The Legacy Good Samaritan project consisted of the renovation of the emergency department, urgent care services, ambulatory procedure center waiting area, and the rework of the entrance and canopy. Construction was performed in an operational hospital with operating rooms located directly below and an ocular operating room adjacent to the work. We communicated daily with the adjoining departments to minimize impacts to hospital operations. In addition, the project was located on a constrained urban site. Collaborative coordination was required to safely route patients into the hospital and the public around the site.