Typically, hospitals are spaces characterised by flat, hard surfaces and long hallways. Although these environments are designed to address needs of infection control, hygiene and washability, they’re certainly not primed for gentle acoustics.
This is something that Phil Grimshaw, the director of Australian-owned architectural and building material supplier Atkar, intends to address.
“Hospitals and healthcare buildings pose a significant challenge to acoustic consultants and designers,” says Grimshaw.
This view is supported by a study conducted by acoustical engineers at Johns Hopkins University, which revealed that “hospital noise levels have grown steadily over the past five decades, disturbing patients and staff members [and] raising the risk of medical errors.”
The researchers leading this study found that, since 1960, average daytime hospital sound levels have risen from 57 decibels (dB) to 72 dB. For context, that’s comparable to a vacuum cleaner in use. Not enough that daytime noise levels are far from ideal, average night-time levels have climbed from 42 to 60dB in the same space of time. Both levels far exceed the World Health Organisation (WHO) recommendation of 35dB as a top measure in patient rooms.
A separate report, called ‘Noise Control’ (2004), found that noise during hospital shift changeovers could reach noise levels equal to a jackhammer – this, keeping in mind that healthcare facilities are important places for the treatment and recovery of patients; a process often requiring plenty of rest and sleep. Ward spaces pose additional challenges, since sleeping activities are not restricted to the night-time. Conversely, nursing and care facilities are not limited to daytime, meaning that noise never sleeps.
Other studies indicate that excessive noise can slow patient healing and even contribute to stress and burnout among hospital workers. Noise can actually be dangerous, too, with findings by Jasper Cole (2005) 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.
Grimshaw has been providing advice on acoustic solutions for over 20 years, and Atkar’s products have been incorporated into a number of major healthcare projects. Recent examples include the Victorian Comprehensive Cancer Centre (VCCC), Alfred Hospital Intensive Care Unit (ICU) and seminar room, Ballarat Regional Integrated Cancer Centre, and University Hospital Geelong.
In buildings where sound management isn’t possible in the design or construction phases – for instance, in an existing building – employing an acoustic engineer or digital decibel meter can be a good way of assessing 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.
A hospital’s walls may be the “first line of defence in acoustic design”, suggests an article by healthcare specialists at manufacturing company Herman Miller. “[But] the floor and ceiling can do more to collar noise. Together, they typically account for 70 to 80 per cent 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,” says Grimshaw. “If necessary, a thin, anti-microbial or impervious film can be applied to absorptive materials […] 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.”
The ceiling system in Alfred Hospital’s ICU in Melbourne is proof of this. In collaboration with architectural practice Billard Leece Partnership, Atkar custom-designed an acoustic solution to meet the most stringent health regulations around particle contamination in this highly-sensitive environment.
As professionals working within the industry come to take a more holistic view of treatment, recovery and wellbeing, we are seeing an increased emphasis on creating environments that are more pleasant to be in than the aesthetically ‘sterile’ hospital wards we are used to experiencing. The VCCC is an example of this, for which Atkar worked closely with architects STHDI+MCR to customise a patterned effect on the Welcome Hall ceiling. Relatively simple additions such as these can help bring a sense of warmth and cheer to the space.
As the above case studies suggest, providing contemporary acoustic solutions in modern healthcare that meet stringent health standards while remaining aesthetically pleasing is just another way to care for patients and staff.