An overview of how green performance indicators could be applied to healthcare. I put this together shortly before joining OHA.

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Key Performance Indicators:
Energy Efficiency and GHG Performance
Graham Takata
July 8, 2009

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Objective
 Using some established benchmarks, practices or standards,
make a recommendation of a set of common indicators that
could be used to report hospitals Energy and Green House
Gases performance.
Bluewater Health, Sarnia (LEED) under construction

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Scope
 This Presentation focuses on KPIs related to Energy and GHG
Emissions, which form part of the overall sustainability
package.
• Energy Use, GHGs, and
Be Green Efficiency
• GHG Protocol
• LEED Design Standards
Build Green • Green Guide for
Healthcare
• Green Procurement
Buy Green • Global Health and Safety
Initiative

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Hospital Emissions
Why Focus on Energy and Greenhouse Gases?
Hospitals and GHG Emissions Greenhouse Gas Emissions
 Hospitals have 2.5 x the GHG
emissions as commercial use 1.6
buildings
9 Fleet Vehicles
 In the US, the CO2e/sqft has been
estimated to be 13.5 kg CO2e/sqft
Medical Gases
 Hospitals have a significant capacity
23
and opportunity to reduce emissions Natural Gas
and reduce operating costs
66
Emergency
 Kingston General’s Energy Audit: Generation
 Capital Investment $1,000,000
0.2
Electricity
 Annual Savings $200,000
 Expected Payback: < 5 years
Kaiser Permanente (2007)
U.S. Hospital Energy Alliance (HEA)
NRCan Office of Energy Efficiency (OEE)

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Energy and GHG Metrics
Industry Standard for Measurement
 The Standard Methodology for Benchmarking Energy and
Greenhouse Gas Performance is the GHG Protocol:
 WBCSD/WRI Greenhouse Gas Protocol: A Corporate
Accounting and Reporting Standard, Revised Edition (2004).
 It is an internationally recognized, transparent methodology to
quantify the environmental footprint of an organizations:
 Scope 1: Fuel use for Heating and Transportation
 Scope 2: Electricity & Steam
 Scope 3: Waste, Water Consumption, Contracted Services

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Key Performance Indicators
Meaningful Indicators
 KPIs should be:
 Quantitative and Measureable
 Align with the Outcome we are striving to achieve
 Impartial, Transparent, and Reproducible
 They should:
 Inform us on where we stand
 Indicate how we compare with others
 Provide a metric to assess progress to date
 Align with relevant internal or Industry-wide Initiatives
 KPIs should not only inform us of where we are, but where we
need to go.

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Key Performance Indicators
Environmental Metrics + Operational Intelligence
Op
Energy KPI
Intel
 kWh  Capital Costs  Carbon Footprint
 M3 gas  Operating Costs per:
 BTU  Beds  Dollar Spent
 GJ  Building Age, Sqft  Patient Served
 Water  Admissions  Sqft of Space
 Steam  Staff  Functional Unit

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Key Performance Indicators
Data Collection
 Energy and GHG data
 Electricity (kWh, $)
 Heat (NG, Steam, m3/BTU, $)
Balanced Collect  Other fuels – Fleet, Diesel
backups, etc.
Scorecard Data  Water Consumption (m3)
 Waste Generation (%, tonnes)
 Financial Data
 Expenditures for Facility
Management
 Operational Data
 Sqft, Operating Hours, Staff
Analyze KPI  Outpatient volumes
 Direct Admissions
 Functional Units
 Allows classification of hospitals

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Key Performance Indicators
Energy and GHG KPIs
 Efficiency:
 GJ Electricity / sqft
 GJ Heat / sqft
Balanced  m3 Water / sqft
Collect Data
Scorecard  Per admission, per bed, per
operating hour
 Economy:
 Expenditures for Operations
and Maintenance
 Capital Investment for Green
Retrofits
Analyze
 Emissions:
KPI  Total CO2e / sqft
 Includes Water, Waste, Overall
Footprint

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Key Performance Indicators
Evaluate, Plan, and Improve
 A Balanced Scorecard:
 Efficiency, Economy, and Total
Emissions KPIs are weighted
Balanced Collect Data  Participating Hospitals are ranked
Scorecard based on their energy efficiency and
GHG emissions
 In addition to setting a standard for
benchmarking participating
hospitals, rating EE/GHG can form
part of a larger Green Hospital
Evaluation that includes other Green
KPIs.
Analyze KPI  Examples:
 Green Operational Practices
 Green Building Standards
 Green Procurement

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Outcomes
Developing a Strategy from KPIs
 KPIs provide the basis for Strategic Planning:
 A fair and transparent evaluation of participating hospitals
green performance and progress
 A benchmark to compare relative performance among OHA’s
member Hospitals, the country, and the world
 Identification of opportunities for Green Investment – a “green
ROI” through energy savings
 Identification of potential high impact and priority areas
 A method to measure and monitor the effectiveness of Green
Hospital Champion Fund’s investments

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Thank You!
Graham Takata
gtakata@greentactics.ca

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Appendix
Key Performance Indicators:
Energy Efficiency and GHG Performance

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Appendix
GHG Protocol: Emissions Classifications
 In accordance with the GHG Protocol, emissions are divided into three
categories: scope 1, scope 2, and scope 3.
 Scope 1 emissions are direct emissions that occur from sources owned or
controlled by the company, such as natural gas used to heat company
buildings or emissions due to company owned fleet vehicles.
 Scope 2 accounts for GHG emissions from the generation of purchased
electricity consumed by the company. Purchased electricity is defined as
electricity that is purchased or otherwise brought into the organizational
boundary of the company. Scope 2 emissions physically occur at the facility
where electricity is generated.
 Scope 3 is an optional reporting category that allows for the treatment of all
other indirect emissions. Scope 3 emissions are a consequence of the activities
of the company, but occur from sources not owned or controlled by the
company. Some examples of scope 3 activities are extraction and production of
purchased materials; transportation of purchased fuels; and use of sold
products and services (such as paper use or shipping services).

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Appendix
Sustainability Operations, Infrastructure, and
Management
• Energy
Use, GHGs, and
Be Green Efficiency
• GHG Protocol
• LEED Design
Standards
Build Green • Green Guide for
Healthcare
• Green Procurement
Buy Green • Global Health and
Safety Initiative

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Appendix
Industry Initiatives
Global Health and Safety Initiative
A sector-wide collaboration to transform the way Author of: Eco-Health Footprint
that healthcare designs, builds and operates its Guide: Measuring your
facilities as well as the products healthcare uses Organization's Impact on Public
within those facilities. Health and the Environment
Health Care Without Harm
An international coalition of hospitals and health Author of: Healthy Hospitals,
care systems, medical professionals, community Healthy Planet, Healthy People -
groups, health-affected constituencies, labor Addressing Climate Change in
unions, environmental and environmental health Health Care Settings
organizations and religious groups.
Green Guide for Health Care
A best practices guide for healthy and sustainable The Green Guide for Health Care
building design, construction, and operations for applies LEED design principles to
the healthcare industry. Hospitals and their operation.