Hospitals and other healthcare providers are embarking on retrofit projects to replace aging facility infrastructure and address tightening sustainability regulations, shrinking budgets and rising patient demands, Schneider Electric says in a white paper.
Healthcare facility retrofits are typically faster to implement, less disruptive to care delivery, more financially viable and have a significantly lower environmental impact than new construction, Schneider said in the paper, which it prepared in partnership with JLL.
The study evaluates the energy, carbon and financial impact of nine commercially available energy and carbon conservation measures, or ECCMs, across seven hospital locations. Each project was in a distinct climate zone and had a different grid profile, with results demonstrating how conservation measure impacts can vary depending on facility location.
For example, an upgrade that involved tuning building management system controls to ASHRAE Guideline 36 resulted in an 11.5% improvement in efficiency in a medical facility in New York while generating virtually no change in a facility in Italy. Similarly, a power supervisory control and data acquisition, or SCADA, retrofit generated a relatively uniform improvement of between 2.0% and 2.6% in all nine project areas, the paper found. A project to improve envelope insulation led to virtually no improvement to a facility in Italy but improvement of 2.8% at a facility in Norway and 4.8% to one in Adelaide, Australia.
Other projects the white paper examined made programming changes to building management systems’ distributed energy resource settings; added occupancy- and daylighting-based zone controls; implemented power factor correction and harmonic reduction; combined power management software with connected metering; added energy supply management software; added a high-efficiency modular uninterruptible power supply; and deployed continuous commissioning. Continuous commissioning refers to a process where smart building systems are utilized to monitor equipment performance and identify deficiencies to be addressed continuously, Schneider says.
A combination of six ECCMs tended to produce the most optimal results, the study found: BMS control upgrades, occupancy-based zone controls, power factor and harmonic correction, power monitoring software, power SCADA and continuous commissioning.
“These form a core retrofit scenario for healthcare facilities worldwide,” the report said.
The analysis found that insulation consistently failed to meet the 1% energy savings threshold when combined with other ECCMs. with digital solutions like BMS upgrades and occupancy-based controls outperforming insulation across all climate zones, according to the paper.
“Even in cold climates, where insulation traditionally offers the greatest benefit, its impact was marginal when HVAC systems were already optimized,” the paper said. “In equipment-intensive buildings like hospitals, added insulation can trap waste heat, increasing cooling demand during moderate and warm periods.”
Combining occupancy-based controls and BMS upgrades delivered synergistic benefits, especially in non-critical zones, according to the paper. This pairing more than doubled energy savings of BMS upgrades alone, it said.
In regions like New York, where heating loads dominate energy consumption, the most effective measures included advanced BMS upgrades to fine-tune heating system performance, which reduced natural gas use by as much as 40%, and power monitoring and control systems that reduced electrical demand by more than 5%.
“New York delivered one of the most impressive results: an 80% reduction in total heating energy consumption from the BMS-related combination of ECCMs,” the authors said.
Whole-life carbon analysis is essential for evaluating the true climate impact of retrofit strategies, the report states, noting physical envelope upgrades carry about three times the up-front carbon burden compared with digital or service-based interventions.
In warmer climates where HVAC demand is driven primarily by cooling, insulation offers limited climate benefit, the paper states. Insulation can provide more significant benefit in cold regions, where heating is dominant and the grid is already clean. Even in these cases, however, switching to district heating can significantly reduce the need for insulation as the embodied carbon of the material outweighs its operational savings, the paper said.
