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Friday, April 19, 2019

Dampening the Din - reducing noise through design in veterinary reception areas

Since I have sold Okaw Veterinary Clinic,  I have been creating webinars, speaking at seminars, and providing in clinic consultations to general veterinary practices.  The clinic consults are fun.  I call this my " Super Nanny" service.  Like the TV show,  I follow the staff around for the first hour to assess where they are  with Low Stress Handling skills,  where additional training is needed and any physical changes to the practice environment to reduce patient stress.  I present to the staff and demonstrate the Low Stress Handling skills that need polishing up, do some hands on coaching,  and will discuss cases.  I round out the day by meeting with the practice manager to outline what  protocols I will develop for this practice.  Email and video chat support is included in the consultation to support the process of staff development.
This is the back wall to the vaulted ceiling line, over the reception desk

  One of my " Super Nanny" visits was focused on a noisy reception area.   This clinic was advanced in reducing waiting area noise from the patients.   They created a " Kitty Concierge" service to prevent the  stressing feline patients  in the waiting area.  Special parking spaces were reserved near the front door, and a staff member would come to the car to directly escort the client and kitty directly to the exam room at appointment time.  Barking dogs were quickly moved to exam rooms or waiting outside to reduce patient agitation and noise.  The staff still noticed how loud one barking dog, even for a moment would be in the waiting area.   Even without any patient noise, the staff sensed a lot of reverberation of echo.  It was clear that there was something about the design of the reception area that was adding to noise problems.  This practice  moved to this newly constructed building less than 10 years ago.  A staff member commented that the " old building" was not as noisy as the new office.  High vaulted ceilings, covered in dry wall graced this new property.  The old property had typical flat ceilings with acoustical tile covering.
this is the free app from the National Institute for Occupational Safety and Health (NIOSH)

  I downloaded a decibel meter on my phone and took measurements at my visit.  In my pre visit research, I learned that noise over 85db  in an 8 hour day can cause hearing damage (OSHA guide)  Also spurts of noise over 115 db are painful, and can affect worker welfare.

 The waiting area had a high vaulted ceiling that met at a back wall to the reception desk.  With few clients in the waiting area, sound  measured  65  to 95 db   When I stood talking in a conversational tone with three other people, the sound increased to 90 db.  Upon showing the readings to the practice manager, she responded " Now I see why it is unbearable when just one barking dog is in here).  I discussed some general ideas for noise reduction and promised to research more solutions.

The very next day, I was at another clinic,  built 2 years earlier.  The lovely reception area had a peaked, vaulted ceiling, with many of the same hard reflective surfaces as the previous clinic.  I took out my phone and covertly checked the decibel levels.  This clinic was averaging 50 db and did not spike over 75db.  I commented to the reception staff that it was fairly quiet for a vaulted ceiling reception area.  The staff immediately responded " It was awful until we had the acoustical panels installed".  They pointed out lovely fabric panels, high on the walls that  absorbed the sound in the waiting area.   I took photos, and the the info of the installer which I  sent that night  to the other clinic.   It felt good to be able to use the experience from one clinic to help another.

 A closer look at the  fabric acoustical panels that helped with noise problems 
Last week I presented at a clinic in Kansas.  This property was about 40 years old, and the owner is planning on building a new clinic.  The present property has a vaulted ceiling, with ceramic tile floor, yet the noise level was generally low.  75 db was the highest recorded level, during  a busy time of  client traffic, phones ringing, and staff conversations.  I noticed the popcorn ceiling finish. This style is dated, yet absorbs noise better than plain drywall. The reception desk area had an 8 foot ceiling with acoustical tile, which also helped reduce noise there.  I strongly advised the practice manager to  review the design, focusing on  the reception area to avoid noise problems.   Many modern clinics are styled with vaulted ceilings, hard flooring, counter and wall surfaces which increase noise problems.  They look lovely but can literally create headaches for our staff and patients.

 The impact on staff stress due to  noise reflection is significant.   Various medical groups have  studied the reduced productivity of office workers due to  noise (noise studies ref).  Strained facial expressions in our staff trying to hear  a client on the phone, or talk to a client across the counter  affects the animals in care too.  Carefully considering the ceiling design, surfaces, and flooring before new construction or remodeling can save a lot of problems.

Solutions are easy and not very expensive for existing practices.   Acoustical panels range in price and effectiveness panel resources .  At first,  I suggest you measure  your noise levels.  Download a decibel meter to a smart phone or i pad at the office.  Measure and record at different times of the day to see the range.  If you have a large reception area, and are at high levels, hire an acoustical consultant and installer.  They can create a plan for you, working with your budget and needs.  If you cannot find an installer in your area, reading some of the info at the resources link above may help you create a plan for yourself.  Simple choices such as cloth upholstery for chairs over hard plastic, fabric wall hangings or canvas paintings are some solutions.   A combination of ideas can create the noise reduction you need.
A comfortable cloth chair, about $50 is an inexpensive furniture fix 

 If you are building new,  be aware that expertise in acoustics can vary.  In my experience, few builders understand  the levels of noise, the intensity of our work and the need for conversations in a practice.  An architect  specialized in veterinary clinical design tends to have this expertise and understanding.  Some of these architects may offer review services for building plans, if they are too far away.  Take time to visit  other clinics and measure the sound level in their reception areas.  Notice  the flooring, ceiling and furnishing choices, especially in the quieter offices.  You may be departing from a popular design style to not opt for a vaulted reception space, yet you may appreciate the quiet environment it helps provide.  One of my friends did these site  visits when he built a new practice building.  When I stopped by the  office, the noise level barely raised about 60 db.  Opting for a flat ceiling in the reception area was a departure from the popular style,  but an important choice for the function of the space.

I look forward to more clinic consults aka " Super Nanny" visits.  Meeting the veterinary staff, clients and seeing the change in veterinary medicine that incorporates the understanding the animal in front of us, right now for care is so exciting.  If you would like to know more about a clinic consult, please email me at


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