at Boston Medical Center. The recognition noted $1.2 million in energy savings during 2008.
The project included construction of a new, 2,700-ton, high-efficiency, chilled-water plant to support the increasing cooling needs of patient care technology, and to enable the future expansion of Boston Medical Center. Other energy conservation equipment included energy-efficient, variable-frequency drives and motors, lighting occupancy sensors, and commissioning equipment and systems to ensure proper operations and optimization.
“This project allows us to be more efficient and helps us continue providing exceptional care regardless of a person’s ability to pay,” said Ron Bartlett, vice president finance and chief financial officer, Boston Medical Center.
“As general contractor for this undertaking, it was vital for us to meet a tight schedule and come in under budget without compromising patient care and the hospital’s operations,” said Gene Dassing, healthcare solutions manager, Johnson Controls.
INFECTION CONTROLSteril-Aire Inc. reported that the new Muskogee Community Hospital (MCH, Muskogee, Okla.) is using its UVC Emitters™ facility-wide as an infection-control strategy. The devices are installed in the air-handling units and in custom-designed, ceiling-mounted devices in surgical and procedural suites.
The devices use high-output UVC energy to eradicate airborne viruses and bacteria, as well as surface biofilm/mold and pathogens, to improve IAQ and reduce hospital-acquired (nosocomial) infections.
“We are hopeful that UVC technology will help us to record some of the lowest infection rates in the country by keeping bacteria and other microbes continuously in check,” said MCH president Mark Roberts. “We have equipped the hospital with two and sometimes even three layers of UVC protection: in the outside air intake, in the individual air-handling units that serve virtually all patient areas, and in ceiling-mounted devices that are specially engineered for ‘after-hours’ disinfection of the surgical and procedural areas with cleansing germicidal light.
“Through this approach,” he said, “we expect to destroy 99-plus percent of microbial contaminants.”
Red Bud Air Filter Sales & Service, Tulsa, supplied the devices to installation contractor Hogle Mechanical, Muskogee, and worked with the consulting engineering firm of Martin Engineering Design Inc., Tulsa, to ensure proper design and application of the product in the hospital’s 77 air-handling units and seven ceiling units.
The extensive use of UVC, with the addition of the ceiling-mount units, is one of many firsts achieved by MCH. Its environmentally friendly construction has made it the first health care facility to garner the EPA’s “Designed to Earn the Energy Star” recognition.
GREEN CONTROLSThe Ottawa Hospital (TOH), Ottawa, Canada, was formed through a merger between two academic hospitals and two community hospitals in 1998.
After working its way through a difficult financial period in the late 1990s, TOH looked to sustain its fiscal strength for the long term. The hospital identified areas where it could be more efficient and drive additional funds into patient care. Two areas that immediately rose to the top were energy costs and facilities infrastructure.
The hospital decided to work with Honeywell to install energy conservation measures in the summer of 2004. The implementation work plan, which was approximately a year and a half, included the following key improvements:
• Installation of a new, state-of-the-art Enterprise Buildings Integrator (EBI) automation platform, which covers approximately 5,500 points of control for all three campuses.
• Replacement of several chillers with more energy-efficient units and environmentally friendly, CFC-free models.
• Retrofit of more than 45,000 light fixtures across all three campuses.
• Upgrades to lighting at two parking garages.
• Installation of high-efficiency hot water and heating boilers.
• Replacement of existing motors and the addition of variable-frequency drives.
• Implementation of power factor correction systems.
• Improvements to building envelopes to reduce drafts and prevent energy leakage.
• Installation of water-conserving fixtures and reduction in process water usage.
• Implementation of an ongoing awareness program to educate staff and community.
Since the overarching efficiency and conservation program was implemented, TOH has reduced natural gas consumption by 40 percent, electricity by 18 percent, steam by 23 percent, and water by 5 percent. These reductions have curbed carbon dioxide emissions by nearly 12,000 tons annually, which has the same environmental impact as planting more than 39,000 trees or removing 2,300 cars from the road, explained Honeywell.
EXPANDING NEEDSAs more hospitals expand their services, their mechanical system needs will need to be addressed in a cost-effective way. One example is the Rush Health Systems complex in Meridian, Miss.
In addition to the 215-bed Rush Foundation Hospital, Rush Health Systems operates two critical-access hospitals, one long-term acute-care hospital, a nursing center, a home-health agency, and 27 family medical clinics. Connected by over-the-street enclosed walkways, the Rush Health Systems complex is housed in four major structures totaling 1.2 million square feet.
“As we have grown and expanded over the years, we’ve always solved our cooling and heating needs by adding onto our central four-pipe chilled water and boiler system,” said Fred Rogers, vice president, chief resource officer and facility manager. “Over the past years, however, we have had increasing patient dissatisfaction with the temperature and comfort factor in our patient rooms.”
In 2005, Rogers began a multi-million-dollar renovation of the third-floor women’s services center spanning four wings of the hospital. By summer 2006, he had completed Phase I of this modernization, the neonatal intensive-care unit and nursery.
For the Phase II, 14,500-square-foot labor and delivery center, Rogers wanted a new HVAC solution. He needed a system to provide individual zones for each room; a system to satisfy one patient who wanted his/her room very warm, next door to one who wanted it very cold.
Rogers searched online and discovered City Multi® VRFZ (Variable Refrigerant Flow Zoning) technology from the Mitsubishi Electric HVAC Advanced Products Division, which was distributed by General Supply & Machine Co. Inc., Meridian. In the past, Alex Weddington, vice president, General Supply & Machine Co., had provided Mr. Slim® split-ductless systems for the hospital’s pharmacy and radiology center. Rogers gave him a call.
Rogers learned that it was the only two-pipe system in the industry delivering simultaneous cooling and heating. It could deliver personalized, zoned comfort to each room in the renovated women’s services center. He also learned that the compressor technology and Branch Circuit (BC) controllers made the system’s two-pipe simultaneous cooling and heating possible.
Meridian’s outdoor temperatures fluctuate between 80-100-plus °F with high humidity eight months a year. The system automatically adjusts the motor compressor speed to react dynamically, delivering the exact amount of refrigerant needed to maintain the temperature inside. Rogers concluded that a comfortable interior environment would be maintained, while saving the hospital energy costs.
The labor and delivery center renovation design work had already started under the supervision of general contractor Yates Construction, Philadelphia, Miss. When the HVAC blueprint was completed, Yates solicited bids on the Phase II mechanical and electrical work and awarded it to McLain Plumbing & Electrical Service Inc., Philadelphia, Miss.
For example, for the 18 labor and delivery rooms, Rogers selected ceiling-recessed cassettes with square grilles and four-way deflectors. For the staff break room, he chose the same ceiling-recessed cassettes with one-way airflow. Where additional ceiling space would allow, in the corridors, changing areas, and nurse stations, Rogers employed ceiling-concealed ducted units.
Based on what he has seen so far, Rogers’ plan is to employ the systems in the final two phases of this major renovation.
“The two-pipe system is going to save us money, give me added capacity to my central system, and the variable-frequency drive will provide much needed energy efficiency,” said Rogers. It also will take some of the load off the old chillers, which he refers to as “huge energy hogs. I call this the great energy swap-out!”
With the enormous challenges being faced by the health care industry, the HVAC and mechanical systems can play an integral role to helping these clients contain both costs and diseases, and reach patient care objectives.