In 2003, Le Bonheur Children's Medical Center was set to build a fifth major addition to their original, circa 1952 main hospital building. They quickly realized that the planned expansion would fill the last available space on their lot and eliminate options for future expansion. We were brought on to study options that would allow the Medical Center to grow and meet their needs through 2014.

Two options were developed and presented to Le Bonheur. The first called for the Medical Center to stay on the existing block, build a new addition on the last available land, and then expand backward, demolishing a portion of old building with each phase. The second option was to obtain the poorly used adjacent block, build a major new building there, close the street and begin to expand back onto this new block over time.

We developed conceptual plans for both options with detailed cost, phasing and constructability analysis. The exercise showed that the first option would take longer, cost more and leave them stuck again after 2015, but would not require new land. The second option would require obtaining new land, but would cost less to build, cause less disruption during construction, and leave them with room to grow well beyond 2014. The second option was selected.