Pebble Partner Affinity Health System's St. Elizabeth Hospital, located in Appleton, Wisconsin, applies Lean principles to identify and eliminate waste, evidence-based design (EBD) practices to enhance the patient experience, and sustainable criteria to design and build environmentally friendly buildings. All three concepts--Lean, EBD, and sustainable design--are required to help carry out Affinity Health System's promise of personalized care of listening, treating patients with respect, and putting their needs and interests first. As part of implementing evidence-based design in a renovation of the Emergency Department (ED) waiting room, Affinity Health System selected a new acoustically absorbing wallcovering product to use on the ED waiting room walls. To evaluate the effectiveness of this approach, Affinity partnered with fellow Pebble Partner Johns Manville and product manufacturer SoundTech to measure both the acoustical change in the room and the perceived noise and privacy from patients, families, and staff in the ED. Acoustics in healthcare--What are the issues?