How private is your consultation? Acoustic and audiological measures of speech privacy in the otolaryngology clinic

Abstract

The right to confidentiality is a central tenet of the doctor-patient relationship. In the United Kingdom this right to confidentiality is recognised in published GMC guidance. In USA the Healthcare Insurance Portability and Accountability Act of 1996 (HIPAA) strengthened the legal requirement to protect patient information in all forms and failure to do so now constitutes a federal offence. The aims of this study are to assess the acoustic privacy of an otolaryngology outpatient consultation room. Acoustic privacy was measured using the articulation index (AI) and Bamford-Kowal-Bench (BKB) speech discrimination tests. BKB speech tests were calibrated to normal conversational volume (50 dB SPL). Both AI and BKB were calculated in four positions around the ENT clinic: within the consultation room, outside the consulting room door, in the nearest waiting area chair and in the farthest waiting area chair. Tests were undertaken with the clinic room door closed and open to assess the effect on privacy. With the clinic room door closed, mean BKB scores in nearest and farthest waiting area chairs were 51 and 41% respectively. AI scores in the waiting area chairs were 0.03 and 0.02. With the clinic room door open, privacy was lost in both AI and BKB testing, with almost 100% of word discernable at normal talking levels. The results of this study highlight the poor level of speech privacy within a standard ENT outpatient department. AI is a poor predictor or privacy.

The Impact of Personal Protective Equipment on Speech Discrimination and Verbal Communication in the Operating Room and the Role of Audio Communication Devices

“…This replicates several speakers talking at the same time indicative of a busy clinical environment. These values were selected in keeping with previous studies on background noise within operating room and intensive care environments (approximately 55–70 dBA), with common peak levels measured greater than 80 to 90 dBA 10–13 …”

“…These values were selected in keeping with previous studies on background noise within operating room and intensive care environments (approximately 55-70 dBA), with common peak levels measured greater than 80 to 90 dBA. [10][11][12][13] Identical PPE was standardized and provided to each participant (see photo, Supplementary Digital Content 3, demonstrating standardized PPE, http://links.lww.com/SIH/A832). A Filtering Facepiece 2 (FFP2) antiparticle respirator was used (GB2626-2006 KN95, http://links.lww.com/SIH/A832) along with a transparent face-shield visor and disposable surgical scrub cap throughout.…”