36C24518R0176-0001001.pdf

QUALITY ASSURANCE SURVEILLANCE PLAN

The contractor shall be evaluated in accordance with the following QASP.

QUALITY ASSURANCE SURVEILLANCE PLAN

For: Medical Services/Telephone Lifestyle Coaching Services

Contract Number: TBD

Contract Description: Telephone Lifestyle Coaching services for VA patients.

Contractor’s name: TBD

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) provides a systematic method to evaluate performance for the stated contract. This QASP explains the following:

What will be monitored.

How monitoring will take place.

Who will conduct the monitoring.

How monitoring efforts and results will be documented.

This QASP does not detail how the contractor accomplishes the work. Rather, the QASP is created with the premise that the contractor is responsible for management and quality control actions to meet the terms of the contract. It is the Government’s responsibility to be objective, fair, and consistent in evaluating performance.

This QASP is a “living document” and the Government may review and revise it on a regular basis. However, the Government shall coordinate changes with the contractor. Copies of the original QASP and revisions shall be provided to the contractor and Government officials implementing surveillance activities.

2. GOVERNMENT ROLES AND RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. Contracting Officer (CO) - The CO shall ensure performance of all necessary actions for effective contracting, ensure compliance with the contract terms, and shall safeguard the interests of the United States in the contractual relationship. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment under this contract. The CO is ultimately responsible for the final determination of the adequacy of the contractor’s performance.

Assigned CO: Jabbar Pringle

Organization or Agency: Department of Veterans Affairs

b. Contracting Officer’s Representative (COR) - The COR is responsible for technical administration of the contract and shall assure proper Government surveillance of the contractor’s performance. The COR shall keep a quality assurance file. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the

Government’s behalf.

Assigned COR: Gregory Moore, Executive Assistant

Organization or Agency: National Center for Health Promotion and Disease Prevention (NCP), Durham, NC.

3. CONTRACTOR REPRESENTATIVES

The following employees of the contractor serve as the contractor’s program manager for this contract.

a. Program Manager – TBD

4. PERFORMANCE STANDARDS

Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards.

The Performance Requirements are listed below in Section 6. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

5. METHODS OF QA SURVEILLANCE

Various methods exist to monitor performance. The COR shall use the surveillance methods listed below in the administration of this QASP.

Task ID Performance

Requirement Standard

Acceptable

Quality

Level

Method of

Surveillance

Met AQL/Did not meet AQL-

CPAR rating/Add comments

Enrollment

Task 5.4.2

1/page

Referred patients receive enrollment call

Contractor will call referred patients within 5 business days at time preferred by patient

95% Monthly reports

Exercise of

Option Period and past performance

Documentation

Task 5.6

2/page

Patient summary program notes documented in CPRS

Patient summary progress notes written within 3 business days of end of each month of contact

100%

Random inspection

(auditing)

Exercise of

Option Period and past performance

Maintenance of participants

Task 5.4.3

3/page

Maintaining patient engagement after minimum of

4 required calls

Contractor will maintain participant engagement beyond 4 required calls as requested by participant

80% Monthly reports

Exercise of

Option Period and past performance

Fidelity to protocol

Task 5.10.4

4/page

Fidelity to approved coaching protocol

Fidelity to approved coaching protocol must be maintained by all coaches

100%

Coach supervisor must monitor

5% of each

Coach’s telephone contacts;

Random inspection

(auditing)

Exercise of

Option Period

Task ID Performance

Requirement Standard

Acceptable

Quality

Level

Method of

Surveillance

Met AQL/Did not meet AQL-

CPAR rating/Add comments

Management of patient complaints

Task 5.10.4

5/page

Process for addressing participant complaints

All complaints will be addressed following

VA/NCP

approved process

100%

Validated user/customer complaint reports

Exercise of

Option Period

a. MONTHLY REPORTS. Monthly contractor reports will be reviewed for completeness and accuracy.

b. RANDOM INSPECTION. Patient CPRS files to be reviewed will be randomly selected and cover the period of service. In addition to monitoring of coach telephone contacts by the coaches’ supervisors, a sample of patient telephone contacts will be randomly selected and reviewed by VA or another agent of VA’s choosing.

c. VALIDATED USER/CUSTOMER COMPLAINTS. Customer complaint data are compiled quarterly and reviewed by COR. All complaints must be addressed following VA/NCP approved process.

d. Verification and/or documentation provided by contractor.

6. RATINGS

Metrics and methods are designed to determine if performance exceeds, meets, or does not meet a given standard and acceptable quality level. A rating scale shall be used to determine a positive, neutral, or negative outcome. The following ratings shall be used:

One (1) incident of not meeting the performance standard will result in verbal counseling, second incident will be documented in a written warning any further incidents will result in immediate dismissal.

7. DOCUMENTING PERFORMANCE

a. ACCEPTABLE PERFORMANCE

The Government shall document positive performance. Any report may become a part of the supporting documentation for any contractual action.

b. UNACCEPTABLE PERFORMANCE

When unacceptable performance occurs, the COR shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the

COR shall document the discussion and place it in the COR file.

When the COR determines formal written communication is required, the COR shall prepare a

Contract Discrepancy Report (CDR), and present it to the contractor's program manager.

The contractor shall acknowledge receipt of the CDR in writing. The CDR will specify if the contractor is required to prepare a corrective action plan to document how the contractor shall correct the unacceptable performance and avoid a recurrence. The CDR will also state how long after receipt the contractor has to present this corrective action plan to the COR. The

Government shall review the contractor's corrective action plan to determine acceptability.

Any CDRs may become a part of the supporting documentation for any contractual action deemed necessary by the CO.

10. FREQUENCY OF MEASUREMENT

a. Frequency of Measurement.

During contract performance, the COR will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

b. Frequency of Performance Assessment Meetings.

The COR shall meet with the contractor semi-annually to assess performance and shall provide a written assessment.

<After award, both the contractor’s Program Manager and the COR shall sign this document.>

Signature – Contractor Program Manager

Signature – Contracting Officer’s Representative