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Most malpractice cases are framed around one moment: a missed diagnosis, a medication error, or a decision that changed everything. It is tempting to treat that moment as a fluke or a lapse in judgment. But it’s almost never just one thing. What looks like a single mistake is usually the result of a system that was already broken. And if you know how to read the record, the cracks are everywhere. You just have to look past the obvious. It's Already in the Notes When I review a case, I don’t start with the outcome. I start with the patterns. That med error? The EMR had issues long before the dose was missed. That delayed code response? The staffing was unsafe all week. That "sudden" decline? A chart full of vague assessments and lazy documentation for days. These are not isolated incidents. They’re the predictable result of ignoring warning signs. Systems Don’t Fail All at Once Healthcare systems love policies and checklists. They look great on paper. But when the pressure’s on, people fall into survival mode. Corners get cut. Shortcuts get routine. Documentation becomes a box to check, not a source of truth. When a medical record starts showing signs of collapse, you’ll see: Missing or backdated notes Copy-pasted entries across multiple days Vitals charted with no context Orders placed without follow-through Nursing assessments that skip details or contradict each other The problem isn’t just what happened. It’s how often it was allowed to keep happening. What I Do With That Information I build timelines and summaries that pull it all together. I give attorneys a clear picture of what went wrong and why. Not just a list of facts, but a story. I describe what’s in the chart. I show how it got that way. Medical harm rarely comes out of nowhere. The signs are there. The record is full of red flags. Your job is to prove accountability. Mine is to make sure the documentation backs you up. Need support on a case? You know where to find me.

A 46-year-old woman dies in the ER. The chart said she got timely care. The timeline said otherwise. Vitals worsened for hours before anyone ordered antibiotics. Med times didn’t match the orders. The discharge summary called it “sudden.” It wasn’t. Then came the kicker: a provider note was added three days after her death , backdated to appear as if it had been written in real time. That note shifted their narrative from “we missed it” to “we did all we could.” This isn’t a real patient, but is based on common practices in medical records. Yes, providers are busy. Adding or amending notes after the fact occurs often, and it’s rarely questioned. Is it legal to add documentation to a medical record after the fact? Yes. But only if it’s done transparently and properly. Adding or amending documentation after the fact is called a late entry, addendum, or correction, and it’s allowed under both legal and regulatory standards as long as: The entry is clearly marked as late, with the current date and time it was entered. It never falsifies the timeline or misrepresents when care occurred. It doesn’t overwrite or alter the original record in a way that hides prior entries. Here’s the law and regulation side: HIPAA (45 CFR §164.526) - Patients have the right to request an amendment to their records, and providers can make amendments, but the original entry must remain intact. The amended record must clearly indicate: When the amendment was made, Who made it, and What was changed. The Joint Commission - Late entries, addenda, and corrections are permitted, but they must not be used to conceal errors or falsify records. Time-stamped EHR entries make these changes traceable, and that’s the point. CMS (Centers for Medicare & Medicaid Services) - For Medicare records: “Any amendments, corrections, or addenda must be clearly identified as such and must be dated and signed.” What’s not legal: Backdating a note to make it appear contemporaneous. Altering a record without noting it’s been changed. Adding documentation to avoid liability or misleading an investigation. Tampering with time stamps in an EHR (often logged and auditable). If a note is quietly added days later with no disclosure, especially if it conveniently fixes a liability problem? That’s not documentation. That’s evidence tampering.

Healthcare leaders are constantly juggling a million things at once: patient care, staff needs, compliance, and financial pressures. And in the middle of it all, you're being told that data is the answer to every problem . But when data is noisy, it becomes another stressor, and that's the last thing you need. It doesn’t have to be that way. The Problem: Data Overload and Lack of Action Chances are, you’re sitting on a mountain of data. Every department generates it, but it's just a bunch of numbers unless you have a clear strategy for turning that data into action. And this is what happens: Staff are overwhelmed  with too many reports that don’t help them do their jobs better. Decision-making is reactionary . Patient care suffers  because leadership can’t access real-time insights. When this happens, frustration and burnout set in. You and your team are bogged down in the vicious cycle of inefficiency and missed opportunities. The Solution: A Data-Driven Strategy You can turn things around with a data governance strategy  that works for your organization. It sounds crazy, but this isn’t about adding complexity, it’s about streamlining your operations and making your data work for you, not against you. So where do you start? 1. Get Clear on What You Need to Measure The first step in creating a data-driven organization is to know exactly what metrics matter. As a healthcare leader, you don’t need all the data. You need the right   data. Focus on the key performance indicators (KPIs) that directly impact patient care, staff efficiency, and operational performance. This might look like: Patient outcomes and safety metrics Staff productivity and engagement Operational efficiency (e.g., time spent on administrative tasks) Financial performance (e.g., cost of care, revenue cycle) 2 . Build a Data Governance Framework Data governance isn’t an IT issue; it’s an organizational one. A clear framework keeps that data consistent, accessible, and accurate across all departments. Here’s what you’ll need: Data Ownership : Identify who’s responsible for each type of data. This ensures accountability and accuracy, and it is the #1 area that most organizations neglect. Data Quality Standards : Create processes to clean and validate data regularly so you always have reliable information. Data Access : Ensure that the right people have access to the correct data at the right time. Ask for Help: Work with a data governance or data literacy professional like me who has the time to help organize and train your staff on how to use data correctly. 3. Leverage Data to Make Decisions Now that you’ve cleaned up your data and defined your KPIs, it’s time to make it work for you. Use the insights you have now to drive decision-making, not just report on what’s happening. For example: Predictive Analytics : Use your data to identify potential issues before they become problems. Spot trends in patient care, staff workloads, or billing discrepancies early so you can address them proactively. Workflow Optimization : Look for patterns in your data that highlight inefficiencies. Are there bottlenecks in patient flow? Duplicate work in administrative tasks? Streamlining processes based on data insights saves time and reduces frustration for your staff. 4. Communicate Clearly Across Teams Finally, once you have the data and insights, make sure your teams know what to do with them . Communicate so the data isn’t just collected but acted upon. Create clear reports that guide decision-making. Provide training to help staff understand how to use data effectively in their roles. Foster a culture where data-driven decisions are the norm, not the exception. Why It Matters The truth is that healthcare leaders are expected to do more with less, especially now. You’re constantly balancing quality care with cost control and staff satisfaction with patient outcomes. And to do all that, data has to be part of the solution . But it needs to be the right kind of data, used in the right way. By adopting a data-driven strategy and improving your data governance, you’ll be able to make smarter, faster decisions that improve patient care and operational efficiency. It’s not just about collecting data. That means nothing. You must use it to make better decisions. Walk your talk. Your patients, community, and staff deserve it. Let’s Get Started Stop drowning in data and start using it to drive real change. I’m here to help. Let’s talk about how we can make data work for you . Work smarter, not harder.

Data is king. Anyone in a leadership position knows this. Organizations rely on data to decide how their business operates, what staff they need, and if they are doing what they are meant to do. However, not all data is created equal. While a lack of data is a challenge, bad data is dangerous. What is "bad data"? Bad data is inaccurate, incomplete, outdated, or misleading. It can cause serious problems for your organization; I'll explain why. Inaccurate information leads to poor decisions. The primary function of data is to guide leadership so that they understand what needs to be done for the organization to function correctly. When data is flawed, well-meaning leaders drive the organization in the wrong direction. This means missed opportunities and wasted resources in the best situations. At worst, it has disastrous consequences and creates a false sense of confidence. Bad data hits hard financially. Sales teams that act on incorrect customer information waste time pursuing no longer viable leads. Faulty information on inventory levels results in over- or under-ordering. Instead of optimizing costs and resources, bad data leads to inefficiencies that drain the bottom line. When the data is inaccurate, the insights are compromised, leaving organizations blind to real emerging opportunities . . . and problems. For customers and clients, bad data decisions erode their trust and damage an organization's reputation when errors are caused by inaccurate information. Operations slow down due to inefficiencies in every department, causing delays and reducing productivity. In regulated industries, inaccurate records used in financial reports, healthcare documents, or any other reporting will lead to legal action. Employees will disengage when they are given incomplete or contradictory information. If they are repeatedly told to act on bad data, they will question the entire system's integrity, and you will lose them. However, the most dangerous aspect of bad data is the illusion of progress . Teams that are fed inaccurate data feel like they are taking action and making improvements when, in reality, they are heading in the wrong direction. This false sense of control and progress is far more damaging than the uncertainty of having no data at all. Do not despair; there is hope. To prevent bad data from sabotaging an organization's goals, it must prioritize data quality over data quantit y. How to do that? The process isn't easy, but it is worth it. Work with a consultant to implement proper data management practices and create a formal data governance program. Build a communication structure that ensures data accuracy, consistency, and security. As part of this data governance program, regular audits and annual cleaning processes must be scheduled to keep the data free of errors and up-to-date. Do not skimp on training for your staff . Employees need to understand the importance of good data practices and be held accountable for the data they input. Investing in the right tools to gather data will go a long way to assuring decisions are being made with good information. Not sure where to start? Head over to my Services page or book a call with me and I will explain how we can work together on breaking bad (data).

It’s no secret that healthcare CEOs walk a tightrope. On one side, they genuinely desire to help people, while on the other, they face an avalanche of demands that leads to frustration at best and burnout at worst. The struggle to balance an organization's mission with the realities of running a business is enough to drive one mad. Most healthcare CEOs' drive is rooted in a deep passion for improving lives. They envision hospitals and clinics where patients feel cared for, staff are supported, and communities thrive. Yet, the daily grind forces them to prioritize spreadsheets over people.  There is never enough time to do it all. Healthcare is paradoxically both a business and a human right. CEOs know their institutions must turn a profit or at least break even to survive. But this clashes with their altruistic goals. Rising equipment, medication, and labor costs compound the issue, while fluctuating reimbursements from insurers and government programs make budget planning a headache.  Every compromise feels like a betrayal of the mission. The relentless bureaucracy of the healthcare system eats up valuable time and resources. The workforce crisis in healthcare adds yet another layer. Staffing shortages, high turnover rates, and burnout among clinical staff create a domino effect that lands squarely on the CEO’s desk. How can they provide excellent patient care when they can’t even fill critical roles? They know the root cause is systemic, but addressing it requires time and resources they do not have. The pressure of reconciling business demands with a compassionate mission takes a toll. Many report feeling isolated and disheartened. They entered healthcare leadership to make a difference, yet barriers beyond their control bogged them down. Still, these leaders persist. They innovate, advocate, and adapt, knowing the stakes are too high to do otherwise. Healthcare CEOs don’t need platitudes. They need allies. When CEOs are freed to focus on what truly matters, caring for people, everyone benefits.  Be that ally and ask, “How can I help.”

Face it: healthcare operations in the United States are nuts. Organizations are forced to jump through so many hoops all while juggling the flaming chainsaws of State, Federal, and Payor requirements and regulations. Understanding the daily data a health system produces is the only way to survive. Consider this your guide to The Hunger Games: Healthcare Data Edition. Say the word data, and you typically get one of two reactions:  Blank stares or outright fear.   Data is something that everyone needs, and not everyone knows how to use it correctly.  It’s time to stop looking at your data as an alien being or numbers on a spreadsheet and start looking at it for what it is.  The story of your business. Data should be the backbone of all decision-making and strategy development, from patient outcomes and operational efficiency to regulatory compliance. It reveals patterns, predicts trends, and guides what you must do when effectively leveraged. But without a strong data governance program and a data-literate workforce, your data's story might be incomplete or, worse, misleading. Healthcare organizations generate a ridiculous amount of data every day. Each dataset has a role to play in the bigger picture. When data is well-organized and accessible, it will do more for your organization and healthcare system than you can imagine.  Truly understanding the story that your data tells about your healthcare organization enhances patient care.   By identifying trends that improve clinical decision-making, you support preventive care initiatives. Insights derived from data streamline operations by minimizing inefficiencies, optimizing resource allocation, and improving scheduling. Accurate and timely data drives compliance and reporting.  With the right tools and education, data fosters innovation, allowing organizations to adopt cutting-edge treatments, improve patient engagement, and ultimately enhance the overall patient experience.  It makes all the difference.  So, how do you get that story to come out? It starts with a solid data governance program.  This structure is the cornerstone of effective data utilization. It certifies that your data is accurate, consistent, and secure. A successful data governance program includes: Data Quality:  Verified sources and regular audits to validate data accuracy and integrity. Data Security:  Compliance with regulations like HIPAA to safeguard patient information. Standardization:  Consistent data formats and definitions across the organization. Access Management:  Making sure the right people have access to the right data at the right time. Without these measures, data becomes a liability rather than an asset. Governance lays the foundation for turning raw data into something you can work with. However, no amount of perfect data in the world will help you if your staff doesn’t know how to use it.  A data-literate workforce that understands how to read reports and do something with the information they are provided will do more for your organization than a thousand leadership retreats.  And I’m not just talking about the directors and high-level staff; I am talking to everyone, right down the workplace food chain; everyone must understand data at some level and how it impacts the organization and them directly.  A data-literate workforce is a workforce that gets the big picture. But what is data literacy? Data literacy refers to reading, understanding, analyzing, and acting on data. Why does being data-literate matter?  Data-literate employees interpret reports and dashboards through the lens of their role.  This means their decisions for those roles are based on solid evidence rather than assumptions. Looking across departments, when everyone speaks the language of data, teams work together more effectively to solve complex problems and are better equipped to adapt to new technologies and processes. Employees who understand data security and privacy reduce the risk of breaches and compliance violations.  Bring this all together: a solid data governance program and a data-literate workforce, and you know what you get?  A data CULTURE.  And that culture, that level of understanding across the board, will move your organization to new levels. So, where does one start in creating this data culture with a governance program and data-literate teams?  Don’t skimp, invest in real training and not just some lunch and learn.  Offer workshops, online courses, or one-on-one coaching tailored to your staff to build data literacy skills across your organization.  Make sure the foundation is solid and develop clear data policies with guidelines for data collection, access, storage, and usage. Equip your team with user-friendly tools to visualize and interpret data effectively.   And finally, but most importantly, keep fostering a data-driven culture that encourages employees at all levels to use data in their daily workflows and reward data-driven successes. Your data is the story of your healthcare organization, but it’s up to you to tell it well. By implementing a strong data governance program and empowering your staff with data literacy, you can access the full potential of your data and have a competitive edge in a demanding industry. (Shameless Self Promotion Coming) Ready to take the next step? Contact Clockwork & Cursive today, and let’s see how I can help you build a data-driven future.

Step right up, those of every persuasion! Welcome to the grand spectacle of the analytics big top, where pie charts roar and data wranglers (that’s me) subdue the chaos. In today’s show, I’ll teach you how to tame those colorful beasts, turning them from perplexing to polished. Grab your laptop and let the data circus begin! The Ferocious Pie Chart A pie chart can appear intimidating, much like a lion in a circus ring. Its slices and shades often feel more like a jumble than a masterpiece. But fear not! Pie charts, when tamed, are an elegant way to showcase proportions, categories, and relationships within your data. The trick? Keep it simple. A pie chart with more than six slices is like a tent with too many colors; confusing and messy. Stick to the basics, and remember: not every dataset needs to be presented. Dress the Part: Your Ringmaster Toolkit Every great wrangler has their tools, and for a pie chart, those are: Contrast and Color : Each slice should stand out. Think bold reds, blues, and yellows—not fifty shades of gray. Labels, Not Guesswork : The audience never wants to guess where the lion is. Make it clear what each slice represents. Use clear, concise labels or a neat legend. Command the Audience’s Attention No one comes to a circus to see a dull act. Present only the most relevant data slices. If one slice is overwhelmingly dominant, consider breaking it into subcategories or switching to a different chart type (a bar chart might be your high-flying trapeze artist!). The Balancing Act In a circus, balance is everything—just ask the tightrope walkers. Similarly, the slices of your pie chart must sum up to a neat and tidy 100%. Anything more or less, and your audience will start questioning the entire act. Turn the Spotlight on the Star Every act has its star performer. In your pie chart, this is the slice that tells the most important story. Whether it’s a soaring 60% market share or a humble 5% slice with big implications, highlight this with a pop of color, a bold label, or even a callout annotation. The Grand Finale Once your pie chart is prepped, it’s time for the grand reveal. Place it in your presentation or report like a ringmaster presenting the final act. Add a bit of pizzazz—a title that draws attention, and voila! Your audience will applaud your style. Final Bow Wrangling pie charts isn’t just about showing numbers; it’s about telling a story with flair . The next time you find yourself staring at a wild, untamed dataset, remember the tools of the circus ring. With some practice, you’ll transform every chart into a roaring success. So, step into the analytics ring, take your bow, and let the data applause begin. Bravo!