Restructuring the inpatient practice of an academic internal medicine department

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