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When it comes to health care design, energy efficiency is always a challenge. Kaiser Health News stated hospitals use up to five times more energy than a fancy hotel. But with the catastrophic strains the health care field has endured through 2020 due to the COVID-19 pandemic, health care leadership must consider every possible means of economic sustainability, even if environmental sustainability has not been a top priority in the past. 

Evidence-based design in conjunction with strategic energy management may be one means to reduce the significant costs associated with energy consumption in health care facilities. In the recent additions to The Center for Health Design’s Knowledge Repository, we find several studies from all over the world focused on energy efficiency in health care design. Three are highlighted here. 

As in many parts of the world, the majority of Italian hospitals (60%) were built before 1980, making it critical to know which energy efficient updates to prioritize. A study out of Italy by Cesari and colleagues points to the potential of window glazing for large patient room windows. 

Larger patient room windows bring in more natural light, improving patient experience and satisfaction, but at the same time “opening up” the building for major heating/cooling energy loss. Using building energy dynamic simulations, the researchers examined various window sizes, glazing types and window orientations on energy efficiency in the patient room. 

Findings highlight the importance of evaluating the heating and cooling demands separately, and how the priority between the two will differ depending on specific climate. They suggest appropriate glazing may make it possible to increase the size of windows in patient rooms — and all the patient and staff benefits that come with it — without major thermal transmission losses in the winter or solar gains in the summer.

Energy savings in hot-humid climates can be especially challenging. In a study out of Alexandria, Egypt, by William and colleagues, simulation tools are used to explore potential energy savings and operating costs. The team applied ASHRAE standards from the United States and several energy-saving strategies such as dedicated outdoor air systems, double glazing and LED lighting. They found these methods to be effective in reducing HVAC energy consumption and whole building energy use. 

In a study on machine learning models by Cao and colleagues, the authors provide an overview of single versus ensemble learning prediction. Referencing actual energy outcomes at a hospital in China, they were able to validate the findings from the two models, and suggest that ensemble learning provides a more accurate prediction of energy use. They were also able to identify several features (e.g., outdoor temperature) as the most influential features in load prediction. 

With the growing body of research, as well as simulation and machine learning resources, we are seeing more and more design strategies that can achieve all three principles of sustainability for a health care organization: economic, environmental and societal/person-centered goals. 

The following citations from The Center for Health Design’s Knowledge Repository of health care design resources were used by the author when writing this column:

  • J. Appleby, “Energy-Hog Hospitals: When They Start Thinking Green, They See Green,” Kaiser Health News, Aug. 16, 2018.
  • S. Cesari et al., “The Energy Saving Potential of Wide Windows in Hospital Patient Rooms, Optimizing the Type of Glazing and Lighting Control Strategy under Different Climatic Conditions,” Energies 13, no. 8 (2020): 2116.
  • M. A. William et al., “Energy-Efficient Retrofitting Strategies for Healthcare Facilities in Hot-Humid Climate: Parametric and Economical Analysis,” Alexandria Engineering Journal, 2020, in press.
  • L. Cao et al., “Electrical Load Prediction of Healthcare Buildings through Single and Ensemble Learning,” Energy Reports 6 (2020): 2751–67.

About this column

“Design Discoveries” highlights research from The Center for Health Design’s Knowledge Repository, a user-friendly library of health care design resources. This research effort is supported by the American Society for Health Care Engineering, the American Institute of Architects, the Academy of Architecture for Health Foundation and the Facility Guidelines Institute.