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University of Vermont

Medical CenterApproach and Strategy for Sustainable Design

and Construction

Presenters

Dave Keelty, BS, CEM, CHFM, CHC

Director Facilities Planning and Development,

University of Vermont Medical Center

Owner

William Repichowskyj, AIA

Partner, E4H - MorrisSwitzer Environments for Health

Planning & Architecture

Michael Pulaski, Ph.D., LEED AP BD+C

Senior Associate, Weidlinger and Thornton Tomasetti

LEED & Sustainability Consultant

Agenda

Project Overview

Our Commitment to Sustainable Design and Construction

Master Plan Guiding Principles

Sustainability Approach

Start Early in the Planning Process…before Programming and Design

Assemble a Team that Represents all Constituencies

Use Industry Standard Benchmarks

Clearly Communicate Expectations

Set Measurable Targets

Include a rigorous Commissioning Process

Analysis & Implementation

Just a Thought

Project Overview

Seven-story inpatient building above existing Emergency

Department parking area

180,000 Square Feet

Four inpatient floors of 32-single-occupancy medical-surgical,

telemetry-capable rooms: 128 Beds

Increase single-rooms from 30% to 90%

Replacement of oldest inpatient rooms

Project cost is $187M (of which $12.35M is capitalized

interest)

Our Commitment to Sustainable Design & Construction

Master Facility Planning Guiding Principles

Be informed by and strive to reinforce the strategy of the organization

Promote a safe, healing and pleasing environment for patients, families, visitors and staff

Strive for LEED certification

Seek input from our key constituents including patients and the communities we serve

Be sensitive to the neighborhoods within which our facilities are located and responsive to the concerns of

our neighbors

Ensure that all planning is fiscally responsible

Preserve our heritage, promote a sense of community ownership and reinforce our brand promise

Minimize the disruption of the environment

Master Facility Planning Guiding Principle

The master facility plan will strive for LEED certification (Leadership in Energy and

Environmental Design) that recognizes performance in five key areas of human

and environmental health:

Sustainable Site Development

Water Savings

Energy Efficiency

Materials Selection

Indoor Environmental Quality

LEED Projects and Recognition

Practice Greenhealth

Top 25 for Environmental Excellence and 6

Circles of Excellence awards:

Leadership

Waste Reduction

Chemical Reduction

Greening the OR

Sustainable Food Services

Green Building

LEED Projects

Inpatient Bed Building Goal: Silver -

Healthcare

Radiation Oncology Garden Pavilion: Gold-

New Construction

Clinical Research Center: Gold- Interiors

Renovation

Mother-Baby Unit: Gold- Interiors Renovation

Hinesburg Family Practice: Certified- New

Construction

Other Projects Pending Certification

Shelburne Road- Core and Shell and

Interiors

Garden Atrium- Interiors Renovation

Sustainability Approach

Establish Sustainability Goals Early in the Planning Process

Project Conceptual Planning

Programming

Schematic Design

Design Development

Construction Documents

Bidding

Construction

Occupancy

Post Occupancy Evaluation

Set Sustainability

Goals Here

Starting Assumptions

Meet 2010 FGI Guideline for Commissioning*

Achieve LEED Certification

Design to meet Energystar rating of 75

Meet CON Standards 1.9 and 1.10

Meet Act 250 Criteria 9 (F) Energy Conservation

*Currently following 2014 FGI Guidelines.

Sustainability Team and Roles

Facility Master Planning Steering Committee -Project Oversight

Sustainability Council - Established Overarching Sustainability Goals for the Project

Internal Departments – Developed Owner’s Project Requirements

Facilities Management

Infectious Disease

Environmental Services

Environmental Health and Safety

Supply Chain

Community Health Improvement

Patient Safety

Nutrition Services

You Need Everyone's Input

Design User Groups

Patients and Families Design User Group

Utility Partners

Burlington Electric Department

Vermont Gas

Project Design, Engineering, Sustainability and Commissioning Consultants

E4H Environments for Health - Architect

Bard, Rao + Athanas Consulting Engineers (BR+A)

Thornton Tomasetti - LEED and Sustainability Consultant

CxAssociates – Commissioning Agent

Whiting-Turner Contracting Company

Sustainability Council

A multi-disciplinary steering committee charged with

oversight of all elements of sustainability programming.

M I S S I O N S TAT E M E N T

Our mission and vision are built on a foundation of values that

include a longstanding commitment to being prudent stewards of

limited natural resources. We continue to look for new ways to

build on our long tradition of environmental responsibility. We will

continue our efforts to reduce energy consumption, waste stream

and carbon footprint, and to increase the use of health, locally

produced foods.

Areas of Focus

Leadership

Waste

Chemicals

Greening the OR

Healthier Food

Smarter Purchasing

Leaner Energy

Water

Climate

Green Buildings

Members

Dawn LeBaron - Vice President Hospital Services & Council Leader

John Berino - Occupational/Environmental Program Coordinator

Matt Bushlow – Communications Specialist

Janet Carroll – Administrative Director of Nursing

Jack Conry – Director, Security/Safety/Parking

Sidney Hamilton – Manager Purchasing, Contract & Value Analysis

Diane Imrie – Director, Nutrition Services

Dave Keelty – Director, Facilities Planning & Development

Karen McBride – Director, Pharmacy

Maria McClellan – Sr. Community Relations Strategist

Wes Pooler – Director, Facilities Management

Paul Rosenau, MD – Pediatrics

Lori Ann Roy – Manager, Radiation Oncology

Brooke Stahle – Director, Peri-Operative Services

Industry Standard Benchmarks

LEED is an internationally recognized green building certification

system: providing third-party verification that a building or

community was designed and built using strategies aimed at improving

performance across all the metrics that matter most:

Energy Savings

Water Efficiency

CO2 Emissions Reduction

Improved Indoor Environmental Quality

Stewardship of Resources and Sensitivity to their Impacts

Source: USGBC Web Site

Leadership in Energy & Environmental Design (LEED)

Energy Star Score

Energy Star ScoreEUI Defined

EUI is defined as energy consumed per square foot per year

It’s calculated by dividing the total energy consumed by the building in one year by the total gross floor area of the building

Typically expressed as kBtu per square foot

Energy Star: EUI

Why EUI ? - It’s an increasingly important metric

It has become the common currency for measuring and reporting energy

consumption in buildings

It is now the universal measurement for energy performance

It can measure energy performance “apples to apples” overtime and building to

building providing management and decision making information

Emerging as the standard for performance reporting and benchmarking by

Healthcare Executives

EPA Energy Star Target Finder


Metric Design Project

Design Target*

Median Property*

ENERGY STAR score (1-100) Not Available 75 50

Source EUI (kBtu/ft²) Not Available 378.1 436.5

Site EUI (kBtu/ft²) Not Available 201.7 232.9

Source Energy Use (kBtu) Not Available 68,060,143.2 78,578,758.1

Site Energy Use (kBtu) Not Available 36,303,410.0 41,914,060.0

Energy Cost ($) Not Available 787,954.85 909,732.36

Total GHG Emissions (Metric Tons CO2e)

0.0 2,553.3 2,947.9


EUI as a Tool

27

2

20

4

16

1

14

3

10

0

-

50

100

150

200

250

300

MCHV Existing Base (VAV system) Alt 1 (ACB in core) Alt 2 (ACB in core+floor 6) Target

KB

TU/S

F

Total EUI

Use and Value as a

decision making tool

What’s the best

investment

What system will be

the most sustainable

and afford the lowest

operating costs

Chilled Beam vs. Variable Air Volume System

Active Chilled Beam

Variable Air Volume


Owner’s Project Requirements:

o A written document that details the functional requirements of a project and the

expectations of how it will be used and operated. These include project goals, measurable

performance criteria, cost considerations, benchmarks, success criteria, and supporting

information.

The Owner’s Project Requirements should include the following:

Energy efficiency goals

Environmental and sustainability goals

Community requirements

Adaptability for future facility changes and expansion

Systems integration requirements, especially across disciplines

Expectation Setting: Owners Operating Requirements (OPR)

Reflect UVM Medical Center’s commitment to ongoing environmental stewardship in order to minimize our environmental footprint by utilizing design and building practices that to the extent possible minimize the consumption of energy and natural resources.

Achieve LEED Silver Certification

Achieve a site EUI of 143,000 BTU/sf/year Enhanced Commissioning Requirement Complete Utility Metering Capability

To Support Post Occupancy Measurement and Verification Patient Room Energy Consumption Research Water Metering by Floor

LED Lighting

Innovative HVAC Chilled Beams While meeting FGI requirements

Building Envelope Air Tightness Thermal Insulation

Setting Measureable Targets: Owners Operating Requirements (OPR)


Commissioning

ASHRAE definition: Commissioning is the process of ensuring that systems are designed, installed,

functionally tested, and capable of being operated and maintained to perform in conformity with the

design intent.

Owners Operating Requirements (OPR)

Estimated Costs

Enhanced Commissioning with Measurement and Verification $ 2.50/SF

LEED Consulting with Full Sustainability Consulting Services $ .75/SF

Additional General Conditions and General Requirements $ 1.00/SF

Additional Hard Construction Costs (if sustainability efforts begin early) $ 0.00/SF

Total $ 4.25/SF

As a Percent of Project Cost .05 %

Simple Payback 4.9 Years

Potential Value Management Impacts

Sustainable Design &

The Inpatient Building

Analysis & Implementation:

Where we are now?

Currently, hospitals consume 5% of all energy consumed in the

United States. Healthcare energy consumption continues to rise up

to 5.5% of the commercial building energy, from 4.3% in 2004.

Although energy represents a small

portion of a hospitals overall operating

costs, reducing utility expenditures can

provide low risk high yield, and stable

investment for the future.

Targeting 100! Getting to 100 EUI

Targeting 100! Is a research project completed by the University of Washington’s College of

Built Environments. The project examined the efficiency of two massing options for six

regions across the United States to determine the best strategies for getting to an EUI of 100.

Copyright ©2012 University of Washington

Background

The research team met with over 200 stakeholders in each of six study regions, collecting data with

respect to regions specific approaches for deep energy savings and a balanced capital investment.

The Targeting 100!

Case studies did not

include Region 6 so

we have provided

data for Chicago’s

climate which most

closely relates to

Vermont’s Climate.

Targeting 100 Studies

Typical Hospital Energy Demands

Reheat energy: A good place to Start!

Keys for Success: High Performance Healthcare Design

1. Reduce Internal Loads (Equipment, Lighting)

2. Reduce Peak Heating and Cooling Loads

3. Decouple Heating and Cooling from Ventilation

4. Optimize the Central Plant Equipment

Reduce Peak Loads with Good Architectural Design

Heating and Cooling Load Reduction

Example Loads – Patient Rooms (WEST)

Mechanical Systems

Decouple Heating and Cooling from Ventilation

Significantly reduces re-heat energy

Displacement Ventilation

Low side-wall radiant heating panels

Ceiling cooling panels

Plant Options

Energy - Savings

2010-2015 = 60% Reduction from code energy use

2030 = Net Zero annual energy demand

• Major reductions in heating energy

use (reheat).

• Heating savings 73%-97%

• Load reductions & maximized

efficiency in equipment

• A4 & B4 = ground coupled heat

pumps Most Energy Efficient!

Cost – Per Square Foot

Project Analysis

Keys for Success:

1. Reduce Internal Loads (Equipment, Lighting)

2. Reduce Peak Heating and Cooling Loads

3. Decouple Heating and Cooling from Ventilation

4. Optimize the Central Plant Equipment

Patient Room Estimated

Equipment Load Intensity

HVAC Options:

1. VAV at 6ACH

2. VAV at 4ACH

3. VAV at 4ACH + Chilled Panels

4. Chilled Beams at 2 ACH

5. DV at 4 ACH

6. DV at 4 ACH with Chilled Panels

Envelope Options Patient Room Glazing

204

195

211

179

149

201

203

175

221

138

135 146

189

146

208

211

157

233

0

50

100

150

200

250

KBT

U/S

F

Total EUI

West Patient Room

B C

70% Glazing 40% Glazing 90% Glazing

A

Envelope and HVAC Systems Analysis Equipment Load Intensity

-$200,000 $0 $200,000 $400,000 $600,000 $800,000 $1,000,000 $1,200,000 $1,400,000

VAV 6ACH, Opt 1A

Opt 1B

Opt 1C

VAV 4 ACH Opt 2A

Opt 2B

Opt 2C

VAV 4 ACH + CH Panels, Opt 3A

Opt 3B

Opt 3C

Chilled Beams 2 ACH, Opt 4A

Opt 4B

Opt 4C

Disp Vent 4 ACH, Opt 5A

Opt 5B

Opt 5C

Disp Vent 4 ACH CH Panels, Opt 6A

Opt 6B

Opt 6C

First Cost

Ten Year EnergySavings

Patient Room HVAC Systems Cost Analysis

Equipment Load Intensity

Whole Building Modeling Process

Managing and Analyzing ECMS

B. ECMs Included in Base Building Scope

2 Interior Light Power Density Reduction using LED lights

11 Triple glazing with high performance curtain wall frame

14 Fan Array technology for AHU supply and return fans

18 Envelope insulation upgrade R20 (effective)

22 Chilled water delta T - 18F

23 Heat-recovery bypass dampers open during air-side economizer mode

24 Partial heat recovery glycol run around on dedicated exhaust

26 Pressure-independent control valves (PICVs) at chilled water coils

28 Comprehensive air sealing and Façade Cx (0.25 cfm/sf 75Pa)

34 Chilled beams with DOAS for core spaces and 6th floor patient rooms

35 Low static pressure and low velocity across coils and fi lters at AHU

B. ECMs for Future Consideration

1 Occ sensors in patient rooms - Reduce ACH to X unoccupied

2 Supply low dew point at higher air temp

3 Daylighting controls in Patient rooms

4 Condition MER (penthouse) with relief air

C. ECMs Reviewed but not included

1 External shades at (7.5'ht 3' wide)

2 Reduced glazing (sil l ht at 24")

3 Reduced glazing (sil l ht at 36")

4 Nursing stations - low occupancy mode demand control ventilation

5 Heat recovery of steam condensate return

Energy Use Intensity Profile Comparison

-2 0 2 4 6 8 10

$(5,000) $- $5,000 $10,000 $15,000 $20,000 $25,000

Envelope insulation upgrade R30

Roof Insulation R40

Roof insulation R50

SHGC 0.2

SHGC 0.3

Double Pane Dynamic glass

Automated interior blinds

Regen (traction) elevators

DHW drain water heat recovery on showers

Chilled water delta T - 20 F

Heat-recovery bypass dampers open during air-side economizer mode

Partial heat recovery glycol run around on dedicated exhaust

Wrap around heat pipe for chilled beam exhaust

Energy Valves at main CHW coils (AHUs)

Pressure-independent control valves (PICVs) at chilled water coils

Change in EUI (kBTU/sf/year)

Annual Operationsal Savings ($)

ECM EUI vs. Annual Savings

Whole Building Energy Use Intensity Breakdown

EUI (kBtu/sf)

End Uses

Baseline -

90.1 ASHRAE

2007

Compliance Design Case

Percent

Savings

Heating 100.37 23.86 76%

Cooling 45.65 44.77 2%

Interior Lighting 21.74 10.66 51%

Interior Equipment 37.94 37.74 1%

Fans 18.89 20.49 -8%

Pumps 2.68 2.67 0%

Heat Rejection - - 0%

DHW 4.49 1.35 70%

Total 231.76 141.53 39%

-

20.00

40.00

60.00

80.00

100.00

120.00

Heating Cooling InteriorLighting

InteriorEquipment

Fans Pumps HeatRejection

DHW

Energy Use Intensity Comparison (kbtu/sf/yr)

Baseline - 90.1 ASHRAE 2007 Compliance Design Case

$-

$20,000

$40,000

$60,000

$80,000

$100,000

$120,000

$140,000

$160,000

Heating Cooling InteriorLighting

InteriorEquipment

Fans Pumps DHW HeatRejection

Energy Cost Savings Comparison

Baseline - 90.1 ASHRAE 2007 Compliance Design Case

Whole Building Annual Energy Cost Breakdown

TOTAL ENERGY COST

End Uses

Baseline -

90.1 ASHRAE

2007

Compliance Design Case

Percent

Savings

Heating $ 77,315 $ 18,380 76%

Cooling $ 40,188 $ 39,410 2%

Interior Lighting $ 78,980 $ 38,208 52%

Interior Equipment $ 137,877 $ 135,297 2%

Fans $ 68,657 $ 73,448 -7%

Pumps $ 9,726 $ 9,585 1%

DHW $ 3,458 $ 1,037 70%

Heat Rejection $ - $ -

Total End Uses $ 416,201 $ 315,366 24%

Whole Building Energy Modeling Results

24% better than ASHRAE

38% energy savings

EUI: 142 kbtu/sf/yr

Targeting LEED Silver

Campus View

Overall Floor Plan

Partial Floor Plan

Exterior Design Options Reviewed

Building Exterior and Window Studies

Key Architectural Design Decisions

Building Location

Determined by campus master

planning

Building Orientation

Maintain existing Emergency

Department and Ambulance drop-off

Maximize Views

Respectful of existing campus

architecture

Existing site conditions


Façade design

Curtain wall design driven by patient

& family environment, aesthetics, &

energy efficiency

Balancing size of window with energy

efficiency

Solar Considerations

o Reducing Solar Gains

o Electro Chromatic Film


Wall System Overview

UVMMC OPR – Envelope Goals:

Energy Performance

Thermal Performance

Durability

Air Tightness: whole building/assembly

tightness .25CFM

West Wall Section

Air Tightness & Durability High-performance AVB transition assembly

at window opening

Detailing at offsets in plane at insulation,

cladding, and window.

Ensurs performance between adjacent

assemblies

Tighter detailing at corners

Maintains continuity of AVB

Cavity closure at wall

assemblies maintains

continuity of AVB transition at

curtainwall /window frame

East Wall Section

Metal Panel Assembly Pressure-equalized rain screen mitigates wind

driven rain

Pressure and drainage composed of

compartmentalized ventilation cavities that allow

pressure inside to match outside air pressure,

preventing moisture from being driven toward the

inner wall assembly

Ultra-Thermal Window System

Thermal Performance

Metal Panel Assembly

Use of EAI Thermal Clip System to drastically

reduce thermal bridging

Slotted Stainless Steel Masonry Tie Minimize conductivity, minimal thermal degradation

of continuous insulation

Patient Room

Family

Zone

Patient

Zone

Caregiver

Zone

Greeter & Nurse Station

Corridor

Corridor

Corridor

Tools and Resources

www.sustainabilityroadmap.org

The 2015 Vermont Commercial Building Energy Standard

http://codes.iccsafe.org/Vermont.html#2015

Act 250 Criterion 9F (Energy Conservation) Must Use Best Available

Technology https://energycode.pnl.gov/COMcheckWeb

2014 FGI Guidelines

ASHE Health Facility Commissioning Handbook

Health Facility Commissioning Handbook

Health Facility Commissioning Guidelines

EPA Energystar Program

Portfolio Manager/Target Finder

http://www.energystar.gov/buildings/service-providers/design/step-step-

process/evaluate-target/epa’s-target-finder-calculator

http://codes.iccsafe.org/Vermont.html

https://energycode.pnl.gov/COMcheckWeb

http://www.energystar.gov/buildings/service-providers/design/step-step-process/evaluate-target/epa’s-target-finder-calculator

CON STANDARD 1.9: Applicants proposing construction projects shall show that costs and methods of

the proposed construction are necessary and reasonable. Applicants shall show that the project is cost-

effective and that reasonable energy conservation measures have been taken.

CON STANDARD 1.10: Applicants proposing new health care projects requiring construction shall

show such projects are energy efficient. As appropriate, applicants shall show that Efficiency Vermont,

or an organization with similar expertise, has been consulted on the proposal.

CON Standards

Criterion 9(F) -- Energy Conservation: All projects must incorporate the best available technology for

energy efficiency and reflect principles of energy conservation, including reduction of greenhouse gas

emissions from the use of energy. All projects must also provide evidence that the project complies

with the applicable building energy standards under 30 V.S.A. § 51 or 53.

Commercial buildings (all buildings which are not residential buildings three stories or less) are

subject to Vermont’s Commercial Building Energy Standards (CBES) (3021 V.S.A. § 53). Applicants

must provide evidence that their project at least complies with the CBES. This can be done through

the web-based tool COMCheck. The CBES do not create a rebuttable presumption with respect to

Criterion 9(F). Therefore, the project must incorporate the best available technology for energy

efficiency and reflect principles of energy conservation, including reduction of greenhouse gas

emissions from the use of energy. For more information about CBES, contact the Public Service

Department at toll-free at 1-800-642-3281 (in-state only) or 802-8283183.

Act 250 Criteria 9(F) Energy Conservation

Evidence of compliance with the Commercial Building Energy Standards (CBES) does not

provide a presumption of compliance under criterion 9(F). Therefore, even if an applicant

provides the evidence necessary to demonstrate that a subdivision or development complies

with the CBES as required, the applicant still must meet the other explicit requirements of

criterion 9(F). Pursuant to 10 V.S.A. § 6086(a)(9)(F), an applicant must demonstrate “the

planning and design of the subdivision or development reflect the principles of energy

conservation, including reduction of greenhouse gas emissions from the use of energy, and

incorporate the best available technology for efficient use or recovery of energy.”

Act 250 Criteria 9(F) Energy Conservation