Impacts of noise on staff cognitive performance in a hospital emergency department

Abstract

The soundscape of a typical modern hospital emergency department is undoubtedly noisy. Noise-related stress can contribute to human error, adverse medication events, and physician burnout and may negatively affect physicians’ mental health and limit clinicians’ ability to provide high-quality patient care. Previous studies have revealed average sound pressure levels for hospitals worldwide to be in significant excess of the World Health Organization firm guidelines. However, neither sound pressure level measurements nor loudness evaluations provide enough insight into the problem or potential solutions. Noise sources in hospitals include monitor alarms, overhead paging, echogenic surfaces, trash bins, ring binders, and patient crying out, among others. These sounds can be abrupt, yet not sustained. In order to evaluate the impact of hospital staff distraction and propensity for human error due to noise, the authors have conducted research at a busy, urban emergency department. The effects of various sonic occurrences on the cognitive load and working memory of physicians operating in the emergency department were assessed using binaural augmented acoustic environments as the backdrop for cognitive executive function evaluations. This paper discusses the methods for the binaural augmentation, cognitive testing, and initial results and offers interpretation and potential solutions to address these results.