Hushing our noisy hospital

Jack Chubb: April 04, 20126 Comments

Hospitals are just noisy places – there’s no doubt about it! Physicians and employees are hard at work and at times seem to be unaware of how they are contributing to the noisy environment.  We’ll always have an endless parade of visitors creating noisy activity. When I walked the halls of our hospital this morning I listened to the noise buzzing around me - medical equipment beeping, cell phones, pagers, people talking loudly– some were visitors, but most were staff and residents talking loudly to one another as they hustled up and down the hallway. There was the sound of carts rattling and “clanging” over thresholds and as I closed my eyes I could still hear elevators dinging, a patient moaning and even a helicopter hovering above … no wonder it’s so hard for patients to get decent rest!

But I’m elated to find us involved in a “H.U.S.H” (Help Us Support Healing) movement to change some of these things and by instituting “quiet time” from 9 p.m. to 7 a.m. we will further promote healing and provide a time for less interrupted sleep.  Knowing that high sound levels affect patients' sleep, raises their anxiety levels and lowers their ability to manage symptoms, noise reduction in our hospital has been a patient experience improvement goal for more than three years now.

In 2008 we initiated “Silent Hospitals Help Healing” (SHHH), and those early efforts had initially helped decrease noisy conditions all over the hospital. We even worked with the City of Fresno to implement quiet zones outside the hospital preventing trains from sounding horns in specific zones unless in an emergency.  Other efforts included posters in hallways and at nurse stations featuring employees with a finger to their lips reminding employees and visitors to be quiet, carts and equipment with squeaky wheels were lubed or changed out, and ear plugs were made available to patients to help them sleep better.

We were pleased that patient satisfaction survey results had improved as a result of SHHH, but we’ve seen a steady increase of noise at night again - just over the past year.  To help refresh our noise management efforts, another multi-disciplinary noise reduction workgroup has prepared a new kind of SHHH initiative to increase awareness of how noise levels can affect patient healing and progress. The committee has been working with staff and leaders to hardwire daytime and nighttime quiet practices and provided tools and handouts that will aid staff, physicians, patients and visitors in keeping noise levels down.

Our “hush” initiative includes reminder signage that has been installed at the entrances to patient unit hallways, stating “You are entering a quiet zone.” New “hush” posters replace the old, asking all staff, physicians and visitors to help by setting cell phones on vibrate mode or off if required to do so in specific areas, using quiet voices when talking, not socializing in the hallways, and adhering to visiting hours and guidelines.  I believe that two of the biggest challenges we face will be “habitually” related. First, getting staff out of the habit of yelling down the hall at one another and second, not socializing in the hallways.  Now staff, and physicians – more particularly our residents who round in groups, are guilty of this.  Okay, and I’m guilty too – I round with associates regularly and I think I’ve violated this practice on more than one occasion. These reminders, along with additional training and staff awareness will cause us (staff, physicians, residents and visitors) to think about where and how loudly we are having these conversations.

Even though we are a 24-hour-a-day operation, our patients need a little peace and quiet – it’s essential to their recovery.  Hopefully, we'll see improvement reflected in our inpatient surveys that come back over the next few months. And until then, please work on hush … our patients deserve it!

6 responses to Hushing our noisy hospital


We too love the HUSH posters. Can you tell me where you had them printed so we could check into getting some? Appreciate your help.

Quiet Zone

Love the article and posters. How do I purchas the posters? I would like to put then in our elevators.

Implementing a Good Idea

I feel the concept is fantastic and one that other hospitals have been utilizing for quite some time. I still feel it will take a while to get used to, especially at night. Patients are continually being admitted and of course family members are anxiously waiting to see them and make sure they are receiving great care. Nurses are often put in the middle and will allow visitors after hours, sometimes, even now this seems to get a little out of control but with continued support and reminders family and staff will get used to the idea of HUSH and how it helps promote healing.

We are working on it

The posted signs are a great visual for family members and for staff as well. We get caught up in the work and forget that the noise we make affects the rest periods that our patients desperately need. I think that we all need reminders and we shouldn't take offense to having someone hush you. We are all in this together!! Thanks to all of you who work hard for all of our patients :)

This is very good news, as we

This is very good news, as we had a family member in the hospital several months ago and we took turns spending the night. I was astounished at how loud the staff talked even in the wee hours of the morning.

I think this is a awesome

I think this is a awesome idea, I work nights and always find myself hushing my coworkers but now with the hospital support I wont feel like a "oddball" I can just continue to hush people in a friendly way and with support.

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