April 4, 2017

Two Kaiser CEOs were admitted to the system's hospitals. Here's what went well—and what didn't

Daily Briefing

    Editor's note: This popular story from the Daily Briefing's archives was republished on Feb. 8, 2019.

    In 2017, two executives—Bernard Tyson, CEO of Kaiser Permanente, and Robert Pearl, CEO of The Permanente Medical Group—became patients themselves. Both penned praise of their physicians and caregivers, but Pearl also offered some difficult reflections on the frustrations of being a patient.

    A 'personal tribute' to Kaiser's medical team

    Tyson, who has a history of cardiac problems, explains in a LinkedIn post that while he was "going about business as usual," he realized something wasn't right with his heart. He called his cardiologist and rushed to a Kaiser ED where, after a series of tests, "the ED team pinpointed the problem and stabilized me to normalcy within a short period of time."

    Next, Tyson's cardiologist came to the ED and took charge: "She explained. She touched. She observed. She instructed. She listened. She cared," Tyson writes. Based on her examination and guidance, Tyson had surgery a week later and "experienced first-hand the medical excellence we deliver." In Tyson's words, the "master" interventional cardiologist who performed the procedure described what he would do in a way that made Tyson feel like he was "meeting with an artist."

    The procedure went "exceptionally well," Tyson writes, and he returned to health in a few days. "I have fully recovered to enjoy life with my family and to lead this incredible organization."

    Tyson says that his experience has made him extremely grateful. "This is my personal tribute to our physicians—to my personal physicians with their dedication, expertise and professionalism who returned me to health—and to the 22,600 Permanente Medical Group physicians who practice skillfully for the 11.7 million members of Kaiser Permanente," he writes.

    "While I've always loved our physicians," Tyson concludes, "I walked out of the hospital with even more respect and gratitude for what they do for all of us. Thank you."

    A challenging ride

    Robert Pearl, CEO of The Permanente Medical Group, also recently became a patient after he severely fractured his leg in an accident—but his patient experience included some difficult moments.

    Like Tyson, Pearl praises the care and professionalism of the clinicians and staff who guided him from the ED to surgery and eventually to discharge. He says Kaiser's focus on evidence-based best practices, integration, telemedicine, and "wonderful" medical team created an extremely high-quality clinical experience.

    But during his three-day stay at the hospital, Pearl became "disoriented, verging on delirium," a "frighten[ing]" condition that he realized in retrospect stemmed from a lack of sleep. "The underlying reason was that the hospital staff, in order to complete the tasks required by hospital policy and state regulations, came into my room more than 30 times throughout the day and night," Pearl writes. And while those interruptions were "well-intentioned," they took a heavy toll on his ability to rest.

    Pearl lists some of the constant interruptions which kept him awake, including:

    • Vital signs every four hours;
    • Adjustments to medical equipment;
    • Food orders and deliveries;
    • Shift-change introductions;
    • Clinical rounds; and
    • Visits with a physical therapist.

    "Most of this was essential, but why couldn't all of it be coordinated to minimize the total number and prolong the time between them?" Pearl asks. For instance, he wonders if it might have been possible for medication dosages to be synchronized or, since he wasn't acutely ill, whether his vitals could have been checked less frequently.

    "I'm grateful for the remarkable care I received," Pearl writes, but there's room for improvement, both at the hospital and regulatory level. He chalks up the negative aspects of his experience to "a combination of regulation, standard hospital protocol, and compliance." A better system, Pearl writes, would allow clinicians and staff to exercise "common sense" to create a healing environment, one that's "more patient-focused and less regulation-based."

    He also has some concrete—if unconventional—advice: "Maybe once a year, every hospital CEO and hospital regulator should be required to spend a few days and nights in a hospital bed," he concludes. "After that experience, they most likely would change hospital rules and job descriptions and, as a result, make the nation's facilities healthier and safer for patients" (Tyson, LinkedIn, 3/28; Pearl, Forbes, 3/30).

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