by Jennifer Sippel, PhD
Program Manager, Spinal Cord Injury Service, VA North Texas Healthcare System
Assistant Professor, Physical Medicine & Rehabilitation, UT Southwestern Medical Center

In the age of efficiency and rising cost, healthcare leaders and front line providers alike sometimes wonder if it’s possible to add “one more thing” to the myriad of performance measures.  If we identify noise as a problem, those we lead will want a good rationale for spending time and effort on solving it.

Plenty of research suggests that uninterrupted, quality sleep can, in and of itself, provide powerful, healing effects.  System redesign and healthcare safety professionals know that a quiet environment can reduce errors and improve work efficiency.  Ample information and experience suggests that a quiet healthcare environment can greatly improve safety, effectiveness, outcomes, and patient satisfaction.

So why is achieving a quiet healthcare environment still eluding so many healthcare systems?

One right answer might be that “quiet” in a healthcare environment isn’t just about the easily-measured (and devilishly difficult to attain) absence of decibels.  Quiet is, in fact, a personal way of being.  It is a felt presence and healing energy sensed by a critically-injured patient the moment she must start trusting strangers working in a hospital.  Quiet is the empowerment afforded a patient feeling most vulnerable when he receives devastating, life-changing news.  Quiet is a healthcare worker who knows what health and well-being means to her, and that her organization supports her investing in personal vitality.  Quiet is a potent and cost-free gift to patients that creates space for their voices and values.  Quiet encompasses all the humanity, in every moment a patient is cared for, in healthcare systems around the globe.  In other words, a quiet healthcare environment is not about the noise.  It’s about our common humanity and honoring the role of healing in the world.

We can all imagine a time we dealt with unwanted, stressful noise and how it impacted us—maybe in a healthcare environment or maybe someplace else.  Regardless of context, we likely remember it was about much more than the noise itself and possibly involved experiences of frustration, resentment, anger, burnout, powerlessness, suffering, or indignity, to name a few.  When we as healthcare leaders and front line providers face the consequences of a less-than-optimally-quiet healthcare environment, we are called to engage with much more than noise.  We must meet the calling of our patients’ deepest, most heartfelt human needs—dignity, respect, loving-kindness, and compassion.

If we begin to believe that quiet really is about honoring all of these intensely meaningful human rights, it can seem overwhelming.  However, there are a growing number of accessible practices related to compassion and mindfulness which can actually address critical healthcare factors such as healing environment, patient experience and employee resilience.  An example includes employees at VA North Texas Healthcare System which in FY15 volunteered to participate in Compassion Cultivation Training (CCT), an eight-week, 16-hour course including daily compassion meditation exercises.  Participants reporting doing more daily compassion meditation practice were protected against burnout compared to their less-frequently-practicing classmates at the end of the course.

Strengthening these qualities in healthcare employees can serve as a formidable foundation for employees’ commitment to creating a quieter environment, as well as other positive healthcare delivery transformations.  When we are less stressed and more engaged, we can be better listeners and focus our attention and healing presence on patients.  Patients are then more likely to report a quieter, calmer, more healing experience.  They are more likely to report feeling listened to and valued as human beings.

If you find yourself in a position of leading healthcare change, and part of that change involves creating a quieter environment, consider the possibility of not focusing exclusively on noise levels.  Instead, consider focusing on the human beings relying on your leadership.  Connect with your patients.  Inspire those you lead.  Listen deeply.  Instead of focusing on a noise problem, ask your patients and your healthcare providers what a quiet, healing environment looks like and feels like.  They will tell you what matters to them most, and that’s a powerful place to start.

Interested in changing the conversation about noise, healing quiet, and common humanity in your healthcare system?

Consider these resources…


  • In Pursuit of Silence: Listening for Meaning in a World of Noise by George Prochnik
  • Silence: The Power of Quiet in a World Full of Noise by Thich Nhat Hanh
  • Practicing the Sacred Art of Listening by Kay Lindahl


About the Author

Dr. Jennifer Sippel has served Veterans at VA North Texas Health Care System for over fifteen years, and is currently a Program Manager with the Spinal Cord Injury Center.  She works to integrate complimentary and integrative health (CIH) services into Veterans’ care, and recently developed and is evaluating a new Spinal Cord Injury Acupuncture Clinic, which also provides mindfulness and aroma therapies.

In her career, she has received approximately $2 million in grant funding to implement patient-centered and whole health programs within Veterans Health Administration (VHA).  In FY16, she received a grant from the VA Office of Patient Centered Care & Cultural Transformation for over $500,000 to hire a health coach for each primary care team at a new VHA outpatient clinic in the Dallas area.

Dr. Sippel also serves on her facility’s Organizational Health Committee and created new interview questions to help hire health care employees who are best qualified to provide patient-centered care and engage in behaviors aligned with the vision of transforming health care from traditional problem-focused care, to care that is personalized, proactive and patient-driven.

In 2014, Dr. Sippel trained at Stanford School of Medicine, Center for Compassion & Altruism Research & Education (CCARE) and received their certification as a Compassion Cultivation Training (CCT) teacher.  She has developed many unique Veteran and employee training programs, including Autonomy Support Training (AST).

Dr. Sippel’s program evaluation and research areas of interest include complementary and integrative health (CIH), spinal cord injury home care, health care employee resilience, experiential learning models, Whole Health implementation and outcomes, VA hiring practices, and values-based organizational change.

Dr. Sippel is a licensed clinical psychologist in the state of Texas and provides executive/leadership coaching services to VA leaders and private clients.  She is also an Assistant Professor with the department of Physical Medicine & Rehabilitation at UT Southwestern Medical Center.