Care Variation Improvement for Illinois Hospital

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HSHS St. John’s is a 439-bed regional medical center offering an array of comprehensive healthcare services to central and southern Illinois. Located in Springfield, Illinois, St. John’s is the flagship hospital of the Hospital Sisters Health System (HSHS), a multi-institutional healthcare system that sponsors 14 hospitals across Illinois and Wisconsin, as well as an integrated physician network.


Prism and St. John’s identified Heart Failure (HF) patient care as a significant area of financial and clinical performance opportunity. The team designed and implemented a rigorous, structured and evidence-based approach for primary HF patient care, setting targets in four key metrics:

  • Reduce Heart Failure length of stay
  • Reduce Heart Failure cost per case
  • Increase Heart Failure order set utilization compliance
  • Increase Cardiology consults for inpatients with HF primary DRG

During the process, St. John’s was also transitioning to EPIC. Prism helped confirm the new EPIC order sets met HF patients’ needs and created a prompting process for patient admissions and concurrent inpatient stay. Prism formed a workgroup to train clinicians and staff, including employed and contracted physicians, hospitalists, nurses and the patient placement team, on the revised policies and processes. To sustain the improvements, St. John’s stipulated metric reviews and updates must occur at least quarterly for all provider groups. Within 8 months, metrics confirmed St. John’s was providing more standardized care when treating patients with a Heart Failure diagnosis. In addition, the work team created an implementation packet so St. John’s can replicate the success for other diagnoses.


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Laura Jacquin, RN

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Bonnie Barndt-Maglio, RN, PhD

Managing Director

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