In order to improve the personnel safety evacuation efficiency of the hospital outpatient building, a general hospital outpatient building was chosen as the research object and the personnel information was confirmed through field investigation. The evacuation model was set by Pathfinder software and study was conducted from four aspects: plane layout, evacuation door width, staircase design and functional zoning. The results show that a reasonable layout can improve the evacuation efficiency; the use of two-run stairs increases the evacuation efficiency by 11% compared with three-run stairs; the relative optimal evacuation efficiency can be achieved when the width of the evacuation door is consistent with that of the ladder, but it needs to be determined by comprehensive consideration; arranging functional zones according to the characteristics of different groups can effectively reduce the evacuation time. Appropriate architectural design optimization can effectively improve the safety evacuation efficiency of hospital outpatient buildings and reduce disaster risks.