36C25619Q0485-007.docx

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Radiation Safety Officer Federal contract opportunity
Solicitation number
36C25619Q0485
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 16

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36C25619Q0485 ATTACHMENT C - QUALITY ASSURANCE SURVEILLANCE PLAN (QASP).docx

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ATTACHMENT C – QUALITY ASSURANCE SURVEILLANCE PLAN

36C25619Q0485

QUALITY ASSURANCE SURVEILLANCE PLAN

For: Nuclear Medicine Service

Contract Number: TBD

Contract Description: Radiation Safety Officer Services

Contractor’s name: TBD

Period of Performance: April 1, 2019 through September 30, 2023 (base plus four option periods)

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: Tina Harris / Beth Cook Organization or Agency: Department of Veterans Affairs, Network Contract Office 16

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: Danny Duke

c. Other Key Government Personnel – TBD

3. CONTRACTOR REPRESENTATIVES

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

a. Program Manager – TBD

b. Other Contractor Personnel – 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.

Performance Requirements Summary Matrix:

The Government will use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

Task
ID
Indicator
Standard
Acceptable Quality Level
Method of Surveillance
Incentive

Rating

General
1
Insurance Requirements
Contractor shall maintain all required insurance.
100%
100% Inspection

Positive Past Performance & Exercise of Option Period

2
Review of operational elements

Ref SOW Para3

Annual review of all operational elements of the as low as is reasonably achievable (ALARA) Program & Take Action when necessary.
100%
Direct Observation
3
Contractor Employees & Personnel Qualifications
Contractor shall furnish qualified personnel names and certifications
100%
100% Inspection
4
Reasonable Practices & Controls

Ref SOW Para. 4

Contractor shall Ensure use of reasonable practices & controls to maintain doses in compliance w/10 CFR 20.1101(b).
100%
Direct Observation & Analysis of Contractors reports
5
Educational Programs

Ref SOW Para. 4

Conduct Educational Programs At least Annually to instruct personnel on ALARA Program.
100%
Direct Observation & Analysis of Contractors reports

General

6
Total Effective Dose Equivalent (TEDE) Ref. SOW Para. 4
Contractor shall ensure Public does Not Receive a TEDE of more than 10mRemNr
100%
Analysis of Contractors reports
Positive Past Performance & Exercise of Option Period
7
Management Approved Procedures Ref. SOW Para 5
Collect Management Approved Procedures in a Centralized Location.
100%
Direct Observation
8
Training Ref SOW Para 6
Contractor shall train personnel on safe Handling /storage of radioactive material annually.
90%
Direct Observation & Analysis of Contractors reports
9
Record System

Ref SOW Para. 6

Contractor to oversee record system of radiation protection program until permit terminated by NHPP
100%
Direct Observation & Analysis of Contractors reports
10
Action Levels

Ref SOW Para 7

Contractor to evaluate action levels monthly for compliance w/ 10 CRF 20.1501 & 1502.
100%
Direct Observation & Analysis of Contractors reports
11
Records review Ref SOW Para 7
Radiation Protection Program Records to be reviewed Monthly.
100%
Analysis of Contractor’s Reports
General
12
Written Report Ref SOW

Para. 8 Provide Written Report on Radiation Safety Program to GCVHCS Director Annually

100%
Analysis of Contractor’s Reports
General
13
Outpatient Clinic Inspections Ref. SOW

Para. 10

Conduct Required Radiation Safety Inspections of Outpatient Clinics
100%
Direct Observation
General
14
VA On-Line Computer Training Ref. SOW

Para. 11

Complete Annual VA Online Computer Training.
100%
100% Inspection

5. INCENTIVES

The Government shall use Exercise of Option Period and Past Performance as incentives. Incentives shall be based on exceeding, meeting, or not meeting performance standards.

6. 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.

a. DIRECT OBSERVATION. (Can be performed periodically or through 100% surveillance.)

Performance Standard(s) ID: 2, 4, 5 ,7, 8, 9, 10, 13

b. PERIODIC INSPECTION. (Evaluates outcomes on a periodic basis. Inspections may be scheduled [Daily, Weekly, Monthly, Quarterly, or annually] or unscheduled, as required.)

Performance Standard (s) ID: N/A

c. USER SURVEY. (Combines elements of validated user complaints and random sampling. Random survey is conducted to solicit user satisfaction. May also generate inspections and sampling.)

Performance Standard(s) ID: N/A

d. VALIDATED USER/CUSTOMER COMPLAINTS. (Relies on the patient to identify deficiencies. Complaints are then investigated and validated.)

Performance Standard(s) ID: N/A

e. 100% INSPECTION. (Evaluates all outcomes.)

Performance Standard(s) ID: 1, 3, 14

f. PERIODIC SAMPLING. (Variation of random sampling. However, sample is only taken when a problem/deficiency is suspected. Sample results are applicable only for the specific work inspected. Since sample is not entirely random, it cannot be applied to total activity performance.)

Performance Standard(s) ID: N/A

g. RANDOM SAMPLING. (Designed to evaluate performance by randomly selecting and inspecting a sample of cases.

Performance Standard(s) ID: N/A

h. Progress or status meetings.

Performance Standard(s) ID: N/A

i. Analysis of contractor's progress reports. (Evaluate cost, schedule, etc.)

Performance Standard(s) ID: 4, 5, 6, 8, 9, 10, 11, & 12

7. 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:

Excellent (“E”) = Exceeds Standards Satisfactory (“S”) = Meets Standards Unsatisfactory (“U”) = Fails To Meet Standards

8. 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.

9. 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 quarterly to assess performance and shall provide a written assessment.

Signature Contracting Officer’s Representative

Contract Discrepancy Report

Contract No.
Report No. for this Discrepancy:

Contractor/Manager’s Name:

From: (Name of Project Officer)

Dates

Prepared:

Returned by Contractor:

Action Complete:

Discrepancy or Problem:

Signature of Contracting Officer:

To: (Contracting Officer)

From: (Contractor)

Contractor Response as to Cause, Corrective Action and Actions to Prevent Recurrence (Attach Continuation Sheet if Necessary)

Signature of Contractor Representative:

Date:

Government Evaluation:

Government Actions:

Close Out

Name
Title
Signature
Date

Contractor Notified

Project Officer

Contracting Officer

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