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.

NOISE 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 tasks 8 . 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 months 9 . 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 Digital 11 . 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 decibels 12 . An evaluation of noise pollution in ORs show that procedures regularly register noise levels of more than 90 decibels, significantly higher than recommended safe guidelines 13 . 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

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leads to more time off and people leaving the profession. As a recent report found, stress and burnout are two of the leading causes for people leaving their jobs 14 . 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% 15 .

The Financial Calculation Noise, therefore, can be expensive. By investing in measures which reduce or eliminate noise pollution, hospitals will save money in the longer run. But the question remains: can they afford that investment?

The financial struggles of the health service have been well documented. Rising patient numbers, better technology and an aging population requiring long term and complex care, are putting health budgets under pressure. A lack of investment from successive governments has left health services across the world struggling to make ends meet.

A report in the Guardian found that hospitals are already struggling to afford new equipment 16 . This forces staff to use out of date equipment which reduces the quality of care. For example, because radiologists are using out of data scanners, health services can be forced to spend significant resources rescanning patients. Substandard equipment costs money in many different ways - It reduces performance, increases workload and, if it’s noisy, creates a stressful and uncomfortable operating environment.

This is a considerable and ongoing drain on resources. By addressing noise pollution, hospitals can make gains at multiple points. They can reduce the strain on medical professionals, improve care and reduce errors. To do this, they will have to look at the type of equipment they are using. Loud mechanical devices such as vacuum pumps can push noise levels inside the operating theatre well beyond healthy levels. Manufacturers are increasingly looking at solutions to reduce the noise their devices make. As we’ve seen in this article, this not only makes life more comfortable for surgical teams and patients, but also the people in the accounts department!

Substandard equipment costs money in many different ways - It reduces performance, increases workload and, if it’s noisy, creates a stressful and uncomfortable operating environment Noise, therefore, can be expensive. By investing in measures which reduce or eliminate noise pollution, hospitals will save money in the longer run