Healthcare Energy End-Use Monitoring - NREL

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Healthcare Energy End-UseMonitoringMichael Sheppy, Shanti Pless, and Feitau KungNational Renewable Energy LaboratoryNREL is a national laboratory of the U.S. Department of EnergyOffice of Energy Efficiency & Renewable EnergyOperated by the Alliance for Sustainable Energy, LLCThis report is available at no cost from the National Renewable EnergyLaboratory (NREL) at www.nrel.gov/publications.Technical ReportNREL/TP-5500-61064August 2014Contract No. DE-AC36-08GO28308

Healthcare Energy End-UseMonitoringMichael Sheppy, Shanti Pless, and Feitau KungNational Renewable Energy LaboratoryPrepared under Task No. ARCB1301NREL is a national laboratory of the U.S. Department of EnergyOffice of Energy Efficiency & Renewable EnergyOperated by the Alliance for Sustainable Energy, LLCThis report is available at no cost from the National Renewable EnergyLaboratory (NREL) at www.nrel.gov/publications.National Renewable Energy Laboratory15013 Denver West ParkwayGolden, CO 80401303-275-3000 www.nrel.govTechnical ReportNREL/TP-5500-61064August 2014Contract No. DE-AC36-08GO28308

NOTICEThis report was prepared as an account of work sponsored by an agency of the United States government.Neither the United States government nor any agency thereof, nor any of their employees, makes any warranty,express or implied, or assumes any legal liability or responsibility for the accuracy, completeness, or usefulness ofany information, apparatus, product, or process disclosed, or represents that its use would not infringe privatelyowned rights. Reference herein to any specific commercial product, process, or service by trade name,trademark, manufacturer, or otherwise does not necessarily constitute or imply its endorsement, recommendation,or favoring by the United States government or any agency thereof. The views and opinions of authorsexpressed herein do not necessarily state or reflect those of the United States government or any agency thereof.This report is available at no cost from the National Renewable EnergyLaboratory (NREL) at www.nrel.gov/publications.Available electronically at http://www.osti.gov/scitechAvailable for a processing fee to U.S. Department of Energyand its contractors, in paper, from:U.S. Department of EnergyOffice of Scientific and Technical InformationP.O. Box 62Oak Ridge, TN 37831-0062phone: 865.576.8401fax: 865.576.5728email: mailto:[email protected] for sale to the public, in paper, from:U.S. Department of CommerceNational Technical Information Service5285 Port Royal RoadSpringfield, VA 22161phone: 800.553.6847fax: 703.605.6900email: [email protected] ordering: http://www.ntis.gov/help/ordermethods.aspxCover Photos: (left to right) photo by Pat Corkery, NREL 16416, photo from SunEdison, NREL 17423, photo by Pat Corkery, NREL16560, photo by Dennis Schroeder, NREL 17613, photo by Dean Armstrong, NREL 17436, photo by Pat Corkery, NREL 17721.NREL prints on paper that contains recycled content.

AcknowledgmentsThe authors would like to thank the U.S. Department of Energy’s (DOE) Building TechnologiesOffice for its support of this project. This report was prepared by the National Renewable EnergyLaboratory’s (NREL) Buildings and Thermal Systems Center under Task Number ARCB.1301.The authors would like to thank the following partners for their energy monitoring and datacontributions: Partners HealthCare and Massachusetts General Hospital (MGH) in Boston,Massachusetts The State University of New York Upstate Medical University (SUNY UMU) inSyracuse, New York Mazzetti, Inc.We also acknowledge the input of Brian Ball and William Livingood of NREL during projectplanning, and we thank Ross Reucker of Mazzetti for sharing data from his work with medicaloffices. We also thank the following individuals for reviewing drafts of this document: MichaelDeru and Ron Judkoff of NREL; Paul Holliday of Holliday Electrical Mechanical Engineering;Andrew Maynard and Chris Longchamps of Partners HealthCare; and Ron Westbrook of SUNYUMU.iiiThis report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

Executive SummaryHospital facility and energy managers find it challenging to identify the energy inefficiencies intheir buildings, because the industry lacks measured energy use data for major hospital end uses,such as cooling, heating, lighting, and plug loads. Historically, when these managers havecompared alternative energy efficiency investments for various end-use systems, theirbenchmarks have been limited to end-use estimates derived from modeling.To address this challenge, DOE commissioned NREL to partner with two hospitals (MGH andSUNY UMU) to collect data on the energy used for multiple thermal and electrical end-usecategories, including preheat, heating, and reheat; humidification; service water heating; cooling;fans; pumps; lighting; and select plug and process loads. Additional data from medical officebuildings were provided for an analysis focused on plug loads. Facility managers, energymanagers, and engineers in the healthcare sector will be able to use these results to moreeffectively prioritize and refine the scope of investments in new metering and energy audits.Highlighted findings include: For the MGH Gray Building in Boston, Massachusetts, Table ES-1 lists the end-usecategories with the highest site energy use intensities (EUIs). Whole-building meterswere also available at this site, enabling estimation of end-use percentages relative tototal building energy consumption.Table ES-1MGH Gray: End-Use Categories With the Highest EUIsSite EUI(kBtu/ft·yr)% of BuildingSite EnergyUseReheat and Heating108.427%Lighting and Other Electric Loads (e.g., Plug)86.221%Steam Piping Losses58.514%Fans (Supply, Return, and Exhaust)51.013%Chiller Plant Energy (Chillers, Cooling Tower Fans,Cooling System Pumps) Allocated to Building42.310%ivThis report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

For the SUNY UMU East Wing in Syracuse, New York, Table ES-2 lists the end-usecategories with the highest site EUIs.Table ES-2SUNY UMU: End-Use Categories With the Highest EUIsSite EUI(kBtu/ft·yr) Fans (Supply and Return/Exhaust)63.0Reheat and Heating53.6Lighting28.9Chiller Energy Allocated to Building26.8Pumps14.4The variability in the medical imaging equipment load profiles and the nighttime powerconsumption of some medical office building plug loads suggest an opportunity fordevice manufacturers and healthcare stakeholders to examine device operational modesmore closely to determine if improvements can be made to: (1) the energy efficiency of“idle” modes; and (2) built-in controls for transitions between operational modes. Anexample of the first case is that, when medical devices remain at full power in a medicaloffice building during non-business hours, such devices should be assessed morecarefully to determine which ones can be powered down. An example of the second caseis that manufacturers should consider designing controls that can reduce idle power whileensuring fast response and emergency readiness.vThis report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

Y UMUUPSVFDair handling unitautomatic transfer switchbuilding management systemBritish thermal unitscomputed tomographycurrent transducersdigital energy meterenergy use intensityheating, ventilation, and air conditioningkilowattMassachusetts General Hospitalmagnetic resonance imagingState University of New York Upstate Medical Universityuninterruptible power supplyvariable frequency driveviThis report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

ContentsAcknowledgments .iiiExecutive Summary . ivNomenclature . viContents .viiFigures and Tables . viiiFigures . viiiTables . viii1.0 Background and Motivation . 12.0 Overview of Hospitals in This Study . 22.1 Massachusetts General Hospital: The Gray Building . 22.2 The State University of New York Upstate Medical University: The East Wing . 23.0 Analysis of Major End Uses . 33.1 End-Use Energy for the Massachusetts General Hospital Gray Building . 33.2 End-Use Energy for the State University of New York Upstate Medical UniversityEast Wing. 64.0 Medical Equipment in Hospitals and Medical Office Buildings . 104.1 Hospital Medical Imaging Equipment . 104.2 Medical Office Building Plug Loads . 165.0 Conclusions . 205.1 End-Use Data for Informing Decisions . 205.2 Considerations for Medical Equipment . 206.0 References . 21Appendix A: Hospital End-Use Energy Metering Methodology . 22A.1 Data Collection for the Massachusetts General Hospital Gray Building . 22Preheat, Heating, and Reheat. 22Humidification . 22Service Water Heating . 22Cooling and Dehumidification . 22Fans . 23Pumps . 24Lighting . 25Large Hard-Wired Medical Imaging Equipment . 25Elevators . 25A.2 Data Collection for the State University of New York Upstate Medical UniversityEast Wing. 25Preheat, Heating, and Reheat. 25Humidification . 26Service Water Heating . 26Cooling and Dehumidification . 26Fans . 26Pumps . 26Interior Ambient Lighting . 27Large Hard-Wired Medical Imaging Equipment . 27Operating Room Plug Loads . 27Appendix B: Sources of Uncertainty in End-Use Measurements and Calculations . 28Appendix C: Additional Medical Office Building Plug Load Data . 31Appendix D: Additional Resources . 34viiThis report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

Figures and TablesFiguresFigure 3-1MGH Gray Building: 1 year of monthly site energy end-use breakdowns . 5Figure 3-2SUNY UMU East Wing: one year of monthly site energy end-use breakdowns . 8Figure 4-1Frequency of CT power measurements rounded to the nearest 1 kW . 11Figure 4-2Frequency of MRI power measurements rounded to the nearest 1 kW . 12Figure 4-3CT 15-minute load profiles for an example weekend day (Sunday) . 14Figure 4-4CT 15-minute load profiles for an example weekday (Wednesday) . 14Figure 4-5MRI 15-minute load profiles for an example weekend day (Sunday) . 15Figure 4-6MRI 15-minute load profiles for an example weekday (Wednesday) . 15Figure 4-7Medical office plug loads (with peak power lower than 40 W) . 18Figure 4-8Medical office plug loads (with peak power higher than 40 W) . 19TablesTable ES-1MGH Gray: End-Use Categories With the Highest EUIs. ivTable ES-2SUNY UMU: End-Use Categories With the Highest EUIs . vTable 2-1Location, Age, and Square Footage of the Hospitals . 2Table 3-1MGH Gray Building: Annual End Use Summary . 4Table 3-2SUNY UMU East Wing: Annual End Use Summary . 7Table 4-1CT and MRI Power Summary . 13Table 4-2Medical Office Building Characteristics . 16Table 4-3Summary of Medical Office Medical Plug Load Data . 17Table 4-4Plug Load Location Abbreviations . 18Table C-1Medical Office Building 1: Plug and Process Load Data by Panel and Department . 31Table C-2Medical Office Building 1: Plug and Process Load Data by Space Type . 31Table C-3Medical Office Building 2: Plug and Process Load Data by Department . 32Table C-4Medical Office Building 2: Plug and Process Load Data by Department . 32Table C-5Medical Office Building 3: Plug and Process Load Data by Department/SpaceType . 33Table C-6Medical Office Building 5: Plug and Process Load Data by Space Type . 33viiiThis report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

1.0 Background and MotivationHospital facility and energy managers find it challenging to identify the energy inefficiencies intheir buildings, because the industry lacks measured energy use data for major hospital end uses,such as cooling, heating, lighting, and plug loads. Historically, when these managers havecompared alternative energy efficiency investments for various end-use systems, theirbenchmarks have been limited to end-use estimates derived from modeling.To address this challenge, the U.S. Department of Energy (DOE) commissioned the NationalRenewable Energy Laboratory (NREL) to partner with two hospitals to collect data on theenergy used for multiple thermal and electrical end-use categories, including preheat, heating,and reheat; humidification; service water heating; cooling; fans; pumps; lighting; and select plugand process loads. The hospital partners in this study were Massachusetts General Hospital(MGH) and the State University of New York Upstate Medical University (SUNY UMU).Additional data from medical office buildings were provided for an analysis focused on plugloads. Facility managers, energy managers, and engineers in the healthcare sector will be able touse these results to more effectively prioritize and refine the scope of investments in newmetering and energy audits. A list of complementary resources is also provided in Appendix D,including the “Targeting 100!” hospital end-use energy study conducted by the University ofWashington (Hatten et al. 2011) and hospital benchmarking work conducted by LawrenceBerkeley National Laboratory (LBNL 2014).1This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

2.0 Overview of Hospitals in This StudyThis study included two hospitals in which major end uses were monitored. The hospitallocations, ages, and square footage are summarized in Table 2-1. Both sites are located inClimate Zone 5A as defined by the 2006 International Energy Conservation Code and ASHRAEStandard 90.1.Table 2-3CityYear BuiltTotal Floor SpaceLocation, Age, and Square Footage of the HospitalsMGH: Gray BuildingSUNY UMU: East WingBoston, MASyracuse, NY196619952143,000 ft2332,664 ft2.1 Massachusetts General Hospital: The Gray BuildingMGH is a 900-bed medical center located in the heart of Boston, Massachusetts, that offersdiagnostic and therapeutic care in multiple specialties of medicine and surgery through fourBoston area health centers. The hospital also holds concurrent Level 1 verification for adult andpediatric trauma and burn care.The Gray Building is an inpatient facility located at 90 Blossom Street on the MGH campus. Thebuilding has 16 floors above ground, a basement, and a subbasement for a total floor area of332,664 ft2. It was built in 1966 and has been renovated substantially over the years.Space types in the Gray Building include: exam rooms; treatment rooms; procedure rooms;operating rooms; research laboratory space; patient rooms; mechanical/electrical spaces;corridors, elevators, and stairs; offices; storage; and common areas.2.2 The State University of New York Upstate Medical University: The East WingThe East Wing, also known as the Concentrated Care Center, is a seven-story addition to SUNYUMU Hospital in Syracuse, New York. Opened in 1995, the building has a total gross floor areaof approximately 143,000 ft2.The East Wing was built to provide expanded services that were formerly located in theUniversity Hospital plus new service groups, including: the emergency medicine department; adiagnostic imaging center with three computed tomography (CT) units and two magneticresonance imaging (MRI) units; the endoscopy department; 58 single-patient intensive carerooms, including 14 infectious isolation rooms and two protective environment rooms; and apharmacy with pharmacy prep laboratories. All areas of the East Wing are used for hospitalservices and were covered in this monitoring study.2This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

3.0 Analysis of Major End UsesThe figures and tables in this section summarize end-use energy consumption for the twomonitored hospitals. Each hospital had a different metering approach based on site-specificconditions, including different systems and differences in the organization of existing electricalcircuitry, so some of the end-use categories differ. The metering methodology for each buildingis documented in Appendix A, and a discussion of sources of uncertainty in end-usemeasurements and calculations is provided in Appendix B.3.1 End-Use Energy for the Massachusetts General Hospital Gray BuildingAt the MGH Gray Building, the end-use categories that consumed the most annual site energywere: reheat and heating (27% combined); “other electric loads (including lighting)” (21%);steam piping distribution losses (14%); fans (13%); and chiller plant energy allocated to thisbuilding (10%). Its overall site energy use intensity (EUI) was 407 kBtu/ft2·yr. Annual andmonthly totals are summarized in Table 3-1 and Figure 3-1. The source energy calculation usessimplified typical site-to-source factors of 1.21 for steam and 3.34 for grid electricity (EPA2011).3This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

Table 3-4MGH Gray Building: Annual End Use SummaryEnd-Use CategorySupply FansForm yr9,952Site EUI(kBtu/ft yr)29.9% MMBtu/yr33,239SourceEUI(kBtu/ft yr)99.9% ofBuildingSourceEnergyUse11.3%Return haust 2%Pumps for Hot Water and Heat RecoverySteam1625531.70.4%1966702.00.2%Reheat and 6125.12.8%Domestic Hot WaterChiller Plant Energy (Chillers, CoolingTower Fans, Cooling System Pumps)Allocated to edical r Electric 87.732.4%Steam Piping tricityBuilding Total Energy The “other electric loads” category includes lighting systems and plug and process load equipment that were not directly monitored during the study.4This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.8.0%100.0%

Figure 3-1MGH Gray Building: 1 year of monthly site energy end-use breakdownsReheat and heating are coupled in the same measurement, but some information about these enduses can be inferred by reviewing the monthly data. From December 2011 through March 2012,cooling is minimal, so the “reheat and heating” energy is assumed to be predominantly heatingenergy. Similarly, during July and August 2012, this building is unlikely to have requiredsignificant heating, so the “reheat and heating” energy is assumed to be predominantly reheatenergy. If the percent contributions of reheat and heating are interpolated for other months, anestimate of the annual site energy breakdown between reheat and heating would be 13,0005This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

MMBtu/yr for reheat and 23,000 MMBtu/yr for heating. This would mean that reheat andheating consume 10% and 17% of annual whole-building site energy use, respectively.The “other electric loads” category includes lighting systems and plug and process loadequipment that were not directly monitored during the study. Energy consumption for thiscategory was estimated by taking readings from a whole-building electric meter (excluding thechiller plant) and subtracting readings from electric end-use meters.Similarly, energy consumption for the steam piping losses category was estimated by takingreadings from a whole-building steam meter and subtracting readings from the steam end-usemeters. Based on the steam end-use metering plan used in this building, one would expect thewhole-building steam consumption value to be greater than the sum of the monitored steam enduse consumption values, because additional thermal losses occur from distributing steamthroughout the building.One apparent anomaly is that steam piping losses appear higher in summer months than in wintermonths. At the time of this report, this was being investigated. Sources of uncertainty arediscussed further in Appendix B.3.2 End-Use Energy for the State University of New York Upstate MedicalUniversity East WingAt the SUNY UMU East Wing, the end-use categories with the highest annual site EUIs were:fans (63.0 kBtu/ft2·yr); reheat and heating (53.6 kBtu/ft2·yr combined); lighting (28.9kBtu/ft2·yr); chiller energy allocated to this building (26.8 kBtu/ft2·yr); and pumps (14.4kBtu/ft2·yr). Monitoring at this site excluded cooling tower fans, six small fans with fractionalhorsepower motors, preheat, humidification, steam piping losses, plug loads, and a 10-tonprocess cooling unit that serves the rooms with MRI devices. In order to install meters for manyof the excluded electrical loads, it would have been necessary to interrupt hospital operations,which was not practical. The site did not have whole-building meters for steam or electricity, butannual and monthly totals for monitored end uses are summarized in Table 3-2 and Figure 3-2.The source energy calculation uses simplified typical site-to-source factors of 1.21 for steam and3.34 for grid electricity (EPA 2011).6This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

Table 3-5End-Use CategoryFans (Supply andReturn/Exhaust)PumpsChiller Energy Allocated toBuildingLightingMedical ImagingReheat Loop (Reheat andHeating)Radiation Loop (Heating)Domestic Hot WaterSUNY UMU East Wing: Annual End Use SummaryForm ofEnergy SupplySiteMWh/yrSiteMMBtu/yrSite EUI(kBtu/ft yr)SourceMWh/yrSourceMMBtu/yrSource EUI(kBtu/ft 1.9480.317580.4Steam7This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

Additionally, during April 2013, plug load data were collected for multiple operating rooms andextrapolated to the total operating room area, as discussed in Appendix A. Total operating roomplug load energy was estimated to have a monthly site EUI of 1.7 kBtu/ft2·mo in April.Assuming these loads are fairly constant throughout the year, extrapolating this result to othermonths results in an estimated annual site EUI of 21.2 kBtu/ft2·yr.Figure 3-2SUNY UMU East Wing: one year of monthly site energy end-use breakdownsIn Figure 3-2, the “reheat loop” provides both reheat and heating; thus, the reheat loop values arepositive in months with little or no cooling. As with the MGH Gray Building, some informationabout reheat and heating in the SUNY UMU East Wing can be inferred from review of themonthly data. From January through March 2013, cooling is minimal, so the “reheat andheating” energy is assumed to be predominantly heating energy. Similarly, during July andAugust 2012, this building is unlikely to have required significant heating, so the “reheat andheating” energy is assumed to be predominantly reheat energy. If the percent contributions of8This report is available at no cost from the National Renewable Energy Laboratory (NREL) at www.nrel.gov/publications.

reheat and heating are interpolated for other months, an estimate of the annual site energybreakdown between reheat and heating would be 4,300 MMBtu/yr for reheat and 3,100MMBtu/yr for heating. This would mean that reheat and heating have annual site EUIs of 30.2kBtu/ft2·yr and 29.2 kBtu/ft2

Cover Photos: (left to right) photo by Pat Corkery, NREL 16416, photo from SunEdison, NREL 17423, photo by Pat Corkery, NREL 16560, photo by Dennis Schroeder, NREL 17613, photo by Dean Armstrong, NREL 17436, photo by Pat Corkery, NREL 17721. . Interior Ambient Lighting .

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