Most hospital executives probably know that one of the most frequent patient complaints relates to noise. For many years, nationwide, HCAHPS “quiet at night” scores have shown that noise in acute healthcare settings impacts patient satisfaction—and, therefore, your organization’s reputation and reimbursements.
More importantly, noise exposure can create or exacerbate patient health issues. Even mild noise levels have been linked to increased levels of stress, increased heart rate, higher blood pressure and poor mental health. These discussions aren’t about excessive sound levels that can damage hearing if they are loud enough, for long enough. Rather, patients respond negatively to typical noise levels often found in acute and ambulatory healthcare facilities, from people (staff/public/patients), medical equipment, carts and internal building systems.
In a noise managed healthcare facility design, we are pursuing the idea of lowering or eliminating noise levels that produce biological effects to the facility occupants that would result in an improved experience and better clinical outcomes. Noise management requires a multidirectional strategy involving the building design, and the operation of the facility.
How can healthcare executives directly help manage noise levels? Ideally, noise reduction starts with the design process at the outset of new construction and renovation projects. As we all know, there are many demands on limited project budgets. Often these project budgets are too strained to provide additional investment in things hidden from view, especially if they are not required by building codes. In the case of acoustical design, codes have been evolving to require more attention to acoustical design with each update, particularly for highly specialized areas like neonatal ICUs.
However, for most areas of acute care and particularly for ambulatory care, the investment above and beyond the requirements may be necessary to meet the exacting standards of patient satisfaction. Your healthcare architect may suggest the following for new construction, remodeling, or an existing structure to help reduce noise:
- Acoustical wall partitions.
- Sound absorptive materials.
- Vibration isolation.
- Quieter building equipment.
- Special exterior building envelope.
Executive leadership can often define or heavily influence the goals and budgets for new and renovation projects within the built healthcare environment. By creating a design goal at the start of a project, championed by the executive team, we can make certain that adequate budget is provided. This goal, set from the top, will help create buy-in from all parties, including the entire design and construction team who are responsible for delivering the project.
The selection of medical equipment and communication technology can also be a big part of the solution, and it may require leadership to help acquire some new tools that are not only quieter to use, but more efficient to the overall operations of the facility. Planning the floor plan layout with a noise management emphasis, can isolate noise sources away from critical areas with reasonable clinical trade-offs kept in balance. This last concept can often require leadership to emphasize the importance of some operational changes that support the goal of building an environment designed to improve patient outcomes by managing noise.
When these leadership strategies are applied to the operations of the facility, particularly when combined with smart design, the overall result is a much quieter and more comfortable facility in which to work, visit and, most importantly, heal. A quiet facility improves both patient and staff experiences and has an overall calming effect by reducing levels of stress. The results can often be measured with improved HCAHPS scores for the “quiet at night” question, though in an ambulatory setting, many of the same benefits apply even without an overnight stay.
By implementing a noise managed design that exceeds the minimum requirements of the code, you are making an investment in your customer experience, the health of the building occupants and in the perception of your facility brand. The American College of Healthcare Architects supports the goal of designing and building noise-managed healthcare facilities. This goal is measurable, achievable and relevant in today’s modern healthcare environment.
Editor’s note: This blog was created in collaboration with the American College of Healthcare Architects.
Clyde “Ted” Moore III, AIA, ACHA, LEED BD+C, is operations manager of architecture for FreemanWhite (a Haskell Company), and secretary treasurer on the Executive Committee for the American College of Healthcare Architects (tmoore@freemanwhite.com).