APS :: Energy Answers for Healthcare

Power & Energy Services, Residential and Business: APS

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Electric costs in outpatient health care facilities average about $1.31 per square foot per year, or $1,310 per 1,000 square feet per year. Interior lighting and space cooling are the largest contributors to the electric bill with the rest being mostly miscellaneous equipment, ventilation and exterior lighting. The chart below provides a breakdown of annual electric costs for a typical outpatient care facility in the Phoenix area. It is based on a survey of APS small office customers and can be used as a guide for determining how energy is used in your facility.

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Annual Electricity Cost for a Typical Outpatient Care Facility in the Phoenix Area

Electricty end use	Annual cost per square foot	Annual cost per 1,000 square foot
Interior lighting	$0.42	$420
Space cooling	$0.42	$420
Miscellaneous	$0.18	$180
Ventilation	$0.24	$240
Exterior lighting	$0.04	$40
Total	$1.31	$1,310

Lighting and cooling are the highest costs and are a good place to start, but it’s also important not to ignore office equipment. It has become a major source of power consumption particularly with the wide-scale use of personal computers, printers, fax machines and small copiers. Here are some ideas for managing energy costs in outpatient care facilities:

Turn it off when not in use -- Lighting and cooling costs are not difficult to manage. It’s as simple as turning the lights off when not needed and setting the thermostat up in summer or down in winter when the clinic is not in use. The addition of simple controls such as those described below can often automate the process. Turning off office equipment when not in use is also a good way to save.
Energy-efficient lighting equipment -- Most new buildings are built with energy-efficient T8 fluorescent lighting, compact fluorescent downlights, and light-emitting diode (LED) exit signs. It is often cost effective to retrofit existing buildings with the same products. The table below provides a brief comparison of the annual operating costs of some of the most common lighting fixtures for health care facilities, and the savings you might expect with their energy-efficient alternative. You can use these values to estimate the savings that could be gained at your facility.

Comparison of Energy-Efficient Outpatient Care Lighting Options

Fixture	Typical annual energy cost	Savings with energy-efficient option
Standard 3-lamp T12 fluorescent fixture	$27
Energy-efficient 3-lamp T8 fluorescent fixture	$18	$9
75 Watt incandescent downlight	$16
20 Watt compact fluorescent downlight	$4	$12
Standard incandescent exit sign	$28
LED exit sign	$3	$25

Lighting controls -- Control over the indoor lighting environment is important for both energy efficiency purposes and occupant comfort and productivity. Common types of lighting control for health care facilities include dimmer switches, bi-level switching, and occupancy sensors. Familiar dimmer switches can be installed on fixtures designed to be dimmed1 and can be used to set the lighting mood in areas such as reception rooms. Energy savings of 5% to 10% are possible with dimmer switches. Bi-level switching is another popular option where one switch controls two lamps and a second switch controls the third lamp in a 3-lamp fluorescent fixture. Occupancy sensors detect the presence of people and automatically turn off the lights in areas that are used intermittently such as examination rooms, restrooms and stock rooms. Occupancy sensors can save 40% to 50% on energy use.
Task lighting -- Task lights illuminate the work surface but don’t illuminate the entire area. Greater use of task lighting puts the light where it’s most needed such as nurse’s stations, patient rooms and laboratories and can save on general area lighting costs.
Setback thermostats -- Setback or programmable thermostats can be programmed to set the thermostat setting up automatically in the summer and down in the winter saving money on heating and cooling costs when the building is unoccupied. When using programmable thermostats, it’s important to allow enough time in the morning to bring the facility back to a comfortable temperature before patients arrive.
Energy-efficient heating and cooling equipment -- If you are constructing a new facility, doing a major remodel, or are faced with major repairs consider specifying high efficiency equipment. It’s usually not cost effective to replace older equipment that is working properly. When considering the purchase of a new unit, some of the features to look for include a high Seasonal Energy Efficiency Ratio (SEER) or Energy Efficiency Ratio (EER), multi-stage compressors for efficient part-load performance (which is most of the time), thermal expansion valves to better match cooling capacity to building load, economizers to take advantage of “free cooling” during much of the year, and premium-efficiency fan motors.

Energy-efficient office equipment -- Turn off office equipment when it is not needed. Computers, printers, fax machines and copiers use energy even when they are not in use. From an energy conservation point of view it is almost always better to turn off equipment when not in use. There may be good reasons for leaving computers on overnight such as automatic file backup and virus scanning. Even so, the monitor (which actually draws the most power) should be turned off. While the energy required to warm up equipment is high, it usually lasts only for a few seconds. So, if the equipment will be unused for any significant length of time, say 15-30 minutes, you should consider turning it off. Strongly consider turning it off over the lunch hour and definitely turn it off over night. The table below provides some examples of how much you can save by turning office equipment off during unneeded periods.

Hourly Energy Cost and Potential Savings of Office Equipment

Equipment	Operating costs (cents/hour)	Annual savings by turning off nights and weekends
Computer	$0.004	$27
Monitor	$0.005	$33
Laser printer	$0.004	$27
Fax machine	$0.003	$20
Copier (small)	$0.008	$53
Copier (large)	$0.022	$146

You can multiply the annual savings from this table by the number of each equipment type to get total savings, or you can conduct a more detailed energy comparison of your office equipment.

Conduct your own assessment of office energy use. Most equipment is labeled with basic electric use descriptions on the nameplate. The nameplate will usually list information such as volts, amperes (amps) and watts. Electricity is sold by the kilowatt-hour, or kWh, which is equal to the power draw of 1,000 watts over a 60 minute period. For most office equipment, kilowatt-hours = volts x amps x hours ÷ 1000. You can use this formula to estimate the energy cost of a device. For example, if a device is rated at 12 amps and it uses standard 120 volt power, the estimated cost for one month of operation is 120 volts x 12 amps x 8 hrs/day x 22 work days/month ÷ 1,000 x $0.08/kWh = $20.27/month. Compare the energy cost of competing devices that meet your needs. It may be better to pay a little more for one that uses less energy. Look for equipment with the ENERGYSTAR® label. It is among the most energy efficient.

Power quality concerns. Most modern office and medical equipment includes digital processing components that are more susceptible to disturbances in the electrical supply (power quality) than older equipment. According to Electric Light and Power magazine, 30 to 40 percent of all business downtime is related to power quality problems. Other studies have shown that up to 80 percent of power quality problems are created inside of the facility by other electrical equipment. For example, devices that use a lot of power, such as x-ray machines, may cause power quality problems that effect some electronic equipment. Consider high quality surge protectors available at computer stores to protect sensitive electronics. See the “For More Information” section at the end of this sheet for instructions on how to find other fact sheets, one of which deals specifically with power quality.

Don’t be concerned only with saving money. Consider how electricity can add value to your business.

The “energy systems” of a building (i.e., the heating/cooling and lighting systems) are responsible for creating and maintaining the indoor environment. Three keys to a high-quality indoor environment are good temperature control, adequate ventilation and good lighting (including natural lighting).

Poor temperature controls are one of the most frequent complaints of commercial building occupants. Good temperature control is particularly important in patient examination and treatment rooms. These complaints can often be alleviated by improved zone controls of air conditioning systems. A qualified air conditioning contractor can conduct an assessment of the facility and make recommendations for improving zone controls to improve comfort throughout the facility.

Indoor air quality (IAQ) is an important concern in health care facilities. IAQ in a health care facility is a function of fresh-air ventilation, air filtration, and pressurization and control of air movement around the building. Health care facilities require 100% outside air in some locations in order to remove airborne bacterial and viral contaminants and avoid their spread around the building. In other areas the air conditioning system needs to provide air movement patterns and pressurization that limits the spread of airborne contaminants. These are complicated issues and well beyond the scope of this fact sheet. Consult with an air conditioning systems engineer that is knowledgeable about and experienced with health care facilities if you have questions or concerns about your facility. The American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) provides detailed information and design criteria for air conditioning systems designed for health care facilities and other buildings.

Quality of lighting is a function of ambient natural light from windows and artificial lighting from light fixtures. Well-lighted examination and treatment rooms and public areas can give the facility a bright and cheerful appearance. Light sources with a high Color Rendering Index (CRI) give truer and more natural colors. High CRI incandescent and halogen lamps and specially designed fluorescent lamps enhance the appearance of skin tones and accurately render the color of tissue samples. Fluorescent lights in the ceiling are common in medical facilities, however computers and test equipment screens tend to reflect the light from the ceiling and that can be distractive or fatiguing to the operator. Indirect and task lighting produces less glare than direct overhead lighting and task lighting puts light where it is needed for writing, reading and tissue inspection tasks. Bi-level switching and dimming are excellent energy-efficient means of controlling lighting levels to match the activity in offices, examination, and treatment rooms. In facilities with long business hours, light sources with long lamp lives such as compact fluorescent lamps can reduce maintenance costs.

Recommended Resources

APS Solutions for Business

Energy Analyzer

ENERGY STAR: Appliances, HVAC, lighting, office equipment, and partner resources.

Department of Energy:
Cost calculators for energy-efficient products.

Operations and Maintenance Best Practices Guide

New Buildings Institute Advanced Lighting Guidelines

The APS Solutions for Business program is funded by APS customers and is approved by the Arizona Corporation Commission.