The Endoscopy Center project was a challenging expansion and major remodel of an existing outpatient endoscopy procedure center. The project included major remodel and expansion of all components, including doubling the number of procedure rooms, corresponding support, pre-procedure, recovery, intake, check-in and administration. All work was designed to be completed while maintaining ongoing operations of the existing Endoscopy Center and also the adjacent multispecialty medical clinic. The project also included an upgrade to components supporting patient, staff, and physician efficiency as well as a complete refresh of the care environment. Design team defined phasing was key to safe and logical construction processes that coincided with facility operations.