The role of acoustics in healthcare design has been well documented, in particular, the detrimental effects of noise in healing environments. Excess noise can raise heart rate and blood pressure, increase pain after surgery, slow the healing process, and lengthen hospital stay. As architects and designers of healthcare facilities we can help mitigate the role of noise using specific acoustic principles and technology.
It also bears mentioning that a noisy healthcare environment negatively affects staff. Studies have found that excessive noise can reduce employee productivity and efficiency.
With so much at stake, architects are tasked with finding or creating solutions that mitigate noise.
Special Care Nursery, The Ottawa Hospital
This past year, we were retained by The Ottawa Hospital (TOH) to review the General Site, Special Care Nursery; and the Civic Site, Special Care Nursery. Our review found that preemies and newborns were exposed to excessive noise and light due to lack of noise-control separations in the large rooms where the babies were cared for. Additionally, the rooms had no acoustically attenuating materials or individual lighting controls.
To correct this we designed a new Special Care Nursery at the Civic Site, with specialized materials, technological devices and areas that would improve acoustic management.
Physical boundaries act as the first line of defence when it comes to noise pollution. Acoustic management of ceilings, floors and walls relies on the meticulous selection of sound-absorbing materials. They should fit a space’s function, absorb noise and bounce back the right sounds. For neonates with extremely sensitive ears, background noise is the primary issue.
For TOH we selected highly noise-absorbent ceiling tiles, resilient flooring and acoustic wall panels. These soft surfaces are effective at absorbing high frequency tones, like those of alerts and alarms on monitoring equipment.
Part of the solution to the noise problem relies on the healthcare staff and visitors to the unit. They needed to be cognizant of noise levels, the necessity of conversation and whether they could take calls elsewhere. To help staff and family members be more aware of the decibel level in the unit a device called SoundEar was installed.
Initially staff were concerned that the SoundEar was making audio recordings of their conversation, but what the device actually does is monitor decibel levels. It acts as a visual barometer for those in the area and lights up depending on whether the level of noise is acceptable. If the decibel level is in the range of what’s accepted, the ear stays green, if it starts to get nosier it turns yellow and if it’s above what is tolerable, it turns red. Based on a study the hospital did on internal noise levels, it deemed a decibel level of 45 (equivalent to the sound of rustling leaves) or less to be acceptable within the NICU.
Following a review of the data collected by the SoundEar the NICU noted that the ambient decibels levels lowered by 10.
Single Occupancy Rooms
It’s important to design an optimal healing environment for the especially ill babies. Creating individuals rooms for preemies and their families enhances privacy, and minimizes interruptions due to traffic in and out of the room. It also eliminates bleed-through noise from another (or multiple) occupant/s.
An added benefit in this design and the trend away from multiple-patient rooms is that infection is more easily controlled. Again, this is important to neonates and other infants whose immune systems may be compromised.
Satellite Nursing Stations
As the hub of activity on a floor or in a unit, the nursing station is typically the source of noise in the form of conversation. Here, to allow nurses to work more closely with patients, multiple satellite stations were incorporated. These smaller stations are staffed by fewer nurses and have helped to reduce the number of conversations and noise levels.
For more information on The Ottawa Hospital project and Special Care Nursery, opening this year, please listen to this CBC White Coat, Black Art podcast: http://podcast.cbc.ca/mp3/podcasts/whitecoat_20161111_90970.mp3 (beginning at 13:20)