Focus

Energy Management in Hospitals

Rising costs and depleting resources have prompted hospitals to adopt energy management systems. K Deepalakshmi studies how some hospitals across India managed to cut costs through efficient energy management practices

The eleventh five-year plan aims to conserve 10,000 MW of power, through various energy efficient technologies. One report estimates that hospitals in India spend Rs 1,000 crore every year to meet their energy demands. This is expected to double in the next three years. Aware of the growing importance of energy management, the Confederation of Indian Industry (CII) in association with Kovai Medical Centre, Coimbatore conducted a conference on 'Efficient Energy Management Practices in Healthcare Industry'. While energy management is a hot topic of discussion, some hospitals are already practising it and have started reaping the benefits.

Multiple Uses

Uninterrupted power supply is the foremost need in hospitals. "Energy is becoming a larger proportion of operating cost," observes Hema Hattangady, Vice Chairman & CEO, Conzerv Energy Systems. In a 600-bed hospital, approximately 55 per cent of energy is consumed by Heat Ventilation and Air Conditioning (HVAC), 10 per cent by lighting, 9 per cent by medical equipment and the rest is used for elevators, laundry, kitchen, autoclave, etc.

"Bed occupancy, continuous additions of hi-tech equipment, expansion of hospital, number of procedures, investigations, surgical interventions and length of patient stay are some factors that determine the energy consumption in a hospital," enumerates Sandip Kadam, Chief Engineer, Jehangir Hospital, Pune. With growing demand for energy, high cost, shortage of power, contribution to green house effect and most important of all, quality service to the patients have made energy conservation inevitable in hospitals.

Explaining the need for energy management, UK Ananthapadmanabhan, President, Kovai Medical Centre, Coimbatore, says, "Conserving energy using energy efficient equipment, opting for non-conventional sources of energy and recycling resources like water is not only beneficial to hospitals but also a part of corporate social responsibility."

Reduce, Reuse, Recycle

S Seshadri Narayanan, Senior Manager, Engineering, Apollo Hospitals, Chennai, sums up energy management as, "Reducing the use of electricity, checking the fuel usage, using renewable source of energy and recycling the resources."

For some hospitals, energy management is a part of the engineering department; some hospitals have set up a separate cell for energy management and conservation. They have also formulated a policy for energy management. "The EC cell in our hospital closely monitors and reviews the energy consumption (shift wise/ day wise/ month wise/ year wise)," says Ujjal Majumdar, Chief Engineer, Energy Conservation Project, Batra Hospital & Medical Research Centre, New Delhi.

Energy management is carried out in three steps.

• Calculating the energy expenditure.
• Identifying the areas of concern.
• Executing the changes.

Calculating Energy Expenditure

"Anything not measured, cannot be controlled," says Ananthapadmanabhan. An energy audit is carried out to identify and evaluate energy management opportunities. The efficiency and energy consumption of every appliance, medical instruments, and other utilities are measured. The data collected through the energy audit forms the basis for identifying the sectors to implement the changes. Energy audit also helps in calculating the investment needed and time required for the payback.

Exclusive firms called Energy Service Companies (ESCo) conduct energy audit, prescribe and carry out the measures on behalf of hospitals or any institution. However, the process is carried out by the hospitals themselves in some cases.

"Bed occupancy, hi-tech equipment and surgical interventions are some factors that determine the energy consumption in a hospital" - Sandip Kadam Chief Engineer Jehangir Hospital Pune

"Conserving energy is not only beneficial to hospitals but also becomes part of corporate social responsibility" - UK Ananthapadmanabhan President Kovai Medical Centre Coimbatore

Identifying Areas of Concern

"We decided to find out and work on areas where energy expenditure can be cut, when the energy cost was shooting up," says Rajiv Goyal, GM, Business Development, Sterling Hospital, Ahmedabad. Once an exhaustive energy audit is performed, the collected data is thoroughly analysed to identify the areas of controlling energy usage, improving efficiency and finding alternate resources. A plan is drawn up for the changes and steps necessary to cut cost.

Executing the Changes

Next comes the execution part, where the decided changes are implemented in a phased manner. The changes could be anything from repairing the existing appliances, to replacing them with better equipment, adding or removing some appliances to give optimum benefits. Explaining the steps taken in Ruby Hall Clinic, Pune, its Manager, Engineering & Projects, AK Paliwal, says, "The projects undertaken include improving efficiencies of the utility systems— including but not limited to indoor and street lighting, steam and hot water systems, air-conditioning systems, domestic water pumping and so on. We have also optimised the utility consumption through effective automation and control."

Controlling Energy Usage

In hospitals, the major portion of energy is consumed by HVAC systems. "With 80 percent of Apollo Hospitals air-conditioned, 60 per cent of the total energy load is used by air-conditioners," points out Narayanan. Thus, any change carried out to control the usage by ACs will contribute to sizable reduction in the energy cost.

A common approach followed by hospitals is to replace the reciprocatory compressors of AC machines with screw type compressors or centrifugal compressors. This saves around 30 per cent of energy.

Another novel idea is followed in Sterling Hospital, where the entire building is divided into four quadrants. "We switch off the chillers of quadrants that are unoccupied," says Goyal. The OPD, dialysis and physiotherapy, which are in the same block of the hospital, do not function in the late evenings and hence their chillers are switched off after 8 pm. A hospital is a place where activities go on round-the-clock. Proper lighting is essential and hence lighting is the second major user of energy. Incandescent bulbs and fluorescent lights are replaced by energy saving Compact Fluorescent Lights (CFL) with electronic chokes. "Though CFL lamps are costlier, they provide better illumination and are more efficient," says Kadam. In Batra Hospital, the double fittings were changed to single fittings with reflectors to maintain the same illumination with fewer lamps.

Installing automatic power correction panels fitted with harmonic suppression filters not only ensures the continuous flow of electricity without fluctuation, but also cuts down wastage and thereby reduces cost.

In most hospitals, the latest equipment is controlled by computers, which require uninterrupted power supply for proper functioning. Even though hospitals rely on the power supplied by the government, they do have generators as back up during power-cuts. The generators use diesel, which is costlier than electricity. Hence UPS have to be used to their maximum capacity to control wastage. "All UPS are connected to equipment such that they load optimally," says Ananthapadmanabhan. Kovai Medical Centre has reduced a couple of UPS and saved Rs 2-3 lakh.

Identifying Alternatives

With the con ventional resources depleting day-by-day, the need to bank on alternate energy sources is unavoidable. The common resource of all is solar energy, which is in abundance in a tropical country like India. Solar heating systems have replaced electric heaters in Kovai Medical Centre. The hospital plans to increase the capacity of solar heating systems by another 20,000 litres from the existing 12,000 litres.

Pointing out the low maintenance cost of solar heating panels, Kadam says, "We could bring down our electricity cost by almost Rs 6.4 lakh/annum."

Sterling Hospitals and Ruby Hall Clinic too are using solar heating panels. The implementation is under way in Batra Hospitals and possibilities of erecting the system are being evaluated in Apollo Hospital.

Recycling Waste

The steam generated from the boilers is used to heat water in Batra Hospital. The same method is followed in Apollo Hospital, where they have managed to save 10 per cent of energy used for heating water through this method.

Jehangir Hospital has installed a biogas hot water boiler. This boiler can generate about 3,500-4,000 litre of hot water with the help of biogas being generated from 350 kg of food waste. The hospital saves Rs 1.83 lakh per nnum through this process.

Used water is also treated and recycled for gardening purposes in Apollo Hospital. In addition to that, Batra Hospitals uses it for laundry too.

Power Factor

Maintaining a consistent power factor, close to unity, accounts for considerable saving in electricity consumption. Kovai Medical Centre manages to maintain more than 0.95 as power factor. This helped the Hospital to earn a rebate of Rs 40,000 to Rs 50,000 per month in electricity bills. Apollo too maintains a power factor of 0.97 and above. Jehangir Hospital has installed a power factor panel. "We used to pay a penalty of Rs 1.6 lakh prior to the installation, now we are able to earn a rebate of Rs 8 lakh per annum," claims Kadam.

The IT solution

Information technology has a role to play in effective energy management systems. Energy management system software is available, capable of monitoring, calculating and controlling the use of energy consumption. "IT is superior to manual logging because of the speed at which the information can be processed and presented for decision making. It also eliminates human errors," says Hattangady.

Conzerv has provided IT solutions to Kovai Medical Centre, Apollo Hospital and various other institutions. "Ours is a three-step plan for energy management, consisting of measure, detect and control," she explains.

Conzerv provides digital measuring instruments to measure the energy load. Once the accurate measurement is available, it is possible to detect wastage or excesses in specific areas. In the next step, energy audit is conducted and less efficient machines are identified. The data analysis, data warehousing and data mining are taken care by Conzerv at their outsourcing centre.

Control comes in the form of correction such as avoiding simultaneous starting of heavy motors, improvement of power factor, mitigation of harmonics, savings measures in lighting etc.

"The three step plan has worked successfully in industry and is equally applicable for hospitals resulting in a significant amount of savings," says Hattangady.

The cost of the system would vary from Rs 5 lakh to Rs 15 lakh. The investment can be recovered within a year in most cases. The benefits wo uld become visible as soon as the system starts functioning.

"Hospitals of today have a load pattern similar to star hotels," says Hattangady. The energy expenditure is bound to increase with the hospitals expanding their infrastructure and the availability of new medical equipment. The cost of fuel is also on the rise, leading to additional increase in the overall cost. Energy is the second most spent area in a hospital, next to manpower. Employing methods like energy management is more than effective means to reduce the expenditure. "This also helps us contribute to our environment by reducing the effect of global warming," says Paliwal. The act of switching off a light that is not needed is also a small contribution to conserving energy.

k.deepalakshmi@expressindia.com