SPECIAL REPORT: REDUCING NOISE POLLUTION IN THE OPERATING ROOM
The Financial Cost of Noise Pollution in the Operating Theatre Jo Roth, Staff Writer Noise pollution has a serious drain on healthcare resources. At a time when money is tight, addressing noise pollution is becoming increasingly important.
N Stressed professionals also make more mistakes. A study which used technology to measure the electrical activity of a surgeon’s heart during procedures found that a loud noise could trigger short term intervals of stress, which also increase the risk of a mistake by 66%
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OISE POLLUTION is a serious but underestimated problem in the healthcare sector. It is stressful for staff and patients; it impacts physical and mental health and can increase the risk of surgical error. By all important metrics, this is an issue which health services should be taking more seriously. Even so, one thing always stands in the way: money. Budgets are stretched and almost every decision, no matter how important, will have to make a financial case. In this article we will attempt to analyse the fiscal impact of noise pollution.
Lower Standards The most serious claim is that noise pollution increases the risk of error. A literature review found that noise in the operating room hinders communication, affects concentration and makes it more difficult to perform complex tasks8. The inevitable result, the review implies, is that the risk of error will be higher. Distracted surgeons, struggling to hear their colleagues are more likely to make mistakes, which has serious implications for patient safety and hospital finances. First, let’s look at the very obvious threat to patient safety. Patients who suffer a surgical error are seven times more likely to die while hospitalised and are much more likely to be readmitted within three months9. Controlling noise pollution should be seen as part and parcel of a hospital’s duty of care towards its patients. The financial impact comes from increased care requirements and possible legal action. Mistakes lead to more serious and urgent interventions, longer hospital stays and more expensive care. If errors are serious, they will also expose the hospital to legal action. Figures suggest that negligence claims against the NHS have doubled in five years following a steep rise in delays. In total, 1,789 patients, or their bereaved families, received payments in 2017/18, a rise
from 1,406 cases in 2013/14. This equated to payments of £655 million, up from £327 million.10 Part of this rise comes from pressures on NHS services as well as a burgeoning claims market. As a quick search on Google demonstrates, this is a healthy market full of participants, some more trustworthy than others. The noisier ORs become, the more likely it is that errors will happen and the more difficult it will be to reduce the cost of negligence claims.
Staff Wellbeing A secondary and slightly difficult to measure impact is staff wellbeing. As we saw in the first article, noise pollution contributes to mental health problems. The last few years have seen a surge in stress related illnesses among NHS staff. They are taking 100,000 more sick days than they did six years ago, according to figures from NHS Digital11. In acute departments there has been a 35% rise in the number of sick days taken. The most common anecdotal reason given by professionals include staff shortages and an overwhelming workload. However, noise pollution also subtly increases stress and feelings of exhaustion in ways which are not always immediately apparent. In the UK, employers must provide protective equipment for workers exposed to more than 85 decibels. Hearing checks are also required for workers regularly exposed to noise levels more than 85 decibels12. An evaluation of noise pollution in ORs show that procedures regularly register noise levels of more than 90 decibels, significantly higher than recommended safe guidelines13. The literature review mentioned earlier suggested peak operational procedures could see noise levels as high as 130 decibels. This noise increases stress levels for staff, which has multiple impacts. Firstly, it reduces the happiness and wellbeing of staff which
