What did the empty chair say to the vacant desk? “I wish someone would sit down to enjoy the breeze from this fan.”
While scenes like this are not specific to health care, practicing energy efficiency in hospitals does pose some unique challenges. Hospitals are big, busy places with sometimes thousands of staff providing dozens of different services to tens-of-thousands of patients, twenty-four hours a day, 365 days a year. Add to this the specific ventilation and equipment needs of a hospital, and things get exponentially more complicated. Because of this, energy management was often approached as an add-on to someone’s job, or as an afterthought.
Things are changing with utility costs on the rise and as our understanding of the effects of energy use on climate change and the environment increases.
At the University Health Network (UHN), environmental stewardship has been part of planning and day-to-day operations since the implementation of its environmental management system in 1999. Working to minimize its environmental impacts through waste reduction, pollution prevention, and hazardous waste management, UHN has been recognized across North America for its “greening healthcare” accomplishments.
There have been successes in energy efficiency as well, with a variety of initiatives leading to savings of over $2 million per year. But as the easier opportunities for efficiency were implemented and the last of the incandescent bulbs switched to fluorescent, it became apparent that in order to improve energy management, a new approach was needed. For inspiration, UHN turned to the University of Toronto’s Sustainability Office and its successful Rewire program designed to “empower students, staff and faculty to reduce their own energy consumption through changes in their habits and behaviours.” Building on Rewire’s social marketing approach to energy awareness, the hospital’s Energy and Environment department decided to develop an integrated energy management plan, one that combined both technology and the human element.
A partnership between UHN and the University was formed. With partial funding provided by the Ontario Power Authority, Toronto Atmospheric Fund and the Ontario Ministry of the Environment, the “TLC – Care to Conserve” program was launched at UHN’s Toronto Western Hospital in the fall of 2006. The concept behind TLC (which stands for Thermostats, Lights and Controls) is that energy efficiency is not the job of single person, or even a single department, but that it’s everybody’s responsibility to incorporate conservation measures into their jobs. To accomplish this, four interrelated program elements were developed:
• Retro-commissioning and retrofits: The intent of retro-commissioning is to ensure that hospital buildings are operated as efficiently as possible. Starting with an audit, areas for improvement were identified, such as departments originally intended for clinical use, with high ventilation requirements, now being used for administrative purposes. A retrofit audit was also conducted to identify areas where the replacement of building equipment could lead to further efficiencies.
• Operator training: Having increased building efficiency through retro-commissioning, the next step was to ensure that the savings remained, and that things don’t slowly slip back. With that in mind, the operator training program was designed specifically for facilities staff around how their day-to-day activities affect energy use at the hospital. Staff are trained in energy management basics as well as how to spot energy saving opportunities.
• Staff awareness: A hospital-wide energy awareness campaign based on the principles of Community-Based Social Marketing was put into place. Far more than your average poster and sticker session, social marketing first looks at the barriers to behaviour change (e.g., why don’t people turn off the lights when they leave at night?) before designing a campaign to address those barriers. Follow-up is conducted to ensure that good energy efficiency habits remain long after the campaign launch.
• Employee engagement: Once staff have an increased energy awareness, the next step is to engage them into taking ownership over how energy is used in their work area. The hospital’s employee engagement program encourages all members of the UHN community to identify any efficiency measures they notice in their daily work that may be overlooked by the hospital’s Energy and Environment or Facilities departments, such as a room with no light switches, or the need for a “lights off” reminder poster in one of the lunch rooms.
TLC is already showing terrific results for UHN, with the Toronto Western Hospital realizing energy savings of 3.4 per cent, which translates into $67,000 after the first seven months, with implementation of many of the identified opportunities pending. The program is being expanded at the Toronto General Hospital, with expansion of the program to Princess Margaret Hospital being planned for next year.