Cognitive impacts of hospital noise on emergency department staff performance

Abstract

The soundscape of a typical hospital emergency department today is undoubtedly noisy. Noise-related stress can contribute to adverse medication events, human error, physician burnout, and could negatively affect the mental health of physicians and limit the ability of clinicians to provide the expected high-quality patient care. Previous studies have cataloged average sound pressure levels for hospitals around the world, which are in gross excess of the World Health Organization (WHO) guidelines. The sources of this noise in hospitals include overhead paging, monitor alarms, echogenic surfaces, ring binders, trash cans, and patients crying out, among others. These sounds are often abrupt, yet not sustained. In order to evaluate how these transient, intermittent noises impact hospital staff distraction and propensity for human error, deeper insight beyond loudness and sound pressure level is likely required. The author is building off of Master's thesis research conducted by Rensselaer Polytechnic Institute graduate, Peter Dodds. In 2015, Dodds collected field recordings and binaural room impulse response measurements at a busy, urban hospital emergency department. Using these recordings and impulse response measurements, simulated binaural acoustic environments were created as the auditory backdrop for visual cognitive executive function evaluations. The impact of various sonic occurrences on the working memory and cognitive load of hospital staff was analyzed in this way. These objective results were then compared with subjective results from a visual analog scale survey conducted in conjunction with the cognitive testing. This paper details the methods for binaural augmentation and audio file creation, for the cognitive and perceptual testing, and discusses and offers interpretations of the results.