QASP- ONSITE PHLEBOTOMY rv cor signed.pdf

D .1 A

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F o r: P h leb o tom y S taffin g

S e rvice s

C o n tra c t D e s crip tio n : C o n tra cto r sha ll p rovide to 1 6 fu ll tim e equ ivale nt (3 3,2 h o u rs pe r yea

r) ph le boto m ists o n a n as ne ede d ba sis. T he ph le bo to m ists w ill p e rfo rm p le bo to m y du tie s a t th e M ich ae l E . D eB a key V A

M e d ica l C e n te r, 20

H o lco m b e

B lvd

H o u ston , T e xas, 77 fo r th e p e riod o f p e rfo rm an ce

-0

-20 to

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T h is Q u a lity A ssuran ce

S u rve illa n ce

P lan

(Q A

S P

) p ro vide s a system a tic m eth od to e va lu ate p e rform a n ce fo r th e sta te d co n tra

ct. T h is Q

A S

P e xp lain s the fo llo w in g:

W h at w ill b e m on ito re d

H o w m on ito rin g w ill ta ke p la ce

W h o w ill co n d uct the m o n ito rin g

H o w m on ito rin g e ffo rts a n d re su lts w ill b e d o cum en ted

T h is Q A

S P d oe s n o t deta il ho w th e co ntra ctor a cco m p lishe s th e w o

rk. R a the r, the

Q A

S P is crea te d w ith th e p rem ise th at the co n tracto r is re sp o n sib le fo r m a n agem en t a n d q ua lity co n tro l a ctio n s to m ee t the te rm s o f th e co ntract. It is the re sp o n sibility to be ob je ctive

, fa ir, a nd co n sisten t in e va lua ting pe rfo rm an ce

G ove rn m e n t m a y re view a nd re vise it on a re g u la r ba sis. H ow ever, th e G o ve rnm en t sh a ll co o rdinate ch a ng e s w ith the con tra cto r.

C o p ie s of th e o rig ina l Q

A S

P a n d revisio n s sh a ll b e p ro vide d to the co n tra cto r a nd

G ve rnm e nt officia ls im p lem en tin g su rve illa nce a ctivitie s.

G O

V E

R N

M E

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R O

L E

S A

N D

R E

S P

O N

S

IB

IL

IT

IE

S

T h e fo llow ing pe rsonne l sh a ll o ve rse e a nd coo rdin a te su rve illa n ce a ctivities.

a

C o ntra ctin g O fficer (C

O ) - T h e

C O sha ll e nsu re p e rfo rm an ce o f a ll n e cessa ry a ction s fo r e ffe ctive con tra cting

, en su re co m p lia nce w ith th e co ntra ct te rm s, and sha ll sa feg u a rd th e inte re sts of th e U n ite d S ta te s in the co n tra ctu a l re la tio n ship. T he C

O sha ll a lso e n su re th at the co n tracto r re ce ive s im pa rtia l, fa ir, an d e qu itab le trea tm e nt und e r th is co n tra

ct. T h e C

O is u ltim a tely resp on sib le fo r th e fin a l dete rm in a tio n o f the a d equ a cy o f b C

O R

) - T h e C

O R is re spo n sib le fo r te chn ica l a d m in istration o f th e co n tra ct a nd sha ll e n su re p ro pe r G o ve rn m e n t su rve illa n ce of th

C

O R sh a ll ke ep a q ua lity a ssu ran ce file

. T h e C O

R is n ot e m po w ere d to m a ke an y co ntra ctua l com m itm e nts o r to au tho rize an y co ntractua l ch a ng e s o n th be ha lf.

T T

A C

H M

E N

T

A ssig n ed

C O

R

B e rn ita

H u dson

D e p a rtm e nt o f V e te ra ns A ffa irs

P a tho lo g y a nd La b o rato ry M e d icin e S e rvice

Lin e

H o lcom be B ou leva rd

H u ston

, T X c.

the r K e y G o ve rnm e n t P e rso nn e l sam e ag e n cy:

A d am C a lca ron e

, S upe rviso ry H e a lth T e ch n ician

(3 rd F lo o

r) A n a

A . T re vino

, A ssista n ce

L a bo ra to ry M an ag e r

N ikya

Ja ckso n , S upe rviso ry H e a lth

T e ch n ician ( 1 st F loo r)

C O

N T

R A

C T

O R

R E

P R

E S

E N

T A

T

IV

E S p ro g ram m a na g e r fo r th is con tra ct.

a

P ro g ram

M a nag e r b

O th e r C o ntracto r P erson n e l - N A

P E

R F

O R

M A

N C

E S

T A

N D

A R

D S

P e rfo rm a nce stan d a rds d e fine de sire d se rvice

s. T he G o ve rnm e nt pe rfo rm s su rve illa n ce to de te rm in e if th e co n tracto r e xce e d s, m e e ts o r d oes no t m e e t the se sta n da rd s.

T h e P e rfo rm an ce R e qu ire m en ts S u m m a ry M a trix, S e ctio n

: C lin ical E xp e cta tion s in th

P e rfo rm a nce W o rk S ta te m e nt (P W

S ), in clu d e s p e rfo rm ance sta nd a rd

s. T ve rnm e nt sha ll u se th ese stan d a rd s to d e te rm ine co n tra cto r pe rfo rm an ce an d sh a ll com p are co ntra cto r p e rfo rm a n ce to the A cce p ta b le Q u ality L e ve l (A

Q L

E a ch p h lebo to m ist sh all p o sse ss n o less th an tw o yea rs o f e xp e rience in th fo llo w in g indicated a rea s: E xpe rie n ce sh ou ld inclu d e inp a tie n t colle ctio n a s w e ll a s o utp a tien t e xperie n ce . C on tra ct p h lebo tom ists sho u ld lso be xp e rie nce d in d ra w ing b loo d from p a tien ts w ith d ifficu lt ve in s to a cce ss, su ch s g e ria tric p atien ts, sp in a l co rd p atie n ts a nd ca n ce r p a tien

ts. M e d ica l T e ch n icia n / P h lebo tom ist du tie s sh a ll in clud e

P e rfo rm s P h leb o to m y d u tie s o n inp a tie n ts a nd o utp atie nts a s d ire cte b y S up e rvisor(s) of th e M E

D V

A M

C S p e cim en A cq u isition se ctio n

C on tract P hleb oto m ists m u st b e co m p ete nt to perfo rm ta sks an d assig nm en ts ind ep end ently, w hich m a y in clu de d ra w in g b lo od from

0 to 80 pa tien ts p er da y a nd handling at le ast 2 0% o f ha rd sticks.

A sse m b les equ ipm en t su ch a s tou rn iq uet, n ee d le s, b lo od co lle ction vice s, g au ze

, co tton

, a lco ho l e

tc. o n w o rk tray.

V e rifie s a n d co rre ctly id e n titie s p atie n ts p rio r to d ra w ing b loo d

, p e r

JC

A H

O g u ide lin es, a nd co n ve rse s w ith th e p atie n t to a lla y fe a r o f the ro ce du

T T

A C

H M

E N

TD

ra w s b lo o d from p atie n ts u sin g ve n ipu n cture te ch n iq ue

s. U s a syrin g e

, pla stic va cu um tu b e o r bu tte rfly to ob ta in sa m p le s.

A p p lie s to urniqu e t to arm

, lo cate s a ccessible ve in

, sw ab s p un ctu a w ith d isinfe cta nt, a n d in se rts ne edle on to ve in to d ra w b loo d w ith d ra w s n ee dle, a pp lie s tre a tm en t to p un cture site

L a be ls a nd tran sp o rts b lo o d co lle cte d to p roce ssin g a re a ; U se s T ran s

L o g ic syste m to tu be sp e cim e n s to th ird floo r la b o ra to ry.

E n su re s th at the p roper am ou n t o f b lo od is d ra w n fo r e a ch re q ue sted te st o r p roce du re.

M a y p e rfo rm va riou s o th e r te ch n ical lab orato ry p roce du re s su ch a s co m pu te r te st a cce ssion in g , sp e cim e n ce ntrifu g a tio n , se ru m a ra tio n, e tc.

h a rd co p ies o f o rde rs an d m a y inp u t test o rde rs in to th e co m p u ter;

U se s M u ltip u rp o se A cce ssio n in g o ptio n

R o ta te s to a n sw e r te lep h on e req u ests fo r te st re su lts; utilize s com p ute r to a cce ss the ne ce ssa ry d a ta an d co m m un icate s th is d a ta

(re su lts) to ysicia n s, nu rses a nd o the r a u th o rize d m ed ica l p e rson n e l a s n e ce ssa ry.

R e co rd s re je cte d sp e cim e n s a cco rd in g to rejectio n p roto co ls su ch a s m isid e ntifie d, u n ide n tifie d spe cim e n s or spe cim e n s w ith in su fficie nt vo lu m e d ra w n.

M in im a l p e rform a n ce sta n da rd s:

a e xp e cta tion s o f co u rtesy a n d co n side ratio n to w ard the

M E

D V

A M

C p a tien ts a n d fa cility p e rso n ne l.

b

M a in ta ins q ua lified pe rso n ne l d u ring re quire d h o u rs at re qu ire d loca tio n c.

P a tie nt S a fe ty in ciden ts re p o rted tim ely (w ith in

4 h ou

rs) d

C o m p lete s fa cility m an da to ry tra in in g e

M a in ta ins p atien t p riva cy a n d co nfid e ntia lity f.

M a in ta ins licensing

, certifica tio n s, e tc.

g

In vo ice s tim ly

D.1 ATTACHMENT

Measure (ID)

PWS

Reference Performance Requirement Standard

Acceptable Quality Level

Surveillance Method Incentive

Personnel (1) 1.4 2.1

Provide required phlebotomy services as specified in the requirements.

Qualified personnel are available and in location as needed to properly perform tasks as specified.

100%

Random Inspection, Time and Attendance Sheets, Quality Assurance Reports

Favorable contractor performance evaluation.

Shift Coverage (2)

Section 3: Staffing Provide required coverage for contract phlebotomist absences.

Qualified personnel are available and in location as needed to properly perform tasks as specified.

100%

Random Inspection, Time and Attendance Sheets, Quality Assurance Reports

Favorable contractor performance evaluation.

Phlebotomist Duties (3)

4.1

Provide effective and courteous services to internal and external customers and patients.

Contractor will not have any valid instances of complaints.

100% Validated User/Customer Complaints

Favorable contractor performance evaluation.

Duties/Workpl ace Safety (4)

4.2 4.3

Properly identifies all patients according to two patient identifiers.

Patient safety incidents must be reported using Patient Incident Report.

All patients must be identified using two approved patient identifiers.

All patient safety incidents reported immediately (within 24 hours.)

100% Direct Observation

Favorable contractor performance evaluation.

Mandatory Training:

Privacy, Confidentiality and HIPPA (5)

3.3 5.1 5.2

Contractor completes all mandatory required training

Contractor will complete all required training by VAMC policy Zero breaches of privacy or confidentiality

100%

Contractor to provide evidence of annual training required by VAMC, reports violations of policy.

Favorable contractor performance evaluation.

T T

A C

H M

E N

T

. IN

C E

N T

IV

E

S T h e

G o ve rnm e nt sha ll u st P e rform a n ce R e co rd a s in ce n tive

s. In ce n tive s sha ll b e b a se d o n e xceed ing, m e e tin g , o r n ot m eting rfo rm a nce stan da rds.

. M

E T

H O

D S

O F

Q A

S U

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E

IL

L A

N

E

V rio u s m e th od s e xist to m o n ito r pe rfo rm an ce . T he C

O R sha ll u se th e surveilla ce m th o ds liste d b e lo w in the ad m inistration o f th is Q

A S

P a . D

IR

E

C T

O B

S E

R V

A T

IO

N

. (C a n b e p e rfo rm ed p e riod ica lly o r th ro u gh

00% su rve illa n ce

P tie nt sa fety incid e nts m u st b e re po rted to th e C

O R an d

/o r L ab o rato ry

M a n a ge r.

b . V

A L

ID

A

T E

D U

S E

R /C

U S

T O

M E

R C

O M

P L

A

IN

T S

. (R e lie s on the pa tie n t to id e ntify d e ficie n cies. C om p la in ts are th en in ve stigate d an d va lid a te tie nt/C u sto m e r com p la in ts a b out th e q u a lity o f se rvice a re rep o rted to th e C

R d

/o r th e La b o rato ry M an a ge r fo r re so lu tion

c. R A

N D

O M

S A

M P

L

IN

G . (D e sign e d to e va lua te p e rfo rm an ce b y ran d om ly se le ctin d in spe ctin g a sam p le o f ca s.)

K y P e rso n ne l im e ly In vo icing

. C

O N

T R

A C

T O

R P

R O

V

ID

E D

D O

C U

M E

N T

A T

IO

N

. (R e lie s on docu m entatio ro vid e d b y the co n tracto r).

M n d a tory T ra inin riva cy, C on fiden tia lity, H

IP

. R

A T

IN

S trics a n d m eth od s are d e sign e d to d ete rm in e if p e rfo rm a nce e xcee d s, m ee ts, o r d o e s n ot m ee t a g ive n sta n da rd a nd a ccep ta ble q ua lity leve

l. A rating sca le sh ll be u d to de te rm in e a p ositive

, n eu tra l, or neg a tive o u tco m e . T he fo llow in g ra tin g s sh a ll b e u se d

E xce ss: 2

-5 ab o ve acce p ta ble leve l in ta b le a b ve e ts: R ea ch a cce ptab le le ve l in tab le ab ove e s N o t M ee t: 5 o r m o re b e lo w a cce pta ble le ve l in ta b le ab ve

. D

O C

U M

E N

T

IN

G P

E R

F O

R M

A N

. A C

C E

P T

A B

LE

P

E R

F O

R M

A N

T T

A C

H M

E e G o ve rnm e nt sha ll d o cum ent po sitive p e rfo rm an ce . A n y re p ort m a y b e com e a p a rt o f the su p portin g d o cum e nta tion fo r a n y co ntra ctu a l a ctio n b

. U N

A C

C E

P T

A B

L E

P E

R F

O R

M A

N

W en u n accep tab le p erfo rm a n ce o ccurs, th e C

O R sh a ll in fo rm the co n tra cto

r. T h is w ill n o rm a lly b e in w ritin g un le ss circu m sta n ce s n ece ssita te ve rba l com m u n ica tion. In an y ca se th e C

O R sh a ll d ocu m en t th e d iscu ssion a n d place it in th e

C O

R file

W h en th e C

O R d e te rm ine s fo rm a l w ritten com m u n icatio n is requ ired

, the C

O R sha ll p re p a re a C ontract D iscrep a n cy R e p o rt (C D

R ) a n d p re se nt it to the co n tra cto r's p ro g ram m ana g e r.

T h e con tra ctor sha ll a ckn o w le d ge re ce ip t of th e C D

R in w ritin g . T he C

D R w ill sp e cify if th e co n tracto r is re qu ire d to p rep a re a co rre ctive a ction p lan to d ocum e nt ho w the co tra cto r sh ou ld co rrect th e u naccep ta b le perfo rm a n ce an d a vo id a re cu rre n ce . T h e

C D

R w ill a lso sta te h ow lon g a fte r re ce ip t th e co ntracto r ha s to p re se n t th is corre ctive a ctio n p lan to th e

C O

R . T h e G o ve rn m e nt sh all re vie w th e co n tra cto r's co rre ctive a ctio n p la n to d e te rm ine a ccep ta b ility.

A n y C D

R s m ay b ecom e a p a rt of the sup po rtin g do cum en ta tio n fo r an y co ntra ctu a l a ctio n d eem e d n e ce ssa ry b y the

C O

. F

R E

Q U

E N

C Y

O F

M E

A S

U R

E M

E

. F re qu en cy o f M ea sure m en t.

D u rin g co ntra ct pe rfo rm a nce , th e C

O R w ill pe rio d ically a na lyze w he th er th e n eg o tiate d fre q u en cy o f su rve illa nce is a pp ro p ria te fo r the w o rk b e in g p erform ed b

. F re qu en cy o f P e rfo rm a n ce

A sse ssm e n t M e e ting s.

T h e C

O R m e ets w ith th e con tracto r e ve ry q ua rter to a sse ss p e rform a n ce an d sh a ll p ro vid e a w ritte n a sse ssm e nt.

S ig n a tu re

C o n tra cto r

S ig n a tu