June 2006
752 still apply today and are supported by the experiences and observations of Medical Center
Facilities Managers (see Appendix A). The VAHBS permits a much greater ease, time saving, and
quality of routine and emergency maintenance, and alterations or changes with substantially less
impact on occupied spaces. These factors can be expected to pro\duce cost savings compared to
traditional construction. However, methods and procedures used by VA for funding operation,
maintenance, and alterations; and tracking expenses still make detailed assignment of costs and
analysis difficult (and beyond the scope of this Supplement).
Recent trends in construction costs will likely affect
the relationship of Life Cycle Costs to First Costs.
For example, construction costs (first costs) would
appear to be seeing considerable escalation at
present. As noted previously, some sub-systems
or components such as steel and concrete are
increasing faster than the overall escalation rate.
Some portions of the country are affected to a
much greater degree than others. Such "spikes" in
first costs will affect the relationship between Life
Cycle Costs and First Costs. In certain instances,
the result may be a longer "pay-back" period for
John D. Dingell VAMC,
savings in housekeeping, maintenance and
Detroit, MI 1995
renovations.
The basic premise outlined in Section 752.5 of the Red Book, i.e., that the cost of major alterations
within a VAHBS building are less than those for a conventional building should still hold true. In-
deed given the apparent current market place preference by bidding contractors in certain loca-
tions, savings may actually be magnified.
General trends suggest that more "difficult" alteration projects with greater phasing, access and
temporary work considerations and restrictions are considerably less attractive than "new" build or
"less restrictive" alteration construction projects.
The cost of "General Conditions" will be greater than for less restrictive projects and bidders may
add a factor for the perceived greater risk. Remodeling in VAHBS buildings compared to remodel-
ing in conventional buildings should offer greater ease of construction, attractiveness to bidders
and lower "premiums" for actual and/or perceived risk.
Schedule
The planning, design, and construction of a major new facility takes several years. Shortening
the duration of a project reduces the impact of inflation or cost escalation, reduces over-
head/general conditions, and delivers services to veterans sooner. The VAHBS includes sev-
eral strategies with the potential to accelerate the design and construction of new hospital build-
ings. Because each project will have its own unique combination of opportunities and con-
straints not all strategies may be applicable to every project.
Planning, Design and Construction
The integrated approach to functional and systems design proposed in the Red Book can
shorten the time for planning and design due to earlier involvement by the engineering disci-
plines. The development of the service modules to be used in the design of each new facility
SUPPLEMENT TO RESEARCH STUDY REPORT
VA HOSPITAL BUILDING SYSTEM
SECTION 3-5
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