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Under a new program called "Silent Hospitals Help Healing" (SHHH), Montefiore Medical Center is addressing one of the biggest complaints patients have about hospitals: they are too noisy. "Noise is not only an irritant, but an obstacle to healing," said Margaret Amato-Hayes, RN, clinical director of nursing, Montefiore. "Studies have shown there is a relationship between excessive noise and a slowing of the healing process. Noise also contributes to increasing stress and anxiety levels."

Elodia Mercier, RN, the administrative nurse manager who implemented the SHHH program, found sources of noise everywhere. "Ringing telephones, blaring TVs, hospital alarms and intercom announcements added up to excessive noise levels," said Mercier. "The glucometer carts were so loud they sounded like the D train!"

Mercier launched SHHH on her unit to provide Montefiore patients with a quieter environment in which to receive care. "All equipment, from IV poles to medication carts, is sent for lubrication and inspection," said Mercier. "Administrative nursing managers are monitoring hallway conversations to keep them to a minimum. Staff are reminded to switch their beepers to vibrate mode and intercoms are now turned down," she said.

Signs placed in hallways read "SHHH," and patients, staff and visitors are given buttons that show a nurse with her finger to her lips.

Sound meters were used to record ambient noise levels at different times, such as during the change in shifts, at mid-day and in the evenings in patient care areas, including medical floors, in surgical units and in the adult emergency department.

"The effects of SHHH have been remarkable," said Mercier. "Within two weeks, patients said they were sleeping better, and staff told us they felt less stressed." As a result, overall decibel levels have fallen significantly. On Mercier's unit, noise levels had been as high as 78 decibels. They have dropped to 50 to 60 decibels, a level more typical of libraries. When shifts change, noise levels used to range from 62 to 70 decibels. After SHHH was implemented, noise levels have been measured at a reduced 55 to 60 decibels.

"When people are ill, they are even more sensitive to stressors like noise," said Mercier. "At Montefiore we believe we owe our patients quality care and compassion, including a quiet, calm environment in which they can heal. And that's what we have created with our SHHH program."

Montefiore Medical Center, The University Hospital and Academic Medical Center for the Albert Einstein College of Medicine, ranks among the top one percent of all US hospitals based on its investments in medical innovation and cutting-edge technology.