The 3,325-square-foot Office to Exam Project was the phased conversion of existing medical staff office areas to thirteen new Patient Exam Rooms and the addition of eleven new Touchdown Areas for clinical staff purposes in the Oncology, ENT and Otolaryngology/Audiology clinics on the 2nd and 3rd levels of Texas Childrens Hospital West Campus. The reconstruction of the areas were performed during typical normal business hours when clinic areas were operational and at the same time, patients/ hospital staff occupied each area. In order to maintain constant hospital operations, temporary barriers, infectious prevention barriers, negative air machines and directional signage were utilized to isolate construction from clinic areas. The importance of daily communication between construction staff and key hospital staff were critical to ensure success.