By Trish Carney
The Department of Energy, in a 2003 survey of commercial building energy consumption, had this to say, “The health care industry has a critical role to play in climate change mitigation. Energy usage is medical facilities is highly intensive. In fact, hospitals expend about twice as much total energy per square foot as traditional office space.” Things have not changed all that much over the past 6 years.
Healthcare has a vested interest in working towards climate change, as well as encouraging others to do the same. Healthcare can support the Hippocratic Oath, keep economies afloat and save the planet with a few sweeps of its mighty arm. It has to be sensible, and it has to attack the issues from many angles at once, but it can be done.
What’s the rub? You are not “healthcare”; you’re just one guy trying to do a job. Why are you, representatives of local of healthcare providing facilities, reading about this again today? Because, without reminders, many good intentions and responsibilities fall to the wayside and, given periodic prompts, being provided with resources, having guidelines clearly offered increases the chance that you and your facility will be the ones to take it to the next level
Where do you start?
Individuals can make an impact. Start simple. Look around with a fresh eye. Where can YOU improve things?
Analyze your personal, and your facility’s, waste streams. What is being thrown out or wasted every day? Do you have control over simple garbage separation? Recycle anything/everything that you discard. Buy recycled products for your department or office. Can you dictate what types of light bulbs are used in any area of the facility? Switch incandescents for compact fluorescents, LEDs or go solar outdoors. Turning down thermostats a degree or two really does count when you are controlling hundreds or thousands of square feet.
Is your voice heard by the “powers that be”? The green Guide for Health Care (GGHC) is a good place to start. It provides a toolkit to guide your organization through greening efforts (view it at www.GGHC.org). Suggest bringing in an energy reduction consultant, a greening engineer or other expert who can help take you to the next level. Make sure mechanical infrastructure upgrades include the most energy efficient equipment available (visit http://www.energystar.gov). Propose networked system software that manages power usage
Water Conservation
Wherever water is used in a health care facility, there is probably an opportunity for conservation. Here are some ideas.
The Basics
Increase employee awareness of water conservation (educate staff, seek suggestions, assign responsibility, post signs, etc.).
Increase patient and visitor awareness of water conservation (e.g., signs in patient rooms and restrooms, publicize water conservation policy).
Locate and correct drips, leaks, and unnecessary flows in bathrooms, laundry, kitchen, labs, etc.
Repair/adjust flush mechanisms on toilets so that they work as designed.
Irrigate grounds and wash vehicles less often.
Domestic Water Reduction
Toilets and urinals Install toilet tank water displacement devices on older models or replace inefficient toilets and urinals with low-flow models. Retrofit flushometer toilets with water-saving diaphragms. Before selecting new equipment (e.g., low flush, dual flush), check out third party tests to determine actual effectiveness. Under third party maximum performance (MaP) tests, toilets are tested to see how much waste they will flush away instead of their ability to clear away a minimal amount of media.
Sinks and showers Install flow reducers (<2.5 gpm) and aerators on applicable plumbing fixtures. Install automatic shutoff valves or motion sensor-activated faucets.
Process Equipment
General As appliances and equipment wear out, replace with air cooled or water-saving models.
Steam traps Steam traps are automatic valves that release condensed steam (condensate) from a steam space while preventing the loss of live steam. They are present throughout many facilities (air and water heating, kitchen, laundry equipment, sterilizers, autoclaves, etc.). Once steam has transferred heat and has condensed to become hot water, it is removed by the trap from the steam side as condensate and either returned to the boiler via condensate return lines or discharged to atmosphere (a wasteful practice). Faulty or inoperative steam traps can waste water and energy. Develop a steam trap inspection plan. Replace faulty steam traps with effective, low-maintenance units.
Sterilization equipment Install steam condensate temping systems (makes use of high-temperature-sensing probe that causes use of the minimal amount of injection water into discharge leaving the sterilizer) on vacuum and gravity sterilizers (retrofit kits are available). Replace water-induced vacuum devices on sterilizers with electric pumps (retrofit kits are available).
Film processors Replace or retrofit continuous flow-through systems with flow control equipment.
Refrigeration equipment Recover condensate from refrigerators, freezers and ice makers for reuse.
Water Reuse
Radiation therapy linear accelerator (creates high-energy radiation to treat cancers). Water can be taken from the reject side of the linear accelerator heat exchangers and pumped to the facility’s cooling towers and reused for evaporative cooling.
Reverse osmosis (RO) Reject water produced in the RO process can be reclaimed for non-miscellaneous potable water use or in the cooling towers.
Water Supply/Systems
Water pressure Install pressure-reducing valves where system pressure is higher than 60 psi.
Cooling towers Reduce excessive blow-down. Operate cooling towers near manufacturer recommended level of total dissolved solids (TDS). Consider using ozone as a cooling tower treatment to reduce water used for make-up.
Boiler Return steam condensate to boiler for reuse.
Sprinklers Minimize water use for irrigation (e.g., adjust repair sprinklers, install wet weather shutoff and/or soil moisture controllers). Investigate sources of used water.
Kitchen
Dish washing Wash full loads only.
Other Turn off the continuous flow used to clean the drain trays of the coffee/soda beverage island (only clean the trays as needed).
Laundry
Washers Reprogram machines to eliminate additional rinse cycles, if possible and not restricted by the health department.
Wash full loads only or reduce water levels to minimize water required per load of washing.
Waste Reduction and Prevention
Ready to get started reducing waste in your health care facility? Use the information provided to form a team, conduct assessments, perform data collection, and provide education and training to implement a successful waste reduction program.
Learn how green purchasing, also known as Environmentally Preferable Purchasing (EPP), can effectively minimize the volume and toxicity of the products purchased by the facility, and what obstacles to EPP are common in hospitals. Practice Greenhealth has a wealth of information on the EPP team, Group Purchasing Organizations (GPOs), lists of prohibited chemicals, Preferred Vendor Programs, and environmental certification labeling. Finally, read Practice Greenhealth’s 10 Step Guide to EPP to learn how to incorporate EPP into your waste reduction program, and check out the H2E Products & Services Directory for a list of companies that offer more environmentally friendly products and services.
Find out how recycling can reduce the amount of waste being disposed of by hospitals, and identify specific recyclable materials that may be used at your facility. Practice Greenhealth provides case studies and step-by-step guides to setting up and managing effective recycling programs in a health care setting.
Learn about various solid waste disposal contracting options and recommendations for working with solid waste haulers to minimize costs.
Discover several methods for minimizing waste, including source reduction and reuse, donation and surplus programs. In addition, learn about opportunities to minimize food and yard wastes through composting, as well as strategies to minimize the generation of pharmaceutical waste. Finally, learn about the potential benefits of single-use device reprocessing through a third party reprocessor or an original equipment manufacturer.
The operations and maintenance employees still know more about the buildings than anyone in an organization. You need to continue to make efforts influencing which green building management practices are implemented and observed.
Works Cited www.willyoujoinus.com www.eere.energy.gov www.noharm.org www.practicegreenhealth.org www.thesimpledollar.com www.ciwmb.ca.gov http://cms.h2e-online.org/ee/facilities/waterconserve/ http://cms.h2e-online.org/ee/waste-reduction/
HE Number 14 part 1