The Grace Hospital project required a functional program that followed a Lean planning methodology. Bob Croft utilized current state data and captured real time patient flow through a patient tracking tool resource that made visible waste and delays in care time. Value stream mapping identified steps in the process to be removed or reduced, and informed the required space that supported the new process. The concept design and functional program tracked 50% improvements in patient time in the ED and other operational improvements that provided patient care with optimal flow within the facility. Overall space requirements were reduced by 50 percent when compared with current state space requirements.