SECTION C revised.docx

SECTION C - DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

C.1 BACKGROUND

The Centers for Medicare & Medicaid Services (CMS) will implement the Partnership for Patients (PFP). The PFP is a priority project designed to reduce inpatient harm by 40% and readmissions by 20% over a 3 year period. The PFP has identified ten areas of focus. Although the PFP will not limit its work to these areas and will pursue the reduction of all-cause harm, these focus areas are those for which content will be developed and learning activities conducted and made available to hospitals participating in the partnership. The Hospital Engagement Contractor (HEC) may address additional forms of harm and complications beyond this core set.

1. Adverse drug events (ADE)

1. Catheter-associated urinary tract infections (CAUTI)

1. Central line-associated blood stream infections (CLABSI)

1. Injuries from falls and immobility

1. Obstetrical adverse events

1. Pressure ulcers

1. Surgical site infections

1. Venous thromboembolism (VTE)

1. Ventilator-associated pneumonia (VAP)

1. Preventable readmissions

Through coordinated efforts with industry and experts in the field of medicine, CMS has an interest in testing models such as large improvement networks aimed at rapidly studying, and identifying alternative methodologies and care models for bringing about rapid change and improvements in patient care. In support of the PFP, CMS will engage the hospital, provider and broader care-giver communities to quickly implement well-tested and measured best practices; the end result of the overall initiative is the anticipated reduction in hospital-based harm and preventable readmissions for our beneficiary population. Provided in Section J, Attachment 1 is a document outlining the overall goals of the PFP and the expected impact on the Medicare and Medicaid populations as well as the exponential impact on the broader population. Further information on other work in the PFP arena and other contracts in support of PFP may be found at J, Attachment 2.

C.2 Purpose

Under the terms and conditions of this contract, the HECs will design and conduct various types of training events and sessions for hospitals. The training should be rooted in establishing and measuring/evaluating ongoing improvement projects in each participating hospital (or facility). All education activities are designed to achieve reductions in the ten core events and producing measurable improvements in quality measures associated with the ten core events. The success of the HEC will, in large part, be assessed through objective measurement of the incidence of the ten core events. The HECs will be required to coordinate their efforts with government and other contractor personnel involved in the PFP while performing tasks of this contract as defined in the requirements below. In order to successfully perform this contract, the HECs must host various training sessions for hospitals engaged in ongoing improvement projects. While it is anticipated that the HECs will engage in methods such as webinars, meetings and conferences to accomplish the work as defined in this contract, it must be noted that this is a performance-based contract; the expectation is that the contractors will specify in detail the methods they plan to use to meet the requirements as established by the Government.

C.3 REQUIREMENTS

TASK ONE: FINALIZE THE DESIGN OF THE PFP HOSPITAL BASED CAMPAIGN

The contractor shall finalize its project design for the rollout and implementation of the PFP hospital-based intensive improvement program. The design report should provide extensive detailed of how the HEC will conduct activities required under the PFP. Additional detail will be provided as a result of the kick-off meeting with the Government personnel and information shared regarding the National Content Developer (NCD) contract. NOTE: The NCD contractor is accountable under a separate contract for the development of the campaign materials that will be provided to the HEC contractors.

The plan shall identify critical milestones, timelines and activities to be performed by the HEC in order to engage and educate hospitals in learning collaborative to share best practices for the reduction of patient harm. The plan shall identify significant items such as, but not limited to:

· The manner in which the HEC will enroll hospital participants in its training sessions and to ensure no duplication of a hospital engaging with another HEC; the plan shall also address actions to be taken by the HEC in the event it cannot engage a particular hospital or a hospital drops out of the HEC’s learning collaborative efforts;

· The methodology employed by the HEC to develop collaborative learning networks and successfully coordinate and deliver ongoing learning sessions, dissemination of educational materials, and oversight of work in the PFP performed by hospitals as a result of the HEC educational campaign.

· The manner in which the HEC will coordinate with and communicate with the NCD to obtain the necessary materials and to provide feedback on the response to the materials after each training session;

· The manner in which the HEC will reach out and coordinate with other impacted entities and/or stakeholders in the PFP arena.

· The approach planned by the HEC to engage the various hospitals (e.g., face-to-face meetings, large conferences, monthly webinars) to address and foster improvements in ten (10) core adverse events (J-3). The HEC shall be required to address all ten core adverse events and target two additional topics relative to supporting the adaption of organizational changes to reduce adverse events;

· The plans for the HEC to keep the government personnel up-to-date on status and ongoing lessons learned; this section should address how the HEC will address to resolution any issues that may arise throughout this contract based upon their expert knowledge of the materials, the issues and the hospital community.

TASK TWO: CONDUCT TRAINING

The contractor shall conduct training activities that address each of the ten (10) hospital acquired conditions and patient re-admissions events. The contractor is encouraged to develop and present training on hospital acquired conditions and patient re-admissions not identified in the PFP for submission to the NCD and other PFP participants. Meeting schedules and locations must support and foster widespread participation in events. The amount and types of trainings conducted should afford all enrolled hospitals an opportunity to participate in as many training sessions as necessary to cover the core topics. Applicants should describe a proposed mix of training events (these may include in-person meetings, conference calls, webinars and other meeting formats) and describe why its proposed mix is both effective and efficient in providing training opportunities.

The contractor shall collaborate with the NCD to obtain educational materials to support training activities. The HEC may produce additional training support materials to augment or enhance NCD materials. When necessary the HEC will collaborate with the NCD to obtain licensure or certification required to utilize educational materials obtained from participant hospitals. Educational materials may include webinars, educational brochures, DVDs, CDs, and various other forms of educational media deemed appropriate by the HEC.

The contractor shall provide the government with a schedule of proposed training events identifying the HAC/Re-admission issue being addressed.

The contractor shall provide a training activity report within 15 days of a scheduled event identifying the following data:

· Core HAC/Re-admission event addressed in training

· Method of instruction

· Number of organizations attending training activity

· Name of participants and their associated organization

· Training evaluation utilizing participant feedback from training surveys

TASK THREE: TECHNICAL ASSISTANCE & SUPPORT TO HOSPITALS

The HEC, in coordination with the NCD, provide technical assistance to participant hospitals to ensure that methods proposed to reduce the ten core events are implemented among hospital participants. Such technical assistance may include establishing learning collaboratives, developing data sharing networks, developing mechanisms to support peer to peer training among hospitals, conducting conference calls, and conducting site visits to participating hospitals. These activities must be conducted to ensure hospital engagement and continuous participation in all PFP improvement efforts.

TASK FOUR: MEASURE AND TRACK HOSPITAL PERFORMANCE

The HEC shall establish and implement a system to track and monitor hospital progress towards operational and quality improvement goals. Within this task, the HEC shall at a minimum collect operational metrics, and improvement metrics amongst participating hospitals.

The HEC must collect data to track improvements in care delivered by hospitals participating in the collaborative efforts of the HEC (e.g., process and outcome measures associated with hospital improvements); the data collection plan must be in compliance with HIPAA as well as FISMA as defined in Sections H and I of this contract);

To complete the measurement and tracking task the HEC must establish a set of “improvement measures” for each improvement project. These measures should be determined in collaboration the contractor’s constituent hospitals, and should be selected based on their usefulness in supporting hospital improvement activities and with an understanding of the capabilities of member hospitals. Unless the contractor can provide a strong argument to do otherwise, each improvement project should include at least one process measure and one outcome measure. (Outcome measures need not be risk adjusted.) Participating hospitals should be strongly encouraged to use these measures in support of their improvement activities; however, they are not required to do so. Relevant educational resources related to basic statistics and the role of measurement in improvement projects should be deployed to hospitals.

The HEC will provide unlimited rights in data to the government for all data it submits to the PFP collected under this contract, including, but not limited to, hospitals names and locations of hospital participants and non-participants within its jurisdiction, as well as operational metrics and aggregate improvement measures results.

TASK FIVE: ONGOING STATUS AND QUARTERLY UPDATES

The HEC will be responsible for providing ongoing ad hoc status information at the request of the COTR as well as formal monthly and quarterly reports to CMS/CMMI staff to address progress issues and lessons learned during each quarter of the performance period. Monthly reports must include an update on operational metrics describing the participation status among hospital participants. The updates should also include information on the status of the project to include data on hospital progress on improvement measures. At a minimum the monthly report must include the following metrics:

· Number, name, and location (city, state) of hospitals that have joined the contractor’s improvement network;

· Number, name, and location (city, state) of eligible hospitals that have not joined the contractor’s improvement network;

· Number, name, and location (city, state) of hospitals participating in each improvement projects;

· Percent of applicable hospitals participating in major training sessions or meetings (to be tracked for each such event); and

· Number, name, and location (city, state) of hospitals participating in each improvement projects that have submitted all available improvement measure data

The quarterly reports should include information on the status of the project, including aggregate data on hospital progress on improvement measures for each project. Additionally, noteworthy aggregate improvements and milestones, identification of areas of outstanding improvement, and identification of areas where progress has not been made, should be addressed. The report shall provide information to the government on successes, failures, pitfalls and areas of improvement in each requirement performed by the HEC. The update shall also provide recommended next steps to the government for the continuation of the work in both the option year of this particular contract and the work possibly under new contracts in support of.

The exact form of monthly and quarterly reports will be determined in conjunction with the COTR and the PFP Evaluation contractor.

TASK SIX: PREPARE A FINAL REPORT

The HEC shall be responsible for the preparation of a final report at the conclusion of the 24 month implementation. The report shall provide information to the government on successes, failures, pitfalls and areas of improvement in each requirement performed by the HEC. The report shall also provide recommended next steps to the government for the continuation of the work in both the option year of this particular contract and the work possibly under new contracts in support of PFP.

The final report must describe the activities carried out during the project year, and provide a detailed description of lessons learned regarding best methods to identify and solve problems in improving inpatient safety processes. The report will be reviewed and evaluated by CMS, and the contractor will make revisions as needed. The contractor shall deliver final versions of all training materials developed in the project to CMS in a format that may be easily reproduced and disseminated. The annual report for the final year of the project will summarize all of the activities during the entire contract

TASK SEVEN: Collaboration with Other PFP Participants

The contractor must collaborate with other PFP Participants as needed. The contractor will coordinate with other PFP Participants to collect and share data and other elements necessary to successfully implement, operate, and evaluate the PFP.

In particular, electronic copies of monthly, quarterly, and annual progress reports should be sent to the evaluator, and the contractor must respond to email and phone inquiries from the evaluator in a reasonable timeframe, and cooperate with evaluator requests for information or access to staff.