Challenges are inherent in any building project. This is especially true during a phased construction project in a functioning critical access hospital. There’s an enormous contradiction between a health care environment and a construction environment. It’s critical to maintain infection control and adhere to life safety codes throughout a construction project. The right architect will guide a health care facility through a phased project with honesty and frequent communication. It’s important that he or she avoids underselling the disruption that will be involved in a phased project. When hospital staff are fully engaged in a project’s planning process, they know what to expect and are typically able to be flexible as the work is completed. An example of this is illustrated by the case of a critical access hospital that needed to replace sewer pipes underneath the entire hospital because they had been eroded by acids used in the lab. The hospital needed to continue working during the project—services could not be moved off-site. All hospital staff were included in conversations about the impact of jack-hammering. Staff helped formulate a plan to schedule construction during times when disruptions would be most manageable. As a result, hospital work was able to continue without interruption and there were no staff complaints about the process.