Why is noise so prevalent in healthcare facilities? To simplify, they are places filled with flat, hard surfaces and long hallways. In such an acoustically harsh environment it takes much longer for noise to stop travelling.
Think of a tennis ball. Throw it against a hard surface, and then throw it against a pillow. When the ball hits the hard surface it keeps bouncing around. When it hits a pillow, it drops. Sound behaves in much the same way.
“Hospitals and healthcare buildings pose a significant challenge to acoustic consultants and designers,” says Phil Grimshaw, a director at Australian-owned architectural and building material supplier Atkar.
The company’s products have been incorporated into a number of major recent healthcare projects, including the Victorian Comprehensive Cancer Centre, Alfred Hospital ICU and seminar room, Ballarat Regional Integrated Cancer Centre and University Hospital Geelong.
Healthcare facilities are typically a hive of activity with a multitude of different spaces and a wide range of sensitivity and privacy requirements. While the need for infection control, hygiene and washability generally lends itself to hard surfaces that keep noise bouncing around, this doesn’t always have to be the case.
A study by acoustical engineers at Johns Hopkins University found that “hospital noise levels internationally have grown steadily over the past five decades, disturbing patients and staff members [and] raising the risk of medical errors.”
The researchers found that, since 1960, average daytime hospital sound levels have risen from 57 decibels (dB) to 72 dB – that’s comparable to a vacuum cleaner in use. Average night-time levels have climbed from 42 to 60 dB. Both night and day levels far exceed the World Health Organisation’s recommendation of 35 dB as a top measure in patient rooms. A separate report found that noise during hospital shift changeovers could reach jackhammer levels!
Healthcare facilities are also importantly places for the treatment and recovery of patients, who need plenty of rest and sleep. Ward spaces pose additional challenges since sleeping activities are not restricted to the night time.
Conversely, nursing and care activities are not limited to daytime, meaning noise never sleeps.
Other studies have indicated that excessive noise can slow patient healing and even contribute to stress and burnout among hospital workers. Noise can actually be dangerous, too with recent findings revealing that mentally intensive activities are especially noise-sensitive. Frequent interruptions and distractions from noise can even result in medication errors, one of today’s most challenging issues in healthcare.
Fortunately, there are a wide range of strategies and design solutions that can be applied to manage and mitigate noise.
“Planning for sound management in the design and construction stages of a healthcare facility will always be far more effective and cost efficient than applying retroactive measures,” says Grimshaw, who has provided industry advice on acoustic solutions for over 20 years.
In existing buildings where that’s not possible, employing an acoustic engineer or digital decibel meter can be a good way of assessing existing noise levels. Different types of activities and equipment, from rolling carts to electronic monitors and public address (PA) systems, will combine in different areas and times to form a pattern of noise.
Identifying the areas where it is most critical to adjust noise levels, is often the first step towards doing something about it.
Walls may be the “first line of defence in acoustic design,” as suggested in an article by healthcare specialists at manufacturer Herman Miller, but “the floor and ceiling can do more to collar noise. Together they typically account for 70 to 80 percent of the acoustical properties of a patient room.” Hospitals that replace ‘hard-lid’ ceilings with high-performance acoustic panels “have been able to reduce decibel levels and improve patient sleep without sacrificing cleanliness or infection control.” Acoustic underlay can also be added to floor surfaces to minimise footfall sounds and
that of rolling equipment.
“In addition to ceiling treatments, absorptive wall panels should be installed, on large vertical surfaces and in key reflective locations, such as corridors,” Grimshaw adds. “If necessary, a thin antimicrobial or impervious film can be applied to absorptive materials in order to maintain sterility and washability without significantly affecting performance. There is a perception that acoustic management is at odds with infection control but that doesn’t have to be the case,” he explains.
Evidence of this can be seen in the ceiling system in Melbourne’s Alfred Hospital’s ICU. In collaboration with architects Billard Leece Partnership, Atkar custom designed an acoustic solution to meet the most stringent health regulations around particle contamination in this highly sensitive environment.
So what are the more tangible benefits of these types of acoustics solutions in for healthcare? As healthcare professionals come to take a more holistic view of treatment, recovery and wellbeing, we see an increased emphasis on creating environments that are more pleasant to be in than the aesthetically ‘sterile’ hospital wards we’ve seen traditionally. A great example of this is the Victorian Comprehensive Cancer Centre, where Atkar worked closely with architects STHDI+MCR, to customise a patterned effect on the ceiling of the Welcome Hall, bringing a sense of warmth and cheer to the space.
As these case studies suggest, providing contemporary acoustic solutions in modern healthcare which meet stringent health standards while being aesthetically pleasing, is just another way to care for the wellbeing of patients and staff.