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floor layout designs such as corridor turns and branching hall- ways, relative grid distance, and visual fragmentation. These architectural features were found to relate to the reverberation time in units and allow for hospital designs to consider the soundscape at the design stage.
Finally, at the receiver, interventions that have been studied include earplugs and headphones. Schlesinger et al. (2017) studied noise-canceling headphones designed to specifically eliminate clinical alarms while passing the rest of the sound with as little distortion as possible. Laboratory results showed significant improvement in speech intelligibility while alarms were sounding.
Taken as a whole, interventions to improve the hospital sound- scape show some benefits but have not been consistently successful. They have tended to focus on modest improvements rather than the significant reuse, redesign, and transformation that is probably required for hospital soundscapes to become more pleasant for staff, patients, and visitors.
Conclusions
Hospital soundscapes do not currently project an aura of calm and restfulness that patients and staff would prefer. Instead, they are loud and chaotic, with lots of sound peaks from normal hospital operations and medical equipment. Furthermore, hospital sound levels have been increasing for decades. There is research that supports the notion that the soundscape impacts medical staff primarily by increasing stress and patients through impacting the ability to sleep and the sense of well-being.
Recent work on hospitals indicate that staff and patients crave a soundscape that could be described as calm, and patients are willing to experience noises when they understand their origin and meaning. Interventions parallel work more gener- ally on building noise. The addition of quiet times on units has been found to be useful for staff and patients and their families and masking the sounds of nature show promise in creating a more restful space as well.
There are many avenues of research still to be pursued to understand hospital soundscapes. These include investiga- tions of how we might better use audible and nonaudible alarms, studies to determine whether there is a direct link between patient medical outcomes and elements of the hos- pital soundscape, and demonstration of interventions that can be scaled across a broad range of hospitals.
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