In response to requirements outlined by the National Defense Authorization Act (NDAA), the Department of War contracted with Deloitte, UC Davis, and the University of Colorado Anschutz to develop and prototype innovative hospital expansion solutions designed to expand clinical care delivery during sustained medical emergencies. This initiative produced a supporting operational framework designed to meet both policy and implementation demands required to address critical gaps in healthcare preparedness exposed by recent national and global emergencies. While many systems can manage short-term patient overflow, few are equipped with scalable, deployable solutions that can expand bed capacity for weeks or months. The HxS Deployment Playbook was developed to address this critical gap. The HxS Playbook provides a comprehensive, adaptable framework that guides planners through a range of medical surge solutions, from soft- and hard-sided facilities to rapid hotel conversions. This suite of medical surge solutions can scale care expansion for speed of deployment, durability and length of use and spectrum of potential care. Created around a large-scale combat operation (LSCO) scenario provided and funded by the Department of War, the HxS Playbook consolidates research, design, testing, and operational expertise into one practical resource. It serves as both a planning tool and a real-time operational guide, helping state, local, and healthcare partners plan for, scale, and sustain Hospital Expansion Solutions (HxS) tailored to diverse environments and mission requirements. This session will showcase how the HxS Playbook functions as a textbook for resilience, providing step-by-step planning considerations, infrastructure adaptation guidance, cost modeling, staffing templates, and operational decision aids. Presenters developing portable models as well as a hotel conversion (Hotel2Hospital-H2H) model will share real-life lessons learned from their respective proof-of-concept demonstrations. Team Colorado will share field-tested insights from the H2H demonstration, highlighting innovations in rapid construction, IT integration, supply chain agility, and interdisciplinary coordination that informed the HxS Playbook’s development. Teams Deloitte and UCDavis will share findings from their demonstrations to make soft and hard-sided solutions interoperable and best practices related to the same. Attendees will leave this 60-minute session with a practical understanding of how to use the HxS Deployment Playbook to enhance preparedness across diverse operating environments. They will gain valuable insights into how to think about and plan for protracted medical surges. Participants will also gain access to tools and frameworks to support planning across multiple modalities, be that expanding existing hospital capacity, deploying soft- or hard-sided structures, or rapidly converting hotels into alternate care sites. By reframing surge response as an adaptable system rather than a single solution, the HxS Deployment Playbook redefines what it means to be ready for the next protracted healthcare emergency, examining national readiness through the lens of what is best for patients, staff and community and transforming spaces, systems, and strategies into readiness.