Jigsaw was approached to help determine the most cost-effective means for removing pedestrian traffic across a busy road between a Pikeville Medical Center, the major regional healthcare provider in Central Appalachia, and its nearby parking areas after internal polling revealed that employees considered the need for safer access to their workplace to be a primary concern. The medical center is located in a narrow valley, constrained by mountains on three sides and the roadway in front. The site conditions were further complicated by the preexistence of all the utilities necessary to support such a large facility, as well as a stream which flows beneath the building.


In initial discussions with Pikeville Medical Center, the proposed concept was to build an elevated walkway between the parking lot and the medical center which would cross over the roadway. However, the elevation difference between the two areas is equivalent to approximately four stories in height, requiring many flights of stairs and the installation of an elevator in order to meet ADA requirements. After analyzing the site, Jigsaw proposed a new solution: the construction of a pedestrian walkway that would go beneath the roadway instead of above it. Before commencing on the project’s design, Jigsaw mapped the existing underground utilities so that the tunnel could be built around these lines without disturbing them. Furthermore, because it was critical that the medical center continued to operate smoothly throughout construction, Jigsaw created a virtual reality model showing the location and type of each underground utility; prior to construction, each member of the team working on this phase of the project utilized this VR model to better visualize the site conditions and limitations. Once each member of the team had a thorough understanding of the site conditions, construction commenced, and the tunnel was completed without any disruption to the hospital’s daily operations. 


Jigsaw utilized precast tunnel segments in order to shorten the construction timeline and reduce costs on the project. In addition, the tunnel was designed so that it can serve as an emergency spillway in the event of flooding from the stream underneath the hospital–drastically reducing the risk of potential flooding within the medical center. By incorporating innovative design and cutting-edge technology such as VR, Jigsaw created a solution that allows employees to safely access their workplace and reduces flood risk to the hospital–all without disrupting the hospital’s daily activities.


  • Engineering design
  • Virtual reality
  • Traffic control
  • Mass excavation
  • Tunnel construction
  • Engineered fill
  • Reinforced concrete retaining walls
  • Asphalt paving