I wasn't sure exactly what to expect as our HEALTHCARE DESIGN.11 facility tour bus drove up to Vanderbilt Health's One Hundred Oaks Outpatient Clinic Mall. Sandwiched between a TJ Maxx and a K&G Men's Store, One Hundred Oaks was the first closed indoor shopping mall in Nashville, originally built in 1968. By 2005, the mall was dead in the water, another casualty of suburban flight.

At the same time, just 4 miles away, Vanderbilt Health was growing and quickly running out of space on campus to expand services. Vanderbilt and architect Gresham, Smith and Partners repurposed the 880,000-square-foot mall into a 450,000-square-foot medical center (only 300,00 of which is currently being used), home to 22 specialty clinics (as well as pharmacy, imaging, and a lab) housed in a LEED-certified building--no mean feat considering that the infrastructure was built 40 years ago as a retail space. The budget? A mere 30 million for construction.

Architecturally, the space still shares many characteristics with a shopping mall: strolling its 800-foot circulation spine, one passes clinics just as if they were mall shops. After check-in, patients can grab a pager and go next door to shop while wating for their appointments. And of course it isn't often you see a medical center where the main corridor has 20-foot ceilings. Finishes and furnishings were kept as simple as possible to allow for that low budget number, but the effect is a unified look rather than cheapness. Skylights were added, and valet parking is an option.

Completed in late 2008 and opened in early 2009, the project has been embraced by the community, as well. A truly unique recycling project.