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More than one hundred new hospitals open every year across North America. Only a small number of them meet current high energy performance code standards. Others are spending hundreds of millions of dollars in excessive utility costs and emitting tens of thousands of metric tons of unnecessary greenhouse gas emissions. Learning from the best can enable every new hospital to maximize its energy efficiency. Opened in 2021, the 1.2 million sf Cortellucci Vaughan Hospital north of Toronto is now among the most energy efficient major acute care hospitals in the world, with a (cold climate) energy intensity of 90 kBtu/sf. On August 21st, 2024, the project team joined more than one hundred hospital executives and industry professionals at the hospital to explore the planning, design, commissioning and operational practices responsible for this world-class standard of energy performance. This session will present the conclusions and recommendations. Learning Outcomes: Assess the actual energy intensity of recently opened and planned hospitals. Identify where failures in the new hospital development process have the biggest impact on final energy performance. Explain the importance of energy targets, commissioning and facility management in energy performance. Engage in this ongoing research to achieve better energy performance outcomes in your hospital.