Is noise, or silence, important in healthcare?

The Care Quality Commission 2009 Survey of Patients in NHS Hospitals revealed that patients' experiences had deteriorated or not improved with regard to noise.

• A higher proportion of patients were bothered by noise at night from hospital staff
• There has been no improvement since 2008 in patients being bothered by noise at night from other patients

This is only one aspect of noise (acoustics) in Healthcare. With high background noise levels on wards, alarm signals may be missed, communication can be difficult and the recuperative benefits of sleep may not be fully realised. Whilst the source of the noise may be from staff, patients and medical equipment, it may also come from traffic noise outside or from ventilation systems.

There are often potential problems too with confidentiality in consulting rooms or at reception desks. Poorly designed buildings may have walls or doors that do not provide sufficient privacy and public areas that echo or reverberate.

The issue of noise has attracted high profile media attention. Attention that is only likely to increase with awareness of potential health risks of noise under current research .

So how can the issue of noise and improving the patient's experience be addressed?
The DH Estates Health Technical Memorandum 08-01 sets out acoustic criteria for the design and management of new and existing sites and can be used at various stages during the whole building lifecycle.

There have also been initiatives in the US and in this country such as Shhh (Silent Hospitals Help Healing) to encourage staff to take ownership of the noise levels on their units.

However, a scattergun approach to treating problems is never the most efficient in an era of tight budgets and it is important to focus precious resources on high priority areas that can have the most impact.

Each Trust Estate, Hospital, Health Care Centre or Care Home will have individual needs that should be assessed first. The most appropriate solution may be a staff-led managed approach or this may be ineffective if the building is fundamentally flawed.

In upcoming blog entries, I will look at examples of each of the problems discussed above and suggest some solutions and approaches. I will also look at the concept of acoustic surveys to assess the current conditions in any Estate or building, so that High Priority Areas can be identified and resources targeted.

For more information, please contact Robert Adnitt, e: robert@adnitt.com w: www.adnitt.com
References
1. Supporting Briefing Note: Issues Highlighted By The 2009 Survey Of Patients In NHS Hospitals In England
2. Although there was no significant change between 2008 and 2009 in the proportion of respondents saying that they were bothered by noise at night from other patients, this has increased steadily, from 37% in 2005 when the question was first asked to 40% in 2009. Around a fifth of respondents (21%) said that they were bothered by noise at night from hospital staff, a significant increase of less than one percentage point from 2008. This figure has been increasing steadily since 2005 when it was 18%.
3. Hospital wards break world health 'noise limits' - http://news.bbc.co.uk/1/hi/health/8387836.stm
4. http://www.euro.who.int/en/what-we-do/health-topics/environmental-health/noise