When people talk about the challenges involved in opening a new healthcare building project, different considerations may come to mind depending on which stakeholder you talk to. Is it the grand opening events with all of the pomp and circumstance? Is it the never ending list of punch-list items and overlooked details? Is it obtaining the necessary regulatory approvals to operate the new facility? Is it communicating the changes to staff? The community? Anyone who has been through the process knows it is a carefully orchestrated dance of all of these and more.

Opened in July 2009, the new 259,000-square-foot Pavilion at Paoli Hospital in Paoli, Pennsylvania, included a replacement ED, ORs, Surgery Department, and ICU/PCU. It also provided new private med-surg rooms. The addition, a $145 million project, nearly doubled the size of the existing hospital's square footage. The dollars were funded out of operations and the hospital's largest capital campaign ever-a three-year philanthropy endeavor that paid for more than 10% of real project costs.

Like many healthcare systems, Paoli had to consider the impact of moving fully functioning departments into a new wing, while seamlessly maintaining the organization's level of service in all of the existing areas. To keep things running smoothly, the Operations Steering Committee covered everything from life safety inspections to approval of purchase orders at biweekly meetings.

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An extensive marketing and public relations campaign that included the mediums of print, TV, Internet, and radio, conveyed to both internal and external audiences a consistent message about the new facility, the evidence-based design features that had been used, and how they could improve patient care.

The team developed a “Diary of an Opening” to focus on the increasing level of activity required in the four months preceding the July opening.

Lessons learned:

• Preparation, preparation, preparation! Each purchase order required nine signatures to ensure compliance with approved budgets and scopes. Despite considerable fluctuations in the cost of materials over the course of the project, Paoli still opened the facility on time and on budget.

• The team involved many people in its process for operational planning and education. Operationally, it was important to have key stakeholders attend all meetings to provide consistency and keep the teams on the path to the same goal.