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Centerstone facility integrates behavioral, primary care

October 28, 2014
by Margie Monin Dombrowski
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Editor's note: This article originally ran on sister site Healthcare Design.

Opening its doors on Feb. 4, behavioral health not-for-profit Centerstone of Tennessee celebrated its new 18,090-square-foot outpatient facility on the six-acre Dede Wallace Campus in Nashville, Tenn. With the goal of improving its coordination of care and enhancing patient outcomes, the $6 million facility combines primary and behavioral healthcare services for children, adolescents, and adults—all under one roof.

Centerstone’s goal is to serve the local community with convenient access to a continuum of health services with a fully integrated facility, in partnership with Unity Medical Clinic.

Traditionally, primary care and mental health services are delivered separately, but Centerstone CEO Bob Vero says that integration comes with great benefit. “We want to treat the whole person by coordinating patient care and addressing those critical healthcare gaps that all too often result in premature death,” he says.

The new facility, designed by InForm Smallwood + Nickle LLC (Nashville, Tenn.) and built by Orion Building Corp. (Brentwood, Tenn.), was several years in the making. After the team was chosen in 2007, the programming phase was immediately underway, with InForm collaborating with Centerstone staff on how best to support the operations and workflow, as well as the warm, welcoming patient experience it aspired to achieve.

Redefining behavioral health
Centerstone’s new facility is fully integrated to make physical and behavioral healthcare accessible and approachable. With 37 clinicians’ offices, three exam rooms, a physicians’ workspace, group therapy and play therapy areas, a community room, and staff touchdown space, the focus is on healing both the minds and bodies of its patients.

There’s no physical separation between the behavioral and primary care spaces. Primary care is located in the right wing of the building, but primary care services are provided in behavioral care spaces, as well. For example, clusters of clinicians’ offices are adjacent to an exam room, while group therapy and meeting rooms are interspersed throughout. This type of flow allows a patient to walk from a therapy room for behavioral care right to an exam room for primary care. Likewise, a behavioral care specialist can join a primary care physician during an exam. Additionally, a physician may choose to move a conversation with a patient or patient’s family down the hall to one of the therapy rooms.

Since patients will oftentimes go to their primary care doctor with mental health issues, while other behavioral care patients may not want to discuss their physical health problems with a therapist, the layout strives to remove barriers that might traditionally prevent a patient from seeking either type of treatment and help ensure that needs are addressed.

Another design goal is to decrease any discomfort patients might feel in seeking behavioral care. For example, the facility uses one common reception area. “No one would know whether you’re there to see someone on the behavioral health side or the physical health side,” Vero says.

Finishing touches
Many of the existing buildings Centerstone used for its behavioral health services were dark and institutional in feel. Creating the open and inviting environment the organization was an effort to make patients and visitors more comfortable.

“We spent a lot of time trying to develop a solution that integrated a level of wayfinding that was extremely straightforward to reduce confusion as well as develop a way to bring light into the building so that every office had the opportunity to have natural daylight,” says Brian Smallwood, the InForm partner in charge of the project.

The new layout is easy to navigate with extra-wide corridors in a figure-eight configuration. Making right turns from anywhere in the building will ultimately lead a patient back to the lobby area that’s located at the center of the eight.

And with 17.5-foot-tall ceilings and 4-foot-tall windows on all sides, the building receives plenty of daylighting. All interior offices have clerestory windows to take advantage of the natural light and provide privacy. A palette of warm wood finishes, metal accents, and bright colors throughout add to an overall sense of calm and well-being.

Therapy rooms were designed to put patients at ease and are filled with comfortable furnishings, such as loveseats, oversized chairs, and children’s-sized tables and chairs. To encourage interaction, there are no desks between the patient and therapist. Instead, a portable laptop cart allows the therapist to make notations while engaging in conversation with the patient. “It feels very much like a private practice environment,” Vero says.

Technology as part of the solution
Modern technology brings Centerstone into the 21st century, while also enhancing the patient and visitor experience. When guests first walk into the lobby, they’re greeted by the warm voice of professional actors in a video playing on a flat-screen monitor, explaining what to expect on their visit and the care coordination process.