According to a 2003 U.S. Energy Information Administration survey of commercial buildings, hospitals are one of the most intensive users of energy among building types.

The top five areas of energy use in hospitals are lighting, ventilation, water heating, space heating, and space cooling. Let’s look at each of the five categories and see how energy can be saved. 

Replacing a lighting system with a lighting retrofit of newer and more efficient lamps will pay dividends in energy and cost savings. Installing occupancy controls, dimmers, and daylighting controls can also have a dramatic affect in reducing lighting electrical use.

De-lamping in areas of excessive illumination will also reduce energy consumption, while lowering the lighting energy will also have a positive effect on lowering the cooling load in summer. 

Most air handlers use an “economizer cycle” that allows fresh air to supplement the temperature control of hospital spaces when the outside air conditions are appropriate.

However, the dampers, actuators, or controls of the economizer cycle can either get stuck open or fail to operate correctly causing a dramatic increase in energy use by having to condition an excessive amount of very hot or very cold air. Re-commissioning the economizer control on the air handling units can save both heating and cooling energy. 

Water heating
Water heating can use an excessive amount of energy in a hospital. The installation of low-flow plumbing fixtures and automatic hands-free controls can reduce water use, therefore lowering energy consumption.

Using condenser heat from the hospitals chilled water system to preheat the domestic hot water is a good investment and saves energy. 

Space heating
Most existing hospitals have large steam boilers that create steam for the building’s heating system. Steam traps are designed to keep the steam from migrating from the steam system to the condensate return system.

A good steam trap maintenance program can prevent steam trap leaking, which saves large amounts of energy. Reducing air volumes in areas of excessive ventilation can reduce the amount of reheat required, saving both cooling and heating energy. 

Space cooling
Central cooling systems use energy transferring heat from the building to the atmosphere. These systems are energy intensive and temperamental to changing conditions.

Technology is now available to optimize the control of these systems and minimize their energy use. Installing this technology is well worth the cost.

John Sauer, PE, LEED AP, is Senior Director Engineering Design at BSA LifeStructures in Indianapolis. John is a strong advocate for sustainability and the use of energy-efficient design in traditionally high-consuming healthcare environments. John has leveraged his knowledge of heating, ventilation, vacuum, air conditioning, steam distribution, energy centers, and piping design to identify cost efficient and sustainable solutions for all types of healthcare facilities. He can be reached at For more information, please visit