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What are the Challenges when Renovating an Active Healthcare Facility?

Renovations in healthcare facilities present a challenging and exciting opportunity for construction professionals. The design requirements are intense and require architects to engineers to be familiar with medical facility specific code requirements. The construction often requires the contractor to work in and around patient care areas that have high risk population, requiring very strict guideless and procedures for work. Healthcare work can be very rewarding though as the final product often drastically improves the care provided to the community.


Healthcare facilities can be broken up in to two primary facility types: Ambulatory Care and Acute Care. Acute care is typically what people as a hospital – facilities that have inpatient care and procedures. Acute care facilities have a high level of requirements due to the extreme conditions the patients are in and high-level activities that are happening. Ambulatory care is typically in a medical office building where patients will see routine check-ups or follow-up appointments with their provider. These buildings may have some minor procedures or equipment required but typically the patients are in a more stable condition, so the projects do not require the same facility code requirements. Other common facility types are surgery centers, walk-in clinics, rural access hospitals, and imaging centers. Below are some common considerations when performing construction in healthcare facilities.

  1. Infection control/epidemiology

    1. Maintaining a clean and safe work environment is critical in healthcare settings. The most common risk is construction dust escaping the work site and impacting a vulnerable patient population. Contractors are required to perform an Infection Control Risk Assessment to identify potential threats construction may cause to the area. Typical measures taken include utilizing HEPA air filters, air-tight sealed barriers around the work zone, and frequent mopping or cleaning around entrances.

  2. Patient experience

    1. Studies have found that patient experience in a hospital has a direct correlation with their recovery. Often construction can be very disruptive, whether it be loud sounds, closed walkways, or increased traffic. Construction managers must work directly with nurses and other support staff to limit all impacts to the patients and visitors of the facility.

  3. Code implications

    1. Healthcare construction requires that engineering and design professionals have a deep understanding of healthcare facility code requirements. This most often relates to air exchanges, building redundancies, heightened life safety requirements, layouts to maximize efficiencies and safety, knowledge of equipment technical needs, among many other things.

  4. Managing healthcare system standards

    1. Many healthcare facilities are ever changing organisms that see various departments undergo construction at different times due to patient care needs and/or technology changes. To prevent creating a disjointed visual experience, many facilities have a very detailed set of system standards so that the design and maintenance of buildings remain consistent. This helps to create a more visually appealing space as it changes over time.

  5. Managing internal stakeholders

    1. Healthcare facilities are made up of a wide variety of departments and staff. Internal construction managers must balance the needs and impacts of all parties that help to support the building.

      1. Security – Security helps to maintain a safe construction environment within the overall facility.

      2. Clinical staff – Nurses and managers help provide additional information about schedules and upcoming conflicts, as well as helping to maintain a positive patient experience.

      3. Interior design planners/master planners – These individuals help with equipment and furniture planning in the space and confirming it corresponds with the design documents for the project.

      4. Epidemiology – Epidemiologists help to create a safe health care environment but providing infection control protocols and monitoring to ensure all guidelines are being followed.

      5. IT – The on-site IT staff helps to maintain staff and patient technology as well as integrating new equipment into the space as a part of the project.

      6. Facilities/operations – The on-site facilities team is critical piece of any construction project as they help in tying into the existing infrastructure and making sure the changes will have a long-term impact .

      7. Procurement/resource managers – This team helps to handle vendor contracts and receiving competitive pricing for equipment, fixtures, furniture, supplies, and services.

      8. EVS – The on-site environmental services team helps to keep adjacent areas clean and keep it clean after the project is complete.

  6. Growing hybrid/work from home concept, virtual appointments, etc.

    1. Like many other industries, healthcare is experiencing changes to how they deliver their product with the advancement of technology used over the past few years. More and more patients are being seen by providers through virtual appointments from their inpatient hospital beds or even their homes. It is important that design and construction teams are considering these everchanging means of healthcare delivery when undergoing construction of a facility.

Healthcare is a constantly evolving field full of new technologies and methods of delivery. This requires design and construction professionals to be up to date on requirements and best practices. These projects are truly a team effort between the construction professionals and the owner’s stakeholders. Building the right team is critical to a safe and successful project delivery.


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