Number 016. January / February 2016
HOSPITALS OF THE FUTURE
CONTENTS published CARTIF Research Centre Boecillo Technology Park. Valladolid, Spain www.cartif.com
staff CARTIF Communication Department
collaborations Researchers from Smart Hospital Project
CARTIF news
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Keywords
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One of us
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Events
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design www.typopotamo.com
photography CARTIF archive. HURH Cover and back cover picture: Typop贸tamo
SMART AN
EDITOR’S NOTE The health sector demands enormous quantity of energy resources and generates plenty of wastes, contributing to climate change, which is considered as a global problem. In some countries, like Brazil, this sector consumes 10% of total energy while in others, such as United Kingdom, is the origin of 25% of CO2 emissions into the atmosphere. Hospitals are the second biggest energy consumer buildings per square meter, after restaurants. Light, climate and water represent a high general expense, which is added in the final bill that the patient must pay for their hospitalization. In national health systems, like in Spain, this expense is paid by the government, but it is still very expensive, and this money could be destined to other necessities such as more personal or more funding in medications. The search of a sustainable management for this kind of public buildings is the main topic of this CARTIF NEWSVIEW. Applying appropriate technologies, savings in energy consumption and emissions’ reductions can be spectacular.
ND SUSTAINABLE
cartif news
cartif news This news selection is just a small sample of the Center activities in the last months. You can follow us through our web and social networks. CommONEnergy PROJECT AT THE EXPO IN MILANO CommONEnergy project has been presented during a workshop at the EXPO in Milano. The event gathered more than 50 experts and industry representatives to engage in a constructive discussion on how to do the best balance comfort, environmental impact and energy consumption in shopping malls across Europe. They reminded that CommONEnergy is a mix of research and demonstration activities, with the final goal to develop new technologies and apply them in real cases.
LIFE COLRECEPS RAISES AWARENESS OF POLYSTYRENE REUSE IN SCHOOLS The project, which was launched to construct a demonstration plant for the recycling of expanded polystyrene (EPS) waste in the Spanish province of Valladolid, has been working with the nursery school to develop activities for children. When adapted for playschool-age children, the message of the project is simple: “White foam [expanded polystyrene] is not for throwing away.� Activities are also teaching the children about cooperation and team work.
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cartif news
SmartEnCity, THE NEW URBAN REGENERATION PROJECT OF CARTIF During the following five years, this European project will implement a model of integrated and sustainable urban regeneration based on innovative technological solutions in the fields of energy, transport and ICT. Vitoria (Spain), Sonderborg (Denmark) and Tartu (Estonia) are the three cities chosen to participate as demonstrators. In Vitoria, the scope will be mainly Coronación neighborhood, where they will carry out the rehabilitation of 750 homes/75 buildings. Given its experience in this kind of projects, CARTIF will be the main responsible of the tasks will be defined to evaluate the impact of interventions for the entire project, monitoring programs and quantifying the benefits achieved during the execution of the project.
DIRECTION PROJECT GATHERS EXPERTS FOR ITS FINAL EVENT For the first time, United Nations Climate Change Conference, dedicated a whole day to discuss about how buildings and construction sector are able to tackle climate change. The ‘Building Day’ event was celebrated on 3rd December in the French capital. In this context, DIRECTION project, led by CARTIF, has created a video to show two of its demo sites in order to demonstrate how buildings can play a crucial role in keeping global warming below 2ºC, which is the main objective of the planet right now.
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keywords smart hospital waste
water
Hospitals contribute significantly to climate change owing to the natural resources and products they consume, as well as the waste generated from service deliveries. For example, the National Health Service (NHS) in England estimates its carbon footprint in more than 18 million tons of CO2 per year, meaning 25% of total emissions in the public sector1. In Spain, the specific weight of lighting in relation with the total energy use in a hospital or primary care center ranges between 20% and 30%; therefore, lighting consumption in this sector is 1000 GWh/year, representing 0,6% of national electricity consumption. This volume is responsible for the emission of about 544,200 tons of CO2 to the atmosphere every year2. Hospital centers are the second building –right after restaurants– concerning total energy expenditure per square meter. Lighting consumption, air conditioning and heating systems, and water, have a very high general expenditure, which is eventually added to the patient’s hospital bill. In national public health systems, as is the case with Spain, this expenditure is covered by public administrations, even though it raises the price of the service provided to the user. These additional costs could have been assigned to an increase of hospital staff or funding of medicines. 1 Saving carbon, improving health: NHS carbon reduction strategy. National Health Service, Sustainable Development Unit, Cambridge, January 2009 2 Guía Técnica de Eficiencia Energética en Iluminación. Hospitales y Centros de Atención Primaria. Instituto para la Diversificación y Ahorro de la Energía, 2001
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neutral carbon emissions energy savings
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The idea is therefore to improve the efficient management of hospitals, integrating them into the smart concept along with other buildings and cities. On the basis of this innovative and necessary idea, a research team from CARTIF sought to develop a pilot project in this area; this is how LIFE Smart Hospital came about. LIFE Smart Hospital is a European project whose objective is to increase the resilience of hospitals to climate change and to reduce their ecological footprint. An actual demonstrator was chosen to launch the project, displaying best practices and available technologies along three axes: energy, water, and waste. In this case, the University Hospital RĂo Hortega (HURH) of Valladolid, Spain, was the most suitable candidate for various reasons: it is one of the biggest centers in the region of Castile and Leon; it is the center of reference at regional level in the specialties of liver transplantation, peritoneal cancer surgery, and burn unit; and it has a modern infrastructure that demands higher energy consumption. Since HURH started to operate at the beginning of 2009, they implemented various measures that allowed to reduce natural gas and electricity consumption in 30%, and water consumption in 50%. However, it got to a point where, in order to keep improving, it was necessary to adopt more complex measures considering the required investment or the technical development they entailed.
Main entrance at HURH
Given the hospital’s needs on the one hand and the new technological approaches on the other, it became necessary to create a consortium that provides the necessary knowledge to implement them. To accomplish this, the Packaging, Transport
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and Logistics Research Centre (ITENE) and the Spanish Organizational Corporation for Global Engineering (COINGES), created a partnership with CARTIF and the Regional Healthcare Administration of Castile and León.
Waste treatment at HURH
Objectives of the project To accomplish the Smart Hospital concept, researchers have determined to apply measures that could reduce its carbon footprint by 10% and its water footprint by 30%.
Central cistern at HURH
These measures are structured along three axes: energy, water, and waste.
• Improving efficiency of burners in boilers. • Improving the lighting system: installation of LED lighting in those sections with intensive use, and implementation of a DALI lighting control system. • Streamlining the ventilation system of the 18 HURH operating rooms.
Hemodialysis Unit at HURH
• Streamlining ventilation in common areas and adjustment of air conditioning engines. • Reducing net consumption by implementing reuse measures. • Installing water meters to determine consumption patterns. • Good practices on water management. • Improving the structure of classification, separation, and collection. • Implementing a traceability system. • Introducing personnel training, adapted to the hospital’s needs.
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Energy simulation at HURH
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The project set a series of deadlines to apply those measures: in 2015, the installation of equipment and identified traceability systems with an investment of 630,000€; In 2016 and 2017, monitoring that equipment to estimate savings, the water footprint, and the greenhouse gas emissions; finally, developing a manual of good practices as a reference document for other hospital centers.
Improvements in 2016 A year and a half since the development phase started, the project has already implemented the majority of the designed measures. Waste control has been enhanced by implementing a new container system that improves its separation. This new distribution will allow the classification of waste in four different groups: Group I • paper • cardboard • containers • plastic bottles (PET) • soda cans • glass • polyethylene film • expanded polystyrene (EPS) • organic matter • wood • scrap metal • construction and demolition waste (CDW) • textiles • cooking oil • rest of Group I.
Besides, the actions to adapt the hospital to this new separation system have commenced: designing location maps and marking new containers; setting collection frequency; and assignment of managers. On the other hand, improvement measures linked to waste traceability are being implemented at unit level and intermediate and final storage level. In the first two cases, labelling of containers is being implemented, depending on the specific typology of the waste in question and its source unit. At final storage level, the actions for container weighing are being taken, including the computer record of these data. Improvements in traceability will allow realtime recording of the quality and amount of generated waste in each section of the hospital,
Group II • waste from Group II.
Group IV • cytostatics • halogenated solvents • formalin • xylol • alcohol • non-halogenated solvents • laboratory • reagents • aqueous solutions • acid-base solutions • paraffins • mineral oils
Group III • sharp objects • biological • liquids from screening equipment. • remains from medicinal products • contaminated containers • paint and solvent containers • glass containers • textiles • fluorescent tubes • bulbs • electronic waste • lead-acid batteries • nickel-cadmium batteries • mercury batteries • alkaline batteries • toner and ink cartridges.
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promoting cost optimization and resilience to potential changes during the generation of waste. Finally, given the necessity for personnel training, a training programme has been designed to allow the engagement of employees in the project objectives. This programme will be adopted during 2016. Actions implemented in water management include reuse measures, consumption monitoring, and personnel training in its efficient use. In the first place, it has been considered that waste water from the hemodialysis unit should be reused. This unit has a water production plant for its use as dialysis fluid, consisting of, among others, two stages of reverse osmosis (RO) in series that provide water of excellent quality. Since January 2016, waste water from the first RO has been redirected to the general water cistern of the hospital, making it suitable for human consumption, and bringing savings of 18m3 per day. In addition, the hospital has four coolers that work during the summer, each device with an approximate consumption of 10 m3 per hour. In this regard, the waste accumulated in the cooling pads would be collected in a pool for later reuse in the flush valves of the hospital, bringing savings of 90 m3 per day. In parallel with the previous actions, counters have been installed to determine patterns of irrigation water consumption, cold water for human consumption, domestic hot water, flush valves, and well production. An adequate combination of data will make it possible to determine the water consumption of evaporative cooling pads, and estimate the
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water evaporated during the cooling process. Thanks to this measure, savings from all the actions in process will be quantifiable, allowing to establish consumption patterns. Finally, during the second semester of 2016, training would be provided to the HURH staff in different sections: general, domestic water, equipment, kitchen and cafeteria, and efficient irrigation.
Adopting all these measures, the University Hospital RĂo Hortega will become, in two years, the first smart hospital in Spain To achieve a more efficient energy management, a digital control system was implemented in January 2016, intended to be used in the combustion of four boilers equipped with modulating burners that function based on thermal energy demand. This control system allows better adjustment of the air introduced through the burner in the boiler to the level required at any moment by the operating point of the burner, resulting in electric and thermal energy savings. Besides, a lighting control system of lights has been installed in dressing rooms and the hallways of outpatient wards using DALI technology. Additionally, LED lighting has been installed there and in the emergency and labor wards, including other sections. These measures will bring LIFE Smart Hospital savings of at least 10% from previous consumption levels.
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Another measure that has been implemented in the framework of the project is the optimization of ventilation in hospital operating rooms (17 units and 2 for minor surgery). According to current legislation, climate control in these spaces must be under an overpressure protection system and with filtered air ventilation levels of 20 times per hour. In the framework of the project, change of air in operating rooms when not in use has been reduced to 10 times. Air conditioning in hallways has also been optimized. Before this project, air conditioners worked heating in the winter and cooling in the summer the air that went through them according to some procedures established in the return air. This mechanism required constant functioning of the fans in the air conditioners while they were turned on, regardless of whether heating or cooling had to be provided or not, resulting in an absolute waste of energy. Within the same project, the necessary elements to reduce the air that is supplied with a high thermal gap have been implemented, and they will probably lead to considerable savings, especially when outdoor conditions are mild, as in fall or spring. Finally, within the energy axis, the project has replaced the oversized air-conditioning engines from HURH by more efficient equipment in accordance with real demand curves. Adopting all these measures, the University Hospital RĂo Hortega will become, in two years, the first smart hospital in Spain.
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HURH. Indoor
one of us
one of us Joseph Engelberger
(New York City 1925 - 2015)
Engineer and physicist. Father of the first industrial robot. Industrial robotics has its roots in Danbury, Connecticut, in the 1960s, when Joseph Engelberger took the robots he saw in books and science fiction movies to factories and hospitals. Industry 4.0 took off thanks to the implementation of the information technologies in the sector, something that would have been inconceivable without his revolutionary invention. Engelberger, of German heritage, graduated in Physics in 1946. Later, he graduated from Columbia University with a Master’s degree in Mechanical Engineering. During those years, he took part in the development of the atomic bomb and the design of control systems for nuclear energy plants and jet engines. He met his future partner George Devol in the late 1950s. Both shared an interest in the theories of Isaac Asimov and their potential application to automated equipment operations. Together, they co-founded the company Unimation. This company devised the first programmable robotic arm, and the first of these machines was installed in a General Motors assembly plant in New Jersey in 1961, after having been rejected by other factories. The arm was such a success that other automotive companies like Chrysler and Ford started to demand it. The robot was designed to lift and pile up cast metal pieces extracted from their molds at a high temperature. Later, new applications were added like welding, applying spray paint or glues. Engelberger’s main objective was carrying his inventions to those factories were automated tasks could potentially harm workers. At this moment, his
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robot symbolized the dawn of industrial robotics. The robot grew in popularity even in other sectors, especially after its appearance in an American TV show that showed how it could serve beverages or conduct an orchestra. These anecdotal examples demonstrated the multiple applications of ‘Unimate.’ Committed to applying robotics for the welfare of humanity, Engelberger kept working on the design of new and more automatic mobile machinery. In the field of medicine, the engineer created a robotic mailing service to deliver lunches or medical records; more than a hundred hospitals acquired it. Throughout his career, Joseph Engelberger wrote many books and received various honors for his contribution to the industrial sector. One of the most relevant awards he received was the Japan Prize in 1997, the highest honor given in the technology sector in Japan.
events
events
spring 2016
march 22
april 5 - 7
april 13 / 14
Plastics Recycling Show 2016
Save the planet 2016
+ INFO
+ INFO
II Congreso de Ciudades Inteligentes
Brussels (Belgium)
Sofia (Bulgary)
Madrid (Spain)
+ INFO
april 25 - 29
april 25 - 28
Hannover Messe
Feria Alimentaria 2016
+ INFO
+ INFO
Hannover (Germany)
Barcelona (Spain)
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Building the present
from a not too distant future