36C26120Q0153-002.docx

QUALITY ASSURANCE SURVEILLANCE PLAN

For: Retina Consultant of Nevada Contract Number: < upon award, enter contract number> Contract Description: < The Contractor shall provide Retinal Ophthalmology Services in the form of consultation, secondary (in office) care and tertiary (surgical) care to Veterans beneficiaries through the Surgical Service at the VA Southern Nevada Healthcare System in Las Vegas, NV.

Contractor’s name: < upon award, enter contractor name > (hereafter referred to as the contractor).

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. In addition, the QASP should recognize that unforeseen and uncontrollable situations may occur.

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. Updates shall ensure that the QASP remains a valid, useful, and enforceable document. 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: David J. Alvarez Organization or Agency: Department of Veterans Affairs. VISN 21 Network Contracting Office 21 Telephone: (916) 923-4588 Email: David.alvarez4@va.gov

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. At the conclusion of the contract or when requested by the CO, the COR shall provide documentation to the CO. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government’s behalf. The contractor shall refer any changes they deem may affect contract price, terms, or conditions to the CO for action.

Assigned COR: Linda S. Duenas Telephone: (702) 791-9000 ext. 14264 Email: linda.duenas@va.gov

c. Other Key Government Personnel – The Chief, Optometry Section and the staff ophthalmologist will also serve as Eye Clinic Technical Quality Experts.

3. CONTRACTOR REPRESENTATIVES

The following employees of the contractor serve as the contractor’s Program Manager and Task Manager for this contract.

Program Manager - <upon award, enter name> Telephone: <enter number> Email: <enter address>

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, paragraph 4 in the Performance Work Statement includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL).

94% - 76%: Satisfactory;

75% or lower: Unsatisfactory Direct Observation and Periodic Inspection

Verbal results: immediately (within 24 hours)

Written test results: within 24 hours

Access (for Retinal Ophthalmology Services)

Quality Care

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.

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

Performance standard(s): 1, 3

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): 2, 4, 5, 6, 7, 8

c. USER SURVEY. (Combines elements of validated user complaints and random sampling. Random survey is conducted to solicit user satisfaction. Appropriate for high quantity activities that have historically been satisfactory. May also generate inspections and sampling) Performance standard(s): 5, 6, 7

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

Performance standard(s): 10

e. PERIODIC SAMPLING. (Variation of random sampling. However, sample is only taken when a 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): 9

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:

Example 1:

EXCEPTIONAL: Performance significantly exceeds contract requirements to the Government’s benefit.

SATISFACTORY: Performance meets contractual requirements.

UNSATISFACTORY: Performance does not meet contractual requirements.

Example 2:

<A numerical scale with numbers 1 through 10 where 1 is poor and 10 is excellent.>

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. Performance Standard quality level: 100% - 76%.

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. Performance Standard quality level: 75% or below.

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.

8. 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 or designate shall meet with the contractor at least every 4 months 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