Hospitals & Healthcare

The High Cost of Noise in a Hospital on the Patients and Staff

When we think of where we would like to rest and recuperate from illness or medical treatment, most of us visualize places that are quiet and peaceful. This is a stark contrast to the typical hospital where sounds of beepers, alarms, machines, telephones and people's voices are more of the "normal environment".

Noise is one of the biggest complaints of patients and staff.  Hospitals provide year round, round the clock residential & sleeping accommodations for patients, but in today's high tech environment of health care, there is noise everywhere and patients are paying a price. Hospitals are also paying the price because of lower HCAHPS scores as well as higher stress levels for the staff.

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients' perspectives of hospital care. HCAHPS (pronounced "H-caps"), also known as the CAHPS Hospital Survey, is a survey instrument and data collection methodology for measuring patients' perceptions of their hospital experience. While many hospitals have collected information on patient satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and publicly reporting information about patient experience of care that allowed valid comparisons to be made across hospitals locally, regionally and nationally.

All this noise needs to be managed.

The noise that the equipment and mechanical systems makes, along with the noise of the hustle & bustle of a busy hospital has a serious impact on patients & the staff alike. To name only a few problems that patients in poorly acoustically designed healthcare facilities experience, are:

  • Elevated blood pressure levels
  • Sleep disruption
  • Decreased oxygen saturation
  • Decreased rates of wound healing
  • And higher incidences of re-hospitalization
  • Neonatal intensive care patients have increased heart & respiration rates.

Remember, this is supposed to be a HEALING environment. 

Noise not only affects the patients, it affects the staff as well!

Research is showing that a noisy environment causes emotional exhaustion & burnout among critical care nurses and noise is strongly related to increased stress & annoyance among nurses in general.

Healthcare providers polled also showed a lower job satisfaction rate in noisy environments than in quieter ones.

Interesting enough, patients in noisy hospitals were less satisfied with the level of care they received than in quieter ones.

Research shows that a healthcare worker who is working in a noisy environment will have to concentrate harder & exert more effort to be able to perform their function properly, which leads to them being more fatigued.

Trying to work with so much noise going on obviously opens the door to increased errors.

Why is noise so prevalent in healthcare facilities? It's a place of hard surfaces. In the world of hard surfaces it takes much longer for the noise to stop bouncing around. Think of a tennis ball. Throw it against a hard surface, and then throw it against a pillow. When the ball hits a hard surface it keeps bouncing around. When it hits a pillow, it drops. That's what happens to noise.
When the absorption of all that noise is not accounted for when the building is being designed, then working in it or being a patient in it can be very hard on the body.

Hospital Noise Studies

A hospital in India did a study of the effects of noise in the operating room. Not low frequency noise, but the more typical high frequency noise. This is the only study of it's kind. They wanted to test 2 cognitive functions: mental efficiency & short term memory.

In 5 separate operating suites, they made professional grade recordings of noise that was generated during surgical procedures.

The noise levels were measured over 3 to 5 hours and it recorded the noise made by surgical instruments, suction apparatus, monitors & alarms and the ambient noises of doctors nurses & other operating room staff.

The microphones were placed 10 inches from the anesthesiologist's ears. The average noise level turned out to be slightly over 77 decibels, which is considerably louder than an alarm clock at 2 feet.

The results of the study showed that the anesthesiologists who were exposed to this level of noise for prolonged periods of time were less efficient & had decreased short term memory.

Much of the anesthesiologist's job involves obtaining information from various sources. Verifying the validity of the information, formulating priorities and taking prompt & immediate action based on the information obtained.

The conclusion of the study was "the administration of anesthesia is a task where even momentary inefficiency can result in serious consequences to the patient. Hence, operating room noise should be reduced."

In 5 published studies over the last 45 years, not 1 study reported noise levels that complied with the World Health Organization guidelines for hospital noise levels.

However, hospital noise levels have been rising consistently since the 1960s. The background noise levels rose from 57 decibels during daytime hours in 1960 to 72 decibels today, and from 42 decibels during nighttime hours in 1960 to 60 decibels today. Many studies indicate that peak hospital noise levels often exceed 85 to 90 decibels.

It is not surprising that high noise levels in hospitals have serious implications for staff & patient health & well being.

Think of the surgery and testing sections of the hospital. Scanning & optical microscopes, MRI machines, CAT scanners, laser devices, and other sensitive equipment can be badly compromised by the low frequency rumble from HVAC systems & by vibration. Sensitive equipment can be affected by vibrations that humans cannot feel. In fact, these are at levels of vibration 1 to 3 orders of magnitude below what a human tactile sense can detect.

MRI equipment, for example, can give what are called "Ghost Images" if they are not properly acoustically isolated from vibration.

And, not only does low frequency noise affect the equipment, it affects the people using them as well.

Cornell University did a study on low frequency noise and they found that prolonged exposure to low frequency noise, such as the low rumble of HVAC equipment could :

  • Raises a person's blood pressure level
  • Makes them feel more stressed
  • Causes headaches
  • And Respiratory ailments

What Can Be Done?

If the project is still in the design phase, AcoustiControl can make recommendations to make sure there are no noise or vibration issues down the road. If it is after the project has been completed and there are noise or vibration issues, we can help  solve them.

There's good news...

Those hospitals that have addressed the noise problem successfully by looking equipment and making acoustical modifications to their facilities have improved patient satisfaction.

At Northside Hospital in Atlanta Georgia, a committee of employees from throughout the hospital ( even accounting) studied ways to reduce noise. In 2 years, the committee was able to drop the decibel level by as much as 40% in some hospital areas.
At other hospitals that took steps to reduce noise levels, patients were more satisfied with their care, slept better, had lower blood pressure and were less likely to be re hospitalized. Also, the staff felt better about their jobs and they also reported improved sleep quality.

Poor acoustics have dramatic consequences in healthcare environments, and using the services of AcoustiControl when designing them will help ensure that the facility will perform the purpose for which they have been designed.