Medicolegal Issues

Hospitalists Provide Leadership as Unit Medical Directors


A project to formalize “local leadership models”—partnering leadership teams comprising a hospitalist and a nurse manager on each participating unit—at the University of Michigan Health System helped to redefine the role of unit medical director and led to allocating sufficient time (15% to 20% of an FTE) for hospitalists to fill that role. The process also led to a joint role description for the physician and nurse leaders.

“In our organization, we had the medical director concept in place previously, but things were missing, with no direct accountability, no dedicated effort, and lack of clarity on reporting,” explains hospitalist Christopher Kim, MD, MBA, lead author of an article about the project published in the American Journal of Medical Quality.1 “We learned from other organizations, and one of the first things we learned was to make sure we hired the right person as medical director. We need an energetic, enthusiastic physician who can reach out to nurses and bridge gaps in communication and coordination of care.”

The clinical partnership model was piloted on five units—four adult and one pediatric—and has since been adopted by eight others. The physician/nurse leaders work on such issues as improving care transitions, reducing pressure ulcers and catheter-related urinary tract infections, developing multi-disciplinary rounding on the units, and sharing quality data with staff.

“Take UTIs or pressure ulcers; we’re all familiar with recommended practice, but how it gets played out on the units varies. If team leaders understand this, they can champion the processes and

create an educational push for them,” Dr. Kim says. “Those organizations that have done this well cite higher staff satisfaction as a result.”

Study results show that the initial five units were “among the highest-performing units in our facility on satisfaction,” he adds. “It’s an exciting opportunity to bring change processes necessary to build a local clinical care environment that will improve the overall experience of the patient.”


  1. Kim CS, Calarco M, Jacobs T, et al. Leadership at the front line: A clinical partnership model on general care inpatient units. Am J Med Qual. 2011 (epub ahead of print).

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