Background

An academic health system with a highly regarded Department of Medicine managed its inpatient population without hospitalists. The Department of
Medicine believed this was a tremendous advantage in residency program recruitment. However, this also required more faculty time and effort. Administration believed an investment in a hospitalist program would result in a lower inpatient length of stay and Medicine faculty would then have the ability to enhance new patient access via additional clinic sessions.

Process Used

Interviews of Medicine clinical and administrative leaders as well as resident physicians were done. Inpatient discharge, daily census and length of stay were reviewed as were ambulatory new and total visit volumes. Also collected national and local benchmark data. Market research was done to determine “best practice” hospitalist program principles. Created a SWOT summary analysis with all of this information.

Issues Addressed

Introducing a hospitalist program, despite evidence that competing systems had done so substantially and successfully, was going to be a substantial change for the Department of Medicine faculty and residents. It would impact several workstreams and need to be well supported by clinical leaders and well-coordinated by administration. It would also be essential to have Chair and other leadership buy-in for this to succeed.