The Project Green Hospital is an initiative implemented by the USL Tuscany Southeast to make more efficient and friendly hospitals.
The management focused on the reduction of heat and electricity uses, that are the main aspect of the good practice. The implementation started with an high quality energy audits of the hospitals.
The main action was the installation of cogeneration plants to produce electricity and heat, fuelled by methane gas in the Hospitals of Arezzo and Valdarno (the two most important Hospitals in terms of energy consumption) through which it is possible today to self-produce about half the electrical energy of which the two hospitals require. This intervention was followed by the energy upgrading of thermal power plants of 5 hospitals, which in three cases (Bibbiena, Sansepolcro, Cortona) has seen the passage of old thermal plants steam / hot water to new central with modern boilers and burners modulating whilst in the other two (Arezzo, Valdarno) saw the change of obsolete hot water boilers with new high efficiency combined with modulating burners. A 47 kW photovoltaic system at the Hospital of Arezzo has been installed and have started procedures to entrust the work to build one 50 kW at the Cortona Hospital.
In Arezzo and Bibbiena Hospital were replaced the old refrigeration units with new high efficiency condensates groups. The traditional system boiler has been upgraded with a system of plate heat exchangers (Bibbiena, Sansepolcro, Valdarno).
The ASL signed a contract of high-performance energy service with a private company.

Resources needed

The financing resources (about 4 million €) came 80% from a non-refundable grant of the Ministry restricted to energy efficiency in public administration, and the remainder 20% from the Italian Health Authority funding, in order to support the Project Green Hospitals.

Evidence of success

Works in order to improve energy efficiency in 39 buildings (Hospitals, Clinics and Offices)
Reduction of energy consumption: - 2.976,09 TEP/year (-26,8%)
Reduction of energy expenses: - 1.608.853 €/year (-26,4%)
reduction of CO2 emissions: - 7.385.912 kg/year (- 27,1%)
The expenses for energy improvement had a payback time of 2,38 years, allowing better services and new investments in the future.

Difficulties encountered

The difficulties encountered are mainly related to the analysis of the building and the search for all data at a level of accuracy suitable for the purpose.

Potential for learning or transfer

This good practice has high level of transferability of planning. Health facilities, because of their energy-consuming nature, allow an extraordinary opportunity in the field of rationalization of consumption and therefore of the public current expenditure, and represent excellent sites for the development of new technological solutions, thanks to the high visibility of the results. The implementation of the same good practice is very easy., so the transferability really high. Insulation, renewable energy, promotion of technological innovation, monitoring the provision of energy services, control of lighting, heating and air-conditioning activities are applicable to all public buildings and especially those most energy such as hospitals. The selection process is a good monitoring system (market research, system comparison, etc.) and is transferable. All these aspects can be translated into training and educational materials, which can increase the transferability of capacity building.

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Main institution
Florentine Energy Agency (FEA)
Toscana, Italy (Italia)
Start Date
April 2012
End Date


Sergio Gatteschi Please login to contact the author.