How An Intelligent Infrastructure Reduces Operating Costs and Improves Patient Care

How an intelligent infrastructure
reduces operating costs and

improves patient care
Graeme Robertson
Global Business Development Director,
Healthcare Solutions, Schneider Electric
Key Elements of an Intelligent
Infrastructure
HVAC Controls/BMS ICT/Data Centre
Operating Theatre OT Power Infrastructure
Medical Wards
Life Safety Systems
Integrated Security Enterprise Management
Lighting Control
Schneider Electric - Division - Name – Date 2

Key Technologies
Noise Monitoring Systems
Infection Control Systems

Staff Support Systems
Visitor Management
Patient Healing Environment

Intelligent Interoperation
Lighting Control Integrated Security Integrated Building Data Centre
Operating Theatre
System Systems Automation Infrastructure
Dimmer units IP CCTV HVAC controls Power distribution Electrical distribution

Lighting controllers Access control Utilities metering UPS
Room switch units IPS
Staff attack Pred maintenance In-row cooling units
Multi sensors UPS
Infant tagging SCADA Integrated security
Surgeons panel
Scene setting
RFID LOCATION Video intercom M&T Room cooling RFID LOCATION
Environmental
External lighting
SYSTEM Intruder detection Energy reclaim SYSTEM
Hospital Intelligent Technology Infrastructure
RFID LOCATION Servers

RFID LOCATION
HV/ MV / LV switchgear
24/ 7 remote services SYSTEM
SYSTEM
Fire alarm Nurse call Video recording
Energy modeling
Emergency lighting Bedhead services Transformers POE switches
Entertainment Bill validation
Public address Generator integration Firewalls
RFID systems Energy pricing
Voice evacuation Busbar trunking Quality of service
Load shedding
Fire dampers Environment Distribution Digital signage
Maximum demand
Fire Safety Electrical Energy

Medical Areas ICT
Systems Distribution Management

Integration – Infant Abduction
HVAC Controls/BMS Power Infrastructure Integrated Security Lighting Control
Bed
Elevators
Services
Car Park Management 24/7 Remote Management Nurse Call & RTLS
Integration – Life Safety
Bed
Elevators
Services
Integration – Patient Room
Bed
Elevators
Services
Integration – Operating Room
Bed
Elevators
Services
Integration – Asset Management
Bed
Elevators
Services
Human Interaction Executive
Executive View
Dashboards
Reporting

KPI reports
Energy efficiency
environment Energy efficiency
Staff efficiency
Security overview
Operational View
Operating
Fire Panel Nurse Station Patient Panel
Theatre
Environment Environment
Lighting control Lighting control UPS status
Fire alarms
Nurse call Nurse call Environmental
Fireman's override
Security RFID Internet Alarm status
Intercom entertainment

Expert Monitoring
Energy Building Security

Data Centre
Management Management Management
and Control
24/7 remote Maintenance

Security Operations
services SCADA
Video analytics management
Energy modeling Environmental
Access control Energy efficiency
Bill validation Lighting control
Safety control Network
Load shedding M&T
M&T Remote access
Maximum demand Remote access
Building Lighting Integrated Operating

Automation Control Security Theatre
Dimmer units IP CCTV
Electrical
HVAC controls Controllers Access control
distribution
Integrated Systems
Utilities metering Room switch units Staff attack

IPS
Room controllers Multi sensors Infant tagging
UPS
Control panels Scene setting Video intercom
Surgeon’s panel
External lighting Intruder
Electrical Data Centre Life Safety

ICT Medical Areas
Distribution Infrastructure Systems
Power distribution Servers Nurse call
Switchgear Fire alarm
UPS Digital video Bedhead services
Transformers Emergency lighting
In-row cooling POE switches Entertainment
Generators Public address
Integrated security Firewalls RFID location
Busbar trunking Voice evacuation
Room cooling Quality of service systems
Plug & play Fire dampers
Energy reclaim Digital signage Environment

Healing Environment
Patient Environment Staff Environment

•Reduce Patient Falls •Facilitate Hand Cleaning
•Provide Access to Daylight & Views •Increase Patient Visibility
•Improve Indoor Air Quality •Reduce Travel Distances
•Consider Ergonomics/ Accessibility •Provide Appropriate Lighting
•Reduce Infection Risk •Provide Easy Access to
•Reduce Noise Information
•Create Restorative Spaces

Reduce Airborne Infections - UVC

Efficient Fluid Power
Damper
Filter Cooling coil UVC
Outside air
contains
viruses,
bacteria, mold
spores, and
VOCs
Spores UVC EmittersTM destroy Clean Air

reproduce in mold, bacteria, viruses, supplied to
filter, cooling and VOCs preventing building
coil and drip pan them from the airflow
reducing coil and increases coil
efficiency efficiency
99% Kill rate of 77% Increase in

airborne pathogens Cooling Coil
Efficiency
Case Study
Ultra Violet Air Treatment
Before and after study for the

installation of UVC emitters in
all hospital air systems
conducted in October 2010.
Cooling Coil
Efficiency
Improvement 77%
Bacteria Reduction 99%
Return on Investment 15 months

UVC Study Results
BEFORE AFTER
BOTTOM OF COOLING COIL
AFTER
BEFORE
DAMPER BLADES
Automatic Hand Hygiene Monitoring
67% reduction in hospital-

acquired infections

Case Studies
Automatic Hand Hygiene Compliance Monitoring
1000% increase in hand hygiene

observations
Compliance levels maintained above 90% for all

working shifts
HAI’s (Healthcare Associated Infections) reduced by

67% in following 3 years after installation

Case Studies
Automatic Hand Hygiene Compliance Monitoring
The Hawthorne Effect:

“The tendency to perform or
perceive differently when one
knows they are being observed”

Infection control – auto flushing
Hygienic flushing unit links to the Schneider Electric intelligent hospital
infrastructure:
Hospital intelligent
infrastructure
H.F.U
H.F.U
Each hygienic flushing unit

incorporates intelligent valve
technology with temperature
and volume control.

Case Study
Automatic Hygienic Flushing
Cold water supply acts as heat

sink for building
40% reduction in legionella
bacteria in existing hospital –
Liverpool Broadgreen Study.
100% elimination of legionella
bacteria in Manchester Hospital –
2 year study
Water Savings due to elimination

of unnecessary flushing

Integrated Infection Control
UVC anti-bacterial Automatic hand

air treatment hygiene monitoring
Wireless monitored
hand sanitizer
Automatic
Anti-bacterial
Flushing Unit
Staff base human

machine interface
Patient Micro Climate
•Contamination
•Air quality
•Smoke detection
•Temperature
•Humidity
Lighting control
•Autoblinds
•Daylight control
•Touchpad interface
•Internet
Nurse call
•Telephone
•TV/Radio
•Room controls
Staff base human

Ambient noise machine interface
Case Study
Patient Micro Climate Control
270 bed hospital installed

effective control and monitoring
of patient room environment
including lighting and solar blind
configuration to increase amount
of natural light received by
patients.
Patients with increased natural
light:
1. Reported less perceived
stress, resulting in 20% less
pain medication costs.
2. Had a reduced Average
Length of Stay (ALOS)

Hospital Noise and Sleep Fragmentation
John Hopkins Hospital USA
•
50%
increase
Night 60
Sound
Level 40
dB(A)
1960 2010
Noise Effects:
•Lower oxygen saturation
•Higher respiratory rate
•Higher blood pressure
•Faster heart rate
•Slower weight gain
•Impaired sleep

Noise Monitoring
Display Unit
Control Unit
External
Microphone

Case Study
Noise Monitoring
Study of noise monitoring and
1.5 hours per day mandatory
quiet time:
• TV’s & music only via noise
cancelling headphones
• Limited staff movement
• Visitor restrictions
Results:
1. 50% reduction in noise levels
2.Patients twice as likely to
gain undisturbed sleep
3. Positive effect on patient blood
pressure, pain experience and
emotional wellbeing.
Case Study - Quiron Hospital, Madrid
24/7 Remote Management

Energy Efficient Installation &

Intelligent Functionality for lighting
Reduced power losses and

improved power quality
Efficiency based HVAC control for

central plant and ventilation
Extensive sub metering and 24/7

enterprise energy management

ENERGY
SAVING
CAPEX
SAVING

Case Study – Skane Hospitals Sweden
Staff Training Water

Management
Kristianstad Lund Helsingborg

120,479 m2 191,296 m2 131,970 m2
Performance Assurance 24/7 Remote Management

Energy Efficient Installation &

Intelligent Functionality for lighting
Reduced power losses and
improved power quality
Efficiency based HVAC control for
central plant and ventilation
Staff Training Extensive sub metering and 24/7 Water
enterprise energy management Management
Intelligent integrated water saving
technology installed throughout
Performance assurance service
with predictive maintenance

Savings District Heating Dist Dist Elec Elec %

& Electricity Htg Htg % MWh/yr
MWh/yr
Lund 7,860 27% 207 13%
Helsingborg 4,984 26% 1,343 8%
Kristianstad 6,298 30% 116 8%
Overall 19,142 28% 1,666 9%
Staff Training Water

Management
Overall Water Savings 56,000m³/yr

Efficient Data Centre/Server Rooms
Heat recovery In row cooling
Reduced Floor Area

Dynamic Simulation – Pilot Study
A pilot study was conducted using a standard building design model and
applying Schneider Electric’s EcoStruxure for energy efficiency design
measures at neutral capital cost impact.
Standard Design

Pilot Study Building Data
Building Type & Location Acute Hospital, London, UK

Number of Beds 400
Number of Floors 7
Building Floor Area 36,384m²
Building Conditioned Volume 145,536m³
Configuration Energy & Ventilation Plant Roof Mounted
Floors – mix single, 4bed & 6 bed wards
Operating Theatres & departments
Design Parameters Compliant to current building regulations

Energy Saving Design Features
ADVANCED METERING AND
ENERGY MANAGEMENT
HIGH EFFICIENCY
SMART ELECTRICAL EFFICIENCY BASED
POWER BUILDING SERVICES
INFRASTRUCTURE CONTROL
• Power Quality • Main Energy Plant
• Reduced Losses • Ventilation Plant
• Power Management • DDC Terminal Control
• Energy Alarms • HVAC Set Back

• Advanced Analysis • Power De-energisation
• Corrective Actions • Lighting switch off
24/7 REMOTE OCCUPANCY BASED

SPECIALIST ENERGY INTEROPERATION
ANALYSIS
INTELLIGENT LOW
ENERGY LIGHTING
CONTROL

Dynamic Simulation Results
Total Energy: Typical v. Proposed

Total Energy (MWh)
Hospital Typical
7000.00
6000.00 Total Energy (MWh)
5000.00 Hospital Proposed
MWh
4000.00
3000.00
2000.00
1000.00
0.00
1 2 3 4 5 6 7 8 9 10 11 12
Months
Typical – 43,607 MWh/year
Proposed – 29,552 MWh/year

Lighting Energy
200.00
Hospital Typical
180.00
160.00
140.00
MWh
100.00
80.00
60.00
40.00
20.00
0.00
1 2 3 4 5 6 7 8 9 10 11 12
Months

Total Gas: Typical v. Proposed
6,000.00
5,000.00 Hospital Typical
4,000.00
MWh
Hospital Proposed
3,000.00
2,000.00
1,000.00
0.00
1 2 3 4 5 6 7 8 9 10 11 12
Months

Total Electricity: Typical v. Proposed
1,600.00
1,400.00
1,200.00
1,000.00
MWh
800.00 Hospital Typical
400.00
200.00
0.00
1 2 3 4 5 6 7 8 9 10 11 12
Months

Holistic Infrastructure Model
• Department
KPI’s
• Process • Patient KPI’s • Building +
Data centre efficiency • Hospital KPI • Process environment +
• Electronic data sheets dashboard analysis tools asset dashboards
Infrastructure Management
health records
• X-ray
• Diagnostic data
level level
Intelligent Technology Infrastructure

Facility level
Admissions Procedures Recovery Discharge Home

Doctor’s surgery
• Wireless • Data input • Environment • Data input • Telecare
devices • Tracking • Measurement • Patient satisfaction
• Data input • Measurement • Patient control • Measurements of
• Infection control performance

Design Considerations - Delivery
Ability to impact cost and functional capabilities
Design Effort / Effect
Cost of design
changes
IPD process
Traditional process
Pre-design Schematic Design Construction Agency permit/ Construction

design development documents bidding
Conceptualization Criteria Detailed Implementation Agency Construction
design design documents coordination/
final buyout
IPD – Integrated Project Delivery

Summary
Five main reasons why an intelligent infrastructure

should be installed in hospitals: -
1. Improve Patient Care
2. Improve Staff Prodcutivity
3. Improve Adaptability & Future Proofing of the
Facility
4. Reduce Life Cycle Costs
5. Reduce Waste

How An Intelligent Infrastructure Reduces Operating Costs and Improves Patient Care

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How an intelligent infrastructure

reduces operating costs and

Operating Theatre OT Power Infrastructure

Integrated Security Enterprise Management

Schneider Electric - Division - Name – Date 2

Noise Monitoring Systems

Infection Control Systems

Patient Healing Environment

Schneider Electric - Division - Name – Date 3

Dimmer units IP CCTV HVAC controls Power distribution Electrical distribution

Hospital Intelligent Technology Infrastructure

RFID LOCATION Servers

Fire Safety Electrical Energy

Schneider Electric - Division - Name – Date 4

Hospital Intelligent Technology Infrastructure

Hospital Intelligent Technology Infrastructure

Energy Building Security

24/7 remote Maintenance

Building Lighting Integrated Operating

Utilities metering Room switch units Staff attack

Electrical Data Centre Life Safety

Schneider Electric - Division - Name – Date 10

Patient Environment Staff Environment

Schneider Electric - Division - Name – Date 11

Schneider Electric - Division - Name – Date 12

Spores UVC EmittersTM destroy Clean Air

99% Kill rate of 77% Increase in

Before and after study for the

Bacteria Reduction 99%

Return on Investment 15 months

Schneider Electric - Division - Name – Date 14

BOTTOM OF COOLING COIL

67% reduction in hospital-

Schneider Electric - Division - Name – Date 16

1000% increase in hand hygiene

Compliance levels maintained above 90% for all

HAI’s (Healthcare Associated Infections) reduced by

Schneider Electric - Division - Name – Date 17

The Hawthorne Effect:

Schneider Electric - Division - Name – Date 18

Each hygienic flushing unit

Schneider Electric - Division - Name – Date 19

Cold water supply acts as heat

Water Savings due to elimination

Schneider Electric - Division - Name – Date 20

UVC anti-bacterial Automatic hand

Staff base human

Staff base human

270 bed hospital installed

Schneider Electric - Division - Name – Date 23

Schneider Electric - Division - Name – Date 24

Hospital Intelligent Technology Infrastructure

Schneider Electric - Division - Name – Date 25

24/7 Remote Management

Energy Efficient Installation &

Reduced power losses and

Efficiency based HVAC control for

Extensive sub metering and 24/7

24/7 Remote Management

24/7 Remote Management

Staff Training Water

Kristianstad Lund Helsingborg