Consultation_and_Post-Graduate_proposed_SOW.pdf

STATEMENT OF WORK

Indian Health Service (IHS) OB/GYN Consultation and Post-Graduate

Education

1 BACKGROUND

The purpose and function of the Indian Health Service (IHS) is to provide comprehensive health care services to American Indians and Alaska Natives (AI/AN) through the IHS hospital and clinic system. IHS seeks professional support to maintain and improve these services through the use of professional consultation site visits and provision of education and hands on training in the disciplines of obstetrics and gynecology (OB/GYN), Neonatal, and Women’s Health.

Site visits and consultation are focused on assessing the content and quality of OB/GYN and women’s health care in sites under IHS supervision. Areas of need and staff questions identified during the site visits will be addressed by offering educational opportunities on site and at separate trainings and courses.

2 PURPOSE

The purpose of this contract is to obtain the services of a contractor: 1) to provide professional consultation usually in one IHS Area per year to involve 3-5 site visits within that Area and to provide follow-up consultation to at least one Area, usually the Area visited in the previous year; and 2) to develop, handle logistics, and teach a course in OB/GYN, Neonatal, and Women’s Health, or provide other equivalent educational opportunities.

The IHS Chief Clinical Consultant for OB/GYN (CCC) shall determine each year the nature and extent of educational and consultative activities to be supported through this contract based on agency priorities, available funding, and relevant logistic factors.

3 SCOPE OF WORK

3.1 Women’s Health Consultation Site Visits, Follow-up and Reports:

3.1.1 Task 1 - Consultation Site Visits:

a. The contractor shall meet with the Government Project Officer (GPO) within 10 business days of contract award. The purpose of this meeting is to review IHS objectives, priorities, initiatives, and IHS program information.

b. The Contractor shall conduct women’s health consultation visits within an Area chosen by the IHS Chief Clinical Consultant for OB/GYN. Three or more sites within the Area will be selected to visit. Representatives from the American College of Nurse- Midwives (ACNM), the Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN), and the American Academy of Pediatrics (AAP) shall be included in the contractor committee carrying out the site visits. The practice and educational needs of the site will be considered when selecting an interdisciplinary team for each visit. Logistics, including arrangement of travel for all non-federal consultants to, from, and within the area, lodging, and procurement of meeting sites during the site visit will be supported by the Contractor. Written reports of the site visits and a summary report and recommendations shall be produced by the respective teams. The report will be sent to IHS Headquarters, the Area Director of Area visited, the IHS Chief Clinical Consultant for OB/GYN, and senior leadership at the sites visited. The reports will be due to these officials no more than 3 months after the site visits are completed.

The Consultation and Site visit meeting is typically a 3-day meeting. The contractor will conduct the women’s health consultation visits within one of the Indian Health Service Areas. The contractor and the site visit team will convene the meeting at a place convenient to the IHS Area Office. The Area will be chosen by the IHS Chief Clinical Chief Clinical Consultant for OB/GYN. A typical agenda would include: A day of consultation with National, Area, and Local IHS and Tribal staff. A minimum of one day will be spent conducting visits at health care sites. The third day will consist of a review of the site visit findings from each site with briefing of Area and National staff.

A site visit protocol will guide the visit and will include a review of individual patient health records, summary data on deliveries by mode of delivery and outcomes, GYN surgeries, and other descriptive data on women’s health including domestic violence screening and counseling, mental health and substance use disorder services, and breast and cervical cancer screening. Community based organizations related to women’s health will be invited to present and describe their linkage with the hospital and the services provided.

c. The Contractor shall arrange follow-up consultation with the Sites/Area visited approximately 6 months after the site visit is conducted. This follow-up may be on site, off-site, or conducted remotely, as appropriate to the issues identified in the original consultation and with direction from the IHS Chief Clinical Consultant for Ob/Gyn.

Additional targeted site visits and/or consultation may be requested by the IHS Chief Clinical Consultant as time and funding allows. These activities will be reflected in the Annual Report supplied by the Contractor. Reports will be due to the offices cited above no more than 3 months after the follow-up is completed.

d. The Contractor shall maintain ongoing liaison relationships with the IHS Chief

Clinical Consultant for OB/GYN.

3.1.2 Task 2 - Continuing Education:

The Contractor shall provide continuing medical education presentations in conjunction with the consultation visits to women’s health professionals and others in the AI/AN community and Service Unit (SU). The contractor will collaborate with SUs to request continuing education units (CEU) from the IHS Clinical Support Center and/or other appropriate CEU-granting organization.

3.1.3 Task 3 – National Support for American Indian and Alaska Native Women’s Health:

The contractor shall provide evidence of efforts to advance American Indian/Alaska Native (AI/AN) women’s health through the preparation of policy statements, publications, and/or presentations and exhibits at national and/or regional meetings. These efforts may include the publicizing of successful strategies being used in AI/AN women’s health programs around the country so that they may be adapted for use elsewhere. Activities may also include publicity of opportunities for employment with IHS, Tribal, and Urban Indian Health programs.

3.2 Educational Opportunities in OB/GYN, Neonatal and Women’s Health

The purpose of annual educational opportunities selected by the Chief Clinical Consultant (CCC) for Ob/Gyn is 1) to assist IHS and Tribal health professionals to better recognize obstetric, neonatal, and gynecologic conditions and health problems, refine patient referral strategies, identify appropriate consultants, and provide comprehensive and culturally appropriate patient care consistent with national guidelines; 2) to enhance patient safety and reduce medical error through improved functioning of interdisciplinary perinatal/women’s health teams; and 3) to better recognize the psychosocial conditions which influence health outcomes and the public health programs which address these risks. The knowledge and expertise are to be gained through a combination of lectures and practical workshops.

The Contractor may conduct or collaborate in a women’s health course, or other educational events that cover knowledge and expertise in obstetric, neonatal, and gynecologic care appropriate for IHS and Tribal physicians, advanced practice nurses, and women’s health and perinatal nurses working at IHS and Tribal clinical care settings. The specific knowledge and expertise taught shall include interdisciplinary obstetric, neonatal, and gynecologic care, patient safety, and psychosocial conditions which influence health and which are especially relevant to the mission of the IHS. The course may include adjunct training such as ALSO (Advanced Life Support in Obstetrics), NPR, (Neonatal Resuscitation Program), and Buprenorphine/MAT waiver certification.

In the case of brief educational opportunities or those provided in collaboration with other educational entities at the direction of the CCC, task components may be rescaled or redefined, or responsibility shared with a collaborating entity. Such decisions will be made by the CCC, in collaboration with the contractor and the project officer to fit the circumstances and the funding available for the contract.

3.2.1 Task 1 – Planning Educational Opportunities:

The contractor shall plan educational opportunities in collaboration with a committee including, as appropriate, the IHS Chief Clinical Consultant for OB/GYN, the ACNM and AWHONN consultants and representatives of the contractor. The planning is to include consideration of the prior courses and, at the discretion of the CCC, is to result in the following:

a. Development of the anticipated course structure and program outline

b. Preliminary faculty identification

c. Assignment to the respective faculty of anticipated modifications to the course content and materials

d. Planning for and collaborating in promotion of the course

3.2.2 Task 2 - Register Participants:

The contractor shall, alone or in collaboration with other educational entities as noted shall develop and distribute the course brochure, which advertises the course and includes registration and tuition/tuition waiver information, to course participants. Register all course participants.

3.2.3 Task 3 - Course Curriculum:

The contractor will collaborate in the development of a course curriculum that addresses the unique and special primary care, obstetrics, gynecology, and neonatal needs of Indian Health physicians, advanced practice nurses, and perinatal and women’s health nurses. The course curriculum must provide Category I Physician Continuing Medical Education credits and Nurse Contact hour credits commensurate with instructional time. Responsibility for educational credits may rest with the contractor or with collaborating educational entities.

Identification of patients at increased risk and appropriate steps in their initial management/stabilization, as well as the importance of developing a close working relationship with the regional consultant obstetrician-gynecologist and/or neonatologist will be stressed as appropriate. Topical areas shall include from those listed, the most essential as agreed on by the planning committee:

Obstetrics:

a. Routine prenatal care (e.g., diagnosis, gestational age dating criteria, laboratory studies, fetal growth and development, and identification and referral of high risk patients)

b. Principles of genetics as appropriate to the IHS settings

c. Complications of pregnancy:

i. Reproductive complications (e.g., placenta previa, abruptio placenta, premature rupture of the membranes)

ii. Medical complications (e.g., hypertension, diabetes)

d. Management of labor (e.g., fetal monitoring, recognition of abnormal labor patterns)

e. Delivery (e.g., immediate postpartum care, prevention and management of postpartum hemorrhage)

f. Postpartum care

g. Regional consultation and referral standards

h. Nurse-Midwifery and Perinatal Nursing practices

i. Traditional birthing practices

j. Obstetric and Rural Maternity Safety

k. Breastfeeding Support

Gynecology and Wome n’s Healt h:

a. Common problems in gynecology including gynecologic infections, pelvic pain, and cervical and breast cancer screening.

b. Family planning concepts and methods, including infertility services

c. Management of abnormal bleeding, amenorrhea and menopause

d. Management of gynecologic emergencies such as incomplete spontaneous abortion and ectopic pregnancy.

e. Behavioral health (BH) issues including screening and management and model program integrating BH into primary care for women.

f. Screening and primary care management of chronic diseases common in

AI/AN women.

g. Care for survivors of sexual assault and domestic violence, including physical examination, mental health issues, etc.

h. Management of substance use disorder.

Neonatology:

a. Newborn assessment.

b. Transport: indications, stabilization, records.

c. Immunization.

d. Problems in the first weeks of life.

Patie nt Safety:

a. Team building and communication strategies to improve perinatal and women’s health team function

b. Creating a culture of patient safety

c. Systems changes to support patient safety and reduce medical errors

3.2.4 Task 4 – Develop and Distribute Course Training Materials:

The contractor shall develop or procure, as appropriate, training materials for educational offerings. The training materials and training agenda, etc., may be distributed to participants in advance of the course to aid participants’ preparation for the course. Additional relevant literature may be displayed during the course/conference or given to attendees at that time.

3.2.6 Task 5 - Provide and Orient Course Faculty/Consultants:

The contractor shall provide faculty members/consultants who have acquired nationally recognized expertise in the topics and issues to be presented. When possible, these specialists shall be individuals who have backgrounds either as former IHS personnel, medical or nursing school faculty, IHS clinical care contract consultants or all three, and thus shall be fully acquainted and familiar with the special problems of OB/GYN and neonatal care in IHS and tribal settings. They shall have been recognized for their cultural sensitivity as well as for their scientific and teaching expertise. Faculty may include physicians, advanced practice nurses, nurses, and others with appropriate expertise in the subject matter to be taught. They may also be specialists practicing in regions with a high concentration of IHS and/or tribal facilities. This circumstance provides optimal faculty leadership for the course experience as well as offering the attendees the opportunity for first hand acquaintance with specialists representing the private and/or academic sectors who can serve as consultants once the attendees are back at their respective worksites.

The contractor shall arrange all travel and reimbursement for the faculty members/consultants to be supported by the contract; expenses incurred by any additional faculty members/consultants who are specifically provided by IHS or any entity other than the contractor are to be supported by IHS or their sponsoring entity.

The concurrence of the IHS project officer or his/her designee and IHS Chief Clinical Consultant for OB/GYN must be obtained prior to utilization of non-government specialists.

The federal government will provide qualified IHS faculty on an as available basis, as deemed appropriate, and the contractor may coordinate, with the project officer or designee, the selection of IHS faculty. Note: All travel, transportation, and per diem costs of the IHS- provided faculty and course attendees (physicians and nurses) will be reimbursed by the government in accordance with federal travel regulations.

3.2.7 Task 7 - Offer Educational Opportunities:

The contractor may collaborate in the offering of educational opportunities (e.g. course, conference, or shorter focused educational opportunity at the discretion of the CCC) at suitable sites. These may include Advanced Life Support in Obstetrics (ALSO), Neonatal Resuscitation Program (NRP) and Substance Use Disorder/Buprenorphine Waiver training.

The contractor shall, alone or in collaboration with other educational entities, make arrangements for the required lecture hall, the smaller seminar-style rooms for the concurrent workshops, the resuscitation laboratory, and the appropriate audiovisual equipment. The contractor may coordinate availability and use of necessary equipment (i.e.

laptops/projectors) with which to conduct and facilitate the course. The contractor may provide opportunities for active individual participation and practical hands-on experience (e.g. techniques for emergency delivery).

3.2.8 Task 8 - Provide Educational Evaluation Instruments:

As appropriate for each educational event, the contractor shall prepare a course evaluation instrument, designed to permit the assessment by each attendee, to evaluate the quality of each session presented. The responses of the attendees are to be collected into a summary course evaluation document and included in the final report.

3.2.9 Task 9 - Final Report:

The contractor shall prepare an annual report, completed in both electronic and hard copy format, encompassing all of the activities performed to prepare, develop and present the educational opportunities. The report shall be submitted to the project officer within 12 months following completion of the event.

INSPECTION AND ACCEPTANCE

The COR, as a duly authorized representative of the Contracting Officer, shall assume the responsibilities for monitoring the Contractor's performance, evaluating the quality of services provided by the Contractor, and performing final inspection and acceptance of all deliverables and services called for by the contract.

Performance Based Quality Assurance Surveillance Pla n

The contractor shall provide services in such a manner as to meet the highest standards of professional ethics and conduct, particularly in regard to confidentiality and patient rights. If at any time during the term of this contract, the Government suspects unprofessional behavior, the contractor will be contacted and requested to take action.

EVALUATION DELIVERABLES AND TIME TABLE

Item Description Qty Delivery C.4.1 Women’s Health Consultation, Site Visits, Follow-up, & Reports

C.4.1.1a Post award conference 1 Within 10 business days of the date of contract award *For the Base Period:

within 10 business days of Task award date.

C.4.1.1b Consultation and Site Visits 3

Within 10 months of the date of contract award

C.4.1.1.2 Continuing Medical Education 1 Within 10 months of the date of contract award

C.4.1.1.3 Advocacy 1 Within 10 months of the date of contract award

C.4.1.1.4 Final Report (*See note 1) 1 Within 10 months of the date of the site visits

C.4.2 Educational Opportunities in Ob/Gyn, Neonatal, and Women’s

Health

C.4.2.1 Course Planning 1 Within 3 months of date of contract award. *For the Base Period:

within 3 months of Task award C.4.2.2 Register Participants/Arrange for

Scholarships As required Within 10months of the date of contract award.

C.4.2.3 Course Curriculum 1 Within 10 months of the date of award

C.4.2.4 Develop and distribute Course Materials

As required

Within 10 months of the date of contract award.

C.4.2.5 Develop Course and Materials 1 Within 10 months of the date of contract award.

C.4.2.6 Provide and Orient Course Faculty 5 Within 10 months of the date of contract award.

C.4.2.7 Conduct Educational Opportunities 1 Within 10 months of the date of contract award.

C.4.2.8 Course Evaluation 1 Within 10 months of the completion of the course

C.4.2.9 Final Report (*See note 1) 1 Within 10 months of the completion of the course

C.4.3.1 Advertisement/informational materials

Within 4 weeks of date of contract award.

C.4.3.2 Final Reports 1 Final reports are due within 3 weeks following the completion date of each contract period.