Keeping Track of the Industry’s Vital Signs
edited by Anne DiNardo
Home Base embraces an open, flexible office model for its new clinic that delivers outpatient mental healthcare and support services to veterans and their families
Founded in 2009, Home Base, a Red Sox Foundation and Massachusetts General Hospital program, is dedicated to healing invisible wounds such as traumatic brain injury and post-traumatic stress for U.S. veterans, service members, and their families through clinical care, wellness, education, and research. The organization experienced steady growth over the years, resulting in clinical operations and administrative functions split across multiple sites. Then in 2016, it launched an Intensive Clinical Program (ICP), which treats teams of veterans within a group dynamic over a two-week period, further stressing Home Base’s operations and space capacity.
Looking to consolidate its services into one expanded facility, Home Base partnered with Margulies Perruzzi (Boston), which designed Home Base’s first facility, to work on early programming. Using a standard behavioral health planning model of one caregiver per office, the original plan resulted in a 40,000-square foot facility, with more than 60 percent of the space specified as enclosed private offices for counseling services. The dense layout included a labyrinth of corridors and offered little access to natural light.
Looking for a more innovative solution, Home Base decided to rethink its approach—both to its operations and building layout—by studying its staff occupancy rates, patient flow, and conference room usage. Among the findings were that most clinicians utilized their private offices only 30 percent of the time, while the rest of the time those vacant offices were unusable to others. Additionally, Home Base’s highly collaborative clinical model meant most clinician time is spent meeting with larger patient groups or families in conference rooms. The organization concluded that by reducing the number of offices, it could create more flexible, patient-focused treatment spaces that support both patients and staff. Construction began in March 2018, and Home Base Veteran and Family Care Center in Charlestown, Mass., opened in September 2018.
Within the new facility, staff work in an open, shared workspace populated with benched workstations, casual break-out areas, and small enclosed work settings, while therapy rooms are now unassigned consult spaces that clinicians can book online. The new layout also right-sized the number of enclosed private consult rooms necessary for patients and increased the number of meeting and group therapy spaces to accommodate Home Base’s ICP offerings, with 20 individual therapy rooms, three large group therapy rooms, and a patient/family lounge. As a result, Home Base decreased its space needs to 26,000 square feet—a net savings of 35 percent, which the staff agreed would be used to add non-traditional treatment spaces for integrative services, including fitness, yoga, and art/music therapies and a demonstration kitchen.
One request from staff was that every room should include as much glass as possible to maximize access to natural light. However, designers also needed to ensure that the spaces for individual or group counseling protected the acoustical and visual privacy of patients. Mock-ups of patient consult rooms were constructed to establish the most effective level of visual and acoustical barriers, with all patient-oriented treatments spaces being outfitted with motorized blinds and adjustable sound-masking.
“For veterans and their family members walking into our new facility, the space truly represents hope and honors their service,” says Michael Allard, chief operating officer for Home Base. “The center reminds me every day that Home Base has one of the noblest missions that we have been afforded the privilege to work on. The space enables all of that, and it’s truly remarkable.”—Jason B. Costello, partner and associate principal, leader of healthcare studio, and Joe Flynn, senior associate and workplace strategist, Margulies Perruzzi (Boston)