W911SF-21-R-0007 PWS 19 Nov 20.pdf

Performance Work Statement for Research, Development, and Consulting Services

1. GENERAL:

1.1 INTRODUCTION: With the recent outbreak of the COVID-19 virus and its impact upon the Military Health System (MHS) as well as civilian healthcare facilities, the Martin Army Community Hospital at Fort Benning, Georgia has a need for new employee orientation, basic nurse skills, team building, Arbinger Mindset marketing strategies, support for A3 performance improvement activities, implementation of virtual health capabilities and emerging Education and Training programs for officer, enlisted and civilian personnel.

1.2 BACKGROUND: The speed with which the COVID-19 virus has spread throughout the country has a direct impact upon the Fort Benning MEDDAC, in its ability to carry out its missions of a Medically Ready Force, a Ready Medical Force and the care of critically ill patients.

Historically, in many MTFs over the past several decades, a variety of training programs have been created and implemented to address the needs of new employees. Often, they have included orientation to their Command, development of team building and strategy planning skills, and support for some of their performance improvement work. For the most part, these programs have been reasonably effective, particularly in non-crisis situations. Some have been of a formal nature, some have been informal, depending upon each MTF’s priorities. However, most recently, as a result of the huge scale of the virus pandemic and the “National Defense Authorization Act for Fiscal Year 2017, Title VII, Section 702 (10 U.S.C. 1073c)” with the expanded requirements of the MHS’ Defense Health Agency (DHA) to have direct control over the MTFs, the importance has risen dramatically for integrating education and training elements into a cohesive, formal program framework. This would significantly aid MTF personnel in understanding the impact of their day-to-day work on the command, upon the MHS and how to do it inside of crises such as

COVID-19.

1.2.1 This is a non-personal services contract.

1.3 PROGRAM OBJECTIVES: There is a consensus that the development and implementation of a cohesive, formal program framework would be more cost-effective and manageable if all the program segments or elements were placed in a single, comprehensive program vs multiple ones scattered throughout the command with different coordinators and trainers. Additionally, it is evident that an updated list of proposed program segments should encompass: Arbinger Mindset Training and marketing, New Employee Orientation, Individual Critical Task Lists (ICTLs) for enlisted and officer medical personnel, support for A3 Process Improvement, Medical Group Practice Skills Development, and other Education & Training skills development (i.e. Building Effective Teams and Developmental Planning skills). The newest addition would include implementation of Virtual Health. The successful implementation of a large-scale framework will necessitate (a) prioritization of the segments, (b) identification of the gaps or missing elements of current ones, (c) and a critical evaluation of resources available to begin and sustain the program.

This is particularly true for initial development and documentation of the following program segments, along with an evaluation of their successes:

1.3.1 New Employee Orientation – The contractor shall assist in designing and implementing an Orientation program for new employees. This would include information pertinent to the roles and responsibilities of their work at the MTF and as a key member of the MHS along with ensuring a video capabilities for sections of employee orientation. The contractor shall videotape up to eighty

(80) hours of Orientation and training for dissemination to outlying clinics.

1.3.2 Arbinger Mindset Training – The contractor shall coordinate with Education and Training and Orientation personnel to understand the impact Arbinger (including changing the mindset, transforming cultures, collaborating, resolving conflict, and sustainably improving results) will have on the MTF. The contractor shall develop and present courses of action for implementation of marketing strategy and assist in coordinating suitable training for all levels of employees, including development of a marketing plan for long-term sustainment.

1.3.3 Individual Critical Task List (ICTL) for Medical Personnel - The contractor shall assist with developing and deploying of a detailed ICTL checklist for each level of medical personnel.

Typically, a list such as this includes the Knowledge, Skills and Abilities of Officer and Enlisted personnel at each level to successfully perform their job. Information shall be obtained from the Army’s approved list of critical skills as well as interviews with individual personnel.

1.3.4 A3 Process Support - The contractor shall coordinate with the Quality Managers in the medical, ancillary, or administrative departments to provide support for staff to complete and execute A3s for improving specific processes.

1.3.5 Medical Group Practice Skills Development – The contractor shall develop with the directors of the physician medical groups an ongoing program that incorporates two key skill sets: (1) the logistical day-to-day skills required to operate a group medical practice specifically focused on Utilization Management, Case Management, and Disease Management, (2) the evaluation of a medical group’s delivery of services to its patients and the use of data gained to determine opportunities for improvement.

1.3.6 Strategic Planning utilizing a Medical Management model and Team Building Leadership Skills – Using proven principles and practices from Army Medicine, other military and secular healthcare practices, the contractor shall coordinate the development and implementation of specific strategy planning sessions such as the MTF’s Executive Planning Session (EPS). To enhance the success of strategy planning sessions, the contractor shall assist in developing training programs for specific team building and leadership skills for all levels of employees.

1.3.7 Virtual Health Implementation – Drawing upon recent experiences in the implementation of Virtual Health, the contractor shall assist the MTF in developing a requirements portfolio that documents the necessity for a sustainable Virtual Health program. The portfolio would include a Project Management report that includes required startup costs & personnel needed, project schedule of tasks to be performed, logistical setup of equipment and facility, and patient care considerations.

1.3.8 Additional Education and Training (E & T) Programs – With the long-term impact of COVID-19 virus unknown, and other emerging needs of the MEDDAC medical and other staff personnel, the contractor shall prioritize with the senior leaders the requirements most suitable to their mission. Additionally, the contractor shall help design and conduct the needed training programs, utilizing multi-media methodologies, video teleconferencing, scenario-based training, hands-on skills development, and other modalities to significantly enhance the learning of the medical and administrative personnel.

1.4 PROGRAM SCOPE: The contractor shall: (a) support the program managers and coordinators in obtaining final acceptance of the program’s framework and deliverables, including methods to ensure from the customers’ perspective that the program scope and objectives shall be met; (b) develop a process for implementation and long-term program sustainment; (c) and distribute to all stakeholders in a final status report all information that is related to the program implementation, evaluation and identification of opportunities for improvement.

The contractor shall provide a minimum number of full time equivalents (FTE) as indicated in the following charts. The government considers 1 FTE to be equal to 1920 hours/year.

Command Number of SMEs

(FTE)

Number of Knowledge Management Experts(FTE)

Martin Army MADDAC, Ft Benning, GA

1 1

1.5 DELIVERABLES

1.5.1 Monthly Report. By the 10th of each month, the contractor shall provide a status report to the COR, and Government’s Project Manager for the previous calendar month. The report shall detail the following:

Brief overview of contractor accomplishments for the reporting period. Status of milestone and accomplishments regarding the Program, including training and project status.

Significant problems experienced, recommended solution(s), plan of action and milestones for correction, and status of correction. Continue to report each significant problem until resolution.

Anticipated/emerging problems and potential implications to the Government.

Proposed courses of action, plans or strategies as required in paragraphs 1.3.1 through 1.3.8.

1.6 QUALIFICATIONS

The contractor shall accomplish the tasks stated by providing individuals with the following qualifications in order to provide the following services:

1.6.1 Subject Matter Expert:

Possess at least a Bachelor’s degree such as Business Administration or Nursing.

Possess a minimum of 15 years of relevant field experience. Training and development experience in the health care industry.

Practice continuously as a Master Black Belt since certification.

Possess experience in all elements of ASQ MBB Book of Knowledge (BOK) or equivalent industry recognized quality organization (i.e., NCQA, Institute for Healthcare Improvement (IHI) and others).

Demonstrate knowledge and experience associated with accomplishing the requirements in paragraphs 1.3.1 -1.3.6.

Master’s Degree is desirable; particularly as M.Ed, MSN, or MBA.

1.6.2 Knowledge Management Expert:

Possess at least a Bachelor’s degree such as Business Administration, or Information Technology – Or appropriate certifications to complete the tasks stated in paragraphs

1.3.1 -1.3.6.

Possess a minimum of 5 years of relevant experience such as engineering or performance improvement.

Possess a high level of proficiency in the use of HTML/XML coding.

Possess a high level of proficiency in the use of the Microsoft Office suite, including

Microsoft SharePoint Designer.

Possess a high level of proficiency in working with business intelligence tools such as

Power BI, Tableau, Qlikview, and others.

Demonstrate knowledge and experience associated with successfully accomplishing the requirements 1.3.1-1.3.8.

Contractor should have experience performing services identified in this PWS in military healthcare environment.

1.7 PLACES OF PERFORMANCE:

1.7.1 Training and support services shall be rendered at Martin Army MADDAC, Ft Benning, GA and other government locations as needed.

1.7.2 Knowledge Management services have been rendered at Martin Army MADDAC, Ft Benning, GA and other government locations as needed.

1.7.3 The Government will typically provide space within the Army facilities for contractor personnel; however, space constraints may require the contractor to work remotely. The normal operating hours are 0700-1700

1.7.4 Services shall be performed at Martin Army MADDAC, Ft Benning, GA and other government locations as needed.

1.8 SECURITY REQUIREMENTS: The contract employee or any representative of the contractor entering Fort Benning, Georgia shall abide by all security regulations and shall be subject to security checks.

1.8.1 The contract employee shall not be permitted on the installation when their presence is considered detrimental to the security of the installation. The Government reserves the right to remove from the job site any contract employee whose continued employment is not consistent with the interest of military security or who is found to be otherwise impaired.

1.8.2 Performance of the contract shall not be allowed without full compliance with the Crime Control Act of 1990 and Department of the Army (DA) Circular 690-92-1, 15 November 1992, Criminal History Background Checks (CHBCs), on individuals in Child Care Services. The contractor shall conduct criminal background checks on all contract employees IAW the procedures set forth in Public Law 100-235, DOD Directive 5200.28, Enclosure 6, paragraph E6.4.1.2, DOD Directive 5200.R, DODI 1402.5. The contractor is responsible for ensuring background check submissions are initiated IAW BMACH procedures prior to the contract employee providing services at the MTF, and that they are properly cleared and meet the requirements of the law. Background checks shall be based on fingerprints of individuals and on inquiries conducted through the Federal Bureau of Investigation (FBI), State Criminal History Repository (SCHR) check, and a local Installation Record Check (IRC), if required.

1.8.2.1 An IRC shall be conducted by DoD Component personnel at the installation level. Upon favorable completion of the IRC, an individual may be selected to provide services to a minor child under line-of-sight supervision (LOSS) until the required background checks are successfully completed. Line-of-sight supervision is defined in DODI 1402.5.

1.8.3 KEY CONTROL. The contract employee shall be responsible for any key(s) issued by the Government to him/her for use in at BMACH. The key(s) shall not be duplicated. The contractor shall be responsible for the replacement of any lost key(s) and the associated lock(s). All areas, for which the contract employee possesses the key, shall be locked when not in use and at the close of each work period.

1.8.4 The contract employee shall return all key(s) issued by the Government to the department/service Key Control Officer upon termination of his/her employment with the contractor or termination of the contract.

1.8.5 The contractor shall report any occurrence of duplicated, misplaced, and/or lost keys to the COR or the Administrative Officer of the Day (AOD) on a non-duty day immediately after discovery of occurrence and submit a written report to the KO by close of the next business day.

The written report shall provide complete details related to duplication, misplaced key(s), or loss.

1.8.6 The contractor shall reimburse the Government for replacement of all locks or re-keying required as a result of keys being duplicated, misplaced, or lost by contract employee. The contractor shall also reimburse the Government for any Government property lost or stolen as determined by the Report of Survey as a result of unauthorized key duplication, misplaced key, or loss of key by contractor or contract employee.

1.8.7 VEHICLE REGISTRATION. The contract employee shall comply with all applicable requirements of Headquarters United States Army Maneuver Center of Excellence (MCoE)

Regulation 190-5, Motor Vehicle Regulation, in effect during the performance of this contract.

Evidence of vehicle ownership and vehicle liability insurance must be presented upon request.

1.8.8 VEHICLE OPERATION. Contractor personnel operating motor vehicles on the installation shall have a valid state license for the category of vehicle being operated and shall comply with vehicle operation directives regarding motor vehicle use on the installation.

1.8.9 OPERATIONS SECURITY (OPSEC) STANDARD OPERATING PROCEDURES (SOP)

PLAN REQUIREMENTS. The contractor shall adhere to the Government’s Operations Security (OPSEC) Standard Operating Procedure (SOP)/Plan during the entire period of performance

(POP).

1.8.10 HANDLING OR ACCESS TO CLASSIFIED INFORMATION. The contractor shall comply with FAR 52.204-2, Security Requirements. This clause involves access to information classified as “(Con)fidential”, “(Sec)ret”, or “Top (Sec)ret” and requires contractors to comply with the Security Agreement (DD Form 441), including the National Industrial Security Program Operating Manual (DoD 5220.22-M) and any revisions to DoD 5220.22-M, notice of which has been furnished to the contractor.

1.8.11 Antiterrorism/Operations Security Requirements: Antiterrorism (AT) Level I Training.

All contractor employees, to include subcontractor employees, requiring access Army installations, facilities and controlled access areas shall complete AT Level I awareness training within 90 calendar days after contract start date or effective date of incorporation of this requirement into the contract, whichever is applicable. The contractor shall submit certificates of completion for each affected contractor employee and subcontractor employee, to the COR or to the KO, if a COR is not assigned, within 10 calendar days after completion of training by all employees and subcontractor personnel. AT level I awareness training is available at the following website: https://atlevel1.dtic.mil/at.

1.8.12 Access and General Protection/Security Policy and Procedures: Contractor and all associated sub- contractors employees shall comply with applicable installation, facility and area commander installation/facility access and local security policies and procedures (provided by government representative). The contractor shall also provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. Contractor workforce must comply with all personal identity verification requirements as directed by DOD, HQDA and/or local policy. In addition to the changes otherwise authorized by the changes clause of this contract, should the Force Protection Condition (FPCON) at any individual facility or installation change, the Government may require changes in contractor security matters or processes.

1.8.13 For contractors requiring Common Access Card (CAC). Before CAC issuance, the contractor employee requires, at a minimum, a favorably adjudicated National Agency Check with Inquiries (NACI) or an equivalent or higher investigation in accordance with Army Directive 2014-05. The contractor employee shall be issued a CAC only if duties involve one of the following: (1) Both physical access to a DoD facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more. At the discretion of the sponsoring activity, an initial CAC may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

1.8.14 iWATCH Training. The contractor and all associated sub-contractors shall brief all employees on the local iWATCH program (training standards provided by the requiring activity ATO). This locally developed training will be used to inform employees of the types of behavior to watch for and instruct employees to report suspicious activity to the COR. This training shall be completed within 30 calendar days of contract award and within 05 calendar days of new employees commencing performance with the results reported to the COR NLT 30 calendar days after contract award. Link to iWATCH Training:

https://www.youtube.com/watch?v=eNdfdH8ZXoUAccess to Government Information Systems.

All contractor employees shall successfully complete the DOD Information Assurance Awareness prior to access to the IS and then annually thereafter.

1.8.15 OPSEC Training. In accordance with AR 530-1 all personnel, to include contractor employees and associated sub-contractor employees must complete Level I Operations Security (OPSEC) training which is composed of both initial and continual awareness training (annually).

All personnel within the first 30 days of arrival in the organization must receive initial training to include a briefing on the organizations critical information and read/sign the OPSEC Individual User Compliance Agreement form. The end state of initial and continual awareness training is that each individual should have the requisite knowledge to safeguard critical information.

1.8.7.6 For Cyber Awareness (Information assurance (IA)/information technology (IT)) training.

All contractor employees and associated sub-contractor employees must complete the DoD Cyber awareness training before issuance of network access and annually thereafter. All contractor employees working IA/IT functions must comply with DoD and Army training requirements in DoDD 8570.01, DoD 8570.01-M and AR 25-2 within six months of appointment to IA/IT functions. DoD Cyber Awareness Challenge Training is available at the following website: https://ia.signal.army.mil/DoDIAA/

1.8.8 PHYSICAL SECURITY. Contract employee shall keep Government furnished supplies, equipment and work areas in clean condition. Contract employees shall abide by all MTF and Army requirements for physical security of Army property and equipment.

1.8.9 Security. All contractor personnel shall obtain a SECRET clearance in Joint Personnel Adjudication System (JPAS). See Attachment I for additional information. Contractor personnel may not work on-site unless they possess a CAC and have approval to work on-site by the COR.

2.0 DEFINITIONS/ABBREVIATIONS/ACRONYMS

2.1 STANDARD DEFINITIONS

2.1.1 A3. A3 problem solving is a structured problem-solving and continuous-improvement approach, first employed at Toyota and typically used by lean manufacturing practitioners. It provides a simple and strict procedure that guides problem solving by workers.

2.1.2 ACTIVE DUTY MEMBER. Full-time duty in uniformed services of the United States (US), including the U.S. Coast Guard, National Atmospheric and Oceanographic Administration (NOAA), and the Commissioned Corps of the U.S. Public Health Service. This includes full-time training duty, annual training duty, and attendance while in the active service at a school designated as a service school by the law or the Secretary of the Military Department concerned.

2.1.3 ADVISORY DOCUMENT. A directive which the contractor may use for information and guidance but is not binding for compliance.

2.1.4 ANCILLARY PERSONNEL. Personnel commonly referred to as radiologists, pathologists, and/or medical and pharmacy technicians/technologists. Also, clerical, secretarial, and receptionist personnel are commonly considered administrative personnel.

2.1.5 Arbinger. Arbinger is a derivative of the word “harbinger.” It means “one that indicates or foreshadows what is to come; a forerunner.” The Arbinger Institute is a forerunner, or “harbinger,” of change.

2.1.6 BENEFICIARIES. Those individuals who are entitled to care at the MTF IAW AR 40-3.

2.1.7 BOARD CERTIFICATION/BOARD CERTIFIED. Physicians who have completed a residency program with recognition by the American Board of Medical Specialties or by the American Osteopathic Association of an inclusive medical osteopathic specialization.

2.1.8 CLINICAL PRIVILEGES. Authorization by the MTF Commander to provide specific patient care and treatment services in the organization, within well-defined limits based on the individual’s license, education, training, experience, competence, judgment, and physical and mental health.

2.1.9 CONTINUING MEDICAL EDUCATION. Education beyond initial professional preparation that is relevant to the type of patient care delivered in the organization that provides current knowledge relevant to the individual’s field of practice and that is related to findings from PI activities.

2.1.10 CONTRACTING OFFICER. A person with the authority to enter into, administer, and/or terminate contracts, and make findings and determinations on behalf of the Government.

2.1.11 CONTRACTING OFFICER’S REPRESENTATIVE. An individual appointed in writing by the KO who monitors the technical and performance aspects of a contract and performs other duties as specified by the KO.

2.1.12 CREDENTIALS VERIFICATION. Confirmation from a primary source (granting agency) or a service that confirms credentials from a primary source that the information provided by the contract HCP is current, correct, and substantiates qualifications.

2.1.13 DEFECT. Any nonconformance of a unit of service with specified requirements.

2.1.14 DEFENSE ENROLLMENT ELIGIBILITY REPORTING SYSTEM (DEERS). A

computerized system which maintains current eligibility status for all eligible health care beneficiaries.

2.1.15 FAMILY ADVOCACY. A DOD program that addresses child and spouse abuse. The medical mission is to provide medical services and rehabilitative counseling to both victims and abusers.

2.1.16 FISCAL YEAR. A period beginning October 1 and ending September 30 of consecutive calendar years. The fiscal year is designated by the calendar year in which it ends.

2.1.17 FULL-TIME EQUIVALENT (FTE). Personnel employed by the contractor working 40 hours per week.

2.1.18 GOVERNMENT FURNISHED PROPERTY. All equipment, goods, and land possessed by the Government and subsequently delivered or otherwise made available to the contractor.

2.1.19 HEALTH CARE FINDER. A person who is tasked with assisting the contract HCP or patient with a referral for a specialty appointment within the MEDDAC through the TRICARE Provider Network or a civilian provider.

2.1.20 HEALTH CARE PROVIDER (HCP). Personnel participating in clinical patient care (doctors, nurses, social workers, psychologists, technicians, etc.) are considered Health Care Providers.

2.1.21 Individual Critical Task List (ICTL). A list such as this includes the Knowledge, Skills and Abilities of Officer and Enlisted personnel at each level to successfully perform their job

2.1.22 LEGAL PUBLIC HOLIDAYS. Holidays in each calendar year identified as follows:

New Year’s Day January 1 Martin Luther King’s Birthday Third Monday in January President’s Day Third Monday in February Memorial Day The last Monday in May Independence Day July 4 Labor Day First Monday in September Columbus Day Second Monday in October Veteran’s Day November 11 Thanksgiving Day Fourth Thursday in November Christmas Day December 25

*Any of the above holidays falling on a Saturday will be observed on the preceding Friday;

holidays falling on a Sunday will be observed the following Monday.

2.1.23 LICENSE/LICENSED. All references refer to, and require, an unrestricted license.

2.1.24 MANDATORY DOCUMENT. A directive in which the contractor is obliged to perform the effort strictly IAW the method specified in the directive to meet the stated results of the directive.

2.1.25 MEDICAL/PATIENT RECORDS. Those documents generated in conjunction with, or as a result of, an episode of preventive, diagnostic, or therapeutic and rehabilitative care.

2.1.26 MILITARY TIME is on a 24-hour clock:

8:00 a.m. 0800 9:10 a.m. 0910 Noon 1200 12:18 p.m. 1218 8:00 p.m. 2000 Midnight 2400 12:01 a.m. 0001

2.1.27 MILITARY DATES are written by placing the day of the month, followed by the first three letters of the month, followed by the last two digits of the year:

2.1.28 MILITARY TRAINING HOLIDAY. A day designated by the BMACH Commander as authorized time off for military personnel in non-critical patient care areas.

2.1.29 RESERVED.

2.1.30 PERFORMANCE REQUIREMENT SUMMARY. Identifies the key service outputs of the contract that will be evaluated by the Government to assure contract performance standards are met by the contractor (Attachment 1).

2.1.31 PERFORMANCE BASED WORK STATEMENT. A document that accurately describes the essential and technical requirements for items, materials, or services, including the standards used to determine whether the contractual requirements have been met.

2.1.32 POPULATION HEALTH IMPROVEMENT. A program designed to ensure that high quality patient care is provided in the most cost-effective manner. Cost effectiveness is achieved when resources (defined as people, equipment, space, time, and money) are properly allocated.

Inappropriate use of resources may be identified through reviews conducted using written measurable criteria or a result of related QI activities.

2.1.33 PRESCRIPTION ORIGINAL. Original prescriptions are the handwritten, electronic entry, or verbal orders of a person licensed to practice medicine for the dispensing of drugs and/or devices intended for use in the diagnosis, cure, treatment, or prevention of disease of humans. Original prescriptions are those dispensing orders that are contemporaneous to a patient’s clinic visit and the patient consulting a HCP.

2.1.34 PRESCRIPTION REFILLS. Refills are those transactions at the pharmacy which result in the patient receiving additional supplies for continuation of drugs/devices specified in the original/renewal prescription. The prescribing HCP may authorize the refilling of an original prescription by indicating the number of refills on the original prescription.

2.1.35 PRIMARY CARE. The provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.

2.1.36 PRIMARY CARE MANAGER. A credentialed HCP or group of healthcare professionals who coordinate a patient’s medical care.

2.1.37 PRIVILEGING. The overall process of review and evaluation of a HCP’s professional qualifications and demonstrated current competence for the purpose of granting delineated clinical privileges. The process involves the verification of credentials and observation of clinical skills, record keeping, ethics, professional decorum, and participation in staff meetings and professional committees.

2.1.38 PRIVILEGING PROCESS. Process established by DOD, BMACH, and AR 40-68 for granting clinical privileges to HCPs.

2.1.39 PROFILE. Placing Soldiers on bed rest or duty restriction.

2.1.40 PERFORMANCE IMPROVEMENT. An ongoing program designated to objectively and systematically monitor and evaluate the quality and appropriateness of patient care, to pursue opportunities to improve patient care, and to resolve identified problems.

2.1.41 QUALITY ASSURANCE. Those actions taken by the Government to assure that the quality of purchased goods and services received are acceptable IAW established standards and requirements of the contract.

2.1.42 QUALITY ASSURANCE EVALUATOR. A Government representative responsible for performing surveillance and inspection of contractor performance (may be referred to as a Quality Assurance Specialist; Technical Monitor, Inspector).

2.1.43 RANDOM NUMBER TABLE. A table of numbers arranged in random fashion; a table used to select random samples.

2.1.44 RANDOM SAMPLE. A sampling method whereby each service output in a lot has an equal chance of being selected.

2.1.45 RANDOM SAMPLING. A method for looking at a few individual items in a lot to measure the quality of that lot against a standard.

2.1.46 REGISTRATION. The process by which a beneficiary and/or dependents become a member for coverage in the military managed health care plan.

2.1.47 RESIDENCY TRAINING/RESIDENCY TRAINED. Successful completion of a residency accredited by the Accreditation Council for Graduate Medical Education or by the Department of Education of the American Osteopathic Association.

2.1.48 STANDARD. A measure of comparison; an acceptability criterion; a benchmark, or yardstick against which a service will be measured.

2.1.49 THIRD PARTY COLLECTIONS PROGRAM. A DOD program which identifies those eligible beneficiaries who are also beneficiaries of another health insurance, health indemnity, or pre-paid health plan. The goal of this program is to recover and retain costs of care provided to these beneficiaries to the benefit of the Government (10 U.S.C. 1095 1990).

2.1.50 TRIAGE. Assessing the status of walk-in patients to determine the appropriate disposition and to classify priority of care (urgent, non-urgent).

2.2 TRICARE. The DOD managed care program for members of the uniformed services and their families, survivors, and retired members and their families. TRICARE brings together into one system the clinics and hospitals belonging to each Military Department (Army, Navy, and Air Force) and the providers and institutions that accept Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). The purpose of this change is to enhance access to high quality health care services at the lowest cost possible, always ensuring that patients have a choice that minimizes out of pocket expenses.

2.2.1 TRICARE ACCESS STANDARDS

2.2.2 EMERGENT. Emergent patients shall be seen immediately upon presentation. Emergent is defined as a sudden and unexpected medical condition which requires immediate medical attention and for which delay is harmful to the patient. Such disorder potentially threatens life, limb, or sight.

2.2.3 URGENT. Urgent patients shall be seen within 24 hours of patient’s request for an appointment (considered same-day appointment based on medical condition). Urgent is defined as a condition which requires medical attention within a few hours or the medical condition may be aggravated or deteriorate.

2.2.4 PREVENTIVE/HEALTH MAINTENANCE/WELLNESS. A preventive/health maintenance appointment is for a wellness exam to promote health maintenance and prevention;

e.g., physical exams, PAP smears, screening procedures, etc. or a return follow-up appointment for a stable chronic condition to include diabetes, pulmonary, rheumatologic, arthritis, hypertension, and cardiovascular disease. Wellness appointments shall be scheduled within four

(4) weeks (28 days).

2.2.5 RELAY HEALTH. is the premier provider of Web-based communication services that connect doctors and their patients efficiently, affordably, and securely.

2.2.6 SPECIALTY CARE. Care provided by a specialist after a referral by a PCM. The maximum waiting time for specialty care is four (4) weeks (28 days).

2.2.7 ROUTINE. A routine appointment is an appointment not meeting the definition of Emergent, Urgent, Acute or Preventive/Health Maintenance appointment; medical care for symptoms such as colds, flu or low back pain, for which intervention is required, but is not urgent.

Routine appointments shall be scheduled within seven (7) days.

2.2.8 TRICARE PRIME. A plan similar to a health maintenance organization (HMO) that provides the lowest out- of-pocket cost in return for the requirement that the patients use only doctors, hospitals, and other HCPs who are part of the TRICARE network, and have all care coordinated by a PCM.

2.2.9 TRICARE EXTRA. A plan that provides for lowest out-of-pocket cost when a patient receives services from TRICARE’s network of HCPs. Health care at BMACH is on a space available basis.

2.2.10 TRICARE STANDARD. Standard CHAMPUS coverage. Health care at BMACH is on a space available basis.

2.2.11 TRICARE ON-LINE: Web-base appointment system for beneficiaries to make their own appointments based on MTF guidelines.

2.2.12 WALK-IN PATIENTS/WALK-INS. An individual who presents himself or herself for evaluation, treatment, or care without having an appointment.

2.2.13 WELL CARE. Medical care to promote health maintenance and prevention, for example, Pap tests. The maximum waiting time for well care is four weeks.

2.3 ABBREVIATIONS.

ACLS Advanced Cardiac Life Support ADM Ambulatory Data Module ADP Automated Data Processing AHA American Hospital Association AHLTA Armed Forces Longitudinal Technology Application ALP Acceptable Level of Performance AMA American Medical Association

ADS Ambulatory Data Systems AOD Administrative Officer of the Day AR Army Regulation AT Anti-Terrorism ATLS Advanced Trauma Life Support BLS Basic Life Support BMACH Benning Martin Army Community Hospital CAC Common Access Card COVID-19 Coronavirus disease 2019 CDR Contract Discrepancy Report; Commander CEU Continuing Education Unit CHCC Center for Health Care Contracting CHCS Composite Health Care System CLIN Contract Line Item Number CIS Clinical Information System CME Continuing Medical Education COR Contracting Officer’s Representative CPR Cardiopulmonary Resuscitation CPT Current Procedure Terminology Codes CRNA Certified Registered Nurse Anesthetist DA Department of the Army DCCS Deputy Commander for Clinical Services DBH Department of Behavioral Health DHA Defense Health Agency DPC Department of Deployment Health DEA Drug Enforcement Administration DEERS Defense Enrollment Eligibility Reporting System DMHRSi Defense Medical Human Resources System internet DOD Department of Defense ECFMG Educational Commission for Foreign Medical Graduates EFT Electronic Funds Transfer EKG Electrocardiogram EMS Emergency Medical Service ER Emergency Room FAR Federal Acquisition Regulation FTE Full-Time Equivalent GFP Government Furnished Property HCP Health Care Provider HEDIS Health Effectiveness Data and Information Set HIPAA Health Insurance Portability & Accountability Act of 1996 IAW In accordance with ID Identification IDES Integrated Disability Evaluation Board IRC Installation Record Check IS Information System(s) IV Intravenous

KO Contracting Officer LOSS Line of Sight Supervision MCoE Maneuver Center of Excellence MEB Medical Evaluation Board MEDCOM Medical Command MEDDAC Medical Department Activity MHS Military Health System MTF Military Treatment Facility NACI National Agency Check with Inquiries NARSUM Narrative Summary NCOIC Noncommissioned Officer in Charge NRP Neonatal Resuscitation Program OIC Officer in Charge OPSEC Operations Security OSHA Occupational Safety and Health Administration OPR Outpatient Record PAD Patient Administration Division PALS Pediatric Advance Life Support PAM Pamphlet PCF Practitioner’s Credentials File PCM Primary Care Manager PCMH Primary Care Medical Home PEBLO Physical Evaluation Board Liaison Officer PI Performance Improvement PL Public Law POC Point of Contact POP Period of Performance PBWS Performance Based Work Statement QA Quality Assurance QA&I Quality Assessment & Improvement QC Quality Control SOP Standard Operating Procedures SOW Statement of Work TJC The Joint Commission (formerly known as JCAHO)

3. Government Furnished Property: As described in Para. 1.

4. Contractor furnished Property: The contractor shall furnish all equipment, personnel, travel and lodging for videotaping of the orientation and training.

5. Specific Tasks:

5.1 New Employee Orientation – The contractor shall assist in designing and implementing an Orientation program for new employees. This would include information pertinent to the roles and responsibilities of their work at the MTF and as a key member of the MHS along with ensuring a video capabilities for sections of employee orientation. The contractor shall videotape up to eighty

(80) hours of orientation and training sessions for dissemination to outlying clinics.

5.1.1 Videotaping shall be accomplished by a professional videographer furnished by the contractor.

5.2 Arbinger Mindset Training – The contractor shall coordinate with Education and Training and Orientation personnel to understand the impact Arbinger (including changing the mindset, transforming cultures, collaborating, resolving conflict, and sustainably improving results) will have on the MTF. The contractor shall develop and present courses of action for implementation of Arbinger marketing strategy, and will assist in marketing and coordinating suitable training for all levels of employees, including development of instructors for long-term sustainment.

5.3 ICTLs for Medical Personnel - The contractor shall assist with developing and deploying a detailed Individual Critical Task List for each level of medical personnel. Typically, a list such as this includes the Knowledge, Skills and Abilities of Officer and Enlisted personnel at each level to successfully perform their job. Information will be obtained from the Army’s approved list of critical skills as well as interviews with individual personnel.

5.4 A3 Process Support - The contractor shall coordinate with the Quality Managers in the medical, ancillary, or administrative departments to provide support for staff to complete and execute A3s for improving specific processes.

5.4.1 The contractor shall coordinate with the Quality Managers in the medical, ancillary, and administrative departments to provide support for their staff to complete and execute A3s for improving specific MEDDAC processes.

5.4.2 The contractor shall meet with the Quality Management staff for each of the departments or divisions that are currently engaged in Performance Improvement (PI) and those that have intentions to do so in the near future. In doing this, all meetings, interviews or other contacts made by the contractor shall be held under strict HIPPA requirements, ensuring confidentiality, security and careful handling of such information obtained.

5.4.3 The contractor shall conduct face-to-face and telephone interviews with the staff to determine their knowledge of the A3 process. If more training is needed, the contractor shall provide it to them in a hands-on basis and will reference recent A3 guidelines and formats available from DHA.

5.4.4 For the A3 projects currently underway, the contactor shall assist the staff in the correct wording requirements for each of the 8 steps. Additionally, the contractor shall train the staff how to utilize data to identify the problem, determine the Current State and forecast the Future State, and determine if the solutions have actually improved the process.

5.4.5 The contractor shall assist the staff with any needed calculations of data as well as the building of tables and charts to clearly display the required data inside the A3 format.

5.4.6 As the staff conducts their PI project, the contractor shall help the staff verbally and in written format articulate what is occurring, why it is occurring and how to present this information concisely and accurately to their Senior Leadership.

5.4.7 To ensure a complete tracking of their PI projects, the contractor shall help the staff utilize currently available DHA systems or adapt electronic portfolios to be readily accessible on the Command’s sharepoint drive.

5.5 Medical Group Practice Skills Development – The contractor shall develop with the directors of the physician medical groups an ongoing program that incorporates two key skill sets: (1) the logistical day-to-day skills required to operate a group medical practice, (2) the evaluation of a medical group’s delivery of services to its patients and the use of data gained to determine opportunities for improvement.

5.5.1 The contractor shall obtain from Army MEDDAC leadership their requirements for creating or expanding an Army Medical Group practice as applicable to a MTF the size and complexity of Martin Army Community Hospital.

5.5.2 From the Army’s information, the contractor shall develop a “Requirement’s Portfolio” that would contain such elements as (a) the type(s) of care to be provided in a Group Practice modality for both inpatient and outpatient; (b) the patient populations to be served to ensure a Medically Ready Force and to meet other patient population’s requirements; (c) the provider medical personnel skill mix needed to serve those populations; and (d) the time frame for implementation.

5.5.3 To ensure a complete understanding of a Medical Group Practice, the contractor shall survey such practices in the private sector to ascertain the parameters of the care they provide. The contractor estimates that a comparison with 3-4 private sector Group Practices will provide sufficient data.

5.5.4 The contractor shall compare the Army’s requirements with those of the private sector and build a user-friendly, cost-effective draft model for review by Senior Leadership at the MEDDAC.

This will enable the leadership to view the pros and cons of each type in light of their specific needs.

5.5.5 From whichever model the MEDDAC leadership chooses as its “to be” model, the contractor shall assist the medical staff in developing a portfolio that includes: (a) logistics for setting up the Group Practice that includes staffing, equipment, space, IT support requirements along the lines needed for day-to-day operations; and (b) a training platform to educate all staff involved in the Group Practice as to how such a model actually works. The training will consist of group discussions, simulations of Group Practice patient care, and the use of guest speakers from well-established practices.

5.5.6 In order to build a successful, sustainable Group Practice, the contractor shall emphasis the critical importance of hiring the right personnel with the right skills and with the correct mindset for functioning inside a Group Practice versus that of an individual medical practice.

5.5.7 If additional training is needed, the contractor shall establish a series of visits to community-based Medical Group Practices to enable larger and more expansive Q & A sessions, discussions with patients as well as Providers, and a critical examination of the patient population mix.

5.5.8 Since the logistics of setting up a Medical Group Practice at the MEDDAC may entail significant costs, the contractor shall assist the staff in developing and presenting to the Senior Leadership a costing and staffing outline. The outline will contain an opportunity for both a full-phase startup of the Practice and a more phased-approached over a longer period of time to match funding that is available.

5.5.9 To ensure the success of the Medical Group Practice, the contractor shall coordinate and guide the participants in collecting and utilizing data to determine if the Practice is meeting its goals. This will include whatever is needed for initial and on-going accreditation, requirements from other regulatory agencies, as well as feedback from the patients and other stakeholders.

The contactor shall guide the staff in building a first-rate Quality Management program that includes building upon opportunities for improvement.

5.6 Strategic Planning utilizing a Medical Management model and Team Building Leadership Skills – Using proven principles and practices from Army Medicine, other military and secular healthcare practices, the contractor shall coordinate the development and implementation of specific strategy planning sessions such as the MTF’s Executive Planning Session (EPS). To enhance the success of strategy planning sessions, the contractor shall assist in developing training programs for specific team building and leadership skills for all levels of employees.

5.6.1 As part of the initial work, the contractor shall meet with Senior Leadership, Chiefs of Service, Department and Division Heads and other stakeholders to determine their experiences with Strategic Planning. Given the wide usage of Strategic Planning and multiple methodologies available throughout military medicine and perhaps at this MEDDAC, the contractor shall utilize interviews to better understand not only their experiences with it (good or bad), but their receptivity to it.

5.6.2 The contractor shall obtain current information on Army Medicine’s HQ incorporation of Medical Management modalities into Strategic Planning, such as the Executive Planning Session (EPS) format. If Medical Management modalities have been successful, the contractor shall obtain available information as to: specific format(s) utilized, scope of involvement, evaluation of the methodology and lessons learned.

5.6.3 The contractor shall also look at the DHA’s long-term use of Executive Planning Sessions and its fit for this MEDDAC. It is important for the contractor to understand DHA’s successes with their EPS format and if it is utilized as a primary mode of Strategic Planning. If so, the contractor shall likely contact other MHS Regions and similar-sized MTFs to ascertain their experiences.

5.6.4 The contractor’s ultimate goal shall be to help the MEDDAC develop and implement a Medical Management model style of planning that is user-friendly, easily teachable and has long-term value.

5.6.5 Since any implementation of Strategic Planning involves the training of the participants, the contractor shall assess through interviews and focus groups the use of Team Building and other Leadership skills throughout all levels of the MEDDAC. The contractor shall guide staff personnel into acquiring Team Building/Leadership skills into two formats: (1) first, as the heart of Strategic Planning in order that the technical skills for creating Command strategies are married with the people skills for building successful teams; (2) second as a stand-alone training for anyone coming into a leadership position, including those newly appointed to lead Performance Improvement (PI) teams. This training would be offered frequently year-round through the Hospital Education and Training Department to ensure the widest possible availability.

5.6.6 The contractor shall draw from Army Medicine and other MHS resources, professional literature and case studies on Team Building/ Leadership and combine them with those available from private sector resources to build a unique strategy that meets the specific current as well as the future needs of the MEDDAC. This would enable the Senior Leadership of the MEDDAC to have a strategy that they would “own” and could easily stylize to fit the differing situations and circumstances immediately as they emerge, and a strategy they can grow with over long term.

5.7 Virtual Health Implementation – Drawing upon recent experiences in the implementation of Virtual Health, the contractor shall assist the MTF in developing a requirements portfolio that documents the necessity for a sustainable Virtual Health program. The portfolio would include a Project Management report that includes required startup costs & personnel needed, project schedule of tasks to be performed, logistical setup of equipment and facility, and patient care considerations.

5.7.1 Drawing upon recent experiences in the MHS implementation of Virtual Health, the contractor shall assist the MTF in developing a requirements portfolio that documents the necessity for a sustainable Virtual Health program.