By Mark Pipher / Special to Healthcare Facilities Today

While commercial and educational facilities went quiet during the COVID-19 pandemic, hospitals and healthcare facilities worked overtime, adjusting their critical operations to ensure the safety of the public. These facilities, which already consume more than twice as much energy per square foot as hotels, schools and office buildings, now have to evaluate the impact of these changes across various areas, including their sustainability management practices - according to new guidelines set forth by ASHE.  

During this evaluation period, healthcare facilities in New York City must also address another looming concern – Local Law 97 (LL97) of the Climate Mobilization Act. New York is still holding firm to its 2024 deadlines for this decarbonization mandate, which establishes a significant emission reduction goal of 40 percent by 2030 and 80 percent by 2050. Failure to work these targets into sustainability restructuring could result in fines in the thousands or even millions, making it even more important to evaluate and create a plan that reduces energy use without compromising safety. 

What to consider when emerging from the COVID-19 crisis

At the peak of the COVID-19 pandemic, COVID-19 care spaces were transformed to handle this novel virus and secondary bacterial co-infections. Airflow, pressure, air handler unit (AHU) filtration and air changes were all modified to ensure airborne contaminants were removed, transmission risks were minimized, and patient and staff safety was improved. Now, each of these areas must be evaluated to identify the impacts. In many cases, this swift action resulted in increased energy use – a secondary thought to the primary focus of managing infection control and comfort. 

Hospitals already are at risk for facing alarmingly high fines under the LL97 mandate. Stringent limits are put in place based on building type, and high fines of $268 per each metric ton over the limit coupled additional fines for failure to report properly could cost these facilities. For example, a 600,000 square foot hospital that goes over its emissions limit by only 15 percent could end up paying an annual fine of over $574,000. These fines, already high operating costs, recovery efforts and recalibration of systems, and added pressure for increased hospital profitability strains hospitals and healthcare facilities at a time when they’re already stretched thin. 

Creating a decarbonization roadmap

Decarbonizing a facility in a post-pandemic world first requires hospitals to determine what was changed and how drastically this may have impacted energy use. Airflow relationships have to be rebalanced and brought back to the original design intent, pressure relationships in pressure-related rooms must be appropriate, AHUs and media need to be evaluated and changed without causing disruptions and air changes can be scaled back slightly. Each of these changes increased kWh, spiking electric bills and completely side-tracking any sustainability goals. While recalibrating operations, healthcare facilities can and are determining how much energy was used, reset systems to original intent, and most importantly, identify human errors or areas missed that may continue to be large energy drains. 

The second part of decarbonization is determining what and when changes will be rolled out across a facility. Hospitals and healthcare facilities are among some of the most complex buildings in the U.S., let alone the world. Different demands for air pressure, need for general infection control through high air quality, and general maintenance demands for boilers, chillers, and other equipment can send staff on nothing short of a wild goose chase to identify issues or changes and fix them before beginning the process all over again. This reactive approach in the wake of a pandemic where more time must be spent undoing all of the manual changes made, has resulted in the emission levels we see today, and unfortunately, will make it impossible to achieve drastic carbon emission reduction. 

During this reevaluation of operations and sustainability management practices, hospitals need to take advantage in places where they’re already bringing in engineering and commissioning services to overhaul operations and introduce new tools and technologies that shift maintenance and sustainability efforts from a reactive to proactive approach. Only once hospitals and healthcare facilities are equipped with these tools, can they make a drastic impact in their carbon reduction goals and maintain compliance with multiple regulations – including LL97. 

Introducing monitoring-based commissioning

Monitoring-Based Commissioning (MBCx) systems are increasingly becoming the standard for hospital and healthcare facility management. These tools, when deployed within a facility and equipped with advanced analytics, metrics and intelligent alerting capabilities, are helping engineers, maintenance staff and even executives get a full understanding of how their building is operating in real-time. 

The monitoring aspect of MBCx, pulls in all available system and equipment data for evaluation and identification of existing and potential issues, which are then transformed into actionable guidance and sent to the team using intelligent mobile alerts that help shorten the time from notification to issue resolution. With specific feedback on where issues exist and what may be causing them, changes for carbon reduction and cost savings are simplified, and facility managers and engineers no longer have to spend significant amounts of time and money just chasing down the actual issue. 

Going beyond monitoring, the added layer of intelligence eliminates alarming noise in already busy hospitals, helping them distinguish actual issues from false alarms, and spend more time making adjustments that will help reach carbon emission reduction goals. Furthermore, the use of analytics helps deploy a predictive model, allowing healthcare facilities to more strategically plan maintenance and identify potential issues before they impact their emissions, patient comfort & safety, and costs. In addition to helping drastically reduce carbon footprint for LL97 compliance, MBCx systems with Air Optimization can also automatically identify changes with temperature, airflow, air turns, pressure, and humidity in and out of critical zones and provide actionable notifications for nosocomial risk mitigation – making it a win-win for both COVID-19 and LL97 efforts.   

As we emerge into the new normal created by the COVID-19 pandemic, sustainability management practices and drastic decarbonization is becoming a priority for healthcare facilities that want to avoid additional costs and fines. MBCx technology is a necessary tool to get these facilities on track for both COVID-19 recovery and forward looking LL97 compliance. Without it, achieving both will be nearly impossible. 

Mark Pipher is Vice President and General Manager of FacilityConneX