The Sound of Healing – Why acoustics in healthcare matter

Why sound matters – for everyone

Hearing is unique among the senses: it never switches off, even during sleep. As Quast explains, “Whilst all other senses switch off when you sleep, hearing continues. Noise at night causes stress and can have a direct impact on the power and functioning of the brain, promoting deterioration of the brain, especially if you already live with dementia,” he adds.

Scientific evidence supports this. Poor acoustics raises heart rate and blood pressure, increasing risks of stroke and heart attack. In another study of hospital wards from 2014, it was shown that noisy wards mean patients struggle to sleep, staff suffer stress, and visitors endure discomfort and anxiety – not the conditions conducive to healing.

For residents and patients alike, it causes agitation and confusion. For staff, it leads to fatigue and burnout. Davies frames it simply: “There are three groups of users in any healthcare facility: staff, patients and visitors. We need to design for all of them.”

The status quo problem

Despite its impact, acoustics is often marginalised. “Too many times I’ve seen projects where ceilings are going in and someone suddenly realises there’s no acoustic control. At that point, it’s too late and too costly,” says Davies.  The Health Technical Memorandum 08-01: Acoustics, confirms this, pointing out that the late discovery of acoustic shortfalls leads to expensive retrofits, and it adds that early design control reduces risk.

Cutting costs on engineering exacerbates the problem, says the Health Technical Memoranda (HTMs) on Accoustics (HTM 08-01). Good acoustic conditions improve patient privacy and dignity, and promote essential sleep patterns, says the HTM, but it finds removing soundproof, absorptive finishes reduces speech intelligibility and privacy. Acoustic ceilings and panels are stripped out to cut capital costs, even though this has been shown to undermine long-term operational efficiency.

Design vs. product interventions

There are two main approaches to acoustic control: first, spatial design, shaping the size, layout and surfaces of rooms to minimise reverberation; and second, product solutions, using acoustic ceilings, wall panels or discreet materials to absorb sound.

“Clients often think of acoustics as white ceiling tiles,” Davies notes. “But we can deliver monolithic ceilings with excellent sound absorption. Acoustic control can be very discreet,” he adds. “Some of the issues with sub-division you take away sight lines for people, and for those with dementia, we must keep these. Panels can provide acoustic control but can also double as artwork, providing way-finding cues for people with dementia while controlling noise,” he adds. In a care home setting, a good example of this approach would be a “Memory Lane” corridor where different sections of the hallway are distinguished by unique acoustic art panels.

This shift from institutional aesthetics to integrated solutions is crucial. As Davies puts it, “We can kill two birds with one stone, provide acoustic control and enhance the environment, and provide access to the services. Getting this in place early will save money in the long run.”

Infection control vs. acoustics

A common objection is infection control. Soft, absorbent surfaces raise concerns in clinical spaces. Davies argues this is outdated: “In care homes, requirements are different from acute hospitals; we don’t have surgical procedures, etc. We can use removable canvases that can be washed or ceilings that can be vacuum cleaned. Infection control doesn’t have to mean noisy, hard spaces.”

Materials matter, for example, stone wool, which is naturally inorganic and resistant to bacterial growth, is a good option in the cavities of internal partition walls. And strategically placing sound-absorbing material on the ceiling, generally the largest uninterrupted surface and less likely to come into direct contact with patients or equipment, will still effectively control reverberation in the space.

Quast adds that in day-to-day areas, infection risk is more about cleaning regimes and workflow separation than surfaces themselves. The challenge is integrating both perspectives without compromising either.

Standards, regulations and gaps

As stated above WHO recommends that average sound levels in healthcare be maintained at or below 35 dB during the day, but few healthcare settings achieve these targets.

UK Health Building Notes and Health Technical Memoranda specify acoustic performance for clinical areas, but implementations can slip when not embedded in the brief. Certification schemes such as Building Research Establishment Environmental Assessment Method (BREEAM) and the WELL Building Standard add further incentives for early integration.

How to lock acoustics in early

“Locking in early can give you a BREEAM certificate of excellence, just the thought process of how we can work acoustics with the space, you can save a lot of hassle in the long run,” says Conrad Quast.

People in Spaces

The impact of acoustics is felt daily in very subtle ways. Residents may avoid dining halls because noise overwhelms their hearing aids. “These big posh spaces might look great, but if you have a hearing impediment, you won’t use them,” says Quast.

Families struggle to talk, and staff experience cognitive load from constant alarms and reverberation.

Targeted interventions, for example, subdividing spaces, adding absorption, and changing furniture profiles, can transform experiences. Davies describes ‘psychologically’ safe spaces, for example, out of healthcare, going to a restaurant where seats are higher at the back can make eating out a much more enjoyable experience for people with hearing problems.

Critical Care in Neonatal Intensive Care

In critical environments such as Neonatal Intensive Care Units (NICUs) and Intensive Care Units (ICUs), excessive noise can disrupt an infant’s physiological systems and interfere with their development, while also affecting family and staff wellbeing and communication. US research, shared in the BMJ, shows that high sound levels in neonatal units, often exceeding 80 dB (compared to the American Academy of Paediatrics’ recommended 45 dB) are linked to physiological instability, including fluctuations in heart rate, blood pressure, oxygen saturation, and increased cortisol levels. In preterm or low-birthweight babies, this can contribute to disrupted sleep, delayed neurodevelopment, and extended recovery times. Implementing strategies such as reducing overall sound levels and transitioning from open bays to single-family rooms helps create calmer, developmentally supportive environments for newborns and their families.

Strategic Benefits of Early Acoustic Thinking

Embedding acoustic planning early in a project, ideally at Stage 2 (Concept Design) of the RIBA Plan of Work, is highly effective for several key reasons:

• Cost-Effectiveness – designing acoustics in the early stages significantly reduces cost compared to expensive retrofits later on. Integrating acoustic requirements during the design phase avoids the need for disruptive and costly post-construction modifications.
• Operational resilience – proper early acoustic planning supports operational resilience in various environments:
  • Fewer complaints. Addressing noise concerns early leads to fewer noise-related complaints.
  • Calmer patients in a quieter, less stressful atmosphere contribute to reduced patient anxiety and improved recovery times.
  • Clearer communication. Effective acoustic design ensures optimal speech intelligibility in critical areas