Swenson G, 2004

Article written by hospital director, reporting the experience in the organization. It presents a graph with results obtained and spreadsheets to calculate savings obtained used with employees.

Interventions to reduce energy consumption in existing buildings. Gradual investments and reinvestment of savings obtained.

It only mentions the management of improvement opportunities in existing buildings, with monitoring of results.

Restricted to recover the initial investment in the operation phase.

Raising workers’ awareness of energy savings, data usage, customized calculation tools. Potentially benefited community through the reproduction of learning.

Technological update of the boiler, air conditioning and lighting systems. Window replacement as a passive strategy. In old buildings, adoption of more efficient solutions according to the need for maintenance and adaptations.

Lanser EG, 2003

Article. Interview with building systems specialist. Provides an approach to improve the organization’s financial and operational performance.

Building systems design, with emphasis on operating costs.

Long-term evaluation should guide the project. This should be linked to the facilities master plan and integrated with strategic planning.

The concept should guide the project, with the evaluation guiding the decisions. It presents the information that 75% of the cost is in the operation phase.


Long-term plans, avoiding fragmented and reactive maintenance; greater control over costs and risks in contracts with third-party providers; results-based agreements.

Ruby, 2003

Article. Highlights the impact of HU energy consumption. It uses quantitative data and comparison with other types of buildings.

Possibility of reducing energy consumption by joining a government program.




Reduction of energy consumption; greater systems efficiency; adherence to the government’s Energy Star program.

Quayle C, 1998

Article. Reports hospital adherence to an energy conservation program. It presents consumption reduction data and a simplified methodology for calculating the internal rate of return on investments.

Gradual upgrade of systems. Measures in line with the US Environmental Protection Agency’s Energy Star Building program. Saving financial resources and reducing environmental impacts.

Intervention planning in five phases, with gradual disbursements, with a return on investments. Focus on decision makers based on the attractiveness of return estimates.

Restricted to recover the initial investment in the operation phase.

Provides estimates of internal rates of return and risk factor.


Digital climate control; more efficient building systems; lighting as an initial target. Sequence of interventions initiated by the least costly, aimed at reducing the thermal load, finally updating air conditioning equipment.

Hall BG; Stauffer H, 1980

Article. Case report with company energy conservation strategy that controlled more than 170 hospitals of the USA. Displays consumption indicators per unit of floor area.

Reduced energy consumption for lower operating costs. Adoption of innovative solutions, some of which are not yet viable or have operational problems.

Internal team of professionals to identify needs and project guidance activities. Control and evaluation of construction quality, performed by third parties.

The evaluation of alternatives by the internal team and representatives of the architecture, engineering and construction companies occurs based on the life-cycle cost.

Highlights the support of management and workers to the team responsible for maintenance as a key point.

More efficient lighting, considering the work surfaces and coating materials of the environments; thermal insulation of the envelope; solar energy; harnessing the heat from incinerators.

Hospitals, 1977

Article. Reports characteristics and design strategies of a hospital completed in 1975.

Project methodology based on life-cycle cost assessment and operational flexibility.

Environment layout, possibility of modifications and resizing, according to flow criteria and specifications based on the life-cycle cost assessment.

Explicit concept in the text. Evaluation to specify materials, systems and components, aiming at lower operational cost, despite the higher initial cost reported.

Comfort and convenience for the patient; objective location criteria as a facilitator of work processes; good relationship with the community.

Streamlined construction with panels and shafts for installations independent of the structure; durable materials with low maintenance cost; greater efficiency of the heating system.