Achieving high-performance acoustical design in healthcare facilities is a challenge that often requires decisions balancing competing interests, but nevertheless, effective acoustical performance is a critical need for all types of healthcare facilities.
A growing awareness of the problem of noise in healthcare environments has become most evident in recent years. A widely-reported 2005 study at Johns Hopkins Hospital (Busch-Vishniac, West, et. al. ) determined that hospital noise has been rising to levels well beyond the World Health Organization’s recommended guidelines since the 1960s to the detriment of patients and caregivers. In “A Review of the Research Literature on Evidence-based Healthcare Design” (Ulrich, Zimring, et al., Health Environments Research and Design 2008), this and other examples illustrate the negative effects of noise on caregivers and patients. These negative impacts include elevated psychological and physiological stress levels that can worsen other outcomes, create difficulty in staff communications, and contribute to poor sleep quality, which is detrimental to healing. In some cases, noise distractions can be linked to medical error.
Standards have recently been introduced to help address this problem. The 2010 edition of the Guidelines for Design and Construction of Health Care Facilities from the Facilities Guidelines Institute includes a new detailed section on acoustical performance. The authors of the Green Guide for Heath Care (GGHC) and LEED for Healthcare worked together to include a two-point credit holistically addressing acoustics—exterior noise, acoustical finishes, room noise levels, sound isolation, paging, and call systems—and building vibration.
Consider the measureable benefits of high acoustical performance: it helps to facilitate speech communications, supports a more focused work environment to reduce medical error, lessens stress for staff and patients, promotes healing, enhances patient privacy, and supports HIPPA compliance. GGHC highlights improved health, economic, and even ecological benefits. Also consider how a noisy environment and lack of sleep may influence a patient’s perception of the healthcare facility and quality of care as measured through the widely-used Press Ganey patient satisfaction survey.
Many factors contribute to the successful acoustical performance of space—the physical configuration, engineering systems, equipment features, and facility operations greatly contribute to acoustical performance, and many factors such as noise generated by equipment and staff are out of the designer’s hands. A team consisting of the client, architect, interior designer, acoustician, and engineer can work together to achieve the greatest possible improvement to the acoustical environment.
A positive example is the Mayo Clinic, which has been building quality healthcare environments for many years, evolving the designs through lessons learned, and striving for the most supportive spaces for all occupants. In 2004, the Mayo Clinic implemented procedures to reduce noise at their Rochester, Minnesota, facility and recognized the importance of high acoustical performance in the operations and design for the new Mayo Hospital in Jacksonville, Florida, which opened in 2008. Perkins+Will configured the space to support patient care, but also to reduce sound transmission to the patient bedside, integrating an acoustical expert’s recommendations in order to reduce noise. The following guiding principles were recommended by Mark Penz, an acoustical engineering consultant with Kirkegaard Associates:
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