This document discusses the importance of perception in resolving human factors and change management issues during design projects. It provides an overview of a project to design a new patient care tower at Akron Children's Hospital that used an integrated project delivery approach involving clinical staff. The project employed various tools and techniques to manage staff perceptions and expectations during the design process, including value stream mapping, mockups, and pulse surveys. The presentation emphasizes that perception is reality, and change starts with addressing initial perceptions. It also discusses how involving staff voices, managing expectations, and closing gaps between perception and reality are key to leading successful transitions during change.