Wollongong Hospital is a third of the way through its massive makeover, with old buildings bulldozed to make way for multi-million dollar modern amenities.
Project manager Albert Vasquez said the first 12 months had seen work start on the Illawarra Cancer Care Centre's $14 million expansion and preparations were under way for construction of the $86 million Illawarra Elective Surgical Service Centre.
"We have now commenced the bulk excavation works on the old Elouera House extension site, which is a significant milestone in itself," Mr Vasquez said.
"This is also a hugely important step in establishing the footprint of the new and expanded campus."
Diversions are in place in and around the hospital as the demolition and construction activity continues.
As the scale of works continues to grow, visitors to the hospital are being urged to take extra care.
"This is a very exciting time for Wollongong Hospital but we understand that the diversions and busy activity on campus are inconvenient," Mr Vasquez said.
"We want to reassure the community that we are doing everything we can to minimise disruption and noise.
"Loftus Street, especially, will continue to be extremely busy with contractors, heavy vehicles and machinery.
"A traffic management plan, developed in consultation with Wollongong City Council, is in place to coordinate heavy vehicle access but we are asking people to be alert and take extra care when travelling around the hospital or crossing the road.
"We are urging everyone to pay close attention to the safety signage."
Patients and their families unsure about diversions or changes at the hospital should speak with staff in their treatment area.
Drop-off/pick-up zones remain in place at Loftus and Crown Street entrances, and at the Emergency Department off Darling Street.
Construction of the Illawarra Elective Surgical Services Centre is scheduled for completion in 2015.