Doing major, invasive construction surgery without compromising sensitive treatment activities in a high-intensity, critical care hospital takes extreme planning and an immersive level of quality control, but so far, about halfway through a five-phase project in Englewood, Colo., the owners representative says the contractor "has made it work."

Since 1956, more than 30,000 people with spinal cord and traumatic brain injuries have been served by the patient-centered treatment and research of Craig Hospital in suburban Denver. Ranked by U.S. News and World Report as one of the top 10 rehab hospitals in the U.S. since 1990, its specialists receive patients from intensive care units and, a few months later, release them with state-of-the art therapies and new skills for living.

GE Johnson Construction Co., Colorado Springs and Denver, broke ground in March 2013 on a $66-million vertical addition to Craig's west building and a four-level, horizontal renovation of 84,000 sq ft. More than 120,000 sq ft is undergoing a complete renovation to provide 52 new private patient rooms, a two-story rehabilitation center, two therapy gyms and two rehabilitation swimming pools. The HVAC, elevator and electrical systems are being replaced in the west building.

Within the hospital, innovative technology will allow patients to use eye and motion controls to manage nearly every operable element of their suites, including TV, shades, lighting, audio and more.

The renovation and addition is being undertaken while the hospital maintains 100% patient occupancy. GE Johnson has compiled noise, vibration and communication protocols to minimize disruptions to sensitive-care patients and is providing a full-time onsite staff and patient liaison to monitor disruption issues.

Craig averages 80 patients at any given time; most are highly sensitive to noise and will spend all of their three- to six-month stay in a facility that is quite literally being taken apart and put back together before their eyes.

Immersion Planning

The original hospital was built in 1969, with additions constructed in 1983 and 1995. Craig started looking at rehabbing the infrastructure 10 years ago but couldn't imagine how to avoid disrupting patients in the process. GE Johnson's sequencing of the work helped to minimize disruptions.

When the current three-and-a-half-year, multiphase project is complete, the bed count will not have changed; however, the makeover shifts patients from rooms with two and three beds to 93 private rooms.

"Another of the main drivers of the project was to upgrade the mechanical systems in the patient rooms to provide more comfort," says Lee Means, Craig's director of engineering. Temperature control is a crucial element for patients recovering from traumatic brain and spinal cord injuries; they can easily spike a fever if the room is too hot and often cannot sense or regulate their body temperature.

"The last thing we want to do is to further inconvenience people who have already been so inconvenienced in life," Means says. "We realized we needed to build an outlet where we could move from an occupied space to a new space and start fresh."

While it would have been logistically easier to build a greenfield facility outside of town, Craig Hospital also relies on the support services contracted through the adjacent Swedish Medical Center. It didn't want to lose that connection, Means says.

"Craig [Hospital] is part of the history of Englewood—it's a landmark," adds GE Johnson project manager Theron Skidmore. "Finding the land to build an entirely new structure and let this one go just didn't make sense. This is their home, and they had the capacity to add on to it and stay right where they are."

One benefit of constructing the addition and remodeling in a fully functioning hospital is that the design and construction staff could observe the day-to-day workings of the atypical setting. "For this out-of-the-ordinary project, we felt it necessary to do an immersion," says Randy Thorne, an architect and principal with project designer RTA Architects of Colorado Springs. "Several of us spent a week living in the hospital. We observed patients learning how to steer their quad chairs for the first time," Thorne says. "We followed staff into the med rooms where there are literally hundreds of medications, with tech assistants helping with [the tremendous level of] checks and balances.