Many rooms in hospitals require special design considerations because of intensified infection concerns, high air change rates, special equipment, unique procedures, high internal loads, and the presence of immunocompromised patients. But in no other health-care space does the design of the HVAC system take on more importance than in an operating room (OR), where its purpose is to minimize infection, maintain staff comfort, and contribute to an environment of patient care.

This presentation will delve into the complex dynamics of designing and maintaining energy-efficient and sustainable hospital operating room environments which will:

1. Provide consistent compliance with ASHRAE Standard 170, drastically reducing or eliminating excursions in high OR space relative humidity, as commonly experienced.
2. Produce the ultimate in OR comfort for the surgeon and staff, helping eliminate complaints.
3. Garner substantial HVAC system energy-and-sustainability improvements, in many cases reducing or eliminating the requirement for wasteful reheat.

The materials presented will be based on information found in three peer-reviewed ASHRAE Journals articles on this topic, authored by the presenter. After this presentation, the attendee will be able to…

1. Understand the performance differences between traditional refrigerant-based cooling systems (which produce dehumidification as a byproduct) and dedicated desiccant dehumidification equipment which can perform independently of the OR space sensible heat ratio.
2. Learn how to reduce the need for energy wasting “reheat” when designing hospital ORs using a more effective desiccant dehumidification system approach.
3. Discover how desiccant dehumidification systems may allow for increasing the hospital’s chilled water supply temperature, reducing chiller lift and producing energy reductions across the entire facility.

Hospitals are among the biggest energy consumers in the country when considering how they are run and the number of people who use them. They are open 24 hours a day and have sophisticated energy needs, such as code mandated air change rates and temperatures along with specialized HVAC systems. Yet of all the challenges facing the nation's health care system, one of the most prevalent -- yet solvable -- is its overwhelming energy consumption.

Heat recovery-chiller systems aim to capture energy that would otherwise be wasted to the atmosphere. It is possible to capture the rejected heat from the condenser and use it to produce hot water for use in the hospital, therefore overall system efficiencies can be significantly increased. In addition, heat recovered from the building can be used to offset wasteful reheat, which can contribute to over 60% of a large hospitals natural gas energy bill.

Recovering heat by using heat recovery chiller systems can drastically reduce fossil fuel use. In addition to the environmental benefits, this has advantages for building management in the form of lower operating costs.

Learning Objective:

Many spaces in a hospital require special design considerations due to intensified infection concerns, high air change rates, special equipment, unique procedures, high internal loads, and the presence of immunocompromised patients. But in no other healthcare environment does the design of the HVAC system take on more importance than in operating rooms, where its purpose is to minimize infection, contribute to an environment of patient care, and maintain surgeon and staff comfort.

Hospital operating rooms are notoriously plagued with environmental control problems revolving around the inability to maintain temperature and relative humidity conditions that comply with various healthcare codes-and-standards while satisfying the comfort demands of surgeons and staff.

This presentation will provide an understanding of the underlying causes for some of the most predominant of these issues, while giving guidance on how to best cope with them. Unfortunately, many hospital facility professionals have resigned themselves to the idea that these problems cannot be resolved, which is often far from the truth.

Questions answered include:

1. Why do surgeons want the operating room cooled to such low temperatures, many times demanding 60°F (15.6°C) or colder?
2. Why does lowering the operating room temperature (at the request of the surgeon) result in the space relative humidity going up?
3. Why, at times, does it ‘rain’ in the operating room, with water dripping from surfaces?
4. On days when outdoor relative humidity is low, why does the humidity in the hospital facility increase when more ventilation air is introduced?

After this presentation attendees will be equipped to apply their newfound knowledge in designing or maintaining dehumidification systems that may be better positioned to achieve outstanding environmental performance and improved energy-efficiency.

Many rooms within hospitals require special design considerations because of intensified infection concerns, high air-change rates, special equipment, unique procedures, high internal air-conditioning loads and the presence of immunocompromised patients. In no other healthcare space does the design of the Heating-Ventilating and Air-Conditioning (HVAC) system take on more importance than in an Operating Room (OR), where its sole purposes is to minimize infection, maintain staff comfort and contribute to improving the environment of patient care.

Learning Objectives:

In the U.S., a new healthcare-delivery model is emerging and large centrally located urban hospitals are giving way to smaller community-based facilities intended to attract patients by being more accessible. ASHRAE has supported this movement through publication of “Advanced Energy Design Guide for Small Hospitals and Healthcare Facilities: 30% Energy Savings.” One of the guide’s recommendations to reduce operational costs and greenhouse-gas emissions is to utilize air-cooled chillers.

Technological innovations, combined with advances in manufacturing practices, have resulted in considerable improvements in air-cooled-chiller performance, particularly in terms of efficiency, sound, and footprint. This presentation will cover the recent evolution in air-cooled chillers and discuss the various improvements helping drive the air-cooled advantage. It will detail the first-cost and life-cycle cost differences between air-and-water cooled chillers and will speak to the “delivered-system” as a whole, pointing out that concentrating on chiller efficiency alone may not produce the most favorable chiller plant.

Presentation Objectives:

The Advanced Energy Design Guide for Large Hospitals is an ASHRAE publication designed to provide strategies and recommendations for achieving 50% energy savings over the minimum code requirements of ANSI/ASHRAE/IESNA Standard 90.1-2004, Energy Standard for Buildings Except Low-Rise Residential Buildings. The Guide provides user-friendly, how-to design guidance and efficiency recommendations for large hospitals, showing how reliable technologies and design philosophies can be used to reduce energy use. In essence, the guide provides design teams a methodology for achieving energy savings goals that are financially feasible, operationally workable, and otherwise readily achievable.

This seminar is intended as a “primer” for those healthcare design and facility professionals who may not have had time yet to review the ASHRAE Design Guide and its recommendations in detail. It will cover various HVAC technologies and systems that have been demonstrated to produce substantial energy savings, and will qualify the financial aspects of those savings to a typical hospital facility. Many of the recommendations in the guide can be applied equally to new construction as well as add-on/retrofit or energy upgrade projects.

Presentation Objectives:

Healthcare facilities in the United States account for 4.8% of the total area of all commercial buildings yet are responsible for 10.3% of their total energy consumption. If the healthcare sector were a country, it would be the fifth-largest emitter of greenhouse gasses on the planet. As well, the number of healthcare facilities has increased by 22% since 2003, leading to a 21% rise in energy consumption which has placed a sustainability target on the back of every hospital in the country.

The American Society for Health Care Engineering (ASHE) defines decarbonization as the reduction of greenhouse gas (GHG) (CO2) emissions resulting from human activity, with the eventual goal of eliminating them. In practice, getting to zero net emissions requires shifting from fossil fuels to alternative low-carbon energy sources. The scale of the current climate crisis means that full decarbonization of the economy rather than partial reduction of emissions is now the goal. Instead of just using fossil fuels more efficiently, this requires ceasing using them at all. This in turn requires moving to zero carbon energy vectors, notably via electrification of end-uses previously not served by electricity.

Energy efficiency has delivered the largest share of historic greenhouse gas mitigation and is an anticipated path for hospitals to follow into the immediate future. ASHE has suggested facility managers begin their decarbonization journey by implementing measures that will deliver the biggest bang for the buck. This presentation will define the current situation faced by facility managers and suggest some simple cost-effective strategies that can produce immediate energy and GHG reductions for any healthcare operation.

Learning Objective:

1. Understand what greenhouse gas reduction involves and exactly what hospital facilities are tasked to deliver.

2. Provide references to industry resources which can be used to help create a road map to success.

3. Explain the various contributors of hospital GHG emissions including direct, indirect, and other source emissions that must be addressed.

4. Define hospital “energy use intensity” (EUI) and show exactly which process within the facility consume the most energy, and why.

5. Outline three opportunities within a hospital that can deliver the largest energy-source reduction and understand practical ways to implement solutions with little or no first-cost consequence.

6. Clarify a simple and effective way to communicate the financial benefit of any energy-efficiency initiative to the CFO, in a manner that will garner a positive response.

HVAC systems in hospitals provide a broad range of services in support of a population who are uniquely vulnerable to an elevated risk of health, fire and safety hazard. Operated 24 hours/day, 7 days/week, the often unique environmental conditions associated with these facilities, and the critical performance, reliability and maintainability of the HVAC systems necessary for their success, demand a specialized set of engineering practices and design criteria.

Air-handling units (AHU’s) in hospitals provide a variety of functions that may include comfort conditioning, maintaining air quality, reducing airborne infections, odor control, and smoke ventilation, while directly contributing to thetemperature, humidity, air movement, ventilation and filtration within these facilities. Additionally, they must operate as efficiently as possible in order to eliminate the burden of excessive energy costs which diminish a hospitals financial bottom line. The proper design, selection, installation and operation of these significant system components is key to a HVAC system that contributes positively to the complex dynamics of patient wellbeing and outcome.Much of the information in this presentation comes from various ASHRAE and ASHE publications, including the ASHRAE HVAC Design Manual for Hospitals and Clinics and the ASHE Mechanical Systems Handbook for Health Care Facilities.

Learning Objective:

Many rooms within hospitals require special design considerations because of intensified infection concerns, high air change rates, special equipment, unique procedures, high internal loads and the presence of immunocompromised patients. ANSI/ASHRAE/ASHE Standard 170, Ventilation of Health Care Facilities is considered the cornerstone of healthcare ventilation design. This standard defines minimum design requirements, but due to the wide diversity of patient population and variations in their vulnerability and sensitivity, it may not guarantee an environment that will satisfactorily provide comfort and control of airborne contagions and other elements of concern.

This presentation will cover various aspects of HVAC system and ventilation design that when properly applied can help ensure an environment that is favorable to both occupant comfort and enhanced patient care. Along with Standard 170, comprehensive design assistance and best practice techniques as outlined in the ASHRAE HVAC Design Manual for Hospitals and Clinics will also be introduced.

Presentation Objectives:

Desiccant-based dehumidification transfers moisture in its vapor phase from the air to the surface of a desiccant through adsorption, without the need to “condense” water on a chilled cooling coil. This allows desiccant technology to achieve absolute moisture conditions much lower than possible using more traditional refrigerant based cooling systems that dehumidify by making the air cold.

Desiccant based systems are utilized for applications requiring 45% relative humidity down to 1% (or less) and many times are the only dehumidification solution that will work. Desiccant dehumidification can be more efficient, economical, and sustainable than its refrigeration-based counterpart, particularly when lower indoor temperatures and reduced relative humidities are required.

This presentation will delve into the dynamics of designing and maintaining energy-efficient and sustainable desiccant dehumidification systems for various market segments. It will provide attendees with an understanding of the following:

1. How desiccant dehumidification works and how components interact to provide a thermodynamically eloquent moisture removal system.
2. Why desiccant based dehumidification differs from that of more traditional refrigerant based DX or chilled water methods, and why this is important in achieving lower indoor moisture conditions.
3. The myriad of applications including hospitals, clean rooms, pharmaceutical, food processing, archival storage, aerospace, and others where desiccant dehumidification is the perfect solution.
4. Why dedicated desiccant dehumidification equipment can perform independently of the space sensible heat ratio (SHR), eliminating associated frosting and freezing issues that traditional cooling coils face when trying to achieve low leaving air temperatures.

After this presentation attendees will be equipped to apply their newfound knowledge in designing dehumidification systems that may be better positioned to achieve outstanding environmental performance and improved energy-efficiency.