First Hospital Designed to Earn the ENERGY STAR: Muskogee Community Hospital

Muskogee Community Hospital (MCH) in Muskogee, Oklahoma, is the first hospital in the nation to be designed to earn EPA’s ENERGY STAR for superior energy performance. The 45-bed acute care facility is intended to rank among the top 20% nationwide after a year of operations, using 24% less energy and emitting 24% less carbon dioxide on average than its peers.

When the physician-owned Muskogee hospital opens its doors in February 2009, patients will not only be treated in a comfortable energy efficient building, they will be cared for in a green one, too. MCH will be the first hospital in Oklahoma to be designed and built using Green Guide for Healthcare (GGHC) standards. It will also pursue LEED certification from the U.S. Green Buildings Council.

“Three years ago, when I started talking about building a green hospital, people thought I was referring to the color, and would ask me what shade I preferred,” said Mark Roberts, president of Muskogee Community Hospital, LLC. “We all have come a long way since then, and I’m proud to say this facility will be a centerpiece of environmental sustainability in our community.”

Roberts says MCH started down the path of green by first planning strategically about energy, noting that energy costs in buildings never go down. “Minimizing energy costs in the design means we can spend more money on our mission—offering world class medical service to our community.”

To garner the EPA’s Designed to Earn the ENERGY STAR recognition, MCH employed a strategy centered around utilizing a huge, but largely untapped energy source—geothermal energy—to heat and cool the hospital and its state-of-the-art energy efficient building systems and equipment.

The Underground Advantage

DOE’s National Renewable Energy Laboratory estimates that if all the heat trapped up to 2 miles under the United States were tapped, it could generate enough electricity to meet all of the country’s power needs for 30,000 years. Besides electricity production, geothermal energy is also used to heat or cool buildings by utilizing the earth’s constant temperature below the frost line. Geothermal technology uses this temperature (usually 55°F) to exchange energy between the building and the earth.

The geothermal system employed by MCH harnesses the earth’s warmth to heat and cool their facility. It includes over 35 miles of vertical piping installed in 280 wells, 300 feet deep under current parking lots and landscaped areas throughout the 22-acre site. In winter, water circulating inside the loop absorbs heat from the earth and carries it to over 70 heat pumps in the hospital. After it is compressed to a higher temperature, the heat is sent as warm air to the indoor system. In summer, the system reverses itself and expels heat from the facility into the cooler earth through the loop.

Only a handful of U.S. hospitals currently use geothermal systems including St. Mary’s Hospital, in Pierre, SD; VA Hospital in Boise, ID; Great River Medical Center in Burlington, Iowa; and Sherman Hospital (scheduled to open June 2009) in Elgin, IL. Muskogee Community Hospital will be the first to use a closed loop ground source geothermal system that covers the facility’s entire heating and cooling needs.

Roberts says the advantages of geothermal ENERGY STARt with aesthetics. Traditional mechanical systems like cooling towers and associated service yards are big, noisy, and unsightly. Architects have to hide them or seclude them on campus away from patients and visitors. Not so with geothermal. It’s underground, out of sight, and relatively silent, allowing architects to put patient rooms and view corridors on all sides of the hospital.

Scalability is also an advantage. There is enough capacity in the current design to cover future additions when MCH expands. Scalability reduces vulnerability to system-wide failure as well. Unlike traditional mechanical systems, if one of the heat pumps goes down, only a small part of the hospital is affected. The units are compact in size and are very easily interchangeable, creating efficiencies in maintenance staff. Since each patient room is serviced by individual air handling units with specially installed air cleaning ultraviolet lights, Roberts believes infection rates from airborne pathogens will be minimized.

Roberts says the upfront cost of MCH’s geothermal system wasn’t cheap—approximately $4.2 million or about 11% of total construction costs. But the real savings, like so many other energy efficient technologies, comes in reduced operational costs over the long term. Cooling costs are expected to be halved. And in Oklahoma, where hot summer days mean A/C units rarely cycle off, that’s saying (and saving) a lot.

If Muskogee Community Hospital was only being built to perform at the industry average, its source energy use intensity (EUI) would be 491 kBtu/ft2/year (see Figure 1). Instead, enhanced design features will enable it to perform more efficiently at 375 kBtu/ft2/year, saving approximately $50,000 in energy costs per year, or more if prices continue to escalate. That lower EUI also drops annual carbon emissions by 24%, from 3217 tons to 2860 tons, making Muskogee Community Hospital a leading hospital in the fight against climate change.

Figure 1.

Other Green Features

Roberts says that after MCH made the decision to include a geothermal system, his design team began looking for other ways to green their hospital. “Once we realized that we could strengthen the delivery of medical services by improving environmental performance, adopting that mindset became much easier for us.” Indeed many studies are finding that green healthcare facilities offer improved patient outcomes and reduced health risk. In a report by Practice GreenHealth entitled “The Business Case for Greening the Healthcare Sector,” researchers found that patients in green hospitals recover faster, staff retention was higher, and nosocomial infections were reduced.

Muskogee Community Hospital will adopt other green practices that include water efficiency, reduction in pollutant emissions, renewable materials use, and construction waste management. For instance, MCH may be the first hospital to use CPVC in lieu of copper for its domestic water service. CPVC is made with recycled content, is faster to install, and is believed to be more cost effective than copper.

The hospital’s landscape will use a subsurface drip irrigation system that helps reduce evaporation loss common to above-ground systems. The hospital-owned sewage treatment plant will treat the sewage and discharge clean water back to the landscape through the drip irrigation system. No public sewer systems will be used and all storm water drainage will flow into nearby streams feeding the Arkansas River.

Roberts reports that over the project’s lifetime, more than 75% of total waste was recycled. In fact, during the last quarter of 2008, crews recycled nearly 96% of the 274,650 pounds of construction waste generated.

It’s Not Always Easy but It’s Right

Roberts believes green building and operations will be adopted more fully by hospitals. “It has to be,” he says. “If becoming green is good for the patient, community, and our environment, then it’s a decision we all must make.” Being on the leading edge of change can be hard, but according to Roberts, success at changing is mostly in our control. “If you don’t think you can, you’re right. But if you think you can do it, you will figure out a way.”

EPA’s Target Finder lets users establish an energy performance target for design projects and major building renovations. By entering a project’s estimated energy consumption, users can generate an energy performance rating. Outstanding projects are eligible for EPA recognition, including use of official ENERGY STAR logos and plaques. For more information, see www.energystar.gov/designtoearn.

Clark Reed is the Director of the Healthcare Facilities Division for ENERGY STAR at the U.S. EPA. In 2007, ENERGY STAR helped Americans save enough energy to avoid greenhouse gas emissions equivalent to that of 27 million cars—all while saving consumers $16 billion. To join, visit energystar.gov/buildings or contact the author at the U.S. Environmental Protection Agency - MC 6202J, 1200 Pennsylvania Ave NW, Washington, D.C. 20460. Email: reed.clark@epa.gov Phone: 202-343-9146.