Turning Down the Volume: Establishing Emergency Department Noise Baselines for a Consensus-Driven Noise Reduction Intervention Strategy

Excessive noise in the ED impacts provider communication and wellness, as well as patient safety and patient experience. ED noise levels routinely exceed recommended noise thresholds - 35 dB (WHO) and 45 dB (EPA) - yet most hospital noise-reduction efforts have focused on ICUs, operating rooms, or procedural time-outs. Prior ED interventions have produced only modest, short-lived improvements. This study establishes baseline ED noise levels and temporal variation as the first phase of a larger, consensus-driven initiative to design, implement, and evaluate stakeholder-informed noise-reduction strategies.

HIPAA-compliant noise meters (made by FeedbackNow, Inc.) were deployed across three ED pods and a resuscitation bay. Discrete decibel readings were captured every 5 minutes, 24 hours/day, for two weeks. Statistical comparisons were performed for readings from one pod using Two Independent-Sample t-tests.

Baseline ED noise in this pod ranged from 41–84 dB (mean 65 ± 9 dB). Noise levels rose significantly during overlapping RN/MD shift changes (p<.0001), with a mean increase of 3.67 dB (95% CI: 1.99–5.35). Overnight noise was lowest, averaging 3.6 dB below daytime levels (95% CI: –5.38 to –1.72). Weekend mornings were quieter than weekday mornings by an average of 1.6 dB (95% CI: –2.82 to –0.47).

ED noise consistently exceeds recommended limits, underscoring the need for targeted, sustainable interventions, especially at change of shift. These baseline data provide the foundation for testing a consensus-driven, stakeholder-informed approach to reducing ED noise. Limitations include generalizability and the inability of these noise meters to capture peak sound events.