This greenfield hospital gives residents of Cumberland County, Perry County, and the Harrisburg region access to high-quality, comprehensive health services. The facility features 108 single-patient rooms, state-of-the-art ED, physician offices, inpatient services, imaging and lab services, and complete medical and surgical capabilities. The pace of this project required a new approach to achieving speed to market we call “design to construction.” While designers completed traditional phases, we focused on what was required to facilitate the earliest possible start and progression of construction. Specific packages were released independent of design milestones using IPD and IPD-Lite practices like collaboration, Pull Planning, Target Value Delivery, prefabrication, and Design-Assist. These strategies allowed us to break ground just six months after the first design meeting and at seven months we started pouring foundations.