The Legacy Health Systems Good Samaritan Emergency Department project consisted of a 16,000-square-foot renovation of the emergency department, urgent care services and ambulatory procedure center waiting area. Included in the remodel was a rework of the entrance and a new canopy. The work was performed in a completely functioning, operational hospital. Operating rooms were located directly below the project, and adjacent to the remodel was an ocular operating room. We communicated daily with the adjoining departments in order to minimize impact on hospital operations.