A case study of Rafic Hariri University Hospital in Beirut , Lebanon

1. HOSPITAL BUILD & INFRASTRUCTURE MAGAZINE ISSUE 3 2013
044
W
ith carbon dioxide levels at their highest point in at least
800,000 years, a quote from world-renowned natural
environment photographer Yann Arthus-Bertrand springs
to mind; “It is too late to be pessimistic”. We have to
get serious about sustainability, and the challenge now is to facilitate a 94%
reduction in energy use in order to restrict emissions to 2002 levels by 2050.
Buildings are an important part of the environmental
solutions to climate change, and the healthcare sector has a key role to
play in this. Hospitals are notorious energy hogs: They operate 24/7; they
must adhere to strict lighting and HVAC/IAQ codes and they consume
more than 2.5 times the energy that a commercial building of the same size
does. In the US, for example, healthcare buildings represent less than 1% of
all commercial buildings, and 2% by commercial floor space, but they are
responsible for 5.5% of commercial building energy consumption.
THE COST OF ENERGY
Energy costs have been continuously increasing since the early 2000s and
are expected to continue to increase in general, while energy use in the
healthcare market has increased by 36% since 1995, due to changes in
technology and data centre requirements, as well as an increase in patients.
SUSTAINABILITY AND ENERGY EFFICIENCY IN HOSPITALS
A CASE STUDY OF RAFIC HARIRI UNIVERSITY HOSPITAL
By: Ronald Diab, Managing Director, Energy Efficiency Group

2. www.lifesciencesmagazines.com
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FEATURE ENERGY
EEM Brief description
% savings of total
energy consumption
KWh
savings
Cost savings
(US$)
1
Chilled water ‘temperature
reset and sequencing
1.72 350,184 $36,764.07
2
Hot water boilers
temperature control
1.82 299,920 $15,948.90
3 Lighting control scheduling 0.98 198,438 $20,832.97
TOTAL $73,546
TABLE 1: Low cost/no cost measuresGiven all of this, and the fact that hospitals are limited in the amount of
energy costs they can pass on to patients, why hasn’t the healthcare sector
taken stock and actually done something about it? The answer is that
energy costs, whilst still massive in absolute terms, represent only 1% of
total operating costs, and so do not get the attention of top administrators.
This is changing slowly and, with ever tightening budgets, more hospitals
are realising that they must find ways to do more with less cash. Energy
efficiency projects can unlock trapped capital that can improve a hospital’s
profit margin or be used to fund technological advancements, purchase
medical equipment, or improve the patient experience.
IN SHORT
Hospitals are notoriously energy inefficient and consume
more than 2.5 times the energy that a commercial building
of the same size does
An energy efficiency programme together with an energy
audit can help identify where money and energy can be saved
Energy efficiency projects can unlock trapped capital and
improve a hospital’s profit margin, or be used to fund
technological advancements and purchase medical equipment

3. HOSPITAL BUILD & INFRASTRUCTURE MAGAZINE ISSUE 3 2013
046
EEM Brief description Project cost (US$)
% savings of total energy
consumption
KWh savings Cost savings (US$) Payback
1 Retrofit to LED light sources 830,080 10.29 2,089,052 219,319 0.26
2 Motion detectors 41,820 0.65 188,389 19,778 2.11
3 Photocell and daylight control 49,500 0.60 160,624 18,337 2.70
4 Power factor correction (main) 2,700 0.14 4,216 0.64
5 Decentralised power factor correction 74,430 1.47 430,297 44,677 1.67
6 Inverters/VFD on the CWP/HWP 245,000 2.49 730,499 75,846 4.02
7 Adiabtic cooling on air cooled chillers 156,000 2.07 615,246 63,417 2.46
TOTAL 1,399,530 17.1 1,776,042 445,590 3.14
EEM Brief description Project cost (US$)
% savings of total energy
consumption
Cost savings (US$) Payback
1 Blow down heat recovery 24,000 0.14 4,239.78 5.66
2 Steam boiler retrofit 185,000 7.59 230,975.79 0.80
3 Hot water boiler retrofit 420,000 4.33 131,711.61 3.19
4 Waste heat recovery from generators 224,999 2.09 62,432.09 3.60
5 Solar thermal system 285,000 2.22 67,645.35 4.21
TOTAL 1,138,999 16.37 497,005 2.29
TABLE 2A: Electrical EEMs
TABLE 2B: Thermal EEMs
CASE STUDY
This is where an energy services company like Energy Efficiency
Group (EEG) can assist and help facilities set up an energy efficiency
programme. An energy efficiency programme starts with an energy
audit, a multi-process in depth look at everything from historical
energy use through to the facility layout and operational hours. The
data is used to build an energy simulation of the facility in order to
create a detailed load and cost breakdown along with a detailed
study of the consumption of the facility. Following this, all potential
energy efficiency measures are considered, from the low cost/no
cost ones to those with low CAPEX and quick returns, to those with
higher CAPEX and longer returns. Table 1 shows an example of low
cost/no cost measures.
In 2009, EEG were asked to carry out a comprehensive energy
audit for the Rafic Hariri University Hospital (RHUH), the largest public
hospital in Beirut, Lebanon, under the direct supervision of the Lebanese
Centre for Energy Conservation (LCEC). RHUH’s main building has a
maximum capacity of 544 hospital beds, and comprises a total of seven
floors, three annex buildings, a 50-bed hotel, four villas hosting staff
dormitories, outpatient clinics and administrative services.
The energy audit, which took three months
to complete, included an in depth analysis
of baseline operations and energy usage
of each load in the hospital building, the
students’ and nurses’ dorm building, and the
nursing university building.
The results showed the hospital consumed more
than 20,915 MWh electrical energy annually, with related
total costs just under US$2.2 million for a 12-month period
from August 2007 to July 2008. With 78% dependence on the
EDL substation, the facility’s onsite generators produced around
4,556 MWh at a cost of US$638, 279. The thermal energy use
exceeded 59,400 GJ (16,500 MWhth) with related total costs of
more than US$878,000.
Analysis found that the cooling load was the largest electrical energy
consumer, representing around 25% of the total cost and some 36%
of the total electrical load, followed by the lighting load at 23% of the
total cost and 11.5% of the total electrical load.
After analysing the energy consumption profile at RHUH,
the investigation process for possible opportunities for Energy
Conservation Measures (ECM) identified every aspect of the total
load. EEG proposed a list of ECMs that would reduce the energy
consumption, table 2A shows Electrical EEMs and table 2B the thermal.
FINDINGS
The findings of the audit were impressive - if all of the recommendations
were taken into account, the total energy bill for RHUH could be
reduced by around 6,910,489 KWh annually, representing over US$1
million of cost reductions, with possible CO2 emission reduction
reaching 5,756 tons per year. That is US$1 million that could be put back
into the hospital and used for patient and staff welfare.
With potential savings like this, every hospital should look to their
energy use sooner rather than later.