VETERAN ADMINISTRATION HOSPITAL SYSTEM

Veteran Administration Hospital System

Veteran Administration Hospital System

Introduction

The Veterans Administration Hospital Building System (VAHBS) represents a major effort that responds to these requirements. Between 1974 and 1988, the time span on which this study focuses, ten hospitals were built using VAHBS. The common characteristics of these hospitals include the organization of building blocks and services and use of interstitial space. While there have been individual hospital studies, a comprehensive and comparative analysis of this group of VAHBS hospitals has not been done. An objective analysis of the accomplishments and shortcomings of the system and improvements of the theoretical basis of VAHBS would be significant contributions towards designing and building efficient, effective and excellent hospitals. The VAFIBS was developed in 1972 by the joint venture of Building Systems Development and Stone, Marracini and Patterson for the Research Staff of Veterans Administration (VA). Their research study report, titled VA Hospital Building System Development _Study, is used as a design manual by VA and by architectural/engineering retained by VA to design VAHBS buildings. This document is referred to within this dissertation as the VAJTBS manual (Agron 2001). The system included modular building blocks, an organizational discipline for positioning services, interstitial space, and inclusion of a service bay in each building block. The Veterans Administration, currently known as Department of Veterans Affairs, has spent nearly a billion dollars in hospital buildings that incorporate VAHBS. The Army Corps of Engineers have started adopting the system for their hospitals (US Army Corps of Engineers 1987). During the next decade and beyond, these two agencies could spend several billions of dollars in constructing new or replacement hospitals and adding to or renovating existing hospitals. An objective analysis of the accomplishments and shortcomings of the system and improvements of the theoretical basis of VAHBS would be significant contributions towards designing and building efficient, effective and desirable hospitals by these agencies and by others. The VA Hospital Building System (VAHBS) represents a significant accomplishment in the development of hospital architecture, which explicitly accommodated operation, maintenance, cost control and change. Between 1974 and 1988, ten hospitals were built using VAUBS. These hospitals are located across the USA, from Loma Linda (near Los Angeles) in the West to Richmond, Virginia in the East, from Minneapolis in the North to Bay Pines (Florida) in the South. They were designed by different architectural/engineering teams from different offices and built by different contractors in different social and political contexts. The common characteristics of these hospitals are the organization of building blocks and services, interstitial space, extended floor to floor height and inclusion of a service bay in each building block (Bahuva 2010).

Cost & revenue

The increased budget comes at a rather bad time: 25 percent of beds in America's 173 V.A. hospitals remain empty; the veteran population has shrunk from 30 million in 1980 to 26 million today, and the Veteran's Health Administration continues to resist trends toward less expensive outpatient care while keeping patients in hospitals much longer than community hospitals ...