510
Generalized Needs and Requirements: Hospital Needs
result in substantial change in the current pattern of inpatient and
outpatient utilization. Development of a strategy for growth and change is
therefore considered fundamental to the long-range effectiveness of a
hospital building system for the VA.
512.1.3
Non-nursing areas of the hospital may be contrasted with nursing areas
with regard to growth and change. In nursing areas:
1. The frequency of change is less than in non-nursing areas.
2. The type of change is more predictable.
3. Growth is apt to be in functional unit increments, so existing units are
not affected.
4. The density of services is considerably less than many non-nursing
areas, consequently service change is also less.
In the supporting areas of the hospital, growth and change assume a quite
different character. Procedures, both medical and industrial, are more
sophisticated. Therefore, change for technological reasons is apt to more
frequent and more demanding of services. In addition, activities in these
areas are apt to be of a more critical nature, and thus are less capable of
being disrupted during change. Expansion of any element in the hospital
"base" is apt to affect other areas. Significant growth of a department is
often not merely additive, but also requires a partial reorganization of
existing spaces. In addition, growth may require modification or relocation
of adjacent departments. This is particularly true in large base units seen
in most current VA hospitals.
512.1.4
In addition to growth and change of existing departments, the supporting
medical service units must be able to accommodate the introduction of
additional treatment modalities. In recent years, we have seen the
introduction of cardiac catheterization, inhalation therapy, pulmonary
function evaluation and other new diagnostic and treatment functions
requiring new departments or space in existing departments.
512.2
MAINTENANCE
512.2.1
Maintenance activities are conducted on both a routine preventative and
an as-needed basis. Activities include all repairs and alterations not
requiring the services of an outside contractor. The primary objective of
building maintenance is to provide an optimum medical and operational
environment at all times.
2-3
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