Extra precautions are being taken as well to keep the site clean, and just-in-time deliveries are helping the team keep the area uncluttered.

Linking the new facility with existing structures has been a significant challenge.

"Starting to peel away that skin and tie in [new] skin conditions to existing ones is presenting some issues," Thomas says. "We want to make sure we deliver a good weatherproof building. But we've been able to overcome that with building information modeling."

Additionally, the new tower must tie into a basement underneath the existing hospital structure. "We're tunneling it as we speak," Thomas says. "We've made all the cuts through the low level wall on the construction side, and we're starting now to dig out all the dirt.

"We'll then put in new structural elements, micropiles and concrete walls and beef up that structure before we make a cut in the existing lower level of the hospital," he says.

Completion

The project team topped out the tower on Aug. 9, and as of September, crews were working on exterior skin elements and had framed out the building through the fourth floor.

Despite the complexities, work continues to move forward on schedule, with the project on track to meet its September 2014 completion date.

"For me to give Methodist the best project possible, I need the best team possible, but I have to have that team in an environment where they can succeed," Wilson says.