🏥 Institutional Noise

Institutional noise refers to:

Variability or distortion in clinical outcomes, data quality, or procedural metrics that arises from non-clinical institutional factors rather than the intervention or treatment itself.

🔍 Sources of institutional noise include:

Differences in perioperative protocols (e.g., antibiotic timing, discharge criteria)

Variations in nursing care, infection control practices, or rehabilitation pathways

Documentation habits or data collection inconsistencies across staff

Surgical scheduling, OR availability, or bed management policies

Team composition variability (e.g., resident turnover, surgeon pairings)

🧠 In research, it affects:

Comparative studies: outcomes may appear better for one group simply due to how that group was handled institutionally

Multicenter trials: results may be difficult to generalize or compare due to heterogeneity in institutional practices

Quality metrics: may reflect system quirks rather than actual patient care quality