The Observation Unit/Conference Center Project consisted of two separate phases which were built consecutively and completed in 9 months. The first phase of the project consisted of an 11,000 square feet, 2nd floor interior build-out of an observation unit consisting of 20 patient rooms, 2 nurse stations, staff lounge with work space, medication room and a family waiting area. This brand-new observation unit expanded the hospitals capacity nearly 200 percent to a total of 31 patient rooms. Within the construction zone was an existing IT closet that had to remain fully operational as it served some of the existing hospital's critical life safety monitoring systems. The second phase of the project was the Conference Center which consisted of 10,000 square feet of new construction on the ground level. This required a new foundation and exterior shell to be built in a location bounded by the restricting structure above. With this phase, the hospital expanded operations by providing 2 conference rooms including all supporting audio-visual components, a reception desk with waiting areas for existing medical disciplines, and an 1,850 square foot shell space for future expansion. Both Phase 1 and 2 were constructed in the centermost location of the existing hospital. All work was closely coordinated and communicated daily between construction and key hospital staff. In order to maintain consistent hospital operations during both construction phases; PCRAs, ICRAs, temporary barriers, negative air machines and directional signage were utilized to isolate construction from hospital areas. All components of construction were designed and constructed to match the existing building standards and the bordering clinical areas. Additionally, a Patient's First program was implemented to create greater awareness around construction work regarding patient safety and to assist in preventing disruption of hospital procedures. All construction personnel were required to attend this policy orientation which focuses on the importance of the patients experience while receiving treatment and for those visiting the hospital. The renovation of existing space and new construction were executed with minimal impact to hospital operations and end users.