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Designers go all out to cut noise levels, with vibrating phones, quiet flooring
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Designers of the new Children's Hospital have poured countless hours into something that they hope patients and families won't even notice: the noise, or lack thereof.
From soft wheels on hospital carts to specially insulated walls to nurses' vibrating phones, they hope that the new Children's Hospital will be one of the quietest in the country.
In the current Children's Hospital in Oakland, the level of noise -- and accompanying privacy intrusion -- is a common topic of complaints from parents and staff, said Diane Hupp, vice president and chief nursing officer.
The neonatal and pediatric intensive care units in Oakland, for example, have beds crammed together, separated only with curtains.
And with the loudspeaker as a primary means of communication for paging patients, nurses and doctors, disruptive overhead announcements are constant.
"It's very loud," in the intensive care units, said Ms. Hupp. "It's overwhelming for those families."
Hospital noise not only is annoying, but according to a 2005 Johns Hopkins University study, it can also raise the risk of medical errors and hinder hospital modernization efforts. That study reported that average daytime hospital sound levels have risen from 57 decibels to 72 (equivalent to a loud alarm clock or busy traffic) since 1960, while nighttime levels have increased from 42 decibels to 60 (equivalent to a loud dishwasher or conversation).
Studies linking a quiet environment with improved patient healing and better staff satisfaction also drove the decision to focus on quietness, said Eric Hess, Children's Hospital vice president and project executive.
To damp down the noise levels, Children's Hospital is making changes to numerous current practices -- many of the which involve the nursing staff.
Under the new "silent nurse call" system, which replaces noisy pagers and overhead announcements, the nurses will carry wireless phones set to vibrate. When a patient presses the nurse call button, the signal will go directly to the nurse's phone.
Infrared scanners in each hospital room will track whether the nurses have entered the room to respond to the call. If the designated nurse does not respond within a minute or two, the phones of other nurses will start vibrating until somebody enters the room.
Traditional nursing stations, where large banks of nurses work together, have been replaced by multiple "small care team stations" to eliminate large aggregations of people that might get loud.
And patients and parents waiting to be called for appointments will be given restaurant-style "coaster" beepers that will work -- silently -- anywhere on hospital grounds.
Rather than the crowded intensive care units and semi-private emergency room and in-patient rooms at the Oakland facility, all hospital rooms at the new Children's Hospital will be private, with the exception of a few inpatient rooms designed for siblings.
To minimize interruptions, inpatient rooms have cabinets for food trays and dirty linens that are accessible from both inside the room and the hallway. When patients are finished eating, they can put their food trays in the cabinet; maintenance staff can remove the trays from the hallway without entering the rooms and disturbing the patients.
The rooms also have shutters that the patients can close, but medical personnel can open from outside the room to check on the patient without entering the room.
"We've flipped the dynamic," said Mr. Hess. "This is essentially their hotel room and we're the guests."
The hospital is even considering a pilot program in which the monitors for a patient's vital statistics, such as heart rate and blood pressure, would vibrate instead of beep when the levels get out of the normal range. In such an event, an alarm would still show at a central monitoring system.
Structurally, the hospital also incorporates sound muffling features from floor to ceiling. Environmentally friendly "Marmoleum" floors muffle noise, a double concrete slab separates a penthouse housing mechanical systems from a patient floor, and acoustical ceiling tiles have replaced hard ceilings.
Ms. Hupp views the recently renovated neonatal intensive care unit at Magee-Womens Hospital, which incorporates some of the same features, as a model for the new Children's Hospital as a whole.
"You almost tiptoe and whisper," now at Magee, she said, "because you're afraid to be the person making the noise."
First Published April 26, 2009 12:00 am
