The 300,000-sf Ambulatory Care Complex is the first phase of the University of Utah’s Health Science Campus Transformation, and VBFA’s mechanical, plumbing, fi re protection, and civil engineering team held an integral role in the design of this state-of-the-art facility. The project includes seven stories, with inpatient floors, outpatient clinics, surgery suites, faculty offices, and a loading dock, and needed to integrate with the fully-functioning hospital buildings adjacent to the site. The University desired to evaluate the transformation projects with respect to infrastructure delivery of district high-temperature water heating, central chilled water cooling, culinary water, sewer and natural gas. VBFA assisted this effort to develop a capacity study and economic analysis of existing infrastructure and to determine the path forward. As a result of this effort, the paradigms were adjusted so that the hospital generates heating onsite and utilizes central chilled water from campus. The innovative surgical ceiling air distribution system is expected to improve patient outcomes by reducing contamination of the surgical field. In alignment with the University’s commitment to achieve carbon neutrality by 2050, the project was designed in pursuit of LEED Silver certification.