Like many towns in the Mountain West, the city of Bozeman, Mont., is dealing with the demands of population growth. Surrounded by mountain ranges in the southwest corner of the state, the city is home to Montana State University and the seat of Gallatin County. With a population of about 112,000, it has been the fastest-growing part of the state in recent years.

Bozeman Health Deaconess hospital, operated by the nonprofit Bozeman Health system, serves as a tertiary care center for the region and is in the middle of a $75-million phased expansion and renovation project. Designed by regional architecture and engineering firm Cushing Terrell (formerly CTA Architects Engineers), with Layton Construction of Sandy, Utah, as the general contractor, the expansion is the largest project undertaken at the hospital since it opened in 1986, says Mike Noli, executive project director for Franklin, Tenn.-based NoliWhite group, which is providing program management.

“The last major addition was the expansion of the emergency department about 10 years ago, but this is wider in scope and accounts for future growth,” says Noli, who worked with system administrators to develop a master plan in fall 2017. “The portion going on now is about $45 million of the total we’ll spend on this upgrade.”

The project includes a new main entrance for the hospital, the addition of a three-story intensive care unit and expansion of surgical suites, according to architect Jeff Hultgren of Cushing Terrell. Some of the new space will be left as an unfinished shell to be completed as future demands require. He says the work will bring a big change to the overall look and feel of the hospital.

“Bozeman Health is moving toward establishing a corporate identity for the main hospital as well as outlying clinics and their affiliated hospital in Big Sky,” he adds. “It was important to the hospital administration, and they were heavily involved in the design decisions. They wanted to enhance the professional image of the facility.

“It was requested that the design include welcoming, comfortable spaces for patients and families,” Hultgren adds. “Bozeman is fortunate to have spectacular views from almost any location, so the design embraces views from public and private areas as well as patient rooms and family spaces.”

Jeremy Hobbs, senior project manager for Layton Construction, says work began by closing the hospital’s main entrance in fall 2018 to start demolition. Construction also got underway on the additional OR suites, adjacent to the current ones, as well as the existing ICU rooms.

New Components

“The new additions will all tie into the existing buildings, and it is challenging because we are building on the other side of the wall from the current OR,” says Hobbs. “The other challenge we’re dealing with is we are installing a new elevator to serve the new ORs—right in the middle of the building. It will make [the hospital’s] operations more efficient in the future, but it is disruptive right now. We’ve tried to minimize disruptions to the patients. We actually got a thank you note from a patient who said their ICU stay was better because our workers would wave at them every day.”

The hospital currently has six operating rooms. The expansion will add two more, larger OR suites and shelled-in space for two more in the future. The ICU expansion is also designed with growth in mind, Hultgren says.

“The new ICU tower is currently being constructed as three floors and a basement, but it is designed to be five floors. The hospital has the option to add two new floors in the future if the need arises,” he says. The new rooms will be on the second floor of the tower, with administrative offices moved into space on the main floor.

The hospital currently has eight ICU rooms, each about 150 sq ft. The current project will provide 20 new rooms, each with 300 sq ft of space, a design that was determined after extensive input from employees in all departments involved in ICU care, according to Hultgren.

“The area was designed with significant staff input. The design team conducted extensive lean workflow sessions [a process to determine what is valued by patients and how to deliver it most efficiently] to incorporate the best practices and greatest efficiency for each hospital entity that will be affecting patients in the new ICU,” Hultgren says.

Hobbs says doing work while the hospital is still in operation has taken an extra layer of planning and coordination.

“We are in-filling part of the campus for the new ORs,” he says. “Our sole access point is right next to the loading docks, and the fresh air intake is there as well. We’ve worked with subcontractors and the design team to make good design decisions early on and run temporary air intakes so fumes from our equipment won’t be pulled into the hospital. We’ve only partially closed the loading dock to make sure trucks can still get in and out to service the hospital.” 

Noli says new portions of the project will be commissioned and turned over as they are completed, with final completion slated for September 2020.