June 2006
Fire sprinklers are now required throughout VA patient care buildings. Because the service
zones in VAHBS buildings featured highly ordered distribution of service systems with allow-
ances for expansion, fire sprinkler systems could be added or extended with minimal disruptions
to other services or occupied space. In new buildings fire sprinkler and standpipe systems
should be added to the list of integrated subsystems.
JCAHO and AIA/HHS guidelines for hospital design, equipment and systems have been revised
several times and may be expected to continue to evolve. While these changes have made
some of the specific planning data in the Red Book obsolete, they reinforce the need for designs
and building services with high degrees of adaptability.
VA and ASHRAE standards for ventilation rates, energy efficient design, and indoor air quality
have been updated and will continue to evolve.
The 2002 National Electrical Code introduced requirements that abandoned, low-voltage
communications cabling of many systems be removed in order to reduce the combustible fuel
load present in the cable insulation. Much legacy telephone, intercom, coaxial, and other wiring
was abandoned in place when newer cable plants were installed in the 1990's. While this
concern is moot in regard to the construction of new VA hospitals, it is a critical component of
renovation projects in existing hospitals where cabling may or may not have been installed per
VA criteria.
Cost and Schedule
Cost
Many of the basic principles and observations contained within the Red Book related to cost still
hold true today. However, recent market fluctuations, changes in procurement selection, and
amendments to contract requirements have had an effect on many of the Analyses. Future
analyses of costs associated with VAHBS building comparisons should therefore give greater
consideration to location, market conditions and procurement methods.
It is extremely important, as stated later in Section 4, to hold thorough pre-bid conferences for
prime and sub-contractors, and material suppliers using models, diagrams, video simulations,
and other techniques illustrating project sequence and the time and labor saving opportunities
inherent in the VAHBS.
Cost of VAHBS Hospitals
A VA Study compared the Bid Cost / GSF for facilities built using VAHBS over a 22 year period
(from Loma Linda, CA in 1974 to Hampton, VA in 1996) with R.S. Means cost data for hospital
construction over the same period (See Fig Below). Means includes nationwide cost data for
hospital types ranging from small, community hospitals to large, complex medical centers
(including non-VAHBS construction). VA hospitals tend to be in the category of large to very large
medical centers. The median and 75th percentile costs from Means Cost Data were selected as
representing costs for hospitals of similar size and with programs similar to VA hospitals.
Except for Bay Pines, the costs for the VAHBS hospitals are at or below the Means 75th percentile.
Costs for three of the hospitals (Albuquerque, Portland, and Minneapolis) were below the Means
median. It should be noted that the construction contract for Bay Pines included electric powered
SUPPLEMENT TO RESEARCH STUDY REPORT
VA HOSPITAL BUILDING SYSTEM
SECTION 3-3
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