June 2006
Changes in Technology
As technology for healthcare is invented and implemented, continuing changes in functional
space and building service will be necessary to support the new equipment and processes.
Hospital designs that incorporate adaptable plans and services are essential to continued
viability. Over the last 30 years some of the greatest impacts from new technology have been
to the electrical, and communications systems.
Digital data networks have become the prevalent means for information transport, necessitating
installation of fiber optic backbones, electronic components, and copper station cabling of ever-
increasing bandwidth. These requirements were not anticipated when the VAHBS was
instituted, and installation of data network cabling has been generally performed with little
regard for the organization of VAHBS service systems and subzones; this is in large part due to
the fact that most cable plants were not installed as part of the original construction project, but
at a later date. Replacement of older telephone cabling, which often accompanied data network
installation, was subject to the same lack of discipline. Further, the trend for most special
systems such as nurse call and fire alarm to use digital communication protocols, the growth of
digital building environmental control systems, the current trend away from coaxial cable to
twisted-pair wiring for signal systems such as MATV and CCTV, and the movement towards
integration of different systems by gateways or standard protocols (such as Ethernet, BacNet, or
TCP/IP) onto a common network have driven the need for structured cabling systems coupled
with rigorous installation and maintenance practices. Any systems whose information is
transported over the data network become integrated systems by default per this Supplement to
the VAHBS. Remaining communications systems are non-integrated and are separately treated
in VA design manuals and master specifications.
Changes in Regulatory Requirements
Building codes and, in particular, seismic requirements have become increasingly stringent.
Most of these changes affect the specification, detailing, or installation of services, but will not
affect the space modules or overall VAHBS concept. However, changes in structural require-
ments will affect decisions concerning bay size, lateral restraint systems, and member sizes.
These will, in turn, influence service zone dimensions, floor-to-floor height, and planning mod-
ules.
Fire and life safety codes have undergone numerous revisions since the Red Book was first
published. The fire and life safety concepts used for the prototype design in the Red Book were
based on a health care model with primarily inpatient care and comparatively small outpatient
and administration areas. The usual approach was to consider the entire hospital building as a
single institutional occupancy and not to create multiple occupancies. This allowed for expan-
sion or relocation of departments and services without having to worry about occupancy separa-
tions. However, requirements for fire and smoke compartments were extended into areas
where they might not otherwise have been required. Automatic fire sprinklers were not required
nor were they typically installed throughout the building.
As the percentage of outpatient care areas increased, the fire and life safety strategy shifted
from single-occupancy to multiple-occupancy buildings. The fire protection strategies for new
buildings will need to consider multiple occupancies when establishing fire and smoke com-
partments, and service modules.
SUPPLEMENT TO RESEARCH STUDY REPORT
VA HOSPITAL BUILDING SYSTEM
SECTION 3-2
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