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Contributors
Peter Doueihi, Senior Project Manager
Dean Taaffe, Senior Project Manager
Live-environment day hospital construction is largely about managing risk to programme, cost, and operational continuity throughout construction. Done well, it allows operators to keep serving patients, protect staff, and improve facilities without a complete facility shutdown.
The right design and construction partner is one that understands the risks involved and how site suitability, equipment procurement, and scheduled shutdowns affect the cost and programme of a day hospital or live-environment project. Disruptions to programme continuity can mean delayed open dates and a loss to high demand specialist staff, revenue and shareholder confidence.
To share what makes these projects successful, we spoke with Peter Doueihi and Dean Taaffe, Interite’s project managers, who lead our complex Class 9a refurbishments. Below, they discuss what’s often overlooked, the common risks in live healthcare delivery, and how Interite works with clients to ensure a smooth pathway from concept to completion.
The main purpose is to determine the suitability and buildability of the design intent. Where there’s no formal design in place, a builder’s practical experience often gives you a lot more insight than just looking at standard drawings. Something might look feasible on paper, but that doesn’t mean it’s been tested against real-world implementation.
A lot of the time, clients end up choosing unsuitable sites simply because the practical side of implementing the design hasn’t been fully thought through. Architects can confirm whether a building fits the requirements and whether a class change – say from Class 5 to Class 9a – is achievable. But that doesn’t always cover the less obvious things: Is there enough space in the ceiling cavity? Are there limitations that could affect critical hospital services, like a suitable spot for medical gas storage? And having a lift big enough to move materials and equipment around is absolutely critical too.
People often forget that a ‘live environment’ means people are actively present – above, below, or adjacent to the works – and that any design has to work around what’s already there, rather than having the full flexibility of a new build.
The primary challenge is managing disruption to that surrounding environment and the people in it. Noise constraints, for instance, often restrict when certain works can be carried out, which affects the overall project timeline. Broader operational impacts also need to be considered – shutting down power to a floor or building can affect other tenants and stakeholders, while shutting down water across a hospital, even for a few hours, requires careful coordination, as we managed on our Liverpool project.
For this reason, works need to be carefully staged around the facility’s daily operations. One effective strategy is completing the project in stages, allowing each area to be tested, cleaned, and safely handed back while the facility continues operating. This is what we have done on projects like Ramsay Health, where the small oncology unit was expedited in 6 weeks, with a larger extension scheduled for stage 2.
Often underestimated is that the construction programme and equipment lead times are closely linked. For day hospitals, specialist equipment often carries longer lead times than clients realise, and this can significantly impact overall project delivery timeframes. A suction plant, for example, can take up to 16 weeks to arrive from the point of order.
Specialist HVAC requirements present a similar challenge. IVF Laboratory environments require a much higher level of filtration than standard areas, and equipment capable of meeting this standard is often sourced overseas, with lead times of around 14 weeks. These delays create flow-on impacts across the programme. Without the HVAC unit installed, ceilings, walls, penetrations, and ductwork cannot be completed, meaning a single long-lead item can hold up multiple downstream trades.
Beyond equipment, the primary considerations in a live environment are dust, noise, and infection control. Again, in an IVF laboratory, low VOC conditions are essential. This means restrictions on staff wearing certain deodorants or colognes, as well as ensuring all construction materials used are low VOC. For the day hospital side, the key challenge is planning around scheduled procedures to ensure ongoing works don’t disrupt planned activity.
Sequencing works and equipment installation in a way that allows the facility to keep operating throughout is, ultimately, the biggest challenge.
Communication is one of the most important parts of a live healthcare project. Clear planning of upcoming works, and early notification of any impacts, help keep everyone aligned. Regular PCG meetings, along with consistent emails and updates, remain the most effective way of keeping everyone informed. Understanding the facility’s specific requirements is essential, and any planning must account for the operational demands of that environment.
Where services need to be isolated, we need early visibility into when those services are actually in use. In many cases, this means coordinating an after-hours window for the work, ensuring there’s no disruption to ongoing operations.
Successful live-environment healthcare delivery isn’t about avoiding disruption altogether. It’s about engaging the right D&C partner to anticipate, plan and communicate through it. From early feasibility assessments to managing 16-week equipment lead times, the projects that stay on programme and on budget are the ones where risk is identified early.
For operators considering a day hospital upgrade, IVF facility fit-out, or any construction within a live clinical setting, the insight from Peter and Dean consistently leans to engage a construction partner early. One who understands the operational realities of healthcare delivery, not just the technical requirements of the build.
Interite’s track record across Ramsay Healthcare, Genea, and Liverpool reflects exactly this approach. These three stand-out projects were all successfully delivered within live operational hospital environments, on low-disruption expedited programmes:
