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Low stimulus environments: reducing noise levels in continuing care

Originally Published:
Key Point Summary
Key Point Summary Author(s):
Dickey, Andrew
Key Concepts/Context

This article highlights a project that aimed to reduce levels of intrinsic background noise on an adult mental health ward. Following intervention, the ward was able to decrease the background noise decibel level from 60dB to 53dB (on average).


The article summarizes a project that aimed to reduce levels of intrinsic background noise on an adult mental health ward, combining a quantitative measure on decibel level and incidences of violence, and a qualitative measure on perceived stress reduction.


Baseline measures were taken using a decibel measure, and review of hospital records for incidences of violence. The model for improvement was used to design the project. First, a small team downloaded a dB measure tool (phone app), and time and locations for measurement were standardized (five minutes, three times per day); averages were recorded. Second, a poster was developed and posted to remind staff, patients and carers of the benefits of lower noise levels. Third, a visual tracker called the “Yacker Tracker” was installed, showing visual cues and colors of noise levels using a traffic light design. Finally, simple modifications to furniture was made, such as adding felt pads to the chair legs. 

Design Implications
Successful design implications included the following: use of posters to remind staff and caregivers about noise levels, visual indication of noise level in public spaces, such as Yacker Tracker, addition of soothing background music, and adaptation to furniture, such as adding felt pads on tables and chairs to reduce scrapping of furniture legs.

The noise level quickly dropped from 62dB to 53dB and remained low throughout the project time. In addition, days between incidences of violence increased from one every three days to one every six days from early 2014 to late 2015. Staff absentee rates also decreased by 40% over the project period, based on reports by Human Resources. 


It is not possible to conclude that noise reduction alone has a direct impact on violence reduction when combined with other measures. This project took place in one adult mental health ward, and results may not be generalizable to all adult mental health settings.

Design Category
Acoustic Environment|Furniture, Fixtures & Equipment (FF&E)
Outcome Category
Environmental impact|Organizational outcomes|Patient / resident health outcomes|Staff health outcomes|Staff productivity / efficiency|Staff satisfaction|Patient / resident satisfaction and comfort
Environmental Condition Category
Key Point Summary Author(s):
Dickey, Andrew
Primary Author
Brown, J.