relatively inconspicuous railings on the stairway adjacent to the Cancer Center lobby. Elsewhere, they stayed.

Compromise was likewise a driving principle behind the 540-space parking garage adjacent to the new outpatient clinics (and reserved entirely for patients). Built of whitewashed concrete, the garage is as unremarkable as the Doctors' Office Building is noteworthy. More of the garage's nine levels were originally slated to be underground, but cost—and the topographic reality of a site that slopes upward by 60 feet from north to south—intervened. "We looked at dropping the grade," explains Judge, "but people would have been driving into a hole." [For insight into challenges the architects faced, see the video.]

Still, the garage gave some relief to DHMC's notorious parking shortage without consuming acres and acres of the site's surrounding woodlands and wetlands. That speaks to Judge's roots as a landscape architect. And it also vindicates the view, held by both Judge and DHMC officials, that Lloyd Acton was right—when it comes to hospital design, patients should come first. "Physicians would love to park right next to their offices and go right to their exam rooms," Judge says. But at DHMC, it's patients who get to do that.

Yet few patients know they prevailed in such behind-the-scenes struggles, and likewise few probably notice much of what is most important about Project for Progress. The Emergency Department went from occupying the hospital equivalent of a back porch, with waiting areas befitting a bus terminal, to a carefully planned space designed to speed the patient's journey from ambulance bay to inpatient bed. And, not incidentally, to provide comfort and privacy to concerned family members.

Same-Day Surgery has also been expanded and reengineered to promote the efficient delivery of care. There are more operating rooms, and the new ones

Glass House Photo: Jon Miller, Hedrich Blessing

The parking garage vindicates the view, held by both Judge and DHMC officials, that patients should come first. Doctors "would love to park right next to their offices and go right to their exam rooms," Judge says. But at DHMC, patients do.