APPENDIX E
HOSPITAL BUILDING SYSTEMS

The Veterans Administration (VA; now the Department of Veterans Affairs) hospital building system (VAHBS) was developed in the late 1960s to be a set of modular planning and organizational rules establishing the relationships among hospital systems and spaces. The functional units are characterized by fixed dimensions and volumes, but they can be adjusted within stated guidelines to suit a wide variety of sites, configurations, and aesthetic treatments. After two decades of actual use, the VA has found the VAHBS to be very cost effective in facilitating introduction of new mechanical and electrical systems to support advancing medical technology.

A key element of VAHBS is the use of interstitial space (see Figure E-1), a 9-foot floor-between-floors that houses mechanical and electrical components. This space is constructed as a working floor, and seven vertical layers are reserved for various main, branch, and lateral distribution elements.

Figure E-2 illustrates how the interstitial space fits into the VAHBS one-story building module. The module is restricted by fire safety regulations to no larger than 22,500 square feet overall, but structural bays may vary from 24 to 27 feet wide, 41 to 59 feet deep, and 19 to 21 feet high. A service bay located on the narrow side of the module provides a vertical link to carry mechanical and electrical equipment, and shafts and stairs so that the modules can be combined to form a tower, a series of pavilions off a central corridor, a superblock with open cores, or a number of other forms.

The VAHBS has attracted considerable praise and received a 1992 Federal Design Achievement Award. However, there is not uniform agreement in professional circles that the design system is either consistently less costly or more flexible than other designs. Debate focuses primarily on the amount of



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The Fourth Dimension in Building: Strategies for Minimizing Obsolescence APPENDIX E HOSPITAL BUILDING SYSTEMS The Veterans Administration (VA; now the Department of Veterans Affairs) hospital building system (VAHBS) was developed in the late 1960s to be a set of modular planning and organizational rules establishing the relationships among hospital systems and spaces. The functional units are characterized by fixed dimensions and volumes, but they can be adjusted within stated guidelines to suit a wide variety of sites, configurations, and aesthetic treatments. After two decades of actual use, the VA has found the VAHBS to be very cost effective in facilitating introduction of new mechanical and electrical systems to support advancing medical technology. A key element of VAHBS is the use of interstitial space (see Figure E-1), a 9-foot floor-between-floors that houses mechanical and electrical components. This space is constructed as a working floor, and seven vertical layers are reserved for various main, branch, and lateral distribution elements. Figure E-2 illustrates how the interstitial space fits into the VAHBS one-story building module. The module is restricted by fire safety regulations to no larger than 22,500 square feet overall, but structural bays may vary from 24 to 27 feet wide, 41 to 59 feet deep, and 19 to 21 feet high. A service bay located on the narrow side of the module provides a vertical link to carry mechanical and electrical equipment, and shafts and stairs so that the modules can be combined to form a tower, a series of pavilions off a central corridor, a superblock with open cores, or a number of other forms. The VAHBS has attracted considerable praise and received a 1992 Federal Design Achievement Award. However, there is not uniform agreement in professional circles that the design system is either consistently less costly or more flexible than other designs. Debate focuses primarily on the amount of

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The Fourth Dimension in Building: Strategies for Minimizing Obsolescence Figure E-1 VAHBS vertical zone organization within module (figure courtesy of Stone Marraccini Patterson [SMP]). interstitial space in the VAHBS, which some designers feel is overly generous. The Army Corps of Engineers also has had a satisfactory experience with its integrated building systems (IBS). The Corps' Medical Design Standards include guidance on evaluation and design of IBS hospital facilities. The IBS systems module is a unit one floor high, and is served by its own service distribution systems and utility pod, with a floor area of 10,000 to 22,500 square feet. Easy equipment accessibility to maximize facility life span is cited as one of the factors comprising the IBS design intent.

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The Fourth Dimension in Building: Strategies for Minimizing Obsolescence Figure E-2 VAHBS one-floor basic building module.

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