By Merrill Kaney, Contributing Writer

Editor’s note: This is the second part of a two-part article. Check here to read part one. 

Sustainability remains a high priority for hospitals and other healthcare facilities as they integrate a growing number of environmentally friendly practices into their buildings' operational planning and objectives. In recent years, decarbonization has drawn increasing attention from healthcare facilities managers seeking to achieve their organizations’ sustainability goals.  

Encouraging initiative 

Facility managers seeking to improve facilities’ sustainability need time to analyze their teams and buildings’ current performance. Managers can implement these tactics to help facility team members identify opportunities for the hospital. The individuals on your team will significantly impact the success of the program to improve energy use and build a sustainable future. Consider these strategies to help ensure their success: 

• Ensure team members have these essential attributes: 
• All members must understand the objectives and their roles in the process. 
• The process needs a sustainability champion. Who in the organization executively will be this change agent? 
• Members need to embrace the vision and commit to the new protocols and procedures. 
• Establish a new baseline. Review current facility assets, and account for new construction, remodeling and space expansion or contraction changes. Is the new equipment installed operating correctly? How are the sustainable programs running compared to specific objectives established? Were staffing and budgets adjusted? 
• Review changes in the square footage plan and goals. Hospital leadership must understand that achieving savings goals requires business, organizational and behavior change. Embracing these important initiatives requires strategy planning, new construction and significant renovations, evaluation of existing facility operations and upgrades, procurement practices alignment, and financial analysis and measurement. Managers need to consider the compliance component, as well. 

System by system 

When developing the plan to improve facilities sustainability, managers need to evaluate the components initially targeted to determine the goals and objectives achieved. They need to look at this plan collectively from an operational performance perspective with the environment of care and financial outcome. A system-by-system checklist might look like this:  

Energy: 

• Implement efficient surgical task lighting. Is the task lighting meeting the lumens required and achieving savings with a technological approach or application? 
• Re-evaluate temperature and airflow settings, particularly with infection control in mind. Is setback during off-hours determined by occupancy, space type and the capability of controls? What technologies are being used to ensure high-quality air is going to the spaces? 
• Manage a retrocommissioning review of HVAC controls and building automation systems. 
• Evaluate HVAC commissioning. Are risk assessments being completed? 
• Evaluate steam traps for possible repair or replacement following the preventive maintenance (PM) plan established at inception. 
• Check insulation on hot water system equipment and piping. 
• Replace air handling unit filters regularly by PM system's initial plan. 
• Ensure that variable-frequency drives are installed on pumps and motors. 
• Did technicians determine that harmonics do not affect equipment? Did they apply reduction technologies if needed? 

Water: 

• Re-establish a baseline for current water consumption. Is a holistic water management plan in place that will best serve the patients and customers? 
• Re-evaluate steam traps for repair or replacement. 
• Re-evaluate hot water system equipment and piping. 
• Review cooling tower efficiency to improve water quality. Be sure to reference the water management plan and treatment for bacterial prevention. 
• Review fixture repairs and replacements to determine if they meet operational and savings goals. Determine whether high-usage areas have been put on a rounding schedule with an eye toward operational integrity and identification of required repairs or upgrades. 
• Implement low-flow flush fixtures where practical. 
• Evaluate and optimize faucet water flows to determine if efficiency has been achieved. 
• Repair equipment and piping leaks.

Waste: 

• Review opportunities for waste minimization and form a committee to evaluate end-user participation. 
• Re-conduct a waste audit. 
• Evaluate electronic waste recycling effectiveness. 
• Implement a facility-wide battery recycling program. 
• Review the facility's recycling program for effectiveness and opportunities to increase efficiency. 
• Review construction and demolition recycling pertinent to daily operations and adjust where needed. 
• Reduce the generation of regulated medical. Are the right end-users involved? 
• Reduce paper waste by using sustainable printing or avoiding printing. 

Managers also should perform a complete analysis of the PM programs. If adequately implemented, PM programs can save hospitals sizable amounts of capital, not only from an operations perspective but also from energy. Such programs should apply to all building systems and components. They must be regularly evaluated to ensure they are running correctly. 

The next generation 

As labor shortages continue nationwide, retaining healthcare facility managers and technical maintenance trades to ensure the ongoing success of an organization’s sustainability efforts will likely become more challenging. Organizations with creative and exclusive recruitment strategies will appear more attractive to candidates in the job market. 

The goal is to locate facility managers with acumen toward energy sustainability and decarbonization strategies, coupled with a compliance background to meet technical and monetary moving targets. 

Research shows that inspired millennials want the opportunity to make a difference. They want to feel like they are working for an employer that leaves the world in better shape. Many people are seeking jobs in the healthcare industry since it presents career opportunities where the organization's goal and mission statements include sustainability practices. Managers who invest to attract the top talent can ensure employee skillsets and retention as hospital campuses establish reputations by incorporating sustainability to improve the facility environment. 

Merrill Kaney is a member of healthcare management and technical support teams with ABM. He has more than 40 years of experience in plant operations management and engineering.