The existing hospital required significant capital upgrades and was no longer appropriately sized and laid out for the community’s needs and the modern delivery of healthcare. Percival’s assessment focused on the goal of balancing capital investments with projected patient volumes and factored in service line priority strategy, physician alignment targets, and optimal facility sizes. Percival arrived at the conclusion that Yale should pursue a phased campus redevelopment that would result in the creation of a new micro-hospital and ambulatory care center (ACC), both more optimally sized and designed to meet the projected needs of the Westerly patient community.