Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
CHAPTER 286: SURGICAL SERVICE: STANDARD, INTERMEDIATE OR COMPLEX
CENTER
1
PURPOSE AND SCOPE ......................................................................................... 286-2
2
DEFINITIONS ......................................................................................................... 286-2
3
OPERATING RATIONALE AND BASIS OF CRITERIA ........................................... 286-5
4
INPUT DATA STATEMENTS .................................................................................. 286-5
5
SPACE CRITERIA .................................................................................................. 286-6
6
PLANNING AND DESIGN CONSIDERATIONS .................................................... 286-16
7
FUNCTIONAL RELATIONSHIPS .......................................................................... 286-19
8
FUNCTIONAL DIAGRAM ...................................................................................... 286-20
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 1 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
1
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
PURPOSE AND SCOPE
This document outlines Space Planning Criteria for Chapter 286: Surgical Service. It
applies to all medical facilities at the Department of Veterans Affairs (VA).
VHA Directive 2010-18, Facility Infrastructure Requirements to Perform Standard,
Intermediate, or Complex Surgical Procedures, dated May 6, 2010, and the VHA
Directive 2011-37, Facility Infrastructure Requirements to Perform Invasive Procedures in
an Ambulatory Surgery Center, dated October 14, 2011, have been reviewed as part of
the development of this Space Criteria Chapter.
Refer to the following PG 18-9 Space Planning Criteria Chapters that also may require
space in Surgical Services:
2
DEFINITIONS
Ambulatory Surgery: Ambulatory Surgery refers to surgical or invasive diagnostic
procedures performed by qualified providers in an inpatient surgical suite or Ambulatory
Surgery Center (ASC) with pre-procedural and immediate post-procedure care completed
on the same day, or observation without hospitalization. Refer to Chapter 265: Outpatient
Clinic for the Surgical Service: Ambulatory Surgery Center (ASC) component.
Anesthesia Procedure Room: A dedicated space for Anesthesia Providers to perform
regional blocks or line placement prior to surgery. A patient would be transported to this
area or room from the Pre-Op area or another area of the hospital if applicable. If this
space is authorized, it should be near the ORs but observable by staff working at a
nursing station.
Anesthesia Workroom: Room with space for storing and maintaining anesthesia
equipment and supplies. Includes a workstation for the anesthesia technician, space for
work counter(s) and sink(s) and racks for cylinders.
Biplane System: Advanced interventional imaging technology. It is capable of covering
the full size of the patient’s lateral and frontal anatomy simultaneously. Provides real time
images which can be processed into 3-D images. Used for a variety of cardiovascular
and neurovascular image-guided interventional procedures. The biplane imaging system
is physically large because it is made up of two x-ray systems, or two C-arms, rather than
the typical single plane system which has one C-arm.
Clean Core: Operating rooms are grouped around a clean core. The Clean Core is used
for sterile supply storage. This is the cleanest area of the entire Operating Suite. Only
staff wearing appropriate surgical attire should be allowed in the Clean Core.
Case Carts: Case Carts are used to bring sterile materials and instruments from Supply
Processing and Distribution (SPD) to the Operating Room. A typical case cart contains
specific items required for each specific case, including all required surgical instruments
and other supplies. After the operation is completed, used items are reloaded onto the
cart and sent back to SPD for decontamination, disposal or reprocessing. Case carts are
also supplied and kept in the surgery department for most frequently performed
emergency cases.
Control Station: A space located to permit visual observation of all traffic which enters the
operating suite.
Family Resource Room: A place for patients, family and staff to obtain resources, learn
more about a patient’s condition, access the internet and email, read, relax and conduct
personal business.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 2 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
Frozen Section Laboratory: This is the area for preparation and examination of frozen
sections. The frozen section procedure is performed under a microscope by the surgical
pathologist while surgery is taking place. Interpretation is rapid and results are
communicated with the surgeon while surgery is taking place.
Full-Time Equivalent (FTE): A staffing parameter equal to the amount of time assigned to
one full time employee. It may be composed of several part-time employees whose total
time commitment equals that of a full-time employee. One FTE equals a 40 hours per
week.
Functional Area: The grouping of rooms and spaces based on their function within a
clinical service. Typical Functional Areas are Reception Area, Patient Area, Support
Area, Staff and Administrative Area, Education Area.
Immediate Use Sterilization: It is a process designed for the steam sterilization of patient
care items for immediate use. Also known as “emergent sterilization” or “flash
sterilization”. VA Directive 7176 states that the flash sterilizer may be used during a
surgical procedure for an unanticipated event. An example would be a dropped
instrument. Sterilizers for flash sterilization should be located as close as possible to the
Operating Rooms, preferably in a shared space adjacent to the Operating Rooms with
immediate access from the semi-restricted corridor for service.
Input Data Statement: A set of questions designed to elicit information about the
healthcare project in order to create a Program for Design (PFD) based on the criteria
parameters set forth in this document. Input Data Statements could be Mission related,
based in the project’s Concept of Operations; and Workload or Staffing related, based on
projections and data provided by the VHA or the VISN about the estimated model of
operation. This information is processed through mathematical and logical operations in
SEPS.
Operating Room (OR): A room designed and equipped to perform a wide variety of
operative procedures. This includes most types of surgical procedures but especially
those involving administration of anesthesia, multiple personnel, recovery room access,
and a fully controlled environment. Operating Rooms can be General Purpose, Specialty
Purpose, or Hybrid.
Specialty OR: Includes vascular surgery, cardiac surgery, neurosurgery and orthopedic
surgery and other surgeries which utilize additional personnel and/or special equipment
requiring a larger space.
Hybrid OR: A hybrid OR integrates the traditional surgical functions of the OR with
advanced imaging and intervention functions. This is the largest OR in size.
Net Square Feet (NSF): The area of a room or space derived by multiplying
measurements of the room or space taken from the inside surface of one wall to the
inside surface of the opposite wall
Patient Discharge Lounge: A quiet, private area for patients to relax while waiting for their
transportation after being discharged from the hospital.
Picture Archiving and Communication System (PACS) Viewing Room: A digital radiology
reading room that consists of workstations for interpretation. The foundations of digital
radiology reading room design are lighting, ergonomics, acoustics, room design and
connectivity.
Phase II Recovery: The patient is transitioned from Phase I recovery to Phase II recovery
when intensive nursing care is no longer needed and the patient becomes more alert and
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 3 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
functional. Phase II allows preparations to be made to progress the patient towards
discharge to home.
Post Anesthesia Care Unit (PACU) / Phase I Recovery: Patient cubicle area for the
recovery of patients after surgical procedures PACU / Phase I Recovery is an area
dedicated to receive patients following general anesthesia, regional anesthesia, or
monitored anesthesia care. Phase I requires close monitoring, including airway,
ventilator, and hemodynamic support. Patients are generally accommodated in a
stretcher bay or cubicle.
Pre-Operative Holding / Phase II Recovery: This is where the majority of surgical patients
are prepared for their surgical procedures under the care of a nurse. In this area, the
patient changes into a gown, a nursing assessment is performed and teaching is
provided. Belongings will be secured, and an Intravenous line may be started.
Anesthesiology will interview the patient here and may give intravenous sedation. Patient
will be transported from this area to the OR.
Program for Design (PFD): A project specific document consisting of an itemized listing of
the spaces, rooms, and areas required for the proper operation of a specific service and
the corresponding net square foot area of each space, room, and area. The PFD is
based on criteria set forth in this document and specific information from the Concept of
Operations addressing the project’s mission, workload projections and staffing levels
authorized.
Scrub Exchange Room: This is a room or area to dispense and receive scrubs. Space
may be provided within the locker rooms or directly adjacent to them. This may include
an automated scrub management system / automated dispensing and receiving machine.
Substerile Room: This is a room accessible from the operating room(s) it serves. It may
be located between two ORs or a group of adjacent ORs. This room contains a sink, a
counter top, and a steam sterilizer for the purpose of immediate use (“flash”) sterilization.
Scrub Alcoves: The scrub sink alcoves are located in the semi-restricted corridor.
Room Efficiency Factor: A factor that provides flexibility in the utilization of a room to
account for patient delays, scheduling conflicts, and equipment maintenance. Common
factors are in the 80 to 85% range. A room with 80% room efficiency provides a buffer to
assume that this room would be available 20% of the time beyond the planned
operational practices of the room. This factor may be adjusted based on the actual and /
or anticipated operations and processes of the room / department.
SEPS (VA-SEPS): Acronym for Space and Equipment Planning System, a digital tool
developed by the Department of Defense (DoD) and the Department of Veterans Affairs
to generate a Program for Design (PFD) and an Equipment List for a VA healthcare
project based on specific information entered in response to Input Data Questions. VASEPS incorporates the propositions set forth in this chapter as well as all chapters in
VA’s Program Guide (PG) 18-9 (formerly Handbook 7610). VA-SEPS has been designed
to aid healthcare planners in creating a space plan based on a standardized set of criteria
parameters.
Technical Information Library (TIL): The Office of Construction and Facilities
Management (CFM) provides support for all major construction and lease projects. The
TIL contains design and construction standards for the Department of Veterans Affairs.
The TIL is aimed at VA employees in medical centers, community based clinics, regional
offices and national cemeteries as well as A/E consultants and provides relevant
technical information for project development. Department of Veterans Affairs' Technical
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 4 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
Information Library (http://www.cfm.va.gov/TIL/).
Workload: Workload is the anticipated number of procedures or suite stops that is
processed through a department/service area. The total workload applied to
departmental operational assumptions will determine overall room requirements by
modality.
3
OPERATING RATIONALE AND BASIS OF CRITERIA
A. Workload for this chapter is defined as the number of projected Patient Uniques for a
given inpatient facility; this parameter determines the number or General Operating
Rooms required. The Specialty and Hybrid Operating Rooms are driven by both the
workload parameter and the Mission Statement (authorization). The Office of Policy
and Planning (OPP), based upon the expected veteran population and services
required in the respective market / service area, shall provide with the projected
number of Patient Uniques for a market / service area.
B. The calculated number of Operating Rooms (of all types) determines the number
and/or size of the remaining spaces in this chapter except for the last two Functional
Areas which are staff / mission driven.
C. Space planning criteria have been developed based on an understanding of the
activities involved in the functional areas required for Surgical Service and the
relationships with other services of a medical facility. Criteria is predicated on the
established and / or anticipated best practice standards, as adapted to provide
environments which will support the highest quality heath care for Veterans.
D. Space Planning Criteria is subject to modification, relative to development in medical
practice and equipment, vendor requirements, and subsequent planning and design.
The selection of the size and type of Surgical Service equipment is determined by
VACO and upon Veterans Health Administration (VHA) anticipated medical needs.
Refer to this chapter’s correspondent PG18-12: Equipment Guide List and PG 18-5:
Design Guide.
E. Per VHA’s Surgical Service direction the minimum number of General Operating
Rooms in any facility is two; additional rooms are generated based on an increment
of 10,000 patient uniques greater than 20,000.
4
INPUT DATA STATEMENTS
A. Mission Input Data Statements
1. Is a Family Waiting authorized? (M)
2. Is a PACS Viewing Room authorized in the Pre-Operative Holding / Phase II
Recovery Area? (M)
3. Is an Anesthesia Procedure Area authorized? (M)
4. Is a Satellite Laboratory authorized? (M)
5. Is Orthopedic Surgery authorized? (M)
6. Is a biplane system for the Hybrid Operating Room authorized? (M)
7. Are Interventional Radiology procedures authorized? (M)
8. Is use of Pre-Operative Holding / Phase II Recovery Patient Rooms authorized?
(M)
9. Is use of Robotics equipment authorized? (M)
10. Is a PACS Viewing Room authorized in the PACU / Phase I Recovery Patient
Area? (M)
11. Is an Education Program authorized? (M)
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 5 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
a. How many Resident / Student FTE positions are authorized? (S)
12. Are Specialty (Vascular, Cardio-thoracic, Orthopedic and Neurology) Operating
Rooms authorized? (M)
13. Is a Hybrid Operating Room authorized? (M)
14. Is this facility designated as a Complex Facility? (M)
B. Workload Input Data Statements
1. How many unique patients are projected for this facility? (W)
C. Staffing Input Data Statements
1. How many Receptionist FTE positions are authorized? (S)
2. How many Assistant Chief of Surgical Service FTE positions are authorized? (S)
3. How many Assistant Chief of Anesthesiology FTE positions are authorized? (S)
4. How many Staff Surgeon FTE positions are authorized? (S)
5. How many Operating Room Nurse Manager FTE positions are authorized? (S)
6. How many Nurse Anesthetist FTE positions are authorized? (S)
7. How many Operating Room Coordinator FTE positions are authorized? (S)
8. How many Scheduler FTE positions are authorized? (S)
9. How many Secretary FTE positions are authorized? (S)
10. How many Administrative Officer FTE positions are authorized? (S)
11. How many Administrative Officer Secretary FTE positions are authorized? (S)
12. Is a Biomedical Engineer FTE position authorized? (S)
D. Miscellaneous Input Data Statements
1. Is a Family Resource room authorized? (Misc)
2. Is Patient Discharge Lounge for the Pre-Operative Holding / Phase II Recovery
Room Area authorized? (Misc)
3. Is a Frozen Section Lab authorized for the Operating Room? (Misc)
4. Is a Satellite Pharmacy authorized? (Misc)
5. Is a Case Cart System authorized for the Specialty Operating Rooms? (Misc)
6. Is care of PACU / Phase I patients authorized to be provided in an open bay
setting? (Misc)
7. How many Specialty Operating Rooms are authorized to perform Open Heart
surgical procedures? (Misc)
8. How many PACU / Phase I Recovery Patient Rooms greater than one are
authorized? (Misc)
9. How many PACU / Phase I Recovery FTEs will work on peak shift? (Misc)
5
SPACE CRITERIA
A. FA 1: Reception Area:
1. Waiting, General (WRC01) ................................................... 195 NSF (18.2 NSM)
Minimum NSF; provide an additional 65 NSF per each Operating Room, of any
type, greater than two.
Allocated minimum NSF provides for six standard seats, three wheelchair
accessible seats and circulation. The additional 65 NSF allocates space for one
accessible seat, two standard seats and circulation. Waiting should be adjacent to
the patient entrance and be under visual control of the Reception / Registration.
2. Waiting, Family (WRF01) ......................................................... 80 NSF (7.5 NSM)
Provide one if a Family Waiting is authorized.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 6 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
This space, including its furniture and accessories, should be designed to
accommodate children’s play activities. This space shall be included within the
General Waiting.
3. Reception / Registration (RECP1) ...........................................80 NSF (7.5 NSM)
Minimum NSF; provide an additional 40 NSF per each Receptionist FTE position
authorized greater than one.
This space accommodates patient check-in and scheduling activities.
4. Toilet, Family (TLTF3) ..............................................................75 NSF (7.0 NSM)
Provide one for Surgical Service.
Locate adjacent to Public Toilet; provide baby changing station.
5. Toilet, General (TLTU1) ............................................................60 NSF (5.6 NSM)
Minimum two; provide an additional two for every increment of six Operating
Rooms, of any type, greater than six.
Locate near the General Waiting Area.
6. Workstation, Patient Education (CLSC1)................................40 NSF (2.8 NSM)
Minimum one; provide an additional one for every increment of four Operating
Rooms, of any type, greater than four if a Family Resource Room is not
authorized.
Includes space for My HealtheVet computer terminal.
7. Family Resource Room (CLSC3) ........................................ 120 NSF (11.2 NSM)
Minimum NSF; provide an additional 60 NSF for every increment of four
Operating Rooms, of any type, greater than four if a Family Resource Room is
authorized.
This space will be designed as a place for patients, family and staff to obtain
resources, learn more about a patient’s condition, access the internet and email,
read, relax, and conduct personal business.
8. Multipurpose Room (OFDC2) ..............................................120 NSF (11.2 NSM)
Provide one for Surgical Service.
Allocated NSF accommodates the following functions: Family consultation,
grieving, conflict resolution, quiet room, etc.
9. Alcove, Refreshment Center (NCWD4) ...................................60 NSF (5.6 NSM)
Minimum NSF; provide an additional 30 NSF for every increment of six Operating
Rooms, of any type, greater than six.
B. FA 2: Patient Pre-Operative Holding / Phase II Recovery:
1. Patient Room,
Pre-Operative Holding / Phase II Recovery (RRPR2) ......... 130 NSF (12.1 NSM)
Provide three per each Operating Room, of any type, if Pre-Operative Holding /
Phase II Recovery Patient Rooms are not authorized.
A single bed-room, accommodating only one patient. Pre-Op and Phase II
recovery can take place in this room which will ideally be located directly adjacent
to the PACU. A sink shall be provided.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 7 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
2. Patient Bay,
Pre-Operative Holding / Phase II Recovery (RRBP2) ........ 130 NSF (12.1 NSM)
Provide three per each Operating Room, of any type, if Pre-Operative Holding /
Phase II Recovery Patient Rooms are authorized.
A space accommodating only one patient. Pre-Op and Phase II recovery can take
place in this room which will ideally be located directly adjacent to the PACU. A
sink shall be provided.
3. Toilet, Pre-Operative Holding / Phase II Recovery
Surgical Patient (TLTU1) ......................................................... 60 NSF (5.6 NSM)
Minimum one; provide an additional one for every increment of four Pre-Operative
Holding / Phase II Recovery Patient Rooms or Pre-Operative Holding / Phase II
Recovery Patient Bays greater than four.
4. Alcove, Patient Personal Property (LR001)............................ 80 NSF (7.5 NSM)
Minimum NSF; provide an additional 8 NSF for every increment of three PreOperative Holding / Phase II Recovery Rooms or Pre-Operative Holding / Phase II
Recovery Patient Bays greater than twelve.
An area to securely store patient belongings in half-sized lockers.
5. Lounge, Patient Discharge (DL001) .................................... 120 NSF (11.2 NSM)
Minimum NSF; provide an additional 30 NSF for every increment of four PreOperative Holding / Phase II Recovery Rooms or Pre-Operative Holding / Phase II
Recovery Patient Bays greater than four if authorized.
Quiet, private area for patients to relax while waiting for their transportation after
being discharged from the hospital. Minimum allocated NSF accommodates
three lounge chairs / recliners at 30 NSF each and a touchdown workstation for
the discharge Nurse assigned to this area.
6. Nurse Station (NSTA1) ........................................................ 160 NSF (14.9 NSM)
Minimum NSF; provide an additional 20 NSF for every increment of two PreOperative Holding / Phase II Recovery Patient Rooms or Pre-Operative Holding /
Phase II Recovery Patient Bays greater than four.
This NSF may be distributed (centralized or decentralized) per individual project
design.
7. Workroom, Provider (WRCH1) ............................................ 160 NSF (14.9 NSM)
Minimum NSF; provide an additional 40 NSF per each Operating Room greater
than four.
Touchdown space for dictation and charting. This NSF may be distributed
(centralized or decentralized) per individual project design.
8. Viewing Room, Picture Archiving and
Communication System - PACS (XVC01)........................... 160 NSF (14.9 NSM)
Provide one if a PACS Viewing Room is authorized.
9. Handwashing Station (SINK1)................................................. 10 NSF (1.0 NSM)
Minimum one; provide an additional one for every increment of four Pre-Operative
Holding / Phase II Recovery Patient Rooms or Pre-Operative Holding / Phase II
Recovery Patient Bays greater than four.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 8 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
10. Medication Room (MEDP1) ......................................................80 NSF (7.5 NSM)
Minimum one; provide an additional one for every increment of ten Pre-Operative
Holding / Phase II Recovery Rooms or Pre-Operative Holding / Phase II Recovery
Patient Bays greater than ten.
11. Nourishment Room (NCWD3)..................................................80 NSF (7.5 NSM)
Minimum one; provide an additional one for every increment of ten Pre-Operative
Holding / Phase II Recovery Rooms or Pre-Operative Holding / Phase II Recovery
Patient Bays greater than ten.
12. Lounge, Staff (SL001) ..........................................................120 NSF (11.2 NSM)
Minimum NSF; provide an additional 30 NSF for every increment of eight PreOperative Holding / Phase II Recovery Rooms or Pre-Operative Holding / Phase II
Recovery Patient Bays greater than eight.
Locate near the Operating Rooms.
13. Toilet, Staff (TLTU1) .................................................................60 NSF (5.6 NSM)
Provide two for the Patient Pre-Operative Holding / Phase II Recovery Area.
14. Utility Room, Clean (UCCL1) ...................................................80 NSF (7.5 NSM)
Provide one for the Patient Pre-Operative Holding / Phase II Recovery Area.
15. Utility Room, Soiled (USCL1) ..................................................80 NSF (7.5 NSM)
Provide one for the Patient Pre-Operative Holding / Phase II Recovery Area.
The Soiled Utility Room provides an area for cleanup of medical equipment and
instruments, and for disposal of medical waste material. It provides temporary
holding are for material that will be picked up by Supply, Processing and
Distribution (SPD), or similar service. It should be accessible from the main
corridor.
16. Alcove, Crash Cart (RCA01) ....................................................20 NSF (1.9 NSM)
Provide one for the Patient Pre-Operative Holding / Phase II Recovery Area.
17. Alcove, Clean Linen (LCCL3) ..................................................40 NSF (3.8 NSM)
Minimum one; provide an additional one for every increment of eight Patient PreOperative Holding / Phase II Recovery Rooms or Pre-Operative Holding / Phase II
Recovery Patient Bays greater than eight.
18. Alcove, Portable Imaging Equipment (XRM01) ......................20 NSF (1.9 NSM)
Provide one for the Patient Pre-Operative Holding / Phase II Recovery Area.
19. Storage, Equipment (SRE01) ...............................................120 NSF (11.2 NSM)
Provide one for the Patient Pre-Operative Holding / Phase II Recovery Area.
20. Housekeeping Aides Closet (HAC) (JANC1) ..........................60 NSF (5.6 NSM)
Provide one for the Patient Pre-Operative Holding / Phase II Recovery Area.
C. FA 3: Anesthesia Procedure Area:
1. Patient Room,
Anesthesia Procedure (ORPP1) .......................................... 120 NSF (11.2 NSM)
Minimum one; provide an additional one for every increment of four Operating
Rooms, of any type, greater than four if an Anesthesia Procedure Area is
authorized.
This room is for one patient requiring regional blocks or line placement prior to
surgery or holding—following transport from the Pre-Op area or another area of
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 9 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
the hospital. This room shall be near the Operating Rooms but observable by staff
working at a control or nursing station.
2. Nurse Station,
Anesthesia Procedure Area (NSTA1) ..................................... 80 NSF (7.5 NSM)
Minimum NSF; provide an additional 40 NSF per each Anesthesia Procedure
Patient Room greater than one if an Anesthesia Procedure Area is authorized.
This space shall be provided for the purpose of observing patients in the
Anesthesia procedure area if needed.
3. Workroom, Anesthesia (ANCW1) ....................................... 240 NSF (22.3 NSM)
Minimum one; provide an additional 30 NSF per each Operating Room, of any
type, greater than four if an Anesthesia Procedure Area is authorized.
Space for cleaning, testing and storing anesthesia equipment. Space for work
counter(s) and sink(s) and racks for cylinders.
4. Team Room, Anesthesiology (WRTM1) ............................. 240 NSF (22.3 NSM)
Minimum NSF; provide an additional 30 NSF per each Operating Room, of any
type, greater than four if an Anesthesia Procedure Area is authorized.
Provide space for up to 6 people at computer workstations.
D. FA 4: Patient Procedure Area (Sterile):
1. Operating Room (OR), General (ORGS1) ........................... 650 NSF (60.4 NSM)
Minimum two; provide an additional one for every increment of 10,000 projected
unique patients (for this facility) greater than 20,000 if the total number of
projected unique patients is 60,000 or less; the minimum workload to generate a
General OR is 3,000.
2. Equipment Room,
General Operating Room (SRE01) ...................................... 160 NSF (14.9 NSM)
Minimum NSF; provide an additional 100 NSF per each General Operating Room
greater than two.
3. Operating Room (OR), Specialty (ORSP1) ......................... 750 NSF (69.7 NSM)
Provide one if the total number of projected unique patients is greater than
63,000; provide an additional one if the total number of projected unique patients
is greater than 82,000 if a Specialty OR is authorized.
4. Equipment Room, Specialty OR (ORSE1) .......................... 180 NSF (16.8 NSM)
Minimum NSF; provide an additional 120 NSF per each Specialty Operating
Room greater than one.
5. Pump Room, Specialty OR (ORHL1) .................................. 200 NSF (18.6 NSM)
Provide one per each Operating Room dedicated to open-heart surgical
procedures.
Where open-heart surgery is performed, provide a Pump Room in the sterile area,
preferably adjacent to the Cardiology Operating Room. The Pump Room is where
extra corporeal pump(s), supplies, and accessories are stored and serviced.
6. Equipment Room, Orthopedic (OROE1)............................. 180 NSF (16.8 NSM)
Provide one if Orthopedic Surgery is authorized.
Where complex orthopedic surgery is performed, additional equipment storage for
large equipment is needed. Space preferably will be located adjacent to the
specialty room.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 10 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
7. Operating Room (OR), Hybrid (ORHY1) .............................. 900 NSF (83.7 NSM)
Provide one if the total number of projected unique patients is greater than 73,000
if facility is designated as a “Complex Facility”; provide an additional 200 NSF if a
biplane system is authorized.
For Interventional & Vascular / Neurosurgery specialties. Allocated NSF
accommodates Monoplane, Biplane or articulated biplane for Cardiologic,
Neurologic, Orthopedic, and Trauma / Vascular cases.
8. Control Room, Hybrid OR (ORHC1) .................................... 220 NSF (20.5 NSM)
Minimum one; provide an additional one for every increment of two Hybrid
Operating Rooms greater than two.
9. Equipment Room, Hybrid OR (ORHE1) .............................. 200 NSF (18.6 NSM)
Minimum NSF; provide an additional 140 NSF per each Hybrid Operating Room
greater than one.
10. Pump Room, Hybrid OR (ORHL1) ....................................... 200 NSF (18.6 NSM)
Provide one per each Hybrid Operating Room.
Where open-heart surgery is performed, provide a Pump Room in the sterile area,
preferably adjacent to the Hybrid Operating Room. The Pump Room is where
extra corporeal pump(s), supplies, and accessories are stored and serviced.
11. Clean Core (ORCC1) ............................................................420 NSF (39.1 NSM)
Minimum NSF; provide an additional 200 NSF per each Operating Room, of any
type, greater than two.
Allocated minimum NSF includes area for sterile supplies and holding of case
carts for two Operating Rooms. Blanket warmer placed in this room.
12. Equipment Room, Surgical (SRE01) ..................................... 100 NSF (9.3 NSF)
Minimum one; provide an additional one per each increment of four Operating
Rooms, of any type, greater than four.
This room shall not include a flash sterilizer and may be located between two
adjacent Operating Rooms, or for a group of adjacent Operating Rooms.
13. Immediate Use Sterilization Room (ORSR1) ...................... 120 NSF (11.2 NSF)
Minimum one; provide an additional one for every increment of four Operating
Rooms, of any type, greater than four.
Space allocated for immediate use sterilization (Flash Sterilizer); provide a double
basin sink.
14. Scrub Sink Area (ORSA1) ........................................................60 NSF (5.6 NSM)
Provide one per each Operating Room, of any type.
Allocated NSF allows for two adjacent scrub positions and should be located near
the entry point to each Operating Room. If located between two adjacent
Operating Rooms; four positions should be provided. This area will be accessed
from the restricted corridor.
15. Laboratory, Satellite (LBSP2) ..................................................80 NSF (7.5 NSM)
Provide one if a Satellite Laboratory is authorized.
This space includes a sink and countertop with space for equipment such as
blood analyzer (cardiac markers, blood gases, chemistry, and electrolytes).
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 11 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
16. Storage, Interventional Radiology (SRE01) ........................... 80 NSF (7.5 NSM)
Provide one if Interventional Radiology procedures are authorized.
17. Storage, Robotics Equipment (SRCH1) ............................. 160 NSF (14.9 NSM)
Provide one if use of Robotics Equipment is authorized.
Includes space for charging stations.
18. Alcove, Blood Bank Refrigerator (RCA03) ............................. 30 NSF (2.8 NSM)
Provide one for the Patient Procedure Area (Sterile).
For temporary holding of a portable blood refrigerator.
19. Alcove, Stretcher Holding (RCA02) ........................................ 80 NSF (7.5 NSM)
Minimum one; provide an additional 20 NSF per each Operating Room, of any
type, greater than four.
E. FA 5: Post-Anesthesia Care Unit (PACU) / Phase I Recovery:
1. Patient Room, Isolation
PACU / Phase I Recovery (RRIR1) ...................................... 130 NSF (12.1 NSM)
Minimum one; provide additional ones if authorized.
This space shall be used for isolation patients.
2. Patient Bay / Stretcher Cubicle,
PACU / Phase I Recovery (RRBP1) ..................................... 130 NSF (12.1 NSM)
Provide two per each Operating Room, of any type, if authorized; deduct the
number of authorized PACU / Phase I Recovery Isolation Patient Rooms
authorized.
Allocated NSF accommodates open or semi-enclosed space with walls on three
sides with stretcher and a curtain on the fourth.
3. Nurse Station,
PACU / Phase I Recovery (NSTA1) ..................................... 120 NSF (11.2 NSM)
Minimum NSF; provide an additional 30 NSF per each PACU / Phase I Recovery
Patient Bay / Stretcher Cubicle and PACU / Phase I Recovery Room greater than
four.
This NSF may be distributed (centralized or decentralized) per individual project
design.
4. Consult Room (OFDC2) ....................................................... 120 NSF (11.2 NSM)
Provide one for the PACU / Phase I Recovery Area.
5. Handwashing Station (SINK1)................................................. 10 NSF (1.0 NSM)
Minimum one; provide an additional one for every increment of four PACU /
Phase I Recovery Patient Bay / Stretcher Cubicle and PACU / Phase I Recovery
Patient Room greater than four.
6. Team Room, Surgeon (WRTM1) ......................................... 160 NSF (14.9 NSM)
Minimum NSF; provide an additional 40 NSF per each Operating Room, of any
type, greater than four.
This is a touchdown space for dictation and charting. This NSF may be distributed
(centralized or decentralized) per individual project design.
7. Viewing Room, Picture Archiving and
Communication System - PACS (XVC01)........................... 160 NSF (14.9 NSM)
Provide one if a PACS Viewing Room is authorized.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 12 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
8. Utility Room, Clean (UCCL1) ...................................................80 NSF (7.5 NSM)
Minimum NSF; provide an additional 40 NSF for every increment of eight PACU /
Phase I Recovery Patient Bay / Stretcher Cubicles and PACU / Phase I Recovery
Patient Rooms greater than twelve.
9. Utility Room, Soiled (USCL1) ..................................................80 NSF (7.5 NSM)
Minimum NSF; provide an additional 40 NSF for every increment of eight PACU /
Phase I Recovery Patient Bay / Stretcher Cubicles and PACU / Phase I Recovery
Patient Rooms greater than twelve.
10. Medication Room (MEDP1) ......................................................80 NSF (7.5 NSM)
Provide one for the PACU / Phase I Recovery Area.
11. Alcove, Crash Cart (RCA01) ....................................................20 NSF (1.9 NSM)
Provide one for the PACU / Phase I Recovery Area.
12. Alcove, Clean Linen (LCCL3) ..................................................40 NSF (3.8 NSM)
Provide one for the PACU / Phase I Recovery Area.
13. Alcove, Portable Imaging Equipment (XRM01) ......................20 NSF (1.9 NSM)
Provide one for the PACU / Phase I Recovery Area.
14. Alcove, Blanket Warmer (RCA04) ...........................................20 NSF (1.9 NSM)
Provide one for the PACU / Phase I Recovery Area.
15. Storage, Equipment (SRE01) .................................................100 NSF (9.3 NSM)
Provide one for the PACU / Phase I Recovery Area.
16. Lounge, Staff (SL001) ..........................................................120 NSF (11.2 NSM)
Minimum NSF; provide an additional 15 NSF per each PACU / Phase I Recovery
FTE Staff position working on peak shift greater than six.
Locate near the Operating Rooms.
17. Toilet, Staff (TLTU1) .................................................................60 NSF (5.6 NSM)
Provide two for the PACU / Phase I Recovery Area.
One for male and one for female.
18. Housekeeping Aides Closet (HAC) (JANC1) ..........................60 NSF (5.6 NSM)
Provide one for the PACU / Phase I Recovery Area.
F. FA 6: Support Area:
1. Control Station (NSTA5) ........................................................100 NSF (9.3 NSM)
Provide one for Surgical Service.
Space located to permit visual observation of all traffic into the Operating Rooms.
2. Frozen Section Laboratory (LBUL1) ................................... 120 NSF (11.2 NSM)
Provide one if a Frozen Section Laboratory is authorized.
Area for preparation and examination of frozen sections. Excluded if specimens
are transported to the main lab.
3. Pharmacy, Satellite (PHDS1) .................................................100 NSF (9.3 NSM)
Provide one if a Satellite Pharmacy is authorized.
4. Utility Room, Soiled (USCL1) .............................................. 120 NSF (11.2 NSM)
Provide one for Surgical Service.
Allocated NSF includes space for recycling.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 13 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
5. Storage, Equipment (SRE01) .............................................. 120 NSF (11.2 NSM)
Provide one for Surgical Service.
6. Computer Network Operations Room (CMP01) ..................... 80 NSF (7.5 NSM)
Minimum NSF; provide an additional 40 NSF per each OR, of any type, greater
than two.
7. Holding, Soiled Case Cart (CHS01) ........................................ 40 NSF (3.8 NSM)
Minimum NSF; provide an additional 20 NSF per each Operating Room, of any
type, greater than two if use of Case Cart System for the Specialty Operating
Rooms is authorized.
8. Storage, Gas Cylinder (SRGC2) .............................................. 60 NSF (5.6 NSM)
Provide one for Surgical Service.
Gas provided for back-up.
9. Housekeeping Aides Closet (HAC) (JANC1) .......................... 60 NSF (5.6 NSM)
Minimum one; provide an additional one for every increment of eight Operating
Rooms, of any type, greater than eight.
G. FA 7: Staff and Administrative Area:
1. Office, Surgical Service Chief (OFA09) ................................ 100 NSF (9.3 NSM)
Provide one for Surgical Service.
2. Office,
Surgical Service Assistant Chief (OFA09) ........................... 100 NSF (9.3 NSM)
Provide one per each Assistant Chief of Surgical Service FTE position authorized.
3. Office, Anesthesiology Chief (OFA09) ................................. 100 NSF (9.3 NSM)
Provide one for Surgical Service.
4. Office,
Anesthesiology Assistant Chief (OFA09)............................. 100 NSF (9.3 NSM)
Provide one per each Assistant Chief of Anesthesiology FTE position authorized.
5. Office, Head of Surgical Section (OFA09) ............................ 100 NSF (9.3 NSM)
Provide one for Surgical Service.
6. Workstation, Staff Surgeon (OFA07) ...................................... 56 NSF (5.3 NSM)
Provide one per each Staff Surgeon FTE position authorized.
7. Office, OR Nurse Manager (OFA09) ...................................... 100 NSF (9.3 NSM)
Provide one per each Operating Room Nurse Manager FTE position authorized.
8. Workstation, Nurse Anesthetist (OFA07) ............................... 56 NSF (5.3 NSM)
Provide one per each Nurse Anesthetist FTE position authorized.
9. Workstation, OR Coordinator (OFA07) ................................... 56 NSF (5.3 NSM)
Provide one per each Operating Room Coordinator FTE position authorized.
10. Secretary / Waiting (SEC01) ................................................ 120 NSF (11.2 NSM)
Provide one per each Secretary FTE position authorized.
Allocated NSF includes space for Waiting; locate near the Office of Chief Surgical
Service.
11. Office, Administrative Officer (OFA09) ................................. 100 NSF (9.3 NSM)
Provide one per each Administrative Officer FTE position authorized.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 14 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
12. Workstation,
Administrative Officer Secretary (OFA07) ..............................56 NSF (5.3 NSM)
Provide one per each Administrative Officer Secretary FTE position authorized.
Allocated NSF includes space for Waiting; locate near the Office Administrative
Officer.
13. Workstation, Scheduler (OFA07) ............................................56 NSF (5.3 NSM)
Provide one per each Scheduler FTE position authorized.
14. Conference Room (CRA01) .................................................300 NSF (27.9 NSM)
Provide one for Surgical Service.
15. Workroom, Copier / Printer (RPR01) ...................................... 80 NSF (7.5 MSM)
Provide one for Surgical Service.
16. Workroom, Biomedical Engineer (BMWS1)............................80 NSF (7.5 NSM)
Provide one if a Biomedical Engineer FTE position is authorized.
17. On-Call Room (DUTY1) ........................................................120 NSF (11.2 NSM)
Provide one for Surgical Service.
Locate adjacent to Operating Rooms.
18. Scrubs Distribution Room (LR005) ..................................... 120 NSF (11.2 NSM)
Provide one for Surgical Service.
Provide space to dispense and receive scrubs. Space may be provided within
each locker room or directly adjacent. It may be a space for an automated scrub
management system. Locate adjacent to Operating Room.
19. Lounge, Staff (SL001) ..........................................................200 NSF (18.6 NSM)
Minimum NSF; provide an additional 15 NSF per each Surgical Service FTE
position authorized greater than five.
Locate near the Operating Rooms.
20. Locker Room, Male Staff (LR004) .........................................100 NSF (9.3 NSM)
Minimum NSF if total number of Surgical Service FTE positions authorized is
between five and thirteen; provide an additional 8 NSF per Surgical Service FTE
position authorized greater than thirteen.
Provide space for changing into surgical attire. Provide one-way changing flow
from Staff Entrance to semi-restricted area. Provide locker space only for those
FTEs without assigned office or work space. Locate near the Operating Rooms.
21. Toilet / Shower, Male Staff (TLTS1) .........................................80 NSF (7.5 NSM)
Minimum two if the total number of Surgical Service FTE positions authorized is
between five and thirteen; provide an additional one for every increment of ten
Surgical Service FTE positions authorized greater than thirteen.
22. Locker Room, Female Staff (LR004) .....................................100 NSF (9.3 NSM)
Minimum NSF if total number of Surgical Service FTE positions authorized is
between five and thirteen; provide an additional 8 NSF per each Surgical Service
FTE position authorized greater than thirteen.
Provide space for changing into surgical attire. Provide one-way changing flow
from Staff Entrance to semi-restricted area. Provide locker space only for those
FTEs without assigned office or work space. Locate near the Operating Rooms.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 15 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
23. Toilet / Shower, Female Staff (TLTS1) .................................... 80 NSF (7.5 NSM)
Minimum two if the total number of Surgical Service FTE positions authorized is
between five and ten; provide an additional one for every increment of ten
Surgical Service FTE positions authorized greater than ten.
H. FA 8: Education Area:
1. Office, Residency Program Director (OFA09) ...................... 100 NSF (9.3 NSM)
Provide one if a Surgical Service Education Program is authorized.
2. Workstation, Resident / Student (OFA07) .............................. 56 NSF (5.3 NSM)
Provide one per each Resident / Student FTE position authorized if a Surgical
Service Education Program is authorized.
3. Conference Room / Classroom (CLR01) ............................ 300 NSF (27.9 NSM)
Provide one if a Surgical Service Education Program is authorized.
6
PLANNING AND DESIGN CONSIDERATIONS
A. Refer to Department of Veterans Affairs (VA) Office of Facilities Management
Handbooks, Standards, Standard Details, and Design Guides for technical criteria.
B. Departmental Net-to-Gross factor (DNTG) for Surgical Service is 1.70. This number
when multiplied by the programmed net square foot (NSF) area determines the
departmental gross square feet.
C. The surgical suite will be divided into three distinct areas; unrestricted, semirestricted, and restricted.
1. Unrestricted: Street clothes are permitted, and the area to have control point for
monitoring entry for patients, staff, and materials.
2. Semi-restricted: Surgical attire is required, and traffic is limited to authorized
personnel. Storage and work areas for processing of instruments and corridors
leading to the restricted areas are included.
3. Restricted: these areas include the operating room, clean core and scrub sinks.
Surgical attire and hair covering is required, along with masks where open sterile
supplies are utilized.
D. Create a separate flow between patients and staff (‘on stage’ and ‘off stage’) to
provide privacy, safety and patient/staff satisfaction.
E. The Surgical Suite should be restricted to the general public as well as to non
authorized staff.
F. Provide for bariatric patients where applicable.
G. Provision should be made for isolation patients in both the Pre-Operative Holding
Phase II Recovery and PACU / Phase I Recovery areas.
H. Consider ceiling mounted patient lifts in key areas to eliminate need for staff-assisted
lifting of patients.
I.
For detailed information on infection prevention and control, refer to ______
J. Provide visual and acoustic privacy for patients in examination, treatment and
procedure areas.
K. Control of sound transmission between rooms is a critical design consideration.
L. Provide acoustic privacy wherever patient information is exchanged.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 16 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
M. Whenever possible, provide natural lighting in the PACU, Pre-op and Phase II
Recovery areas.
N. Whenever possible, provide natural lighting in staff areas (i.e. staff lounge) and
General Waiting.
O. The movement of patients and materials within the Surgery Suite should be physically
separated. Clean Supplies, such as medical/surgical and linen, shall be separate
from the retrieval of used/unused soiled supplies and equipment (instruments).
P. Patient corridors should be a minimum of 8’-0” wide, to accommodate wheelchairs,
equipment, or gurneys.
Q. Consideration should be given to the effects of building vibration, as building vibration
could interfere with the accuracy of patient testing.
R. Pre-Operative Holding / Phase II Recovery
1. The Pre-Operative Holding Area should be co-located or merged into one shared
suite with the Phase II Recovery Area to allow for more efficient use of that space.
Since most surgical procedures are started in the morning, the Pre-Operative /
Holding Area can occupy underutilized Phase II Recovery Space in the morning
but the same area can be used for additional Phase II recovery in the afternoon.
Patient is accommodated in a private space to allow more privacy, include family,
and provide space for changing.
2. Provide private rooms built to universally support the patient from prep through
recovery.
3. Provide a ‘relaxing’ environment to counteract the stress a rapid turnover unit can
convey, including muted lighting, soothing wood tones, and in-room televisions.
4. Provide space for family seating, with cell phone and internet access.
5. If part of the model of care, providing decentralized nursing stations will put the
staff closer to the patients so as to lessen noise, reduce falls and minimize
walking distances.
6. Windows with a view to allow for positive distraction while waiting for procedure or
recovering from procedure.
S. PACU
1. The PACU should be self contained and located in close proximity to all ORs.
2. Layout of PACU spaces and acoustic separation of reception and nurse station
spaces from patient bays should be carefully considered in order to maintain
privacy and noise control.
T. Operating Rooms
1. Universal, same-sized rooms where procedures from multiple different specialties
can be performed will increase efficiency in the surgery department.
2. The operating room suite will be designed with a sterile core to have no cross
traffic of clean supplies and soiled/decontaminated areas. Flow of clean and
soiled/decontaminated supplies and equipment to suite itself shall be designed to
not compromise universal precautions or aseptic techniques.
3. Operating Rooms are to have the following:
a. Provision will be made for (List technology needs)
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 17 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
b. Communication needs are as follows: (List)
4. Including infrastructure to support the trend towards integration. This will help
Operating Rooms remain up to date in the years to come as integration
technology continues to develop.
5. Include systems for integrated image routing. This will simplify the management of
feeds from multiple video sources, and will make intra-operative imaging more
efficient.
6. Design nursing stations inside the Operating Rooms that collocate control of
lights, booms, audiovisual and other equipment. This nurse control station
provides a platform for nurses to control Operating Rooms equipment,
streamlining Operating Rooms use and enhancing the work environment of
surgeons and other Operating Rooms staff.
7. All floors of the Operating Rooms to be homogeneous with a coved floor base
extending no less than 6” above finish floor. No floor drains are permitted.
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 18 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
7
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
FUNCTIONAL RELATIONSHIPS
Relationship of Surgical Service to services listed below:
TABLE 1: FUNCTIONAL RELATIONSHIP MATRIX
SERVICES
Voluntary Service
Patient Care Units - SCI/Disorders Center
Rehabilitation Medicine Service
SCI/Disorders Center – Admin. Offices
Ambulatory Care
Day Hospital
Day Treatment Center
Mental Hygiene Clinic
Patient Care Units – Substance Abuse
Patient Care Units – MS&N
Patient Care Units – Nursing Home
Patient Care Units – Psychiatric
Patient Care Units - Respiratory
Psychiatric Services Administration
Prosthetic Service
Social Work Service – Administration Office
Dialysis Center
Drug Dependency Clinic
Inhalation Therapy unit
Library
Medical Media
Service Organizations
Supply Services - Warehouse
RELATIONSHIP
REASON
1
2
2
2
3
3
3
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
G,I
G, H
G,H
A,B,G,I
G,H
G,H
G, H
G,H
G,H
G,H
G,H
G,H
G,H
G
G,H
G
G,H
G,H
G,H
A,B,G
A,B,G
G
A,B
Legend:
Relationship:
Reasons:
1.
2.
3.
4.
X.
(Use as many as appropriate)
Adjacent
Close / Same Floor
Close / Different Floor Acceptable
Limited Traffic
Separation Desirable
A. Common use of resources
B. Accessibility of supplies
C. Urgency of contact
D. Noise or vibration
E. Presence of odors or fumes
F. Contamination hazard
G. Sequence of work
H. Patient’s convenience
I. Frequent contact
J. Need for security
K. Others (specify)
L. Closeness inappropriate
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 19 of 20
Department of Veterans Affairs
Veterans Health Administration
Washington, DC 20420
8
PG-18-9: Space Planning Criteria
June 1, 2014
Revised: October 01, 2015
FUNCTIONAL DIAGRAM
Chapter 286: Surgical Service: Standard, Intermediate or Complex Center - Page 20 of 20