The vertical addition and surgical suite expansion presented several project challenges including minimized disruption to the existing hospital functions, misalignment of existing floors, and low ceiling clearance in what would become operating rooms. The project also required calculating for snow drift loads in areas not originally designed to carry the added load. As a solution, MBJ framed over the existing roof with structural steel in order to set the new roof high enough to create an interstitial space for mechanical equipment. This also aligned with the existing floor of the original hospital bed tower, an important design feature to ensure floor alignment for future expansion.

In addition to the design challenges of adding onto an existing hospital, the design was produced on a fast-track schedule using an integrated steel delivery process, which integrates the steel fabrication detailing with the overall structural design. By using BIM as a tool to begin detailing before the design was completed, MBJ reduced the shop drawing production and review time by several weeks, saving both time and money.