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Water Efficiency and Management for Hospitals
Massachusetts Water Resources Authority


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> Case Study: Norwood Hospital

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The MWRA's Industrial, Commercial and Institutional (ICI) Water Management Program was developed to help businesses, industries and institutions improve their water efficiency. Since its formation in 1989, the ICI program has helped various companies in the MWRA service area reduce their water consumption, thereby reducing operational costs.

Through the development of Water Efficiency Measures (WEMs) all facilities have the potential to evaluate opportunities for water savings without adversely affecting operations. Water saving measures need not be expensive nor complex to be effective. The program has aided hospitals ranging from 130 bed capacity to over 500 beds, with annual water consumption from 15 million gallons to 145 million gallons. Each hospital study conducted has shown at least one area of each facility where significant reductions in water usage can be achieved.

Important Note: When a water efficiency measure is considered in a health care facility all regulatory agencies and local code requirements must be followed.

Listed below are some suggestions and examples of WEMs for hospitals that have proven successful or have potential applications in area facilities examined. Water and sewer rates, as well as cost/savings payback, are based on 1993 figures for all examples.


Case Study Example #1
Carney Hospital in Dorchester is installing flow control fixtures on all patient and exam room faucets at their facility. The existing flow rate of the faucets was measured at 5 gallons per minute (gpm). After retrofitting the faucets the flow was reduced by 3.5 gpm to 1.5 gpm. The average usage of sinks at the facility is estimated at 25 minutes per day. This results in a water savings of 88 gallons per day, or 32,000 gallons of heated water per year for a combined water and energy savings of approximately $280 annually per sink. The cost to retrofit one sink is estimated at $12 resulting in a payback of less than one month.

  • Install flow control fixtures on all faucets.
  • Install water saving shower heads.
  • Retrofit flushometer toilets and urinals with low consumption valve replacement kits.
  • Replace existing higher consumption toilets and urinals with Massachusetts Plumbing Code conforming Ultra Low Flush (ULF) toilets and urinals which use 1.6 gallons per flush (gpf) and 1.0 gpf respectively.

Case Study Example #2
New England Memorial Hospital in Stoneham has over 300 flushometer toilets in their facility which use approximately 4.5 gallons per flush. Replacing all the existing toilets with ULF toilets would save over 5 million gallons of water annually based on estimates of average daily population in the hospital and information on toilet use. The cost of this measure is estimated at $65,000 and the water and sewer savings of approximately $42,000 result in a payback of 18 months.


  • Avoid excessive cooling tower blowdown by minimizing consumption with automatic controls and conductivity meters.
  • Ensure return of steam condensate to boiler for reuse.
  • Replace water-cooled equipment with air-cooled units where possible and economically feasible.
  • Modify once-through water-cooled refrigeration and air conditioning units and incorporate into recirculating cooling loop.

Case Study Example #3
Carney Hospital in Dorchester has several refrigeration and air conditioning units that are cooled with once through water. By incorporating these units into a recirculating closed cooling loop, the facility can reduce water consumption by 3 million gallons per year to save over $20,000 in annual water and sewer costs. Initial cost of this project is estimated at $29,000 and payback would occur in less than 18 months.


  • Use full loads in sanitizers, sterilizers and lab equipment dishwashers.
  • Eliminate use of city water for cooling sterilizer condensate before dumping to drain when possible, considering drain material and diversity of drains or available floor space for holding tanks.
  • Reduce flow to surgical vacuum pumps to acceptable minimum level and maintain proper operation.
  • Install automatic valves on X-ray film processing equipment to stop water flow when units are not in use.

Case Study Example #4
New England Memorial Hospital has an opportunity to save water in their x-ray developing process. By retrofitting the flow restrictors to the developing machines, water consumption can be reduced by 176,00 gallons annually. The estimated cost of modifying the machines is $150 and the water and sewer savings is approximately $1,400 resulting in a payback of less than two months.


  • Operate dishwashers with full loads only, and shut off when they are not in use.
  • Control flow of water to garbage disposer or consider eliminating the use of the disposer all together.
  • Investigate reusing rinsewater from dishwasher for garbage disposer or for prewash cycle.
  • Install spray rinses for pot washing and reduce flow of spray rinsers for prewash.

Case Study Example #5
Milton Hospital has installed a foot pedal operated spray rinser on the pot scrubbing sink in their kitchen. This has resulted in a much more efficient rinsing process saving approximately 370,000 gallons of water per year. The cost to implement this measure today is estimated at $240 and the annual savings is approximately $3,300 resulting in a payback of less than one month.


  • Evaluate wash program considering daily wash loads. Consult manufacturer for specifications regarding minimizing water necessary for various load soil conditions.
  • Check with chemical vendor and evaluate wash formula.
  • Investigate a rinsewater reclamation system to reuse rinsewater for wash cycle.
  • Consider installing a washwater and rinsewater treatment and reclamation system.

Case Study Example #6
Newton-Wellesley Hospital recently had a rinsewater reuse system installed in their laundry that the installer estimates will reduce water consumption in the laundry process by 1.8 million gallons annually.


  • Read water meters daily if your facility uses more than 7.5 million gallons of water per year. Refer to the "Improving Water Efficiency " guide available from the MWRA to help track water used at your facility.
  • Locate and repair leaks.
  • Check steam traps periodically, repair when necessary.

Case Study Example #7

In one New England area hospital a solenoid valve on a bacteriology lab incubator failed, resulting in an unnecessary constant flow of 5 gpm, or 2.6 million gallons annually. At present water and sewer rates that is $18,00 wasted per year. The cost to rectify the situation is estimated at $200, giving an immediate payback.


  • Initiate employee awareness program, get input and ideas from staff, offer incentives. Encourage employee water conservation at home as well.
  • Evaluate daily routines of staff (i.e. patient showering, clean up, scrubbing and hand washing) and encourage efficient practices and procedures regarding water use.
  • Develop a water management plan at your facility, consult the "Improving Water Efficiency" guide from the MWRA's ICI Program for help

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