Building Better Sounding Facilities

Healthcare facilities standards for providers are summarized in several documents published by the American Society for Healthcare Engineering (ASHE), part of the American Hospital Association. These documents are governed by the Facilities Guidelines Institute (FGI). The FGI Guidelines are used as the governing standards by organizations like the Joint Commission (JC) when they conduct site survey evaluations for the accreditation of health care providers. The Guidelines cover topics from the planning, design, construction and commissioning of facilities, to the specific requirements for each of a wide variety of facility types, serving a range of patients and procedures.

 

Of particular interest for us are the FGI requirements for the acoustical design of facilities. The Guidelines cover topics such as meeting legal requirements for speech privacy for HIPAA, workplace noise for OSHA, local and state building codes, and local and state limits on environmental sound from facility exterior noise sources.

 

Not specifically included in these standards is the evolving science of patient experience, which is a key factor for producing successful patient outcomes. The science of perception, by patients and caregivers, of their acoustical environment is called Soundscape Analysis.

 

Beyond the basics of meeting building codes and legal requirements, the ultimate goal of a facility should be achieving the best possible patient experience and outcomes. This objective should be kept in mind when building or renovating any facility, major system or process. The acoustic parts of these building components should be planned, designed and implemented in such a way as to enhance the healing process. In architectural terms these efforts are done in a series of phases:

– Conceptual design and space programming

– Schematic design (SD)

– Design development (DD)

– Construction documents (CD)

– Construction administration (CA)

– Commissioning

 

Considerations of acoustics are key factors in improving the patient experience, and should be discussed and planned for in the early stages of conceptual design. These considerations include mechanical system (air conditioning/ventilation) noise, sound isolation between spaces, speech privacy where needed (admitting/examination rooms/billing), room reverberation and sound absorption in vital spaces (nurses stations and dining halls), and sleep enhancing quiet in patient wards. It is much easier to create a successful, efficient and productive facility when critical factors are included from the beginning.

 

The costs to build a better sounding facility are similar to, and often less than the costs to build a poor facility. These savings can include the initial costs as well the life cycle costs for the facility.

 

The creative use of resources, financial, material and human, is the key to a well-crafted building plan. It is important to engage the team of caregivers who will be working in each area of the new or renovated facility, early on in the planning process, in order to develop a facility design which is responsive to provider and patient needs. As part of this planning process a soundscape analysis of the planned facility should be conducted, based on leveraging the experience of caregivers and patient perception data. Workshops and charrettes are great tools to bring providers into the design team and to incorporate their ideas into the building plan. The role of the acoustical consultant is to translate the sonic needs of providers and patients into architectural and engineering design solutions and specifications.

 

The results of careful facility planning include better patient outcomes, satisfying patient experiences and a sense of accomplishment for caregivers. That can be very rewarding for the provider.

 

We welcome your thoughts on the acoustics of facilities, and how that relates to your efforts to create an environment of healing.