Healthcare environments have become increasingly complex. It is imperative that we understand the impact of the built environment and integrated technology make on operational models for patient care and patient safety. This presentation will explore the use of virtual and physical mockups along with clinical simulation practices to inform the design of complex patient treatment areas such as operating rooms, procedure rooms and patient rooms. The Naval Medical Center in Portsmouth, Virginia undertook a complex renovation of their existing perioperative suite, central procedure unit and Pediatric ICU to improve patient safety and modernize the environment of care. In addition to the complex patient care provided in these departments, there were added complications of phasing, physical and operational constraints that also impacted the design. Given the scope, this project presented an opportunity to dramatically improve the care environment for patient safety, operational efficiency, staff and patient experience. In order to do so, virtual mockups were generated during the early stages of design. They were later developed to show interior finishes and equipment. Physical mockups were then built with a mixture of actual and representative equipment placed within the spaces. Guided clinical simulations were conducted to test the design. Changes were recorded and modified real-time in the virtual mock-ups so users can see the finished room with updates for further decision-making. Through working back and forth between simulation, virtual and physical mockups, clinical staff and project leaders are able to evaluate the impact of design decisions in a rapid manner. The project team was able to adjust and implement changes with confidence to minimize changes later in the design which will ultimately result in cost and schedule savings. Core Competencies: Space Planning and Programming, Design, Equipment Planning, Construction Management, Strategic Planning, Equipment Acquisition, A-E Selection Process AIA Course Number: 2025.04.006 AIA LU/HSW = 1 LU/HSW