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Bettesworth Construction
Construction Planning

How Hospitals Keep Emergency Access Open During Construction

Hospitals keep emergency departments accessible through phased work, risk assessment, protected occupied areas, and clear directions for changing entrances and traffic routes.

By Bettesworth Construction Team 9 min read
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Hospitals keep emergency departments reachable by coordinating construction phases with clinical operations, protecting occupied areas, and directing patients, visitors, staff, and emergency vehicles along clear routes. That may mean keeping the usual entrance open, creating a temporary entrance, changing campus traffic circulation, or combining those approaches. The right arrangement is site- and phase-specific; a familiar door or driveway may change even when the emergency department remains open.

What “keeping emergency access open” means

Emergency access is more than an open door. A workable plan has to account for ambulance arrival, walk-in patients, visitors, staff, construction traffic, patient movement inside the hospital, and safe operation of the areas around the work. The route people used last month may no longer be the route they should use today.

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Construction plans therefore need to address both the work zone and the occupied hospital around it. The aim is to continue patient services safely while work proceeds, not simply to preserve the original driveway or entrance. The precise arrangement depends on the building, the construction phase, the services affected, and the applicable project requirements.

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How hospitals plan construction around care

Divide work into phases

Phasing breaks a project into stages so that work can proceed while other parts of the hospital remain in use. The 2010 edition of the Facility Guidelines Institute (FGI) Guidelines for Design and Construction of Health Care Facilities, section 1.2-7.1, says: “Projects involving renovation of existing buildings shall include phasing to minimize disruption of existing patient services. This phasing is essential to ensure a safe environment in patient care areas.”

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That edition identifies planning provisions that include emergency procedures, written notification when protections are interrupted, and clarity about who has authority to communicate such interruptions. It also addresses clean-to-dirty airflow, criteria for interruptions to protection, roof-surface construction, and consideration of noise and vibration. These are connected considerations: the construction sequence affects how the hospital protects patients and staff, as well as how it tells affected people about changes.

In practical terms, phasing means the access plan needs to make sense alongside the work sequence. If a stage changes a route or affects a protective measure, the project plan needs to account for that interruption and specify how it will be communicated. The FGI guidance also calls for documenting existing conditions and operations before work begins, including mechanical, electrical, and structural capacities and quantities. That record gives the team a baseline for planning work around the hospital’s actual operating conditions.

Assess risks with the people who understand the work and care

FGI’s application guidance describes a functional program and a safety risk assessment (SRA) as part of project planning and design. It also describes the infection control risk assessment (ICRA) as a way for the project team to consider how spaces should be allocated and whether new or renovated areas support the organization’s infection-prevention practices. The guidance identifies clinical and infection-prevention staff, designers, and other care providers as contributors to planning and risk assessment; this is not a task for construction staff alone.

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The SRA and ICRA address related but distinct planning concerns. FGI describes the SRA Toolkit as a resource for identifying built-environment conditions that could negatively affect patients, staff, or visitors, then mitigating or eliminating those risks. The ICRA, meanwhile, helps the team consider infection-prevention practices and allocation of space. Together, they encourage a review that goes beyond the construction fence: teams consider how the project and the operating environment interact.

FGI’s Safety Risk Assessment Toolkit for Health Care Facility Environments is a resource for identifying and mitigating or eliminating built-environment conditions that could negatively affect patients, staff, or visitors. FGI says the Center for Health Design developed it through a consensus process with support from AHRQ and FGI. It can inform planning, but it does not replace a project-specific review or applicable requirements.

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Protect areas that remain occupied

FGI’s 2010 renovation guidance says renovation areas are to be isolated from occupied areas based on the ICRA, while required air quality and utilities in occupied areas are maintained. Before work begins, it calls for documenting existing conditions and operations, including mechanical, electrical, and structural capacities and quantities. That baseline helps the team plan work against what the operating hospital actually depends on, rather than assuming systems or space can be taken out of service without consequences.

For emergency access, this matters because construction effects can extend beyond the immediate work area. Utility continuity, air quality, barriers, noise, vibration, and patient movement all belong in the wider operating plan. The specific controls and route layout must be worked out for the site; the guidance does not prescribe one entrance arrangement for every hospital.

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Access planning is also connected to wider continuity decisions. FGI’s emergency-conditions resource covers risk assessment, surge response, alternate care sites, resiliency, renovations, and temporary and long-term solutions. Those topics help frame how an organization thinks about care during disruption, but they do not dictate that a particular department must move or that every hospital needs the same backup arrangement.

What access changes can look like on a real campus

Official project updates show two different ways to keep emergency services accessible. They are examples of local arrangements, not templates or universal specifications.

Project update Emergency and public access Other navigation changes described
St. Mary’s Hospital Centre, Montréal; October 2026 project page The page says the emergency department entrance will remain accessible and the ambulance route will be maintained. Phased work, temporary signs for access points, recommended routes and closed areas, and advice to allow extra time; it also notes potential traffic from workers, deliveries, materials, and equipment. Read the project update.
Finley Hospital, New South Wales; May 2026 project update for Stage 3 The page says patient and visitor access, including to the emergency department, will use a temporary main entry during that construction stage; emergency department operation continues. Changed vehicle circulation, temporary effects on some driveways and parking, onsite signs, and traffic controllers. Read the project update.

The contrast is useful: an open emergency department does not necessarily mean the public should use its usual entrance, or that ambulances and other vehicles follow unchanged routes. A hospital may maintain the existing approach, direct visitors to a temporary entry, alter campus circulation, relocate services, or combine measures. The local notice—not another hospital’s layout—is the guide to a particular site.

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These examples also show why “access” should be checked from more than one perspective. The ambulance route may be maintained while pedestrians are directed to a temporary entry; a temporary public entrance may coexist with changed driveways or parking. A project notice can identify which parts of circulation change and which remain accessible for that construction stage. It should not be assumed that one route description covers every user or vehicle.

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How to evaluate an access plan

Patients and visitors can use a project notice to work out where to go. Hospital teams and project planners can use the same questions to check whether the arrangement is understandable and coordinated. These are practical comparison points, not a universal checklist of mandated specifications.

  • Ambulance route: Does the usual route remain available, or is an alternative clearly communicated to the people who need it?
  • Walk-in and visitor entrance: Is the normal emergency entrance still the public entrance, or has a temporary entry been designated?
  • Vehicle circulation: What changes for emergency vehicles, construction deliveries, staff, and visitors? Where the plan calls for it, how are their routes separated?
  • Wayfinding: Are entrance changes, closed areas, recommended routes, and parking effects explained and signed onsite?
  • Clinical continuity: Is the emergency department continuing in place, or are services temporarily relocated?
  • Safety in occupied areas: How does the plan address isolation of work, air quality, utilities, and noise or vibration?

A sign or traffic controller can help people follow a changed route, but neither substitutes for a coordinated plan. The route information should match the actual phase of work, and the hospital’s project communication should tell people what has changed rather than expecting them to infer it from construction barriers.

For a project team, the comparison is not simply “usual entrance or temporary entrance.” It is whether the chosen approach works for the relevant users and services during that phase: ambulance arrivals, walk-in patients and visitors, construction and service traffic, and the movement of patients and staff inside the facility. The plan also needs to fit the protections and utilities required in occupied areas. No single configuration is established for every site by the cited guidance or project examples.

What patients and visitors should do

  1. Check the hospital’s current project notice. Look for the date or construction stage, the emergency department entrance, ambulance or vehicle-route information if published, parking changes, and any closed areas. Conditions can change as phases advance.
  2. Follow temporary signs and onsite directions. St. Mary’s and Finley both describe temporary wayfinding measures in their project updates; Finley also describes traffic controllers. Follow the instructions posted at the campus rather than relying on an old map or a remembered route.
  3. Allow extra time for a planned visit. St. Mary’s advises allowing extra time for route changes and notes possible traffic associated with workers, deliveries, materials, and equipment. Other sites may communicate different local effects, so use their current notice.
  4. Use emergency services for an emergency. Do not delay seeking emergency help to investigate a construction route. If you are already on campus and cannot find the entrance, follow onsite directions or ask hospital staff for guidance.

When reading a notice, distinguish the emergency department’s operating status from the entrance or route instructions. A department can continue operating while the usual public entry, vehicle circulation, or nearby parking changes. If a notice names a construction stage, use the directions for that stage rather than assuming they will stay the same throughout the project.

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Standards, editions, and local requirements

The renovation provisions discussed above come from FGI’s 2010 guidelines. They should not be read as proof that every jurisdiction currently enforces that edition. FGI’s editions information says the 2026 facility codes are scheduled for release in fall 2026; which edition and requirements apply to a project depends on adoption and effective dates in its jurisdiction. The authority having jurisdiction determines the applicable requirements for a specific project.

FGI’s resource on designing facilities that respond and adapt to emergency conditions discusses broader preparedness topics, including risk assessment, surge response, alternate care sites, resiliency, renovations, and temporary and long-term solutions. It provides context for continuity planning, but does not establish one access layout for all construction projects.

Why access arrangements change during a project

Construction creates practical conflicts: work areas occupy space, deliveries and equipment can add traffic, and the hospital still needs routes for patients, visitors, staff, and emergency vehicles. Phasing and risk assessment help the team account for those interactions while maintaining care. As a result, a route that works in one stage may need to change in another, even if the emergency department stays open.

For an individual hospital, the most useful information is the latest site-specific notice and the instructions at the campus. The overall plan involves clinical, facilities, infection-prevention, emergency-management, and construction leads, alongside applicable project authorities. A general article cannot determine the safe route for a particular building or construction phase.

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Frequently Asked Questions

Can construction close a hospital emergency department?

There is no single answer for every project. The cited FGI guidance calls for phasing renovations to minimize disruption to patient services, and the Finley and St. Mary’s project updates describe emergency departments continuing to operate during their respective work stages. A specific hospital’s operating plan and current notice are the best guide.

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Where do ambulances go when a hospital is being renovated?

It depends on the site and construction phase. St. Mary’s says its ambulance route will be maintained; other projects may communicate changed circulation or an alternative route. Check the hospital’s latest project notice and follow onsite directions.

How can I find the emergency entrance during hospital construction?

Check the current hospital project notice for the construction stage, entrance, route, and parking changes, then follow temporary signs and onsite instructions. Some hospitals retain the usual entrance; others direct visitors to a temporary entry.

Why might the emergency department be open but its usual entrance closed?

The entrance and vehicle circulation can change while clinical services continue. A hospital may use a temporary public entrance, alter campus traffic, or combine measures to fit the work phase. The local notice explains which routes remain accessible.

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The Bottom Line

Hospitals keep emergency access workable by phasing construction around care, assessing risks with clinical and infection-prevention staff, protecting occupied areas, and communicating route changes. The emergency department may remain open even when its usual entrance or driveway changes. For patients and visitors, the latest site-specific notice and onsite directions are more reliable than a remembered route or another hospital’s example.

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