Methodology Used to Determine Watershed Health Quality Metrics

Communication

The Watershed Health software platform (Watershed) measures the elapsed time between when each message is received by an organization and when that message is marked as read by any user of the receiving organization. These message latency values are recorded and an average of the preceding 30 days is calculated for each organization. Statistical analysis of the average message latency values for all participating Watershed organizations is periodically performed and thresholds are determined to stratify organizations into quintiles expressed on a scale between 1 and 5, with 5 being best.


Quality Assurance (QA)

When specific patient-related adverse events (such as 30-day readmission) occur, Watershed automatically sends each organization linked to the patient a Quality Assurance Request Form. Users can complete the form, ignore the form, or opt out if the receiving organization was not, in fact, involved in the patient's care at the time of the adverse event. Organizations have 7 days to complete the form. Watershed calculates an average of the percentage of time that each participating organization completes this form during the preceding 12 months. Statistical analysis of the percentage values for all participating Watershed organizations is periodically performed and thresholds are determined to stratify organizations into quintiles expressed on a scale between 1 and 5, with 5 being best.


Readmission

Certain hospitalized patients enrolled in Watershed are followed by care coordinators for a period of 30 days after hospital discharge. If the patient returns to any hospital during that period, organizations linked to the patient will be credited with a hospital readmission. An organization’s Readmission metric is the average of the percentage of linked patients who are readmitted to the hospital during the 30-day post-acute period over the preceding 12 months.


Deviation from Estimated Length of Stay (DELOS)

Hospitals that use Watershed to connect patients to other inpatient facilities (such as skilled nursing facilities) have the option of including an estimated length of stay on the connection form. When this is done, Watershed will compare the estimated length of stay to the actual length of stay and record the difference. An organization's DELOS metric is the average of all such measured differences over the preceding 90-day period and is expressed as a negative value when the actual length of stay is less than the estimated length of stay and a positive value when the actual length of stay is greater than the estimated length of stay.


Handoff Duration

When inpatient facilities (such as hospitals) use Watershed to connect patients to post-discharge organizations (such as home health, hospice, skilled nursing facilities, etc.), Watershed measures the elapsed time between when a patient is discharged from the inpatient facility and when the post-discharge organization establishes face-to-face services.  An organization’s Handoff Duration metric is the average of all such measured times during the preceding 90-day period.


Patient Ratings

Certain patients enrolled in Watershed have an opportunity to rate organizations involved in their care on a scale between 1 and 5, with 5 being best. Watershed aggregates and averages the numeric information for each organization over the preceding 12-month period to determine the Patient Ratings metric.

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