Rethinking Buildings to Heal Patients: The Shift Toward Energy Efficiency in Hospital Facilities
by Isabel Figueredo, Researcher | Analyst
How do we maintain satisfaction among a growing patient population while decreasing the immense amounts of energy consumption in hospital facilities? The answer is complicated.
Energy consumption is one of the most prevalent problems facing U.S. healthcare delivery. U.S. healthcare facilities spend 8.8 billion dollars on energy annually. Individually, they use almost three times the amount of energy a typical office building requires (Bendewald and Tupper 2013). As a result, there has been a dramatic shift towards energy efficiency initiatives that can decrease operational expenses while allowing the facility to retain maximum operational efficiency and patient satisfaction.
Managing energy costs in hospital facilities is never straightforward. Almost all hospital facilities are open 24 hours and require cooling and heating systems that vary significantly by climate (Bendewald and Tupper 2013).
“In a typical hospital, lighting, heating, and hot water represent between 61 and 79 percent of total energy use depending on climate”.(National Grid 2014)
Although there are basic fixes and practices that can be conducted in order to decrease overall energy use, the tools for understanding space occupancy, activity, and energy requirements have yet to be effectively constructed or deployed. In other words, there could be an air-handling unit that is serving an unoccupied area at night, but how do we know it is unoccupied (National Grid 2014)?
By being more energy efficient, hospitals could assist in preventing greenhouse gas emissions, improve the air quality in their local communities, and serve as a lead example in their dedication to public health (energystar.gov). An even larger selling factor is that by being more energy efficient, hospitals would save a significant amount of money. As an example, the New York Presbyterian Hospital (NYPH) has developed diligent energy saving initiatives since 2003, and as a result saves $1.77 million in annual savings. Providence Health and Services, a Seattle-based healthcare system has made similar advances and has increased their energy savings from $700,000 in 2003 to $3.4 million in 2006 (energystar.gov). Even so, the majority of hospital facilities have made very little progress towards addressing these challenges and opportunities.
In order to holistically rethink systems that generate inefficiency, it is also important to consider other issues the healthcare system needs to address. For example, new policies and regulations have made health care more accessible to a much larger population (Anderson 2014). Because of this increase in access, healthcare organizations’ energy demand costs are dramatically spiking to meet patient needs. With volume increases, hospitals simultaneously struggle to maintain overall patient satisfaction, the basis for their Medicaid reimbursement revenues.
Hospitals view patient satisfaction as a key priority for various reasons. It has a heavy influence on revenue, cost, and government reimbursements. Hence there has been an abundant push towards studying what factors within the hospital environment can affect a patient’s overall experience. The majority of this research has focused on social environmental factors, such as the staff’s attitude and its effect on patients’ experience.
Even though there has been less focus on environmental and architectural design, there is still a significant amount of existing empirical research to suggest that properly designed hospital facilities can improve patient safety, satisfaction, and overall experience (Reiling et al. 2008; Joseph et al. 2011). Evidenced-based research has also found that properly designed hospital facilities can decrease the facilities’ energy consumption and energy costs (Bendewald and Tupper 2013). Regardless of the multiple studies conducted on each subject, there has been little to no research that suggests looking at the relationship between them.
Understanding the relationship between energy consumption and patient satisfaction and their influences on hospital productivity and cost can lead to essential information the healthcare system could use to decrease energy consumption while maintaining or increasing overall work functionality.
Fig 2. Energy consumption and its relationship to patient satisfaction. Graphic by Annie Liu
It is evident that further research is required to explore how physical structures and environments interact and shape cultural outcomes within hospital facilities. Understanding how the environment, culture, and facility structure may influence the overall experience of the patient is essential to helping hospitals meet their primary objective of customer satisfaction.
Architecture, Culture, and Assets all intersect to create a holistic understanding of how patient health is contingent on multiple factors.
MKThink believes that opportunity for operational and planning improvements can be found through studying the relationships between physical and social structures. We have developed a framework that studies the overlaps of three dimensions: Assets, Environment, and Culture. This logic has been used to help give organizations the ability to increase human performance, use fewer resources through optimized resource use, and develop more effective investments in technology and energy efficiency. The initiative has already been supported through the Office of Naval Research (ONR) and the Asia-Pacific Technology (APTEP), and is in the process of expanding and becoming more accessible, non-technical, and efficient.
Implementing this unique framework could benefit hospital facilities in determining what decisions would be the most effective in order to decrease their energy consumption while retaining or even improving overall patient satisfaction.
With all this in mind, back to the original question: how do we maintain satisfaction among a growing patient population while decreasing the immense amounts of energy consumption in hospital facilities? It is still complicated. However, the first step is to reform the way we think about current issues within the healthcare system. Only then can we can use the rapidly developing technologies and preexisting cultural factors around us to determine what the most efficient, cost-effective decisions for the future would be.
Cited references: Anderson, Amy. 2014. “The Impact of the Affordable Care Act on the Health Care workforce.” The Heritage Foundation, March 18. Retrieved September 8,2014. (http://www.heritage.org/research/reports/2014/03/the-impact-of-the-affordable-care-act-on-the-health-care-workforce).
Bendewald, Michael and Kendra Tupper. 2013. “A positive diagnosis: How hospitals are reducing energy consumption.” Green Biz, November 21. Retrieved August 9,2014 (http://www.greenbiz.com/blog/2013/11/21/health-care-energy-consumption-retrofits).
Energy Star. Healthcare and Overview of Energy Use and Energy Efficiency Opportunities. Retrieved August 8,2014 (http://www.energystar.gov/ia/business/challenge/learn_more/Healthcare.pdf).
Joseph, Anjali, Eileen Malone, Debajyotie Pati and Xiaobo Quan. 2011. “Healthcare Environmental Terms and Outcomes Measures: An Evidence-Based Design Glossary.” Tandus Flooring, November 2011. Retrieved September 8,2014 (https://www.healthdesign.org/chd/research/healthcare-environmental-terms-and-outcome-measures-evidence-based-design-glossary).
Reiling, John, Ronda G. Hughes and Mike R. Murphy. 2008. “The Impact of Facility Design on Patient Safety.” Patient Safety and Quality: An Evidence-Based Handbook for Nurses, edited by R.G. Hughes. Rockville, MD/United States: Agency for Healthcare Research and Quality.
National Grid. Managing Energy Costs in Hospitals. E Source Customer Direct. Retrieved August 9,2014 (http://www.nationalgridus.com/non_html/shared_energyeff_hospitals.pdf).
Originally published at www.mkthink.com on September 25, 2014.