Bracing for Troubled Waters

As water-use concerns rise among health care facilities nationwide, one hospital gets a jump-start on measures to hold down rising costs

By Dan Hounsell  

Not that long ago, most health care facilities tended to take for granted the availability and relatively low cost of water. Hospitals brought in water, used it, and disposed of it for myriad functions, often paying little attention to whether the water was being used efficiently. Given the seeming endless supply, this attitude — common in facilities in general — was not surprising in the least.

But times have changed. Droughts in the Western United States and across the Great Plains have made water a more precious commodity than ever. And many municipalities, seeking to upgrade their deteriorating water and sewer infrastructures, are passing on the costs of these big-ticket projects to users.

These factors have combined to drive up water and sewer bills nationwide, prompting institutional and commercial facilities of all kinds to pay much closer attention to the way their facilities use and dispose of water. But the challenges are especially acute for the nation’s hospitals.

“Let’s face it, hospitals operate 24 hours a day seven days a week,” says Tom Muratore, executive vice president of H2O Applied Technologies, a Boston-based firm that specializes in helping health care facilities control costs related to their water use and disposal. “In any community, the hospital is the biggest water user.

One hospital’s effort

For maintenance and engineering managers, the increasingly important task of ensuring cost-effective water use often means taking both a narrow view — rethinking the technology and equipment used in HVAC and plumbing systems — and a broader view — keeping their eyes open for water waste in all areas of operations.

The water-use issues facing Fairview Southdale Hospital in Edina, Minn., are not atypical of those facing health care facilities nationwide. Since 1995, the hospital’s efforts to get water use costs under control have included taking a broader look at the way the hospital gets and uses water, says says David Fashant, the hospital’s director of plant operations and maintenance.

Prior to 1995, Fashant says, the 550,000-square-foot, 390-bed hospital used a single-pass cooling system. The facility pumped well water into its the system, used it one time, and then sent it down the drain.

When the U.S. Environmental Protection Agency (EPA) mandated an end to such cooling systems by 1997, the hospital’s chief engineer, Jim Knudtson, began investigating cooling options for the facility, as well as ways the hospital could conserve water in general.

The hospital’s efforts have included updates in its cooling system, such as relying more on centrifugal chillers and cooling towers, as well as upgrading pumps and compressors to take greater advantage of air cooling. Also, technicians have installed solenoids and timers on instrument sterilizers in operating rooms, Fashant says. Now, instead of using water continually, the devices use it only as needed.

Their efforts have gone beyond the usual suspects to include water-using processes in the hospital that, though not directly related to the HVAC system, nonetheless contributed to water waste. For example, the hospital’s cafeteria had been using an inordinate amount of water disposing of leftover food, Fashant says. Now, the hospital donates leftovers to a local food bank.

This situation demonstrates the numerous ways hospitals use water and, as a result, the difficulty many managers have in quantifying and monitoring facility water use. For more on this challenge, see the article on page 8.

Fairview Southdale’s efforts have paid off handsomely, however. Between 1995 and 2000, the hospital was able to cut its water use by about 220 million gallons per year, Fashant says.

The Role of Maintenance

Because maintenance and engineering managers and their staffs work most closely with water-using systems in hospitals, they generally are seen as the best sources of information and ideas regarding potential savings. But in many cases, managers, as well as facility executives, are behind the curve in terms of having a deep understanding of their facilities’ water use patterns.

“Most facilities don’t know what their water and sewer costs are,” Muratore says. “No one has it on their to-do list. It’s not really anyone’s top priority.” Muratore sees evidence of this information gap regularly.

“We go around with engineering managers, and they think they’re doing everything right,” he says, but adds that in about 10 percent of the cases his firm handles,the facility has a major leak that previously had gone undetected, in some cases for years.

In the case of Fairview Southdale, the maintenance and engineering staffs have been attuned to the issue of water conservation longer than most.

“Our maintenance group is very experienced,” Fashant says. “They are always on the lookout for opportunities to save energy and cut costs.”

For example, one section of the hospital contained operating rooms that had been served by a separate rooftop air handler and chiller, Fashant says. During planning for a renovation of that section, one of the hospital’s engineers suggested moving the air-handling unit and connecting the section to the hospital’s main chilled-water system. The move, Fashant says, improved both the reliability of the system and resulted in lower operating costs.

The maintenance department also has helped in testing products and equipment to ensure they contribute the hospital’s water-saving efforts. In one instance, the hospital was considering installing faucets with low flow rates for use by medical staff scrubbing for surgery. But after testing the products, the maintenance staff pointed out that because of the faucets’ reduced water flow, they weren’t able to fully dissolve the soap used by medical staff. And, as a result, sink drains were clogging more than before.

Hospitals will continue to need large amounts of water to function, so the ongoing issue for managers and staffs will be to keep the issue of water conservation a high priority in the face of expanding facilities operations and tight budgets.

Dilemma: Water, Water Everywhere

The task of controlling water use in a hospital is challenging enough for maintenance and engineering managers, considering the numerous systems they oversee that use water. But those systems are only part of a much larger picture when it to hospital water use, says Tom Muratore, executive vice present of H20 Applied Technologies, a Boston-based firm specializing in helping health care facilities control costs related to water use and disposal.

“About 70 percent of a hospital’s water use is not under the control of the facilities management department,” Muratore says. For example, maintenance mangers generally control water use related to chillers, cooling towers, plumbing systems and HVAC-equipment cooling. But water use in other areas, including food service, radiology, operating rooms and dialysis centers often is some other manager’s responsibility, he says. As a result, managers looking to get an accurate picture of their facilities’ water use will need to consider all operations in a facility.

— Dan Hounsell

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  posted on 2/1/2003   Article Use Policy

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