Recent crises that have shaken the world (Covid-19, rising energy prices) have highlighted the fragility of the healthcare system in France, and more specifically the outdated state of healthcare facilities such as hospitals. The aging of infrastructure and equipment has a direct impact on the quality of care provided. It is therefore essential to undertake a comprehensive energy renovation of France's hospital system.
The challenges of energy renovation in hospitals
Both public and private hospitals face numerous challenges that energy renovation can effectively address.
Aging infrastructure
According to figures from Francetv info, “for more than 10 years, the rate of obsolescence (of hospitals) has been steadily increasing in France, reaching 80% of equipment and more than 55% of buildings.”
However, machines nearing the end of their lifespan consume more energy than new, high-performance equipment. As for buildings, if they are poorly insulated, heat loss can be significant, leading to very high heating or cooling costs.
Acceleration of heatwave episodes
With warming , France is experiencing increasingly frequent and deadly heat waves. However, many hospitals are not adequately equipped with air conditioning, which are often reserved for operating rooms. The lack of cooling in the rooms of particularly vulnerable patients (the elderly or those in critical condition) or in areas reserved for healthcare workers is therefore a serious concern.
Emergence of global health crises
Many hospitals have faulty, outdated, or undersized ventilation systems . However, a high-performance mechanical ventilation system significantly reduces humidity , bacterial transmission , fungal growth , and other issues. In other words, it helps protect the health of the building's occupants. Therefore, one might wonder to what extent poor hospital ventilation contributed to accelerating the spread of the coronavirus in some hospitals.
High energy consumption
According to a 2008 study by ADEME (the French Agency for Ecological Transition), the average energy consumption of healthcare facilities in the Île-de-France region is approximately 270 kWh/m²/year. The largest expenditure category is heating (170 kWh/m²/year), followed by electricity (100 kWh/m²/year). Hospitals require significant energy to operate medical equipment, radiology systems, air-condition patient rooms, and run laundry and kitchen facilities. This energy consumption can represent up to 7% of a healthcare facility's expenses, excluding payroll.
Increasingly restrictive regulations
Tertiary buildings, such as hospitals, are subject to several regulations, starting with the Tertiary Decree. This decree requires establishments larger than 1000 m2 to:
- gradually reduce their final energy consumption (40% in 2030, 50% in 2040, 60% in 2050);
- enter consumption data on the OPERAT managed by Ademe.
Furthermore, commercial buildings equipped with a heating or air conditioning system with a nominal useful output exceeding 70 kW are also subject to the BACS (Building Automation and Control System) decree. This decree mandates the implementation of a BMS (Building Management System) by deadlines that vary depending on the project.
Hospitals are therefore very often affected by these two compliance obligations.
Energy renovation of hospitals: priority solutions
Powesco, a specialist operator in the energy transition of the service sector, recommends several energy renovation solutions for hospitals. Of course, these may vary depending on the project and its complexity.
Thermal insulation of hospitals
As we've mentioned, hospitals far too often suffer from poor thermal insulation. The first step, therefore, is to renovate the building envelope to improve energy efficiency. This can involve:
- wall insulation , attic insulation , roof insulation ;
- the thermal insulation of water pipes with type 4 insulation;
- the insulation of singular points in the boiler room (valves, taps, reducers, meters).
Air conditioning and heating
Heating is the largest energy expense in a hospital. It is therefore essential to analyze existing systems to determine whether they require repair or replacement with new, more efficient equipment .
For HVAC (heating, air conditioning, ventilation), Powesco recommends installing a heat pump: this machine produces both cooling and heating, all from arenewable energy : waste heat. This environmentally friendly and economical appliance, which renews the air, controls humidity , and produces domestic hot water, perfectly meets the needs of healthcare facilities.
Relamping
Finally, a project regularly undertaken as part of hospital energy renovation is relamping. In other words, replacing energy-intensive discharge lamps and fluorescent tubes with LED. Energy savings can easily reach between 50 and 80% with this type of work.
How does the energy renovation of a hospital take place?
The processes vary depending on the service provider in charge of the project. However, these key steps are often the same.
Energy audit
Before embarking on renovation work, a thorough analysis must be conducted within the hospital to identify the largest energy consumption areas as well as any potential energy savings. This energy audit is carried out by a specialist professional such as Powesco's partner consulting firm: Esope.
Renovation work under close surveillance
Most of the time, energy renovation work in hospitals is carried out while the facility remains open to the public. It is therefore essential to call upon a specialist who understands the specific requirements of the sector in order to eliminate any risk of infection related to the work site (water outages, proliferation of bacteria in the air or through pipes, noise pollution).
Financing and guarantees
Undertaking renovation work in a hospital can represent a investment for institutions already facing financial difficulties. Fortunately, the government has launched several programs to finance certain types of work. Among the best-known tools are:
- the Energy Savings Certificates (CEE) scheme ;
- the heat fund.
In addition, some energy transition specialists offer their own solutions. For example, Powesco provides hospitals with a performance-guaranteed contract : this contract guarantees energy savings for the beneficiary over a given period.
Energy consumption monitoring
Finally, following energy renovation work, energy consumption must be measured and closely monitored to assess the project's effectiveness. Powesco, for example, provides its clients with an Energy Management System that offers real-time information on energy consumption.
Sources:
https://www.francetvinfo.fr/sante/hopital/crise/hopitaux-quand-la-vetuste-s-accroit_6306825.html
