510
Generalized Needs and Requirements: Hospital Needs
Any user need statement will, in time, become obsolete. It is
recommended that these statements be periodically revised to maintain a
relevant body of information for the Veterans Administration and its
architect-engineer contractors. (See Section 630).
512
USER NEEDS FOR THE TOTAL HOSPITAL
Certain user needs common to all of the hospital are highlighted in the
following sections: growth and change, maintenance, building
management, fire safety, asepsis, materials handling and transportation,
and communications.
512.1
GROWTH AND CHANGE
512.1.1
Change is inherent in the practice of medicine. Currently, hospitals must
respond to changing operational and social needs as well as those of
medicine. Traditionally, the ability to respond to change has been, for all
practical purposes, frozen during the period necessary to plan and
construct a hospital. This pattern is no longer desirable. Hospitals must
be capable of responding to changing needs at any time before or after
occupancy.
A building's configuration determines, to a large extent, the limits of its
subsequent ability to adapt. Shape and the location of fixed (permanent)
elements are particularly important in the nursing tower portion of the
hospital where many activities require perimeter exposure and where
patterns of space organization are relatively rigid.
The performance of non-replaceable elements, such as the building
structure, also limits future adaptability. Hospitals are normally not
demolished because they cease to function as basic shelter; most are
adequate to house people comfortably and safely. Rather, demolition is
the result of the inability to meet changing user needs to a degree, which
is totally unacceptable.
Long before the demolition point is reached, most hospital buildings
impose constraints which result in sub-optimal performance. It is highly
desirable to minimize the constraint imposed by the building upon the
activities and environment contained therein.
512.1.2
National medical care patterns are currently undergoing close scrutiny at
the highest levels of government. It is probable that, as a result of this
examination, reorganization of the national health care system will affect
all health facilities, including those of the VA. It is also likely that this will
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