When Kathy Donovan joined Springfield, Ill.-based Hospital Sisters Health System as senior vice president and chief operating officer in 2023, the system was losing more than $100 million a year. Spread across Illinois and Wisconsin, HSHS hospitals were operating with separate agendas and in some markets, competing against each other for the same patients.
Ms. Donovan and her team devised a structural fix she hoped would lead to better outcomes and operational performance. HSHS consolidated oversight into three core markets — Central Illinois, Southern Illinois and Wisconsin — each led by a market-level executive accountable for systemwide performance. Rather than managing individual hospitals with individual rules, the system built shared accountability into its operating architecture.
From there, the system developed what Ms. Donovan calls playbooks: codified approaches to running emergency departments, inpatient units and operating rooms that would apply consistently across all 13 ministries.
“Once you get the playbook in place, then that drives the metrics that you’re going to measure and the KPIs you’re going to hold your operators accountable to,” Ms. Donovan said during a recent “Becker’s Healthcare Podcast” interview. “Everyone’s singing from the same songbook and answering to the same metrics.”
The results surfaced first in the data. Left-without-being-seen rates in HSHS emergency departments, a direct measure of patient access and ED throughput, had been running at roughly 10% before the structural consolidation and now run below 1%.
Financial performance improvement followed. Shared services work — standardizing supply chain, pharmacy, lab, radiology and other support functions at the system level — produced meaningful savings while improving consistency and quality across ministries.
“We took a health system that was losing more than $100 million a year. And in less than two years, we brought the system to break even,” she said. “This year, we’re pushing margin.”
The turnaround has since created room for investment. HSHS has a long-range capital plan touching each of its three core markets, has advanced strategic partnerships to support growth, and has accelerated a systemwide Magnet designation journey with all 13 ministries on a path to achieve Magnet accreditation. The health system is also implementing technology and taking time to reduce variation in service lines.
“We need to congregate around the hubs and then in our markets supply what we need, but have the hubs for higher end care, manage our assets differently and be very intentional about where we invest as well,” she said. “The challenge for leaders is to balance this financial stewardship with our obligation to our patients, our colleagues and our communities, and adhere to our sisters as well who started this legacy in mission-driven organizations. Those decisions have to be made with both discipline and humanity at the heart of it.”
Workforce stability has also improved significantly over the same period, providing further footing for what comes next.
“This is the best time at HSHS right now,” she said. “It’s about turning the corner in a new day and really focusing on long term sustainability for a Catholic health system that means so much to the communities that we’re in.”
