Department of Veterans Affairs PG-18-9: Space Planning Criteria

Veterans Health Administration March 2008

Washington, DC 20420 Revised: October 03, 2016

CHAPTER 300: DAY HOSPITAL

1 PURPOSE AND SCOPE .............................................................................................300-2

2 DEFINITIONS ..............................................................................................................300-2
3 OPERATING RATIONALE AND BASIS OF CRITERIA ..............................................300-3
4 INPUT DATA STATEMENTS ......................................................................................300-4
5 SPACE CRITERIA ......................................................................................................300-5
6 PLANNING AND DESIGN CONSIDERATIONS .........................................................300-8
7 FUNCTIONAL RELATIONSHIPS ................................................................................300-9
8 FUNCTIONAL DIAGRAM ..........................................................................................300-10

Chapter 300: Day Hospital - Page 1 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

1 PURPOSE AND SCOPE

This document outlines space planning criteria for Chapter 300: Day Hospital. It applies
to all medical facilities at the Department of Veterans Affairs (VA).

2 DEFINITIONS
Accessible: A site, building, facility, or portion thereof that complies with provisions
outlined in the Architectural Barriers Act of 1968 (ABA).
Architectural Barriers Act (ABA): A set of standards developed to insure that all buildings
financed with federal funds are designed and constructed to be fully accessible to
everyone. This law requires all construction, renovation, or leasing of sites, facilities,
buildings, and other elements, financed with federal funds, to comply with the
Architectural Barriers Act Accessibility Standards (ABAAS). The ABAAS replaces the
Uniform Federal Accessibility Standards (UFAS).
Day Room: Dedicated space in a nursing unit for patients to engage in social and
therapeutic activities.
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 Areas, Patient Areas, Support
Areas, Staff and Administrative Areas, and Residency Program.
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 for the facility. This information is processed through mathematical and logical
operations in VA-SEPS.
Program for Design (PFD): A space program based on criteria set forth in this document
and specific information about Concept of Operations, Workload projections and Staffing
levels authorized.
Provider: A medical professional, who examines, diagnoses, treats, prescribes
medication and manages the care of the patients within his or her scope of practice as
established by the governing body of a healthcare organization.
Psychiatrist: A professional that is licensed as a medical doctor (MD), and can prescribe
medications.
Psychologist: A professional specializing in diagnosing and treating diseases of the brain,
emotional disturbance, and behavioral problems. Psychologists can only use talk therapy
as treatment; and are not licensed to prescribe medication.
Quiet Room: A small room where a patient can go and calm down if over stimulated by
other activities or events.
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

Chapter 300: Day Hospital - Page 2 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

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. VA-
SEPS incorporates the propositions set forth in all Space Planning Criteria chapters. VA-
SEPS has been designed to aid healthcare planners in creating a space plan based on a
standardized set of criteria parameters.
Workload: Workload is the anticipated number of procedures or suite stops that are
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

Workload Projections or planned services / modalities for a specific VA medical center,
hospital or satellite outpatient clinic project are provided by the VA Central Office (VACO)
/ VISN CARES Capacity Projection Model. The workload projections are generated by
methodology based upon the expected veteran population in the respective market /
service area. Healthcare planners working on VA medical center, hospital or outpatient
clinic projects will utilize and apply the workload criteria set forth herein for identified
services and modalities to determine room requirements for each facility.
Space planning criteria have been developed on the basis of an understanding of the
activities involved in the functional areas of a Day Hospital and their relationship with
other services of a medical facility. These criteria are predicated on established and/or
anticipated best practice standards, as adapted to provide environments supporting the
highest quality heath care for Veterans.
These criteria are based on established and anticipated standards, which are subject to
modification relative to development in standards of practice, equipment, vendor
requirements, and/or healthcare planning and design developments.
Room capacity calculation per year should be based on:
Operating days per year x Hours of operation per day
= Number of
Minutes per clinic stop / 60 minutes annual clinic stops
1. The general planning model for VA facilities assumes 250 Operating Days per
Year and 8 Hours of Operation per Day. Room capacity will fluctuate as hours of
operation are modified, i.e., additional capacity may be generated by extending
the daily hours of operation within the same physical setting.
2. Basic Room Efficiency Factor selected for Day Hospital is 85%.
Example: For a Day Hospital clinic stop that averages 40 minutes:
250 operating days per year x 8 hours of operation per day
= 3,030 annual
40 minutes per clinic stop / 60 minutes clinic stops

Chapter 300: Day Hospital - Page 3 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

A maximum capacity of 3,030 clinic stops per year, assuming 100% utilization.
However, 100% utilization is not realistic. We will apply an 85% Efficiency
Factor as a design standard for Day Hospital.
3,030 x 85% = 2,575 annual clinic stops.
TABLE 1: WORKLOAD PARAMETER CALCULATION
AVERAGE ANNUAL MINIMUM
LENGTH OF CLINIC STOPS WORKLOAD TO
CLINIC CLINIC STOP UTILIZATION PER ROOM GENERATE ONE
STOP (minutes) RATE (rounded) ROOM
Exam
40 85% 2,575 770
Room
The number of annual clinic stops per room will be used as a criteria parameter to
calculate the number of exam rooms in the Space Criteria section of this
document. The minimum workload to generate one room is 30% of the calculated
annual clinic stops per room.

4 INPUT DATA STATEMENTS

A. Mission Input Data Statements
None
B. Workload Input Data Statements
1. How many annual Day Hospital clinic stops are projected? (W)
C. Staffing Input Data Statements
1. How many Psychiatrist FTE positions are authorized? (S)
2. How many Psychologist FTE positions are authorized? (S)
3. How many Social Worker FTE positions are authorized? (S)
4. How many Resident Trainee FTE positions are authorized? (S)
5. How many Rehabilitation Therapist FTE positions are authorized? (S)
6. How many Nurse FTE positions are authorized? (S)
7. How many Secretary FTE positions are authorized? (S)
D. Miscellaneous Input Data Statements
1. How many FTEs working on peak shift? (Misc)
2. How many FTE positions are not authorized to have office or work space? (Misc)

Chapter 300: Day Hospital - Page 4 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

5 SPACE CRITERIA
A. FA 1: Reception Area:
1. Waiting (WTG02) ....................................................................... 45 NSF (4.2 NSM)
Provide one if the projected number of Exam / Treatment Rooms is two; provide
WTG03 if the projected number of Exam / Treatment Rooms is three; provide
WTG04 if the projected number of Exam / Treatment Rooms is four; provide
WTG05 if the projected number of Exam / Treatment Rooms is five; provide
WTG06 if the projected number of Exam / Treatment Rooms is six; provide
WTG07 if the projected number of Exam / Treatment Rooms is seven; provide
WTG08 if the projected number of Exam / Treatment Rooms is eight; provide
WTG09 if the projected number of Exam / Treatment Rooms is nine; provide
WTG10 if the projected number of Exam / Treatment Rooms is ten; provide
WTG11 if the projected number of Exam / Treatment Rooms is eleven; provide
WTG12 if the projected number of Exam / Treatment Rooms is twelve; provide
WTG13 if the projected number of Exam / Treatment Rooms is thirteen; provide
WTG14 if the projected number of Exam / Treatment Rooms is fourteen; provide
WTG15 if the projected number of Exam / Treatment Rooms is fifteen; provide.
WTG02: Allocated NSF accommodates one bariatric chair @ 14 NSF, one
accessible space @ 10 NSF, and circulation; total two people.
WTG03: Allocated space accommodates one standard chair @ 9 NSF, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
three people.
WTG04: Allocated space accommodates two standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
four people.
WTG05: Allocated space accommodates three standard chairs @ 9 NSF each,
one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total five people.
WTG06: Allocated space accommodates four standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
six people.
WTG07: Allocated space accommodates five standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
seven people.
WTG08: Allocated space accommodates six standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
eight people.
WTG09: Allocated space accommodates seven standard chairs @ 9 NSF each,
one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total nine people.
WTG10: Allocated space accommodates eight standard chairs @ 9 NSF each,
one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total ten people.

Chapter 300: Day Hospital - Page 5 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

WTG11: Allocated space accommodates nine standard chairs @ 9 NSF each,

one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total eleven people.
WTG12: Allocated space accommodates ten standard chairs @ 9 NSF each, one
bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total
twelve people.
WTG13: Allocated space accommodates eleven standard chairs @ 9 NSF each,
one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total thirteen people.
WTG14: Allocated space accommodates twelve standard chairs @ 9 NSF each,
one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation;
total fourteen people.
WTG15: Allocated space accommodates eleven standard chairs @ 9 NSF each,
two bariatric chairs @ 14 NSF each, two accessible spaces @ 10 NSF each, and
circulation; total fifteen people.
2. Communication Center (NSTA1) ............................................ 100 NSF (9.3 NSM)
Minimum NSF; provide an additional 10 NSF per each Psychiatrist, Psychologist
and Social Worker FTE position authorized greater than four; maximum 200 NSF.
Area includes space for secretary / receptionist.
3. Toilet, Public (TPG01) ............................................................... 60 NSF (5.6 NSM)
Provide two for Day Hospital.
Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible
wall-hung lavatory @ 13 NSF, ABA clearances, and circulation. One for male and
one for female.
B. FA 2: Patient Area:
1. Exam Room (EXRG3) .....................................................120 NSF (11.2 NSM)
Provide one for every increment of 2,575 annual Day Hospital clinic stops
projected; minimum projected workload to provide a room is 770 (see Table 1).
2. Treatment Room (TRGM1) ............................................. 160 NSF (14.9 NSM)
Provide one for every increment of four Exam Rooms.
3. Consult Room (OFDC2) ...................................................100 NSF (9.3 NSM)
Provide one for every increment of eight Exam Rooms.
4. Group Therapy Room (OPMH1) .................................... 300 NSF (27.9 NSM)
Provide one for every increment of six Exam Rooms.
5. Activities / Dining Room (FSCD1) ................................. 800 NSF (74.4 NSM)
Minimum NSF; provide an additional 100 NSF for every increment of two Exam
Rooms greater than six.
6. Storage, Activities / Dining (SRS01) ............................... 100 NSF (9.3 NSM)
Minimum NSF; provide an additional 50 NSF for every increment of 250 NSF of
Activity / Dining Room greater than 800.
7. Quiet Room (DAYR1) .....................................................120 NSF (11.2 NSM)
Minimum one; provide an additional one for every increment of six Exam Rooms
greater than six.

Chapter 300: Day Hospital - Page 6 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

8. Storage, Medication (MEDP1) ........................................... 80 NSF (7.5 NSM)

Provide one for Day Hospital.
This space should be located adjacent to Communication Station.
9. Nourishment Room (NCWD1) ........................................... 70 NSF (6.6 NSM)
Provide one for Day Hospital.
This space should be located adjacent to Communication Station.
10. Toilet, Patient (TPG01) ...................................................... 60 NSF (5.6 NSM)
Minimum two; provide an additional two for every increment of ten Exam Rooms.
Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible
wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.
C. FA 3: Staff and Administrative Area:
1. Office, Day Hospital Chief (OFA09) ................................ 100 NSF (9.3 NSM)
Provide one for Day Hospital.
2. Workstation, Secretary (OFA07) ...................................... 56 NSF (5.3 NSM)
Provide one per each Secretary FTE position authorized.
3. Office, Psychiatrist (OFDC1) ........................................ 120 NSF (11.2 NSM)
Provide one per each Psychiatrist FTE position authorized.
4. Office, Psychologist (OFDC1) ...................................... 120 NSF (11.2 NSM)
Provide one per each Psychologist FTE position authorized.
5. Office, Social Worker (OFDC1) ..................................... 120 NSF (11.2 NSM)
Provide one per each Social Worker FTE position authorized.
6. Workstation, Resident Trainee (OFA07) .......................... 56 NSF (5.3 NSM)
Provide one per each Resident Trainee FTE position authorized.
7. Workstation, Rehabilitation Therapist (OFA07) .............. 56 NSF (5.3 NSM)
Provide one per each Rehabilitation Therapist FTE position authorized.
8. Workstation, Nurse (OFA07) ............................................. 56 NSF (5.3 NSM)
Provide one per each Nurse FTE position authorized.
Locate adjacent to Communication Station.
9. Lounge, Staff (SL001) ........................................................ 80 NSF (7.5 NSM)
Minimum NSF; provide an additional 15 NSF per each Day Hospital FTE position
working on peak shift greater than five; maximum 210 NSF.
10. Locker Room, Staff (LR001).............................................. 80 NSF (7.5 NSM)
Minimum NSF if total number of Day Hospital FTE positions not authorized to
have office or work space is between five and thirteen; provide an additional 6
NSF per each Day Hospital FTE position not authorized to have office or work
space is greater than thirteen.
Provide locker space only for those FTEs without assigned office or work space.
For less than five FTE combine Locker Room facilities with adjacent department
or sum in chapter 410.

Chapter 300: Day Hospital - Page 7 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

11. Toilet, Staff (TNPG1) ..........................................................60 NSF (5.6 NSM)

Minimum one; provide an additional one for every increment of fifteen Day
Hospital FTE positions working on peak shift greater than fifteen.
Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung
lavatory @ 12 NSF, ABA clearances, and circulation.
D. FA 4: Education Area:
1. Training Room, Staff (CFR01) ....................................... 240 NSF (22.3 NSM)
Provide one for Day Hospital.
Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x
2’-0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six
people.

6 PLANNING AND DESIGN CONSIDERATIONS

A. Net-to-department gross factor (NTDG) for Day Hospital is 1.45. This number when
multiplied by the programmed net square foot (NSF) area determines the
departmental gross square feet.
B. Centralize check-in/check-out for more efficient use of staff.
C. Consider location of Travel Office (See Chapter 265 Outpatient Clinic) in vicinity of
main check-in / checkout or other central location. Use comparable criteria for
administrative office / reception areas. (If these programs are part of a larger
outpatient facility)
D. Co-locate groups of exam and office rooms so other service teams can use rooms, as
the demand fluctuates.
E. Create clinic modules with connecting corridors to allow internal circulation of patients
and staff; avoid crossing public circulation patterns.
F. Configure patient waiting area with partitions to provide clustered seating and privacy,
in order to reduce large waiting spaces and to improve patient environment and
reduce noise and confusion. A Women Veterans sub-waiting area may be provided
within Waiting, and located adjacent to the patient care spaces.
G. Locate staff lounge convenient to staff area(s) but separate from patient care spaces.
H. Plan to minimize walking distances for patients from building main entrance to clinical
destination and from clinical waiting area to clinical exam or treatment space.
I. Design corridors a minimum of six (6) feet in width, to accommodate passage of two
(2) wheelchairs.
J. In order to accommodate the designated equipment and a patient in a wheelchair,
examination rooms require a minimum clear dimension of 10'-0”.
K. The Day Hospital should be located adjacent to the psychiatric inpatient program.
L. Egress should be independent of ward units.
M. Visitor circulation to Group Therapy Rooms through the Day Hospital should be
controlled.

Chapter 300: Day Hospital - Page 8 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

7 FUNCTIONAL RELATIONSHIPS
Relationship of the Day Hospital to services listed below:
TABLE 2: FUNCTIONAL RELATIONSHIP MATRIX
SERVICES RELATIONSHIP REASON
Mental Health and Behavioral Patient Care Unit 1 A
Police Service 2 C,J
Pharmacy-Outpatient Satellite 3 H
Social Work 3 H
Physical Medicine and Rehabilitation Service 3 H
Mental Health Clinic 4 A
Psychology Service 4 A
Substance Abuse Clinic 4 A
Spinal Cord Injury / Disorders Center X L

Legend:
Reasons:
Relationship:
A. Common use of resources
1. Adjacent
B. Accessibility of supplies
2. Close / Same Floor
C. Urgency of contact
3. Close / Different Floor Acceptable
D. Noise or vibration
4. Limited Traffic
E. Presence of odors or fumes
X. Separation Desirable
F. Contamination hazard
G. Sequence of work
H. Patient’s convenience
I. Frequent contact
J. Need for security
K. Others (specify)

Chapter 300: Day Hospital - Page 9 of 10

Department of Veterans Affairs PG-18-9: Space Planning Criteria
Veterans Health Administration March 2008
Washington, DC 20420 Revised: October 03, 2016

8 FUNCTIONAL DIAGRAM

Chapter 300: Day Hospital - Page 10 of 10