University of Vermont
Medical CenterApproach and Strategy for Sustainable Design
and Construction
Presenters
Dave Keelty, BS, CEM, CHFM, CHC
Director Facilities Planning and Development,
University of Vermont Medical Center
Owner
William Repichowskyj, AIA
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
Agenda
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
Just a Thought
Project Overview
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)
Our Commitment to Sustainable Design & 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
LEED Projects and Recognition
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
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
Set Sustainability
Goals Here
Starting Assumptions
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
*Currently following 2014 FGI Guidelines.
Sustainability Team and Roles
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
You Need Everyone's Input
Design User Groups
Patients and Families Design User Group
Utility Partners
Burlington Electric Department
Vermont Gas
Project Design, Engineering, Sustainability and Commissioning Consultants
E4H 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 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)
Energy Star Score
Energy Star ScoreEUI 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: 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
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
EUI as a Tool
27
2
20
4
16
1
14
3
10
0
-
50
100
150
200
250
300
MCHV Existing Base (VAV system) Alt 1 (ACB in core) Alt 2 (ACB in core+floor 6) Target
KB
TU/S
F
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
Chilled Beam vs. Variable Air Volume System
Active Chilled Beam
Variable Air Volume
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)
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 Envelope Air Tightness Thermal Insulation
Setting Measureable Targets: Owners Operating Requirements (OPR)
Clearly Communicate Expectations
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)
Estimated Costs
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
Potential Value Management Impacts
Sustainable Design &
The Inpatient Building
Analysis & Implementation:
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.
Copyright ©2012 University of Washington
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: 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
204
195
211
179
149
201
203
175
221
138
135 146
189
146
208
211
157
233
0
50
100
150
200
250
KBT
U/S
F
Total EUI
West Patient Room
B C
70% Glazing 40% Glazing 90% Glazing
A
Envelope and HVAC Systems Analysis Equipment Load Intensity
-$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 EnergySavings
Patient Room HVAC Systems Cost Analysis
Equipment Load Intensity
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 frame
14 Fan Array technology for AHU supply and return fans
18 Envelope insulation upgrade R20 (effective)
22 Chilled water delta T - 18F
23 Heat-recovery bypass dampers open during air-side economizer mode
24 Partial heat recovery glycol run around on dedicated exhaust
26 Pressure-independent control valves (PICVs) at chilled water coils
28 Comprehensive air sealing and Façade Cx (0.25 cfm/sf 75Pa)
34 Chilled beams with DOAS for core spaces and 6th floor patient rooms
35 Low static pressure and low velocity across coils and fi lters at AHU
B. ECMs for Future Consideration
1 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 included
1 External shades at (7.5'ht 3' wide)
2 Reduced glazing (sil l ht at 24")
3 Reduced glazing (sil l ht at 36")
4 Nursing stations - low occupancy mode demand control ventilation
5 Heat recovery of steam condensate return
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%
-
20.00
40.00
60.00
80.00
100.00
120.00
Heating Cooling InteriorLighting
InteriorEquipment
Fans Pumps HeatRejection
DHW
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 InteriorLighting
InteriorEquipment
Fans Pumps DHW HeatRejection
Energy Cost Savings Comparison
Baseline - 90.1 ASHRAE 2007 Compliance Design Case
Whole Building Annual Energy Cost Breakdown
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 Energy Modeling Results
24% better than ASHRAE
38% energy savings
EUI: 142 kbtu/sf/yr
Targeting LEED Silver
Campus View
Overall Floor Plan
Partial Floor Plan
Exterior Design Options Reviewed
Building Exterior and Window Studies
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
Key Architectural Design Decisions
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
Key Architectural Design Decisions
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
Thermal Performance
Metal Panel Assembly
Use of EAI Thermal Clip System to drastically
reduce thermal bridging
Slotted Stainless Steel Masonry Tie Minimize conductivity, minimal thermal degradation
of continuous insulation
Patient Room
Family
Zone
Patient
Zone
Caregiver
Zone
Greeter & Nurse Station
Corridor
Corridor
Corridor
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