The Miriam Hospital, which has served the Providence, R.I., area since 1926, has experienced an increasing demand for its emergency department (ED) over the years. As patient visits grew, the nearly 20-year old department was becoming overcrowded and unable to accommodate medical and technical advances.

A renovation project was started in September 2012 and broken into five phases, which allowed the ED to remain operational during construction. It was completed in May 2014.

Among the goals were expanding the facility from 42 to 47 licensed beds and creating new critical care and triage areas to improve traffic flow. Designed by the Rhode Island Hospital design team (Providence, R.I.) and constructed by Shawmut Design and Construction (Boston), the project included replacing curtained bays with private exam rooms for better infection control, patient privacy, and noise reduction.

New critical care rooms are designed to efficiently store and organize equipment, as well as reduce clutter.  An alcove was added in the ambulance entrance to enable rescue teams to easily determine their destination within the new department.

The triage area was redesigned to better accommodate stretchers and the workflow was improved by adding computers in the majority of patient rooms and remodeling provider workstations to bring physicians and nurses together to facilitate teamwork.

A new CT suite houses a dedicated, 64-slice CT-scanner in the center of the five-pod department. The addition reduces the wait time for critical care patients who were previously being transported to another area of the hospital.

Throughout each phase, measures were put in place to ensure safety and minimal impact on the patients and staff. For example, during the renovation of the triage area, patient entry flow was re-routed through a temporarily modified entry point. Demolition debris removal was carefully managed to minimize disruption to patient care.

The ability to maintain a functioning ED during construction allowed the hospital to treat an estimated 60,000 patients during the renovation project.