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checkEvaluate equipment water use.

All PIM content was independently developed and reviewed to be vendor-, product-, and service provider-neutral.


A typical hospital has many different types of water-consuming equipment. Evaluate equipment for low-cost opportunities to reduce water consumption.

  • Project Talking Points

    • Water-consuming mechanical systems (which are often coordinated by the medical equipment planner, piping engineers, kitchen consultants and others) include medical vacuum systems, laundry equipment, sterilizers, water treatment systems, and kitchen equipment.
    • Water-consuming medical equipment includes x-ray processors, large imaging equipment (e.g., MRIs) that can be water-cooled (though those that use closed loop systems do not consume potable water), refrigeration units, ice machines, and dialysis systems.
    • Significant savings can be achieved by using equipment at optimum settings for water efficiency and upgrading to more efficient equipment when possible.
  • Triple Bottom Line Benefits

    • Cost benefits: Low-cost upgrades will result in cost savings. Measuring and understanding water consumption related to specific equipment processes is the first step to identifying improvements that will offer a high return on investment.
    • Environmental benefits: Maximizing equipment water efficiency has the benefits of decreased amount of water withdrawn from natural water bodies, protecting the natural water cycle and decreasing strain on the municipal water supply. This also reduces energy use and emissions associated with treating, supplying, and heating potable water.
    • Social benefits: Reducing water use by making low-cost upgrades saves resources that can be applied to the health care mission of a hospital. Water conservation supports environmental stewardship and healthy communities.
    • Quality and outcomes - Metrics are in development. If you have suggestions, please contact us or participate in the discussion below.
  • How-To

    1. As part of equipment evaluation, conduct a water usage survey.
    2. For all equipment, perform routine maintenance to ensure and verify efficient performance.
    3. Kitchens: For water-intensive equipment, such as steamers and dishwashers, review with your vendor how to reduce or adjust water limits without compromising equipment function; or alternatively, explore upgrading to new, more efficient options (e.g., boilerless steamers). Consider replacing a water-intensive garbage disposal with a pulper system (i.e., one that operates on processed kitchen waste water) or beginning a composting program.
    4. Medical vacuum plants: To reduce unnecessary operation time, perform a medical vacuum system audit that targets user and equipment connections. Repair and replace outlets as necessary to eliminate system leaks. Consider alternative cooling water sources (e.g., reclaimed water, closed loop systems, chilled water). Consult equipment manufacturer for ways to maximize cooling efficiency.
    5. Laundry: Evaluate water used for daily wash loads. Consult manufacturer for specifications regarding minimum water necessary depending on degree of dirt and stains—from lightly to heavily soiled. Consult the manufacturer for other ways to increase water efficiency.
    6. Refrigeration units and ice machines: Audit all refrigeration units and ice machines to develop baseline for water consumption. Monitor and track ice machine output with actual use. If output is greater than actual use, consult the operating manual for ways to adjust the machine to dispense less ice. If possible, stop dispensing ice during periods of no use (e.g., late night hours).  Implement processes to monitor machine output on a regular basis and make adjustments as necessary.
    7. Medical equipment (including scanners and X-ray machines): Make note of any equipment that uses once-through water cooling. Consult with equipment vendor and adjust flow rates to minimum levels. Install flow meters and timers to monitor and control flow in off-use hours. Look at using reclaimed water or tapping into chilled water sources to provide cooling.
    8. Water treatment systems: Consult vendors for options, including timers, to limit regeneration cycles. Discuss the possibility of using updated and more efficient systems including ones that offer the option of re-using reject water.
    9. List equipment that uses domestic water for once-through cooling. For larger capacity equipment, consider cooling the unit with an existing chilled water loop, where one is available. Where one is not available, look at limiting cooling water discharge by using temperature sensors or timers. Also, consider alternative water sources (such as recycled water) for once-through uses.
    10. Confirm that water pressures are set no higher than required for equipment operation. Confirm that pressure reducing valve assemblies are functioning properly.
  • Tools

    • The watermark! health care  benchmarking tool is a free and growing database of health care water consumption. The tool allows facility managers and building owners to compare their facility's water consumption with that of similar buildings throughout the nation.
    • Energy Star’s Portfolio Manager includes water reporting options. This program, which tracks utility data for electricity, gas and water, is a widely used program. Some states require hospitals to enter their utility data into Portfolio Manager.

    If you have an ROI tool, calculator, or similar resources to share, please contact us or participate in the discussion below.

  • Case Studies

    Do you have a case study to share? Please contact us.

  • Regulations, Codes and Standards, Policies

  • Cross References: LEED

    LEED for Healthcare New Construction & Major Renovations

    Water Efficiency Prerequisite 1: Water Use Reduction

    Water Efficiency Prerequisite 2: Minimize Potable Water Use for Medical Equipment Cooling

    Water Efficiency Credit 3: Water Use Reduction

    Water Efficiency Credit 4.1: Water Use Reduction-Building Equipment

    Water Efficiency Credit 4.2: Water Use Reduction-Cooling Towers

    Water Efficiency Credit 4.3: Water Use Reduction-Food Waste Systems

  • Cross References: GGHC

    Green Guide for Health Care Operations Section

    • Operations: Facilities Management Credit FM 2.1-2.5: Potable Water Use Reduction: Total Building Reduction
    • Operations: Facilities Management Credit FM 5.3: Performance Measurement: Enhanced Water Metering
    • Operations: Innovation in Operations Credit IN 2.1: Documenting Sustainable Operations Cost Impacts: Overall Operating Costs
  • Cross References: EEP

    If you have sample environmentally preferable purchasing language for products or contracted services to share, or other related resources, please contact us or participate in the discussion below.

  • PIM Synergies

  • More Resources

  • PIM Descriptors


    Level: Beginner

    Category List:

    • Strategic Operations

    PIM Attributes:

    • Strategies/Projects

    Improvement Type:

    • Operations


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