While it is common practice to use energy saving technologies to achieve energy reductions, people ultimately control how technologies are used and achieve energy savings. Energy management that includes the human dimension is known as Energy Behaviour.
Energy Behaviour approaches have been shown to be successful in the residential sector to reduce home energy use and to induce energy savings in businesses. The application of Energy Behaviour in the institutional sector and how a sector approach can be designed to achieve energy savings is not well understood or documented, although it has been demonstrated in several hospital settings, some which have shown energy savings of 3-10%.
In support of Energy Behaviour practices, the Coalition has awarded outstanding health care facilities through our annual Green Health Care Awards, associated with our Green Hospital Scorecard Program. To view past winners and explore data on Energy Behaviour in the sector, visit the GHS webpage and read our Green Health Care Reports.
Health Care-specific Energy Behaviour Resources
- Energy Behaviour in Healthcare: Stories from the Field. Kady Cowan. Presentation to Canadian Coalition for Green Health Care. February 20, 2019.
- Designing Behaviour Change Programs for Encouraging Energy Efficiency. March 7, 2019. Behaviour Energy and Climate Change (BECC) Sponsored Webinar. Behaviour Change 101: Theory and Practice
- How to design, implement and evaluate behaviour change interventions in hospitals. Kady Cowan, Dr Reuven Sussman, Dr Sea Rotmann. International Energy Association Webinar. December 21, 2017. View the slides.
- Training Building Operators to be Energy Champions Prof. Robert Cox. Presentation BECC, 2018.
- It’s not my job: Changing Behavior and Culture in a Healthcare Setting. Kady Cowan, Dr Reuven Sussman, Dr Sea Rotmann, Dr. Eric Mazzi. August 2018. Conference Paper. ACEEE Summer Study at Monterey, California.
- Chapter 21, Behaviour and Energy Facility Management. In 8th Edition of ‘Guide to Energy Management’ Capehart, Turner & Kennedy (Fairmont Press). Authors: Dr Eric Mazzi, PE, CEM, Mazzi Consulting Services, and New York Institute of Technology; Ms Kady Cowan, University Health Network, Toronto, Canada; and Ms Eileen Westervelt, PE, CEM, Westervelt Engineering.
- Perspective on M&V behavioral change programs in commercial and industrial facilities. Eric Mazzi. Efficiency Valuation Organization (EVO). EVO’s Measurement & Verification Magazine. February 2019. M&V Focus Issue #4.
- Morgenstern, P. Understanding hospital electricity use: an end-use(r) perspective. A Thesis Submitted for the Degree of Doctor of Philosophy University College London University of London. UCL Energy Institute. The Bartlett School of Environment, Energy and Resources. University College London. 2016.
- Saving Energy in Hospitals A study of Behaviour Change Opportunities by Department. Prism Engineering. April 30, 2014.
- International Energy Agency: Task 24. Phase 1. Closing the Loop: Behaviour Change in DSM- From Theory to Practice
- Task 24 Phase II. Behaviour Change in DSM- Helping the Behaviour Changers Subtask 8: Toolbox for Behaviour Changers
- Cowan, K., Sussman, R., Rotmann, S. & R. Cox (2017). Subtask 11: Real-life case studies Designing a Behaviour Change Programme for Hospital Facilities Staff. IEA DSM Task 24.
Examples of Initiatives in Hospitals
Facility Name | London Health Science Centre (LHSC) |
| Location | London, Ontario, Canada |
| Program Name | The Chester Program |
| What is it? | LHSC has been running an employee engagement program for energy efficiency since 2003 using an energy mascot CHESTER. The program inspires active participation by staff to help the hospital save energy and is hosted by the energy mascot CHESTER to keep the program fun and friendly. The program incorporates behaviour change strategies and activities that help to get staff involved while increasing awareness around energy use. The departmental Energy Challenge has been a great success with energy reductions tracked using a portable power analyzer. The challenges are run for five weeks at a time and daily savings are presented on a ‘game board’ inside the department area, providing immediate feedback on how their actions helps save electricity. Staff Engagement is a component of Demand Side Management within their Energy Management Plan, and identifies the Chester Network/program to engage staff through Department Challenges, Energy Heros, and the Marketing Campaign. |
| Successes | Departmental challenges run over five weeks typically reduce electricity use by 10 – 15% |
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| Case Studies | Chester Network: Includes London Health Sciences Centre, St. Josephs Health Care Centre London, Alexander Marine and General Hospital, Huron Perth HealthCare Alliance, and Alberta Health Services. Available in: Implementing an Energy Efficiency Awareness Program. Office of Energy Efficiency. Government of Canada. 2012. Pg 22 |
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Facility Name | University Health Network |
| Location | Toronto, Ontario, Canada |
| Program Name | TLC (Thermostats Lights and Controls) |
| What is it? | UHN piloted a unique, comprehensive energy management and engagement program in their three hospitals (Toronto Western Hospital, Toronto General Hospital and Princess Margaret Hospital over three years (2007–2010). |
| Successes | By the end of the three-year pilot, the TLC program achieved: -Total energy use reduction: 2.4% net reduction / |
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Facility Name | Lower Mainland Health Authority |
| Location | British Columbia (BC), Canada |
| Program Name | Green + Leaders |
| What is it? | Green+Leaders started in 2008 to provide staff with direct support in making energy and environmental sustainability changes in their work-spaces. The program provides direct one-on-one engagement with staff around energy and environmental conservation. |
| Successes | Since the program’s inception, Green+Leaders has implemented several successful energy reduction campaigns to encourage staff to turn off equipment. Some departments have reported up to an 80 % improvement in “turn-it-off” behaviour. |
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Facility Name | Atrium Health (formerly Carolina Health System) |
| Location | North Carolina, USA |
| Program Name | Energy Connect |
| Successes | First-year results in six facilities showed annual energy savings at three facilities ranged from 3.5% to 12%, with all pilot sites saving energy attributable to Energy Connect. |
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Facility Name | Vancouver Island Health Authority (IH) |
| Location | 150 health care facilities in Vancouver Island, Georgia Strait, and mainland communities north of Powell River and south of Rivers Inlet. |
| Program Name | Originally called: ‘Turn it Off’; in 2016 rebranded as Energy Wise Network (EWN) program. |
| What is it? | Energy behaviour change program started in 2010 guided by Prism Engineering, with a focus on two key behaviours: turning off lights and monitors. Cost-effective tools and techniques included: setting up Green Teams and training Green Team members to conduct energy walkabouts, campaigns using emails, posters and stickers, green cupcake events, light bulb exchange days, Good to be Green contests, Turn It Off Tours conducted with BC Hydro staff, and post-program surveys. The program leads believed the success of the program depended on the use of Community Based Social Marketing Techniques, which emphasised the importance of person to person contact to prompt the new behaviours. IH developed Greening Care program in 2016 which had three components: organization-wide staff communications and engagement; the Green Champion Program for staff who carry out green initiatives at select facilities (replacing the Green Team program); and a Facilities Maintenance and Operations (FMO) Engagement Program aimed towards FMO staff at all owned sites. FMO staff participated in year-long Building Energy Challenge Campaign in 2017 which included targeting different continuous optimization opportunities to encourage new habits of looking for energy saving opportunities as a part of daily rounds. Topics included reduced lighting, optimized VFD, air supply and reduced equipment runtime. In 2017 ran successful ‘fans and pumps’ campaign. In 2018 focused on direct digital controls (DDC) such as turn of equipment when not needed, reduced heating or increased cooling temperature setpoints after-hours, improved sequence of operations and enhanced maintenance procedures. A checklist developed for crews to help identify energy savings. Three well-received webinars encouraged dialogue among FMO staff from various locations. |
| Successes | With ‘Turn It Off’ program: reduced lighting in sample office by 50% following walkabouts. Other areas reported lighting reduced by 10 – 15% following program promotion. With FMO programs: staff identified substantial energy savings, including from replacing old equipment. |
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Facility Name | Manchester Trust and ‘Jump’ |
| Location | Manchester, England |
| Program Name | Green Rewards Programme |
| What is it? | Manchester University NHS Foundation Trust has launched an incentivised sustainability and wellbeing behaviour change programme for its 20,000 employees. The Green Rewards programme, aims to encourage positive actions among employees through use of an online platform and mobile app. The programme was launched on 7 May 2019 and is available to staff in nine hospitals, as well as the NHS community health services through Manchester Local Care Organisation (MLCO). Using an online platform and mobile app, employees are able to track positive behaviours and earn ‘green points’. Desired behaviours include recycling, energy saving, sustainable travel, and wellbeing activities such as keeping active, travelling to work actively, and spending time outside. The activities are divided into six categories: engage, nature, nurture, consumption, journeys and fuel. Some of the behaviours being promoted include switching off electrical equipment, pledging to use less plastic, a step challenge and meat-free Mondays. |
| Successes | Savings per year on energy bill; |
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Facility Name | Barts Health NHS Trust and Global Action Plan |
| Location | London, England |
| Program Name | Operation TLC: Turning equipment off, Lights out, Close doors |
| What is it? | Operation TLC is a hospital behavior change program that links reduced energy costs with improved patient experience. Initiated in 2013 by Barts Health NHS Trust and Global Action Plan (GAP), the program encouraged staff in six hospitals to turn off unused equipment, switch off lights, and close doors, allowing the hospitals to save money from energy efficiency, create a healing environment for patients, boost staff productivity, and reduce emissions. Operation TLC has become an award-winning behavior-modification program, where training hospital staff to adopt simple energy efficient behaviors saves health organizations energy and money while also creating healing environments for patients. 12 other Trusts have also adopted Operation TLC |
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