HCA Healthcare (HCA) consists of 178 hospitals and 1,800 sites of care located in 20 states and the United Kingdom. HCA had three different EHRs (Meditech Magic, Meditech 6.0, and Epic) and tremendous variation in documentation content. HCA’s council of 14 regional Chief Nursing Officers (CNOs) were driven to tackle clinical documentation redesign, fueled by nursing engagement surveys listing documentation as a leading pain point. In 2007, the system embarked on a data-driven journey to standardize nursing documentation over its multiple EHR platforms. HCA aimed to substantially reduce documentation time and produce information from electronic documentation to inform clinical decision-making. A new nursing clinical documentation program was created.
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