Attachment_J.11_Sample_Task_Order_Statement_of_Work.pdf

Attachment J.11 Sample Task Order Statement of Work

Quality Improvement (QI) Sample Test Scenario Task Order

Table of Contents

Quality Improvement (QI) Sample Test Scenario Task Order

1.0 Introduction

2.0 Program Objectives

3.0 Quality Improvement Tasks

4.0 Personnel Requirements:

4.1 Key Personnel Qualifications

5.0 Task Order QI Outcomes:

5.1 Task Order QI Core Requirements:

Table 1: Value of Proposed National Reach by Provider Type and Communities

Table 2: Documentation of Outcome Based Interventions

Performance Work Statement

1.0 Introduction

This Statement of Work includes a “test” scenario that will be used for organizations to propose on the NQIIC IDIQ. There is no current outbreak of V123 infection, and the details associated with this SOW are not real. The “test” scenario is described below in the language enclosed in quotation marks, and should be used by the proposer to demonstrate their capabilities.

TEST SCENARIO (NOTE: THIS IS ONLY A TEST. IT IS NOT REAL)

“The United States is currently experiencing an outbreak of a virulent viral upper respiratory infection currently named V123 that is variable in symptomology and highly contagious. When treated within the first two days of infection, the prognosis is favorable for infected individuals.

However, due to the highly variable symptoms upon onset, V123 has been difficult to identify and control. As a result, V123 is spreading rapidly and affecting nearly every state and territory in the U.S. Currently the mortality rate for this disease is 30%. V123 produces symptoms for a prolonged period of time, typically 1-2 months, requiring patients to remain bedridden and out of work or school for the entire course of the disease. The Centers for Disease Control and Prevention (CDC) has developed preliminary guidelines for control and treatment of V123.

Contractors awarded this task order will be responsible for controlling and eliminating V123 by disseminating the current CDC guidelines to quality improvement (QI) provider networks, providing technical assistance (TA) to these provider networks regarding best practices for identification, control and treatment, and gathering data on infection rates, in order to decrease incidence of V123.

QI contractors’ provider networks shall develop root cause analyses in areas with high rates of infection to determine variables affecting transmission of V123. Additionally, QI contractors shall disseminate best practices for control and treatment within the provider networks and work with Centers for Medicare & Medicaid/CDC (CMS/CDC) as new interventions are developed and show promise among providers. These efforts will better inform CMS.

The purpose of this Task Order is to procure an investigation on the effectiveness of V123-related quality improvement interventions that if implemented at scale would greatly improve healthcare quality. The Centers for Medicare & Medicaid (CMS) is seeking interventions for which a moderate level of evidence regarding their effectiveness already exists at small scale;

however, little or no evidence currently exists in larger populations and/or settings. Specifically, CMS is seeking interventions that:

• Reduce the incidence of V123 in the nation;

• Reduce the mortality of V123 in the nation;

• Increase the number of people appropriately diagnosed within the first two days of infection (to allow effective early treatment);

• Increase the number of people appropriately treated within the first two days of infection.

END TEST SCENARIO

2.0 Program Objectives

This general quality improvement Task Order aligns to the Quality Improvement & Innovation Group (QIIG) strategic goals:

• Exceptional service to patients and providers;

• Bold national results that scale

• Empower patients and doctors to make decisions about their health care

• Usher in a new era of state flexibility and local leadership

• Support innovative approaches to improve quality, accessibility, and affordability; and

• Improve the CMS customer experience

National Quality Improvement & Innovation Contractors (NQIIC) are encouraged to draw from academia, payers, nation-wide quality improvement experts, the provider community, as well as federal and/or state partners and patients, residents and families to examine interventions to address this V123 outbreak. If implemented, these interventions would result in better health, better healthcare and smarter spending through improvement for specific populations, regions and/or the nation.

3.0 Quality Improvement Tasks

All QI activities must be linked to two or more of the CMS Strategic goals, grounded in evidence (data, literature, and/or root cause analysis) with baseline data and community trends, and include rigorous quality improvement interventions and an evaluation strategy. The QI contractor should link intervention to the outcome, have appropriate interim metrics to determine direction midstream, show proof of partnership with Federal, State, and/or Private Organizations, and include patients/families in each project (i.e., Health Departments, Academia, and/or providers that know and understand the needs of their community as it relates to quality). QI support may be through technical assistance (TA), Learning and Action Networks (LAN) or more directly through idea formation, project execution, data sharing or some combination thereof.

More specifically, the Contractor shall support CMS for a duration of 12 months starting from award date by:

1. Identifying the healthcare quality issue/problem and population to be addressed through robust data analysis and/or key partnerships;

2. Reviewing current literature on V123;

3. Planning and implementing quality improvement interventions within the NQIIC's region in a manner that targets geographic areas and populations of greatest need for improvement. It is expected that the NQIIC will have QI activities underway in all states in the contractor's region, and aim for maximum input;

4. Dissemination of known best practices from the CDC;

5. Identifying locations and providers in the contract area already demonstrating high performance, studying their methods, and spreading their learnings;

6. Researching or developing an appropriate quality improvement intervention (where none exist) to address the issue;

7. Designing a rigorous methodology to ensure the effectiveness of the intervention towards achievement of the chosen outcome;

8. Measuring development for process and outcome(s) as warranted;

9. Administration and oversight of the project from conception to end;

10. Testing the intervention;

11. Data collection, manipulation and analysis as required;

12. Creating and maintaining partnerships that add value to the proposed project/intervention, with the inclusion of patients, residents and/or families in each project;

13. Providing ongoing evaluation of project progress and intervention effectiveness;

14. Communicating project goals, progress and outcomes to the constituency, CMS, partners, the Learning & Action Networks etc…;

15. Reforming, streamlining, and implementing policies and procedures that will result in sustainment of successful interventions;

16. Reporting findings/results consistent with Standards for Quality Improvement

Reporting Excellence (SQUIRE) Guidelines;

The offeror should, in addition to responding to our “Test” Scenario, also list a specific example, in real life, of a quality improvement project that illustrates the approach requested above, as applied to a real project from their past performance.

4.0 Personnel Requirements:

Certain positions designated as “Key Personnel”, within the meaning of Health and Human Services Acquisition Regulation 352.237-75. For the overall contract and each Task Order/Task, unless otherwise specified, the following position(s) are determined as Key Personnel:

• Task Order Lead– Required for the overall Task Order

4.1 Key Personnel Qualifications

Task Order Lead

Demonstrated concrete and real-life examples and experience to generate documented results in past projects.

o Demonstrated experience in identifying pockets of already existing high performance in any distribution of performance.

o Proven ability to manage the contract at a strategic level including overseeing and navigating internal and external customer relationships.

o Demonstrated experience with having authority and accountability for meeting all contract deliverables and requirements within budget and the use of appropriate tools to track project deliverables such as project plans, and timelines.

o Demonstrated experience and skills in excellent oral and written communication spanning executives to the general public.

o Proven skill and experience in innovative continuous learning approaches to drive delivery system transformation.

o Masters level degree in a healthcare education or healthcare quality field.

5.0 Task Order QI Outcomes:

In a one year (12 month) period, the NQIIC shall provide population based initiatives to meet the following CMS QI outcomes:

• Achieve 30% reduction of incidence rate of V123 in targeted community

• Achieve 30% relative improvement in mortality rate of V123 in targeted community

• Increase the number of people appropriately diagnosed within the first two days of the

V123 infection by 30% Relative Improvement Rate (RIR)

• Increase the number of people appropriately treated within the first two days of the V123 infection by 30% RIR

Note, NQIIC will be responsible to formulate and identify baseline information including a timeline this information to CMS.

In addition to responding to this “Test” Scenario, with the parameters listed above, please also describe at least one project of this kind, where all of the required parameters in meeting outcomes, meeting core requirements, meeting recruitment requirements, and establishing effective LANs was actually accomplished, in a real life project as part of past performance.

5.1 Task Order QI Core Requirements:

CMS requires the NQIIC contractor to meet the expected reach, scale, and scope of the requirements specified within Recruitment, Learning and Action Network, and Task Order monitoring in order to meet three cross cutting areas:

• Systematic engagement of patients, family members and caregivers in the improvement work

• Support rural providers and communities

• Special attention to and focus on vulnerable populations and reducing disparities

As a reference point, NQIIC will also adhere to the IDIQ general capabilities referenced below:

• NQIIC Services (referenced within Section 2.0. with additional specifics below for Recruitment and Learning and Action Networks)

• Collaboration and Coordination (referenced within Section 3.0)

• Key Elements of Evaluation (referenced within Section 4.0)

5.1.2 Recruitment:

CMS requires the QI contractor to recruit a variety of provider types and community partners within the NQIIC geographic region to collaboratively work toward the shared goals of this task order. Refer to section 2.c of the IDIQ NQIIC SOW contract for further information regarding recruitment requirements.

In order to complete this task order, each contractor shall complete Table 1 and provide population-based improvement to reach 25,000 Medicare beneficiaries in rural areas and within their geographic region via recruited provider types within their geographic region. The provider types may include hospitals, nursing homes, physicians, dialysis facilities, home health providers, long term care providers etc.

5.1.3 Learning and Action Networks (LAN):

LANs shall serve an integral role in this task order by acting as the central mechanism for communication and distribution of best practices and promising practices throughout the community. LANs will also work to identify communities with the highest rates of infection and mortality due to V123, complete root cause analyses for these communities, and find interventions appropriate to reduce infection and mortality rates. LANs should also identify areas of high performance, and quantitate and spread these learnings through the community of practice, showcasing those who achieve documented high performance. Refer to section 2.e of the IDIQ NQIIC SOW contract for further information regarding LAN requirements.

5.1.4 Task Order Monitoring:

5.1.4.a Monthly Progress Report

The monthly report is a descriptive summary of the project’s status inclusive of:

• Quantitative data that clearly depicts the trajectory of both process and outcome(s) as indicated by the problem to be addressed;

• Summary of activities that support the intervention strategy during previous reporting period;

• Any challenges, obstacles, or risk encountered or anticipated along with proposed alternatives and/or recommended solution(s) for the identified issue(s);

• Any new interventions developed during the month should be documented on the intervention and outcomes sheet (Table 2); and

• Identification of areas of high performance.

Monthly reports are monthly, three days prior to the scheduled COR monitoring call.

5.1.4.b Draft Final Report

The contractor shall provide a draft final report 60 days prior to contract end. This report shall be comprehensive and include all results, data, and any tools, processes, interventions, policies that were developed. The contractor shall provide final updated intervention tables including results.

At the request of CMS, a presentation of results shall be required via teleconference. Please refer to/utilize the Standards for Quality Improvement Reporting Excellence SQUIRE Guidelines when developing draft final reports.

5.1.4.c Final Contract Report

The contractor shall provide the final report 30 days prior to contract end that incorporates CMS comments and requests for clarification. This report shall be comprehensive and include all results, data, and any tools, processes, policies that were developed. It shall include a power point presentation that includes the problem statement, abstract, quality strategy goal(s) addressed, background, methodology and results. At the request of CMS, a presentation of results shall be required via teleconference. Please refer to/utilize the SQUIRE Guidelines when developing final reports.

Table 1: Value of Proposed National Reach by Provider Type and Communities

• Note, select one or two provider types and specify if rural applies to any subset. Please provide justification if there are cost variances for rural providers.

Provider Type: Proposed number of providers reached for Sample TO

Proposed Number of beneficiaries reached for Sample

TO

Total Proposed Cost for Sample

TO

Average Cost per beneficiary proposed

Average Cost per provider

Hospital Nursing Home

Home Health

Clinician Dialysis Facility

Long Term Care

Community Coalitions

Other (specify)

TOTAL

Table 2: Documentation of Outcome Based Interventions

Improvement Area

Goal within 3 months of start of intervention

Results within 3 months of start of intervention

Results Within 3 months of start of intervention

Goal by end of performance period

Results by end of performance period

Target Population – type of patient/clinician and number to be recruited to participate or impacted by the proposed intervention please include rural or vulnerable populations that will be targeted.

Healthcare Outcomes to be achieved:

• Achieve 30% reduction of incidence rate of V123in targeted community

• Achieve 30% relative improvement in mortality rate of V123 in targeted community

• Increase the number of people appropriately diagnosed within the first two days of infection by

30% RIR

• Increase the number of people appropriately treated within the first two days of infection by

30% RIR

Key interventions to be utilized to reach goal(s), and level of engagement with clinicians and providers