10 CFR 440.21 - Weatherization materials standards and energy audit procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Weatherization materials standards and energy audit procedures. 440.21 Section 440.21 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION WEATHERIZATION ASSISTANCE FOR LOW-INCOME PERSONS § 440.21 Weatherization materials standards and energy audit procedures. (a...

10 CFR 440.21 - Weatherization materials standards and energy audit procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Weatherization materials standards and energy audit procedures. 440.21 Section 440.21 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION WEATHERIZATION ASSISTANCE FOR LOW-INCOME PERSONS § 440.21 Weatherization materials standards and energy audit procedures. (a...

10 CFR 440.21 - Weatherization materials standards and energy audit procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Weatherization materials standards and energy audit procedures. 440.21 Section 440.21 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION WEATHERIZATION ASSISTANCE FOR LOW-INCOME PERSONS § 440.21 Weatherization materials standards and energy audit procedures. (a...

75 FR 42088 - Policy Statement Establishing a Pilot Program for Requesting Consideration of Legal Questions by...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-20

... program for a procedure to provide a means for persons and entities to have a legal question considered by... means for persons and entities to have a legal question considered by the Commission earlier in both the... includes the Report Analysis Division and the Audit Division) requests that a person or entity take...

14 CFR 331.17 - How will the Department verify and audit claims under this part?

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF TRANSPORTATION (AVIATION PROCEEDINGS) PROCEDURAL REGULATIONS PROCEDURES FOR REIMBURSEMENT OF... Department of Justice. If an audit is necessary, a ceiling amount reached, and the audit does not support the...

Defense Commissary Resale Stock Fund Financial Statements For FY 1992

DTIC Science & Technology

1993-06-30

present DeCA’s accounting procedures during FY 1992. We understand DeCA is aggressively working to improve its financial management system. However...the year ended September 30, 1992, we considered the related internal control structure. The purpose of the planning work was to determine the...auditing procedures we would apply for the purposes of expressing our opinion on the Financial Statements. Planning work included obtaining an

Antibiotic prophylaxis audit and questionnaire study: Traffic Light Poster improves adherence to protocol in gastrointestinal surgery.

PubMed

Cameron, Michaella; Jones, Stacey; Adedeji, Olufunso

2015-07-01

To measure adherence to antibiotic prophylaxis (AP) protocol amongst surgeons and anesthetists and explore their understanding of AP prescribing in practice. A prospective audit of AP in gastrointestinal surgery and re-audit after intervention. A questionnaire survey of practice. 58 (38%- clean; 62%- clean contaminated) operations were audited and 73 (48%-clean; 51%-clean contaminated) operations were re-audited after intervention with "Traffic Light Poster" (TFP) .55 colleagues (32 consultants and 23 trainees) were recruited for questionnaire survey in three West Midlands hospitals. Audit and Re-Audits. Only 31% of procedures followed the protocol correctly in the initial audit and this increased to 73% in the re-audit. 73% of patients undergoing clean procedures received AP inappropriately in the initial audit but reduced significantly to 20% (p < 0.002) in the re-audit. In the initial audit, 62% of clean contaminated procedures did not receive the appropriate first line AP but this fell to 35% (p < 0.05) in the re-audit. Questionnaire Survey- Only 30% of respondents would not give AP in clean surgery as recommended. 45% would use appropriate AP for clean-contaminated wounds. 73% of respondents will give AP at induction, 20% 1 h pre op and 7% just before incision. There is poor compliance with AP protocols in gastrointestinal surgery in part due to general lack of awareness. An educational intervention in the form of a 'Traffic Light Poster' improved adherence to AP protocol two fold. There was improved rationalizing of AP. Clean procedures, in particular, had less inappropriate prescribing. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

40 CFR 63.8 - Monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... in the relevant standard; or (B) The CMS fails a performance test audit (e.g., cylinder gas audit), relative accuracy audit, relative accuracy test audit, or linearity test audit; or (C) The COMS CD exceeds...) Data recording, calculations, and reporting; (v) Accuracy audit procedures, including sampling and...

47 CFR 1.1121 - Billing procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Schedule of Statutory Charges and... Telecommunications Settlements (§ 1.1103 of this subpart), Accounting and Audits Field Audits and Review of Arrest Audits (§ 1.1106 of this subpart) should not be paid with the filing or submission of the request. The...

Recommended Procedures for the Internal Financial Auditing of University Libraries.

ERIC Educational Resources Information Center

Kurth, William H.; Zubatsky, David S.

This study develops a generalized procedure for the internal financial auditing of university libraries. It identifies critical internal control points in library operations, and develops questions to measure and evaluate fiscal operations effectiveness. Auditing data and advice were gathered from a survey of 87 members of the Association of…

23 CFR 172.7 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Audits. 172.7 Section 172.7 Highways FEDERAL HIGHWAY... SERVICE CONTRACTS § 172.7 Audits. (a) Performance of audits. When State procedures call for audits of contracts or subcontracts for engineering design services, the audit shall be performed to test compliance...

Remote Video Auditing in the Surgical Setting.

PubMed

Pedersen, Anne; Getty Ritter, Elizabeth; Beaton, Megan; Gibbons, David

2017-02-01

Remote video auditing, a method first adopted by the food preparation industry, was later introduced to the health care industry as a novel approach to improving hand hygiene practices. This strategy yielded tremendous and sustained improvement, causing leaders to consider the potential effects of such technology on the complex surgical environment. This article outlines the implementation of remote video auditing and the first year of activity, outcomes, and measurable successes in a busy surgery department in the eastern United States. A team of anesthesia care providers, surgeons, and OR personnel used low-resolution cameras, large-screen displays, and cell phone alerts to make significant progress in three domains: application of the Universal Protocol for preventing wrong site, wrong procedure, wrong person surgery; efficiency metrics; and cleaning compliance. The use of cameras with real-time auditing and results-sharing created an environment of continuous learning, compliance, and synergy, which has resulted in a safer, cleaner, and more efficient OR. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Auditing the Records of Student-Athletes.

ERIC Educational Resources Information Center

Riggs, Robert O.; Hedden, Carole R.

1985-01-01

A 1985 survey showed that NCAA members favored mandating annual audits of athletics budgets by institutional or independent auditors. Development of Tennessee's internal audit system is described, and its internal audit procedures is outlined. (MLW)

76 FR 34986 - Agency Procedure for Disclosure of Documents and Information in the Enforcement Process

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-15

... referrals to the Office of General Counsel from the Commission's Reports Analysis Division or Audit Division... hearing before the Commission prior to the Commission's adoption of a Final Audit Report,\\11\\ and (3) a.../2009/notice_2009-11.pdf . \\11\\ See Procedural Rules for Audit Hearings, 74 FR 33140 (July 10, 2009...

Principles of blood transfusion service audit.

PubMed

Dosunmu, A O; Dada, M O

2005-12-01

Blood transfusion is still an important procedure in modern medical practice despite efforts to avoid it. This is due to it's association with infections especially HIV. It is therefore necessary to have proper quality control of its production, storage and usage [1]. A way of controlling usage is to do regular clinical audit. To effect this, there has to be an agreed standard for appropriate use of blood. The aim of this paper is to briefly highlight the importance of audit, audit procedures and tools i.e. required records, development of audit criteria and audit parameters. Every hospital/blood transfusion center is expected to develop a system of audit that is appropriate to its needs. The suggestions are mainly based on the experience at the Lagos University Teaching Hospital and the Lagos State Blood Transfusion Service.

20 CFR 645.250 - What procedures apply to the resolution of findings arising from audits, investigations...

Code of Federal Regulations, 2011 CFR

2011-04-01

...) of subrecipients. (2) A State or competitive grantee, as appropriate, must use the audit resolution... competitive grantee, as appropriate, does not have such procedures, it must prescribe standards and procedures... Administrative Law Judges under the procedures at § 645.800. (c) Resolution of nondiscrimination findings...

20 CFR 645.250 - What procedures apply to the resolution of findings arising from audits, investigations...

Code of Federal Regulations, 2010 CFR

2010-04-01

...) of subrecipients. (2) A State or competitive grantee, as appropriate, must use the audit resolution... competitive grantee, as appropriate, does not have such procedures, it must prescribe standards and procedures... Administrative Law Judges under the procedures at § 645.800. (c) Resolution of nondiscrimination findings...

20 CFR 601.9 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 601.9 Section 601.9 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADMINISTRATIVE PROCEDURE Grants, Advances and Audits § 601.9 Audits. The Department of Labor's audit regulations at 29 CFR Part 96 and 29...

The Educational Programs Audit Dress Rehearsal; Paradigm One: Practice Makes Perfect or How a New Approach to the Audit Helps Programs Succeed.

ERIC Educational Resources Information Center

Pfeffer, Eileen; Kester, Donald L.

Described is a procedure (Audit Dress Rehearsal) used in a special education program audit consultation service which included a practice audit designed to lower anxiety and raise awareness of concern for program success. The introduction includes sections dealing with evaluation and audit personnel, planning and implementing an audit, and stages…

31 CFR 50.60 - Audit authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Audit authority. 50.60 Section 50.60... Audit and Investigative Procedures § 50.60 Audit authority. The Secretary of the Treasury, or an... pursuant to subpart H of this part, for the purpose of investigation, confirmation, audit and examination...

7 CFR 210.22 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 210.22 Section 210.22 Agriculture Regulations... Responsibilities § 210.22 Audits. (a) General. Unless otherwise exempt, audits at the State and school food... mentioned in this paragraph, please refer to 5 CFR 1310.3. (b) Audit procedure. These requirements call for...

20 CFR 632.33 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 632.33 Section 632.33 Employees... AND TRAINING PROGRAMS Administrative Standards and Procedures § 632.33 Audits. (a) General. The audit provisions of 41 CFR part 29-70 shall apply to Native American grantees. Until unified or single audit...

[Pharmaceutical revision of hospital drug administration].

PubMed

Smith-Meyer, Ellen; Bjørneklett, Arvid; Swärd, Elisabeth; Refsum, Nina

2002-01-20

Quality audits of the implementation of drug administration procedures are carried out in order to determine objectively to what extent implementation conforms to procedures. Since September 1997, the pharmacy at Rikshospitalet University Hospital in Norway has performed quality audits of drug administration at the hospital, using interviews and surveys. Staff members in the audited unit and the auditing pharmacist agree on prospects for quality improvements and review possible action. A survey was carried out in the autumn of 2000 in order to determine staff opinion of the quality audits. On the basis of the observations made, improvements have been carried out at all levels of the organisation. The survey indicates that hospital staff members are satisfied with the quality audits performed by the pharmacy.

[Thoughts on the Witnessed Audit in Medical Device Single Audit Program].

PubMed

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-02-08

Medical Device Single Audit Program is one of the key projects in International Medical Device Regulators Forum, which has much experience to be used for reference. This paper briefly describes the procedures and contents of the Witnessed Audit in Medical Device Single Audit Program. Some revelations about the work of Witnessed Audit have been discussed, for reference by the Regulatory Authorities and the Auditing Organizations.

[Introduction of Quality Management System Audit in Medical Device Single Audit Program].

PubMed

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-01-30

The audit of the quality management system in the medical device single audit program covers the requirements of several national regulatory authorities, which has a very important reference value. This paper briefly described the procedures and contents of this audit. Some enlightenment on supervision and inspection are discussed in China, for reference by the regulatory authorities and auditing organizations.

The management of acute myocardial infarction: guidelines and audit standards. Report of a workshop of the Joint Audit Committee of the British Cardiac Society and the Royal College of Physicians.

PubMed

De Bono, D P; Hopkins, A

1994-01-01

Successful management of acute myocardial infarction depends in the first instance on the patient recognising the symptoms and seeking help as quickly as possible. Once in hospital, fast track admission procedures and protocols for pain relief, early thrombolysis and appropriate ancillary measures (eg aspirin, i.v. betablockers) should be promptly instituted. Specialist advice and, if necessary, transfer to specialist unit should be considered if additional complications arise. Follow-up management after discharge from hospital requires cooperation between primary and secondary care to prolong survival by reducing risk factors, using aspirin, betablockers and angiotensin converting enzyme inhibitors and instituting a suitable rehabilitation programme. Audit measures are included in the report to help general practitioners and hospital doctors review their practice and assess it against the standards set.

49 CFR 385.313 - Who will conduct the safety audit?

Code of Federal Regulations, 2010 CFR

2010-10-01

... FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.313 Who will conduct the safety audit? An individual certified under the FMCSA regulations to perform safety audits will conduct the safety audit. ... 49 Transportation 5 2010-10-01 2010-10-01 false Who will conduct the safety audit? 385.313 Section...

20 CFR 667.500 - What procedures apply to the resolution of findings arising from audits, investigations...

Code of Federal Regulations, 2010 CFR

2010-04-01

..., monitoring and oversight reviews? (a) Resolution of subrecipient-level findings. (1) The Governor is... recipient level OMB Circular A-133 audits. (2) The Secretary uses the DOL audit resolution process... (including OMB Circular A-133 audits) of subrecipients. (2) A State must utilize the audit resolution, debt...

40 CFR Appendix A to Part 58 - Quality Assurance Requirements for SLAMS, SPMs and PSD Air Monitoring

Code of Federal Regulations, 2011 CFR

2011-07-01

... in section 4.3.1 of this appendix. 3.2.7PM2.5 Performance Evaluation Program (PEP) Procedures. The... evaluation audit means that both the primary monitor and PEP audit concentrations are valid and above 3 µg/m3... Evaluation Program (PEP) Procedures. Each year, one performance evaluation audit, as described in section 3.2...

40 CFR Appendix A to Part 58 - Quality Assurance Requirements for SLAMS, SPMs and PSD Air Monitoring

Code of Federal Regulations, 2012 CFR

2012-07-01

... in section 4.3.1 of this appendix. 3.2.7PM2.5 Performance Evaluation Program (PEP) Procedures. The... evaluation audit means that both the primary monitor and PEP audit concentrations are valid and above 3 µg/m3... Evaluation Program (PEP) Procedures. Each year, one performance evaluation audit, as described in section 3.2...

48 CFR 242.7502 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 242.7502 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Accounting Systems and Related Controls 242.7502 Procedures. (a) Upon receipt of an audit report identifying...

15 CFR 995.14 - Auditing.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED or...

15 CFR 995.14 - Auditing.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED or...

15 CFR 995.14 - Auditing.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED or...

15 CFR 995.14 - Auditing.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REQUIREMENTS FOR NOAA HYDROGRAPHIC PRODUCTS AND SERVICES CERTIFICATION REQUIREMENTS FOR DISTRIBUTORS OF NOAA HYDROGRAPHIC PRODUCTS Certification and Procedures § 995.14 Auditing. NOAA reserves the right to audit CED or...

Impact of attributed audit on procedural performance in cardiac electrophysiology catheter laboratory.

PubMed

Sawhney, V; Volkova, E; Shaukat, M; Khan, F; Segal, O; Ahsan, S; Chow, A; Ezzat, V; Finlay, M; Lambiase, P; Lowe, M; Dhinoja, M; Sporton, S; Earley, M J; Hunter, R J; Schilling, R J

2018-06-01

Audit has played a key role in monitoring and improving clinical practice. However, audit often fails to drive change as summative institutional data alone may be insufficient to do so. We hypothesised that the practice of attributed audit, wherein each individual's procedural performance is presented will have a greater impact on clinical practice. This hypothesis was tested in an observational study evaluating improvement in fluoroscopy times for AF ablation. Retrospective analyses of fluoroscopy times in AF ablations at the Barts Heart Centre (BHC) from 2012-2017. Fluoroscopy times were compared pre- and post- the introduction of attributed audit in 2012 at St Bartholomew's Hospital (SBH). In order to test the hypothesis, this concept was introduced to a second group of experienced operators from the Heart Hospital (HH) as part of a merger of the two institutions in 2015 and change in fluoroscopy times recorded. A significant drop in fluoroscopy times (33.3 ± 9.14 to 8.95 ± 2.50, p < 0.0001) from 2012-2014 was noted after the introduction of attributed audit. At the time of merger, a significant difference in fluoroscopy times between operators from the two centres was seen in 2015. Each operator's procedural performance was shared openly at the audit meeting. Subsequent audits showed a steady decrease in fluoroscopy times for each operator with the fluoroscopy time (min, mean±SD) decreasing from 13.29 ± 7.3 in 2015 to 8.84 ± 4.8 (p < 0.0001) in 2017 across the entire group. Systematic improvement in fluoroscopy times for AF ablation procedures was noted byevaluating individual operators' performance. Attributing data to physicians in attributed audit can promptsignificant improvement and hence should be adopted in clinical practice.

An audit cycle of consent form completion: A useful tool to improve junior doctor training.

PubMed

Leng, Catherine; Sharma, Kavita

2016-01-01

Consent for surgical procedures is an essential part of the patient's pathway. Junior doctors are often expected to do this, especially in the emergency setting. As a result, the aim of our audit was to assess our practice in consenting and institute changes within our department to maintain best medical practice. An audit of consent form completion was conducted in March 2013. Standards were taken from Good Surgical Practice (2008) and General Medical Council guidelines. Inclusion of consent teaching at a formal consultant delivered orientation programme was then instituted. A re-audit was completed to reassess compliance. Thirty-seven consent forms were analysed. The re-audit demonstrated an improvement in documentation of benefits (91-100%) and additional procedures (0-7.5%). Additional areas for improvement such as offering a copy of the consent form to the patient and confirmation of consent if a delay occurred between consenting and the procedure were identified. The re-audit demonstrated an improvement in the consent process. It also identified new areas of emphasis that were addressed in formal teaching sessions. The audit cycle can be a useful tool in monitoring, assessing and improving clinical practice to ensure the provision of best patient care.

Reducing healthcare costs facilitated by surgical auditing: a systematic review.

PubMed

Govaert, Johannes Arthuur; van Bommel, Anne Charlotte Madeline; van Dijk, Wouter Antonie; van Leersum, Nicoline Johanneke; Tollenaar, Robertus Alexandre Eduard Mattheus; Wouters, Michael Wilhemus Jacobus Maria

2015-07-01

Surgical auditing has been developed in order to benchmark and to facilitate quality improvement. The aim of this review is to determine if auditing combined with systematic feedback of information on process and outcomes of care results in lower costs of surgical care. A systematic search of published literature before 21-08-2013 was conducted in Pubmed, Embase, Web of Science, and Cochrane Library. Articles were selected if they met the inclusion criteria of describing a surgical audit with cost-evaluation. The systematic search resulted in 3608 papers. Six studies were identified as relevant, all showing a positive effect of surgical auditing on quality of healthcare and therefore cost savings was reported. Cost reductions ranging from $16 to $356 per patient were seen in audits evaluating general or vascular procedures. The highest potential cost reduction was described in a colorectal surgical audit (up to $1,986 per patient). All six identified articles in this review describe a reduction in complications and thereby a reduction in costs due to surgical auditing. Surgical auditing may be of greater value when high-risk procedures are evaluated, since prevention of adverse events in these procedures might be of greater clinical and therefore of greater financial impact. This systematic review shows that surgical auditing can function as a quality instrument and therefore as a tool to reduce costs. Since evidence is scarce so far, further studies should be performed to investigate if surgical auditing has positive effects to turn the rising healthcare costs around. In the future, incorporating (actual) cost analyses and patient-related outcome measures would increase the audits' value and provide a complete overview of the value of healthcare.

Evaluating Internal Communication: The ICA Communication Audit.

ERIC Educational Resources Information Center

Goldhaber, Gerald M.

1978-01-01

The ICA Communication Audit is described in detail as an effective measurement procedure that can help an academic institution to evaluate its internal communication system. Tools, computer programs, analysis, and feedback procedures are described and illustrated. (JMF)

Improvement to visualization of nodes in breast cancer patients following audit: are we seeing the problem?

PubMed

Paterson, Carolyn L; Hendry, Fraser R; Bolster, Alison A

2018-06-01

Successful localization of nodes in breast cancer patients depends upon the effectiveness of the lymphoscintigraphy technique employed. A benefit of performing imaging as part of this procedure is that it allows sites to audit their technique. An audit of breast cancer patients at the Glasgow Royal Infirmary (GRI) hospital showed nodes to be visualized in only 81% of patients. Current guidelines state that nodes should be seen in more than 95% of patients. A period of investigation and review led to changes being made to the injection and imaging technique employed at the GRI site. Following these changes a re-audit was performed that showed that the node visualization rate has successfully been increased to 97%, thereby meeting the standards set in the guidelines. This technical note details the results of the initial audit and re-audit, and explains the investigation and changes made to clinical procedures at the GRI site to improve the node visualization rate. The challenges that can occur when performing breast sentinel node procedures are also discussed.

7 CFR 1773.9 - Disclosure of fraud, illegal acts, and other noncompliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., the auditor must design the audit to provide reasonable assurance of detecting fraud that is material... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit... statements, auditors should apply audit procedures specifically directed to ascertaining whether an illegal...

76 FR 71287 - Public Housing Energy Audits

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

...-AC84 Public Housing Energy Audits AGENCY: Office of the Assistant Secretary for Public and Indian Housing, HUD. ACTION: Proposed rule. SUMMARY: This rule proposes to revise HUD's energy audit requirements... identifying energy-efficient measures that need to be addressed in the audit and procedures for improved...

Notification: Audit New Mexico Environment Department's timekeeping practices and procedures for EPA grants

EPA Pesticide Factsheets

May 4, 2012. The U.S. Environmental Protection Agency (EPA), Office of the Inspector General, is initiating an audit of New Mexico Environment Department’s (NMED’s) timekeeping practices and procedures for EPA grants.

7 CFR 1773.7 - Audit standards.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... (b) The audit must include such tests of the accounting records and such other auditing procedures... imposed by the borrower, the CPA should use professional judgment to determine what levels of the borrower...

7 CFR 1773.7 - Audit standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... (b) The audit must include such tests of the accounting records and such other auditing procedures... imposed by the borrower, the CPA should use professional judgment to determine what levels of the borrower...

7 CFR 1773.7 - Audit standards.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... (b) The audit must include such tests of the accounting records and such other auditing procedures... imposed by the borrower, the CPA should use professional judgment to determine what levels of the borrower...

7 CFR 1773.7 - Audit standards.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... (b) The audit must include such tests of the accounting records and such other auditing procedures... imposed by the borrower, the CPA should use professional judgment to determine what levels of the borrower...

7 CFR 1773.7 - Audit standards.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... (b) The audit must include such tests of the accounting records and such other auditing procedures... imposed by the borrower, the CPA should use professional judgment to determine what levels of the borrower...

External Quality Control Review of the Defense Information Systems Agency Audit Organization

DTIC Science & Technology

2012-08-07

We are providing this report for your information and use. We have reviewed the system of quality control for the audit organization of the Defense...audit organization encompasses the audit organization’s leadership, emphasis on performing high quality work, and policies and procedures established

41 CFR 102-118.435 - What procedures does GSA use to perform a postpayment audit?

Code of Federal Regulations, 2010 CFR

2010-07-01

... use to perform a postpayment audit? 102-118.435 Section 102-118.435 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Postpayment Transportation Audits § 102-118.435 What...

20 CFR 637.310 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 637.310 Section 637.310 Employees... TRAINING PARTNERSHIP ACT Additional Title V Administrative Standards and Procedures § 637.310 Audits. The Governor shall ensure that the State complies with the audit provisions at § 629.480 of this chapter. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Accounting and audit. 151.127 Section 151...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151.127 Accounting and audit. The requirements of § 151.55 relating to accounting and audit of project...

41 CFR 102-118.275 - What must my agency consider when designing and implementing a prepayment audit program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... consider when designing and implementing a prepayment audit program? 102-118.275 Section 102-118.275 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation...

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 1773.45 be performed annually by the CPA during the audit of the RUS borrowers' financial statements, which audit procedures may be in addition to the conduct of a GAGAS audit. (b) The CPA must exercise...

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 1773.45 be performed annually by the CPA during the audit of the RUS borrowers' financial statements, which audit procedures may be in addition to the conduct of a GAGAS audit. (b) The CPA must exercise...

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 1773.45 be performed annually by the CPA during the audit of the RUS borrowers' financial statements, which audit procedures may be in addition to the conduct of a GAGAS audit. (b) The CPA must exercise...

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1773.45 be performed annually by the CPA during the audit of the RUS borrowers' financial statements, which audit procedures may be in addition to the conduct of a GAGAS audit. (b) The CPA must exercise...

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 1773.45 be performed annually by the CPA during the audit of the RUS borrowers' financial statements, which audit procedures may be in addition to the conduct of a GAGAS audit. (b) The CPA must exercise...

Audit Oversight: Quality Control System at U.S. Special Operations Command Inspector General Audit Division

DTIC Science & Technology

2002-08-21

The Audit Division provides the Commander, U.S. Special Operations Command (USSOCOM) with professional auditing services to safeguard, account for...and ensure the proper use of special operations forces assets in accomplishing the USSOCOM mission. The Audit Division reports to the USSOCOM Inspector...U.S. Army Special Operations Command, Naval Special Warfare Command, and the Joint Special Operations Command. Appendix A contains a summary of the Audit Division policy and procedures.

49 CFR 385.315 - Where will the safety audit be conducted?

Code of Federal Regulations, 2010 CFR

2010-10-01

... SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.315 Where will the safety audit be conducted? The safety audit will generally be conducted at the new entrant's business premises. ... 49 Transportation 5 2010-10-01 2010-10-01 false Where will the safety audit be conducted? 385.315...

49 CFR 385.319 - What happens after completion of the safety audit?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false What happens after completion of the safety audit... REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.319 What happens after completion of the safety audit? (a) Upon completion of the safety audit, the auditor will review the findings...

Current standards for infection control: audit assures compliance.

PubMed

Flanagan, Pauline

Having robust policies and procedures in place for infection control is fundamentally important. However, each organization has to go a step beyond this; evidence has to be provided that these policies and procedures are followed. As of 1 April 2009, with the introduction of the Care Quality Commission and The Health and Social Care Act 2008 Code of Practice for the NHS on the Prevention and Control of Healthcare-Associated Infections and Related Guidance, the assurance of robust infection control measures within any UK provider of health care became an even higher priority. Also, the commissioning of any service by the NHS must provide evidence that the provider has in place robust procedures for infection control. This article demonstrates how the clinical audit team at the Douglas Macmillan Hospice in North Staffordshire, UK, have used audit to assure high rates of compliance with the current national standards for infection control. Prior to the audit, hospice staff had assumed that the rates of compliance for infection control approached 100%. This article shows that a good quality audit tool can be used to identify areas of shortfall in infection control and the effectiveness of putting in place an action plan followed by re-audit.

21 CFR 203.34 - Policies and procedures; administrative systems.

Code of Federal Regulations, 2010 CFR

2010-04-01

... distribution security and audit system, including conducting random and for-cause audits of sales... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Policies and procedures; administrative systems...; administrative systems. Each manufacturer or authorized distributor of record that distributes drug samples shall...

46 CFR 205.2 - Policy.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false Policy. 205.2 Section 205.2 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION POLICY, PRACTICE AND PROCEDURE AUDIT APPEALS; POLICY AND PROCEDURE § 205.2 Policy. If you disagree with audit findings and fail to settle any differences with the...

46 CFR 205.2 - Policy.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false Policy. 205.2 Section 205.2 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION POLICY, PRACTICE AND PROCEDURE AUDIT APPEALS; POLICY AND PROCEDURE § 205.2 Policy. If you disagree with audit findings and fail to settle any differences with the...

49 CFR 385.311 - What will the safety audit consist of?

Code of Federal Regulations, 2010 CFR

2010-10-01

... SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.311 What will the safety audit consist of? The safety audit will consist of a review of the new entrant's safety management systems and a... 49 Transportation 5 2010-10-01 2010-10-01 false What will the safety audit consist of? 385.311...

49 CFR 385.309 - What is the purpose of the safety audit?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false What is the purpose of the safety audit? 385.309... SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.309 What is the purpose of the safety audit? The purpose of a safety audit is to: (a) Provide educational and technical assistance to...

Compliance with the guide for commissioning oral surgery: an audit and discussion.

PubMed

Modgill, O; Shah, A

2017-10-13

Introduction The Guide for commissioning oral surgery and oral medicine published by NHS England (2015) prescribes the level of complexity of oral surgery and oral medicine investigations and procedures to be carried out within NHS services. These are categorised as Level 1, Level 2, Level 3A and Level 3B. An audit was designed to ascertain the level of oral surgery procedures performed by clinicians of varying experience and qualification working in a large oral surgery department within a major teaching hospital.Materials and methods Two audit cycles were conducted on retrospective case notes and radiographic review of 100 patient records undergoing dental extractions within the Department of Oral Surgery at King's College Dental Hospital. The set gold standard was: '100% of Level 1 procedures should be performed by dental undergraduates or discharged back to the referring general dental practitioner'. Data were collected and analysed on a Microsoft Excel spreadsheet. The results of the first audit cycle were presented to all clinicians within the department in a formal meeting, recommendations were made and an action plan implemented prior to undertaking a second cycle.Results The first cycle revealed that 25% of Level 1 procedures met the set gold standard, with Level 2 practitioners performing the majority of Level 1 and Level 2 procedures. The second cycle showed a marked improvement, with 66% of Level 1 procedures meeting the set gold standard.Conclusion Our audit demonstrates that whilst we were able to achieve an improvement with the set gold standard, several barriers still remain to ensure that patients are treated by the appropriate level of clinician in a secondary care setting. We have used this audit as a foundation upon which to discuss the challenges faced in implementation of the commissioning framework within both primary and secondary dental care and strategies to overcome these challenges, which are likely to be encountered in any NHS care setting in which oral surgery procedures are performed.

48 CFR 1631.205-82 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HEALTH BENEFITS ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES Contracts With Commercial Organizations 1631.205-82 Audits. Carriers should ensure that the public accounting firms with which they contract for audits of FEHB accounts are registered with the Public Company...

41 CFR 102-118.335 - What does the GSA Audit Division consider when verifying an agency prepayment audit program?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What does the GSA Audit Division consider when verifying an agency prepayment audit program? 102-118.335 Section 102-118.335 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118...

Time to audit.

PubMed

Smyth, L G; Martin, Z; Hall, B; Collins, D; Mealy, K

2012-09-01

Public and political pressures are increasing on doctors and in particular surgeons to demonstrate competence assurance. While surgical audit is an integral part of surgical practice, its implementation and delivery at a national level in Ireland is poorly developed. Limits to successful audit systems relate to lack of funding and administrative support. In Wexford General Hospital, we have a comprehensive audit system which is based on the Lothian Surgical Audit system. We wished to analyse the amount of time required by the Consultant, NCHDs and clerical staff on one surgical team to run a successful audit system. Data were collected over a calendar month. This included time spent coding and typing endoscopy procedures, coding and typing operative procedures, and typing and signing discharge letters. The total amount of time spent to run the audit system for one Consultant surgeon for one calendar month was 5,168 min or 86.1 h. Greater than 50% of this time related to work performed by administrative staff. Only the intern and administrative staff spent more than 5% of their working week attending to work related to the audit. An integrated comprehensive audit system requires a very little time input by Consultant surgeons. Greater than 90% of the workload in running the audit was performed by the junior house doctors and administrative staff. The main financial implications for national audit implementation would relate to software and administrative staff recruitment. Implementation of the European Working Time Directive in Ireland may limit the time available for NCHD's to participate in clinical audit.

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Policy. 140.803 Section 140.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.803 Policy. Project related audits performed in accordance with generally accepted auditing...

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Policy. 140.803 Section 140.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.803 Policy. Project related audits performed in accordance with generally accepted auditing...

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Policy. 140.803 Section 140.803 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.803 Policy. Project related audits performed in accordance with generally accepted auditing...

30 CFR 250.1920 - What are the auditing requirements for my SEMS program?

Code of Federal Regulations, 2013 CFR

2013-07-01

... subpart and API RP 75, Section 12 (incorporated by reference as specified in § 250.198). The audit process...) Your audit plan and procedures must meet or exceed all of the recommendations included in API RP 75...

30 CFR 250.1920 - What are the auditing requirements for my SEMS program?

Code of Federal Regulations, 2014 CFR

2014-07-01

... subpart and API RP 75, Section 12 (incorporated by reference as specified in § 250.198). The audit process...) Your audit plan and procedures must meet or exceed all of the recommendations included in API RP 75...

Academic Advising Audit: An Institutional Evaluation and Analysis of the Organization and Delivery of Advising Services.

ERIC Educational Resources Information Center

Crockett, David S.

Designed to assist institutions in evaluating the current status of their academic advising program, this manual provides guidelines and materials used to conduct a four-step audit. Following a brief introduction, an overview of the audit procedure is presented. The next four sections, corresponding to the steps in the audit, are presented: (1)…

49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 5 2012-10-01 2012-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

49 CFR 385.317 - Will a safety audit result in a safety fitness determination by the FMCSA?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false Will a safety audit result in a safety fitness... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.317 Will a safety audit result in a safety fitness determination by the FMCSA? A safety audit will not result in a safety...

20 CFR 637.310 - Audits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Audits. 637.310 Section 637.310 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR PROGRAMS UNDER TITLE V OF THE JOB TRAINING PARTNERSHIP ACT Additional Title V Administrative Standards and Procedures § 637.310 Audits. The...

7 CFR 277.17 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) Purpose of audit. Audits will include, at a minimum, an examination of the systems of internal control...) Include comments on weaknesses in and noncompliance with the systems of internal control, separately... expenditure of Federal funds; (4) Internal procedures have been established to meet the objectives of...

42 CFR 137.22 - May the Secretary consider uncorrected significant and material audit exceptions identified...

Code of Federal Regulations, 2010 CFR

2010-10-01

... and material audit exceptions identified regarding centralized financial and administrative functions... Tribes for Participation in Self-Governance Planning Phase § 137.22 May the Secretary consider uncorrected significant and material audit exceptions identified regarding centralized financial and...

Your Audit and Financial Controls.

ERIC Educational Resources Information Center

Hatch, Mary B.; And Others

Audits should be performed on school accounting systems because they are required by law and they provide independent reviews of school financial procedures and suggestions for improvement. A licensed certified public accountant, public accountant, or an accountant who has met the Continuation of Education requirement should perform the audit.…

10 CFR 436.37 - Annual energy audits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 3 2012-01-01 2012-01-01 false Annual energy audits. 436.37 Section 436.37 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methods and Procedures for Energy Savings Performance Contracting § 436.37 Annual energy audits. (a) After contractor...

10 CFR 436.37 - Annual energy audits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 3 2014-01-01 2014-01-01 false Annual energy audits. 436.37 Section 436.37 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methods and Procedures for Energy Savings Performance Contracting § 436.37 Annual energy audits. (a) After contractor...

10 CFR 436.37 - Annual energy audits.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Annual energy audits. 436.37 Section 436.37 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methods and Procedures for Energy Savings Performance Contracting § 436.37 Annual energy audits. (a) After contractor...

10 CFR 436.37 - Annual energy audits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Annual energy audits. 436.37 Section 436.37 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methods and Procedures for Energy Savings Performance Contracting § 436.37 Annual energy audits. (a) After contractor...

10 CFR 436.37 - Annual energy audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Annual energy audits. 436.37 Section 436.37 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION FEDERAL ENERGY MANAGEMENT AND PLANNING PROGRAMS Methods and Procedures for Energy Savings Performance Contracting § 436.37 Annual energy audits. (a) After contractor...

49 CFR 1511.9 - Accounting and auditing requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 9 2010-10-01 2010-10-01 false Accounting and auditing requirements. 1511.9... SECURITY INFRASTRUCTURE FEE § 1511.9 Accounting and auditing requirements. (a) Each air carrier and foreign... fairness and reasonableness of the air carrier's and foreign air carrier's procedures used for accounting...

J&K Fitness Supply Company: Auditing Inventory

ERIC Educational Resources Information Center

Clikeman, Paul M.

2012-01-01

This case provides auditing students with an opportunity to perform substantive tests of inventory using realistic-looking source documents. The learning objectives are to help students understand: (1) the procedures auditors perform in order to test inventory; (2) the source documents used in auditing inventory; and (3) the types of misstatements…

The role of field auditing in environmental quality assurance management.

PubMed

Claycomb, D R

2000-01-01

Environmental data quality improvement continues to focus on analytical laboratoryperformance with little, if any, attention given to improving the performance of field consultants responsible for sample collection. Many environmental professionals often assume that the primary opportunity for data error lies within the activities conducted by the laboratory. Experience in the evaluation of environmental data and project-wide quality assurance programs indicates that an often-ignored factor affecting environmental data quality is the manner in which a sample is acquired and handled in the field. If a sample is not properly collected, preserved, stored, and transported in the field, even the best laboratory practices and analytical methods cannot deliver accurate and reliable data (i.e., bad data in equals bad data out). Poor quality environmental data may result in inappropriate decisions regarding site characterization and remedial action. Field auditing is becoming an often-employed technique for examining the performance of the environmental sampling field team and how their performance may affect data quality. The field audits typically focus on: (1) verifying that field consultants adhere to project control documents (e.g., Work Plans and Standard Operating Procedures [SOPs]) during field operations; (2) providing third-party independent assurance that field procedures, quality assurance/ quality control (QA/QC)protocol, and field documentation are sufficient to produce data of satisfactory quality; (3) providing a defense in the event that field procedures are called into question; and (4) identifying ways to reduce sampling costs. Field audits are typically most effective when performed on a surprise basis; that is, the sampling contractor may be aware that a field audit will be conducted during some phase of sampling activities but is not informed of the specific day(s) that the audit will be conducted. The audit also should be conducted early on in the sampling program such that deficiencies noted during the audit can be addressed before the majority of field activities have been completed. A second audit should be performed as a follow-up to confirm that the recommended changes have been implemented. A field auditor is assigned to the project by matching, as closely as possible, the auditor's experience with the type of field activities being conducted. The auditor uses a project-specific field audit checklist developed from key information contained in project control documents. Completion of the extensive audit checklist during the audit focuses the auditor on evaluating each aspect of field activities being performed. Rather than examine field team performance after sampling, a field auditor can do so while the samples are being collected and can apply real-time corrective action as appropriate. As a result of field audits, responsible parties often observe vast improvements in their consultant's field procedures and, consequently, receive more reliable and representative field data at a lower cost. The cost savings and improved data quality that result from properly completed field audits make the field auditing process both cost-effective and functional.

State Education Department: Security over Pupil Evaluation Program and Program Evaluation Test Materials Needs Improvement. Report 91-S-2.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany.

Findings of an audit of the New York State Education Department's procedures to maintain security over Pupil Evaluation Program (PEP) and Program Evaluation Test (PET) examination materials are presented in this report. The audit sought to determine whether the department's security procedures adequately prevented unauthorized access to exam…

Building Energy Simulation Test for Existing Homes (BESTEST-EX) (Presentation)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Judkoff, R.; Neymark, J.; Polly, B.

2011-12-01

This presentation discusses the goals of NREL Analysis Accuracy R&D; BESTEST-EX goals; what BESTEST-EX is; how it works; 'Building Physics' cases; 'Building Physics' reference results; 'utility bill calibration' cases; limitations and potential future work. Goals of NREL Analysis Accuracy R&D are: (1) Provide industry with the tools and technical information needed to improve the accuracy and consistency of analysis methods; (2) Reduce the risks associated with purchasing, financing, and selling energy efficiency upgrades; and (3) Enhance software and input collection methods considering impacts on accuracy, cost, and time of energy assessments. BESTEST-EX Goals are: (1) Test software predictions of retrofitmore » energy savings in existing homes; (2) Ensure building physics calculations and utility bill calibration procedures perform up to a minimum standard; and (3) Quantify impact of uncertainties in input audit data and occupant behavior. BESTEST-EX is a repeatable procedure that tests how well audit software predictions compare to the current state of the art in building energy simulation. There is no direct truth standard. However, reference software have been subjected to validation testing, including comparisons with empirical data.« less

A clinical audit programme for diagnostic radiology: the approach adopted by the International Atomic Energy Agency.

PubMed

Faulkner, K; Järvinen, H; Butler, P; McLean, I D; Pentecost, M; Rickard, M; Abdullah, B

2010-01-01

The International Atomic Energy Agency (IAEA) has a mandate to assist member states in areas of human health and particularly in the use of radiation for diagnosis and treatment. Clinical audit is seen as an essential tool to assist in assuring the quality of radiation medicine, particularly in the instance of multidisciplinary audit of diagnostic radiology. Consequently, an external clinical audit programme has been developed by the IAEA to examine the structure and processes existent at a clinical site, with the basic objectives of: (1) improvement in the quality of patient care; (2) promotion of the effective use of resources; (3) enhancement of the provision and organisation of clinical services; (4) further professional education and training. These objectives apply in four general areas of service delivery, namely quality management and infrastructure, patient procedures, technical procedures and education, training and research. In the IAEA approach, the audit process is initiated by a request from the centre seeking the audit. A three-member team, comprising a radiologist, medical physicist and radiographer, subsequently undertakes a 5-d audit visit to the clinical site to perform the audit and write the formal audit report. Preparation for the audit visit is crucial and involves the local clinical centre completing a form, which provides the audit team with information on the clinical centre. While all main aspects of clinical structure and process are examined, particular attention is paid to radiation-related activities as described in the relevant documents such as the IAEA Basic Safety Standards, the Code of Practice for Dosimetry in Diagnostic Radiology and related equipment and quality assurance documentation. It should be stressed, however, that the clinical audit does not have any regulatory function. The main purpose of the IAEA approach to clinical audit is one of promoting quality improvement and learning. This paper describes the background to the clinical audit programme and the IAEA clinical audit protocol.

78 FR 17646 - Agency Information Collection Activities; eZ-Audit: Electronic Submission of Financial Statements...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

...Z-Audit: Electronic Submission of Financial Statements and Compliance Audits AGENCY: Federal Student... in response to this notice will be considered public records. Title of Collection: eZ-Audit: Electronic Submission of Financial Statements and Compliance Audits. OMB Control Number: 1845-0072. Type of...

Corrosion Prevention for Wheeled Vehicle Systems

DTIC Science & Technology

1993-08-13

The audit objective was to evaluate the effectiveness and efficiency of the Army’s procedures for acquiring corrosion prevention and chemical agent...resistant coatings for wheeled vehicle systems. To accomplish this objective, we reviewed corrosion controls and painting processes. The audit also...included a review of the adequacy of internal controls related to the audit objective.

32 CFR 22.420 - Pre-award procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... to obtain a pre-award credit report, audit, or any other specific piece of information. On a case-by... the grants officer in a particular case decide that a pre-award credit report, audit, or survey is... § 22.710), and decide whether pre-existing surveys or audits of the recipient, such as those of the...

32 CFR 22.420 - Pre-award procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... to obtain a pre-award credit report, audit, or any other specific piece of information. On a case-by... the grants officer in a particular case decide that a pre-award credit report, audit, or survey is... § 22.710), and decide whether pre-existing surveys or audits of the recipient, such as those of the...

Internal audit in a microbiology laboratory.

PubMed Central

Mifsud, A J; Shafi, M S

1995-01-01

AIM--To set up a programme of internal laboratory audit in a medical microbiology laboratory. METHODS--A model of laboratory based process audit is described. Laboratory activities were examined in turn by specimen type. Standards were set using laboratory standard operating procedures; practice was observed using a purpose designed questionnaire and the data were analysed by computer; performance was assessed at laboratory audit meetings; and the audit circle was closed by re-auditing topics after an interval. RESULTS--Improvements in performance scores (objective measures) and in staff morale (subjective impression) were observed. CONCLUSIONS--This model of process audit could be applied, with amendments to take local practice into account, in any microbiology laboratory. PMID:7665701

Monitoring of the Quality of the Defense Contract Audit Agency FY 2010 Audits

DTIC Science & Technology

2013-03-07

performed by regional audit managers include reviewing high risk assignments and reports prior to their issuance, performing post-issuance reviews, or...brainstorming procedure requires the audit team ( managers , supervisors, and auditors) to discuss the risk of fraud for that engagement and to discuss the risk ...auditors to make inquiries of contractor management of management’s knowledge of fraud risks during its annual planning meeting with major contractors

Environmental auditing and the role of the accountancy profession: a literature review.

PubMed

de Moor, Philippe; de Beelde, Ignace

2005-08-01

This review of the literature on environmental auditing and the potential role of accountants distinguishes between compliance audits and audits of the environmental management system. After an extensive introduction to the concept, this review focuses on the similarities and differences between an environmental audit and a financial statement audit. The general approach to both types of audits is similar, except that environmental audits are largely unregulated. Both audits place an emphasis on the evaluation of control systems, which is an argument in favor of external auditors playing a role in environmental audits. Another argument for including external accountants is their code of ethics. However, these professionals seem to be reluctant to enter the field of environmental auditing. It is argued that this reluctance is because of a lack of generally accepted principles for conducting environmental audits. If external accountants are engaged in environmental auditing, they should be part of multidisciplinary teams that also include scientists and engineers to avoid a too strong focus on procedures. Rather than treating these audits as totally different, it is proposed that there be a move towards integrated, or even universal, audits.

Communication Audits and the Effects of Increased Information: A Follow-up Study.

ERIC Educational Resources Information Center

Hargie, Owen; Tourish, Dennis; Wilson, Noel

2002-01-01

Considers how communication audits are typically presented as one-shot events, whose impact is not measured. Employs a follow-up audit to track the effects of an initial audit upon a major health care organization. Illustrates how the audit can play a useful role in an organization's communication strategy. (SG)

Managing Productivity.

DTIC Science & Technology

1985-01-01

could be a small construction , management firm, where project managers keep track of all phases and evolutions of contracts by hand. An obvious polution ...overview of productivity measurement. This idea can be expanded much further with the concept of productivity audits . Productivity auditing is a...comprehensive procedure, not unlike traditional audit practices which monitors and evaluates organizational practices to determine whether functional units

20 CFR 645.250 - What procedures apply to the resolution of findings arising from audits, investigations...

Code of Federal Regulations, 2012 CFR

2012-04-01

... of subrecipient level findings. (1) The WtW grantee is responsible for the resolution of findings that arise from its monitoring reviews, investigations and audits (including OMB Circular A-133 audits... for the WtW grant program. (b) Resolution of State level findings. (1) The Secretary is responsible...

20 CFR 645.250 - What procedures apply to the resolution of findings arising from audits, investigations...

Code of Federal Regulations, 2014 CFR

2014-04-01

... of subrecipient level findings. (1) The WtW grantee is responsible for the resolution of findings that arise from its monitoring reviews, investigations and audits (including OMB Circular A-133 audits... for the WtW grant program. (b) Resolution of State level findings. (1) The Secretary is responsible...

20 CFR 645.250 - What procedures apply to the resolution of findings arising from audits, investigations...

Code of Federal Regulations, 2013 CFR

2013-04-01

... of subrecipient level findings. (1) The WtW grantee is responsible for the resolution of findings that arise from its monitoring reviews, investigations and audits (including OMB Circular A-133 audits... for the WtW grant program. (b) Resolution of State level findings. (1) The Secretary is responsible...

Auditing radiation sterilization facilities

NASA Astrophysics Data System (ADS)

Beck, Jeffrey A.

The diversity of radiation sterilization systems available today places renewed emphasis on the need for thorough Quality Assurance audits of these facilities. Evaluating compliance with Good Manufacturing Practices is an obvious requirement, but an effective audit must also evaluate installation and performance qualification programs (validation_, and process control and monitoring procedures in detail. The present paper describes general standards that radiation sterilization operations should meet in each of these key areas, and provides basic guidance for conducting QA audits of these facilities.

Recoupment of Transportation Costs Incurred on Foreign Military Sales Cases

DTIC Science & Technology

1990-02-23

We are providing this final report on the Audit of Recoupment of Transportation Costs Incurred on Foreign Military Sales (FMS) Cases for your review...and comment. The audit was made during the period December 1988 through March 1989. The primary objectives of the audit were to determine whether...subject area. During FY’s 1987 and 1988, FMS transportation billings to foreign customers amounted to $30.5 million. The audit showed that basic procedures

13 CFR 120.490 - Audits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... financial statement submitted to SBA before the audit. The fee schedule is set forth in SBA's Standard Operating Procedures manual. [61 FR 3235, Jan. 31, 1996. Redesignated at 73 FR 75516, Dec. 11, 2008] ...

13 CFR 120.490 - Audits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... financial statement submitted to SBA before the audit. The fee schedule is set forth in SBA's Standard Operating Procedures manual. [61 FR 3235, Jan. 31, 1996. Redesignated at 73 FR 75516, Dec. 11, 2008] ...

13 CFR 120.490 - Audits.

Code of Federal Regulations, 2013 CFR

2013-01-01

... financial statement submitted to SBA before the audit. The fee schedule is set forth in SBA's Standard Operating Procedures manual. [61 FR 3235, Jan. 31, 1996. Redesignated at 73 FR 75516, Dec. 11, 2008] ...

13 CFR 120.490 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial statement submitted to SBA before the audit. The fee schedule is set forth in SBA's Standard Operating Procedures manual. [61 FR 3235, Jan. 31, 1996. Redesignated at 73 FR 75516, Dec. 11, 2008] ...

13 CFR 120.490 - Audits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... financial statement submitted to SBA before the audit. The fee schedule is set forth in SBA's Standard Operating Procedures manual. [61 FR 3235, Jan. 31, 1996. Redesignated at 73 FR 75516, Dec. 11, 2008] ...

Internal audit consider the implications.

PubMed

Baumgartner, Grant D; Hamilton, Angela

2004-06-01

Internal audit can not only allay external and internal concerns about appropriateness of business operations, but also help improve efficiency and the bottom line. To get an internal audit function under way, healthcare organizations need to obtain board buy-in, form an audit committee of the board, determine resources needed, perform a risk assessment, and develop an internal audit plan.

7 CFR 1773.1 - General.

Code of Federal Regulations, 2012 CFR

2012-01-01

... accountant (CPA), satisfactory to RUS, and accompanied by a report of such audit, in form and substance... instrument by setting forth the criteria for CPAs to be deemed satisfactory to RUS and the audit procedures...

7 CFR 1773.1 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... accountant (CPA), satisfactory to RUS, and accompanied by a report of such audit, in form and substance... instrument by setting forth the criteria for CPAs to be deemed satisfactory to RUS and the audit procedures...

7 CFR 1773.1 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... accountant (CPA), satisfactory to RUS, and accompanied by a report of such audit, in form and substance... instrument by setting forth the criteria for CPAs to be deemed satisfactory to RUS and the audit procedures...

7 CFR 1773.1 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... accountant (CPA), satisfactory to RUS, and accompanied by a report of such audit, in form and substance... instrument by setting forth the criteria for CPAs to be deemed satisfactory to RUS and the audit procedures...

7 CFR 1773.1 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... accountant (CPA), satisfactory to RUS, and accompanied by a report of such audit, in form and substance... instrument by setting forth the criteria for CPAs to be deemed satisfactory to RUS and the audit procedures...

48 CFR 52.214-26 - Audit and Records-Sealed Bidding.

Code of Federal Regulations, 2010 CFR

2010-10-01

...: Audit and Records—Sealed Bidding (OCT 2010) (a) As used in this clause, records includes books, documents, accounting procedures and practices, and other data, regardless of type and regardless of whether...

14 CFR 158.69 - Recordkeeping and auditing: Collecting carriers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... audit shall be performed by an accredited independent public accountant and may be of limited scope. The accountant shall express an opinion on the fairness and reasonableness of the carrier's procedures for...

14 CFR 158.69 - Recordkeeping and auditing: Collecting carriers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... audit shall be performed by an accredited independent public accountant and may be of limited scope. The accountant shall express an opinion on the fairness and reasonableness of the carrier's procedures for...

Development of a diagnosis- and procedure-based risk model for 30-day outcome after pediatric cardiac surgery.

PubMed

Crowe, Sonya; Brown, Kate L; Pagel, Christina; Muthialu, Nagarajan; Cunningham, David; Gibbs, John; Bull, Catherine; Franklin, Rodney; Utley, Martin; Tsang, Victor T

2013-05-01

The study objective was to develop a risk model incorporating diagnostic information to adjust for case-mix severity during routine monitoring of outcomes for pediatric cardiac surgery. Data from the Central Cardiac Audit Database for all pediatric cardiac surgery procedures performed in the United Kingdom between 2000 and 2010 were included: 70% for model development and 30% for validation. Units of analysis were 30-day episodes after the first surgical procedure. We used logistic regression for 30-day mortality. Risk factors considered included procedural information based on Central Cardiac Audit Database "specific procedures," diagnostic information defined by 24 "primary" cardiac diagnoses and "univentricular" status, and other patient characteristics. Of the 27,140 30-day episodes in the development set, 25,613 were survivals, 834 were deaths, and 693 were of unknown status (mortality, 3.2%). The risk model includes procedure, cardiac diagnosis, univentricular status, age band (neonate, infant, child), continuous age, continuous weight, presence of non-Down syndrome comorbidity, bypass, and year of operation 2007 or later (because of decreasing mortality). A risk score was calculated for 95% of cases in the validation set (weight missing in 5%). The model discriminated well; the C-index for validation set was 0.77 (0.81 for post-2007 data). Removal of all but procedural information gave a reduced C-index of 0.72. The model performed well across the spectrum of predicted risk, but there was evidence of underestimation of mortality risk in neonates undergoing operation from 2007. The risk model performs well. Diagnostic information added useful discriminatory power. A future application is risk adjustment during routine monitoring of outcomes in the United Kingdom to assist quality assurance. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Testing the methodology for dosimetry audit of heterogeneity corrections and small MLC-shaped fields: Results of IAEA multi-center studies

PubMed Central

Izewska, Joanna; Wesolowska, Paulina; Azangwe, Godfrey; Followill, David S.; Thwaites, David I.; Arib, Mehenna; Stefanic, Amalia; Viegas, Claudio; Suming, Luo; Ekendahl, Daniela; Bulski, Wojciech; Georg, Dietmar

2016-01-01

Abstract The International Atomic Energy Agency (IAEA) has a long tradition of supporting development of methodologies for national networks providing quality audits in radiotherapy. A series of co-ordinated research projects (CRPs) has been conducted by the IAEA since 1995 assisting national external audit groups developing national audit programs. The CRP ‘Development of Quality Audits for Radiotherapy Dosimetry for Complex Treatment Techniques’ was conducted in 2009–2012 as an extension of previously developed audit programs. Material and methods. The CRP work described in this paper focused on developing and testing two steps of dosimetry audit: verification of heterogeneity corrections, and treatment planning system (TPS) modeling of small MLC fields, which are important for the initial stages of complex radiation treatments, such as IMRT. The project involved development of a new solid slab phantom with heterogeneities containing special measurement inserts for thermoluminescent dosimeters (TLD) and radiochromic films. The phantom and the audit methodology has been developed at the IAEA and tested in multi-center studies involving the CRP participants. Results. The results of multi-center testing of methodology for two steps of dosimetry audit show that the design of audit procedures is adequate and the methodology is feasible for meeting the audit objectives. A total of 97% TLD results in heterogeneity situations obtained in the study were within 3% and all results within 5% agreement with the TPS predicted doses. In contrast, only 64% small beam profiles were within 3 mm agreement between the TPS calculated and film measured doses. Film dosimetry results have highlighted some limitations in TPS modeling of small beam profiles in the direction of MLC leave movements. Discussion. Through multi-center testing, any challenges or difficulties in the proposed audit methodology were identified, and the methodology improved. Using the experience of these studies, the participants could incorporate the auditing procedures in their national programs. PMID:26934916

Testing the methodology for dosimetry audit of heterogeneity corrections and small MLC-shaped fields: Results of IAEA multi-center studies.

PubMed

Izewska, Joanna; Wesolowska, Paulina; Azangwe, Godfrey; Followill, David S; Thwaites, David I; Arib, Mehenna; Stefanic, Amalia; Viegas, Claudio; Suming, Luo; Ekendahl, Daniela; Bulski, Wojciech; Georg, Dietmar

2016-07-01

The International Atomic Energy Agency (IAEA) has a long tradition of supporting development of methodologies for national networks providing quality audits in radiotherapy. A series of co-ordinated research projects (CRPs) has been conducted by the IAEA since 1995 assisting national external audit groups developing national audit programs. The CRP 'Development of Quality Audits for Radiotherapy Dosimetry for Complex Treatment Techniques' was conducted in 2009-2012 as an extension of previously developed audit programs. The CRP work described in this paper focused on developing and testing two steps of dosimetry audit: verification of heterogeneity corrections, and treatment planning system (TPS) modeling of small MLC fields, which are important for the initial stages of complex radiation treatments, such as IMRT. The project involved development of a new solid slab phantom with heterogeneities containing special measurement inserts for thermoluminescent dosimeters (TLD) and radiochromic films. The phantom and the audit methodology has been developed at the IAEA and tested in multi-center studies involving the CRP participants. The results of multi-center testing of methodology for two steps of dosimetry audit show that the design of audit procedures is adequate and the methodology is feasible for meeting the audit objectives. A total of 97% TLD results in heterogeneity situations obtained in the study were within 3% and all results within 5% agreement with the TPS predicted doses. In contrast, only 64% small beam profiles were within 3 mm agreement between the TPS calculated and film measured doses. Film dosimetry results have highlighted some limitations in TPS modeling of small beam profiles in the direction of MLC leave movements. Through multi-center testing, any challenges or difficulties in the proposed audit methodology were identified, and the methodology improved. Using the experience of these studies, the participants could incorporate the auditing procedures in their national programs.

Practice Audit in Gastroenterology (PAGE) program: A novel approach to continuing professional development

PubMed Central

Armstrong, David; Hollingworth, Roger; Gardiner, Tara; Klassen, Michael; Smith, Wendy; Hunt, Richard H; Barkun, Alan; Gould, Michael; Leddin, Desmond

2006-01-01

BACKGROUND: Practice audit is an important component of continuing professional development that may more readily be undertaken if it were less complex. This qualitative study assessed the use of personal digital assistants to facilitate data collection and review. METHODS: Personal digital assistants programmed with standard questionnaires related to upper gastrointestinal endoscopies (Practice Audit in Gastroenterology-Endoscopy [‘PAGE-Endo’]) and colonoscopies (PAGE-Colonoscopy [‘PAGE-Colo’]) were provided to Canadian gastroenterologists, surgeons and internists. Over a three-week audit period, participants recorded indications, and the expected (E) and reported (R) findings for each procedure. Thereafter, participants recorded compliance with reporting, the ease of use and value of the PAGE program, and their willingness to perform another audit. RESULTS: Over 15 to 18 months, 173 participants completed PAGE-Endo (6168 procedures) and 111 completed PAGE-Colo (4776 procedures). Most respondents noted that PAGE was easy to use (99%), beneficial (88% to 95%), and that they were willing undertake another audit (92% to 95%). In PAGE-Endo, alarm features were prevalent (55%), but major reported findings were less common than expected: esophagitis (E 29.9%, R 14.8%), esophageal stricture (E 8.3%, R 3.6%), gastric ulcer (E 17.0%, R 4.7%), gastric cancer (E 4.3%, R 1.0%) and duodenal ulcer (E 11.5%, R 5.7%). In PAGE-Colo, more colonoscopies were performed for symptom investigation (55%) than for screening (25%) or surveillance (20%). There were marked interprovincial variations with respect to sedation, biopsies and technical aspects of colonoscopy. CONCLUSION: Secure, real-time data entry with review of aggregate and individual data in the PAGE program provided an acceptable, straightforward methodology for accredited practice audit activities. PAGE has considerable potential for continuing professional development in gastroenterology and other specialties. PMID:16779458

Requests for electroencephalography in a district general hospital: retrospective and prospective audit

PubMed Central

Smith, D; Bartolo, R; Pickles, R M; Tedman, B M

2001-01-01

Objectives To determine the number of inappropriate requests for electroencephalography (EEG) and whether guidelines on use could reduce this number. Design Audit with retrospective and prospective components. Setting EEG department in district general hospital and centre for neurology and neurosurgery. Participants Retrospective: 368 at the general hospital and 143 patients at the neurology centre. Prospective: 241 patients undergoing EEG at the general hospital. Interventions Guidelines for EEG issued to users of service at the general hospital. Outcomes Retrospective: differences in requesting practice, result in different clinical scenarios, relative roles of procedure, clinical acumen in establishing diagnosis, usefulness of procedure. Prospective: change of requesting practice, impact on use. Results There were considerable differences in requesting practice. Non-specialists seem to use EEG as a diagnostic tool, especially in patients with “funny turns,” when it is much more likely to yield potentially misleading than clinically useful information. The overall proportion of procedures considered to influence management, to be justifiable, and to be inappropriate were 16% (59), 28.3% (104), and 55.7% (205), respectively. In the prospective study the total number of requests was significantly reduced (χ2=33.85, df=5, P<0.0001), mainly because of fewer requests in patients with non-specific “funny turns” (χ2=21.90, df=6, P=0.0013). There was a concomitant change in the usefulness of EEG (χ2 =26.99, df=2, P<0.0001). Conclusions This original audit informed clinical practice and had potential benefits for patients, clinicians, and provision of service. Systematic replication of this project, possibly on a regional basis, could result in financial savings, which would allow development of accessible local neurophysiology services. What is already known on this topicThere is unrestricted access to EEG in most district general hospitals throughout the United KingdomThe combination of equivocal symptoms and non-specific abnormalities carries a risk of misdiagnosis of epilepsyWhat this study addsAn audit of requests for EEG showed that a large proportion were inappropriate, mainly because of the prevalent misconception that the procedure could prove or exclude a diagnosis of epilepsy in patients with “funny turns”After intervention with clinicians, which used an educative approach, there was a considerable and sustained change in requesting practice PMID:11312226

49 CFR 385.321 - What failures of safety management practices disclosed by the safety audit will result in a...

Code of Federal Regulations, 2010 CFR

2010-10-01

... disclosed by the safety audit will result in a notice to a new entrant that its USDOT new entrant... MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.321 What failures of safety management practices disclosed by the safety audit will result in a notice...

A criteria-based audit of the management of severe pre-eclampsia in Kampala, Uganda.

PubMed

Weeks, A D; Alia, G; Ononge, S; Otolorin, E O; Mirembe, F M

2005-12-01

To improve the quality of clinical care for women with severe pre-eclampsia. A criteria-based audit was conducted in a large government hospital in Uganda. Management practices were evaluated against standards developed by an expert panel by retrospectively evaluating 43 case files. Results of the audit were presented, and recommendations developed and implemented. A re-audit was conducted 6 months later. The initial audit showed that most standards were rarely achieved. Reasons were discussed. Guidelines were produced, additional supplies were purchased following a fundraising effort, labor ward procedures were streamlined, and staffing was increased. In the re-audit there were significant improvements in diagnosis, monitoring, and treatment. Criteria-based audit can improve the quality of maternity care in countries with limited resources.

Contracting for Audit Services.

ERIC Educational Resources Information Center

Heifetz, Harry S.

1987-01-01

The Single Audit Act of 1984 requires most school districts receiving over $25,000 in federal funds to undergo financial audits. This article highlights requirements for selecting certified public accountants to perform the audit and suggests factors to be considered before drafting a contract or letter of engagement. A sample letter is included.…

20 CFR 435.71 - Closeout procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Employees' Benefits SOCIAL SECURITY ADMINISTRATION UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND.... (g) In the event a final audit has not been performed prior to the closeout of an award, SSA will... disallowed costs resulting from the final audit. ...

Guidelines for quality assurance in multicenter trials: a position paper.

PubMed

Knatterud, G L; Rockhold, F W; George, S L; Barton, F B; Davis, C E; Fairweather, W R; Honohan, T; Mowery, R; O'Neill, R

1998-10-01

In the wake of reports of falsified data in one of the trials of the National Surgical Adjuvant Project for Breast and Bowel Cancer supported by the National Cancer Institute, clinical trials came under close scrutiny by the public, the press, and Congress. Questions were asked about the quality and integrity of the collected data and the analyses and conclusions of trials. In 1995, the leaders of the Society for Clinical Trials (the Chair of the Policy Committee, Dr. David DeMets, and the President of the Society, Dr. Sylvan Green) asked two members of the Society (Dr. Genell Knatterud and Dr. Frank Rockhold) to act as co-chairs of a newly formed subcommittee to discuss the issues of data integrity and auditing. In consultation with Drs. DeMets and Green, the co-chairs selected other members (Ms. Franca Barton, Dr. C.E. Davis, Dr. Bill Fairweather, Dr. Stephen George, Mr. Tom Honohan, Dr. Richard Mowery, and Dr. Robert O'Neill) to serve on the subcommittee. The subcommittee considered "how clean clinical trial data should be, to what extent auditing procedures are required, and who should conduct audits and how often." During the initial discussions, the subcommittee concluded that data auditing was insufficient to achieve data integrity. Accordingly, the subcommittee prepared this set of guidelines for standards of quality assurance for multicenter clinical trials. We include recommendations for appropriate action if problems are detected.

Virtual EPID standard phantom audit (VESPA) for remote IMRT and VMAT credentialing

NASA Astrophysics Data System (ADS)

Miri, Narges; Lehmann, Joerg; Legge, Kimberley; Vial, Philip; Greer, Peter B.

2017-06-01

A virtual EPID standard phantom audit (VESPA) has been implemented for remote auditing in support of facility credentialing for clinical trials using IMRT and VMAT. VESPA is based on published methods and a clinically established IMRT QA procedure, here extended to multi-vendor equipment. Facilities are provided with comprehensive instructions and CT datasets to create treatment plans. They deliver the treatment directly to their EPID without any phantom or couch in the beam. In addition, they deliver a set of simple calibration fields per instructions. Collected EPID images are uploaded electronically. In the analysis, the dose is projected back into a virtual cylindrical phantom. 3D gamma analysis is performed. 2D dose planes and linear dose profiles are provided and can be considered when needed for clarification. In addition, using a virtual flat-phantom, 2D field-by-field or arc-by-arc gamma analyses are performed. Pilot facilities covering a range of planning and delivery systems have performed data acquisition and upload successfully. Advantages of VESPA are (1) fast turnaround mainly driven by the facility’s capability of providing the requested EPID images, (2) the possibility for facilities performing the audit in parallel, as there is no need to wait for a phantom, (3) simple and efficient credentialing for international facilities, (4) a large set of data points, and (5) a reduced impact on resources and environment as there is no need to transport heavy phantoms or audit staff. Limitations of the current implementation of VESPA for trials credentialing are that it does not provide absolute dosimetry, therefore a Level I audit is still required, and that it relies on correctly delivered open calibration fields, which are used for system calibration. The implemented EPID based IMRT and VMAT audit system promises to dramatically improve credentialing efficiency for clinical trials and wider applications.

Virtual EPID standard phantom audit (VESPA) for remote IMRT and VMAT credentialing.

PubMed

Miri, Narges; Lehmann, Joerg; Legge, Kimberley; Vial, Philip; Greer, Peter B

2017-06-07

A virtual EPID standard phantom audit (VESPA) has been implemented for remote auditing in support of facility credentialing for clinical trials using IMRT and VMAT. VESPA is based on published methods and a clinically established IMRT QA procedure, here extended to multi-vendor equipment. Facilities are provided with comprehensive instructions and CT datasets to create treatment plans. They deliver the treatment directly to their EPID without any phantom or couch in the beam. In addition, they deliver a set of simple calibration fields per instructions. Collected EPID images are uploaded electronically. In the analysis, the dose is projected back into a virtual cylindrical phantom. 3D gamma analysis is performed. 2D dose planes and linear dose profiles are provided and can be considered when needed for clarification. In addition, using a virtual flat-phantom, 2D field-by-field or arc-by-arc gamma analyses are performed. Pilot facilities covering a range of planning and delivery systems have performed data acquisition and upload successfully. Advantages of VESPA are (1) fast turnaround mainly driven by the facility's capability of providing the requested EPID images, (2) the possibility for facilities performing the audit in parallel, as there is no need to wait for a phantom, (3) simple and efficient credentialing for international facilities, (4) a large set of data points, and (5) a reduced impact on resources and environment as there is no need to transport heavy phantoms or audit staff. Limitations of the current implementation of VESPA for trials credentialing are that it does not provide absolute dosimetry, therefore a Level I audit is still required, and that it relies on correctly delivered open calibration fields, which are used for system calibration. The implemented EPID based IMRT and VMAT audit system promises to dramatically improve credentialing efficiency for clinical trials and wider applications.

49 CFR 385.337 - What happens if a new entrant refuses to permit a safety audit to be performed on its operations?

Code of Federal Regulations, 2010 CFR

2010-10-01

... safety audit to be performed on its operations? 385.337 Section 385.337 Transportation Other Regulations... TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.337 What happens if a new entrant refuses to permit a safety audit to be performed on its...

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine Program. Part 2: Analysis of Results.

PubMed

Dondi, Maurizio; Torres, Leonel; Marengo, Mario; Massardo, Teresa; Mishani, Eyal; Van Zyl Ellmann, Annare; Solanki, Kishor; Bischof Delaloye, Angelika; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Ordonez, Felix Barajas; Paez, Diana; Pascual, Thomas

2017-11-01

The International Atomic Energy Agency has developed a program, named Quality Management Audits in Nuclear Medicine (QUANUM), to help its Member States to check the status of their nuclear medicine practices and their adherence to international reference standards, covering all aspects of nuclear medicine, including quality assurance/quality control of instrumentation, radiopharmacy (further subdivided into levels 1, 2, and 3, according to complexity of work), radiation safety, clinical applications, as well as managerial aspects. The QUANUM program is based on both internal and external audits and, with specifically developed Excel spreadsheets, it helps assess the level of conformance (LoC) to those previously defined quality standards. According to their level of implementation, the level of conformance to requested standards; 0 (absent) up to 4 (full conformance). Items scored 0, 1, and 2 are considered non-conformance; items scored 3 and 4 are considered conformance. To assess results of the audit missions performed worldwide over the last 8 years, a retrospective analysis has been run on reports from a total of 42 audit missions in 39 centers, three of which had been re-audited. The analysis of all audit reports has shown an overall LoC of 73.9 ± 8.3% (mean ± standard deviation), ranging between 56.6% and 87.9%. The highest LoC has been found in the area of clinical services (83.7% for imaging and 87.9% for therapy), whereas the lowest levels have been found for Radiopharmacy Level 2 (56.6%); Computer Systems and Data Handling (66.6%); and Evaluation of the Quality Management System (67.6%). Prioritization of non-conformances produced a total of 1687 recommendations in the final audit report. Depending on the impact on safety and daily clinical activities, they were further classified as critical (requiring immediate action; n = 276; 16% of the total); major (requiring action in relatively short time, typically from 3 to 6 months; n = 604; 36%); whereas the remaining 807 (48%) were classified as minor, that is, to be addressed whenever possible. The greatest proportion of recommendations has been found in the category "Managerial, Organization and Documentation" (26%); "Staff Radiation Protection and Safety" (17.3%); "Radiopharmaceuticals Preparation, Dispensing and Handling" (15.8%); and "Quality Assurance/Quality Control" and "Management of Equipment and Software" (11.4%). The lowest level of recommendations belongs to the item "Human Resources" (4%). The QUANUM program proved applicable to a wide variety of institutions, from small practices to larger centers with PET/CT and cyclotrons. Clinical services rendered to patients showed a good compliance with international standards, whereas issues related to radiation protection of both staff and patients will require a higher degree of attention. This is a relevant feedback for the International Atomic Energy Agency with regard to the effective translation of safety recommendations into routine practice. Training on drafting and application of standard operating procedures should also be considered a priority. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Audit of 117 otoplasties for prominent ear by one surgeon using a cartilage-cutting procedure.

PubMed

Brian, Tess; Cheng, Paul T; Loo, Stanley S

2018-02-07

The plethora of surgical procedures for prominent ear correction reflects lack of satisfaction with outcomes achieved. This paper describes a cartilage-cutting otoplasty procedure and reports an audit of its outcomes. Discharge coding was used to retrospectively identify patients who had undergone the otoplasty of interest at Middlemore Hospital, Auckland, during the 5 years from March 2010 to the end of February 2015. Hospital records were accessed. Demographic, procedure and patient satisfaction data were recorded and analysed (PASW/SPSS Statistics 18.0). Chi-square test and t-test were used to assess associations, with significance accepted at two-sided P < 0.05. Sixty-four patients underwent the specified otoplasty (54.7% females: mean age 9.5 years (standard deviation, SD: 4.2; range: 4-20)), of whom 93.8% had bilateral procedures with mean surgical time of 61 min (SD: 14; range: 34-94). This was significantly shorter (P < 0.001) than for bilateral surgeries by all other techniques and surgeons in the review period. None of the 117 procedures of interest subsequently had suture extrusion or revision surgery. Mean time from surgery to satisfaction determination was 993 days (SD: 521; range: 111-1850) for 43 (67.2%) patients. 23.3% believed that there had been aesthetically insignificant partial recurrence of prominence, typically of one ear only. This was insufficient for all but one patient to consider repeat otoplasty. Surgery outcome was rated 'very satisfactory' and 'satisfactory' by 90.7% and 9.3% of patients/parents, respectively. All would recommend the surgery to others. With infrequent complications and recurrence requiring revision, and without long-term reliance on sutures, the otoplasty reported is time-efficient, safe and generates high patient satisfaction. © 2018 Royal Australasian College of Surgeons.

Implementation of alanine/EPR as transfer dosimetry system in a radiotherapy audit programme in Belgium.

PubMed

Schaeken, B; Cuypers, R; Lelie, S; Schroeyers, W; Schreurs, S; Janssens, H; Verellen, D

2011-04-01

A measurement procedure based on alanine/electron paramagnetic resonance (EPR) dosimetry was implemented successfully providing simple, stable, and accurate dose-to-water (D(w)) measurements. The correspondence between alanine and ionization chamber measurements in reference conditions was excellent. Alanine/EMR dosimetry might be a valuable alternative to thermoluminescent (TLD) and ionization chamber based measuring procedures in radiotherapy audits. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Final Report on the Audit of Subcontract Prices on Firm-Fixed-Price Contracts Awarded to McDonnell Aircraft Company

DTIC Science & Technology

1990-12-03

This is our final report on the audit of Subcontract Prices on Firm-Fixed-Price Contracts Awarded to McDonnell Aircraft Company (MCAIR). The Contract Management Directorate made the audit from October 1989 through June 1990. The objective of the audit was to compare proposed and negotiated subcontract prices and determine reasons for significant variances. We also evaluated applicable internal control procedures. For a 6-month period ending December 1989, MCAIR issued 517 subcontracts valued at $679 million.

Tax-deferred annuity plans: meeting the IRS audit challenge.

PubMed

Schussler, M

1997-01-01

A growing number of nonprofit organizations are being fined for violations of IRS regulations following IRS audits of their tax-deferred annuity (TDA) plans. To ensure that their organizations can withstand the scrutiny of an IRS audit, TDA plan administrators must ensure that plans meet IRS regulations and be prepared for IRS audits. Documentation--particularly of the TDA plan itself, and procedures related to salary reduction programs, compensation limits, excess deferrals and other excess contributions, loans, and distributions--must be comprehensive and in compliance with IRS regulations.

DoD Actions Were Not Adequate to Reduce Improper Travel Payments

DTIC Science & Technology

2016-03-10

this audit in accordance with generally accepted government auditing standards. We considered management comments on a draft of this report when...DoD Travel Pay program were effective. See Appendix A for the scope and methodology and prior audit coverage. Background Public Law 111-204, the...conducted this performance audit from May 2015 through January 2016 in accordance with generally accepted government auditing standards. Those

Discharge communication from inpatient care: an audit of written medical discharge summary procedure against the new National Health Service Standard for clinical handover.

PubMed

Reid, Daniel Brooks; Parsons, Shaun R; Gill, Stephen D; Hughes, Andrew J

2015-04-01

To audit written medical discharge summary procedure and practice against Standard Six (clinical handover) of the Australian National Safety and Quality Health Service Standards at a major regional Victorian health service. Department heads were invited to complete a questionnaire about departmental discharge summary practices. Twenty-seven (82%) department heads completed the questionnaire. Seven (26%) departments had a documented discharge summary procedure. Fourteen (52%) departments monitored discharge summary completion and 13 (48%) departments monitored the timeliness of completion. Seven (26%) departments informed the patient of the content of the discharge summary and six (22%) departments provided the patient with a copy. Seven (26%) departments provided training for staff members on how to complete discharge summaries. Completing discharge summaries was usually delegated to the medical intern. The introduction of the National Service Standards prompted an organisation-wide audit of discharge summary practices against the external criterion. There was substantial variation in the organisation's practices. The Standards and the current audit results highlight an opportunity for the organisation to enhance and standardise discharge summary practices and improve communication with general practice.

Privacy Act System of Records: Office of the Inspector General AutoAudit, EPA-50

EPA Pesticide Factsheets

Learn more about the Office of the Inspector General AutoAudit System, including who is covered in the system, the purpose of data collection, routine uses for the system's records, and other security procedures.

7 CFR 1753.39 - Closeout documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., 1400 Independence Ave., SW., Washington, DC 20250-1522. (d) Grounding system audit. A grounding system audit shall be performed and found acceptable for equipment provided under Form 525 and 545 Contracts... AGRICULTURE TELECOMMUNICATIONS SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Purchase and Installation of...

48 CFR 242.7203 - Review procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

....7203 Section 242.7203 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Material...) of this section); and (B) Issues an audit report for incorporation into the MMAS report based on an...

Quality assurance and gastrointestinal endoscopy: an audit of 500 colonoscopic procedures.

PubMed

Denis, Bernard; Weiss, Anne-Marie; Peter, André; Bottlaender, Jacques; Chiappa, Pascale

2004-12-01

The aim of this study was to assess the quality of colonoscopic procedures in our endoscopy unit with the goal of improving performance. We prospectively audited 500 consecutive colonoscopic procedures and assessed sixty-two process or outcome indicators for each procedure. Most of the measured indicators were within standard limits: cecal intubation rate (92%), inadequate bowel preparations (24%), inappropriate procedures (9.7%), normal procedures (54%), yield for neoplasia (32%), morbidity (0.4%), and overall patient satisfaction (95.8%). Some indicators were outside standard limits suggesting our practices should be modified: endoscopy withdrawal time less than 6 minutes (78%), forceps removal of polyps (31%), resected polyps not recovered for pathological examination (12%), adenomas with villous elements (22%), patients unsatisfied because of time spent waiting for the procedure (19%), patients unsatisfied because of inadequate explanations (10%). There was no standard for a few indicators: patient discomfort (6.9%), diagnostic success (89%), therapeutic success (92%). Three new indicators were proposed: proportion of patients aged<50 years, number of normal colonoscopic procedures to perform to detect one advanced adenoma or cancer, and proportion of colonoscopic procedures causing discomfort. The diagnostic yield of colonoscopy was dependent on age, gender, indication and appropriateness of indication but not on the prescriber. This audit allowed us to evaluate our endoscopic practices and to detect certain shortcomings and deviations from standards. It enabled us to change some of our practices with the goal of improving the quality of our colonoscopic procedures.

Nurses' participation in audit: a regional study.

PubMed

Cheater, F M; Keane, M

1998-03-01

To find out to what extent nurses were perceived to be participating in audit, to identify factors thought to impede their involvement, and to assess progress towards multidisciplinary audit. Qualitative. Focus groups and interviews. Chairs of audit groups and audit support staff in hospital, community and primary health care and audit leads in health authorities in the North West Region. In total 99 audit leads/support staff in the region participated representing 89% of the primary health care audit groups, 80% of acute hospitals, 73% of community health services, and 59% of purchasers. Many audit groups remain medically dominated despite recent changes to their structure and organisation. The quality of interprofessional relations, the leadership style of the audit chair, and nurses' level of seniority, audit knowledge, and experience influenced whether groups reflected a multidisciplinary, rather than a doctor centred approach. Nurses were perceived to be enthusiastic supporters of audit, although their active participation in the process was considered substantially less than for doctors in acute and community health services. Practice nurses were increasingly being seen as the local audit enthusiasts in primary health care. Reported obstacles to nurses' participation in audit included hierarchical nurse and doctor relationships, lack of commitment from senior doctors and managers, poor organisational links between departments of quality and audit, work load pressures and lack of protected time, availability of practical support, and lack of knowledge and skills. Progress towards multidisciplinary audit was highly variable. The undisciplinary approach to audit was still common, particularly in acute services. Multidisciplinary audit was more successfully established in areas already predisposed towards teamworking or where nurses had high involvement in decision making. Audit support staff were viewed as having a key role in helping teams to adopt a collaborative approach to audit. Although nurses were undertaking audit, and some were leading developments in their settings, a range of structural and organisational, interprofessional and intraprofessional factors was still impeding progress. If the ultimate goal of audit is to improve patient care, the obstacles that make it difficult for nurses to contribute actively to the process must be acknowledged and considered.

Pleural procedures and patient safety: a national BTS audit of practice.

PubMed

Hooper, Clare E; Welham, Sally A; Maskell, Nick A

2015-02-01

The BTS pleural procedures audit collected data over a 2-month period in June and July 2011. In contrast with the 2010 audit, which focussed simply on chest drain insertions, data on all pleural aspirations and local anaesthetic thoracoscopy (LAT) was also collected. Ninety hospitals submitted data, covering a patient population of 33 million. Twenty-one per cent of centres ran a specialist pleural disease clinic, 71% had a nominated chest drain safety lead, and 20% had thoracic surgery on site. Additionally, one-third of centres had a physician-led LAT service. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

23 CFR 140.805 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 23 Highways 1 2014-04-01 2014-04-01 false Definitions. 140.805 Section 140.805 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency...-aid highway projects. Audits performed in accordance with the requirements of 23 CFR part 12, audits...

23 CFR 140.805 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Definitions. 140.805 Section 140.805 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency...-aid highway projects. Audits performed in accordance with the requirements of 23 CFR part 12, audits...

23 CFR 140.805 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Definitions. 140.805 Section 140.805 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency...-aid highway projects. Audits performed in accordance with the requirements of 23 CFR part 12, audits...

AN AUDITING FRAMEWORK TO SUBSTANTIATE ELECTRONIC RECORDKEEPING PRACTICES

EPA Science Inventory

Quality assurance audits of computer systems help to ensure that the end data meet the needs of the user. Increasingly complex systems require the stepwise procedures outlined below.

The areas reviewed in this paper include both technical and evidentiary criteria. I...

38 CFR 41.400 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) For biennial audits permitted under § 41.220, consider auditee requests to qualify as a low-risk... Section 41.400 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS... § 41.400 Responsibilities. (a) Cognizant agency for audit responsibilities. Recipients expending more...

Completion of hand-written surgical consent forms is frequently suboptimal and could be improved by using electronically generated, procedure-specific forms.

PubMed

St John, E R; Scott, A J; Irvine, T E; Pakzad, F; Leff, D R; Layer, G T

2017-08-01

Completion of hand-written consent forms for surgical procedures may suffer from missing or inaccurate information, poor legibility and high variability. We audited the completion of hand-written consent forms and trialled a web-based application to generate modifiable, procedure-specific consent forms. The investigation comprised two phases at separate UK hospitals. In phase one, the completion of individual responses in hand-written consent forms for a variety of procedures were prospectively audited. Responses were categorised into three domains (patient details, procedure details and patient sign-off) that were considered "failed" if a contained element was not correct and legible. Phase two was confined to a breast surgical unit where hand-written consent forms were assessed as for phase one and interrogated for missing complications by two independent experts. An electronic consent platform was introduced and electronically-produced consent forms assessed. In phase one, 99 hand-written consent forms were assessed and the domain failure rates were: patient details 10%; procedure details 30%; and patient sign-off 27%. Laparoscopic cholecystectomy was the most common procedure (7/99) but there was significant variability in the documentation of complications: 12 in total, a median of 6 and a range of 2-9. In phase two, 44% (27/61) of hand-written forms were missing essential complications. There were no domain failures amongst 29 electronically-produced consent forms and no variability in the documentation of potential complications. Completion of hand-written consent forms suffers from wide variation and is frequently suboptimal. Electronically-produced, procedure-specific consent forms can improve the quality and consistency of consent documentation. Copyright © 2015 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Audit of nuclear medicine scientific and technical standards.

PubMed

Jarritt, Peter H; Perkins, Alan C; Woods, Sandra D

2004-08-01

The British Nuclear Medicine Society has developed a process for the service-specific organizational audit of nuclear medicine departments. This process identified the need for a scheme suitable for the audit of the scientific and technical standards of a department providing such a service. This document has evolved following audit visits of a number of UK departments. It is intended to be used as a written document to facilitate the audit procedure and may be used for both external and self-audit purposes. Scientific and technical standards have been derived from a number of sources, including regulatory documents, notes for guidance and peer-reviewed publications. The audit scheme is presented as a series of questions with responses graded according to legal and safety obligations (A), good practice (B) and desirable aspects of service delivery (C). This document should be regarded as part of an audit framework and should be kept under review as the process evolves to meet the future demands of this high-technology-based clinical service.

An audit of the nature and impact of clinical coding subjectivity variability and error in otolaryngology.

PubMed

Nouraei, S A R; Hudovsky, A; Virk, J S; Chatrath, P; Sandhu, G S

2013-12-01

To audit the accuracy of clinical coding in otolaryngology, assess the effectiveness of previously implemented interventions, and determine ways in which it can be further improved. Prospective clinician-auditor multidisciplinary audit of clinical coding accuracy. Elective and emergency ENT admissions and day-case activity. Concordance between initial coding and the clinician-auditor multi-disciplinary teams (MDT) coding in respect of primary and secondary diagnoses and procedures, health resource groupings health resource groupings (HRGs) and tariffs. The audit of 3131 randomly selected otolaryngology patients between 2010 and 2012 resulted in 420 instances of change to the primary diagnosis (13%) and 417 changes to the primary procedure (13%). In 1420 cases (44%), there was at least one change to the initial coding and 514 (16%) health resource groupings changed. There was an income variance of £343,169 or £109.46 per patient. The highest rates of health resource groupings change were observed in head and neck surgery and in particular skull-based surgery, laryngology and within that tracheostomy, and emergency admissions, and specially, epistaxis management. A randomly selected sample of 235 patients from the audit were subjected to a second audit by a second clinician-auditor multi-disciplinary team. There were 12 further health resource groupings changes (5%) and at least one further coding change occurred in 57 patients (24%). These changes were significantly lower than those observed in the pre-audit sample, but were also significantly greater than zero. Asking surgeons to 'code in theatre' and applying these codes without further quality assurance to activity resulted in an health resource groupings error rate of 45%. The full audit sample was regrouped under health resource groupings 3.5 and was compared with a previous audit of 1250 patients performed between 2007 and 2008. This comparison showed a reduction in the baseline rate of health resource groupings change from 16% during the first audit cycle to 9% in the current audit cycle (P < 0.001). Otolaryngology coding is complex and susceptible to subjectivity, variability and error. Coding variability can be improved, but not eliminated through regular education supported by an audit programme. © 2013 John Wiley & Sons Ltd.

Operative blood transfusion quality improvement audit.

PubMed

Al Sohaibani, Mazen; Al Malki, Assaf; Pogaku, Venumadhav; Al Dossary, Saad; Al Bernawi, Hanan

2014-01-01

To determine how current anesthesia team handless the identification of surgical anaesthetized patient (right patient). And the check of blood unit before collecting and immediately before blood administration (right blood) in operating rooms where nurses have minimal duties and responsibility to handle blood for transfusion in anaesthetized patients. To elicit the degree of anesthesia staff compliance with new policies and procedures for anaesthetized surgical patient the blood transfusion administration. A large tertiary care reference and teaching hospital. A prospective quality improvement. Elaboration on steps for administration of transfusion from policies and procedures to anaesthetized patients; and analysis of the audit forms for conducted transfusions. An audit form was used to get key performance indicators (KPIs) observed in all procedures involve blood transfusion and was ticked as item was met, partially met, not met or not applicable. Descriptive statistics as number and percentage Microsoft excel 2003. Central quality improvement committee presented the results in number percentage and graphs. The degree of compliance in performing the phases of blood transfusion by anesthesia staff reached high percentage which let us feel certain that the quality is assured that the internal policy and procedures (IPP) are followed in the great majority of all types of red cells and other blood products transfusion from the start of requesting the blood or blood product to the prescript of checking the patient in the immediate post-transfusion period. Specific problem area of giving blood transfusion to anaesthetized patient was checking KPI concerning the phases of blood transfusion was audited and assured the investigators of high quality performance in procedures of transfusion.

Auditing Staff-Management Communication in Schools: A Framework for Evaluating Performance.

ERIC Educational Resources Information Center

Tourish, Dennis; Hargie, Owen

1998-01-01

Outlines the principles and procedures of an organizational communication audit as a measure of the effectiveness of personnel management in elementary and secondary schools, examining the principal tools used and the benefits that this approach offers to school management teams. (Author/MSE)

The Communication Audit as a Class Project.

ERIC Educational Resources Information Center

Conaway, Roger N.

1994-01-01

Describes a class project in which students conduct a "communication audit" or assessment of an off-campus organization, providing students with opportunities to explore, examine, monitor, and evaluate communication in a practical way. Discusses grading, beginning the class, contacting clients, instrumentation and procedures, costs, and…

[Audit of general hospitals and private surgical clinics in Israel].

PubMed

Freund, Ruth; Dor, Michael; Lotan, Yoram; Haver, Eitan

2007-12-01

Supervision and inspection of medical facilities are among the responsibilities of the Ministry of Health (MOH) anchored in the "Public Health Act 1940". In order to implement the law, the General Medical Division of the MOH began the process of auditing hospitals and private surgical clinics prior to considering the reissue of their license. The audit aimed to implement the law, activate supervision on general hospitals and private surgical clinics, provide feed-back to the audited institution and upgrade quality assurance, regulate medical activities according to the activities elaborated in the license and recommend the license renewal. Prior to the audits, 20 areas of activity were chosen for inspection. For each activity a check list was developed as a tool for inspection. Each area was inspected during a 4-5 hour visit by a MOH expert, accompanied by the local service manager in the institution under inspection. A comprehensive report, summarizing the findings was sent to the medical institute, requesting correction in those areas where improvements were needed. Recommendation for license renewal was sent to the Director of Licensing Division Ministry of Health. Between June 2003 and July 2006, 91 structured audits took place. A total of 47 general hospitals and 24 private surgical clinics were visited at least once. Most general hospitals were found abiding, functioning according to the required standards and eligible for license renewal. Licenses of institutions that complied with the standards determined by the audit teams, were renewed. Two private hospitals in central Israel, that were given an overall poor evaluation, were issued with a temporary license and subsequently re-audited 4 times over the next two years. Generally, the standards in private surgical clinics were lower than those found in general public hospitals. In one clinic the license was not renewed, and in another an order was issued to cease surgical procedures requiring general anesthesia. The evaluations were mainly qualitative, deliberately avoiding numerical rating. In order to improve the process in the future and facilitate common scale rating to establish an equitable comparison system between institutions, it will be necessary to develop more quality measures and compulsory standards, based on the measures used during the first round of audits. Publication of the results of such comparisons, will elevate medical performance, and ultimately improve the quality of services and medical care in Israel.

An Environmental Management Model of Thermal Waters in Entre Ríos Province, Argentina

NASA Astrophysics Data System (ADS)

Pablo, Mársico Daniel; Luís, Díaz Eduardo; Ivana, Zecca; Oscar, Dallacosta; Antonio, Paz-González

2015-04-01

Deep exploratory drillings, i.e. those with more than 500 meters depth, have been performed in the Entre Ríos province, Argentina, in order to ascertain the presence of thermal water. Drilling began in 1994, and until now there have been 18 polls with very variable results in terms of mineralization, resource flow, and temperature. The aim of this study was to present a management model, which should allow operators of thermal complexes to further develop procedures for safeguarding the biodiversity of the ecosystems involved, both during exploration and exploitation activities. The environmental management Plan proposed is constituted by a set of technical procedures that are formulated and should be performed during the stages of exploration and exploitation of the resource, and consists of: environmental monitoring, environmental audit, public information and contingency programs. This Plan describes the measures and proposals aimed at protecting environmental quality in the area of influence of a thermal complex project, ensuring that its execution remains environmentally responsibly, and allowing implementation of specific actions to prevent or correct environmental impacts, as predicted in the evaluation of the Environmental Program. The audit of environmental impact includes and takes into account natural factors, such as water, soil, atmosphere, flora and fauna, and also cultural factors. The technical audit Plan was prepared in order to get a systematic structure and organization of the verification process, and also with regard to document the degree of implementation of the proposed mitigation measures. Finally, an environmental contingency program was implemented, and its objective was to consider the safeguarding of life and its natural environment. Thus, a guide has been developed with the main actions to be taken on a contingency, since forecast increases the efficiency of the response. The methodology developed here was adopted as the procedure required by the authority for the application and regulation of the hydro-geo-thermal resources of the province of Entre Ríos, and it is also useful for the control and protection of the resource.

[Audit "Toys and incubators in neonatology"].

PubMed

Raginel, T; Bigoin-Dupont, M; Aguelon, V; Fines-Guyon, M; Guillemin, M G

2009-08-01

Owing to an increase in nosocomial septicaemias in the Neonatalogy department, we've judged it necessary to consider the role of items not linked to the nursing procedures, and nevertheless present in the incubators, as well as the hygiene techniques applied to them. In November 2007, we've made a longitudinal prospective study consisting in an observation audit during 3 successive days, observing every single incubator with a newborn baby. In each incubator, we've checked whether there were or not items that weren't required by the nursing activities, along with their characteristics and the hygiene procedures applied to them. We've inquired as well whether the parents and the nursing staff knew and applied the required hygiene procedures. In 13 among the 17 incubators under survey, at least one item not strictly required by the nursing procedures could be found. The number of toys in each incubator varied from seven to one. Among the 33 toys surveyed, 24 (73%) of them showed a score of maximum fluffiness (4 out of 4), and only 10 wore labels giving cleansing advice from the manufacturers. Without any record about the cleaning/disinfecting of the toys brought in hospital, we have observed that the parents were given varied advice about how to clean the toys at home before putting them in the incubators (only four parents had washed the toys in their washing machines at more than 30 degrees C). From the six samples under scrutiny, all the culture results were tested positive. In particular two of the soft toys sampled were found infected by a Pseudomonas oryzihabitans. These particular toys belonged to a baby who had been diagnosed with a septicaemia characterized by hemocultures positive to a P. oryzihabitans of a different strain. Our audit has been an efficient reminder that any item put in an incubator is a potential vector and reservoir of pathogen organisms. After a general feedback towards the department staff, the medical staff then prescribed to permanently ban all the items not strictly required by the nursing activities from all the incubators of the department.

Report: Weiss, Sugar, Dvorak & Dusek, Ltd., Single Audit of the Delta Institute and Affiliates for Year Ended June 30, 2003

EPA Pesticide Factsheets

Report #2006-S-00004, August 17, 2006. Weiss, Sugar, Dvorak & Dusek, Ltd., did not have sufficient quality control review procedures in place to ensure that all audit work performed was adequately supported by documentary evidence.

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

38 CFR 36.4348 - Servicer Appraisal Processing Program.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirement, routine reviews of SAPP cases will be made by VA staff based upon quality control procedures..., that its activities do not deviate from high standards of integrity. The quality control system must include frequent, periodic audits that specifically address the appraisal review activity. These audits...

49 CFR 385.107 - The safety audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 5 2010-10-01 2010-10-01 false The safety audit. 385.107 Section 385.107 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES Safety Monitoring System for Mexico-Domicile...

42 CFR 124.513 - Public facility compliance alternative.

Code of Federal Regulations, 2010 CFR

2010-10-01

... if not received, claimed, as reimbursement under titles XVIII and XIX of the Social Security Act... certified audit, conducted in accordance with procedures specified by the Secretary, of the facility's records maintained pursuant to § 124.510. If the audit establishes to the Secretary's satisfaction that no...

42 CFR 124.513 - Public facility compliance alternative.

Code of Federal Regulations, 2011 CFR

2011-10-01

... if not received, claimed, as reimbursement under titles XVIII and XIX of the Social Security Act... certified audit, conducted in accordance with procedures specified by the Secretary, of the facility's records maintained pursuant to § 124.510. If the audit establishes to the Secretary's satisfaction that no...

Working Together To Improve Middle School Student Achievement.

ERIC Educational Resources Information Center

Hatch, Holly; Hytten, Kathy

1997-01-01

Involving stakeholders in school-district assessment and planning provides a common learning experience that results in numerous organizational and professional growth benefits. This paper describes one district's experiences with a middle-grades reform audit, examining the rationale, procedures, and application of the audit and planning process…

12 CFR 19.244 - Automatic removal, suspension, and debarment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 19.244 Automatic removal, suspension, and debarment. (a) An independent public accountant or accounting firm may not perform audit services for insured national banks if the accountant or firm: (1) Is...

12 CFR 19.244 - Automatic removal, suspension, and debarment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 19.244 Automatic removal, suspension, and debarment. (a) An independent public accountant or accounting firm may not perform audit services for insured national banks if the accountant or firm: (1) Is...

12 CFR 19.244 - Automatic removal, suspension, and debarment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 19.244 Automatic removal, suspension, and debarment. (a) An independent public accountant or accounting firm may not perform audit services for insured national banks if the accountant or firm: (1) Is...

12 CFR 19.244 - Automatic removal, suspension, and debarment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 19.244 Automatic removal, suspension, and debarment. (a) An independent public accountant or accounting firm may not perform audit services for insured national banks if the accountant or firm: (1) Is...

48 CFR 642.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Procedures. 642.1503 Section 642.1503 Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 642.1503 Procedures. ...

40 CFR 92.506 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 92.506 Section 92.506... and Audit Programs § 92.506 Test procedures. (a)(1) For locomotives and locomotive engines subject to the provisions of this subpart, the prescribed test procedures are those procedures described in...

21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... accordance with its standard operating procedure of the information identified in paragraphs (a)(1), (a)(2... shall establish a written standard operating procedure for the collection, maintenance, and auditing of... standard operating procedure: (1) Data collection and recording procedures, which shall include a procedure...

12 CFR 308.600 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... procedures for the removal, suspension, or debarment of independent public accountants and accounting firms... PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 308.600 Scope...

12 CFR 308.600 - Scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 308.600 Scope... procedures for the removal, suspension, or debarment of independent public accountants and accounting firms...

12 CFR 308.600 - Scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 308.600 Scope... procedures for the removal, suspension, or debarment of independent public accountants and accounting firms...

12 CFR 308.600 - Scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 308.600 Scope... procedures for the removal, suspension, or debarment of independent public accountants and accounting firms...

12 CFR 308.600 - Scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 308.600 Scope... procedures for the removal, suspension, or debarment of independent public accountants and accounting firms...

34 CFR 600.20 - Application procedures for establishing, reestablishing, maintaining, or expanding institutional...

Code of Federal Regulations, 2010 CFR

2010-07-01

... accordance with Generally Accepted Accounting Principles (GAAP) published by the Financial Accounting... accreditation status, including approval of any non-degree programs it offers; (iii) Audited financial... accordance with the requirements of 34 CFR 668.23; and (iv) Audited financial statements of the institution's...

Virtual Road Safety Audits: Recommended Procedures for Using Driving Simulation and Technology to Expand Existing Practices

DOT National Transportation Integrated Search

2018-02-02

One approach that has been proposed to address the limitations of the current reactive safetymonitoring approaches is the use of road safety audits (RSAs). As part of an RSA, the existing or expected characteristics and traffic conditions of a locati...

17 CFR 1.31 - Books and records; keeping and inspection.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commission or the Department of Justice, facilities for immediate, easily readable projection or production... the request. (ii) Develop and maintain written operational procedures and controls (an “audit system... electronic storage media such that: (A) The results of such audit system are available at all times for...

Why Audit Communication in Organizations?

ERIC Educational Resources Information Center

White, Noel D.; Greenbaum, Howard H.

The purpose of this paper is to present a common sense proposal, as opposed to a documented proposal, arguing for the adoption of a periodic communication audit procedure in organizations. The paper presents an approach and information the communication consultant can utilize in addressing management practitioners on the topic: "Why Audit…

The Use of Fractionation Scales for Communication Audits.

ERIC Educational Resources Information Center

Barnett, George A.; And Others

A study investigated a new method of measuring organizational communication other than the audit methods currently in use. The method, which employs fractionation procedures, was used with workers from five different business groups within a large multinational corporation. The results showed that: (1) workers could use the scales reliably, (2)…

49 CFR 385.319 - What happens after completion of the safety audit?

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 5 2011-10-01 2011-10-01 false What happens after completion of the safety audit...) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.319 What happens after...

12 CFR 1710.18 - Change of audit partner.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Change of audit partner. 1710.18 Section 1710.18 Banks and Banking OFFICE OF FEDERAL HOUSING ENTERPRISE OVERSIGHT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SAFETY AND SOUNDNESS CORPORATE GOVERNANCE Corporate Practices and Procedures § 1710.18 Change of...

14 CFR 151.55 - Accounting and audit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Accounting and audit. 151.55 Section 151.55... FEDERAL AID TO AIRPORTS Rules and Procedures for Airport Development Projects § 151.55 Accounting and... accounting record to allow appropriate personnel of the FAA to determine all funds received (including funds...

Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study.

PubMed

Dawson, Samantha L; Baker, Tim; Salzman, Scott

2015-04-01

There is little evidence that useful electronic data could be collected at Australian small rural emergency services. If in future their funding model changed to the Activity-Based Funding model, then they would need to collect and submit more data. We determine whether it is possible to collect episode-level data at six small rural emergency services and quantify the accuracy of eight fields. A prospective cross-sectional study. South-West Victoria, Australia. Six small rural emergency services. We collected and audited episode-level emergency data from participating services between 1 February 2011 and 31 January 2012. A random sample of these data were audited monthly. Research assistants located at each service supported data entry and audited data accuracy for four hours per week. Rates for data completeness, accuracy and total accuracy were calculated using audit data. Episode-level data were collected for 20 224 presentations across six facilities. The audit dataset consisted of 8.5% (1504/17 627) of presentations from five facilities. For all fields audited, the accuracy of entered data was high (>93%).Triage category was deemed appropriate for 95.9% (95% confidence interval (CI): 94.9-96.9%) of the patient records reviewed. Some procedures were missing (28.7%, 95%CI: 27.2-30.3%). No significant improvement in data accuracy over 12 months was observed. All six services collected useful episode-level data for 12-months with four hours per week of assistance. Data entry accuracy was high for all fields audited, and data entry completeness was low for procedures. © 2015 National Rural Health Alliance Inc.

Report on the Audit of Unattended Ground Sensor Systems

DTIC Science & Technology

1991-02-26

This final report on the Audit of Unattended Ground Sensor Systems is for your information and use. Comments on the draft were considered in...preparing the final report and changes have been made where appropriate. We performed the audit from February through August 1990. The objective was to

Flexible Audit Trailing in Interactive Courseware.

ERIC Educational Resources Information Center

Judd, Terry; Kennedy, Gregor

This paper reports on the development and implementation of a flexible audit trail system comprising a library of auditing functions that can be embedded into interactive courseware and customized to the requirements of researchers and developers. A series of essential criteria considered critical to the development of a robust, flexible audit…

Equality Audits in Education: Exercises in Compliance or Frameworks for Inclusion?

ERIC Educational Resources Information Center

Morrison, Marlene

2007-01-01

Ethnography is used sparingly in audits, giving "richness" to phenomena which are preferably measured rather than interrogated. This paper considers the development of qualitative tools for equality audits in education settings, drawing upon an equal status review conducted in Ireland during 2005-2006 with dual interests in…

48 CFR 42.902 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Procedures. 42.902 Section 42.902 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Bankruptcy 42.902 Procedures. (a) When notified of bankruptcy...

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1503 Procedures. (a) Agency procedures for the past performance evaluation system shall generally provide for input to the.... Those individuals identified may obtain information for the evaluation of performance from the program...

Inspector General, Department of Defense, Semiannual Report to the Congress, April 1, 2010 - September 30, 2010

DTIC Science & Technology

2010-10-01

Centers 06/21/2010 USAAA A-2010-0121-ALO Real Property Sustainment, Restoration, and Modernization 06/25/2010 USAAA A-2010-0124- FFM Review of Port...Supply Enhanced System, Project Manager, 07/07/2010 Cruise Missile Defense System USAAA A-2010-0131- FFM Agreed-Upon Procedures Attestation of Audit... FFM Follow-up Audit of FY 05 Subsistence Charges 07/29/2010 USAAA A-2010-0144-ALR Follow-up Audit of Property Accountability, Oklahoma Army National

[Blood transfusion audit methodology: the auditors, reference systems and audit guidelines].

PubMed

Chevrolle, F; Hadzlik, E; Arnold, J; Hergon, E

2000-12-01

The audit has become an essential aspect of the blood transfusion sector, and is a management tool that should be used judiciously. The main types of audit that can be envisaged in blood transfusion are the following: operational audit concerning a predetermined activity; systems quality audit; competence audit, combining the operational audit on a specific activity with quality management, e.g., laboratory accreditation; audit of the environmental management system; and social audit involving the organization of an activity and the management of human resources. However, the main type of audit considered in this article is the conformity audit, which in this context does not refer to internal control but to conformity with an internal guideline issued by the French National Blood Service. All audits are carried out on the basis of a predescribed method (contained in ISO 10 011). The audit is a system of investigation, evaluation and measurement, and also a means of continuous assessment and therefore improvement. The audit is based on set guidelines, but in fact consists of determining the difference between the directions given and what has actually been done. Auditing requires operational rigor and integrity, and has now become a profession in its own right.

The challenges of implementing a multi-centre audit of end-of-life care in care homes.

PubMed

Levy, Jean; Kinley, Julie; Conway, Frances

2016-11-02

This article aims to share the experience of a hospice in facilitating a multi-centre audit of end-of-life care in care homes, particularly noting the challenges and enablers of carrying out the audit. The audit was a retrospective multi-centre survey of bereaved relatives/next of kin of residents who died in the care home, using an anonymous, validated questionnaire: the Family Perception of Care Scale. Questionnaires were sent 3-months after bereavement. Returned questionnaires were analysed using SPSS and Excel. The care homes were in areas encompassing outer and inner city populations. The team identified eight challenges to the audit process, in particular, embedding procedures within the care homes, non-responses and developing action plans for improvement. Overall, the audit provided an indication of where improvements could be made and where care was already excellent, built confidence and increased expertise in the care-home staff.

The value to blood establishments of supplier quality audit and of adopting a European Blood Alliance collaborative approach

PubMed Central

Nightingale, Mark J.; Ceulemans, Jan; Ágoston, Stephanie; van Mourik, Peter; Marcou-Cherdel, Céline; Wickens, Betty; Johnstone, Pauline

2014-01-01

Background The assessment of suppliers of critical goods and services to European blood establishments is a regulatory requirement proving difficult to resource. This study was to establish whether European Blood Alliance member blood services could collaborate to reduce the cost of auditing suppliers without diminishing standards. Materials and method Five blood services took part, each contributing a maximum of one qualified auditor per audit (rather than the usual two). Four audits were completed involving eight auditors in total to a European Blood Alliance agreed policy and process using an audit scope agreed with suppliers. Results Audits produced a total of 22 observations, the majority relating to good manufacturing practice and highlighted deficiencies in processes, procedures and quality records including complaints’ handling, product recall, equipment calibration, management of change, facilities’ maintenance and monitoring and business continuity. Auditors reported that audits had been useful to their service and all audits prompted a positive response from suppliers with satisfactory corrective action plans where applicable. Audit costs totalled € 3,438 (average € 860 per audit) which is no more than equivalent traditional audits. The four audit reports have been shared amongst the five participating blood establishments and benefitted 13 recipient departments in total. Previously, 13 separate audits would have been required by the five blood services. Discussion Collaborative supplier audit has proven an effective and efficient initiative that can reduce the resource requirements of both suppliers and individual blood service’s auditing costs. Collaborative supplier audit has since been established within routine European Blood Alliance management practice. PMID:24553596

Audit of lymphadenectomy in lung cancer resections using a specimen collection kit and checklist

PubMed Central

Osarogiagbon, Raymond U.; Sareen, Srishti; Eke, Ransome; Yu, Xinhua; McHugh, Laura M.; Kernstine, Kemp H.; Putnam, Joe B.; Robbins, Edward T.

2014-01-01

Background Audits of operative summaries and pathology reports reveal wide discordance in identifying the extent of lymphadenectomy performed (the communication gap). We tested the ability of a pre-labeled lymph node specimen collection kit and checklist to narrow the communication gap between operating surgeons, pathologists, and auditors of surgeons’ operation notes. Methods We conducted a prospective single cohort study of lung cancer resections performed with a lymph node collection kit from November 2010 to January 2013. We used the kappa statistic to compare surgeon claims on a checklist of lymph node stations harvested intraoperatively, to pathology reports, and an independent audit of surgeons’ operative summaries. Lymph node collection procedures were classified into 4 groups based on the anatomic origin of resected lymph nodes: mediastinal lymph node dissection, systematic sampling, random sampling and no sampling. Results From the pathology report, 73% of 160 resections had a mediastinal lymph node dissection or systematic sampling procedure, 27% had random sampling. The concordance with surgeon claims was 80% (kappa statistic 0.69 [CI 0.60 – 0.79]). Concordance between independent audits of the operation notes and either the pathology report (kappa 0.14 [0.04 – 0.23]), or surgeon claims (kappa 0.09 [0.03 – 0.22]), was poor. Conclusion A pre-labeled specimen collection kit and checklist significantly narrowed the communication gap between surgeons and pathologists in identifying the extent of lymphadenectomy. Audit of surgeons’ operation notes did not accurately reflect the procedure performed, bringing its value for quality improvement work into question. PMID:25530090

The assessment and management of chemotherapy-induced nausea and vomiting among cancer patients in a chemotherapy ward: a best practice implementation project.

PubMed

Gu, Lingli; Li, Jing

2016-03-01

Chemotherapy-induced nausea and vomiting (CINV) are considered to be two of the most distressing side-effects of chemotherapy. They have a negative impact on a patient's quality of life and can influence the continuance of treatment. Owing to the lack of effective management of CINV, regular assessment and management of CINV is recommended for patients undergoing chemotherapy. The aim of this project was to integrate the available evidence on the assessment and management of CINV into practice, and implement strategies to improve compliance with evidence-based practice. The project carried out a pre- and post-implementation audit procedure using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice programs. Five audit criteria were established according to the best available evidence on the assessment and management of CINV. The program was divided into three phases and conducted over four months in the chemotherapy ward, Fudan University Shanghai Cancer Center, Shanghai, China. Sixty patients and 14 oncology nurses were involved in this project. The results of the follow-up cycle showed that the compliance rates regarding patient education, risk factors evaluation and non-pharmacologic managements were 100%, 100% and 80%, respectively. The rate of validated tools being used by patients and nurses improved by 93% and 97%, respectively. This project demonstrated that the use of pre- and post-best practice audits is an effective method for incorporating evidence into practice in a chemotherapy ward. The practice of assessing and managing CINV was significantly improved. The next step is to develop strategies for sustaining the new procedures of CINV assessment and management.

A risk-based auditing process for pharmaceutical manufacturers.

PubMed

Vargo, Susan; Dana, Bob; Rangavajhula, Vijaya; Rönninger, Stephan

2014-01-01

The purpose of this article is to share ideas on developing a risk-based model for the scheduling of audits (both internal and external). Audits are a key element of a manufacturer's quality system and provide an independent means of evaluating the manufacturer's or the supplier/vendor's compliance status. Suggestions for risk-based scheduling approaches are discussed in the article. Pharmaceutical manufacturers are required to establish and implement a quality system. The quality system is an organizational structure defining responsibilities, procedures, processes, and resources that the manufacturer has established to ensure quality throughout the manufacturing process. Audits are a component of the manufacturer's quality system and provide a systematic and an independent means of evaluating the manufacturer's overall quality system and compliance status. Audits are performed at defined intervals for a specified duration. The intention of the audit process is to focus on key areas within the quality system and may not cover all relevant areas during each audit. In this article, the authors provide suggestions for risk-based scheduling approaches to aid pharmaceutical manufacturers in identifying the key focus areas for an audit.

40 CFR 86.608-98 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 20 2012-07-01 2012-07-01 false Test procedures. 86.608-98 Section 86... Auditing of New Light-Duty Vehicles, Light-Duty Trucks, and Heavy-Duty Vehicles § 86.608-98 Test procedures. (a) The prescribed test procedures are the Federal Test Procedure, as described in subpart B and/or...

Is audit research? The relationships between clinical audit and social-research.

PubMed

Hughes, Rhidian

2005-01-01

Quality has an established history in health care. Audit, as a means of quality assessment, is well understood and the existing literature has identified links between audit and research processes. This paper reviews the relationships between audit and research processes, highlighting how audit can be improved through the principles and practice of social research. The review begins by defining the audit process. It goes on to explore salient relationships between clinical audit and research, grouped into the following broad themes: ethical considerations, highlighting responsibilities towards others and the need for ethical review for audit; asking questions and using appropriate methods, emphasising transparency in audit methods; conceptual issues, including identifying problematic concepts, such as "satisfaction", and the importance of reflexivity within audit; emphasising research in context, highlighting the benefits of vignettes and action research; complementary methods, demonstrating improvements for the quality of findings; and training and multidisciplinary working, suggesting the need for closer relationships between researchers and clinical practitioners. Audit processes cannot be considered research. Both audit and research processes serve distinct purposes. Attention to the principles of research when conducting audit are necessary to improve the quality of audit and, in turn, the quality of health care.

[Assessment of the announcement procedure in 29 cancer-accredited hospitals in the Aquitaine region: the EVADA project].

PubMed

Rongère-Casteigt, Julie; Pinon, Elodie; Domecq, Sandrine; Hoppe, Stéphanie; Bousser, Véronique; Vimard, Edwige; Saillour-Glenisson, Florence

2015-01-01

An announcement procedure is mandatory to obtain accreditation to treat cancer patients. Health care professionals in the Aquitaine region evaluated the organization of this announcement procedure in their institutions and the patients' perception, in order to initiate actions to improve the structure and traceability of this procedure. Self-assessment approach based on a retrospective study plan comprising three concomitant steps: organizational audit, medical records audit and patient experience survey. 29 institutions participated in the study. Heterogeneous organizations were observed, although progress had been made in the deployment of the announcement procedure in terms of personnel training,formal organization and the resources devoted to this procedure, but there remains considerable room for improvement in terms of traceability, coordination between doctors and nursing staff, and referral of patients to supportive care. This evaluation triggered active mobilization of hospital teams concerning the announcement procedure in the Aquitaine region and a better awareness of the patient's perception. The regional dynamic allowed exchanges between institutions, facilitating the implementation of improvement actions.

In Need of Review? The Audit Commission's Report on Statutory Assessment and Statements of Special Educational Needs.

ERIC Educational Resources Information Center

Pinney, Anne

2002-01-01

This article summarizes findings presented in a report by the Audit Commission on the provision for children with disabilities. It discusses widespread dissatisfaction with student assessment, development of statements, resource allocation to support children with special educational needs, and procedures to ensure services are effective.…

78 FR 56740 - Grant of Individual Exemption Involving UBS AG (UBS or the Applicant); Located in Zurich...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-13

... requirements: (1) An independent auditor, who has appropriate technical training and proficiency with Title I of ERISA, shall conduct an annual written audit; (2) The audit shall specifically require the auditor... and written policies and procedures requirements described in paragraph (f); (4) The auditor shall...

75 FR 38812 - Sunshine Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-06

... FEDERAL ELECTION COMMISSION Sunshine Act Notice DATE AND TIME: Thursday, July 1, 2010, at 10 a.m. PLACE: 999 E Street, NW., Washington, DC (Ninth Floor). STATUS: This meeting will be open to the public. Items To Be Discussed Correction and Approval of Minutes. Discussion of Audit Policies and Procedures. Report of the Audit Division on the...

17 CFR 240.13b2-2 - Representations and conduct in connection with the preparation of required reports and documents.

Code of Federal Regulations, 2012 CFR

2012-04-01

... misleading” include, but are not limited to, actions taken at any time with respect to the professional... material violations of generally accepted accounting principles, generally accepted auditing standards, or other professional or regulatory standards); (ii) Not to perform audit, review or other procedures...

17 CFR 240.13b2-2 - Representations and conduct in connection with the preparation of required reports and documents.

Code of Federal Regulations, 2011 CFR

2011-04-01

... misleading” include, but are not limited to, actions taken at any time with respect to the professional... material violations of generally accepted accounting principles, generally accepted auditing standards, or other professional or regulatory standards); (ii) Not to perform audit, review or other procedures...

17 CFR 240.13b2-2 - Representations and conduct in connection with the preparation of required reports and documents.

Code of Federal Regulations, 2014 CFR

2014-04-01

... misleading” include, but are not limited to, actions taken at any time with respect to the professional... material violations of generally accepted accounting principles, generally accepted auditing standards, or other professional or regulatory standards); (ii) Not to perform audit, review or other procedures...

17 CFR 240.13b2-2 - Representations and conduct in connection with the preparation of required reports and documents.

Code of Federal Regulations, 2010 CFR

2010-04-01

... misleading” include, but are not limited to, actions taken at any time with respect to the professional... material violations of generally accepted accounting principles, generally accepted auditing standards, or other professional or regulatory standards); (ii) Not to perform audit, review or other procedures...

17 CFR 240.13b2-2 - Representations and conduct in connection with the preparation of required reports and documents.

Code of Federal Regulations, 2013 CFR

2013-04-01

... misleading” include, but are not limited to, actions taken at any time with respect to the professional... material violations of generally accepted accounting principles, generally accepted auditing standards, or other professional or regulatory standards); (ii) Not to perform audit, review or other procedures...

A Communication Audit of a State Mental Health Institution.

ERIC Educational Resources Information Center

Eadie, William F.; And Others

An adaptation of "communication audit" procedures was used to evaluate the communication patterns at a mental health center (MHC). The evaluation included initial interviews with 28 MHC workers/administrators, a survey of 215 staff members for a communication network analysis, and followup interviews with another 28 persons. The data produced four…

Mortality reporting in interventional radiology: experience of a pilot audit with the Scottish Audit of Surgical Mortality.

PubMed

White, R D; Ingram, S; Moss, J G; Pace, N; Chakraverty, S

2013-10-01

To describe the initial pilot phase of the 2009 Scottish Audit of Surgical Mortality (SASM), which includes outcomes and difficulties that arose during any interventional radiology (IR) procedure performed on patients in this audit over an 18 month period. Approximately 40 consultant interventional radiologists from all units in Scotland elected to participate in the audit. Each response was then peer reviewed after anonymisation of the patient and institution. If a relevant ACON (area for consideration or area of concern) was generated, this was checked by one of the other reviewers before communication with the original reporting radiologist and colleagues. There was then a right of reply by the reporting unit before formal documentation was sent out. Initial results were analysed after 18 months period, during which time 95 forms relating to deaths of surgical inpatients were sent to interventional radiologists identified as having been involved in an IR procedure at some time during the patient's admission. Seventy-one forms had been returned by July 2010, of which 46 had gone through the entire SASM process. From these, 10 ACONs were attributed. Anonymised case vignettes and reports from these were used as educational tools. Involvement with SASM is a useful process. Significant safety issues and learning points were identified in the pilot. The majority of ACONs identified by the audit were in patients who had undergone percutaneous biliary interventions. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Audit of transfusion procedures in 660 hospitals. A College of American Pathologists Q-Probes study of patient identification and vital sign monitoring frequencies in 16494 transfusions.

PubMed

Novis, David A; Miller, Karen A; Howanitz, Peter J; Renner, Stephen W; Walsh, Molly K

2003-05-01

Hemolytic transfusion reactions are often the result of failure to follow established identification and monitoring procedures. To measure the frequencies with which health care workers completed specific transfusion procedures required for laboratory and blood bank accreditation. In 2 separate studies, participants in the College of American Pathologists Q-Probes laboratory quality improvement program audited nonemergent red blood cell transfusions prospectively and completed questionnaires profiling their institutions' transfusion policies. A total of 660 institutions, predominantly in the United States, at which transfusion medicine services are provided. The percentages of transfusions for which participants completed 4 specific components of patient and blood unit identifications, and for which participants monitored vital signs at 3 specific intervals during transfusions. In the first study, all components of patient identification procedures were performed in 62.3%, and all required patient vital sign monitoring was performed in 81.6% of 12 448 transfusions audited. The median frequencies with which institutions participating in the first study performed all patient identification and monitoring procedures were 69.0% and 90.2%, respectively. In the second study, all components of patient identification were performed in 25.4% and all patient vital sign monitoring was performed in 88.3% of 4046 transfusions audited. The median frequencies with which institutions participating in the second study performed all patient identification and monitoring procedures were 10.0% and 95.0%, respectively. Individual practices and/or institutional policies associated with greater frequencies of patient identification and/or vital sign monitoring included transporting units of blood directly to patient bedsides, having no more than 1 individual handle blood units in route, checking unit labels against physicians' orders, having patients wear identification tags (wristbands), reading identification information aloud when 2 or more transfusionists participated, using written checklists to guide the administration of blood, instructing health care personnel in transfusion practices, and routinely auditing the administration of transfusions. In many hospitals, the functions of identification and vital sign monitoring of patients receiving blood transfusions do not meet laboratory and blood bank accreditation standards. Differences in hospital transfusion policies influence how well health care workers comply with standard practices. We would expect that efforts designed to perfect transfusion policies might also improve performance in those hospitals in which practice compliance is substandard.

Building thermography as a tool in energy audits and building commissioning procedure

NASA Astrophysics Data System (ADS)

Kauppinen, Timo

2007-04-01

A Building Commissioning-project (ToVa) was launched in Finland in the year 2003. A comprehensive commissioning procedure, including the building process and operation stage was developed in the project. This procedure will confirm the precise documentation of client's goals, definition of planning goals and the performance of the building. It is rather usual, that within 1-2 years after introduction the users complain about the defects or performance malfunctions of the building. Thermography is one important manual tool in verifying the thermal performance of the building envelope. In this paper the results of one pilot building (a school) will be presented. In surveying the condition and energy efficiency of buildings, various auxiliary means are needed. We can compare the consumption data of the target building with other, same type of buildings by benchmarking. Energy audit helps to localize and determine the energy saving potential. The most general and also most effective auxiliary means in monitoring the thermal performance of building envelopes is an infrared camera. In this presentation some examples of the use of thermography in energy audits are presented.

Quality of inguinal hernia operative reports: room for improvement

PubMed Central

Ma, Grace W.; Pooni, Amandeep; Forbes, Shawn S.; Eskicioglu, Cagla; Pearsall, Emily; Brenneman, Fred D.; McLeod, Robin S.

2013-01-01

Background Operative reports (ORs) serve as the official documentation of surgical procedures. They are essential for optimal patient care, physician accountability and billing, and direction for clinical research and auditing. Nonstandardized narrative reports are often of poor quality and lacking in detail. We sought to audit the completeness of narrative inguinal hernia ORs. Methods A standardized checklist for inguinal hernia repair (IHR) comprising 33 variables was developed by consensus of 4 surgeons. Five high-volume IHR surgeons categorized items as essential, preferable or nonessential. We audited ORs for open IHR at 6 academic hospitals. Results We audited 213 ORs, and we excluded 7 femoral hernia ORs. Tension-free repairs were the most common (82.5%), and the plug-and-patch technique was the most frequent (52.9%). Residents dictated 59% of ORs. Of 33 variables, 15 were considered essential and, on average, 10.8 ± 1.3 were included. Poorly reported elements included first occurrence versus recurrent repair (8.3%), small bowel viability in incarcerated hernias (10.7%) and occurrence of intraoperative complications (32.5%). Of 18 nonessential elements, deep vein thrombosis prophylaxis, preoperative antibiotics and urgency were reported in 1.9%, 11.7% and 24.3% of ORs, respectively. Repair-specific details were reported in 0 to 97.1% of ORs, including patch sutured to tubercle (55.1%) and location of plug (67.0%). Conclusion Completeness of IHR ORs varied with regards to essential and nonessential items but were generally incomplete, suggesting there is opportunity for improvement, including implementation of a standardized synoptic OR. PMID:24284146

30 CFR 1206.363 - When is an ONRR audit, review, reconciliation, monitoring, or other like process considered final?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false When is an ONRR audit, review, reconciliation, monitoring, or other like process considered final? 1206.363 Section 1206.363 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE PRODUCT VALUATION...

30 CFR 1206.363 - When is an ONRR audit, review, reconciliation, monitoring, or other like process considered final?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 3 2013-07-01 2013-07-01 false When is an ONRR audit, review, reconciliation, monitoring, or other like process considered final? 1206.363 Section 1206.363 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE PRODUCT VALUATION...

30 CFR 1206.363 - When is an ONRR audit, review, reconciliation, monitoring, or other like process considered final?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 3 2014-07-01 2014-07-01 false When is an ONRR audit, review, reconciliation, monitoring, or other like process considered final? 1206.363 Section 1206.363 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR NATURAL RESOURCES REVENUE PRODUCT VALUATION...

Development of a Methodology for Customizing Insider Threat Auditing on a Linux Operating System

DTIC Science & Technology

2010-03-01

information /etc/group, passwd ,gshadow,shadow,/security/opasswd 16 User A attempts to access User B directory 17 User A attempts to access User B file w/o...configuration Handled by audit rules for root actions Audit user write attempts to system files -w /etc/group –p wxa -w /etc/ passwd –p wxa -w /etc/gshadow –p...information (/etc/group, /etc/ passwd , /etc/gshadow, /etc/shadow, /etc/sudoers, /etc/security/opasswd) Procedure: 1. User2 logs into the system

Audit of lymphadenectomy in lung cancer resections using a specimen collection kit and checklist.

PubMed

Osarogiagbon, Raymond U; Sareen, Srishti; Eke, Ransome; Yu, Xinhua; McHugh, Laura M; Kernstine, Kemp H; Putnam, Joe B; Robbins, Edward T

2015-02-01

Audits of operative summaries and pathology reports reveal wide discordance in identifying the extent of lymphadenectomy performed (the communication gap). We tested the ability of a prelabeled lymph node specimen collection kit and checklist to narrow the communication gap between operating surgeons, pathologists, and auditors of surgeons' operation notes. We conducted a prospective single cohort study of lung cancer resections performed with a lymph node collection kit from November 2010 to January 2013. We used the kappa statistic to compare surgeon claims on a checklist of lymph node stations harvested intraoperatively with pathology reports and an independent audit of surgeons' operative summaries. Lymph node collection procedures were classified into four groups based on the anatomic origin of resected lymph nodes: mediastinal lymph node dissection, systematic sampling, random sampling, and no sampling. From the pathology reports, 73% of 160 resections had a mediastinal lymph node dissection or systematic sampling procedure, 27% had random sampling. The concordance with surgeon claims was 80% (kappa statistic 0.69, 95% confidence interval: 0.60 to 0.79). Concordance between independent audits of the operation notes and either the pathology report (kappa 0.14, 95% confidence interval: 0.04 to 0.23) or surgeon claims (kappa 0.09, 95% confidence interval: 0.03 to 0.22) was poor. A prelabeled specimen collection kit and checklist significantly narrowed the communication gap between surgeons and pathologists in identifying the extent of lymphadenectomy. Audit of surgeons' operation notes did not accurately reflect the procedure performed, bringing its value for quality improvement work into question. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

A multidisciplinary audit of clinical coding accuracy in otolaryngology: financial, managerial and clinical governance considerations under payment-by-results.

PubMed

Nouraei, S A R; O'Hanlon, S; Butler, C R; Hadovsky, A; Donald, E; Benjamin, E; Sandhu, G S

2009-02-01

To audit the accuracy of otolaryngology clinical coding and identify ways of improving it. Prospective multidisciplinary audit, using the 'national standard clinical coding audit' methodology supplemented by 'double-reading and arbitration'. Teaching-hospital otolaryngology and clinical coding departments. Otolaryngology inpatient and day-surgery cases. Concordance between initial coding performed by a coder (first cycle) and final coding by a clinician-coder multidisciplinary team (MDT; second cycle) for primary and secondary diagnoses and procedures, and Health Resource Groupings (HRG) assignment. 1250 randomly-selected cases were studied. Coding errors occurred in 24.1% of cases (301/1250). The clinician-coder MDT reassigned 48 primary diagnoses and 186 primary procedures and identified a further 209 initially-missed secondary diagnoses and procedures. In 203 cases, patient's initial HRG changed. Incorrect coding caused an average revenue loss of 174.90 pounds per patient (14.7%) of which 60% of the total income variance was due to miscoding of a eight highly-complex head and neck cancer cases. The 'HRG drift' created the appearance of disproportionate resource utilisation when treating 'simple' cases. At our institution the total cost of maintaining a clinician-coder MDT was 4.8 times lower than the income regained through the double-reading process. This large audit of otolaryngology practice identifies a large degree of error in coding on discharge. This leads to significant loss of departmental revenue, and given that the same data is used for benchmarking and for making decisions about resource allocation, it distorts the picture of clinical practice. These can be rectified through implementing a cost-effective clinician-coder double-reading multidisciplinary team as part of a data-assurance clinical governance framework which we recommend should be established in hospitals.

Renal biopsies in children: current practice and audit of outcomes.

PubMed

Hussain, Farida; Mallik, Meeta; Marks, Stephen D; Watson, Alan R

2010-02-01

There is considerable variation in the way that children are prepared for and the techniques employed in a renal biopsy. There was national agreement between UK paediatric renal centres to review current practice and audit outcomes An initial questionnaire survey was undertaken and a 12-month prospective audit performed of renal biopsies against agreed standards for the number of needle passes, adequacy of biopsy material and complication rates. Eleven of 13 centres participated. Information leaflets are sent pre-biopsy in five centres with only one using play preparation. Six of 11 routinely perform biopsies as day-case (DC) procedures and 6 use general anaesthesia (GA). Real-time ultrasound is the favoured method in eight centres. Biopsies are performed by nephrologists only in four centres, nephrologists with radiologists in five and radiology alone in two. Of 531 biopsies (352 native), 31% were performed as a DC with 49% being done under GA. The standard for the number of passes of native kidneys (95%). The major complication rate was higher than the standard of

31 CFR 205.9 - What is included in a Treasury-State agreement?

Code of Federal Regulations, 2010 CFR

2010-07-01

... subpart A, consistent with §§ 205.3 and 205.4. A State must use its most recent Single Audit report as a... period instead of Single Audit data, if specified in the Treasury-State agreement. (c) Funding techniques... (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE RULES AND PROCEDURES FOR...

49 CFR 385.307 - What happens after a motor carrier begins operations as a new entrant?

Code of Federal Regulations, 2010 CFR

2010-10-01

... MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385... controls that are operating effectively. (b) A safety audit will be conducted on the new entrant, once it... records and documents required for the safety audit shall be made available for inspection upon request by...

Report on Fiscal and Compliance Accountability: Fiscal Year 1990-91. Report 92-2.

ERIC Educational Resources Information Center

California Community Colleges, Sacramento. Office of the Chancellor.

A summary of the results of various California community college financial audits and reviews for fiscal year (FY) 1990-91 are presented in this report. Section I explains the scope, purpose, and procedures of annual financial and compliance audits which are conducted to evaluate financial statements, encourage sound fiscal management practices,…

20 CFR Appendix C to Part 617 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2010 CFR

2010-04-01

... cases to test the effectiveness of the agency's procedures for the prevention of payments which are not... records are comonly made either by post-audit or by industry surveys. The so-called “post-audit” is a... to be checked against concurrent benefit lists. A plan of investigation based on a sample post-audit...

20 CFR Appendix C to Part 617 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2013 CFR

2013-04-01

... cases to test the effectiveness of the agency's procedures for the prevention of payments which are not... records are comonly made either by post-audit or by industry surveys. The so-called “post-audit” is a... to be checked against concurrent benefit lists. A plan of investigation based on a sample post-audit...

20 CFR Appendix C to Part 617 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2011 CFR

2011-04-01

... cases to test the effectiveness of the agency's procedures for the prevention of payments which are not... records are comonly made either by post-audit or by industry surveys. The so-called “post-audit” is a... to be checked against concurrent benefit lists. A plan of investigation based on a sample post-audit...

30 CFR 250.1920 - What are the auditing requirements for my SEMS program?

Code of Federal Regulations, 2011 CFR

2011-07-01

... or your designated and qualified personnel according to the requirements of this subpart and API RP... subpart and API RP 75 to identify areas in which safety and environmental performance needs to be improved. (b) Your audit plan and procedures must meet or exceed all of the recommendations included in API RP...

30 CFR 250.1920 - What are the auditing requirements for my SEMS program?

Code of Federal Regulations, 2012 CFR

2012-07-01

... designated and qualified personnel according to the requirements of this subpart and API RP 75, Section 12... thirteen elements of your SEMS program to evaluate compliance with the requirements of this subpart and API... audit plan and procedures must meet or exceed all of the recommendations included in API RP 75 section...

Space and Naval Warfare Systems Command and Overall Navy Needs to Improve Management of Waiver and Deferral Requests

DTIC Science & Technology

2015-10-08

Management of Waiver and Deferral Requests Visit us at www.dodig.mil Objective Our objective for this audit was to evaluate the Space and Naval Warfare...We conducted this audit in accordance with generally accepted government auditing standards. We considered management comments on a draft of...OFFICIAL USE ON Y Introduction DODIG-2016-003 │ 1 Introduction Objective Our objective for this audit was to evaluate the Space and Naval Warfare

Audits of radiopharmaceutical formulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Castronovo, F.P. Jr.

A procedure for auditing radiopharmaceutical formulations is described. To meet FDA guidelines regarding the quality of radiopharmaceuticals, institutional radioactive drug research committees perform audits when such drugs are formulated away from an institutional pharmacy. All principal investigators who formulate drugs outside institutional pharmacies must pass these audits before they can obtain a radiopharmaceutical investigation permit. The audit team meets with the individual who performs the formulation at the site of drug preparation to verify that drug formulations meet identity, strength, quality, and purity standards; are uniform and reproducible; and are sterile and pyrogen free. This team must contain an expertmore » knowledgeable in the preparation of radioactive drugs; a radiopharmacist is the most qualified person for this role. Problems that have been identified by audits include lack of sterility and apyrogenicity testing, formulations that are open to the laboratory environment, failure to use pharmaceutical-grade chemicals, inadequate quality control methods or records, inadequate training of the person preparing the drug, and improper unit dose preparation. Investigational radiopharmaceutical formulations, including nonradiolabeled drugs, must be audited before they are administered to humans. A properly trained pharmacist should be a member of the audit team.« less

Notification: Methods for Procuring Supplies and Services Under Simplified Acquisition Procedures

EPA Pesticide Factsheets

Project #OA-FY15-0193, June 18, 2015. The EPA OIG plans to begin the preliminary research phase of auditing the methods used in procuring supplies and services under simplified acquisition procedures.

Contemporary trends in urinary tract stone surgery, a regional perspective: Auckland, New Zealand.

PubMed

Acland, George; Zargar-Shoshtari, Kamran; Rice, Michael

2016-04-01

The aim of the study is to assess the contemporary patterns of utilization of various therapeutic options for the management of nephrolithiasis in our tertiary referral institution in Auckland, New Zealand. A retrospective audit was conducted for all urinary stone procedures between January 2007 and December 2013. Procedure-related information was collected for each year. All elective and emergency procedures were included. Data were collected on the elective waiting lists for each procedure. A total of 5512 stone-related cases were performed during the study period. Six hundred and fifty-three cases were performed in 2007 compared with 945 in 2013. Total number of percutaneous nephrolithotomy (PCNLs) performed, as well as the proportion of PCNL cases, demonstrated a significant decline from 84 (12.9%) in 2007 to 67 (7.1%) in 2013. While the annual numbers of extracorporeal shock wave lithotripsy (ESWLs) have increased, the percentage of ESWLs performed relative to total stone procedures has declined from 33% to 23% over the last 4 years of this audit. There has been a significant rise in the numbers of rigid and flexible ureteroscopies, with these now being the most utilized procedure. The number of patients awaiting elective procedures declined over the duration of this audit, with an associated improvement in meeting annual demand for treatment of nephrolithiasis from 78% in 2007 to 91% in 2013. A proportional decline in PCNL and ESWL utilization with a significant increase in flexible and rigid ureteroscopic procedures has been observed over this time and this pattern has been associated with improved adherence to surgical targets despite an increasing number of cases. © 2015 Royal Australasian College of Surgeons.

Skills Planning for Industry Growth: A Case Study of the Katherine Arts Industry. Occasional Paper

ERIC Educational Resources Information Center

Curry, Catherine

2009-01-01

The findings of a cultural industries skills audit undertaken in 2008 in Katherine, Northern Territory, are explored. The case study focusses in particular on the practical challenges and implications of auditing skills in a diverse industry sector and considers the usefulness of such an audit in preparing an industry for predicted change. This…

Comparison of AIHA ISO 9001-based occupational health and safety management system guidance document with a manufacturer's occupational health and safety assessment instrument.

PubMed

Dyjack, D T; Levine, S P; Holtshouser, J L; Schork, M A

1998-06-01

Numerous manufacturing and service organizations have integrated or are considering integration of their respective occupational health and safety management and audit systems into the International Organization for Standardization-based (ISO) audit-driven Quality Management Systems (ISO 9000) or Environmental Management Systems (ISO 14000) models. Companies considering one of these options will likely need to identify and evaluate several key factors before embarking on such efforts. The purpose of this article is to identify and address the key factors through a case study approach. Qualitative and quantitative comparisons of the key features of the American Industrial Hygiene Association ISO-9001 harmonized Occupational Health and Safety Management System with The Goodyear Tire & Rubber Co. management and audit system were conducted. The comparisons showed that the two management systems and their respective audit protocols, although structured differently, were not substantially statistically dissimilar in content. The authors recommend that future studies continue to evaluate the advantages and disadvantages of various audit protocols. Ideally, these studies would identify those audit outcome measures that can be reliably correlated with health and safety performance.

Independent Quality Control Review of EPA OIG Operations

EPA Pesticide Factsheets

The review considers selected audit work performed by EPA OIG, Office of Audit, Congressional and Public Liaison, Mission Systems, and Program Evaluation, during the period for 1 October 2006 through 30 September 2007 .

75 FR 70704 - Sunshine Act Meeting of the Board of Directors

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-18

... audit report on the Technology Initiatives Grants (``TIG'') program.\\1\\/ \\1\\ Any portion of the closed... Inspector General's audit report regarding the Technology Initiatives Grants (``TIG'') program. 9. Consider...

Undertaking clinical audit, with reference to a Prescribing Observatory for Mental Health audit of lithium monitoring.

PubMed

Paton, Carol; Barnes, Thomas R E

2014-06-01

Audit is an important tool for quality improvement. The collection of data on clinical performance against evidence-based and clinically relevant standards, which are considered by clinicians to be realistic in routine practice, can usefully prompt reflective practice and the implementation of change. Evidence of participation in clinical audit is required to achieve intended learning outcomes for trainees in psychiatry and revalidation for those who are members of the Royal College of Psychiatrists. This article addresses some of the practical steps involved in conducting an audit project, and, to illustrate key points, draws on lessons learnt from a national, audit-based, quality improvement programme of lithium prescribing and monitoring conducted through the Prescribing Observatory for Mental Health.

Audits for advanced treatment dosimetry

NASA Astrophysics Data System (ADS)

Ibbott, G. S.; Thwaites, D. I.

2015-01-01

Radiation therapy has advanced rapidly over the last few decades, progressing from 3D conformal treatment to image-guided intensity modulated therapy of several different flavors, both 3D and 4D and to adaptive radiotherapy. The use of intensity modulation has increased the complexity of quality assurance and essentially eliminated the physicist's ability to judge the validity of a treatment plan, even approximately, on the basis of appearance and experience. Instead, complex QA devices and procedures are required at the institutional level. Similarly, the assessment of treatment quality through remote and on-site audits also requires greater sophistication. The introduction of 3D and 4D dosimetry into external audit systems must follow, to enable quality assurance systems to perform meaningful and thorough audits.

Auditing of chromatographic data.

PubMed

Mabie, J T

1998-01-01

During a data audit, it is important to ensure that there is clear documentation and an audit trail. The Quality Assurance Unit should review all areas, including the laboratory, during the conduct of the sample analyses. The analytical methodology that is developed should be documented prior to sample analyses. This is an important document for the auditor, as it is the instrumental piece used by the laboratory personnel to maintain integrity throughout the process. It is expected that this document will give insight into the sample analysis, run controls, run sequencing, instrument parameters, and acceptance criteria for the samples. The sample analysis and all supporting documentation should be audited in conjunction with this written analytical method and any supporting Standard Operating Procedures to ensure the quality and integrity of the data.

Southwestern Power Administration Combined Financial Statements, 2006-2009

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2009-09-01

We have audited the accompanying combined balance sheets of the Southwestern Federal Power System (SWFPS), as of September 30, 2009, 2008, 2007, and 2006, and the related combined statements of revenues and expenses, changes in capitalization, and cash flows for the years then ended. As described in note 1(a), the combined financial statement presentation includes the hydroelectric generation functions of another Federal agency (hereinafter referred to as the generating agency), for which Southwestern Power Administration (Southwestern) markets and transmits power. These combined financial statements are the responsibility of the management of Southwestern and the generating agency. Our responsibility is tomore » express an opinion on these combined financial statements based on our audits. We conducted our audits in accordance with auditing standards generally accepted in the United States of America. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the combined financial statements are free of material misstatement. An audit includes consideration of internal control over financial reporting as a basis for designing audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of Southwestern and the generating agency’s internal control over financial reporting. Accordingly, we express no such opinion. An audit also includes examining, on a test basis, evidence supporting the amounts and disclosures in the combined financial statements, assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall combined financial statement presentation. We believe that our audits provide a reasonable basis for our opinion. In our opinion, the combined financial statements referred to above present fairly, in all material respects, the respective financial position of the Southwestern Federal Power System, as of September 30, 2009, 2008, 2007, and 2006, and the results of its operations and its cash flow for the years then ended, in conformity with U.S. generally accepted accounting principles. Our audits were conducted for the purpose of forming an opinion on the 2009, 2008, 2007, and 2006 SWFPS’s combined financial statements taken as a whole. The supplementary information in the combining financial statements is presented for purposes of additional analysis and is not a required part of the basic combined financial statements. The supplementary information has been subjected to the auditing procedures applied in the audit of the basic combined financial statements and, in our opinion, is fairly stated in all material respects in relation to the basic combined financial statements taken as a whole.« less

Clinical audit of leg ulceration prevalence in a community area: a case study of good practice.

PubMed

Hindley, Jenny

2014-09-01

This article presents the findings of an audit on venous leg ulceration prevalence in a community area as a framework for discussing the concept and importance of audit as a tool to inform practice and as a means to benchmark care against national or international standards. It is hoped that the discussed audit will practically demonstrate how such procedures can be implemented in practice for those who have not yet undertaken it, as well as highlighting the unexpected extra benefits of this type of qualitative data collection that can often unexpectedly inform practice and influence change. Audit can be used to measure, monitor and disseminate evidence-based practice across community localities, facilitating the identification of learning needs and the instigation of clinical change, thereby prioritising patient needs by ensuring safety through the benchmarking of clinical practice.

40 CFR 91.607 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 91.607 Section 91.607... EMISSIONS FROM MARINE SPARK-IGNITION ENGINES Selective Enforcement Auditing Regulations § 91.607 Test procedures. (a)(1) For marine SI engines subject to the provisions of this subpart, the prescribed test...

Organization and Procedures for Funding Higher Education in the Federal Republic of Germany.

ERIC Educational Resources Information Center

Karpen, Ulrich

1985-01-01

The system for financing higher education in West Germany is outlined, including the principles, organization, and procedures for resource allocation, state and university responsibilities, institutional governance and the roles of individuals and groups at various levels of governance, and institutional procedures for budgeting and auditing. (MSE)

49 CFR 385.333 - What happens at the end of the 18-month safety monitoring period?

Code of Federal Regulations, 2010 CFR

2010-10-01

... SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.333 What happens at the end of the 18-month safety monitoring period? (a) If a safety audit has been performed within... the same basis as any other carrier. (d) If a safety audit or compliance review has not been performed...

State University of New York Stony Brook University Hospital: Selected Expenditure Controls. Report 92-S-66.

ERIC Educational Resources Information Center

New York State Office of the Comptroller, Albany. Div. of Management Audit.

An audit was done of selected expenditure controls at the State University of New York (SUNY) at Stony Brook University Hospital particularly payroll costs and procurement practices. The Hospital reported an operating loss of $24 million in 1992. The audit reviewed Hospital management and staff and applicable policies and procedures as well as…

Report: Audit of American Recovery and Reinvestment Act-Funded Cooperative Agreement 2S-96099601 Awarded to the Idaho Department of Environmental Quality

EPA Pesticide Factsheets

Report #13-R-0206, Mar 28, 2013. Ollie Green & Company, the firm hired by the OIG to conduct the audit, found that IDEQ complied with Idaho’s state procurement policies and procedures, as required by 40 CFR §35.6550(a), which referenced 40 CFR §31.36(a).

48 CFR 2942.1503 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... at least annually for submission to the Past Performance Information Retrieval System (PPIRS), and... ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 2942.1503 Procedures. (a) In accordance with... criteria within their contracting activities. (d) Release of contractor performance evaluation information...

48 CFR 2942.1503 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... at least annually for submission to the Past Performance Information Retrieval System (PPIRS), and... ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 2942.1503 Procedures. (a) In accordance with... criteria within their contracting activities. (d) Release of contractor performance evaluation information...

48 CFR 2942.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... at least annually for submission to the Past Performance Information Retrieval System (PPIRS), and... ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 2942.1503 Procedures. (a) In accordance with... criteria within their contracting activities. (d) Release of contractor performance evaluation information...

48 CFR 2942.1503 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... at least annually for submission to the Past Performance Information Retrieval System (PPIRS), and... ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 2942.1503 Procedures. (a) In accordance with... criteria within their contracting activities. (d) Release of contractor performance evaluation information...

48 CFR 2942.1503 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... at least annually for submission to the Past Performance Information Retrieval System (PPIRS), and... ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 2942.1503 Procedures. (a) In accordance with... criteria within their contracting activities. (d) Release of contractor performance evaluation information...

48 CFR 242.7401 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Procedures. 242.7401 Section 242.7401 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Technical Representation at...

Preanalytical Nonconformity Management Regarding Primary Tube Mixing in Brazil.

PubMed

Lima-Oliveira, Gabriel; Cesare Guidi, Gian; Guimaraes, Andre Valpassos Pacifici; Abol Correa, Jose; Lippi, Giuseppe

2017-01-01

The multifaceted clinical laboratory process is divided in three essential phases: the preanalytical, analytical and postanalytical phase. Problems emerging from the preanalytical phase are responsible for more than 60% of laboratory errors. This report is aimed at highlighting and discussing nonconformity (e.g., nonstandardized procedures) in primary blood tube mixing immediately after blood collection by venipuncture with evacuated tube systems. From January 2015 to December 2015, fifty different laboratory quality managers from Brazil were contacted to request their internal audit reports on nonconformity regarding primary blood tube mixing immediately after blood collection by venipuncture performed using evacuated tube systems. A minority of internal audits (i.e., 4%) concluded that evacuated blood tubes were not accurately mixed after collection, whereas more than half of them reported that evacuated blood tubes were vigorously mixed immediately after collection, thus magnifying the risk of producing spurious hemolysis. Despite the vast ma jority of centers declaring that evacuated blood tubes were mixed gently and carefully, the overall number of inversions was found to be different from that recommended by the manufacturer. Since the turbulence generated by the standard vacuum pressure inside the primary evacuated tubes seems to be sufficient for providing solubilization, mixing and stabilization between additives and blood during venipuncture, avoidance of primary tube mixing probably does not introduce a major bias in tests results and may not be considered a nonconformity during audits for accreditation.

7 CFR 3015.120 - Closeout.

Code of Federal Regulations, 2010 CFR

2010-01-01

... audits (See Attachment L, Circular A-102 and Attachment K of Circular A-110) are not a required part of... are problems with a grant or subgrant that require audit attention. If a USDA agency considers a final...

7 CFR 3015.120 - Closeout.

Code of Federal Regulations, 2011 CFR

2011-01-01

... audits (See Attachment L, Circular A-102 and Attachment K of Circular A-110) are not a required part of... are problems with a grant or subgrant that require audit attention. If a USDA agency considers a final...

Report on the Audit of Screening of Materiel Available in the Defense Reutilization and Marketing Service

DTIC Science & Technology

1990-06-06

the Audit of Screening of Materiel Available in the Defense Re utilization and Marketing Service (DRMS) for your information and use. Comments on a draft of this report were considered in preparing the final report. We performed the audit from October 1988 through June 1989. The audit objectives were to evaluate the adequacy and effectiveness of the DoD wholesale inventory management activities’ screening and requisitioning of materiel in the DRMS during the Front End Screening (FES) and Final Asset Screening (FAS)

Quality assurance of clinical transfusion practice by implementation of the privilege of blood prescription and computerized prospective audit of blood requests.

PubMed

Marconi, M; Almini, D; Pizzi, M N; Riccardi, D; Bergamaschi, W; Giovanetti, A M; Rebulla, P; Sirchia, G

1996-03-01

Guidelines, algorithms and recommendations have been issued in the attempt to ensure appropriateness of transfusion practice, but the results are less than satisfactory, mainly due to the difficulty to turn paper procedures into actual practice. In our hospital we have tried to overcome this difficulty through the implementation of a quality assurance programme which includes giving the privilege of nonurgent blood prescription to a limited number of physicians and a computerized prospective audit of blood requests. The latter is performed through verification of the compliance of blood requests, which are designed to include a patient's laboratory and clinical data, with hospital guidelines for the proper use of blood. In the 12 months since implementation of the computerized prospective audit the transfusion service has evaluated 7884 requests. Of these, 63.4% (n = 4998) were for red blood cells, 21.1% (n = 1664) for platelets and 15.5% (n = 1222) for fresh frozen plasma. The prospective audit showed that 96.8% and 98.1% of requests for red units and platelets were appropriate, respectively. Conversely, approximately 27% of plasma requests did not comply with guidelines, mainly because the evidence of coagulopathy was missing. However, inappropriateness of plasma requests for elective general surgery decreased from 39% at the onset of the programme to 14% in the last trimester considered. Moreover, the evaluation by retrospective audit of the proportion of patients transfused with both red blood cells and plasma in the perioperative period out of those transfused with red blood cells only, as an indicator of unwanted reconstitution of whole blood, showed that this proportion decreased from 47.6% (320/672) in the 12 months before implementation of computerized audit to 37.8% (244/646) in the following 12 months (difference = -9.8%, 95% confidence interval of the difference from -4.5% to -15.1%; P < 0.005 by chi 2 test). Our initial experience, together with the present system, shows that (1) the restriction of nonurgent blood prescription to a group of clinicians more educated in transfusion medicine than average clinicians practicing in a large multispecialty hospital is feasible; (2) prospective audit is a useful tool for assuring the quality of blood requesting.

Using Audit Information to Adjust Parameter Estimates for Data Errors in Clinical Trials

PubMed Central

Shepherd, Bryan E.; Shaw, Pamela A.; Dodd, Lori E.

2013-01-01

Background Audits are often performed to assess the quality of clinical trial data, but beyond detecting fraud or sloppiness, the audit data is generally ignored. In earlier work using data from a non-randomized study, Shepherd and Yu (2011) developed statistical methods to incorporate audit results into study estimates, and demonstrated that audit data could be used to eliminate bias. Purpose In this manuscript we examine the usefulness of audit-based error-correction methods in clinical trial settings where a continuous outcome is of primary interest. Methods We demonstrate the bias of multiple linear regression estimates in general settings with an outcome that may have errors and a set of covariates for which some may have errors and others, including treatment assignment, are recorded correctly for all subjects. We study this bias under different assumptions including independence between treatment assignment, covariates, and data errors (conceivable in a double-blinded randomized trial) and independence between treatment assignment and covariates but not data errors (possible in an unblinded randomized trial). We review moment-based estimators to incorporate the audit data and propose new multiple imputation estimators. The performance of estimators is studied in simulations. Results When treatment is randomized and unrelated to data errors, estimates of the treatment effect using the original error-prone data (i.e., ignoring the audit results) are unbiased. In this setting, both moment and multiple imputation estimators incorporating audit data are more variable than standard analyses using the original data. In contrast, in settings where treatment is randomized but correlated with data errors and in settings where treatment is not randomized, standard treatment effect estimates will be biased. And in all settings, parameter estimates for the original, error-prone covariates will be biased. Treatment and covariate effect estimates can be corrected by incorporating audit data using either the multiple imputation or moment-based approaches. Bias, precision, and coverage of confidence intervals improve as the audit size increases. Limitations The extent of bias and the performance of methods depend on the extent and nature of the error as well as the size of the audit. This work only considers methods for the linear model. Settings much different than those considered here need further study. Conclusions In randomized trials with continuous outcomes and treatment assignment independent of data errors, standard analyses of treatment effects will be unbiased and are recommended. However, if treatment assignment is correlated with data errors or other covariates, naive analyses may be biased. In these settings, and when covariate effects are of interest, approaches for incorporating audit results should be considered. PMID:22848072

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the Past Performance Information Retrieval System (PPIRS) at www.ppirs.gov. The process for submitting... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1503 Procedures. (a.... Those individuals identified may obtain information for the evaluation of performance from the program...

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the Past Performance Information Retrieval System (PPIRS) at www.ppirs.gov. The process for submitting... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1503 Procedures. (a.... Those individuals identified may obtain information for the evaluation of performance from the program...

48 CFR 42.902 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTRACT ADMINISTRATION AND AUDIT SERVICES Bankruptcy 42.902 Procedures. (a) When notified of bankruptcy... appropriate agency offices (e.g., contracting, financial, property) and affected buying activities; (2) Determine the amount of the Government's potential claim against the contractor (in assessing this impact...

QA in Radiation Therapy: The RPC Perspective

NASA Astrophysics Data System (ADS)

Ibbott, G. S.

2010-11-01

The Radiological Physics Center (RPC) is charged with assuring the consistent delivery of radiation doses to patients on NCI-sponsored clinical trials. To accomplish this, the RPC conducts annual mailed audits of machine calibration, dosimetry audit visits to institutions, reviews of treatment records, and credentialing procedures requiring the irradiation of anthropomorphic phantoms. Through these measurements, the RPC has gained an understanding of the level of quality assurance practiced in this cohort of institutions, and a database of measurements of beam characteristics of a large number of treatment machines. The results of irradiations of phantoms have yielded insight into the delivery of advanced technology treatment procedures.

The European general thoracic surgery database project.

PubMed

Falcoz, Pierre Emmanuel; Brunelli, Alessandro

2014-05-01

The European Society of Thoracic Surgeons (ESTS) Database is a free registry created by ESTS in 2001. The current online version was launched in 2007. It runs currently on a Dendrite platform with extensive data security and frequent backups. The main features are a specialty-specific, procedure-specific, prospectively maintained, periodically audited and web-based electronic database, designed for quality control and performance monitoring, which allows for the collection of all general thoracic procedures. Data collection is the "backbone" of the ESTS database. It includes many risk factors, processes of care and outcomes, which are specially designed for quality control and performance audit. The user can download and export their own data and use them for internal analyses and quality control audits. The ESTS database represents the gold standard of clinical data collection for European General Thoracic Surgery. Over the past years, the ESTS database has achieved many accomplishments. In particular, the database hit two major milestones: it now includes more than 235 participating centers and 70,000 surgical procedures. The ESTS database is a snapshot of surgical practice that aims at improving patient care. In other words, data capture should become integral to routine patient care, with the final objective of improving quality of care within Europe.

Assessing the work of medical audit advisory groups in promoting audit in general practice.

PubMed

Baker, R; Hearnshaw, H; Cooper, A; Cheater, F; Robertson, N

1995-12-01

Objectives--To determine the role of medical audit advisory groups in audit activities in general practice. Design--Postal questionnaire survey. Subjects--All 104 advisory groups in England and Wales in 1994. Main measures--Monitoring audit: the methods used to classify audits, the methods used by the advisory group to collect data on audits from general practices, the proportion of practices undertaking audit. Directing and coordinating audits: topics and number of practices participating in multipractice audits. Results--The response rate was 86-5%. In 1993-4, 54% of the advisory groups used the Oxfordshire or Kirklees methods for classifying audits, or modifications of them. 99% of the advisory groups collected data on audit activities at least once between 1991-2 and 1993-4. Visits, questionnaires, and other methods were used to collect information from all or samples of practices in each of the advisory group's areas. Some advisory groups used different methods in different years. In 1991-2, 57% of all practices participated in some audit, in 1992-3, 78%, and in 1993-4, 86%. 428 multipractice audits were identified. The most popular topic was diabetes. Conclusions--Advisory groups have been active in monitoring audit in general practice. However, the methods used to classify and collect information about audits in general practices varied widely. The number of practices undertaking audit increased between 1991-2 and 1993 1. The large number of multipractice audits supports the view that the advisory groups have directed and coordinated audit activities. This example of a national audit programme for general practice may be helpful in other countries in which the introduction of quality assurance is being considered.

Using health care audit to improve quality of clinical records: the preliminary experience of an Italian Cancer Institute.

PubMed

Cadeddu, Chiara; Specchia, Maria Lucia; Cacciatore, Pasquale; Marchini, Raffaele; Ricciardi, Walter; Cavuto, Costanza

2017-01-01

Audit and feedback are recognized as part of a strategy for improving performance and supporting quality and safety in European health care systems. These considerations led the Clinical Management Staff of the "Regina Elena" Italian Cancer Institute to start a project of self-assessment of the quality of clinical records and organizational appropriateness through a retrospective review. The evaluation about appropriateness and congruity concerned both clinical records of 2013 and of 2015. At the end of the assessment of clinical records of each Care Unit, results were shared with medical staff in scheduled audit meetings. One hundred and thirteen clinical records (19%) did not meet congruity criteria, while 74 (12.6%) resulted as inappropriate. Considering the economic esteem calculated from the difference between Diagnosis Related Groups (DRG) primarily identified as main diagnosis and main surgical intervention or procedure and those modified during the Local Health Unit (LHU) assessment, 2 surgical Care Units produced a high negative difference in terms of economic value with a consequent drop of hospital discharge form (named in Italian "scheda di dimissione ospedaliera", SDO) remuneration, 7 Care Units produced about the same medium difference with almost no change as SDO remuneration, and 2 Care Units had a positive difference with a profit in terms of SDO remuneration. Concerning the quality assessment of clinical records of 2015, the most critical areas were related to medical documents and hospital discharge form compilation. Our experience showed the effectiveness of clinical audit in assessing the quality of filling in medical records and the appropriateness of hospital admissions and the acceptability of this tool by clinicians.

A survey on auditing, quality assurance systems and legal frameworks in five selected slaughterhouses in Bulawayo, south-western Zimbabwe.

PubMed

Masanganise, Kaurai E; Matope, Gift; Pfukenyi, Davies M

2013-01-01

The purpose of this study was to explore the audits, quality assurance (QA) programmes and legal frameworks used in selected abattoirs in Zimbabwe and slaughterhouse workers' perceptions on their effectiveness. Data on slaughterhouse workers was gathered through a self-completed questionnaire and additional information was obtained from slaughterhouse and government records. External auditing was conducted mainly by the Department of Veterinary Public Health with little contribution from third parties. Internal auditing was restricted to export abattoirs. The checklist used on auditing lacked objective assessment criteria and respondents cited several faults in the current audit system. Most respondents (> 50.0%) knew the purposes and benefits of audit and QA inspections. All export abattoirs had QA programmes such as hazard analysis critical control point and ISO 9001 (a standard used to certify businesses' quality management systems) but their implementation varied from minimal to nil. The main regulatory defect observed was lack of requirements for a QA programme. Audit and quality assurance communications to the selected abattoirs revealed a variety of non-compliances with most respondents revealing that corrective actions to audit (84.3%) and quality assurance (92.3%) shortfalls were not done. A high percentage of respondents indicated that training on quality (76.8%) and regulations (69.8%) was critical. Thus, it is imperative that these abattoirs develop a food safety management system comprising of QA programmes, a microbial assessment scheme, regulatory compliance, standard operating procedures, internal and external auditing and training of workers.

Dosimetry for audit and clinical trials: challenges and requirements

NASA Astrophysics Data System (ADS)

Kron, T.; Haworth, A.; Williams, I.

2013-06-01

Many important dosimetry audit networks for radiotherapy have their roots in clinical trial quality assurance (QA). In both scenarios it is essential to test two issues: does the treatment plan conform with the clinical requirements and is the plan a reasonable representation of what is actually delivered to a patient throughout their course of treatment. Part of a sound quality program would be an external audit of these issues with verification of the equivalence of plan and treatment typically referred to as a dosimetry audit. The increasing complexity of radiotherapy planning and delivery makes audits challenging. While verification of absolute dose delivered at a reference point was the standard of external dosimetry audits two decades ago this is often deemed inadequate for verification of treatment approaches such as Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT). As such, most dosimetry audit networks have successfully introduced more complex tests of dose delivery using anthropomorphic phantoms that can be imaged, planned and treated as a patient would. The new challenge is to adapt this approach to ever more diversified radiotherapy procedures with image guided/adaptive radiotherapy, motion management and brachytherapy being the focus of current research.

Eye dose to staff involved in interventional and procedural fluoroscopy

NASA Astrophysics Data System (ADS)

McLean, D.; Hadaya, D.; Tse, J.

2016-03-01

In 2011 the International Commission on Radiological Protection (ICRP) lowered the occupational eye dose limit from 150 to 20 mSv/yr [1]. While international jurisdictions are in a process of adopting these substantial changes, medical physicists at the clinical level have been advising medical colleagues on specific situations based on dose measurements. Commissioned and calibrated TLDs mounted in commercially available holders designed to simulate the measurement of Hp(3), were applied to staff involved in x-ray procedures for a one month period. During this period clinical procedure data was concurrently collected and subject to audit. The use or not of eye personal protective equipment (PPE) was noted for all staff. Audits were conducted in the cardiac catheterisation laboratory, the interventional angiography rooms and the procedural room where endoscopic retrograde cholangiopancreatography (ERCP) procedures are performed. Significant levels of occupational dose were recorded in the cardiac and interventional procedures, with maximum reading exceeding the new limit for some interventional radiologists. No significant eye doses were measured for staff performing ERCP procedures. One outcome of the studies was increased use of eye PPE for operators of interventional equipment with increased availability also to nursing staff, when standing in close proximity to the patient during procedures.

Federal Student Loan Programs: Opportunities Exist to Improve Audit Requirements and Oversight Procedures. Report to Congressional Committees. GAO-10-668

ERIC Educational Resources Information Center

Daly, Kay L.

2010-01-01

The Higher Education Opportunity Act of 2008, Pub. L. No. 110-315, mandated GAO (Government Accountability Office) to study the financial and compliance audits and reviews required or conducted for the Federal Family Education Loan (FFEL) program and the Federal Direct Student Loan (DL) program. The Department of Education's (Education) Office of…

Building the Joint Battlespace Infosphere. Volume 1: Summary

DTIC Science & Technology

1999-12-17

Integrity guarantees. The information staff will conduct audits and other routine procedures to ensure that the JBI platform and its clients are...delete the object; thereafter, the object will not be available to other JBI clients, but it will have been saved in an archive for auditing or...this project are maintaining multiyear, multilocation programs in nomadic networking and assuring quality of service in emerging networks. Dynamic

Evaluation of audit-based performance measures for dental care plans.

PubMed

Bader, J D; Shugars, D A; White, B A; Rindal, D B

1999-01-01

Although a set of clinical performance measures, i.e., a report card for dental plans, has been designed for use with administrative data, most plans do not have administrative data systems containing the data needed to calculate the measures. Therefore, we evaluated the use of a set of proxy clinical performance measures calculated from data obtained through chart audits. Chart audits were conducted in seven dental programs--three public health clinics, two dental health maintenance organizations (DHMO), and two preferred provider organizations (PPO). In all instances audits were completed by clinical staff who had been trained using telephone consultation and a self-instructional audit manual. The performance measures were calculated for the seven programs, audit reliability was assessed in four programs, and for one program the audit-based proxy measures were compared to the measures calculated using administrative data. The audit-based measures were sensitive to known differences in program performance. The chart audit procedures yielded reasonably reliable data. However, missing data in patient charts rendered the calculation of some measures problematic--namely, caries and periodontal disease assessment and experience. Agreement between administrative and audit-based measures was good for most, but not all, measures in one program. The audit-based proxy measures represent a complex but feasible approach to the calculation of performance measures for those programs lacking robust administrative data systems. However, until charts contain more complete diagnostic information (i.e., periodontal charting and diagnostic codes or reason-for-treatment codes), accurate determination of these aspects of clinical performance will be difficult.

41 CFR 102-118.535 - Are there principles governing my agency's TSP debt collection procedures?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Are there principles governing my agency's TSP debt collection procedures? 102-118.535 Section 102-118.535 Public Contracts and... REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Claims and Appeal Procedures General Agency...

Colonoscopy audit over 10 years--what can be learnt?

PubMed

Fraser, Alan G; Gamble, Greg D; Rose, Toby R; Dunn, John P

2013-09-13

The goals of colonoscopy are changing over time and it is important to regularly determine if endoscopists are achieving key performance indicators. Data on key performance indicators were recorded independently by nursing staff for all colonoscopies performed during a 10-year period. The results were discussed at regular meetings and feedback given to endoscopists. Audit data was recorded for 67,570 procedures. The key performance indicators (time to caecum, withdrawal time, adjusted caecal intubation rate and polyp detection rate) all improved over the audit period (p<0.0001 for trend). For each endoscopist the mean withdrawal time was highly variable ranging from 3.1 mins (95%CI 3.0; 3.1) to 11.2 mins (11.0; 11.3). For each endoscopist mean polyp detection rate varied from 29% (CI 26, 31%) to 69% (CI 68, 70%). There was a significant correlation between mean withdrawal time and mean polyp detection rate for each endoscopist (r=0.42; p=0.03). The polyp detection rate improved from 29% in 1999 to 49% in 2010. The proportion of procedures with more than 2 polyps increased from 22% in 2001 to 33% in 2010. There was a significant association of patient discomfort with time to caecum and also to level of consciousness, p<0.0001. There was a significant decrease in the proportion with significant discomfort over the audit period, p<0.0001. Colonoscopy audit as a routine process with data collection by endoscopy nurses over several years may be able to improve key performance indicators by the process of regular feedback to endoscopists. Audit should be encouraged as a routine process rather than simply as a research tool for a limited period.

Report: EPA Needs to Reexamine How It Defines Its Payment Recapture Audit Program

EPA Pesticide Factsheets

Report #11-P-0362, July 19, 2011. EPA makes numerous efforts to recapture improper payments, but does not consider its activities to be a formal payment recapture audit program, as defined by OMB guidance.

Educational Accounting Procedures.

ERIC Educational Resources Information Center

Tidwell, Sam B.

This chapter of "Principles of School Business Management" reviews the functions, procedures, and reports with which school business officials must be familiar in order to interpret and make decisions regarding the school district's financial position. Among the accounting functions discussed are financial management, internal auditing,…

48 CFR 42.705-2 - Auditor determination procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Auditor determination... CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.705-2 Auditor determination procedure. (a) Applicability and responsibility. (1) The cognizant Government auditor shall...

40 CFR Table 7 to Subpart Lllll of... - Applicability of General Provisions to Subpart LLLLL

Code of Federal Regulations, 2010 CFR

2010-07-01

... approval procedures 3. Performance audit requirements 4. Internal and external QA procedures for testing.... Keep old versions for 5 years after revisions No; § 63.8688 specifies the CMS requirements. § 63.8(e...

40 CFR Table 10 to Subpart Dddd of... - Applicability of General Provisions to Subpart DDDD

Code of Federal Regulations, 2010 CFR

2010-07-01

... plan approval procedures; performance audit requirements; internal and external QA procedures for... control plan on record for 5 years. Keep old versions for 5 years after revisions Yes. § 63.8(e) CMS...

40 CFR Table 3 to Subpart Cccccc... - Applicability of General Provisions

Code of Federal Regulations, 2010 CFR

2010-07-01

... procedures; performance audit requirements; internal and external QA procedures for testing Yes. § 63.7(d... quality control plan on record for 5 years; keep old versions for 5 years after revisions No. § 63.8(e...

48 CFR 42.705-2 - Auditor determination procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Auditor determination... CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 42.705-2 Auditor determination procedure. (a) Applicability and responsibility. (1) The cognizant Government auditor shall...

Integrating field methodology and web-based data collection to assess the reliability of the Alcohol Use Disorders Identification Test (AUDIT).

PubMed

Celio, Mark A; Vetter-O'Hagen, Courtney S; Lisman, Stephen A; Johansen, Gerard E; Spear, Linda P

2011-12-01

Field methodologies offer a unique opportunity to collect ecologically valid data on alcohol use and its associated problems within natural drinking environments. However, limitations in follow-up data collection methods have left unanswered questions regarding the psychometric properties of field-based measures. The aim of the current study is to evaluate the reliability of self-report data collected in a naturally occurring environment - as indexed by the Alcohol Use Disorders Identification Test (AUDIT) - compared to self-report data obtained through an innovative web-based follow-up procedure. Individuals recruited outside of bars (N=170; mean age=21; range 18-32) provided a BAC sample and completed a self-administered survey packet that included the AUDIT. BAC feedback was provided anonymously through a dedicated web page. Upon sign in, follow-up participants (n=89; 52%) were again asked to complete the AUDIT before receiving their BAC feedback. Reliability analyses demonstrated that AUDIT scores - both continuous and dichotomized at the standard cut-point - were stable across field- and web-based administrations. These results suggest that self-report data obtained from acutely intoxicated individuals in naturally occurring environments are reliable when compared to web-based data obtained after a brief follow-up interval. Furthermore, the results demonstrate the feasibility, utility, and potential of integrating field methods and web-based data collection procedures. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Bias and precision of selected analytes reported by the National Atmospheric Deposition Program and National Trends Network, 1984

USGS Publications Warehouse

Brooks, M.H.; Schroder, L.J.; Willoughby, T.C.

1987-01-01

The U.S. Geological Survey operated a blind audit sample program during 1974 to test the effects of the sample handling and shipping procedures used by the National Atmospheric Deposition Program and National Trends Network on the quality of wet deposition data produced by the combined networks. Blind audit samples, which were dilutions of standard reference water samples, were submitted by network site operators to the central analytical laboratory disguised as actual wet deposition samples. Results from the analyses of blind audit samples were used to calculate estimates of analyte bias associated with all network wet deposition samples analyzed in 1984 and to estimate analyte precision. Concentration differences between double blind samples that were submitted to the central analytical laboratory and separate analyses of aliquots of those blind audit samples that had not undergone network sample handling and shipping were used to calculate analyte masses that apparently were added to each blind audit sample by routine network handling and shipping procedures. These calculated masses indicated statistically significant biases for magnesium, sodium , potassium, chloride, and sulfate. Median calculated masses were 41.4 micrograms (ug) for calcium, 14.9 ug for magnesium, 23.3 ug for sodium, 0.7 ug for potassium, 16.5 ug for chloride and 55.3 ug for sulfate. Analyte precision was estimated using two different sets of replicate measures performed by the central analytical laboratory. Estimated standard deviations were similar to those previously reported. (Author 's abstract)

Office of Inspector General audit report on credit card usage at the Ohio Field Office and the Fernald and Miamisburg Environmental Management Projects

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1999-03-01

In 1994 the Department of Energy (Department) obtained the services of Rocky Mountain BankCard System, through the use of a General Services Administration contract, as a means for the Department and its contractors to make small purchases. The use of credit cards was expected to simplify small purchase procedures and improve cash management. The Ohio Field Office (Field Office) uses the credit card system and oversees usage by its area offices. Contractors under the Field Office also use the credit card system to make small purchases. The Office of Inspector General (OIG) has issued one audit report concerning the usemore » of credit cards. In April 1996, the OIG issued Report WR-B-96-06, Audit of Bonneville Power Administration`s Management of Information Resources. The audit concluded that improvements could be made in implementing credit card and property procedures in Bonneville`s management of computer-related equipment. Specifically, many credit card purchases were made by employees whose authority to buy was not properly documented, and the purchasing files often lacked invoices that would show what was purchased. Additionally, some cardholders split purchases to avoid credit card limits. The objective of this audit was to determine whether the Field Office, Fernald and Miamisburg Environmental Management Projects, Fluor Daniel, and B and W were using credit cards for the appropriate purposes and within the limitations established by Federal and Departmental regulations.« less

An audit of the patient's experience of arterial blood gas testing.

PubMed

Crawford, Anne

Arterial puncture is the most common method used to obtain a sample for the measurement of arterial blood gases (ABGs) and is essential to guide the prescription of long-term oxygen therapy (LTOT) in patients with chronic hypoxic lung disease. However, this procedure is often reported by patients as a painful and unpleasant experience, which to date has not been explored. This audit specifically examines the subjective views of a small group of patients (n = 41) who are receiving LTOT who have experienced repeated ABGs. Results demonstrated that 49% (n = 20) were poorly informed regarding what the procedure involved, almost half the patients 49% (n = 20) recalled pain levels of 5 and above on a visual analogue scale and 66% (n = 27) were totally unaware that the test could make a considerable difference to their treatment. While highlighting the deficits in current practice locally, this audit concludes that the respiratory nurse specialist is in an ideal position to implement changes to improve the patient's experience of chronic disease management.

48 CFR 42.503-2 - Postaward conference procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Postaward conference procedure. 42.503-2 Section 42.503-2 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Postaward Orientation 42.503-2 Postaward...

48 CFR 242.705-1 - Contracting officer determination procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Contracting officer determination procedure. 242.705-1 Section 242.705-1 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES...

48 CFR 242.503-2 - Post-award conference procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Post-award conference procedure. 242.503-2 Section 242.503-2 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES...

48 CFR 42.1701 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CONTRACT ADMINISTRATION AND AUDIT SERVICES Forward Pricing Rate Agreements 42.1701 Procedures. (a) Negotiation of forward pricing rate agreements (FPRA's) may be requested by the contracting officer or the... obtain the contractor's forward pricing rate proposal and require that it include cost or pricing data...

48 CFR 42.1701 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT ADMINISTRATION AND AUDIT SERVICES Forward Pricing Rate Agreements 42.1701 Procedures. (a) Negotiation of forward pricing rate agreements (FPRA's) may be requested by the contracting officer or the... obtain the contractor's forward pricing rate proposal and require that it include cost or pricing data...

Quality assurance in melanoma surgery: The evolving experience at a large tertiary referral centre.

PubMed

Read, R L; Pasquali, S; Haydu, L; Thompson, J F; Stretch, J R; Saw, R P M; Quinn, M J; Shannon, K; Spillane, A J

2015-07-01

The quality of melanoma surgery needs to be assessed by oncological outcome and complication rates. There is no published consensus on complication rates for common melanoma surgeries, namely wide excision (WE), sentinel node biopsy (SNB) and regional lymph node dissection (RLND). Consequently there are no agreed standards by which surgeons can audit their practices. Surgical standards were proposed in 2008 following review of the literature and from expert opinion. Melanoma Institute Australia (MIA) self-reported audit data from 2011 and 2012 were compared with these standards. To quality check the self-reported audit, RLND data were extracted from the MIA database. Six surgeons performed a mean of 568 surgeries each quarter; with a mean of 106 major procedures. Following WE with primary closure or flap repair, wound infection or dehiscence occurred in <1% of cases. When skin grafting was required non-take of >20% of the grafted area was observed in 5.9% of cases. Following SNB wound infection and significant seroma occurred in 1.8% of cases. RLND node counts were below the 90% standard in 4 of 409 procedures. In comparison, data extraction identified 405 RLNDs, with node counts below the 90% standard in eight procedures. Two of these patients had previously undergone surgery removing nodes from the field and two had gross coalescing disease with extensive extra-nodal spread. The quality standards proposed in 2008 have been validated long-term by high volume caseloads. The data presented provide standards by which melanoma surgeons can audit their surgical performance. Copyright © 2015 Elsevier Ltd. All rights reserved.

Defense Logistics Agency Procurements from Federal Prison Industries, Inc.

DTIC Science & Technology

1998-10-05

an arbitration board. The decision of the arbitration board is "final and binding upon all parties." Department of Justice Opinion. Because of the...summary of prior audit coverage related to the audit objectives. 3 Finding A. Dispute Resolution The statutory prcess and regulatory procedures for...buying decisions . Action is to be completed by December 1998. 19 Finding C. Exercising Federal Prison Industries, Inc. Warranty Defense supply centers

A multicentre 'end to end' dosimetry audit for cervix HDR brachytherapy treatment.

PubMed

Palmer, Antony L; Diez, Patricia; Gandon, Laura; Wynn-Jones, Andrea; Bownes, Peter; Lee, Chris; Aird, Edwin; Bidmead, Margaret; Lowe, Gerry; Bradley, David; Nisbet, Andrew

2015-02-01

To undertake the first multicentre fully 'end to end' dosimetry audit for HDR cervix brachytherapy, comparing planned and delivered dose distributions around clinical treatment applicators, with review of local procedures. A film-dosimetry audit was performed at 46 centres, including imaging, applicator reconstruction, treatment planning and delivery. Film dose maps were calculated using triple-channel dosimetry and compared to RTDose data from treatment planning systems. Deviations between plan and measurement were quantified at prescription Point A and using gamma analysis. Local procedures were also discussed. The mean difference between planned and measured dose at Point A was -0.6% for plastic applicators and -3.0% for metal applicators, at standard uncertainty 3.0% (k=1). Isodose distributions agreed within 1mm over a dose range 2-16Gy. Mean gamma passing rates exceeded 97% for plastic and metal applicators at 3% (local) 2mm criteria. Two errors were found: one dose normalisation error and one applicator library misaligned with the imaged applicator. Suggestions for quality improvement were also made. The concept of 'end to end' dosimetry audit for HDR brachytherapy has been successfully implemented in a multicentre environment, providing evidence that a high level of accuracy in brachytherapy dosimetry can be achieved. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Development of a TLD mailed system for remote dosimetry audit for (192)Ir HDR and PDR sources.

PubMed

Roué, Amélie; Venselaar, Jack L M; Ferreira, Ivaldo H; Bridier, André; Van Dam, Jan

2007-04-01

In the framework of an ESTRO ESQUIRE project, the BRAPHYQS Physics Network and the EQUAL-ESTRO laboratory have developed a procedure for checking the absorbed dose to water in the vicinity of HDR or PDR sources using a mailed TLD system. The methodology and the materials used in the procedure are based on the existing EQUAL-ESTRO external radiotherapy dose checks. A phantom for TLD postal dose assurance service, adapted to accept catheters from different HDR afterloaders, has been developed. The phantom consists of three PMMA tubes supporting catheters placed at 120 degrees around a central TLD holder. A study on the use of LiF powder type DTL 937 (Philitech) has been performed in order to establish the TLD calibration in dose-to-water at a given distance from (192)Ir source, as well as to determine all correction factors to convert the TLD reading into absorbed dose to water. The dosimetric audit is based on the comparison between the dose to water measured with the TL dosimeter and the dose calculated by the clinical TPS. Results of the audits are classified in four different levels depending on the ratio of the measured dose to the stated dose. The total uncertainty budget in the measurement of the absorbed dose to water using TLD near an (192)Ir HDR source, including TLD reading, correction factors and TLD calibration coefficient, is determined as 3.27% (1s). To validate the procedures, the external audit was first tested among the members of the BRAPHYQS Network. Since November 2004, the test has been made available for use by all European brachytherapy centres. To date, 11 centres have participated in the checks and the results obtained are very encouraging. Nevertheless, one error detected has shown the usefulness of this audit. A method of absorbed dose to water determination in the vicinity of an (192)Ir brachytherapy source was developed for the purpose of a mailed TL dosimetry system. The accuracy of the procedure was determined. This method allows a check of the whole dosimetry chain for this type of brachytherapy afterloading system and can easily be performed by mail to any institution in the European area and elsewhere. Such an external audit can be an efficient QC method complementary to internal quality control as it can reveal some errors which are not observable by other means.

Auditing psychiatric out-patient records.

PubMed

Pillay, Selena; O'Dwyer, Sarah; McCarthy, Marguerite

2010-01-01

Up-to-date patient records are essential for safe and professional practice. They are an intrinsic component for providing adequate care and ensuring appropriate and systematic treatment 2009 plans. Furthermore, accurate and contemporaneous notes are essential for achieving professional standards from a medico-legal perspective. The study's main aim was to investigate current record-keeping practices by looking at whether out-patient communication pathways to general practitioners, from letter dictation to insertion in the chart, were being satisfied. From current out-patient attendees over six months, 100 charts were chosen randomly, and reviewed. A pro-forma was used to collect data and this information was also checked against electronic records. Of the charts reviewed, 15 per cent had no letter. If one considers that one-month is an acceptable time for letters to be inserted into the chart, then only 11 per cent satisfied this condition. Electronic data were also missing. It is impossible to discern whether letters to GPs were dictated by the out-patient doctor for each patient reviewed. Another limitation was that some multidisciplinary hospital teams have different out-patient note-keeping procedures, which makes some findings difficult to interpret. The review drew attention to current record-keeping discrepancies, highlighting the need for medical record-keeping procedures and polices to be put in place. Also brought to light was the importance of providing a workforce sufficient to meet the out-patient team's administrative needs. An extended audit of other medical record-keeping aspects should be carried out to determine whether problems occur in other areas. The study highlights the importance of establishing agreed policies and procedures for out-patient record keeping and the need to have a checking mechanism to identify system weaknesses.

29 CFR 99.400 - Responsibilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... auditee, and, if known, the auditor of the reassignment. The cognizant agency for audit shall: (1) Provide technical audit advice and liaison to auditees and auditors. (2) Consider auditee requests for extensions to...-Federal auditors, and provide the results, when appropriate, to other interested organizations. (4...

Notification: Audit of EPA's Adherence to Policies, Procedures and Oversight Controls Pertaining to the Administrator’s Travel

EPA Pesticide Factsheets

Project #OA-FY17-0382, August 28, 2017. The EPA OIG plans to begin preliminary research on the EPA’s adherence to policies, procedures and oversight controls pertaining to the Administrator’s travel to Oklahoma.

2 CFR 176.200 - Procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Single Audit Information for Recipients of Recovery Act Funds § 176.200 Procedure. The award official shall insert the standard award term in this subpart in all awards funded in whole or in part with... AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS Reserved AWARD TERMS FOR ASSISTANCE...

48 CFR 342.7101-2 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Procedures. 342.7101-2 Section 342.7101-2 Federal Acquisition Regulations System HEALTH AND HUMAN SERVICES CONTRACT MANAGEMENT... data received; (2) Request audit or cost advisory services, and technical support, as necessary, for...

A Multicentre Audit of Single-Use Surgical Instruments (SUSI) for Tonsillectomy and Adenoidectomy

PubMed Central

O'Flynn, P; Silva, S; Kothari, P; Persaud, R

2007-01-01

INTRODUCTION Prions are resistant to conventional sterilisation procedures and, therefore, could be transmitted iatrogenically through re-usable adenoid and tonsil surgical instruments. Using disposable instruments would avoid the risk of transmission. We present the results of a complete audit loop using BBraun single-use surgical instruments (SUSI). PATIENTS AND METHODS This was a prospective multicentre audit. Surgeons were asked to fill in a standardised questionnaire recording details including postoperative complications, and evaluation of each piece of equipment compared with their own experience of conventional re-usable instruments. In the first cycle, constructive criticisms of the instruments were noted and the manufacturers modified the instruments accordingly. A second cycle of audit was subsequently undertaken. RESULTS A total of 86 patients were audited in the first cycle and 97 in the second cycle. Postoperative haemorrhage rate for both cycles was well within acceptable range. In the first audit cycle, surgeons generally found the Draffin rods, Boyle-Davis gag and bipolar diathermy forceps of poor quality and difficult to use. These were redesigned and, on repeat evaluation during the second audit cycle, were found to be just as good, if not better, than the re-usable instruments. CONCLUSIONS This study suggests that SUSI may be just as good as re-usable instruments. Furthermore, they may be more cost effective. PMID:18201478

Use of HIV PEPSE and Hepatitis B vaccine following the introduction of a SARC.

PubMed

Bennett, Judy; Johnson, Sandie

2011-11-01

Adherence to local guidelines on the use of HIV post exposure prophylaxis (PEP) and hepatitis B vaccine following sexual assault was evaluated by means of audit. Forensic Medical Examiners (FMEs) were asked to complete an audit form after conducting sexual offence examinations at Gloucester Sexual Assault Referral Centre (SARC). Only one HIV PEP pack was prescribed during the six and a half month audit period. Examination of the SARC records of the allegations made by complainants did not reveal any high-risk cases involving a failure to offer HIV post-exposure prophylaxis following sexual exposure (PEPSE). The majority of the examinations performed at the SARC were carried out by trained sexual offence examiners (SOEs). The audit indicates that these SOEs were considering the appropriate use of HIV PEPSE and hepatitis B vaccine when they performed examinations. Some examinations were performed by general forensic medical examiners who completed the audit forms infrequently. It was not possible to determine whether these examiners were considering the appropriate use of HIV PEPSE and hepatitis treatments. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Results from an audit feedback strategy for chronic obstructive pulmonary disease in-hospital care: a joint analysis from the AUDIPOC and European COPD audit studies.

PubMed

Lopez-Campos, Jose Luis; Asensio-Cruz, M Isabel; Castro-Acosta, Ady; Calero, Carmen; Pozo-Rodriguez, Francisco

2014-01-01

Clinical audits have emerged as a potential tool to summarize the clinical performance of healthcare over a specified period of time. However, the effectiveness of audit and feedback has shown inconsistent results and the impact of audit and feedback on clinical performance has not been evaluated for COPD exacerbations. In the present study, we analyzed the results of two consecutive nationwide clinical audits performed in Spain to evaluate both the in-hospital clinical care provided and the feedback strategy. The present study is an analysis of two clinical audits performed in Spain that evaluated the clinical care provided to COPD patients who were admitted to the hospital for a COPD exacerbation. The first audit was performed from November-December 2008. The feedback strategy consisted of personalized reports for each participant center, the presentation and discussion of the results at regional, national and international meetings and the creation of health-care quality standards for COPD. The second audit was part of a European study during January and February 2011. The impact of the feedback strategy was evaluated in term of clinical care provided and in-hospital survival. A total of 94 centers participated in the two audits, recruiting 8,143 admissions (audit 1∶3,493 and audit 2∶4,650). The initially provided clinical care was reasonably acceptable even though there was considerable variability. Several diagnostic and therapeutic procedures improved in the second audit. Although the differences were significant, the degree of improvement was small to moderate. We found no impact on in-hospital mortality. The present study describes COPD hospital care in Spanish hospitals and evaluates the impact of peer-benchmarked, individually written and group-oral feedback strategy on the clinical outcomes for treating COPD exacerbations. It describes small to moderate improvements in the clinical care provided to COPD patients with no impact on in-hospital mortality.

Patient safety ward round checklist via an electronic app: implications for harm prevention.

PubMed

Keller, C; Arsenault, S; Lamothe, M; Bostan, S R; O'Donnell, R; Harbison, J; Doherty, C P

2017-11-06

Patient safety is a value at the core of modern healthcare. Though awareness in the medical community is growing, implementing systematic approaches similar to those used in other high reliability industries is proving difficult. The aim of this research was twofold, to establish a baseline for patient safety practices on routine ward rounds and to test the feasibility of implementing an electronic patient safety checklist application. Two research teams were formed; one auditing a medical team to establish a procedural baseline of "usual care" practice and an intervention team concurrently was enforcing the implementation of the checklist. The checklist was comprised of eight standard clinical practice items. The program was conducted over a 2-week period and 1 month later, a retrospective analysis of patient charts was conducted using a global trigger tool to determine variance between the experimental groups. Finally, feedback from the physician participants was considered. The results demonstrated a statistically significant difference on five variables of a total of 16. The auditing team observed low adherence to patient identification (0.0%), hand decontamination (5.5%), and presence of nurse on ward rounds (6.8%). Physician feedback was generally positive. The baseline audit demonstrated significant practice bias on daily ward rounds which tended to omit several key-proven patient safety practices such as prompting hand decontamination and obtaining up to date reports from nursing staff. Results of the intervention arm demonstrate the feasibility of using the Checklist App on daily ward rounds.

Medicaid Integrity Program; eligible entity and contracting requirements for the Medicaid Integrity audit program. Final rule.

PubMed

2008-09-26

Section 1936 of the Social Security Act (the Act) (as added by section 6034 of the Deficit Reduction Act of 2005 (DRA) established the Medicaid Integrity Program to promote the integrity of the Medicaid program by requiring CMS to enter into contracts with eligible entities to: (1) Review the actions of individuals or entities furnishing items or services (whether on a fee-for-service, risk, or other basis) for which payment may be made under an approved State plan and/or any waiver of such plan approved under section 1115 of the Act; (2) audit claims for payment of items or services furnished, or administrative services rendered, under a State plan; (3) identify overpayments to individuals or entities receiving Federal funds; and (4) educate providers of services, managed care entities, beneficiaries, and other individuals with respect to payment integrity and quality of care. This final rule will provide requirements for an eligible entity to enter into a contract under the Medicaid integrity audit program. The final rule will also establish the contracting requirements for eligible entities. The requirements will include procedures for identifying, evaluating, and resolving organizational conflicts of interest that are generally applicable to Federal acquisition and procurement; competitive procedures to be used; and procedures under which a contract may be renewed.

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials.

PubMed

Clark, Catharine H; Aird, Edwin G A; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia A D; Thomas, Russell A S; Venables, Karen; Thwaites, David I

2015-01-01

Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed.

Radiotherapy dosimetry audit: three decades of improving standards and accuracy in UK clinical practice and trials

PubMed Central

Aird, Edwin GA; Bolton, Steve; Miles, Elizabeth A; Nisbet, Andrew; Snaith, Julia AD; Thomas, Russell AS; Venables, Karen; Thwaites, David I

2015-01-01

Dosimetry audit plays an important role in the development and safety of radiotherapy. National and large scale audits are able to set, maintain and improve standards, as well as having the potential to identify issues which may cause harm to patients. They can support implementation of complex techniques and can facilitate awareness and understanding of any issues which may exist by benchmarking centres with similar equipment. This review examines the development of dosimetry audit in the UK over the past 30 years, including the involvement of the UK in international audits. A summary of audit results is given, with an overview of methodologies employed and lessons learnt. Recent and forthcoming more complex audits are considered, with a focus on future needs including the arrival of proton therapy in the UK and other advanced techniques such as four-dimensional radiotherapy delivery and verification, stereotactic radiotherapy and MR linear accelerators. The work of the main quality assurance and auditing bodies is discussed, including how they are working together to streamline audit and to ensure that all radiotherapy centres are involved. Undertaking regular external audit motivates centres to modernize and develop techniques and provides assurance, not only that radiotherapy is planned and delivered accurately but also that the patient dose delivered is as prescribed. PMID:26329469

Automated Data Processing Support of Investigation and Security Missions at the Defense Investigative Service

DTIC Science & Technology

1990-03-29

This is our final report on the Audit of Automated Data Processing Support of Investigative and Security Missions at the Defense Investigative...Service for your information and use. Comments on a draft of this report were considered in preparing the final report. The audit was made from May through...October 1989. The objectives of the audit were to determine if the Defense Investigative Service (DIS) was effectively managing automated data

Auditing fetal nasal bone images in the first trimester of pregnancy: results from a peer review program.

PubMed

Palermo, Fernanda Gasparin; Albuquerque, Débora de Paula Soares de Medeiros; Martins, Wellington P; Araujo Júnior, Edward; Bruns, Rafael Frederico

2016-09-01

To establish a structured review process to facilitate the identification of the fetal nasal bone (NB) in the first trimester ultrasound scan to improve the quality images. We conducted a retrospective observational study in fetal NB images obtained during ultrasound exams of singleton pregnancies that underwent first trimester screening (crown-rump length 45-84 mm). When the images were obtained the examiner was not aware of the study. Audit was conducted by an examiner according criteria established by the Fetal Medicine Foundation. Fetal NB images were assessed regarding adequate magnification, mid-sagittal view and transducer held parallel to the direction of the nose. The transvaginal and transabdominal as well as anterior and posterior fetal back groups were compared using χ(2) test. We considered 874 fetal NB images for auditing. Fetal NB was considered present in 865 images (99%). During the audit process, we identified 72 (8.2%) cases of disagreement between examiner and auditor assessments. Disagreement was higher when image quality was poor (62 cases = 7%). Transvaginal approach performed better in the following criteria: adequate magnification (p < 0.001), midline (p < 0.001) and completely adequate (p < 0.001). A peer reviewed audit program for fetal NB is feasible in a clinical scenario. Image quality appears to play an important role in compliance to image standards audited and in agreement between examiner and auditor.

Tuition Assistance Program (TAP) at ASA Institute of Computer and Business Technology, Inc. Audit for 1991-1992 through 1993-1994 Academic Years. Report 95-T-5 (Revised).

ERIC Educational Resources Information Center

Maldonado, Carmen

In an audit of the records and procedures for ASA Institute of Computer and Business Technology, Inc. (ASA), the New York Office of the State Comptroller determined that ASA was overpaid $696,352 because school officials incorrectly certified certain students as eligible for Tuition Assistance Program (TAP) awards. This error was discovered using…

Measuring Outcomes of Clinical Care: Victorian Emergency Laparotomy Audit Using Quality Investigator.

PubMed

Stevens, Claire L; Brown, Christopher; Watters, David A K

2018-07-01

The Australian and New Zealand Audit of Surgical Mortality (ANZASM) National Report 2015 found that within the cohort of audited deaths, 85% were emergencies with acute life-threatening conditions, and by far, the most common procedures were laparotomy and colorectal procedures. Emergency laparotomy outcomes have shown improvement through audit and reporting in the UK. The purpose of this study was to determine the outcome of emergency laparotomy in the state of Victoria, Australia. The Dr Foster Quality Investigator (DFQI) database was interrogated for a set of Australian Classification of Health Intervention (ACHI) codes defined by the authors as representing an emergency laparotomy. The dataset included patients who underwent emergency laparotomy from July 2007 to July 2016 in all Victorian hospitals. There were 23,115 emergency laparotomies conducted over 9 years in 66 hospitals. Inpatient mortality was 2036/23,115 (8.8%). Mortality in the adult population increased with age and reached 18.1% in those patients that were 80 years or older. 51.3% were females, and there was no significant difference in survival between genders. Patients with no recorded comorbidities had a mortality of 4.3%, whereas those with > 5 comorbidities had 19.3% mortality. Administrative data accessed via a tool such as DFQI can provide useful population data to guide further evidence-based improvement strategies. The mortality for emergency laparotomy within Victorian hospitals is comparable, if not better than that seen in overseas studies. There is a need to continue routine audit of mortality rates and implement systems improvement where necessary.

Structural Group-based Auditing of Missing Hierarchical Relationships in UMLS

PubMed Central

Chen, Yan; Gu, Huanying(Helen); Perl, Yehoshua; Geller, James

2009-01-01

The Metathesaurus of the UMLS was created by integrating various source terminologies. The inter-concept relationships were either integrated into the UMLS from the source terminologies or specially generated. Due to the extensive size and inherent complexity of the Metathesaurus, the accidental omission of some hierarchical relationships was inevitable. We present a recursive procedure which allows a human expert, with the support of an algorithm, to locate missing hierarchical relationships. The procedure starts with a group of concepts with exactly the same (correct) semantic type assignments. It then partitions the concepts, based on child-of hierarchical relationships, into smaller, singly rooted, hierarchically connected subgroups. The auditor only needs to focus on the subgroups with very few concepts and their concepts with semantic type reassignments. The procedure was evaluated by comparing it with a comprehensive manual audit and it exhibits a perfect error recall. PMID:18824248

18 CFR 41.3 - Shortened procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Shortened procedure. 41.3 Section 41.3 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION... notifies the Commission that it seeks to challenge one or more audit findings, or proposed remedies, or...

18 CFR 158.3 - Shortened procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Shortened procedure. 158.3 Section 158.3 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION... notifies the Commission that it seeks to challenge one or more audit findings, or proposed remedies, or...

18 CFR 286.105 - Shortened procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Shortened procedure. 286.105 Section 286.105 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION... challenge one or more audit findings, or proposed remedies, or both, in any combination, by the shortened...

40 CFR 267.143 - Financial assurance for closure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... procedures engagement in accordance with professional auditing standards and shall describe the procedures... parent corporation of the owner or operator, or a firm with a “substantial business relationship” with... the guarantor is a firm with a “substantial business relationship” with the owner or operator, this...

40 CFR 261.147 - Liability requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... insurance policy must be issued by an insurer which, at a minimum, is licensed to transact the business of... minimum, is licensed to transact the business of insurance, or eligible to provide insurance as an excess... procedures engagement in accordance with professional auditing standards and shall describe the procedures...

2 CFR 176.200 - Procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS NATIONAL POLICY REQUIREMENTS AWARD TERMS..., PUBLIC LAW 111-5 Single Audit Information for Recipients of Recovery Act Funds § 176.200 Procedure. The award official shall insert the standard award term in this subpart in all awards funded in whole or in...

2 CFR 176.200 - Procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS NATIONAL POLICY REQUIREMENTS AWARD TERMS..., PUBLIC LAW 111-5 Single Audit Information for Recipients of Recovery Act Funds § 176.200 Procedure. The award official shall insert the standard award term in this subpart in all awards funded in whole or in...

2 CFR 176.200 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Reserved AWARD TERMS FOR ASSISTANCE AGREEMENTS THAT INCLUDE FUNDS UNDER THE AMERICAN RECOVERY AND REINVESTMENT ACT OF 2009, PUBLIC LAW 111-5 Single Audit Information for Recipients of Recovery Act Funds § 176.200 Procedure. The award official shall insert the standard award term in this subpart in all awards...

2 CFR 176.200 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Single Audit Information for Recipients of Recovery Act Funds § 176.200 Procedure. The award official shall insert the standard award term in this subpart in all awards funded in whole or in part with... AND BUDGET GOVERNMENTWIDE GUIDANCE FOR GRANTS AND AGREEMENTS [Reserved] AWARD TERMS FOR ASSISTANCE...

48 CFR 942.705-1 - Contracting officer determination procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contracting officer determination procedure. 942.705-1 Section 942.705-1 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Indirect Cost Rates 942.705-1 Contracting...

Audit of accuracy of clinical coding in oral surgery.

PubMed

Naran, S; Hudovsky, A; Antscherl, J; Howells, S; Nouraei, S A R

2014-10-01

We aimed to study the accuracy of clinical coding within oral surgery and to identify ways in which it can be improved. We undertook did a multidisciplinary audit of a sample of 646 day case patients who had had oral surgery procedures between 2011 and 2012. We compared the codes given with their case notes and amended any discrepancies. The accuracy of coding was assessed for primary and secondary diagnoses and procedures, and for health resource groupings (HRGs). The financial impact of coding Subjectivity, Variability and Error (SVE) was assessed by reference to national tariffs. The audit resulted in 122 (19%) changes to primary diagnoses. The codes for primary procedures changed in 224 (35%) cases; 310 (48%) morbidities and complications had been missed, and 266 (41%) secondary procedures had been missed or were incorrect. This led to at least one change of coding in 496 (77%) patients, and to the HRG changes in 348 (54%) patients. The financial impact of this was £114 in lost revenue per patient. There is a high incidence of coding errors in oral surgery because of the large number of day cases, a lack of awareness by clinicians of coding issues, and because clinical coders are not always familiar with the large number of highly specialised abbreviations used. Accuracy of coding can be improved through the use of a well-designed proforma, and standards can be maintained by the use of an ongoing data quality assurance programme. Copyright © 2014. Published by Elsevier Ltd.

Hygiene auditing in mass catering: a 4-year study in a university canteen.

PubMed

Osimani, A; Milanović, V; Aquilanti, L; Polverigiani, S; Garofalo, C; Clementi, F

2018-06-01

The outcomes of hygiene audits carried out two times per year were used to determine the correct execution of the procedures foreseen by the Hazard Analysis and Critical Control Points (HACCP) plan over 4 years (2013-2016) in a university canteen producing about 1200 meals a day. Critical analysis of hygiene audits. Hygiene audits were carried out on the basis of a checklist divided into seven main items and subitems that covered all the production areas of the canteen. For each audit subitem, total percentage of inadequacy was calculated as the total number of negative answers (N) divided by the total number of answers (n = 8) collected in the period 2013-2016. The results showed a discontinuous trend among years. In more detail, the highest percentage of inadequacy was seen for food maintaining temperatures, thus highlighting management issues mainly related to time taken for food preparation. A relatively high level of inadequacy was also recorded for staff clothing and hygiene. The critical analysis of data emerged from the audits was useful to obtain an overview of improvements and emerging criticalities. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Accountability and Innovation in Higher Education: A Disabling Tension?

ERIC Educational Resources Information Center

Findlow, Sally

2008-01-01

This article is an empirically grounded critical exploration of conflict between two associated higher education agendas--audit-driven accountability and academic innovation. Feeding into a discourse of quality, audit and power, it considers how far prevailing economic-bureaucratic models of higher education accountability might actually inhibit…

7 CFR 3401.3 - Eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial resources for performance, the necessary experience, organizational and technical qualifications... system and audit procedure which provides efficient and effective accountability and control of all...

7 CFR 3400.3 - Eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... financial resources for performance, the necessary experience, organizational and technical qualifications... system and audit procedure which provides efficient and effective accountability and control of all...

Medicare changes create accounting, reporting, and auditing problems. Task Force on Federal Health Care Legislation, American Institute of Certified Public Accountants.

PubMed

1984-11-01

Hospital auditors and financial officers must adjust and react to the changing financial healthcare environment brought about by PPS. A close review of accounting systems, reporting methods, auditing procedures, and internal control systems should be made to determine that assets are safe-guarded and financial information is presented in conformity with GAAP. This article identified new problems and suggested solutions. Old tasks may no longer be necessary. For example, retroactive adjustments are not as important as they used to be. Estimates for capital and outpatient costs may continue to be required, but elaborate cost-finding techniques may no longer be necessary to estimate retroactive adjustments for reimbursable items. We recommend that prior to beginning an audit of a hospital's financial statements, each hospital's financial officers and its auditors discuss the possible accounting, reporting, and auditing implications as a result of PPS.

Charge auditing from a nursing perspective.

PubMed

Obert, S J

1990-01-01

Many third-party payors, which include commercial health and auto insurance companies and workmen's compensation carriers, are requesting access to their clients' itemized patient statements and medical records for verifying accuracy of charges and documentation of services rendered. If even a portion of the payment is withheld until the audit is completed, slowing of cash flow results. A slow cash flow may ultimately have profound effects on the quality, or even availability, of patient care. Hospitals are finding it cost effective to have someone within their institution audit patient accounts and medical records to identify problem areas that may result in denial of payment. Nurses are being recruited to perform these audits because of their knowledge of documentation standards and patient account charging procedures. With this background, the nurse auditor is also able to assess educational needs of the nursing staff and work collaboratively with other departments to correct deficiencies.

DoD Librarian Interfaces Military Librarians’ Workshop Proceedings (32nd) Held in San Diego, California on 12-14 October 1988

DTIC Science & Technology

1989-03-01

can control--their mission, goals, objectives, plans, and marketing mix . The organization, in responding to the environment in which it operates...comparisons. * Determination of areas to be audited. o A horizontal audit (often referred to as a marketing mix audit) studies the overall marketing...favorably responding to a marketing mix tailored to a specialized need of the segment. There are a number of steps that a Library should consider in

Wartime Expansion Capacity of Military Hospitals in Conus

DTIC Science & Technology

1990-02-27

the Audit of Wartime Expansion Capacity of Military Hospitals in CONUS for your information and use. Comments on a draft of this report were considered in preparing this final report. We made the audit from May through September 1989, at the request of the Assistant Secretary of Defense (Health Affairs) because of a Program Decision Memorandum directed...facilities during wartime. We did not assess the adequacy of internal controls applicable to the audit objectives because reported bed capacities and...mobilization expansion

A methodology for TLD postal dosimetry audit of high-energy radiotherapy photon beams in non-reference conditions.

PubMed

Izewska, Joanna; Georg, Dietmar; Bera, Pranabes; Thwaites, David; Arib, Mehenna; Saravi, Margarita; Sergieva, Katia; Li, Kaibao; Yip, Fernando Garcia; Mahant, Ashok Kumar; Bulski, Wojciech

2007-07-01

A strategy for national TLD audit programmes has been developed by the International Atomic Energy Agency (IAEA). It involves progression through three sequential dosimetry audit steps. The first step audits are for the beam output in reference conditions for high-energy photon beams. The second step audits are for the dose in reference and non-reference conditions on the beam axis for photon and electron beams. The third step audits involve measurements of the dose in reference, and non-reference conditions off-axis for open and wedged symmetric and asymmetric fields for photon beams. Through a co-ordinated research project the IAEA developed the methodology to extend the scope of national TLD auditing activities to more complex audit measurements for regular fields. Based on the IAEA standard TLD holder for high-energy photon beams, a TLD holder was developed with horizontal arm to enable measurements 5cm off the central axis. Basic correction factors were determined for the holder in the energy range between Co-60 and 25MV photon beams. New procedures were developed for the TLD irradiation in hospitals. The off-axis measurement methodology for photon beams was tested in a multi-national pilot study. The statistical distribution of dosimetric parameters (off-axis ratios for open and wedge beam profiles, output factors, wedge transmission factors) checked in 146 measurements was 0.999+/-0.012. The methodology of TLD audits in non-reference conditions with a modified IAEA TLD holder has been shown to be feasible.

The factor structure of the Alcohol Use Disorders Identification Test (AUDIT).

PubMed

Doyle, Suzanne R; Donovan, Dennis M; Kivlahan, Daniel R

2007-05-01

Past research assessing the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) with various exploratory and confirmatory factor analytic techniques has identified one-, two-, and three-factor solutions. Because different factor analytic procedures may result in dissimilar findings, we examined the factor structure of the AUDIT using the same factor analytic technique on two new large clinical samples and on archival data from six samples studied in previous reports. Responses to the AUDIT were obtained from participants who met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria for alcohol dependence in two large randomized clinical trials: the COMBINE (Combining Medications and Behavioral Interventions) Study (N = 1,337; 69% men) and Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity; N = 1,711; 76% men). Supplementary analyses involved six correlation matrices of AUDIT data obtained from five previously published articles. Confirmatory factor analyses based on one-, two-, and three-factor models were conducted on the eight correlation matrices to assess the factor structure of the AUDIT. Across samples, analyses supported a correlated, two-factor solution representing alcohol consumption and alcohol-related consequences. The three-factor solution fit the data equally well, but two factors (alcohol dependence and harmful alcohol use) were highly correlated. The one-factor solution did not provide a good fit to the data. These findings support a two-factor solution for the AUDIT (alcohol consumption and alcohol-related consequences). The results contradict the original three-factor design of the AUDIT and the prevalent use of the AUDIT as a one-factor screening instrument with a single cutoff score.

18 CFR 349.3 - Shortened procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Shortened procedure. 349.3 Section 349.3 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION... described in § 349.1 notifies the Commission that it seeks to challenge one or more audit findings, or...

Notification: Audit of EPA’s Adherence to Policies, Procedures and Oversight Controls Pertaining to the Administrator’s Travel (2nd notification)

EPA Pesticide Factsheets

Project #OA-FY17-0382, October 6, 2017 - The EPA OIG plans to expand the scope of preliminary research on the EPA’s adherence to policies, procedures and oversight controls pertaining to the Administrator’s travel.

40 CFR 60.58b - Compliance and performance testing.

Code of Federal Regulations, 2014 CFR

2014-07-01

... monitored and record the output of the system and shall comply with the test procedures and test methods....1.1 (relative accuracy test audit) shall apply to the monitor. (6) If carbon dioxide is selected for... established during the initial performance test according to the procedures and methods specified in...

40 CFR 60.58b - Compliance and performance testing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... monitored and record the output of the system and shall comply with the test procedures and test methods....1.1 (relative accuracy test audit) shall apply to the monitor. (6) If carbon dioxide is selected for... established during the initial performance test according to the procedures and methods specified in...

40 CFR 60.58b - Compliance and performance testing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... monitored and record the output of the system and shall comply with the test procedures and test methods....1.1 (relative accuracy test audit) shall apply to the monitor. (6) If carbon dioxide is selected for... established during the initial performance test according to the procedures and methods specified in...

Undergraduate Program Reviews at Brock University. Report of the UPRAC Auditors.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

Pursuant to the Council of Ontario Universities' procedures for periodic quality reviews of undergraduate programs, auditors examined the policies and programs of Brock University (BU) during 1997. Three departments were selected for audits of their program review procedures: Philosophy, Geography, and Physics; additionally, the Oenology and…

48 CFR 809.406-1 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (3) Whether the contractor conducted internal and external audits as appropriate. (4) Whether the... contractor conducted periodic reviews of company business practices, procedures, policies, and internal...

77 FR 75417 - Renewal of the Veterans' Advisory Board on Dose Reconstruction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-20

...-discretionary federal advisory committee that shall provide review and oversight of the Radiation Dose... administration of the Radiation Dose Reconstruction Program as it considers appropriate as a result of the audits.... Conduct periodic, random audits of dose reconstructions under the Radiation Dose Reconstruction Program...

Educational Auditing and Quality Assurance. Occasional Paper No. 4.

ERIC Educational Resources Information Center

Conner, James E.; Lessinger, Leon M.

This paper considers how to respond to new requirements for adequate disclosure of the schools' performance to the public. It proposes the use of three powerful constructs--quality control, quality assurance, and an independent educational accomplishment audit (IEAA). The essential elements of quality control are agreeing on and specifying desired…

Enhancing Reflective Practice in Multicultural Counseling through Cultural Auditing

ERIC Educational Resources Information Center

Collins, Sandra; Arthur, Nancy; Wong-Wylie, Gina

2010-01-01

Counselors work in an increasingly complex cultural milieu where every encounter with a client must be considered multicultural in nature. Reflective practice is a central component of professional competence and necessarily involves attention to culture. The cultural auditing model provides an effective and flexible reflective process for…

7 CFR 1773.6 - Auditor communication.

Code of Federal Regulations, 2013 CFR

2013-01-01

... communication must take the form of an audit engagement letter prepared by the CPA and formally accepted by the... Client”. It must also include the following: (1) The borrower and the CPA acknowledge that the audit is... provisions of RUS's security instrument; (2) The borrower and CPA acknowledge that RUS will consider the...

7 CFR 1773.6 - Auditor communication.

Code of Federal Regulations, 2014 CFR

2014-01-01

... communication must take the form of an audit engagement letter prepared by the CPA and formally accepted by the... Client”. It must also include the following: (1) The borrower and the CPA acknowledge that the audit is... provisions of RUS's security instrument; (2) The borrower and CPA acknowledge that RUS will consider the...

7 CFR 1773.6 - Auditor communication.

Code of Federal Regulations, 2011 CFR

2011-01-01

... communication must take the form of an audit engagement letter prepared by the CPA and formally accepted by the... Client”. It must also include the following: (1) The borrower and the CPA acknowledge that the audit is... provisions of RUS's security instrument; (2) The borrower and CPA acknowledge that RUS will consider the...

7 CFR 1773.6 - Auditor communication.

Code of Federal Regulations, 2012 CFR

2012-01-01

... communication must take the form of an audit engagement letter prepared by the CPA and formally accepted by the... Client”. It must also include the following: (1) The borrower and the CPA acknowledge that the audit is... provisions of RUS's security instrument; (2) The borrower and CPA acknowledge that RUS will consider the...

Australasian brachytherapy audit: results of the 'end-to-end' dosimetry pilot study.

PubMed

Haworth, Annette; Wilfert, Lisa; Butler, Duncan; Ebert, Martin A; Todd, Stephen; Bucci, Joseph; Duchesne, Gillian M; Joseph, David; Kron, Tomas

2013-08-01

We present the results of a pilot study to test the feasibility of a brachytherapy dosimetry audit. The feasibility study was conducted at seven sites from four Australian states in both public and private centres. A purpose-built cylindrical water phantom was imaged using the local imaging protocol and a treatment plan was generated to deliver 1 Gy to the central (1 of 3) thermoluminescent dosimeter (TLD) from six dwell positions. All centres completed the audit, consisting of three consecutive irradiations, within a 2-h time period, with the exception of one centre that uses a pulsed dose rate brachytherapy unit. All TLD results were within 4.5% of the predicted value, with the exception of one subset where the dwell position step size was incorrectly applied. While the limited data collected in the study demonstrated considerable heterogeneity in clinical practice, the study proved a brachytherapy dosimetry audit to be feasible. Future studies should include verification of source strength using a Standard Dosimetry Laboratory calibrated chamber, a phantom that more closely mimics the clinical situation, a more comprehensive review of safety and quality assurance (QA) procedures including source dwell time and position accuracy, and a review of patient treatment QA procedures such as applicator position verification. © 2013 The Authors. Journal of Medical Imaging and Radiation Oncology © 2013 The Royal Australian and New Zealand College of Radiologists.

Research ethics committee auditing: the experience of a university hospital.

PubMed

Marchetti, Daniela; Spagnolo, Angelico; Cicerone, Marina; Cascini, Fidelia; La Monaca, Giuseppe; Spagnolo, Antonio G

2013-09-01

The authors report the first Italian experience of a research ethics committee (REC) audit focused on the evaluation of the REC's compliance with standard operating procedures, requirements in insurance coverage, informed consent, protection of privacy and confidentiality, predictable risks/harms, selection of subjects, withdrawal criteria and other issues, such as advertisement details and justification of placebo. The internal audit was conducted over a two-year period (March 2009-February 2011) divided into quarters to better value the influence of the new insurance coverage regulation that came into effect in March 2010 (Ministerial Decree of 14 July, 2009) and expand the requirements to safeguard participants in clinical drug trials including other critical items as information and consent and the risks to benefits ratio. Out of a total of 639 REC's opinions and research studies, 316 were reviewed. Regarding the insurance policy requirements, Auditor/REC non-compliance occurred only in one case. The highest number of Auditor/REC non-compliance was in regard to information and consent, which should have incurred a suspended decision rather than a favorable opinion. This internal audit shows the importance and the difficulty of the review process. For this reason, specific courses for members of the research ethics committee and for those who aspire to become auditors will be provided. There may also be efforts to improve the standard operating procedures already in place.

The UK Haemophilia Doctors Organisation triennial audit of UK Comprehensive Care Haemophilia Centres.

PubMed

Wilde, J T

2012-07-01

Under the auspices of the United Kingdom Haemophilia Doctors Organisation (UKHCDO) the UK Comprehensive Care Haemophilia Centres (CCCs) have undergone a three yearly formal audit assessment since 1993. This report describes the evolution of the audit process and details the findings of the most recent audit round, the sixth since inception. The audit reports from the 2009 audit round were reviewed by the audit organizing group and a structured analysis of the data was compiled. CCCs in the UK offer a high standard of comprehensive care services. The main areas of concern were the state of the premises (seven centres), lack of dental services (seven centres), physiotherapy (seven centres) and social work support (11 centres). Major concerns were identified at eight centres requiring a formal letter from the chairman of UKHCDO to the chief executive of the host trust. Since inception of the triennial audit process centre report recommendations have resulted in major improvements in the services available at UK CCCs. The audit process is considered to be a highly effective means of improving the quality of care for patients with bleeding disorders and can be used as a model for the introduction of a similar process in other countries. © 2012 Blackwell Publishing Ltd.

48 CFR 3.502-2 - Subcontractor kickbacks.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the consequences of detection; procurement procedures to minimize the opportunity for kickbacks; audit... gifts or gratuities received from subcontractors; annual employee declarations that they have violated...

10 CFR 63.43 - License specification.

Code of Federal Regulations, 2011 CFR

2011-01-01

...: (1) Restrictions as to the physical and chemical form and radioisotopic content of radioactive waste... the provisions relating to organization and management, procedures, recordkeeping, review and audit...

Suboptimal care and perinatal mortality in ten European regions: methodology and evaluation of an international audit.

PubMed

Richardus, J H; Graafmans, W C; Bergsjø, P; Lloyd, D J; Bakketeig, L S; Bannon, E M; Borkent-Polet, M; Davidson, L L; Defoort, P; Leitão, A Esparteiro; Langhoff-Roos, J; Garcia, A Moral; Papantoniou, N E; Wennergren, M; Amelink-Verburg, M P; Verloove-Vanhorick, S P; Mackenbach, J P

2003-10-01

A European concerted action (the EuroNatal study) investigated differences in perinatal mortality between countries of Europe. This report describes the methods used in the EuroNatal international audit and discusses the validity of the results. Perinatal deaths between 1993 and 1998 in regions of ten European countries were identified. The categories of death chosen for the study were singleton fetal deaths at 28 or more weeks of gestational age, all intrapartum deaths at 28 or more weeks of gestational age and neonatal deaths at 34 or more weeks of gestational age. Deaths with major congenital anomalies were excluded. An international audit panel used explicit criteria to review all cases, which were blinded for region. Subjective interpretation was used in cases of events or interventions where explicit criteria did not exist. Suboptimal factors were identified in the antenatal, intrapartum and neonatal periods, and classified as 'maternal/social', due to 'infrastructure/service organization', or due to 'professional care delivery'. The contribution of each suboptimal factor to the fatal outcome was listed and consensus was reached on a final grade using a procedure that included correspondence and plenary meetings. In all regions combined, 90% of all known or estimated cases in the selected categories were included in the audit. In total, 1619 cases of perinatal death were audited. Consensus was reached in 1543 (95%) cases. In 75% of all cases, the grade was based on explicit criteria. In the remaining cases, consensus was reached within subpanels without reference to predefined criteria. There was reasonable to good agreement between and within subpanels, and within panel members. The international audit procedure proved feasible and led to consistent results. The results that relate to suboptimal care will need to be studied in depth in order to reach conclusions about their implications for assessing the quality of perinatal care in the individual regions.

Mitigating Cybersecurity Risks.

PubMed

Rose, Rachel V; Kass, Joseph S

2017-04-01

Cybersecurity issues and their impact on compliance with the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act are becoming more of an enforcement focus for a variety of government agencies, including the US Department of Health and Human Services, the Federal Trade Commission, and the Department of Justice. In the case presented in this article, a nurse in a neurology practice opted to speak with a patient about human immunodeficiency virus testing procedures in a manner audible to others in the waiting room. Computer screens with patient information were visible to anyone approaching a desk, the staff had not been trained on cybersecurity issues, and malware infected the computers used in the practice. In light of these circumstances and the launch of Phase 2 of the HIPAA Audit Program by the US Department of Health and Human Services Office for Civil Rights, the neurology practice must consider the following questions. First, could the gaps in the technical, administrative, and physical requirements of HIPAA and the HITECH Act result in an adverse audit and penalties? Second, what course of action does the law mandate in response to a ransomware attack?

Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units.

PubMed

Miettunen, Kirsi; Metsälä, Eija

2017-06-01

Background The purpose of clinical audits performed in radiology units is to reduce the radiation dose of patients and staff and to implement evidence-based best practices. Purpose To describe auditor recommendations in three Finnish clinical audit rounds performed in 2002-2014, and to determine if auditor recommendations have had any impact on improving medical imaging practice. Material and Methods The retrospective observational study was performed in radiology units holding a radiation safety license issued by the Finnish Radiation and Nuclear Safety Authority. The data comprised a systematic sample (n = 120) of auditor reports produced in three auditing rounds in these units during the years 2002-2014. The data were analyzed by descriptive methods and by using the Friedman two-way ANOVA test. Results The number of auditor recommendations given varied between clinical audit rounds and according to the type of imaging unit, as well as according to calculation method. Proportionally, the most recommendations in all three clinical audit rounds were given about defining and using quality assurance functions and about guidelines and practices for carrying out procedures involving radiation exposure. Demanding radiology units improved their practices more than basic imaging units towards the third round. Conclusion Auditor recommendations help to address the deficiencies in imaging practices. There is a need to develop uniform guidelines and to provide tutoring for clinical auditors in order to produce comparable clinical audit results.

The internal audit of clinical areas: a pilot of the internal audit methodology in a health service emergency department.

PubMed

Brown, Alison; Santilli, Mario; Scott, Belinda

2015-12-01

Governing bodies of health services need assurance that major risks to achieving the health service objectives are being controlled. Currently, the main assurance mechanisms generated within the organization are through the review of implementation of policies and procedures and review of clinical audits and quality data. The governing bodies of health services need more robust, objective data to inform their understanding of the control of clinical risks. Internal audit provides a methodological framework that provides independent and objective assurance to the governing body on the control of significant risks. The article describes the pilot of the internal audit methodology in an emergency unit in a health service. An internal auditor was partnered with a clinical expert to assess the application of clinical criteria based on best practice guidelines. The pilot of the internal audit of a clinical area was successful in identifying significant clinical risks that required further management. The application of an internal audit methodology to a clinical area is a promising mechanism to gain robust assurance at the governance level regarding the management of significant clinical risks. This approach needs further exploration and trial in a range of health care settings. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Evaluating and operationalizing an environmental auditing program: a pilot study.

PubMed

Gordon, Laura; Bruce, Natalie; Suh, Kathryn N; Roth, Virginia

2014-07-01

Environmental auditing is an important tool to ensure consistent and effective cleaning. Our pilot study compared an alcohol-based fluorescent marking product and an adenosine-5'-triphosphate bioluminescence product for use in an environmental auditing program to determine which product was more practical and acceptable to users. Both products were tested on 15 preselected high touch objects in randomly selected patient rooms, following regular daily cleaning. A room was considered a "pass" if ≥80% of surfaces were adequately cleaned as defined by manufacturers' guidelines. A qualitative survey assessed user preference and operational considerations. Using fluorescent marking, 9 of 37 patient rooms evaluated (24%) were considered a "pass" after daily cleaning. Using adenosine-5'-triphosphate bioluminescence, 21 of 37 patient rooms passed (57%). There was great variability in results between different high touch objects. Eighty percent of users preferred the alcohol-based fluorescent marking product because it provided an effective visual aid to coach staff on proper cleaning techniques and allowed simple and consistent application. Environmental auditing using translucent, alcohol-based fluorescent marking best met the requirements of our organization. Our results reinforce the importance of involving a multidisciplinary team in evaluating and operationalizing an environmental auditing program. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Lessons learned in preparing method 29 filters for compliance testing audits.

PubMed

Martz, R F; McCartney, J E; Bursey, J T; Riley, C E

2000-01-01

Companies conducting compliance testing are required to analyze audit samples at the time they collect and analyze the stack samples if audit samples are available. Eastern Research Group (ERG) provides technical support to the EPA's Emission Measurements Center's Stationary Source Audit Program (SSAP) for developing, preparing, and distributing performance evaluation samples and audit materials. These audit samples are requested via the regulatory Agency and include spiked audit materials for EPA Method 29-Metals Emissions from Stationary Sources, as well as other methods. To provide appropriate audit materials to federal, state, tribal, and local governments, as well as agencies performing environmental activities and conducting emission compliance tests, ERG has recently performed testing of blank filter materials and preparation of spiked filters for EPA Method 29. For sampling stationary sources using an EPA Method 29 sampling train, the use of filters without organic binders containing less than 1.3 microg/in.2 of each of the metals to be measured is required. Risk Assessment testing imposes even stricter requirements for clean filter background levels. Three vendor sources of quartz fiber filters were evaluated for background contamination to ensure that audit samples would be prepared using filters with the lowest metal background levels. A procedure was developed to test new filters, and a cleaning procedure was evaluated to see if a greater level of cleanliness could be achieved using an acid rinse with new filters. Background levels for filters supplied by different vendors and within lots of filters from the same vendor showed a wide variation, confirmed through contact with several analytical laboratories that frequently perform EPA Method 29 analyses. It has been necessary to repeat more than one compliance test because of suspect metals background contamination levels. An acid cleaning step produced improvement in contamination level, but the difference was not significant for most of the Method 29 target metals. As a result of our studies, we conclude: Filters for Method 29 testing should be purchased in lots as large as possible. Testing firms should pre-screen new boxes and/or new lots of filters used for Method 29 testing. Random analysis of three filters (top, middle, bottom of the box) from a new box of vendor filters before allowing them to be used in field tests is a prudent approach. A box of filters from a given vendor should be screened, and filters from this screened box should be used both for testing and as field blanks in each test scenario to provide the level of quality assurance required for stationary source testing.

12 CFR 19.241 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... rules and procedures for the removal, suspension, or debarment of independent public accountants and..., and Debarment of Accountants From Performing Audit Services § 19.241 Scope. This subpart, which...

21 CFR 26.66 - Designation and listing procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN MEDICAL DEVICE PRODUCT EVALUATION REPORTS: UNITED STATES AND THE EUROPEAN...

12 CFR 19.241 - Scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., and Debarment of Accountants From Performing Audit Services § 19.241 Scope. This subpart, which... rules and procedures for the removal, suspension, or debarment of independent public accountants and...

12 CFR 19.241 - Scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., and Debarment of Accountants From Performing Audit Services § 19.241 Scope. This subpart, which... rules and procedures for the removal, suspension, or debarment of independent public accountants and...

12 CFR 19.241 - Scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., and Debarment of Accountants From Performing Audit Services § 19.241 Scope. This subpart, which... rules and procedures for the removal, suspension, or debarment of independent public accountants and...

12 CFR 19.241 - Scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., and Debarment of Accountants From Performing Audit Services § 19.241 Scope. This subpart, which... rules and procedures for the removal, suspension, or debarment of independent public accountants and...

NASA Case Sensitive Review and Audit Approach

NASA Astrophysics Data System (ADS)

Lee, Arthur R.; Bacus, Thomas H.; Bowersox, Alexandra M.; Newman, J. Steven

2005-12-01

As an Agency involved in high-risk endeavors NASA continually reassesses its commitment to engineering excellence and compliance to requirements. As a component of NASA's continual process improvement, the Office of Safety and Mission Assurance (OSMA) established the Review and Assessment Division (RAD) [1] to conduct independent audits to verify compliance with Agency requirements that impact safe and reliable operations. In implementing its responsibilities, RAD benchmarked various approaches for conducting audits, focusing on organizations that, like NASA, operate in high-risk environments - where seemingly inconsequential departures from safety, reliability, and quality requirements can have catastrophic impact to the public, NASA personnel, high-value equipment, and the environment. The approach used by the U.S. Navy Submarine Program [2] was considered the most fruitful framework for the invigorated OSMA audit processes. Additionally, the results of benchmarking activity revealed that not all audits are conducted using just one approach or even with the same objectives. This led to the concept of discrete, unique "audit cases."

Don't be scared.

PubMed

Killick, S

1996-01-01

In the UK, recent changes to prescribing oral contraceptives (OCs) have contributed to acute difficulties in providing clinical services, interruptions or discontinuations of audit and research projects of the Royal College of Obstetricians and Gynaecologists' Faculty of Family Planning and Reproductive Health Care, and criticisms of the way its audit unit has handled nationally important information. Professional auditors should consider the problems caused by the sudden change in a long accepted gold standard as an opportunity. The unit has already received audits of the effect of changes concerning the risk of thromboembolism from gestodene and desogestrel containing OCs. Family planning providers need to consider whether their cascade system of information dissemination did not inform them quickly and completely of a necessary change in practice or whether it followed the information system available to clients (i.e., the national press) so that family planning providers are not prepared for consumer reports both qualitatively and quantitatively. Some potentially long-term difficulties have occurred, which probably could not have been avoided regardless. Some clinics had to dispense only a two-months supply of second generation OCs at a time. Problems linked to a large increase in clinic attendances (potentially longer waiting times, counseling time, poorer attendance rates, and possibly more OC discontinuations) will recur at two months and at regular intervals thereafter until new stocks are available to allow staggered follow-up appointments. Thus, the audit unit can refer to its on-going audits for these figures. The most difficult step of the audit cycle is to initiate a change in practice. The audit unit must first acquire data to handle appropriately OC scares from articles in the national press.

Developing and Implementing a Quality Assurance Strategy for Electroconvulsive Therapy.

PubMed

Hollingsworth, Jessa; Baliko, Beverly; McKinney, Selina; Rosenquist, Peter

2018-04-17

The literature provides scant guidance in effective quality assurance strategies concerning the use of electroconvulsive therapy (ECT) for the treatment of psychiatric conditions. Numerous guidelines are published that provide guidance in the delivery of care; however, little has been done to determine how a program or facility might ensure compliance to best practice for safety, tolerability, and efficacy in performing ECT. The objective of this project was to create a quality assurance strategy specific to ECT. Determining standards for quality care and clarifying facility policy were key outcomes in establishing an effective quality assurance strategy. An audit tool was developed utilizing quality criteria derived from a systematic review of ECT practice guidelines, peer review, and facility policy. All ECT procedures occurring over a 2-month period of May to June 2017 were retrospectively audited and compared against target compliance rates set for the facility's ECT program. Facility policy was adapted to reflect quality standards, and audit findings were used to inform possible practice change initiatives, were used to create benchmarks for continuous quality monitoring, and were integrated into regular hospital quality meetings. Clarification on standards of care and the use of clinical auditing in ECT was an effective starting point in the development of a quality assurance strategy. Audit findings were successfully integrated into the hospital's overall quality program, and recognition of practice compliance informed areas for future quality development and policy revision in this small community-based hospital in the southeastern United States. This project sets the foundation for a quality assurance strategy that can be used to help monitor procedural safety and guide future improvement efforts in delivering ECT. Although it is just the first step in creating meaningful quality improvement, setting clear standards and identifying areas of greatest clinical need were crucial beginning for this hospital's growing program.

Patientsmate©: the implementation and evaluation of an online prospective audit system.

PubMed

McHugh, Seamus Mark; Loh, Kah Poh; Corrigan, Mark Anthony; Sheikh, Athar; Lehane, Elaine; Hill, Arnold David Konrad

2012-04-01

Inaccuracy in Hospital Inpatient Enquiry (HIPE)/Casemix-based data has been reported as high as 26%. This results in financial waste and makes effective audit impossible. We aimed to develop a novel web-based outcome audit system. A web-based online audit system, Patientsmate©, was developed using an integrated database system written in the programme language PHP. Data were inputted by the surgical team responsible for the patients care. A prospective comparison study of the new Patientsmate© and the standard HIPE systems, was performed over a 1-month period and involving two general surgical teams in April 2010. In addition, a Likert-scale based questionnaire was designed and hosted within the Patientsmate© system. A focus group of those clinicians directly involved in data accessing and input were then invited to complete the questionnaire in order to assess usability of the system. During the study period there were a total of 108 patients and 88 procedures. Our study confirms the accuracy of clinician derived data, with the Patientsmate© system more accurately recording number of patients (83% vs. 80.6%), number of procedures (85.2% vs. 68.1%) and hospital day case rate (52% vs. 47.1%). Inputting data using Patientsmate© for a single patient took 6-7 minutes. Of those using the system, 75% reported feeling comfortable after using it once only and 100% were satisfied with the layout of the online interface. The Patientsmate© system allows for increased accuracy in outcome-based data as compared with the HIPE system, facilitating audit, financial savings and the appropriate allocation of services. © 2010 Blackwell Publishing Ltd.

The direct environmental impact of hip arthroscopy for femoroacetabular impingement: a surgical waste audit of five cases

PubMed Central

de SA, Darren; Stephens, Kellee; Kuang, Michelle; Simunovic, Nicole; Karlsson, Jon; Ayeni, Olufemi R.

2016-01-01

Health care facilities produce significant waste (2200 kg/bed/year) creating 2% of greenhouse gas emissions and 1% total solid waste nationwide, with 20–70% of waste coming from operating rooms. We performed a waste audit of hip arthroscopy for femoroacetabular impingement (FAI) to understand its environmental impact and identify areas for greening practices. A waste audit of five hip arthroscopy procedures for FAI was performed. All waste was collected and separated into six waste streams in real time: (i) normal/landfill waste; (ii) recyclable cardboards and plastics; (iii) biohazard waste; (iv) sharp items; (v) linens and (vi) sterile wrapping. The surgical waste (except laundered linens) from five FAI surgeries totaled 47.4 kg, including 21.7 kg (45.7%) of biohazard waste, 11.7 kg (24.6%) of sterile wrap, 6.4 kg (13.5%) of normal/landfill waste, 6.4 kg (13.5%) of recyclable plastics and 1.2 kg (2.6%) of sharp items. An average of 9.4 kg (excluding laundered linens) of waste was produced per procedure. Given the considerable biohazard waste produced by FAI procedures, additional recycling programs, continued adherence to proper waste segregation and an emphasis on ‘green outcomes’ is encouraged to demonstrate environmental responsibility and effectively manage and allocate finite resources. PMID:27583149

Report on Audit for the Year Ended June 30, 2000.

ERIC Educational Resources Information Center

Kucharski, Walter J.

This report, from the Auditor of Public Accounts of the Commonwealth of Virginia, discusses an audit of the Virginia Community College System (VCCS) balance sheet as of June 30, 2000. The auditors considered internal controls over financial reporting and tested compliance with certain provisions of laws, regulations, contracts, and grants in…

24 CFR 84.87 - Closeout procedures, subsequent adjustments and continuing responsibilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the award. HUD may approve extensions when requested by the recipient. (2) The recipient shall account... responsibilities. (1) The closeout of an award does not affect any of the following: (i) Audit requirements in § 84...) Closeout procedures. (1) Recipients shall submit, within 90 calendar days after the date of completion of...

24 CFR 84.87 - Closeout procedures, subsequent adjustments and continuing responsibilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the award. HUD may approve extensions when requested by the recipient. (2) The recipient shall account... responsibilities. (1) The closeout of an award does not affect any of the following: (i) Audit requirements in § 84...) Closeout procedures. (1) Recipients shall submit, within 90 calendar days after the date of completion of...

24 CFR 84.87 - Closeout procedures, subsequent adjustments and continuing responsibilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the award. HUD may approve extensions when requested by the recipient. (2) The recipient shall account... responsibilities. (1) The closeout of an award does not affect any of the following: (i) Audit requirements in § 84...) Closeout procedures. (1) Recipients shall submit, within 90 calendar days after the date of completion of...

24 CFR 84.87 - Closeout procedures, subsequent adjustments and continuing responsibilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the award. HUD may approve extensions when requested by the recipient. (2) The recipient shall account... responsibilities. (1) The closeout of an award does not affect any of the following: (i) Audit requirements in § 84...) Closeout procedures. (1) Recipients shall submit, within 90 calendar days after the date of completion of...

24 CFR 84.87 - Closeout procedures, subsequent adjustments and continuing responsibilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the award. HUD may approve extensions when requested by the recipient. (2) The recipient shall account... responsibilities. (1) The closeout of an award does not affect any of the following: (i) Audit requirements in § 84...) Closeout procedures. (1) Recipients shall submit, within 90 calendar days after the date of completion of...

33 CFR 96.440 - How will the Coast Guard decide whether to approve an organization's request to be authorized?

Code of Federal Regulations, 2014 CFR

2014-07-01

... clear assignment of management duties; (2) Ethical standards for managers and auditors; (3) Procedures... recognized industry standards; (4) Procedures for auditing safety management systems that are consistent with... Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE...

33 CFR 96.440 - How will the Coast Guard decide whether to approve an organization's request to be authorized?

Code of Federal Regulations, 2010 CFR

2010-07-01

... clear assignment of management duties; (2) Ethical standards for managers and auditors; (3) Procedures... recognized industry standards; (4) Procedures for auditing safety management systems that are consistent with... Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE...

33 CFR 96.440 - How will the Coast Guard decide whether to approve an organization's request to be authorized?

Code of Federal Regulations, 2011 CFR

2011-07-01

... clear assignment of management duties; (2) Ethical standards for managers and auditors; (3) Procedures... recognized industry standards; (4) Procedures for auditing safety management systems that are consistent with... Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE...

33 CFR 96.440 - How will the Coast Guard decide whether to approve an organization's request to be authorized?

Code of Federal Regulations, 2013 CFR

2013-07-01

... clear assignment of management duties; (2) Ethical standards for managers and auditors; (3) Procedures... recognized industry standards; (4) Procedures for auditing safety management systems that are consistent with... Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE...

33 CFR 96.440 - How will the Coast Guard decide whether to approve an organization's request to be authorized?

Code of Federal Regulations, 2012 CFR

2012-07-01

... clear assignment of management duties; (2) Ethical standards for managers and auditors; (3) Procedures... recognized industry standards; (4) Procedures for auditing safety management systems that are consistent with... Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE...

40 CFR 63.8075 - What reports must I submit and when?

Code of Federal Regulations, 2010 CFR

2010-07-01

... demonstrations to verify that control devices subject to § 63.8000(d)(3) are operating as designed. (3) A... procedures and quality assurance procedures. (iii) Descriptions of monitoring devices, monitoring frequencies...) Identification of the CMS. (J) The date of the latest CMS certification or audit. (K) The operating day or...

Undergraduate Program Reviews at the University of Ottawa. Report of the UPRAC Auditors.

ERIC Educational Resources Information Center

Council of Ontario Universities, Toronto.

Pursuant to the Council of Ontario Universities' procedures for periodic quality reviews of undergraduate programs, auditors examined the policies and programs of the University of Ottawa (UO) during 1997. The English, Chemistry, and Physiotherapy departments were selected for audits of their program review procedures; the Environmental Studies…

An examination of the relationships between physicians' clinical and hospital-utilization performance.

PubMed Central

Saywell, R M; Bean, J A; Ludke, R L; Redman, R W; McHugh, G J

1981-01-01

To examine the relationships between measures of attending physician teams' clinical and utilization performance, inpatient hospital audits were conducted in 22 Maryland and western Pennsylvania nonfederal short-term hospitals. A total of 6,980 medical records were abstracted from eight diagnostic categories using the Payne and JCAH PEP medical audit procedures. The results indicate weak statistical associations between the two medical care evaluation audits; between clinical performance and utilization performance, as measured by appropriateness of admissions and length of stay; and between three utilization measures. Based on these findings, it does not appear valid to use performance in one area to evaluate performance in the other in order to measure or evaluate and ultimately improve physicians; clinical or utilization performance. PMID:6946048

On the RAC. CIOs must work to make their organization's time with CMS Recovery Audit Contractors as painless as possible.

PubMed

Lawrence, Daphne

2009-01-01

CIOs should act as a team with HIM and Finance to prepare for RAC audits. CIOs can take the lead in looking at improved coding systems, and can be involved in creating policies and procedures for the hospital's RAC team. RAC is an opportunity to improve documentation, coding and data analysis. RAC appeals will become more common as states share lessons learned. Follow the money and check on claims that are frequently returned.

Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina.

PubMed

López, Mariana Beatriz; Lichtenberger, Aldana; Conde, Karina; Cremonte, Mariana

2017-07-01

Background  Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective  To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPS-QF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods  A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results  All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions  In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low reliability of those instruments and a better performance of the AUDIT in this population. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

External audit on the clinical practice and medical decision-making at the departments of radiotherapy in Budapest and Vienna.

PubMed

Esik, O; Seitz, W; Lövey, J; Knocke, T H; Gaudi, I; Németh, G; Pötter, R

1999-04-01

To present an example of how to study and analyze the clinical practice and the quality of medical decision-making under daily routine working conditions in a radiotherapy department, with the aims of detecting deficiencies and improving the quality of patient care. Two departments, each with a divisional organization structure and an established internal audit system, the University Clinic of Radiotherapy and Radiobiology in Vienna (Austria), and the Department of Radiotherapy at the National Institute of Oncology in Budapest (Hungary), conducted common external audits. The descriptive parameters of the external audit provided information on the auditing (auditor and serial number of the audit), the cohorts (diagnosis, referring institution, serial number and intention of radiotherapy) and the staff responsible for the treatment (division and physician). During the ongoing external audits, the qualifying parameters were (1) the sound foundation of the indication of radiotherapy, (2) conformity to the institution protocol (3), the adequacy of the choice of radiation equipment, (4) the appropriateness of the treatment plan, and the correspondence of the latter with (5) the simulation and (6) verification films. Various degrees of deviation from the treatment principles were defined and scored on the basis of the concept of Horiot et al. (Horiot JC, Schueren van der E. Johansson KA, Bernier J, Bartelink H. The program of quality assurance of the EORTC radiotherapy group. A historical overview. Radiother. Oncol. 1993,29:81-84), with some modifications. The action was regarded as adequate (score 1) in the event of no deviation or only a small deviation with presumably no alteration of the desired end-result of the treatment. A deviation adversely influencing the result of the therapy was considered a major deviation (score 3). Cases involving a minor deviation (score 2) were those only slightly affecting the therapeutic end-results, with effects between those of cases with scores 1 and 3. Non-performance of the necessary radiotherapeutic procedures was penalized by the highest score of 4. Statistical evaluation was performed with the BMDP software package, using variance analysis. Bimonthly audits (six with a duration of 4-6 h in each institution) were carried out by three auditors from the evaluating departments; they reviewed a total of 452 cases in Department A, and 265 cases in Department B. Despite the comparable staffing and instrumental conditions, a markedly higher number (1.5 times) of new cases were treated in Department A, but with a lower quality of radiotherapy, as adequate values of qualifying parameters (1-6) were more frequent for the cases treated in Department B (85.3%, 94%, 83.4%, 28.3%, 41.9% and 81.1%) than for those in Department A (67%, 83.4%, 87.8%, 26.1%, 33.2% and 17.7%). The responsible division (including staff and instrumentation), the responsible physician and the type of the disease each exerted a highly significant effect on the quality level of the treatment. Statistical analysis revealed a positive influence of the curative (relative to the palliative/symptomatic) intention of the treatment on the level of quality, but the effect of the first radiotherapy (relative to the second or further one) was statistically significant in only one department. At the same time, the quality parameters did not vary with the referring institution, the auditing person or the serial number of the audit. The external audit relating to the provision of radiotherapeutic care proved feasible with the basic conformity and compliance of the staff and resulted in valuable information to take correction measures.

'Screening audit' as a quality assurance tool in good clinical practice compliant research environments.

PubMed

Park, Sinyoung; Nam, Chung Mo; Park, Sejung; Noh, Yang Hee; Ahn, Cho Rong; Yu, Wan Sun; Kim, Bo Kyung; Kim, Seung Min; Kim, Jin Seok; Rha, Sun Young

2018-04-25

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice (GCP) and protocol compliance in clinical research. However, they are laborious, time consuming, and require expertise. Therefore, we developed a simple auditing process (a screening audit) and evaluated its feasibility and effectiveness. The screening audit was developed using a routine audit checklist based on the Severance Hospital's Human Research Protection Program policies and procedures. The measure includes 20 questions, and results are summarized in five categories of audit findings. We analyzed 462 studies that were reviewed by the Severance Hospital Human Research Protection Center between 2013 and 2017. We retrospectively analyzed research characteristics, reply rate, audit findings, associated factors and post-screening audit compliance, etc. RESULTS: Investigator reply rates gradually increased, except for the first year (73% → 26% → 53% → 49% → 55%). The studies were graded as "critical," "major," "minor," and "not a finding" (11.9, 39.0, 42.9, and 6.3%, respectively), based on findings and number of deficiencies. The auditors' decisions showed fair agreement with weighted kappa values of 0.316, 0.339, and 0.373. Low-risk level studies, single center studies, and non-phase clinical research showed more prevalent frequencies of being "major" or "critical" (p = 0.002, < 0.0001, < 0.0001, respectively). Inappropriateness of documents, failure to obtain informed consent, inappropriateness of informed consent process, and failure to protect participants' personal information were associated with higher audit grade (p < 0.0001, p = 0.0001, p < 0.0001, p = 0.003). We were able to observe critical GCP violations in the routine internal audit results of post-screening audit compliance checks in "non-responding" and "critical" studies upon applying the screening audit. Our screening audit is a simple and effective way to assess overall GCP compliance by institutions and to ensure medical ethics. The tool also provides useful selection criteria for conducting routine audits.

Informational analysis involving application of complex information system

NASA Astrophysics Data System (ADS)

Ciupak, Clébia; Vanti, Adolfo Alberto; Balloni, Antonio José; Espin, Rafael

The aim of the present research is performing an informal analysis for internal audit involving the application of complex information system based on fuzzy logic. The same has been applied in internal audit involving the integration of the accounting field into the information systems field. The technological advancements can provide improvements to the work performed by the internal audit. Thus we aim to find, in the complex information systems, priorities for the work of internal audit of a high importance Private Institution of Higher Education. The applied method is quali-quantitative, as from the definition of strategic linguistic variables it was possible to transform them into quantitative with the matrix intersection. By means of a case study, where data were collected via interview with the Administrative Pro-Rector, who takes part at the elaboration of the strategic planning of the institution, it was possible to infer analysis concerning points which must be prioritized at the internal audit work. We emphasize that the priorities were identified when processed in a system (of academic use). From the study we can conclude that, starting from these information systems, audit can identify priorities on its work program. Along with plans and strategic objectives of the enterprise, the internal auditor can define operational procedures to work in favor of the attainment of the objectives of the organization.

45 CFR 5.51 - Records available.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of Finding issued by the Office for Civil Rights in civil rights complaints, and Social Security... will not make available, however, manuals or instructions that reveal investigative or audit procedures...

45 CFR 5.51 - Records available.

Code of Federal Regulations, 2011 CFR

2011-10-01

... of Finding issued by the Office for Civil Rights in civil rights complaints, and Social Security... will not make available, however, manuals or instructions that reveal investigative or audit procedures...

Surgical Mortality Audit-lessons Learned in a Developing Nation.

PubMed

Bindroo, Sandiya; Saraf, Rakesh

2015-06-01

Surgical audit is a systematic, critical analysis of the quality of surgical care that is reviewed by peers against explicit criteria or recognized standards. It is used to improve surgical practice with the ultimate goal of improving patient care. As the pattern of surgical care is different in the developing world, we analyzed mortalities in a referral medical institute of India to suggest interventions for improvement. An analysis of total admissions, different surgeries, and mortalities over 1 year in an urban referral medical institute of northern India was performed, followed by "peer review" of the mortalities. Mortality rates as outcomes and classification was done to provide comparative results. Of 10,005 surgical patients, 337 (male = 221, female = 116) deaths were reported over 1 year. The overall mortality rate was 3.36%, while mortality in operative cases was 1.76%. Total deaths were classified into (1) Viable: 153 (45%), (2) Nonviable: 174 (52%), and (3) Indeterminate: 10 (3%). Exclusion of the nonviable group reduced the mortality rate from 3.36% to 1.62%. Trauma was the major cause of mortality (n = 235; 70%) as compared to other surgical patients (n = 102; 30%). Increased mortality was also associated with emergency procedures (3.66%) as compared to elective surgeries (0.34%). In conclusion, audit of mortality and morbidity helps in initiating and implementing preventive strategies to improve surgical practice and patient care, and to reduce mortality rates. The mortality and morbidity forum is an important educational activity. It should be considered a mandatory activity in all postgraduate training programs.

The impact of SLMTA in improving laboratory quality systems in the Caribbean Region.

PubMed

Guevara, Giselle; Gordon, Floris; Irving, Yvette; Whyms, Ismae; Parris, Keith; Beckles, Songee; Maruta, Talkmore; Ndlovu, Nqobile; Albalak, Rachel; Alemnji, George

Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow. To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA) training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS). Audits were conducted at baseline, six months, exit (at 12 months) and post-SLMTA (at 18 months) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation.

Assessing data quality and the variability of source data verification auditing methods in clinical research settings.

PubMed

Houston, Lauren; Probst, Yasmine; Martin, Allison

2018-05-18

Data audits within clinical settings are extensively used as a major strategy to identify errors, monitor study operations and ensure high-quality data. However, clinical trial guidelines are non-specific in regards to recommended frequency, timing and nature of data audits. The absence of a well-defined data quality definition and method to measure error undermines the reliability of data quality assessment. This review aimed to assess the variability of source data verification (SDV) auditing methods to monitor data quality in a clinical research setting. The scientific databases MEDLINE, Scopus and Science Direct were searched for English language publications, with no date limits applied. Studies were considered if they included data from a clinical trial or clinical research setting and measured and/or reported data quality using a SDV auditing method. In total 15 publications were included. The nature and extent of SDV audit methods in the articles varied widely, depending upon the complexity of the source document, type of study, variables measured (primary or secondary), data audit proportion (3-100%) and collection frequency (6-24 months). Methods for coding, classifying and calculating error were also inconsistent. Transcription errors and inexperienced personnel were the main source of reported error. Repeated SDV audits using the same dataset demonstrated ∼40% improvement in data accuracy and completeness over time. No description was given in regards to what determines poor data quality in clinical trials. A wide range of SDV auditing methods are reported in the published literature though no uniform SDV auditing method could be determined for "best practice" in clinical trials. Published audit methodology articles are warranted for the development of a standardised SDV auditing method to monitor data quality in clinical research settings. Copyright © 2018. Published by Elsevier Inc.

14 CFR 21.137 - Quality system.

Code of Federal Regulations, 2012 CFR

2012-01-01

... procedures must include the following, as applicable: (1) A flight test of each aircraft produced unless that... planning, conducting, and documenting internal audits to ensure compliance with the approved quality system...

14 CFR 21.137 - Quality system.

Code of Federal Regulations, 2014 CFR

2014-01-01

... procedures must include the following, as applicable: (1) A flight test of each aircraft produced unless that... planning, conducting, and documenting internal audits to ensure compliance with the approved quality system...

14 CFR 21.137 - Quality system.

Code of Federal Regulations, 2013 CFR

2013-01-01

... procedures must include the following, as applicable: (1) A flight test of each aircraft produced unless that... planning, conducting, and documenting internal audits to ensure compliance with the approved quality system...

20 CFR Appendix C to Part 614 - Standard for Fraud and Overpayment Detection

Code of Federal Regulations, 2010 CFR

2010-04-01

... to claimants' entitlement to benefits paid to them in a sufficient proportion of cases to test the... post-audit or by industry surveys. The so-called “post-audit” is a matching of central office wage... concurrent benefit lists. A plan A. of investigation based on a sample post-audit will be considered as...

Program audit, A management tool

NASA Technical Reports Server (NTRS)

Miller, T. J.

1971-01-01

Program gives in-depth view of organizational performance at all levels of the management structure, and provides means by which managers can effectively and efficiently evaluate adequacy of management direction, policies, and procedures.

48 CFR 242.1203 - Processing agreements.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Novation and Change-of... execute novation and change-of-name agreements in accordance with the procedures at PGI 242.1203. [70 FR...

Caesarean section audit to improve quality of care in a rural referral hospital in Tanzania.

PubMed

Dekker, Luuk; Houtzager, Tessa; Kilume, Omary; Horogo, John; van Roosmalen, Jos; Nyamtema, Angelo Sadock

2018-05-15

Caesarean section (CS) is often a life-saving procedure, but can also lead to serious complications, even more so in low-resource settings. Therefore unnecessary CS should be avoided and optimal circumstances for vaginal delivery should be created. In this study, we aim to audit indications for Caesarean sections and improve decision-making and obstetric management. Audit of all cases of CS performed from January to August 2013 was performed in a rural referral hospital in Tanzania. The study period was divided in three audit blocks; retrospective (before auditing), prospective 1 and prospective 2. A local audit panel (LP) and an external auditor (EA) judged if obstetric management was adequate and indications were appropriate or if CS could have been prevented and yet retain good pregnancy outcome. Furthermore, changes in modes of deliveries, overall pregnancy outcome and decision-to-delivery interval were monitored. During the study period there were 1868 deliveries. Of these, 403 (21.6%) were Caesarean sections. The proportions of unjustified CS prior to introduction of audit were as high as 34 and 75%, according to the respective judgments of LP and EA. Following introduction of audit, the proportions of unjustified CS decreased to 23% (p = 0.29) and 52% (p = 0.01) according to LP and EA respectively. However, CS rate did not change (20.2 to 21.7%), assisted vacuum delivery rate did not increase (3.9 to 1.8%) and median decision-to-delivery interval was 83 min (range 10 - 390 min). Although this is a single center study, these findings suggest that unnecessary Caesarean sections exist at an alarming rate even in referral hospitals and suggest that a vast number can be averted by introducing a focused CS audit system. Our findings indicate that CS audit is a useful tool and, if well implemented, can enhance rational use of resources, improve decision-making and harmonise practice among care providers.

Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

PubMed

Gupta, Deepak; Haber, Halim

2014-06-01

Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had undergone LERP or MERP at our Same Day Surgery Center.

Inconsistencies between alcohol screening results based on AUDIT-C scores and reported drinking on the AUDIT-C questions: prevalence in two US national samples

PubMed Central

2014-01-01

Background The AUDIT-C is an extensively validated screen for unhealthy alcohol use (i.e. drinking above recommended limits or alcohol use disorder), which consists of three questions about alcohol consumption. AUDIT-C scores ≥4 points for men and ≥3 for women are considered positive screens based on US validation studies that compared the AUDIT-C to “gold standard” measures of unhealthy alcohol use from independent, detailed interviews. However, results of screening—positive or negative based on AUDIT-C scores—can be inconsistent with reported drinking on the AUDIT-C questions. For example, individuals can screen positive based on the AUDIT-C score while reporting drinking below US recommended limits on the same AUDIT-C. Alternatively, they can screen negative based on the AUDIT-C score while reporting drinking above US recommended limits. Such inconsistencies could complicate interpretation of screening results, but it is unclear how often they occur in practice. Methods This study used AUDIT-C data from respondents who reported past-year drinking on one of two national US surveys: a general population survey (N = 26,610) and a Veterans Health Administration (VA) outpatient survey (N = 467,416). Gender-stratified analyses estimated the prevalence of AUDIT-C screen results—positive or negative screens based on the AUDIT-C score—that were inconsistent with reported drinking (above or below US recommended limits) on the same AUDIT-C. Results Among men who reported drinking, 13.8% and 21.1% of US general population and VA samples, respectively, had screening results based on AUDIT-C scores (positive or negative) that were inconsistent with reported drinking on the AUDIT-C questions (above or below US recommended limits). Among women who reported drinking, 18.3% and 20.7% of US general population and VA samples, respectively, had screening results that were inconsistent with reported drinking. Limitations This study did not include an independent interview gold standard for unhealthy alcohol use and therefore cannot address how often observed inconsistencies represent false positive or negative screens. Conclusions Up to 21% of people who drink alcohol had alcohol screening results based on the AUDIT-C score that were inconsistent with reported drinking on the same AUDIT-C. This needs to be addressed when training clinicians to use the AUDIT-C. PMID:24468406

Comparing short versions of the AUDIT in a community-based survey of young people

PubMed Central

2013-01-01

Background The 10-item Alcohol Use Disorders Identification Test (AUDIT-10) is commonly used to monitor harmful alcohol consumption among high-risk groups, including young people. However, time and space constraints have generated interest for shortened versions. Commonly used variations are the AUDIT-C (three questions) and the Fast Alcohol Screening Test (FAST) (four questions), but their utility in screening young people in non-clinical settings has received little attention. Methods We examined the performance of established and novel shortened versions of the AUDIT in relation to the full AUDIT-10 in a community-based survey of young people (16–29 years) attending a music festival in Melbourne, Australia (January 2010). Among those reporting drinking alcohol in the previous 12 months, the following statistics were systematically assessed for all possible combinations of three or four AUDIT items and established AUDIT variations: Cronbach’s alpha (internal consistency), variance explained (R2) and Pearson’s correlation coefficient (concurrent validity). For our purposes, novel shortened AUDIT versions considered were required to represent all three AUDIT domains and include item 9 on alcohol-related injury. Results We recruited 640 participants (68% female) reporting drinking in the previous 12 months. Median AUDIT-10 score was 10 in males and 9 in females, and 127 (20%) were classified as having at least high-level alcohol problems according to WHO classification. The FAST scored consistently high across statistical measures; it explained 85.6% of variance in AUDIT-10, correlation with AUDIT-10 was 0.92, and Cronbach’s alpha was 0.66. A number of novel four-item AUDIT variations scored similarly high. Comparatively, the AUDIT-C scored substantially lower on all measures except internal consistency. Conclusions Numerous abbreviated variations of the AUDIT may be a suitable alternative to the AUDIT-10 for classifying high-level alcohol problems in a community-based population of young Australians. Four-item AUDIT variations scored more consistently high across all evaluated statistics compared to three-item combinations. Novel AUDIT versions may be more effective than many established shortened versions as an alternative screening tool to the AUDIT-10 to measure hazardous or harmful alcohol consumption in this population. PMID:23556543

Software quality assurance plan for GCS

NASA Technical Reports Server (NTRS)

Duncan, Stephen E.; Bailey, Elizabeth K.

1990-01-01

The software quality assurance (SQA) function for the Guidance and Control Software (GCS) project which is part of a software error studies research program is described. The SQA plan outlines all of the procedures, controls, and audits to be carried out by the SQA organization to ensure adherence to the policies, procedures, and standards for the GCS project.

External audits of electron beams using mailed TLD dosimetry: preliminary results.

PubMed

Gomola, I; Van Dam, J; Isern-Verdum, J; Verstraete, J; Reymen, R; Dutreix, A; Davis, B; Huyskens, D

2001-02-01

A feasibility study has been performed to investigate the possibility of using mailed thermoluminescence dosimetry (TLD) for external audits of clinical electron beams in Europe. In the frame of the EC Network Project for Quality Assurance in Radiotherapy, instruction sheets and mailing procedures have been defined for mailed TLD dosimetry using the dedicated holder developed by a panel of experts of the International Atomic Energy Agency (IAEA). Three hundred and thirty electron beam set-ups have been checked in the reference centres and some local centres of the EC Network Project and in addition through the centres participating to the EORTC Radiotherapy Group trial 22922. The mean ratio of measured dose to stated dose is 0.2% and the standard deviation of measured dose to stated dose is 3.2%. In seven beam set-ups, deviations greater than 10% were observed (max. 66%), showing the usefulness of these checks. The results of this feasibility study (instruction sheets, mailing procedures, holder) are presently endorsed by the EQUAL-ESTRO structure in order to offer in the future to all ESTRO members the possibility to request external audits of clinical electron beams.

Template matching for auditing hospital cost and quality.

PubMed

Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Mukherjee, Nabanita; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

2014-10-01

Develop an improved method for auditing hospital cost and quality. Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, Texas, and New York between 2004 and 2006. A template of 300 representative patients was constructed and then used to match 300 patients at hospitals that had a minimum of 500 patients over a 3-year study period. From each of 217 hospitals we chose 300 patients most resembling the template using multivariate matching. The matching algorithm found close matches on procedures and patient characteristics, far more balanced than measured covariates would be in a randomized clinical trial. These matched samples displayed little to no differences across hospitals in common patient characteristics yet found large and statistically significant hospital variation in mortality, complications, failure-to-rescue, readmissions, length of stay, ICU days, cost, and surgical procedure length. Similar patients at different hospitals had substantially different outcomes. The template-matched sample can produce fair, directly standardized audits that evaluate hospitals on patients with similar characteristics, thereby making benchmarking more believable. Through examining matched samples of individual patients, administrators can better detect poor performance at their hospitals and better understand why these problems are occurring. © Health Research and Educational Trust.

Sault Tribe Building Efficiency Energy Audits

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holt, Jeffrey W.

2013-09-26

The Sault Ste. Marie Tribe of Chippewa Indians is working to reduce energy consumption and expense in Tribally-owned governmental buildings. The Sault Ste. Marie Tribe of Chippewa Indians will conduct energy audits of nine Tribally-owned governmental buildings in three counties in the Upper Peninsula of Michigan to provide a basis for evaluating and selecting the technical and economic viability of energy efficiency improvement options. The Sault Ste. Marie Tribe of Chippewa Indians will follow established Tribal procurement policies and procedures to secure the services of a qualified provider to conduct energy audits of nine designated buildings. The contracted provider willmore » be required to provide a progress schedule to the Tribe prior to commencing the project and submit an updated schedule with their monthly billings. Findings and analysis reports will be required for buildings as completed, and a complete Energy Audit Summary Report will be required to be submitted with the provider?s final billing. Conducting energy audits of the nine governmental buildings will disclose building inefficiencies to prioritize and address, resulting in reduced energy consumption and expense. These savings will allow Tribal resources to be reallocated to direct services, which will benefit Tribal members and families.« less

Performance of the internal audit department under ERP systems: empirical evidence from Taiwanese firms

NASA Astrophysics Data System (ADS)

Tsai, Wen-Hsien; Chen, Hui-Chiao; Chang, Jui-Chu; Leu, Jun-Der; Chao Chen, Der; Purbokusumo, Yuyun

2015-10-01

In this study, the performance of the internal audit department (IAD) and its contribution to a company under enterprise resource planning (ERP) systems was examined. It is anticipated that this will provide insight into the factors perceived to be crucial to a company's effectiveness. A theoretical framework was developed and tested using the sample of Taiwanese companies. Using mail survey procedures, we elicited perceptions from key internal auditors about the ERP system and auditing software, as well as their opinions concerning the IAD's effectiveness and its contribution within a company. Data were analysed using the partial least square (PLS) regression to test the hypotheses. Drawing upon a sample of Taiwanese firms, the study suggests that a firm can improve the performance of the IAD through an enterprise-wide integrated, effective ERP system and appropriate auditing software. At the same time, the performance of the IAD can also contribute significantly to the company. The results also show that investments in computer-assisted auditing techniques (CAATs) are crucial due to their tremendous effectiveness in regard to the performance of the IAD and for the contributions CAATs can make to a company.

An audit of environmental health calls to a department of public health medicine.

PubMed

Chappel, D; Fernandes, V

1995-11-01

To audit telephone calls concerning general issues in communicable disease control and environmental health to a department of public health medicine. A department of public health medicine in a district with a population of 190,000 during 1993. A retrospective audit of forms designed to record all calls concerning environmental health and communicable disease control. The intervention was a change in design of forms and education of doctors dealing with the calls. A re-audit was done after these changes had been implemented. The number of recorded calls increased from 1.75 (1992) to 3.29 (mid-1993) per week. Signing of forms increased from 61% to 83% and dating from 6% to 72%. All forms filled in by registrars or senior registrars were reviewed by the Consultant in Communicable Disease Control (CCDC). Very few calls were considered to be inappropriate. The increase in the number of calls was probably artefactual owing to better recording as a result of the audit. Improved recording will help in future training and audit, and be a medico-legal safeguard.

Evaluation and communication: using a communication audit to evaluate organizational communication.

PubMed

Hogard, Elaine; Ellis, Roger

2006-04-01

This article identifies a surprising dearth of studies that explicitly link communication and evaluation at substantive, theoretical, and methodological levels. A three-fold typology of evaluation studies referring to communication is proposed and examples given. The importance of organizational communication in program delivery is stressed and illustrative studies reviewed. It is proposed that organizational communication should be considered in all program evaluations and that this should be approached through communication audit. Communication audits are described with particular reference to established survey questionnaire instruments. Two case studies exemplify the use of such instruments in the evaluation of educational and social programs.

Influence of an independent quarterly audit on publicly reported vancomycin-resistant enterocococi bacteremia data in Ontario, Canada.

PubMed

Prematunge, Chatura; Policarpio, Michelle E; Johnstone, Jennie; Adomako, Kwaku; Nadolny, Emily; Lam, Freda; Li, Ye; Brown, Kevin A; Garber, Gary

2018-04-13

All Ontario hospitals are mandated to self-report vancomycin-resistant enterocococi (VRE) bacteremias to Ontario's Ministry of Health and Long-term Care for public reporting purposes. Independent quarterly audits of publicly reported VRE bacteremias between September 2013 and June 2015 were carried out by Public Health Ontario. VRE bacteremia case-reporting errors between January 2009 and August 2013 were identified by a single retrospective audit. Employing a quasiexperimental pre-post study design, the relative risk of VRE bacteremia reporting errors before and after quarterly audits were modeled using Poisson regression adjusting for hospital type, case counts reported to the Ministry of Health and Long-term Care, and autocorrelation via generalized estimating equation. Overall, 24.5% (126 out of 514) of VRE bacteremias were reported in error; 114 out of 367 (31%) VRE bacteremias reported before quarterly audits and 12 out of 147 (8.1%) reported after audits were found to be incorrect. In adjusted analysis, quarterly audits of VRE bacteremias were associated with significant reductions in reporting errors when compared with before quarterly auditing (relative risk, 0.17; 95% confidence interval, 0.05-0.63). Risk of reporting errors among community hospitals were greater than acute teaching hospitals of the region (relative risk, 4.39; 95% CI, 3.07-5.70). This study found independent quarterly audits of publicly reported VRE bacteremias to be associated with significant reductions in reporting errors. Public reporting systems should consider adopting routine data audits and hospital-targeted training to improve data accuracy. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Comparison of AUDIT-C collected via electronic medical record and self-administered research survey in HIV infected and uninfected patients.

PubMed

McGinnis, Kathleen A; Tate, Janet P; Williams, Emily C; Skanderson, Melissa; Bryant, Kendall J; Gordon, Adam J; Kraemer, Kevin L; Maisto, Stephen A; Crystal, Steven; Fiellin, David A; Justice, Amy C

2016-11-01

Using electronic medical record (EMR) data for clinical decisions, quality improvement, and research is common. While unhealthy alcohol use is particularly risky among HIV infected individuals (HIV+), the validity of EMR data for identifying unhealthy alcohol use among HIV+ is unclear. Among HIV+ and uninfected, we: (1) assess agreement of EMR and research AUDIT-C at validated cutoffs for unhealthy alcohol use; (2) explore EMR cutoffs that maximize agreement; and (3) assess subpopulation variation in agreement. Using data from the Veterans Aging Cohort Study (VACS), EMR AUDIT-C cutoffs of 2+, 3+, and 4+ for men (2+ and 3+ for women) were compared to research AUDIT-C 4+ for men (3+ for women). Agreement was compared by demographics, HIV, hepatitis C infection, and alcohol related diagnosis. Among 1082 HIV+ and 1160 uninfected men, 14% and 22% had an EMR and research AUDIT-C 4+, respectively. Among 32 HIV+ and 115 uninfected women, 9% and 14% had an EMR and research AUDIT-C 3+. For men, EMR agreement with the research AUDIT-C 4+ was highest at a cutoff of 3+ (kappa=0.49). For women, EMR agreement with AUDIT-C 3+ was highest at a cutoff of 2+ (kappa=0.46). Moderate agreement was consistent across subgroups. EMR AUDIT-C underestimates unhealthy alcohol use compared to research AUDIT-C in both HIV+ and uninfected individuals. Methods for improving quality of clinical screening may be in need of investigation. Researchers and clinicians may consider alternative EMR cutoffs that maximize agreement given limitations of clinical screening. Published by Elsevier Ireland Ltd.

A National Framework for Energy Audit Ordinances

DOE Office of Scientific and Technical Information (OSTI.GOV)

Taylor, Cody; Costa, Marc; Long, Nicholas

A handful of U.S. cities have begun to incorporate energy audits into their building energy performance policies. Cities are beginning to recognize an opportunity to use several information tools to bring to real estate markets both motivation to improve efficiency and actionable pointers on how to improve. Care is necessary to combine such tools as operational ratings, energy audits, asset ratings, and building retro-commissioning in an effective policy regime that maximizes market impact. In this paper, the authors focus on energy audits and consider both the needs of the policies' implementers in local governments and the emerging standards and federalmore » tools to improve data collection and practitioner engagement. Over the past two years, we have compared several related data formats such as New York City's existing audit reporting spreadsheet, ASHRAE guidance on building energy auditing, and the DOE Building Energy Asset Score, to identify a possible set of required and optional fields for energy audit reporting programs. Doing so revealed tensions between the ease of data collection and the value of more detailed information, which had implications for the effort and qualifications needed to complete the energy audit. The resulting list of data fields is now feeding back into the regulatory process in several cities currently working on implementing or developing audit policies. Using complementary policies and standardized tools for data transmission, the next generation of policies and programs will be tailored to local building stock and can more effectively target improvement opportunities through each building's life.« less

Use of diagnostic information submitted to the United Kingdom Central Cardiac Audit Database: development of categorisation and allocation algorithms.

PubMed

Brown, Kate L; Crowe, Sonya; Pagel, Christina; Bull, Catherine; Muthialu, Nagarajan; Gibbs, John; Cunningham, David; Utley, Martin; Tsang, Victor T; Franklin, Rodney

2013-08-01

To categorise records according to primary cardiac diagnosis in the United Kingdom Central Cardiac Audit Database in order to add this information to a risk adjustment model for paediatric cardiac surgery. Codes from the International Paediatric Congenital Cardiac Code were mapped to recognisable primary cardiac diagnosis groupings, allocated using a hierarchy and less refined diagnosis groups, based on the number of functional ventricles and presence of aortic obstruction. A National Clinical Audit Database. Patients Children undergoing cardiac interventions: the proportions for each diagnosis scheme are presented for 13,551 first patient surgical episodes since 2004. In Scheme 1, the most prevalent diagnoses nationally were ventricular septal defect (13%), patent ductus arteriosus (10.4%), and tetralogy of Fallot (9.5%). In Scheme 2, the prevalence of a biventricular heart without aortic obstruction was 64.2% and with aortic obstruction was 14.1%; the prevalence of a functionally univentricular heart without aortic obstruction was 4.3% and with aortic obstruction was 4.7%; the prevalence of unknown (ambiguous) number of ventricles was 8.4%; and the prevalence of acquired heart disease only was 2.2%. Diagnostic groups added to procedural information: of the 17% of all operations classed as "not a specific procedure", 97.1% had a diagnosis identified in Scheme 1 and 97.2% in Scheme 2. Diagnostic information adds to surgical procedural data when the complexity of case mix is analysed in a national database. These diagnostic categorisation schemes may be used for future investigation of the frequency of conditions and evaluation of long-term outcome over a series of procedures.

General RMP Guidance - Chapter 6: Prevention Program (Program 2)

EPA Pesticide Factsheets

Sound prevention practices are founded on safety information, hazard review, operating procedures, training, maintenance, compliance audits, and accident investigation. These must be integrated into a risk management system that you implement consistently.

14 CFR 21.165 - Responsibility of holder.

Code of Federal Regulations, 2011 CFR

2011-01-01

... following, as applicable: (1) A flight test of each aircraft produced unless that aircraft will be exported... § 45.15(c) of this chapter. (l) Internal audits. Procedures for planning, conducting, and documenting...

14 CFR 249.20 - Preservation of records by certificated air carriers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... internal audits and procedural studies; operational, management, accounting, financial, and legal service... operational records relevant to computation of subsidy mail pay 3 years. (b) For each calendar year, all basic...

Evaluating the value and impact of the Victorian Audit of Surgical Mortality.

PubMed

Retegan, Claudia; Russell, Colin; Harris, Darren; Andrianopoulos, Nick; Beiles, C Barry

2013-10-01

Since the Victorian Audit of Surgical Mortality (VASM) commenced in 2007, 95% of Victorian Fellows have agreed to participate and have provided data on the deaths of patients receiving surgical care. All public, and the majority of private, hospitals involved in the delivery of surgical services in Victoria have been submitting data on deaths associated with surgery. De-identified reports on this data are distributed in regular annual reports and case note review booklets. Although informal feedback on the perceived value of the audit was encouraging, a formal review of all aspects of the audit was felt necessary. An independent formal review of VASM governance, documentation, datasets and data analysis was performed, in addition to a survey of 257 individuals (surgeons and other stakeholders) on the perceived impact of VASM. The review confirmed increasing participation and acceptance by surgeons since the inception of the project. Governance mechanisms were found to be effective and acknowledged by stakeholders and collaborators. Robust participation rates have been achieved, and stakeholders were generally satisfied with the quality of feedback. Suggestions for improvement were provided by some surgeons and hospitals. External review of VASM processes and procedures confirmed that the audit was operating effectively, with robust quality control and achieving the trust of stakeholders. The educational value of the audit to the surgical community was acknowledged and areas for future improvement have been identified. © 2013 Royal Australasian College of Surgeons.

Patient outcome of emergency laparotomy improved with increasing "number of surgeons on-call" in a university hospital: Audit loop.

PubMed

Hussain, Anwar; Mahmood, Fahad; Teng, Chui; Jafferbhoy, Sadaf; Luke, David; Tsiamis, Achilleas

2017-11-01

Emergency laparotomy is a commonly performed high-mortality surgical procedure. The National Emergency Laparotomy Network (NELA) published an average mortality rate of 11.1% and a median length of stay equivalent to 16.3 days in patients undergoing emergency laparotomy. This study presents a completed audit loop after implementing the change of increasing the number of on-call surgeons in the general surgery rota of a university hospital. The aim of this study was to evaluate the outcomes of emergency laparotomy in a single UK tertiary centre after addition of one more consultant in the daily on-call rota. This is a retrospective study involving patients who underwent emergency laparotomy between March to May 2013 (first audit) and June to August 2015 (second audit). The study parameters stayed the same. The adult patients undergoing emergency laparotomy under the general surgical take were included. Appendicectomy, cholecystectomy and simple inguinal hernia repair patients were excluded. Data was collected on patient demographics, ASA, morbidity, 30-day mortality and length of hospital stay. Statistical analysis including logistic regression was performed using SPSS. During the second 3-month period, 123 patients underwent laparotomy compared to 84 in the first audit. Median age was 65(23-93) years. 56.01% cases were ASA III or above in the re-audit compared to 41.9% in the initial audit. 38% patients had bowel anastomosis compared to 35.7% in the re-audit with 4.2% leak rate in the re-audit compared to 16.6% in the first audit. 30-day mortality was 10.50% in the re-audit compared to 21% and median length of hospital stay 11 days in the re-audit compared to 16 days. The lower ASA grade was significantly associated with increased likelihood of being alive, as was being female, younger age and not requiring ITU admission post-operatively. However, having a second on-call consultant was 2.231 times more likely to increase the chances of patients not dying (p = 0.031). Our audit-loop suggests that adding a second consultant to the daily on-call rota significantly reduces postoperative mortality and morbidity. Age, ASA and ITU admission are other independent factors affecting patient outcomes. We suggest this change be applied to other high volume centres across the country to improve the outcomes after emergency laparotomy.

Admiral Furman Academy: A Case Study in Selected Not-for-Profit Auditing Issues

ERIC Educational Resources Information Center

Grippo, Frank J.; Nassiripour, Sia

2009-01-01

The purpose of this case is to help students explore accounting and auditing issues often confronted by auditors of not-for-profit organizations. Given final financial statements, the goal of the case is to require students to prepare the footnotes that would be considered an integral part of the financial statements. The case is intended for…

Setting standards for planning off duty and audit of practice.

PubMed

Walker, Linda; Minchin, Anne; Pickard, Jane

The off duty or rostering system is an important part of managing any ward or department. This article looks at the issues that need to be considered when drawing up and managing off duty. It recommends standards for off-duty planning and shares the results of an audit carried out against some of these standards in one NHS trust.

A monitoring/auditing mechanism for SSL/TLS secured service sessions in Health Care Applications.

PubMed

Kavadias, C D; Koutsopoulos, K A; Vlachos, M P; Bourka, A; Kollias, V; Stassinopoulos, G

2003-01-01

This paper analyzes the SSL/TLS procedures and defines the functionality of a monitoring/auditing entity running in parallel with the protocol, which is decoding, checking the certificate and permitting session establishment based on the decoded certificate information, the network addresses of the endpoints and a predefined access list. Finally, this paper discusses how such a facility can be used for detection impersonation attempts in Health Care applications and provides case studies to show the effectiveness and applicability of the proposed method.

Air Force Contract Management Division Aircrew Standardization and Evaluation: A Handbook for Government Flight Representatives.

DTIC Science & Technology

1985-04-01

and all boldface procedures. In addition, include questions from AFR 60-16 and AFR 51-37. Document all such testing on memos to provide an audit trail...your contractor to use simi 1 ar forms. They will provide a clear audit trail for both you and the STAN/EVAL Inspection Team. 22 Supervisory Evaluations...OS m(Mal-j Bedil, 8 72- 3930) 190~e~br1 BJFCTFor-%at of AFForms 8 Acca -mplished by SAC Exaxiners T:AF PRO/F0 (Dot 47) 1. Certificate:- of .%ircrew

Can GPs audit their ability to detect psychological distress? One approach and some unresolved issues.

PubMed Central

Howe, A

1998-01-01

BACKGROUND: General practitioners (GPs) should be able to detect psychological distress in their patients. However, there is much evidence of underperformance in this area. The principle of clinical audit is the identification of underperformance and amelioration of its causes, but there appear to be few evaluated models of audit in this area of clinical practice. AIM: To evaluate the feasibility of auditing GPs' performance as detectors of psychological distress. Specific objectives were to test a model of the audit cycle in the detection of psychological distress by GPs; to research GP perceptions of prior audit activity in this area and the validity of the instruments used to measure GP performance; and to research GP perceptions of the value of this specific approach to the audit of their performance and the particular value of different aspects of the model in terms of its impact on clinician behaviour. METHOD: Prospective controlled study of an audit cycle of GP detection of psychological distress. Nineteen GP principals used a self-directed educational intervention involving measurement of their performance, followed by data feedback and review of selected videotaped consultations. Qualitative data on GP views of audit in this area of clinical activity were collected before and after the quantitative data collection. RESULTS: The study shows that the GP cohort had not previously considered auditing their performance as detectors of psychological distress. They found the instruments of measurement and the model of audit acceptable. However, they also suggested modifications that might be educationally more effective and make the audit more practical. These included smaller patient numbers and more peer contact. The implications of the study for a definitive model of audit in this area are discussed. CONCLUSION: Effective audit of GP performance in detection of psychological distress is possible using validated instruments, and GP performance can be improved by educational intervention. GPs in this study appear more motivated by individual case studies and reflection through video analysis on undiagnosed patients than by quantitative data feedback on their performance. This study therefore supports other evidence that clinical audit has most impact when quantitative data is coupled with clinical examples derived from patient review. PMID:9604413

Can GPs audit their ability to detect psychological distress? One approach and some unresolved issues.

PubMed

Howe, A

1998-01-01

General practitioners (GPs) should be able to detect psychological distress in their patients. However, there is much evidence of underperformance in this area. The principle of clinical audit is the identification of underperformance and amelioration of its causes, but there appear to be few evaluated models of audit in this area of clinical practice. To evaluate the feasibility of auditing GPs' performance as detectors of psychological distress. Specific objectives were to test a model of the audit cycle in the detection of psychological distress by GPs; to research GP perceptions of prior audit activity in this area and the validity of the instruments used to measure GP performance; and to research GP perceptions of the value of this specific approach to the audit of their performance and the particular value of different aspects of the model in terms of its impact on clinician behaviour. Prospective controlled study of an audit cycle of GP detection of psychological distress. Nineteen GP principals used a self-directed educational intervention involving measurement of their performance, followed by data feedback and review of selected videotaped consultations. Qualitative data on GP views of audit in this area of clinical activity were collected before and after the quantitative data collection. The study shows that the GP cohort had not previously considered auditing their performance as detectors of psychological distress. They found the instruments of measurement and the model of audit acceptable. However, they also suggested modifications that might be educationally more effective and make the audit more practical. These included smaller patient numbers and more peer contact. The implications of the study for a definitive model of audit in this area are discussed. Effective audit of GP performance in detection of psychological distress is possible using validated instruments, and GP performance can be improved by educational intervention. GPs in this study appear more motivated by individual case studies and reflection through video analysis on undiagnosed patients than by quantitative data feedback on their performance. This study therefore supports other evidence that clinical audit has most impact when quantitative data is coupled with clinical examples derived from patient review.

Improving Building Energy Simulation Programs Through Diagnostic Testing (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2012-02-01

New test procedure evaluates quality and accuracy of energy analysis tools for the residential building retrofit market. Reducing the energy use of existing homes in the United States offers significant energy-saving opportunities, which can be identified through building simulation software tools that calculate optimal packages of efficiency measures. To improve the accuracy of energy analysis for residential buildings, the National Renewable Energy Laboratory's (NREL) Buildings Research team developed the Building Energy Simulation Test for Existing Homes (BESTEST-EX), a method for diagnosing and correcting errors in building energy audit software and calibration procedures. BESTEST-EX consists of building physics and utility billmore » calibration test cases, which software developers can use to compare their tools simulation findings to reference results generated with state-of-the-art simulation tools. Overall, the BESTEST-EX methodology: (1) Tests software predictions of retrofit energy savings in existing homes; (2) Ensures building physics calculations and utility bill calibration procedures perform to a minimum standard; and (3) Quantifies impacts of uncertainties in input audit data and occupant behavior. BESTEST-EX is helping software developers identify and correct bugs in their software, as well as develop and test utility bill calibration procedures.« less

Organisation of Prostate Cancer Services in the English National Health Service.

PubMed

Aggarwal, A; Nossiter, J; Cathcart, P; van der Meulen, J; Rashbass, J; Clarke, N; Payne, H

2016-08-01

The National Prostate Cancer Audit (NPCA) started in April 2013 with the aim of assessing the process of care and its outcomes in men diagnosed with prostate cancer in England and Wales. One of the key aims of the audit was to assess the configuration and availability of specialist prostate cancer services in England. In 2014, the NPCA undertook an organisational survey of all 143 acute National Health Service (NHS) Trusts and 48 specialist multidisciplinary team (MDT) hubs cross England. Questionnaires established the availability and location of core diagnostic, treatment and patient-centred support services for the management of non-metastatic prostate cancer in addition to specific diagnostic and treatment procedures that reflect the continuing evolution of prostate cancer management, such as high-intensity focused ultrasound (HIFU) and stereotactic body radiotherapy. The survey received a 100% response rate. The results showed considerable geographical variation with respect to the availability of core treatment modalities, the size of the target population and catchment areas served by specialist MDT hubs, as well as in the uptake of additional procedures and services. Specifically there are gaps in the availability of core radiotherapy procedures; high dose rate and low dose rate brachytherapy are available in 44% and 75% of specialist MDTs, respectively. By comparison, there seems to be a relative 'over-penetration' of surgical innovation, with 67% of specialist MDTs providing robotic-assisted laparoscopic prostatectomy and 21% HIFU. There is also evidence of increased centralisation of core surgical procedures and regional inequity in the availability of surgical innovation across England. The organisational survey of the NPCA has provided a comprehensive assessment of the structure and function of specialist MDTs in England and the availability of prostate cancer procedures and services. As part of the prospective audit, the NPCA will assess the effect of the availability of prostate cancer services on access regionally and subsequent outcomes of care according to evidence-based guidelines. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Quality audit of colonoscopy reports amongst patients screened or surveilled for colorectal neoplasia.

PubMed

Beaulieu, Daphnée; Barkun, Alan; Martel, Myriam

2012-07-21

To complete a quality audit using recently published criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior colorectal neoplasia (CRN) by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional database providing pathological results. Required documentation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a standardized glossary with 10% independent data validation. Sample size calculations determined the number of reports needed. Two hundreds and fifty patients (63.2 ± 10.5 years, female: 42.8%, average risk: 38.5%, personal/family history of CRN: 43.3%/20.2%) were scoped in June 2009 by 8 gastroenterologists and 3 surgeons (mean practice: 17.1 ± 8.5 years). Procedural indication and informed consent were always documented. 14% provided a previous colonoscopy date (past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness). Most procedural indicators were recorded (exam date: 98.4%, medications: 99.2%, difficulty level: 98.8%, prep quality: 99.6%). All reports noted extent of visualization (cecum: 94.4%, with landmarks noted in 78.8% - photodocumentation: 67.2%). No procedural times were recorded. One hundred and eleven had polyps (44.4%) with anatomic location noted in 99.1%, size in 65.8%, morphology in 62.2%; removal was by cold biopsy in 25.2% (cold snare: 18%, snare cautery: 31.5%, unrecorded: 20.7%), 84.7% were retrieved. Adenomas were noted in 24.8% (advanced adenomas: 7.6%, cancer: 0.4%) in this population with varying previous colonic investigations. This audit reveals lacking reported items, justifying additional research to optimize quality of reporting.

Quality audit of colonoscopy reports amongst patients screened or surveilled for colorectal neoplasia

PubMed Central

Beaulieu, Daphnée; Barkun, Alan; Martel, Myriam

2012-01-01

AIM: To complete a quality audit using recently published criteria from the Quality Assurance Task Group of the National Colorectal Cancer Roundtable. METHODS: Consecutive colonoscopy reports of patients at average/high risk screening, or with a prior colorectal neoplasia (CRN) by endoscopists who perform 11 000 procedures yearly, using a commercial computerized endoscopic report generator. A separate institutional database providing pathological results. Required documentation included patient demographics, history, procedure indications, technical descriptions, colonoscopy findings, interventions, unplanned events, follow-up plans, and pathology results. Reports abstraction employed a standardized glossary with 10% independent data validation. Sample size calculations determined the number of reports needed. RESULTS: Two hundreds and fifty patients (63.2 ± 10.5 years, female: 42.8%, average risk: 38.5%, personal/family history of CRN: 43.3%/20.2%) were scoped in June 2009 by 8 gastroenterologists and 3 surgeons (mean practice: 17.1 ± 8.5 years). Procedural indication and informed consent were always documented. 14% provided a previous colonoscopy date (past polyp removal information in 25%, but insufficient in most to determine surveillance intervals appropriateness). Most procedural indicators were recorded (exam date: 98.4%, medications: 99.2%, difficulty level: 98.8%, prep quality: 99.6%). All reports noted extent of visualization (cecum: 94.4%, with landmarks noted in 78.8% - photodocumentation: 67.2%). No procedural times were recorded. One hundred and eleven had polyps (44.4%) with anatomic location noted in 99.1%, size in 65.8%, morphology in 62.2%; removal was by cold biopsy in 25.2% (cold snare: 18%, snare cautery: 31.5%, unrecorded: 20.7%), 84.7% were retrieved. Adenomas were noted in 24.8% (advanced adenomas: 7.6%, cancer: 0.4%) in this population with varying previous colonic investigations. CONCLUSION: This audit reveals lacking reported items, justifying additional research to optimize quality of reporting. PMID:22826619

An audit of bronchoscopy practice in the United Kingdom: a survey of adherence to national guidelines

PubMed Central

Honeybourne, D.; Neumann, C. S.

1997-01-01

BACKGROUND: Both patient and staff safety are of major importance during the procedure of fibreoptic bronchoscopy. Patient safety depends partly on adequate disinfection of instruments and accessories used as well as careful monitoring during the procedure. Adequate facilities, manpower and training are also essential. Staff safety depends partly on adequate procedures to minimise any risks of sensitisation to agents such as glutaraldehyde. An audit was carried out of bronchoscopy procedures in hospitals in the UK and the findings were compared with published guidelines on good practice and clinical consensus. METHODS: A postal questionnaire was sent to 218 bronchoscopy units in the UK. Findings were then compared with published evidence of good practice in the areas of disinfection, including the use of glutaraldehyde, patient monitoring, manpower, facilities, and training. RESULTS: A 73% response rate was obtained. Recommended minimum disinfection times before and after routine bronchoscopies were not achieved by 35% of units. No disinfection was carried out in 34% of units before emergency bronchoscopies and in 19% of units after suspected cases of tuberculosis. Adequate rinsing of the bronchoscope with sterile or filtered water was not carried out by 43% of units. Contrary to recommendations, 31% of departments were still using glutaraldehyde in the patient examination room and inadequate room ventilation was common. Protective clothing was often not worn by staff during bronchoscopy. Inadequate intravenous access and use of supplementary oxygen were found in many units. Practice standards were higher in departments where dedicated bronchoscopy/endoscopy units of the hospital were used, and also where staff had been on external training courses. CONCLUSIONS: This audit has shown that many units do not adhere to guidelines on disinfection procedures and patient monitoring. Unnecessary potential risks due to staff exposure to glutaraldehyde were apparent. National guidelines on good practice are not being followed in areas which may potentially affect patient and staff safety. 


 PMID:9337830

Access to specialist gastroenterology care in Canada: The Practice Audit in Gastroenterology (PAGE) Wait Times Program

PubMed Central

Armstrong, David; Barkun, Alan NG; Chen, Ying; Daniels, Sandra; Hollingworth, Roger; Hunt, Richard H; Leddin, Desmond

2008-01-01

BACKGROUND: Canadian wait time data are available for the treatment of cancer and heart disease, as well as for joint replacement, cataract surgery and diagnostic imaging procedures. Wait times for gastroenterology consultation and procedures have not been studied, although digestive diseases pose a greater economic burden in Canada than cancer or heart disease. METHODS: Specialist physicians completed the practice audit if they provided digestive health care, accepted new patients and recorded referral dates. For patients seen for consultation or investigation over a one-week period, preprogrammed personal digital assistants were used to collect data including the main reason for referral, initial referral and consultation dates, procedure dates (if performed), personal and family history, and patient symptoms, signs and test results. Patient triaging, appropriateness of the referral and timeliness of care were noted. RESULTS: Over 10 months, 199 physicians recorded details of 5559 referrals, including 1903 visits for procedures. The distribution of total wait times (from referral to procedure) nationally was highly skewed at 91/203 days (median/75th percentile), with substantial interprovincial variation: British Columbia, 66/185 days; Alberta, 134/284 days; Ontario, 110/208 days; Quebec, 71/149 days; New Brunswick, 104/234 days; and Nova Scotia, 42/84 days. The percentage of physicians by province offering average-risk screening colonoscopy varied from 29% to 100%. DISCUSSION: Access to specialist gastroenterology care in Canada is limited by long wait times, which exceed clinically reasonable waits for specialist treatment. Although exhibiting some methodological limitations, this large practice audit sampling offers broadly generalized results, as well as a means to identify barriers to health care delivery and evaluate strategies to address these barriers, with the goals of expediting appropriate care for patients with digestive health disorders and ameliorating the personal and societal burdens imposed by digestive diseases. PMID:18299734

Justification of diagnostic medical exposures: some practical issues. Report of an International Atomic Energy Agency Consultation.

PubMed

Malone, J; Guleria, R; Craven, C; Horton, P; Järvinen, H; Mayo, J; O'reilly, G; Picano, E; Remedios, D; Le Heron, J; Rehani, M; Holmberg, O; Czarwinski, R

2012-05-01

The Radiation Protection of Patients Unit of the International Atomic Energy Agency (IAEA) is concerned about the effectiveness of justification of diagnostic medical exposures. Recent published work and the report of an initial IAEA consultation in the area gave grounds for such concerns. There is a significant level of inappropriate usage, and, in some cases, a poor level of awareness of dose and risk among some key groups involved. This article aims to address this. The IAEA convened a second group of experts in November 2008 to review practical and achievable actions that might lead to more effective justification. This report summarises the matters that this group considered and the outcome of their deliberations. There is a need for improved communication, both within professions and between professionals on one hand, and between professionals and the patients/public on the other. Coupled with this, the issue of consent to imaging procedures was revisited. The need for good evidence-based referral guidelines or criteria of acceptability was emphasised, as was the need for their global adaptation and dissemination. Clinical audit was regarded as a key tool in ensuring that justification becomes an effective, transparent and accountable part of normal radiological practice. In summary, justification would be facilitated by the "3 As": awareness, appropriateness and audit.

77 FR 56178 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... programs. FSIS will use the PEPRL-F-0008-04 form as a self assessment audit checklist to collect information related to the quality assurance/quality control procedures in place at in-plant and private...

20 CFR 633.203 - Review of funding request.

Code of Federal Regulations, 2010 CFR

2010-04-01

... SEASONAL FARMWORKER PROGRAMS Grant Planning and Application Procedures § 633.203 Review of funding request... farmworkers. (d) General administrative and financial management capability. (e) Prior performance with respect to financial management, audit and program outcomes. ...

12 CFR 308.605 - Application for reinstatement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit... Board of Directors, an application for reinstatement by an independent public accountant, an accounting... removal, suspension, or debarment of an accountant or firm. ...

12 CFR 308.605 - Application for reinstatement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit... Board of Directors, an application for reinstatement by an independent public accountant, an accounting... removal, suspension, or debarment of an accountant or firm. ...

12 CFR 308.605 - Application for reinstatement.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit... Board of Directors, an application for reinstatement by an independent public accountant, an accounting... removal, suspension, or debarment of an accountant or firm. ...

12 CFR 308.605 - Application for reinstatement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF PRACTICE AND PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit... Board of Directors, an application for reinstatement by an independent public accountant, an accounting... removal, suspension, or debarment of an accountant or firm. ...

Utility of the Alcohol Consumption Questions in the Alcohol Use Disorders Identification Test for Screening At-Risk Drinking and Alcohol Use Disorders among Korean College Students

PubMed Central

Kwon, Ui Suk; Kim, Sung Soo; Jung, Jin Gyu; Yoon, Seok-Joon; Kim, Seong Gu

2013-01-01

Background This study evaluated the utility of the Alcohol Use Disorders Identification Test Alcohol Consumption Questions (AUDIT-C) in screening at-risk drinking and alcohol use disorders among Korean college students. Methods For the 387 students who visited Chungnam National University student health center, drinking state and alcohol use disorders were assessed through diagnostic interviews. In addition, Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and cut down, annoyed, guilty, eye-opener (CAGE) were applied. The utility of the questionnaires for the interview results were compared. Results The areas under the receiver operating characteristic curves (AUROCs) of AUDIT-C for screening at-risk drinking were 0.927 in the male and 0.921 in the female participants. The AUROCs of AUDIT and CAGE were 0.906 and 0.643, respectively, in the male, and 0.898 and 0.657, respectively, in the female participants. The optimal screening scores of at-risk drinking in AUDIT-C were ≥6 in the male and ≥4 in the female participants; and in AUDIT and CAGE, ≥8 and ≥1, respectively, in the male, and ≥5 and ≥1 in the female participants. The AUROCs of AUDIT-C in screening alcohol use disorders were 0.902 in the male and 0.939 in the female participants. In the AUDIT and CAGE, the AUROCs were 0.936 and 0.712, respectively, in the male, and 0.960 and 0.844, respectively, in the female participants. The optimal screening scores of alcohol use disorders in AUDIT-C were ≥7 in the male and ≥6 in the female participants; and in AUDIT and CAGE, ≥10 and ≥1, respectively, in the male, and ≥8 and ≥1 in the female participants. Conclusion AUDIT-C is considered useful in screening at-risk drinking and alcohol use disorders among college students. PMID:23904957

The impact of SLMTA in improving laboratory quality systems in the Caribbean Region

PubMed Central

Gordon, Floris; Irving, Yvette; Whyms, Ismae; Parris, Keith; Beckles, Songee; Maruta, Talkmore; Ndlovu, Nqobile; Albalak, Rachel; Alemnji, George

2014-01-01

Background Past efforts to improve laboratory quality systems and to achieve accreditation for better patient care in the Caribbean Region have been slow. Objective To describe the impact of the Strengthening of Laboratory Management Toward Accreditation (SLMTA) training programme and mentorship amongst five clinical laboratories in the Caribbean after 18 months. Method Five national reference laboratories from four countries participated in the SLMTA programme that incorporated classroom teaching and implementation of improvement projects. Mentors were assigned to the laboratories to guide trainees on their improvement projects and to assist in the development of Quality Management Systems (QMS). Audits were conducted at baseline, six months, exit (at 12 months) and post-SLMTA (at 18 months) using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist to measure changes in implementation of the QMS during the period. At the end of each audit, a comprehensive implementation plan was developed in order to address gaps. Results Baseline audit scores ranged from 19% to 52%, corresponding to 0 stars on the SLIPTA five-star scale. After 18 months, one laboratory reached four stars, two reached three stars and two reached two stars. There was a corresponding decrease in nonconformities and development of over 100 management and technical standard operating procedures in each of the five laboratories. Conclusion The tremendous improvement in these five Caribbean laboratories shows that SLMTA coupled with mentorship is an effective, user-friendly, flexible and customisable approach to the implementation of laboratory QMS. It is recommended that other laboratories in the region consider using the SLMTA training programme as they engage in quality systems improvement and preparation for accreditation. PMID:27066396

Results from the Australasian Vascular Surgical Audit: the inaugural year.

PubMed

Beiles, C Barry; Bourke, Bernie; Thomson, Ian

2012-03-01

The Australian and New Zealand Society for Vascular Surgery has incorporated a constitutional change to administer a self-funded compulsory vascular surgery audit since January 2010. This is a bi-national quality assurance activity that captures all procedures performed in both countries. Data is collected at two points in the clinical admission; at operation and at discharge and data entry is via the Internet. Security is stringent and confidentiality is guaranteed by Commonwealth privilege. Data privacy is maximized by encryption. The application is flexible and administered by a dedicated administrator with a help-desk facility. Reports are available to provide real-time feedback of user performance compared with the peer group data in key categories of arterial surgery. A structured hierarchy for data management has been established to assess four main categories of performance: mortality after aortic surgery, stroke and death after carotid surgery, patency and limb salvage after infrainguinal bypass and patency after arteriovenous access for haemodialysis. Data is analysed using risk-adjustment techniques and an algorithm for management of underperformance has been followed. Data validation has been performed. The outcomes in all categories have been of a high standard and correction of erroneous data in a single statistical outlier has negated underperformance. The audit has captured only 65% of the estimated procedures in Australia in the first year, but data quality is good. The feasibility of a complete compulsory bi-national audit has now been established and will be the benchmark for other craft groups in the current environment of accountability. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Quality assurance audit: a prospective non-randomised trial of chemotherapy and radiotherapy for osteolymphoma (TROG 99.04/ALLG LY02).

PubMed

Christie, D; Le, T; Watling, K; Cornes, D; O'Brien, P; Hitchins, R

2009-04-01

A quality assurance (QA) audit of the Trans Tasman Radiation Oncology Group and Australasian Lymphoma and Leukaemia Group trial (TROG 99.04/ALLG LY02) began after accrual of 25 patients. The trial is a prospective non-randomized study of standard treatment for osteolymphoma. Data relating to informed consent, eligibility, chemotherapy and radiotherapy were reviewed. The audit showed a relatively low level of major variations from the protocol, with an overall rate of 3.6%. As this trial has accrued slowly over a long period, the concept of QA has also developed. Amendments were made to the protocol accordingly. In the future, QA procedures should be predetermined, conducted rapidly in real time, and appropriately funded in order to be relevant to the ongoing conduct of the trial.

[Quality management in a public health agency].

PubMed

Villalbí, Joan R; Ballestín, Manuela; Casas, Conrad; Subirana, Teresa

2012-01-01

This article describes the introduction of quality improvement actions in a public health organization. After ISO 17025 accreditation, which was legally mandated, was granted to the official control laboratory, the management decided to expand a quality policy in 2003, through a series of actions based on process analysis and proposals for improvement, further definition of standard operating procedures, exploration of users' opinions, the creation of improvement groups, and external audits or certification. The organizational response to these initiatives was diverse. External audit or certification of services seems to be the most powerful tool for change. Costing studies showed that up to 75% of the total expenditure of the agency in 2010 was spent on public health services subject to external audit or certification. Copyright © 2011 SESPAS. Published by Elsevier España, S.L. All rights reserved.

Comparison of AUDIT-C Collected via Electronic Medical Record and Self-Administered Research Survey in HIV Infected and Uninfected Patients

PubMed Central

McGinnis, Kathleen A.; Tate, Janet P.; Williams, Emily C.; Skanderson, Melissa; Bryant, Kendall J.; Gordon, Adam; Kraemer, Kevin L.; Maisto, Stephen A.; Crystal, Steven; Fiellin, David A.; Justice, Amy C.

2016-01-01

Background Using electronic medical record (EMR) data for clinical decisions, quality improvement, and research is common. While unhealthy alcohol use is particularly risky among HIV infected individuals (HIV+), the validity of EMR data for identifying unhealthy alcohol use among HIV+ is unclear. Among HIV+ and uninfected, we: 1) assess agreement of EMR and research AUDIT-C at validated cutoffs for unhealthy alcohol use; 2) explore EMR cutoffs that maximize agreement; and 3) assess subpopulation variation in agreement. Methods Using data from the Veterans Aging Cohort Study (VACS), EMR AUDIT-C cutoffs of 2+, 3+, and 4+ for men (2+ and 3+ for women) were compared to research AUDIT-C 4+ for men (3+ for women). Agreement was compared by demographics, HIV, hepatitis C infection, and alcohol related diagnosis. Results Among 1,082 HIV+ and 1,160 uninfected men, 14% and 22% had an EMR and research AUDIT-C 4+, respectively. Among 32 HIV+ and 115 uninfected women, 9% and 14% had an EMR and research AUDIT-C 3+. For men, EMR agreement with the research AUDIT-C 4+ was highest at a cutoff of 3+ (kappa = 0.49). For women, EMR agreement with AUDIT-C 3+ was highest at a cutoff of 2+ (kappa = 0.60). Moderate agreement was consistent across subgroups. Conclusions EMR AUDIT-C underestimates unhealthy alcohol use compared to research AUDIT-C in both HIV+ and uninfected individuals. Methods for improving quality of clinical screening may be in need of investigation. Researchers and clinicians may consider alternative EMR cutoffs that maximize agreement given limitations of clinical screening. PMID:27694059

Incorporating Comorbidity Within Risk Adjustment for UK Pediatric Cardiac Surgery.

PubMed

Brown, Katherine L; Rogers, Libby; Barron, David J; Tsang, Victor; Anderson, David; Tibby, Shane; Witter, Thomas; Stickley, John; Crowe, Sonya; English, Kate; Franklin, Rodney C; Pagel, Christina

2017-07-01

When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality. A mixture of expert consensus based opinion and empiric statistical analyses were used to define and test the new comorbidity groups. The study dataset consisted of 21,838 pediatric cardiac surgical procedure episodes in 18,834 patients with 539 deaths (raw 30-day mortality rate, 2.5%). In addition to surgical procedure type, primary cardiac diagnosis, univentricular status, age, weight, procedure type (bypass, nonbypass, or hybrid), and era, the new risk factor groups of non-Down congenital anomalies, acquired comorbidities, increased severity of illness indicators (eg, preoperative mechanical ventilation or circulatory support) and additional cardiac risk factors (eg, heart muscle conditions and raised pulmonary arterial pressure) all independently increased the risk of operative mortality. In an era of low mortality rates across a wide range of operations, non-procedure-based risk factors form a vital element of risk adjustment and their presence leads to wide variations in the predicted risk of a given operation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Dreading the boards: stress response to a competitive audition characterized by social-evaluative threat.

PubMed

Boyle, Neil Bernard; Lawton, Clare; Arkbage, Karin; Thorell, Lars; Dye, Louise

2013-01-01

The capacity of psychosocial stressors to provoke the hypothalamic-pituitary-adrenal axis has been demonstrated to vary depending upon a number of psychological factors. Laboratory stressors characterized by social-evaluative threat are proposed to be the most efficacious in the elicitation of a cortisol stress response. Salivary cortisol, cardiovascular, and subjective responses of 16 healthy adults facing a naturalistic stressor characterized by social-evaluative threat (competitive performance auditions) were examined. Audition exposure was sufficient to provoke significant cortisol, arterial blood pressure (systolic and diastolic), and subjective stress responses. Cortisol response reactivity (area under the curve with respect to increase [AUCi]) also correlated with participants' subjective rating of social-evaluative threat. The competitive performance audition context is therefore considered a promising context in which to further explore cortisol responsivity to social-evaluative threat.

Measuring surgical outcomes in neurosurgery: implementation, analysis, and auditing a prospective series of more than 5000 procedures.

PubMed

Theodosopoulos, Philip V; Ringer, Andrew J; McPherson, Christopher M; Warnick, Ronald E; Kuntz, Charles; Zuccarello, Mario; Tew, John M

2012-11-01

Health care reform debate includes discussions regarding outcomes of surgical interventions. Yet quality of medical care, when judged as a health outcome, is difficult to define because of impediments affecting accuracy in data collection, analysis, and reporting. In this prospective study, the authors report the outcomes for neurosurgical treatment based on point-of-care interactions recorded in the electronic medical record (EMR). The authors' neurosurgery practice collected outcome data for 19 physicians and ancillary personnel using the EMR. Data were analyzed for 5361 consecutive surgical cases, either elective or emergency procedures, performed during 2009 at multiple hospitals, offices, and an ambulatory spine surgery center. Main outcomes included complications, length of stay (LOS), and discharge disposition for all patients and for certain frequently performed procedures. Physicians, nurses, and other medical staff used validated scales to record the hospital LOS, complications, disposition at discharge, and return to work. Of the 5361 surgical procedures performed, two-thirds were spinal procedures and one-third were cranial procedures. Organization-wide compliance with reporting rates of major complications improved throughout the year, from 80.7% in the first quarter to 90.3% in the fourth quarter. Auditing showed that rates of unreported complications decreased from 11% in the first quarter to 4% in the fourth quarter. Complication data were available for 4593 procedures (85.7%); of these, no complications were reported in 4367 (95.1%). Discharge dispositions reported were home in 86.2%, rehabilitation center in 8.9%, and nursing home in 2.5%. Major complications included culture-proven infection in 0.61%, CSF leak in 0.89%, reoperation within the same hospitalization in 0.38%, and new neurological deficits in 0.77%. For the commonly performed procedures, the median hospital LOS was 3 days for craniotomy for aneurysm or intraaxial tumor and less than 1 day for angiogram, anterior cervical discectomy with fusion, or lumbar discectomy. With prospectively collected outcome data for more than 5000 surgeries, the authors achieved their primary end point of institution-wide compliance and data accuracy. Components of this process included staged implementation with physician pilot studies and oversight, nurse participation, point-of-service data capture, EMR form modification, data auditing, and confidential surgeon reports.

Criteria for clinical audit of the quality of hospital-based obstetric care in developing countries.

PubMed Central

Graham, W.; Wagaarachchi, P.; Penney, G.; McCaw-Binns, A.; Antwi, K. Y.; Hall, M. H.

2000-01-01

Improving the quality of obstetric care is an urgent priority in developing countries, where maternal mortality remains high. The feasibility of criterion-based clinical audit of the assessment and management of five major obstetric complications is being studied in Ghana and Jamaica. In order to establish case definitions and clinical audit criteria, a systematic review of the literature was followed by three expert panel meetings. A modified nominal group technique was used to develop consensus among experts on a final set of case definitions and criteria. Five main obstetric complications were selected and definitions were agreed. The literature review led to the identification of 67 criteria, and the panel meetings resulted in the modification and approval of 37 of these for the next stage of audit. Criterion-based audit, which has been devised and tested primarily in industrialized countries, can be adapted and applied where resources are poorer. The selection of audit criteria for such settings requires local expert opinion to be considered in addition to research evidence, so as to ensure that the criteria are realistic in relation to conditions in the field. Practical methods for achieving this are described in the present paper. PMID:10859855

Nuclear materials control and accountability (NMC and A) auditors in the 90's

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barham, M.A.; Abbott, R.R.

1991-01-01

The increase in emphasis on the adequacy of the NMC and A internal control systems requires that management define what type of training and experience is needed by NMC and A Internal Audit Program. At Martin Marietta Energy Systems, inc. (the prime contractor for the Department of Energy at Oak Ridge, Tenn.), the Central NMC and A Manager has developed a comprehensive set of NMC and A Internal Audit policies that defines performance standards, methods of conducting audits, mechanisms for ensuring appropriate independence for NMC and A auditors, structure for standardized audit reports and working papers, and a section thatmore » addresses the development of training plans for individual NMC and A auditors. The training requirements reflect the unique combination of skills necessary to be an effective NMC and A Internal Auditor- a combination of the operational auditing skills of a Certified Internal Auditor, the accounting auditing capabilities of a Certified Public Accountant, and the specific technical knowledge base associated with nuclear materials. This paper presents a mechanism for identifying an individual training program for NMC and A auditors that considers the above requirements and the individual's long-range career goals.« less

Matched-pair analyses of resting and dynamic morphology between Monarc and TVT-O procedures by ultrasound.

PubMed

Yang, Jenn-Ming; Yang, Shwu-Huey; Huang, Wen-Chen; Tzeng, Chii-Ruey

2013-07-01

To determine morphologic differences between Monarc and TVT-O procedures in axial and coronal planes by three- and four-dimensional (3D and 4D) ultrasound. Retrospective chart audits and ultrasound analyses were conducted on 128 women who had undergone either Monarc or TVT-O procedures for urodynamic stress incontinence. Thirty matched pairs of the two successful procedures were randomly selected and compared. Matched variables were age, parity, body mass index, cesarean status, menopausal status, and primary surgeries. Six-month postoperative 3D and 4D ultrasound results obtained at rest, on straining, and during coughing in these 60 women were analyzed. Assessed ultrasound parameters included the axial tape urethral distance (aTUD), axial central urethral echolucent area (aUCEA), axial tape angle (aTA), and coronal tape angle (cTA), all of which were measured at three equidistant points along the tapes. Paired t-tests were used to compare differences in ultrasound parameters between women after the two procedures and a P value <0.004 was considered significant after Bonferroni correction. At rest, women subjected to Monarc procedures had a significantly wider aTA at one-fourth of the tape and a wider cTA at one-, two-, and three-fourths of the tape than did those subjected to TVT-O procedures. There were no significant differences in other resting ultrasound parameters between these two procedures. Additionally, after both procedures women had comparable straining and coughing ultrasound manifestations as well as respective dynamic changes. Despite flatter resting tape angulations in women following Monarc procedures, both Monarc and TVT-O tapes had equivalent dynamic patterns and changes assessed by 4D ultrasound. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Objective review of mediastinal lymph node examination in a lung cancer resection cohort.

PubMed

Osarogiagbon, Raymond U; Allen, Jeffrey W; Farooq, Aamer; Wu, James T

2012-02-01

Accurate staging of resected lung cancer requires mediastinal lymph node (MLN) examination. MLN dissection (MLND) and systematic sampling (SS) are acceptable procedures; random sampling (RS) and no sampling (NS) are not. Forty percent of US lung cancer resections have NS. We closely examined the pattern of MLN examination in a lung resection cohort. This is a retrospective review of all lung cancer resections in Memphis, TN, from 2004 to 2007. We compared operating surgeons' claims to the pathology report and an audit of the operation narrative by an independent surgeon. Forty-five percent of resections were reported by surgeons as MLND, 8% RS, and 48% NS. None met pathology criteria for MLND, 9% were SS, 50% were RS, and 42% were NS. The concordance rate between the operating surgeon and pathology report was 39%. The surgeon audit suggested 29% of resections had MLND, 26% RS, and 45% NS. Concordance between operating and auditing surgeons was 71%. Sublobar resection, T1 stage, and age were associated with NS. Most resections had suboptimal MLN examination. Concordance was poor between surgeon claims, objective review of pathology reports, and an independent surgeon audit. The higher concordance between operating and auditing surgeons may suggest incomplete pathology examination of MLN material. The terms used by operating surgeons to describe MLN retrieval were often inaccurate.

Optimising use of the mini C-arm in foot and ankle surgery.

PubMed

Gangopadhyay, Soham; Scammell, Brigitte E

2009-01-01

The mini C-arm reduces exposure to ionising radiation compared to the conventional C-arm. Optimising radiation exposure is not only desirable, but also a legal requirement and protocols should be in place to achieve this. Since 2004, all elective foot surgery requiring intraoperative imaging was performed using the mini C-arm. Screening times and radiation doses were recorded for each procedure. Following a learning curve, the screening times stabilised around the median value for the individual procedures. For subtalar or triple arthrodesis this was less than 60 s, for ankle arthrodesis, less than 90 s, for hindfoot arthrodesis using a nail, less than 100 s and for joint injections less than 12 s. Screening time can be used as an audit tool to measure optimum use of the mini C-arm. A protocol is presented including an audit form for every operation where the mini C-arm is used. Radiation protection issues are addressed.

Managing security and privacy concerns over data storage in healthcare research.

PubMed

Mackenzie, Isla S; Mantay, Brian J; McDonnell, Patrick G; Wei, Li; MacDonald, Thomas M

2011-08-01

Issues surrounding data security and privacy are of great importance when handling sensitive health-related data for research. The emphasis in the past has been on balancing the risks to individuals with the benefit to society of the use of databases for research. However, a new way of looking at such issues is that by optimising procedures and policies regarding security and privacy of data to the extent that there is no appreciable risk to the privacy of individuals, we can create a 'win-win' situation in which everyone benefits, and pharmacoepidemiological research can flourish with public support. We discuss holistic measures, involving both information technology and people, taken to improve the security and privacy of data storage. After an internal review, we commissioned an external audit by an independent consultant with a view to optimising our data storage and handling procedures. Improvements to our policies and procedures were implemented as a result of the audit. By optimising our storage of data, we hope to inspire public confidence and hence cooperation with the use of health care data in research. Copyright © 2011 John Wiley & Sons, Ltd.

Audit and Certification Process for Science Data Digital Repositories

NASA Astrophysics Data System (ADS)

Hughes, J. S.; Giaretta, D.; Ambacher, B.; Ashley, K.; Conrad, M.; Downs, R. R.; Garrett, J.; Guercio, M.; Lambert, S.; Longstreth, T.; Sawyer, D. M.; Sierman, B.; Tibbo, H.; Waltz, M.

2011-12-01

Science data digital repositories are entrusted to ensure that a science community's data are available and useful to users both today and in the future. Part of the challenge in meeting this responsibility is identifying the standards, policies and procedures required to accomplish effective data preservation. Subsequently a repository should be evaluated on whether or not they are effective in their data preservation efforts. This poster will outline the process by which digital repositories are being formally evaluated in terms of their ability to preserve the digitally encoded information with which they have been entrusted. The ISO standards on which this is based will be identified and the relationship of these standards to the Open Archive Information System (OAIS) reference model will be shown. Six test audits have been conducted with three repositories in Europe and three in the USA. Some of the major lessons learned from these test audits will be briefly described. An assessment of the possible impact of this type of audit and certification on the practice of preserving digital information will also be provided.

Procedures Manual: A Guide to Uniform Grant and Contract Management Standards and The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments.

ERIC Educational Resources Information Center

Conable, Sharon R.

This manual has been compiled to provide consistent grant application and administrative procedures for state agencies which award grants or contracts to local governments. It provides a conceptual framework of information concerning the reporting, financial, contractual, and auditing requirements for recipients of Texas State Library grants…

Template Matching for Auditing Hospital Cost and Quality

PubMed Central

Silber, Jeffrey H; Rosenbaum, Paul R; Ross, Richard N; Ludwig, Justin M; Wang, Wei; Niknam, Bijan A; Mukherjee, Nabanita; Saynisch, Philip A; Even-Shoshan, Orit; Kelz, Rachel R; Fleisher, Lee A

2014-01-01

Objective Develop an improved method for auditing hospital cost and quality. Data Sources/Setting Medicare claims in general, gynecologic and urologic surgery, and orthopedics from Illinois, Texas, and New York between 2004 and 2006. Study Design A template of 300 representative patients was constructed and then used to match 300 patients at hospitals that had a minimum of 500 patients over a 3-year study period. Data Collection/Extraction Methods From each of 217 hospitals we chose 300 patients most resembling the template using multivariate matching. Principal Findings The matching algorithm found close matches on procedures and patient characteristics, far more balanced than measured covariates would be in a randomized clinical trial. These matched samples displayed little to no differences across hospitals in common patient characteristics yet found large and statistically significant hospital variation in mortality, complications, failure-to-rescue, readmissions, length of stay, ICU days, cost, and surgical procedure length. Similar patients at different hospitals had substantially different outcomes. Conclusion The template-matched sample can produce fair, directly standardized audits that evaluate hospitals on patients with similar characteristics, thereby making benchmarking more believable. Through examining matched samples of individual patients, administrators can better detect poor performance at their hospitals and better understand why these problems are occurring. PMID:24588413

Setting the standard, implementation and auditing within haemodialysis.

PubMed

Jones, J

1997-01-01

With an ever increasing awareness of the need to deliver a quality of care that is measurable in Nursing, the concept of Standards provides an ideal tool (1). Standards operate outside the boundaries of policies and procedures to provide an audit tool of authenticity and flexibility. Within our five Renal Units, while we felt confident that we were delivering an excellent standard of care to our patients and continually trying to improve upon it, what we really needed was a method of measuring this current level of care and highlighting key areas where we could offer improvement.

Automatically inserted technical details improve radiology report accuracy.

PubMed

Abujudeh, Hani H; Govindan, Siddharth; Narin, Ozden; Johnson, Jamlik Omari; Thrall, James H; Rosenthal, Daniel I

2011-09-01

To assess the effect of automatically inserted technical details on the concordance of a radiology report header with the actual procedure performed. The study was IRB approved and informed consent was waived. We obtained radiology report audit data from the hospital's compliance office from the period of January 2005 through December 2009 spanning a total of 20 financial quarters. A "discordance percentage" was defined as the percentage of total studies in which a procedure code change was made during auditing. Using Chi-square analysis we compared discordance percentages between reports with manually inserted technical details (MITD) and automatically inserted technical details (AITD). The second quarter data of 2007 was not included in the analysis as the switch from MITD to AITD occurred during this quarter. The hospital's compliance office audited 9,110 studies from 2005-2009. Excluding the 564 studies in the second quarter of 2007, we analyzed a total of 8,546 studies, 3,948 with MITD and 4,598 with AITD. The discordance percentage in the MITD group was 3.95% (156/3,948, range per quarter, 1.5- 6.1%). The AITD discordance percentage was 1.37% (63/4,598, range per quarter, 0.0-2.6%). A Chi-square analysis determined a statistically significant difference between the 2 groups (P < 0.001). There was a statistically significant improvement in the concordance of a radiology report header with the performed procedure using automatically inserted technical details compared to manually inserted details. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Auditing Rational Adversaries to Provably Manage Risks

DTIC Science & Technology

2012-05-23

series of white papers on accountability-based privacy governance in which one recommendation is that organisations should have in place policies and...that this state of affairs raises is how to design effective audit and punishment schemes. This paper articulates a desirable property and presents an...In this section, we provide an overview of our model using a motivating scenario that will serve as a running example for this paper . Consider a

Quality of Construction Central Artery / Third Harbor Tunnel Federal Highway Administration Region 1

DOT National Transportation Integrated Search

1996-12-19

The objective of this audit was to evaluate the Federal Highway : Administration's (FHWA) oversight of the Central Artery / Third Harbor Tunnel : Project's (Project) testing procedures to ensure construction was completed in : accordance with applica...

21 CFR 26.1 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS, AND CERTAIN... regulatory systems means that the systems are sufficiently comparable to assure that the process of... require that the respective regulatory systems have identical procedures. (c) Good Manufacturing Practices...

11 CFR 201.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Elections FEDERAL ELECTION COMMISSION ADMINISTRATIVE REGULATIONS EX PARTE COMMUNICATIONS § 201.1 Purpose and scope. This part prescribes procedures for handling ex parte communications made in connection with public funding, Commission audits, litigation, rulemaking proceedings and the advisory opinion process...

Verifying patient identity and site of surgery: improving compliance with protocol by audit and feedback.

PubMed

Garnerin, P; Arès, M; Huchet, A; Clergue, F

2008-12-01

The potential severity of wrong patient/procedure/site of surgery and the view that these events are avoidable, make the prevention of such errors a priority. An intervention was set up to develop a verification protocol for checking patient identity and the site of surgery with periodic audits to measure compliance while providing feedback. A nurse auditor performed the compliance audits in inpatients and outpatients during three consecutive 3-month periods and three 1-month follow-up periods; 11 audit criteria were recorded, as well as reasons for not performing a check. The nurse auditor provided feedback to the health professionals, including discussion of inadequate checks. 1,000 interactions between patients and their anaesthetist or nurse anaesthetist were observed. Between the first and second audit periods compliance with all audit criteria except "surgical site marked" noticeably improved, such as the proportion of patients whose identities were checked (62.6% to 81.4%); full compliance with protocol in patient identity checks (9.7% to 38.1%); proportion of site of surgery checks carried out (77.1% to 92.6%); and full compliance with protocol in site of surgery checks (32.2% to 52.0%). Thereafter, compliance was stable for most criteria. The reason for failure to perform checks of patient identity or site of surgery was mostly that the anaesthetist in charge had seen the patient at the preanaesthetic consultation. By combining the implementation of a verification protocol with periodic audits with feedback, the intervention changed practice and increased compliance with patient identity and site of surgery checks. The impact of the intervention was limited by communication problems between patients and professionals, and lack of collaboration with surgical services.

An audit of local government planning tools for their potential use in addressing community food and nutrition issues.

PubMed

Good, Elizabeth; Hammond, Melinda; Martin, Caroline; Burns, Catherine; Groos, Anita

2010-04-01

This project aimed to identify how local government planning tools could be used to influence physical and policy environments to support healthy eating behaviours in communities. An audit of Queensland's legislative and non-legislative local government planning tools was conducted by a public health nutritionist to assess their potential use in addressing strategies to achieve positive nutrition outcomes. Ten strategies were identified and covered the following themes: improving access to healthy foods and drinks; increasing access to breastfeeding facilities; decreasing fast food outlet density; and unhealthy food advertising. The audit found that all of the 10 strategies to achieve positive nutrition outcomes could be considered through three or more of the planning tools. Based on the findings of this audit, local government planning tools provide opportunities to address food and nutrition issues and contribute toward creating physical and policy environments that support healthy eating behaviours.

Applying new AICPA accounting rules on special reports.

PubMed

Reinstein, A; Dery, R J

1998-04-01

Two new standards on agreed-upon procedures, issued by the American Institute of Certified Public Accountants, provide healthcare organizations and associated decision makers with new flexibility in acquiring professional accounting services. Effective January 1, 1996, these procedures allow organizations to target the type and volume of services performed by accountants and potentially avoid the time and expense involved in completing a full financial statement audit. As with any other accounting engagement, both the healthcare organization and the accounting firm need to establish what procedures will be conducted, who will be allowed to use the resulting report, and how the procedures will be conducted.

An audit of dental prescriptions between clinics and dental laboratories.

PubMed

Stewart, C A

2011-08-12

To discover the quality of written instructions from dentists to dental technicians and the nature of non-compliant prescriptions. An audit of laboratory prescription compliance was conducted within an NHS Trust Dental Teaching Hospital to determine the level of communication between dentists and dental technicians. One hundred and fifty prescriptions were audited from dental undergraduates and qualified dentists throughout the different departments. A total of two-thirds of prescriptions were considered non-compliant and failed to meet relevant ethical and legal guidelines. This problem was seen throughout all departments and at all professional levels. A breakdown in communication between dentists and technicians through the use of prescriptions is evident even within a close working environment.

British Society of Interventional Radiology Iliac Artery Angioplasty-Stent Registry III

DOE Office of Scientific and Technical Information (OSTI.GOV)

Uberoi, Raman, E-mail: raman.uberoi@orh.nhs.uk; Milburn, Simon; Moss, Jon

2009-09-15

The objective of this study was to audit current practice in iliac artery intervention in the United Kingdom. In 2001 the British Society of Interventional Radiology Iliac Artery Angioplasty-Stent (BIAS) III registry provided the first national database for iliac intervention. It recommended that data collection needed to continue in order to facilitate the dissemination of comparative data to individual units. BIAS III was designed to continue this work and has a simplified data set with an online submission form. Interventionalists were invited to complete a 3-page tick sheet for all iliac angioplasties and stents. Questions covered risk factors, procedural data,more » and outcome. Data for 2233 patients were submitted from 37 institutions over a 43-month period. Consultants performed 80% of the procedures, 62% of which were for claudication. Fifty-four percent of lesions were treated with stents and 25% of patients underwent bilateral intervention, resulting in a residual stenosis of <50% in 98%. Ninety-seven percent of procedures had no limb complication and there was a 98% inpatient survival rate. In conclusion, these figures provide an essential benchmark for both audit and patient information. National databases need to be expanded across the range of interventional procedures, and their collection made simple and, preferably, online.« less

Training and Proficiency Testing for Commuter and Air Taxi Pilots - Federal Aviation Administration

DOT National Transportation Integrated Search

1996-10-21

The objective of this audit was to determine whether the Federal Aviation : Administration (FAA) has established procedures and oversight controls to assure : that commuter and air taxi pilots, engaged in passenger-carrying operations, : hold valid p...

Notification: Review of Religious Compensatory Time

EPA Pesticide Factsheets

Project #OA-FY15-0180, August 5, 2015. The Office of Inspector General (OIG) for the U.S. Environmental Protection Agency (EPA) plans to begin field work on our audit of the EPA’s practices, policies and procedures for religious compensatory time.

12 CFR 308.601 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... independent public accountant by section 36 of the FDIA and 12 CFR part 363, including attestation services. (c) Independent public accountant (accountant) means any individual who performs or participates in... PROCEDURE Removal, Suspension, and Debarment of Accountants From Performing Audit Services § 308.601...

23 CFR 140.801 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 23 Highways 1 2013-04-01 2013-04-01 false Purpose. 140.801 Section 140.801 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.801 Purpose. To establish the reimbursement criteria for Federal participation in...

23 CFR 140.801 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Purpose. 140.801 Section 140.801 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PAYMENT PROCEDURES REIMBURSEMENT State Highway Agency Audit Expense § 140.801 Purpose. To establish the reimbursement criteria for Federal participation in...