From one staff member's idea to a clinic-wide rollout
Clínica Alemana de Santiago became the first clinic in Chile to join the Hidden Disabilities Sunflower in 2024.
What began as a suggestion from one staff member developed into a phased rollout involving leadership support, staff training, a pilot in eight areas, patient communications and expansion across outpatient and inpatient services.
Clínica Alemana’s Sunflower rollout at a glance
How the Sunflower began at Clínica Alemana
The Sunflower began with a Clínica Alemana staff member whose daughter has a disability.
While travelling, she encountered the Sunflower and believed it could also help patients at the clinic. She contacted the team and encouraged them to explore joining the Sunflower network.
As Merivette Torres Erpel, Head of Diversity and Inclusion at Clínica Alemana, explained:
It began with one of our staff, who discovered the Sunflower through her daughter, who has a disability. She emailed us to say that she had encountered the Sunflower and thought Clínica Alemana could join. She brought the idea to us, motivated us and that is how we began working on it.
The team spent several months learning about the Sunflower, contacting the Hidden Disabilities Sunflower team and considering how it could be introduced within the clinic.
Macarena Albornoz joined Clínica Alemana in March 2024 as Occupational Therapist and Diversity and Inclusion Coordinator. She began working with Merivette on the strategy, logistics and implementation, and the Sunflower was introduced internally in July 2024.
Implementing the Sunflower in a 24-hour healthcare setting
Clínica Alemana needed to introduce the Sunflower across a large healthcare institution operating around the clock, with staff working across numerous services, units and shifts.
Macarena explained:
First, we needed to understand our own reality and how we could reach every staff member in a large organisation with many different shifts that never switches off. The greatest challenge was that people did not know about the Sunflower.
A single presentation or announcement would not reach everyone. Staff needed to understand the Sunflower before it could be promoted more widely to patients. The training delivered in person and virtually, as well as the materials created to communicate the initiative internally and externally. It was a full-scale rollout, involving the creation of audiovisual, digital and printed materials to introduce the initiative and provide information. A dedicated section about the project was also created on the website: https://www.clinicaalemana.cl/centros-y-programas/collar-de-girasol
Merivette and Macarena also spoke to people from other organisations that had introduced the Sunflower. This helped them learn from previous experiences while developing an approach suited to Clínica Alemana.
Clínica Alemana’s phased Sunflower rollout
Preparing staff for the Sunflower
The initial launch involved leaders, department heads and managers.
Throughout 2024, Merivette and Macarena worked directly with individual services and units to build understanding across the organisation.
Macarena described the approach:
The whole of 2024 was focused on internal work: training staff and leaders and going door to door, service by service and unit by unit.
Staff complete the Sunflower training through Clínica Alemana’s ACADEMIA CAS learning platform. The internal guidance states that staff who have completed the training may wear a white-background Sunflower pin, identifying them as someone who understands the Sunflower.
A separate green-background Sunflower pin is available to staff with a non-visible disability who choose to communicate their own possible need for support.
Green Sunflower lanyards, identification cards and holders are provided to patients with a non-visible condition who choose to use the Sunflower.
Training reach
By April 2026, 89.20% of Clínica Alemana’s workforce had completed the training.
Testing the patient process
At the beginning of 2025, Clínica Alemana moved from internal preparation to a patient-facing pilot in eight areas.
The pilot areas were:
- Vitacura Paediatric Department
- Vitacura General Emergency Department
- Paediatrics, 8th floor
- Neurology, 10th floor
- Vitacura Adolescent Centre
- La Dehesa Children’s Centre
- Paediatric Emergency Department
- General Emergency Department
Feedback identified what was working, what remained unclear and what needed to change. Suggestions included:
- An internal information brochure
- A dedicated digital information page
- Clearer information for patients and other clinic users
- Defined locations where patients could request the Sunflower
The internal leaflet subsequently developed for staff explains the purpose of the Sunflower, distinguishes between the different Sunflower identifiers and provides practical guidance on how staff should respond.
Moving into outpatient and inpatient services
Outpatient services were prioritised because the team believed the Sunflower aligned particularly well with the adjustments and forms of support available in an outpatient setting.
The Sunflower was then introduced across the clinic’s outpatient services.
How patients access and use the Sunflower
Clínica Alemana worked with its marketing team and other departments to develop a coordinated communications approach.
The team recognised that patients already receive a significant amount of information during their care, including information about disability and preferential care. The purpose of the Sunflower therefore needed to be explained clearly and consistently.
Merivette linked the progress of the rollout to the involvement of different departments and to staff understanding both what the Sunflower means and its limits.
How patients learn about the Sunflower
Some Sunflower identifiers were initially distributed to staff before wider patient communications began.
Communications with patients included:
- Emails
- A dedicated section of the Clínica Alemana website
- Information about where the Sunflower was available
- Short videos shown on screens throughout the clinic
- Videos displayed on lift screens
- Graphics in outpatient areas
How patients request and use it
Patients can request the Sunflower from designated distribution points without providing medical documents or certificates, as their health information is confidential. The Sunflower is voluntary, and staff should not automatically offer one or assume that someone needs it.
Clínica Alemana established dedicated distribution points so patients would know where to go and staff could provide clear, consistent information. This also helped the clinic manage availability as the Sunflower was introduced across more services. Current distribution points are listed on Clínica Alemana’s website.
Each patient receives a kit containing a Sunflower lanyard, an ID card and a card holder. The Sunflower indicates that the person may need support, understanding or more time.
Clínica Alemana uses digital screens and patient communications located in strategic areas throughout the Clinic, such as corridors, waiting rooms and lifts to explain the Sunflower and how patients can access it.
How staff respond when they notice the Sunflower
Clínica Alemana’s internal guidance follows the ‘Sunflower Rule of Six’ and asks staff to begin by asking whether they can help. It also advises them to:
- Communicate directly with the person
- Listen carefully
- Allow additional time for the person to express themselves
- Avoid asking about the person’s health condition
- Avoid judging why they are using the Sunflower
- Be patient, kind and respectful
Where someone is accompanied by a service dog, staff are advised not to touch, distract or speak to the dog while it is working.
Recognising the Sunflower at Clínica Alemana
Personal perspectives on the Sunflower
A family perspective
For Flavia Callafange, Latin America Director for Hidden Disabilities Sunflower, seeing the Sunflower throughout Clínica Alemana had personal significance.
Her autistic daughter attended the clinic when she was younger. Flavia said:
I feel very proud and emotional when I see the clinic filled with Sunflower videos, displays and posters, so that other families and patients can experience the same sense of welcome that I have felt.
An staff member and Sunflower wearer
Clínica Alemana has also shared the experience of Paula Galindo, whom it identified as an Admissions Coordinator and one of its first staff members to wear the Sunflower because she has a non-visible disability.
I voluntarily share that I have a disability and need understanding or more time.
Paula explained that the Sunflower discreetly indicates that she may need support or adjustments, and said that she wears it with pride. She also described the experience as evidence that inclusion enriches both people and the organisation.
Lessons for healthcare organisations introducing the Sunflower
Prepare staff before communicating with patients
Public communications should follow internal understanding, training and the development of clear operational processes.
Adapt the Sunflower rollout to the organisation
Clínica Alemana learned from other organisations but developed a rollout suited to its own scale, shifts, services and patient journeys.
Use a pilot to test the full process
The eight-area pilot tested how information was understood, what supporting resources were needed and how the Sunflower could be made available consistently.
Use staff and patient feedback to improve
The team used feedback to identify gaps and improve the rollout rather than continuing with the original plan unchanged.
Explain how staff should respond
The Sunflower becomes meaningful when staff know how to approach, listen to and respond to the person wearing it.
Next steps for the Sunflower at Clínica Alemana
Clínica Alemana’s next priorities are to continue providing information, guidance and support to everyone who uses the Hidden Disabilities Sunflower, helping to keep this project alive within Clínica Alemana de Santiago.
Introduce the Hidden Disabilities Sunflower in your healthcare organisation
Learn how Sunflower membership, training and official products can support your employees and patients.