How do you minimize disruption to existing operations during facility expansion?

You minimize disruption by sequencing construction in phases, creating swing space, scheduling off-hour work for noisy or invasive activities, and tightly managing shutdowns through infection control and life safety protocols.

Why it matters

Construction inside an operating clinic can reduce access, frustrate patients, and depress provider productivity if not carefully planned. A 20,000 SF multi-specialty clinic seeing 120 visits per day at a $70–$100 contribution per visit can forfeit $42,000–$60,000 in margin with just one week of downtime.

Disruption also compounds staffing risk. Noise, dust, detours, and unpredictable utility interruptions increase burnout and turnover, while unclear wayfinding harms patient experience scores and referral confidence.

How it works

Start with an operational baseline and critical thresholds. Map daily patient volumes by hour, exam room turns, imaging schedules, and procedures that cannot be moved. Identify “red lines” such as maximum acceptable room closures, parking loss, and call center hold times to anchor phasing decisions.

Build a phased plan with swing space. Decant one service line at a time into temporary space—modular units, shelled suites, or leased space nearby—so construction zones can be fully separated. Clear access paths, temporary reception and check-in areas, and dedicated contractor entries prevent cross-traffic with patients.

Deploy ICRA and ILSM from day one. Infection Control Risk Assessment (ICRA) defines dust, airflow, and barrier requirements to keep clinical areas safe; Interim Life Safety Measures (ILSM) address temporary egress, alarms, and fire protection. Negative air machines, HEPA filtration, hard wall barriers, and pressure monitoring protect sterile environments and high-risk patients.

Schedule invasive work off-hours and manage shutdowns like surgical procedures. Electrical, medical gas, and IT cutovers are executed in tightly planned 4–8 hour windows with redundancy, temporary power, and “rollback” contingencies. Night and weekend premiums of 10–20% often cost far less than the margin lost from daytime closures.

Key considerations

Separate people, paths, and pressure. Create distinct routes for patients, staff, and contractors with clear signage and door controls, and maintain negative pressure in construction zones to prevent dust migration. For imaging, ensure vibration isolation and shielded barriers are installed and tested before adjacent rooms reopen.

Protect clinical capacity with micro-phasing. Renovate in room blocks so only a predictable portion of exam rooms are offline at any time, rotating closures to equalize provider impact. For ASCs and procedure suites, stage work by room and plan terminal cleaning and air exchanges to restore rooms quickly after work shifts.

Coordinate utilities and technology early. Develop a shutdown matrix for electrical, HVAC, oxygen, vacuum, medical air, and data, including exact endpoints, durations, and contingency power. Pre-stage switchovers with temporary generators or UPS, and coordinate EMR downtime procedures and read-only modes well in advance.

Communicate relentlessly to patients and staff. Publish weekly look-aheads that translate construction tasks into operational impacts: hours, room counts, parking changes, detours, and noise levels. Update appointment reminders with parking and entrance directions, and provide real-time wayfinding in lobbies to reduce late arrivals and cancellations.

Actionable takeaway

Create a disruption-minimization plan in the first 30–45 days that includes swing space, micro-phasing, an ICRA/ILSM program, and a utilities shutdown matrix, then execute invasive work off-hours with clear contingencies. Quantify the cost of downtime versus night/weekend premiums to make objective tradeoffs, and publish weekly operational look-aheads for leaders and staff. For support building a phased plan that protects access and margin, explore our healthcare real estate development and strategy services, review our real estate services overview, or request a consultation.

What is the best way to maintain clinic volumes during construction?

Use swing space and micro-phasing to keep most exam rooms online while one block is renovated. Combine off-hour work for noisy or invasive tasks with clear patient communications to minimize cancellations and no-shows.

How do ICRA and ILSM reduce risk during renovations?

ICRA (Infection Control Risk Assessment) sets barrier, airflow, and cleaning standards so dust and pathogens do not reach clinical areas. ILSM (Interim Life Safety Measures) ensures safe egress, alarms, and fire protection when building systems are altered, maintaining compliance and safety during construction.

When should we schedule utility shutdowns and equipment cutovers?

Plan shutdowns 3–6 weeks in advance and execute them at night or on weekends in 4–8 hour windows. Pre-stage temporary power, finalize method-of-procedure documents, and staff rollback plans in case the system does not start as expected.

Is off-hour construction worth the premium?

Often yes, because labor premiums of 10–20% are typically lower than the margin lost from daytime closures and canceled procedures. A simple pro forma comparing added labor cost to projected visit or case loss clarifies the return on investment.

How far in advance should we communicate changes to patients and staff?

Issue an initial 60–90 day look-ahead after phasing is set, then provide weekly updates as work progresses. Update appointment reminders 3–7 days prior with parking, entrance, and detour details so patients arrive on time and prepared.

Bremner Real Estate partners with health systems to align real estate strategy with clinical performance and capital efficiency.