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Case study


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Case study


Case study

Hospitals use an average of 139,214 gallons per day of water

This checklist will help facility managers evaluate the appropriateness of water-saving adjustments for improving the efficiency of your health care facility. Remember, water savings often bring energy savings, too.

This information is based on the results of water use evaluations of 26 industrial, commercial and institutional (ICI) facilities throughout the Tampa Bay area. The checklist has been adapted from a publication of the Metropolitan Water District of Southern California, and measures should be checked to be sure they are consistent with Health Department codes.

Many of the water-saving suggestions involve specific equipment. Contact the Southwest Florida Water Management District for information about water-conservation equipment for ICI facilities. This simple checklist can get you on your way to reducing your water use and improving the efficiency of your facilities.

Operations & equipment

  • Recycle and reduce water use wherever possible, consistent with Health Department requirements.
  • Use full loads in sanitizers, dishwashers, sterilizers and laundry washing machines, consistent with infection control requirements.
  • Install automatic valves on film processing equipment to stop water flow when equipment is not in use. Use temperature control valves.
  • Recycle brine from reverse osmosis, or filter backwash, for cooling.
  • Replace lab aspirators with a central vacuum system.

Bathrooms & restrooms

Domestic water use accounts for an average of 24% of the water use in health care facilities.

  • Repair Leaks! A leaking toilet can waste more than 50 gallons of water each day, and a dripping faucet or showerhead can waste up to 1,000 gallons per week!
  • Showerheads and toilets that must be replaced due to normal wear-and-tear should be replaced with low-volume models, which are widely available.
  • Low-volume showerheads use only 2 gallons of water each minute; older models may use as much as 3 gallons per minute.

Water use in toilets can be reduced by:

  • Installing toilet tank water displacement devices, such as toilet dams, bags, or weighted bottles.
  • Retrofitting flushometer (tank-less) toilets with water-savings diaphragms, which save one gallons (20%) per flush.
  • Replacing toilets with low-volume models. Toilets can use as much as 4.5 gallons per flush, while low-volume toilets use only 1.6 gallons per flush. An average savings of more than 7% of a hospital's total water use was possible through this one water conservation action.
  • Install spring-loaded valves or timers of all non-clinical faucets.
  • Consider the use of flow-straighteners on faucets.

Water use in urinals can be reduced by:

  • Setting urinals with programmable automatic flush valves to a water saving mode that flushes the urinal after more than one use.
  • Replacing urinals with low-volume models. Urinals can use as much as 5 gallons per flush, while low-volume urinals use only 1 gallon per flush.

These Water Conservation at Work suggestions are more than just a good idea. Low-volume water fixtures are also required by most local building codes.

Building maintenance


  • Check the water supply system for leaks, and turn off unnecessary flows.
  • Shut off the water supply to equipment and areas that are unused.
  • Discontinue water circulation pumping in areas not in use.
  • Read water meters monthly. Compare the results to the same month of the previous year. This will help to identify leaks as they occur, as well as monitor your conservation efforts.
  • Check the pressure. Where system pressure is higher than 60 psi, install pressure-reducing valves.
  • Consider using water-efficient ice machines.


  • Cooling can account for up to 53% of the water use in a hospital.
  • Reduce excessive blowdown! Many cooling towers operate below the suggested levels of total dissolved solids (TDS) unnecessarily. Adjust boiler and cooling tower blowdown rate to maintain TDS at levels recommended by manufacturers' specifications.
  • Return steam condensate to the boiler for reuse.
  • Consider using ozone as a cooling tower treatment to reduce water used for make-up.
  • Shut off water-cooled air conditioning units when not needed, or replace water-cooled equipment with air-cooled systems.


  • Water used for general cleaning averages 10% of all of the water used in a hospital.
  • Overhaul faulty steam traps on sterilizers.
  • Instruct cleaning crews to use water efficiently for mopping.
  • Switch from "wet" carpet cleaning methods, such as steam, to "dry," powder methods.
  • Change window cleaning schedule from "periodic" to "as required."

Cafeteria & food service

This accounts for an average of 5% of the water used in hospitals.

  • Turn off the continuous flow used to wash the drain trays of the coffee/milk/soda beverage island. Clean thoroughly as needed.
  • Adjust ice machines to dispense less ice if ice is being wasted.
  • Upgrade equipment with water-efficient models.
  • Provide table signs urging water conservation.

Dishwasher hints

  • Wash only full loads in the dishwashers.
  • Turn dishwashers off when dishes are not being processed.
  • Reuse the rinse water from the dishwasher as flush water in garbage disposal units.

Outdoor water use


  • Apply water, fertilizer, or pesticides to your landscape only when needed. Look for signs of wilt before watering established plants.
  • Water early in the morning or in the evening when wind and evaporation are lowest.
  • Install an automatic rain shut-off device on sprinkler systems.
  • Consider using low-volume irrigation, such as a drip system.
  • Avoid runoff! Make sure sprinklers are directing water to landscape areas, and not to parking lots, sidewalks, or other paved areas.
  • Adjust the irrigation schedule for seasonal changes. Sprinklers generally do not have to be run as often in cooler weather, or during the rainy season.
  • Use mulch around landscape plants to reduce evaporation and weed growth.
  • Consider using drought-tolerant, low-maintenance plants.


  • Be sure all hoses have shut-off nozzles.
  • Use a broom, rather than a hose, to clear sidewalks, driveways, loading docks and parking lots.
  • Wash vehicles only when needed.
  • Investigate the availability of reclaimed water for irrigation and other approved uses.

Make it a company policy

  • Educate employees about the importance and benefits of water conservation.
  • Create water conservation suggestion boxes, and place them in prominent areas.
  • Install signs in restrooms and cafeterias which encourage water conservation.
  • Assign an employee to evaluate water conservation opportunities and effectiveness.

Any retrofitting and/or plumbing changes to facilities must be consistent with regulatory agencies. Check with the appropriate agencies before making changes.

View a case study specific to hospitals.

Use Average water use
(% of total)
Potential savings
(% of total)
Cooling 53 32
Domestic 24 10
Cleaning 10 9
Kitchen 5
Process 4
Other 4
TOTALS 100% 139,214 gpd 51% 71,000

Source: ICI Conservation in the Tri-County Area of the SWFWMD. SWFWMD, November 1997.

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