At Becker’s 15th Annual Meeting, healthcare leaders from Northwestern Medicine (Chicago), University Hospitals (Cleveland), UI Health (Chicago) and St. Francis Regional Medical Center (partially owned by Minneapolis-based Allina Health) gathered to share how they are breaking down internal silos and reengineering care delivery around patients — not processes.
The panel, moderated by Amanda Heidemann, MD, physician advisor at Wolters Kluwer Health, highlighted best practices in standardization, governance, and clinician engagement.
Here are four key takeaways from the session, “No More Silos: How Top Systems are Tackling Efficient Care Delivery”.
1. Standardization starts with shared infrastructure and clear governance.
Kristin Ramsey, MSN, RN, chief nursing officer at Northwestern Medicine, described how her organization’s transformation from a single hospital to an integrated health system hinged on a strategic decision to unify its core platforms: the EHR, financial systems and HR systems. While early integrations were challenging, this standardization proved essential for scaling improvements and maintaining consistency across the growing system.
“We have a playbook now,” Ms. Ramsey said. “One of the first things we do if we integrate another care center or hospital, we get them on those base systems.”
She added that their initial missteps — including a disrupted local workflow during early integrations — taught them the importance of rigorous, system-level thinking and governance. Northwestern now limits systemwide quality committees to four cross-functional teams, each with defined accountability and metrics.
2. Real change happens when stakeholders define problems together.
Across the panel, leaders emphasized the importance of collaborative problem definition, noting it can be tempting to jump to the solution, especially with AI, but it’s essential to start with the problem at hand.
“Having challenges that relate to technology, but solutions that are largely operational — I think that’s one of the biggest silos I view informatics as trying to bridge,” David Chestek, DO, CMIO at UI Health, said.
Laura Randgaard, RN, vice president of patient care services and chief nursing officer at St. Francis Regional Medical Center, echoed that sentiment, underscoring how effective collaboration begins with stripping away personal interests and framing everything around who the organization serves.
“It’s important to define the problem together as an interdisciplinary team,” Ms. Randgaard said. “That resetting of the commitments together — what I see locally and within our system — makes a big difference for us being more innovative.”
University Hospitals piloted low-tech “triad rounds” — bringing nurses, doctors and patients together daily to align on goals. Judy Wolfe, MD, chief medical officer at University Hospitals St. John Medical Center said the initiative has yielded greater clinician satisfaction.
“It’s the ultimate de-implementation,” she said. “This is putting the computers to the side for just a couple of minutes while we connect as human beings and ensure mutual understanding. That’s really where we need to get back to in many ways.”
3. AI should enable — not replace — clinician judgment.
Panelists cautioned against seeing AI as a quick fix. Dr. Chestek raised the issue of a crowded AI tech market. “About 80 to 90 percent of what’s out there is garbage,” he said. “But the other 10 to 20 percent of it is truly transformative. Our challenge is to try to sift through all of that noise and make the conscious, good bets — and it’s difficult to sort out which is which.”
Dr. Chestek said UI Health has established a multidisciplinary governance group, including ethics, technology, clinical and security personnel to evaluate new tools.
Similarly, Northwestern Medicine screens all new tech through a multidisciplinary application committee focused on ROI, security and clinical impact. “We have to ask ourselves how it’s really improving services, our safety, engagement and the health of the population — I think we have to strip as close down to center and values as we can to ward off the shiny distractions,” Ms. Ramsey said.
4. Staying aligned requires humility, trust and relentless prioritization.
The leaders agreed that culture, not just technology, is the real lever for long-term integration. Dr. Wolfe urged organizations to place inclusion and belonging at the center.
“It’s not us and them — it’s all of us, and the patient,” Dr. Wolfe said. “The patient is fundamental to our work. If we can all agree that’s the most important thing to focus on and we ensure everybody has a seat at the table that should have a seat at the table, then we’re going to be able to prevent silos as we move down the line.”
As health systems deploy new strategies and innovations, Ms. Randgaard encouraged leaders to consider the flexible structures and teams they need to advance the work.
“You have to constantly be looking for who you missed or who’s not at the table,” she said. “You’ve got to stay humble and vulnerable as a leader to ensure you’re not making mistakes and continue to iterate.”
Systemic strategies like these reinforce the value of collaboration and adaptable leadership. For further insights and actionable strategies to break down silos in healthcare, read Dr. Heidemann’s full article, “Five Ways Health Leaders Can Address Silos in Healthcare,” offering practical approaches for leaders to address these pivotal challenges.
