Ascension Health – Saint Thomas Rutherford Hospital


Murfreesboro, TN


Architecture, Interior Design, MEP Engineering, Structural Engineering, Experiential Design and Wayfinding, Planning

Located in the heart of downtown Murfreesboro, Tennessee, one of the nation’s fastest growing counties, Middle Tennessee Medical Center – renamed Saint Thomas Rutherford Hospital in 2013 – was outdated. Most sections of the original hospital were 30-60 years old and lacked the infrastructure needed to keep up with advancing technologies. The hospital was losing patients and, as a result, credibility within the community. When the City of Murfreesboro began planning a new Gateway Design District to be the retail center for the area, the new replacement hospital was chosen to be the development’s anchor.

Gresham Smith partnered with Ascension Health to create a cutting-edge hospital that met the hospital’s core values – including a focus on patient safety, the patient and family experience and creating a healing environment. The result: a 286-bed, 550,000-square-foot hospital and two medical office buildings that allow caregivers to operate more efficiently and modernize medical care for the Murfreesboro community.

square feet
under budget

An Efficient Layout

Our team spent a lot of time studying circulation patterns in the old facility before designing the new Saint Thomas Rutherford hospital. Our main goal was to keep back-of-house functions out of view. We located the chapel, administrative offices, outpatient diagnostics, imaging, emergency, same-day surgery and waiting rooms off of the main lobby, allowing visitors to easily access each area. We also placed the hospital’s emergency department at the front of the facility instead of at the back.

patient room

Safety Through Standardization

Every patient room is standardized, or same-handed, allowing caregivers to consistently approach patients from the right side of the bed. This configuration allows staff to easily move from floor to floor or room to room without having to reorient themselves. We also incorporated distinct zones in patient rooms for family, patients and caregivers.

chapel exterior
religious statue

Faith-Based Care

Our team’s design supports the organization’s mission of providing faith-based care. The entire hospital is centered around a prominent chapel, which can be seen from a variety of places throughout the facility. The campus’ healing garden includes water features, plants and seating for patients and visitors and is also visible from many patient rooms.


Inspired by the Stones River

Our team was inspired by Murfreesboro’s Stones River and incorporated unique stone elements throughout the hospital. We also used natural light, neutral colors and warm wood tones to create a calm, welcoming environment.

entrance signage

Award-Winning Wayfinding

Our environmental graphics team developed an award-winning, comprehensive campus wayfinding program that revolves around the patient and family experience. The interior sign system is clean and simple and images of well-known local attractions at key decision points on patient floors serve as wayfinding tools. The campus’ exterior sign system blends architectural materials with the hospital’s brand and the modular components mean the system can expand as the campus grows.

exterior at night

Master Planned Medical Office Buildings

As part of Gresham Smith’s long-range master planning effort, two medical office buildings were built on the hospital’s site. The DePaul and Seton Medical Office Buildings complement the architectural essence of the existing campus and connect to the main hospital via a two-level walkway connector. The spaces were designed for maximum flexibility, enabling clinics to interconnect and expand as needed.


Growing with the City

Nearly a decade in, our initial hospital design has proved to be adaptable, providing the flexibility needed to meet the demands of Murfreesboro’s rapid growth. To accommodate the additional patients, the Gresham Smith project team is designing a nearly 90,000-square-foot, three-story addition to the west patient tower. Seventy-two new inpatient beds will provide additional capacity, while adaptable nurse stations will improve workflow and encourage collaboration. The eighth-floor lobby will feature a two-story atrium with floor-to-ceiling windows, flooding the space with natural light and providing a birds-eye view of the surrounding area. Our team is also adding three operating rooms and expanding the hospital’s sterile processing and materials management areas.

Throughout the planning and design phase, Gresham Smith identified process improvements which enable nurses to obtain patient history, initiate treatment and admit patients faster than ever…This project further supports our vision to be our community’s first choice for excellent care. Gordon Ferguson CEO, Saint Thomas Rutherford Hospital