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The purpose of this study is to investigate the implementation of a novel organizational structure in a specialized hospital department. The key issue was to optimize the efficacy of the process “hospital treatment” in a patient‐oriented approach.

A new organizational concept, i.e. the Cologne Consultant Concept (CCC), was developed by and implemented at the Department of Neurology, Cologne University Hospital in August 2007. The outcome of this reorganization was evaluated via a number of critical performance parameters (effects on daily routines and performance data, feedback from quality control and house officers). Furthermore, the strengths and weaknesses of this novel system were compared to the traditional ward‐based system in Germany, the Anglo‐American consultant model and care provided by sub‐specialized teams.

The reorganization of the healthcare services by the CCC provided flexible medical care for inpatients. The independent assignment of patients to a ward, and to a team of physicians offered incentives for case‐oriented and efficient medical treatment. Importantly, the time‐consuming admission process could be distributed evenly between physicians in chronological order. Furthermore, beneficial effects on the department's overall performance compared to the traditional ward‐based system were observed.

The CCC constitutes a valuable new organizational structure that can provide medical care in any specialized hospital department.