Acoustical evaluation of quiet time and its impact on patient outcomes

Abstract

As healthcare evolves from focusing on survival to prioritizing patient care, more efforts have been devoted to exploring the characteristics of an optimal environment. Intensive care units (ICUs) often involve more urgent situations that require more medical equipment, in-unit procedures, and staff that all contribute to the noisy soundscape. Recently, administrative noise reduction strategies such as Quiet Time (QT) and behavioral modification and noise awareness programs have gained popularity. The literature typically demonstrates some positive effects from these interventions; however, there are inconsistencies in magnitude and sustainability. We conducted an 18-month, longitudinal study of QT aimed at (a) characterizing the Neonatal Intensive Care Unit (NICU) soundscape more extensively and with newly developed metrics and (b) determining the impacts of sound on patient physiological responses. Results show some evidence of trends toward decreased noise levels after QT implementation. For example, QT generally resulted in lowered occurrence rates, indicating a decreased number of high-level noise events. Additionally, spectral data showed significant decreases in level across the vocal frequency range and improved speech intelligibility index scores with QT implementation. Ultimately, these results begin to provide a template for determining the optimal soundscape to aid more targeted administrative and architectural design strategies.