In "Saving Hope", when charismatic Chief of Surgery Charlie Harris (Shanks) at Hope-Zion Hospital ends up in a coma, he leaves the hospital in chaos - and his fiancee and fellow surgeon, Alex Reid (Durance), in a state of shock. Along with newly arrived star surgeon, Joel Goran (Gillies), Reid races to save Harris' life. As the action unfolds, the comatose Harris explores the hospital halls in "spirit" form, not sure if he's a ghost or a figment of his own imagination. Reid, along with her fellow doctors, press on to save his life and those of their other patients as they deal with the complicated and courageous decisions that are made in their daily struggle to keep hope alive.

Following last season's shocking finale, it's a time of new beginnings for the doctors at Hope Zion Hospital. As the Hope Zion Hospital staff continue to deal with the aftermath of the death of their colleague and friend, Alex is back at work following her maternity leave as she works to balance motherhood and a busy OR, while Dr. Charlie Harris (Michael Shanks) continues to be haunted by his ghost-seeing abilities and the question of whether or not he is baby Luke's biological father. Dr. Zach Miller (Benjamin Ayres) is still struggling to cope with the traumatic death of his close friend, and Dr. Maggie Lin (Julia Taylor Ross) ponders where she stands in the new landscape of Hope Zion Hospital. Chief of Surgery Dr. Dawn Bell (Michelle Nolden) struggles to keep a lid on the hospital, Dr. Shahir Hamza (Huse Madhavji) develops a surprising new partnership, and Dr. Dana Kinney (Wendy Crewson) discovers a higher calling in a traumatizing case that hits a little too close to home. 'Saving Hope' 4th season sets the stage for a journey into an ever-evolving Hope Zion Hospital that will continue to challenge its doctors, and in some cases, shake their foundations down to their core.