Fifth Ave Outpatient Clinic Adaptive Re-use

Project Details

Knoxville, Tennessee


Cherokee Health Systems


Renovation/Restoration, Healthcare


Architecture, Interior Design

Team Members



This project is an outpatient clinic for physical and behavioral health housed in an existing pre-engineered metal building. The program includes exam rooms, clinical offices, lab, nurses workroom, and associated support spaces. A future expansion is planned for additional exam rooms.

The Owner and Architect seized an opportunity to dramatically improve a blighted property on Knoxville’s downtown fringe with an outpatient clinic, in service of the area’s low-income and homeless population. A conscious decision was made to salvage as much of the existing building as possible as opposed to depositing it in a landfill, the Project’s first sustainable strategy that would appear to run against recent norms in our City.

In the effort of salvaging much of the existing building, a pre-engineered steel frame on masonry bearing walls with a concrete double-tee floor structure, a significant expenditure was made to bring an inadequate structure up to code; and the remedial costs required that the new design be very clean and simple in nature; simple strategies like extending a clean masonry plane beyond the existing building envelope at the building’s entrance elevation helps to mitigate the “pre-engineered metal building aesthetic.”

Sustainable strategies include: Adaptive re-use of an existing structure; locating exam rooms with vertical, translucent glazing on west façade to provide daylighting while affording privacy and minimizing heat gain; a highly-efficient variable refrigerant flow (VRF) mechanical system; LED and other energy efficient light sources used in conjunction with light sensors and daylighting; efficient low-flow plumbing fixtures; significant additional insulation in the building’s thermal envelope; and a pervious paving system parking lot.

The Owner, always a champion of the “underserved,” was intent on providing a place of dignity and good design for a population of low-income and homeless patients.