Wednesday, December 9, 2009

Hospital Noise

Ring, Buzz, Tone, all sounded as Caregivers bustled and hustled past my seat with IV bags, food, charts, and doctors. My heart rate increased. It seems no matter how long I have worked with hospitals those noises still make me nervous. It’s kind of like taking your first airplane ride – you are not quite sure what the noises mean but you know the plane could fall from the sky at any moment. I began thinking about noise, as I waited to speak to the Nursing Director, why is it so noisy? When you are sick all you want to do is rest, yet how do you rest when an IV pump - that sounds like the worst alarm clock in the world - is going off randomly down the hallway.

Noise is measured in decibels(db) - I learned that from my early days of designing sound systems. The average bedside monitor is approximately 79db (Hospitals & Health Networks Dagmara Scalise Mayo Clinic May 2004) but what does that mean? Compare it to a heavy truck driving by – a diesel mind you – which is 80 decibels. At Mayo clinic they documented the loudest point of the day to be at a pre-intervention shift change which was at 113db – to compare a gunshot is 140db.

Is a “decibel” really the right method or measure? Do we really expect the Clinicians to be concerned with actual decibel readings? Is it practical to think that they are going to carry around a little decibel meter in their pocket and then say ohhh we are 15 decibels too loud? Impractical, Difficult, and Inefficient….

Since assessing all noise on a unit is a huge undertaking (footsteps, conversations, cell phones, chatter, beds running into walls) - What if we took the section of noise that has to do with alarms and began to create a method to quickly and efficiently assess it? Total quantity of alarms multiplied by total devices in the rooms = the Noise Issue. (that’s way too simplistic but it helps establish the initial concept)

The initial solution by hospitals (and manufactures trying to sell a product) is “send it to a wireless phone or device”. While I am onboard with the mobility revolution – I think that it’s an overused medium that manufactures and vendors use to pull at the overworked heart strings of the caregivers. The mantra “We can make your life easier – just send it to a wireless phone” conceptually is wonderful but realistically how many alarms can we actually take on our hip? (See earlier post) Don’t jump on the band wagon that mobility is always best - jump on the band wagon that efficiency – ease of use – reduced redundancy is always best.

At Sphere3 we utilize a sophisticated equation in our workflow analysis and link it back to proper categorization of alarms which decreases alarm fatigue. One of the items we look at is noise and utilizing a scoring system we help establish the most effective area to automate.

I think that it would be interesting to create a calculator that the caregivers could easily use to establish their noise level – efficiently and effectively. Anyone interested?

Check out the article posted by @BhawkesRN (Beth Hawkes) on Noise.

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