Energy consumption in hospitals has a direct connection to lighting, air conditioning, heating, water pumping, elevators, and medical equipment. Through the efficient use of energy and pursuit of autonomy, Rede D’Or aims to minimize the energy impact on its processes.

• City: Rio de Janeiro
• State/province/region: RJ
• Country: Brazil
• Type of institution: private health institution
• Number of full-time staff: 71,026
• Number of beds: 9,469 operating beds 
• 5.4 million served annually (emergency care)
  • 2.7 million patient-days served annually (total of inpatient and outpatient)
  • Geographic area served: 12 states – Alagoas, Bahia, Ceará, Maranhão, Mato Grosso do Sul, Minas Gerais, Paraíba, Paraná, Pernambuco, Rio de Janeiro, São Paulo e Sergipe, plus Distrito Federal.
  • Health equity concerns experienced by your population: patient experience; health promotion and prevention; climate change.

Air conditioning systems at Rede D’Or represent around 50% of energy consumption. Of the total energy consumed in 2021 (1,129,626.80 GJ), approximately 87% corresponded to electricity. Seeking energy autonomy and risk mitigation, this initiative invests in low-carbon initiatives, particularly renewable energy and solutions that promote the reduction of energy consumption, such as the adoption of more efficient equipment and automation of the air conditioning system, heat recovery system, and consumption pattern monitoring.

The hospital aimed to ensure the effectiveness of the air-conditioning system based on chilled water plant automation, monitoring, and optimizing energy consumption. 

By the end of 2023,  an estimated 99% of the hospital’s units of consumption will come from renewable sources. This is part of Rede D’Or’s ESG strategic planning goal to reduce GHG relative emissions by 36%.

The focus on the chilled water plant (CAG) is due to the high energy consumption of the air conditioning system. By implementing heat recovery steam generator technology, heat-generated (and previously dissipated) systems used to heat water for use in other areas (showers, sinks, cleaning) are now utilized. The process can reduce natural gas consumption in conventional heating systems by as much as 60%. Currently, Rede D’Or has 20 energy efficiency projects at CAG in operation. The topic is addressed in our course platform, which is exclusively accessible to employees. All reported indicators are audited externally.

The implementation of the resource advisor system by the technology company Schneider Electric has allowed more robust management of indicators and data, replacing the internal key performance indicator system. Using this tool, it has been possible to monitor the performance of the indicators with more quality.

A Rede D’Or corporate office of sustainability and environment conducted periodic performance audits in all hospital units to map and identify all possible impacts and establish action plans in the case of deviations and non-compliance from the plan.

The first step towards the implementation of the energy efficiency program was the analysis of the economic, financial, and technical viability of the units to be considered. In 2021, the following units of Rede D'Or São Luiz were included in the scope: Itaim,

São Caetano, Anália Franco, São Luiz Morumbi, Maternidade Brasil, Sino Brasileiro and Copa. Considering these seven units, there was an average monthly savings of R$48,198. The departments involved in the project were:

• Corporate department of maintenance engineering, which is responsible for project management, monitoring indicators, identifying problems, and helping to solve and optimize energy consumption. 
• Maintenance, which provides tools to make the project viable, such as access to the hospital's structure or a survey of necessary indicators for further analyses. 
• Internal sustainability committee, which supports the dissemination of practices. 
• A contracted company  to monitor reduction of consumption, operational optimization of related maintenance, and monthly reporting. 

Another aspect was the use of renewable energy sources in hospital units.

The establishment of a methodology for measuring results from the beginning of the project is fundamental. The consulting companies focused on energy efficiency measures before and after implementation and aimed to use a fixed parameter. However, the indicator for measuring results cannot be fixed, as a series of variables must be considered as a parameter, such as seasonality and temperature in the region. It is necessary to measure results month by month and not set a standard indicator commonly established in the market.

In 2022, the results achieved for the implemented energy and water efficiency projects were a net savings of USD 440,000 (BRL 2,284,856). For environmental benefits, more than 326 tons of CO2e were avoided; more than 2,200 low-income homes could be served annually with this saved energy; more than 1,400 trees would have been needed to offset CO2 emissions; and more than 43 million liters of water would be saved. Other benefits include reduction of equipment breakage, longer use life, and positive impact on quality as perceived by the user. With the automation of several hospital systems, indicators in the maintenance department began to be monitored in real-time, allowing online analysis of consumption, data on the use of specific equipment, and the quality of energy supplied.

The preliminary analysis was essential for the success of the energy efficiency project. Determining the project’s economic, financial, and technical viability made it possible to previously detect the units without conditions for implantation. Establishing a methodology for measuring results from the beginning of the project was important because consulting companies measure indicators before and after, seeking to establish a fixed parameter without considering other variables during the course of the project. It is necessary to measure results month by month and not set a standard indicator.

The hospital aims to develop new partners to expand projects and implement projects that apply to other units, which will expand the results already achieved. Within the mapped projects, the goal is to develop projects to reduce fuel consumption. We intend to publish the consolidated results at the end of 2023.