Project Background
You are the program manager embedded in Kaiser Permanente’s Northern California Facilities & Clinical Operations group. A flagship hospital in San Jose is running at 92–98% average bed occupancy, with a busy Level II Emergency Department (~210 visits/day) and a surgical center performing 35–45 procedures/day. Patient satisfaction scores have slipped for “quietness at night,” and infection prevention has flagged several aging surfaces as harder to sanitize.
The hospital has approved a set of “minor renovations” that are operationally high-risk: refurbishing two med-surg unit nurse stations, replacing flooring and wall protection in three corridors, upgrading handwashing sinks in a 12-room step-down pod, and modernizing wayfinding signage near the ED entrance. None of the work is structurally complex, but it must occur while the hospital remains fully operational. The CEO has committed to completing the work before the state Department of Public Health (DPH) survey in 10 weeks, and before the seasonal respiratory surge begins.
You will act as the primary liaison between construction contractors and hospital staff. The general contractor (GC) has done outpatient clinics but has limited experience in live acute-care environments. On the hospital side, clinical leaders are supportive but skeptical due to past disruptions (dust alarms, blocked corridors, noisy overnight work). Your job is to create an execution plan that keeps patient care safe, staff informed, and the project on schedule.
Stakeholder Landscape
- Clinical Operations (CNO + unit managers) want zero impact to staffing workflows, medication delivery, and patient monitoring. They will push back on any plan that adds steps for nurses.
- Infection Prevention (IP) + Environment of Care (EOC) require strict controls: negative air where needed, dust containment, cleaning protocols, and documented ICRA compliance. They can stop work immediately for violations.
- Facilities/Engineering wants the project done fast and within budget, but they also own life-safety systems (fire alarms, med gas shutoffs) and will not accept uncoordinated outages.
- General Contractor + subs want predictable access windows and minimal stop-start changes. They are incentivized to finish quickly but may underestimate hospital constraints.
- Patient Experience cares about noise, signage clarity, and maintaining accessible routes for visitors.
Competing priorities are explicit: the CNO prefers to avoid any overnight work due to fatigue and safety concerns, while the GC claims nights are the only feasible time to close corridors without disrupting traffic.
Constraints
- Timeline: 10 weeks total. DPH survey begins Week 11; all work must be complete and punch-list closed by end of Week 10.
- Budget: $1.2M total, with only $80K contingency remaining after material pre-orders.
- Access windows: No work allowed in step-down pod 7:00–9:00 AM (rounds/med pass) and 6:00–8:00 PM (shift change). ED entrance signage work cannot block ambulance access at any time.
- Noise limits: Quiet hours 9:00 PM–6:00 AM; patient complaints trigger escalation to the COO.
- Regulatory/safety: ICRA required for all work; interim life safety measures (ILSM) required for any egress changes; fire marshal requires 48-hour notice for any corridor reroute.
- Resourcing: Hospital has 1 facilities supervisor available nights/weekends; IP has 1 practitioner who covers the whole campus and can only attend two on-site walk-throughs per week.
Deliverables (what you must produce in the interview)
- A liaison operating model: how you will structure communication, decision-making, and escalation between contractors and hospital staff (cadence, artifacts, roles, and “who decides what”).
- A 10-week execution plan with milestones, access windows, and how you will sequence work to minimize clinical disruption.
- A trade-off proposal for the CNO vs GC conflict (nights vs days): what you recommend, what you will not do, and what mitigations you’ll put in place.
- A risk register: top risks across safety, schedule, and stakeholder alignment, with triggers and mitigations.
- Success criteria and monitoring for the first 2 weeks after each area reopens (e.g., complaints, safety incidents, workflow issues).
Complications (assume these occur)
- Week 3: A subcontractor trips a dust sensor, causing a localized alarm and a social media post from a visitor. The COO demands “no repeat incidents,” and IP threatens to require IP presence for all future work (which is not feasible).
- Week 5: The flooring material shipment is delayed by 12 days due to a supplier issue. The GC proposes swapping to an alternative product that is in stock but has different cleaning compatibility and slip rating.
- Week 7: The step-down pod experiences an unexpected census spike; the unit manager refuses to decant any rooms for sink replacement, jeopardizing the schedule.
Your answer should demonstrate how you act as a calm, credible liaison in a high-stakes environment: aligning stakeholders, making trade-offs explicit, protecting patient safety, and still delivering on time.
