New technology, old wisdom

In sifting through resources on my continued quest to improve health care’s utility footprint, one theme has cropped up consistently: the basics of quality control at every phase of designing, building, commissioning and operating our hospitals. Our field’s challenges around energy management highlight the need to enhance best practices around predictive (aka “fault detection”) software targeting a building’s heating, ventilating and air-conditioning (HVAC) system. Why my compulsive focus on utilities and energy efficiency? Well, to quote Willie Sutton, “That’s where the money is!”

Some technological improvements, if standardized, could help. HVAC building control systems (BCSs) configured out of the box with graphical dashboards would allow users to track key performance indicators (KPIs). Fault detection software integrated into BCS packages and enhanced with machine learning scripts could capture out-of-range conditions while listing corrective actions. We need integrated HVAC controls that incorporate seasonal reset sequences, basic measurement and verification data, and KPIs such as chiller efficiency with predicted versus actual building performance targets based on current occupancy and weather conditions.

But the health care planning, design and construction (PDC) process also must rethink many existing processes across the board to improve reliability and energy efficiency, including testing, adjusting and balancing; and commissioning systems for typical off-peak weather conditions. Our buildings perform fine for that “design day,” but how are we assured that buildings operate at peak comfort and efficiency during off-peak (in other words, most) hours of operation, thus reducing utility consumption and cost?

Installing next-generation building controls and utility systems in our facilities will not improve energy utilization until we reinvent the PDC process by embracing peer reviews, commissioning, test/balance and reliability-centered maintenance as a collaborative approach to quality control, from concept through post-occupancy.

I am excited to see these improvements catch on in our field, the prize being significantly reduced utility consumption and improvements to an organization’s bottom line. Let’s get back to basics (with innovation) of building performance — and I’ll see you in Columbus, Ohio, for the Health Care Facilities Innovation Conference™!