620
Conclusions: Benefits
particular regard for the impact these decisions may have on the hospital
as a system. Experience has shown that these devices are in fact often
very wasteful in terms of the final cost-effectiveness of the project. The
allocation of budgetary surpluses, and response to program changes, are
likewise frequently inefficient in the context of traditional design and cost
control procedures.
The principle impact of the Prototype Design on cost is intended to be in
the areas of maintenance and alterations, rather than first cost.
Nevertheless, the very characteristics which have been developed to
reduce life costs simplicity, adaptability and accessibility are bound to
have a beneficial effect on construction cost also, for example, by
improving the feasibility of field changes. The simplicity and
standardization of subsystem design also makes estimating itself a much
simpler and more efficient process, less subject to accidental omissions
and similar errors.
In a project constrained to use only currently available non-proprietary
products, but directed to improve performance, some increase in first cost
over present methods is implicit. There are prospects of compensating for
this effect quite directly through significant reductions in design and
construction time made possible by the deliberate detailing of the system
for that purpose. But how much of a savings is realized depends on how
far the VA is willing to go in the way of altering customary decision-making
procedures, how well A/E's and building contractors understand the
scheduling benefits of the system, and on what theoretical basis time
savings are translated into cost savings.
621.1.2
Life Cost
A major part of the design effort has been on the organization of service
distribution, the provision of convenient access for maintenance, repair
and replacement, and the control of interface conditions for ease of
alteration. The theory is that this discipline will pay off in the long run.
However, an attempt to reliably predict actual cost savings in these areas
is not feasible. There are too many variables involved, and not enough
field experience with the particular kind of solution proposed. Nor is there
any reasonable way to estimate what it is currently costing the VA to not
have properly accessible and adaptable spaces in terms of physical plant
utilization.
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