Environmental and energy sustainability are high priorities for the 10 academic campuses and five medical centers of the University of California system. Recently,
UC announced a system-wide goal of 100 percent reliance on clean electricity supplies across its campuses and medical centers by 2025, complementing the university’s prior pledge to also become operationally carbon neutral, which means all the buildings and vehicle fleets would emit net zero greenhouse gases by 2025.
UC San Diego Health is on its way to achieving these goals, and received national recognition this year for environmental excellence and reducing energy usage.
Sustainability in the hospital setting has specific challenges. In addition to round-the-clock energy demands, hospitals have areas of environmental controls that are much more stringent than in non-clinical facilities. Heating, cooling, lighting, air circulation and infection prevention are all highly regulated in hospitals because they have measurable effects on patient care.
“Medical centers have not historically emphasized sustainability because our focus is, of course, on patient care,” says Anna Levitt, energy manager at UC San Diego Health. “However, it is increasingly clear that being a responsible environmental steward is part of creating a healthier world, and is, in a sense, an extension of patient care.
Patrick Bowens, director of Facilities Engineering and Biomed, and Anna Levitt, energy manager, were instrumental in achieving energy efficiency at Jacobs Medical Center.
Levitt joined UC San Diego Health in 2016 thanks to a sustainability initiative by UC Office of the President (UCOP) to fund the hiring of energy managers for the medical centers. To help achieve the carbon neutral goal, UC San Diego Health is developing a program to reduce energy use and procure energy from renewable sources. “The institutional support for these efforts has been key to us getting traction and results,” says Levitt.
Sustainable energy sources
This includes developing an energy management scorecard for Facilities Engineering, responsible for operating and maintaining systems that are the biggest users of energy at UC San Diego Health. Chief among them is the massive heating and cooling systems that keep the wide variety of clinical and administrative spaces — over 2 million square feet total for both campuses — at safe and comfortable temperatures.
“Different spaces have different demands on heating and cooling,” says Levitt. “Patient rooms are optimized for comfortable temperatures; for an elderly person, that could be 78 degrees Fahrenheit. Meanwhile, there are telecommunications equipment closets and operating rooms that require cooler temperatures. The energy scorecard helps us keep a close eye on usage trends, and a monthly audit identifies opportunities for improvement, many of which are related to the heating, ventilation and air conditioning systems.”
According to Levitt, the greatest savings so far relate to peak electricity demand, a tiered pricing system whereby electricity costs are driven by moments of high demand, typically in the early afternoon on hot days. Half of the Hillcrest campus’ energy bill comes from peak demand fees.
The La Jolla campus is particularly innovative in the area of on-site electricity generation. Eighty-five percent of the electricity used by both UC San Diego’s main academic campus and the health system in La Jolla is generated on-site at the academic campus via natural gas turbines, with some supplemental solar energy.
Eight percent of UC San Diego Health’s electricity usage in La Jolla is accounted for by a bank of fuel cells — essentially large electrochemical cells that cleanly and efficiently produce electricity via the chemical reactions of a gas with a catalyst — that were installed in 2011. The tennis court-sized fuel cell facility uses redirected biogas (methane) from the Point Loma Wastewater Treatment Plant as fuel. The resultant electricity from the fuel cells and other generation sources is stored at the Advanced Energy Storage Facility, which provides electricity for use during peak demand times.
The fuel cells also make use of an innovative heat-reclamation system used to power a water chiller for air conditioning at several facilities. Altogether, the fuel cells produce 2.8 megawatts of electricity every day, which is enough to serve Jacobs Medical Center on a typical day.
Where traditional air conditioners work well for small rooms and residential units, for large facilities, chilled water containers help save on industrial cooling costs through economies of scale. Athena Parking Structure on the La Jolla campus contains two enormous water tanks that store a total of 2.4 million gallons. These tanks are filled at night with water for cooling use during the day, saving on electric cooling costs when rates are lower at night. When the chilled water is pumped to facilities, including Moores Cancer Center, Shiley Eye Institute and Altman Clinical and Translational Research Institute, it draws indoor heat out of the air and out of the facility.
Recognition by American Society of Healthcare Engineers
Reducing energy use intensity on the La Jolla campus took a leap forward with the opening of Jacobs Medical Center in 2016. The 509,500-square foot facility was designed with a low-energy footprint in mind, resulting in an overall 14 percent reduction in energy use intensity at La Jolla in 2017. The American Society of Healthcare Engineers presented the 2018 Energy to Care Award to UC San Diego Health for this impressive reduction.
Overall in 2017, 43 percent of the health system’s electricity in Hillcrest and La Jolla was procured from carbon-free sources, including 25 percent from solar energy panels and 16 percent from hydroelectric sources.
While the La Jolla campus has won awards for decreasing its energy footprint, the Hillcrest campus has taken steps in leading-edge energy installations. Levitt estimates 90 percent of external lights have already been replaced with efficient LEDs and internal lighting is also being replaced. Electric car charging stations have been installed in the Arbor Parking Structure. Additionally, all UC San Diego employees are eligible for incentives on purchases and leases of electric vehicles from various manufacturers.
Keeping it local
The sustainability team at UC San Diego Health is exploring areas where it can reduce energy usage and waste creation, as well as ways to communicate its efforts to employees and the public.
UC San Diego Health is one of only two health systems in the nation to receive the 2018 Sustainability Breakthrough Award from Cardinal Health Sustainable Technologies for showing the most significant improvement year over year in sustainability program performance efforts. In 2017 alone, the health system recycled 40,666 medical devices, diverting over 4 tons of waste from landfills.
The health system’s achievements in sustainability and reducing waste in the areas of food production and delivery have also been recognized. In addition to food packaging, all of which is either recyclable or compostable, food sourcing has continually improved. Practice Greenhealth awarded UC San Diego Health the 2018 Environmental Excellence Partner for Change Award for its dedication to reducing waste, renewable energy adoption, sustainable food purchasing and increasing recycling rate.
“We use Practice Greenhealth’s guidelines in our food procurement,” says Chris McCracken, director of Nutrition Services. “We try to source as much produce and meat as possible from within 250 miles. Barring that, we aim to purchase healthy food from sources within California.”
The drive to improve the quality and safety of meat served to patients was an early effort toward sustainability in food service. This effort is part of UC San Diego Health’s recognition of both diet and environment having a direct impact on human health.
“For more than four years, the chicken breast, ground beef and hamburger patties we purchase have been antibiotic free and we source from local fish suppliers as much and possible,” says McCracken. “In 2017, we surpassed our goal of sourcing more than 20 percent of our food budget on local and sustainable items, and for 2018 we calculated it to be 28 percent.”
The two industrial-sized kitchens at the La Jolla and Hillcrest hospitals, which produce over 4,000 meals per day, also reduce waste through food composting. A vendor collects the food waste for conversion to soil-enhancing compost at a facility in east San Diego County.
According to McCracken, “in 2017, we diverted 163 tons of organic material from landfills to compost — almost a quarter-pound per meal, on average.”
McCracken also has his eye on plastic drinking straws. He hopes to put a plan in motion by the end of the year to switch to paper-based straws and is exploring the procurement of drink cup lids that don’t require straws, similar to coffee cup lids.
Carl Solomon, director of Environmental Services, is likewise exploring options to reduce both costs and environmental impacts in hospital operations. Solid waste disposal is an enormous cost for UC San Diego Health, almost $3 million per year.
“Currently, we spend money on our comingled recycling, but we are looking at ways to possibly generate revenue instead,” says Solomon. “We will soon have corrugated cardboard bailers on our La Jolla campus. We’ll bail the cardboard, make it available for purchase and direct those funds back toward patient care.”
Drought conditions are a constant concern in Southern California. According to the National Integrated Drought Information System, all of San Diego County is under “severe drought” conditions. UC San Diego Health has several innovative measures in place to reduce water waste on its 350-acre La Jolla campus.
UC San Diego Health buys so-called “gray water” from the main academic campus. This wastewater is treated by the City of San Diego’s North City Water Reclamation Plant (NCWRP) and pumped back to the medical center for use in irrigation via purple pipes visible on the exterior of some facilities. The new Koman Family Outpatient Pavilion also reclaims water that would otherwise go directly to a treatment facility; water condensed by its air conditioners is used for landscape irrigation.
The central plant on the La Jolla campus, the first stand-alone medical center energy plant to achieve LEED Gold certification from the United States Green Building Council, gets 80 percent of the water it uses in its massive cooling systems from the NCWRP. This sourcing reduced potable water usage by more than 12 million gallons in 2017.
Facilities Engineering plant operators have been able to optimize the operation of the central plant to reduce peak demand through strategic timing and loading of the chilled water storage tank and gas-fired absorption chiller. This led to a savings of more than $100,000 in 2017. UC San Diego Health is also pursuing a goal of a 2 percent annual reduction in energy use intensity — energy used per square foot per year — to support UC-wide policies.
Additionally, both UC San Diego Health campuses have saved over 2 million gallons of water per year by installing new, more efficient plumbing fixtures, such as motion-activated faucets.
The pace of sustainability efforts at UC San Diego Health has quickened in recent years, becoming fundamentally integrated into both business practices and patient care.
Sustainability in the form of low energy footprints and natural light usage are part of every new building. Individual facilities, such as Jacobs Medical Center and Koman Family Outpatient Pavilion, are impressive in their engineering and construction. As the health system embarks on updating the Hillcrest campus, sustainability will be a core focus of design and construction. It will be unique among the UC health systems in its breadth and pace of construction and replacement of existing facilities, as well as providing a laboratory for sustainability from the ground up.