The East Expansion of the Mayo Clinic’s Phoenix campus includes a 330,000-sf hospital and clinic renovation and expansion resulting in a new high-rise tower that prioritizes innovation, longevity, and the highest level of care. This went beyond a traditional construction project; it was a collaborative journey that brought together architects, engineers, trade partners, and Mayo Clinic representatives in a deeply integrated process. From early visioning sessions in the “Little Big Room” to co-located teamwork in the Big Room, the integrated team embraced a culture of transparency, shared goals, and mutual respect. This ethos set the team up for success against a litany of complex scenarios, from design challenges to navigating collaboration in a global pandemic.