Recent reports have established the need for change in the US health system. Building projects can play an important role in enabling change to support organizational objectives. The current major investment in hospital construction in the US provides an opportunity to improve health service. Planning and design of hospitals generally uses benchmarks and experience without rigorous analysis of processes, resources and facility requirements. This paper considers an improved approach to planning and design of hospitals by using Discrete Event Simulation (DES) to enable improvement in the quality and productivity of health services and an improved workplace environment for staff.