Research : Replacing Overhead Paging with Smartphones to Reduce Hospital Noise

Abstract

Hospital noise is associated with adverse effects on patients and staff. Communication through overhead paging is a major contributor to hospital noise. Replacing overhead paging with smartphones through a clinical mobility platform has the potential to reduce transitory noises in the hospital setting, though this result has not been described. The current study evaluated the impact of replacing overhead paging with a smartphone-based clinical mobility platform on transitory noise levels in a labor and delivery unit. Transitory noises were defined as sound levels greater than 10 dB above baseline, as recorded by a sound level meter. Prior to smartphone implementation, 77% of all sound levels at or above 60 dB were generated by overhead paging. Overhead pages occurred at an average rate of 3.17 per hour. Following smartphone implementation, overhead pages were eliminated and transitory noises decreased by two-thirds ( P < 0.001). The highest recorded sound level decreased from 76.54 to 57.34 dB following implementation. The percent of sounds that exceeded the thresholds recommended by the Environmental Protection Agency and International Noise Council decreased from 31.2% to 0.2% following implementation ( P < 0.001). Replacement of overhead paging with a clinical mobility platform that utilized smartphones was associated with a significant reduction in transitory noise. Clinical mobility implementation, as part of a noise reduction strategy, may be effective in other inpatient settings.

Impact of Obstetric Communication on Decision-to-Delivery Time

“…In a subgroup analysis of evaluating cesarean sections performed for critical fetal distress (cord prolapse and bradycardia), no differences were seen in the time to delivery (pre implementation 13.7 [range: 4-37] versus postimplementation 12.4 [range: 4-25] minutes, p ¼ 0.531), arterial pH (preimplementation 7.14 [6.81-7.34] vs. postimplementation 7.12 [6.75-7.29], p ¼ 0.284), or 5-minute Apgar's score (preimplementation 9 [range: 0-9] vs. postimplementation 8 [2][3][4][5][6][7][8][9], p ¼ 0.205).…”

“…Moreover, the broader platform eliminated all overhead paging within the L&D unit substantially, reducing excess noise for patients and staff. 7 Limitations A limitation of the study is that the implementation of this technology occurred in the context of a redesigned labor and delivery unit. 20 Thus, while personnel did not change, the physical infrastructure of the unit changed between the two cohorts of the study.…”

“…Moreover, the broader platform eliminated all overhead paging within the L&D unit substantially, reducing excess noise for patients and staff. 7…”

“…Over the last decade, the development of clinical mobility (CM) platforms has enhanced communication among medical providers, improving clinical workflows. [7][8][9] CM platforms facilitate the exchange of real-time bedside data to clinician's smartphones, allowing providers to respond rapidly to critical situations. 8 Such platforms allow for direct and synchronous exchange of data between care providers, patients and providers, and between medical devices and providers.…”

Going Silent: Redesigning the Activation Process for In-Hospital Cardiopulmonary Arrests

“…7,8 Although there are many contributors to a noisy hospital environment, overhead paging or activation of response teams contribute to noise disruptions, with intercoms being a source of up to 39% of documented noise disruptions in hospitals. 3,9 Transitioning form an overhead paging system to a mobile communication platform has been previously described as an effective strategy to reduce decibel levels within a hospital unit. 9 More specifically, in a survey of 107 hospitals within the United States completed in 2018, 91% of cardiac arrest team activations were called overhead, 10 creating a clear opportunity for a noise-reduction intervention.…”