case study


Week 1 Case Study: Foundations of U.S. Health Care Delivery 

The coordination of care through integrated delivery systems is at the foundation of health care delivery in the United States. Often a primary goal of government officials, public health professionals, and health care administrators, measuring care coordination is a key performance indicator that directly correlates with the overall success of the health system (Johnson & Stokopf, 2010).

Northwestern Hospital first opened its doors back 1882 in Minneapolis, Minnesota. Early hospitals were small, often with fewer than 50 beds, unsanitary, and nonscientific compared to their modern counterparts (Allina Health). Moreover, they mainly served the poorest members of the community or patients who were mentally ill or facing life-threating illnesses. Northwestern Hospital was an early pioneer in the establishment of what would eventually become an evidence-based medicine (EBM) practice and featured one of the first schools of nursing in the United States (Allina Health).


For over a century Northwestern Hospital’s use of EBM has enabled clinicians and practitioners to incorporate best treatment practices at the point of patient care in both their hospital and ambulatory organizations. For example, Northwestern’s goal to enhance quality delivery and overall patient care hastened the formation of a new entity, Minneapolis Medical Center Incorporated (MMCI). In 1966, Northwestern Hospital, along with other health care facilities in the Minneapolis area, formed the nucleus of an organization that would significantly master care coordination and delivery in the ensuing decades. Ultimately, an EBM environment created a standard of patient care that enabled MMCI to advance care delivery and medical education and lay the foundations of a modern health care delivery system. 

Case Report

MMCI established a culture of continuous quality improvement (CQI). Wenke, Jongwha, LaClair, and Paz (2013) have linked CQI to better clinical quality and improved patient satisfaction. The best practice in EBM methodology is to ensure that patient care is coordinated and of high quality through the use of objective clinical data from credible sources and references. By the 1980s, a desire to add resources and support services for the coordinated care of patients such as physical rehabilitation helped lead an evolution from Northwestern Hospital to MMCI and then formation of Abbott Northwestern Hospital. Since that time, the hospital’s health services offerings have grown into a primary health system, supporting cardiovascular care, medical education, and health plans. 


MMCI recently went through a merger and is now part of a larger health system called Allina Health that serves patients in locations across the Midwest. It has significantly expanded its portfolio of EBM to include mental health services, neuroscience, orthopedic care, and cancer treatment. Additionally, decision makers throughout this newly formed health system must understand and master each care component to maximize system efficiency and effectiveness. For example, the diagnosis of a medical condition is a fundamental activity that clinical professionals perform during a physical examination. It is crucial in modern health systems that clinicians execute due diligence by ordering the necessary laboratory tests, medical procedures, and diagnostic imaging. Patients who seek treatment from multiple health care organizations ought to raise a red flag to clinicians to prudently exhaust all evidence-based options to resolve symptoms through medical treatment. 


Your paper should be in APA style including a cover page and a reference page. You do not need an abstract 


1. In your own words, what is EBM? Is it a worthy goal for U.S. health care delivery? Why or why not? 

2. How has MMCI/Allina Health mirrored how U.S. health care delivery has evolved into a modern EBM institution? 


Allina Health. (n.d.).

Johnson, J., & Stoskopf, C. (2010). Comparative health systems. Global perspectives. Boston, MA: Jones & Bartlett Publishers.

Wenke, H., Jongwha, C., LaClair, M., & Paz, H. (2013). Effects of integrated delivery system on cost and quality. American Journal of Managed Care, 19(5), e175–e184. http://dx/doi/org/10.2471/BLT.13.126698

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