By Joel Beckman with Tyler Gray
There’s a danger plaguing hospitals and clinics around the country: sound. It could be a powerful tool for healing, but it’s mostly used wrongly today. It causes stress in patients and alarm fatigue among health care workers, threatening recovery and, in some cases, lives.
Used without strategy, the very beeps, dings, and alarms intended to alert workers to emergencies become a nuisance they tune out.
According to a January 27, 2014 NPR story, a joint commission to address the problem of alarm fatigue “received 98 reports of alarm-related incidents — including 80 deaths — in the 3½-year period ending in June 2012.”1 In most of the cases, alarms were turned off or inaudible. For example, Mariah Edwards, a 17-year-old in Pennsylvania who went into a surgical center to have her tonsils removed, died after surgery when health care workers failed to hear a warning alarm on a machine monitoring her recovery. The commission estimates there were about 1,000 incidents in which patients died, were injured or faced unnecessary risks because of improper uses of sound. “The ECRI Institute, a Pennsylvania-based patient-safety organization listed alarm hazards as the No. 1 issue on its annual list of the top 10 health-technology dangers for 2012 and 2013.”1
Attempts at solutions have led to another layer of concern. Fixing the problem isn’t as simple as fewer or silenced alarms, as most hospitals and commissions suggest. Rather, researchers have suggested standardizing alarm sounds. A universal sonic vocabulary would simplify training for health care workers and limit the number of noises to which they must respond. But what’s actually needed is a deeper, holistic sonic strategy, one that takes advantage of the full power of sound to instantly convey emotion—tones or tunes that immediately make workers feel danger or urgency, for example.
Unique or unexpected tones could quickly convey specific direction and action. Sounds are already being used this way in other life-and-death situations. A Danish audio software company called AM3D uses sound in a helmet that allows firefighters in smoke-filled, nearly blind environments to know where their team members are. A similar apparatus in A-10 and F-16 fighter aircraft uses sound to tell pilots when missiles from enemy fighters are fired and, in an instant, what direction threats are coming from (including above, below, or behind them).
Sound could extend well beyond emergency situations, too. Some hospitals have begun to experiment with architecture as part of the healing equation, with sound as an important element in the design. Experiments at hospitals in Massachusetts, Maryland, and Minnesota have found that music affects blood pressure, heart rate, or blood flow through arteries.
Many of us get this, almost instinctively. We use sound as a pick-me-up all the time in everyday life. Somehow we forget the skill when we’re sick or visiting people in the hospital. Want to help a friend recover from an illness or help your wife through labor pains? Don’t tell her to push that painkiller plunger again; plug in a sound dock or speaker to a smartphone and dial up songs you know she likes. There are documented cases of sound working this way, even in extreme medical circumstances.
Melodic intonation therapy and music are proven forms of therapy for stroke victims. They help ameliorate the deteriorating effects on the brain. U.S. Representative Gabrielle Giffords (D-Ariz.) used it to regain her ability to speak after being shot in the head by a would-be assassin. Roy Orbison’s “Crying” caused comatose Bee Gees member Robin Gibb to shed tears with his wife. And when his son played him the song they collaborated on, he awoke.
When you really start to think about it, ameliorating alarm fatigue is just the beginning of dealing with the sound problems in hospitals and fostering a better healing environment—one where patients could choose their own soundtracks in operating and recovery rooms; music could help signal “morning,” or “evening” and help give patients a better sense of circadian rhythms. What if music were part of living wills?
It’s time for a more holistic approach to the noise problem in health care. Better, more strategic sound is the prescription that could save lives.
1. Alice Crites. “Too much noise from hospital alarms poses risk for patients.” The Washington Post. 07 July 2013.