Hospitals TABLES

Advanced Energy Design Guide
for Large Hospitals

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Achieving 50% Energy Savings Toward a Net Zero Energy Building

Climate Zone Tables
© 2012 ASHRAE
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ASHRAE
The American Institute of Architects
Illuminating Engineering Society of North America
U.S. Green Building Council
U.S. Department of Energy
Climate zones for United States counties.
Reproduced from ANSI/ASHRAE Standard 169-2013, Climatic Data for Building Design Standards, © 2013 ASHRAE.
Chapter 4—Strategies and Recommendations by Climate Zone | 81
Climate Zone 1 Recommendation Table for Large Hospitals

Item Component Recommendation How-to Tips 
Group similar space types within the building
Form/space planning Proper zoning DL4–6
footprint.
Insulation entirely above deck R-20.0 c.i. EN2, 15–17
Roofs
Solar reflectance index (SRI) 78 EN1
Mass (HC > 7 Btu/ft2) R-5.7 c.i. EN3, 15–17
Walls Steel framed R-13.0 + R-7.5 c.i. EN4, 15–17
Below-grade walls Comply with Standard 90.1* EN5, 15–17
Mass R-4.2 c.i. EN6, 15–17
Floors
Steel framed R-19.0 EN7, 15–17
Unheated Comply with Standard 90.1*
Slabs
Envelope
Heated R-7.5 for 12 in. EN9–10, 15–17

Swinging U-0.70 EN11, 16
Doors
Nonswinging U-1.45 EN12, 16
Vestibules At primary visitor building entrance Comply with Standard 90.1* EN14
Continuous air barriers Continuous air barriers Entire building envelope EN13
Window-to-wall ratio 40% of net wall (floor-ceiling) DL7, EN20
Nonmetal framing windows = 0.56 EN18–20,
Thermal transmittance
Metal framing windows = 0.65 23–25
Vertical fenestration
(full assembly—NFRC rating) Solar heat gain coefficient (SHGC)
Light-to-solar gain ratio (LSG) All orientations 1.5 EN24
Exterior sun control South orientation only – PF = 0.5 EN21, DL13–14
Comply with LEED for healthcare credits
All spaces DL3–6
IEQ 8.1 (daylighting) and IEQ 8.2 (views)
Shape the building footprint and form such
Diagnostic and treatment block that the area within 15 ft of the perimeter DL6
exceeds 40% of the floorplate.
Form-driven daylighting option Ensure that 75% of the occupied space not
Inpatient units including patient rooms lies within 20 ft of the DL6
perimeter.
Staff areas (exam rooms, nurse stations,
Design the building form to maximize access
offices, corridors); public spaces (waiting,
to natural light, through sidelighting and DL8–14, 20–23
reception); and other regularly occupied
toplighting.
spaces as applicable
Add daylight controls to any space within 15 ft
Nonform-driven daylighting option offices, corridors) and public spaces DL20–23
of a perimeter window.
(waiting, reception)
Daylighting/ Lighting
Ceilings  80%
Interior finishes Room interior surface average reflectance DL17
Walls  70%
Whole building= 0.9 W/ft2
Lighting power density (LPD) EL1, 12–20
Space-by-space per Table 5-4
T8 & T5 > 2 ft = 92
Light source efficacy
T8 & T5 < 2 ft = 85 EL2–5
(mean lumens per watt)
All other >50
Nondimming = NEMA Premium
Interior lighting Ballasts—4 ft T8 Lamps EL2
Dimming= NEMA Premium Program Start
Ballasts—Fluorescent and HID Electronic EL2–5
Dimming controls daylight harvesting Dim all fixtures in daylighted zones. DL20–23, EL11
Manual ON, auto/timed OFF in all areas as
Lighting controls—general EL6, 21
possible.
Surgery task lights Use LED lights exclusively. EL14
0.1–0.2 W light emitting capacitor (LEC) exit
Exit signage EL22
signs exclusively
Façade and landscape lighting LPD = 0.15 W/ft2 EL23
Parking lots and drives LPD = 0.1 W/ft2 EL23
Exterior lighting
LPD = Comply with Standard 90.1*
All other exterior lighting EL23
Auto reduce to 25% (12am–6am)
Laptops = minimum 2/3 of total computers
Computers PL2
All others = mini desktop computers
Equipment choices
ENERGY STAR® equipment All computers, equipment, appliances PL5
Vending machines Delamp and specify best in class efficiency. PL3, 7
Network control with power saving modes
PPL
Computer power control and control during unoccupied hours or IT PL2

enterprise power management software
Controls Occupancy sensors Office plug occupancy sensors PL3
Water coolers, coffee makers, small
Timer switches appliances = auto OFF during unoccupied PL3
hours
*Note: Where the table says “Comply with Standard 90.1,” the user must meet the more stringent of either the most current version of Standard 90.1 or the local code requirements.
82 | Advanced Energy Design Guide for Large Hospitals
Climate Zone 1 Recommendation Table for Large Hospitals (Continued)

ENERGY STAR or California rebate-qualified
Cooking equipment PL8–9
equipment
6 in. insulation on low-temp walk-in
equipment, insulated floor, LED lighting,
Refrigeration equipment floating-head pressure controls, liquid PL8–9, 12
Kitchen equipment
pressure amplifier, subcooled liquid
PPL
refrigerant, evaporative condenser

Side panels, larger overhangs, rear seal at
Exhaust hoods appliances, proximity hoods, VAV demand- PL8, 10, 13
based exhaust
Use traction elevators for all elevators, and
Process loads Elevators use regenerative traction elevators for all PL16
high-use elevators.
Gas water heater (condensing) 95% Efficiency WH3, HV8
SWH
Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Service water heating
Electric-heat-pump water heater 2.33 EF WH3
Pipe insulation (d < 1.5 in./d  1.5 in.) 1.0 in./1.5 in. WH7
No central steam Point-of-use steam for humidification and
Heating system HV33
Use hot-water distribution system sterilization
Water-cooled chiller 6.5 COP HV8, 35
Water-circulation pumps VFD and NEMA premium HV35
Surgery
Cooling towers VFD on tower fans HV37

Central air-handling system
Boiler efficiency 90% Ec HV8
Maximum fan power bhp  supply cfm × 0.0012 + A HV21–22, 24
Economizer Comply with Standard 90.1* HV19
WSHP part-load/full-load cooling efficiency 17.6/15.0 EER HV2
WSHP part-load/full-load heating efficiency 5.7/5.0 COP HV2
WSHP compressor capacity control Two-speed or variable-speed HV2
Water-source heat pump Closed-circuit cooling tower VFD on fans HV37
(WSHP) system with DOAS Boiler efficiency 90% Ec HV8
Maximum fan power 0.4 W/cfm HV21–22, 24
A (humid zones) = 60% total effectiveness
Exhaust-air energy recovery in DOAS HV9, 15–16
B (dry zones) = 60% sensible effectiveness
DOAS ventilation control DCV with VFD HV10–11
HVAC

Nonsurgery

Fan-coil system with DOAS Maximum fan power 0.4 W/cfm HV21–22, 24
FCU fans Multiple speed HV5
Heat recovery water-cooled chiller 4.55 COP HV8, 36, 38
Mixed-air VAV system with
separate OA treatment and
heat recovery system Maximum fan power bhp  supply cfm × 0.0012 + A HV21–22, 24
OA damper Motorized HV14, 31
Ducts and dampers Duct seal class Seal class A HV22, 24
Insulation level R-6 HV22–23
Design and circuit for separate submeters for
Electrical submeters lighting, HVAC, general 120V, service water QA12–14
heating, renewables, and whole building
QA
Measurement and verification

Benchmarks Benchmark monthly energy use. QA15
Training Facility operator on continuous benchmarking QA12–15

footprint.
Roofs
Below-grade walls Comply with Standard 90.1* EN5, 15–17
Mass R-10.4 c.i. EN6, 15–17
Floors
Slabs
Heated R-10.0 for 12 in. EN9–10, 15–17
Envelope

Doors
Thermal transmittance
Vertical fenestration Nonmetal framing windows = 0.25 EN19–20,
Solar heat gain coefficient (SHGC)
(full assembly—NFRC rating) Metal framing windows = 0.25 23–25
Light-to-solar gain ratio (LSG) All orientations 1.5 EN24
EN21, DL13–14
Exterior sun control South orientation only – PF = 0.5

All spaces DL3–6
perimeter.
toplighting.
Ceilings  80%
Walls  70%
Whole building = 0.9 W/ft2
T8 & T5 > 2 ft = 92
Light source efficacy (mean lumens per
T8 & T5 < 2 ft = 85 EL2–5
watt)
All other >50
Interior lighting Ballasts—4 ft T8 Lamps EL2
Lighting controls—General EL6, 21
possible.
0.1–0.2 W Light Emitting Capacitor (LEC) exit
Exit signage EL22
signs exclusively
Exterior lighting
Auto reduce to 25% (12 am–6 am)
Computers PL2
Equipment choices
Network control with power saving modes and
PPL
Computer power control control during unoccupied hours or IT PL2

hours

equipment
Kitchen equipment
PPL

based exhaust
Process loads Elevators use regenerative traction elevators for all high- PL16
use elevators.
SWH

Pipe insulation (d < 1.5 in./d 1.5 in.) 1.0 in./1.5 in. WH7
Heating system HV33
Surgery

HVAC

Nonsurgery

Q&A
Measurement and verification heating, renewables, and whole building

Climate Zone 3 Recommendation Table for Table for Large Hospitals

footprint.
Roofs
Below-grade walls R-7.5 c.i. (Comply with Standard 90.1* in 3A) EN5, 15–17
Mass R-12.5 c.i. EN6, 15–17
Floors
Slabs
Envelope
Heated R-15.0 for 24 in. EN9–10, 15–17

Doors
Nonmetal framing windows = 0.56
Thermal transmittance EN18-20, 22–25
Metal framing windows = 0.65
Vertical fenestration
(full assembly—NFRC rating) Solar heat gain coefficient (SHGC) EN19–20, 23–25
Light-to-solar gain ratio (LSG) All orientations  1.5 EN24
All spaces DL3–6
perimeter.
toplighting.
Add daylight controls to any space within 15
Nonform-driven daylighting option offices, corridors) and public spaces (waiting, DL20–23
ft of a perimeter window.
reception)
Ceilings  80%
Walls  70%
T8 & T5 > 2 ft = 92
Light source efficacy (mean lumens per watt) T8 & T5 < 2 ft = 85 EL2–5
All other >50

Ballasts—4 ft T8 Lamps EL2
Interior lighting Dimming= NEMA Premium Program Start
Lighting controls—General EL6,21
possible.
0.1–0.2 W Light Emitting Capacitor (LEC)
Exit signage EL22
exit signs exclusively
2
Façade and landscape lighting LPD = 0.15 W/ft EL23
Exterior lighting
Computers PL2
Equipment choices
PPL

hours
Climate Zone 3 Recommendation Table for Table for Large Hospitals (Continued)
equipment
Kitchen equipment
PPL

based exhaust
high-use elevators.
SWH

Heating system HV33
Surgery

Closed-circuit cooling tower VFD on fans HV37
Water-source heat pump
Exhaust-air energy recovery in DOAS B (dry zones) = 60% sensible effectiveness HV9, 15–16
C (marine zones) = 60% total effectiveness
HVAC

Nonsurgery

Mixed-air VAV system with Boiler efficiency 90% Ec HV8
separate OA treatment and Maximum fan power bhp  supply cfm × 0.0012 + A HV21–22, 24
heat recovery system
Q&A

Facility operator on continuous
Training QA12–15
benchmarking

Group similar space types within the
building footprint.
Roofs
Solar reflectance index (SRI) Comply with Standard 90.1*
Below-grade walls R-7.5 c.i. EN5, 15–17
Mass R-14.6 c.i. EN6, 15–17
Floors
Unheated Comply with Standard 90.1* EN8, 10, 15–16
Slabs
Heated R-20 for 24 in. EN9–10, 15–17
Envelope

Doors
DL7, EN20,
Window-to-wall ratio 40% of net wall (floor-ceiling)
26–27
Thermal transmittance EN19–20, 25–28
Vertical fenestration Metal framing windows = 0.44
(full assembly—NFRC rating) Nonmetal framing windows = 0.26
Solar heat gain coefficient (SHGC) EN19–20, 25–28
All spaces DL3–6
Inpatient units including patient rooms lies within 20 ft of DL6
the perimeter.
Design the building form to maximize
offices, corridors); public spaces (waiting, DL8–13, 15,
access to natural light, through sidelighting
reception); and other regularly occupied 20–23
and toplighting.
Add daylight controls to any space within 15
ft of a perimeter window.
reception)
Ceilings  80%
Walls  70%
T8 & T5 > 2 ft = 92
All other >50

Interior lighting Nondimming = NEMA Premium
possible.
0.1–0.2 W Light Emitting Capacitor (LEC)
Exit signage EL22
exit signs exclusively
Exterior lighting
Computers PL2
Equipment choices
PPL

hours

ENERGY STAR or California rebate-
qualified equipment
Kitchen equipment
PPL

based exhaust
high-use elevators.
SWH

Pipe insulation (d < 1.5 in./d 1.5 in.) 1.0 in./1.5 in. WH7
Heating system HV33
Surgery

HVAC

Nonsurgery

Mixed-air VAV system with Boiler efficiency 90% Ec HV8
separate OA treatment and Maximum fan power bhp  supply cfm × 0.0012 + A HV21–22, 24
Design and circuit for separate submeters
for lighting, HVAC, general 120V, service
Electrical submeters QA12–14
water heating, renewables, and whole
Q&A
Measurement and verification building

Facility operator on continuous
Training QA12–15
benchmarking

footprint.
Roofs
Mass R-14.6 c.i. EN6, 15–17
Floors
Unheated Comply with Standard 90.1* EN8,10, 15–17
Slabs
Heated R-20 for 24 in. EN9–10, 15–17
Envelope

Doors
DL7, EN20,
26–27
(full assembly—NFRC rating) Nonmetal framing windows = 0.25 EN19–20,
All spaces DL3–6
perimeter.
to natural light, through sidelighting and
toplighting.
Ceilings  80%
Walls  70%
T8 & T5 > 2 ft = 92
T8 & T5 < 2 ft = 85 EL2–5
watt)
All other >50
possible.
Exit signage EL22
signs exclusively
Exterior lighting
Computers PL2
Equipment choices
PPL

hours

equipment
Kitchen equipment
PPL

based exhaust
use elevators.
SWH

Heating system HV33
Surgery

(WSHP) system with DOAS
Water-cooled chiller 6.5 COP HV8,35
HVAC

Nonsurgery

Heat recovery water-cooled chiller 4.55 COP HV8,36,38
OA damper Motorized HV14,31
Q&A


footprint.
Roofs
Mass R-16.7 c.i. EN6, 15–17
Floors
Unheated R-10 for 24 in. EN8,10, 15–17
Slabs
Heated R-20 for 48 in. EN9–10, 15–17
Envelope

Doors
DL7, EN20,
26–27
All spaces DL3–6
perimeter.
toplighting.
Ceilings  80%
Walls  70%
T8 & T5 > 2 ft = 92
T8 & T5 < 2 ft = 85 EL2–5
watt)
All other >50
possible.
Exit signage EL22
signs exclusively
Exterior lighting
Computers PL2
Equipment choices
PPL

hours

equipment
Kitchen equipment
PPL

based exhaust
high-use elevators.
SWH

Heating system HV33
Surgery

HVAC

Nonsurgery

Q&A


footprint.
Roofs
Mass R-20.9 c.i. EN6, 15–17
Floors
Slabs
Heated R-25 for 48 in. EN9–10, 15–17
Envelope

Doors
DL7, EN20,
26–27
All spaces DL3–6
perimeter.
toplighting.
reception)
Ceilings  80%
Walls  70%
T8 & T5 > 2 ft = 92
All other >50

possible.
Exit signage EL22
signs exclusively
Exterior lighting
Computers PL2
Equipment choices
PPL

hours

equipment
Kitchen equipment
PPL

based exhaust
use elevators.
SWH

Heating system HV33
Surgery

HVAC

Nonsurgery

Q&A


footprint.
Roofs
Mass R-23.0 c.i. EN6, 15–17
Floors
Slabs
Heated R-20 full slab EN9–10, 15–17
Envelope

Doors
DL7, EN20,
26–27
All spaces DL3–6
Use LED lights exclusively Ensure that 75% of the occupied space not
perimeter.
toplighting.
Surgery task lights
Ceilings  80%
Walls  70%
T8 & T5 > 2 ft = 92
T8 & T5 < 2 ft = 85 DL2–5
watt)
All other >50
possible.
Exit signage EL22
signs exclusively
Exterior lighting
Computers PL2
Equipment choices
PPL

hours

equipment
Kitchen equipment
PPL

based exhaust
high-use elevators.
SWH

Heating system HV33
Water-cooled chiller Comply with Standard 90.1* HV8, 35
Surgery

Exhaust-air energy recovery in DOAS 60% sensible effectiveness HV9, 15–16
HVAC

Nonsurgery

Fan-coil system with DOAS
separate OA treatment and Boiler efficiency 90% Ec HV8
Q&A


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Achieving 50% Energy Savings Toward a Net Zero Energy Building

All rights reserved.

Climate Zone 1 Recommendation Table for Large Hospitals

Heated R-7.5 for 12 in. EN9–10, 15–17

Computer power control and control during unoccupied hours or IT PL2

Climate Zone 1 Recommendation Table for Large Hospitals (Continued)

refrigerant, evaporative condenser

Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Cooling towers VFD on tower fans HV37

Water-circulation pumps VFD and NEMA premium HV35

Boiler efficiency 90% Ec HV8

Measurement and verification

Climate Zone 2 Recommendation Table for Large Hospitals

Swinging U-0.70 EN11, 16

Comply with LEED for healthcare credits

Computer power control control during unoccupied hours or IT PL2

Climate Zone 2 Recommendation Table for Large Hospitals (Continued)

refrigerant, evaporative condenser

Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Cooling towers VFD on tower fans HV37

Water-circulation pumps VFD and NEMA premium HV35

Boiler efficiency 90% Ec HV8

Measurement and verification heating, renewables, and whole building

Climate Zone 3 Recommendation Table for Table for Large Hospitals

Heated R-15.0 for 24 in. EN9–10, 15–17

All other >50

Computer power control and control during unoccupied hours or IT PL2

refrigerant, evaporative condenser

Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Cooling towers VFD on tower fans HV37

Cooling towers VFD on tower fans HV37

Boiler efficiency 90% Ec HV8

Measurement and verification

Climate Zone 4 Recommendation Table for Large Hospitals

Swinging U-0.50 EN11, 16

All other >50

Computer power control and control during unoccupied hours or IT PL2

Climate Zone 4 Recommendation Table for Large Hospitals (Continued)

refrigerant, evaporative condenser

Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Cooling towers VFD on tower fans HV37

Cooling towers VFD on tower fans HV37

Boiler efficiency 90% Ec HV8

Measurement and verification building

Climate Zone 5 Recommendation Table for Large Hospitals

Swinging U-0.50 EN11, 16

Computer power control control during unoccupied hours or IT PL2

Climate Zone 5 Recommendation Table for Large Hospitals (Continued)

refrigerant, evaporative condenser

Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Cooling towers VFD on tower fans HV37

Water-circulation pumps VFD and NEMA premium HV35

Boiler efficiency 90% Ec HV8

Measurement and verification heating, renewables, and whole building

Climate Zone 6 Recommendation Table for Large Hospitals

Swinging U-0.50 EN11, 16

Computer power control and control during unoccupied hours or IT PL2

Climate Zone 6 Recommendation Table for Large Hospitals (Continued)

refrigerant, evaporative condenser

Point-of-use water heater 0.81 EF or 81% Et PL11, WH3

Cooling towers VFD on tower fans HV37

Water-circulation pumps VFD and NEMA premium HV35