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As care expands beyond inpatient settings and quality scrutiny grows, hospitals must elevate clinical documentation integrity into a strategic, enterprise-wide capability supported by aligned leadership, strong processes, and thoughtful technology to accurately reflect patient complexity and performance.

After successfully reducing average length of stay (LOS) at its flagship hospital, Carilion Clinic set out to do something many health systems attempt, but few achieve: replicate a successful intervention across a diverse set of regional facilities. The result is a case study in the power and the challenge of operational systemness.