Hospital stay lessons from Permanente CEO Robert Pearl

A hospital stay was an eye-opener for CEO Robert Pearl.

As a doctor and surgeon, Robert Pearl, M.D., has spent much of his life in hospitals. But a recent injury that required him to spend three nights in the hospital was an eye-opener for the CEO of The Permanente Medical Group.

The experience has changed his perception of hospitalization forever, Pearl wrote in Forbes.

Pearl ended up in the Kaiser Permanente hospital in San Jose, California, after he fractured his knee when he was knocked over by a man who slipped on a wet flight of stairs. The injury required surgery and three nights in the hospital in order to receive intravenous antibiotics, manage the pain and learn to walk on crutches. The constant interruption to his sleep by hospital staff led to disorientation that verged on delirium, a life-threatening event that can occur even in relatively healthy patients.

While he got excellent care from everyone from the surgeon to the housekeepers, Pearl went 72 hours unable to sleep even a full hour at a time. Staff came into his room more than 30 times throughout the day and night—to take vital signs every four hours, take meal orders twice a day, deliver meals three times a day, empty the trash three times a day, and introduce themselves at the start of the shift.

Pearl suggests hospitals could create an environment to facilitate healing if staff were able to coordinate activities to minimize the total number of interruptions and prolong the time between them to allow patients to sleep. “We would be better served if common sense replaced rigid rules and nonessential regulatory requirements. We need to make hospital processes more patient-focused and less regulation-based,” he said.

Pearl also proposes that hospitals try the technique of one of his friends, an orthopedist, who puts new staff hires in a cast for a few days so they can experience what patients go through. “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 said.