36C26118Q0376-001.docx

Statement of Work – Palo Alto Health Care System Consultant Services

1. PROJECT TITLE: Lean Consultant Services to further develop VA Palo Alto Healthcare System’s (VAPAHCS) Lean Management System branded as the Service Improvement Model.

2. BACKGROUND: VAPAHCS has been on a seven year lean journey focused on implementing a management system as a standard for how business is conducted throughout the healthcare system. The purpose of this task order is to further the development of VAPAHCS’s Service Improvement Model (SIM). Consultant services are required to assist in the development and execution of the SIM roadmap which will guide the next evolution and continued deployment of SIM.

3. SCOPE

VAPAHCS requires expert consultant services in the areas of executive coaching for organizational performance, development, deployment, and management of strategic initiatives, and maturation of the existing lean management system. Consultants must be flexible to adapt to changing needs of the healthcare system and potential changes to the SIM roadmap.

The following table represents the facility’s Lean Maturity thus far:

FACILITY: PALO ALTO

Organizational Maturity Level

Level One - Little or No Evidence that Driver Exists

Level Two - Limited Evidence that Driver Exists

Year In

CRITICAL PILLARS

STRATEGIC

X

ORGANIZATIONAL CULTURE

X

INNOVATION AND

IMPROVEMENT

X

INFORMED DECISION MAKING

X

GLOBAL SCORE

I. Service Improvement Model (SIM) Overview:

SIM is a structured management system that is deployed systematically through the organization focused on immersing the organization in lean thinking and lean behaviors. SIM aligns large scale system improvement with micro-level improvement. This is accomplished by setting strategically aligned, long-term improvement goals and overseeing deployment horizontally and vertically through the organization. The methodology of the lean management system is based on three pillars:

A. Respect for People – training and direct participation within Lean activities, support front line staff as the primary problem solvers, and develop internal capacity and capability within the organization.

B. Strategic Alignment – Provide transparency throughout the organization with respect to organizational performance on goals and metrics. Transparency is supported through the use of Visual Management and Leader Standard Work creating alignment with organizational goals. Strategic alignment is organized, executed, and sustained via alignment of the following:

1. Value Stream Analysis (VSA) – horizontal/vertical improvement within product lines/care delivery/support systems

2. Rapid Process Improvement Workshops/Events/Projects – unit or department level improvement aligned to drive VSA improvement goals

3. Unit or team-based continuous improvement huddles

C. Strategic Deployment – ensures that transformational initiatives are tangible and relevant to front line staff and management systems supporting the initiatives are likewise aligned. Strategic deployment is integrated throughout the organization through the use of the Daily Management System which includes but is not limited to:

1. A3 Thinking and methodology

2. Visual Management

3. Leader Standard work

4. KPI Development and Management

II. Program Descriptions:

Lean Sensei will provide in-house facilitative skills, and Executive and Mid-Level mentoring and training, serving to guide and support deployment of the SIM. The primary objectives of the SIM is to enhance the knowledge, understanding and application of Lean principles and tools across the organization, facilitate an enterprise level leadership driven SIM Roadmap, facilitate and support execution of Value Stream Analysis (VSA) and associated Rapid Process Improvement Workshops/Events/Projects. The primary objectives also include training and engaging the organization in the development and use of Standard Work, Leader Standard Work, Continuous Daily Improvement, and A3 Thinking.

The contractor will provide hands-on technical and behavioral training and mentoring to advance SIM. This is accomplished via an Executive Level Sensei and a Mid-Level Sensei.

A. Executive Level Sensei – The executive level sensei is the principle mentor for Healthcare System Leadership and for the Systems Redesign/Lean POC supporting organizational progression through the Lean Management System deployment phases.

1. Primary goals and objectives are to:

a. Enhance Leaderships’ understanding of Lean as it pertains to creating and sustaining a culture of improvement,

b. Develop strategic alignment of organizational improvement and resources, and establish the requisite deployment structures.

2. The executive sensei facilitates the enterprise level strategic improvement plan guiding the Leadership team to design, execute, and monitor improvement efforts including development of the SIM Roadmap.

3. The sensei coaches through open dialogue, encouraging exploration, reflection and open-ended questions leading to “A-ha” moments. Critical to this role is direct modeling and transmission of central Lean tenets:

a. Respect for People,

b. Continuous Improvement,

c. Going to the Gemba,

d. Use of Standard Work and Learning to See.

4. Executive Coaching: Will provide at least 1 hour per week of individual coaching for each member of the Executive Team (7 members). This is in addition to coaching executives on specific improvement initiatives that may be identified at the enterprise level.

B. Mid-Level Sensei – The mid-level sensei facilitates and supports the direct transfer of Lean skills through facilitation and implementation of Rapid Process Improvement Events/Workshops/Projects, and Value Stream Analysis.

1. Primary goal is to enhance the knowledge, understanding and application of Lean principles and tools to front line staff, mid-level managers, and improvement staff.

2. The mid-level sensei supports pre-work assessment required of all Value Stream and Lean RPIW/improvement events, reviews data/materials/documents for relevance, applicability, and appropriateness providing corrective guidance on how to conduct process and value stream maps.

C. Executive and Mid-Level Sensei Collaboration

1. Senseis work collaboratively sharing information, materials, data, and conversations pertinent to successful deployment of the SIM throughout the healthcare system.

2. Sensei work collaboratively with the Chief, Office of Quality, Safety (QSV), and Value and Director, Office of Process Improvement (OPI)

3. Any issues or concerns impacting SIM deployment or where guidance is needed, senseis will contact the Chief, QSV

III. Scope of Work:

Contractor shall provide all labor, supervision, and other resources required to provide on-site facilitation, education, coaching, and mentoring support in order to further the deployment of SIM in accordance with this Statement of Work at the VA Palo Alto Health Care System. All services should be provided in person. Contractor will provide Executive-Level and Mid- Level Sensei personnel. Tasks Include:

A. Provide on-site SIM deployment support from planning through execution and sustainment.

B. Provide on-site SIM education, training and mentoring through direct engagement in Lean activity, modeling and oversight.

C. Provide 1 hour per week of individual, on-site coaching for each member of the Executive Team (7 members/ 7 hours) D. Develop Leadership’s Lean expertise, as well as internal subject matter expertise within the organization, including but not limited to Office of Process Improvement staff and mid-level manger staff.

E. Concepts used by the contractor must align with the SIM model of lean at VAPAHCS and must be able to adapt content, materials, trainings, etc. to align with SIM language, terminology and standards.

F.

G. The contractor shall alert Chief QSV of any events or emergencies impacting the fulfillment of duties or impacting a scheduled site visit as soon as it is known. Communication must be via telephone and not via email communication.

H. Executive Level Sensei Tasks:

· Executive coaching/mentoring, enterprise level strategic improvement work – SIM Roadmap, Value Stream Analysis, Leader Standard Work, CDI, and Visual Management. SIM deployment support, planning, technical assistance as subject matter expert on-site. Coaching/mentoring of OPI Director and Strategic Planner. Collaboration with Mid-Level Sensei and Chief QSV via telephone calls, meetings, submission of monthly standardized SIM sensei report, etc.

I. Mid-Level Sensei Tasks:

· Includes: Facilitation and support of SIM deployment within each site including: RPIW, work design and Value Stream Analysis support (separate from executive coaching), PDCA cycles support and coaching, mid- manager coaching, performance improvement staff coaching, Lean training preparation and support, participation in Chief QSV SIM Sensei meetings and submission of monthly standardized SIM Sensei report.

J. The contractor shall hold Monthly status meetings with Chief QSV to discuss the Monthly Status Report. The contractor shall keep minutes of monthly meeting and distribute for participant review no later than seven (7) calendar days after the meeting.

K. The contractor shall obtain electronic copies of documents generated during improvement work (e.g. A3s, Standard Work, planning documents and progress reports etc.) and upload to QSV sharedrive.

L. Transition-Out: The contractor shall facilitate a seamless transition from the incumbent to an incoming contractor or Government personnel at the expiration of the Task Order. This will be in the form of a formal document identifying each area of work, progress of the work, and plans for transition.

IV. Period of Performance:

The Performance Period of this Task Order is for one Base Period of twelve (12) months after award of the Task Order. Exact period of performance is determined at award of the Task Order.

V. Contractor Key Personnel Requirements:

A. Contractor shall use no more than one (1) key personnel individual to provide Executive and three (3) key personnel individual Mid-Level Sensei support at this site. When practicable, the same individual will provide Executive or Mid-Level Sensei services throughout the period of performance.

B. Sensei Personnel for performance of this contract must demonstrate the following:

1. Minimum of five (5) years of providing consulting services to large-complex healthcare organizations.

2. Minimum of ten (10) years experience facilitating large-scale enterprise level healthcare lean transformation.

3. Experience and ability to successfully teach Lean course materials to all levels of student knowledge and experience (beginning, intermediate, and advanced) to achieve course objectives.

4. Ability to plan, multi-task, and deliver services on schedule; ability to provide on-site support for work.

5. Contractor employees shall abide by the rules and regulations concerning the maintenance of personal standards for instructor integrity, grooming, conduct, speech, and fraternization.

6. Contractor employees must be able to write and speak in clear English so as the employees can be clearly understood by Government personnel.

7. Contractor employees shall present a professional appearance at all times and their conduct shall not reflect discredit upon the United States, the Department of Veterans Affairs (DVA), its policies, leadership or staff.

8. PERFERRED REQUIREMENT: Black Belt level certification (preferably from an American Society for Quality accredited institution)

C. The Government may, at its sole discretion, direct the contractor to remove any contractor employee from performance of this contract. Removal does not relieve the contractor of the responsibility to continue providing the services required under this task order. Within seven (7) calendar days, the Contracting Officer (CO) will provide the contractor with a written explanation to support any request to remove an employee. Any personnel the contractor offers as substitutes shall have the ability and qualifications equal to or better than the key personnel that are being replaced.

D. The contractor agrees that the key personnel shall not be removed, diverted, or replaced from work without approval of the CO. Any personnel the contractor offers as substitutes shall have the ability and qualifications equal to or better than the key personnel that are being replaced. Requests to substitute personnel shall be approved by the CO. All requests for approval of substitutions in key personnel shall be submitted to the Chief, QSV and the CO within 30 calendar days prior to making any change in key personnel. The request shall be written and provide a detailed explanation of the circumstances necessitating the proposed substitution. The contractor shall submit a complete resume for the proposed substitute and any other information requested by the CO needed to approve or disapprove the proposed substitution. The CO will evaluate such requests and promptly notify the contractor of approval or disapproval thereof in writing.

VI. Lean Management System Core Materials:

A. SIM orientation and training will be provided to selected contractor through a variety of methods including but not limited to face to face orientation and printed/electronic materials. Access to all materials including Lean educational presentation materials, forms, templates, Lean event specific materials, agendas, and any Lean training supplies will be provided to the contractor by QSV.

VII. Contract Deliverables:

1. Contractor will provide 30 days (240 hours) of consulting services per month

2. Monthly Status Report – Due 15 Calendar Days after completion of Report Period

a. Current Value Stream or work design/improvement projects. Contractor will provide an overall Project Work Plan that includes current state assessment and planning, work redesign, and milestones for implementation. Status during reporting period (Note: Include documentation of activities performed i.e. Meeting Minutes, Class Evaluations and Rosters, RPIE/RPIW materials or minutes, etc.)

i. Ongoing Activities ii.Completed Activities iii.New Activities identified iv.A3 Reports

b. Upcoming Value Streams/improvement work/A3s Identified and Progress towards implementation

c. Problems and Corrective Actions Taken (include potential issues or concerns with proposed resolutions)

d. Changes in Personnel, to include Security Clearance

e. Government actions required

f. Progressed SIM Schedule

g. Upon completion of events listed in the table below, contractor shall include the deliverable(s) listed for that event in the Monthly Status Report for that reporting period.

Support

Executive Sensei Support (1)

Management system infrastructure

· Complete development of governance structure

· Monthly transformation report summarizing activity & sensei role

· Revise enterprise master calendar

· Submission of tangible outputs and/or documented evidence of activity (e.g.

· Develop enhanced version of executive visibility system

· Develop next version of Operations Huddle to support daily performance

· Support SIM Education/Training program in collaboration with OPI staff.

· Curriculum development and coaching of internal staff developing the internal training program.

Enterprise master calendar, governance structure document, project plan, A3 etc.)

Strategy deployment

· Develop enterprise strategy (3-5 year plan)

· Enterprise A3 or monthly transformation report summarizing activity & sensei role

· Coaching development of Strategic A3s/charters

· Deploy enterprise strategy

· Development of a SIM Roadmap as a Strategic Initiative

· Submission of tangible outputs and/or documented evidence of activity (e.g. Outline of tactics and progress report on tactics, A3, meeting minutes, agendas, examples, etc.)

· Develop tactics at service level

· Check progress on tactics

· Link to VISN and VHA strategy

· Develop standard work for the processes above

Leader coaching

· Coach each executive team member on lean leader mindset & behaviors. Provide one hour per week of coaching to all 7 Executive Team members

· Monthly transformation report summarizing activity & sensei role

· Support the executives in developing and standardizing lean leader practices (leader standard work)

· Submission of tangible outputs and/or documented evidence of activity (e.g. A3, meeting minutes, agendas, examples, org charts, rosters and evaluations from lean training provided to leaders etc.)

· Support evolution/clarity in roles & responsibilities using Responsible/Accountable/Consulted/Informed (RACI) charts driven by clinical dyad position implementation and other org chart changes

Mid-Level Sensei Support (2)

Strategy execution: Stability* & financial viability

· Support the development and deployment of Strategic Initiatives by coaching Strategic A3 development, providing data analysis, deployment planning, and implementation.

· Monthly transformation report summarizing activity & sensei role

· Current Strategic Initiatives include: Reduction of Hospital Acquired Infections, Reduction in Adjusted Length of Stay, Activation of the new San Jose Outpatient Clinic, Model of Care, Continuous Organizational Readiness.

· Support strategic activities as needed and appropriate as strategy unfolds

· Ensure approaches and tactics in support of enterprise strategy are consistent with lean mindset and practices

· Submission of tangible outputs and/or documented evidence of activity (e.g. Overall output from Strategic Initiatives , KPI report, A3, examples, etc.)

· Provide staffing model analysis based on work redesign and skill task alignment to meet performance needs.

· Monthly transformation report summarizing activity & sensei role

· Submission of tangible outputs and/or documented evidence of activity (e.g. project plan, project progress report, A3, meeting minutes, agendas, staffing models examples, etc.)

Practitioner coaching

· Coach Office of Process Improvement (OPI) specialists on lean principles, practices, consulting skills, and tools

· Monthly transformation report summarizing activity & sensei role

· Consult and coach Chief, Quality, Safety, Value on his/her role as internal lean coach to the Executive Team/Director

· Coaching Director, Office of Process Improvement (OPI) on development of office to be able to support SIM deployment. This includes coaching the building internal OPI standard work, tools, etc. in order to train and assess OPI staff skill sets.

· Submission of tangible outputs and/or documented evidence of activity (e.g. SIM strategy, A3, meeting minutes, agendas, examples, rosters and evaluations from lean training etc.)

· Consult on Service Improvement Model (SIM) strategy for the organization including necessary infrastructure for success

· Coordinate with SIM Promotion Team to prepare for SIM Planning Meeting with VAPAHCS Director.

· Attend SIM Planning and Strategic Planning Leadership Board Planning Meetings for coaching.

· Attend weekly Strategic Planning Leadership Board Meeting, Strategic Planning Retreats, and other lean transformation meetings for coaching as requested.

· Coach middle managers on lean mindset, behaviors, practices and tools

· Support organizational on-going lean learning in general

· Support SIM Education/Training program in collaboration with OPI staff. Include curriculum development and coaching of internal staff developing the internal training program.

Special Delivery Instructions:

1. Instructional Material: All materials shall be provided in softcopy and hardcopy format.

1. Softcopy format: Softcopy materials shall be in Microsoft Excel, Microsoft PowerPoint, or Microsoft Word format.

1. Hardcopy format:

0. The material shall be legible (especially tables and figures).

0. Materials shall be provided in compact, durable formats (for example, double sided when possible).

3. Transition-Out Plan / Close Out Report – Due 30 calendar days prior to expiration of Task Order

a. The Transition-Out plan shall demonstrate how the contractor will coordinate with an incoming contractor for a seamless transition that provides for minimal disruption of the SIM activities ongoing.

b. The Transition-Out plan will address the following at minimum: i.History and background of the site lean journey

ii. Project Management Processes

iii. Points of Contact

iv. Location of Technical and Project Management documentation

v. Status of ongoing Technical Initiatives and historical perspective of all initiatives

vi. Value Stream Schedules and Milestones

vii. Government actions required

VIII. Travel:

VAPAHCS is comprised of 11 sites within commuting distance. Services will primarily be provided at the main campus in Palo Alto, CA. Travel to other sites may be required as part of this contract. Travel would be limited to less than 15% of the time. Contractor is responsible for travel to VAPAHCS sites to provide consulting services as required by this contract.

IX. Security:

Contractors will require access to VA facilities and VA network systems for performance of duties and will be required to obtain a VA Personal Identity Verification (PIV) card.

HSPD-12 directs all federal agencies and departments to issue identity cards to provide government workers, contractors, and affiliates with a credential that provides the attributes of security, authentication, trust, and privacy and can be used to verify identities in order to enter federal buildings or gain access to federal computer networks.

PIV Cards may be issued to employees, contractors, and affiliates, including foreign nationals, who have a verified need to access VA physical and/or logical resources for a period of more than 180 concurrent or aggregate days in a 365 day period and require unsupervised access to VA facilities or information systems.

All contractor employees who require access to the Department of Veterans Affairs’ computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. The contractor must take the required TMS training to get access to the computer system. This requirement is applicable to subcontractor personnel requiring the same access.

1. Position Sensitivity – The position sensitivity has been designated as Low Risk.

2. Background Investigation – The level of background investigation commensurate with the required level of access is a National Agency Check with Written Inquiries.

3. Contractor Responsibilities -

a) The contractor shall prescreen all personnel, to include non-U.S. Nationals requiring access to the computer systems to ensure they are able to pass the Special Agreement Check, and are able to read, write, speak and understand the English language. The term “United States National” includes both U.S. Citizens and U.S. non-citizen nationals (i.e. American Samoans).

b) The contractor shall submit the following information to the CO within 5 days of receipt of contract award:

c) (i) Applicant’s full name to include complete middle names

(ii) SSN

(iii) Date of birth (DOB) and place of birth to include city, state, country

(iv) Occupation

(v) Email address of company’s POC to send results and resolve issues

d) The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract.

e) Failure to comply with the contractor personnel security requirements may result in termination of the contract for default.

f) The required TMS training for computer access is: Privacy and HIPAA training, VA Privacy and Information Security Awareness and Rules of Behavior.