Designing Hospitals for Quiet Recovery

Today's healthcare facilities are evaluated not only for their ability to provide cutting-edge medical treatment, but also by how peaceful they can make the environment for patient recoveries. This can be a challenge because, by nature, hospitals are busy places filled with constant activity and noise.

Not surprisingly, noise often tops the list of patient complaints during a hospital stay. Long hallways, alarming medical equipment and flat surfaces make perfect conditions for echo. In fact, some studies have shown that noise levels in hospitals can rise to over 100dbs*. To put that into perspective, that's about the same level of noise as a typical motorcycle. These levels of environmental noise can augment stress, anxiety and aggravation among patients—not to mention caregivers and visitors.

 As a result, more hospitals are seeking ways to reduce noise and, consequently, increase patient satisfaction. As an architect, there are several key design elements you can implement to provide a quieter healing environment— whether you're designing a new healthcare facility or renovating an existing one.

• Paging Systems: Hospitals that commit to reducing use of pagers and PA systems, having low-volume conversation and shutting off equipment when not in use have helped decrease volume levels, according to studies from such facilities as Stanford Hospital and Mayo Clinic. Instead of using the overhead paging system, nurses can be summoned individually with a beeper-like device.

• Structural Systems: Major sources of hospital noise include heating, ventilation and air conditioning systems. 

 According to a 2012 article in Healthcare Construction & Operations (HCO), ventilation ducts should be properly situated and treated to prevent cross-talk between rooms. Additionally, gasketing material or sweeps can be added to doors to contain noise within a room and keep it from traveling.

• Sound-Masking Systems: The HCO article also states that some hospitals provide a more consistent baseline volume level by installing sound-masking systems. Primarily used in commercial offices, this technology helps control noise through a series of loudspeakers, which are installed in a grid-like pattern above the ceiling to control zoning and output. The sound distributed by loudspeakers is continuous and unobtrusive, limiting noise to an appropriate volume. Any noise below the level of the masking sound is also covered up.

• Single Bed Rooms: Studies show that most noise in multi-bed rooms, acute-care and intensive-care units stems from staff talking and caring for other patients, visitors, equipment, rattling bed rails and patient sounds such as coughing or crying out. (Role of the Physical Environment in the Hospital of the 21st Century, The Center for Health Design, 2004.)

• Ceilings and Floors: The ceiling is usually the largest uninterrupted surface in a facility, making absorptive tile a must. Absorptive materials reduce the energy of noise bouncing off their surfaces back into the space. They shorten the time noise lasts and the distance it travels, lowering overall volume and the echo factor. Noise can also be reduced with flooring choices. A Health Facilities Management article (2010) says rubber flooring generally produces the least noise. Vinyl composition tile placed directly on concrete and terrazzo produces more impact noise. Carpet provides the highest level of noise reduction on all flooring types in healthcare settings.

• Door Hardware: Door hardware is another viable, cost-effective solution healthcare facilities can use to limit noise. A number of options can prevent the loud and abrupt "klunk" every time a door is opened or closed:

• Quiet Electric Latch (QEL): Powered by a motor-driven latch retraction, the QEL provides a much quieter solution than traditional exit devices. Because it also requires less power than other electric latch products, it can be wired up to 800 feet when 12 gauge wire is used. This feature is available on all Von Duprin 98/99, 33A/35A, and 94/95 Series exit devices. 

 • Concealed Vertical Cable System (CVC): The Concealed Vertical Cable system from Von Duprin is a quieter solution over traditional surface and concealed rods. Enclosed cables do not lift up or down like traditional rods; they operate quietly within the door. The CVC is available as 98/9949 and 33/3549A Series. 

• Pneumatic Controlled Exit Device: The pneumatic latch retraction solution provides efficient latch retraction using compressed air. It is available on non-electrified panic and fire exit hardware and as an option on all Von Duprin 98/99 and 33A/35A Series exit devices.

• Door Silencers: Ives offers heavy-duty rubber door silencers that easily affix to the door frame, acting as a sound absorber. When the door is closed, the silencer absorbs the force generated from closing the door, making it virtually silent.

Caregivers Also Benefit from Noise Reduction Patients aren't the only ones who benefit from noise-reducing solutions in hospitals. A quieter, more peaceful environment is conducive for caregivers and visitors as well. The noise from pagers, public address systems and medical equipment can be distracting for caregivers, which can slow the work pace or lead to errors. When noise is reduced, caregivers experience greater sensory perception and are better equipped to tend to patients' needs. Likewise, noise also negatively impacts friends and loved ones who are visiting patients. When a noisy environment creates stress for visitors, that feeling can be unintentionally transferred to the patient, which has an effect on healing.

Allegion can help you specify the appropriate hardware throughout in your hospital design to ensure a quieter environment that fits the building's needs and budget