“Yes, We’re Open”: Your Map to Phased Renovations in an Acute Care Setting


pic_muncy_bernadette150x180Bernadette Muncy

TRO; Boston Medical Center; Code Red Consultants

As a project architect at TRO, Bernadette oversees all phases of healthcare projects, from surveying and programming to construction administration and implementation. A seasoned architect with more than 15 years of experience, Bernadette’s ability to understand the needs of a client and integrate those needs into the design has proven to be invaluable.

picture of nancy hanrightNancy Hanright

Space Management at Boston Medical Center

In her role as Director of Space Management at Boston Medical Center, Nancy oversees the overall planning and allocation of space for inpatient, ambulatory and administrative areas, move coordination, wayfinding, accessibility and furnishings. She also serves as the Project Advisory Team lead in BMC’s $270 million campus redesign project.

pic_lynch_chris150x180Chris Lynch

Code Red Consultants

Chris is a professional Fire Protection Engineer and founding Principal of Code Red Consultants. Mr. Lynch’s healthcare experience is diverse, as he provides consulting services directly to healthcare providers to assist with regulatory compliance issues, as well as to design teams on new construction and renovation and addition projects.


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“Yes, We’re Open”: Your Map to Phased Renovations in an Acute Care Setting

Health care projects often require renovations to take place simultaneously with an operating hospital, with no reduction to its services or capabilities. This means construction activities can occur adjacent to critical hospital operations where a sudden loud disturbance can create further stress for the patient, their supporting family, and medical staff. When Boston Medical Center (BMC) decided to consolidate their campus from two sites to one, they were faced with the compounded complexity of relocating existing, active departments into currently occupied space without interrupting or compromising patient care.

Architects, engineers, interiors, contractors, users, facilities and materials management members from the project team did a walk-through of the project to analyze existing conditions. They identified which items were important by categorizing them as either a “must have” or “wish list” item. Based on feedback from the walk-through, Architects and Interiors from the design team created intensity plans to identify the level of renovation for each area.

The intensity plans were color coded to show the different levels of renovation. Prioritizing the areas allowed the project team to analyze the space as quick as possible and evaluate their impact on neighbors. These plans were further reviewed and edited with the engineering team to include areas affected by MEP/FP needs that would have an impact on the overall scope and level of renovation required to complete the project.

Heat maps were created out of a necessity to communicate to each trade what areas they needed to learn about soonest. The heat maps were color coded to identify level of priority. Vetting existing conditions through heat maps allowed trades to do their own validation and get into many occupied spaces with proper ICRA.

After compiling information on how the renovations would impact adjacent departments, the contractor team assigned durations and created a phasing timeline. When renovating the ED, for example, surgical services upstairs and radiology in the adjacent area were going to be impacted by the construction.

By understanding the larger picture of how the renovation would impact surrounding neighbor departments, the design team was able to create a more detailed and comprehensive project scope. In turn, this gave them a better understanding of impact, costs etc.

All of the careful planning up front resulted in over 60 phases of construction and over 20 occupancy permits. Translation of this complex construction process to the authorities having jurisdiction resulted in a series of phasing plans. The phasing plans identified what areas were under construction, what areas were of existing construction, which areas had been completed and temporary construction was needed to meet phasing requirements. In addition the Life Safety professional created a set of Interim Life Safety Plans which identified temporary means to ensure code compliance during construction. The construction team, Owner, and Life Safety professional walked the site periodically to identify any items of non-compliance and what the team planned to do in order to rectify the issue, this too utilized a graphic tool that referenced back to the phasing plans.

This session will give you an inside look at the intricacies of project documentation, regulatory submissions and Life Safety compliance. We will review the challenges that the design team faced; including project scope and cost implications. And explore how, as an integrated team, they created visual, mapping tools to identify phases, work through the sequences of moves and construction and continuously communicate with the staff, patients, and their supporting families how they would be impacted.