The Humber River Hospital (HRH) is the first fully ICAT SMART hospital in North America, with a lean and green design. There are 45 departments within the 1.8 million-square-foot, 14-storey HRH facility defined in five groups: Ambulatory Care Services; Inpatient Services; Clinical, Diagnostic and Therapeutic Services; Administrative Services; and Support Services. User group, stakeholder, and community engagement were of paramount importance to achieving HRH’s vision and project success. HRH was built to achieve LEED Silver certification through the incorporation of environmentally sustainable construction practices and energy-efficient design aspects. As part of the “Green Initiative,” the design includes a reduction in energy consumption of over 40% (based on ASHRAE 90.1 2007) over the referenced building.