SF330 ATTACHMENT - AE SOW ATTACHMENT 1 - Construct Cancer Treatment Center Project Numbner 607-395.pdf

Room Data Sheets & Equipment

August 10, 2015

Expand Ambulatory Surgery Project Number 607-15-142 September 8, 2015

William S. Middleton Memorial Veterans Hospital

25% Basis of Design Schematic Design

Construct Cancer Treatment Center Project Number 607-395 April 28, 2016

13100 Watertown Plank Road Suite 200

Elm Grove, WI 53122 P: 262-641-0746

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Project Number: 607-395 Project Name: Construct Cancer Treatment Center Project Start Date: 01-28-2016 Project Location: William S. Middleton VAH, Madison, WI

VA Representatives: John Meyers: Contracting Officer 608-280-7225 Mark Blaha: Construction Chief 608-256-1901 ext.11153 Gary Michel: COR for the project 608-256-1901 ext.11155

Prime Architect and Engineer: Nagel Architects Support Design Architect: Kahler Slater Support Design MEP Engineer: Ring & DuChateau, LLP Structural Engineer: GRAEF Environmental Hygienist: Environmental Management Consulting, Inc.

Cost Estimating: The Concord Group

Design Software utilized: AutoCAD Deliverables Specification Format: VA Specification Standards

Project Team and Area of Responsibility:

Name Discipline Contact Responsibility Rich Luce, AIA Contracting Manager 262-641-0746 Prime, AE Services Steven Margis, AIA Project Manager 262-641-0746 Prime, AE Services Joe Heinowski, AIA, EDAC Project Architect 262-641-0746 Prime, Arch. Services Peter Zak, PE Project Engineer 262-641-0746 Prime, Eng. Services Emily Girdauskas AE Draftsperson 262-641-0746 Prime, AE. Services Dave Sheedy Architecture 608-227-7226 Support Architect Gene Wells, AIA Architecture 608-227-7228 Medical Programmer Derek Bushman Civil Engineer 608-266-9281 Civil Engineer Bryant Stempski, PE Structural Engineer 608-245-1967 Structural Engineer Dave Herbert, RD, CPD Mechanical Engineer 414-778-7439 Support MEP Engineer Michael Jushka, PE HVAC Engineer 414-778-7414 Support MEP Engineer Tim O'Rorke Electrical Engineer 414-778-7469 Support MEP Engineer Bryant Stempski, PE Structural Engineer 608-245-1967 Structural Engineer John Bushman Environmental Hygienist 920-648-6343 Hazardous Materials Eamon Ryan Cost Estimator 312-882-2525 Cost Estimating

The Basis of Design, as documented by Nagel Architects, is to be considered a living document that shall be revised as the project evolves through completion of the Scope of Work. It is the responsibility of the Design Team to update as required to maintain currency of this document.

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Nagel Architects Scope of Work:

A. Historically, the Madison VA Hospital has referred its cancer patients to either the Milwaukee, WI VA or to local private hospitals using purchased (fee) care funding. Milwaukee VA is currently the only site within the Northern Tier of VISN 12 that has a radiation therapy program. At present, despite efforts to extend clinic hours to provide in-house radiation therapy for Veterans, Milwaukee has been over workload capacity in cancer treatment services for greater than one year. This has resulted in escalated fee costs and patient travel along with challenges to provide timely access to services and efficient coordination of care for Veteran patients in need of radiation therapy care.

B. In January 2013, the Madison VA Hospital requested approval to begin Radiation Therapy on site, see

Attachment A - Business Plan for Radiation Therapy. This program was approved by the Deputy Under Secretary for Health for Operations and Management (10N), and the Under Secretary for Health (10) in April 2013.

C. In March 2013, the Madison VA Hospital concluded space programming efforts under project 607-12-106 for a project to construct a Cancer Treatment Center, see Attachment B – Cancer Treatment Space Program.

D. This project will construct a new, high quality, state-of-the-art Cancer Treatment Center in a facility with approximately 14,000 GSF of new space. It will be located adjacent to and connected to the existing main hospital, Building 1.

E. Project scope includes provision for construction of two Linear Accelerator Rooms, associated entrance maze and control rooms, one CT Simulator Room, block/mold room, multiple infusion therapy rooms, patient exam/treatment rooms, patient dressing and toilet rooms, treatment planning and dosimetry space, and patient waiting and reception space, along with related program support spaces and staff oncologist/physicist/radiation therapy offices and staff training areas. In addition to construction of the building envelope to house these functions, the project scope includes all necessary site work, underground utility relocations, electrical systems, plumbing and fire protection systems, and all mechanical equipment and distribution systems necessary to support this free-standing facility. Provide a dock location for mobile MRI or CT to operate alongside the building with connection into the Center.

On site utility infrastructure shall be evaluated and upgraded as required within this project.

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The design team shall provide space programming (minor update to existing program) through construction bid documents and construction period services for the VA to construct approximately 13,500 square feet of new space and renovations to approximately 500 square feet of space on the ground floor Awing. Include provisions for the docking of a mobile MRI or CT on the exterior of the building similar to the existing MRI dock. Major elements include civil, geotechnical, structural, architectural, mechanical, plumbing, and electrical design. The A/E shall plan on holding (2) preliminary design meeting and (2) design development meetings with VA staff.

Owner’s Project Requirements:

A. The Architect-Engineer (A/E) shall provide, and prepare and accomplish space programming, schematic design, design development, construction documents, cost estimates, and provide construction period services for this project as described here-in and in the references links.

B. There will be four submissions for review by this Medical Center before copies of the final contract drawings and specifications are produced; one at the completion of schematic design; one at the completion of design development and two construction documents progress submissions (65% & 95%). Designer shall provide response to review comments.

C. Design documents shall be in compliance with the following VA guidelines and standards. Changes may be suggested to the VA standards if they different from industry standards.

• Space programming shall comply with Chapter 277- VETERANS HEALTH ADMINISTRATION -

RADIATION THERAPY SERVICE.

• Design shall comply with VA Design Guide for Radiation Therapy.

• Design shall consider VA Equipment Guide List for Radiation Therapy.

• Design shall comply with VA Design Manuals, including Physical Security.

• Design shall consider accessibility requirements.

• Design shall comply with design alerts.

• Design shall consider Room Finishes, Door and Hardware Schedule.

• Design shall comply with VA Project Document Requirements.

• Design shall be developed from the VA Master Specification (SPECIFICATIONS SHALL BE IN

MASTERFORMAT 2004).

• Design shall incorporate new signage in accordance with VA signage manuals.

D. Design shall comply with all energy and water conservation public laws and VA policies. All applicable life-cycle cost effective recommendations in the ASHRAE Advanced Energy Design Guides shall be utilized to meet these goals: “Small Hospitals and Healthcare Facilities – 30%” for medical areas and “Small to Medium Office Buildings – 50%” for administrative areas. These energy requirements

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E. Include in fee proposal Life safety code review by FP&C. Submit annotated review comments with 95% submission.

F. Project shall comply with environmental requirements where anticipated construction activities disturb hazardous materials.

G. It is not anticipated that this project will be phased; however project sequencing should be discussed and defined as a part of the design development.

H. This project is approved within the VA Minor Construction program. Final bid documents shall include provisions for 20% in deductive bid alternates to ensure the project remains within budget. Provide design to accommodate multiple Bid Items and to provide a list of bid items with complete description and project synopsis for inclusion in the bid documents. A/E shall provide a detailed cost estimate for the construction contract. Cost estimate shall be itemized by labor and material for each trade and specialty.

I. The estimated construction contract price for this project is $7,900,000.

J. A/E shall provide an estimated construction time to complete the entire construction project.

K. VAMC will provide all available architectural, mechanical and electrical as-built plans, and Facility

Floor Plans. A/E is responsible for surveying existing conditions & its accuracy.

L. Design fee proposal shall comply with the requirements of FAR 15.404-4(c)(4)(i)(B) & VAAR 836.606-

73 for architect-engineer services for public works or utilities, the contract price or the estimated cost and fee for production and delivery of designs, plans, drawings, and specifications does not exceed 6 percent of the estimated cost of construction of the public work or utility, excluding fees.

M. Design shall include geotechnical services. Engineer shall develop soil boring plan based on project description provide by design team. Plan shall identify at a minimum three site boring locations. Drill Standard Penetration Test (SPT) soil borings to 20 to 25 feet below existing site grades. Backfill boreholes with bentonite. Prepare and submit geotechnical engineering report providing site preparation, foundation, pavement, below-grade wall and floor slab design/construction recommendations. Include construction period services to provide technical services during soil compaction and concrete placement.

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Design Review/Project Schedule

The Part I and Part II design submission and review schedule for the project is anticipated to take place as follows:

01.28.2016 Kick-off Meeting

02.11.2016 Tour of UW Human Oncology Center / Programming Meeting w/ VA Staff

03.04.2016 Conceptual Design Meeting w/ VA Staff

03.14.2016 Space Programming / Preliminary Design Submission

03.24.2016 Schematic Design / Visioning Meeting w/ VA Staff

04.19.2016 Schematic Design 2 Meeting w/ VA Staff

04.28.2016 Schematic Design Submission

05.05.2016 Interior Design Kick-off Meeting

05.12.2016 VA Review Deadline – Schematic Design Submission

05.19.2016 Design Development Meeting 01 w/ VA Staff

06.09.2016 Design Development Meeting 02 w/ VA Staff

06.23.2016 Design Development Submission

07.14.2016 VA Review Deadline – Design Development Submission

09.01.2016 65% Construction Document Submission

09.22.2016 VA Review Deadline – 65% Construction Document Submission

11.17.2016 95% Construction Document Submission

12.08.2016 VA Review Deadline – 95% Construction Document Submission

12.29.2016 100% Construction Document Submission

General – VA Applicable Publications:

The sections as follows describe the VA publications used in evaluating, establishing the design criteria, and creating the construction documents:

VAHBS 2014 Architectural Design Manual PG 18-1 Master Construction Specifications PG 18-3 Design and Construction Procedures PG 18-4 National CAD Standards PG 18-5 Equipment Guide List PG 18-9 Space and Facility Planning PG 18-10 Design Manuals PG 18-12 Graphical Design Guide – Community Living Centers – June 2011 PG-18-13 Barrier Free Design Guide PG-18-14 Room Finishes, Door, and Hardware Schedules

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PG 18-15 A/E Submission Requirements for VA Medical Center Major New Facilities Additions and Renovations

2015 Physical Security Design Manual: Life-Safety Protected Facilities CFM 2011 Manual for Preparation of Cost Estimates

Architectural -- Code Analysis

Applicable Codes and Standards

1. Architectural Requirements: The following codes, standards, and guidelines will be used for the design as applicable or as directed by the authorities having jurisdiction. The codes, standards, and guidelines listed indicate recommended or minimum requirements. Based on input from Owner representatives, minimum requirements or standards may be exceeded. Unless otherwise indicated by VA criteria, the Codes and Standards of the following organizations were used:

a. Joint Commission on Accreditation of Healthcare Organizations (JACHO), Environment of Care Guidelines and Standards

b. International Building Code 2012

c. NFPA 101 Life Safety

d. NFPA 99 Standard for Health Care Facilities

e. NFPA 220 Standard on Types of Building Construction

f. NFPA 221 Standard for Fire Walls and Fire Barrier Walls

g. American National Standards Institute (ANSI)

h. American Society for Testing Materials (ASTM)

i. Building Industry Consulting Service International (BICSI)

j. U.S. Green Building Council (USGBC) LEED Program & Sustainable Building Design Council

k. The Green Building Initiative (GBI), Green Globes Environmental Assessment and rating

System

l. The American Institute of Architects (AIA) and National Society of Professional

Engineers(NSPE) recent additions to their professional codes of ethics encouraging “environmentally responsible design”

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Architectural Requirements:

1. Assumptions – Existing Building:

a. International Building Code – 2012

b. IBC - 1B Class of Construction, Noncombustible Materials

2. Building Classification: Code Reference

Basic Occupancy Classification: I-2 Institutional IBC 308.1 Occupancy Sub-Classification: Ambulatory Care

3. Construction: Code Reference Fire Ratings: In Hours IBC Table 601

a. Exterior Bearing Wall: 2

b. Exterior Non-Bearing Wall: 1/0 IBC Table 602 for Distance Requirements

c. Interior Bearing Wall: 2

d. Permanent Partitions: 0

e. Shafts: 1 IBC 707, 713 NFPA 101 8.6.5 (1)

f. Columns: 2

g. Trusses, Girders, Beams: 2

h. Floor Construction: 2

i. Roof Construction: 1

j. Exterior Doors & Windows: 1/0 IBC Table 602 for Distance Requirements

k. Inner Court Walls: ? To be confirmed

l. Corridors: 0 IBC 407.3 Smoke Partition per Section 710

m. Parapets: Not Required

n. Smoke Compartments: 2 per Floor 22,500 sf max.

o. Elevator Lobby Enclosure Pressurized shaft? - To be confirmed

4. Sanitation Considerations Code Reference IBC Table 2902.1

Plumbing Fixtures:

170 Occupants = 85 males and 85 females Males Water Closet - 1 per 25 = 3WC Urinal – Confirm VA design intent Lavatory - 1 per 40 = 3 per floor Females Water Closet - 1 per 25 = 3WC Lavatory - 1 per 40 = 3 per floor

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Drinking Fountains: high/ low ADA- provide 1 Note: Calculations above are based on the area of renovation only.

5. Occupancy Load and Exit Width:

Floor or Area Occupancy Sq. Ft. / Person # of Persons Exits Required Req. Exit Width Notes Ground Floor 17,000 SF Institutional 100 170 2 34” min. IBC 1018.2

NFPA 101-7.3.3

IBC Table 1018.2

IBC 1005.3

NFPA 101-7.3.1.2

6. Exit Requirements: Code Reference Number of Exits/Each Floor or Area: 2 Min. IBC 1015.1 NFPA 101 39.2.4 & 7.5.1.1.2 Basement Rooms: NA Maximum Travel Distance to Exit

a. Unsprinklered: Not Permitted

b. Sprinklered: 200’ IBC Table 1016.2 NFPA 101 39.2.6.2

c. Others:

Dead End Corridor Limit: 20’ IBC 1018.4 Common path of Travel 75’ IBC 1014.3 Minimum Exit Passageway 44” min. IBC 1023.2 Minimum Corridor Width 96” min. IBC 1018.2

7. Doors: Code Reference Closures are required at rated doors.

8. Interior Finishes: Code Reference

IBC Table 803.9 Flame Spread Ratings NFPA 101 39.3.3 Stairway: B Corridor: B Rooms: B* Carpet Rating Required: Class B min.

Note: *C rating in Administrative Spaces and rooms with 4 persons or less

ADA Accessibility Analysis

• The accessibility shall be guided by the Architectural Barriers Act Accessibility Standard (ABAAS), except where VA has a more stringent requirement.

• VA guidelines require a 5’-6” turning radius in all rooms requiring ADA accessibility. Bariatric Spaces require a 6’-4” turning radius.

• The public toilets and staff toilets also need a larger footprint to meet the requirements.

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• The project is primarily new construction and there does not appear to be any conditions that would compromise accessibility compliance.

A. Architectural Analysis- (To be completed at the DD submittal)

Architectural – Programming Criteria:

OPERATONS/SERVICES

A. General Comments

1. The space program was developed in a 2013 Master Plan and was updated to reflect the current need in March 2016. A future scenario that affects this project is the intent to build a behavioral health inpatient unit on second floor above this construction. The structural grid should accommodate a future inpatient unit.

2. This addition will be designed for vertical expansion up to the 4th floor with space designated for future elevators and stairs.

3. To provide flexibility, the building is being designed as an I-2 (inpatient) occupancy, the intended use for the current ground floor cancer center is ambulatory (outpatient).

4. The Ground floor to First floor height in the VA is 11’-6”. The required vertical space for a linear accelerator vault varies but is approximately 17’-0” from floor to top of concrete shielding above the iso-center. There are several effective but more expensive shielding methods that can reduce this height by several feet (but not to 11”-6”). These will be evaluated as part of design development.

5. A Mobile Imaging Dock has been added to provide an option for different diagnostic equipment and general imaging flexibility.

6. A vestibule has been added because of the desire to have a dedicated outside entrance.

7. A long term lounge has been added to provide a space for patients with multiple appointments or shared rides a place to spend time while waiting

8. A family consultation room has been added.

9. A resident’s workroom has been added to the program to accommodate the education function of the VA.

10. A sealed source room was deleted from the program because the program will not include hyperbaric treatment.

11. A procedure room was deleted

VHAMADBlahaM Highlight

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B. Units scheduled services/activities

1. 12 hours per day/5 days a week (to be confirmed)

2. This unit will provide inpatient and outpatient radiation therapy treatment to cancer patients. This is a new program and the intent is to serve patients from all over Wisconsin and alleviate some of the overcrowding at the VA medical Center in Milwaukee. See the Wm S Middleton VAH Radiation Therapy Proposal FY 2013.

C. List the major services and activities for the unit:

1. Cancer Care modalities include 2 linear accelerators, 1 CT Simulator and a mobile imaging dock

2. Support treatment spaces include 4 exam rooms and 2 hydration rooms

D. List unit FTE requirements:

See the Wm S Middleton VAH Radiation Therapy Proposal FY 2013.

PHYSICAL BUILDING REQUIREMENTS

A. List of unique aspects of services, facilities or equipment which may affect the unit’s space requirements:

1. The facility will be required to relocate many underground services to accommodate this addition.

2. The addition will wrap around and enclose existing Building 18. This building is designed to allow Building 18 to be removed in the future.

3. The addition of an exterior entry will add substantial site work to the scope of the project. See Civil Requirements.

B. Outline the expected Pharmacy & Medication operational plan:

1. Pharmaceuticals and medication are not a significant part of this treatment process.

Medication will be stored in the nurse station. Pharmaceuticals are in Oncology, a separate department.

C. What are the Bariatric and patient transport requirements for the unit?

1. Typically cancer patients are not bariatric

2. One exam room will be provided with a ceiling track and lift

3. A lift will be stored near to the CT Simulator and Linear Accelerator

4. Inpatients will be escorted and transported to the unit on a gurney

D. How frequently, on average, are the following transported to the unit?

1. Supplies from bulk stores- Assume daily (confirm)

2. Supplies from Central Sterile- none

3. Linen- Assume daily (confirm)

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Architectural – Design Analysis:

GENERAL EXISTING CONDITIONS AND RECOMMENDATIONS

Results of various Architectural field measurements and observations will be included in the CAD-developed as-built documentation and included in the Demolition Drawings as the project progresses.

A. The exterior shell of the building is considered to be solid.

B. Some windows in A wing may be infilled as part of project scope C. Some renovation may be included in the scope at the A wing where the addition is proposed.

D. Stair 4 currently exits into the area that is proposed for the new addition. The exit will be extended to the adjacent exterior ramp which serves the auditorium E. The smoking shelter will be relocated F. The underground salt storage and fuel tank storage may need to be relocated depending on the final building footprint G. There are other underground services that will likely need relocation.

VISION

The vision for this new VA department is still a work in progress. Goals established to date include:

1. Provide a space that recognizes the uniqueness of cancer patients and strives to give them a positive patient experience.

2. Design a safe, friendly and healing patient environment. As the design progresses, the team will endeavor to eliminate environmental stressors, provide positive distractions, create a connection to nature and enable social support.

3. Create a safe, efficient and flexible work environment.

A Visioning Session was conducted on March 17th, 2016. (A summary document is in the appendix) The idea that environment is characterized by people, products, processes and place was posed as a starting point and the group conducted an exercise to discuss each of the 4 P’s relative to the cancer center project. The question was asked, “What should this cancer care facility feel like to patients”?

The group divided into 4 teams and spent time mapping out an ideal experience given a scenario and photo of patients, and then presented each of them for discussion as a team. Many common themes emerged and will guide the design as it goes forward:

• Communicate in every way possible, information empowers the patient

• Image should be clean and uncluttered, well-lit, calming and relaxing

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• Staff should appear professional, measured and efficient, confident and caring

• All staff can help patients, that’s why you are here

• Follow the ICARE principles

• Easy parking and wayfinding is important

• Positive distractions are vending, music and access to outdoors,

• Veterans are cool, they should be treated with respect and have adequate privacy.

FUNCTIONAL NARRATIVE

A. Outpatient Flow

1. Outpatients will be provided with convenient parking to enter in a dedicated entrance to the Cancer Care at the south end of the addition. A drop off will be provided. They will be greeted by a receptionist located next to the waiting area and visible from the entrance.

The receptionist will notify the appropriate staff that the patient has arrived.

2. Returning therapy outpatients can walk back to the techs at the Therapy Room entrance where there will be a small sub-waiting area.

3. For patients that need hydration (as determined by the tech), the tech will notify the nursing staff who will come to the patient and escort them to a hydration room.

4. Outpatients coming for a simulator appointment will be escorted back to the room by the CT tech. The CT tech will direct the patient to the dressing room or into the CT Simulator room and provide for their privacy and comfort

5. Outpatients coming in for an exam or consultation will be escorted by a nurse to the appropriate room.

6. Multiple appointment patients can choose to wait in the long term lounge, which will be an extension of the waiting area and will include positive distractions which have yet to be identified.

B. Inpatient Flow

1. Approximately 10 % of the patients treated here will be inpatients. Inpatients will come from the main hospital entrance at the north end of the addition. They will always be escorted by staff from their inpatient unit to the appropriate tech and room in the Cancer Care unit. Two stretcher holding areas are located to facilitate supervision by staff.

2. Hydration levels of an inpatient should be determined before they travel to the unit.

3. The planning will minimize the visual contact between outpatients and inpatients.

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C. Staff Flow

a. The work areas within this unit are somewhat independent from each other. The functions are designed to be in “work clusters” which is a group of programmatic spaces that function as a unit. These clusters are close together to serve the same patients, and are designed to encourage efficiency and flexibility.

b. The receptionist station clusters with the main waiting room, the nurse work area and the consultation room. It is assumed that communication with the nurses and techs is electronic.

c. The nurse work area cluster includes the main waiting room, exam rooms, hydration rooms, exam rooms, stretcher holding and the waiting area serving the mobile dock.

d. The CT simulator cluster includes the simulator and the control room, dressing rooms and the patient toilet. The tech has a secondary relationship with the nurse work area and the dosimetry room. Access to stretcher holding and the lift alcove is also important.

e. The Therapy Room cluster includes the vault, control rooms and the adjacent sub-waiting area.

f. The staff offices do not require immediate proximity to the clusters listed above, but should be nearby.

Architectural – Design Criteria:

• Room Layouts: Specific Room Layouts will conform with VA TIL Design Guides.

• Building Interior – Doors - General: Comply with TIL - VA Standards for Construction, Room Finishes, Door and Hardware Schedule (PG-18-14), for sizes, types and symbols of doors. Provide solid core wood or hollow metal interior doors. Wood is preferred, except for locations where metal is required for functional reasons. Provide Metal Door Frames.

• Building Interior – Doors – Fire Partition and Smoke Barrier Doors: Doors in fire partitions and smoke barriers shall have fire rated glazing vision panels and be held open with electromagnetic holders, except doors which should remain closed for functional reasons. Do not use wood labeled fire doors in areas where they may be subjected to heavy traffic or hard use, such as by carts, trucks, kitchen equipment, etc., nor for pairs of opposite-swinging (cross corridor) doors. In these locations, use hollow metal labeled doors.

• Building Interior – Partitions – Metal Stud Partitions: For general interior partition framing, refer to TIL - VA Standards for Construction, Master Construction Specifications (PG-18-1), “non-structural metal framing”.

• Building Interior – Partitions – Structural Design: Coordinate with Structural Engineer for design of partitions supporting wall-hung equipment and TV support brackets.

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• Building Interior – Partitions – Gypsum Board: Where gypsum board is called for, use 16 mm (5/8 in.) thick Type X gypsum board, except for special conditions.

• Building Interior – Partitions – Height of Gypsum Board: Specifications (PG-18-1), Division 9 Finishes, for height of gypsum board on metal stud partitions in most applications. For smoke barriers, extend one layer of gypsum board from floor to underside of structure above on partitions enclosing isolation room or suite, and firestop juncture of gypsum board and adjoining material to prevent the passage of smoke.

• Building Interior – Room Finishes / Door / Door Hardware: Refer to TIL - VA Standards for Construction, (PG-18-14), Room Finishes, Door, and Hardware Schedules, Chapter

291. The project management team must review any deviation from the finishes described in this document prior to start of construction document phase. The A/E shall combine the finish schedule and color design schedule and include them in the specifications. The finish schedule format included in Room Finishes, Door, and Hardware Schedule will be used at the cd phase of the project. All interior finishes will be indicated in the specifications.

• Building Interior – Water Coolers: Provide electrical water coolers where specifically required by the TIL - Equipment Information (PG-18-5), Equipment Guide List. All water coolers are to be accessible per requirements of the Uniform Federal Accessibility Standards.

Basis of Design – Interior Design:

Design Concept A Visioning Session for the new Cancer Treatment Center was led by the architectural team and included staff from both the VA as well as Oncology specialists from UW Hospital. Participants were asked to map the expriences of different types of potential patients as well characterize their ideal environment by thinking of the 4P’s. People, products, processes and perception.

From those discussion the following themes/goals related to the design of the facility emerged:

• Connection to Nature

• Use of natural light

• Calming, Peaceful, Relaxing, Uncluttered.

• Contemporary & Warm’

• Positive Distractions.

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• Inspiring Confidence.

• Ease of wayfinding.

This will be the first time cancer treatment is being offered at the W. S. Middleton VA campus and the goal is to provide the best quality of care in the best environment possible to all veterans that will be coming here throughout the state of Wisconsin.

Building on the recent interior design work that is currently being done at the VA, connecting to nature, creating a calming, peaceful and relaxing atmosphere will be accomplished through the use of soft soothing color, pattern, texture and natural imagery. These same design elements will also aid in wayfinding, provide positive distractions and give a sense of natural light where it is needed.

In addition to the goals above, all considerations will be made to the appropriateness of finishes for this project type, budget considerations as well as the standardization and maintenance criteria that have been established by this facility.

Practicality of Design Material selections will be based not only on their connection with the stated design goals but also on several practical factors:

1. Longevity of Design – The use of colors, patterns and textures derived from nature will provide an inherent sense of timelessness.

2. Durability and Maintenance - Materials will be suitable for a healthcare environment and carefully selected for this project type. They will be easy to maintain, and specialty materials will be strategically placed to minimize increased maintenance requirements.

3. Consistency with Existing Spaces – The design will strive to use materials that are standardized or currently in use in this building from recent projects. This will provide a level of consistency in the aesthetic expression and in the maintenance procedures for the building.

4. Budget Impact – The design will creatively use standard finishes to bring visual interest to all patient care and family spaces while reserving the use of specialty finishes to primary public spaces.

5. Sustainability – There are various aspects of sustainability that will also be strongly considered in material selection:

• Raw Material Content

• Amount of Recycled Content

• Source of Raw Materials or Manufacturing

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• Life-Cycle Costs

Preliminary Selections

Because many cancer patients have compromised immune systems, finish selections will generally follow existing inpatient building standards at the VA, with a higher emphasis on infection control.

Preliminary material selections, each serving as a basis-of-design, include the following products along with their sustainable attributes:

Material Type Manufacturer/Pattern Sustainable/Infection Control Attributes Resilient Sheet Flooring

Teknoflor (Wood-Look Visual)

“No-Wax”, Seamless with a flash-coved base where necessary

Carpet Tile Interface, pattern to be determined

High Recycled Content, Sustainable Manufacturing Processes, Intercept preservative in carpet backing protects against growth of mold, mildew and bacteria

Wall protection and Inpro Corporation Greenguard Certified for low VOC handrails emissions; G2 Bioblend, exclusive blend of

PETG and biopolymer – No PVC Porcelain Tile Manufacturer to be determined/product to include “active” finish

Active Finish purifies the air and material surface through the reaction of light and air with a photocatalytic surface.

Acoustical Ceiling Armstrong Healthzone Optima

Recycled Content, Washable/Scrubbable Surface while maintaining high NRC (noise reduction coefficient) rating

Solid Surface Vendura Local Manufacturing, Bio-Based Resin

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Ambulatory - 15% Basis of Design.docx

Signage & Wayfinding

The signage for this project will be based on current VA Standards for color and sign construction. In addition to appropriate signage all efforts will be made to incorporate visual imagery and color to facilitate wayfinding.

Basis of Design – Civil:

I. Basic Design Criteria

A. Applicable Codes, Guidelines, and Standards:

1. The civil utility systems including storm sewers, sanitary sewers, and water distribution piping will be designed in accordance with the following codes, guidelines and standards.

a. Wisconsin State Statutes Chapter SPS 382

b. City of Madison Plumbing Code

2. The site improvements including paving, grading and landscaping will be designed in accordance with the following codes, guidelines and standards.

a. 2010 ADA Standards

b. Veteran Administration Latest Standards

B. Site Preparation

1. Protect trees, plant growth, and features designated to remain as final landscaping and as required by Owner and City of Madison.

2. Demolish and remove existing structures, paving, surfacing, and hardscape elements in their entirety. Dispose of debris off site.

3. Prepare Erosion and Sediment Control Plan (ESCP) in accordance with City of

Madison Municipal Code Chapter 37, “Erosion and Stormwater Runoff Control”, to be submitted to City of Madison Engineering Department for review and approval.

4. Prior to start of any grading activity, a Notice of Intent (NOI) to Discharge Stormwater due to construction activities shall be submitted to the Wisconsin Department of Commerce.

5. Earth Retention System: Place and maintain appropriate systems to support sides of excavation and to prevent soil movement that may endanger adjacent persons, structures, pavements, or utilities.

6. Maintain adequate and positive drainage of entire site for duration of project;

do not allow groundwater, surface water or direct precipitation to accumulate on subgrades or in excavations.

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C. Site Improvements - Modifications outside of the building footprint including concrete walkway and asphalt drive adjustments/additions may need to be made for acceptable pedestrian and vehicular paths of travel.

1. Vehicular Paving.

a. Construct paving/surfacing in compliance with Part 3, Bases and Subbases, and Part 4, Pavements, of the Wisconsin Department of Transportation Standard Specifications For Highways and Structures Construction, 2003 Edition (Standard Specifications).

b. Aggregate base material: 100 percent crushed limestone, 3/4 inch gradation conforming to Section 305, Dense Graded Base, WisDOT Standard Specifications.

c. Asphaltic concrete: HMA mixture type E-3 conforming to Section 460, Hot Mix Asphalt Pavement, WisDOT Standard Specifications.

d. Portland cement concrete: Type 1A, minimum 4000 psi 28-day compressive strength, air entrained concrete reinforced with welded wire fabric or polypropylene fibers per ACI 301 and 304. Construct concrete pavement in accordance with ACI 325.

e. Schedule of paving sections.

1) Asphalt: 4-inch asphalt binder and surface courses over 12-inch aggregate base course.

2) Concrete: 8-inch Portland Cement Concrete over 8-inch aggregate base course.

2. Pedestrian Paving.

a. Aggregate base material: 100 percent crushed limestone, 3/4 inch gradation conforming to Section 305, Dense Graded Base, WisDOT Standard Specifications.

b. Portland cement concrete: Type 1A, minimum 4000 psi 28-day compressive strength, air entrained concrete reinforced with polypropylene fibers per ACI 301 and 304. Construct concrete pavement in accordance with ACI 325. Tooled joints and light broom finish.

c. Schedule of pedestrian paving section.

1) Concrete: 5-inch Portland Cement Concrete over 4-inch aggregate base course

3. Landscaping.

a. Protect trees, plant growth, and features designated to remain as final landscaping and as required by Owner and City of Madison.

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D. Site Utilities

1. Sewer and water piping modifications will need to be made to accommodate a building addition. Existing sewers within the proposed building design will need to be replaced or modified to meet applicable plumbing codes (to be coordinated with others). Existing sewers and water distribution systems will need to be analyzed to verify acceptable capacity and location. If systems are deemed to be insufficient for additional loadings from the building addition, modifications including increased pipe sizing, pipe rerouting, or structure additions may need to be made to existing systems.

2. Watermain Pipe Materials: Class 52 ductile iron pipe with two layers of polyethylene wrap.

3. Site sanitary sewers shall be SDR-35 polyvinyl chloride pipe. Sanitary building services shall be Class 52 ductile iron pipe or SDR-35 polyvinyl chloride pipe depending on location.

4. Storm sewer 10 inch and smaller shall be SDR-35 polyvinyl chloride pipe, or Class 52 ductile iron pipe depending on location. Storm sewer 12 inch and larger shall be Class III to Class V reinforced concrete pipe. Subdrains shall be perforated PVC pipe.

Basis of Design – Structural:

II. Basic Design Criteria

A. Applicable Codes, Guidelines, and Standards:

1. The structural systems will be designed in accordance with the following codes, guidelines and standards.

a. 2012 International Building Code

b. ASCE 7-10

c. Veteran Administration Latest Standards

B. Structural System

We understand that the floors, beams and columns require a 2 hour fire ratings and the roof requires a 1 hour fire rating. We understand vertical expansion is anticipated.

Existing floor-to-floor is 11’-6” and a shallow but efficient structural system will be desired to maximize column spacing, maximize overhead space for mechanical and medical equipment systems and provide a flexible grid system. Three systems were

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Anticipated column locations are shown on the included plan sheet which was overlaid on the existing foundation plan for reference purposes.

The first floor will be slab on grade. Shallow foundations are anticipated. The roof will be a two way flat plate and be designed to accommodate 2 inches of future floor topping.

Concrete beams may be required for deflection criteria should exterior cladding systems be desired.

Basis of Design – Plumbing and Medical Gas:

I. Base Design Criteria

A. Applicable Codes, Guidelines and Standards.

1. The piping systems will be designed in accordance with the following codes, guidelines and standards.

a. Wisconsin Plumbing Code

b. Veteran Administration Latest Standards

c. NFPA 99, Standard for Healthcare Facilities, Latest Adopted Edition.

d. 2009 International Building Code

e. FGI Guidelines for Design and Construction of Hospital and Healthcare

Facilities, Latest Adopted Edition II. Infrastructure

A. Sanitary Waste and Vent

1. System Description

a. A sanitary waste and vent system will be provided for all plumbing fixtures and other devices requiring drainage. Plumbing fixtures will be drained by gravity through conventional soil, waste and vent stacks, and building drains, which will discharge to the sanitary building sewer to south of A Wing.

b. All fixtures will be trapped and vented through the roof.

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2. Design Criteria

a. The sanitary drains will be sloped to maintain a minimum velocity of 2 fps.

3. Equipment and Material

a. Waste and vent piping:

1). Above-ground waste and vent piping shall be no-hub cast iron pipe with heavy-duty stainless steel couplings or type DWV copper tube with soldered joints and wrought copper or cast bronze drainage pattern fittings.

b. Floor drains, floor sinks, and indirect waste receptors shall be provided at HVAC, medical, food service, fire protection and plumbing equipment. Provide trap guards at all floor drains to prevent sever gases from entering the building when there is a loss of trap seal due to evaporation.

c. Drains and receptors, and related drain piping, shall be sized adequately to handle anticipated discharge flow rates during normal operation and system testing from equipment and systems, such as fire protection system drains.

4. Distribution 1). Waste piping shall be routed through the new Cancer Center addition and connect to the existing sanitary building sewer system to the south of A Wing. New sanitary vent piping will be routed to new plumbing fixtures and vented through the roof of the new Cancer Center addition. Waste stacks will be installed at 30 foot intervals at the columns and extended to the roof and capped for future vertical expansion. The underground sanitary building drain will be sized for vertical expansion up to four floors.

2). Sanitary sewer laterals shall be extended to the building by the site utility contractor.

B. Storm Drainage

1. System Description

a. Roof drain conductors will be extended to new roof drains and routed to the site storm building sewer system to the south of A Wing.

b. All above grade horizontal storm, horizontal overflow and waste piping will be insulated.

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2. Equipment and Material

a. Storm drainage piping:

b. Above-ground waste and vent piping will be no-hub cast iron pipe with heavy-duty stainless steel couplings or type DWV copper tube with soldered joints and wrought copper or cast bronze drainage pattern fittings.

c. Provide clear water drains at all below grade exterior areas including area wells and stairwells.

d. Provide backwater valves at clear water drains subject to surcharging.

3. Distribution

1). Roof conductors shall be located throughout the new Cancer Center addition. Long runs of piping across the ceiling at each floor shall be minimized to avoid interferences with other MEP systems.

2). Storm sewer laterals shall be extended to the building by the site utility contractor.

C. Domestic Water

1. System Description

a. Domestic water will be supplied from the existing domestic hot water, hot water return, and cold water systems. Connections will be made in the existing hospital where the new Cancer Center addition interfaces with the A Wing.

b. Domestic cold water piping and valves shall be insulated.

2. Design Criteria

a. The piping will be sized to limit the velocity in any section of the system to a maximum of 6 fps for cold water systems and 4 fps for hot water systems.

b. Water piping mains shall be sized to minimize velocity and allow for future remodeling and expansion.

c. Water piping shall not be run under any slab on grade inside the building.

3. Equipment and Material

a. Domestic water piping shall be type L copper with soldered or roll grooved joints.

b. Valves shall be 2-piece, full port ball type with stainless steel trim or butterfly type with aluminum bronze discs.

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4. Distribution

a. Generally water piping mains shall be run in the ceiling space of the floor where the fixtures served are located. Each floor shall be served by separate mains to facilitate remodeling and renovations. Domestic hot and cold water piping shall be looped so the run out distance from the circulated main and the fixture shall not exceed 7 feet.

b. Area isolation valves will be provided to facilitate remodeling, future additions, maintenance, and where required by code.

c. All branch piping off water distribution mains shall be valved.

d. Provisions shall be incorporated into the water distribution system to control hydraulic shock. Water hammer arrestors shall be provided at all quick closing valves.

e. The domestic cold water system will be sized for vertical expansion up to four floors. Future valves with caps will be provided in the ceiling of the Cancer Center addition for the vertical expansion.

D. Domestic Hot Water Systems

1. System Description

a. Hot water shall be supplied at the appropriate temperature to all fixtures and equipment requiring hot water.

2. Design Criteria

a. The hot water system shall be capable of satisfying 100% of the remodeled area demand.

b. Hot water shall be produced at a minimum of 140° F.

c. An individual mixing valve with fail-safe shut off and by-pass to facilitate heat and flush process to disinfect shall be provided for temperature control to each patient area fixture. Hot water will be supplied to the patient area fixtures at 110° F.

d. The 140° F hot water system temperature to the building will be maintained by circulating hot water supply back to the heaters. To minimize the amount of balancing valves in the system, the Cancer Center addition will have a supply and return loop. Each hot water return zone will include a temperature sensor for monitoring by the building automation system.

e. The hot water return system shall be designed for a 5 degree temperature difference between the supply and return.

f. Hot water piping supply and return mains shall be sized to minimize velocity to 4 fps and allow for future remodeling and expansion.

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3. Equipment and Material

a. Water piping shall be type L copper with soldered or roll grooved joints.

b. Valves shall be full port ball (2-piece with stainless steel trim) or butterfly type.

4. Distribution

a. Generally water piping mains shall be run in the ceiling space of the floor where the fixtures served are located. Each floor shall be served by separate mains to facilitate remodeling and renovations. Domestic hot water piping shall be looped so the run out distance from the circulated main and the fixture shall not exceed 7 feet.

b. Area isolation valves will be provided to facilitate remodeling, future additions, maintenance, and where required by code.

c. The domestic hot water supply and hot water return system will be sized for vertical expansion up to four floors. Future valves with caps will be provided in the ceiling of the Cancer Center addition for vertical expansion.

E. Non-Potable Water Systems

1. Non-potable water system will provide make-up water to mechanical (HVAC) systems such as heating hot water, chilled water, cooling towers and other devices that require water makeup or fill.