Attachment Q1 - Quality Assurance Surveillance Plan_.pdf

Quality Assurance Surveillance Plan Ground Ambulance Services

1. PURPOSE

This Quality Assurance Surveillance Plan (QASP) is a Government developed and applied document used to make sure that systematic quality assurance methods are used in the administration of the Performance Based Service Contract (PBSC) standards included in this contract. The intent is to ensure that the Contractor performs in accordance with performance metrics set forth in the contract documents, that the Government receives the quality of services called for in the contract and that the Government only pays for the acceptable level of services received.

2. SCOPE

To fully understand the roles and the responsibilities of the parties, it is important to first define the distinction in terminology between the Quality Control Plan and the Quality Assurance Surveillance Plan. The Contractor, and not the Government, is responsible for management and quality control actions necessary to meet the quality standards set forth in the contract. The Contractor develops and submits his/her Quality Control Plan (QCP) for Government approval in compliance with his contract deliverables. Once accepted, the Contractor then uses the QCP to guide and to rigorously document the implementation of the required management and quality control actions to achieve the specified results. The QASP on the other hand, is put in place to provide Government surveillance oversight of the Contractor's quality control efforts to assure that they are timely, effective and are delivering the results specified in the contract. The QASP is not a part of the contract, nor is it intended to duplicate the Contractor's QCP. The Government may provide the Contractor an information copy of the QASP as an Attachment to the solicitation to support the Contractor's efforts in developing a QCP that will interrelate with the Government's QASP.

3. GOVERNMENT RESOURCES/RESPONSIBILITIES

The following personnel shall oversee and coordinate surveillance activities.

a. CONTRACTING OFFICER: The Contracting Officer (C.O.), ensures performance of all necessary actions for effective contracting, ensures compliance with the terms of the contract, and safeguards the interests of the United States in the contractual relationship. It is the Contracting Officer that assures the Contractor receives impartial, fair, and equitable treatment under the contract. The Contracting Officer is ultimately responsible for the final determination of the adequacy of the Contractor's performance.

Assigned CO: [ ] Organization or Agency: [ ]

FOR OFFICIAL USE ONLY

b. Contracting Officer's Representative (COR) - The COR provides detailed technical oversight of the Contractor's performance and reports his or her findings to the C.O. in a timely, complete and impartial fashion. The COR is not empowered to make any contractual commitments or to authorize any contractual changes on the Government's behalf Any changes that the Contractor deems may affect contract, price, terms, or conditions shall be referred to the Contracting Officer for action.

Assigned COR: [ ]

4. METHODS OF QA SURVEILLANCE

The below listed methods of surveillance shall be used in the administration of the QASP. In addition to specific instructions that may be mentioned, the appropriate and standardized form that is to be used for documentation of QA surveillance is the Surveillance Activity Checklist, included as Attachment A.

Customer Feedback - Customer feedback may be obtained either from the results of formal customer satisfaction surveys or from random customer complaints. Customer complaints, to be considered valid, must set forth clearly and in writing the detailed nature of the complaint, must be signed and forwarded to the COR. The COR shall maintain a summary log of all formally received customer complaints as well as a copy of each complaint in a documentation file. The COR shall also keep the tabulated results of all customer satisfaction surveys on file and shall enter the summary results into the Surveillance Activity Checklist.

(Copies of all records shall be submitted to the CO upon receipt for placement in the official contract file, and when necessary, determination of actions.)

100% Inspection - The COR shall monitor each patient delivery and enter performance results into the Surveillance Activity Checklist.

Periodic Inspection - Periodic inspections shall be conducted when specified in the contract/PWS. For the potential tasks that have been identified so far and included in this QASP, the COR performs the periodic inspection on a monthly basis.

Random Monitoring - Random monitoring shall be conducted if and when specified in the contract. For the potential tasks that have been identified so far and included in this QASP, the random monitoring shall be performed by the COR.

5. PERFORMANCESTANDARDS

The Performance Requirements Summary in the Performance Work Statement (PWS) includes performance standards. The Government shall use these standards to determine contractor performance and shall compare contractor performance to the Acceptable Quality Level (AQL) and determine incentives.

Date/Ti me of Government POC Primary: Billy Contract: Ground Ambulance Inspection: Scharf

Government POC Alternate:

Organization: Location: 2360 E Pershing Blvd Cheyenne WY, 82001 (Cheyenne VAHCS) ss Performance Objective PWS Para Performance Method of Met Not Remarks Threshold Surveillance Met The contractor shall provide Ambulance service, 24 hours per 100% day, 365 days per year, 95% Surveillance ss 1 1 of each as required in Compliance patient pick-accordance with the up.

terms and conditions contained herein.

The objective of Standards for Maintenance is to protect veterans and to cause no harm to all parties. The contractor ss 2 shall maintain all 4.4.3 95% 100% vehicles in a clean and Compliance Surveillance orderly condition, free from debris and accumulations which may create an accident, injury, or fire hazard.

The contractor shall maintain (and furnish upon request) procedures that outline preventive maintenance and/or repairs on each vehicle in an individual

SS3 vehicle file and in 4.4.3 95% 100%

Compliance Surveillance chronological order, latest service on top. A statement from the Contractor indication compliance of vehicle maintenance files is in place should be ss Performance Objective PWS Para Performance Method of

Met Not

Remarks Threshold Surveillance Met submitted at time of offer for evaluation purposes. Requested submission and verification of these documentation requirements will be a quality assurance procedure during the contract period.

The contractor shall furnish qualified personnel as required by contract specifications

4.3.1 100% 100% to accomplish all Compliance Surveillance services under this contract.

Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours or equivalent including an in-hospital

100% sss training period. Such 4.3.1 SS4 Surveillance training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93- 154, Federal Register 39:24304. (1974).

A licensed MTO shall ensure that sanitation

SS6 procedures are provided Attach 100% 100% ment B Compliance Surveillance to all personnel in a written document that ss Performance Objective PWS Para Performance Method of Met Not Threshold Surveillance Met conforms with current standards as set forth in occupational safety and health administration-blood borne pathogens protocol.

6. INCENTIVES

The Government shall use payment deduction as incentives for Contractors to maintain acceptable performance level. Incentives shall be based on meeting, or not meeting performance standards.

Remarks

The CO and COR shall monthly progress meetings to assess performance and shall provide a written assessment. Should the CO experience marginal or sub-standard performance, they should consider more frequent progress meetings.

Signature - Contracting Officer's Representative

Signature - Contracting Officer

FOR OFFICIAL USE ONLY

Date:

Date:

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