36C25718Q0088-004.docx

Attachment C – Performance Work Statement (Including Quality Assurance Surveillance Plan)

B.6. PERFORMANCE WORK STATEMENT

Performance Work Statement (PWS) for Primary Care Physician West Texas VA Health Care System Big Spring, Texas The Ambulatory Care Service Line at West Texas VA Health Care Systems (WTVAHCS) in Big Spring, Texas, has a requirement for Three (3) board certified or board eligible Primary Care Physicians for direct patient care for a period of six months with the option of six additional months if the locum requirement continues to exist.

CONTRACT DESCRIPTION:

This position is to support the direct patient care needs at the WTVAHCS, located at 300 Veterans Blvd., Big Spring, Texas and work will commence there immediately upon completion of orientation. The physician must be professionally licensed in any state to prescribe controlled substances. The physician will be required to work cooperatively with other physicians, advanced practice nurses, physician assistants, registered nurses, and a variety of allied health professionals to deliver comprehensive health care services to civilian, military patients including women Veterans. Services may be provided face to face or through tele-health. The medical center utilizes a computerized medical record system. The physician must be familiar with personal computers, have adequate typing skills to perform data entry (progress notes and physician orders), and be able to navigate through windows based computer programs. Training on the computerized system will be provided by the medical center. The physician must provide proof that he/she has had a two-step tuberculosis skin test, testing is up-to-date, and documentation must be received the day of employment. If the physician has had a negative test within the past 12 months, a single step test will be done and again documentation needs to be provided prior to starting employment.

SPECIFIC DUTIES AND RESPONSIBILITES:

1. The physician shall follow and meet all WTVAHCS policies, performance measures, rules and regulations.

2. The physician is required to be certified in Basic Life Support (BLS) and to maintain the certification during their work for the WTVAHCS.

3. The physician is required to be Advanced Cardiac Life Support (ACLS) certified and to maintain the certification during their work for the WTVAHCS.

4. The physician shall function as a full team member of the interdisciplinary team, serving patients at the WTVAHCS in Big Spring, TX,. Hours of services worked by the physician shall be documented on a time sheet at the WTVAHCS. Hours worked by physician shall not exceed specified hours on the task order.

5. Provide history, physical examination, diagnosis, and initiation of medical treatment.

6. An outpatient progress note must be completed for each episode of care.

7. Initiate and facilitate treatment and transfer in emergency situations.

8. A discharge summary will be completed when a patient is released from inpatient care. Established criteria will be followed for the completeness and timeliness of the summary.

9. Follow-up office visits for existing medical problems and appropriate diagnostic tests and medication adjustments.

10. Referral of patients as needed to appropriate specialists, health care facilities, and coordination of home health services.

11. Document assessments and plan of care for each patient in accordance with policies and procedures.

12. Clinic note completed, documented, and encounter closed in CPRS same day of visit with the patient.

13. View alerts to be addressed within 24 hours of receipt and no more than 75 view alerts permitted to be carried over to the following day.

14. Participation in the facilities PEER review process, including the external review.

15. Provides telemedicine service via Clinical Video conferencing, as needed, to other WTVAHCS primary care setting for cross coverage.

16. Act as consultant in clinical practice.

17. Collaborate with other disciplines to ensure continuity of patient care (excellent interpersonal skills required).

18. Collaborate and act as a patient advocate (excellent interpersonal skills required).

19. Maintain knowledge of new and current clinical methods.

HOURS OF PERFORMANCE:

1. Work Hours: 8:00 a.m. to 4:30 p.m. Monday through Friday and weekend clinics if required except for National Holidays.

2. National Holidays:

3. When a holiday falls on a Sunday, the following Monday shall be observed as a legal holiday. When a holiday falls on a Saturday, the preceding Friday is observed as a legal holiday by U.S. Government agencies. Also included, would be any other day specifically declared by the President of the United States of America to be a National Holiday.

QUALITY ASSURANCE MONITORING

1. 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.

1. Contracting Officer’s Technical 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 Performance Standards: (OPPE) Performance standards define desired services. The Government performs surveillance to determine if the contractor exceeds, meets or does not meet these standards. The Government shall use these standards to determine contractors’ performance.

Quality Assurance Surveillance Plan (QASP) Project Title: Primary Care Services - performing duties working on outpatient veterans.

Contract Number:_________________________________ Contract Description: Primary Care Physician board eligible or to perform the requirements in accordance with the terms of this contract.

Contractor’s Name:

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: Valeria Gutierrez

Organization or Agency: NCO 17, El Paso

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: Christina Fitzgibbons

Organization or Agency: Department of Veterans Affairs, El Paso VA Health Care System (EPVAHCS)

3. CONTRACTOR REPRESENTATIVES

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

a. Primary: Annette Williams

b. Alternate: None

4. PERFORMANCE STANDARDS

The contractor is responsible for performance of ALL terms and conditions of the contract. CORs will provide contract progress reports quarterly to the CO reflecting performance on this plan and all other aspects of the resultant contract. The performance standards outlined in this QASP shall be used to determine the level of contractor performance in the elements defined.

Performance standards define desired services. The Government performs surveillance to determine the level of Contractor performance to 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 standard and assign a rating. At the end of the performance period, these ratings will be used, in part, to establish the past performance of the contractor on the contract.

5. METHODS OF QA SUREVEILLANCE

a. DIRECT OBSERVATION. 100% surveillance: Reportable by AVAHCS staff daily and use of Action Required Reports provide by Business Office.

b. PERIODIC INSPECTION. Inspections performed on a quarterly basis or as often as determined by the COR to ensure compliance.

c. Verification of documentation provided by the Contractor: Annual verification of Training Requirements.

1.0 Patient Care

2.0 Medical/Clinical Knowledge

Applicable paragraphs in PWS: 19

3.0 Cyber Security

Applicable Paragraph: 9, Page# 13 (2) (4)

4.0 Basic Life Support

Applicable Paragraph: 2, Page# 18.

5.0 Interpersonal & Communication Skills

Paragraph#s 17, 18 Page# 19.

6.0 Professionalism

Applicable paragraphs in PWS: All paragraphs

7.0 System Based Practice

Applicable paragraphs in PWS: 12, Page# 19

6. RATINGS. Metrics and methods are designed to determine rating for a given standard and acceptable quality level. The following ratings shall be used:

Government's benefit. The contractual performance of the element or sub-element being assessed was accomplished with few minor problems for which corrective actions taken by the contractor were highly effective.

Note: To justify an Exceptional rating, you should identify multiple significant events in each category and state how it was a benefit to the GOVERNMENT. However a singular event could be of such magnitude that it alone constitutes an Exceptional rating. Also there should have been NO significant weaknesses identified.

Note: To justify a Very Good rating, you should identify a significant event in each category and state how it was a benefit to the GOVERNMENT. Also there should have been NO significant weaknesses identified.

Note: To justify a Satisfactory rating, there should have been only minor problems, or major problems the contractor recovered from without impact to the contract. Also there should have been NO significant weaknesses identified.

performance of the element or sub-element being assessed reflects a serious problem for which the contractor has not yet identified corrective actions. The contractor's proposed actions appear only marginally effective or were not fully implemented.

Note: To justify Marginal performance, you should identify a significant event in each category that the contractor had trouble overcoming and state how it impacted the GOVERNMENT. A Marginal rating should be supported by referencing the management tool that notified the contractor of the contractual deficiency (e.g,. Management, Quality, Safety or Environmental Deficiency Report or letter).

Reports, or letters).

7. DOCUMENTING PERFORMANCE

a. The Government shall document positive and/or negative performance. Any report may become a part of the supporting documentation for any contractual action and preparing annual past performance using CONTRACTOR PERFORMANCE ASSESSMENT REPORT (CPAR).

b. If contractor performance does not meet the Acceptable Quality level, the CO shall inform the contractor. This will normally be in writing unless circumstances necessitate verbal communication. In any case the CO shall document the discussion and place it in the contract file. When the COR and the CO determines, formal written communication is required, the COR shall prepare a Contract Discrepancy Report (CDR), and present it to CO. The CO will in turn review and will present to the contractor's program manager for corrective action.

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 CO. The Government shall review the contractor's corrective action plan to determine acceptability. The CO shall also assure that the contractor receives impartial, fair, and equitable treatment. The CO is ultimately responsible for the final determination of the adequacy of the contractor's performance and the acceptability of the Contractor's corrective action plan.

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

8.FREQUENCY OF MEASUREMENT

a. Frequency of Measurement.

The frequency of measurement is Quarterly. The government (COR or CO) will periodically analyze whether the negotiated frequency of surveillance is appropriate for the work being performed.

b. Frequency of Performance Reporting.

The COR shall communicate with the Contractor and will provide written reports to the Contracting Officer quarterly to review Contractor performance.

9. COR AND CONTRACTOR ACKNOWLEDGEMENT OF QASP

DATE

SIGNED:

CONTRACTOR NAME/TITLE DATE

Points of Contact: The Contracting Officer and Contracting Officer Representative will act as a liaison for the VA Medical Center and the contractor.

Contracting Officers Representative (COR) Christina Fitzgibbons Administrative Officer Medical Service West Texas VA Health Care System 300 Veterans Boulevard

End of Performance Work Statement/ QASP--------------------------------------------------------