Define project interfaces before mobilization
Identify occupied areas, patient populations, construction boundaries, egress routes, smoke compartments, fire protection systems, utilities, infection-control constraints, security, deliveries, shutdowns, and emergency access. Confirm the provider type, adopted requirements, accreditation process, authority contacts, and facility policies. Assign one coordination path across owner, contractor, design, clinical, infection-prevention, security, and life safety teams.156
Create risk and interim-measure decision points
Define when a planned condition, deficiency, or impairment triggers the facility's construction risk assessment, ILSM evaluation, fire-watch decision, notification, or authority coordination. Record the affected feature, duration, area, patient impact, compensating action, responsible person, inspection frequency, and restoration criteria. Reassess when phasing, schedule, occupancy, or protection status changes.268
Control temporary egress, barriers, and impairments
Show temporary routes, exits, barriers, signage, alarm and sprinkler status, access restrictions, and phase boundaries on controlled project information. Inspect temporary conditions at the frequency established by the approved plan and after meaningful changes. Coordinate utility and fire protection outages so notifications, clinical contingencies, emergency restoration, acceptance testing, and return-to-service authority are clear.135
Manage concealed work and contractor activity
Use permits, orientation, approved assemblies, inspection hold points, above-ceiling controls, daily housekeeping, hot-work processes, and deficiency reporting appropriate to the project. Require stable location identifiers and retain evidence before work is concealed. Stop and escalate unexpected field conditions rather than allowing an improvised repair to become inaccessible behind a ceiling or wall.678
Close the project into facility operations
Turn over verified life safety drawing changes, door and damper inventories, alarm and sprinkler records, approved systems, test results, warranties, training, impairment closures, and remaining deficiencies. Facility owners should review and accept the records before superseding controlled information. Conduct a final field and document reconciliation so new assets enter inspection programs and temporary measures are formally removed.578
Define daily inspection and communication controls
Assign responsibility for inspecting temporary barriers, exits, signage, housekeeping, fire protection status, above-ceiling openings, access control, and other approved measures at the cadence established by the facility plan. Use a location-based record and route exceptions immediately to the project and facility owners who can protect patients and operations.
Set a daily communication method for phase changes, outages, deliveries, hazardous work, clinical restrictions, and unresolved deficiencies. Include nights and weekends when project conditions remain but normal leadership coverage changes. Staff should know how to report a construction-related life safety concern and who can stop work.568
Verify each transition between phases
Before opening a new phase, changing egress, relocating a temporary barrier, concealing work, or returning an area to service, confirm the approved condition in the field. Reevaluate risk, impairments, ILSM, infection-control controls, security, emergency access, and temporary drawings. Record who authorized the transition and what evidence supported it.
Carry remaining deficiency, damper, door, barrier, drawing, and testing items into an explicit punch list with owners and deadlines. A schedule milestone or substantial-completion label should not silently close patient-safety work that still requires inspection, testing, document acceptance, or facility verification.137
Prepare for survey activity during construction
Keep current phase drawings, risk assessments, ILSM decisions, impairment records, permits, daily inspection evidence, open deficiencies, and responsible contacts retrievable while work is active. Train escorts to explain what is temporary, what protection is operating, how conditions are monitored, and when each phase ends. Verify that the field matches that explanation. Construction does not suspend facility responsibility, so the coordination plan should support an accurate survey conversation without representing temporary measures or pending work as permanent compliance.468
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