The Emergency Department underwent a significant renovation to enhance patient care and improve efficiency during high peak occupancy. To address the surge in patients during the pandemic, the Emergency Department (ED) on the first floor of Ackerman Pavilion underwent a strategic renovation. An 18-bed observation unit was created, allowing for the care of Emergency patients requiring extended observation. Standardized patient rooms with clear visibility from the nurse stations ensure optimal care. The unit’s dual clinical pod design, with two dedicated nurse stations but shared support spaces, optimizes patient observation and workflow. Efficiency was key in the redesign of this high patient volume unit due to limited available space. Involving the staff in the design process was crucial and the design of the patient rooms was carefully coordinated with the hospital staff. Likewise, the use of digital scanning devices allowed us to reduce unforeseen challenges allowing for cost control .