This study developed and tested a scenario-based table top simulation method in a user-driven innovation setting. A team of researchers worked together with a user group of five medical staff members from the existing clinic. Table top simulations of a new clinic were carried out in a simple model including patient scenarios, LEGO figures, shoeboxes, and cardboard. The results indicated that table top simulations is a simple, cheap and powerful tool to generate and test innovative conceptual solutions in the early stages of a design process.