Attachment A - PWS - Radiologic Technologist.pdf

PERFORMANCE WORK STATEMENT (PWS)

DIGITAL RADIOGRAPHIC TECHNOLOGIST SERVICES

MAMMOGRAPHY AND COMPUTED TOMOGRAPHY

PHOENIX INDIAN MEDICAL CENTER

1. PURPOSE

The Phoenix Indian Medical Center (PIMC) requires nonpersonal professional Digital Radiographic Technologist (DRT) services to support Mammography and Computed Tomography (CT) operations.

The Contractor shall provide qualified DRT personnel possessing the education, training, certification, experience, competency, and other qualifications necessary to perform the services described in this Performance Work Statement (PWS).

The objective of this requirement is to provide qualified professional personnel capable of supporting PIMC diagnostic imaging operations and maintaining safe, timely, and effective patient care.

2. SCOPE

The Contractor shall provide qualified DRT personnel to perform Mammography and CT services on an as-needed basis.

Services include patient preparation and positioning, performance of diagnostic imaging examinations, documentation, quality assurance and quality control activities, patient-safety activities, use of Government information systems, and other related radiologic services identified in this PWS.

The Contractor shall provide all personnel management, supervision, scheduling, quality control, credential maintenance, and administrative support necessary to accomplish the required services.

3. NONPERSONAL SERVICES

Services performed under this PWS are nonpersonal in nature.

The Contractor shall be responsible for the management, supervision, scheduling, and direction of its personnel. Contractor personnel shall not be subject to supervision or control by Government personnel.

The Government may identify required services, coverage requirements, patient-care requirements, clinical and facility procedures, safety requirements, and performance standards and may monitor and evaluate Contractor performance.

The Contractor remains responsible for assigning personnel, managing its employees, and determining the methods used to satisfy the Government's performance requirements.

4. PLACE OF PERFORMANCE

Services shall be performed on-site at:

Phoenix Indian Medical Center Medical Imaging Department 4212 North 16th Street Phoenix, Arizona 85016

PIMC operates 24 hours per day, seven days per week, 365 days per year and provides healthcare services to patients from multiple Native American communities.

5. REQUIRED COVERAGE

Staffing requirements are variable and are based upon patient-care requirements, workload, Government staffing levels, vacancies, leave, and facility operations.

The Government will identify required coverage and scheduled service periods. The Contractor shall be responsible for assigning qualified personnel to satisfy required coverage.

The Government will normally communicate anticipated coverage requirements at least fifteen (15) calendar days in advance when practicable. Short-notice requirements may occur because of emergent staffing or patient-care needs.

The Contractor shall make a reasonable, good-faith effort to provide qualified personnel for required coverage.

If assigned Contractor personnel become unavailable for scheduled coverage, the Contractor shall promptly notify the Government and make a reasonable, good-faith effort to provide qualified replacement personnel.

5.1 Mammography Coverage

Mammography services may be required Sunday through Saturday.

Anticipated coverage is:

First Shift: 7:30 a.m. – 4:00 p.m.

Actual coverage requirements may vary based upon patient workload and facility operational needs.

Mammography services are on-site services.

No on-call or call-back services are currently required.

5.2 Computed Tomography Coverage

CT services may be required Sunday through Saturday.

Anticipated coverage is:

First Shift: 7:30 a.m. – 4:00 p.m.

Second Shift: 3:30 p.m. – 12:00 a.m.

Third Shift: 11:00 p.m. – 7:30 a.m.

Actual coverage requirements may vary based upon patient workload and facility operational needs.

CT services are on-site services.

No on-call or call-back services are currently required.

6. PERSONNEL QUALIFICATIONS

The Contractor shall ensure that all personnel assigned to perform services satisfy the applicable minimum qualifications before beginning performance and maintain required qualifications throughout performance.

6.1 Mammography Technologist

Experience

Minimum one (1) year of experience performing Digital Radiography and Mammography services.

Qualifications/Certifications

Personnel shall possess:

• Current American Registry of Radiologic Technologists (ARRT) certification in Radiography;

• Qualifications necessary to perform Mammography services in accordance with applicable Food and Drug Administration (FDA) Mammography Quality Standards Act (MQSA) requirements;

• Current Basic Life Support (BLS) certification; and

• Image Gently and Image Wisely training, as applicable.

6.2 Computed Tomography Technologist

Experience

Minimum one (1) year of experience performing Digital Radiography services.

Qualifications/Certifications

Personnel shall possess:

• Current ARRT certification in Radiography and Computed Tomography;

• Current BLS certification; and

• Image Gently and Image Wisely training, as applicable.

7. MAMMOGRAPHY SERVICES

PIMC currently utilizes a Hologic Dimensions 2D and 3D Tomosynthesis unit for Mammography examinations.

Contractor personnel shall be capable of independently performing screening and diagnostic Mammography examinations requested by authorized medical staff for clinical diagnosis.

Required services include:

1. Verify patient identity and applicable examination requirements.

2. Prepare, position, and monitor patients for Mammography examinations.

3. Independently perform screening and diagnostic Mammography examinations within the individual's qualifications.

4. Perform applicable 2D and 3D/Tomosynthesis imaging.

5. Perform Quality Assurance and Quality Control activities required by applicable

FDA/MQSA and American College of Radiology (ACR) standards.

6. Apply appropriate patient-safety and radiation-safety practices.

7. Review images for appropriate technical quality.

8. Properly document services in applicable Government medical records and imaging systems.

9. Perform related professional tasks within the scope of Mammography and radiologic services.

10. Comply with applicable PIMC infection-control, safety, privacy, security, and patient-care requirements.

8. COMPUTED TOMOGRAPHY SERVICES

PIMC currently utilizes a Canon Aquilion Prime SP2000 160-slice Computed Tomography scanner with Bayer Medrad Flex Injector.

Contractor personnel shall be capable of independently performing CT examinations requested by authorized medical staff for clinical diagnosis.

Required services include:

1. Verify patient identity and applicable examination requirements.

2. Prepare, position, and monitor patients for CT examinations.

3. Independently perform CT examinations within the individual's qualifications.

4. Operate applicable CT imaging and contrast-injection equipment.

5. Perform plain-film or Digital Radiography examinations when required within the scope of services.

6. Apply appropriate patient-safety and radiation-safety practices.

7. Review images for appropriate technical quality.

8. Properly document services in applicable Government medical records and imaging systems.

9. Perform related professional tasks within the scope of CT and radiologic services.

10. Comply with applicable PIMC infection-control, safety, privacy, security, and patient-care requirements.

9. MEDICAL RECORDS AND DOCUMENTATION

Contractor personnel shall accurately and timely document services performed in applicable Government medical records and information systems.

Patient-care documentation shall be completed on the date services are rendered unless applicable facility procedures require otherwise.

Contractor personnel may be required to utilize:

• Resource and Patient Management System (RPMS);

• Electronic Health Record (EHR);

• Picture Archiving and Communication System (PACS); and

• Other Government systems necessary to perform assigned services.

The Government will provide authorized access and applicable facility-specific training.

10. PATIENT SAFETY AND QUALITY

Contractor personnel shall perform services in accordance with applicable professional patient-safety and radiation-safety standards.

Contractor personnel shall utilize appropriate imaging techniques and radiation-dose practices consistent with the examination performed, patient condition, professional standards, and applicable PIMC procedures.

Patient-safety incidents involving Contractor personnel shall be reported immediately in accordance with PIMC procedures.

The Contractor shall promptly notify the COR of significant patient-safety or professional-performance incidents involving Contractor personnel.

11. FACILITY ORIENTATION AND TRAINING

Contractor personnel shall complete facility-specific orientation and mandatory training required for access to PIMC facilities, information systems, or performance of services.

Required training may include patient safety, infection control, privacy, information security, facility emergency procedures, and use of Government systems.

Attendance at general Government staff meetings is not required unless participation is specifically necessary to perform contracted services.

Government-provided orientation, facility procedures, technical information, or training does not constitute supervision of Contractor personnel.

12. EMPLOYEE HEALTH REQUIREMENTS

Contractor personnel shall satisfy applicable PIMC employee-health requirements before beginning patient-care services.

Required documentation may include, as applicable:

• Tuberculosis screening;

• MMR vaccination or evidence of immunity;

• Varicella vaccination, immunity, or documented history;

• Hepatitis B vaccination documentation;

• Seasonal influenza vaccination documentation; and

• Other employee-health requirements applicable to patient-care personnel.

REV 6 currently identifies these specific health requirements for both modalities.

13. PROFESSIONAL CONDUCT

Contractor personnel shall maintain professional appearance and conduct consistent with professional radiologic services.

Contractor personnel shall comply with applicable PIMC requirements concerning professional conduct, dress, infection control, patient safety, privacy, security, and use of Government facilities and equipment.

Contractor personnel shall be physically capable of performing the essential functions of the services assigned.

14. PERSONNEL QUALIFICATION VERIFICATION

The Contractor shall ensure that personnel satisfy all applicable qualification, certification, health, security, orientation, and facility-access requirements before beginning performance.

The Contractor shall provide required documentation sufficiently in advance to permit Government verification that personnel satisfy PWS requirements.

Government verification of personnel qualifications does not constitute Government selection, employment, supervision, or control of Contractor personnel.

The Contractor remains responsible for determining which qualified personnel it assigns to perform services.

15. SECURITY REQUIREMENTS

Contractor personnel requiring access to IHS facilities or information systems shall satisfy applicable Government personnel-security and identity-verification requirements before access is granted.

Requirements may include:

• Fingerprinting;

• Background investigation;

• Identity verification;

• Office of Inspector General exclusion screening;

• SAM exclusion screening;

• Facility badging;

• Required security documentation; and

• Information-system access requirements.

Contractor personnel shall not perform services requiring facility or information-system access until applicable access requirements have been satisfied.

The Contractor shall promptly remove from consideration personnel determined ineligible for required Government access.

Contractor personnel must be authorized to work in the United States.

16. INFORMATION SECURITY AND PRIVACY

Contractor personnel requiring access to IHS information systems shall complete applicable Information Systems Security Awareness (ISSA), privacy, and security training.

Training may include:

1. IHS Rules of Behavior;

2. Privacy training;

3. Protection of sensitive information;

4. HIPAA and HITECH requirements;

5. Physical and information security;

6. Appropriate Government email use;

7. Protection of mobile devices and portable media;

8. Social-engineering awareness; and

9. Incident-response requirements.

Contractor personnel shall maintain required annual training throughout their period of Government system access.

The Contractor and Contractor personnel shall protect patient information and other sensitive Government information from unauthorized access, use, or disclosure.

Actual or suspected privacy or information-security incidents shall be reported immediately in accordance with applicable IHS procedures.

REV 6 identifies annual ISSA/privacy training and the underlying topics currently required for IHS system users.

17. PERSONNEL REPLACEMENT

The Contractor may substitute or replace Contractor personnel provided replacement personnel satisfy all applicable qualification, certification, health, security, orientation, and facility-access requirements before beginning performance.

The Contractor shall provide required documentation sufficiently in advance to permit Government verification.

If Contractor personnel fail to satisfy PWS requirements or continued performance presents documented patient-safety, security, professional-conduct, competency, or compliance concerns, the Government may require the Contractor to remove the individual from performance.

The Contractor remains responsible for personnel-management decisions and for providing qualified replacement personnel.

18. CONTRACTOR RESPONSIBILITIES

The Contractor shall:

1. Recruit qualified personnel;

2. Verify personnel qualifications before assignment;

3. Assign and schedule Contractor personnel;

4. Manage and supervise Contractor personnel;

5. Maintain required personnel records;

6. Maintain required certifications and qualifications;

7. Submit required qualification and security documentation;

8. Provide qualified replacement personnel when necessary;

9. Monitor Contractor performance;

10. Maintain an effective Contractor quality-control process;

11. Correct identified performance deficiencies;

12. Maintain applicable insurance; and

13. Manage any subcontractors utilized in performance.

The Contractor remains responsible for all services performed by its employees and subcontractors.

19. GOVERNMENT RESPONSIBILITIES

The Government will:

1. Identify required services and coverage;

2. Provide access to the place of performance;

3. Provide applicable site-specific orientation and facility procedures;

4. Provide medical equipment and medical supplies necessary to perform services;

5. Provide Government computer workstations and authorized information-system access;

6. Provide access to EHR/RPMS/PACS as required;

7. Provide workspace and utilities necessary for on-site services;

8. Provide Government-approved interpreter services when required for patient care;

9. Monitor and accept Contractor performance; and

10. Perform quality assurance surveillance.

The Government's performance of these responsibilities does not constitute supervision of Contractor personnel.

20. DELIVERABLES

The Contractor shall provide the COR applicable personnel documentation before personnel begin performance.

Personnel Documentation

• Current resume/CV;

• Applicable ARRT certification;

• Current BLS certification;

• Applicable modality competency documentation;

• Mammography qualification documentation, when applicable;

• Required employee-health documentation;

• Required security documentation; and

• Other documentation necessary to verify compliance with PWS personnel requirements.

Recurring Requirements

ARRT Certification: Maintain current throughout performance and provide updated documentation before expiration.

BLS Certification: Maintain current throughout performance and provide updated documentation before expiration.

Modality Competencies: Maintain current and provide updated documentation as required.

Mammography Qualifications: Maintain applicable MQSA qualifications throughout performance.

The Contractor shall not assign personnel to perform services when mandatory qualifications have expired.

21. VERIFICATION OF SERVICES PERFORMED

The Contractor shall maintain and submit documentation sufficient for the Government to verify services and hours performed.

Documentation shall identify, at a minimum:

• Contractor personnel performing services;

• Date of service;

• Applicable labor category/service;

• Start and stop time or total hours performed; and

• Other information reasonably necessary to verify performance.

Government verification of services performed does not constitute supervision of Contractor personnel.

22. PATIENT CULTURAL CONSIDERATIONS

PIMC serves patients from diverse Native American communities. Some patients may primarily speak a Native language or Spanish or may have limited English proficiency.

Contractor personnel shall demonstrate professional sensitivity to cultural and language differences and utilize Government-provided interpreter services when necessary.

Contractor personnel should recognize that Tribal customs, traditional healing practices, geographic isolation, transportation limitations, and other circumstances may affect patient-care interactions.

23. APPLICABLE PROFESSIONAL STANDARDS

Contractor personnel shall perform services in accordance with applicable professional, regulatory, accreditation, and facility requirements associated with the services performed.

Applicable requirements may include those established by:

• Indian Health Service (IHS);

• Centers for Medicare & Medicaid Services (CMS);

• The Joint Commission;

• Food and Drug Administration (FDA);

• Mammography Quality Standards Act (MQSA);

• American College of Radiology (ACR); and

• American Registry of Radiologic Technologists (ARRT).

24. CONTRACTOR QUALITY CONTROL

The Contractor shall maintain an effective quality-control process sufficient to ensure services comply with this PWS.

The Contractor's quality-control responsibilities include:

• Monitoring personnel qualifications;

• Monitoring performance;

• Addressing personnel availability;

• Correcting identified performance deficiencies;

• Maintaining required documentation; and

• Ensuring assigned personnel continue to satisfy applicable requirements.

Government quality assurance surveillance does not replace the Contractor's responsibility for quality control.

25. QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)

25.1 Purpose

The Government will monitor Contractor performance to determine whether services satisfy the performance requirements and standards established by this PWS.

Government surveillance focuses on performance outcomes and does not constitute supervision of Contractor personnel.

25.2 Surveillance Methods

The COR may use one or more of the following surveillance methods:

• Periodic inspection;

• Review of services performed;

• Review of required documentation;

• Verification of qualifications and certifications;

• Review of patient-safety incidents;

• Review of privacy/security incidents;

• Validated complaints; and

• Other reasonable methods associated with the performance requirements of this

PWS.

Identified deficiencies will be documented and communicated to the Contractor for corrective action when appropriate.

25.3 Performance Standards

Measure Required Performance Standard/AQL Surveillance

Mammography Coverage

Contractor provides qualified personnel for accepted scheduled Mammography coverage.

100% of accepted scheduled coverage, subject to documented circumstances outside Contractor control.

Schedule/performance review

CT Coverage Contractor provides qualified personnel for accepted scheduled CT coverage.

100% of accepted scheduled coverage, subject to documented circumstances outside Contractor control.

Schedule/performance review

Personnel Qualifications

Personnel performing services maintain all required qualifications and certifications.

100% Credential/document review

Patient Safety Services comply with applicable patient and radiation-safety requirements.

No substantiated Contractor-caused breaches.

Periodic inspection/incident review

Medical Documentation

Required patient documentation is accurate and completed within required timeframes.

100% Record/document review

Privacy and Confidentiality

Contractor personnel protect PHI and sensitive information in accordance with applicable requirements.

No substantiated Contractor-caused breaches.

Incident review/validated complaints

Quality Control – Mammography

Required Mammography QA/QC activities

100% compliance with applicable requirements.

QA/QC documentation review are properly performed and documented.

Mammography Coverage

Contractor provides qualified personnel for accepted scheduled Mammography coverage.

100% of accepted scheduled coverage, subject to documented circumstances outside Contractor control.

Schedule/performance review

A complaint will be considered validated when the Government determines after appropriate review that the complaint is substantiated.

When a performance deficiency is identified, the Government may require the Contractor to provide corrective action. Repeated or material deficiencies may result in remedies available to the Government under the terms and conditions of the award.

26. END OF PERFORMANCE WORK STATEMENT