Utilizing Design to Improve Security at UW Health University Hospital’s Emergency Department

Security and safety are important throughout healthcare facilities but especially in the emergency department. UW Health University Hospital’s Emergency Department (ED) is a Level 1 Trauma Center and one of the busiest emergency departments in Wisconsin. Zimmerman developed design solutions to renovate the ED entry vestibule, reception and waiting areas to provide better sight lines, enhance security measures, and create spaces that integrate the security staff into the ED. 

Zimmerman worked with the ED’s clinical leadership and the hospital security director to identify the vision and goals. The project vision was to improve the safety of patients, families and staff and the security of the entry space. To achieve the vision, the following goals were identified:

  • Protect the emergency department from outside threats
  • Improve visibility of patients and visitors entering the parking structure and ED
  • Integrate security officers into the ED entry and make them visible
  • Improve the position of the reception desk and provide a retreat path for staff
  • Provide more waiting space for patients and visitors

Security and ED leadership determined that a metal detector should be added to the entry vestibule to reduce the risk of weapons entering the department. This equipment required additional space in the vestibule and the development of a new workflow. To test the new layout, Zimmerman led a mockup to simulate the new workflow. The feedback from staff reviews of the mockup informed the size and layout of the new vestibule. Another project goal was to integrate the security staff into the ED entry and make them more visible and active. Security staff are now stationed in the vestibule. The security podium was designed to allow visualization of the parking lot and vehicle entrance, so security staff would be aware of any potential hazards.

The existing registration desk was an open workstation located in the middle of the waiting room. The location did not allow staff to see new patients walking through the main entrance. This issue was resolved by positioning the new desk to have sightlines to the waiting area and parking garage. The new registration desk is wholly enclosed with bullet resistant operable windows which allow staff to still be “hands-on” with patients but offer the opportunity to protect themselves if needed. 

The original waiting area was undersized and often congested. In the renovation, the waiting area was expanded into the existing parking deck, allowing 40% more seating space. A family waiting room was created so families can now wait in a quiet and private space separate from the main waiting area.   There is also a separate waiting area for pediatric patients and families. 

As one of the busiest emergency departments in Wisconsin, the University Hospital Emergency Department provides expert trauma care to thousands of patients in the region every year. With the renovation of the entry, registration and waiting spaces the Emergency Department can provide an improved level of safety and security for patients, visitors, and staff as well. By meeting the goals of integrating security staff and measures, improving sight lines, and adding waiting space, the overall ED experience is improved.


Madison, WI


5,200 sq. ft.

Services Provided:

Architectural Space Planning, Architectural Planning and Design, Structural Analysis, Interior Design

Scott Gosnell


Vice President | Director, Healthcare

As the Director of our Healthcare Studio, Scott leads a team of healthcare planning and design experts who are focused in evidence-based design, Lean healthcare design principles, and biophilic design. Before exclusively concentrating his professional efforts on healthcare facility projects, his main areas of focus were in the firm's healthcare and hospitality project categories. This unique combination of experience has resulted in projects that embody an environment of care that values patient experience in quality, brand, convenience, and amenities as well as staff efficiency and well-planned spaces. Scott has been with Zimmerman for nearly 20 years, having joined the firm shortly after earning his Master’s Degree in Architecture from the University of Wisconsin Milwaukee.