INTRODUCTION AND CHALLENGE.
As Beacon Health System grew from a smaller organization into a multi‑hospital health system based in South Bend, Indiana, clinical and informatics leadership began to see strain in areas that previously “just worked.” One of the most significant pressure points was the ordering experience. As facilities customized order sets to local needs, redundancy increased across the system. While appropriate at the facility level, this lack of standardization made enterprise‑wide updates more difficult and limited Beacon’s
ability to scale.
“As we grew, the lack of standardization started to slow us down,” said Dr. Scott Eshowksy, Chief Medical Information Officer at Beacon Health System. “What worked when we were smaller became harder to manage across multiple hospitals. We had too many versions of the same basic orders, and that made it tougher to keep things consistent system‑wide.”
What once felt flexible became a rate limiter to growth. Disparate order sets required duplicative updates and increased governance, while clinicians faced confusion at the point of ordering when multiple similar options made it difficult to select the right order particularly across facilities.
Beacon’s leadership recognized that as the organization continued to grow, this approach was no longer sustainable.
“Variation can creep up on you over time. And once it’s widespread, it becomes harder to govern safely. We wanted to reduce unnecessary variation so our clinicians could trust the ordering experience wherever they practice in the system.”
Dr. Scott Eshowksy
Chief Medical Information Office, Beacon Health System
THE APPROACH: Standardize what should be standard.
Beacon partnered with Nordic to take a focused, pragmatic approach to order set standardization, balancing clinical autonomy with the need for consistency and scalability.
Rather than attempting to standardize everything at once, the team prioritized high‑impact workflows, starting with admission orders. These workflows touched a large portion of the organization and
had been replicated in numerous forms over time. This effort required careful change management. Some clinicians lost long‑standing “favorites,” and workflows they were accustomed to were restructured.
The Beacon team knew this disruption was unavoidable, but also necessary.
EARLY OUTCOMES.
The impact of this work has been evident across the organization.
- Clinician complaints decreased, particularly around confusion and duplication in basic ordering workflows.
- Providers now use a single, standardized version of common orders (e.g., oxygen, IV fluids), reducing uncertainty and rework.
- In more complex areas such as blood bank orders, clinicians reported that while the new workflows required more deliberate choices, it became easier to select the correct plan.
From a leadership perspective, success was measured less by numbers and more by absence of friction: fewer escalations, fewer questions, and smoother day‑to‑day operations.
While the changes are largely invisible to patients, Beacon sees this work as foundational to creating the consistency and governance needed to support safe, scalable care delivery across the system.
Key lessons for future clinical optimization efforts.
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- Communication is critical.
Large‑scale standardization inevitably introduces change and disruption. Optimization efforts benefit from early, clear, and ongoing communication that explains why changes are happening, what clinicians can expect, and how feedback will be incorporated.
“There’s no way to do work like this without some level of disruption,” Dr. Eshowksy said. “What matters is being clear about why you’re doing it and helping clinicians understand the long‑term benefit.” - Manage scope deliberately.
Order set standardization can easily expand beyond its original intent. Maintaining discipline around scope and resisting the urge to “fix everything at once” helps keep projects manageable and reduces the risk of delays or diluted outcomes.
“It’s very easy for these projects to grow quickly,” Dr. Eshowksy noted. “You have to be thoughtful about what you’re trying to accomplish and stay focused, or you risk slowing yourself down. - Consider experienced external support.
Working with an external partner with prior experience can help accelerate progress and reduce risk. Organizations undertaking similar work may benefit from outside expertise to share lessons learned, provide objective perspective, and challenge assumptions along the way.
“This kind of work is hard to do well on your own,” Dr. Eshowksy said. “Nordic wasn’t just there to carry out tasks. They worked alongside us as a partner, bringing experience, challenging our thinking when needed, and helping us make decisions that will continue to pay off as the organization grows.”
- Communication is critical.
Looking ahead
Order set standardization has become more than a cleanup effort for Beacon. It’s a strategic enabler. By investing in a consistent foundation today, Beacon has positioned itself to adapt more quickly, integrate future growth, and make changes with greater confidence and less disruption.
This work has set the stage for what comes next.
ABOUT BEACON HEALTH SYSTEM.
Beacon Health System is a locally owned, nonprofit healthcare system serving patients across northern Indiana and southwest Michigan. Our nearly 11,000 associates and 2,500 medical staff providers, who are deeply rooted in our region, provide exceptional care with heartfelt compassion at Beacon Children’s Hospital, Beacon Granger Hospital, Community Hospital of Bremen, Elkhart General Hospital, Memorial Epworth Center, Memorial Hospital of South Bend, Three Rivers Health, Beacon Kalamazoo, Beacon Allegan, Beacon Dowagiac and Beacon Plainwell.
We are committed to serving underinsured and uninsured patients, furthering our commitment to community health and well-being.
With our teams at Beacon Medical Group, Memorial Family Medicine Residency Program, Beacon Health Foundation and Beacon Health & Fitness, and through our partnership with Western Michigan University Homer Stryker M.D. School of Medicine, we are dedicated to delivering patient-centered care at every step of your health journey.
Connect with us at BeaconHealthSystem.org.
