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Patients Find Comfort In Auditory Interventions
By Susan E. Mazer, B.A., M.A.

Florence Nightingale said a truth 150 years ago that is still true to this day: "Noise... that which creates expectation ... causes the damage in the patient. Unnecessary noise, then, is the cruelest absence of care."

Despite the fact that healthcare design is focusing more and more on holism as an ethic of care, the auditory environment receives very little attention. However, its influence on the patient experience is undeniable. I was fascinated by a recent article in The Reno Gazette that cited a study done in Italy, which looked at patient's experiences in ICU units. Seventy-two percept of patients surveyed reported a bad experience, including memories of "sleep deprivation, fear and anxiety... loneliness, unceasing noise, seeing or hearing others suffer or die ..." I know that the causes behind each of these symptoms can be linked to one or more auditory factors and are external to the patients' diagnosis.

Jay Kaplan, M.D., FACEP, the chairman of the emergency department at Saint Barnabas Medical Center in Livingston, N.J., told me that in early trials of The Sondrex SystemĘ (a personal music delivery system that includes a communication interface for caregivers to communicate with patients), patients waiting for treatment were protected from sounds coming from the next bed.

In the same hospital, he said that a 60+ year-old Asian male experiencing chest pains was admitted. Once it was determined that he was not experiencing myocardial infarction, he was given The Sondrex System with some soft music. Not long after, in the very next cubicle, a woman was brought in who was having cardiac arrest. For 45-minutes, the activity was hectic and noisy. At one point, Dr. Kaplan looked into the condition of the first gentleman, who was resting quietly listening to the music, calmly oblivious to the crisis occurring right next to him.

At Craig Hospital, a rehab facility in Englewood, CO, patients seemed to experience pain and difficulty at night when they tried to sleep. Hospital administrators told me these hours were particularly difficult for a young man in his early 20's who was rehabilitating from a traumatic accident that left him a quadriplegic. In an effort to provide additional things for patients to do while bed-ridden, hospital administrators installed The C.A.R.E. Channel, a 24-hour environmental channel that provides beautiful nature images and original instrumental music.

Nighttime programming is specifically designed to respect the circadian rhythms by broadcasting a midnight starfield, which looks like a clear night sky and imbues a soft blue light into an otherwise dark hospital room. The young man reported that from the first night The C.A.R.E. Channel was available, the nighttime programming helped him sleep -- late night hours that had been extremely difficult to endure.

In each of these situations, I see the ways in which the auditory environment impacts the patient experience translates into standards of care and clinical outcomes. What's more, in working with hospitals across the country, I have found that by looking at the design of the auditory environment, it forces administrators to consider the issues at stake in the whole environment.

Susan E. Mazer is president of HealingHealthCare Systems (www.healinghealth.com), a Reno, NV, company whose mission is to develop media products and educational programs to assist healthcare organizations in providing clinical environments that are directly supportive of recovery. She is the co-author of the book Sound Choices: Using Music to Design the Environments in which You Live, Work, and Heal (Hay House, Inc., November 1999). Susan can be reached at hhs@healinghealth.com.