Great Western Hospital (GWH) is a community hospital in Wiltshire, South West England and one of England's largest maternity providers, responsible for delivering over 9,000 babies per year. The case discusses the efforts of Dr. Harini Narayan, consultant obstetrician and gynecologist, to reorganize antenatal care delivery at GWH. Rather than treating high-risk pregnancies as a homogeneous group, Dr. Narayan pioneered the development of eleven condition-based, high-risk clinics led by dedicated multidisciplinary teams of physicians, midwives and nurses. The case profiles the Multiple Pregnancy Clinic in particular and its impact on perinatal indicators and outcomes.

The Schon Klinik is a private, for-profit German hospital group trying to establish itself as a premium health care provider in a competitive German market. The case details Schon Klinik's founding, its early focus on measurement and improvement, and the design and implementation of a system-wide structure for measuring and reporting actual health outcomes. The case details the care cycle for eating disorder patients and highlights the role outcomes measurement has played in improving eating disorder care over time. It ends with a discussion of Schon's innovative bundled reimbursement models and challenges the reader to explore how to develop new pricing and care delivery models that encourage integration of care around patient medical conditions. The case also discusses the German health care system, its regulatory constraints, and Schon's attempts to change the paradigm of competition in the sector.