Patients filled all nine beds in the emergency room at University Hospital and Clinics before 10 a.m. Tuesday while two more sat in chairs grouped together for a makeshift treatment area near the entrance.

About 40,000 patients seek care each year at the public hospital’s emergency room in a space that’s about 1,800 square feet.

But by the end of 2016, the size of the emergency room will triple as part of a long-awaited expansion project that began this week. The state-funded project involves a face-lift for the emergency department with a separate entrance for ambulances, a renovated lobby and patient waiting area and 20 private exam rooms.

Its tight quarters and design now make it difficult to navigate a gurney.

“Being able to roll patients through the physical space is a challenge now,” said Deborah Spell, director of emergency services at the hospital. “The biggest impact of the project is going to be the space.”

There are now six curtained bay areas, three exam rooms and one room used for patients with behavioral health issues.

The staff tries to use the space it has efficiently. Closet space that once belonged to an adjacent auditorium is used as a makeshift office area with computers. The staff lounge is the size of a large bathroom stall, and computer stations where doctors and nurses work are cramped.

“It’s needed,” Dr. Ali Sadeghi, ER medical director at UHC said of the expansion later that afternoon when he had a fuller house — nine beds full and six patients being treated in chairs.

The addition of the 20 private exam rooms will help improve patient privacy, he said.

Patients treated in chairs are taken to an office at the back of the ER to provide them with privacy, Sadeghi said.

“Any area where we can see patients, we utilize it,” Sadeghi said. “The expansion will create more privacy for patients and make them more comfortable.”

The more than $4 million project is state-funded and has been included in the capital outlay bill since 2006 with $2 million initially earmarked. In that time, management of the hospital, which is funded by the state, has been put in the hands of Lafayette General Health, though as part of the lease agreement, the state committed to completing the emergency department project.

Doctors, nurses and administrators as well as the Schumacher Group, a Lafayette-based emergency and hospital medicine management company, helped shape the new design, Spell said.

The first phase of the project involves the expansion into the former medical library and the courtyard area adjacent to the emergency department. That part of the project is expected to be complete in early 2016, but is dependent upon the weather, said Daryl Cetnar, community relations director for Lafayette General.

Once the initial expansion project is complete, emergency room operations will move into the new area and the current emergency room will become a temporary waiting room while work to renovate the existing ER lobby and waiting area begins.

The estimated completion date for the waiting area renovation is set for next summer, if the initial project stays on track.

The final phase focuses on the old ER to be fully renovated and integrated into the expanded portion of the emergency room.

“The entire project is expected to be complete next fall,” Spell said.

Follow Marsha Sills on Twitter, @Marsha_Sills.