University of Vermont Medical Center - Efficiency Vermont Dave Keelty, BS, CEM, CHFM, CHC –...

The heart and science of medicine. UVMHealth.org/MedCenter

February 2, 2017

University of Vermont Medical Center Approach and Strategy for Sustainable Design

and Construction

• Dave Keelty, BS, CEM, CHFM, CHC – Director Facilities Planning and Development, University of Vermont Medical Center – Owner

• William Repichowskyj – Partner, E4H - MorrisSwitzer Environments for Health – Planning & Architecture

• Michael Pulaski, Ph.D., LEED AP BD+C – Senior Associate, Weidlinger and Thornton Tomasetti – LEED & Sustainability Consultant

Presenters

Project Overview Our Commitment to Sustainable Design and Construction

Master Plan Guiding Principles

Sustainability Approach Start Early in the Planning Process…before Programming and Design Assemble a Team that Represents all Constituencies Use Industry Standard Benchmarks Clearly Communicate Expectations Set Measurable Targets Include a rigorous Commissioning Process

Analysis & Implementation

Agenda

Just a Thought

Project Overview

Triple Aim: Ensure and Improve Patient Safety and Quality of Care

Enhance the Patient Experience

More Efficient Cost of Care

Four Project Objectives:

Improve Quality

Bed Need: Ensure appropriate bed capacity and care environment

Financial Feasibility: Accomplish objectives within available resources

Affordability: Minimize the impact on patients and payers

Project Objectives

Overhead Campus View

Seven-story inpatient building above existing Emergency Department parking area

180,000 Square Feet

Four inpatient floors of 32-single-occupancy medical-surgical, telemetry-capable rooms: 128 Beds

Increase single-rooms from 30% to 90%

Replacement of oldest inpatient rooms

Project cost is $187M (of which $12.35M is capitalized interest)

Project Overview

Conceptual Floor Plan

Perspective Looking South East

Perspective Looking North East

Our Commitment to Sustainable

Design and Construction

Master Facility Planning Guiding Principles

Be informed by and strive to reinforce the strategy of the organization

Promote a safe, healing and pleasing environment for patients, families, visitors and staff

Strive for LEED certification

Seek input from our key constituents including patients and the communities we serve

Be sensitive to the neighborhoods within which our facilities are located and responsive to the concerns of our neighbors

Ensure that all planning is fiscally responsible

Preserve our heritage, promote a sense of community ownership and reinforce our brand promise

Minimize the disruption of the environment

Master Facility Planning

Guiding Principle

The master facility plan will strive for LEED certification (Leadership in Energy and Environmental Design) that recognizes performance in five key areas of human and environmental health:

Sustainable Site Development Water Savings Energy Efficiency Materials Selection Indoor Environmental Quality

Practice Greenhealth Top 25 for Environmental Excellence and 6 Circles of Excellence awards:

Leadership Waste Reduction Chemical Reduction Greening the OR Sustainable Food Services Green Building

LEED Projects: Inpatient Bed Building Goal: Silver -Healthcare Radiation Oncology Garden Pavilion: Gold- New Construction Clinical Research Center: Gold- Interiors Renovation Mother-Baby Unit: Gold- Interiors Renovation Hinesburg Family Practice: Certified- New Construction Other Projects Pending Certification

Shelburne Road- Core and Shell and Interiors Garden Atrium- Interiors Renovation

LEED Projects and Recognition

Sustainability Approach

Establish Sustainability Goals Early in the Planning Process

Project Conceptual Planning

Programming

Schematic Design

Design Development

Construction Documents

Bidding

Construction

Occupancy

Post Occupancy Evaluation

Planning Design and Construction Define Sustainability Goals Early in the Planning

Set Sustainability Goals Here

Meet 2010 FGI Guideline for Commissioning*

Achieve LEED Certification

Design to meet Energystar rating of 75

Meet CON Standards 1.9 and 1.10

Meet Act 250 Criteria 9 (F) Energy Conservation

Starting Assumptions

*Currently following 2014 FGI Guidelines.

Facility Master Planning Steering Committee - Project Oversight

Sustainability Council - Established Overarching Sustainability Goals for the Project

Internal Departments – Developed Owner’s Project Requirements Facilities Management Infectious Disease Environmental Services Environmental Health and Safety Supply Chain Community Health Improvement Patient Safety Nutrition Services

Design User Groups

Patients and Families Design User Group

Utility Partners Burlington Electric Department Vermont Gas

Project Design, Engineering, Sustainability and Commissioning Consultants MorrisSwitzer~Environments for Health - Architect Bard, Rao + Athanas Consulting Engineers (BR+A) Thornton Tomasetti - LEED and Sustainability Consultant CxAssociates – Commissioning Agent Whiting-Turner Contracting Company

Sustainability Team and Roles You Need Everyone's Input

Sustainability Council

A multi-disciplinary steering committee charged with oversight of all elements of sustainability programming.

M I S S I O N S TAT E M E N T Our mission and vision are built on a foundation of values that include a longstanding commitment to being prudent stewards of limited natural resources. We continue to look for new ways to build on our long tradition of environmental responsibility. We will continue our efforts to reduce energy consumption, waste stream and carbon footprint, and to increase the use of health, locally produced foods.

Areas of Focus

Leadership Waste

Chemicals Greening the OR Healthier Food

Smarter Purchasing Leaner Energy

Water Climate

Green Buildings

Members

Dawn LeBaron - Vice President Hospital Services & Council Leader

John Berino - Occupational/Environmental Program Coordinator

Matt Bushlow – Communications Specialist

Janet Carroll – Administrative Director of Nursing

Jack Conry – Director, Security/Safety/Parking

Sidney Hamilton – Manager Purchasing, Contract & Value Analysis

Diane Imrie – Director, Nutrition Services

Dave Keelty – Director, Facilities Planning & Development

Karen McBride – Director, Pharmacy

Maria McClellan – Sr. Community Relations Strategist

Wes Pooler – Director, Facilities Management

Paul Rosenau, MD – Pediatrics

Lori Ann Roy – Manager, Radiation Oncology

Brooke Stahle – Director, Peri-Operative Services

Industry Standard Benchmarks

LEED is an internationally recognized green building certification system: providing third-party verification that a building or community was designed and built using strategies aimed at improving performance across all the metrics that matter most:

Energy Savings

Water Efficiency

CO2 Emissions Reduction

Improved Indoor Environmental Quality

Stewardship of Resources and Sensitivity to their Impacts

Source: USGBC Web Site

Leadership in Energy & Environmental Design (LEED)

LEED Checklist

Energy Star Score

EUI Defined

EUI is defined as energy consumed per square foot per year

It’s calculated by dividing the total energy consumed by the building in one year by the total gross floor area of the building

Typically expressed as kBtu per square foot

Energy Star

Energy Star: EUI

Why EUI ?-It’s an increasingly important metric

It has become the common currency for measuring and reporting energy consumption in buildings

It is now the universal measurement for energy performance

It can measure energy performance “apples to apples” overtime and building to building providing management and decision making information

Emerging as the standard for performance reporting and benchmarking by Healthcare Executives

EPA Energy Star Target Finder

Metric Design Project

Design Target*

Median Property*

ENERGY STAR score (1-100) Not Available 75 50

Source EUI (kBtu/ft²) Not Available 378.1 436.5

Site EUI (kBtu/ft²) Not Available 201.7 232.9

Source Energy Use (kBtu) Not Available 68,060,143.2 78,578,758.1

Site Energy Use (kBtu) Not Available 36,303,410.0 41,914,060.0

Energy Cost ($) Not Available 787,954.85 909,732.36

Total GHG Emissions (Metric Tons CO2e) 0.0 2,553.3 2,947.9

EPA Energy Star Target Finder

MCHV Existing Base (VAV system) Alt 1 (ACB in core) Alt 2 (ACB in core+floor 6) Target

Total EUI Use and Value as a decision making tool

What’s the best investment

What system will be the most sustainable and afford the lowest operating costs

EUI as a Tool

Chilled Beam vs. Variable Air Volume System

Active Chilled Beam

Variable Air Volume

Exterior Design Options Reviewed

Building Exterior and Window Studies

Clearly Communicate Expectations

Owner’s Project Requirements: o A written document that details the functional requirements of a project

and the expectations of how it will be used and operated. These include project goals, measurable performance criteria, cost considerations, benchmarks, success criteria, and supporting information.

The Owner’s Project Requirements should include the following: Energy efficiency goals Environmental and sustainability goals Community requirements Adaptability for future facility changes and expansion Systems integration requirements, especially across disciplines

Expectation Setting Owners Operating Requirements (OPR)

Setting Measurable Targets

Reflect UVM Medical Center’s commitment to ongoing environmental stewardship in order to minimize our environmental footprint by utilizing design and building practices that to the extent possible minimize the consumption of energy and natural resources.

Achieve LEED Silver Certification

Achieve a site EUI of 143,000 BTU/sf/year Enhanced Commissioning Requirement

Complete Utility Metering Capability

To Support Post Occupancy Measurement and Verification

Patient Room Energy Consumption Research

Water Metering by Floor

LED Lighting

Innovative HVAC Chilled Beams While meeting FGI requirements

Building Envelop

Air Tightness

Thermal Insulation

Setting Measureable Targets Owners Operating Requirements (OPR)

Commissioning

ASHRAE definition: Commissioning is the process of ensuring that systems are designed, installed, functionally tested, and capable of being operated

and maintained to perform in conformity with the design intent.

Owners Operating Requirements (OPR)

• Enhanced Commissioning with Measurement and Verification $ 2.50/SF • LEED Consulting with Full Sustainability Consulting Services $ .75/SF • Additional General Conditions and General Requirements $ 1.00/SF • Additional Hard Construction Costs (if sustainability efforts begin early) $ 0.00/SF Total $ 4.25/SF As a Percent of Project Cost .05 % Simple Payback 4.9 Years

Estimated Costs

Potential Value Management Impacts

Analysis & Implementation:

Sustainable Design & The Inpatient Building

Where we are now?

Currently, hospitals consume 5% of all energy consumed in the United States. Healthcare energy consumption continues to rise up to 5.5% of the commercial building energy, from 4.3% in 2004.

Although energy represents a small portion of a hospitals overall operating costs, reducing utility expenditures can provide low risk high yield, and stable investment for the future.

Targeting 100! Getting to 100 EUI

Targeting 100! Is a research project completed by the University of Washington’s College of Built Environments. The project examined the efficiency of two massing options for six regions across the United States to determine the best strategies for getting to an EUI of 100.

Reserved.

Background

The research team met with over 200 stakeholders in each of six study regions, collecting data with respect to regions specific approaches for deep energy savings and a balanced capital investment.

The Targeting 100! Case studies did not include Region 6 so we have provided data for Chicago’s climate which most closely relates to Vermont’s Climate.

Targeting 100 Studies

Typical Hospital Energy Demands

Reheat energy: A good place to Start!

Keys for Success in High Performance Healthcare Design

1. Reduce Internal Loads (Equipment, Lighting)

2. Reduce Peak Heating and Cooling Loads

3. Decouple Heating and Cooling from Ventilation

4. Optimize the Central Plant Equipment

Reduce Peak Loads with Good Architectural Design

Heating and Cooling Load Reduction

Example Loads – Patient Rooms (WEST)

Mechanical Systems

• Decouple Heating and Cooling from Ventilation – Significantly reduces re-heat energy

• Displacement Ventilation • Low side-wall radiant heating panels • Ceiling cooling panels

Plant Options

Energy - Savings

2010-2015 = 60% Reduction from code energy use 2030 = Net Zero annual energy demand

• Major reductions in heating energy use (reheat).

• Heating savings 73%-97%

• Load reductions & maximized efficiency in equipment

• A4 & B4 = ground coupled heat pumps Most Energy Efficient!

Cost – Per Square Foot

Project Analysis

Keys for Success:

1. Reduce Internal Loads (Equipment, Lighting)

2. Reduce Peak Heating and Cooling Loads

3. Decouple Heating and Cooling from Ventilation

4. Optimize the Central Plant Equipment

Patient Room Estimated Equipment Load Intensity

HVAC Options: 1. VAV at 6ACH 2. VAV at 4ACH 3. VAV at 4ACH + Chilled Panels 4. Chilled Beams at 2 ACH 5. DV at 4 ACH 6. DV at 4 ACH with Chilled Panels

• Envelope Options Patient Room Glazing

West Patient Room Envelope and HVAC Systems Analysis

195 21

135 14

Total EUI

70% Glazing 40% Glazing 90% Glazing

-$200,000 $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000

VAV 6ACH, Opt 1A

Opt 1B

Opt 1C

VAV 4 ACH Opt 2A

Opt 2B

Opt 2C

VAV 4 ACH + CH Panels, Opt 3A

Opt 3B

Opt 3C

Chilled Beams 2 ACH, Opt 4A

Opt 4B

Opt 4C

Disp Vent 4 ACH, Opt 5A

Opt 5B

Opt 5C

Disp Vent 4 ACH CH Panels, Opt 6A

Opt 6B

Opt 6C

First Cost

Ten Year Energy Savings

Patient Room HVAC Systems Cost Analysis

Whole Building Modeling Process Managing and Analyzing ECMS

B. ECMs Included in Base Building Scope

2 Interior Light Power Density Reduction using LED lights

11 Triple glazing with high performance curtain wall frame14 Fan Array technology for AHU supply and return fans

18 Envelope insulation upgrade R20 (effective)

22 Chilled water delta T - 18F23 Heat-recovery bypass dampers open during air-side economizer mode24 Partial heat recovery glycol run around on dedicated exhaust26 Pressure-independent control valves (PICVs) at chil led water coils28 Comprehensive air sealing and Façade Cx (0.25 cfm/sf 75Pa)34 Chilled beams with DOAS for core spaces and 6th floor patient rooms35 Low static pressure and low velocity across coils and fi lters at AHU

B. ECMs for Future Consideration1 Occ sensors in patient rooms - Reduce ACH to X unoccupied

2 Supply low dew point at higher air temp

3 Daylighting controls in Patient rooms

4 Condition MER (penthouse) with relief air

C. ECMs Reviewed but not included1 External shades at (7.5'ht 3' wide)

2 Reduced glazing (si l l ht at 24")3 Reduced glazing (si l l ht at 36")

4 Nursing stations - low occupancy mode demand control ventilation

Energy Use Intensity Profile Comparison

-2 0 2 4 6 8 10

$(5,000) $- $5,000 $10,000 $15,000 $20,000 $25,000

Envelope insulation upgrade R30

Roof Insulation R40

Roof insulation R50

SHGC 0.2

SHGC 0.3

Double Pane Dynamic glass

Automated interior blinds

Regen (traction) elevators

DHW drain water heat recovery on showers

Chilled water delta T - 20 F

Heat-recovery bypass dampers open during air-side economizer mode

Partial heat recovery glycol run around on dedicated exhaust

Wrap around heat pipe for chilled beam exhaust

Energy Valves at main CHW coils (AHUs)

Pressure-independent control valves (PICVs) at chilled water coils

Change in EUI (kBTU/sf/year)

Annual Operationsal Savings ($)

ECM EUI vs. Annual Savings

Whole Building Energy Use Intensity Breakdown

EUI (kBtu/sf)

End Uses

Baseline - 90.1 ASHRAE

2007 Compliance Design Case

Percent Savings

Heating 100.37 23.86 76% Cooling 45.65 44.77 2% Interior Lighting 21.74 10.66 51% Interior Equipment 37.94 37.74 1% Fans 18.89 20.49 -8% Pumps 2.68 2.67 0% Heat Rejection - - 0% DHW 4.49 1.35 70% Total 231.76 141.53 39% -

100.00

120.00

Heating Cooling Interior Lighting

Interior Equipment

Fans Pumps Heat Rejection

Energy Use Intensity Comparison (kbtu/sf/yr)

Baseline - 90.1 ASHRAE 2007 Compliance Design Case

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000

Heating Cooling Interior Lighting

Interior Equipment

Fans Pumps DHW Heat Rejection

Energy Cost Savings Comparison

Baseline - 90.1 ASHRAE 2007 Compliance Design Case

TOTAL ENERGY COST

End Uses

Baseline - 90.1 ASHRAE

2007 Compliance Design Case

Percent Savings

Heating $ 77,315 $ 18,380 76%Cooling $ 40,188 $ 39,410 2%Interior Lighting $ 78,980 $ 38,208 52%Interior Equipment $ 137,877 $ 135,297 2%Fans $ 68,657 $ 73,448 -7%Pumps $ 9,726 $ 9,585 1% DHW $ 3,458 $ 1,037 70%Heat Rejection $ - $ - Total End Uses $ 416,201 $ 315,366 24%

Whole Building Annual Energy Cost Breakdown

• 24% better than ASHRAE • 38% energy savings • EUI: 142 kbtu/sf/yr • Targeting LEED Silver

Whole Building Energy Modeling Results

Key Architectural Design Decisions

Building Location Determined by campus

master planning Building Orientation Maintain existing

Emergency Department and Ambulance drop-off

Maximize Views Respectful of existing

campus architecture Existing site conditions

Façade design Curtain wall design driven by

patient & family environment, aesthetics, & energy efficiency

Balancing size of window with energy efficiency

Solar Considerations

o Reducing Solar Gains

o Electro Chromatic Film

Bathroom Inboard vs. Outboard

Impacts: Increased patient safety by maximizing Nurses’ view from corridor to headwall Increased energy efficiency due to reduced window size

Wall System Overview

UVMMC OPR – Envelope Goals: Energy Performance

Thermal Performance

Durability

Air Tightness: whole

building/assembly tightness .25CFM

West Wall Section

Air Tightness & Durability High-performance AVB

transition assembly at window opening

Detailing at offsets in plane at insulation, cladding, and window.

Ensurs performance between adjacent assemblies

Tighter detailing at corners Maintains continuity of AVB

Cavity closure at wall assemblies maintains continuity of AVB transition at curtainwall /window frame

East Wall Section

Metal Panel Assembly Pressure-equalized rain screen mitigates

wind driven rain Pressure and drainage composed of

compartmentalized ventilation cavities that allow pressure inside to match outside air pressure, preventing moisture from being driven toward the inner wall assembly

Ultra-Thermal Window System

Metal Panel Assembly Use of EAI Thermal Clip

System to drastically reduce thermal bridging

Thermal Performance

Slotted Stainless Steel Masonry Tie Minimize conductivity, minimal

thermal degradation of continuous insulation

Sustainable finishes to meet LEED Checklist : Recycled materials Natural materials Low VOC materials

Interior Design

Appendix

Tools and Resources

www.sustainabilityroadmap.org

The 2015 Vermont Commercial Building Energy Standard http://codes.iccsafe.org/Vermont.html#2015

Act 250 Criterion 9F (Energy Conservation) Must Use Best Available Technology https://energycode.pnl.gov/COMcheckWeb 2014 FGI Guidelines

ASHE Health Facility Commissioning Handbook Health Facility Commissioning Handbook Health Facility Commissioning Guidelines

EPA Energystar Program Portfolio Manager/Target Finder

http://www.energystar.gov/buildings/service-providers/design/step-step-process/evaluate-target/epa’s-target-finder-calculator

CON STANDARD 1.9: Applicants proposing construction projects shall show that costs and methods of the proposed construction are necessary and reasonable. Applicants shall show that the project is cost-effective and that reasonable energy conservation measures have been taken.

CON STANDARD 1.10: Applicants proposing new health care projects requiring construction shall show such projects are energy efficient. As appropriate, applicants shall show that Efficiency Vermont, or an organization with similar expertise, has been consulted on the proposal.

CON Standards

Criterion 9(F) -- Energy Conservation: All projects must incorporate the best available technology for energy efficiency and reflect principles of energy conservation, including reduction of greenhouse gas emissions from the use of energy. All projects must also provide evidence that the project complies with the applicable building energy standards under 30 V.S.A. § 51 or 53.

Commercial buildings (all buildings which are not residential buildings three stories or less) are subject to Vermont’s Commercial Building Energy Standards (CBES) (3021 V.S.A. § 53). Applicants must provide evidence that their project at least complies with the CBES. This can be done through the web-based tool COMCheck. The CBES do not create a rebuttable presumption with respect to Criterion 9(F). Therefore, the project must incorporate the best available technology for energy efficiency and reflect principles of energy conservation, including reduction of greenhouse gas emissions from the use of energy. For more information about CBES, contact the Public Service Department at toll-free at 1-800-642-3281 (in-state only) or 802-8283183.

Act 250 Criteria 9(F) Energy Conservation

Evidence of compliance with the Commercial Building Energy Standards (CBES) does not provide a presumption of compliance under criterion 9(F). Therefore, even if an applicant provides the evidence necessary to demonstrate that a subdivision or development complies with the CBES as required, the applicant still must meet the other explicit requirements of criterion 9(F). Pursuant to 10 V.S.A. § 6086(a)(9)(F), an applicant must demonstrate “the planning and design of the subdivision or development reflect the principles of energy conservation, including reduction of greenhouse gas emissions from the use of energy, and incorporate the best available technology for efficient use or recovery of energy.”

Act 250 Criteria 9(F) Energy Conservation

University of Vermont Medical Center - Efficiency Vermont Dave Keelty, BS, CEM, CHFM, CHC –...

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