In a complex healthcare project, there are specialists for almost every aspect of the built environment, from art consultants to landscape architects. One environmental aspect that’s a critical part to both patient safety and health outcomes is the soundscape, or the sounds heard in a particular location. Too much noise in a setting can affect a patient’s ability to get restorative sleep and can muddle communication between caregivers. But, if the environment is too quiet, there can be an eerie and unpleasant sense of dread felt while in the space.

When I attended Healthcare Design’s HCD Forum in Park City, Utah, last September, the impact of sound and environment was brought to life in a presentation by Man Made Music, a sound design company. Speakers Joel Beckerman and Kevin Perlmutter showed the impact sound has on experience by sharing examples, including some well-known film clips with and without the sound effects that are added after production. While watching “Scary Mary,” a fictional recut trailer for “Mary Poppins” that was set to some rather chilling music, the impact that deliberate sound choices can make on our experiences became clear.

This experience brought home to me how the auditory environment in healthcare has yet to be used as impactfully as it could be. For example:
• Sound can help create a positive user experience. In healthcare, we’ve been focused on mitigating excessive noise through product design, surface materials, and behavioral and cultural changes. What we haven’t focused on is designing soundscapes that add to the experience for patients, families, and staff and contribute to positive outcomes. Many other industries have been using sound for years as a tool to improve the user experience. An article in Food Republic’s January 2017 issue speaks to the connection between our senses and how sound is being used to impact the ways we experience food in restaurants. In retail, music is used to create a brand, increase sales, and fashion an in-store experience that entices people to move away from online shopping. In the same way that music playing over the phone changes the perception of hold time for a caller, retail has turned to audible music near registers to reduce the perception of time spent waiting in line. This example can be directly translated to healthcare spaces where waiting is still a significant part of the equation.
• Sound management can improve productivity. Notification sounds from medical devices can create a cacophony and, if they are ever-present, can become noise that’s tuned out by staff, negating their original intention. Messaging apps like Slack have been created to help teams manage message notifications across industries, separating out the actionable ones from those that are not. I think healthcare providers need an app that could help them navigate through the complex alerts coming from the equipment in patient care areas so that the important signal is visible through the noise. Manufacturers are also looking at ways to address the issue. In 2017, a medical device company teamed up with Yoko K. Sen, an ambient electronic musician, to layer her vocals onto the notifications that patients hear from their cardiac monitors, creating a sound that’s not startling in a home environment but provides instant awareness.
• Sound can be used in a prescriptive way for patients. At the Montefiore Hospital in Hove, England, sound is being use in a functional way to help patients. English musician, record producer, and visual artist Brian Eno, known for his pioneering work in ambient music, worked with the hospital to create an Eno Room, a space with generative music and continuously changing paintings made with light. Nurses at the hospital report that patients who are feeling overwhelmed use the space to process information or just to slow down and decompress. Could it be a matter of time until physicians are prescribing patients to spend time in these types of spaces for specific health outcomes?

A good amount of research has been done about the impact of art and nature on healing, health, and well-being. In the 1850s, Florence Nightingale noted that “variety of form and brilliance of color in the objects presented to patients have a powerful effect and are actual means of recovery.” Sound isn’t the last frontier when it comes to improving experience and outcomes in healthcare environments, but it’s one that we still know far too little about. As an industry, we need to begin scratching the surface to better understand sound and how to leverage it for the benefit of patients, families, and staff.

Debra Levin is president and CEO of The Center for Health Design. She can be reached at dlevin@healthdesign.org.