Something's missing at Jefferson Regional Medical Center but exactly what isn't immediately obvious.

It's the noise.

In the second year of a full-fledged noise reduction initiative, hallways on patient floors at the hospital in Jefferson Hills are noticeably quieter and conversations more hushed. If the staff's educated hunch is correct, patients may be more relaxed, better rested and maybe even healing faster as a result.

All it took was getting hospital staff to buy into the quiet concept, then getting help from an alternative to overhead pages, a few bulletin boards and buttons, as well as something called the Yacker Tracker that monitors noise levels.

"It's part of the healing process to have quiet, it's important to rest. It's important to the patients," said physician Richard Collins Jr., vice president of medical affairs at Jefferson.

That's not a new concept - even Florence Nightingale recognized a quiet, clean, sunlit room provides a more healing environment, noted Louise Urban, vice president and chief nursing officer at Jefferson. The project started in September 2008, she said, when "we really started to pay attention to the patient's perspective of their care."

But reducing noise is more than just a comfort issue, she maintains. It's also safer.

"In our environment, we want to remove as many distractions as we can so our caregivers don't have as much noise traffic going through their heads."

Dr. Collins agreed. With reduced noise levels, he said patients "can focus on the conversation" when their physician stops by on rounds.

As part of the noise reduction initiative headed by nurse and patient care manager Pat West, patients at Jefferson may notice nurses wearing a big blue button that reads, "Shhh ... Quiet Monitor." That means the nurse has both the responsibility and authority that day to intervene when a squeaky food cart comes down the hall or a conversation gets too boisterous.

"It's easy to forget, especially when you work with an elderly person who has trouble hearing. You get used to being loud," said Carol Schaar, a nurse and designated monitor last Thursday.

The most noticeable difference for toning down the decibels, however, has been the recent installation of a new communication system that's all but replaced the noisy overhead paging common in many health care facilities.

Jefferson is using a system from Knoxville, Tenn.-based PerfectServe that operates like a high-tech switchboard for contacting physicians. Using doctors' call schedules, it puts together an algorithm so that a nurse trying to reach a specific doctor just dials four numbers and a message is transmitted to the physician via phone call, text, email or other means, based on the doctor's instructions.

The system, rather than the staff, tracks down the physician. There are no more multiple pages for a doctor who has already left the hospital, and physicians are no longer left on hold while nursing staff track down who was trying to reach the doctor.

Before installing the system in January, Jefferson Regional averaged 1,400 to 1,500 overhead pages per month, or 45-50 per day, said Dr. Collins.

In February, the hospital had 58 overhead pages the entire month and in March, only 44.

Dr. Collins said fewer pages also means people's ears perk up when one occurs. "Before, paging was part of the ambient noise. Now when there's a page, it means something."

Then there's the Yacker Tracker, a tabletop traffic light that flashes red when things get too noisy. Some might find the device amusing, others annoying, but it's a reminder for everyone.

"It has served its purpose," said Ms. Urban.

While the PerfectServe system has been up and running only a few months, 20 of 23 patients who filled out surveys in March said they were not disturbed by noise during their stay and a few commented that their unit was noticeably quiet. Those who were bothered by noise attributed it to loud visitors, or other patients calling out.

A certain amount of noise is unavoidable, said Dr. Collins, noting that "there's too much going on" to expect a hospital to be quiet all the time.

Intensive care and cardiac care units require machinery that makes noise, and some patients on the general floors need alarms if they're at risk of falling.

"We would rather have a little noise than have people falling out of bed."

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