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September 2, 2016

The hospital sound of the future

The sound in a hospital is not the most pleasant sound. The constant beeping of monitors, the gnashing of Qrocs, automatic doors that open continuously, moaning and screaming people. Anyone who has ever slept in a hospital knows that getting asleep is very difficult and people need a good rest to get better.

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A small team of experts – musicians, acoustic experts, scientists and healthcare providers – has dedicated itself to improve the receiving of noise in hospitals. Mainly based on feedback from the patients, the researchers are now working on creating an area less cacophonous and create a harmonious sound.

Portable electronics could send a silent alarm to the nurse when the vitals of a patient changes. Patients would be able to wait in private rooms with light music instead of the TV.

Some hospitals measure more than 100 decibels at night
Hospitals have always been noisy. In 1859, Florence Nightingale wrote a piece about noise and the risk of their patients in her Notes on Nursing. But in the United States the noise is getting worse.

A 2005 study of global hospitals compared the sound of now to the sound in 1960. In 45 years the number of decibels during the day increased from 57 to 72 and at night from 42 to 60 decibels. Noise above 55 decibels can lead to sleep disturbances and increase the risk of heart disease. The World Health Organization recommends to keep the level below 30 decibels. In the survey from 2005, there even were hospitals that exceeded the 100 decibels, a noise as loud as that of a chainsaw.
 
A survey of patients dating from 2008 clearly shows a problem. The survey asked patients to to give a number between 1 and 100 to particular factors of their hospital, from hygiene to communication. Silence got a score of 54, the lowest score of all components.

Smarter design does a lot

At this time, US hospitals are working hard on their design. The merging of a number of factors – parts of the Affordable Care Act where results are rewarded and the position of patients and consumers, combined with the infusion of design-thinking paying attention to the patient in several companies – create services that focus on the patient.

Yoko Kamitani Sen is an electronic musician and founder of Sen Sound, a startup which reviews the sound environment of hospitals. It proposes to introduce wearables to substitute the beebing alarm. For years, people have been talking about the idea that wearables are required in clinical settings, but the annoying beep could well be the straw that gets the wearable actually in the hospital.

The report from 2013 by the Joint Commission, a non-profit healthcare organization, found that 85 to 99% of the sounding alarms required no intervention. In the same year the Boston Medical Center came to the conclusion that there is something like too much alarm, making nursing insensitive to it. The consequences of too much alarm does not only contribute to the annoying sound in hospitals, but can also lead to deaths.

The pain in a voice is the worst

Reducing alarms is a good start, but does not solve everything. In a survey amongst patients and nurses at the John Hopkins a question was what the most annoying sound was. Everyone assumes that the alarm is the most annoying, but the answer that was given most was the voice of someone in pain. Many patients reported that they could hear the moaning and screaming of other patients on the other side of the hall.

There is no technology that can take that away, but by adjusting the design, such as single rooms, it can be reduced. The Josie Robertson Surgery Center, an outpatient clinic of the Memorial Sloan Kettering Cancer Center in New York was opened earlier this year and is completely different from traditional-style hospitals. Patients, family and personnel, for example, get badges, which are linked to a live location system. This allows quieter and more effective communication.

But perhaps just as important, in Josie Robertson hospital patients have their own room, in combination with a tracking system, giving them peace and quiet during treatment.

###Josie Robertson###

There are many adjustments to mention, on which scientists and musicians are working on that could provide more comfort to the clinical environment for both staff and patients. A hospital will never feel like home, but the reduction of noise and common complaints sounds like a beginning.

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