Monday, April 02, 2007

It's not easy being green

I am finally going to write on a topic I know about. (This will come as relief to my hospital colleagues around town!) Most of my career has been in the energy and environmental fields, and I'd like to spend a moment on those topics.

An informative article in the Globe today talked about the new generation of hospital buildings and the attempt to make them more environmentally friendly. This is good, appropriate, and important. Hospitals are huge users of energy and other natural resources, and the best time to make sure they will be efficient is during design and construction. So kudos to the Brigham, MGH, Mt. Auburn and others for incorporating green principles into their new buildings.

But there is also work to be done on old buildings. As energy costs rise, there is a great impetus to control the use of electricity, steam, and chilled water. It is a good idea financially, but also good for the environment.

At BIDMC, we have no ongoing construction of new buildings, but we do have 3 million square feet of existing space and use over five million kilowatt-hours of electricity per year, 25 million pounds of steam, and 1.5 million ton-hours of chilled water. Over the past five years, we have invested $3.6 million in energy efficiency improvements (not counting improvements that are inherent in other renovations). The power of these investments is shown in their rates of return. Those returns range from 85% to 175%, with an overall payback period of less than one year.

Not one of these investments has reduced the quality of the work environment in the hospital. Quite the contrary. And, of course, we have made no changes that adversely affect the quality or safety or comfort of patient care.

The results, though, are pretty dramatic. We have 1000 more employees than we did five years ago. Given this expansion in staff, plus a steady 2% to 4% growth in patient volumes during this period and the installation of more energy-using equipment (computers, imaging machines, a complete surgical and medical simulation center, and the like), it would have been reasonable to expect a 3% to 5% "creep" upwards in electricity, steam, and chilled water use. For electricity, those trends are represented by the red and green lines on the graph above. Instead, electricity use has held virtually constant -- as seen by the blue line. The same pattern occurs for steam and chilled water.

And, it is a good thing that it has! With energy price increases, we will still pay $10 million more for energy this year than in 2002. Had we not taken these steps to reduce energy use, that would have been millions of dollars higher. During this period, electricity has risen 48%, steam 146%, and chilled water 36%. As prices rise, more and more energy efficiency investments become cost effective. So, of course, we are going to continue plowing funds into these areas. It is actually not that hard being green -- especially when you see red if you don't.


Toni Brayer, MD said...

Another great post, Mr. Levy, showing good environmental decisions can also mean good business. I'm lovin' these blogs! TB

Anonymous said...

Thanks, Toni!

Anonymous said...

Hi Paul,
I'm glad you wrote about this. I've been thinking for awhile that we could save a lot of energy around the medical center without compromising patient care or comfort by some simple measures---for example, programmable thermostats that would lower the heat at night and on weekends in non-inpatient areas (e.g. the entire Shapiro building!) The motion-activated lights that are popping up everywhere are a great idea, too. Maybe we could have another employee "contest" for ideas, akin to the "Prepare 21" program Dr. Rabkin launched (ahem) a couple of decades ago? (There is a huge potential savings in our waste management stream as well---everything from plastic packaging recycling to consciousness-raising about not putting trash in the sharps containers, etc.) The possibilities are endless. . .

Anonymous said...


Since you have considerable expertise in the environmental area, I am curious about how you view the concept of carbon taxes to encourage lower energy consumption and greater energy efficiency.

In theory, it seems that carbon taxes could make the total cost of energy more closely reflect the full social cost of producing it as well as, perhaps, reduce the need for other taxes (like higher income taxes) that may cause more economic harm.

Anonymous said...


I am generally in favor of internalizing the costs of environmental externalities along the lines you have suggested. There is always a difficulty in estimating those costs, of course, but the sentiment is right on target. We could start in the US with a higher gasoline tax, recirculating those new revenues into energy efficient investments or R&D.

Dear anon 11:00pm,

There actually is a lot of such stuff going on. Get in touch with Jane Matlaw for details. In fact, Jane may want to comment directly.

Anonymous said...

Kudos! But this is just a piece of what we are doing. On April 24 BIDMC is hosting our 9th annual "Healthy Work/Healthy Home" event. We start the day with our Environmental Action Awards breakfast featuring speaker WBUR's Living on Earth producer Bruce Gellerman. We will be celebrating the top 3 teams at BIDMC who developed and implemented a sucessful, creative, sustainable,high impact, cost saving environmental change within the hospital.
From 11:30-1:10 pm we hold an environmental awareness fair for employees where we give out lots of info on ways to improve habits to promote "environmental health". Employees who come by will receive a free compact flourescent energy saving light bulb. We will also have a mercury thermometer exchange, lithium and cadmium battery collection for recycling, and collect used cell phones for a local domestic violence program.

Later in the afternoon, we are hosting a free showing of "An Inconvenient Truth" for BIDMC employees.

I have been so impressed with the "green lens" that so many of our employees are using in their daily work. Even when things are tried and are not the paper towels..we keep trying!

Brian Crounse said...

To your knowledge, does your hospital or any others you know of utilize combined heat and power (here's an example)? With a hospital's substantial need for heat, cold, and electricity, generating all 3 at once on-site (at very high overall efficiency) seems like it should be a very cost-effective approach.

Anonymous said...

We do that. We are part of a district system that produces electricity, steam, and chilled water in one facility. It serves several hospitals and Harvard Medical School. It's nickname is MATEP -- medical area total energy plant -- and it is owned by NStar.

Brian Crounse said...


MATEP is a big sucker.

Throw some biodiesel in there and you're about as low carbon as you are going to get.

Anonymous said...

Do you see additional improvements in environmental efficiency that result directly from the process improvement initiatives about which you wrote earlier?


Anonymous said...

Not that they could be measured.

Monique said...

I've been interested in developing a program of resource sharing both within and outside the institution. Every department has items that are either outdated, antiquated or no longer needed and could use a new home. By developing a "craigslist" or "BIDslist", on the hospital portal, individual departments could post unneeded supplies and equipment while needy departments could arrange to retrieve or request items . Outdated and antiquated equipment could be offered to individuals involved with third world charities rather than cart the "trash" away to a landfill. We all have items piled in our store rooms,sometimes forgetten, taking up valuable space that could be put to better use. If each department had a designated contact person and the portal link was easy to access it could prove to be a bulletin board of resource sharing involving very little cost by the institution.

Anonymous said...

Hi Paul, I was hoping you could provide me with information on BIDMC's recycling policy. I am an employee of BIDMC and our offices recently moved outside of the Longwood area. We currently do not have any recycling option for disposal of glass bottles and aluminum, and I was told there is no plan for this in the future. I know HMS has a strong recycling program but I was wondering if this applied to BIDMC as well. Thanks.