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Furthermore, many hospitals are shifting to even more automated systems, in which equipment responds to voice commands. But amid a mess of sound in the individual voice frequencies, voice reputation software can not work well. In many hospital units, noise will not have a break at sunset. Measurements made by West and Busch-Vishniac indicated that noise amounts remain high night and day. This is attributed partly to medical center ventilation systems that work at powerful settings also to a proliferation of alarm-laden gadgets. Can anything be done to reduce hospital noise? Although the problem is complex, the Johns Hopkins acoustics specialists attained modest reductions by making two little changes in individual areas.