How Gundersen Lutheran Health System Will Be Energy Independent by 2014

Imagine, for a moment, a hospital that is able to provide its own energy through new renewable energy projects like biofuels and solar power and improved energy efficiency efforts. In other words, the hospital will never have to pay another energy bill again. Sounds a little far-fetched, right?

Gundersen Lutheran Health System is located in La Crosse, Wis.Well, it's not far-fetched at all. In fact, officials at Gundersen Lutheran Health System in La Crosse, Wis., are trying to make their health system 100 percent energy independent — meaning they will be completely self-sufficient on all their energy needs — by 2014.

According to the U.S. Department of Energy, hospitals are some of the most "complex and energy-intensive facilities" in the country. Major heating and lighting needs, 24/7 access and large, energy-sucking machines cause hospitals to use roughly 836 trillion BTUs of energy every year, and they have more than 2.5 times the energy intensity and carbon dioxide emissions of commercial office buildings.

A hospital's energy consumption is both a drain on the environment as well as its bottom line. The DOE estimates U.S. hospitals spend more than $5 billion annually on energy, which equates to roughly 3 percent of an average hospital's operating budget.

However, Gundersen Lutheran is trying to change that path. Through new green energy projects, Gundersen Lutheran is trying to couple sustainable energy efforts through "solid financial business decisions" — and it all starts with its Envision program.

Gundersen Lutheran's Envision program

The Envision program, essentially, is the model and planning of projects that will put Gundersen Lutheran on a path of energy independence by 2014. Jeff Rich, a certified Lean Six Sigma master black belt, is the executive director of Envision and has been with the health system since 2006.

Gundersen Lutheran conducted an energy audit in 2008 after discovering their energy costs were increasing by more than $350,000 per year in 2007. After reviewing the audit, the health system decided Mr. Rich, his colleague Corey Zarecki and the facilities operations team should take on a program to revamp the entire energy strategy — and thus, Envision began.

In the first 18 months of the program, starting in May 2008, Mr. Rich and his team were able to save 20 percent of energy consumption per square foot across the health system through several different projects. To bring Gundersen Lutheran to "net zero," they developed a road map to get them from point A to point B, although it's run into barriers and changed several times. The three key elements they focused on were energy, waste management and recycling, and sustainable design.

•    Energy. The energy component consists of both energy conservation measures as well as new renewable energy measures.

In terms of energy conservation, Gundersen Lutheran has focused on retrocommissioning — a process that examines heating and cooling systems, lighting, employee behavior and other areas that use low- or no-cost measures to improve efficiency. For example, Gundersen Lutheran reprogrammed its cooling system to reduce consumption, adjusted boiler controls, added more efficiency lighting and installed an automatic computer shutdown program among many other changes. All in all, retrocommissioning saved Gundersen Lutheran $1 million in annual savings by the end of 2009.

Gundersen Lutheran teamed up with La Crosse City Brewery on energy.The renewable energy efforts are the big-ticket items that involve bigger investments but are resulting in a complete shift of the energy paradigm. For example, in 2009, Gundersen Lutheran teamed up with the La Crosse City Brewery to turn the brewery's wasted biogas discharge into electricity. The result? Roughly 2 million kilowatt hours per year of electricity are being produced — enough to power 170 average-sized homes — which is roughly 2 percent of the health system's energy independent goal.

Similar to the brewery project, Gundersen Lutheran has also partnered with the county landfill to use their flaring gas discharge as a renewable energy source for one of its campuses. "The flaring gas was just wasted," Mr. Rich says. "It's a heat source. Now, they pipe the gas to us underneath Interstate 90. We produce the energy from a generator here, and now the campus produces more energy than the entire campus uses."

Mr. Rich says they've also installed some smaller solar projects and are gaining electricity from two large wind turbine sites. This fall, the team will be installing a massive biomass boiler that will take woody biomass from around the area and turn it into heat and electricity through a steam turbine. Perhaps one of the most innovative projects involves poop — literally. Gundersen Lutheran is teaming up with local farmers to capture cow manure and turn it into renewable energy. "It creates gas in an anaerobic digester just like a landfill, and the process is cleaning water pollution from manure runoff," Mr. Rich says. "Through anaerobic digesters, we can also turn [the byproduct] into a composted soil amendment or potting soil, which can be sold."

•    Waste management and recycling. Waste is a major cost and concern for hospitals and health systems, and Envision has taken steps to control the health system's waste management and boost recycling efforts. For example, Gundersen Lutheran has increased its recycling of solid waste to 37 percent over the past three years — anything around 25 percent in healthcare is pretty good, Mr. Rich says — and the system also reduces waste in the operating room by reusing, cleaning and sterilizing the right OR instruments.

In addition, Gundersen Lutheran has eliminated Styrofoam completely, reduced food waste by 60 percent and donates what goes unused to a local food shelter. Gundersen Lutheran was also a founding member of a local food co-op that will save money in distributor costs and boost the local La Crosse-area economy.

•    Sustainable design. Going forward, Mr. Rich says all new buildings at Gundersen Lutheran will have energy efficiency in mind: LEED certification, energy intensity targets, commissioning requirements, environmentally friendly materials and high-efficiency HVAC systems. The health system will also be opening a new hospital addition in 2013, and he says a new geothermal pump system will be a major part of its energy-sustaining design.

Gundersen Lutheran has completely shifted how it looks at its energy costs and environmental footprint. For other systems to follow the trend, it requires a systemic outline and a realization that there is always room for improvement. "It's about how do we throw less in a landfill every year, not wasting packaging, handling waste in the OR properly and safely," Mr. Rich says. "We try not to create it to begin with. We've done great things, but we're still very humble and will learn from others. And there are still a lot of opportunities for us to improve."

What makes it work?

Although the Envision program is headed by a somewhat small group of engineers, sustainability professionals and project managers, it was able to get a foothold because it gained immediate acceptance at the C-suite level. "There's been a really intense effort," Mr. Rich says. "You have to have good leadership that is really committed. If you don't have committed leadership, you won't go very far, and our CEO is the biggest champion you can have."

Jeff Rich is executive director of Envision.Jeff Thompson, MD, is president and CEO of Gundersen Lutheran.Jeff Thompson, MD, Gundersen Lutheran's president and CEO, has led the culture behind the mass-scale energy shift at the health system. He says the long-term financial, clinical and environmental benefits of an energy independent health system outweigh any of the short-term costs. "As healthcare organizations, our goal is to improve the health of the communities we serve," Dr. Thompson says. "We believe we need to 'look in the mirror' when it comes to environmental factors that affect human disease. We cannot improve the health of the communities we serve without looking at our organization's environmental impact and how that contributes to disease. In addition, rising energy costs directly affect our ability to invest in and deliver patient care, and they contribute to the rising cost of healthcare."

Achieving energy independence by 2014 is an ambitious goal — Mr. Rich says ultimately he believes the health system can get there within the first few months of the year — and if achieved, Gundersen Lutheran will have set the bar for the entire hospital and healthcare industry. "We can improve the health of the communities we serve and reduce the cost of care with savings generated from our program," Dr. Thompson says. "For us, it was never a question of why would we develop a program like this. It's a question of, why wouldn't we?"

More Articles on Green Hospital Management:

5 Challenges in Renovating or Building a Hospital

5 Keys to a Greener Supply Chain

6 Ways an Operating Room Can Become More Environmentally Friendly

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