REdI - JA FAR Part 6 (redacted).pdf

Source Selection Information – See FAR 2.101 and 3.104

JUSTIFICATION AND APPROVAL

FOR OTHER THAN FULL AND OPEN COMPETITION UNDER PART FAR 6.302-1

1. Contracting Activity: Department of Veterans Affairs (VA) Strategic Acquisition Center – Frederick (SAC-F)

5202 President’s Court, Suite 103 Frederick, MD 21703

2. Description of Action: The proposed sole source action is for a five (5) year Basic Ordering Agreement (BOA) to American Heart Association (AHA), 7272 Greenville Ave Dallas, TX, 75231-5129, United States.

3. Description of Supplies or Services: The Veterans Health Administration (VHA) has a requirement to procure electronic courseware that operates in an on-line environment that provides the ability to demonstrate an objective measurement, assessment and feedback of critical life saving skills and knowledge. The Resuscitation Quality Improvement (RQI) training program is an AHA subscription based solution that provides high frequency, low dose training to enhance retention and increase competence and confidence which results in improved CPR response during a cardiac arrest. This program specifically addresses the problem of cardiopulmonary resuscitation (CPR) skills degradation after training. The total estimated value of the proposed action is $49,930,000.00 (inclusive of options).

4. Statutory Authority: The statutory authority permitting other than full and open competition is 41 U.S.C.3304(a)(1) as implemented by the Federal Acquisition Regulation (FAR) Subpart 6.302-1 entitled, “Only One Responsible Source and No Other Supplies or Services Will Satisfy Agency Requirements.”

5. Rationale Supporting Use of Authority Cited Above:

a. Background: The AHA is a leader in resuscitation science, education, and training. The AHA resuscitation training programs follow the International Liaison Committee on Resuscitation/Consensus on Science Treatment Recommendations (ILCOR/CoSTR) Guidelines for Resuscitation Best Practices. The AHA offers a complete resuscitation portfolio that offers flexibility in training modalities and certification to meet the needs of VHA clinical and non-clinical employees. The current environment within the VHA allows for staff to complete the didactic training and conduct psychomotor skill assessment on a Mobile CPR Testing Station biennially or quarterly approach through the RQI program. VHA published the VHA Plan for Modernization, highlighting its path to a High Reliability Organization (HRO). HRO takes a stand of Zero Harm to patients by implementing and successfully executing policies and procedures to improve the overall quality of care for patients. The American Heart Association (AHA) stated that “poor quality cardiopulmonary resuscitation (CPR) is a preventable harm.” CPR is the strongest predictor of survival for patients who suffer a cardiac arrest, yet three out of four patients do not survive in-hospital cardiac arrest. Basic and advanced life support skills decay rapidly after initial training. Two years between training events is often not sufficient to maintain the skills required for the high-quality CPR. This decay in skills can have a significant impact on the survival rates of patients. The key features of RQI that address this decay of CPR skills are:

REdl BOA (VA-20-00042410) Control Number 20F-0081b

i. RQI incorporates shorter, but more frequent training sessions which are quarterly instead of every two years. Brief, more frequent training sessions have been shown to greatly improve the retention of high-quality CPR skills.

ii. RQI is based on use of automated computer instruction instead of live instructors. This allows the increase in the frequency of training without increasing the cost related to live classroom instruction.

iii. RQI mitigates the scheduling constraints associated with live classroom instruction because it does not depend upon the schedule of a live instructor. The system makes training available when it is convenient for the student.

iv. Real-time CPR feedback and debriefing based on quantitative data has been shown to improve the student's CPR performance and skill retention. The use of the online platform supports this by providing quantitative feedback to the student on the depth and frequency of the chest compressions during a training event and recording this information for use in debriefing.

v. The percentage of healthcare providers performing excellent CPR more than doubled (from 26% to 65%) when healthcare providers were retrained 3 times over 6 months by using an automated manikin system with real-time feedback.

The American Heart Association offers several different types of training that can result in certification. The VA’s requirement calls for only one specific type of training – Resuscitation Quality Improvement (RQI) Program training – available only online through the American Heart Association-developed training.

b. Justification: AHA's evidence based resuscitation education is the standard in healthcare training with over 90% of hospitals utilizing AHA resuscitation training portfolio programs for resuscitation education. The REdl Program has identified the transition from an instructor led, face to face environment to a technology, on-line, based environment provides the ability to demonstrate these skills that provide an objective measurement, assessment and feedback of critical life saving skills and knowledge. The RQI program is only available from AHA who is the originator of this service for this approach to competency-based learning. Only AHA approved courseware and procedures are approved for training and certifications. AHA is the only guarantor of the performance of this product. AHA owns the exclusive accredited content rights to this competency based model. American Heart Association Resuscitation Training is currently the only approved training for VHA staff that includes RQI training under Directive 1177.

These products enable healthcare providers to obtain and retain frequent practice of the critical skills in basic and advanced lifesaving procedures. Additionally, RQI is the only product available in the marketplace with the unique capability that meets AHA standards to retain and improve survival rates while progressing the certification of the healthcare provider. Without this training and subsequent certification, healthcare providers will continue to lose CPR skill proficiency. The REdl program has the ongoing requirement to provide initial and refresher emergency First Aid, CPR and Advanced Life Support training across the VHA. Market research confirms RQI is the only training method that meets the AHA NHA platform standards. Substitutes are not authorized and do not exist.

AHA is the Original Equipment Manufacturer (OEM) for these six items. The OEM is the only distributor of this product. REdl team members reviewed the market and confirmed there are no other products acceptable to meet this training need. Per FAR Part 11.105(a): Items Peculiar to

One Manufacturer, the particular brand name, product, or feature is essential to the Government's requirements, and market research indicated other companies' similar products lack the particular features, do not meet, or cannot be modified to meet the agency's needs. AHA is the only provider for RQI training and certification.

c. Impact: VHA providers are required to be certified in AHA BLS and ACLS lifesaving procedures before working in Veterans Affairs Medical Centers (VAMCs). Providers must be trained and retain these lifesaving skills. Without RQI, the low retention rate of CPR skills required for effective BLS and ACLS will not improve. This low retention rate is a result of the current training methodology, which requires training once every two years. If this training deficiency is not addressed, Veterans will continue to be at risk of a low survival rate from cardiac arrest at VHA facilities. Veterans who suffer cardiac arrest during a VA hospital stay are more likely to survive the experience than patients who have such events cardiac arrests in other U.S. hospitals. In 2018, US Medicine published an article stating that the VA’s national focus on “ensuring high-quality education and certification for its providers through the Resuscitation Education Initiative (REdI)” likely also contributes to the more positive outcomes at VA hospitals. The median adult in-hospital cardiac arrest (IHCA) survival rate is 18%. The VA IHCA survival rate ranges from 38%- 50% while the AHA 2020 IHCA goal is 38%.

6. Efforts to Obtain Competition: Market research was conducted, details of which are in the market research section of this document. This effort did not yield any additional sources that can meet the Government’s requirements. There is no competition anticipated for this acquisition.

Additionally, the proposed action will be synopsized on the Federal Business Opportunities Page in accordance with FAR 5.201. Any proposals that are received shall be evaluated.

7. Actions to Increase Competition: The Government will continue to conduct market research to ascertain if there are changes in the market place that would enable future actions to be competed.

8. Market Research: Market research consisted of internet searches, conducted by VHA Subject Matter Experts (SMEs), interviews with VA SMEs, and VHA Simulation Learning, Education and Research Network (SimLEARN) Integrated Product Team (IPT) members, and follow-up phone calls with potential contractors to confirm on-line research. Market research completed on April 2, 2020 consisted of direct communications with AHA. Market research conducted March 31, 2020 with the American Red Cross confirmed that they do offer online training and that does not involve or interact with the SimLEARN manikin system. After a discussion with one of the authorized SDVOSB distributors, the contractor noted that they would not be able to perform or provide at least 51% of the work required. This communication determined that the VA Rule of Two could not be satisfied. These communications further confirmed that AHA is the only provider and will be the only provider for the foreseeable future. In conclusion, no other sources exist that can legally provide all necessary services under this requirement.

9. Other Facts: AHA is the creator and maker of the certification approved and meeting the required training program. The VA currently owns and maintains 1,137 fully-equipped American Heart Association carts that are used in combination with the courseware to provide the training to certify the VA workforce. This sole source justification and approval for other than full and open competition shall apply to the BOA and all BOA Orders.

10. Technical and Requirements Certification: I certify that the supporting data under my cognizance, which are included in this justification, are accurate and complete to the best of my knowledge and belief.

Name: Lisa Baker Date: ______________________

Title: VHA National Program Director, REdl Signature: ______________________

11. Fair and Reasonable Cost Determination: I hereby determine that the anticipated price to the Government for this contract action will be determined fair and reasonable prior to award.

Name: Nathan Bradley

Procuring Contracting Officer

Date: ___ _______

Signature: ______________________

12. Procuring Contracting Officer Certification: I certify that this justification is accurate and complete to the best of my knowledge and belief.

Name: Nathan Bradley

Procuring Contracting Officer

Date:

Signature: ______________________

NATHAN W.

BRADLEY 704364

Digitally signed by NATHAN

W. BRADLEY 704364

Date: 2020.05.20 09:54:00 -04'00'

NATHAN W.

BRADLEY 704364

Digitally signed by NATHAN W.

BRADLEY 704364

Date: 2020.05.20 09:54:18 -04'00'

Tracey E. Robilotto 219688

Digitally signed by Tracey E.

Robilotto 219688 Date: 2020.05.20 12:52:46 -04'00'

Christy, Phillip Digitally signed by Christy, Phillip Date: 2020.06.04 17:12:56 -04'00'