This session explores how value is added when Lean process improvement, evidence-based design, and clinician engagement are integrated. Presenters will review the Indiana University Health West Vertical Expansion project as a case study and describe the three primary approaches utilized. Lean process improvement techniques studied the current state; evidence-based design was overlaid on the Lean process improvement to uncover current state analysis and future state design interventions; and staff were fully engaged to work on integrated design events, making them stewards of the design across the facility. This combined approach allowed the team to simultaneously address process, design, and people.