Thanks to Mental Health and Dementia Facilities Magazine for running soundscape as their lead story this month. You can read the full magazine online here.
Let’s start with the obvious: Noise in healthcare is a major problem. Step into a hospital and you’ll probably be greeted by bleeping alarms, staff conversations, pagers, slamming doors, rattling trolleys, air conditioning or televisions.
The problem is that most of these sounds aren’t part of a designed experience. And when we listen to the hospital soundscape collectively, these noises don’t tend to come together to form a gentle hubbub of activity. Instead, they tend to be noticeable stressors that punctuate an already uncomfortable environment.
Noise isn’t just annoying; it’s harmful. Noise in hospitals can increase patient stress, prolong recovery times and disrupt vital rest. This can be disastrous for the patient, but they’re not the only ones who suffer. Healthcare staff face increased burnout and even a higher risk of making critical mistakes – like dispensing errors – due to noise. And for visitors, these environments aren’t conducive to calm or comfort when they need it most.
This is where soundscaping comes in—not to eliminate sound altogether but to shape experiences with it.
Counterintuitively, absolute silence isn’t the best background ambience for rest or wellbeing. Silence signals danger, making us feel vulnerable. (Just imagine how you’d feel in a forest if the birds suddenly stopped singing.) Empty, echoey spaces can feel cold, clinical and devoid of warmth. Plus, in silent spaces, distractions that do occur become even more marked.
Soundscaping isn’t about reducing volume levels to zero. It’s about crafting an intelligent auditory experience that supports the functions of different spaces. By carefully designing the sonic environment, healthcare professionals can create spaces that reduce stress, improve focus and even promote faster recovery.
But how does soundscaping actually work? It’s a combination of two active processes: introducing beneficial sound into a physical space and simultaneously reducing the impact of distracting or stressful noise. These processes are made real through a combination of science and new technology.
In 1984, Ulrich’s famous study found that patients whose windows faced a park recovered faster compared with those looked out onto a brick wall. Since then, many thousands of research studies have shown that natural elements can improve health. These principles don't stop at what we see; they extend to what we hear. Sounds from nature can have a similarly profound impact on our health.
As we evolved outdoors, we came to associate certain sounds with safety, comfort, restoration and nourishment –– like birdsong, fresh running water or leaves swaying in the wind. Even though we now tend to live in urban environments and spend most of our time indoors, we’ve retained this connection to nature: When we hear certain natural sounds, our brains and bodies automatically relax.
The benefits of natural sound can be measured in many ways. Researchers measure it in people’s bodies: Heart-rate is reduced, breathing regulated, muscle tension eases and skin conductance response (a measure of stress) reduces. They also see mood improve, with greater feelings of comfort, safety, motivation, calm and escape from everyday concerns in the presence of natural sound. Amazingly, these sounds even reduce pain perception and patients require less pain medication in the presence of natural sounds.
The second process at work involves “masking” distractions.
Of all the annoying noises, overheard speech is the biggest complaint and distraction indoors. As inherently social creatures, we find speech almost impossible to ignore. But listening to it takes up most of our mental bandwidth. In healthcare, noises like overheard conversations disrupt patients trying to sleep and staff trying to focus.
Of equal importance in healthcare is acoustic privacy. On one hand, it’s about protecting patient confidentiality, ensuring that personal health discussions don’t leak out into hallways or waiting rooms. But beyond the legal obligation, there’s the human factor: patients are more likely to open up about sensitive issues when they feel they aren’t being overheard.
When noise is an issue, it might seem counterintuitive to introduce more sound. But by raising the “sound floor” or background level it can diminish distractions. For example, conversations become less intelligible and don’t grab people’s attention.
The beauty of soundscaping is that these masking effects can be achieved with natural sounds. A water soundscape, like a flowing mountain stream, can be designed to meet templates that maximise their efficacy of sound masking as well as acoustic comfort and wellbeing. It’s both soothing and functional – a win, win.
The idea of using sound to heal might sound abstract, but the results are very real. UK-based soundscaping company Moodsonic has been deploying soundscaping technology in corporate environments in the UK and around the world, and now too in healthcare buildings. Last year they announced a collaboration with a leading New York cancer centre to provide new insights into how soundscaping can positively affect patients and staff in healthcare.
Through their corporate work – which includes soundscaping wellbeing rooms, office spaces and waiting areas, among others – Moodsonic’s customers have found significant improvements: 47% reduction in psychological stress, 10% reduction in heart-rate, improved mood, 85% reduced distractions and 31% task accuracy.
The company has developed technology that takes the science of sound and enables it to be delivered as ambient background “soundscapes” in a building. The measurable benefits of sound are tuned into a library of themes to support functions like welcome, restoration, focus, privacy and sleep. Importantly, their sound never loops, as that would only cause more irritation. Instead, it’s generated using a sonic AI engine that evolves the soundscapes over course of a day to match people’s circadian rhythms and, using noise sensors, can adjust the qualities of the soundscapes in response to changing activity levels or distracting events. It’s kind of like a living soundtrack for healing.
Soundscaping isn’t a one-size-fits-all solution. It can be tailored to the needs of its specific spaces and users. Different soundscaping themes plays in different areas and building managers have direct control to change them. These developments also mean the benefits can be delivered at new scale. Moodsonic’s soundscaping technology is deployed throughout twenty-plus storey buildings and is planned in large-scale healthcare projects.
SFCHC’s mission is to transform people’s lives by advancing health, wellness, and equality with a focus on inclusion and social justice.
The soundscaping design process began by defining the building’s audio zones. These are the different functional areas where the soundscaping would play. At SFCHC, this includes waiting areas, corridors and individual behavioural health rooms. These were chosen as important parts of the patient journey: The soundscape could welcome patients into the building, support them as they moved through the space, and create a sense of calm in treatment rooms. Importantly, it would also afford patients extra acoustic privacy for sensitive conversations.
Alongside loudspeakers, amplifiers and a soundscaping generator, noise sensors were also installed in each zone. These sensors are highly secure. They discard any actual audio and extract only metadata about things like the activity level or volume level in the space. (They’ve passed stringent security tests and been installed in hospitals, banks and other high-security environments.) It’s these sensors that will allow the soundscaping at SFCHC to evolve in real-time as these spaces change.
With help from Moodsonic, the centre’s management team chose generative soundscaping themes for each of these areas. Change management is an important part of managing any sensory intervention and so clear communication with clinical staff around purpose and options is beneficial.
SFCHC’s soundscaping system requires very little ongoing management. Staff can directly control the soundscaping themes to create different ambiences when appropriate, but otherwise the sound evolves moment to moment, day to day.
“Moodsonic’s soundscaping has made a marked difference to patient and staff experience”, says the centre’s clinical team. “Staff have commented on the increase in acoustic privacy and say that the sound helps them feel more relaxed. Patients have told us how welcoming the building feels.”
In the mission to build smarter and more supportive healthcare spaces, soundscaping might just be the missing piece.
