Why evidence-based practices are best for patient impacts

Technology and Innovation.

One focus area of HCA Healthcare Nursing is to standardize and consistently measure to demonstrate the impact nursing has on the delivery of patient care. To do this, HCA Healthcare Nursing uses data to identify best practices across all domains of nursing performance and encourage continuous improvement for our patients.

As the nation's largest private provider of healthcare, our scale enables us to deliver great outcomes for our patients and provide superior nursing care in 43 distinct markets. Our pursuit of insights and care advances based on the knowledge and data we gain from approximately 30 million patient encounters a year enables us to move healthcare forward. In recent years, our proprietary research and trials have enhanced our clinical capabilities to drive down incidences of blood stream infections (including MRSA), maternal mortality, infant mortality and NICU admission, just to name a few.

And as a result, we have pioneered a way to reduce the burden of documentation for 94,000 affiliate nurses and allow them more time to provide the best care to patients.

It's called Evidence-Based Clinical Documentation, or EBCD, and it enables nurses to document pertinent information using standard terminology.

Through a survey of more than 800 nurses, our CNO Council identified a reduction in documentation as a key need for advancing nursing practice at HCA Healthcare affiliate hospitals. We found that a large portion of this documentation was neither efficient nor effective. This required a complete rebuild of nursing documentation in the electronic health record (EHR). We needed to find a way to help nurses spend more time with their patients and less time documenting about their patients. EBCD addressed all of those issues.

We streamlined the documentation process and equipped nurses with the technology to make their job of delivering care more efficient. The patient-centered focus of EBCD minimizes the time spent inputting data, and at the same time, allows the information that has been entered into the medical record to be extracted in a more meaningful way. As a result, we've seen our nurses save from 30 minutes to two-hours on documentation, per shift.

When we provide nurses with tools like EBCD and mobile applications, we position them to practice at the top of their profession and allow them to dedicate more time to caring for patients.

More than 170 HCA Healthcare facilities in 20 U.S. states use EBCD. We continue to receive feedback from nurses about how a streamlined and standardized approach to nursing documentation enhances their practice.

"I am continuing to receive ALL overwhelmingly positive feedback," said Jane Englebright, HCA Healthcare's senior vice president and chief nursing executive. "Even the novice nurses say that EBCD helps them have more time at the bedside and less time in front of a computer. This has truly transformed the way we deliver care and is the most direct way I have seen HCA Healthcare support our mission, "Above all else, we are committed to the care and improvement of human life."

EBCD: By the numbers.

Evidence-based Clinical Documentation improves consistency in practice and generates data from which we can better understand and improve nursing care.

• 159 hospitals and 18 behavioral health facilities are using EBCD.
• EBCD saves nurses 30 minutes for every nurse, every shift.
• Some nurses report up to two hours of time savings.