Tap into Conservation

By Nancy E. Berry and Geoffrey Glass, director of facility and technology services at Providence St. Peter Hospital on March 5, 2013

Providence St. Peter Hospital in Olympia, Washington, shares lessons on its efforts to cut water consumption in half.


Many hospitals have addressed energy usage in their conservation efforts, but one resource that is often overlooked is water. According to Christy Love, senior environmental performance analyst at Mazzetti Nash Lipsey Burch, a consulting and design firm focused on the engineered systems of buildings, one-staffed bed in a critical care hospital uses an average of 550 gallons of water per day. That can be upwards of 100,000 gallons of water a day for a large facility. Hospitals not only use water for sterilization and sanitation but also to run HVAC systems and food service. “With water and sewer rates rising between 5 and 10 percent every year in many parts of the country, investments in hospital water efficiency programs can provide attractive returns,” notes Love. In 2003, Providence St. Peter Hospital in Olympia began water conservation efforts as part of its sustainable journey. We spoke to Geoffrey Glass, director of facility and technology services, about the 390-bed hospital’s progress over the past 10 years.

Greenhealth: Geoffrey, when did you start water conservation practices and why did the hospital feel this was an important step?

Geoffrey Glass: Providence St. Peter Hospital began its sustainability journey in 1999 with energy conservation as the first focus. As we began to see double digit increases in our water and sewer utility rates, we added water conservation to our sustainability planning in 2003. Our efforts in water conservation were a natural extension of a plan to improve facility management support for the hospital, with an outcome being improved systems operation and efficiency for patient service and operating cost reduction.

GH: Water is relatively inexpensive in Washington State—what was the incentive?

GG: While water is relatively abundant in western Washington our municipal utilities are struggling with obtaining water rights for our growing population. Interestingly, while water may be more available than other areas of our country the cost of water and sewer treatment in western Washington is typical with other cities in the U.S. A big issue for our region is waste-water treatment and pollution of Puget Sound. If we can reduce our water consumption, our rights to extract water from our rivers and groundwater can last longer and the cost of treating our sewage is reduced. Our local water and sewer utility has been very progressive in creating financial incentives for demand-side management of water resources. This utility has provided incentives to conserve water that are as high as 75 percent of the cost of the measure.

GH: What was the first course of action?

GG: We needed to understand in general terms the places where we used water so that we could create a strategy to make more efficient use of this precious, life-sustaining commodity.

Our first course of action was to create an awareness among our facility operation and maintenance staff and a common vision for water conservation. We followed the water to drain with the mantra “a penny a gallon” and encouraged our staff to identify water conservation opportunities.

GH: How much were you spending on water before you began practicing water conservation?

GG: Our water and sewer combined rate has doubled between 1998 and 2011. Over this same period of time our usage has been reduced by 50 percent. You could say that we have held our actual costs at the same amount over this 12-year period while rates have grown dramatically, and our facility has grown by 21 percent.

GH: What were other initial steps?

GG: Our first steps were to find and fix existing leaks in our building utility systems—to pay attention to our building. We followed this with a commitment to include water conservation in our purchasing standards and decisions for new and replacement equipment. Subsequently, we were able to obtain a large ($144,000) grant from our sewer district for low-flow plumbing fixture change out. I believe that our water conservation program is now comprehensive in that we are aware and always seeking strategies for conserving water use.

GH: How much on average does one patient use in terms of water consumption?

GG: At our facility, one patient in one day consumes 252 gallons of water for all the processes that support patient care. By way of comparison, the average person in the U.S. uses 70 to 100 gallons per day of water.

GH: How much have you saved each year?

GG: We have steadily declined in actual use from 62,203,000 gallons per year in 1998 to 31,590,000 gallons per year in 2011; while our campus has grown by 21 percent over these years.

GH: What are some of the challenges you face with conserving water?

GG: We have had some minor challenges with conserving water; we have had occasional clogging of low-flow urinals when people dispose foreign materials in the urinal. Resources to invest in water-saving strategies can always be a challenge but with the assistance of our local sewer utility grant programs this has been a fairly minor issue. Otherwise, our challenges have been very minimal.

GH: How do you go about establishing your return on investment (ROI) when it comes to water conservation?

GG: Water and sewer costs our hospital about 87 cents per gallon; so we are able to pretty accurately calculate the water saving associated with our projects and apply the cost of water and sewer to establish an ROI. Again, water conservation with new equipment purchasing is often inherent in the purchase; water conservation associated with building operations should be a part of the job and the only area where ROI should impact is specific water conservation projects.

GH: What area has the largest water consumption in a hospital? Where are some hidden areas one may not think about so readily?

GG: The largest water consumer in the hospital is water for chiller cooling associated with air conditioning. Another large user of water is the process for dialysis. Areas where water conservation is an opportunity are not always apparent, such as is in the areas of sterile instrument processing, leaks in building systems, and kitchen operations.

GH: Where have you seen your largest cost savings in terms of water efficiency?

GG: Our largest cost savings have come from identifying and fixing leaks in our building heating systems and in our irrigation systems. We have also retrofitted our sterilizers for significant savings.

GH: What are some of the largest water conservation projects that you have implemented?

GG: In 2009, we completed a project (with 75 percent grant support) to replace 700 plumbing fixtures (toilets and showerheads) in our hospital with low-flow fixtures. This project resulted in 4,000,000 gallons of water savings per year with no negative impacts. The total project cost for this work was $195,500.

GH: In terms of water utility, how much has the hospital spent and how much has the hospital saved?

GG: In 2011, our savings in water and sewer (when compared with 1998 consumption) was $335,809; our sum total of water and sewer cost savings since 1998 is $2,198,216. We have not accounted for every expenditure related to water conservation but we believe that our cost over this period of time was about $275,000. A pretty good investment!

GH: What advice can you give a hospital looking to reduce its water consumption?

GG: Take a “team approach” (facilities, purchasing, dietary, nursing), and seek committed champions in this effort and celebrate and promote successes.

GH: Will water conservation become a focus in the future?

GG: As our country begins to struggle more with scarcity of obtaining water and treating waste water, the cost should continue to rise significantly. At some point in time these costs will grab the interests of hospital decision makers. In the meanwhile, organizations like Practice Greenhealth and others help by promoting water conservation as a focus for the future.

Water, Water Everywhere

Top 20 Water Conservation Moves from Providence St. Peter
  1. Performed facility water audit
  2. Benchmarked water usage
  3. Analyzed facility for leaks
  4. Replaced all single-pass, water-cooled equipment with air-cooled or central chilled water services
  5. Retrofitted four existing vacuum sterilizers
  6. Installed dual-flush Flushometer Retrofit kits
  7. Installed pint urinals
  8. Installed high-efficiency showerheads
  9. Installed flow control faucets
  10. Installed sensor-activated public faucets
  11. Installed sensor-activated public water closets
  12. Planted native landscaping material
  13. Used drip irrigation
  14. Installed rain sensor controls
  15. Switched to microfiber mops
  16. Purchased new kitchen dishwasher
  17. Purchased medical air compressors
  18. Purchased waste anesthesia gas pumps
  19. Specified waterless vacuum pumps or water recycling systems for vacuum pump cooling
  20. Worked closely with water treatment advisor to minimize make-up water to cooling tower systems