Noise Levels in Two Emergency Departments Before and After the Introduction of Electronic Whiteboards

Purpose: Hospital work generates noise. This article investigates the noise level in emergency departments (EDs) to assess the need to address this aspect of the work environment and to investigate whether the replacement of dry-erase with electronic whiteboards lowers the noise level. Method: In Study I we measured the noise level at the three coordination centres of an ED while it was still using dry-erase whiteboards and after it had switched to electronic whiteboards. In Study II we made similar noise measurements at another ED, supplemented with observation. Results: The median daily equivalent continuous noise levels were 60.0, 55.3, and 55.4 dB(A) at the three coordination centres in Study I and 56.5 dB(A) at the coordination centre in Study II. In both studies the noise levels were higher during workdays than weekends and higher during day and evening shifts than during night shifts. The maximum equivalent continuous noise levels across 1 second were above 80 dB(A) at all four coordination centres. At two of the centres above 80 dB(A) noises also occurred at night. After the introduction of electronic whiteboards the noise level was lowered at one ED but unchanged at the other ED. The main noise sources at the ED in Study II were clinicians talking, phones ringing, and equipment being moved around. Conclusion: The noise level at both EDs is above levels previously found to decrease the quality of work, increase the strain on the staff, or both. The transition from dry-erase to electronic whiteboards gave mixed results with respect to alleviating the noise problems.