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The Integrated Inpatient Management Model: A New Approach to Clinical Practice

Laurence F. McMahon Jr., MD, MPH; Frederick A. Creighton, MHA; Annette M. Bernard, MD, MS; Wilbur B. Pittinger, MA; and William N. Kelley, MD
[+] Article and Author Information

Grant Support: Supported in part by the John A. Hartford Foundation, Inc.

Requests for Reprints: Laurence F. McMahon, Jr., MD, MPH, Division of General Medicine, Department of Internal Medicine, 3116 Taubman Center, 1500 East Medical Center Drive, The University of Michigan, Ann Arbor, MI 48109-0376.

Current Author Addresses: Drs. McMahon, Bernard, and Kelley, and Mr. Pittinger: Department of Internal Medicine, Taubman Center, 1500 East Medical Center Drive, The University of Michigan, Ann Arbor, MI 48109.

Mr. Creighton: Department of Medicine, Case Western Reserve University, University Hospitals, 2074 Abington Road, Cleveland, OH 44106.

©1989 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1989;111(4):318-326. doi:10.7326/0003-4819-111-4-318
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The delivery and financing of health care have undergone a metamorphosis over the past 10 years. These changes have been particularly dramatic for hospital care. The new health care environment, with more prospective-payment and managed-care systems and less fee-for-service payment for both physicians and hospitals, has made physicians and hospitals mutually dependent. A hospital's long-term financial viability is now dependent largely on the practice style of its physicians. The Department of Internal Medicine at The University of Michigan has developed a new clinical management system called the Integrated Inpatient Management Model (IIMM). This new system includes a major revision of the hospital organization structure, new administrative information systems, and new clinical information systems. Physicians in the Department of Internal Medicine have assumed for the first time formal organizational responsibility for many aspects of the operations of the inpatient medical service. The IIMM represents a prototype of a system that we believe offers considerable promise for involving physicians to a much greater extent in the management of the nation's hospitals. We hope that describing the system in detail will facilitate the development of other systems for the management of the inpatient practice of internal medicine.







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