March 6, 2019

To accommodate the growing demand for outpatient healthcare services at UAB Medicine, the University of Alabama Health Services Foundation embarked on a more than 70,000-square-foot renovation and expansion of its Whitaker Clinic building at UAB Hospital in Birmingham, Alabama. Gresham Smith was tasked with developing a new prototype clinic design that transformed what was formerly administrative space into clinical areas.

As part of the project, we conducted a series of charrettes involving clinical and support staff to help shape the process. We also collaborated with UAB’s internal Lean advocates/process improvement group. Our design not only increased capacity and improved operational efficiency at the Whitaker Clinic, but also enhanced the patient and staff experience thanks to the collaborative process, which made use of Lean principles as well as value-added design (VAD) methods.

Following the retrofit of the Whitaker Clinic, UAB Medicine asked us to extend our prototype clinic module into a brand-new freestanding medical office building—the recently opened UAB Medicine Primary & Specialty Care at Gardendale. Connected to an adjacent 24/7 freestanding emergency department, the new two-story, 38,000-square-foot facility increases access to essential medical services for residents of Gardendale and North Jefferson County, and expands UAB’s outreach to surrounding communities of the Greater metropolitan Birmingham area.

In this post, I take a sneak peek at the new state-of-the-art facility, and how this evolution of our prototype clinic design delivers a hyper-efficient yet flexible plan in an upscale, inviting environment that better serves patients and staff alike.

A focus on enhancing the patient experience drove the planning and design of the MOB. An open floor plan that provided ease of wayfinding and connectivity to the outdoor space was an important feature.


Exam rooms were designed using Lean principles, combining triage and exam space, and standardizing rooms to maximize utilization across practices. By focusing on three of our VAD drivers—integration of technology integration, improving operational efficiencies, and enhancing the human experience—our design shifts the mechanics of how a physician and patient occupy an exam room by streamlining equipment. This includes an exam chair/table with a built-in scale that not only saves space but also eliminates moving the patient within the room, saving time.


Sliding barn doors reduced wasted space within the exam rooms and increased the functional program space within the clinic. Eliminating the “door swing” allowed for greater flexibility and accessibility within the exam space. The clinic’s arrangement delineates staff-only areas from zones in which caregivers interact with patients. A contiguous staff corridor allows for connectivity between clinics, shared back-of-house functions and the ability for physicians to work out of multiple clinics.


The UAB Medicine Callahan Eye Hospital Clinic is located on the first floor of the MOB. Transom windows allow daylight to filter into each exam room. The transformative properties of natural light were a key consideration when visualizing the floor plan.


Creating a welcoming environment, the common waiting area is organized with a variety of seating arrangements and amenities to accommodate patient comfort. It also improves the efficiency of the clinic planning by reducing duplication. Views provide a positive distraction for patients and their families.


Replacing UAB Medicine’s previous Gardendale facility, the new MOB houses primary care, obstetrics and gynecology, orthopedics, cardiology, dermatology, urology, nephrology and gastrointestinal services, along with diagnostic imaging, lab services, telemedicine and digital self-check-in kiosks, and the UAB Medicine Callahan Eye Hospital Clinic and optical shop.

By incorporating Lean principles within a value-added design framework, we were able to house an extensive program within a more efficient, flexible and patient-centric environment that better serves UAB Medicine and the community at large.