Tag Archive: hospital noise

Hospital noise still a problem? What’s being done?

This photo has been released into the public domain by its author, Tomasz Sienicki

by David M. Sykes, Vice Chair, The Quiet Coalition

This news story asserts that noise in hospitals is steadily increasing. In fact, the trend is actually the other way: for over a decade now, hospitals have been struggling to get this problem under control. And the Affordable Care Act is helping.

How? ACA includes something called the HCAHPS—patient-centered care survey that hospitals are required to send out to every patient within a few days of a hospital stay, and results of this survey are available to the public. The HCAHPS survey is a short one, about 20 questions, including one called the “noise-at-night question” that asks former patients whether their room quiet at night.

Guess what? That question gets the WORST response every time! That’s been an eye-opener for the people who run hospitals–their boards of directors–because before ACA and HCAHPS nobody really cared what patients thought. Now hospitals’ federal reimbursements are linked to their HCAHPS scores. So a big wake-up call went down from hospital board rooms to the clinical staffs—“fix the noise problems, we can’t afford negative patient reviews because they reduce our hospital’s profit margins!”

But what can they do to fix the noise problems? Lots. I’m proud to say that I lead a U.S. national group that has been working on the hospital noise problem since 2005–that’s 15 years–called the Healthcare Acoustics Project, an independent, all-volunteer community of professionals that develops national and international codes and standards for the health care industry. HAP published the first “comprehensive national criteria for noise control in American hospitals and healthcare facilities” in 2010, and we’ve been steadily improving those criteria ever since. Now they’re embedded in the building codes in most of the U.S. and administered by each state’s building code authorities.

So next time you or a loved one is hospitalized, take a close look and a careful listen to noise and privacy levels in their sleeping quarters. If it’s noisy, COMPLAIN LOUDLY and mention that you know about the HCAHPS survey.

We’re pretty certain you’ll get a response pretty quickly. Because patients now have an effective voice thanks to the patient-centered care movement!

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Healthcare Acoustics Project (HAP, a division of Quiet Communities Inc.), American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association and the American Institute of Architects. He is lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA publication “Sound Matters,” and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Hospital noise is bad for health

by Arline L. Bronzaft, Ph.D., Board of Directors, GrowNYC, and Co-founder, The Quiet Coalition

In a 2017 presentation, referring to an earlier paper I had written with Rita Wynne Herzig in 1999, I noted that hospital noise was a serious problem for patients and staff and that not enough has been done to reduce sound levels in hospitals. Suggestions to lessen hospital sounds included better design and quieter equipment.

A recent article, “Noise Pollution in Hospitals,” underscores the fact that noise still remains a hazard for hospital patients and staff. The authors of a study linking sleep loss to increased feelings of pain would agree, as they use their findings to call for lower sound levels in hospitals. In fact, they suggested the distribution of earplugs to patients to lessen the sounds and improve their sleep. But researchers who have studied the impacts of noise on health for many years know that it is best to reduce noise at the source. Some ways to reduce hospital noise can be found at Dr. Susan E. Mazer’s blog.

Dr. Arline Bronzaft is a researcher, writer, and consultant on the adverse effects of noise on mental and physical health. She is co-author of “Why Noise Matters,” author of “Listen to the Raindrops” (children’s book illustrated by Steven Parton), and has written extensively about noise in books, encyclopedias, academic journals, and the popular press.  In addition, she is a Professor Emerita of the City University of New York and Board member of GrowNYC.

Hospitals can be made quieter

by Daniel Fink, MD, Chair, The Quiet Coalition

This BBC report informs us that hospitals can become quieter. Anyone who has been in a hospital–and I have spent decades working in them–knows that despite signs encouraging quiet, they have become noisier. And studies document that, too.

But with a little effort, they can be made quieter.

Most people aren’t aware of major efforts–coordinated over the last several years and involving specialty societies and expert groups setting goals and developing standards to be implemented by hospitals, health care professionals, emergency services responders, and an informed public–that have dramatically improved medical care and patient outcomes for serious medical problems. When someone calls 911 to report a heart attack or stroke, an entire team is mobilized to treat the patient with clot-busting drugs as quickly as possible, ideally within only 60 minutes of the event. These “Code White”, “Code Stroke”, or “Stroke Attack” programs mean that the patient usually walks out of the hospital not only alive but with minimal or even no residual effects from the heart attack or stroke.

If the health care system can organize itself to treat these serious medical problems so quickly that the patients recover without harm, it should be able to work towards making hospitals and other health care facilities quieter. This isn’t rocket science. It’s basic acoustic engineering.

Members of The Quiet Coalition also serve on committees for the Facilities Guidance Institute, which sets standards for health care facilities. There are guidelines and standards for noise levels. The next edition of the guidelines, set to be published in 2022, will address the noise issue more vigorously.

Dr. Daniel Fink is a leading noise activist based in the Los Angeles area. He is the founding chair of The Quiet Coalition, an organization of science, health, and legal professionals concerned about the impacts of noise on health, environment, learning, productivity, and quality of life in America. Dr Fink also is the interim chair of Quiet Communities’ Health Advisory Council, and he served on the board of the American Tinnitus Association from 2015-2018.

Alarming: No end to hospital noise

by David M. Sykes, Vice Chair, The Quiet Coalition

Three years ago, the voluntary hospital accreditation body in the U.S. known as The Joint Commission issued a “National Patient Safety Goal” about the problem of “alarm fatigue” in American hospitals.  When the Joint Commission speaks, hospitals usually listen because their ability to participate in the Medicare program depends on the Commission’s approval. So what’s happened?

In a word: nothing. Last week, in a paper presented at the Acoustical Society of America meeting in New Orleans, the distinguished researcher and former ASA president Ilene Busch-Vishniac spoke about this continuing failure to address patient safety in hospitals.

What’s alarming about this situation is that 11 years ago Dr. Busch-Vishniac, when she was Dean of Johns Hopkins’ School of Engineering, published a nationally recognized paper on this very problem, a paper that has become a classic in her own field. Furthermore, in 2011 she was recognized for this work and invited by the Food and Drug Administration, the Joint Commission, and the Association for the Advancement of Medical Instrumentation to speak to national leaders of the healthcare profession about this problem at the first national meeting convened to focus on the problem of “alarm fatigue.” Thereafter Dr. Busch-Vishniac has continue to write and speak about the subject, for instance in this piece last year.

Noise in hospitals—of which “alarm fatigue” is the most egregious example—is a problem precisely because it endangers the health and even the survival of the thousands of people whose health is already severely compromised (they are hospitalized, after all). It’s critically important.

What this deplorable situation illuminates is the long-standing refusal of federal, state and local agencies in America to recognize that noise is, as one prominent medical authority stated, “much more than a nuisance.” Indeed, it is a serious public health problem. Why can’t the most “at risk” population in America—people hospitalized for their illnesses—have access to the peace and quiet they need to recover? If you are bothered by noise—from aircraft, or from motorcycles, or from leaf blowers or from any other source—keep in mind that you are not alone: even the sickest among us who are being treated in hospitals cannot escape the din.

Nobody is listening—yet—despite the evidence. In the meantime, we congratulate courageous and stubborn researchers like Dr. Busch-Vishniac who continue to push for change.  We need you, Dr. Busch-Vishniac. The money to fund research is hard to come by, but please don’t give up!

In addition to serving as vice chair of the The Quiet Coalition, David Sykes chairs several professional organizations in acoustical science: The Acoustics Research Council, American National Standards Institute Committee S12, Workgroup 44, The Rothschild Foundation Task Force on Acoustics, and the FGI Acoustics Working Group—a partner of the American Hospital Association. He is the lead author of “Sound & Vibration 2.0 (2012, Springer-Verlag), a contributor to the National Academy of Engineering report “Technology for a Quieter America,” and to the US-GSA guidance “Sound Matters”, and co-founded the Laboratory for Advanced Research in Acoustics (LARA) at Rensselaer Polytechnic Institute. He recently retired from the board of directors of the American Tinnitus Association. A graduate of the University of California/Berkeley with graduate degrees from Cornell University, he is a frequent organizer of and speaker at professional conferences in the U.S., Europe, Asia, and the Middle East.

Progress Made Against Hospital Noise

By The Quiet Coalition

Some people care most about airport noise. Others focus on noise in schools or restaurants or stadiums. But one group of about 500 professionals has spent twelve years reducing noise in America’s hospitals and healthcare facilities.

Of course, airport noise is a public health problem—especially for people living near America’s 5,194 airports–but noise is a serious public health problem indoors too. This is particularly so for people whose health is compromised, i.e., the millions of patients in America’s 62,414 hospitals and healthcare facilities, not to mention the quarter-million medical and support staff who work there amid the din.

Healthcare facilities are oftentimes the noisiest, most sleep-deprived places you will find anywhere. Have you tried sleeping in an older-style hospital recently? Furthermore, the noise problem has escalated steadily for decades thanks to the burgeoning use of new technologies such as alarmed medical devices.

Fortunately, a group of about 500 professionals known as the FGI Acoustics Working Group has been working continuously for twelve years to address noise in healthcare facilities. So this story contains good news.

The group published it’s first comprehensive noise control criteria in 2010, which were quickly adopted by most states. To hear the difference, visit just about any recently constructed hospital and compare it to an older hospital.  The group’s criteria have now been “exported” to eighty-seven other countries that struggle with the same indoor noise problems (this was accomplished through partnerships with the International Code Council, the US Green Building Council’s LEED for Health Care initiative, and other groups).

But this group’s crusade against noise is not over. This November 2017, they and their hosts will publish more detailed and updated noise control criteria in three separate volumes, one covering America’s 5,564 hospitals, one for the country’s 25,750 healthcare clinics, and another one for it’s 31,100 residential care facilities. If you’re interested you can see their latest work here, FGI Bulletin #2, and here in their first edition (published in 2012).

The Quiet Coalition is proud that its chair, vice chair, and another TQC co-founder are both involved in leading this important work. According to our vice chair, David Sykes, “this decade-long work shows that a broad coalition of interested professionals–in this case, consisting of doctors, nurses, patients and families, public health advocates, hospital administrators, researchers, regulatory agency personnel, lawyers, planners, architects, engineers, designers, and contractors–can achieve meaningful, national progress toward ending the long-ignored public health problem of noise by taking a focused approach and addressing the needs of people who are particularly vulnerable.”

Originally posted at The Quiet Coalition.

Is It Safe to Turn Down the Volume of Hospital Alarms?

New Study Chimes In: “Yes.” If you have ever spent any time in a hospital, whether as a visitor or especially as a patient, you probably wondered how the patients sleep with the constant din caused by monitors, particularly the alarms. The answer, apparently, is “they can’t.” While some sort of alarm is needed to alert staff when a patient is having a crisis, Anesthesiology News reports that “[t]he overabundance and high volume of hospital alarms can have deleterious effects on patients and providers, impairing clinician performance and possibly compromising patient safety (citation omitted).” The good news? The study’s author found that “clinician performance is maintained with alarms that are softer than background noise.”

Coming soon to a hospital near you: A good night’s rest!

 

It looks like people are finally considering the effect of noise on hospital patients

Intensive care patients plagued by excessive noise, finds research.

As this article on a study by staff in a Belgian intensive care unit (ICU) highlights, the noise levels in ICUs far exceeds World Health Organization guidelines for hospitals.  While the article mentions “subjective feeling of noise pollution experienced by patients, nurses and doctors,” it fails to address more immediate problem with noisy ICUs, namely the interference with sleep and the effects of sleep deprivation on patients–patients who are in an ICU and clearly need rest to recover from a significant health event.  One hopes that recognition of the problem will result in better study and more remedies for this problem than the “practical solution” offered by an ICU doctor, i.e., providing “earplugs or other ear defender devices” to patients.