The Lunder Building, a high-tech, flexible structure, commemorates the bicentennial of Massachusetts General Hospital and advances it into a third century of providing care. The 535,000-sf facility houses procedural programs, 150 inpatient beds, and new emergency and radiation oncology departments. Throughout the design process, the clinical planning reflected a commitment to performance-based design, which utilizes research to reduce falls and injury; minimize medical error and infection; improve staff productivity and communication; and enhance patient and family healing, comfort, and satisfaction.The programmatically-dense building, split into a procedural base and an upper bed tower, connects to five existing buildings via bridges and walkways. The patient floor plan comprises two interlocking, C-shaped groups of single-patient rooms, traversed by a central circulation spine. This configuration fits more rooms into the constrained site, minimizes staff travel times, and brings natural light to not only the patient rooms but staff support areas as well. The bed tower also incorporates two gardens (a five-story indoor atrium, and an outdoor bamboo garden on the sixth floor), as research has demonstrated a link between views to nature and the quality of the healing process. The Radiation Oncology Department, though below-grade, incorporates soft lighting, bamboo accent walls, large garden-themed graphics, and both open and intimate spaces to create a sense of calm.