Hurricane Resilient Hospital Study During Hurricane Florence, Wilmington was isolated from surrounding areas for over a week. With the city effectively an island due to flooding, the only way out was by boat or helicopter. In the wake of this disaster, an in-depth study on resilient hospital design sought to better understand inherent challenges and opportunities and to explore innovative concepts to inform future design and construction. Strategies for hardening the structure and maintaining emergency access in severe weather included perforated metal panels, which protect the building from projectiles up to 200 MPH while allowing filtered natural light into the patient spaces; nonessential spaces positioned at lower levels with critical services and patient floors elevated above potential flood levels; a rooftop solar array which allows the building to operate if the power grid goes down; three entry points at ground level, the second-story bridge, and the helipad; and greatly reduced energy loads, which allow the building to operate much longer on solar power than a typical hospital could. High performance, right-sized mechanical systems are located on a protected floor instead of exposed on a rooftop. The resulting concept allows 50% more natural light and reduces energy use by 50% over a typical hospital design. This holistic approach to resilient design creates the potential for better places for healing, safer access during disasters, and better building performance both in significant weather events and for year-round use.