Drought-resistant landscaping can help to reduce water usage while also providing an aesthetically pleasing environment.

Image courtesy of Rick McGuffey | Sky Lakes Medical Center

Editor’s note: This article is part of a series on the impacts of climate change and climate events on hospitals and health care facilities and related planning, preparedness and response efforts.

The end of 2021 marked the 22-year milestone of a megadrought in the southwestern United States. This drought trend is likely to continue into 2022, with heat and dryness levels not seen since the start of the 20th century. According to the U.S. Drought Monitor, over half of the contiguous United States was in drought at the end of last year.

Drought can exacerbate the effects of other climate change weather events. One example is dry conditions present during extreme heat, which in turn greatly increase the risk of wildfires. Dust and particulate matter from drought-related wildfires then pollutes water sources and affects air quality. Community and public health outcomes include the increased risk of respiratory and infectious diseases and limited access to clean water — impacts that disproportionately affect vulnerable populations.

Research has shown that 7% of total commercial and institutional water usage is by hospitals, and the majority of this water use is for heating and cooling systems, restroom facilities and medical equipment. Because access to water is an essential part of health care facilities operations, drought impacts on water supplies can be significant. Resource management, water conservation, and drought preparation and planning are all important steps to contend with possible water shortages or disruptions.

In California, one of the main impacts of drought on health care facilities is restrictions on water usage, says Devin Hugie, FASHE, CHFM, CHC, DHI Consulting, who was formerly executive director of support services at Children’s Health Orange County and oversaw facilities throughout Southern California.

Facilities can reduce water consumption in a variety of ways, including more drought-resistant landscaping, installation of low-flow toilets and improved cooling tower operations. Hugie points out that water reduction strategies can also boost energy efficiency, and the benefits for larger facilities can be substantial.

“For example, if you have a low-flow showerhead that saves a certain number of gallons per minute, you’re heating less water,” Hugie says. “For one showerhead in a home, you might not even notice it. But if you’re doing that in a larger hospital, if you’re doing 500 showerheads, that could be significant because you’re using much less water. You want to use the least amount of water possible, and you’re trying to optimize across everything from your kitchen to your laundry.”

Other regions experiencing drought conditions are facing additional challenges, says Rick McGuffey, director of facilities management at Sky Lakes Medical Center, Klamath Falls, Ore. A significant number of wells have gone dry in Oregon, and Klamath County (where McGuffey’s facility is located) has declared drought disaster more than any other county in the state. The location also makes it especially vulnerable to the threat of wildfires, which is exacerbated by drought.

“In the last few years, we’ve been more and more concerned because of the drought in more places,” McGuffey says. “More wildfires seem to burn more acreage because it’s so dry. It’s a scary thought because we’re still in a mountainous range. We have a lot of woods and trees around us, and it can spread pretty fast.”

McGuffey says that a large energy conservation project at Sky Lakes Medical Center several years ago pinpointed ways the facility could reduce water waste. He notes, however, that even smaller-scale efforts to save water are worth pursuing since the savings add up over time. In addition, he believes water conservation is an issue all facilities managers need to address since drought conditions are likely to continue into the future.

“We built a parking structure here a few years back, and we had a lot of grass and trees that we had to dig up,” McGuffey says. “But when we came back, we only put in two little small grass areas and the rest are plants and trees. They’re all drip systems except for the small amounts of grass, and the rest is just rock. So then it looks good, but we’re not using much more water than we did in the past.”

McGuffey says that Klamath County is east of the Cascades and very dependent on the winter snowpack. The rural location of Sky Lakes Medical Center has also made self-sufficiency a priority because resources are less readily available than in more urban areas. These regional drought impacts have been an impetus to think ahead about longer-term mitigation measures.

“If the well goes dry, we could end up with less water, and one of the things that we’re looking at is possibly putting in our own water tanks, maybe a couple of 10,000-gallon tanks,” McGuffey says. “If the water does go down, and it has before, or when we do a shutdown, we could still supply water for cleaning and running our boilers or chillers, at least on a temporary basis. Then we could have the water tanker come up and fill those up as needed.”

The threat of drought has made preparation and planning a necessary part of facilities management. But the benefits of implementing water-efficiency best practices extend beyond the risk mitigation, cost savings and environmental impacts.

“The financial return on investment is there, but it’s also the public perception of what organizations are doing,” Hugie says. “If you’re walking into a hospital and you see all of these sprinklers that are misaligned and wet sidewalks and water running down the driveway because of a broken sprinkler head, that’s just wasting water and that doesn’t look good.”

Learn More

The National Drought Mitigation Center has a variety of tools and resources related to drought, including the U.S. Drought Monitor, the Drought Impact Toolkit and the Drought Management Database, which is a collection of information about drought preparation and response.

Preparing for the Health Effects of Drought is a guidebook from the Centers for Disease Control and Prevention to help public health professionals assess vulnerabilities, develop preparedness and response strategies, and collaborate with key partners.

The U.S. Environmental Protection Agency’s WaterSense at Work publication looks at water-efficiency management best practices in all areas of commercial and institutional facilities, and Saving Water in Hospitals is a fact sheet that reviews strategies specific to health care facilities.

The Healthcare Water Efficiency and Program Management Toolkit from Better Buildings, an initiative of the U.S. Department of Energy, includes guidance for water management tailored to the health care sector.

Practice Greenhealth has compiled resources for reducing water consumption while enhancing patient outcomes and minimizing costs.