| Statement of the problem. The hospital is one of the most technically sophisticated and complex buildings. It must meet high standards of performance and must continuously accommodate change.;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 desirable hospitals.;Method. A methodology for developing generalized conclusions from a series of case studies has been used in this dissertation. The evaluation criteria in the case studies were, cost control, coordination, adaptability, time reduction, long range development, avoidance of interruption, and modularity.;Results. As a result of research concerning 15 years of VAHBS application, this dissertation offers new insights, generates new knowledge and suggests modifications to the VAHBS design theory. For example, it was found that, after an initial learning curve, VAHBS overcame the anticipated construction cost premium; the cost per square foot of the first five VAHBS hospitals was more, but the cost for the latter five hospitals was equal to or less than non-VAHBS hospitals, while providing significant design benefits.;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.;Conclusions. VAHBS was a distinctive experiment in the development of hospital architecture. The concepts and lessons learned can be applied to non-VA hospitals and to other complex building types.;VAHBS demonstrated impressive cost performance and the ability to accommodate new developments in medical and building technologies.;Contribution. A new approach to VAHBS and to complex building systems is proposed; a building system would be knowledge and information driven rather than structure driven; structure is redefined as a valuable supporting discipline rather than a primary determinant of the system. |
