Upgrading New York Presbyterian’s busy urban Emergency Room was a multiple phase six-year project. Planned and completed with Davis Brody Bond Architects when principal Charles Calcagni was a partner with DaSilva Architects, now E4H Architects, the department employs a Rapid Medical Evaluation plan to speed the waiting process for patients. As many of the buildings are from the early 1900s, careful consideration had to be employed when demolishing existing fire rated construction. A glass entrance was removed to make way for the new hospital Broadway entrance and waiting area and proceeded section-by-section allowing the existing ED to stay in use while being upgraded and tied together. The project was completed in six years.