Restructuring the inpatient practice of an academic internal medicine department

The authors describe the process undertaken by the Department of Medicine at the Mayo Clinic in Rochester, Minnesota to improve inpatient care. The department systematically analyzed its inpatient practice and developed a set of hypotheses that challenged whether new inpatient models with greater physician commitment could improve the quality of care; patient, resident, and staff satisfaction; and financial performance. The new practice model they developed, which includes using more physicians whose time is dedicated to the hospital practice, has led to a more focused hospital experience for learners and has implications for all academic medical centers involved with primary care, subspecialty care, and hospital consultative services.