The organisational structure at Heartland Health (HH) a US not-for-profit health system and winner of the 2009 Malcolm Baldrige National Quality Award, was its three level Heartland Health Pyramid that depicted the structure for and drove the actions of business entities. At the top was Heartland Regional Medical Centre, a tertiary care hospital focussed on acute illness and injury, and Heartland Clinic, a group practice. In the middle of the pyramid, Community Health Improvement Solutions promo...