SOUND IN HEALTHCARE ENVIRONMENTS
responses. Long corridors designed only with sound-reflective surfaces will carry sound over longer distances. From an acoustic perspective,
An acoustic ceiling helps calm the sound environment.
to hospital within a three-month period following their initial stay. In addition, they recorded a more positive perception of their time in hospital. Patients hopefully have a short hospital
stay, but of course staff are exposed to this noise on a daily basis. Members of staff often rely on clear verbal communication in their work. A sub-optimal acoustic environment affects concentration, and increases the risk of miscommunication and errors, as well as contributing to unnecessarily high stress levels, irritation, tiredness, and fatigue. Long-term this has an impact on a person’s health and wellbeing. Furthermore, the Huddinge University Hospital research also showed that not only did patients perceive staff attitude as better during the period with good room acoustics, but the staff also felt better about their role.
Improving room acoustics in healthcare There are many ways to improve acoustics in hospitals to help achieve a calmer, more restful, environment. Identifying the sources of noise and potential challenges is a good starting point:
Equipment noise Equipment – ranging from food trolleys and bed mechanisms, to monitors and alarms – is one of the main sources of noise in hospitals and other healthcare facilities. Alarms are purposefully noisy – they are designed to jolt us into taking action, and are thus designed to activate areas of the brain that recognise danger. Elements to consider to help may include increasing the distance between noisy equipment and the patient, and whether procedures or timing of events could be changed to be less impactful on patients’ sleep. There are now alarms available that can be remotely monitored, or worn by medical staff, so that they alert the staff member, rather than adding stress to the patient. Some alarms can now be
70 Health Estate Journal January 2023
personalised to an individual’s baseline levels rather than an arbitrary one, and this has been shown to decrease the quantity of alarms that are activated. An option trialled in the US is for a ‘round’ that included an equipment check to decrease the number of alarms that go off due to malfunction, a need for battery replacement, or because medication has run out, thereby treating the potential cause before the alarm sounds, and helping to prevent ‘alarm fatigue’.
Voice noise Overhearing conversations, and patients being in pain or delirious, are examples of vocal noise that can be discomfiting. This noise, alongside the sound of people snoring, is one of the less pleasant memories that many people are left with after being in hospital. Sometimes people are not aware of the sound environment or the impact of their contribution to it – especially visitors to a ward. Signs are available that advise people
that they are entering a quiet area to help encourage quieter behaviour. Visual monitors are also available with a ‘traffic light’ system that shows green when noise levels are within the desired range, amber when increasing, and red when too high. These levels are adjustable to suit the environment and needs of staff and patients. The use of suitable, movable sound-absorbent screens between patients could help limit noise travelling through a ward.
Room design and finishes Our hearing has evolved so that it works best outdoors in the natural world. The objective of good room acoustic design in healthcare is thus to try to imitate nature’s acoustic environment inside hospitals. In the natural world we seldom find the straight, parallel, smooth, hard surfaces we find in hospitals. These reflect sound waves across a space, increasing reverberation, and producing disturbing
irregular spatial design is preferable where possible. An area where this can be used is in Reception. Irregular or convex-shaped reception desks could help, as these distribute sound waves in different directions. If appropriate, sound- absorbent cleanable wall panels may be used to absorb noise around a nurses’ station, and within corridors, waiting areas, and consulting rooms, reducing the reverberation and overall noise level within the space. When printed, these also provide artwork, which can have a positive impact. However, generally it is the ceiling that is used to provide sound absorption, as it is a large, and often relatively uninterrupted, space. Many acoustically absorbent suspended ceiling systems are available that fulfill aesthetic, acoustic, and cleaning and infection control criteria, thus making them eminently suitable for use in healthcare.
A ‘cruel absence of care’ Florence Nightingale wrote in her notes on nursing in 1859 that ‘unnecessary noise is the most cruel absence of care which can be inflicted upon either the sick or well’. So today, over 160 years later, when noise is still a challenge, but solutions are available, we should be advocating good room acoustics in all healthcare spaces.
Andrea Harman
Andrea Harman is the Concept developer for Healthcare for the UK and Ireland for Saint-Gobain Ecophon. Having worked in room acoustics for over 25 years, she is active in developing the link between sound environments and wellbeing, and investigating how the acoustic feel of a space can affect performance, interaction, social inclusion, and patient recovery. Her aim is to use and share this information to help create better, less stressful, more ‘enabling’ spaces and experiences for everyone.
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