When tasked with designing a medical/psychiatric inpatient unit for MU Health in 2018, our team encountered a unique challenge that sparked our curiosity and determination. We delved into understanding the need for a facility catering to patients with both medical and psychiatric diagnoses. Facing complexities like a surgical patient with a history of behavioral/mental health challenges, the objective was to create a unit meeting diverse needs while adhering to code requirements and ensuring a safe, healing environment. In-depth inquiries about staffing, admission criteria, and operational procedures guided our initial programming, fostering the development of operational goals, adjacencies, and security protocols.