Are today’s hospitals creating an environment that encourages healing and recovery?

A 2012 study from the University of Chicago found average noise levels in hospital rooms easily exceeded the recommended 30 decibels, and peak noise levels sometimes approached the decibel level of a chain saw.¹

That sure doesn’t sound therapeutic to me!

At Voalte, we believe reducing hospital noise can improve the patient experience and positively impact HCAHPS scores. Now, there’s evidence that lowering noise also affects patient outcomes. 

In another study last year, Orfeu M. Buxton, Ph.D., of Harvard Medical School found a correlation between patient health and noise levels, stating that lowering the noise level in hospitals “would decrease patient stays and improve healing, and perhaps even reduce readmission rates.”²

He also found that some noises are more disruptive than others. In particular, patient heart rates jumped consistently due to the sound of electronic alarms and ringing telephones.

This anxiety makes perfect sense to me. Imagine being a patient in an unfamiliar setting, away from home, and facing the unknown regarding your health. You might wonder:

- Why are all these alarms going off? Did someone die? Are they for me?
- Why does the nurse keep leaving my room to talk on the phone? Is she talking to my doctor? Why don’t they want me to hear?
- Why is this machine attached to me beeping? What does it mean? Am I taking a turn for the worse? 

Too often, caregivers and the communication tools they use only add to the cacophony … and the anxiety. Many nurses are given phones as their main tool to communicate with other caregivers, departments and doctors. Yet HIPAA requires they don’t discuss clinical matters in front of a patient, so every phone call causes an interruption as the nurse leaves the patient’s bedside to answer the call. If the nurse is too busy to answer, other noisy strategies such as overhead paging attempt to locate them.

Fortunately, there is a solution. Secure text messaging via smartphone can eliminate up to 70 percent of ringing telephones and nearly all overhead paging. Alarm management tools can integrate disjointed devices and assign levels so all alarms are not treated equally.

As scientific evidence supports the importance of lowering the noise level in hospitals, old attitudes are changing gradually. Maybe what will truly push the urgency of this issue will be the new policies linking hospital reimbursement to patient satisfaction.

<sub>1. Jordan C. Yoder, BSE; Paul G. Staisiunas, BA; David O. Meltzer, MD, PhD; Kristen L. Knutson, PhD; Vineet M. Arora, MD, MAPP, Arch Intern Med. 2012;172(1):68-70. doi:10.1001/archinternmed.2011.603.

2. Orfeu M. Buxton, Ph.D., assistant professor, Harvard Medical School, and associate neuroscientist, division of sleep medicine, department of medicine, Brigham and Women's Hospital, Boston; Gulshan Sharma, M.D., M.P.H., director, Medical Intensive Care Unit, University of Texas Medical Branch at Galveston; June 12, 2012, Annals of Internal Medicine.</sub>

What can we do to reduce noise? There are many attempts to reduce noise in hospitals. Reducing noise should improve the patient experience and improve HCAHP scores. Just as important and a bi-product of noise is patient anxiety! Patients unexpectedly find themselves in a new setting, away from home, facing the unknown in the form of a health condition, unfamiliar with their surroundings or the routine. Activity going on all around them that they do not understand:

 

What are all these alarms for? Did someone die? Are they for me?

Why does the nurse keep leaving my room to talk on the phone? Is it my doctor? Why don't they want me to hear?

They are always getting calls when they are treating me and leaving the room.

Are they understaffed? If I need assistance, will it be available?

That's a new alarm sound! What does it mean? I don't see any nurses anywhere? What is going on?

Why is this machine attached to me beeping? What does it mean? Am I taking a turn for the worst? Should I call my nurse? Where are they?

I wish my doctor would call. I asked the nurse to notify him I'm having a new pain. The nurse says they can't do anything without the doctor's approval. When will they contact him? Why hasn't he got back to them? Can't they call him again?

Why didn't the nurse answer her phone when she was in my room? Maybe it was my doctor?

 

Too often caregivers and the communication tools they are given only add to the anxiety.

Alarms all sounding the same and difficult to differentiate their urgency are heard throughout every hospital unit. Nurses go home exhausted from alarm fatigue. Patients lay in bed awakened at all hours of the day and night with anxiety at what the cacophony of alarms and other noises mean.

Nurses are provided phones as the main tool to communicate with other caregivers, departments, and doctors. Unfortunately HIPAA requires they do not talk of clinical matters in front of a patient. The phone causes numerous interruptions for nurses treating patients requiring they leave the room. If they do not answer the phone alternate strategies of overhead paging, and attempts to find them take over.

 

Today's technology offers many other solutions:

 

Alarm management tools can make sense of the numerous disjointed devices producing the cacophony of alarm noise.

Sophisticated nurse text messaging (similar to what is available on smartphones) can eliminate 78% of ringing telephone calls, almost all overhead paging and the potential for missed patient requests.

 

When looking to reduce noise, consider improving patient anxiety as well. It will more than give you justification and urgency to proceed and result in a better environment for all.