Patient Reports of Night Noise in Hospitals Are Associated With Unplanned Readmissions Among Older Adults

Abstract

Objective: Sleep disturbance is a key contributor to posthospital syndrome; a transient period of vulnerability following discharge from hospital. We sought to examine the relationship between patient-reported hospital quietness at night, via a validated survey, and unplanned hospital readmissions among hospitalized seniors (ages 65 and older) in Alberta, Canada. Design: Retrospective, cross-sectional analysis of survey responses, linked with administrative inpatient records. Setting: Using the Canadian Patient Experiences Survey—Inpatient Care and Discharge Abstract Database, patients aged 65 and older, and living with one or more chronic conditions were identified. Participants: Of all, 25 674 respondents discharged from hospital between April 2014 and December 2017. Main Outcome Measure: All-cause, unplanned readmission within 30 or 90 days (yes vs no). Results: Approximately half (50.5%) of the respondents reported that the area around their room was always quiet at night. Eight (8.1%) percent of respondents (2066) were readmitted within 30 days (2241 total readmissions), while 15.6% (4000) were readmitted within 90 days (5070 total readmissions). When controlling for a variety of demographic and clinical factors, patients not reporting “always” to the survey question regarding hospital quietness at night had slightly greater odds of readmission within 30 (adjusted odds ratio [aOR] = 1.32, 95% confidence interval [CI]: 1.20-1.45) and 90 days (aOR = 1.14, 95% CI: 1.06-1.23). Conclusion: Our results demonstrate a clear association between patient-reported hospital quietness at night and subsequent readmission within the first 30 and 90 days following discharge. Efforts to minimize hospital noise, particularly at night, may help promote a restful environment, while reducing readmissions among older patients living with chronic conditions.

ACT Transition from Hospital to Home Orthopaedic Survey: a cross-sectional survey of unplanned 30-day readmissions for patients having total hip arthroplasty

“… 38 This has also been demonstrated in Canada where patient-reported quietness in their hospital environment was associated with a decrease in 30-day and 90-day readmission rates. 39 Our research adds to this evidence in quantifying an association between patients’ perceptions of rest and unplanned readmissions. This finding provides a rationale for hospitals to ensure that patients receive adequate rest and sleep throughout their hospital stay.…”

How to analyze and link patient experience surveys with administrative data to drive health service improvement -- examples from Alberta, Canada

“…In one study, we found that a lack of patient involvement in their care decisions and not receiving written discharge instructions were associated with unplanned readmission to hospital [ 42 ]. Among older adults, we observed that those who reported night noise in their hospital environment had higher odds of being readmitted to hospital [ 43 ]. In another study among adults, we explored use of the 3-item Care Transitions Measure.…”

“…Association with patient-reports of night noise in hospitals with unplanned readmissions among older adults [43] Examine the relationship between patient-reported hospital quietness at night, via a validated survey, and unplanned hospital readmissions among hospitalized seniors (ages 65 and older).…”

Sleep disruption in older surgical patients and its important implications

“…Noise originates from machine notifications, patient care alarms (bed alarm, call bell, codes), care staff, and other patients 64. High levels of noise are correlated with sleep disturbance, longer length of stay (LOS), and unplanned readmissions 65,66…”

“…64 High levels of noise are correlated with sleep disturbance, longer length of stay (LOS), and unplanned readmissions. 65,66 Overhead lights in the hospital are kept at a constant level of brightness throughout most of the working days; designed to provide an optimal environment for health care providers to function. 67 Exposure to light close to bedtime can negatively impact the quality of sleep.…”