ENERGY MANAGEMENT PLAN for Cambridge Memorial Hospital Cambridge

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ENERGY MANAGEMENT PLAN for Cambridge Memorial Hospital Cambridge Powered By Docstoc
					ENERGY MANAGEMENT PLAN

             for

 Cambridge Memorial Hospital

     Cambridge, Ontario




                   ENVIROVEST ENERGY VENTURES INC.
                                2410 Bedell Road, RR # 5
                                  KEMPTVILLE, ONTARIO K0G 1J0
                                        envirovest@sprint.ca
Cambridge Memorial Hospital Energy Management Action Plan                                                                                                            Introduction




TABLE OF CONTENTS
1    INTRODUCTION .............................................................................................................................................................3
2    ACKNOWLEDGEMENTS ...............................................................................................................................................4
3    CAMBRIDGE MEMORIAL HOSPITAL PROFILE ........................................................................................................5
  3.1     Facility Overview.......................................................................................................................................................5
  3.2     Background ................................................................................................................................................................5
     3.2.1     Facility History...................................................................................................................................................5
     3.2.2     Occupancy Patterns and Capacities....................................................................................................................6
     3.2.3     Five Year Capital Plan .......................................................................................................................................7
     3.2.4     Facility Systems .................................................................................................................................................7
     3.2.5     Condition of Existing Equipment .....................................................................................................................13
  3.3     Projects Under Consideration ..................................................................................................................................13
     3.3.1     Major Rebuilding Plan1 ....................................................................................................................................13
  3.4     Energy Management Actions Under Investigation...................................................................................................14
     3.4.1     Boilers2 .............................................................................................................................................................14
     3.4.2     Co-Generation ..................................................................................................................................................15
     3.4.3     Lighting Retrofit...............................................................................................................................................15
     3.4.4     BAS System Enhancement ...............................................................................................................................16
     3.4.5     Fans and Motors...............................................................................................................................................16
4    ENERGY USE PROFILE................................................................................................................................................17
  4.1     Energy Consumption and Costs ...............................................................................................................................17
     4.1.1     Consumption and Costs....................................................................................................................................17
     4.1.2     Data Analysis ...................................................................................................................................................17
     4.1.3     Cost Calculation Methodologies ......................................................................................................................23
  4.2     Sources of Energy ....................................................................................................................................................24
     4.2.1     Electricity .........................................................................................................................................................24
     4.2.2     Emergency Power.............................................................................................................................................25
     4.2.3     Steam / Heating ................................................................................................................................................25
     4.2.4     Chilled Water ...................................................................................................................................................25
5    ENERGY AND ENVIRONMENTAL MANAGEMENT ...............................................................................................26
  5.1     Current Situation ......................................................................................................................................................26
     5.1.1     Energy Management Decision Making ............................................................................................................26
     5.1.2     Environmental and Energy Management Policy ..............................................................................................27
     5.1.3     GHG Emissions Goals and Targets..................................................................................................................27
     5.1.4     Monitoring and Verification.............................................................................................................................29
6    NEXT STEPS ..................................................................................................................................................................30
  6.1     Energy Management Policy Statement.....................................................................................................................30
  6.2     Energy Management Targets....................................................................................................................................30
  6.3     Energy Management Strategies ................................................................................................................................30
     6.3.1     Information, Training and Practises .................................................................................................................30
     6.3.2     Energy Efficiency Retrofit Measures ...............................................................................................................31
     6.3.3     Energy Efficient Building Replacement ...........................................................................................................32




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Cambridge Memorial Hospital Energy Management Action Plan                                     Introduction



1 INTRODUCTION

EnviroVest Energy Ventures Inc. was retained to develop an Energy Management and Greenhouse Gas
Plan (Plan) for the hospital’s Management Team.

This report is based on information collected during a walk-through site audit, through interviews with
key hospital employees, from a careful review of existing studies and documents pertaining to the
hospital, and through an assessment of the energy and water utility bills (records of energy consumption
patterns).




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Cambridge Memorial Hospital Energy Management Action Plan                               Acknowledgements



2 ACKNOWLEDGEMENTS

EnviroVest would like to express its gratitude to the staff of Cambridge Memorial Hospital whose help
is gratefully appreciated. In particular, we would especially like to thank Mr. Michael Sheehan, Mr. Joe
Gurney, Mr. Chris Wolnik and Mr. Frank Shawcross for their generous assistance.




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Cambridge Memorial Hospital Energy Management Action Plan         CAMBRIDGE MEMORIAL HOSPITAL PROFILE



3 CAMBRIDGE MEMORIAL HOSPITAL PROFILE

3.1 FACILITY OVERVIEW

Cambridge Memorial Hospital (Cambridge Memorial Hospital) is located at 700 Coronation Blvd.,
Cambridge, Ontario. The facility is located on the north bank of the Grand River, bordering the Galt
Golf and Country Club.

The facility consists of a single building complex made up of several units which were built at different
periods of time and whose condition, as a result, varies greatly. There are no other properties belonging
to this hospital.

3.2 BACKGROUND

3.2.1 FACILITY HISTORY

The Cambridge Memorial Hospital was constructed between 1954-1956. Major additions were made in
1963-1964, 1973-1974, and 1996. Currently, the overall square footage of the hospital is 388,000 square
feet (ft2).




      ‘C’ Block
                                   ‘A’ Block

                                               ‘B’                       ‘B’ Block
                                               Block
The original 5-storey hospital and 1-storey school of nursing were built in 1954. In 1956, a 2-floor
vertical addition was constructed on the westerly wing. A 1-storey cafeteria and a 5-storey patient wing
were added in 1965 to the west end of the hospital together with a mechanical room at the south end and
additions to the boiler plant.


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Cambridge Memorial Hospital Energy Management Action Plan               CAMBRIDGE MEMORIAL HOSPITAL PROFILE




‘C’ Block view, ‘A’ behind it.          ‘B’ Block view                        Back side of ‘B’ and ‘A” blocks.




‘A’ Block boiler house                  ‘C’ Block heat pumps.                 The Grand River is a potential
                                                                              natural heat sink



A major expansion occurred in 1973. This provided a new 2-level diagnostic and treatment podium and
3 floors of in-patient units on top adjoined to the north face of the 1965 addition. The majority of in-
patient beds are currently housed in this building.

A 3-level ambulatory care centre was opened in 1996. The facility is an addition to the east end of the
original hospital, adjacent to the former school of nursing.

The most heavily utilized diagnostic and treatment areas are located in the 1973 construction, as are
most in-patient facilities. The older areas provide accommodations for support facilities.

3.2.2 OCCUPANCY PATTERNS AND CAPACITIES

The hospital employs approximately 1200 people who work in shifts over the 24-hour period. During the
daytime, there are about 800 staff members in the building. Together with walk-in patients, there are
from 1000 to 1500 people occupying the building throughout the day.

The hospital has the capacity for:
Total Acute                      191 patients
Total Acute and Chronic          267 patients
Total Newborns                   28 patients




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Cambridge Memorial Hospital Energy Management Action Plan          CAMBRIDGE MEMORIAL HOSPITAL PROFILE



3.2.3 FIVE YEAR CAPITAL PLAN

The utility costs are paid from the hospital’s overall operating budget and the fiscal year is from April 1
to March 31.

The five-year capital plan forecasts1 capital budget requirements (over and above the hospital’s regular
maintenance) for the years 1997-2003 as:

Architectural $516,000
Mechanical     $600,000
Electrical   $1,250,000
Total        $2,366,000

3.2.4 FACILITY SYSTEMS

3.2.4.1    Heating Ventilation and Air Conditioning (HVAC) System Description

The heating system of the building is complex, consisting of several independent systems. The ‘C’ block
is heated by glycol-based heat pumps. The rest of the complex is heated by steam / hot water perimeter
radiators in conjunction with air handlers with heating coils. There also are several electric baseboards as
supplementary heaters scattered throughout the building.

3.2.4.2    Heating

Please see the digital photographs of the described equipment. A detailed survey of the boiler plant2 was
undertaken by Chorley & Bisset Ltd. in July 1999.

Heating for the entire facility is provided by 3 natural gas-fired steam boilers of different ages which are
located in ‘A’ Block. Diesel oil is used as an emergency fuel. The steam generating system consists of
three gas/oil – fired boilers, a condensate transfer tank and pumps, chemical water treatment subsystem,
a feed water system with pumps, deaerator and fuel storage.

Domestic soft water is produced in the adjacent water service room. The
chemical treatment system consists of secondary polishing softeners; a
de-alkalizer, a treated water storage tank, and feed water preheat system.

Boilers #1 and #2 are each rated at 300 hp; both were installed in 1973.
Boiler #3 was manufactured in 1973 as a 250 hp boiler, but was not
installed until 1983 when it was converted to a 300 hp unit. Some of the
auxiliary boiler room equipment dates back to the original time of
construction in the early 1950’s.

The normal life expectancy of boilers, as published by ASHRAE, is in           Boiler
the range of 25 to 30 years.

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                                      Boilers #1 and #2 are in relatively good condition, although they
                                      require frequent attention by maintenance personnel. The condition
                                      of Boiler #3 is poor and is always online during winter months and
                                      is used for peak conditions only. The boilers were equipped with
                                      1980 economizers that require replacement.

                                      The existing chimney (masonry) is in relatively poor condition;
                                      repairs are needed to the deteriorating brickwork. If new high-
                                      efficiency boilers are installed, it will be necessary to install an
In –Operational Economizer            internal stainless steel liner inside the chimney.

Two oil pumps are located in Fan Room #1 of the 1974 building. They transfer oil into a 5000-gallon
indoor free standing storage tank located in the Annex Room on the east side of the Boiler Room. Two
oil pumps supply fuel to 3 boilers. The pumps date from 1965 but seem to be in good condition. The
penthouse also contains the steam to water heat exchanger used to supplement the heating.

‘C’ block is served by a series of ceiling mounted water-to-water heat pumps (type 50HQA) by Carrier.
The compressor unit for the system is located in a ‘penthouse’ on the roof of ‘C’ Block.

‘B’ block contains a mechanical room which houses a number of built up air handling systems that serve
the five-story tower. The single story section of ‘B” block has a dedicated mechanical penthouse which
also contains dedicated air handling systems with heating coils. The air handling units in ‘B’ block are
beyond their useful life, are single wall construction and do not contain filtration systems beyond that
satisfied current standards. The B mechanical room is also used as a return air plenum, which is not
accepted as present good engineering practice. All of the air handling units in blocks ‘A’ and ‘B’ are
monitored and controlled by the BAS.

3.2.4.3    Cooling
                                                           The major cooling is provided by two 500-
                                                           ton centrifugal Trane chillers (CVHE-IN-8),
                                                           which are located in the boiler house and
                                                           the cooling tower. These two units have
                                                           recently replaced the old single 800-ton
                                                           unit. According to hospital personnel, the
                                                           chiller system is water based (instead of
                                                           glycol), rusts and needs draining/charging
  “B” Block cooling tower              Chiller
                                                           every year.
                                                           Switching to glycol variant instead of water
requires an investment of about $80,000. This should be considered in future if any HVAC changes are
proposed. Water in the area

is hard and creates extra problems for the chillers. The hospital has just purchased a water-softening
station. This will significantly reduce water consumption.

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Besides the central chilling system, there are also several window-located independent air-conditioning
units in different rooms.

3.2.4.4    Domestic Hot Water

                                   Domestic hot water (DHW) is provided by steam–to–water heat
                                   exchangers. There are three of these in Mechanical Room #1, each
                                   with a capacity of 20-U.S.gallons-per-minute. These units are not
                                   controlled by the BAS, but have their own pneumatic controls. The
                                   hot water circulation pumps run 24 hours per day, regardless of
                                   changes in demand. Storage tank water temperature is maintained at a
                                   minimum 140o to prevent bacterial growth. The condition of storage
                                   tanks is not known.

                                   The ‘A’ Block is equipped with another steam-to-water heat
                                   exchanger, which is also not under control of BAS and has a
                                   constantly running circulating pump. There are several instantaneous
                                   water heaters, ‘FLO-RITE-TEMP ®, model 535’, used for medical and
  3 Main DHW Heat Exchangers       sterilization purposes; these are located in Ambulatory Care.

3.2.4.5    Ventilation Fans and Other Motors

The air handling system dates from the original construction and is inefficient.

Management reports that there is unsatisfactory airflow in most sections of the building, which is not
compliant with modern ASHRAE requirements. The requirements for hospital buildings do not allow
the switching off of some fans. The institution is considering the modernization of the air handling
equipment. They report that the major problem with air handling is that some areas of the building are
normally under negative pressure.

There are many oversized and old motors in this system. They are being replaced with high efficiency
and often less powerful motors by hospital maintenance on an as required basis. A hard copy motor
database does exists. With few exceptions, all motors are original; they range in age up to 44-years old.

Two years ago there was a project under consideration to replace all the air handler units but it was
cancelled due to lack of funding.

The major exhaust fans and air-handling units are under control of the BAS. Simple switches manually
control most other fans. None of the motors have variable speed frequency control.

3.2.4.6    Pumps




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As with the motors in the air handling fans’ motors, there are many oversized motors. The majority of
these pumps (except 10) are not controlled by BAS; many of them run 24 hours a day regardless of
demand. Hospital maintenance staff is replacing the pumps with smaller, more efficient ones as the old
motors fail.

3.2.4.7    Elevators

There are 9 elevators within different wings of the hospital:

2 hydraulic in the ambulatory care addition
3 gear elevators in the 1954 wing – 2 passengers and 1 freight
2 geared passenger elevators in the 1965 addition
2 geared service elevators in the 1973 addition

The age of each elevator corresponds to the age of the wing in which it was installed. 3rd party
contractors maintain all elevators.

3.2.4.8    Kitchen Equipment

The kitchen was completely refurbished and re-equipped with the 1973 addition. In 1999, CMH installed
a complete “cold-plating” with re-therm units. The 1974 vintage equipment is not used extensively at
this time. The kitchen exhaust system is now used to extract warm air from the kitchen area. The fan is
oversized for the present use.

3.2.4.9    Asbestos

An asbestos survey, carried out during the early 1990s, identified that asbestos was utilized in the
insulation for steam and hot water piping, as well as in some floor tiles and ceiling tiles.

3.2.4.10   Building Automation System

The Johnson Controls “Metasys” system is installed in the building. The system is under-utilized and
performs only limited functions. The use of the BAS is limited to monitoring the major metering points
in the electric system. It controls the air handler fans start/stops, boiler operation, and monitors and
controls the major pumps’ start/stops, and monitors the reserve fuel (Diesel) tank level. A major concern
with this BAS is that it is not capable of properly serving the needs of those hospital departments that
shut down over the weekend. As a result, these areas either overheat during unoccupied hours, or require
very long preheating times during which employees are already at work. Another important issue is that
hospital personnel admit they are not adequately trained in the use of the existing system and it is
therefore not being utilized to its full potential.

Since there are no variable speed motors in the building’s systems, the capabilities of the BAS (which
can effectively control them) are currently underutilized.



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3.2.4.11   Meters

There are 1 electric, 1 natural gas and 2 water meters for billing purposes. Steam and chilled water are
not metered.

3.2.4.12   Compressed Air

Compressed air is used for control purposes. A separate system (a liquid seal type) is used for purely
medical needs. The compressors are in good condition. The BAS does not monitor them.

3.2.4.13   Walls

The masonry was thoroughly inspected3, by Trow Consulting Engineers Ltd in 1999. They discovered
problems with the masonry in the 1956 and 1964 sections of the hospital. Some walls of the oldest part
of the building experience poor ventilation within the internal spaces of their bricks. As a result, freezing
occurs inside these spaces in winter, causing pieces of brick to break off. Major restoration is required in
some areas. Walls within the 1974 section require some maintenance (also due to poor venting on top of
the bricks). The hospital’s 1996 addition is in relatively good shape. The masonry’s deterioration is
concentrated on the top floors, roof parapet walls, under the stone accent strips at ground level, along the
shelf angles, and at pavement levels.

3.2.4.14   Roof

Trow Consulting Engineers Ltd. inspected the Roofing System of the Cambridge Memorial Hospital
roof4 in 1999. The 1956 and 1964 sections have built-up roofs. The 1974 roof consists of a single layer
on a concrete under-layer. It is of very poor quality and leaks heavily through to the concrete under-layer.
With the exception of the 1996 addition, these roofs are old and need to be replaced. The “R” values of
all roofs, with the exception of ‘C’ block, is below present standards.

3.2.4.15   Doors and Windows

Windows in the 1956 section are double-glazed with aluminum frames. Weather stripping is worn and
open/close mechanisms fail and should be replaced. Windows in the 1974 section have poor weather
stripping; they need to be replaced or recaulked. Windows in the 1996 section are aluminum and in good
shape.

3.2.4.16   Lighting System

The 1996 addition was constructed with modern T8 lighting fixtures with electronic ballasts. The rest of
the lighting in the building is T12 with electromagnetic ballasts.

The following table represents the estimated quantities of different types of lighting equipment
(precision of this calculation is about ]5%):

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Cambridge Memorial Hospital Energy Management Action Plan                 CAMBRIDGE MEMORIAL HOSPITAL PROFILE




                                                                      Tubes/Bulbs
 T12 tubes (total):                                                   6021
 Out of these:   T12 with old electromagnetic ballasts                5711
                 T12 with ballasts replaced by electronic ballasts    310
 T8 tubes with electronic ballasts                                    1182
 Compact fluorescent lights (small)                                   255
 Compact fluorescent lights (large)                                   166
 Incandescent bulbs (60 & 75 Wt)                                      549
 Incandescent bulbs (150 Wt)                                          24
 Halogen                                                              51

The following provides the hospital’s outdoor lighting:

 Location                                           Type of lamps                             Qty
 Main Visitors’ Lot                                 R250 Mercury Vapor (HR250 DX 37)          22
 Centre Pole                                        1000 Wt High Pressure Sodium              1
                                                    (Lu 1000)
                                                    400 Wt HPs (Lu 400)                       10
 Along River                                        400 Wt Mercury vapor                      2
 Front                                              400 Wt Mercury vapor
                                                    1000 Wt Mercury Vapor. (H36 GWDX
                                                    1000)
                                                    175 W Mercury Vapor (H39 Ballast)         2
                                                    125 W Mercury Vapor (HR 75DX43)           9
                                                    70 W HPS (C70S62/D/N)                     3
                                                    150 W Incandescent                        9

3.2.4.17 Water / Sewer

All faucets, showers and toilets in the building are manually operated. There are no automatic flushes,
presence detectors or any other automated consumption restriction devices. The general quantities of
equipment are:

 Equipment                                                     Qty
 Sinks (all with hot and cold water)                           411
 Toilets (of both tank and flow type)                          238
 Showers                                                       44
 Bathtubs                                                      18

Other major water-consuming equipment in the building includes:

•          A cart wash


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Cambridge Memorial Hospital Energy Management Action Plan           CAMBRIDGE MEMORIAL HOSPITAL PROFILE



•         Dish washer in the kitchen
•         Medical air compressor (water operated)
•         Two cooling towers
•         Boilers blow down/walkup
•         Reverse Osmosis unit

3.2.4.18 Vehicle Fleet

The hospital does not have a vehicle fleet.

3.2.5 CONDITION OF EXISTING EQUIPMENT

In general the existing water and energy consuming equipment is old and in need of replacement. Since
the construction of the early phase of the hospital many new technologies have been introduced into the
marketplace. Many of these technologies are more efficient.

3.2.5.1   Electrical

A recent study by Chorley and Bisset Ltd. TO REVIEW THE CURRENT CONDITION OF THE MAIN
SWITCHBOARD AND SECONDARY PANELS RECOMMENDS THAT A TOTAL
REPLACEMENT BE SCHEDULED AS PART OF THE master Plan implementation. The primary
electric plant is of 1974 vintage and therefore may require replacement within 10 years and the branch
circuit wiring varies in age. Most electrical systems are the original systems installed at the time of
construction and have exceeded their design life.

3.2.5.2   Mechanical

Most of the boiler plant was replaced in 1973-74. The boilers and the air handling system need
replacement.

3.3 PROJECTS UNDER CONSIDERATION

Hospital management identified the following list of potential projects.

3.3.1 MAJOR REBUILDING PLAN1

At a special meeting on February 10, 2000, the hospital’s Board of Directors approved the Revised
Master Plan for Cambridge Memorial Hospital. It includes the construction of a new wing (“River
Wing”) facing the Grand River – parallel and behind the ‘A’ Wing. Once the new wing is operational,
the 50-year-old ‘A’ Wing will be demolished. The Revised Master Plan will be submitted to the Health
Restructuring Implementation Team in the Ministry of Health. Reconstruction plans, financing and
approvals were not yet finalized at the time of this report’s preparation. If this building’s reconstruction



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Cambridge Memorial Hospital Energy Management Action Plan           CAMBRIDGE MEMORIAL HOSPITAL PROFILE



is approved, energy efficiency designs will be incorporated into its rebuilding plan. The following sketch
shows the proposed layout of the Cambridge Memorial Hospital.




          Proposed ‘River’
          Wing to be added



          ‘A’ block to be
          demolished and
          replaced with
          parking lots



3.4 ENERGY MANAGEMENT ACTIONS UNDER INVESTIGATION

A draft program aims toward the “development of most suitable energy efficiency undertakings and not
to overlap with designed reconstruction.” Final plans for this reconstruction are not yet approved and
may be subject to major change.

3.4.1 BOILERS2

•         Boiler replacement: co-generation facilities are desired, but it is difficult for the management
          to agree on the generating / electricity selling rules with the Ministry of Health (this project is
          deferred).
•         In connection with major re-building plans, the estimated future peak load was estimated by
          Chorley & Bisset Ltd at approximately 640 hp. The existing boiler capacity is 900 hp. (the
          reliability of the present system is to be considered a primary concern). A new boiler plant is
          recommended by Chorley & Bisset Ltd2 in their July 1999 study.
•         It was estimated that a new boiler plant would operate considerably more efficiently than the
          existing one.
•         Savings Estimates: annual savings of $14,000 in water treatment chemicals, fuel savings of
          $40,000, additional savings resulting in the reduction of annual operating costs should be in
          the range of $55,000-$65,000.

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•         The total boiler replacement project cost has been estimated at $1,350,0002.
•         Major upgrade of the water heating system was recommended.

3.4.2 CO-GENERATION

The proposal5 developed by Trigen Canada proposes the creation of a third-party co-generation
partnership.

•         According to this proposal, the hospital would enter into a 20-year energy supply agreement
          with Trigen under which Trigen supplies steam, hot water, chilled water and electricity to the
          Cambridge Memorial Hospital.
•         Trigen proposes to install a gas-fired reciprocating engine co-generation plant and replace the
          existing boiler plant and control equipment. Trigen has also offered to operate and maintain
          the new equipment, and install and supply all steam, chiller water metering equipment.
•         Trigen has developed a detailed energy supply charge structure and has submitted the
          following future load calculations, taking into account future additions (i.e. the “River Wing”).

Trigen’s Future Load Calculation:

                            Current SQ FT=366,000                  Future SQ FT=458,000
                            kW               KWh                   kW               KWh
Total Elec.                 1,544            6,661,156             2,315            8,978,134
Chilling Elec.              554              918,225               1066             1,768,725
Boiler Plant Elec.          48               117,749               70               170,248
Balance = General Elec.     942              5,625,181             1178             7,039,161

The dollar savings on electricity is estimated to be $27,171 (or 6%) per year.

The major objectives/outcomes of this project are:

•   Use capital for direct patient care as intended
•   Create long-term relationships with energy experts
•   Extend energy capacity with co-generation
•   Enable strategic management of energy supply
•   Take advantage of other markets
•   Provide energy savings of up to 6% annually

3.4.3 LIGHTING RETROFIT

Currently, T-12 lights and ballasts are replaced with T-8 technology when the existing fixtures require
replacement. A major lighting modernization is under consideration whereby the existing inefficient
lighting would be replaced with modern technologies. Examples of some options are: the conversion of
the existing T12/Electromagnetic ballast fluorescent fixtures with T8 fluorescent tubes and electronic

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ballasts, the replacement of current Exit Lights with LED Exit lights, and the use of photocells and
occupancy sensors where appropriate.

3.4.4 BAS SYSTEM ENHANCEMENT

Modifications to the existing control / monitoring system whereby it could be expanded and re-
commissioned to better control the existing equipment and to control the balance of the systems in the
building are seen as potential projects.

3.4.5 FANS AND MOTORS6

The introduction of frequency–controlled, variable speed motor drives and the replacement of old motors
with new high efficiency motors at the time of replacement were identified as energy efficiency methods.




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Cambridge Memorial Hospital Energy Management Action Plan                                                             ENERGY USE PROFILE



4 ENERGY USE PROFILE

4.1 ENERGY CONSUMPTION AND COSTS

4.1.1 CONSUMPTION AND COSTS

The billing information for all utilities has been collected in order to establish the baselines and enable
the further tracking of energy efficiency undertakings. The billing information is presented in Appendix
B. The following table shows overall intensities of energy consumption and related costs:


  Utility Consumption and
          Intensities

                            Total area    Occupancy       ELECTRICITY
                                                           consumption    cost      consumption per consumption per    cost per         cost per
                                                                                         sq.m          occupant        sq.meter        occupant
            Year               m2        Staff+Patients       kWh           $          kWh/m2          kWh/person       $/m2           $/person
   Year ending 31/03/1997      36,045             1,300        6,304,396 $415,980          174.91           4849.54        $11.55         $319.99
   Year ending 31/03/1998      36,045             1,300        6,642,987 $435,418           184.3           5109.99        $12.08         $334.94
   Year ending 31/03/1999      36,045             1,300        6,973,273 $456,151          193.46           5364.06        $12.66         $350.89

                            Total area    Occupancy       Natural Gas
                                                           consumption    cost      consumption per consumption per    cost per         cost per
                                                                                         sq.m          occupant        sq.meter        occupant
            Year               m2     Staff+Patients           m3           $           m3/m2          m3/person        $/m2           $/person
   Year ending 31/03/1997      36,045         1,300            1,410,047 $179,286           39.12           1084.66            $4.98      $137.92
   Year ending 31/03/1998      36,045         1,300            1,258,256 $179,639           34.91            967.89            $4.99      $138.19
   Year ending 31/03/1999      36,045         1,300            1,514,569 $198,767           42.02           1165.06            $5.52      $152.90

                            Total area    Occupancy       Water and
                                                           Sewer
                                                           consumption    cost      consumption per consumption per    cost per         cost per
                                                                                         sq.m          occupant        sq.meter        occupant
            Year               m2     Staff+Patients           m3          $            m3/m2          m3/person        $/m2           $/person
   Year ending 31/03/1997      36,045         1,300             105,909 $131,077                2.94          81.47            $3.64      $100.83
   Year ending 31/03/1998      36,045         1,300              94,098 $119,944                2.62          72.39            $3.33        $92.27
   Year ending 31/03/1999      36,045         1,300             105,811 $124,214                2.94           81.4            $3.45        $95.55


4.1.2 DATA ANALYSIS

The following charts summarize consumption and cost data for the Cambridge Memorial Hospital.




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Cambridge Memorial Hospital Energy Management Action Plan                                                                  ENERGY USE PROFILE



4.1.2.1                                  Electricity


                                           Cambridge Memorial Hospital Electricity Consumption

                                900000
                                800000
   Consumption (kWh




                                700000
                                600000
                                                                                                        $SU   0DU 
                                500000                                                                  $SU  0DU 
                                400000                                                                  $SU   0DU 
                                300000                                                                  $SU   FXUUHQW
                                200000
                                100000
                                     0
                                          Apr May Jun   Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                                  Months




                                            Cambridge Memorial Hospital Daily Electricity Consumption
   Consumption / day (kWh/day




                                30,000

                                25,000

                                20,000                                                                  Apr 96 - Mar 97
                                                                                                        Apr 97 - Mar 98
                                15,000
                                                                                                        Apr 98 - Mar 99
                                10,000                                                                  Apr 99 - current

                                 5,000

                                    0
                                          Apr May Jun   Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                                 Months




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Cambridge Memorial Hospital Energy Management Action Plan                                                         ENERGY USE PROFILE




                                      Cambridge Memorial Hospital Electricity Demand

                         1800
                         1600
                         1400
   Demand (kW)




                         1200
                                                                                               $SU   0DU 
                         1000                                                                  $SU  0DU 
                          800                                                                  $SU   0DU 
                          600                                                                  $SU   FXUUHQW
                          400
                          200
                            0
                                  Apr May Jun    Jul   Aug Sep Oct Nov Dec Jan Feb Mar
                                                           Months




                                        Cambridge Memorial Hospital Electricity Cost

                         $50,000
                         $45,000
   Electricity cost ($




                         $40,000
                         $35,000
                         $30,000
                                                                                               $SU  0DU 
                         $25,000
                                                                                               $SU   0DU 
                         $20,000
                                                                                               $SU   0DU 
                         $15,000
                                                                                               $SU   FXUUHQW
                         $10,000
                          $5,000
                              $0
                                   Apr May Jun     Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                            Months



                                         Cambridge Memorial Hospital Daily Electricity Cost


                         $1,600
   Cost per day ($/day




                         $1,400
                         $1,200
                                                                                               Apr 96 - Mar 97
                         $1,000
                                                                                               Apr 97 - Mar 98
                          $800
                                                                                               Apr 98 - Mar 99
                          $600
                                                                                               Apr 99 - current
                          $400
                          $200
                            $0
                                   Apr May Jun    Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                           Months




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Cambridge Memorial Hospital Energy Management Action Plan                                                         ENERGY USE PROFILE




4.1.2.2                                 Natural Gas

Regarding gas consumption and costs calculations, it should be noted that there is only one meter in the
facility, therefore the natural gas volume (M3) values shown in the "Gas Consumption" chart are the ones
reported in Union Gas bills. The cost of gas is assembled from monthly payments to Union Gas (delivery
fee + gas supply fee + taxes) and monthly payments to ECNG bulk supplier (gas supply fee, which
replaces the Union Gas's one, + ECNG fees + taxes).


                                        Cambridge Memorial Hospital Natural Gas Consumption

                               450000
                               400000
                               350000
   Consumption (m3




                               300000                                                          $SU   0DU 
                               250000                                                          $SU  0DU 
                               200000                                                          $SU   0DU 
                               150000                                                          $SU   FXUUHQW
                               100000
                                50000
                                    0
                                         Apr May Jun   Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                               Months



                                        Cambridge Memorial Hospital Daily Natural Gas Consumption


                               16,000
   Consumption / day (m3/day




                               14,000
                               12,000
                               10,000                                                          Apr 96 - Mar 97
                                                                                               Apr 97 - Mar 98
                                8,000
                                                                                               Apr 98 - Mar 99
                                6,000                                                          Apr 99 - current
                                4,000
                                2,000
                                   0
                                        Apr May Jun    Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                               Months




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Cambridge Memorial Hospital Energy Management Action Plan                                                              ENERGY USE PROFILE




4.1.2.3                                  Fuel Oil

Fuel Oil is used as a back-up energy source. See Appendix B for all available data on oil costs and
consumption. Oil is not used regularly and is stored only for emergency purposes. The analysis of
consumption patterns is not possible.

4.1.2.4                                  Water and Sewer


                                             Cambridge Memorial Hospital Water Consumption

                               18000
                               16000
                               14000
   Consumption (m3




                               12000
                                                                                                    $SU   0DU 
                               10000                                                                $SU  0DU 
                               8000                                                                 $SU   0DU 
                               6000                                                                 $SU   FXUUHQW
                               4000
                               2000
                                     0
                                          Apr May Jun    Jul    Aug Sep Oct Nov Dec Jan Feb Mar
                                                                    Months




                                             Cambridge Memorial Hospital Daily Water Consumption


                               600
   Consumption / day (m3/day




                               500

                               400                                                                  Apr 96 - Mar 97
                                                                                                    Apr 97 - Mar 98
                               300
                                                                                                    Apr 98 - Mar 99
                               200                                                                  Apr 99 - current

                               100

                                0
                                         Apr May Jun    Jul    Aug Sep Oct Nov Dec Jan Feb Mar
                                                                   Months




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Cambridge Memorial Hospital Energy Management Action Plan                                                        ENERGY USE PROFILE




                                           Cambridge Memorial Hospital Water Cost

                         $25,000
   Total Water Cost ($




                         $20,000

                         $15,000
                                                                                              $SU  0DU 
                                                                                              $SU   0DU 
                         $10,000
                                                                                              $SU   0DU 
                                                                                              $SU   FXUUHQW
                          $5,000

                                $0
                                     Apr May Jun     Jul Aug Sep Oct Nov Dec Jan Feb Mar
                                                              Months




                                           Cambridge Memorial Hospital Daily Water Cost


                         $700
   Cost per day ($/day




                         $600
                         $500
                                                                                              Apr 96 - Mar 97
                         $400                                                                 Apr 97 - Mar 98
                         $300                                                                 Apr 98 - Mar 99
                                                                                              Apr 99 - current
                         $200
                         $100
                           $0
                                 Apr May Jun       Jul   Aug Sep Oct Nov Dec Jan Feb Mar
                                                             Months




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Cambridge Memorial Hospital Energy Management Action Plan                                                              ENERGY USE PROFILE



4.1.3 COST CALCULATION METHODOLOGIES

4.1.3.1                Consumption Costs

All consumption costs are detailed in Appendix B.

4.1.3.2                Baseline

Please see Appendix C for a discussion of the methodologies used to calculate utility information.

4.1.3.3                CO2 Emissions

CO2 emissions and related greenhouse gas levels will be calculated using VCR data (August 1999
guidelines).

                                                           Direct emissions                              Indirect emissions
                                      Natural gas   Diesel
Period                               consumption consumption             CO2      CH4 N2O Electricity consumption              CO2      Total CO2
                                         m3         liters              tonnes   tonnes tonnes      kWh                       tonnes     tonnes


year ending 31/03/97                       1,410,047     175,652    3,194        0.089   0.031   6,304,396             1,134,792       1,137,986

year ending 31/03/98                       1,258,256               0 2,366       0.061   0.026   6,642,987             1,195,738       1,198,104

year ending 31/03/99                       1,514,569               0 2,847       0.073   0.031   6,973,273             1,255,190       1,258,037




                       Cambridge Memorial Hospital Total CO2
                                   Emissions

                 1,300,000
                 1,250,000
    Tonnes CO2




                 1,200,000

                 1,150,000
                 1,100,000

                 1,050,000
                             year ending           year ending           year ending
                              31/03/97              31/03/98              31/03/99
                                                       Years




It should be noted that total Carbon dioxide emissions include both direct (from natural gas
consumption) and indirect for electrical consumption.




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Cambridge Memorial Hospital Energy Management Action Plan                                 ENERGY USE PROFILE




                       Cambridge Memorial Hospital Total CH4 Emissions

                 0.1

                0.08
   Tonnes CH4




                0.06

                0.04

                0.02

                  0
                        year ending 31/03/97 year ending 31/03/98 year ending 31/03/99
                                                    Years




                        Cambridge Memorial Hospital Total N2O
                                    Emissions

                0.032
                0.031
                 0.03
   Tonnes N2O




                0.029
                0.028
                0.027
                0.026
                0.025
                0.024
                0.023
                         year ending 31/03/97 year ending 31/03/98 year ending 31/03/99
                                                     Years




4.2 SOURCES OF ENERGY

4.2.1 ELECTRICITY

A ‘Cambridge and North Dumfries Hydro’ overhead 27.6 kV line runs north south along the property’s
eastern boundary. A tap is made from this line via a two-pole structure opposite the new ambulatory unit.
Mounted on this structure are a load breaker, power fuses and cable terminators (constructed in 1974).
High voltage cables are run underground to a metal enclosed outdoor substation – 2500 kVA transformer
with secondary 347/600 volts.

There are 3 electrical rooms with switchboards and breakers in the building.

Electrical power is currently purchased from Cambridge and North Dumfries Hydro. The hospital has a
maximum demand of 1375 Amperes (summer peak). The peak load is 55% of the transformer capacity.


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Cambridge Memorial Hospital Energy Management Action Plan                              ENERGY USE PROFILE



4.2.2 EMERGENCY POWER

An emergency power generator was installed in 1974: a 650 kW, 347/600-volt unit. It is located in the
dedicated room, air cooled with a caterpillar engine and tamper generator. Fuel (diesel) is stored in two
tanks in the engine room.

4.2.3 STEAM / HEATING

Steam-generating boilers are located in the Block ‘A’ and are surveyed in [6].
The steam loads were recorded in 1999 as:

                                     Base             Peak
Summer                               1200 lb/hr       4000 lb/hr
Winter                               9000 lb/hr       15000 lb/hr

The boilers are all over 25-years old and nearing the end of their life expectancy. Boiler #3 is in very
poor condition and requires replacement.

Although the condition of boilers # 1 and #2 is reasonably good, necessary repairs are increasing2.

The summer base steam load is substantially below the burner minimum of one boiler. This causes short
cycling of the burner and accelerated aging of the heat exchanger.

The condition of the auxiliary plant equipment varies. Some equipment has been replaced recently.
However, equipment in notably poor condition includes the water softeners, associated controls, two of
the three boiler feed water pumps, and the chimney.

Though equipment exists for feed water preheating and blow down heat recovery, these subsystems are
no longer operational.

The overall boiler plant’s operating efficiency is in the range of 70%. Management estimates that it is
10%-15% less efficient than boiler plants utilizing modern equipment.

4.2.4 CHILLED WATER

This is not presently metered.




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Cambridge Memorial Hospital Energy Management Action Plan                         Energy and Environmental management



5 ENERGY AND ENVIRONMENTAL MANAGEMENT

5.1 CURRENT SITUATION

According to Cambridge Memorial Hospital personnel, there are no separate energy or water efficiency
budgets available. All funding is allocated by primacy of medical need and energy efficiency investments
are normally not considered a priority compared with health care needs. However, energy and water
efficiency is designed into capital projects where appropriate.

5.1.1 ENERGY MANAGEMENT DECISION MAKING

The following chart represents the decision making hierarchy for decisions related to energy /
environment policies and projects.


                                                  CEO




                                          Manager Property and
                                               Materials




                Maintenance                    Construction                   Environment
             (Also consumption
                monitoring)


The Cambridge Memorial Hospital Environmental Policy Overview [2] defines the roles and
responsibilities of Cambridge Memorial Hospital’s specially created Green Team:

1.   The Green Team will:
         • Review the policy annually
         • Make recommendations to the Program Managers Committee (annually).

2.   The Program Managers Committee will:
         • Review the Green Team recommendations and decide upon changes to the policy.

3.   The Environmental Coordinator (Mr. Chris Wolnik) will revise the policy as requested by the Program Managers
     Committee.

4.   The CEO will present the proposed policy changes, revisions, and additions to the Board of Directors for review and
     endorsement.

5. The Environmental Coordinator will then re-communicate the policy to all staff, employees and the community
     (annually).



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Cambridge Memorial Hospital Energy Management Action Plan            Energy and Environmental management



5.1.2 ENVIRONMENTAL AND ENERGY MANAGEMENT POLICY

Prior to the change of management in 1995, there were no energy management programs. The major
motivation for energy efficiency undertakings is “operational costs savings”. There is no formal written
energy efficiency policy statement; rather energy management is incorporated into the Environmental
Policy Statement [2] and the institution’s participation in the ISO 14001 Standard.

                                  CAMBRIDGE MEMORIAL HOSPITAL
                                     ENVIRONMENTAL POLICY

  In fulfilling its mandate to provide high quality health care services to the citizens of Cambridge
  and North Dumfries, Cambridge Memorial Hospital will do so in a manner that minimizes undue
  risk and adverse environmental impacts on human health, and the natural environment.
  In doing so, CMH shall as a minimum comply with, or when possible exceed all legal and other
  requirements to which the hospital subscribes, through the application of sustainable development
  principles (balancing environmental, economic, and social and health consideration). We will strive
  for continual improvement in our environmental performance through the prevention of pollution,
  and the optimization of energy efficiency in our everyday activities. We will accomplish this by
  setting and reviewing environmental objectives and targets on a regular basis. We will be
  responsive and sensitive to legitimate community concerns.


All records relating to the EMS are identified, collected, stored and maintained to provide objective
evidence of conformance to the ISO 14001 Standard. These records include training records, EMS Audit
results and the results of Monitoring and Measurement.

5.1.3 GHG EMISSIONS GOALS AND TARGETS

The “Environmental Management System Indicators” of the hospital’s management states the following
historical data:

                             1990 baseline            1997/98
Natural gas consumption      1,483,646 m3             1,617,610 m3 (+9%)
CO2 emissions - direct       2800 tonnes              3040 tonnes
CH4 emissions                71 tonnes                77 tonnes
N2O emissions                0.298 tonnes             0.03235 tonnes
Total direct GHG             2871 tonnes              3117 tonnes
emissions
Emission/ft2                 0.0080646 tonne/ft2      0.0080751 tonne/ft2

There are no quantitative GHG goals or targets at this time.




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Cambridge Memorial Hospital Energy Management Action Plan                         Energy and Environmental management



The Green Team of Cambridge Memorial Hospital, however, maintains and very successfully
implements the following set of Environmental Objectives, Targets and Accomplishments:

1999 Objective                                  1999 Target                               1999 Accomplishment
1. Increase diversion of glass, can newspaper   20% increase in recyclables by Q2/99      40% increase
and cardboard from waste stream
2. Reduce amount of white paper being land      25% reduction of paper disposal           Significant
filled.
3. Reduce amount of biomedical waste            30% reduction by Q3/99                    21.3% reduction achieved

For the year 2000, the Institution established four Environmental Objectives and Targets:

1. Pesticide Usage. Objective: to introduce integrated pest management into hospital landscaping
   practices. Target: to achieve zero chemical application on Cambridge Memorial Hospital grounds.
2. Packaging Waste. Objective: to improve staff awareness of the environmental impact of packaging
   waste. Target: to decrease the quantity of supplier packaging from 5 products purchased.
3. Energy Conservation. Objective: to increase energy conservation awareness as a means of reducing
   hospital-wide energy consumption. Target: to increase the number of instances where energy
   conservation is considered a part of the new product evaluation process.
4. Chemical Substitution. Objective: to explore opportunities for chemical substitution for hazardous
   chemicals. Target: to eliminate 5 hazardous chemicals from daily activities.

5.1.3.1      Energy Conservation Objective

The hospital’s “Energy Conservation” objective, in the form of increased staff awareness, is incorporated
into Cambridge Memorial Hospital’s 2000 Objectives and Targets (see above).

Success in meeting this objective will be measured by:

    •     % of hospital staff who participate in voluntary lunchtime training seminars
    •     The number of initiatives implemented to reduce energy consumption
    •     The reduction of tonnes of GHG emissions

5.1.3.2      Energy Conservation Action Plan

    1. Develop a hospital-wide challenge program to encourage individuals and departments to be
       energy conscious.
    2. Work with purchasing staff and the Product Evaluation Committee to ensure energy conservation
       is built into new product evaluation processes.
    3. Plan and deliver a lunchtime seminar on energy efficiency and its link to greenhouse gases,
       climate change and global warming.




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Cambridge Memorial Hospital Energy Management Action Plan             Energy and Environmental management



The “Environmental Management System Indicators” (Document Number EMSI-001) states Energy and
Fuel Consumption under “Other Environmental Issues”:

                                     Total 1999             % Change from 1998
Energy Consumption                   6,980,374 kWh          +4.75%
Fuel Consumption – Natural Gas       1,533,029 m3           -5.5%
Greenhouse Gas Emissions             2988 tonnes            -4.3%

5.1.4 MONITORING AND VERIFICATION

The energy costs of this hospital are monitored and statistically analyzed at the accounting level, and
technical personnel record the daily patterns of steam, electricity and gas consumption.

However, there is no monitoring system in place that compares differences in the baseline consumption
rates as a direct consequence of energy efficiency undertakings.




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Cambridge Memorial Hospital Energy Management Action Plan                                       Next Steps



6 NEXT STEPS
The Cambridge Memorial Hospital initiated an Energy Conservation Plan under its Environmental
Management Plan (ISO 14001 Standard) for the year 2000. The key actions are focused at raising the
awareness of energy efficiency opportunities and their relationship to Canada’s Climate Change
Challenge amongst staff and employees

A number of key enhancements to the policy and energy management plan were identified in discussions
with the management of Cambridge Memorial Hospital. The following changes are proposed for
inclusion in the plan.

6.1 ENERGY MANAGEMENT POLICY STATEMENT

The Cambridge Memorial Hospital will demonstrate environmental leadership in its community through a
comprehensive energy and water efficiency program.

The Cambridge Memorial Hospital will implement all economic energy and water efficiency measures
as long as they pay for themselves; improve the health care environment for our staff and patients.

It is understood that the Cambridge Memorial Hospital will not spend more for water and energy than it
otherwise would have spent – if it did not implement the energy and water efficiency program and that
the performance of all energy and water efficiency measures will be fully guaranteed or insured.

6.2 ENERGY MANAGEMENT TARGETS

Cambridge Memorial Hospital will reduce its annual emissions of energy related greenhouse gas
emissions by twenty percent (20%) by the year 2010.

6.3 ENERGY MANAGEMENT STRATEGIES

Three key strategies will enable Cambridge Memorial Hospital to realise its targets.

6.3.1 INFORMATION, TRAINING AND PRACTISES

The scope of these measures is the whole hospital.

Efficiency Target:    5% per year reduction in energy and water consumption

a]     Low Cost – No Cost Program

A low cost – no cost program consisting of information seminars, training programs will be used to
encourage staff to implement energy and water efficient practises. The cost of such a program depends



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Cambridge Memorial Hospital Energy Management Action Plan                                         Next Steps



on the number and comprehensiveness of the activities. Key tools: newsletter articles, seminars and
workshops, organizational meetings and targeted training.

Budget Requirement:           $30,000 over a three year period for information. Low cost – high return
                              projects will be funded on their merits.

b]      Efficient Purchase Policies

The replacement of old equipment at the time of burnout is often the most economic time to introduce
energy efficient technologies. A set of purchase policies and strategies will be developed that ensure that
energy and water efficiency be integrated into the current purchase policies and practises. This can be
complemented by the development of an equipment inventory and replacement plans for motors, lighting
systems etc.

Budget Requirement:           No new Funds are required.

c]      Targeting, Monitoring and Reporting

Significant savings can be generated through knowledge and understanding that emanates from the
tracking and monitoring of energy and water consumption and demand. The use of a Utility Management
System such as Metrex will allow the Energy and Environmental Management Staff identify, track and
report on energy and water efficiency practises and projects and the hospitals emission management
performance.

Cost:                  $10,000 for the purchase of Metrix software and the training of staff in its use.

d]      Training

The Cambridge Memorial Hospital will provide the Seneca College “Building Environmental Systems
Accreditation Program” from the local Community College to its facility and key maintenance staff.
Initially a needs assessment of all key facility staff and management will be undertaken to provide the
necessary training to enable the staff to manage the hospital in an efficient manner. This should be
complemented by NRCan’s Dollars to Sen$e Workshop Series.

Budget:        $1,750 per staff member over three years

6.3.2 ENERGY EFFICIENCY RETROFIT MEASURES

Cambridge Memorial Hospital will design and implement a comprehensive energy and water efficiency
program to complement their building replacement program. It will be designed to minimize upfront
costs and in such a way so as to be paid for from future guaranteed or insured savings.

Efficiency Target:  20% per year
a]      Comprehensive Energy and Water Efficiency Management Feasibility Study

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Cambridge Memorial Hospital Energy Management Action Plan                                                        Next Steps




The scope of this action is the full hospital, however two investment hurdle rates will be used. For areas
that are not slated for replacement within the next ten years a simple payback of eight years will be used,
for areas slated for replacement a simple payback sensitised to the future life and plans for that portion of
the facility will be used.

The equipment at the Cambridge Memorial Hospital is old and inefficient when compared to today’s
state-of-the-art technologies. This presents both an opportunity and a challenge. In essence, the worst
investment that Cambridge Memorial Hospital can undertake is to do nothing however, the challenge
will be to determine ways to implement energy efficiency and use the resultant savings to pay for the
costs of retrofitting the facilities.

The first step will be to commission an Investment Grade Feasibility Study1.

Cost:            $50,000 to $65,000

b]      Comprehensive Savings Financed Retrofit Program

The Hospital will implement all economic measures that meet a simple payback of 8 years.

Cost:            ~ $1.2 million to $1.5 in capital costs

6.3.3 ENERGY EFFICIENT BUILDING REPLACEMENT

The hospital will incorporate “best practise” and “best available” energy efficient technologies into all
aspects of its building replacement program.


References
1
        The Waterloo Region Hospital’s “Restructuring Task Force. Facilities Audit.” Cambridge Memorial Hospital,
        April 1997. Report by IBI Group.
2
        Chorley & Bisset Ltd., “Boiler Plant Study – Cambridge Memorial Hospital. July 1999.”
3
        Trow Consulting Engineers Ltd., “Preliminary Visual Review of Exterior Masonry. CMH.1999.”
4
        Trow Consulting Engineers Ltd., “Roofing Condition Survey CMH, 1999.”
5
        Trigen Energy Canada , “Energy Supply Proposal for Cambridge Memorial Hospital.”
6
        Motor, Fan, Air Handler, and Pump Schedules provided by Cambridge Memorial Hospital Staff.




1         An Investment Grade feasibility Study provides sufficient information to allow an insurance company and a financial
institution to provide energy savings financing plus it should have sufficient detail to allow Cambridge Memorial Hospital to
tender the various efficiency measures.

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