by Alexis Kurtz LEEP AP, Project Consultant / Acoustical Consultant, The Sextant Group

Numerous studies confirm that high noise levels in a healthcare setting can have negative implications on patients, staff and visitors. Noise causes sleep disturbances, which in turn have been shown to cause increases in blood pressure and heart rate for patients, as well as have adverse impact on stress levels, pain, inflammation and weight gain. Noise can also inhibit caregivers from being able to hear monitoring machinery alerts, and could mask audible cues from the patient. Over time, policies regarding noise in healthcare settings have begun to creep into federal regulations and guidelines, but only recently have the fines associated with non-compliance become harsh enough to make compliance monetarily significant.

The Health Insurance Portability and Accountability Act (HIPAA) was initially enacted in 1996. Along with establishing national standards for electronic health care transactions, it protects the patient’s right to privacy, including the right to have private conversations regarding their care. Since then, violations penalties have been increased, and the cap for a calendar year was raised from $25,000 to $1,500,000, making it worth the time and effort to conform to these standards.

The Facilities Guidelines Institute’s (FGI) 2010 release of the Guidelines for the Design and Construction of Health Care Facilities included a section dedicated to the acoustic design of healthcare facilities, which has since been adopted as code by 13 states plus the District of Columbia, while another 5 states are using the 2010 edition for reference during their state code rewrite. These guidelines set out requirements for sound isolation and background noise levels for different areas within a healthcare building, and provided design teams with recommendations for sound absorption criteria and mitigating site noise issues.

The FGI Guidelines document was the basis of the two available points for acoustic design in the 2010 release of LEED for Healthcare, the intent of the credit being to “Provide building occupants with an indoor healing environment free of intrusive or disruptive levels of sound.”

Although much of the news today revolves around the accessibility and affordability of healthcare, one of the provisions of the Affordable Care Act is the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Patient satisfaction will have positive or negative impact on the financial compensation the healthcare facility receives from Medicare and Medicaid; the government currently withholds a small percentage of all operating base payments. This withheld money is then redistributed to facilities according to how they perform on quality measures, relative to one another. The patient experience score, a significant factor in the survey, includes questions on the acoustic environment.

A Quieter, Gentler Approach

Since money is now tied to the acoustic environment as perceived by the patients, many hospitals are implementing a “quiet culture”, paying attention to floor layouts, equipment noise, interior finishes and paging procedures and systems, all of which have an impact on the acoustic environment.

By working with a multidisciplinary consultant, the healthcare environment can be holistically designed to allow the technology, lighting, and acoustic designs to be seamlessly integrated, thereby providing the best healing atmosphere possible for the patients, and a calmer, quieter place to work for the providers. The benefits now extend to the healthcare facilities as well, as they are granted the opportunity to receive compensation for their efforts.

About the Author
Alexis D. Kurtz in The Sextant Group’s Washington DC office is one of the authors of the LEED 2010 and LEED V4 for Healthcare Acoustic Credits.

For more information, see Hear and Now: Avoid the Number One Complaint about LEED-certified Buildings and Technology In Healing Hands