What happens when a neighborhood clinic has to serve a large non-English-speaking clientele, including large contingents of patients from Somalia and Vietnam? More to the point, how do you organize and wayfind the clinic to ensure smooth, confusion-free traffic and a calming patient experience for all patients and visitors, regardless of language? This was the challenge confronted by HGA Architects and Engineers of Minneapolis when they were asked to design a new space for the recently relocated University of Minnesota Physicians' Smiley's Clinic in southern Minneapolis. What follows are observations from HGA architect Rachel Hendrickson on key features of the clinic and what makes it work.

Rachel Hendrickson: “When we started the design process, we conducted charettes with staff who had worked with these patient groups and gave us their ideas. For wayfinding we talked about visualizations of woods, rivers, and patterns of circles and squares, and we decided that the use of colors was the easiest answer and most within budget. Green, orange, and purple are colors that the Asian and African cultures are very comfortable with. We laid everything out and color-coded in threes: we had a central triangle, with each side using one color, and a nursing station at each point. Each set of exam rooms along one of the triangle sides is assigned that color. Each side has a three-physician team assigned to it, providing a full range of services. Within the triangle are gathering areas for patients and the teams to have discussions and so forth. Patients, staff, and visitors are directed to their destinations by specific color. The result has been to make the work flow much easier. I visited the clinic myself recently for care and was talking to a Somali family who said how much easier it was for them to use this clinic, with much less confusion. The staff is also comfortable with this and even feels confident double-booking at times.”

“Families are very involved with these patients, so we've designed the exam rooms to accommodate family members and even translators, when they're needed. The rooms are 10′ x 12′—not unusually large, but very accommodating because they use benches rather than chairs and even have an area that can be curtained off for translators, when needed.”

“This 21,000-square-foot building was first designed as a light industrial warehouse, so we were able to take advantage of the high ceilings. The main waiting area has 14-foot ceilings with skylights, which make it feel very spacious and sunny. The nursing stations, with partial-height walls, also benefit from this lighting. We wanted to install transoms in the exam rooms to admit some of this natural lighting but, unfortunately, the budget wouldn't permit it.”

“Another use of color was the bright red soffit over the admissions desk, which attracts people's attention immediately upon entering. From there, patients are assigned and directed to their particular color area, with color-coded carpeting helping lead them in the right direction. We don't have to worry about multilingual signs because very little signage of any kind is needed with this system.”


“This clinic has become so popular that the patient load has doubled since it was opened. Other providers are touring the clinic nearly every day—in fact, it's gotten to the point that we've joked they should start charging admission. There have been hundreds of such visitors.” HD

For further information on Smiley's Clinic, visit http://www.umphysicians.umn.edu. For further information on HGA Architects and Engineers, visit http://www.hga.com.

Healthcare Design 2008 December;8(12):38-42