March 27, 2024

According to the Environmental Protection Agency, each dollar a nonprofit healthcare agency saves through energy efficiency equates to 20 dollars in revenue from patient care. That’s because hospital operating margins are slim compared to other industries. In 2024, the average operating margin has hovered between one and two percent.

While most energy efficiency projects require some initial investment, they pay for themselves over time. From there, any savings go directly to a hospital’s bottom line. Below, Efficiency Smart reviews four key ways healthcare operations teams can save on energy. Many of these projects also deliver additional benefits, such as improving the experience of patients and staff.

  1. Patient spaces

Because hospitals are always open, efficient lighting and good lighting design can dramatically reduce energy bills while improving occupant comfort. Manual lighting controls can be programmed to switch LEDs on or off or move from dim to full strength. However, automatic lighting controls, such as occupancy sensors, should only be used in specific circumstances in patient care areas.

Improving the efficiency of ventilation systems can also yield savings. However, operations staff need to prioritize air pressure specifications above energy efficiency, especially in spaces like operating rooms that require positive air pressure. When making changes that affect the amount of air in a room, staff and vendors should predetermine the pressure relationships between project areas and surrounding rooms to avoid issues. Many hospitals hire a vendor to perform an air balance to ensure that pressure relationships are maintained during energy or construction projects.

For heating (steam and/or hot water) and cooling, hospitals have a year-round need for both. Tools and equipment must be sanitized in steamers and cleaners, while patient rooms include showers. Installing heat recovery systems on chiller plants (see section on central chiller plants) saves energy and money by repurposing preconditioned water for other applications. Certain applications could even consider a Combined Heat and Power (CHP) system.

  1. Administrative spaces and medical offices

Administrative spaces are used differently than patient areas and are often vacant on evenings and weekends. For this reason, the savings associated with lighting retrofits in office spaces aren’t as dramatic as in patient areas. However, installing lighting controls such as occupancy sensors and daylighting can result in additional savings.

Heating, cooling, and ventilation (HVAC) efficiency projects can also yield significant savings since staff can set back temperatures and air changes when no one is working.

Medical offices, which are also closed on nights and weekends, are another good candidate for HVAC efficiency projects and controls. Be sure to refer to ventilation standards for medical buildings, per ASHRAE 170 ventilation requirements for healthcare facilities.


  1. New construction and renovation

One of the best ways to improve energy efficiency in a hospital setting is to write the organization’s construction standards to build to the most current energy standards, even if they have not yet been adopted in your state’s energy code.

Hospitals are owned and managed for decades, which means they can invest in renovations with longer payback periods. Establishing and maintaining energy efficiency requirements for new construction and renovation can help ensure that lighting, HVAC, building shell, and specialty equipment are purchased and programmed to perform efficiently and effectively.

During renovations, it’s also worth considering transitional spaces. For example, if one hall is updated with new LED lighting, consider the spaces adjacent to prevent jarring visual differences for employees and patients.

Finally, as spaces are repurposed, make sure they are not over or under-ventilated. Patient care spaces require higher ventilation rates than non-patient care spaces, and this can result in dramatic swings in energy use.


  1. Central plants

A chiller/boiler water plant generates the energy a hospital needs to heat and cool all the buildings on its campus, so it’s a great place to look for energy efficiency opportunities.

Chillers rarely run at their peak loads and some of the largest savings can come from part load efficiency. For existing equipment, this may mean installing variable frequency drives, optimizing the staging of equipment (especially in modular systems), or driving down condenser water temperatures during cooler weather. When selecting new equipment, you should prioritize the integrated part load value (IPLV) or the non-standard part load value (NPLV) over the peak kW/ton rating.

When selecting a new or retrofit system, the most efficient system may not come in a single package. A modular system will interconnect a series of smaller units to better match the building load at non-peak conditions. Modular systems can also be scaled as hospitals add or renovate buildings, as each module is smaller and can be transported to an existing mechanical room.  Heat recovery technology should also be considered, as these systems save energy by repurposing waste heat for other building needs, such as sterilization and water heating.  

Other energy efficiency opportunities can include installing variable frequency drives (VFDs) on all pumps and motors, including cooling tower fan motors. Installing VFDs minimizes energy use by ensuring that your machinery works only as hard as it needs to at any given time. Finally, existing spaces should move away from pneumatic controls to direct digital control (DDC) systems.  They are more versatile, programmable, and responsive, and do not require the use of compressed air to operate.


Questions? Reach out.

Efficiency Smart partners with hospitals to identify energy efficiency processes and projects that meet their specialized organizational needs. We also provide rebates and technical guidance to help you find vendors and complete projects.

For questions or to get started, contact your local account manager or our customer support team at 877-889-3777 or [email protected]