20130114 eche 2013 green+ hospitals presentationuuid:... · presentation 1. the (hospital) world is...

Green+ HospitalsSustainable Healthcare Infrastructure. More than just Green.

Bern, 12th April 2013 Jens Schneider

Green+ Hospitals

ECHE 2013 5. Europäische Konferenz für

Krankenhaustechnik

Oct 2012 © Siemens AG 2012. All rights reserved.Green+ Hospitals

Executive summary and content of this

presentation

1. The (hospital) world is changing

and early planning for

sustainability is key

2. We have extensive experience

in all elements of sustainable

hospital development and

operation

3. How to make a hospital

“Green”?

Siemens can support all phases

of a hospital’s cycle

Content of this document

Introduction to Green+ Hospitals

concept

Elements of Green+ Hospitals for

new buildings and existing

buildings

Selected references


Megatrends are changing the world …

Source: Stern review, E&EC, UN

The average life

expectancy

increased from ~35

years to ~65 years

within one century!

Highest CO2

concentration since 350,000 years ago! Already ~1°C temperature increase!

In 2050,

9 billion people

will live on our

planet!

Fixed schemes with

decreasing

reimbursement rates

require considerable

efforts for efficiency

improvements!

Health spending has

grown faster than the

GDP in almost every

country of the OECD in

the past 15 years!

Pic

ture

Sourc

e:

Mic

hael G

rabscheit_pix

elio

.de


Today's hospital management needs to cope with

new challenges to be sustainably profitable

GER

30.021.0

GER

20.06.0 8.0

EUNL EUWorld

5.2

By 2012 (Kyoto) By 2020 (Bali)

CO2 emission reduction targets

set for whole economies by

governments in %

Increased competition and

public awareness requires

health care providers to deliver

high quality medical services

Quality

Increasing energy costs

Heating oil Gas

Green

Changing reimbursement system

and global financial situation

requires cost reduction by

efficiency increase for healthcare

providers

Efficiency

Financial limitations

+23%

20112009

+22%

20112009

Source: U.S. Energy Information Administration Short Term Energy Outlook, September 2011

Increased competition

Green


Green+ Hospitals is the Siemens approach for

Sustainability in hospitals

More than just Green.

Green+ Hospitals

Green+ Hospitals not only

focuses on the obvious

“green” aspects – there are

three critical success factors

for sustainable healthcare

infrastructure:

Green

Efficiency

Quality

Quality

Optimized medical care

Convenient and healthy

procedures

Health supporting

environmental conditions

Efficiency

Optimized workflows

Efficient assignment of time

Efficient assignment of

financial resources

Green

Reduction of energy

consumption

Sustainable and careful

use of resources

Pollution reduction


Early consideration of sustainability aspect

required in new hospital building projects

StrategyDetailed planning

Execution/implementation

OperationTenders

Influenceability Effort/cost of

changes

Hospital development process



presentation







operation


“Green”?





concept



buildings

Selected references


Reference example Green:

Clinic Reinkenheide – Energy Saving Performance Contracting

Clinical Center Reinkenheide

Clinical Center Bremerhaven Reinkenheide, Germany

Hospital with more than 700 beds

Owned by the City of Bremerhaven (100%)

Opened in 1976 without any modernization up to now

The annual energy cost amount to 2 million Euros

Situation

Siemens Energy Saving Performance Contracting

guarantees annual energy savings of 520,000 EUR p.a.

corresponding to 25%

Invest by Siemens: Volume 5.2 million EUR

Contracting duration: 12 years

Implementation completed in 2007

4,130 tons less CO2 emissions annually

Award of certificate BUND Gütesiegel:

“energy saving hospital”

Solution*

* Data on file.


Reference example Efficiency and Green:

St. Joseph, Orange CA – Refurbished Systems

St. Joseph, Orange CA

Hospital within St. Joseph Health System (10th largest

not for profit health system in US)

Rated top 12% for adult cardiac surgery by US Society

of Thoracic Surgeons for 4 consecutive years

Challenge of need for significant capacity increase to

accommodate >2,500 cardiovascular patients each

year but budget constraints

Situation

Siemens Proven Excellence “like new” pre owned

medical system: AXIOM Artis dBC

Same quality of images and reliability as for new

system with no detectable difference

Customer service and parts availability guarantee as for

new system

Purchase of more equipment with same budget and

increased capacity

Reduction of CO2 emissions doubled through

reforestation in cooperation with WWF Indonesia and its

NEWtrees Replanting Initiative

Solution


8

6

45 min

Reference example Efficiency:

University Hospital Erlangen – Clinical pathways

22 h

University Hospital Erlangen

University Hospital Erlangen, Germany

Partially inefficient workflow in clinical paths with high

occupancy of beds and avoidable waiting times

Objective has been to optimize workflow, usage of

medical equipment, and employee resources while

simultaneously improving quality of medical care

Situation

Clinical pathways for 5 indications developed

Most important lever: introduction of trans sectoral

path involving family practitioner

Workflows, personnel and equipment planning adapted

to new pathways

Billing procedures optimized leveraging on path

documentation

For ERCP** path total length of stay reduced from

48 to 26 hours

Solution*

*Data on file.

**Endoscopic retrograde cholangiopancreaticography


Ethianum HeidelbergSituation

Reference example new building project:

Ethianum Heidelberg, Germany

Privately run clinic based in Heidelberg, Germany; opened

in July 2010

Specializing in plastic surgery, aesthetic surgery and

preventive medicine

Close cooperation in the clinical and academic domain with

the University Clinic Heidelberg

Joint development and implementation of Siemens

solutions regarding energy management, patient care, and

communication infrastructure

Picture Source: Ethianum

Establishment of short examination times and structured

treatment paths

Hotel standard and "green styled" architecture creates an

atmosphere of well being

Leading edge building technology to optimize energy

consumption incl. geo thermal energy

Green Building Monitor provides data for all current energy

consumption in the building at a glance

MAGNETOM Verio, AXIOM Aristos VX and Acuson S2000

deliver high quality clinical images and operate resource

efficiently

HiPath 4000, HiMed Cockpit and Voice over WLAN –

intelligent communications network supports physicians and

medical staff in delivering the best possible care and

provides optimal patient comfort and entertainment

Solution


Siemens is the proven partner for

sustainable healthcare infrastructure

Market leader in providing energy

efficient products, solutions, and services

Our customers are saving billions

of Euros in thousands of facilities

world wide

Green

In depth experience in analyzing

and optimizing clinical and non clinical

workflows from more than

350 consulting projects

Efficiency

Since years, we have developed a deep

expertise in all 3 dimensions of

sustainability…

… and we offer our customers a comprehensive portfolio of

sustainability products and solutions

Services

Information and

communication

Building and

energy

Maintenance

Consulting

Financing

Operating models

Building

Energy

Security

Lighting

In vivo/in vitro

diagnostic systems

Therapy systems

Clinical IT

Administrative IT

Communication

technology

Deep understanding of clinical process

quality and ways to improve quality from

global best practice analyses, colla

boration with leading experts, and

standard of care projects at hospitals

world wide

Quality

Medical

technology



presentation







operation


“Green”?





concept



buildings

Selected references


Green+ Check approach for assessment of the

sustainability of a hospital

Data driven template

for first evaluation and

workshop preparation

(~ 3 pages)

Data requestData request

2 5 days workshop with contact persons

in hospital

Interview sessions to understand the customer

situation and to collect further data

On the spot inspection

Evaluation of data and preparation of

standardized report

Overall duration 3 4 weeks

Benchmarking

Green+ Radar

Overall Green+ Score

Derivation of improvement

measures

Proposal for prioritization

Final reportWorkshop with interview sessionsWorkshop and interview sessions


Go to market approach: The Green+ Check provides

an initial overview of the customer’s performance

Green+ Score

Measures hospitals’

performance along the 3

dimensions of Green+

Best practice segments

Represent individual strengths

of the hospital

Critical segments

Show areas with improvement

potential


The Green+ Check covers 40 areas in the hospital

Green+ RadarEnergy efficiency management

Heating and cooling (HVAC)Hot steam generationBuildingElectrical energyInformation and communicationLightingWaterSuppliers

HeliumMedical equipmentPaperWaste

Strategic focusProcess managementOccupancy

EmployeesFinancial resultsMedical equipmentITCommunicationBuilding layoutPurchasingLogistics

Food supplyCareEmergency handlingSurgeryResearch and teaching

PatientsEmployees

Referral systemSocietyResourcesMedicationSecurity/safetyQuality managementMedical qualityFollow on treatment

Research and teaching

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40



Green+ Radar

Energy efficiency management

Heating and cooling (HVAC

Hot steam generation

Building

Electrical energy

Information and communication

Lighting

Water

Suppliers

Helium

Medical equipment

Paper

Waste

1

2

3

4

5

6

7

8

9

10

11

12

13

Gre

en

Energy efficiency managementHeating and cooling (HVAC)Hot steam generationBuildingElectrical energyInformation and communicationLighting

WaterSuppliersHeliumMedical equipmentPaperWaste

Strategic focus

Process managementOccupancyEmployeesFinancial resultsMedical equipmentITCommunicationBuilding layout

PurchasingLogisticsFood supplyCareEmergency handlingSurgeryResearch and teaching

PatientsEmployeesReferral systemSocietyResourcesMedicationSecurity/safetyQuality management

Medical qualityFollow on treatmentResearch and teaching

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40



Green+ Radar

Strategic Focus

Process management

Occupancy

Employees

Financial results

Medical equipment

IT

Communication

Building layout

Purchasing

Logistics

Food supply

Care

Emergency handling

Surgery


Eff

icie

nc

y14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29



Strategic focus





1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40



Green+ Radar

Patients

Employees

Referral system

Society

Resources

Medication

Security/safety

Quality management

Medical quality

Follow on treatments


Qu

ali

ty

30

31

32

33

34

35

36

37

38

39



Strategic focus





1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

40


Energy

3

sim

ple

diffic

ult

Purchasing

5

Building

1

KPIs

2

OPs

6

IT

4

Referrers

7Employee

s8

Security

9

16

11

13

Communication

14

15

Med Tech

10

Lig

h

t

12

Light

low

Food

high

Waste

Telemedicine

Effo

rt

Benefit

The Green+ Check provides the basis for a

prioritization of possible improvement areas

Prioritization matrixImprovement areas – packages of measures

1. Building: Further centralization and modernization

2. KPI system: Introduction of KPI system, automated data collection link to targets/incentives

3. Energy: Update of block heating, renovation of ventilation, increase awareness and motivation of employees for energy savings, increase share of renewable energy sources

4. IT: Update of network infrastructure, introduction of electronic patient record, upgrade of data center infrastructure

5. Purchasing: Application of sustainability criteria, consideration of unit dose system

6. Operating theatres: centralization and utilization management, upgrade of monitor equipment

7. Referrers: Strengthening of dialogue with referrers, measurement of satisfaction

8. Employees: Measurement of employee satisfaction; introduction of incentives for coding quality

9. Security: Development of security concept for dementia patients

10. Medical technology: Assessment of total cost of ownershipincl. ecological footprint, increasing use of low radiation dosesystems/upgrades

11. Food: Optimization of cook&serve (variety, transport)

12. Light: Further improvement of lighting concept

13. Telemedicine: Further strengthening

14. Mobile communication: re assessment of possibilities to improve access

15. Patient satisfaction: Introduction of centralized surveys

16. Improvement of waste management

SANITIZED

CUSTOMER EXAMPLE

Patient satisfaction

Final presentation of Green+

Check also includes rough

assessment of energy savings

potential


Current status of Green+ Check

1. Green+ Check has been developed and piloted

hospitals in Germany

2. The pilots have been conducted in 29 hospitals in

several countries namely in Korea, China, Turkey,

Switzerland and Germany

3. We have initiated the localization process and further

discussions in a number of other countries.

Sweden, Finland, Denmark and the Netherlands are

ready for pilots


The building blocks of a Green+ Hospital include an

overall Green+ strategy, sustainable healthcare

infrastructure, and optimized processes

Green+ Hospital strategy

Building structure Building technology

IT/communication

technologyMedical technology

Optimized processes/workflows

6 building blocks of a Green+ Hospital

Infr

astr

uctu

re

Typical

order

for

new

building

projects


Hospital strategy and planning Hospital ramp up

General hospital development process

Strategy OperationTendersPlanningExecution/

implementation

Green hospital elements maybe included in all

stages of hospital lifecycle

Green+ strategy

“What is the medical focus

of the clinic and what are

the synergies with other

specialties?“

“Which LEED level can be

targeted?“

“Which project partners will

be needed?“

1a

Green+ master plan

“What is the right size of the

hospital and its departments?”

„How shall the different

departments be located to

support efficient workflows?

1b

Green+ building

technology plan

“What is important and what

are the prerequisites to

consider to building an

energy efficient hospital?”

2a

Green+ medical

technology realization

Siemens Healthcare products

and solutions

Green+ IT and

communication technology

realization

Atos/Fujitsu/SEN/Siemens

products & solutions

Green+ execution

support

Green+ Account Management

3

Green+ building

technology realization

Siemens BT and Osram

products & solutions

Green+ IT and

communication

technology plan

“Which technology and layout

should be used to create a

Green IT / data and

communication center?”

2b

Green+ medical

technology plan

“What and how to organize

the medical devices to enable

most efficient clinical and

technology workflows?”

2c

Green+ Check

“What is the hospitals’

current sustainability status

and how to further improve

it?”

8

Green+ monitoring

“How to measure, monitor

and further optimize the

energy usage?"

7

Green+ service and

maintenance

“How to keep the equipment

running at high efficiency?”

9

Green+ Hospitals strategy and planning Green+ Hospitals products and solutions

4

5

6

Siemens Healthcare Consulting

Thank you for your attention!

http://www.siemens.com/greenplushospitals

More information:

Green+ HospitalsJens Schneider

Principal of Siemens Healthcare Consulting

Allee am Röthelheimpark 3a

Germany 91052 Erlangen

Tel.: +49 (9131) 84 7199

[email protected]

20130114 eche 2013 green+ hospitals presentationuuid:... · presentation 1. the (hospital) world is...

Documents