A hospital executive in my home state of Texas was telling me about a fairly minor surgery she had about 18 months ago. One of the things she remembers most about her recovery time at the hospital was how quiet it was. "I work in a hospital, I know how noisy it can be. I thought to myself, what is this hospital doing that we aren't?"
Her question got me thinking about hospital noise and how technology is being used to help reduce it. In this case, she later found out the hospital was using wireless voice-activated communication badges instead of an overhead PA system for the majority of their communications—a tool she later adopted for use at her own hospital.
Hospital noise-level might not be on the forefront of many executives' minds, and generally when I ask about priority lists, keeping decibel levels down doesn't quite make it to the top. But think about this: a team of Mayo Clinic nurses studying hospital noise found that during the morning shift change at Saint Mary's Hospital in Rochester, MN, noise levels reached 113 decibels—that's equal to the noise a jackhammer makes. And this: during a two-year research project, acoustics experts Ilene Busch-Vishniac and James E. West learned that hospital noise is among the top complaints of both patients and hospital staff members. During their studies, the researchers found that over the past four decades, average daytime hospital sound levels around the world have risen from 57 decibels to 72; nighttime levels have increased from 42 decibels to 60. All of these figures exceed the World Health Organization's hospital noise guidelines, which suggest that sound levels in patient rooms should not exceed 35 decibels.
Fast, reliable communication is vital in a hospital setting, and, thanks to technology, hospital workers have a variety of tools available them to facilitate instant communication. Smartphones, pocket-PCs, laptops, tablet-PCs, instant message, e-mail, remote voice and video communication are just a tiny sampling of how technology is being used to communicate faster. But since technology is often blamed for the increase in noise over the last few decades, I'm curious about how it's also being used to communicate quietly.
One of the most common and effective methods I've heard of is replacing the overhead intercom system with wireless communication badges, which can page staff anywhere in the hospital. At the hospital I mentioned above, the staff reported improvements in the quality and ease of communication after they started using the badges and patient satisfaction increased to 93%.
Some hospitals have begun to experiment with technology that is designed to mask sound by actually introducing noise into the environment. Saint Thomas Hospital in Nashville installed such a system after patient satisfaction surveys showed that their lowest score was "noise in and around the room."
Sound masking works by covering a distracting sound with a more soothing or less intrusive sound. A series of speakers installed in the ceiling distributes electronically generated background sound that serves to cover or reduce the impact of noise spikes. The result is that noises and conversations are nearly impossible to hear or comprehend. About four months after installing the soundmasking technology, Saint Thomas' follow-up survey showed a 33% increase in patient satisfaction.
If studies suggesting that a noisy environment slows healing aren't enough to make a hospital quiet down, perhaps being publicly outed will. In March the federal government's Hospital Compare site began posting patient satisfaction scores for individual hospitals. Among the items listed: "Percent of patients who reported that the area around their room was always quiet at night" and "cleanliness and quietness of hospital environment." And then there's the money factor. Medicare and Medicaid reimbursements are now tied to those patient satisfaction surveys because hospitals that fail to report the required quality measures may receive an annual payment update that is reduced by 2%, which could make your patient's sleepless stay an expensive stay.
Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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