Documentation for Acute Care

This all-new publication replaces AHIMA's classic Documenation Requirements for the Acute Care Patient Record. Professionals, students, and educators will discover a comprehensive and up-to-date resource for documentation procedures in acute care settings.

The text offers numerous sample forms and screen views, review exercises, and detailed appendices including a standards crosswalk; a bibliography; a glossary; guidelines for form and screen design, data quality management, master patient index maintenance, health record release and disclosure, and health record retention and destruction as well as documentation and guidelines for non-acute care settings.

The accompanying CD-ROMs also provide a complete sample record in paper format, a function EHR demonstration, and information on EHR planning and implementation.