Date: 20 August 2022 (Saturday)
Time: 1300 – 1410
Venue: Suntec Singapore Convention & Exhibition Centre, Sentosa Hall 404, Level 4

The Future of Hospital Sound: Transforming Healthcare Through Sound Experience
Dr Yoko K. Sen, United States
Dr Avery Sen, United States

Key Takeaways

  1. Participants recognize the unintended, often unconscious impacts that the hospital noise – especially sounds of medical devices – can have on themselves, their colleagues, their patients, and patients’ families.
  2. Participants develop an awareness of the particular qualities of the device sounds that they hear, how those qualities affect their experience, and how they could be active participants in their improvement.

Abstract / Session Description

Do you hear the sound of alarms in your dreams? Studies show that sound has a tremendous impact on the hospital environments and the wellbeing of patients and clinicians alike, yet it has often been an afterthought in healthcare, particularly in the field of medical device design. The sounds of medical devices often surround the most vulnerable times of our lives. So these sounds should not only be safe and functional, but also sensible, kind, and respectful of human dignity. And they should be designed with people who have to hear them most often.

This session tells a story about Beepers (people who make beeps) and The Beeped (people who get beeped), and the participatory sound design process for Philips patient monitoring. It will address why sound matters in the hospital sound environments, the distinction between sound and noise, and the impact of noise on both patients and clinicians. It will then introduce a sound design project for the Philips patient monitoring system as a case study to demonstrate the importance of including diverse groups of users (clinicians) and beneficiaries (patients) in the design process to address complex, nuanced challenges. Patient monitors can contribute up to 80% of machine noise in ICUs. This is the first time in decades that the sound of the Philips patient monitoring system is being redesigned. Therefore, improving the sound of this particular medical device will have a significant impact on the hospital soundscape at large.

Alarm sounds should have “attention-getting ability, distinctiveness, clear communication of the desired information, and freedom from annoyance and aversion” (ANSI/AAMI HE75:2009/2018). However, sounds that emphasize the “attention-getting ability” and “distinctiveness” can be harsh, high-pitched, and have a flat, machine-like amplitude envelope, often resulting in “annoyance and aversion,” fatigue, and psychological distress on users and beneficiaries. In order to improve the functionality of a sound (i.e., making it audible, distinctive, informative), as well as its sensibility (i.e., making it reasonably pleasant), it is important to consider the subjective, lived experiences of the people who would be affected. Sounds designed with these considerations can then go through the traditional usability evaluations to explore design strengths and potential for improvements by observing users in simulated environments, reacting to alarms. The presenters argue that functionality and sensibility do not have to be mutually exclusive; improving one could also improve the other.

Anxious. Fearful. Stressed. These are the words that come up when we ask people about how clinical auditory alarms make them feel. To describe the quality of sound itself, many struggle to find any words at all. Some clinicians say they do not feel they have “permission” to critique the alarm sounds that they have to hear every day. The process of improving sounds for the patient monitor can produce within stakeholders an elevated capacity for discourse about the audible aspects of healthcare, so that expectations are raised and other challenges with healthcare soundscapes can be addressed with community participation.

Reducing alarm fatigue in the ICU
Dr Mark-Holger Konrad, Germany

The number of devices that are used in the acute care area is increasing. With strong emphasis on risk management and increasing regulatory requirements, we see an increase in alarms and noise within the ICU. That noise leads to scenarios where alarms fail to attract attention but instead generate stress to both caregivers and patients.

We will share some examples of Alarm Fatigue, try to circle the complexity of identify causes and potential mitigations on a technology but also workflow level.