Attachment E - QASP Summary Report Template.pdf
PDF 281 KB Posted
- Solicitation number
- 36C10G25Q0021
About this file
This is a Quality Assurance Surveillance Plan (QASP) Summary Report template for the Department of Veterans Affairs National Dialysis Services Contract (NDSC). The template is designed to document contractor performance against established metrics and includes sections for contract information, contract summary, QASP metrics reporting, risks and issues summary, and corrective actions/improvements.
The template requires contractors to provide detailed performance data, including network accreditation compliance (with a 98% performance threshold), along with other QASP elements to be inserted. It includes space for documenting contract details like the contractor's name, contract number, period of performance, and completion percentage. The report requires a high-level narrative of work status (limited to two paragraphs), risk assessments with probability and impact scores, and documentation of corrective actions taken to address previously identified issues. This is strictly a reporting template that outlines the format and structure for contractors to submit performance data - it does not contain actual performance information or specific requirements.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment X - CLIN 0002 Utilization Justification Template.pdf | ||
| Attachment Z - CLIN 0002 RFI.pdf | ||
| Attachment Y - NDSC Labor Harmony Agreement RFI.pdf | ||
| Attachment H - Progress Report.pdf | ||
| 36C10G25Q0021.docx | DOCX document | |
| Attachment G - Project Risk Register.xlsx | XLSX spreadsheet | |
| Attachment J - Contractor Training Report.pdf | ||
| 36C10G25Q0021 NDSC Draft RFP.pdf | ||
| Attachment B - Quality Assurance Surveillance Plan.xlsx | XLSX spreadsheet | |
| Attachment D - Facilities Status Report.xlsx | XLSX spreadsheet |
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Text version
Department of Veterans Affairs Integrated Veteran Care
Veterans’ Health Administration
National Dialysis Services Contract (NDSC)
QASP Summary Report
[INSERT CONTRACTOR NAME]
[INSERT REPORTING PERIOD (Ex. “July 2016”)]
CONTRACT INFORMATION
Contractor Name: [INSERT CONTRACTOR NAME]
Contract #: [INSERT CONTRACT NUMBER]
Contracting Officer’s Representative: [INSERT COR NAME]
Contractor’s Project Leader: [INSERT CONTRACTOR’S PL NAME]
Contract Period of Performance: [INSERT POP]
Elapsed Period of Performance: [INSERT PERCENTAGE COMPLETE (ex. Month 6 in a 12-month POP would read, “50%.” Month 8 = “75%”]
CONTRACT SUMMARY
In this section, the Contractor shall place a high-level summary narrative of the status of the work that is being performed, to include Optional CLINs. This section should contain no more than two (2) paragraphs. The narrative can be used for multiple submissions of the report unless there are material changes to the Contractor’s scope and/or contract modification
QASP SUMMARY REPORT
This section shall document the Contractor’s performance against the performance metrics identified in the QASP during the reporting period. The template below may be used:
PWS
Paragraph
Standards /
AQL
Frequency Performanc e Threshold
Actual Performance
Variance from Threshold
2.7:
Network Accreditatio n
Contractor shall maintain accreditation for the provider network or health network
Continuous with an Annual Review of accreditation and credentialing certificate (at a minimum)
98% compliance at any given time
[INSERT
ACTUAL
PERFORMA
NCE
THRESHOLD
; ex., “95%”]
[INSERT DIFFERENCE
OF ACTUAL
PERFORMANCE
THRESHOLD AND
PERFORMANCE
THRESHOLD. Ex. 95%- 98%. Field should report, “-3.”]
[INSERT
NEXT
QASP
ELEMENT]
[INSERT NEXT
QASP
ELEMENT]
[INSERT
NEXT QASP
ELEMENT]
[INSERT
NEXT
QASP
ELEMENT]
[INSERT
NEXT QASP
ELEMENT]
[INSERT NEXT QASP
ELEMENT]
RISKS AND ISSUES SUMMARY
The Contractor shall detail the risks and issues associated with their work during the reporting period.
This section includes the Risk Register, risk scores, probability, impact, and responses. The narrative shall also describe measures to either minimize or eliminate the potential impact on the Customer Service metrics.
CORRECTIVE ACTIONS AND IMPROVEMENTS
The Contractor shall list the corrective actions and improvements that were executed during the reporting period. The narrative shall map the corrective actions to issues that were identified in previous risk reports. The narrative shall also denote how the improvement yields a better outcome for the affected aspect of their solution or to VA communicable outcomes.
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