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Poor acoustics cause patients stress at mental health unit

Hospital trying to fix corridors' reverb and "flutter echo"

Posted: September 19, 2013 - 11:10pm  |  Updated: September 20, 2013 - 12:11am
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Bartlett Regional Hospital Mental Health Unit Director Jennifer Brown, left, and Clinical Nurse Supervisor Penny Fossman look at one of the noisy air vents in their ward's hallway.  Michael Penn | Juneau Empire
Michael Penn | Juneau Empire
Bartlett Regional Hospital Mental Health Unit Director Jennifer Brown, left, and Clinical Nurse Supervisor Penny Fossman look at one of the noisy air vents in their ward's hallway.

Down the long corridors of the mental health unit, a secure wing on the third floor of Bartlett Regional Hospital, Jennifer Brown paused in the middle of a conversation with the nurse supervisor on duty Thursday.

“You can hear the echo, right?” she asked.

The constant reverberation of sound off the bare, hard-finished walls has become a nuisance too loud to ignore. Clinical Nurse Supervisor Penny Fossman said the noise levels keep the patients overstimulated during the day and disrupts their sleep at night.

“I think it can just be an annoyance for people sometimes,” she said. “Sometimes people are just sitting in their rooms and the noise from the fans will be really bothersome to them.”

Brown, the director of the mental health unit and the director of Rainforest Recovery, said sometimes it’s difficult for staff to listen to what their patients are saying, especially if there’s a commotion anywhere in the wing.

“We have some acting out behaviors and things like that, it can become very loud and very disruptive for everybody,” she said. “It’s a very echo-y unit.”

Hospital administrators say the poor acoustics are a problem unique to the mental health unit, where extra precautions are taken for safety reasons. The wing houses up to 12 patients at a time who are either experiencing acute symptoms related to their mental health issues, or detox patients who are withdrawing from drugs. A total of 270 patients stayed there (either voluntarily or involuntarily) from March 2011 through March 2012 for an average stay of eight days, as well as 107 detox patients.

Nothing — not even artwork — adorns the walls, ceiling or floors to help absorb sound. The art was recently taken down after a patient ripped a mounted painting off the wall and tried to hit another patient with it.

Just across the hall in the medical surgery unit, where one would be taken to rest after having surgery for a broken leg, for instance, a drop ceiling and acoustical ceiling tiles help deaden noise. But in the mental health unit, staff say that’s not a possibility since the tiles are not secure and the patients would be able to remove them and potentially harm themselves or others. Their ceilings and walls are made of gypsum board, which has an acoustically “hard” finish. The floor is sheet vinyl rather than carpet.

Aside from the overall unfortunate look of a sterile clinical environment, acoustical engineers found that the geometry of the wing creates what’s known as a flutter echo. That’s when sound bounces off the walls back and forth, but also bounces between the floor and the ceiling, all the while traveling down the length of the corridor.

Independent of that finding is the reverberation time, which was calculated to be 1.80 seconds. That means any sound — from a whisper to the ice machine — takes 1.80 seconds to decrease by 60 decibels after the source of the sound has been stopped.

In an effort to fix the problem, the hospital’s facilities manager Marc Walker requested the study that made those findings in early 2012. He hired a local engineering company to evaluate the existing acoustics conditions in order to see how much it would cost to fix, and that company, Wilson Engineering Inc., consulted with Acoustical Engineer Julie Weibush in Seattle.

Weibush recommended installing absorptive panels on the ceiling that would reduce the noise level by half. Wall panels would further reduce the noise level, she wrote in a memo. The recommended materials were specific: the ceiling panels should be interwoven wood fibers bonded with inorganic hydraulic cement. Wall panels should be a glass fiber panel covered with a perforated co-polymer sheet.

But the materials are not the cost-prohibitive aspect of the project. In the budget the engineering firm came back with, construction cost would cost $185,000. Including costs for contingency, architectural design/bid documents, CBJ contracts/construction administration and escalation into the year 2013, the total project budget cost balloons to $320,000.

With such a high price tag, the hospital has struggled to find funding for the project within its own budget. BRH spokesman Jim Strader said the hospital fully supports the initiative to improve the acoustics but that the project did not make it through the budget process last year as a requested capital project.

“A lot of projects are submitted,” he said. “We obviously — because the hospital does have finite resources — can’t do every project that’s submitted. In fact, it can probably do fewer than a third of the requests that are made.”

He said the things that normally get funded are the ideas that serve the greatest number of patients or that there’s the greatest need for.

“Sometimes items are chosen based on return on investment, a revenue producing idea, for example, a piece of equipment ... that might be worn out and that we use frequently,” he added.

Administrators are presently exploring other options for funding through grants and fundraising, in an effort to address the issue. Finding a less expensive solution is also an option.

Brown, who began her job as the director last year, said that despite the obstacles, the effort to improve the acoustics will remain a priority for her.

“We want to promote a nice healing environment for patients,” she said. “It’s a great unit, it’s a safe unit, it’s a clean unit, but we think we could improve the healing aspect of it.”

• Contact reporter Emily Russo Miller at 523-2263 or at emily.miller@juneauempire.com.

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