30 CFR 14.10 - Post-approval product audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Post-approval product audit. 14.10 Section 14... General Provisions § 14.10 Post-approval product audit. (a) Approved conveyor belts will be subject to... applicant and other persons agreed upon by MSHA and the applicant may be present during audit tests and...

Acquisition: Navy Transition of Advanced Technology Programs to Military Applications

DTIC Science & Technology

2003-02-04

The audit objective was to determine whether the Navy was successful in transitioning advanced technology projects to military applications...they relate to the audit objective. See Appendix A for a discussion of the audit scope and methodology, the review of the management control program, and prior coverage related to the audit objectives.

78 FR 64598 - Bank Enterprise Award (BEA) Program; Programmatic and Administrative Aspects; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... an audit opinion a key indicator of the financial health of an Applicant. As stated in Section VII... the time of application if the Applicant received a going concern opinion on its most recent audit... would inform prospective Applicants that a going concern audit opinion during the Baseline Period or the...

Development and application of an integrated indoor air quality audit to an international hotel building in Taiwan.

PubMed

Kuo, Nae-Wen; Chiang, Hsin-Chen; Chiang, Che-Ming

2008-12-01

Indoor air quality (IAQ) has begun to surface as an important issue that affects the comfort and health of people; however, there is little research concerned about the IAQ monitoring of hotels up to now. Hotels are designed to provide comfortable spaces for guests. However, most complaints related to uncomfortable thermal environment and inadequate indoor air quality appear. In addition, microbial pollution can affect the health of tourists such as the Legionnaire's disease and SARS problems. This study is aimed to establish the comprehensive IAQ audit approach for hotel buildings with portable equipment, and one five-star international hotel in Taiwan was selected to exam this integrated approach. Finally, four major problems are identified after the comprehensive IAQ audit. They are: (1) low room temperature (21.8 degrees C), (2) insufficient air exchange rate (<1.5 h(-1)), (3) formaldehyde contamination (>0.02 ppm), and (4) the microbial pollution (total bacteria: 2,624-3,799 CFU/m(3)). The high level of formaldehyde may be due to the emission from the detergent and cleaning agents used for housekeeping.

Effects of Human Resource Audit on Employee Performance in Secondary Schools in Kenya; a Case of Non Teaching Staff in Secondary Schools in Nyamache Sub County

ERIC Educational Resources Information Center

Moke, Oeri Lydia; Muturi, Willy

2015-01-01

Human Resources Audit measures human resource outputs and effectiveness under the given circumstances and the degree of utilization of human resource skills. The purpose of the study was to assess the effect of Human resource Audit on employee performance in secondary schools in Nyamache Sub County. The specific objectives for the study included…

Report on Quality Control Review of the Raich Ende Malter & Co. LLP FY 2009 Single Audit of the Riverside Research Institute

DTIC Science & Technology

2012-03-07

compliance was based on a determination that 10 of the 14 compliance requirements were applicable to the Institute. However, the audit working papers...for all 14 of the compliance requirements were not adequate to support conclusions on applicability, internal control, and the audit opinion on...compliance with laws, regulations, and award provisions applicable to the R&D cluster program. In addition, the audit firm did not appropriately report an

Junior doctors and clinical audit.

PubMed

Greenwood, J P; Lindsay, S J; Batin, P D; Robinson, M B

1997-01-01

To assess the extent of junior doctor involvement in clinical audit, the degree of support from audit staff, and the perceived value of the resulting audits. Postal survey of National Health Service (NHS) junior doctors. 704 junior doctors in central Leeds hospitals, June 1996. Questionnaires were returned by 232 respondents (33%), 211 (31%) were completed; 157 respondents (74%) had personally performed audit. Mean (+/- SD) duration since last audit project was 14.9 (14.1) (range 0-84) months. Of the respondents who had personally performed audit, 88 (56%) did not use the hospital audit department, 60 (38%) received no guidance and only 19 (12%) were involved in re-auditing the same project. Mean (+/- SD) time spent per audit project was 27.8 (37.7), (range 2-212) hours. Seventy-five junior doctors (48%) were aware of subsequent change in clinical practice, 41 (26%) perceived a negative personal benefit from audit, 33 (21%) perceived a negative departmental benefit, and 42 (27%) felt that audit was a waste of time. A large proportion of junior doctors are involved in audit projects that do not conform to established good practice and which have a low impact on clinical behaviour. Although junior doctors feel that there is inadequate assistance and poor supervision whilst performing audit, they still support the principle of audit. There is a need to improve the quality and supervision of audit projects performed by junior doctors.

UK audit of analysis of quantitative parameters from renography data generated using a physical phantom.

PubMed

Nijran, Kuldip S; Houston, Alex S; Fleming, John S; Jarritt, Peter H; Heikkinen, Jari O; Skrypniuk, John V

2014-07-01

In this second UK audit of quantitative parameters obtained from renography, phantom simulations were used in cases in which the 'true' values could be estimated, allowing the accuracy of the parameters measured to be assessed. A renal physical phantom was used to generate a set of three phantom simulations (six kidney functions) acquired on three different gamma camera systems. A total of nine phantom simulations and three real patient studies were distributed to UK hospitals participating in the audit. Centres were asked to provide results for the following parameters: relative function and time-to-peak (whole kidney and cortical region). As with previous audits, a questionnaire collated information on methodology. Errors were assessed as the root mean square deviation from the true value. Sixty-one centres responded to the audit, with some hospitals providing multiple sets of results. Twenty-one centres provided a complete set of parameter measurements. Relative function and time-to-peak showed a reasonable degree of accuracy and precision in most UK centres. The overall average root mean squared deviation of the results for (i) the time-to-peak measurement for the whole kidney and (ii) the relative function measurement from the true value was 7.7 and 4.5%, respectively. These results showed a measure of consistency in the relative function and time-to-peak that was similar to the results reported in a previous renogram audit by our group. Analysis of audit data suggests a reasonable degree of accuracy in the quantification of renography function using relative function and time-to-peak measurements. However, it is reasonable to conclude that the objectives of the audit could not be fully realized because of the limitations of the mechanical phantom in providing true values for renal parameters.

National audit of continence care: laying the foundation.

PubMed

Mian, Sarah; Wagg, Adrian; Irwin, Penny; Lowe, Derek; Potter, Jonathan; Pearson, Michael

2005-12-01

National audit provides a basis for establishing performance against national standards, benchmarking against other service providers and improving standards of care. For effective audit, clinical indicators are required that are valid, feasible to apply and reliable. This study describes the methods used to develop clinical indicators of continence care in preparation for a national audit. To describe the methods used to develop and test clinical indicators of continence care with regard to validity, feasibility and reliability. A multidisciplinary working group developed clinical indicators that measured the structure, process and outcome of care as well as case-mix variables. Literature searching, consensus workshops and a Delphi process were used to develop the indicators. The indicators were tested in 15 secondary care sites, 15 primary care sites and 15 long-term care settings. The process of development produced indicators that received a high degree of consensus within the Delphi process. Testing of the indicators demonstrated an internal reliability of 0.7 and an external reliability of 0.6. Data collection required significant investment in terms of staff time and training. The method used produced indicators that achieved a high degree of acceptance from health care professionals. The reliability of data collection was high for this audit and was similar to the level seen in other successful national audits. Data collection for the indicators was feasible to collect, however, issues of time and staffing were identified as limitations to such data collection. The study has described a systematic method for developing clinical indicators for national audit. The indicators proved robust and reliable in primary and secondary care as well as long-term care settings.

30 CFR 208.15 - Audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Audits. 208.15 Section 208.15 Mineral Resources... OIL General Provisions § 208.15 Audits. Audits of the accounts and books of lessees, operators, payors... directed by MMS. Such audits will be for the purpose of determining compliance with applicable statutes...

49 CFR 663.9 - Audit limitations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Audit limitations. 663.9 Section 663.9..., DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES General § 663.9 Audit limitations. (a) An audit under this part is limited to verifying compliance with (1) Applicable...

Revalidation and electronic cataract surgery audit: a Scottish survey on current practice and opinion.

PubMed

Megaw, R; Rane-Malcolm, T; Brannan, S; Smith, R; Sanders, R

2011-11-01

To determine current knowledge and opinion on revalidation, and methods of cataract surgery audit in Scotland and to outline the current and future possibilities for electronic cataract surgery audit. In 2010 we conducted a prospective, cross-sectional, Scottish-wide survey on revalidation knowledge and opinion, and cataract audit practice among all senior NHS ophthalmologists. Results were anonymised and recorded manually for analysis. In all, 61% of the ophthalmologists surveyed took part. Only 33% felt ready to take part in revalidation, whereas 76% felt they did not have adequate information about the process. Also, 71% did not feel revalidation would improve patient care, but 85% agreed that cataract surgery audit is essential for ophthalmic practice. In addition, 91% audit their cataract outcomes; 52% do so continuously. Further, 63% audit their subspecialist surgical results. Only 25% audit their cataract surgery practice electronically, and only 12% collect clinical data using a hospital PAS system. Funding and system incompatibility were the main reasons cited for the lack of electronic audit setup. Currently, eight separate hospital IT patient administration systems are used across 14 health boards in Scotland. Revalidation is set to commence in 2012. The Royal College of Ophthalmologists will use cataract outcome audit as a tool to ensure surgical competency for the process. Retrospective manual auditing of cataract outcome is time consuming, and can be avoided with an electronic system. Scottish ophthalmologists view revalidation with scepticism and appear to have inadequate knowledge of the process. However, they strongly agree with the concept of cataract surgery audit. The existing and future electronic applications that may support surgical audit are commercial electronic records, web-based applications, centrally funded software applications, and robust NHS connections between community and hospital.

40 CFR 86.094-22 - Approval of application for certification; test fleet selections; determinations of parameters...

Code of Federal Regulations, 2010 CFR

2010-07-01

... Audit and Production Compliance Audit testing, the adequacy of the limits, stops, seals, or other means... (Selective Enforcement Audit and Production Compliance Audit) only the actual settings to which the parameter... Selective Enforcement Audit, adequacy of limits, and physically adjustable ranges. 86.094-22 Section 86.094...

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.

A collaborative computer auditing system under SOA-based conceptual model

NASA Astrophysics Data System (ADS)

Cong, Qiushi; Huang, Zuoming; Hu, Jibing

2013-03-01

Some of the current challenges of computer auditing are the obstacles to retrieving, converting and translating data from different database schema. During the last few years, there are many data exchange standards under continuous development such as Extensible Business Reporting Language (XBRL). These XML document standards can be used for data exchange among companies, financial institutions, and audit firms. However, for many companies, it is still expensive and time-consuming to translate and provide XML messages with commercial application packages, because it is complicated and laborious to search and transform data from thousands of tables in the ERP databases. How to transfer transaction documents for supporting continuous auditing or real time auditing between audit firms and their client companies is a important topic. In this paper, a collaborative computer auditing system under SOA-based conceptual model is proposed. By utilizing the widely used XML document standards and existing data transformation applications developed by different companies and software venders, we can wrap these application as commercial web services that will be easy implemented under the forthcoming application environments: service-oriented architecture (SOA). Under the SOA environments, the multiagency mechanism will help the maturity and popularity of data assurance service over the Internet. By the wrapping of data transformation components with heterogeneous databases or platforms, it will create new component markets composed by many software vendors and assurance service companies to provide data assurance services for audit firms, regulators or third parties.

How is feedback from national clinical audits used? Views from English National Health Service trust audit leads.

PubMed

Taylor, Angelina; Neuburger, Jenny; Walker, Kate; Cromwell, David; Groene, Oliver

2016-04-01

To explore how the output of national clinical audits in England is used by professionals and whether and how their impact could be enhanced. A mixed-methods study with the primary recipients of four national clinical audits of cancer care of 607 local audit leads, 274 (45%) completed a questionnaire and 32 participated in an interview. Our questions focused on how the audits were used and whether barriers existed to using the audits for local service improvement. We described variation in questionnaire responses between the audits using chi-squared tests. Results are reported as percentages with their 95% confidence intervals. Qualitative data were analysed using Framework analysis. More than 90% of survey respondents believed that the audit findings were relevant to their clinical work, and interviewees described how they used the audits for a range of purposes. Forty-two percent of survey respondents said they had changed their clinical practice, and 56% had implemented service improvements in response to the audits. The degree of change differed between the four audits, evident in both the questionnaire and the interview data. In the interviews, two recurring barriers emerged: (1) the importance of data quality, which, in turn, influenced the perceived relevance and validity of the audit data and therefore the ability to make changes based on it and (2) the need for clear presentation of benchmarked local performance data. The perceived authority and credibility of the professional bodies supporting the audits was a key factor underpinning the use of the audit findings. National cancer audit and feedback is used to improve services, but their impact could be enhanced by improving the data quality and relevance of feedback. © The Author(s) 2016.

One Continuous Auditing Practice in China: Data-oriented Online Auditing(DOOA)

NASA Astrophysics Data System (ADS)

Chen, Wei; Zhang, Jin-Cheng; Jiang, Yu-Quan

Application of information technologies (IT) in the field of audit is worth studying. Continuous auditing (CA) is an active research domain in computer-assisted audit field. In this paper, the concept of continuous auditing is analyzed firstly. Then, based on analysis on research literatures of continuous auditing, technique realization methods are classified into embedded mode and separate mode. According to the condition of implementing online auditing in China, data-oriented online auditing (DOOA) used in China is also one of separate mode of continuous auditing. And the principle of DOOA is analyzed. Furthermore, the advantages and disadvantages of DOOA are also discussed. Finally, advices to implement DOOA in China are given, and the future research topics related to continuous auditing are also discussed.

40 CFR 86.1001 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... EMISSIONS FROM NEW AND IN-USE HIGHWAY VEHICLES AND ENGINES (CONTINUED) Selective Enforcement Auditing of New Heavy-Duty Engines § 86.1001 Applicability. (a) The selective enforcement auditing program described in...

21 CFR 1311.215 - Internal audit trail.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Internal audit trail. 1311.215 Section 1311.215... ORDERS AND PRESCRIPTIONS (Eff. 6-1-10) Electronic Prescriptions § 1311.215 Internal audit trail. (a) The... with audit trail functions. (6) For application service providers, attempted or successful annotation...

24 CFR 884.124 - Audit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 884.124 Section 884.124... HOUSING PROJECTS Applicability, Scope and Basic Policies § 884.124 Audit. (a) Where a State or local..., receiving financial assistance under this part, the audit requirements in 24 CFR part 44 shall apply. (b...

24 CFR 882.124 - Audit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 882.124 Section 882.124...) SECTION 8 MODERATE REHABILITATION PROGRAMS Applicability, Scope and Basic Policies § 882.124 Audit. PHAs receiving financial assistance under this part are subject to audit requirements in 24 CFR part 44. [50 FR...

75 FR 10496 - Tribal Self-Governance Program Planning Cooperative Agreement; Announcement Type: New Funding...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-08

... SF-424 and all necessary assurances and certifications. Audits being sent separately must be received... as no uncorrected significant and material audit exceptions in the required annual audit of the.... Applicants are required to submit complete annual audit reports for the three fiscal years prior to the year...

30 CFR 7.8 - Post-approval product audit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Post-approval product audit. 7.8 Section 7.8... APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY General § 7.8 Post-approval product audit...-holder may observe any tests conducted during this audit. (c) An approved product shall be subject to...

7 CFR 4280.193 - Selecting energy audit and renewable energy development assistance grant applications for award.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Selecting energy audit and renewable energy..., DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.193 Selecting energy audit and renewable energy...

7 CFR 4280.193 - Selecting energy audit and renewable energy development assistance grant applications for award.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Selecting energy audit and renewable energy..., DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.193 Selecting energy audit and renewable energy...

7 CFR 4280.191 - Evaluation of energy audit and renewable energy development assistance grant applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Evaluation of energy audit and renewable energy... OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.191 Evaluation of energy audit and renewable energy...

7 CFR 4280.191 - Evaluation of energy audit and renewable energy development assistance grant applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Evaluation of energy audit and renewable energy... OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.191 Evaluation of energy audit and renewable energy...

40 CFR 63.7525 - What are my monitoring, installation, operation, and maintenance requirements?

Code of Federal Regulations, 2012 CFR

2012-07-01

... audit, and an annual zero alignment audit of each COMS. (6) You must operate and maintain each COMS... assessment, a quarterly performance audit, or an annual zero alignment audit. (7) You must determine and... control activities (including, as applicable, calibration checks and required zero and span adjustments...

40 CFR 63.7525 - What are my monitoring, installation, operation, and maintenance requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

... audit, and an annual zero alignment audit of each COMS. (6) You must operate and maintain each COMS... assessment, a quarterly performance audit, or an annual zero alignment audit. (7) You must determine and... control activities (including, as applicable, calibration checks and required zero and span adjustments...

7 CFR 4280.192 - Scoring energy audit and renewable energy development assistance grant applications.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Scoring energy audit and renewable energy development... AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.192 Scoring energy audit and renewable energy development assistance...

7 CFR 4280.192 - Scoring energy audit and renewable energy development assistance grant applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Scoring energy audit and renewable energy development... AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.192 Scoring energy audit and renewable energy development assistance...

7 CFR 4280.191 - Evaluation of energy audit and renewable energy development assistance grant applications.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Evaluation of energy audit and renewable energy... OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.191 Evaluation of energy audit and renewable energy...

7 CFR 4280.192 - Scoring energy audit and renewable energy development assistance grant applications.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Scoring energy audit and renewable energy development... AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.192 Scoring energy audit and renewable energy development assistance...

7 CFR 4280.193 - Selecting energy audit and renewable energy development assistance grant applications for award.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Selecting energy audit and renewable energy..., DEPARTMENT OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.193 Selecting energy audit and renewable energy...

Implementation of the qualities of radiodiagnostic: mammography

NASA Astrophysics Data System (ADS)

Pacífico, L. C.; Magalhães, L. A. G.; Peixoto, J. G. P.; Fernandes, E.

2018-03-01

The objective of the present study was to evaluate the expanded uncertainty of the mammographic calibration process and present the result of the internal audit performed at the Laboratory of Radiological Sciences (LCR). The qualities of the mammographic beans that are references in the LCR, comprises two irradiation conditions: no-attenuated beam and attenuated beam. Both had satisfactory results, with an expanded uncertainty equals 2,1%. The internal audit was performed, and the degree of accordance with the ISO/IEC 17025 was evaluated. The result of the internal audit was satisfactory. We conclude that LCR can perform calibrations on mammography qualities for end users.

A computer-aided audit system for respiratory therapy consult evaluations: description of a method and early results.

PubMed

Kester, Lucy; Stoller, James K

2013-05-01

Use of respiratory therapist (RT)-guided protocols enhances allocation of respiratory care. In the context that optimal protocol use requires a system for auditing respiratory care plans to assure adherence to protocols and expertise of the RTs generating the care plan, a live audit system has been in longstanding use in our Respiratory Therapy Consult Service. Growth in the number of RT positions and the need to audit more frequently has prompted development of a new, computer-aided audit system. The number and results of audits using the old and new systems were compared (for the periods May 30, 2009 through May 30, 2011 and January 1, 2012 through May 30, 2012, respectively). In contrast to the original, live system requiring a patient visit by the auditor, the new system involves completion of a respiratory therapy care plan using patient information in the electronic medical record, both by the RT generating the care plan and the auditor. Completing audits in the new system also uses an electronic respiratory therapy management system. The degrees of concordance between the audited RT's care plans and the "gold standard" care plans using the old and new audit systems were similar. Use of the new system was associated with an almost doubling of the rate of audits (ie, 11 per month vs 6.1 per month). The new, computer-aided audit system increased capacity to audit more RTs performing RT-guided consults while preserving accuracy as an audit tool. Ensuring that RTs adhere to the audit process remains the challenge for the new system, and is the rate-limiting step.

Software Assists in Extensive Environmental Auditing

NASA Technical Reports Server (NTRS)

Callac, Christopher; Matherne, Charlie

2002-01-01

The Base Enivronmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists on an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign manditory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: It helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

Software Assists in Extensive Environmental Auditing

NASA Technical Reports Server (NTRS)

Callac, Christopher; Matherne, Charlie

2003-01-01

The Base Environmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists of an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign mandatory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: it helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

Software Assists in Extensive Environmental Auditing

NASA Technical Reports Server (NTRS)

Callac, Christopher; Matherne, Charlie; Selinsky, T.

2002-01-01

The Base Environmental Management System (BEMS) is a Web-based application program for managing and tracking audits by the Environmental Office of Stennis Space Center in conformity with standard 14001 of the International Organization for Standardization (ISO 14001). (This standard specifies requirements for an environmental-management system.) BEMS saves time by partly automating what were previously manual processes for creating audit checklists; recording and tracking audit results; issuing, tracking, and implementing corrective-action requests (CARs); tracking continuous improvements (CIs); and tracking audit results and statistics. BEMS consists of an administration module and an auditor module. As its name suggests, the administration module is used to administer the audit. It helps administrators to edit the list of audit questions; edit the list of audit locations; assign mandatory questions to locations; track, approve, and edit CARs; and edit completed audits. The auditor module is used by auditors to perform audits and record audit results: it helps the auditors to create audit checklists, complete audits, view completed audits, create CARs, record and acknowledge CIs, and generate reports from audit results.

Health and Safety Audit Design Manual

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

Ternes, Mark P.; Langley, Brandon R.; Accawi, Gina K.

The Health and Safety Audit is an electronic audit tool developed by the Oak Ridge National Laboratory to assist in the identification and selection of health and safety measures when a home is being weatherized (i.e., receiving home energy upgrades), especially as part of the US Department of Energy (DOE) Weatherization Assistance Program, or during home energy-efficiency retrofit or remodeling jobs. The audit is specifically applicable to existing single-family homes (including mobile homes), and is generally applicable to individual dwelling units in low-rise multifamily buildings. The health and safety issues covered in the audit are grouped in nine categories: moldmore » and moisture, lead, radon, asbestos, formaldehyde and volatile organic compounds (VOCs), combustion, pest infestation, safety, and ventilation. Development of the audit was supported by the US Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control and the DOE Weatherization Assistance Program.« less

30 CFR 1229.123 - Standards for audit activities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... professional proficiency for the tasks required, including a knowledge of accounting, auditing, agency... shall maintain an independent attitude and appearance. (iii) Due professional care. Due professional... accordance with the generally accepted program audit standards (including the applicable General Accounting...

The utility of the Alcohol Use Disorders Identification Test (AUDIT)for the analysis of binge drinking in university students.

PubMed

Cortés Tomás, María T; Giménez Costa, José A; Motos-Sellés, Patricia; Sancerni Beitia, María D; Cadaveira Mahía, Fernando

2017-05-01

The increasingly precise conceptualization of Binge Drinking (BD), along with the rising incidence of this pattern of intake amongst young people, make it necessary to review the usefulness of instruments used to detect it. Little evidence exists regarding effectiveness of the AUDIT, AUDIT-C and AUDIT-3 in the detection of BD. This study evaluates their utility in a sample of university students, revealing the most appropriate cut-off points for each sex. All students self-administered the AUDIT and completed a self-report of their alcohol consumption. A Two-step cluster analysis differentiated 5 groups of BD in terms of: the quantity consumed, the frequency of BD over the past six months and gender. A ROC curve adjusted cut-off points for each case. 862 university students (18-19 years-old/59.5% female), 424 (49.2%) from Valencia and 438 (50.8%) from Madrid, had cut-off points of 4 in AUDIT and 3 in AUDIT-C as a better fit. In all cases, the best classifier was AUDIT-C. Neither version properly classifies students with varying degrees of BD. All versions differentiate BD from non-BD, but none are able to differentiate between types of BD.

47 CFR 1.1106 - Schedule of charges for applications and other filings for the enforcement services.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... Box 979094, St. Louis, MO 63197-9000 with the exception of Accounting and Audits, which will be...($) Paymenttype code 1. Formal Complaints Corres & 159 $200.00 CIZ 2. Accounting and Audits: a. Field Audit Carriers will be invoiced for the amount due 103,215.00 BMA b. Review of Attest Audit Carriers will be...

A systematic review of clinical audit in companion animal veterinary medicine.

PubMed

Rose, Nicole; Toews, Lorraine; Pang, Daniel S J

2016-02-26

Clinical audit is a quality improvement process with the goal of continuously improving quality of patient care as assessed by explicit criteria. In human medicine clinical audit has become an integral and required component of the standard of care. In contrast, in veterinary medicine there appear to have been a limited number of clinical audits published, indicating that while clinical audit is recognised, its adoption in veterinary medicine is still in its infancy. A systematic review was designed to report and evaluate the veterinary literature on clinical audit in companion animal species (dog, cat, horse). A systematic search of English and French articles using Proquest Dissertations and Theses database (February 6, 2014), CAB Abstracts (March 21, 2014 and April 4, 2014), Scopus (March 21, 2014), Web of Science Citation index (March 21, 2014) and OVID Medline (March 21, 2014) was performed. Included articles were those either discussing clinical audit (such as review articles and editorials) or reporting parts of, or complete, audit cycles. The majority of articles describing clinical audit were reviews. From 89 articles identified, twenty-one articles were included and available for review. Twelve articles were reviews of clinical audit in veterinary medicine, five articles included at least one veterinary clinical audit, one thesis was identified, one report was of a veterinary clinical audit website and two articles reported incomplete clinical audits. There was no indication of an increase in the number of published clinical audits since the first report in 1998. However, there was evidence of article misclassification, with studies fulfilling the criteria of clinical audit not appropriately recognised. Quality of study design and reporting of findings varied considerably, with information missing on key components, including duration of study, changes in practice implemented between audits, development of explicit criteria and appropriate statistical analyses. Available evidence suggests the application and reporting of clinical audit in veterinary medicine is sporadic despite the potential to improve patient care, though the true incidence of clinical audit reporting is likely to be underestimated due to incorrect indexing. Reporting standards of clinical audits are highly variable, limiting evaluation, application and repeatability of published work.

7 CFR 735.403 - Audits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS FOR WAREHOUSES REGULATIONS FOR THE UNITED STATES WAREHOUSE ACT Electronic Providers § 735.403... electronic data processing audit that meets the minimum requirements as provided in the applicable provider agreement. The electronic data processing audit will be used by DACO to evaluate current computer operations...

7 CFR 735.403 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REGULATIONS FOR WAREHOUSES REGULATIONS FOR THE UNITED STATES WAREHOUSE ACT Electronic Providers § 735.403... electronic data processing audit that meets the minimum requirements as provided in the applicable provider agreement. The electronic data processing audit will be used by DACO to evaluate current computer operations...

21 CFR 1311.215 - Internal audit trail.

Code of Federal Regulations, 2011 CFR

2011-04-01

... ORDERS AND PRESCRIPTIONS Electronic Prescriptions § 1311.215 Internal audit trail. (a) The pharmacy... minimum, include the following: (1) Attempted unauthorized access to the pharmacy application, or successful unauthorized access to the pharmacy application where the determination of such is feasible. (2...

21 CFR 1311.215 - Internal audit trail.

Code of Federal Regulations, 2012 CFR

2012-04-01

... ORDERS AND PRESCRIPTIONS Electronic Prescriptions § 1311.215 Internal audit trail. (a) The pharmacy... minimum, include the following: (1) Attempted unauthorized access to the pharmacy application, or successful unauthorized access to the pharmacy application where the determination of such is feasible. (2...

21 CFR 1311.215 - Internal audit trail.

Code of Federal Regulations, 2014 CFR

2014-04-01

... ORDERS AND PRESCRIPTIONS Electronic Prescriptions § 1311.215 Internal audit trail. (a) The pharmacy... minimum, include the following: (1) Attempted unauthorized access to the pharmacy application, or successful unauthorized access to the pharmacy application where the determination of such is feasible. (2...

21 CFR 1311.215 - Internal audit trail.

Code of Federal Regulations, 2013 CFR

2013-04-01

... ORDERS AND PRESCRIPTIONS Electronic Prescriptions § 1311.215 Internal audit trail. (a) The pharmacy... minimum, include the following: (1) Attempted unauthorized access to the pharmacy application, or successful unauthorized access to the pharmacy application where the determination of such is feasible. (2...

Data audit as a way to prevent/contain misconduct.

PubMed

Shamoo, Adil E

2013-01-01

Research misconduct is frequently in the media headlines. There is consensus among leading experts on research integrity that the prevalence of misconduct in research is at least 1%, and shoddy work may even go over 5%. Unfortunately, misconduct in research impacts all walks of life from drugs to human subject protections, innovations, economy, policy, and even our national security. The main method of detecting research misconduct depends primarily on whistleblowers. The current regulations are insufficient since dependence on whistleblowers manifests itself as an accidental hit or miss. No other endeavor in our society depends on such a poor system of discovery of misconduct to remedy it. Nearly a quarter of a century ago, I proposed data audit as a means to prevent/contain research misconduct. The audit has to protect the creative process and be non-obtrusive. Data audit evaluates the degree of correspondence of published data with the source data. The proposed data audit does not require any changes in the way researchers carry out their work.

A 2D ion chamber array audit of wedged and asymmetric fields in an inhomogeneous lung phantom.

PubMed

Lye, Jessica; Kenny, John; Lehmann, Joerg; Dunn, Leon; Kron, Tomas; Alves, Andrew; Cole, Andrew; Williams, Ivan

2014-10-01

The Australian Clinical Dosimetry Service (ACDS) has implemented a new method of a nonreference condition Level II type dosimetric audit of radiotherapy services to increase measurement accuracy and patient safety within Australia. The aim of this work is to describe the methodology, tolerances, and outcomes from the new audit. The ACDS Level II audit measures the dose delivered in 2D planes using an ionization chamber based array positioned at multiple depths. Measurements are made in rectilinear homogeneous and inhomogeneous phantoms composed of slabs of solid water and lung. Computer generated computed tomography data sets of the rectilinear phantoms are supplied to the facility prior to audit for planning of a range of cases including reference fields, asymmetric fields, and wedged fields. The audit assesses 3D planning with 6 MV photons with a static (zero degree) gantry. Scoring is performed using local dose differences between the planned and measured dose within 80% of the field width. The overall audit result is determined by the maximum dose difference over all scoring points, cases, and planes. Pass (Optimal Level) is defined as maximum dose difference ≤3.3%, Pass (Action Level) is ≤5.0%, and Fail (Out of Tolerance) is >5.0%. At close of 2013, the ACDS had performed 24 Level II audits. 63% of the audits passed, 33% failed, and the remaining audit was not assessable. Of the 15 audits that passed, 3 were at Pass (Action Level). The high fail rate is largely due to a systemic issue with modeling asymmetric 60° wedges which caused a delivered overdose of 5%-8%. The ACDS has implemented a nonreference condition Level II type audit, based on ion chamber 2D array measurements in an inhomogeneous slab phantom. The powerful diagnostic ability of this audit has allowed the ACDS to rigorously test the treatment planning systems implemented in Australian radiotherapy facilities. Recommendations from audits have led to facilities modifying clinical practice and changing planning protocols.

Environmental Audit of the Environmental Measurements Laboratory (EML)

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

Not Available

1992-02-01

This document contains the findings identified during the Environmental Audit of the Environmental Measurements Laboratory (EML), conducted from December 2 to 13, 1991. The Audit included the EML facility located in a fifth-floor General Services Administration (GSA) office building located in New York City, and a remote environmental monitoring station located in Chester, New Jersey. The scope of this Environmental Audit was comprehensive, covering all areas of environmental activities and waste management operations, with the exception of the National Environmental Policy Act (NEPA), which is the responsibility of the DOE Headquarters Office of NEPA Oversight. Compliance with applicable Federal, state,more » and local requirements; applicable DOE Orders; and internal facility requirements was addressed.« less

13 CFR 130.830 - Audits and investigations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Audits and investigations. 130.830 Section 130.830 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS DEVELOPMENT CENTERS § 130.830 Audits and investigations. (a) Access to records. Applicable OMB Circulars set forth the...

13 CFR 130.830 - Audits and investigations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Audits and investigations. 130.830 Section 130.830 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION SMALL BUSINESS DEVELOPMENT CENTERS § 130.830 Audits and investigations. (a) Access to records. Applicable OMB Circulars set forth the...

5 CFR 950.105 - Principal Combined Fund Organization (PCFO) responsibilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., such as banking, auditing, reporting and distribution separate from the applicant's non-CFC operations... accepted accounting principles. (9) Submitting to the LFCC an audit of collections and disbursements for... accepted auditing standards and OPM guidance. (10) Absorbing the cost of any reproduction and/or reissuing...

Reusable Software Usability Specifications for mHealth Applications.

PubMed

Cruz Zapata, Belén; Fernández-Alemán, José Luis; Toval, Ambrosio; Idri, Ali

2018-01-25

One of the key factors for the adoption of mobile technologies, and in particular of mobile health applications, is usability. A usable application will be easier to use and understand by users, and will improve user's interaction with it. This paper proposes a software requirements catalog for usable mobile health applications, which can be used for the development of new applications, or the evaluation of existing ones. The catalog is based on the main identified sources in literature on usability and mobile health applications. Our catalog was organized according to the ISO/IEC/IEEE 29148:2011 standard and follows the SIREN methodology to create reusable catalogs. The applicability of the catalog was verified by the creation of an audit method, which was used to perform the evaluation of a real app, S Health, application created by Samsung Electronics Co. The usability requirements catalog, along with the audit method, identified several usability flaws on the evaluated app, which scored 83%. Some flaws were detected in the app related to the navigation pattern. Some more issues related to the startup experience, empty screens or writing style were also found. The way a user navigates through an application improves or deteriorates user's experience with the application. We proposed a reusable usability catalog and an audit method. This proposal was used to evaluate a mobile health application. An audit report was created with the usability issues identified on the evaluated application.

Detecting Discrimination in Audit and Correspondence Studies

ERIC Educational Resources Information Center

Neumark, David

2012-01-01

Audit studies testing for discrimination have been criticized because applicants from different groups may not appear identical to employers. Correspondence studies address this criticism by using fictitious paper applicants whose qualifications can be made identical across groups. However, Heckman and Siegelman (1993) show that group differences…

The marketing audit: a new perspective on library services and products.

PubMed Central

Wakeley, P J; Poole, C; Foster, E C

1988-01-01

A marketing audit enables a library to look at audiences, services, and products with a structured approach. The audit can be used to assess operations and to provide a framework for ongoing decision making, evaluation, and long-range planning. An approach to the audit process is presented and its application is demonstrated in a case study featuring the American Hospital Association Resource Center. PMID:3066426

40 CFR 96.72 - Out of control periods.

Code of Federal Regulations, 2010 CFR

2010-07-01

... quality assurance requirements of appendix B of part 75 of this chapter, data shall be substituted using...) Audit decertification. Whenever both an audit of a monitoring system and a review of the initial... certification or recertification application submission and at the time of the audit, the permitting authority...

40 CFR 97.72 - Out of control periods.

Code of Federal Regulations, 2010 CFR

2010-07-01

... assurance or data validation requirements of part 75 of this chapter, data shall be substituted using the...) Audit decertification. Whenever both an audit of an emission monitoring system and a review of the... certification or recertification application submission and at the time of the audit, the Administrator will...

78 FR 53005 - Proposed Data Collection; Comment Request: Community Development Financial Institutions Fund...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-27

...) reviewed or audited by an independent certified public accountant; (ii) Single Audit A-133 (if applicable... has been audited by an independent certified public accountant; (ii) an ILR (including the IRS... general public and other Federal agencies to take this opportunity to comment on continuing information...

Ethnographic Auditing: A New Approach to Evaluating Management in Higher Education.

ERIC Educational Resources Information Center

Fetterman, David

Ethnographic auditing is the application of ethnographic or anthropological concepts and methods to the appraisal of administrative controls over resources. Ethnographic auditing highlights the role of culture, subculture, values, rituals and physical environment in management in higher education. The ethnographic auditor measures the fiscal and…

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.

Ernst and Young LLP South Carolina Research Authority Fiscal Year Ended June 30, 1995.

DTIC Science & Technology

1997-06-30

The objective of a quality control review is to ensure that the audit was conducted in accordance with applicable standards and meets the auditing...requirements of OMB Circular A-133. As the Federal oversight agency for SCRA, we conducted a quality control review of the audit working papers. We...focused our review on the following qualitative aspects of the audit : due professional care, planning, supervision, independence, quality control

40 CFR 92.512 - Suspension and revocation of certificates of conformity.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 92.511(d), effective from the time that auditing of that locomotive or locomotive engine is completed... after the engine family is deemed to be in noncompliance. (c) If the results of testing or auditing... successful completion of testing, or auditing if applicable, on the failed locomotive or locomotive engine...

12 CFR 335.121 - Listing standards related to audit committees.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 5 2012-01-01 2012-01-01 false Listing standards related to audit committees... audit committees. The provisions of the applicable SEC regulation under section 10(A)(m) of the Exchange Act shall be followed as codified at 17 CFR part 240. [75 FR 73949, Nov. 30, 2010] ...

7 CFR 252.4 - Application to participate and agreement.

Code of Federal Regulations, 2013 CFR

2013-01-01

... processor shall obtain an independent audit conducted by a Certified Public Accountant (CPA) for that year... conducted by a CPA every two years and those receiving less than $75,000 in donated food each year shall obtain an independent audit conducted by a CPA every three years. Processors in the three year audit...

7 CFR 252.4 - Application to participate and agreement.

Code of Federal Regulations, 2014 CFR

2014-01-01

... processor shall obtain an independent audit conducted by a Certified Public Accountant (CPA) for that year... conducted by a CPA every two years and those receiving less than $75,000 in donated food each year shall obtain an independent audit conducted by a CPA every three years. Processors in the three year audit...

7 CFR 252.4 - Application to participate and agreement.

Code of Federal Regulations, 2012 CFR

2012-01-01

... processor shall obtain an independent audit conducted by a Certified Public Accountant (CPA) for that year... conducted by a CPA every two years and those receiving less than $75,000 in donated food each year shall obtain an independent audit conducted by a CPA every three years. Processors in the three year audit...

Use and interpretation of routine outcome measures in forensic mental health.

PubMed

Shinkfield, Gregg; Ogloff, James

2015-02-01

The present study aimed to both pilot a method of monitoring mental health nurses' use of routine outcome measures (ROM) and to examine the precision of ratings made with these tools within a forensic mental health environment. The audit protocol used in the present study was found to be effective in evaluating both the accuracy with which nurses were able to interpret ROM items and their degree of adherence with local procedures for completing such instruments. Moreover, the results suggest that despite these ROM having been developed for use in general mental health settings, they could be interpreted and rated with an adequate degree of reliability by nurses in a forensic mental health context. However, difficulties were observed in the applicability of several components of these tools within a forensic environment. Recommendations for future research and implications for practice are discussed. © 2014 Australian College of Mental Health Nurses Inc.

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.

Quality Control Review of Office of the State Auditor Mississippi State University Fiscal Year Ended June 30, 1996

DTIC Science & Technology

1998-04-10

The objective of a quality control review is to ensure that the audit was conducted in accordance with applicable standards and meets the auditing requirements of the 0MB Circular A-i 33. As a Federal finding agency for the University, we conducted a quality control review of the audit working papers. We focused our review on the following qualitative aspects of the audit : due professional

Quality Control Review of Coopers & Lybrand L.L.P. Polytechnic University. Fiscal Year Ended June 30, 1996

DTIC Science & Technology

1998-05-18

The objective of a quality control review is to assure that the audit was conducted in accordance with applicable standards and meets the auditing...requirements of the OMB Circular A-I 33. As the cognizant Federal agency for the University, we conducted a quality control review of the audit working...papers. We focused our review on the following qualitative aspects of the audit : due professional care, planning, supervision, independence, quality

KPMG Peat Marwick LLP GreatLakes Composites Consortium, Inc. Fiscal Year Ended December 31, 1995

DTIC Science & Technology

1997-06-25

The objective of a quality control review is to assure that the audit was conducted in accordance with applicable standards and meets the auditing...requirements of the OMB Circular A-133. As the cognizant agency for the Institute, we conducted a quality control review of the audit working papers. We...focused our review on the qualitative aspects of the audit : due professional care, planning, supervision, independence, quality control, internal

A 2D ion chamber array audit of wedged and asymmetric fields in an inhomogeneous lung phantom

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

Lye, Jessica; Dunn, Leon, E-mail: leon.dunn@arpansa.gov.au; Alves, Andrew

Purpose: The Australian Clinical Dosimetry Service (ACDS) has implemented a new method of a nonreference condition Level II type dosimetric audit of radiotherapy services to increase measurement accuracy and patient safety within Australia. The aim of this work is to describe the methodology, tolerances, and outcomes from the new audit. Methods: The ACDS Level II audit measures the dose delivered in 2D planes using an ionization chamber based array positioned at multiple depths. Measurements are made in rectilinear homogeneous and inhomogeneous phantoms composed of slabs of solid water and lung. Computer generated computed tomography data sets of the rectilinear phantomsmore » are supplied to the facility prior to audit for planning of a range of cases including reference fields, asymmetric fields, and wedged fields. The audit assesses 3D planning with 6 MV photons with a static (zero degree) gantry. Scoring is performed using local dose differences between the planned and measured dose within 80% of the field width. The overall audit result is determined by the maximum dose difference over all scoring points, cases, and planes. Pass (Optimal Level) is defined as maximum dose difference ≤3.3%, Pass (Action Level) is ≤5.0%, and Fail (Out of Tolerance) is >5.0%. Results: At close of 2013, the ACDS had performed 24 Level II audits. 63% of the audits passed, 33% failed, and the remaining audit was not assessable. Of the 15 audits that passed, 3 were at Pass (Action Level). The high fail rate is largely due to a systemic issue with modeling asymmetric 60° wedges which caused a delivered overdose of 5%–8%. Conclusions: The ACDS has implemented a nonreference condition Level II type audit, based on ion chamber 2D array measurements in an inhomogeneous slab phantom. The powerful diagnostic ability of this audit has allowed the ACDS to rigorously test the treatment planning systems implemented in Australian radiotherapy facilities. Recommendations from audits have led to facilities modifying clinical practice and changing planning protocols.« less

Improving energy audit process and report outcomes through planning initiatives

NASA Astrophysics Data System (ADS)

Sprau Coulter, Tabitha L.

Energy audits and energy models are an important aspect of the retrofit design process, as they provide project teams with an opportunity to evaluate a facilities current building systems' and energy performance. The information collected during an energy audit is typically used to develop an energy model and an energy audit report that are both used to assist in making decisions about the design and implementation of energy conservation measures in a facility. The current lack of energy auditing standards results in a high degree of variability in energy audit outcomes depending on the individual performing the audit. The research presented is based on the conviction that performing an energy audit and producing a value adding energy model for retrofit buildings can benefit from a revised approach. The research was divided into four phases, with the initial three phases consisting of: 1.) process mapping activity - aimed at reducing variability in the energy auditing and energy modeling process. 2.) survey analysis -- To examine the misalignment between how industry members use the top energy modeling tools compared to their intended use as defined by software representatives. 3.) sensitivity analysis -- analysis of the affect key energy modeling inputs are having on energy modeling analysis results. The initial three phases helped define the need for an improved energy audit approach that better aligns data collection with facility owners' needs and priorities. The initial three phases also assisted in the development of a multi-criteria decision support tool that incorporates a House of Quality approach to guide a pre-audit planning activity. For the fourth and final research phase explored the impacts and evaluation methods of a pre-audit planning activity using two comparative energy audits as case studies. In each case, an energy audit professionals was asked to complete an audit using their traditional methods along with an audit which involved them first participating in a pre-audit planning activity that aligned the owner's priorities with the data collection. A comparative analysis was then used to evaluate the effects of the pre-audit planning activity in developing a more strategic method for collecting data and representing findings in an energy audit report to a facility owner. The case studies demonstrated that pre-audit planning has the potential to improve the efficiency of an energy audit process through reductions in transition time waste. The cases also demonstrated the value of audit report designs that are perceived by owners to be project specific vs. generic. The research demonstrated the ability to influence and alter an auditors' behavior through participating in a pre-audit planning activity. It also shows the potential benefits of using the House of Quality as a method of aligning data collection with owner's goals and priorities to develop reports that have increased value.

Teaching Auditing Using Cases in an Online Learning Environment: The Role of ePortfolio Assessment

ERIC Educational Resources Information Center

Mihret, Dessalegn Getie; Abayadeera, Nadana; Watty, Kim; McKay, Jade

2017-01-01

While teaching auditing using cases is regarded as an effective approach, spatial separation of students and teachers in online contexts can restrict the application of case teaching. This study examines an undergraduate auditing course implemented to address this challenge by integrating case teaching with ePortfolio assessment. Students' written…

Who's Counting? Legitimating Measurement in the Audit Culture

ERIC Educational Resources Information Center

Ocean, Jude; Skourdoumbis, Andrew

2016-01-01

What gives legitimacy to the numbers that constitute the measurement techniques of the audit culture? We argue that the audit culture's blind application of numbers to people as if there was no moral or ethical dimension to the calculation rests on a military discourse resident in mathematics. This argument is based on the genealogy presented in…

Design and implementation of an audit trail in compliance with US regulations.

PubMed

Jiang, Keyuan; Cao, Xiang

2011-10-01

Audit trails have been used widely to ensure quality of study data and have been implemented in computerized clinical trials data systems. Increasingly, there is a need to audit access to study participant identifiable information to provide assurance that study participant privacy is protected and confidentiality is maintained. In the United States, several federal regulations specify how the audit trail function should be implemented. To describe the development and implementation of a comprehensive audit trail system that meets the regulatory requirements of assuring data quality and integrity and protecting participant privacy and that is also easy to implement and maintain. The audit trail system was designed and developed after we examined regulatory requirements, data access methods, prevailing application architecture, and good security practices. Our comprehensive audit trail system was developed and implemented at the database level using a commercially available database management software product. It captures both data access and data changes with the correct user identifier. Documentation of access is initiated automatically in response to either data retrieval or data change at the database level. Currently, our system has been implemented only on one commercial database management system. Although our audit trail algorithm does not allow for logging aggregate operations, aggregation does not reveal sensitive private participant information. Careful consideration must be given to data items selected for monitoring because selection of all data items using our system can dramatically increase the requirements for computer disk space. Evaluating the criticality and sensitivity of individual data items selected can control the storage requirements for clinical trial audit trail records. Our audit trail system is capable of logging data access and data change operations to satisfy regulatory requirements. Our approach is applicable to virtually any data that can be stored in a relational database.

KPMG Peat Marwick LLP Corporation of Mercer University Fiscal Year Ended June 30, 1995

DTIC Science & Technology

1997-06-11

The objective of a quality control review is to ensure that the audit was conducted in accordance with applicable standards and meets the auditing...requirements of the OMB Circular A-133. We conducted a quality control review of the audit working papers. We focused our review on the following...qualitative aspects of the audit : due professional care, planning, supervision, independence, quality control, internal controls, substantive testing, general and specific compliance testing, and the Schedule of Federal Awards.

Integrated Information Support System (IISS). Volume 4. IISS System. Part 1. System Requirement Document.

DTIC Science & Technology

1985-11-01

access audit trail. 2. Screen audit trail for unauthorized entries. B.6.3.3 Manage CDX Resources B.6.3.3.1 Measure CDX Performance 1. Keep running...response time B-32 SRD620140000 1 November 1985 -ii I B -3 / I 0 / . ".3 SRD620140000 1 November 1985 4. Audit 1ISS hardware performance (LAN, HOSTS...standards on-line. 7. Assist IISS service specifier and application specifier in implementing standards recommendation. 8. Perform audit of IISS

Medical research and audit skills training for undergraduates: an international analysis and student-focused needs assessment.

PubMed

2018-01-01

Interpreting, performing and applying research is a key part of evidence-based medical practice, however, incorporating these within curricula is challenging. This study aimed to explore current provision of research skills training within medical school curricula, provide a student-focused needs assessment and prioritise research competencies. A international, cross-sectional survey of final year UK and Irish medical students was disseminated at each participating university. The questionnaire investigated research experience, and confidence in the Medical Education in Europe (MEDINE) 2 consensus survey research competencies. Fully completed responses were received from 521 final year medical students from 32 medical schools (43.4% male, mean age 24.3 years). Of these, 55.3% had an additional academic qualification (49.5% Bachelor's degree), and 38.8% had been a named author on an academic publication. Considering audit and research opportunities and teaching experience, 47.2% reported no formal audit training compared with 27.1% who reported no formal research training. As part of their medical school course, 53.4% had not performed an audit, compared with 29.9% who had not participated in any clinical or basic science research. Nearly a quarter of those who had participated in research reported doing so outside of their medical degree course. Low confidence areas included selecting and performing the appropriate statistical test, selecting the appropriate research method, and critical appraisal. Following adjustment, several factors were associated with increased confidence including previous clinical research experience (OR 4.21, 2.66 to 6.81, P<0.001), additional degrees (OR 2.34, 1.47 to 3.75, P<0.001), and male gender (OR 1.90, 1.25 to 2.09, P=0.003). Factors associated with an increase in perceived opportunities included formal research training in the curriculum (OR 1.66, 1.12 to 2.46, P=0.012), audit skills training in the curriculum (OR 1.52, 1.03 to 2.26, P= 0.036) and research methods taught in a student selected component (OR 1.75, 1.21 to 2.54, P=0.003). Nearly one-third of students lacked formal training on undertaking research, and half of students lacked formal audit training and opportunities to undertake audit as part of their medical school course. The presence of research training in the cirriculum was associated with an increase in perceived opportunities to participate in MEDINE2 research competencies. Female gender and a lack of previous research experience were significant factors influencing confidence and participation in research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

HS.Register - An Audit-Trail Tool to Respond to the General Data Protection Regulation (GDPR).

PubMed

Gonçalves-Ferreira, Duarte; Leite, Mariana; Santos-Pereira, Cátia; Correia, Manuel E; Antunes, Luis; Cruz-Correia, Ricardo

2018-01-01

Introduction The new General Data Protection Regulation (GDPR) compels health care institutions and their software providers to properly document all personal data processing and provide clear evidence that their systems are inline with the GDPR. All applications involved in personal data processing should therefore produce meaningful event logs that can later be used for the effective auditing of complex processes. Aim This paper aims to describe and evaluate HS.Register, a system created to collect and securely manage at scale audit logs and data produced by a large number of systems. Methods HS.Register creates a single audit log by collecting and aggregating all kinds of meaningful event logs and data (e.g. ActiveDirectory, syslog, log4j, web server logs, REST, SOAP and HL7 messages). It also includes specially built dashboards for easy auditing and monitoring of complex processes, crossing different systems in an integrated way, as well as providing tools for helping on the auditing and on the diagnostics of difficult problems, using a simple web application. HS.Register is currently installed at five large Portuguese Hospitals and is composed of the following open-source components: HAproxy, RabbitMQ, Elasticsearch, Logstash and Kibana. Results HS.Register currently collects and analyses an average of 93 million events per week and it is being used to document and audit HL7 communications. Discussion Auditing tools like HS.Register are likely to become mandatory in the near future to allow for traceability and detailed auditing for GDPR compliance.

Combining ISO/IEC 17025:2005 and European Commission Decision 2002/657 audit requirements: a practical way forward.

PubMed

Kay, Jack F

2012-08-01

Laboratories involved in the analyses of veterinary drug residues are under increasing pressure to demonstrate that they produce meaningful and reliable data. Quality assurance and quality control systems are implemented in laboratories to provide evidence of this and these are subject to external assessment to ensure that they are effective. Audits to ISO/IEC 17025:2005, an internationally accepted standard, and subsequent accreditation provide laboratories and their customers with a degree of assurance that the laboratories are operating in control and the data they report can be relied on. However, national or regional authorities may place additional requirements on laboratories to ensure quality data are reported. For example, in the European Union, all official control laboratories involved in veterinary drug residue analyses must also meet the requirements of European Commission Decision 2002/657/EC which sets performance criteria for analytical methods used in this area and these are subject to additional audits by national or regional authorities. All audits place considerable time and resource demands on laboratories and this paper discusses the burden audits place on laboratories and describes a UK initiative to combine these audits to the benefit of both the regulatory authority and the laboratory. © 2012 John Wiley & Sons, Ltd.

Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy

NASA Astrophysics Data System (ADS)

Palmer, Antony L.; Lee, Chris; Ratcliffe, Ailsa J.; Bradley, David; Nisbet, Andrew

2013-10-01

A novel phantom is presented for ‘full system’ dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy.

PubMed

Palmer, Antony L; Lee, Chris; Ratcliffe, Ailsa J; Bradley, David; Nisbet, Andrew

2013-10-07

A novel phantom is presented for 'full system' dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

Prevention of in-hospital falls: development of criteria for the conduct of a multi-site audit.

PubMed

Giles, Kristy; Stephenson, Matthew; McArthur, Alexa; Aromataris, Edoardo

2015-06-01

Patient falls are a significant issue for hospitals due to the high rates of morbidity and mortality associated with these events, as well as the financial costs for the healthcare system. To establish what constitutes best practice in terms of fall prevention in acute care facilities and use this to inform the development of best practice audit criteria. Criteria for clinical audit were developed from evidence derived from systematic reviews and guidelines. While these were drawn from the best available evidence, they were also developed in conjunction with clinicians undertaking a fall-prevention clinical audit and key stakeholders from the clinical settings to ensure their relevance and applicability to the acute care setting. Current literature recommends a comprehensive and multifactorial approach to fall prevention. Eight audit criteria were derived from the best available evidence including the domains of physical environment, hospital culture and care processes, use of technology and targeted interventions. Existing research evidence and consultation with stakeholders has allowed the development of applicable, evidence-based audit criteria for fall prevention in acute care settings. This model can promote engagement, impact clinical practice and lead to improved outcomes.

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.

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.

Development of ergonomics audits for bagging, haul truck and maintenance and repair operations in mining.

PubMed

Dempsey, Patrick G; Pollard, Jonisha; Porter, William L; Mayton, Alan; Heberger, John R; Gallagher, Sean; Reardon, Leanna; Drury, Colin G

2017-12-01

The development and testing of ergonomics and safety audits for small and bulk bag filling, haul truck and maintenance and repair operations in coal preparation and mineral processing plants found at surface mine sites is described. The content for the audits was derived from diverse sources of information on ergonomics and safety deficiencies including: analysis of injury, illness and fatality data and reports; task analysis; empirical laboratory studies of particular tasks; field studies and observations at mine sites; and maintenance records. These diverse sources of information were utilised to establish construct validity of the modular audits that were developed for use by mine safety personnel. User and interrater reliability testing was carried out prior to finalising the audits. The audits can be implemented using downloadable paper versions or with a free mobile NIOSH-developed Android application called ErgoMine. Practitioner Summary: The methodology used to develop ergonomics audits for three types of mining operations is described. Various sources of audit content are compared and contrasted to serve as a guide for developing ergonomics audits for other occupational contexts.

Final Technical Report. Training in Building Audit Technologies

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

Brosemer, Kathleen

In 2011, the Tribe proposed and was awarded the Training in Building Audit Technologies grant from the DOE in the amount of $55,748 to contract for training programs for infrared cameras, blower door technology applications and building systems. The coursework consisted of; Infrared Camera Training: Level I - Thermal Imaging for Energy Audits; Blower Door Analysis and Building-As-A-System Training, Building Performance Institute (BPI) Building Analyst; Building Envelope Training, Building Performance Institute (BPI) Envelope Professional; and Audit/JobFLEX Tablet Software. Competitive procurement of the training contractor resulted in lower costs, allowing the Tribe to request and receive DOE approval to additionally purchasemore » energy audit equipment and contract for residential energy audits of 25 low-income Tribal Housing units. Sault Tribe personnel received field training to supplement the classroom instruction on proper use of the energy audit equipment. Field experience was provided through the second DOE energy audits grant, allowing Sault Tribe personnel to join the contractor, Building Science Academy, in conducting 25 residential energy audits of low-income Tribal Housing units.« less

Critical features of an auditable management system for an ISO 9000-compatible occupational health and safety standard.

PubMed

Levine, S; Dyjack, D T

1997-04-01

An International Organization for Standardization (ISO) 9001: 1994-harmonized occupational health and safety (OHS) management system has been written at the University of Michigan, and reviewed, revised, and accepted under the direction of the American Industrial Hygiene Association (AIHA) Occupational Health and Safety Management Systems (OHSMS) Task Force and the Board of Directors. This system is easily adaptable to the ISO 14001 format and to both OHS and environmental management system applications. As was the case with ISO 9001: 1994, this system is expected to be compatible with current production quality and OHS quality systems and standards, have forward compatibility for new applications, and forward flexibility, with new features added as needed. Since ISO 9001: 1987 and 9001: 1994 have been applied worldwide, the incorporation of harmonized OHS and environmental management system components should be acceptable to business units already performing first-party (self-) auditing, and second-party (contract qualification) auditing. This article explains the basis of this OHS management system, its relationship to ISO 9001 and 14001 standards, the philosophy and methodology of an ISO-harmonized system audit, the relationship of these systems to traditional OHS audit systems, and the authors' vision of the future for application of such systems.

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

30 CFR 7.91 - Post-approval product audit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Engines Intended for Use in... except for cause, the approval holder shall make a diesel engine available for audit at no cost to MSHA. ...

30 CFR 7.91 - Post-approval product audit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Engines Intended for Use in... except for cause, the approval holder shall make a diesel engine available for audit at no cost to MSHA. ...

30 CFR 7.91 - Post-approval product audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Engines Intended for Use in... except for cause, the approval holder shall make a diesel engine available for audit at no cost to MSHA. ...

30 CFR 7.91 - Post-approval product audit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Engines Intended for Use in... except for cause, the approval holder shall make a diesel engine available for audit at no cost to MSHA. ...

30 CFR 7.91 - Post-approval product audit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... APPROVAL OF MINING PRODUCTS TESTING BY APPLICANT OR THIRD PARTY Diesel Engines Intended for Use in... except for cause, the approval holder shall make a diesel engine available for audit at no cost to MSHA. ...

The Drinkers Degree: Risk Taking Behaviours amongst Undergraduate Student Drinkers

PubMed Central

O'Neill, Gillian; Martin, Neil; Birch, Jennifer; Oldam, Alison; Newbury-Birch, Dorothy

2015-01-01

Objective. To examine risk taking behaviours associated with alcohol consumption amongst UK undergraduate students. Design and Methods. A cross-sectional web survey was used to assess attitudes and health behaviours. The survey included the Alcohol Use Disorders Identification Test (AUDIT). Students were also asked about why they drank alcohol; about their preferred alcoholic beverage; and if they had experienced any consequences associated with drinking alcohol as well as questions relating to sexual risk taking, drug use, and smoking. Results. 2779 (65% female; 84% White British) students completed some part of the survey. Of these, 98% (n = 2711) completed the AUDIT. Of the 92% that drank 66% (n = 1,643) were categorised as being AUDIT positive. 8% (n = 224) were categorised as probably alcohol dependent. Higher AUDIT scores were significantly associated with negative consequences such as unplanned sexual activity, physical injuries, and arguments. Other risk taking behaviours such as drug use and smoking were also found to be positively correlated with higher AUDIT scores; drug use; and smoking. Conclusions. The results from this study provide insight into students' alcohol consumption and associated risk taking. University policies need to protect students' overall health and wellbeing to ensure academic potential is maximised. PMID:26713168

Process audits versus product quality monitoring of bulk milk.

PubMed

Velthuis, A G J; van Asseldonk, M A P M

2011-01-01

Assessment of milk quality is based on bulk milk testing and farm certification on process quality audits. It is unknown to what extent dairy farm audits improve milk quality. A statistical analysis was conducted to quantify possible associations between bulk milk testing and dairy farm audits. The analysis comprised 64.373 audit outcomes on 26,953 dairy farms, which were merged with all conducted laboratory tests of bulk milk samples 12 mo before the audit. Each farm audit record included 271 binary checklist items and 52 attention point variables (given to farmers if serious deviations were observed), both indicating possible deviations from the desired farm situation. Test results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acid (FFA), and milk sediment (SED). Results show that numerous audit variables were related to bulk milk test results, although the goodness of fit of the models was generally low. Cow hygiene, clean cubicles, hygiene of milking parlor, and utility room were positively correlated with superior product quality, mainly with respect to SCC, TBC, BAB, FPD, FFA, and SED. Animal health or veterinary drugs management (i.e., drug treatment recording, marking of treated animals, and storage of veterinary drugs) related to SCC, FPD, FFA, and SED. The availability of drinking water was related to TBC, BAB, FFA, and SED, whereas maintenance of the milking equipment was related mainly to SCC, FPD, and FFA. In summary, bulk milk quality and farm audit outcomes are, to some degree, associated: if dairy farms are assessed negatively on specific audit aspects, the bulk milk quality is more likely to be inferior. However, the proportion of the total variance in milk test results explained by audits ranged between 4 and 13% (depending on the specific bulk milk test), showing that auditing dairy farms provides additional information but has a limited association with the outcome of a product quality control program. This study suggests that farm audits could be streamlined to include only relevant checklist items and that bulk milk quality monitoring could be used as a basis of selecting farms for more or less frequent audits. Copyright © 2011 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

The development of an application for data privacy by applying an audit repository based on IHE ATNA.

PubMed

Bresser, Laura; Köhler, Steffen; Schwaab, Christoph

2014-01-01

It is necessary to optimize workflows and communication between institutions involved in patients' treatment to improve quality and efficiency of the German healthcare. To achieve these in the Metropolregion Rhein-Neckar, a personal, cross-institutional patient record (PEPA) is used. Given the immense sensitivity of health-related information saved in the PEPA, it is imperative to obey the data protection regulations in Germany. One important aspect is the logging of access to personal health data and all other safety-related events. For gathering audit information, the IHE profile ATNA can be used, because it provides a flexible and standardized infrastructure. There are already existing solutions for gathering the audit information based on ATNA. In this article one solution (OpenATNA) is evaluated, which uses the method of evaluation defined by Peter Baumgartner. In addition, a user interface for a privacy officer is necessary to support the examination of the audit information. Therefore, we will describe a method to develop an application in Liferay (an OpenSource enterprise portal project) which supports examinations on the gathered audit information.

Ideas That Work! The Midnight Audit

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

Parker, Steven A.

The midnight audit provides valuable insight toward identifying opportunities to reduce energy consumption—insight that can be easily overlooked during the normal (daytime) energy auditing process. The purpose of the midnight audit is to observe after-hour operation with the mindset of seeking ways to further minimize energy consumption during the unoccupied mode and minimize energy waste by reducing unnecessary operation. The midnight audit should be used to verify that equipment is off when it is supposed to be, or operating in set-back mode when applicable. Even a facility that operates 2 shifts per day, 5 days per week experiences fewer annualmore » hours in occupied mode than it does during unoccupied mode. Minimizing energy loads during unoccupied hours can save significant energy, which is why the midnight audit is an Idea That Works.« less

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.

Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania

PubMed Central

Kidanto, Hussein L; Mogren, Ingrid; van Roosmalen, Jos; Thomas, Angela N; Massawe, Siriel N; Nystrom, Lennarth; Lindmark, Gunilla

2009-01-01

Background Perinatal death is a devastating experience for the mother and of concern in clinical practice. Regular perinatal audit may identify suboptimal care related to perinatal deaths and thus appropriate measures for its reduction. The aim of this study was to perform a qualitative perinatal audit of intrapartum and early neonatal deaths and propose means of reducing the perinatal mortality rate (PMR). Methods From 1st August, 2007 to 31st December, 2007 we conducted an audit of perinatal deaths (n = 133) with birth weight 1500 g or more at Muhimbili National Hospital (MNH). The audit was done by three obstetricians, two external and one internal auditors. Each auditor independently evaluated the cases narratives. Suboptimal factors were identified in the antepartum, intrapartum and early neonatal period and classified into three levels of delay (community, infrastructure and health care). The contribution of each suboptimal factor to adverse perinatal outcome was identified and the case graded according to possible avoidability. Degree of agreement between auditors was assessed by the kappa coefficient. Results The PMR was 92 per 1000 total births. Suboptimal factors were identified in 80% of audited cases and half of suboptimal factors were found to be the likely cause of adverse perinatal outcome and were preventable. Poor foetal heart monitoring during labour was indirectly associated with over 40% of perinatal death. There was a poor to fair agreement between external and internal auditors. Conclusion There are significant areas of care that need improvement. Poor monitoring during labour was a major cause of avoidable perinatal mortality. This type of audit was a good starting point for quality assurance at MNH. Regular perinatal audits to identify avoidable causes of perinatal deaths with feed back to the staff may be a useful strategy to reduce perinatal mortality. PMID:19765312

E-health internationalization requirements for audit purposes.

PubMed

Ouhbi, Sofia; Fernández-Alemán, José Luis; Carrillo-de-Gea, Juan Manuel; Toval, Ambrosio; Idri, Ali

2017-06-01

In the 21st century, e-health is proving to be one of the strongest drivers for the global transformation of the health care industry. Health information is currently truly ubiquitous and widespread, but in order to guarantee that everyone can appropriately access and understand this information, regardless of their origin, it is essential to bridge the international gap. The diversity of health information seekers languages and cultures signifies that e-health applications must be adapted to satisfy their needs. In order to achieve this objective, current and future e-health programs should take into account the internationalization aspects. This paper presents an internationalization requirements specification in the form of a reusable requirements catalog, obtained from the principal related standards, and describes the key methodological elements needed to perform an e-health software audit by using the internationalization knowledge previously gathered. S Health, a relevant, well-known Android application that has more than 150 million users in over 130 countries, was selected as a target for the e-health internationalization audit method and requirements specification presented above. This application example helped us to put into practice the proposal and show that the procedure is realistic and effective. The approach presented in this study is subject to continuous improvement through the incorporation of new knowledge originating from additional information sources, such as other standards or stakeholders. The application example is useful for early evaluation and serves to assess the applicability of the internationalization catalog and audit methodology, and to improve them. It would be advisable to develop of an automated tool with which to carry out the audit method. Copyright © 2017 Elsevier B.V. All rights reserved.

Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology.

PubMed

Esposito, Pasquale; Dal Canton, Antonio

2014-11-06

Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the effectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings.

Clinical audit of diabetes management can improve the quality of care in a resource-limited primary care setting.

PubMed

Govender, Indira; Ehrlich, Rodney; Van Vuuren, Unita; De Vries, Elma; Namane, Mosedi; De Sa, Angela; Murie, Katy; Schlemmer, Arina; Govender, Strini; Isaacs, Abdul; Martell, Rob

2012-12-01

To determine whether clinical audit improved the performance of diabetic clinical processes in the health district in which it was implemented. Patient folders were systematically sampled annually for review. Primary health-care facilities in the Metro health district of the Western Cape Province in South Africa. Health-care workers involved in diabetes management. Clinical audit and feedback. The Skillings-Mack test was applied to median values of pooled audit results for nine diabetic clinical processes to measure whether there were statistically significant differences between annual audits performed in 2005, 2007, 2008 and 2009. Descriptive statistics were used to illustrate the order of values per process. A total of 40 community health centres participated in the baseline audit of 2005 that decreased to 30 in 2009. Except for two routine processes, baseline medians for six out of nine processes were below 50%. Pooled audit results showed statistically significant improvements in seven out of nine clinical processes. The findings indicate an association between the application of clinical audit and quality improvement in resource-limited settings. Co-interventions introduced after the baseline audit are likely to have contributed to improved outcomes. In addition, support from the relevant government health programmes and commitment of managers and frontline staff contributed to the audit's success.

Quality audit--a review of the literature concerning delivery of continence care.

PubMed

Swaffield, J

1995-09-01

This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

47 CFR 54.516 - Auditing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICE Universal Service Support for Schools and Libraries § 54.516 Auditing. (a) Recordkeeping requirements—(1) Schools and libraries. Schools and libraries shall retain all documents related to the... includes schools or libraries shall retain all documents related to the application for, receipt, and...

12 CFR 704.15 - Audit and reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... accordance with generally accepted accounting principles (GAAP), which must be audited by an independent... report signatures. The chief executive officer and either the chief accounting officer or chief financial... financial reporting. Notwithstanding the requirements set forth in applicable professional standards, the...

12 CFR 704.15 - Audit and reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... accordance with generally accepted accounting principles (GAAP), which must be audited by an independent... report signatures. The chief executive officer and either the chief accounting officer or chief financial... financial reporting. Notwithstanding the requirements set forth in applicable professional standards, the...

12 CFR 704.15 - Audit and reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... accordance with generally accepted accounting principles (GAAP), which must be audited by an independent... report signatures. The chief executive officer and either the chief accounting officer or chief financial... financial reporting. Notwithstanding the requirements set forth in applicable professional standards, the...

The ICA Communication Audit: Rationale and Development.

ERIC Educational Resources Information Center

Goldhaber, Gerald M.

After reviewing previous research on communication in organizations, the Organizational Communication Division of the International Communication Association (ICA) decided, in 1971, to develop its own measurement system, the ICA Communication Audit. Rigorous pilot-testing, refinement, standardization, and application would allow the construction…

Environmental auditing: Theory and applications

NASA Astrophysics Data System (ADS)

Thompson, Dixon; Wilson, Melvin J.

1994-07-01

The environmental audit has become a regular part of corporate environmental management in Canada and is also gaining recognition in the public sector. A 1991 survey of 75 private sector companies across Canada revealed that 76% (57/75) had established environmental auditing programs. A similar survey of 19 federal, provincial, and municipal government departments revealed that 11% (2/19) had established such programs. The information gained from environmental audits can be used to facilitate and enhance environmental management from the single facility level to the national and international levels. This paper is divided into two sections: section one examines environmental audits at the facility/company level and discusses environmental audit characteristics, trends, and driving forces not commonly found in the available literature. Important conclusions are: that wherever possible, an action plan to correct the identified problems should be an integral part of an audit, and therefore there should be a close working relationship between auditors, managers, and employees, and that the first audits will generally be more difficult, time consuming, and expensive than subsequent audits. Section two looks at environmental audits in the broader context and discusses the relationship between environmental audits and three other environmental information gathering/analysis tools: environmental impact assessments, state of the environment reports, and new systems of national accounts. The argument is made that the information collected by environmental audits and environmental impact assessments at the facility/company level can be used as the bases for regional and national state of the environment reports and new systems of national accounts.

Performance of the AUDIT in Detecting DSM-5 Alcohol Use Disorders in College Students.

PubMed

Hagman, Brett T

2016-09-18

It is critical that our alcohol screening instruments maintain their accuracy at detecting DSM-5 Alcohol Use Disorder (AUD) symptomatology. The Alcohol Use Disorders Identification Test (AUDIT) is one of the most widely used alcohol screening instruments, despite no studies evaluating its performance for detecting DSM-5 AUDs. The present study evaluated the performance of the AUDIT in the screening of DSM-5 AUDs in non-treatment seeking college students. Participants (N = 251) were undergraduate students who had at least one binge drinking occasion in the past 90-days. The AUROC value for DSM-5 AUD status in the overall sample was.779 (SE =.029; 95% CIs =.721 to.837). The AUROC values for the reference groups of any DSM-IV AUD and any binge drinker were.798 (SE =.028; 95% CIs =.742 to.853) and.827 (SE =.03; 95% CIs.768 -.886), respectively. A similar pattern of findings emerged between males and females. Gender differences emerged in the identification of AUDIT cut-off scores. A score of ≥ 8 and ≥ 9 had the best balance of sensitivity and specificity for females and males in college, respectively. Findings indicate that the AUDIT has a reasonable degree of diagnostic proficiency in screening for DSM-5 AUDs in college students.

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.

24 CFR 4.26 - Permissible and impermissible disclosures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... official audit, inquiry or investigation, if the disclosure is made to an auditor or investigator authorized by the HUD Inspector General to conduct the audit or investigation; (6) Legal activities... purpose of: (1) Communication of the applicant's failure to qualify, after a preliminary review for...

75 FR 57274 - Financial Management and Assurance; Government Auditing Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... contained in the 2010 Exposure Draft update GAGAS to reflect major developments in the accountability and audit profession and emphasize specific considerations applicable to the government environment. In addition, this proposed revision modernizes GAGAS, with updates to reflect major developments in the...

Prevention of DNA contamination during forensic medical examinations in a clinical forensic medical service: A best practice implementation project.

PubMed

Lutz, Tasha

2015-01-01

Contamination of forensic specimens can have significant and detrimental effects on cases presented in court. In 2010 a wrongful conviction in Australia resulted in an inquiry with 25 recommendations to minimize the risk of DNA contamination of forensic specimens. DNA decontamination practices in a clinical forensic medical service currently attempt to comply with these recommendations. Evaluation of these practices has not been undertaken. The aim of this project was to audit the current DNA decontamination practices of forensic medical and nursing examiners in the forensic medical examination process and implement changes based on the audit findings. A re-audit following implementation would be undertaken to identify change and inform further research. The Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice were used as the audit tool in this project. A baseline audit was conducted; analysis of this audit process was then undertaken. Following education and awareness training targeted at clinicians, a re-audit was completed. There were a total of 24 audit criteria; the baseline audit reflected 20 of these criteria had 100% compliance. The remaining 4 audit criteria demonstrated compliance between 65% and 90%. Education and awareness training resulted in improved compliance in 2 of the 4 audit criteria, with the remaining 2 having unchanged compliance. The findings demonstrated that education and raising awareness can improve clinical practice; however there are also external factors outside the control of the clinicians that influence compliance with best practice.

Clinical audit, a valuable tool to improve quality of care: General methodology and applications in nephrology

PubMed Central

Esposito, Pasquale; Dal Canton, Antonio

2014-01-01

Evaluation and improvement of quality of care provided to the patients are of crucial importance in the daily clinical practice and in the health policy planning and financing. Different tools have been developed, including incident analysis, health technology assessment and clinical audit. The clinical audit consist of measuring a clinical outcome or a process, against well-defined standards set on the principles of evidence-based medicine in order to identify the changes needed to improve the quality of care. In particular, patients suffering from chronic renal diseases, present many problems that have been set as topics for clinical audit projects, such as hypertension, anaemia and mineral metabolism management. Although the results of these studies have been encouraging, demonstrating the effectiveness of audit, overall the present evidence is not clearly in favour of clinical audit. These findings call attention to the need to further studies to validate this methodology in different operating scenarios. This review examines the principle of clinical audit, focusing on experiences performed in nephrology settings. PMID:25374819

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

Integrated Information Support System (IISS). Volume 4. IISS System. Part 1. System Requirements Document

DTIC Science & Technology

1990-09-30

audit trail for unauthorized entries. B.6.3.3 Manage CDM Resources B.6.3.3.1 Measure CDM Performance 1. Keep running log of CDM accesses by user types...SYSTEM SPPCIFIA OMA8MSTRTO Figure B-12. System Administrator Role B-3 1 SRD620340000 30 September 1990 4. Audit IISS hardware performance (LAN...SRD620340000 30 September 1990 7. Assist IISS service specifier and application specifier in implementing standards recommendation. 8. Perform audit of IISS

Defense Logistics Agency 1995 Defense Base Realignment and Closure Data Collection Process for the Evaluation Phase.

DTIC Science & Technology

1995-05-04

Commission. The specific objective for the audit was to determine whether the evaluation process that the DLA used to develop recommendations reported to the...1995 Commission was consistently applied and adequately supported. The audit also reviewed applicable management controls.

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…

25 CFR 1000.3 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the planning requirements for admission into the applicant pool, will provide information so that... Tribe wants to plan for Self-Governance and has no material audit exceptions for the last three years of audits). There is no confidential information being solicited and confidentiality is not extended under...

Severe Maternal or Near Miss Morbidity: Implications for Public Health Surveillance and Clinical Audit.

PubMed

Kuklina, Elena V; Goodman, David A

2018-06-01

This chapter reviews the historical development of indicators to identify severe maternal morbidity/maternal near miss (SMM/MNM), and their use for public health surveillance, research, and clinical audit. While there has been progress toward identifying standard definitions for SMM/MNM within countries, there remain inconsistencies in the definition of SMM/MNM indicators and their application between countries. Using these indicators to screen for events that then trigger a clinical audit may both under identify select SMM/MNM (false negative)and over identify select SMM/MNM (false positive). Thus, indicators which support the efficient identification of SMM/MNM for the purpose of facility-based clinical audits are still needed.

77 FR 47399 - Funding Opportunity: Tribal Self-Governance Program; Planning Cooperative Agreement

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-08

... timely and efficient. Planning helps to identify issues in advance and ensures that the Tribe is fully... and financial management capability. Applicants are required to submit complete annual audit reports... the Planning Cooperative Agreement, the Tribe has had no uncorrected significant and material audit...

7 CFR 3052.230 - Audit costs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... principles circulars, the Federal Acquisition Regulation (FAR) (48 CFR parts 30 and 31), or other applicable cost principles or regulations. (b) Unallowable costs. A non-Federal entity shall not charge the....S.C. 7501 et seq.) not conducted in accordance with this part. (2) The cost of auditing a non...

A Structural Reconceptualization of the Organizational Communication Audit, with Application to a State Department of Education.

ERIC Educational Resources Information Center

Grunig, James E.

The standard organizational communication audit measures employees' perceptions of and satisfaction with communication in an organization. It does not, however, examine the structural characteristics of an organization, such as centralization or stratification--characteristics that can disclose whether a total communication system is appropriate…

49 CFR 178.70 - Approval of UN pressure receptacles.

Code of Federal Regulations, 2012 CFR

2012-10-01

... designee. (b) IIA pre-audit. The manufacturer must submit an application for initial design type approval... of the manufacturer and the IIA certifying the design type, the test results, chemical analyses, lot... initial design type approval. If the pre-audit is found satisfactory by the IIA, the manufacturer will...

49 CFR 178.70 - Approval of UN pressure receptacles.

Code of Federal Regulations, 2011 CFR

2011-10-01

... designee. (b) IIA pre-audit. The manufacturer must submit an application for initial design type approval... of the manufacturer and the IIA certifying the design type, the test results, chemical analyses, lot... initial design type approval. If the pre-audit is found satisfactory by the IIA, the manufacturer will...

49 CFR 178.70 - Approval of UN pressure receptacles.

Code of Federal Regulations, 2014 CFR

2014-10-01

... designee. (b) IIA pre-audit. The manufacturer must submit an application for initial design type approval... of the manufacturer and the IIA certifying the design type, the test results, chemical analyses, lot... initial design type approval. If the pre-audit is found satisfactory by the IIA, the manufacturer will...

49 CFR 178.70 - Approval of UN pressure receptacles.

Code of Federal Regulations, 2013 CFR

2013-10-01

... designee. (b) IIA pre-audit. The manufacturer must submit an application for initial design type approval... of the manufacturer and the IIA certifying the design type, the test results, chemical analyses, lot... initial design type approval. If the pre-audit is found satisfactory by the IIA, the manufacturer will...

Clinical audit and quality improvement - time for a rethink?

PubMed

Bowie, Paul; Bradley, Nicholas A; Rushmer, Rosemary

2012-02-01

Evidence of the benefits of clinical audit to patient care is limited, despite its longevity. Additionally, numerous attitudinal, professional and organizational barriers impede its effectiveness. Yet, audit remains a favoured quality improvement (QI) policy lever. Growing interest in QI techniques suggest it is timely to re-examine audit. Clinical audit advisors assist health care teams, so hold unique cross-cutting perspectives on the strategic and practical application of audit in NHS organizations. We aimed to explore their views and experiences of their role in supporting health care teams in the audit process. Qualitative study using semi-structured and focus group interviews. Participants were purposively sampled (n = 21) across health sectors in two large Scottish NHS Boards. Interviews were audio-taped, transcribed and a thematic analysis performed. Work pressure and lack of protected time were cited as audit barriers, but these hide other reasons for non-engagement. Different professions experience varying opportunities to participate. Doctors have more opportunities and may dominate or frustrate the process. Audit is perceived as a time-consuming, additional chore and a managerially driven exercise with no associated professional rewards. Management failure to support and resource changes fuels low motivation and disillusionment. Audit is regarded as a 'political' tool stifled by inter-professional differences and contextual constraints. The findings echo previous studies. We found limited evidence that audit as presently defined and used is meeting policy makers' aspirations. The quality and safety improvement focus is shifting towards 'alternative' systems-based QI methods, but research to suggest that these will be any more impactful is also lacking. Additionally, identified professional, educational and organizational barriers still need to be overcome. A debate on how best to overcome the limitations of audit and its place alongside other approaches to QI is necessary. © 2010 Blackwell Publishing Ltd.

A multicenter study to quantify systematic variations and associated uncertainties in source positioning with commonly used HDR afterloaders and ring applicators for the treatment of cervical carcinomas

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

Awunor, O., E-mail: onuora.awunor@stees.nhs.uk; Berger, D.; Kirisits, C.

Purpose: The reconstruction of radiation source position in the treatment planning system is a key part of the applicator reconstruction process in high dose rate (HDR) brachytherapy treatment of cervical carcinomas. The steep dose gradients, of as much as 12%/mm, associated with typical cervix treatments emphasize the importance of accurate and precise determination of source positions. However, a variety of methodologies with a range in associated measurement uncertainties, of up to ±2.5 mm, are currently employed by various centers to do this. In addition, a recent pilot study by Awunor et al. [“Direct reconstruction and associated uncertainties of {sup 192}Irmore » source dwell positions in ring applicators using gafchromic film in the treatment planning of HDR brachytherapy cervix patients,” Phys. Med. Biol. 58, 3207–3225 (2013)] reported source positional differences of up to 2.6 mm between ring sets of the same type and geometry. This suggests a need for a comprehensive study to assess and quantify systematic source position variations between commonly used ring applicators and HDR afterloaders across multiple centers. Methods: Eighty-six rings from 20 European brachytherapy centers were audited in the form of a postal audit with each center collecting the data independently. The data were collected by setting up the rings using a bespoke jig and irradiating gafchromic films at predetermined dwell positions using four afterloader types, MicroSelectron, Flexitron, GammaMed, and MultiSource, from three manufacturers, Nucletron, Varian, and Eckert & Ziegler BEBIG. Five different ring types in six sizes (Ø25–Ø35 mm) and two angles (45° and 60°) were used. Coordinates of irradiated positions relative to the ring center were determined and collated, and source position differences quantified by ring type, size, and angle. Results: The mean expanded measurement uncertainty (k = 2) along the direction of source travel was ±1.4 mm. The standard deviation associated with the source position reproducibility was within ±1.0 mm for all afterloaders. Maximum source positional variations of 2.1 and 3.9, 1.8 and 5.4, and 2.3 and 3.4 mm were observed at standard treatment positions for the Ø26, Ø30, and Ø32 mm sized 45° and 60° rings, respectively. Mean positional differences between a majority of the rings were within ±1.0 mm. Mean positional differences between a majority of the intracenter ring sets were within the expanded measurement uncertainty. When comparing the 45°–60° source paths, mean differences of 1.6, 0.9, and 0.9 mm were observed across the Ø26, Ø30 (MicroSelectron), and Ø32 mm (GammaMed) rings, respectively. When comparing to manufacturer source path models, maximum offsets of 1.9 and 2.1, 2.6 and 2.3, and 0.8 and 1.6 mm were observed for the Ø26, Ø30 (MicroSelectron), and Ø30 mm (Flexitron) sized 45° and 60° rings, respectively. When comparing the audit to ring commissioning data of participating centers, mean differences of up to 2.4 mm were observed. Conclusions: A majority of the audited rings showed a good degree of manufacturer consistency; however, substantial positional variation observed between some rings emphasizes the importance of commissioning each ring before clinical use. Differences observed between audit and commissioning data also indicate some variation in source treatment positions across centers.« less

Casemix Funding Optimisation: Working Together to Make the Most of Every Episode.

PubMed

Uzkuraitis, Carly; Hastings, Karen; Torney, Belinda

2010-10-01

Eastern Health, a large public Victorian Healthcare network, conducted a WIES optimisation audit across the casemix-funded sites for separations in the 2009/2010 financial year. The audit was conducted using existing staff resources and resulted in a significant increase in casemix funding at a minimal cost. The audit showcased the skill set of existing staff and resulted in enormous benefits to the coding and casemix team by demonstrating the value of the combination of skills that makes clinical coders unique. The development of an internal web-based application allowed accurate and timely reporting of the audit results, providing the basis for a restructure of the coding and casemix service, along with approval for additional staffing resources and inclusion of a regular auditing program to focus on the creation of high quality data for research, health services management and financial reimbursement.

A quality-assurance assessment for constituents reported by the national atmospheric deposition program and the national trends network

NASA Astrophysics Data System (ADS)

See, Randolph B.; Schroder, LeRoy J.; Willoughby, Timothy C.

A continuing quality-assurance program has been operated by the U.S. Geological Survey to evaluate any bias introduced by routine handling, shipping, and laboratory analyses of wet-deposition samples collected in the National Atmospheric Deposition Program (NADP) and National Trends Network (NTN). Blind-audit samples having a variety of constituent concentrations and values were selected. Only blind-audit samples with constituent concentrations and values less than the 95th-percentile concentration for natural wet-deposition samples were included in the analysis. Of the major ions, there was a significant increase of Ca 2+, Mg 2+, Na 2+, K +, SO 42- and Cl -1 in samples handled according to standard protocols and shipped in NADP/NTN sample-collection buckets. For 1979-1987, graphs of smoothed data showing the estimated contamination in blind-audit samples indicate a decrease in the median concentration and ranges of Ca 2+, Mg 2+ and SO 42- contamination of blind-audit samples shipped in sample-collection buckets. Part of the contamination detected in blind-audit samples can be attributed to contact with the sample-collection bucket and lid; however, additional sources also seem to contaminate the blind-audit sample. Apparent decreases in the magnitude and range of sample contamination may be caused by differences in sample-collection bucket- and lid-washing procedures by the NADP/NTN Central Analytical Laboratory. Although the degree of bias is minimal for most constituents, summaries of the NADP/NTN data base may contain overestimates of Ca 2+, Mg 2+, Na -, K + and SO 42- and Cl - concentrations, and underestimates of H + concentrations.

Telephone audit for monitoring stroke unit facilities: a post hoc analysis from PROSIT study.

PubMed

Candelise, Livia; Gattinoni, Monica; Bersano, Anna

2015-01-01

Although several valid approaches exist to measure the number and the quality of acute stroke units, only few studies tested their reliability. This study is aimed at establishing whether the telephone administration of the PROject of Stroke unIt ITaly (PROSIT) audit questionnaire is reliable compared with direct face-to-face interview. Forty-three medical leaders in charge of in-hospital stroke services were interviewed twice using the same PROSIT questionnaire with 2 different modalities. First, the interviewers approached the medical leaders by telephone. Thereafter, they went to the hospital site and performed a direct face-to-face interview. Six independent couples of trained researchers conducted the audit interviews. The degree of intermodality agreement was measured with kappa statistic. We found a perfect agreement for stroke units identification between the 2 different audit modalities (K = 1.00; standard error [SE], 1.525). The agreement was also very good for stroke dedicated beds (K = 1.00; SE, 1.525) and dedicated personnel (K = 1.00; SE, 1.525), which are the 2 components of stroke unit definition. The agreement was lower for declared in use process of care and availability of diagnostic investigations. The telephone audit can be used for monitoring stroke unit structures. It is more rapid, less expensive, and can repeatedly be used at appropriate intervals. However, a reliable description of the process of care and diagnostic investigations indicators should be obtained by either local site audit visit or prospective stroke register based on individual patient data. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

A quality-assurance assessment for constituents reported by the National Atmospheric Deposition Program and the National Trends Network

USGS Publications Warehouse

See, R.B.; Schroder, L.J.; Willoughby, T.C.

1989-01-01

A continuing quality-assurance program has been operated by the U.S. Geographical Survey to evaluate any bias introduced by routine handling, shipping, and laboratory analyses of wet-deposition samples collected in the National Atmospheric Deposition Program (NADP) and National Trends Network (NTN). Blind-audit samples having a variety of constituent concentrations and values were selected. Only blind-audit samples with constituent concentrations and values less than the 95th-percentile concentration for natural wet-deposition samples were included in the analysis. Of the major ions, there was a significant increase of Ca2+, Mg2+, K+ SO42+ and Cl- in samples handled according to standard protocols and shipped in NADP/NTN sample-collection buckets. For 1979-1987, graphs of smoothed data showing the estimated contaminations in blind-audit samples indicate a decrease in the median concentration and ranges of Ca2+, Mg2+ and SO42- contamination of blind-audit samples shipped in sample-collection buckets. Part of the contamination detected in blind-audit samples can be attributed to contact with the sample-collection bucket and lid; however, additional sources also seem to contaminate the blind-audit sample. Apparent decreases in the magnitude and range of sample contamination may be caused by differences in sample-collection bucket- and lid-washing procedures by the NADP/NTN Central Analytical Laboratory. Although the degree of bias is minimal for most constituents, summaries of the NADP/NTN data base may contain overestimates of Ca2+, Mg2+, Na-, K+, SO42- and Cl- concentrations, and underestimates of H+ concentrations.

Financial Audit Guide: Auditing the Statement of Budgetary Resources

DTIC Science & Technology

2001-12-01

financial reporting should assist in fulfilling the government’s duty to be publicly accountable for moneys raised from the public and for their expenditure in accordance with applicable laws that establish the budget and other related laws and regulations. As a means to help achieve this objective, beginning with fiscal year 1998, executive agencies subject to the Chief Financial Officers (CFO) Act of 1990, as expanded by the Government Management Reform Act of 1994, were each required to prepare and submit for audit a Statement of Budgetary Resources (SBR) in

32 CFR 37.1010 - What substantive issues should my award document address?

Code of Federal Regulations, 2010 CFR

2010-07-01

... advances. For an expenditure-based TIA, your payment provision must require the return of interest should... § 37.830. (l) Audits. If your TIA is an expenditure-based award, you must include an audit provision... through 37.905. (p) Assurances for applicable national policy requirements. You must incorporate...

75 FR 61232 - RIEF RMP LLC and Renaissance Technologies LLC; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-04

... for federal and state income tax purposes. \\2\\ ``Audit'' shall have the meaning defined in rule 1-02(d... Pooled Investment Vehicles' registered public accountant shall semi- annually reconcile the prime broker... Vehicle audited by the Pooled Investment Vehicle's independent public accountants. At the end of each...

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...

10 CFR Appendix A to Part 600 - Generally Applicable Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

... Competitive Practices Act of 1974 (49 U.S.C. 1517). Executive Order 12138, “Creating a National Women's... National Program for Women's Business Enterprise,” (May 18, 1979) 3 CFR 1979 Comp., p. 393. Sec. 403(b... Audit at Educational Institutions. OMB Circular A-73, Audit of Federal Operations and Programs. Single...

A Prospective Multi-Center Audit of Nutrition Support Parameters Following Burn Injury.

PubMed

Kurmis, Rochelle; Heath, Kathryn; Ooi, Selena; Munn, Zachary; Forbes, Sharon; Young, Vicki; Rigby, Paul; Wood, Kate; Phillips, Frances; Greenwood, John

2015-01-01

The importance of nutrition support delivery to the severe burn-injured patient is well recognized, however, nutrition provision to the patient may be sub optimal in practice. The aim of this study was to conduct a prospective multi-center audit across Australia and New Zealand using the Joanna Briggs Institute Burns Node Nutrition audit criteria. Thirty-four patients with severe burn injury (≥20% TBSA in adults and ≥10% TBSA in children) were identified on admission or on referral to the Dietitian at the eight participating Burn Units between February 1, 2012 and April 30, 2012 for inclusion in the study. De-identified patient data was analyzed using the Joanna Briggs Institute, Practical Application of Clinical Evidence System. Compliance with individual audit criterion ranged from 33 to 100%. Provision of prescribed enteral feed volumes and weekly weighing of patients were highlighted as key areas for clinical improvement. Clinical audit is a valuable tool for evaluating current practice against best evidence to ensure that quality patient care is delivered. The use of the Joanna Briggs Institute Burns Node audit criteria has allowed for a standardized multi-center audit to be conducted. Improving nutrition support delivery in burn patients was identified as a key area requiring ongoing clinical improvement across Australia and New Zealand. Clinician feedback on use of the audit criteria will allow for future refinement of individual criterion, and presentation of results of this audit has resulted in a review of the Bi-National Burns Registry nutrition quality indicators.

Performing Memorable Monologues.

ERIC Educational Resources Information Center

Ratliff, Gerald Lee

From the director's point of view, a "memorable monologue" is one in which the actor exhibits imagination and invention in role-playing. Memorable audition monologues require a measured degree of "risk taking" and uninhibited abandon--the first task is to select monologues that suit the type of script and the role being cast.…

38 CFR 21.4200 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... grants a post-secondary degree. (4) An educational institution which: (i) Is not located in a State, (ii... grade point average, for example. For this reason it is not the same as an audited course, since it does... course, (vii) A cooperative course, or (viii) A graduate program of research in absentia. (2) The...

38 CFR 21.4200 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... grants a post-secondary degree. (4) An educational institution which: (i) Is not located in a State, (ii... grade point average, for example. For this reason it is not the same as an audited course, since it does... course, (vii) A cooperative course, or (viii) A graduate program of research in absentia. (2) The...

38 CFR 21.4200 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... grants a post-secondary degree. (4) An educational institution which: (i) Is not located in a State, (ii... grade point average, for example. For this reason it is not the same as an audited course, since it does... course, (vii) A cooperative course, or (viii) A graduate program of research in absentia. (2) The...

38 CFR 21.4200 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... grants a post-secondary degree. (4) An educational institution which: (i) Is not located in a State, (ii... grade point average, for example. For this reason it is not the same as an audited course, since it does... course, (vii) A cooperative course, or (viii) A graduate program of research in absentia. (2) The...

38 CFR 21.4200 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... grants a post-secondary degree. (4) An educational institution which: (i) Is not located in a State, (ii... grade point average, for example. For this reason it is not the same as an audited course, since it does... course, (vii) A cooperative course, or (viii) A graduate program of research in absentia. (2) The...

Theater-Level Stochastic Air-to-Air Engagement Modeling via Event Occurrence Networks Using Piecewise Polynomial Approximation

DTIC Science & Technology

2001-09-01

diagnosis natural language understanding circuit fault diagnosis pattern recognition machine vision nancial auditing map learning sensor... ACCA ACCB A ights degree of command and control FCC value is assumed to be the average of all the ACC values of the aircraft in the

Electronic health records and online medical records: an asset or a liability under current conditions?

PubMed

Allen-Graham, Judith; Mitchell, Lauren; Heriot, Natalie; Armani, Roksana; Langton, David; Levinson, Michele; Young, Alan; Smith, Julian A; Kotsimbos, Tom; Wilson, John W

2018-02-01

Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records. This causes inefficiencies in the recall of patient information and can potentially lead to incidences of adverse drug events. What does this paper add? This paper supports the concept of a shared medical record system using 200 audited patient records across five Victorian metropolitan hospitals, comparing the current information systems in place for healthcare practitioners to retrieve data. This research identifies the degree of concordance between these sources of information and in doing so, areas for improvement. What are the implications for practitioners? Implications of this research are the improvements in the quality, storage and accessibility of medical data in Australian healthcare systems. This is a relevant issue in the current Australian environment where no guidelines exist across the board in medical history documentation or in the distribution of discharge summaries to other healthcare providers (general practitioners, etc).

Controls Over Application Software Supporting the Navy’s Inventories Held for Sale (NET)

DTIC Science & Technology

1994-12-30

This audit was made in support of the audit of the FY 1994 consolidated financial statements for the Navy’s Defense Business Operations Fund (the...Wholesale inventories of $18.2 billion, classified as Inventories Held for Sale (Net), were reported on the Navy’s consolidated financial statements for

A Real-Life Case Study of Audit Interactions--Resolving Messy, Complex Problems

ERIC Educational Resources Information Center

Beattie, Vivien; Fearnley, Stella; Hines, Tony

2012-01-01

Real-life accounting and auditing problems are often complex and messy, requiring the synthesis of technical knowledge in addition to the application of generic skills. To help students acquire the necessary skills to deal with these problems effectively, educators have called for the use of case-based methods. Cases based on real situations (such…

Minimally invasive surgery for pedal digital deformity: an audit of complications using national benchmark indicators.

PubMed

Gilheany, Mark; Baarini, Omar; Samaras, Dean

2015-01-01

There is increasing global interest and performance of minimally invasive foot surgery (MIS) however, limited evidence is available in relation to complications associated with MIS for digital deformity correction. The aim of this prospective audit is to report the surgical and medical complications following MIS for digital deformity against standardised clinical indicators. A prospective clinical audit of 179 patients who underwent MIS to reduce simple and complex digital deformities was conducted between June 2011 and June 2013. All patients were followed up to a minimum of 12 months post operatively. Data was collected according to a modified version of the Australian Council of Healthcare standards (ACHS) clinical indicator program. The audit was conducted in accordance with the National Research Ethics Service (NRES) guidelines on clinical audit. The surgical complications included 1 superficial infection (0.53%) and 2 under-corrected digits (0.67%), which required revision surgery. Two patients who underwent isolated complex digital corrections had pain due to delayed union (0.7%), which resolved by 6 months post-op. No neurovascular compromise and no medical complications were encountered. The results compare favourably to rates reported in the literature for open reduction of digital deformity. This audit has illustrated that performing MIS to address simple and complex digital deformity results in low complication rates compared to published standards. MIS procedures were safely performed in a range of clinical settings, on varying degrees of digital deformity and on a wide range of ages and health profiles. Further studies investigating the effectiveness of these techniques are warranted and should evaluate long term patient reported outcome measures, as well as developing treatment algorithms to guide clinical decision making.

Large-scale implementation of enhanced recovery programs after surgery. A francophone experience.

PubMed

Veziant, J; Raspado, O; Entremont, A; Joris, J; Pereira, B; Slim, K

2017-06-01

Enhanced recovery after surgery program (ERP) has now surpassed the stage of clinical research in certain specialties and currently poses the problematic of large-scale implementation. The goal of this study was to report the experience during the first year of implementation in three French-speaking countries. This is a prospective study in which 67 healthcare centers, all registered in the Grace-Audit databank, participated. Included were patients undergoing colorectal (CRS), bariatric (BS) and orthopedic hip and knee surgery (OS), performed within an ERP. The main endpoints were duration of hospital stay, postoperative morbidity, the degree of compliance with the elements of the ERP, the relation between the extent of application of the elements and postoperative hospital stay, and finally the completeness of data inclusions in the databank. A total of 1904 patients were included in the Grace-Audit databank between January 1, 2015 and January 31, 2016, undergoing CRS (n=490), BS (n=431), and OS (n=983). The mean implementation rate was 83.7±10.0% for CRS, 75.0±23.7% for BS, and 83.5±14.9% for OS. The duration of hospital stay was 6.5 days for CRS, 2.6 days for BS and 3.4 days for OS. Overall postoperative morbidity (onset of postoperative undesirable event), surgical morbidity (superficial or deep organ space surgical site complications such as bleeding, infection or defective healing) and readmission rates were 20.6%, 7.5%, and 5.7% for CRS; 2.5%, 1.4%, and 1.6% for BS and 2.9%, 0.2%, and 2% for OS, respectively. A statistically significant relationship was found between the degree of compliance of the elements of ERP and the duration of hospital stay for CRS and BS; hospital stay was reduced when at least 15 of the 22 elements of the program were applied (P<0.001). The patients included in the Grace-Audit databank represented less than 20% of the patients undergoing operation in the same establishments during the study period for all three specialties. This study shows that large-scale ERPs are feasible and safe in French-speaking countries. Nonetheless, although encouraging, these preliminary results highlight that implementation must be improved in specialties such as bariatric surgery and that more complete data collection is needed. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Transfusion audit of fresh-frozen plasma in southern Taiwan.

PubMed

Yeh, C-J; Wu, C-F; Hsu, W-T; Hsieh, L-L; Lin, S-F; Liu, T-C

2006-10-01

The demand for transfusions has increased rapidly in southern Taiwan. Between 1993 and 2003, requests for fresh-frozen plasma (FFP) in particular rose dramatically at Kaohsiung Medical University Hospital (KMUH). Transfusion orders were not tightly regulated, and inappropriate use of blood products was common. We carried out a prospective analysis of transfusion requests from October 2003 to January 2004 at KMUH, and then repeated the audit for another 3-month period after the clinical faculty had undergone five sessions of education on transfusion guidelines. Later, our consultant haematologist applied computerized guidelines to periodic audits. A 5.2% decrease in inappropriate FFP usage followed the educational programme and a further 30% reduction took place after the application of computerized transfusion guidelines. With the guidelines and periodic audits, FFP transfusions decreased by 74.6% and inappropriate requests from 65.2% to 30%. Hospital policy, computerized transfusion guidelines and periodic audits greatly reduced inappropriate FFP transfusions. An educational campaign had a more limited effect.

Resident participation in neighbourhood audit tools — a scoping review

PubMed Central

Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

2018-01-01

Abstract Background Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. Methods A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. Results In total, 13 participatory instruments were identified. The role of residents in most instruments was as ‘data collectors’; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. Conclusions The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. PMID:29346663

Resident participation in neighbourhood audit tools - a scoping review.

PubMed

Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

2018-02-01

Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. In total, 13 participatory instruments were identified. The role of residents in most instruments was as 'data collectors'; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Ethical dilemmas of a large national multi-centre study in Australia: time for some consistency.

PubMed

Driscoll, Andrea; Currey, Judy; Worrall-Carter, Linda; Stewart, Simon

2008-08-01

To examine the impact and obstacles that individual Institutional Research Ethics Committee (IRECs) had on a large-scale national multi-centre clinical audit called the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study. Multi-centre research is commonplace in the health care system. However, IRECs continue to fail to differentiate between research and quality audit projects. The National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes study used an investigator-developed questionnaire concerning a clinical audit for heart failure programmes throughout Australia. Ethical guidelines developed by the National governing body of health and medical research in Australia classified the National Benchmarks and Evidence-based National Clinical guidelines for Heart failure management programmes Study as a low risk clinical audit not requiring ethical approval by IREC. Fifteen of 27 IRECs stipulated that the research proposal undergo full ethical review. None of the IRECs acknowledged: national quality assurance guidelines and recommendations nor ethics approval from other IRECs. Twelve of the 15 IRECs used different ethics application forms. Variability in the type of amendments was prolific. Lack of uniformity in ethical review processes resulted in a six- to eight-month delay in commencing the national study. Development of a national ethics application form with full ethical review by the first IREC and compulsory expedited review by subsequent IRECs would resolve issues raised in this paper. IRECs must change their ethics approval processes to one that enhances facilitation of multi-centre research which is now normative process for health services. The findings of this study highlight inconsistent ethical requirements between different IRECs. Also highlighted are the obstacles and delays that IRECs create when undertaking multi-centre clinical audits. However, in our clinical practice it is vital that clinical audits are undertaken for evaluation purposes. The findings of this study raise awareness of inconsistent ethical processes and highlight the need for expedient ethical review for clinical audits.

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…

Core Issues: Reflections on Sustainability in Australian University Coursework Programs

ERIC Educational Resources Information Center

Sherren, Kate

2006-01-01

Purpose: In addition to mapping the consistency in rhetoric behind education for sustainability, despite changes in jargon over the past 30 years, this paper endeavours to estimate the degree to which these ideas have been integrated into the Australian tertiary sector. Design/methodology/approach: The results of a recent internet-based audit of…

Gestalt Revisited: Spin-Offs and Assessment in International University Co-Operation

ERIC Educational Resources Information Center

Denman, Brian D.

2004-01-01

International university co-operation is in a constant state of metamorphosis. Its future rests upon extraneous forces such as globalization and internationalization and also upon those who make policy decisions. Many international university organizations are auditing their programs and initiatives to such a degree that the cost effectiveness of…

Redesigning a Curriculum for Inquiry: An Ecology Case Study

ERIC Educational Resources Information Center

Spronken-Smith, R. A.; Walker, R.; Dickinson, K. J. M.; Closs, G. P.; Lord, J. M.; Harland, T.

2011-01-01

This article reports on an interdisciplinary ecology degree that was redesigned to provide more research activity for undergraduates. A case study approach explored how the teaching team constructed a curriculum that used inquiry activities. The development of an inquiry curriculum was enabled by a University audit focusing on the links between…

Clinical radiotherapy audits in Belgium, 2011-2014.

PubMed

Scalliet, P G M

2015-10-01

Systematic clinical radiotherapy audits have been introduced in Belgium in 2011, as part of the Federal Cancer Plan. This is in compliance with article 11 of the 97/43 Council directive of Euratom states, translated into the Belgian legislation by royal decree in 2002. The principle of clinical audits has thus been part of the federal legal requirements for more than 10 years. However, its application had to wait for the development of a practical approach: what authority will audit, who will be the auditors, along which methodology, at what frequency, etc. Since 2002, the Federal College of Radiotherapy has the mission to monitor quality of radiotherapy at large. It was therefore decided after discussions with the relevant administration at the Ministry of Health and the Federal Agency for Nuclear Control that the College would practically organise the audits. Early in the 2000s, the IAEA developed a manual for comprehensive audits, as a tool for quality improvement. Auditors were professionals of the domain and the audit visit took the form of a peer review. Great care was taken to assemble an audit party able to cover all aspects of clinical radiotherapy with a radiation oncologist, a medical physicist, a radiation therapist and, on demand, a quality officer. The IAEA manual contains a series of questionnaires to be prepared by the audited centre in advance (pre-audit and self-assessment), indicating what specific areas the auditors would assess. It is also a template for the auditors, ensuring that no area is left aside or forgotten during the site visit. The report, at the end of the visit, is drafted according to a specific report template, also developed by IAEA. Several members of the Belgian radiotherapy community have developed their auditor's skills by participating to the IAEA audit program; they are the core of the auditor Belgian team. Copyright © 2015 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

The Functional Resonance Analysis Method for a systemic risk based environmental auditing in a sinter plant: A semi-quantitative approach

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

Patriarca, Riccardo, E-mail: riccardo.patriarca@uniroma1.it; Di Gravio, Giulio; Costantino, Francesco

Environmental auditing is a main issue for any production plant and assessing environmental performance is crucial to identify risks factors. The complexity of current plants arises from interactions among technological, human and organizational system components, which are often transient and not easily detectable. The auditing thus requires a systemic perspective, rather than focusing on individual behaviors, as emerged in recent research in the safety domain for socio-technical systems. We explore the significance of modeling the interactions of system components in everyday work, by the application of a recent systemic method, i.e. the Functional Resonance Analysis Method (FRAM), in order tomore » define dynamically the system structure. We present also an innovative evolution of traditional FRAM following a semi-quantitative approach based on Monte Carlo simulation. This paper represents the first contribution related to the application of FRAM in the environmental context, moreover considering a consistent evolution based on Monte Carlo simulation. The case study of an environmental risk auditing in a sinter plant validates the research, showing the benefits in terms of identifying potential critical activities, related mitigating actions and comprehensive environmental monitoring indicators. - Highlights: • We discuss the relevance of a systemic risk based environmental audit. • We present FRAM to represent functional interactions of the system. • We develop a semi-quantitative FRAM framework to assess environmental risks. • We apply the semi-quantitative FRAM framework to build a model for a sinter plant.« less

An Overview of Ecological Footprinting and Other Tools and Their Application to the Development of Sustainability Process: Audit and Methodology at Holme Lacy College, UK

ERIC Educational Resources Information Center

Dawe, Gerald F. M.; Vetter, Arnie; Martin, Stephen

2004-01-01

A sustainability audit of Holme Lacy College is described. The approach adopted a "triple bottom line" assessment, comprising a number of key steps: a scoping review utilising a revised Royal Institution of Chartered Surveyors project appraisal tool; an environmental impact assessment based on ecological footprinting and a social and…

Management Auditing. Evaluation of the Marine Corps Task Analysis Program. Technical Report No. 5.

ERIC Educational Resources Information Center

Hemphill, John M., Jr.; Yoder, Dale

The management audit is described for possible application as an extension of the mission of the Office of Manpower Utilization (OMU) of the U.S. Marine Corps. The present mission of OMU is viewed as a manpower research program to conduct task analysis of Marine Corps occupational fields. Purpose of the analyses is to improve the functional areas…

Audit Log for Forensic Photography

NASA Astrophysics Data System (ADS)

Neville, Timothy; Sorell, Matthew

We propose an architecture for an audit log system for forensic photography, which ensures that the chain of evidence of a photograph taken by a photographer at a crime scene is maintained from the point of image capture to its end application at trial. The requirements for such a system are specified and the results of experiments are presented which demonstrate the feasibility of the proposed approach.

Comparison of the Victorian Audit of Surgical Mortality with coronial cause of death.

PubMed

Hansen, Dylan; Retegan, Claudia; Woodford, Noel; Vinluan, Jessele; Beiles, Charles B

2016-06-01

The Victorian Audit of Surgical Mortality (VASM) is designed to improve the level of patient care by educating surgeons of areas for improvement in patient management during a surgical admission. Coronial data obtained via the National Coronial Information System were used as an independent method to validate the cause of death as determined by the treating surgeon. The audit prospectively collected 4905 cases that underwent peer assessment and 842 (17%) received an in-depth second-line assessment of which 200 (24%) also underwent a coronial review. Using the coronial assessment as the reference standard, retrospective comparison of coronial diagnoses compared with the audit case outcomes was conducted to determine the overall accuracy of the stated cause of death. The degree of agreement was also analysed based on whether the patient received a full autopsy (internal examination) or an external examination only. The time taken to obtain the coronial and audit case closure was also analysed. Overall, 195 of the 200 cases had a cause of death identified by the coroner. In 82%, the cause of death reported to VASM by the treating surgeon matched the cause of death determined by the coroner. Concordance was not affected by the extent of post-mortem performed. Time taken to finalize cases was slightly shorter for the coronial process, but unclosed coronial findings resulted in the exclusion of 103 cases. The causes of death data in VASM are accurate when compared with the coronial data independent of whether the coronial investigation included a complete autopsy. © 2015 Royal Australasian College of Surgeons.

Effectiveness of Online Advising on Honors Student Retention and Engagement

ERIC Educational Resources Information Center

VanDieren, Monica

2016-01-01

Academic advising is an important component of a student's education, and more often universities are turning to technology to aid in this task. This paper presents a case study of an online advising system that complements a university degree audit system by providing honors students and advisors up-to-date details on individual progress towards…

The E-Portfolio Continuum: Discovering Variables for E-Portfolio Adoption within Music Education

ERIC Educational Resources Information Center

Taylor, John; Dunbar-Hall, Peter; Rowley, Jennifer

2012-01-01

This article presents the results of audit data compiled from a case study introducing e-portfolios into a Music Education degree program, and highlights the key challenges faced from the initial stages of student use to curricular embedding and student adoption. This article discusses the technological, social and educational impacts inherent in…

Spacecraft System Integration and Test: SSTI Lewis critical design audit

NASA Technical Reports Server (NTRS)

Brooks, R. P.; Cha, K. K.

1995-01-01

The Critical Design Audit package is the final detailed design package which provides a comprehensive description of the SSTI mission. This package includes the program overview, the system requirements, the science and applications activities, the ground segment development, the assembly, integration and test description, the payload and technology demonstrations, and the spacecraft bus subsystems. Publication and presentation of this document marks the final requirements and design freeze for SSTI.

Stage call: Cardiovascular reactivity to audition stress in musicians

PubMed Central

Chanwimalueang, Theerasak; Aufegger, Lisa; Adjei, Tricia; Wasley, David; Cruder, Cinzia; Mandic, Danilo P.

2017-01-01

Auditioning is at the very center of educational and professional life in music and is associated with significant psychophysical demands. Knowledge of how these demands affect cardiovascular responses to psychosocial pressure is essential for developing strategies to both manage stress and understand optimal performance states. To this end, we recorded the electrocardiograms (ECGs) of 16 musicians (11 violinists and 5 flutists) before and during performances in both low- and high-stress conditions: with no audience and in front of an audition panel, respectively. The analysis consisted of the detection of R-peaks in the ECGs to extract heart rate variability (HRV) from the notoriously noisy real-world ECGs. Our data analysis approach spanned both standard (temporal and spectral) and advanced (structural complexity) techniques. The complexity science approaches—namely, multiscale sample entropy and multiscale fuzzy entropy—indicated a statistically significant decrease in structural complexity in HRV from the low- to the high-stress condition and an increase in structural complexity from the pre-performance to performance period, thus confirming the complexity loss theory and a loss in degrees of freedom due to stress. Results from the spectral analyses also suggest that the stress responses in the female participants were more parasympathetically driven than those of the male participants. In conclusion, our findings suggest that interventions to manage stress are best targeted at the sensitive pre-performance period, before an audition begins. PMID:28437466

The application of DEA model in enterprise environmental performance auditing

NASA Astrophysics Data System (ADS)

Li, F.; Zhu, L. Y.; Zhang, J. D.; Liu, C. Y.; Qu, Z. G.; Xiao, M. S.

2017-01-01

As a part of society, enterprises have an inescapable responsibility for environmental protection and governance. This article discusses the feasibility and necessity of enterprises environmental performance auditing and uses DEA model calculate the environmental performance of Haier for example. The most of reference data are selected and sorted from Haier’s environmental reportspublished in 2008, 2009, 2011 and 2015, and some of the data from some published articles and fieldwork. All the calculation results are calculated by DEAP software andhave a high credibility. The analysis results of this article can give corporate managements an idea about using environmental performance auditing to adjust their corporate environmental investments capital quota and change their company’s environmental strategies.

7 CFR 4280.190 - EA/REDA grant applications-content.

Code of Federal Regulations, 2012 CFR

2012-01-01

... America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.190 EA/REDA...) Applicant's experience as follows: (i) If applying for a renewable energy development assistance grant, the applicant's experience in completing similar renewable energy development assistance activities, including...

7 CFR 4280.190 - EA/REDA grant applications-content.

Code of Federal Regulations, 2013 CFR

2013-01-01

... America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.190 EA/REDA...) Applicant's experience as follows: (i) If applying for a renewable energy development assistance grant, the applicant's experience in completing similar renewable energy development assistance activities, including...

7 CFR 4280.190 - EA/REDA grant applications-content.

Code of Federal Regulations, 2014 CFR

2014-01-01

... America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.190 EA/REDA...) Applicant's experience as follows: (i) If applying for a renewable energy development assistance grant, the applicant's experience in completing similar renewable energy development assistance activities, including...

A risk-based approach to scheduling audits.

PubMed

Rönninger, Stephan; Holmes, Malcolm

2009-01-01

The manufacture and supply of pharmaceutical products can be a very complex operation. Companies may purchase a wide variety of materials, from active pharmaceutical ingredients to packaging materials, from "in company" suppliers or from third parties. They may also purchase or contract a number of services such as analysis, data management, audit, among others. It is very important that these materials and services are of the requisite quality in order that patient safety and company reputation are adequately protected. Such quality requirements are ongoing throughout the product life cycle. In recent years, assurance of quality has been derived via audit of the supplier or service provider and by using periodic audits, for example, annually or at least once every 5 years. In the past, companies may have used an audit only for what they considered to be "key" materials or services and used testing on receipt, for example, as their quality assurance measure for "less important" supplies. Such approaches changed as a result of pressure from both internal sources and regulators to the time-driven audit for all suppliers and service providers. Companies recognised that eventually they would be responsible for the quality of the supplied product or service and audit, although providing only a "snapshot in time" seemed a convenient way of demonstrating that they were meeting their obligations. Problems, however, still occur with the supplied product or service and will usually be more frequent from certain suppliers. Additionally, some third-party suppliers will no longer accept routine audits from individual companies, as the overall audit load can exceed one external audit per working day. Consequently a different model is needed for assessing supplier quality. This paper presents a risk-based approach to creating an audit plan and for scheduling the frequency and depth of such audits. The approach is based on the principles and process of the Quality Risk Management guideline (ICH Q9) of the International Conference on Harmonisation (ICH). It proposes that if regulatory conditions allow, it may be possible to remove the need to conduct audits on the sole basis of time elapsed since the last audit, or at least to increase the time interval between such audits without compromising either patient safety or company reputation. The proposal is equally applicable to both large and small companies. Small companies may find it particularly useful in cases where they use a supplier that may have a monopoly position or that serves many other pharmaceutical companies. In such circumstances the supplier may be reluctant or even refuse to accept audits from some individual companies because of their low purchasing levels. A similar approach could be proposed for regulatory authorities for the scheduling of regulatory inspections.

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.

Identifying hazardous alcohol consumption during pregnancy: implementing a research-based model in real life.

PubMed

Göransson, Mona; Magnusson, Asa; Heilig, Markus

2006-01-01

It has been repeatedly demonstrated that hazardous alcohol use during pregnancy is rarely detected in regular antenatal care, and that detection can be markedly improved using systematic screening. A major challenge is to translate research-based strategies into regular antenatal care. Here, we examined whether a screening strategy using the Alcohol Use Disorder Test (AUDIT) and time-line follow-back (TLFB) could be implemented under naturalistic conditions and within available resources; and whether it would improve detection to the extent previously shown in a research context. Regular midwives at a large antenatal care clinic were randomized to receive brief training and then implement AUDIT and TLFB ("intervention"); or to a waiting-list control group continuing to deliver regular care ("control"). In the intervention-condition, AUDIT was used to collect data about alcohol use during the year preceding pregnancy, and TLFB to assess actual consumption during the first trimester. Data were collected from new admissions over 6 months. Drop out was higher among patients of the intervention group than control midwives, 14% (23/162) versus 0% (0/153), and p<0.0001. A one-day training session combined with continuous expert support was sufficient to implement systematic screening with AUDIT and TLFB largely within resources of regular antenatal care. The use of these instruments identified patients with hazardous consumption during the year preceding pregnancy i.e. AUDIT score 6 or higher (17%, 23/139), and patients with ongoing consumption exceeding 70 g/week and/or binge consumption according to TLFB (17%, 24/139), to a significantly higher degree than regular antenatal screening (0/162). The AUDIT- and TLFB-positive populations overlapped partially, with 36/139 subjects screening positive with either of the instrument and 11/139 were positive for both. We confirm previous findings that alcohol use during pregnancy is more extensive in Sweden than has generally been realized. Systematic screening using AUDIT and TLFB detects hazardous use in a manner which regular antenatal care does not. This remains true under naturalistic conditions, following minimal training of regular antenatal care staff, and can be achieved with minimal resources. The proposed strategy appears attractive for broad implementation.

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. ...

An audit of diabetes care at 3 centres in Alexandria.

PubMed

Abou El-Enein, N Y; Abolfotouh, M A

2008-01-01

Selected indicators for structure, process and outcome of care were used to audit diabetes care in 3 centres in Alexandria. Structure was poor: main problems included absence of appointment and recall system, deficiencies in laboratory resources and lack of educational material. Process of care was poor for 69.2% of patients: deficiencies included absence of essential information in records and missing some essential clinical examinations. Degree of control was poor for 49.2% of patients and only 30.6% had no complications. Compliance to appointment was good for about 80% of patients. Better outcome (fewer complications and higher compliance) was significantly associated with poor process of care. This cannot, however, be considered a valid predictor of outcome as good care might be initiated by the presence of complications.

14 CFR 248.1 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Applicability. 248.1 Section 248.1 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC REGULATIONS SUBMISSION OF AUDIT REPORTS § 248.1 Applicability. The requirements of this part shall be...

46 CFR 296.3 - Applications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SECURITY PROGRAM (MSP) Introduction § 296.3 Applications. (a) Action by MARAD—Time Deadlines. Applications... or other governing instruments; (4) Maritime related affiliations; (5) Financial data: (i) Provide an audited financial statement or a completed MARAD Form MA-172 dated within 120 days after the close of the...

45 CFR 96.16 - Applicability of title XVII of the Reconciliation Act (31 U.S.C. 7301-7305).

Code of Federal Regulations, 2011 CFR

2011-10-01

... health services block grant is not subject to any requirements of 31 U.S.C. 7301-7305. (d) The social services and low-income home energy assistance programs are subject only to 31 U.S.C. 7304. (e) The audit provisions of 31 U.S.C. 7305 have, in most cases, been overridden by the Single Audit Act. Pub. L. 98-502, 31...

Application of an Operational Audit Model in a Not For Profit Hospital

DTIC Science & Technology

1993-12-01

Advisor David R. Whipple, Chairman Department of Administrative Sciences ii AIITRCT This thesis has examined various problems facing the not- for...the interviewee and more closely gauge the validity of the comments. ( Fetterman , 1986) As the auditor sifts through bits and pieces of conversations... Fetterman , D.M., "Operational Auditing: A Cultural Approach," The Internal Auditor, April 1986, pp. 48-54. Fisher, J., How to Manage a Nonprofit

Audit of the internal controls over the processing of oil overcharge refunds

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

Not Available

1992-03-31

This report is on internal controls over the processing of oil overcharge refunds. The Office of Hearings and Appeals administers the distribution of refunds to parties that were overcharged during the period of petroleum price controls. The refund process was initiated in 1979. As of September 30, 1991, Hearings and Appeals had received over 200,000 applications for refunds. It had granted refunds with a total value of more than 600 million on about 160,000 applications, with 26,636 applications pending. The objectie of the audit was to evaluate the adequacy of Hearings and Appeals' internal controls over refund practices and procedures,more » specifically those used to ensure that claims approved were complete, systematically processed, and properly distributed.« less

Audit of the internal controls over the processing of oil overcharge refunds

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

Not Available

1992-03-31

This report is on internal controls over the processing of oil overcharge refunds. The Office of Hearings and Appeals administers the distribution of refunds to parties that were overcharged during the period of petroleum price controls. The refund process was initiated in 1979. As of September 30, 1991, Hearings and Appeals had received over 200,000 applications for refunds. It had granted refunds with a total value of more than 600 million on about 160,000 applications, with 26,636 applications pending. The objectie of the audit was to evaluate the adequacy of Hearings and Appeals` internal controls over refund practices and procedures,more » specifically those used to ensure that claims approved were complete, systematically processed, and properly distributed.« less

How Accurately Do Consecutive Cohort Audits Predict Phase III Multisite Clinical Trial Recruitment in Palliative Care?

PubMed

McCaffrey, Nikki; Fazekas, Belinda; Cutri, Natalie; Currow, David C

2016-04-01

Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actual participating sites and recruitment to four Phase III multisite clinical RCTs. The proportion of potentially eligible study participants estimated from an inpatient chart review of people with life-limiting illnesses referred to six Australian specialist palliative care services was compared with recruitment data extracted from study prescreening information from three sites that participated fully in four Palliative Care Clinical Studies Collaborative RCTs. The predominant reasons for ineligibility in the audit and RCTs were analyzed. The audit overestimated the proportion of people referred to the palliative care services who could participate in the RCTs (pain 17.7% vs. 1.2%, delirium 5.8% vs. 0.6%, anorexia 5.1% vs. 0.8%, and bowel obstruction 2.8% vs. 0.5%). Approximately 2% of the referral base was potentially eligible for these effectiveness studies. Ineligibility for general criteria (language, cognition, and geographic proximity) varied between studies, whereas the reasons for exclusion were similar between the audit and pain and anorexia studies but not for delirium or bowel obstruction. The retrospective consecutive case note audit in participating sites did not predict realistic recruitment rates, mostly underestimating the impact of study-specific inclusion criteria. These findings have implications for the applicability of the results of RCTs. Prospective pilot studies are more likely to predict actual recruitment. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Advance care planning in the oncology settings.

PubMed

Samara, Juliane; Larkin, David; Chan, Choi Wan; Lopez, Violeta

2013-06-01

Self-determination and patient choice of end-of-life care are emphasised in palliative care. Advance care planning (ACP) is an approach to enabling patients' choices. The use of ACP has not been extensively studied in our current context. Little is known about oncology care nurses' views and the barriers they face in the implementation of ACP. The aims of this study were to assess the uptake of ACP by health professionals and explore nurses' perceived barriers for implementing ACP. This study employed a pre- and post-implementation audit design using the Joanna Briggs Institute (JBI) Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRIP) programs. An education programme on ACP was provided between pre-and post-implementation audits. Nurses and medical professionals (pre-audit, n = 32; post-audit, n = 30) working in oncology departments were invited to complete a questionnaire based on the audit criteria. A convenience sample of 25 nurses participated in the focus group interview. Interview data were analysed by content analysis. The post-audit results were lower than the pre-audit results with a range of decreased compliance from 1% for criterion 5 to 14% for criterion 6. Lack of time to implement ACP was the most frequently raised barrier by oncology nurses. The study findings were disappointing, but this first audit is significant to provide insights for future dissemination and implementation of ACP interventions. An ongoing mandatory professional development programme in ACP for healthcare staff is promising to promote the uptake of ACP in healthcare settings. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

The Importance of Mentoring Novice and Pre-Service Teachers: Findings from a HBCU Student Teaching Program

ERIC Educational Resources Information Center

Hobson, Lisa D.; Harris, Deborah; Buckner-Manley, Kimberley; Smith, Patricia

2012-01-01

Teacher preparation programs across the country have faced criticisms regarding the quality of their programs. Additionally, these programs now compete with non-traditional programs when their graduates seek positions in public schools. As a result of many conversations as well as audits of the degree program at institutions in the state of Texas,…

City University of New York--Availability of Student Computer Resources. Report.

ERIC Educational Resources Information Center

McCall, H. Carl

This audit reports on the availability of computer resources at the City University of New York's (CUNY) senior colleges. CUNY is the largest urban and the third largest public university system in the United States. Of the 19 CUNY campuses located throughout the five boroughs, 11 are senior colleges offering four-year degrees. For the fall 2001…

Observations on the Re-Emergence of a Binary System in UK Universities for Economics Degree Programmes

ERIC Educational Resources Information Center

Talbot, Steve; Reeves, Alan; Johnston, James

2014-01-01

An audit of economics provision shows that over the past decade economics has disappeared from large parts of the UK's higher education landscape, especially the post-1992 universities. In the north of Britain the binary system has effectively re-emerged leaving many potential students unable to study key subjects such as economics. Post-1992…

Intellectual disability health content within nursing curriculum: An audit of what our future nurses are taught.

PubMed

Trollor, Julian N; Eagleson, Claire; Turner, Beth; Salomon, Carmela; Cashin, Andrew; Iacono, Teresa; Goddard, Linda; Lennox, Nicholas

2016-10-01

Individuals with intellectual disability experience chronic and complex health issues, but face considerable barriers to healthcare. One such barrier is inadequate education of healthcare professionals. To establish the quantity and nature of intellectual disability content offered within Australian nursing degree curricula. A two-phase national audit of nursing curriculum content was conducted using an interview and online survey. Australian nursing schools offering pre-registration courses. Pre-registration course coordinators from 31 universities completed the Phase 1 interview on course structure. Unit coordinators and teaching staff from 15 universities in which intellectual disability content was identified completed the Phase 2 online survey. Quantity of compulsory and elective intellectual disability content offered (units and teaching time) and the nature of the content (broad categories, specific topics, and inclusive teaching) were audited using an online survey. Over half (52%) of the schools offered no intellectual disability content. For units of study that contained some auditable intellectual disability content, the area was taught on average for 3.6h per unit of study. Units were evenly distributed across the three years of study. Just three participating schools offered 50% of all units audited. Clinical assessment skills, and ethics and legal issues were most frequently taught, while human rights issues and preventative health were poorly represented. Only one nursing school involved a person with intellectual disability in content development or delivery. Despite significant unmet health needs of people with intellectual disability, there is considerable variability in the teaching of key intellectual disability content, with many gaps evident. Equipping nursing students with skills in this area is vital to building workforce capacity. Crown Copyright © 2016. Published by Elsevier Ltd. 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.

Leveraging OpenStudio's Application Programming Interfaces: Preprint

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

Long, N.; Ball, B.; Goldwasser, D.

2013-11-01

OpenStudio development efforts have been focused on providing Application Programming Interfaces (APIs) where users are able to extend OpenStudio without the need to compile the open source libraries. This paper will discuss the basic purposes and functionalities of the core libraries that have been wrapped with APIs including the Building Model, Results Processing, Advanced Analysis, UncertaintyQuantification, and Data Interoperability through Translators. Several building energy modeling applications have been produced using OpenStudio's API and Software Development Kits (SDK) including the United States Department of Energy's Asset ScoreCalculator, a mobile-based audit tool, an energy design assistance reporting protocol, and a portfolio scalemore » incentive optimization analysismethodology. Each of these software applications will be discussed briefly and will describe how the APIs were leveraged for various uses including high-level modeling, data transformations from detailed building audits, error checking/quality assurance of models, and use of high-performance computing for mass simulations.« less

The PAR index for evaluation of treatment outcomes in orthodontics: a clinical audit of 50 cases.

PubMed

Fadiga, Mohamed Siddick; Diouf, Joseph Samba; Diop Ba, Khady; Gueye, Idrissa; Ngom, Papa Ibrahima; Diagne, Falou

2014-03-01

In the context of this study, a clinical audit of cases treated by a single orthodontist was carried out to illustrate one practical application of the PAR index. Fifty pairs of dental casts taken from the patient group before and at the end of orthodontic treatment were evaluated by an orthodontist trained in the use of the PAR index. This evaluation shows that the average overall PAR score for the subjects included in the study fell from an initial value of 25.64 ± 11.73 points to 1.78 ± 2.79 points at the end of orthodontic treatment. The average reduction attributable to orthodontic treatment was 23.86 ± 0.95 points, for an average percentage reduction of 93.36 ± 9.02%. When cases were classified according to the degree of improvement suggested by the nomogram of the PAR index, 23 (46%) were in the "Improved" category after treatment, and 27 cases (54%) in the "Greatly improved" category. This adds up to a total of 100% in these two categories, with none in the "No better" or "Worse" categories. It should be recalled that a high standard of orthodontic treatment is considered to be reached when the average percentage reduction of the PAR score exceeds 70% and when the number of cases in the "Worse or no better" category is below 5%. Copyright © 2014. Published by Elsevier Masson SAS.

Intertemporal Choice Behavior in Emerging Adults and Adults: Effects of Age Interact with Alcohol Use and Family History Status

PubMed Central

Smith, Christopher T.; Steel, Eleanor A.; Parrish, Michael H.; Kelm, Mary K.; Boettiger, Charlotte A.

2015-01-01

Adults with alcohol use disorders (AUDs) show marked immediate reward selection (or “Now”) bias in intertemporal choice tasks. This Now bias persists long into abstinence, suggesting an irreversible consequence of chronic alcohol abuse or a pre-existing AUD intermediate phenotype. However, some data show substantial Now bias among emerging adults (18–25), regardless of drinking behavior, suggesting age-dependent effects on Now bias. The objectives of the present study were to determine (1) whether Now bias is greater among emerging adults relative to adults, (2) whether any such age effect on Now bias is diminished in sub-clinical heavy alcohol users, and (3) whether having a problem drinking first degree relative is independently associated with elevated Now bias. To achieve these objectives, we used an intertemporal choice task to quantify Now bias in n = 237 healthy participants (ages 18–40; 50% female), and a wide range of non-zero alcohol use, based on the Alcohol Use Disorders Identification Test (AUDIT). We found that among non-heavy drinkers, Now bias inversely correlated with age; this relationship was not present among heavy drinkers. We found no significant relationship between AUDIT score and Now bias among emerging adults, but AUDIT scores and Now bias were positively correlated among 26–40 year olds. Additionally, non-heavy drinking adults who reported a problem drinking first degree relative showed greater Now bias compared to those not reporting familial problem drinking. While not definitive, these findings lend support for elevated Now bias in adulthood as an intermediate phenotype for AUDs. Moreover, non-additive effects of age and heavy drinking on Now bias suggest perturbations in largely common neural circuits in both groups. PMID:26635580

ICAM (Integrated Computer-Aided Manufacturing) Manufacturing Cost/Design Guide. Volume 7. Technology Transfer Summary.

DTIC Science & Technology

1984-09-01

Application Cited Deere and Company e Assist in design of electronic systems for tractors, crawlers, graders, scrapers, etc. Defense Contract Audit Agency . Aid...in developing and enhancing operational audits . DoD, Cameron Station e Conduct affordability analyses; evalu- ate new start systems. DoD, Defense...document productivity gains. e Promotes better inLustry and customer re~latons by providing a common baseline or starting polut for cost vs. perfor- vanz

Applicability of Spares Acquisition Integrated with Production (SAIP) to Naval Aviation Weapon Systems

DTIC Science & Technology

1993-06-01

are listed on ASO BOAs or contracts. Although contractors can be expected to incur some additional costs in making such determinations, this option...Reduction in Administration costs . "* Auditing "* Contracts "* Purchasing (Administration of one P.O. instead of administration of two P.O.s) 3) Cost ... audits revealed several of the procurement "horror stories," moved out ahead of the legislation to improve its spare parts procurement practices. The

5 CFR 950.203 - Public accountability standards.

Code of Federal Regulations, 2010 CFR

2010-01-01

... insure organizations wishing to solicit donations from Federal employees in the workplace are portraying... conducting activities affecting, human health and welfare. The organization's application must provide... organization's most recent annual audited financial statements must be included with the application. The...

Computer-aided auditing of prescription drug claims.

PubMed

Iyengar, Vijay S; Hermiz, Keith B; Natarajan, Ramesh

2014-09-01

We describe a methodology for identifying and ranking candidate audit targets from a database of prescription drug claims. The relevant audit targets may include various entities such as prescribers, patients and pharmacies, who exhibit certain statistical behavior indicative of potential fraud and abuse over the prescription claims during a specified period of interest. Our overall approach is consistent with related work in statistical methods for detection of fraud and abuse, but has a relative emphasis on three specific aspects: first, based on the assessment of domain experts, certain focus areas are selected and data elements pertinent to the audit analysis in each focus area are identified; second, specialized statistical models are developed to characterize the normalized baseline behavior in each focus area; and third, statistical hypothesis testing is used to identify entities that diverge significantly from their expected behavior according to the relevant baseline model. The application of this overall methodology to a prescription claims database from a large health plan is considered in detail.

Optimizing adherence to advice from antimicrobial stewardship audit and feedback rounds.

PubMed

Rawlins, Matthew D M; Sanfilippo, Frank M; Ingram, Paul R; McLellan, Duncan G J; Crawford, Colin; D'Orsogna, Luca; Dyer, John

2018-02-01

We examined adherence to antimicrobial stewardship prospective audit and feedback rounds in a rehabilitation service compared with the remainder of the acute hospital, and explored the reasons for this. Between October 2014 and December 2015, we retrospectively assessed the rate of non-adherence to advice from antimicrobial stewardship prospective audit and feedback rounds between the rehabilitation service and the acute hospital, along with the source of the patient referral. Compared with the rehabilitation service, acute hospital medical staff were almost twice as likely to not adhere to advice provided on antimicrobial stewardship prospective audit and feedback rounds (13.8% vs. 7.6%, p < 0.0001, relative risk 1.8 [95% confidence interval 1.3, 2.5]). In the rehabilitation service, referrals were more likely to come from medical staff (61.9% vs. 16.3%, p < 0.0001). These findings may be explained by regular, direct engagement of the antimicrobial stewardship team with the rehabilitation service clinical team, a model potentially applicable to other settings.

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.

Development and Deployment of the Computer Assisted Neighborhood Visual Assessment System (CANVAS) to Measure Health-Related Neighborhood Conditions

PubMed Central

Bader, Michael D. M.; Mooney, Stephen J.; Lee, Yeon Jin; Sheehan, Daniel; Neckerman, Kathryn M.; Rundle, Andrew G.; Teitler, Julien O.

2014-01-01

Public health research has shown that neighborhood conditions are associated with health behaviors and outcomes. Systematic neighborhood audits have helped researchers measure neighborhood conditions that they deem theoretically relevant but not available in existing administrative data. Systematic audits, however, are expensive to conduct and rarely comparable across geographic regions. We describe the development of an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of neighborhood environments. We use this system to assess the inter-rater reliability of 187 items related to walkability and physical disorder on a national sample of 150 street segments in the United States. We find that many items are reliably measured across auditors using CANVAS and that agreement between auditors appears to be uncorrelated with neighborhood demographic characteristics. Based on our results we conclude that Google Street View and CANVAS offer opportunities to develop greater comparability across neighborhood audit studies. PMID:25545769

Resource Planning in Glaucoma: A Tool to Evaluate Glaucoma Service Capacity.

PubMed

Batra, Ruchika; Sharma, Hannah E; Elaraoud, Ibrahim; Mohamed, Shabbir

2017-12-28

The National Patient Safety Agency (2009) publication advising timely follow-up of patients with established glaucoma followed several reported instances of visual loss due to postponed appointments and patients lost to follow-up. The Royal College of Ophthalmologists Quality Standards Development Group stated that all hospital appointments should occur within 15% of the intended follow-up period. To determine whether: 1. Glaucoma follow-up appointments at a teaching hospital occur within the requested time 2. Appointments are requested at appropriate intervals based on the NICE Guidelines 3. The capacity of the glaucoma service is adequate Methods: A two-part audit was undertaken of 98 and 99 consecutive patients respectively attending specialist glaucoma clinics. In the first part, the reasons for delayed appointments were recorded. In the second part the requested follow-up was compared with NICE guidelines where applicable. Based on the findings, changes were implemented and a re-audit of 100 patients was carried out. The initial audit found that although clinical decisions regarding follow-up intervals were 100% compliant with NICE guidelines where applicable, 24% of appointments were delayed beyond 15% of the requested period, due to administrative errors and inadequate capacity, leading to significant clinical deterioration in two patients. Following the introduction of an electronic appointment tracker and increased clinical capacity created by extra clinics and clinicians, the re-audit found a marked decrease in the percentage of appointments being delayed (9%). This audit is a useful tool to evaluate glaucoma service provision, assist in resource planning for the service and bring about change in a non-confrontational way. It can be widely applied and adapted for use in other medical specialities.

Educational audit on drug dose calculation learning in a Tanzanian school of nursing.

PubMed

Savage, Angela Ruth

2015-06-01

Patient safety is a key concern for nurses; ability to calculate drug doses correctly is an essential skill to prevent and reduce medication errors. Literature suggests that nurses' drug calculation skills should be monitored. The aim of the study was to conduct an educational audit on drug dose calculation learning in a Tanzanian school of nursing. Specific objectives were to assess learning from targeted teaching, to identify problem areas in performance and to identify ways in which these problem areas might be addressed. A total of 268 registered nurses and nursing students in two year groups of a nursing degree programme were the subjects for the audit; they were given a pretest, then four hours of teaching, a post-test after two weeks and a second post-test after eight weeks. There was a statistically significant improvement in correct answers in the first post-test, but none between the first and second post-tests. Particular problems with drug calculations were identified by the nurses / students, and the teacher; these identified problems were not congruent. Further studies in different settings using different methods of teaching, planned continuing education for all qualified nurses, and appropriate pass marks for students in critical skills are recommended.

40 CFR 91.601 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Applicability. 91.601 Section 91.601 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE SPARK-IGNITION ENGINES Selective Enforcement Auditing Regulations § 91.601...

7 CFR 735.100 - Application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Regulations of the Department of Agriculture (Continued) FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... documents must include a current review or an audit-level financial statement prepared according to... applicable licensing agreements. The amount of the bond or financial assurance, net worth, and inspection and...

7 CFR 3575.52 - Processing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... applicable); (iii) Supporting documentation necessary to make an eligibility determination such as financial statements, audits, copies of organizational documents, existing debt instruments, etc.; and (iv...

Collecting various sustainability metrics of observatory operations on Maunakea

NASA Astrophysics Data System (ADS)

Kuo Tiong, Blaise C.; Bauman, Steven E.; Benedict, Romilly; Draughn, John Wesley; Probasco, Quinn

2016-07-01

By collecting metrics in fleet operations, data center usage, employee air travel and facilities consumption at the Canada France Hawaii Telescope, the collective impact of CFHT and other observatories on the Maunakea Astronomy Precinct can be estimated. An audit of carbon emissions in these aspects as well as specific efficiency metrics such as data center Power Use Efficiency gives a general scale of environmental and social alterations. Applications of the audit would be for such things as crafting sustainability strategies.

A Guide for the Perspective Navy Contractor

DTIC Science & Technology

1991-01-01

11. FAR 52.214-26, Audit -Sealed Bidding (APR 1985) (Applicable if award exceeds $100,000) 12. FAR 52.214-27, Price Reduction for Defective Cost or...services in acca . -ce itih theter_ s and conditions. (3) For progress payzents, Goer-ent arowa! shall be deenedd to have occurred on the 5the working day...the event that an audit or other review of a specific financing request is required to ensure compliance with the terms and conditions of the contract

Perception of Simultaneous Auditive Contents

NASA Astrophysics Data System (ADS)

Tschinkel, Christian

Based on a model of pluralistic music, we may approach an aesthetic concept of music, which employs dichotic listening situations. The concept of dichotic listening stems from neuropsychological test conditions in lateralization experiments on brain hemispheres, in which each ear is exposed to a different auditory content. In the framework of such sound experiments, the question which primarily arises concerns a new kind of hearing, which is also conceivable without earphones as a spatial composition, and which may superficially be linked to its degree of complexity. From a psychological perspective, the degree of complexity is correlated with the degree of attention given, with the listener's musical or listening experience and the level of his appreciation. Therefore, we may possibly also expect a measurable increase in physical activity. Furthermore, a dialectic interpretation of such "dualistic" music presents itself.

45 CFR 2519.400 - What must an applicant include in an application for a grant?

Code of Federal Regulations, 2010 CFR

2010-10-01

... information and assurances specified by the Corporation in the grant application package. (c) Assurances that... to the program as may be required for fiscal audits and program evaluation; (2) Comply with the... and protect the rights of those employees; and (4) Comply with any other assurances that the...

28 CFR 100.18 - Audit.

Code of Federal Regulations, 2012 CFR

2012-07-01

... such as disk, tape) or type (e.g., data bases, applications software, data base management software...., date bases, applications software, data base management software, utilities), sufficient to reflect... timeliness of the cost data, the FBI or other representatives of the Government shall have the right to...

28 CFR 100.18 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... such as disk, tape) or type (e.g., data bases, applications software, data base management software...., date bases, applications software, data base management software, utilities), sufficient to reflect... timeliness of the cost data, the FBI or other representatives of the Government shall have the right to...

28 CFR 100.18 - Audit.

Code of Federal Regulations, 2011 CFR

2011-07-01

... such as disk, tape) or type (e.g., data bases, applications software, data base management software...., date bases, applications software, data base management software, utilities), sufficient to reflect... timeliness of the cost data, the FBI or other representatives of the Government shall have the right to...

28 CFR 100.18 - Audit.

Code of Federal Regulations, 2013 CFR

2013-07-01

... such as disk, tape) or type (e.g., data bases, applications software, data base management software...., date bases, applications software, data base management software, utilities), sufficient to reflect... timeliness of the cost data, the FBI or other representatives of the Government shall have the right to...

28 CFR 100.18 - Audit.

Code of Federal Regulations, 2014 CFR

2014-07-01

... such as disk, tape) or type (e.g., data bases, applications software, data base management software...., date bases, applications software, data base management software, utilities), sufficient to reflect... timeliness of the cost data, the FBI or other representatives of the Government shall have the right to...

24 CFR 585.501 - Application of OMB Circulars.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 84 (Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other... CFR part 45 (Audit Requirements for Institutions of Higher Education and other Nonprofit Institutions... Requirements § 585.501 Application of OMB Circulars. (a) The policies, guidelines and requirements of OMB...

24 CFR 585.501 - Application of OMB Circulars.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 84 (Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other... CFR part 45 (Audit Requirements for Institutions of Higher Education and other Nonprofit Institutions... Requirements § 585.501 Application of OMB Circulars. (a) The policies, guidelines and requirements of OMB...

24 CFR 585.501 - Application of OMB Circulars.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 84 (Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other... CFR part 45 (Audit Requirements for Institutions of Higher Education and other Nonprofit Institutions... Requirements § 585.501 Application of OMB Circulars. (a) The policies, guidelines and requirements of OMB...

24 CFR 585.501 - Application of OMB Circulars.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 84 (Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other... CFR part 45 (Audit Requirements for Institutions of Higher Education and other Nonprofit Institutions... Requirements § 585.501 Application of OMB Circulars. (a) The policies, guidelines and requirements of OMB...

24 CFR 585.501 - Application of OMB Circulars.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 84 (Grants and Cooperative Agreements with Institutions of Higher Education, Hospitals, and other... CFR part 45 (Audit Requirements for Institutions of Higher Education and other Nonprofit Institutions... Requirements § 585.501 Application of OMB Circulars. (a) The policies, guidelines and requirements of OMB...

12 CFR 363.3 - Independent public accountant.

Code of Federal Regulations, 2013 CFR

2013-01-01

.... Notwithstanding the requirements set forth in applicable professional standards, the accountant's report must... forth in applicable professional standards, the independent public accountant must report the following on a timely basis to the audit committee: (1) All critical accounting policies and practices to be...

12 CFR 363.3 - Independent public accountant.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... Notwithstanding the requirements set forth in applicable professional standards, the accountant's report must... forth in applicable professional standards, the independent public accountant must report the following on a timely basis to the audit committee: (1) All critical accounting policies and practices to be...

12 CFR 363.3 - Independent public accountant.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... Notwithstanding the requirements set forth in applicable professional standards, the accountant's report must... forth in applicable professional standards, the independent public accountant must report the following on a timely basis to the audit committee: (1) All critical accounting policies and practices to be...

12 CFR 363.3 - Independent public accountant.

Code of Federal Regulations, 2011 CFR

2011-01-01

.... Notwithstanding the requirements set forth in applicable professional standards, the accountant's report must... forth in applicable professional standards, the independent public accountant must report the following on a timely basis to the audit committee: (1) All critical accounting policies and practices to be...

40 CFR 90.501 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Applicability. 90.501 Section 90.501 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NONROAD SPARK-IGNITION ENGINES AT OR BELOW 19 KILOWATTS Selective Enforcement Auditing § 90...

40 CFR 89.501 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Applicability. 89.501 Section 89.501 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM NEW AND IN-USE NONROAD COMPRESSION-IGNITION ENGINES Selective Enforcement Auditing § 89.501...

Computer-supported feedback message tailoring: theory-informed adaptation of clinical audit and feedback for learning and behavior change.

PubMed

Landis-Lewis, Zach; Brehaut, Jamie C; Hochheiser, Harry; Douglas, Gerald P; Jacobson, Rebecca S

2015-01-21

Evidence shows that clinical audit and feedback can significantly improve compliance with desired practice, but it is unclear when and how it is effective. Audit and feedback is likely to be more effective when feedback messages can influence barriers to behavior change, but barriers to change differ across individual health-care providers, stemming from differences in providers' individual characteristics. The purpose of this article is to invite debate and direct research attention towards a novel audit and feedback component that could enable interventions to adapt to barriers to behavior change for individual health-care providers: computer-supported tailoring of feedback messages. We argue that, by leveraging available clinical data, theory-informed knowledge about behavior change, and the knowledge of clinical supervisors or peers who deliver feedback messages, a software application that supports feedback message tailoring could improve feedback message relevance for barriers to behavior change, thereby increasing the effectiveness of audit and feedback interventions. We describe a prototype system that supports the provision of tailored feedback messages by generating a menu of graphical and textual messages with associated descriptions of targeted barriers to behavior change. Supervisors could use the menu to select messages based on their awareness of each feedback recipient's specific barriers to behavior change. We anticipate that such a system, if designed appropriately, could guide supervisors towards giving more effective feedback for health-care providers. A foundation of evidence and knowledge in related health research domains supports the development of feedback message tailoring systems for clinical audit and feedback. Creating and evaluating computer-supported feedback tailoring tools is a promising approach to improving the effectiveness of clinical audit and feedback.

Initial development of a practical safety audit tool to assess fleet safety management practices.

PubMed

Mitchell, Rebecca; Friswell, Rena; Mooren, Lori

2012-07-01

Work-related vehicle crashes are a common cause of occupational injury. Yet, there are few studies that investigate management practices used for light vehicle fleets (i.e. vehicles less than 4.5 tonnes). One of the impediments to obtaining and sharing information on effective fleet safety management is the lack of an evidence-based, standardised measurement tool. This article describes the initial development of an audit tool to assess fleet safety management practices in light vehicle fleets. The audit tool was developed by triangulating information from a review of the literature on fleet safety management practices and from semi-structured interviews with 15 fleet managers and 21 fleet drivers. A preliminary useability assessment was conducted with 5 organisations. The audit tool assesses the management of fleet safety against five core categories: (1) management, systems and processes; (2) monitoring and assessment; (3) employee recruitment, training and education; (4) vehicle technology, selection and maintenance; and (5) vehicle journeys. Each of these core categories has between 1 and 3 sub-categories. Organisations are rated at one of 4 levels on each sub-category. The fleet safety management audit tool is designed to identify the extent to which fleet safety is managed in an organisation against best practice. It is intended that the audit tool be used to conduct audits within an organisation to provide an indicator of progress in managing fleet safety and to consistently benchmark performance against other organisations. Application of the tool by fleet safety researchers is now needed to inform its further development and refinement and to permit psychometric evaluation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Audit of a Scientific Data Center for Certification as a Trustworthy Digital Repository: A Case Study

NASA Astrophysics Data System (ADS)

Downs, R. R.; Chen, R. S.

2011-12-01

Services that preserve and enable future access to scientific data are necessary to ensure that the data that are being collected today will be available for use by future generations of scientists. Many data centers, archives, and other digital repositories are working to improve their ability to serve as long-term stewards of scientific data. Trust in sustainable data management and preservation capabilities of digital repositories can influence decisions to use these services to deposit or obtain scientific data. Building on the Open Archival Information System (OAIS) Reference Model developed by the Consultative Committee for Space Data Systems (CCSDS) and adopted by the International Organization for Standardization as ISO 14721:2003, new standards are being developed to improve long-term data management processes and documentation. The Draft Information Standard ISO/DIS 16363, "Space data and information transfer systems - Audit and certification of trustworthy digital repositories" offers the potential to evaluate digital repositories objectively in terms of their trustworthiness as long-term stewards of digital resources. In conjunction with this, the CCSDS and ISO are developing another draft standard for the auditing and certification process, ISO/DIS 16919, "Space data and information transfer systems - Requirements for bodies providing audit and certification of candidate trustworthy digital repositories". Six test audits were conducted of scientific data centers and archives in Europe and the United States to test the use of these draft standards and identify potential improvements for the standards and for the participating digital repositories. We present a case study of the test audit conducted on the NASA Socioeconomic Data and Applications Center (SEDAC) and describe the preparation, the audit process, recommendations received, and next steps to obtain certification as a trustworthy digital repository, after approval of the ISO/DIS standards.

The energy audit process for universities accommodation in Malaysia: a preliminary study

NASA Astrophysics Data System (ADS)

Dzulkefli Muhammad, Hilmi

2017-05-01

The increase of energy consumption in the Malaysian Universities has raised national concerns due to the fact that its consumption increase government fiscal budget and at the same time contributes negative impacts towards the environment. The purpose of this research is to focus on the process of energy audit conducted in the Malaysian universities and to identify the significant practice that can improve energy consumption of the selected universities. The significant criteria in energy audit may be found by comparing the energy implementation process of selected Malaysian universities through the investigation of energy consumption behavior and the number of electrical appliances, equipment, machinery and buildings activities that have an impact on energy consumption that can improve energy-efficiency in building. The Energy Efficiency Index (EEI) will be used as an indicator and combined with the suggested application of HOMER software to obtain solution and possible improvement of energy consumption during energy audit implementation. A document analysis approach will also be obtained in order to identify the best practice through the selected energy documentations. The result of this research may be used as a guideline for other universities that consume high energy in order to help improving the implementation of energy audit process in their universities.

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.

[Management of glycemia: an audit in 66 ICUs].

PubMed

Orban, J-C; Scarlatti, A; Lefrant, J-Y; Molinari, N; Leone, M; Jaber, S; Constantin, J-M; Allaouchiche, B; Ichai, C

2013-02-01

The interest of tight glucose control in ICU is still debated. In France, no data are available regarding this therapy and the implementation of its guidelines. Sub-study of a one-day audit performed between January and May 2009. During a one-day audit performed in 66 ICUs, trained residents collected data regarding the presence of a formal glucose control protocol and its practical application. A formalized glucose control protocol was found in 88% of patients. During the day before the audit, 3645 glycemia measurements were performed accounting for six measurements [4-9] per patient with a median higher value of 1.6 [1.4-2.1]. Hypoglycemia (<0.8 g/L) and hyperglycemia (>1.4 g/L in non-diabetic and >1.8 g/L in diabetic patients) were found in 81 (15%) and 326 (58%) patients respectively. Two episodes (0.36%) of severe hypoglycemia (<0.4 g/L) were reported. Factors associated with glucose control protocol application were: a high SOFA score, cardioversion, mechanical ventilation, intracranial pressure monitoring, steroid use and nurse to patient ratio less than 1/2.5. Hepatic failure was the only factor associated with hypoglycemia. Glucose control protocols are available in more than 80% ICUs but their implementation is still imperfect. However, the median glycemia meets international current recommendations. Severe hypoglycemia is a very rare event in ICU. Copyright © 2012 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

Network Monitoring: A 360-Degree Plan--Learn How to Get the Vital Feedback You Need to Make Your System--And Its Users--More Secure

ERIC Educational Resources Information Center

Miller, Steven E.; Seiberling, Chris

2004-01-01

This article represents the second part of a series in this journal called "How to Perform a Security Audit." It continues the conversation on setting up a process for identifying security-related concerns and implementation safeguards. It continues the conversation from the perspective of system monitoring. This article discusses how to use a…

Improving CTE Student Retention and Transfer at Rend Lake College with Degree Audit and Reengagment Strategies. Pathways to Results: Implementation Partnerships Strategy Brief

ERIC Educational Resources Information Center

Rockey, Marci

2016-01-01

Rend Lake College (RLC) has participated in several Pathways to Results (PTR) projects over the last five years. The PTR model has been an essential tool to drive evidence-based changes throughout the College. In 2015, RLC used the PTR Model to evaluate institutional processes related to the Perkins Career and Technical Education (CTE) Student…

An audit of clinical service examining the uptake of genetic testing by at-risk family members.

PubMed

Forrest, Laura; Delatycki, Martin; Curnow, Lisette; Gen Couns, M; Skene, Loane; Aitken, Maryanne

2012-01-01

The aim of this study was to investigate the uptake of genetic testing by at-risk family members for four genetic conditions: chromosomal translocations, fragile X syndrome, Huntington disease, and spinal muscular atrophy. A clinical audit was undertaken using genetics files from Genetic Health Services Victoria. Data were extracted from the files regarding the number of at-risk family members and the proportion tested. Information was also collected about whether discussion of at-risk family members and family communication during the genetic consultation was recorded. The proportion of at-risk family members who had genetic testing ranged from 11% to 18%. First-degree family members were most frequently tested and the proportion of testing decreased by degree of relatedness to the proband. Smaller families were significantly more likely to have genetic testing for all conditions except Huntington disease. Female at-risk family members were significantly more likely to have testing for fragile X syndrome. The majority of at-risk family members do not have genetic testing. Family communication is likely to influence the uptake of genetic testing by at-risk family members and therefore it is important that families are supported while communicating to ensure that at-risk family members are able to make informed decisions about genetic testing.

24 CFR 511.74 - Audit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT SLUM... financial management systems used by grantees and, where applicable, State recipients shall provide for...

42 CFR 57.215 - Records, reports, inspection, and audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) Approved student applications for health professions student loans; (2) Documentation of the financial need of applicants; and (3) Copy of financial aid transcript(s). (c) The following repayment records for... retained until resolution of all questions. (e) Institutional officials who have information which...

21 CFR 26.79 - Territorial application.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Territorial application. 26.79 Section 26.79 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL MUTUAL RECOGNITION OF PHARMACEUTICAL GOOD MANUFACTURING PRACTICE REPORTS, MEDICAL DEVICE QUALITY SYSTEM AUDIT REPORTS...

Protecting the Privacy of Individuals in Terrorist Tracking Applications

DTIC Science & Technology

2005-04-01

THE PRIVACY OF INDIVIDUALS IN TERRORIST TRACKING APPLICATIONS 6. AUTHOR(S) Teresa Lunt, Paul Aoki, Dirk Balfanz , Glenn Durfee, Philippe Golle...in Data Mining and Knowledge Discovery. 3) Brent Waters, Dirk Balfanz , Glenn Durfee, and Diana Smetters. Building an encrypted and searchable audit

44 CFR 152.4 - Roles and responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Roles and responsibilities... Roles and responsibilities. (a) Applicants must: (1) Complete the application and certify to the... grant, available if requested for an audit to ensure compliance with any requirement of the grant...

Clinical governance in practice: closing the loop with integrated audit systems.

PubMed

Taylor, L; Jones, S

2006-04-01

Clinical governance has been acknowledged as the driving force behind National Health Service (NHS) reform since the government white paper outlined a new style of NHS in the UK in 1997. The framework of clinical governance ensures that NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop. A major component of a clinical governance framework requires utilizing audit procedures, which assess the effectiveness of current systems and ultimately direct continual quality improvement. This paper describes the audit component of a local clinical governance framework designed for a unit based within an NHS trust, which has utilized a multidisciplinary approach to assess the effectiveness of a newly commissioned service and its impact on the residents and staff. The unit is a 12-bedded, low-secure-intensive rehabilitation unit for clients with severe and enduring mental illness. Using recognized and standardized psychometric outcome measures, information was collected on clinical symptoms, social functioning, social behaviour, quality of life, relationship quality with named nurses and medication side-effects. Additionally, confidential staff measures were included to assess levels of burnout, identify expressed emotion and assess staff perception of models of illness. The paper includes a comprehensive account of how managerial commitment, teaching processes and application of technology ensured prompt data collection and maintained the momentum through the audit timescale. Data analysis and presentation of data in both clinical reviews and in senior management meetings within the unit are discussed. Findings highlight the full integration of the audit system into the processes of the unit. Clinically, the paper highlights the enhancement of the knowledge base of the client group and the influence on clinical decision-making processes and care delivery as a result of the audit. Brief clinical examples are given. In conclusion, the impact of the audit on unit strategy and organizational efficiency are discussed to highlight the importance of closing the audit loop and completing the cycle of clinical governance. The audit system has positive implications for replication in other services.

Equity in interviews: do personal characteristics impact on admission interview scores?

PubMed

Lumb, Andrew B; Homer, Matthew; Miller, Amy

2010-11-01

Research indicates that some social groups are disadvantaged by medical school selection systems. The stage(s) of a selection process at which this occurs is unknown, but at interview, when applicant and interviewer are face-to-face, there is potential for social bias to occur. We performed a detailed audit of the interview process for a single-entry year to a large UK medical school. Our audit included investigating the personal characteristics of both interviewees and interviewers to find out whether any of these factors, including the degree of social matching between individual pairs of interviewees and interviewers, influenced the interview scores awarded. A total of 320 interviewers interviewed 734 applicants, providing complete data for 2007 interviewer-interviewee interactions. The reliability of the interview process was estimated using generalisability theory at 0.82-0.87. For both interviewers and interviewees, gender, ethnic background, socio-economic group and type of school attended had no influence on the interview scores awarded or achieved. Staff and student interviewer marks did not differ significantly. Although numbers in each group of staff interviewers were too small for formal statistical analysis, there were no obvious differences in marks awarded between different medical specialties or between interviewers with varying amounts of interviewing experience. Our data provide reassurance that the interview does not seem to be the stage of selection at which some social groups are disadvantaged. These results support the continued involvement of senior medical students in the interview process. Despite the lack of evidence that an interview is useful for predicting future academic or clinical success, most medical schools continue to use interviews as a fundamental component of their selection process. Our study has shown that at least this arguably misplaced reliance upon interviewing is not introducing further social bias into the selection system. © Blackwell Publishing Ltd 2010.

21 CFR 1311.205 - Pharmacy application requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... that indicates the prescription was signed; or (ii) Display the field for the pharmacist's verification... must display the information for the pharmacist's verification. (10) The pharmacy application must... § 1311.215 in a format that is readable by the pharmacist. Such an internal audit may be automated and...

21 CFR 1311.205 - Pharmacy application requirements.

Code of Federal Regulations, 2013 CFR

2013-04-01

... that indicates the prescription was signed; or (ii) Display the field for the pharmacist's verification... must display the information for the pharmacist's verification. (10) The pharmacy application must... § 1311.215 in a format that is readable by the pharmacist. Such an internal audit may be automated and...

21 CFR 1311.205 - Pharmacy application requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... that indicates the prescription was signed; or (ii) Display the field for the pharmacist's verification... must display the information for the pharmacist's verification. (10) The pharmacy application must... § 1311.215 in a format that is readable by the pharmacist. Such an internal audit may be automated and...

21 CFR 1311.205 - Pharmacy application requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... that indicates the prescription was signed; or (ii) Display the field for the pharmacist's verification... must display the information for the pharmacist's verification. (10) The pharmacy application must... § 1311.215 in a format that is readable by the pharmacist. Such an internal audit may be automated and...

40 CFR 91.603 - Applicability of part 91, subpart F.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Applicability of part 91, subpart F. 91.603 Section 91.603 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CONTROL OF EMISSIONS FROM MARINE SPARK-IGNITION ENGINES Selective Enforcement Auditing...

25 CFR 1000.26 - Under what circumstances will a Tribe/Consortium be removed from the applicant pool?

Code of Federal Regulations, 2010 CFR

2010-04-01

... Participation in Tribal Self-Governance Admission into the Applicant Pool § 1000.26 Under what circumstances... Tribe/Consortium will only be removed if it: (a) Fails to satisfy the audit criteria in § 1000.17(c); or...

An audit of the toxicology findings in 555 medico-legal autopsies finds manner of death changed in 5 cases.

PubMed

Langlois, Neil E I; Gilbert, John D; Heath, Karen J; Winskog, Calle; Kostakis, Chris

2013-03-01

An audit of toxicological analysis in Coronial autopsies performed at Forensic Science South Australia was conducted on the cases of three pathologists. Toxicological analysis had been performed in 555 (68 %) from a total of 815 autopsies. It was found that the proffered manner of death was changed from the provisional report (provided immediately after the post-mortem examination) in five cases (just under 1 %) as a consequence of the toxicological findings. This is a limited study as it is retrospective, not all cases had toxicological analysis and the findings are constrained by the range of the substances that could be detected. Nonetheless, the audit supports the application of toxicological analysis in medico-legal death investigation and suggests that an inclusive policy should be adopted.

Professional values and informatics: what is the connection?

PubMed

Pritchard, Peter

2004-01-01

General practitioners (GPs) need to feel that they are doing a good job in providing care of high quality in a humane manner - that they are "good" doctors. The General Medical Council booklet Good Medical Practice is full of imperatives, but short on values that are the determinants of behaviour. Much has been written on doctors' professional values in the past decade, but it is not easy for individual GPs and teams to define their own values and consider to what extent they live up to them. Values and informatics, at first glance, might seem to have little in common, or even to be mutually antipathetic, and this is possible within the limitations of current technology. However, providing high-quality care involves the application of knowledge, evidence and guidelines, as well as auditing outcomes. For all these tasks, informatics provides the essential means of discovering whether we, as individuals and teams, are living up to our espoused values so that they become values-in-action that drive behaviour. Application of advanced informatics has the potential to improve and measure diagnostic and therapeutic skills. Technical advances are impressive, but their application lags. The next logical step would seem to be a comprehensive and easy-to-use knowledge-based decision support (KBDS) system in a convenient format. Locally based KBDS could facilitate self-audit and provide a step towards the ideal of a "self-organising system" requiring little external audit.

Pre-use anesthesia machine check; certified anesthesia technician based quality improvement audit.

PubMed

Al Suhaibani, Mazen; Al Malki, Assaf; Al Dosary, Saad; Al Barmawi, Hanan; Pogoku, Mahdhav

2014-01-01

Quality assurance of providing a work ready machine in multiple theatre operating rooms in a tertiary modern medical center in Riyadh. The aim of the following study is to keep high quality environment for workers and patients in surgical operating rooms. Technicians based audit by using key performance indicators to assure inspection, passing test of machine worthiness for use daily and in between cases and in case of unexpected failure to provide quick replacement by ready to use another anesthetic machine. The anesthetic machines in all operating rooms are daily and continuously inspected and passed as ready by technicians and verified by anesthesiologist consultant or assistant consultant. The daily records of each machines were collected then inspected for data analysis by quality improvement committee department for descriptive analysis and report the degree of staff compliance to daily inspection as "met" items. Replaced machine during use and overall compliance. Distractive statistic using Microsoft Excel 2003 tables and graphs of sums and percentages of item studied in this audit. Audit obtained highest compliance percentage and low rate of replacement of machine which indicate unexpected machine state of use and quick machine switch. The authors are able to conclude that following regular inspection and running self-check recommended by the manufacturers can contribute to abort any possibility of hazard of anesthesia machine failure during operation. Furthermore in case of unexpected reason to replace the anesthesia machine in quick maneuver contributes to high assured operative utilization of man machine inter-phase in modern surgical operating rooms.

75 FR 4424 - Records Schedules; Availability and Request for Comments

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-27

... contains information concerning forensic evidence used in criminal investigations, such as related case..., audit records, and antenna application and registration information. 23. Federal Energy Regulatory...

Fake Plate Vehicle Auditing Based on Composite Constraints in Internet of Things Environment

NASA Astrophysics Data System (ADS)

Li, Shasha; Xiangji Huang, Jimmy; Tohti, Turdi

2018-03-01

Accordance to the real application demands, this paper proposes a fake plate vehicle auditing method based on composite constrains strategy, a corresponding simulated IOT (internet of things) environment was created and uses liner matrix, Base64 encryption and grid monitoring technology and puts forward a real-time detecting algorithm for fake plate vehicles. The developed real system not only shows the superiority on its speed, detection accuracy and visualization, it also be good at realizing the vehicle’s real-time position and predicting the possible traveling trajectory.

Accurate falls risk assessment and interventions for preventing falls in patients in the acute care setting within a private hospital in a large capital city: a best practice implementation project.

PubMed

Szymaniak, Samara

2015-09-01

Patient falls are a leading cause of adverse events in Australian hospitals. Most Australian hospitals have fall prevention policies, procedures and programs for preventing inpatient falls; however despite these resources many preventable falls continue to occur in Australian hospitals.It is imperative that clinicians understand the potential impact of inpatient falls, and what triggers can be identified and managed by a multifactorial team approach. Patients admitted to hospital often experience changes in physical and/or cognitive function which is then exacerbated by an unfamiliar environment and medical interventions. Adverse outcomes post falling can range from minor injuries such as skin tears to significant injuries such as intracranial hemorrhages and fractures which can ultimately result in permanent disability or death.In 2007, Calvary Wakefield Hospital implemented a Falls Minimization Program requiring routine assessment of all patients admitted using an Admission Risk Screening Tool in conjunction with completion of a detailed Falls Risk Assessment Tool when indicated. The aim of this implementation was to review current nursing practice against compliance with the Falls Minimization Program and also identify areas for improvement with a focus on preventative strategies. It was essential that the project and its outcomes also complement the National Safety and Quality Health Service Standards (standard 10 - Preventing Falls and Harm from Falls) that provide a benchmark for Calvary Wakefield Hospital. This was achieved by completing a baseline audit, implementing a corrective action plan post audit and then re-auditing in three months once strategies had been implemented This project used the pre- and post-implementation audit strategy made up of eight criteria using the Joanna Briggs Institute Practical Application of Clinical Evidence System and Getting Research into Practice. The audit, review, implementation and re-audit sequence was the strategy used to improve clinical practice, and the project was conducted over a five-month period, with the addition of a third audit cycle six months post completion of the implementation phase.Results were generated using the JBI-PACES module and were scrutinized by the project lead in conjunction with members of the project team. Results were discussed with key clinicians throughout the duration of the project. Baseline audit results provided the foundation for generating change and this data was then compared with the first follow-up audit to identify improvements in compliance with criteria. Again this data was compared with audits from six months post implementation to identify sustainability of the project. The results from the baseline audit highlighted that there was significant opportunity for improvement in all criteria audited. It was pleasing to report that in the first follow-up audit cycle, nearly all criteria showed an improvement in both medical and surgical fields. The greatest areas of improvement pertained to healthcare professionals receiving formal education (improvement of 46%), and patient and family education improved by 43%. To measure sustainability, a second follow-up audit was conducted using the same criteria and identified that strategies implemented had in fact been maintained, and the results were consistent with those from the first follow-up audit. The project used the pre- and post-audit strategy to translate evidence into practice, and not only demonstrated that implementation of evidence-based practice is possible in the acute setting but also showed improvement in the prevention of falls and harm from falls in that setting.

Towards Dynamic Remote Data Auditing in Computational Clouds

PubMed Central

Khurram Khan, Muhammad; Anuar, Nor Badrul

2014-01-01

Cloud computing is a significant shift of computational paradigm where computing as a utility and storing data remotely have a great potential. Enterprise and businesses are now more interested in outsourcing their data to the cloud to lessen the burden of local data storage and maintenance. However, the outsourced data and the computation outcomes are not continuously trustworthy due to the lack of control and physical possession of the data owners. To better streamline this issue, researchers have now focused on designing remote data auditing (RDA) techniques. The majority of these techniques, however, are only applicable for static archive data and are not subject to audit the dynamically updated outsourced data. We propose an effectual RDA technique based on algebraic signature properties for cloud storage system and also present a new data structure capable of efficiently supporting dynamic data operations like append, insert, modify, and delete. Moreover, this data structure empowers our method to be applicable for large-scale data with minimum computation cost. The comparative analysis with the state-of-the-art RDA schemes shows that the proposed scheme is secure and highly efficient in terms of the computation and communication overhead on the auditor and server. PMID:25121114

Towards dynamic remote data auditing in computational clouds.

PubMed

Sookhak, Mehdi; Akhunzada, Adnan; Gani, Abdullah; Khurram Khan, Muhammad; Anuar, Nor Badrul

2014-01-01

Cloud computing is a significant shift of computational paradigm where computing as a utility and storing data remotely have a great potential. Enterprise and businesses are now more interested in outsourcing their data to the cloud to lessen the burden of local data storage and maintenance. However, the outsourced data and the computation outcomes are not continuously trustworthy due to the lack of control and physical possession of the data owners. To better streamline this issue, researchers have now focused on designing remote data auditing (RDA) techniques. The majority of these techniques, however, are only applicable for static archive data and are not subject to audit the dynamically updated outsourced data. We propose an effectual RDA technique based on algebraic signature properties for cloud storage system and also present a new data structure capable of efficiently supporting dynamic data operations like append, insert, modify, and delete. Moreover, this data structure empowers our method to be applicable for large-scale data with minimum computation cost. The comparative analysis with the state-of-the-art RDA schemes shows that the proposed scheme is secure and highly efficient in terms of the computation and communication overhead on the auditor and server.

Physical interventions to manage patients with brain injury: an audit on its use and staff and patient injuries from the techniques.

PubMed

Stubbs, Brendon; Alderman, Nick

2008-08-01

To report the use of physical interventions (PI) used to manage aggressive behaviour in a neurobehavioural unit and any injuries that were sustained to patients and staff during its implementation. A retrospective audit was adopted utilizing a standard accident and incident recording database. Records of PI utilized to manage the aggressive behaviour of 75 adults with acquired brain injury were analysed over the course of one calendar year. In addition duration PI, frequency of use and injuries sustained to staff and patients from its application were investigated. During the 12 month period records were audited, PI was used on 1427 occasions. The majority (90.1%) lasted less than 10 minutes. Injury rates to patients (0.98%) and staff (6.5%) were both considerably lower than those rates reported for other clinical populations. Use of PI with people who have an acquired brain injury is particularly challenging due to complex patterns of physical impairment that can be an outcome of this condition. This study describes how a multidisciplinary approach to the application of PI and the contribution of the physiotherapist in particular can result in comparatively low injury rates.

Health care worker hand hygiene in the pediatric special care unit at Mulago National Referral Hospital in Uganda: a best practice implementation project.

PubMed

Muhumuza, Christine; Gomersall, Judith Streak; Fredrick, Makumbi E; Atuyambe, Lynn; Okiira, Christopher; Mukose, Aggrey; Ssempebwa, John

2015-03-01

The hands of a health care worker are a common vehicle of pathogen transmission in hospital settings. Health care worker hand hygiene is therefore critical for patients' well being. Whilst failure of health care workers to comply with the best hand hygiene practice is a problem in all health care settings, issues of lack of access to adequate cleaning equipment and in some cases even running water make practicing good hand hygiene particularly difficult in low-resource developing country settings. This study reports an audit and feedback project that focused on the hand hygiene of the health care worker in the pediatric special care unit of the Mulago National Referral Hospital, which is a low-resource setting in Uganda. To improve hand hygiene among health care workers in the pediatric special care unit and thereby contribute to reducing transmission of health care worker-associated pathogens. The Joanna Briggs Institute three-phase Practical Application of Clinical Evidence System audit and feedback tool for promoting evidence utilization and change in health care was used. In phase one of the project, stakeholders were engaged and seven evidence-based audit criteria were developed. A baseline audit was then conducted. In phase two, barriers underpinning areas of noncompliance found in the baseline audit were identified and three strategies - education, reminders and provision of hand cleaning equipment - were implemented to overcome them. In phase three, a follow-up audit was conducted. Compliance with best practice hygiene was found to be poor in the baseline audit for all but one of the audit criteria. Following the implementation of the strategies, hand hygiene improved. The compliance rate increased substantially across all criteria. Staff education achieved 100%, whilst criterion 4 increased to 70%. However, use of alcohol-based hand-rub for hand hygiene only improved to 66%, and for six of the seven audit criteria, compliance remained below 74%. The project provides another example of how audit can be used as a tool to improve health practice, even in a low-resource setting. At the same time, it showed how difficult it is to achieve compliance with best hand hygiene practice in a low-resource hospital. The project highlights the importance of continued education/awareness raising on the importance of good hand hygiene practice as well as investment in infrastructure and cleaning supplies for achieving and sustaining good hand hygiene among workers in a low-resource hospital setting. A key contribution of the project was the legacy it left in the form of knowledge about how to use audit and feedback as a tool to promote the best practice. A similar project has been implemented in the maternity ward at the hospital and further audits are planned.

The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle

PubMed Central

2013-01-01

Background Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research). Methods With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013. Results The findings show an increase in both the single and repeated use of outcome measures from the time of the original audit, with repeated use (baseline and follow-up) of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) scale increasing from 10% to 50% of cases. Re-audited case-notes contained more combined use of different outcome measures, with greater consensus on which measures to use. Outcome measures that were applicable across a wide range of clinical conditions were more likely to be used than symptom-specific measures, and measures that were completed by the clinician were found more often than measures completed by the service user. Conclusions The findings show a substantial improvement in the use of outcome measures within CAMHS. These increases in use were found across different service organisations which were subject to different types of local service priorities and drivers. PMID:24139139

The STAR score: a method for auditing clinical records

PubMed Central

Tuffaha, H

2012-01-01

INTRODUCTION Adequate medical note keeping is critical in delivering high quality healthcare. However, there are few robust tools available for the auditing of notes. The aim of this paper was to describe the design, validation and implementation of a novel scoring tool to objectively assess surgical notes. METHODS An initial ‘path finding’ study was performed to evaluate the quality of note keeping using the CRABEL scoring tool. The findings prompted the development of the Surgical Tool for Auditing Records (STAR) as an alternative. STAR was validated using inter-rater reliability analysis. An audit cycle of surgical notes using STAR was performed. The results were analysed and a structured form for the completion of surgical notes was introduced to see if the quality improved in the next audit cycle using STAR. An education exercise was conducted and all participants said the exercise would change their practice, with 25% implementing major changes. RESULTS Statistical analysis of STAR showed that it is reliable (Cronbach’s a = 0.959). On completing the audit cycle, there was an overall increase in the STAR score from 83.344% to 97.675% (p<0.001) with significant improvements in the documentation of the initial clerking from 59.0% to 96.5% (p<0.001) and subsequent entries from 78.4% to 96.1% (p<0.001). CONCLUSIONS The authors believe in the value of STAR as an effective, reliable and reproducible tool. Coupled with the application of structured forms to note keeping, it can significantly improve the quality of surgical documentation and can be implemented universally. PMID:22613300

Auditing as part of the terminology design life cycle.

PubMed

Min, Hua; Perl, Yehoshua; Chen, Yan; Halper, Michael; Geller, James; Wang, Yue

2006-01-01

To develop and test an auditing methodology for detecting errors in medical terminologies satisfying systematic inheritance. This methodology is based on various abstraction taxonomies that provide high-level views of a terminology and highlight potentially erroneous concepts. Our auditing methodology is based on dividing concepts of a terminology into smaller, more manageable units. First, we divide the terminology's concepts into areas according to their relationships/roles. Then each multi-rooted area is further divided into partial-areas (p-areas) that are singly-rooted. Each p-area contains a set of structurally and semantically uniform concepts. Two kinds of abstraction networks, called the area taxonomy and p-area taxonomy, are derived. These taxonomies form the basis for the auditing approach. Taxonomies tend to highlight potentially erroneous concepts in areas and p-areas. Human reviewers can focus their auditing efforts on the limited number of problematic concepts following two hypotheses on the probable concentration of errors. A sample of the area taxonomy and p-area taxonomy for the Biological Process (BP) hierarchy of the National Cancer Institute Thesaurus (NCIT) was derived from the application of our methodology to its concepts. These views led to the detection of a number of different kinds of errors that are reported, and to confirmation of the hypotheses on error concentration in this hierarchy. Our auditing methodology based on area and p-area taxonomies is an efficient tool for detecting errors in terminologies satisfying systematic inheritance of roles, and thus facilitates their maintenance. This methodology concentrates a domain expert's manual review on portions of the concepts with a high likelihood of errors.

49 CFR 365.507 - FMCSA action on the application.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS RULES... databases of the governments of Mexico and the United States. (c) Pre-authorization safety audit. Every...

49 CFR 365.507 - FMCSA action on the application.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS RULES... databases of the governments of Mexico and the United States. (c) Pre-authorization safety audit. Every...

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2010 CFR

2010-04-01

... standards (as modified by the Comptroller General of the United States) and applicable Federal laws and... public agency, and Federal audit organizations as well as licensed or certified public accounting firms...

Auditing Associative Relations across Two Knowledge Sources

PubMed Central

Vizenor, Lowell T.; Bodenreider, Olivier; McCray, Alexa T.

2009-01-01

Objectives This paper proposes a novel semantic method for auditing associative relations in biomedical terminologies. We tested our methodology on two Unified Medical Language System (UMLS) knowledge sources. Methods We use the UMLS semantic groups as high-level representations of the domain and range of relationships in the Metathesaurus and in the Semantic Network. A mapping created between Metathesaurus relationships and Semantic Network relationships forms the basis for comparing the signatures of a given Metathesaurus relationship to the signatures of the semantic relationship to which it is mapped. The consistency of Metathesaurus relations is studied for each relationship. Results Of the 177 associative relationships in the Metathesaurus, 84 (48%) exhibit a high degree of consistency with the corresponding Semantic Network relationships. Overall, 63% of the 1.8M associative relations in the Metathesaurus are consistent with relations in the Semantic Network. Conclusion The semantics of associative relationships in biomedical terminologies should be defined explicitly by their developers. The Semantic Network would benefit from being extended with new relationships and with new relations for some existing relationships. The UMLS editing environment could take advantage of the correspondence established between relationships in the Metathesaurus and the Semantic Network. Finally, the auditing method also yielded useful information for refining the mapping of associative relationships between the two sources. PMID:19475724

21 CFR 1311.205 - Pharmacy application requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... pharmacist's verification. (7) The pharmacy application must read and retain the full DEA number including... information is present or must display the information for the pharmacist's verification. (10) The pharmacy... events specified in § 1311.215 in a format that is readable by the pharmacist. Such an internal audit may...

43 CFR 12.44 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Applicability. 12.44 Section 12.44 Public Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST... expenses under The Food Stamp Act of 1977 (section 16 of the Act). (7) A grant for an experimental, pilot...

38 CFR 36.4352 - Authority to close loans on the automatic basis.

Code of Federal Regulations, 2010 CFR

2010-07-01

... reviewed and approved by the underwriter. (4) Financial requirements. Each application must include the most recent annual financial statement audited and certified by a certified public accountant (CPA). If the date of the annual financial statement precedes that of the application by more than six months...

Masterclass Pedagogy for Multimedia Applications in Teacher Education

ERIC Educational Resources Information Center

Doherty, Catherine

2007-01-01

This paper describes an elective unit in the application of new technologies for pre-service teachers which employed a metaphor of masterclasses in its design to engage the students in value-added interactions around their individual multimedia projects. A masterclass involves the class group auditing an individual's detailed consultation with a…

20 CFR 404.2118 - Applicability of these provisions to alternate participants.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Applicability of these provisions to alternate participants. 404.2118 Section 404.2118 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... CFR part 74 or 41 CFR parts 1-15 as appropriate; and (b) Any disputes, including appeals of audit...

20 CFR 404.2118 - Applicability of these provisions to alternate participants.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Applicability of these provisions to alternate participants. 404.2118 Section 404.2118 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL... CFR part 74 or 41 CFR parts 1-15 as appropriate; and (b) Any disputes, including appeals of audit...

20 CFR 416.2218 - Applicability of these provisions to alternate participants.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Applicability of these provisions to alternate participants. 416.2218 Section 416.2218 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... CFR part 74 or 41 CFR part 1-15 as appropriate; and (b) Any disputes, including appeals of audit...

20 CFR 416.2218 - Applicability of these provisions to alternate participants.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Applicability of these provisions to alternate participants. 416.2218 Section 416.2218 Employees' Benefits SOCIAL SECURITY ADMINISTRATION... CFR part 74 or 41 CFR part 1-15 as appropriate; and (b) Any disputes, including appeals of audit...

49 CFR 385.607 - FMCSA action on the application.

Code of Federal Regulations, 2013 CFR

2013-10-01

... FITNESS PROCEDURES Special Rules for New Entrant Non-North America-Domiciled Carriers § 385.607 FMCSA...-authorization safety audit. Every non-North America-domiciled motor carrier that applies under this part must... Appendix to this subpart. (d) An application of a non-North America-domiciled motor carrier requesting for...

49 CFR 385.607 - FMCSA action on the application.

Code of Federal Regulations, 2014 CFR

2014-10-01

... FITNESS PROCEDURES Special Rules for New Entrant Non-North America-Domiciled Carriers § 385.607 FMCSA...-authorization safety audit. Every non-North America-domiciled motor carrier that applies under this part must... Appendix to this subpart. (d) An application of a non-North America-domiciled motor carrier requesting for...

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.

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

Sparks, Sandy; Miller, Russell B.

This project evaluated the information security posture of QUALCOMM regarding its Internet connections. It also enhanced and refined the ability of LLNL to perform these evaluations and add to its body of knowledge concerning Internet threats, vulnerabilities, and countermeasures. The evaluations required a high degree of trust and cooperation between the assessors (LLNL) and the target organization (QUALCOMM). Without this high level of cooperation, the activity could easily have become an adversarial audit type situation and counterproductive to all parties.

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...

AUDIT OF THE AUDITS.

PubMed

Alam, Malik Mahmood

2015-01-01

Audits play an important role in improving the services to patient care. Our department was involved in carrying out Audits by the trainees on regular basis as suggested by the Royal college and each House officer or the Registrar rotating through was doing an Audit in his/her tenure. Ninteen Audits were done in 3 years in the Pediatric department. We used the criteria suggested for evaluating the quality of Audits and put into the category of full Audits, Partial Audits, Potential Audits and planning Audits. Six of our Audits were full Audits, eleven were partial Audits, two were Potential Audits and none were Planning Audits. We think that as a general trend we had similar shortcomings in quality of our Audits which need to be improved by involving seniors specially in implementing the changes suggested in the Audits otherwise it will not fulfill the Aims and objectives.

Audited credential delegation: a usable security solution for the virtual physiological human toolkit.

PubMed

Haidar, Ali N; Zasada, Stefan J; Coveney, Peter V; Abdallah, Ali E; Beckles, Bruce; Jones, Mike A S

2011-06-06

We present applications of audited credential delegation (ACD), a usable security solution for authentication, authorization and auditing in distributed virtual physiological human (VPH) project environments that removes the use of digital certificates from end-users' experience. Current security solutions are based on public key infrastructure (PKI). While PKI offers strong security for VPH projects, it suffers from serious usability shortcomings in terms of end-user acquisition and management of credentials which deter scientists from exploiting distributed VPH environments. By contrast, ACD supports the use of local credentials. Currently, a local ACD username-password combination can be used to access grid-based resources while Shibboleth support is underway. Moreover, ACD provides seamless and secure access to shared patient data, tools and infrastructure, thus supporting the provision of personalized medicine for patients, scientists and clinicians participating in e-health projects from a local to the widest international scale.

Audited credential delegation: a usable security solution for the virtual physiological human toolkit

PubMed Central

Haidar, Ali N.; Zasada, Stefan J.; Coveney, Peter V.; Abdallah, Ali E.; Beckles, Bruce; Jones, Mike A. S.

2011-01-01

We present applications of audited credential delegation (ACD), a usable security solution for authentication, authorization and auditing in distributed virtual physiological human (VPH) project environments that removes the use of digital certificates from end-users' experience. Current security solutions are based on public key infrastructure (PKI). While PKI offers strong security for VPH projects, it suffers from serious usability shortcomings in terms of end-user acquisition and management of credentials which deter scientists from exploiting distributed VPH environments. By contrast, ACD supports the use of local credentials. Currently, a local ACD username–password combination can be used to access grid-based resources while Shibboleth support is underway. Moreover, ACD provides seamless and secure access to shared patient data, tools and infrastructure, thus supporting the provision of personalized medicine for patients, scientists and clinicians participating in e-health projects from a local to the widest international scale. PMID:22670214

Nutritional screening, assessment and implementation strategies for adults in an Australian acute tertiary hospital: a best practice implementation report.

PubMed

Smith, Louise; Chapman, Amanda; Flowers, Kelli; Wright, Kylie; Chen, Tanghua; O'Connor, Charmaine; Astorga, Cecilia; Francis, Nevenka; Vigh, Gia; Wainwright, Craig

2018-01-01

The project aimed to improve the effectiveness of nutritional screening and assessment practices through clinical audits and the implementation of evidence-based practice recommendations. In the absence of optimal nutrition, health may decline and potentially manifest as adverse health outcomes. In a hospitalized person, poor nutrition may adversely impact on the person's outcome. If the nutritional status can be ascertained, nutritional needs can be addressed and potential risks minimized.The overall purpose of this project was to review and monitor staff compliance with nutritional screening and assessment best practice recommendations ensuring there is timely, relevant and structured nutritional therapeutic practices that support safe, compassionate and person-centered care in adults in a tertiary hospital in South Western Sydney, Australia, in the acute care setting. A baseline retrospective chart audit was conducted and measured against 10 best practice criteria in relation to nutritional screening and assessment practices. This was followed by a facilitated multidisciplinary focus group to identify targeted strategies, implementation of targeted strategies, and a post strategy implementation chart audit.The project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRIP) tool, including evidence from other available supporting literature, for promoting change in healthcare practice. The baseline audit revealed deficits between current practice and best practice across the 10 criteria. Barriers for implementation of nutritional screening and assessment best practice criteria were identified by the focus group and an education strategy was implemented. There were improved outcomes across all best practice criteria in the follow-up audit. The baseline audit revealed gaps between current practice and best practice. Through the implementation of a targeted education program and resource package, outcomes improved in the follow up audit. The findings indicated that engagement from multidisciplinary team members and consumers was effective in developing tailored education that improved knowledge of best practice. This was demonstrated by an increase in the percentage of compliance across the 10 criteria, although leaving room for more improvement. A policy has been developed for implementation and future audits are planned to measure whether improved practices have been sustained.

10 CFR 611.109 - Audit and access to records.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., papers and records of the Borrower or DOE, as applicable. Such inspection may be made during regular... rights hereunder, the Secretary may utilize employees of other Federal agencies, independent accountants...

10 CFR 611.109 - Audit and access to records.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., papers and records of the Borrower or DOE, as applicable. Such inspection may be made during regular... rights hereunder, the Secretary may utilize employees of other Federal agencies, independent accountants...

10 CFR 611.109 - Audit and access to records.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., papers and records of the Borrower or DOE, as applicable. Such inspection may be made during regular... rights hereunder, the Secretary may utilize employees of other Federal agencies, independent accountants...

10 CFR 611.109 - Audit and access to records.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., papers and records of the Borrower or DOE, as applicable. Such inspection may be made during regular... rights hereunder, the Secretary may utilize employees of other Federal agencies, independent accountants...

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.

A systematic indoor air quality audit approach for public buildings.

PubMed

Asadi, Ehsan; da Silva, Manuel C Gameiro; Costa, J J

2013-01-01

Good indoor air quality (IAQ) in buildings provides a comfortable and healthy environment for the occupants to work, learn, study, etc. Therefore, it is important to ascertain the IAQ status in the buildings. This study is aimed to establish and demonstrate the comprehensive IAQ audit approach for public buildings, based on Portugal national laws. Four public buildings in Portugal are used to demonstrate the IAQ audit application. The systematic approach involves the measurement of physical parameters (temperature, relative humidity, and concentration of the suspended particulate matter), monitoring of the concentrations of selected chemical indicators [carbon dioxide (CO(2)), carbon monoxide, formaldehyde, ozone, and total volatile organic compounds], and the measurements of biological indicators (bacteria and fungi). In addition, air exchange rates are measured by the concentration decay method using metabolic CO(2) as the tracer gas. The comprehensive audits indicated some situations of common IAQ problems in buildings, namely: (1) insufficient ventilation rate, (2) too high particle concentration; and (3) poor filtration effectiveness and hygienic conditions in most of the air handling units. Accordingly, a set of recommendations for the improvement of IAQ conditions were advised to the building owner/managers.

Using Unix system auditing for detecting network intrusions

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

Christensen, M.J.

1993-03-01

Intrusion Detection Systems (IDSs) are designed to detect actions of individuals who use computer resources without authorization as well as legitimate users who exceed their privileges. This paper describes a novel approach to IDS research, namely a decision aiding approach to intrusion detection. The introduction of a decision tree represents the logical steps necessary to distinguish and identify different types of attacks. This tool, the Intrusion Decision Aiding Tool (IDAT), utilizes IDS-based attack models and standard Unix audit data. Since attacks have certain characteristics and are based on already developed signature attack models, experienced and knowledgeable Unix system administrators knowmore » what to look for in system audit logs to determine if a system has been attacked. Others, however, are usually less able to recognize common signatures of unauthorized access. Users can traverse the tree using available audit data displayed by IDAT and general knowledge they possess to reach a conclusion regarding suspicious activity. IDAT is an easy-to-use window based application that gathers, analyzes, and displays pertinent system data according to Unix attack characteristics. IDAT offers a more practical approach and allows the user to make an informed decision regarding suspicious activity.« less

Alcohol Use-Related Problems Among a Rural Indian Population of West Bengal: An Application of the Alcohol Use Disorders Identification Test (AUDIT).

PubMed

Barik, Anamitra; Rai, Rajesh Kumar; Chowdhury, Abhijit

2016-03-01

To examine alcohol use and related problems among a rural subset of the Indian population. The Alcohol Use Disorders Identification Test (AUDIT) was used as part of Health and Demographic Surveillance of 36,611 individuals aged ≥18 years. From this survey data on 3671 current alcohol users were analysed using bivariate and multivariate ordered logit regression. Over 19% of males and 2.4% of females were current alcohol users. Mean ethanol consumption on a typical drinking day among males was estimated to be higher (96.3 gm) than females (56.5 gm). Mean AUDIT score was 11 among current alcohol users. AUDIT showed in the ordered logit regression estimated alcohol use-related problems to be low among women, Scheduled Tribes and unmarried people, whereas alcohol use-related problems registered high among Muslims. This rural population appears to be in need of an effective intervention program, perhaps targeting men and the household, aimed at reducing the level of alcohol use and related problems. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Use of self-heating gel mattresses eliminates admission hypothermia in infants born below 28 weeks gestation.

PubMed

Ibrahim, C P Hafis; Yoxall, C W

2010-07-01

Hypothermia at birth is strongly associated with mortality and morbidity in pre-term infants. A local audit showed limited effectiveness of occlusive wrapping in preventing admission hypothermia in very pre-term infants. Self-heating acetate gel mattresses were introduced as a result to prevent hypothermia at birth in infants born at or below 28 weeks gestation. A retrospective audit was conducted to evaluate the effectiveness of self-heating acetate gel mattresses at resuscitation of infants born at or below 28 weeks to prevent hypothermia at birth. All infants born at or below 28 weeks gestation during 18 months before and 18 months after self-heating acetate gel mattresses were introduced during resuscitation were included. One hundred five babies were born when acetate gel mattresses were not used, and 124 were born during the period when they were. Four (3.3%) babies were hypothermic (temperature <36 degrees C) at admission when the mattresses were used compared to 21 (22.6%) babies who were hypothermic during the period it was not (p < 0.001). Hyperthermia (temperature >37 degrees C) rose from 30.1% prior to use of gel mattresses to 49.6% when they were used (p = 0.004). Self-heating acetate gel mattresses are highly effective in reducing admission hypothermia in infants born at or below 28 weeks gestation. The use of these mattresses is associated with a significant increase in hyperthermia.

Visual and computer software-aided estimates of Dupuytren's contractures: correlation with clinical goniometric measurements.

PubMed

Smith, R P; Dias, J J; Ullah, A; Bhowal, B

2009-05-01

Corrective surgery for Dupuytren's disease represents a significant proportion of a hand surgeon's workload. The decision to go ahead with surgery and the success of surgery requires measuring the degree of contracture of the diseased finger(s). This is performed in clinic with a goniometer, pre- and postoperatively. Monitoring the recurrence of the contracture can inform on surgical outcome, research and audit. We compared visual and computer software-aided estimation of Dupuytren's contractures to clinical goniometric measurements in 60 patients with Dupuytren's disease. Patients' hands were digitally photographed. There were 76 contracted finger joints--70 proximal interphalangeal joints and six distal interphalangeal joints. The degrees of contracture of these images were visually assessed by six orthopaedic staff of differing seniority and re-assessed with computer software. Across assessors, the Pearson correlation between the goniometric measurements and the visual estimations was 0.83 and this significantly improved to 0.88 with computer software. Reliability with intra-class correlations achieved 0.78 and 0.92 for the visual and computer-aided estimations, respectively, and with test-retest analysis, 0.92 for visual estimation and 0.95 for computer-aided measurements. Visual estimations of Dupuytren's contractures correlate well with actual clinical goniometric measurements and improve further if measured with computer software. Digital images permit monitoring of contracture after surgery and may facilitate research into disease progression and auditing of surgical technique.

Alcohol consumption in college students from the pharmacy faculty.

PubMed

Miquel, Laia; Rodamilans, Miquel; Giménez, Rosa; Cambras, Trinitat; Canudas, Ana María; Gual, Antoni

2016-09-15

Alcohol consumption is highly prevalent in university students. Early detection in future health professionals is important: their consumption might not only influence their own health but may determine how they deal with the implementation of preventive strategies in the future. The aim of this paper is to detect the prevalence of risky alcohol consumption in first- and last-degree year students and to compare their drinking patterns.Risky drinking in pharmacy students (n=434) was assessed and measured with the AUDIT questionnaire (Alcohol Use Disorders Identification Test). A comparative analysis between college students from the first and fifth years of the degree in pharmacy, and that of a group of professors was carried to see differences in their alcohol intake patterns.Risky drinking was detected in 31.3% of students. The highest prevalence of risky drinkers, and the total score of the AUDIT test was found in students in their first academic year. Students in the first academic level taking morning classes had a two-fold risk of risky drinking (OR=1.9 (IC 95%1.1-3.1)) compared with students in the fifth level. The frequency of alcohol consumption increases with the academic level, whereas the number of alcohol beverages per drinking occasion falls.Risky drinking is high during the first year of university. As alcohol consumption might decrease with age, it is important to design preventive strategies that will strengthen this tendency.

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...

5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...

5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...

5 CFR 960.107 - Authorized activities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 960.107 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS... resources in finance, internal auditing, personnel management, automated data processing applications... educational development of Government employees, improvement of labor-management relations, equal employment...

24 CFR 511.72 - Applicability of uniform Federal administrative requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... and Urban Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT... and Federally recognized Indian Tribal Governments,” 1 OMB Circular A-128, “Audits of State and Local...

Human-factors engineering control-room design review/audit: Waterford 3 SES Generating Station, Louisiana Power and Light Company

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

Savage, J.W.

1983-03-10

A human factors engineering design review/audit of the Waterford-3 control room was performed at the site on May 10 through May 13, 1982. The report was prepared on the basis of the HFEB's review of the applicant's Preliminary Human Engineering Discrepancy (PHED) report and the human factors engineering design review performed at the site. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. The review team was assisted by consultants from Lawrence Livermore National Laboratory (University of California), Livermore, California.

Defense Science Board 1986 Summer Study: Use of Commercial Components in Military Equipment

DTIC Science & Technology

1987-01-01

I 0 LU 0L c/) LU C- 0.. < o 0. Ui LU C FL/ zD 5 aZz z o C.0 0 cc U ~ ’ 4 i i 0 U-4 ZZ .J •-• go--’ E c : L -- 4 L- u z V 0 acca )0 V f.z ?A 4. CV...Guidebook Certify and Audit IC Suppliers Yes-Who? and Processes Use Industrial Plastic Encap- Partial sulated ICs in Selected Application Remove MIL...removal of precedence between IC selections. The first question concerns certification/ audit , specifically, who performs this function -- the

HIPAA-compliant automatic monitoring system for RIS-integrated PACS operation

NASA Astrophysics Data System (ADS)

Jin, Jin; Zhang, Jianguo; Chen, Xiaomeng; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Feng, Jie; Sheng, Liwei; Huang, H. K.

2006-03-01

As a governmental regulation, Health Insurance Portability and Accountability Act (HIPAA) was issued to protect the privacy of health information that identifies individuals who are living or deceased. HIPAA requires security services supporting implementation features: Access control; Audit controls; Authorization control; Data authentication; and Entity authentication. These controls, which proposed in HIPAA Security Standards, are Audit trails here. Audit trails can be used for surveillance purposes, to detect when interesting events might be happening that warrant further investigation. Or they can be used forensically, after the detection of a security breach, to determine what went wrong and who or what was at fault. In order to provide security control services and to achieve the high and continuous availability, we design the HIPAA-Compliant Automatic Monitoring System for RIS-Integrated PACS operation. The system consists of two parts: monitoring agents running in each PACS component computer and a Monitor Server running in a remote computer. Monitoring agents are deployed on all computer nodes in RIS-Integrated PACS system to collect the Audit trail messages defined by the Supplement 95 of the DICOM standard: Audit Trail Messages. Then the Monitor Server gathers all audit messages and processes them to provide security information in three levels: system resources, PACS/RIS applications, and users/patients data accessing. Now the RIS-Integrated PACS managers can monitor and control the entire RIS-Integrated PACS operation through web service provided by the Monitor Server. This paper presents the design of a HIPAA-compliant automatic monitoring system for RIS-Integrated PACS Operation, and gives the preliminary results performed by this monitoring system on a clinical RIS-integrated PACS.

The Chinese Translations of Alcohol Use Disorders Identification Test (AUDIT) in China: A Systematic Review

PubMed Central

Li, Qing; Babor, Thomas F.; Hao, Wei; Chen, Xinguang

2011-01-01

Aims: To systematically review the literature on the Chinese translations of the Alcohol Use Disorders Identification Test (AUDIT) and their cross-cultural applicability in Chinese language populations. Methods: We identified peer-reviewed articles published in English (n = 10) and in Chinese (n = 11) from 1980 to September 2009, with key words China, Chinese and AUDIT among PubMed, EBSCO, PsycInfo, FirstSearch electronic databases and two Chinese databases. Results: Five teams from Beijing, Tibet, Taiwan and Hong Kong reported their region-specific translation procedures, cultural adaptations, validity (0.93–0.95 in two versions) and reliability (0.63–0.99). These Chinese translations and short versions demonstrated relatively high sensitivity (0.880–0.997) and moderate specificity (0.709–0.934) for hazardous/harmful drinking and alcohol dependence, but low specificity for alcohol dependence among Min-Nan Taiwanese (0.58). The AUDIT and its adaptations were most utilized in workplace- and hospital-settings for screening and brief intervention. However, they were under-utilized in population-based surveys, primary care settings, and among women, adolescents, rural-to-urban migrants, the elderly and minorities. Among 12 studies from mainland China, four included both women and men, and only one in Tibet was published in English. Conclusion: There is a growing amount of psychometric, epidemiologic and treatment research using Chinese translations of the AUDIT, much of it still unavailable in the English-language literature. Given the increase in burden of disease and injury attributable to alcohol use in the Western Pacific region, the use of an internationally comparable instrument (such as the AUDIT) in research with Chinese populations presents a unique opportunity to expand clinical and epidemiologic knowledge about alcohol problem epidemics. PMID:21467046

The Chinese translations of Alcohol Use Disorders Identification Test (AUDIT) in China: a systematic review.

PubMed

Li, Qing; Babor, Thomas F; Hao, Wei; Chen, Xinguang

2011-01-01

To systematically review the literature on the Chinese translations of the Alcohol Use Disorders Identification Test (AUDIT) and their cross-cultural applicability in Chinese language populations. We identified peer-reviewed articles published in English (n = 10) and in Chinese (n = 11) from 1980 to September 2009, with key words China, Chinese and AUDIT among PubMed, EBSCO, PsycInfo, FirstSearch electronic databases and two Chinese databases. Five teams from Beijing, Tibet, Taiwan and Hong Kong reported their region-specific translation procedures, cultural adaptations, validity (0.93-0.95 in two versions) and reliability (0.63-0.99). These Chinese translations and short versions demonstrated relatively high sensitivity (0.880-0.997) and moderate specificity (0.709-0.934) for hazardous/harmful drinking and alcohol dependence, but low specificity for alcohol dependence among Min-Nan Taiwanese (0.58). The AUDIT and its adaptations were most utilized in workplace- and hospital-settings for screening and brief intervention. However, they were under-utilized in population-based surveys, primary care settings, and among women, adolescents, rural-to-urban migrants, the elderly and minorities. Among 12 studies from mainland China, four included both women and men, and only one in Tibet was published in English. There is a growing amount of psychometric, epidemiologic and treatment research using Chinese translations of the AUDIT, much of it still unavailable in the English-language literature. Given the increase in burden of disease and injury attributable to alcohol use in the Western Pacific region, the use of an internationally comparable instrument (such as the AUDIT) in research with Chinese populations presents a unique opportunity to expand clinical and epidemiologic knowledge about alcohol problem epidemics.

[Reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test].

PubMed

Zhang, C; Yang, G P; Li, Z; Li, X N; Li, Y; Hu, J; Zhang, F Y; Zhang, X J

2017-08-10

Objective: To assess the reliability and validity of the Chinese version on Alcohol Use Disorders Identification Test (AUDIT) among medical students in China and to provide correct way of application on the recommended scales. Methods: An E-questionnaire was developed and sent to medical students in five different colleges. Students were all active volunteers to accept the testings. Cronbach's α and split-half reliability were calculated to evaluate the reliability of AUDIT while content, contract, discriminant and convergent validity were performed to measure the validity of the scales. Results: The overall Cronbach's α of AUDIT was 0.782 and the split-half reliability was 0.711. Data showed that the domain Cronbach's α and split-half reliability were 0.796 and 0.794 for hazardous alcohol use, 0.561 and 0.623 for dependence symptoms, and 0.647 and 0.640 for harmful alcohol use. Results also showed that the content validity index on the levels of items I-CVI) were from 0.83 to 1.00, the content validity index of scale level (S-CVI/UA) was 0.90, content validity index of average scale level (S-CVI/Ave) was 0.99 and the content validity ratios (CVR) were from 0.80 to 1.00. The simplified version of AUDIT supported a presupposed three-factor structure which could explain 61.175% of the total variance revealed through exploratory factor analysis. AUDIT semed to have good convergent and discriminant validity, with the success rate of calibration experiment as 100%. Conclusion: AUDIT showed good reliability and validity among medical students in China thus worth for promotion on its use.

Auditing as Part of the Terminology Design Life Cycle

PubMed Central

Min, Hua; Perl, Yehoshua; Chen, Yan; Halper, Michael; Geller, James; Wang, Yue

2006-01-01

Objective To develop and test an auditing methodology for detecting errors in medical terminologies satisfying systematic inheritance. This methodology is based on various abstraction taxonomies that provide high-level views of a terminology and highlight potentially erroneous concepts. Design Our auditing methodology is based on dividing concepts of a terminology into smaller, more manageable units. First, we divide the terminology’s concepts into areas according to their relationships/roles. Then each multi-rooted area is further divided into partial-areas (p-areas) that are singly-rooted. Each p-area contains a set of structurally and semantically uniform concepts. Two kinds of abstraction networks, called the area taxonomy and p-area taxonomy, are derived. These taxonomies form the basis for the auditing approach. Taxonomies tend to highlight potentially erroneous concepts in areas and p-areas. Human reviewers can focus their auditing efforts on the limited number of problematic concepts following two hypotheses on the probable concentration of errors. Results A sample of the area taxonomy and p-area taxonomy for the Biological Process (BP) hierarchy of the National Cancer Institute Thesaurus (NCIT) was derived from the application of our methodology to its concepts. These views led to the detection of a number of different kinds of errors that are reported, and to confirmation of the hypotheses on error concentration in this hierarchy. Conclusion Our auditing methodology based on area and p-area taxonomies is an efficient tool for detecting errors in terminologies satisfying systematic inheritance of roles, and thus facilitates their maintenance. This methodology concentrates a domain expert’s manual review on portions of the concepts with a high likelihood of errors. PMID:16929044

Public Auditing with Privacy Protection in a Multi-User Model of Cloud-Assisted Body Sensor Networks

PubMed Central

Li, Song; Cui, Jie; Zhong, Hong; Liu, Lu

2017-01-01

Wireless Body Sensor Networks (WBSNs) are gaining importance in the era of the Internet of Things (IoT). The modern medical system is a particular area where the WBSN techniques are being increasingly adopted for various fundamental operations. Despite such increasing deployments of WBSNs, issues such as the infancy in the size, capabilities and limited data processing capacities of the sensor devices restrain their adoption in resource-demanding applications. Though providing computing and storage supplements from cloud servers can potentially enrich the capabilities of the WBSNs devices, data security is one of the prevailing issues that affects the reliability of cloud-assisted services. Sensitive applications such as modern medical systems demand assurance of the privacy of the users’ medical records stored in distant cloud servers. Since it is economically impossible to set up private cloud servers for every client, auditing data security managed in the remote servers has necessarily become an integral requirement of WBSNs’ applications relying on public cloud servers. To this end, this paper proposes a novel certificateless public auditing scheme with integrated privacy protection. The multi-user model in our scheme supports groups of users to store and share data, thus exhibiting the potential for WBSNs’ deployments within community environments. Furthermore, our scheme enriches user experiences by offering public verifiability, forward security mechanisms and revocation of illegal group members. Experimental evaluations demonstrate the security effectiveness of our proposed scheme under the Random Oracle Model (ROM) by outperforming existing cloud-assisted WBSN models. PMID:28475110

Public Auditing with Privacy Protection in a Multi-User Model of Cloud-Assisted Body Sensor Networks.

PubMed

Li, Song; Cui, Jie; Zhong, Hong; Liu, Lu

2017-05-05

Wireless Body Sensor Networks (WBSNs) are gaining importance in the era of the Internet of Things (IoT). The modern medical system is a particular area where the WBSN techniques are being increasingly adopted for various fundamental operations. Despite such increasing deployments of WBSNs, issues such as the infancy in the size, capabilities and limited data processing capacities of the sensor devices restrain their adoption in resource-demanding applications. Though providing computing and storage supplements from cloud servers can potentially enrich the capabilities of the WBSNs devices, data security is one of the prevailing issues that affects the reliability of cloud-assisted services. Sensitive applications such as modern medical systems demand assurance of the privacy of the users' medical records stored in distant cloud servers. Since it is economically impossible to set up private cloud servers for every client, auditing data security managed in the remote servers has necessarily become an integral requirement of WBSNs' applications relying on public cloud servers. To this end, this paper proposes a novel certificateless public auditing scheme with integrated privacy protection. The multi-user model in our scheme supports groups of users to store and share data, thus exhibiting the potential for WBSNs' deployments within community environments. Furthermore, our scheme enriches user experiences by offering public verifiability, forward security mechanisms and revocation of illegal group members. Experimental evaluations demonstrate the security effectiveness of our proposed scheme under the Random Oracle Model (ROM) by outperforming existing cloud-assisted WBSN models.

An Audit of the Use of Gonadorelin Analogues to Prevent Recurrent Acute Symptoms in Patients with Acute Porphyria in the United Kingdom.

PubMed

Schulenburg-Brand, Danja; Gardiner, Tricia; Guppy, Simon; Rees, David C; Stein, Penelope; Barth, Julian; Felicity Stewart, M; Badminton, Michael

2017-01-01

Severe recurrent acute attacks of porphyria have traditionally been treated with either prophylactic human haemin or gonadorelin analogues (GnA) in females. Evidence on the most effective treatment for this patient subgroup is lacking. This audit surveyed the use of prophylactic GnA in the UK.Twenty female patients (who experienced between 2 and 45 acute attacks of porphyria requiring hospitalisation and treatment with human haemin prior to GnA prophylaxis) were included in the audit. Data was retrospectively collected based on patient history and case review.Twenty three treatment courses were given lasting a median period of 12 months. Monthly subcutaneous Goserelin was most commonly used. In three patients in whom timing with the menstrual cycle was not considered, an acute attack occurred after initiation of the first dose. The majority of patients experienced oestrogen deficiency symptoms during treatment. Fifty percent of the prescribed courses of GnA resulted in a degree of clinical benefit. This successfully treated group experienced between 3 and 20 acute attacks prior to and between 0 and 6 acute attacks during GnA treatment.The audit revealed large variation in practice in the United Kingdom regarding indication, duration of treatment, specific drug used and management of side effects. In view of the limited treatment options available for this cohort and the mixed outcome successes reported, we believe it is reasonable for porphyria specialists to continue offering GnA treatment to women with severe recurrent debilitating acute attacks of porphyria associated with the menstrual cycle, and we propose best practice guidelines to standardise management.

Clinical Audit of the Radiotherapy Process in Rectal Cancer: Clinical Practice Guidelines and Quality Certification Do Not Avert Variability in Clinical Practice.

PubMed

Torras, M G; Canals, E; Jurado-Bruggeman, D; Marín-Borras, S; Macià, M; Jové, J; Boladeras, A M; Muñoz-Montplet, C; Molero, J; Picón, C; Puigdemont, M; Aliste, L; Torrents, A; Guedea, F; Borras, J M

2018-06-01

The therapeutic approach to cancer is complex and multidisciplinary. Radiotherapy is among the essential treatments, whether used alone or in conjunction with other therapies. This study reports a clinical audit of the radiotherapy process to assess the process of care, evaluate adherence to agreed protocols and measure the variability to improve therapeutic quality for rectal cancer. Multicentre retrospective cohort study in a representative sample of patients diagnosed with rectal cancer in the Institut Català d'Oncologia, a comprehensive cancer centre with three different settings. We developed a set of indicators to assess the key areas of the radiotherapy process. The clinical audit consisted of a review of a random sample of 40 clinical histories for each centre. The demographic profile, histology and staging of patients were similar between centres. The MRI reports did not include the distance from tumour to mesorectal fascia (rCRM) in 38.3% of the cases. 96.7% of patients received the planned dose, and 57.4% received it at the planned time. Surgery followed neoadjuvant treatment in 96.7% of the patients. Among this group, postoperative CRM was recorded in 65.5% of the cases and was negative in 93.4% of these. With regard to the 34.5% (n = 40) of cases where no CRM value was stated, there were differences between the centres. Mean follow-up was 3.4 (SD 0.6) years, and overall survival at four years was 81.7%. The audit revealed a suboptimal degree of adherence to clinical practice guidelines. Significant variability between centres exists from a clinical perspective but especially with regard to organization and process. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

An approach to industrial water conservation--a case study involving two large manufacturing companies based in Australia.

PubMed

Agana, Bernard A; Reeve, Darrell; Orbell, John D

2013-01-15

This study presents the application of an integrated water management strategy at two large Australian manufacturing companies that are contrasting in terms of their respective products. The integrated strategy, consisting of water audit, pinch analysis and membrane process application, was deployed in series to systematically identify water conservation opportunities. Initially, a water audit was deployed to completely characterize all water streams found at each production site. This led to the development of a water balance diagram which, together with water test results, served as a basis for subsequent enquiry. After the water audit, commercially available water pinch software was utilized to identify possible water reuse opportunities, some of which were subsequently implemented on site. Finally, utilizing a laboratory-scale test rig, membrane processes such as UF, NF and RO were evaluated for their suitability to treat the various wastewater streams. The membranes tested generally showed good contaminant rejection rates, slow flux decline rates, low energy usage and were well suited for treatment of specific wastewater streams. The synergy between the various components of this strategy has the potential to reduce substantial amounts of Citywater consumption and wastewater discharge across a diverse range of large manufacturing companies. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

What Is To Be Expected from an Ethics Audit Integrated Within the Accreditation Process of Hospitals from Romania?

PubMed Central

AGHEORGHIESEI, Daniela Tatiana; ILIESCU, Liliana; GAVRILOVICI, Cristina; OPREA, Liviu

2013-01-01

Background We aimed to verify the issue of the ethics audit and its use in the system of accreditation of hospitals. It presents the results of a survey conducted among hospital managers from Romania. Methods: Our article highlights the results of the second part of a research carried out in 2012 on the pertinence and the structure of the ethics audit integrated within the accreditation process of hospitals, according the opinion of the 47 executives and managers involved in the quality management of Romania hospitals. The data have been gathered with the aid of the online questionnaire. Results: An ethics audit integrated within the accreditation process of hospitals should include primarily the respect of the patients’ rights, the good relations of the institutions with its patients and the respect of the moral rights of the employees. Conclusion: The usefulness of this study is due to the fact that it consults precisely those who should really contribute to the creation, application and monitoring of ethical policies and instruments necessary in every hospital which are permanently under the scrutiny of public opinion and confront themselves with the obligation to give a thorough account of their results and spending of the public resources. This study gain consistency as the relevant aspects that could form the structure of a hospital ethics audit are identified with the direct help of the managers responsible for implementing it. PMID:24427752

Assessment and management of burn pain at the Komfo Anokye Teaching Hospital: a best practice implementation project.

PubMed

Bayuo, Jonathan; Munn, Zachary; Campbell, Jared

2017-09-01

Pain management is a significant issue in health facilities in Ghana. For burn patients, this is even more challenging as burn pain has varied facets. Despite the existence of pharmacological agents for pain management, complaints of pain still persist. The aim of this project was to identify pain management practices in the burns units of Komfo Anokye Teaching Hospital, compare these approaches to best practice, and implement strategies to enhance compliance to standards. Ten evidence-based audit criteria were developed from evidence summaries. Using the Joanna Briggs Institute Practical Application of Clinical Evidence Software (PACES), a baseline audit was undertaken on a convenience sample of ten patients from the day of admission to the seventh day. Thereafter, the Getting Research into Practice (GRiP) component of PACES was used to identify barriers, strategies, resources and outcomes. After implementation of the strategies, a follow-up audit was undertaken using the same sample size and audit criteria. The baseline results showed poor adherence to best practice. However, following implementation of strategies, including ongoing professional education and provision of assessment tools and protocols, compliance rates improved significantly. Atlhough the success of this project was almost disrupted by an industrial action, collaboration with external bodies enabled the successful completion of the project. Pain management practices in the burns unit improved at the end of the project which reflects the importance of an audit process, education, providing feedback, group efforts and effective collaboration.

41 CFR 102-118.405 - Are my agency's prepayment audited transportation bills subject to periodic postpayment audit...

Code of Federal Regulations, 2010 CFR

2010-07-01

... prepayment audited transportation bills subject to periodic postpayment audit oversight from the GSA Audit... Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services Waivers from Mandatory Prepayment Audit...

A Novel Network Attack Audit System based on Multi-Agent Technology

NASA Astrophysics Data System (ADS)

Jianping, Wang; Min, Chen; Xianwen, Wu

A network attack audit system which includes network attack audit Agent, host audit Agent and management control center audit Agent is proposed. And the improved multi-agent technology is carried out in the network attack audit Agent which has achieved satisfactory audit results. The audit system in terms of network attack is just in-depth, and with the function improvement of network attack audit Agent, different attack will be better analyzed and audit. In addition, the management control center Agent should manage and analyze audit results from AA (or HA) and audit data on time. And the history files of network packets and host log data should also be audit to find deeper violations that cannot be found in real time.

17 CFR 3.13 - Registration of agricultural trade option merchants and their associated persons.

Code of Federal Regulations, 2010 CFR

2010-04-01

... accepted accounting principles; (ii) The agricultural trade option merchant must identify each of the... accepted auditing standards prepared within the prior 12 months. (3) These applications must be...

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. ...

45 CFR 301.0 - Scope and applicability of this part.

Code of Federal Regulations, 2011 CFR

2011-10-01

.... This part deals with the administration of title IV-D of the Social Security Act by the Federal... under the approved plan; review and audit of State and local expenditures; and reconsideration of...

Clinical trials integrity: a CRO perspective.

PubMed

Beach, J E

2001-01-01

When contract research organizations (CROs) were first formed, pharmaceutical companies outsourced to them only certain aspects of the conduct of their clinical trials. At first CROs were highly specialized entities, providing, for example, either biostatistical advice, clinical research associates who monitored investigational sites for regulatory compliance, or regulatory support. Gradually, full service CROs emerged, offering a full range of services for clinical trials, including the selection of investigators and investigational sites, assistance with patient recruitment, safety surveillance and reporting, site audits, and data management and biostatistics. This evolving relationship between CROs and the pharmaceutical and medical device industries has resulted in CROs assuming more and more of the regulatory and ethical risks and responsibilities inherent in the conduct of clinical trials. In this full service role, CROs, unlike sponsors, are not interested in the outcome of study, but like sponsors, are subject to heavy regulation by the federal government, must follow applicable state laws, must respect international guidelines, and are obliged to follow their own operating procedures. Moreover, they are judged by the industry on the basis of the scope and quality of services provided, including the degree of adherence to the research protocol, regulatory requirements, and timelines; the quality of the professional working relationships with investigators and institutions, both academic and community-based; and the validity of the data. Further, CROs are subject to comprehensive audits by sponsoring companies, FDA, and other regulatory authorities. For all these reasons, CROs are being tasked with strict vigilance of all stages of the clinical trial process to ensure that the laws, regulations, and industry standards designed for the protection of human subjects and data integrity are maintained.

The 15-Minute Audition: Translating a Proof of Concept into a Domain-Specific Screening Device for Mathematical Talent

ERIC Educational Resources Information Center

Subotnik, Rena F.; Worrell, Frank C.; Olszewski-Kubilius, Paula

2017-01-01

In 2011, Subotnik, Olszewski-Kubilius, and Worrell proposed a conceptual model for talent development applicable to all domains. Although grounded in available psychological research, significant questions remain regarding practical applications of each tenet of the model. In this article, we highlight a method of implementing the model's focus on…

Factors Influencing Clinical Performance of Baccalaureate Nursing Majors: A Retrospective Audit.

PubMed

Johnston, Sandra; Fox, Amanda; Coyer, Fiona Maree

2018-06-01

Transition of nursing student to new graduate depends on successful completion of clinical work placement during an undergraduate course. Supporting students during the clinical placement is imperative. This study examined associations between grade point average, domestic or international status, course entry qualification, and single or dual nursing degree to successful completion of clinical placement. A retrospective audit of 665 students in a baccalaureate nursing program was conducted to examine factors influencing clinical performance of baccalaureate nursing students. A significant association between entry qualification, lower grade point average, international status, and receipt of a constructive note was found: χ 2 = 8.678, df = 3, p = .034, t(3.862), df = 663, p ⩽ .001, and Fisher's exact test = 8.581, df = 1, p = .003, respectively. Understanding factors that affect clinical performance may help early identification of students at risk and allow for supportive intervention during placement and subsequent program completion. [J Nurs Educ. 2018;57(6):333-338.]. Copyright 2018, SLACK Incorporated.

Designing Academic Audit: Lessons Learned in Europe and Asia.

ERIC Educational Resources Information Center

Dill, David D.

2000-01-01

Reviews lessons learned from early experiments with academic audits in the United Kingdom, Sweden, New Zealand, and Hong Kong in areas such as: focus of audits, selection and training of audit teams, nature of audit self-studies, conduct of audit visits, audit reports, and audit follow-up and enhancement activities. Suggests guidelines for design…

38 CFR 41.215 - Relation to other audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Relation to other audit... (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits. An audit made in accordance...

Temporal Assessment of Mental Disorders, Smoking, and Hazardous Drinking in United States Troops Deployed in Support of the Operations in Iraq and Afghanistan

DTIC Science & Technology

2012-04-26

drinking may have occurred, since the questionnaire includes only two of ten questions of Alcohol Use Disorders Identification Test (AUDIT).44 The degree...Psychiatric disorders and stages of smoking. Biol Psychiatry. 2004;55(1):69-76. 30. Romberger DJ, Grant K. Alcohol consumption and smoking...from human genetic studies. Mol Psychiatry. 2010;15(6):574-588. 44. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the

42 CFR 137.170 - When does the 365 day period commence?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 137.170 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and... other applicable law. ...

Application of the MERIT survey in the multi-criteria quality assessment of occupational health and safety management.

PubMed

Korban, Zygmunt

2015-01-01

Occupational health and safety management systems apply audit examinations as an integral element of these systems. The examinations are used to verify whether the undertaken actions are in compliance with the accepted regulations, whether they are implemented in a suitable way and whether they are effective. One of the earliest solutions of that type applied in the mining industry in Poland involved the application of audit research based on the MERIT survey (Management Evaluation Regarding Itemized Tendencies). A mathematical model applied in the survey facilitates the determination of assessment indexes WOPi for each of the assessed problem areas, which, among other things, can be used to set up problem area rankings and to determine an aggregate (synthetic) assessment. In the paper presented here, the assessment indexes WOPi were used to calculate a development measure, and the calculation process itself was supplemented with sensitivity analysis.

First Order Reliability Application and Verification Methods for Semistatic Structures

NASA Technical Reports Server (NTRS)

Verderaime, Vincent

1994-01-01

Escalating risks of aerostructures stimulated by increasing size, complexity, and cost should no longer be ignored by conventional deterministic safety design methods. The deterministic pass-fail concept is incompatible with probability and risk assessments, its stress audits are shown to be arbitrary and incomplete, and it compromises high strength materials performance. A reliability method is proposed which combines first order reliability principles with deterministic design variables and conventional test technique to surmount current deterministic stress design and audit deficiencies. Accumulative and propagation design uncertainty errors are defined and appropriately implemented into the classical safety index expression. The application is reduced to solving for a factor that satisfies the specified reliability and compensates for uncertainty errors, and then using this factor as, and instead of, the conventional safety factor in stress analyses. The resulting method is consistent with current analytical skills and verification practices, the culture of most designers, and with the pace of semistatic structural designs.

Quality Control Review of the Defense Contract Management Agency Internal Review Audit Function

DTIC Science & Technology

2013-04-18

DMI-2011-001, “Audit of DCMA Telework Program,” November 29, 2011, we identified issues with independence. For the Audit of DCMA Telework Program...and Audit of DCMA Telework Program, we identified issues with audit planning. Specifically, we found that both audits did not include documentation...of fraud risks had been performed during audit planning. For the audit of the DCMA Telework Program, steps were added to the audit program to

Report on Review of the Department of Military and Veterans Affairs Single Audit for the Audit Period October 1, 2005 through September 30, 2007

DTIC Science & Technology

2009-05-22

State of Michigan, single audit and supporting workpapers for the audit period October I, 2005 through September 30, 2007 (biennial audit period), to...determine whether the audit was conducted in accordance with government auditing standards and the auditing and reporting requirements of Office of

12 CFR 550.440 - When do I have to audit my fiduciary activities?

Code of Federal Regulations, 2010 CFR

2010-01-01

... have to audit my fiduciary activities? (a) Annual Audit. If you do not use a continuous audit system... audit, you may adopt a continuous audit system. Under a continuous audit system, you must arrange for a... 12 Banks and Banking 5 2010-01-01 2010-01-01 false When do I have to audit my fiduciary activities...

29 CFR 96.43 - Relation of organization-wide audits to other audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Relation of organization-wide audits to other audit requirements. 96.43 Section 96.43 Labor Office of the Secretary of Labor AUDIT REQUIREMENTS FOR GRANTS, CONTRACTS, AND OTHER AGREEMENTS Access to Records, Audit Standards and Relation of Organization-wide Audits to Other Audit Requirements § 96.43 Relation...

29 CFR 99.215 - Relation to other audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Relation to other audit requirements. 99.215 Section 99.215... Audits § 99.215 Relation to other audit requirements. (a) Audit under this part in lieu of other audits... audited as a major program using the risk-based audit approach described in § 99.520 and, if not, the...

[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.

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.

Comprehensive Auditing in Nuclear Medicine Through the International Atomic Energy Agency Quality Management Audits in Nuclear Medicine (QUANUM) Program. Part 1: the QUANUM Program and Methodology.

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; Paez, Diana; Pascual, Thomas

2017-11-01

An effective management system that integrates quality management is essential for a modern nuclear medicine practice. The Nuclear Medicine and Diagnostic Imaging Section of the International Atomic Energy Agency (IAEA) has the mission of supporting nuclear medicine practice in low- and middle-income countries and of helping them introduce it in their health-care system, when not yet present. The experience gathered over several years has shown diversified levels of development and varying degrees of quality of practice, among others because of limited professional networking and limited or no opportunities for exchange of experiences. Those findings triggered the development of a program named Quality Management Audits in Nuclear Medicine (QUANUM), aimed at improving the standards of NM practice in low- and middle-income countries to internationally accepted standards through the introduction of a culture of quality management and systematic auditing programs. QUANUM takes into account the diversity of nuclear medicine services around the world and multidisciplinary contributions to the practice. Those contributions include clinical, technical, radiopharmaceutical, and medical physics procedures. Aspects of radiation safety and patient protection are also integral to the process. Such an approach ensures consistency in providing safe services of superior quality to patients. The level of conformance is assessed using standards based on publications of the IAEA and the International Commission on Radiological Protection, and guidelines from scientific societies such as Society of Nuclear Medicine and Molecular Imaging (SNMMI) and European Association of Nuclear Medicine (EANM). Following QUANUM guidelines and by means of a specific assessment tool developed by the IAEA, auditors, both internal and external, will be able to evaluate the level of conformance. Nonconformances will then be prioritized and recommendations will be provided during an exit briefing. The same tool could then be applied to assess any improvement after corrective actions are taken. This is the first comprehensive audit program in nuclear medicine that helps evaluate managerial aspects, safety of patients and workers, clinical practice, and radiopharmacy, and, above all, keeps them under control all together, with the intention of continuous improvement. Copyright © 2017. Published by Elsevier Inc.

Outcomes of in-hospital, out of intensive care and operation theatre cardiac arrests in a tertiary referral hospital

PubMed Central

Chakravarthy, Murali; Mitra, Sona; Nonis, Latha

2012-01-01

Objective Cardiac arrest in the hospital wards may not receive as much attention as it does in the operation theatre and intensive care unit (ICU). The experience and the qualifications of personnel in the ward may not be comparable to those in the other vital areas of the hospital. The outcome of cardiac arrest from the ward areas is a reasonable surrogate of training of the ward nurses and technicians in cardiopulmonary resuscitation. We conducted an audit to assess the issues surrounding the resuscitation of cardiac arrest in areas other than operation theatre and ICU in a tertiary referral hospital. Aims of the audit To assess the outcomes of cardiac arrest in a tertiary referral hospital. Areas such as wards, dialysis room and emergency room were considered for the audit. Methods This is a retrospective observational audit of the case records of all the adult patients who were resuscitated from ‘code blue’. Data for 2 years from 2007 was analysed by a research fellow unconnected with the resuscitations. Results Twenty-two thousand three hundred and forty-four patients were admitted as in-patients to the hospital during the 2 years, starting May 2007 through May 2009. One hundred code blue calls were received during this time. Twenty-two of the total calls received were false. Among the 78 confirmed cardiac arrests 69 occurred in the wards, 2 in emergency room, 1 in cardiac catheterisation laboratory and 3 in dialysis room. Twenty-eight patients were declared dead after unsuccessful cardiopulmonary resuscitation. Among the 50 who were resuscitated with a return of spontaneous rhythm 26 died. Twenty-four patients were discharged (survival rate of 30%). The survival decreased significantly as the age progressed beyond 60. The resuscitation rates were better in day shifts in contrast to the night. Higher survival was noted in patients who received resuscitation in less than a minute. Conclusion A overall survival to discharge rate of 30% was noted in this audit. Higher survival rates might be attributable to high rate and degree of training at the time of their employment, which was repeated at yearly interval. PMID:22572417

Alcohol withdrawal management in adult patients in a high acuity medical surgical transitional care unit: a best practice implementation project.

PubMed

Sukhenko, Olga

2016-01-15

Excessive alcohol consumption, a major health problem worldwide, affects about 6% of the United States population. Caring for patients with alcohol withdrawal syndrome in a hospital ward presents complex physiologic and psycho-social challenges which are best met with evidence-based practices. An academic medical center in the United States has been experiencing an increase in patients with alcohol withdrawal syndrome. However, gaps in clinician knowledge and infrastructure supporting the management of these patients still existed. The aim of this project was to improve the continuity of care of patients undergoing alcohol withdrawal in a medical surgical high acuity transitional care unit by incorporating evidence-based practices, and thereby to positively impact on patient outcomes. Specific objectives were related to standardized assessments and pharmacologic management strategies. The project used the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research into Practice audit tool for promoting change in health practice. A baseline clinical audit was conducted to assess compliance with best practices for managing alcohol withdrawal syndrome, which was followed by several interventions targeted at nurses and providers. A follow-up audit was conducted to assess compliance with the implemented strategies. The follow-up audit used the same evidence-based audit criteria as those used for the baseline audit. A non-probabilistic, convenience sampling approach was used. A sample size of 15 patients was used for both the baseline and follow-up audits. The baseline audit revealed a high compliance rate for four of the five audit criteria concerning risk assessment and pharmacologic strategies. There was sub-optimal compliance (53%) with the criterion regarding use of the Clinical Institute Withdrawal Assessment of Alcohol Scale (revised) (CIWA-Ar) scale to assess patients with alcohol withdrawal. After the interventions were implemented this criterion recorded an improvement to 100% compliance. None of the patients in the pilot were transferred to the intensive care unit (ICU) for reasons relating to alcohol withdrawal. The outcomes of this project demonstrated alcohol withdrawal management can be safely undertaken outside the ICU when the patients are appropriately assessed and treated for the severity of their withdrawal symptoms. This new clinical program significantly impacted on continuity of care. Challenges were resolved using an interdisciplinary team approach. The project resulted in plans for further areas of work concerning alcohol withdrawal management, including adoption of similar approaches by other acute and transitional care units. The Joanna Briggs Institute.

18 CFR 286.103 - Notice to audited person.

Code of Federal Regulations, 2010 CFR

2010-04-01

... AUTHORITIES ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF CONTESTED AUDIT FINDINGS AND PROPOSED REMEDIES Disposition of Contested Audit Findings and Proposed Remedies § 286.103 Notice to audited person. An audit... deficiency or audit report or similar document containing a finding or findings that the audited person has...

18 CFR 158.1 - Notice to audited person.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., records, accounts, books, communications or papers relevant to the audit of the audited person; matters... DISPOSITION OF CONTESTED AUDIT FINDINGS AND PROPOSED REMEDIES Disposition of Contested Audit Findings and Proposed Remedies § 158.1 Notice to audited person. An audit conducted by the Commission's staff under...

A survey of community child health audit.

PubMed

Spencer, N J; Penlington, E

1993-03-01

Community child health medical audit is established in most districts surveyed. A minority have integrated audit with hospital paediatric units. Very few districts use an external auditor. Subject audit is preferred to individual performance audit and school health services were the most common services subjected to medical audit. The need for integrated audit and audit forms suitable for use in the community services is discussed.

Developing leading indicators from OHS management audit data: Determining the measurement properties of audit data from the field.

PubMed

Robson, Lynda S; Ibrahim, Selahadin; Hogg-Johnson, Sheilah; Steenstra, Ivan A; Van Eerd, Dwayne; Amick, Benjamin C

2017-06-01

OHS management audits are one means of obtaining data that may serve as leading indicators. The measurement properties of such data are therefore important. This study used data from Workwell audit program in Ontario, a Canadian province. The audit instrument consisted of 122 items related to 17 OHS management elements. The study sought answers regarding (a) the ability of audit-based scores to predict workers' compensation claims outcomes, (b) structural characteristics of the data in relation to the organization of the audit instrument, and (c) internal consistency of items within audit elements. The sample consisted of audit and claims data from 1240 unique firms that had completed one or two OHS management audits during 2007-2010. Predictors derived from the audit results were used in multivariable negative binomial regression modeling of workers' compensation claims outcomes. Confirmatory factor analyses were used to examine the instrument's structural characteristics. Kuder-Richardson coefficients of internal consistency were calculated for each audit element. The ability of audit scores to predict subsequent claims data could not be established. Factor analysis supported the audit instrument's element-based structure. KR-20 values were high (≥0.83). The Workwell audit data display structural validity and high internal consistency, but not, to date, construct validity, since the audit scores are generally not predictive of subsequent firm claim experience. Audit scores should not be treated as leading indicators of workplace OHS performance without supporting empirical data. Analyses of the measurement properties of audit data can inform decisionmakers about the operation of an audit program, possible future directions in audit instrument development, and the appropriate use of audit data. In particular, decision-makers should be cautious in their use of audit scores as leading indicators, in the absence of supporting empirical data. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

A survey of audit activity in general practice.

PubMed Central

Hearnshaw, H; Baker, R; Cooper, A

1998-01-01

BACKGROUND: Since 1991, all general practices have been encouraged to undertake clinical audit. Audit groups report that participation is high, and some local surveys have been undertaken, but no detailed national survey has been reported. AIM: To determine audit activities in general practices and the perceptions of general practitioners (GPs) regarding the future of clinical audit in primary care. METHOD: A questionnaire on audit activities was sent to 707 practices from 18 medical audit advisory group areas. The audit groups had been ranked by annual funding from 1992 to 1995. Six groups were selected at random from the top, middle, and lowest thirds of this rank order. RESULTS: A total of 428 (60.5%) usable responses were received. Overall, 346 (85%) responders reported 125.7 audits from the previous year with a median of three audits per practice. There was no correlation between the number of audits reported and the funding per GP for the medical audit advisory group. Of 997 audits described in detail, changes were reported as 'not needed' in 220 (22%), 'not made' in 142 (14%), 'made' in 439 (44%), and 'made and remeasured' in 196 (20%). Thus, 635 (64%) audits were reported to have led to changes. Some 853 (81%) of the topics identified were on clinical care. Responders made 242 (42%) positive comments on the future of clinical audit in primary care, and 152 (26%) negative views were recorded. CONCLUSION: The level of audit activity in general practice is reasonably high, and most of the audits result in change. The number of audits per practice seems to be independent of the level of funding that the medical audit advisory group has received. Although there is room for improvement in the levels of effective audit activity in general practice, continued support by the professionally led audit groups could enable all practices to undertake effective audit that leads to improvement in patient care. PMID:9624769

A model of four hierarchical levels to train Chinese residents' teaching skills for "practice-based learning and improvement" competency.

PubMed

Yang, Ying-Ying; Yang, Ling-Yu; Hsu, Hui-Chi; Huang, Chia-Chang; Huang, Chin-Chou; Kirby, Ralph; Cheng, Hao Min; Chang, Ching-Chi; Chuang, Chiao-Lin; Liang, Jen-Feng; Lin, Chun-Chi; Lee, Wei-Shin; Ho, Shung-Tai; Lee, Fa-Yauh

2015-01-01

The current study focused on validating a protocol for training and auditing the resident's practice-based learning and improvement (PBLI) and quality improvement (QI) competencies for primary care. Twelve second-year (R2), 12 first-year (R1) and 12 postgraduate year-1 residents were enrolled into group A, B and C, respectively, as trainees. After three training protocols had been completed, a writing test, self-assessed questionnaire and mini-OSTE and end-of-rotation assessment were used in auditing the PBLI competency, performance and teaching ability of trainees. Baseline expert-assessed PBLI and QI knowledge application tool writing scores were low for the R1 and R2 residents. After three training protocols, PBLI and QI proficiencies, performance and teaching abilities were improved to similar levels cross the three training levels of residents based on the expert-assessed writing test-audited assessments and on the faculty and standardized clerk-assessed end-of-rotation-/mini-OSTE-audited assessments. The different four-level hierarchical protocols used to teach group A, B and C were equally beneficial and fitted their needs; namely the different levels of the trainees. Specifically, each level was able to augment their PBLI and QI proficiency. This educational intervention helps medical institutions to train residents as PBLI instructors.

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.

Large-scale, Exhaustive Lattice-based Structural Auditing of SNOMED CT.

PubMed

Zhang, Guo-Qiang; Bodenreider, Olivier

2010-11-13

One criterion for the well-formedness of ontologies is that their hierarchical structure forms a lattice. Formal Concept Analysis (FCA) has been used as a technique for assessing the quality of ontologies, but is not scalable to large ontologies such as SNOMED CT (> 300k concepts). We developed a methodology called Lattice-based Structural Auditing (LaSA), for auditing biomedical ontologies, implemented through automated SPARQL queries, in order to exhaustively identify all non-lattice pairs in SNOMED CT. The percentage of non-lattice pairs ranges from 0 to 1.66 among the 19 SNOMED CT hierarchies. Preliminary manual inspection of a limited portion of the over 544k non-lattice pairs, among over 356 million candidate pairs, revealed inconsistent use of precoordination in SNOMED CT, but also a number of false positives. Our results are consistent with those based on FCA, with the advantage that the LaSA pipeline is scalable and applicable to ontological systems consisting mostly of taxonomic links.

Large-scale, Exhaustive Lattice-based Structural Auditing of SNOMED CT

PubMed Central

Zhang, Guo-Qiang; Bodenreider, Olivier

2010-01-01

One criterion for the well-formedness of ontologies is that their hierarchical structure forms a lattice. Formal Concept Analysis (FCA) has been used as a technique for assessing the quality of ontologies, but is not scalable to large ontologies such as SNOMED CT (> 300k concepts). We developed a methodology called Lattice-based Structural Auditing (LaSA), for auditing biomedical ontologies, implemented through automated SPARQL queries, in order to exhaustively identify all non-lattice pairs in SNOMED CT. The percentage of non-lattice pairs ranges from 0 to 1.66 among the 19 SNOMED CT hierarchies. Preliminary manual inspection of a limited portion of the over 544k non-lattice pairs, among over 356 million candidate pairs, revealed inconsistent use of precoordination in SNOMED CT, but also a number of false positives. Our results are consistent with those based on FCA, with the advantage that the LaSA pipeline is scalable and applicable to ontological systems consisting mostly of taxonomic links. PMID:21347113

Auditing Orthopaedic Audit

PubMed Central

Guryel, E; Acton, K; Patel, S

2008-01-01

INTRODUCTION Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. PATIENTS AND METHODS We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. RESULTS Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. CONCLUSIONS A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change. PMID:18828963

Auditing orthopaedic audit.

PubMed

Guryel, E; Acton, K; Patel, S

2008-11-01

Clinical audit plays an important role in the drive to improve the quality of patient care and thus forms a cornerstone of clinical governance. Assurance that the quality of patient care has improved requires completion of the audit cycle. A considerable sum of money and time has been spent establishing audit activity in the UK. Failure to close the loop undermines the effectiveness of the audit process and wastes resources. We analysed the effectiveness of audit in trauma and orthopaedics at a local hospital by comparing audit projects completed over a 6-year period to criteria set out in the NHS National Audit and Governance report. Of the 25 audits performed since 1999, half were presented to the relevant parties and only 20% completed the audit cycle. Only two of these were audits against national standards and 28% were not based on any standards at all. Only a third of the audits led by junior doctors resulted in implementation of their action plan compared to 75% implementation for consultant-led and 67% for nurse-led audits. A remarkably large proportion of audits included in this analysis failed to meet accepted criteria for effective audit. Audits completed by junior doctors were found to be the least likely to complete the cycle. This may relate to the lack of continuity in modern medical training and little incentive to complete the cycle. Supervision by permanent medical staff, principally consultants, and involvement of the audit department may play the biggest role in improving implementation of change.

Audit of Orthopaedic Audits in an English Teaching Hospital: Are We Closing the Loop?

PubMed Central

Iqbal, H.J; Pidikiti, P

2010-01-01

Background: Clinical audit is an important tool to improve patient care and outcomes in health service. A significant proportion of time and economic resources are spent on activities related to clinical audit. Completion of audit cycle is essential to confirm the improvements in healthcare delivery. We aimed this study to evaluate audits carried out within trauma and orthopaedic unit of a teaching hospital over the last 4 years, and establish the proportions which were re-audited as per recommendations. Methods: Data was collected from records of the clinical audit department. All orthopaedic audit projects from 2005 to 2009 were included in this study. The projects were divided in to local, regional and national audits. Data regarding audit lead clinicians, completion and presentation of projects, recommendations and re-audits was recorded. Results: Out of 61 audits commenced during last four years, 19.7% (12) were abandoned, 72.1% (44) were presented and 8.2 % (5) were still ongoing. The audit cycle was completed in only 29% (13) projects. Conclusion: Change of junior doctors every 4~6 months is related to fewer re-audits. Active involvement by supervising consultant, reallocation of the project after one trainee has finished, and full support of audit department may increase the ratio of completion of audit cycles, thereby improving the patient care. PMID:20721318

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.

10 CFR 603.645 - Periodic audits and award-specific audits of for-profit participants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... amounts or adjusts performance outcomes. The periodic audit provides some assurance that the reported... 10 Energy 4 2010-01-01 2010-01-01 false Periodic audits and award-specific audits of for-profit... Financial Matters § 603.645 Periodic audits and award-specific audits of for-profit participants. The...

10 CFR 603.1295 - Periodic audit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Periodic audit. 603.1295 Section 603.1295 Energy... Used in this Part § 603.1295 Periodic audit. An audit of a participant, performed at an agreed-upon... an audit may cover. A periodic audit of a participant differs from an award-specific audit of an...

Scholastic Audits. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2009-01-01

What is a scholastic audit? The purpose of the audit is to assist individual schools and districts improve. The focus is on gathering data and preparing recommendations that can be used to guide school improvement initiatives. Scholastic audits use a multi-step approach and include: (1) Preparing for the Audit; (2) Audit process; (3) Audit report;…

Auditing audits: use and development of the Oxfordshire Medical Audit Advisory Group rating system.

PubMed Central

Lawrence, M.; Griew, K.; Derry, J.; Anderson, J.; Humphreys, J.

1994-01-01

OBJECTIVES--To assess the value of the Oxfordshire Medical Audit Advisory Group rating system in monitoring and stimulating audit activity, and to implement a development of the system. DESIGN--Use of the rating system for assessment of practice audits on three annual visits in Oxfordshire; development and use of an "audit grid" as a refinement of the system; questionnaire to all medical audit advisory groups in England and Wales. SETTING--All 85 general practices in Oxfordshire; all 95 medical audit advisory groups in England and Wales. MAIN OUTCOME MEASURES--Level of practices' audit activity as measured by rating scale and grid. Use of scale nationally together with perceptions of strengths and weaknesses as perceived by chairs of medical audit advisory groups. RESULTS--After one year Oxfordshire practices more than attained the target standards set in 1991, with 72% doing audit involving setting target standards or implementing change; by 1993 this had risen to 78%. Most audits were confined to chronic disease management, preventive care, and appointments. 38 of 92 medical audit advisory groups used the Oxfordshire group's rating scale. Its main weaknesses were insensitivity in assessing the quality of audits and failure to measure team involvement. CONCLUSIONS--The rating system is effective educationally in helping practices improve and summatively for providing feedback to family health service authorities. The grid showed up weakness in the breadth of audit topics studied. IMPLICATIONS AND ACTION--Oxfordshire practices achieved targets set for 1991-2 but need to broaden the scope of their audits and the topics studied. The advisory group's targets for 1994-5 are for 50% of practices to achieve an audit in each of the areas of clinical care, access, communication, and professional values and for 80% of audits to include setting targets or implementing change. PMID:8086911

Is There An Academic Audit in Your Future? Reforming Quality Assurance in U.S. Higher Education.

ERIC Educational Resources Information Center

Dill, David D.

2000-01-01

Describes a new form of academic quality assurance, the academic audit. Reviews use of academic audits abroad and experimental use of such audits in the United States. Identifies issues in academic audits, including focus of audits, auditor selection and training, institutional preparation for an audit, interaction between institutional policies…

25 CFR 39.410 - What qualifications must an audit firm meet to be considered for auditing ISEP administration?

Code of Federal Regulations, 2010 CFR

2010-04-01

... considered for auditing ISEP administration? 39.410 Section 39.410 Indians BUREAU OF INDIAN AFFAIRS... qualifications must an audit firm meet to be considered for auditing ISEP administration? To be considered for auditing ISEP administration under this subpart, an independent audit firm must: (a) Be a licensed...

Feasibility of using routinely collected inpatient data to monitor quality and inform choice: a case study using the UK inflammatory bowel disease audit

PubMed Central

Roberts, Stephen E; Williams, John G; Cohen, David R; Akbari, Ashley; Groves, Sam; Button, Lori A

2011-01-01

Objective To assess the utility and cost of using routinely collected inpatient data for large-scale audit. Design Comparison of audit data items collected nationally in a designed audit of inflammatory bowel disease (UK IBD audit) with routinely collected inpatient data; surveys of audit sites to compare costs. Setting National Health Service hospitals across England, Wales and Northern Ireland that participated in the UK IBD audit. Patients Patients in the UK IBD audit. Interventions None. Main outcome measures Percentage agreement between designed audit data items collected for the UK IBD audit and routine inpatient data items; costs of conducting the designed UK IBD audit and the routine data audit. Results There were very high matching rates between the designed audit data and routine data for a small subset of basic important information collected in the UK IBD audit, including mortality; major surgery; dates of admission, surgery, discharge and death; principal diagnoses; and sociodemographic patient characteristics. There were lower matching rates for other items, including source of admission, primary reason for admission, most comorbidities, colonoscopy and sigmoidoscopy. Routine data did not cover most detailed information collected in the UK IBD audit. Using routine data was much less costly than collecting designed audit data. Conclusion Although valuable for large population-based studies, and less costly than designed data, routine inpatient data are not suitable for the evaluation of individual patient care within a designed audit. PMID:28839601

Safety Auditing and Assessments

NASA Technical Reports Server (NTRS)

Goodin, James Ronald (Ronnie)

2005-01-01

Safety professionals typically do not engage in audits and independent assessments with the vigor as do our quality brethren. Taking advantage of industry and government experience conducting value added Independent Assessments or Audits benefits a safety program. Most other organizations simply call this process "internal audits." Sources of audit training are presented and compared. A relation of logic between audit techniques and mishap investigation is discussed. An example of an audit process is offered. Shortcomings and pitfalls of auditing are covered.

Safety Auditing and Assessments

NASA Astrophysics Data System (ADS)

Goodin, Ronnie

2005-12-01

Safety professionals typically do not engage in audits and independent assessments with the vigor as do our quality brethren. Taking advantage of industry and government experience conducting value added Independent Assessments or Audits benefits a safety program. Most other organizations simply call this process "internal audits." Sources of audit training are presented and compared. A relation of logic between audit techniques and mishap investigation is discussed. An example of an audit process is offered. Shortcomings and pitfalls of auditing are covered.

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.

Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test.

PubMed

Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony P; Conigrave, Katherine M; Simpson, Lynette; Bliss, Donna; Allan, Julaine

2014-09-01

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90.

Controls Over Copyrighted Computer Software

DTIC Science & Technology

1993-02-19

The Army Audit Agency issued five installation reports as a result of one multilocation audit . The audit found that 41 percent of the computers...ARMY AUDIT AGENCY REPORTS ON COMPUTER SOFTWARE MANAGEMENT The U.S. Army Audit Agency conducted three multilocation audits from March 1988 through...December 1990, covering the acquisition, use, control, and accountability of commercial software. One multilocation audit resulted in five

23 CFR 140.805 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Audit Expense § 140.805 Definitions. (a) Project related audits. Audits which directly benefit Federal-aid highway projects. Audits performed in accordance with the requirements of 23 CFR part 12, audits of third party contract costs, and other audits providing assurance that a recipient has complied...

The Legal Audit: Preventing Problems.

ERIC Educational Resources Information Center

Perlman, Daniel H.

1987-01-01

Suffolk University initiated two audits that proved beneficial: a legal audit and an insurance audit. A legal audit involves having an attorney review a college's contracts, personnel handbooks, catalogs, etc., in order to anticipate and prevent problems. An insurance audit reviews an institution's risk coverage. (MLW)

Inspector General, DOD, Oversight of the Air Force Audit Agency Audit of the FY 1995 Air Force Consolidated Financial Statements.

DTIC Science & Technology

1996-04-18

financial statements . We delegated the audit of the FY 1995 Air Force consolidated financial statements to the Air Force Audit Agency. On March 1...1996, the Air Force Audit Agency issued its "Report of Audit: Opinion on Fiscal Year 1995 Air Force Consolidated Financial Statements " (Project 94053001...disclaimer of opinion. The audit objective was to determine the accuracy and completeness of the audit of the FY 1995 Air Force consolidated financial statements conducted

7 CFR 1773.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... accounting principles (GAAP) and for determining whether the borrower has complied with applicable laws...”. GAAP means generally accepted accounting principles. GAGAS means generally accepted government auditing... an asset resulting from an action of a regulator as prescribed in Statement of Financial Accounting...

13 CFR 120.1822 - What is the process to apply for an SISMBD Loan?

Code of Federal Regulations, 2010 CFR

2010-01-01

... loan; (2) A statement of the amount requested; (3) Applicant's IRS tax identification number; (4) A... prepared by an accountant, including a copy of its most recent outside audit report, a balance sheet, an...

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...

24 CFR 570.405 - The insular areas.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Threshold requirements. HUD shall review each grantee's progress on outstanding grants made under this..., HUD will consider program achievements and the applicant's effectiveness in using program funds. Effectiveness in using program funds shall be measured by reviewing audit, monitoring and performance reports...

30 CFR 74.9 - Quality assurance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... registration under ISO Q9001-2000, American National Standard, Quality Management Systems-Requirements... ISO Q9001-2000, American National Standard, Quality Management Systems-Requirements. The Director of... management audits. Upon request, applicants or approval holders must allow NIOSH to inspect the quality...

13 CFR 500.205 - Application process.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Program, as described in the Loan Documents, and agreeing to permit audits by the General Accounting... consistent with the “Uniform Standards of Professional Appraisal Practice,” promulgated by the Appraisal... financial statements reviewed by a certified public accountant following generally accepted accounting...

13 CFR 500.205 - Application process.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Program, as described in the Loan Documents, and agreeing to permit audits by the General Accounting... consistent with the “Uniform Standards of Professional Appraisal Practice,” promulgated by the Appraisal... financial statements reviewed by a certified public accountant following generally accepted accounting...

13 CFR 500.205 - Application process.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Program, as described in the Loan Documents, and agreeing to permit audits by the General Accounting... consistent with the “Uniform Standards of Professional Appraisal Practice,” promulgated by the Appraisal... financial statements reviewed by a certified public accountant following generally accepted accounting...

13 CFR 500.205 - Application process.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Program, as described in the Loan Documents, and agreeing to permit audits by the General Accounting... consistent with the “Uniform Standards of Professional Appraisal Practice,” promulgated by the Appraisal... financial statements reviewed by a certified public accountant following generally accepted accounting...

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...

40 CFR Table 7 to Subpart Ppppp of... - Applicability of General Provisions to Subpart PPPPP

Code of Federal Regulations, 2010 CFR

2010-07-01

... Yes. 3. Performance audit requirements Yes. 4. Internal and external QA procedures for testing Yes... keep quality control plan on record for 5 years. Keep old versions for 5 years after revisions Yes...

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...

13 CFR 400.205 - Application process.

Code of Federal Regulations, 2010 CFR

2010-01-01

... appropriate environmental site assessments, and current personal and corporate financial statements of any... statements of guarantors shall be prepared by independent Certified Public Accountants; (8) Consolidated financial statements of the Borrower for the previous three years that have been audited by an independent...

43 CFR 12.44 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Lands: Interior Office of the Secretary of the Interior ADMINISTRATIVE AND AUDIT REQUIREMENTS AND COST... Services; Social Services; Low-Income Home Energy Assistance; States' Program of Community Development... out the following programs of the Social Security Act: (i) Aid to Needy Families with Dependent...

Development and Usefulness of a District Health Systems Tool for Performance Improvement in Essential Public Health Functions in Botswana and Mozambique.

PubMed

Bishai, David; Sherry, Melissa; Pereira, Claudia C; Chicumbe, Sergio; Mbofana, Francisco; Boore, Amy; Smith, Monica; Nhambi, Leonel; Borse, Nagesh N

2016-01-01

This study describes the development of a self-audit tool for public health and the associated methodology for implementing a district health system self-audit tool that can provide quantitative data on how district governments perceive their performance of the essential public health functions. Development began with a consensus-building process to engage Ministry of Health and provincial health officers in Mozambique and Botswana. We then worked with lists of relevant public health functions as determined by these stakeholders to adapt a self-audit tool describing essential public health functions to each country's health system. We then piloted the tool across districts in both countries and conducted interviews with district health personnel to determine health workers' perception of the usefulness of the approach. Country stakeholders were able to develop consensus around 11 essential public health functions that were relevant in each country. Pilots of the self-audit tool enabled the tool to be effectively shortened. Pilots also disclosed a tendency to upcode during self-audits that was checked by group deliberation. Convening sessions at the district enabled better attendance and representative deliberation. Instant feedback from the audit was a feature that 100% of pilot respondents found most useful. The development of metrics that provide feedback on public health performance can be used as an aid in the self-assessment of health system performance at the district level. Measurements of practice can open the door to future applications for practice improvement and research into the determinants and consequences of better public health practice. The current tool can be assessed for its usefulness to district health managers in improving their public health practice. The tool can also be used by the Ministry of Health or external donors in the African region for monitoring the district-level performance of the essential public health functions.

MO-D-213-08: Remote Dosimetric Credentialing for Clinical Trials with the Virtual EPID Standard Phantom Audit (VESPA)

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

Lehmann, J; University of Sydney, Sydney, NSW; Miri, N

Purpose: Report on implementation of a Virtual EPID Standard Phantom Audit (VESPA) for IMRT to support credentialing of facilities for clinical trials. Data is acquired by local facility staff and transferred electronically. Analysis is performed centrally. Methods: VESPA is based on published methods and a clinically established IMRT QA procedure, here extended to multi-vendor equipment. Facilities, provided with web-based comprehensive instructions and CT datasets, create IMRT treatment plans. They deliver the treatments directly to their EPID without phantom or couch in the beam. They also deliver a set of simple calibration fields. Collected EPID images are uploaded electronically. In themore » analysis, the dose is projected back into a virtual phantom and 3D gamma analysis is performed. 2D dose planes and linear dose profiles can be analysed when needed for clarification. Results: Pilot facilities covering a range of planning and delivery systems have performed data acquisition and upload successfully. Analysis showed agreement comparable to local experience with the method. Advantages of VESPA are (1) fast turnaround mainly driven by the facility’s capability to provide 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 1 audit still required, and that it relies on correctly delivered open calibration fields, which are used for system calibration. Conclusion: The implemented EPID based IMRT audit system promises to dramatically improve credentialing efficiency for clinical trials and wider applications. VESPA for VMAT will follow soon.« less

Development and Usefulness of a District Health Systems Tool for Performance Improvement in Essential Public Health Functions in Botswana and Mozambique

PubMed Central

Bishai, David; Sherry, Melissa; Pereira, Claudia C.; Chicumbe, Sergio; Mbofana, Francisco; Boore, Amy; Smith, Monica; Nhambi, Leonel; Borse, Nagesh N.

2018-01-01

Introduction This study describes the development of a self-audit tool for public health and the associated methodology for implementing a district health system self-audit tool that can provide quantitative data on how district governments perceive their own performance of the essential public health functions. Methods Development began with a consensus building process to engage Ministry of Health and provincial health officers in Mozambique and Botswana. We then worked with lists of relevant public health functions as determined by these stakeholders to adapt a self-audit tool describing essential public health functions to each country’s health system. We then piloted the tool across districts in both countries and conducted interviews with district health personnel to determine health workers’ perception of the usefulness of the approach. Results Country stakeholders were able to develop consensus around eleven essential public health functions that were relevant in each country. Pilots of the self-audit tool enabled the tool to be effectively shortened. Pilots also disclosed a tendency to up code during self-audits that was checked by group deliberation. Convening sessions at the district enabled better attendance and representative deliberation. Instant feedback from the audit was a feature that 100% of pilot respondents found most useful. Conclusions The development of metrics that provide feedback on public health performance can be used as an aid in the self-assessment of health system performance at the district level. Measurements of practice can open the door to future applications for practice improvement and research into the determinants and consequences of better public health practice. The current tool can be assessed for its usefulness to district health managers in improving their public health practice. The tool can also be used by ministry of health or external donors in the African region for monitoring the district level performance of the essential public health functions. PMID:27682727

Discharge planning for heart failure patients in a tertiary hospital in Shanghai: a best practice implementation project.

PubMed

Chen, Yu; Zhu, Li; Xu, Fei; Chen, Jun

2016-02-01

Heart failure is a major public health concern which contributes significantly to rising healthcare costs. Comprehensive discharge planning can improve health outcomes and reduce readmission rates which, in turn, can lead to cost savings. The aim of this project was to promote best practice in the discharge planning of heart failure patients admitted in the coronary care unit of Zhongshan Hospital. A clinical audit was undertaken using the Joanna Briggs Institute Practical Application of Clinical Evidence System tool. Five audit criteria that represent best practice recommendations for heart failure discharge planning were used. A baseline audit was conducted followed by the implementation of multiple strategies, and the project was finalized with a follow-up audit to determine change in practice. Improvements in practice were observed for all five criteria. The most significant improvements were in the following: completion of a discharge checklist (from 0% to 100% compliance), comprehensive (i.e. inclusion of six topics for self-care) discharge education for patients (from 7% to 100% compliance), and conducting a telephone follow-up (from 0% to 76% compliance). The compliance rates for the two remaining criteria, completion of a structured education for patients and scheduling an outpatient clinic visit, both increased from 93% to 100%.Strategies that were implemented to achieve change in practice included development of a local discharge planning checklist, provision of training for nurses, and development of resources. The project demonstrated positive changes in the discharge planning practices of nurses in the coronary care unit of Zhongshan Hospital. A formalized discharge planning is currently in place and plans for sustaining practice change are underway. A continuous cycle of audit and re-audit will need to be carried out in the future to determine the impact of this evidence implementation activity on heart failure patient outcomes.

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...

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…

Barriers to conducting effective obstetric audit in Ifakara: a qualitative assessment in an under-resourced setting in Tanzania.

PubMed

van Hamersveld, Koen T; den Bakker, Emil; Nyamtema, Angelo S; van den Akker, Thomas; Mfinanga, Elirehema H; van Elteren, Marianne; van Roosmalen, Jos

2012-05-01

To explore barriers to and solutions for effective implementation of obstetric audit at Saint Francis Designated District Hospital in Ifakara, Tanzania, where audit results have been disappointing 2 years after its introduction. Qualitative study involving participative observation of audit sessions, followed by 23 in-depth interviews with health workers and managers. Knowledge and perceptions of audit were assessed and suggestions for improvement of the audit process explored. During the observational period, audit sessions were held irregularly and only when the head of department of obstetrics and gynaecology was available. Cases with evident substandard care factors were audited. In-depth interviews revealed inadequate knowledge of the purpose of audit, despite the fact that participants regarded obstetric audit as a potentially useful tool. Insufficient staff commitment, managerial support and human and material resources were mentioned as reasons for weak involvement of health workers and poor implementation of recommendations resulting from audit. Suggestions for improvement included enhancing feedback to all staff and managers to attend sessions and assist with the effectuation of audit recommendations. Obstetric staff in Ifakara see audit as an important tool for quality improvement. They recognise, however, that in their own situation, insufficient staff commitment and poor managerial support are barriers to successful implementation. They suggested training in concept and principles of audit as well as strengthening feedback of audit outcomes, to achieve structural health care improvements through audit. © 2012 Blackwell Publishing Ltd.

46 CFR 272.42 - Audit requirements and procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... procedures. (a) Required audit. In connection with the audit of the Operator's subsidizable expenses, the... of audit results. Upon completion of the audit by the Office of Inspector General, the MARAD Office of Financial Approvals shall notify the Operator of the audit results, including any items disallowed...

41 CFR 102-118.415 - Will the widespread mandatory use of prepayment audits eliminate postpayment audits?

Code of Federal Regulations, 2010 CFR

2010-07-01

... mandatory use of prepayment audits eliminate postpayment audits? 102-118.415 Section 102-118.415 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Postpayment Transportation Audits...

76 FR 55124 - Audit Committee Meeting of the Board of Directors; Sunshine Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... NEIGHBORHOOD REINVESTMENT CORPORATION Audit Committee Meeting of the Board of Directors; Sunshine... Internal Audit Director III. Internal Audit Report with Management's Response IV. FY `11 and `12 Risk Assessments and Internal Audit Plans V. Internal Audit Resource Capacity Proposal VI. Communication of...

78 FR 70964 - Sunshine Act Meeting; Audit Committee of the Board of Directors

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

... NEIGHBORHOOD REINVESTMENT CORPORATION Sunshine Act Meeting; Audit Committee of the Board of... with the Chief Audit Executive III. Executive Session: Chief Audit Executive Performance Review IV... Audit Reports with Management's Response VI. Internal Audit Status Reports VII. MHA/NFMC/EHLP Compliance...

46 CFR Sec. 12 - Audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Audit. Sec. 12 Section 12 Shipping MARITIME... TRANSACTIONS UNDER AGENCY AGREEMENTS Reports and Audit Sec. 12 Audit. (a) The owner will audit as currently as possible subsequent to audit by the agent, all documents relating to the activities, maintenance and...

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.

AUDIT, AUDIT-C, and AUDIT-3: Drinking Patterns and Screening for Harmful, Hazardous and Dependent Drinking in Katutura, Namibia

PubMed Central

Seth, Puja; Glenshaw, Mary; Sabatier, Jennifer H. F.; Adams, René; Du Preez, Verona; DeLuca, Nickolas; Bock, Naomi

2015-01-01

Objectives To describe alcohol drinking patterns among participants in Katutura, Namibia, and to evaluate brief versions of the AUDIT against the full AUDIT to determine their effectiveness in detecting harmful drinking. Methods A cross-sectional survey was conducted in four constituencies and 639 participants, 18 years or older, completed a sociodemographic survey and the AUDIT. The effectiveness of the AUDIT-C (first three questions) and the AUDIT-3 (third question) was compared to the full AUDIT. Results Approximately 40% were identified as harmful, hazardous or likely dependent drinkers, with men having a higher likelihood than women (57.2% vs. 31.0%, p<.0001). Approximately 32% reported making and/or selling alcohol from home. The AUDIT-C performed best at a cutoff ≥ 3, better in men (sensitivity: 99.3%, specificity: 77.8%) than women (sensitivity: 91.7%, specificity: 77.4%). The AUDIT-3 performed poorly (maximum sensitivity: < 90%, maximum specificity: <51%). According to AUROC, the AUDIT-C performed better than the AUDIT-3. Conclusions A large proportion of participants met criteria for alcohol misuse, indicating a need for screening and referral for further evaluation and intervention. The AUDIT-C was almost as effective as the full AUDIT and may be easier to implement in clinical settings as a routine screening tool in resource-limited settings because of its brevity. PMID:25799590

AUDIT, AUDIT-C, and AUDIT-3: drinking patterns and screening for harmful, hazardous and dependent drinking in Katutura, Namibia.

PubMed

Seth, Puja; Glenshaw, Mary; Sabatier, Jennifer H F; Adams, René; Du Preez, Verona; DeLuca, Nickolas; Bock, Naomi

2015-01-01

To describe alcohol drinking patterns among participants in Katutura, Namibia, and to evaluate brief versions of the AUDIT against the full AUDIT to determine their effectiveness in detecting harmful drinking. A cross-sectional survey was conducted in four constituencies and 639 participants, 18 years or older, completed a sociodemographic survey and the AUDIT. The effectiveness of the AUDIT-C (first three questions) and the AUDIT-3 (third question) was compared to the full AUDIT. Approximately 40% were identified as harmful, hazardous or likely dependent drinkers, with men having a higher likelihood than women (57.2% vs. 31.0%, p<.0001). Approximately 32% reported making and/or selling alcohol from home. The AUDIT-C performed best at a cutoff ≥ 3, better in men (sensitivity: 99.3%, specificity: 77.8%) than women (sensitivity: 91.7%, specificity: 77.4%). The AUDIT-3 performed poorly (maximum sensitivity: < 90%, maximum specificity: <51%). According to AUROC, the AUDIT-C performed better than the AUDIT-3. A large proportion of participants met criteria for alcohol misuse, indicating a need for screening and referral for further evaluation and intervention. The AUDIT-C was almost as effective as the full AUDIT and may be easier to implement in clinical settings as a routine screening tool in resource-limited settings because of its brevity.

24 CFR 84.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... education or other non-profit organization (including hospitals) shall be subject to the audit requirements... 84 shall comply with the audit requirements of revised OMB Circular A-133, “Audits of States, Local... subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 U.S.C. 7501...

45 CFR 2543.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (including hospitals) shall be subject to the audit requirements contained in the Single Audit Act Amendments..., and Non-Profit Organizations.” (b) State and local governments shall be subject to the audit... hospitals not covered by the audit provisions of revised OMB Circular A-133 shall be subject to the audit...

28 CFR 70.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... organizations (including hospitals) shall be subject to the audit requirements contained in the Single Audit Act..., and Non-Profit Organizations.” (b) State and local governments shall be subject to the audit... hospitals not covered by the audit provisions of revised OMB Circular A-133 shall be subject to the audit...

41 CFR 102-118.440 - What are the postpayment audit responsibilities and roles of the GSA Audit Division?

Code of Federal Regulations, 2010 CFR

2010-07-01

... audit responsibilities and roles of the GSA Audit Division? 102-118.440 Section 102-118.440 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Postpayment Transportation Audits...

The Communication Audit: A Framework for Teaching Management Communication.

ERIC Educational Resources Information Center

Shelby, Annette N.; Reinsch, N. Lamar, Jr.

1996-01-01

Describes a communication audit project used in a graduate-level management communication course. Reviews literature concerning communication audits, explains why and how an audit project is used in the author's classes, and describes specific audit-related assignments. Concludes that, although a challenging assignment, the audit is worthwhile.…

38 CFR 41.200 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit requirements. 41...) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.200 Audit requirements. (a) Audit required. Non-Federal entities that expend $500,000 or more in a year in Federal awards shall have...

20 CFR 655.1312 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 655.1312 Section 655.1312 Employees... United States (H-2A Workers) § 655.1312 Audits. (a) Discretion. The Department will conduct audits of... selected for audit will be chosen within the sole discretion of the Department. (b) Audit letter. Where an...

30 CFR 735.22 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Audit. 735.22 Section 735.22 Mineral Resources... ENFORCEMENT § 735.22 Audit. The agency shall arrange for an independent audit no less frequently than once..., Attachment P. The audits will be performed in accordance with the “Standards for Audit of Governmental...

16 CFR 703.7 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Audits. 703.7 Section 703.7 Commercial... Audits. (a) The Mechanism shall have an audit conducted at least annually, to determine whether the... be kept under § 703.6 of this part shall be available for audit. (b) Each audit provided for in...

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...

[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.

Naval Audit Service: Effectiveness of Navy’s Internal Audit Organization is Limited.

DTIC Science & Technology

1988-02-24

reports were inaccurate or incomplete in reporting audit findings. Additionally, summary reports on multilocation audits con- tained findings not reported... Audit Reports 29 Deficiencies in Multilocation Audits 30 ; Deficiencies in Supervision 32 Conclusions 34 " Recommendations 34 Agency Comments and Our...Congress, the Sec- retary of the Navy, or the general public. After multilocation audits , NAS headquarters issues summary reports which consolidate the

Reference Architecture for MNE 5 Technical System

DTIC Science & Technology

2007-05-30

of being available in most experiments. Core Services A core set of applications whi directories, web portal and collaboration applications etc. A...classifications Messages (xml, JMS, content level…) Meta data filtering, who can initiate services Web browsing Collaboration & messaging Border...Exchange Ref Architecture for MNE5 Tech System.doc 9 of 21 audit logging Person and machine Data lev objects, web services, messages rification el

AUDIT and AUDIT-C as screening instruments for alcohol problem use in adolescents.

PubMed

Liskola, Joni; Haravuori, Henna; Lindberg, Nina; Niemelä, Solja; Karlsson, Linnea; Kiviruusu, Olli; Marttunen, Mauri

2018-07-01

The Alcohol Use Disorders Identification Test (AUDIT) is commonly used in adults to screen for harmful alcohol consumption but few studies exist on its use among adolescents. Our aim was to validate the AUDIT and its derivative consumption questionnaire (AUDIT-C) as screening instruments for the detection of problem use of alcohol in adolescents. 621 adolescents (age-range, 12-19 years) were drawn from clinical and population samples who completed the AUDIT questionnaire. Psychiatric diagnoses were assessed using K-SADS-PL. A rating based on the K-SADS-PL was used to assess alcohol use habits, alcohol use disorders, screening and symptom criteria questions. Screening performance of the AUDIT and AUDIT-C sum scores and Receiver Operating Characteristic (ROC) curves were calculated. The diagnostic odds ratios (dOR) were calculated to express the overall discrimination between cut-offs. Comparisons of ROC between the AUDIT and AUDIT-C pairs indicated a slightly better test performance by AUDIT for the whole sample and in a proportion of the subsamples. Optimal cut-off value for the AUDIT was ≥5 (sensitivity 0.931, specificity 0.772, dOR 45.22; 95% CI: 24.72-83.57) for detecting alcohol problem use. The corresponding optimal cut-off value for the AUDIT-C was ≥3 in detecting alcohol problem use (sensitivity 0.952, specificity 0.663, dOR 39.31; 95% CI: 19.46-78.97). Agreement between the AUDIT and AUDIT-C using these cut-off scores was high at 91.9%. Our results for the cut-off scores for the early detection of alcohol problem use in adolescents are ≥5 for AUDIT, and ≥3 for AUDIT-C. Copyright © 2018 Elsevier B.V. All rights reserved.

Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

PubMed Central

2014-01-01

Background The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Methods Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. Results The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Conclusions Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90. PMID:25179547

Desiderata for a Computer-Assisted Audit Tool for Clinical Data Source Verification Audits

PubMed Central

Duda, Stephany N.; Wehbe, Firas H.; Gadd, Cynthia S.

2013-01-01

Clinical data auditing often requires validating the contents of clinical research databases against source documents available in health care settings. Currently available data audit software, however, does not provide features necessary to compare the contents of such databases to source data in paper medical records. This work enumerates the primary weaknesses of using paper forms for clinical data audits and identifies the shortcomings of existing data audit software, as informed by the experiences of an audit team evaluating data quality for an international research consortium. The authors propose a set of attributes to guide the development of a computer-assisted clinical data audit tool to simplify and standardize the audit process. PMID:20841814

7 CFR 37.2 - Services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ASSESS ORGANIC CERTIFYING AGENCIES § 37.2 Services. Organic certifying agencies requesting assessment...—General Requirements for Bodies Operating Product Certification Systems, Ref. No. ISO/IEC Guide 65:1996... manual against the requirements of ISO Guide 65; and (2) Onsite auditing of an applicant's organic...

13 CFR 307.12 - Revolving Loan Fund Income.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 307.12 Business Credit and Assistance ECONOMIC DEVELOPMENT ADMINISTRATION, DEPARTMENT OF COMMERCE ECONOMIC ADJUSTMENT ASSISTANCE INVESTMENTS Special Requirements for Revolving Loan Funds and Use of Grant..., RLF Recipients must comply with applicable federal cost principles and audit requirements as found in...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

14 CFR 151.127 - Accounting and audit.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) AIRPORTS FEDERAL AID TO AIRPORTS Rules and Procedures for Advance Planning and Engineering Proposals § 151... costs are also applicable to advance planning proposal costs. However, the requirement of segregating and grouping costs applies only to § 151.55(a) (5) and (7) classifications. ...

42 CFR 488.9 - Onsite observation of accreditation organization operations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the application review process, the validation review process, or the continuing oversight of an... limited to, the review of documents, auditing meetings concerning the accreditation process, the evaluation of survey results or the accreditation decision-making process, and interviews with the...

42 CFR 488.9 - Onsite observation of accreditation organization operations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the application review process, the validation review process, or the continuing oversight of an... limited to, the review of documents, auditing meetings concerning the accreditation process, the evaluation of survey results or the accreditation decision-making process, and interviews with the...

42 CFR 488.9 - Onsite observation of accreditation organization operations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the application review process, the validation review process, or the continuing oversight of an... limited to, the review of documents, auditing meetings concerning the accreditation process, the evaluation of survey results or the accreditation decision-making process, and interviews with the...

42 CFR 488.9 - Onsite observation of accreditation organization operations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the application review process, the validation review process, or the continuing oversight of an... limited to, the review of documents, auditing meetings concerning the accreditation process, the evaluation of survey results or the accreditation decision-making process, and interviews with the...

41 CFR 102-118.445 - Must my agency pay for a postpayment audit when using the GSA Audit Division?

Code of Federal Regulations, 2010 CFR

2010-07-01

... postpayment audit when using the GSA Audit Division? 102-118.445 Section 102-118.445 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...

30 CFR 725.19 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Audit. 725.19 Section 725.19 Mineral Resources... REGULATIONS REIMBURSEMENTS TO STATES § 725.19 Audit. The agency shall arrange for an independent audit no less... Circular No. A-102, Attachment P. The audits will be performed in accordance with the “Standards for Audit...

32 CFR 37.1325 - Periodic audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Periodic audit. 37.1325 Section 37.1325 National... TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1325 Periodic audit. An audit of... awards. Appendix C to this part describes what such an audit may cover. A periodic audit of a participant...

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Audits. 96.31 Section 96.31 Public Welfare... Audits. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits in accordance with the Single Audit Act Amendments of 1996 (31 U.S.C. 7501-7507) and revised OMB Circular A-133, “Audits...

29 CFR 99.220 - Frequency of audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Frequency of audits. 99.220 Section 99.220 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.220 Frequency of audits. Except for the provisions for biennial audits provided in paragraphs (a) and...

29 CFR 99.230 - Audit costs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Audit costs. 99.230 Section 99.230 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.230 Audit... years ending after December 31, 2003) and is thereby exempted under § 99.200(d) from having an audit...

Analysis of the 323rd Flying Training Wing Using Organizational Development and the Action Research Model: A Communications Audit.

DTIC Science & Technology

1979-05-15

United - -r’TA a~ y, Colorado Submitted in partial satisfaction of the requirements for the degree of MASTER OF ARTS in SPEECH COMMUNICATION V.r at...were developed, one by Fiedler and the other by Vroom , and finally the action research model proposed by French and Bell. All three have a different... Performance ," Org.anizational Behavior and Human Performance 3(1968): 143. 9 David A. Nadler, Philip H. Mirvis, and Cortland T. Cammann, "The Ongoing Feedback

Reviewing audit: barriers and facilitating factors for effective clinical audit.

PubMed

Johnston, G; Crombie, I K; Davies, H T; Alder, E M; Millard, A

2000-03-01

To review the literature on the benefits and disadvantages of clinical and medical audit, and to assess the main facilitators and barriers to conducting the audit process. A comprehensive literature review was undertaken through a thorough review of Medline and CINAHL databases using the keywords of "audit", "audit of audits", and "evaluation of audits" and a handsearch of the indexes of relevant journals for key papers. Findings from 93 publications were reviewed. These ranged from single case studies of individual audit projects through retrospective reviews of departmental audit programmes to studies of interface projects between primary and secondary care. The studies reviewed incorporated the experiences of a wide variety of clinicians, from medical consultants to professionals allied to medicine and from those involved in unidisciplinary and multidisciplinary ventures. Perceived benefits of audit included improved communication among colleagues and other professional groups, improved patient care, increased professional satisfaction, and better administration. Some disadvantages of audit were perceived as diminished clinical ownership, fear of litigation, hierarchical and territorial suspicions, and professional isolation. The main barriers to clinical audit can be classified under five main headings. These are lack of resources, lack of expertise or advice in project design and analysis, problems between groups and group members, lack of an overall plan for audit, and organisational impediments. Key facilitating factors to audit were also identified: they included modern medical records systems, effective training, dedicated staff, protected time, structured programmes, and a shared dialogue between purchasers and providers. Clinical audit can be a valuable assistance to any programme which aims to improve the quality of health care and its delivery. Yet without a coherent strategy aimed at nurturing effective audits, valuable opportunities will be lost. Paying careful attention to the professional attitudes highlighted in this review may help audit to deliver on some of its promise.

Utility of Brief Versions of the Alcohol Use Disorders Identification Test (AUDIT) to Identify Excessive Drinking Among Patients in HIV Care in South Africa.

PubMed

Morojele, Neo K; Nkosi, Sebenzile; Kekwaletswe, Connie T; Shuper, Paul A; Manda, Samuel O; Myers, Bronwyn; Parry, Charles D H

2017-01-01

In sub-Saharan Africa, large proportions of patients who are on antiretroviral therapy (ART) engage in excessive alcohol use, which may lead to adverse health consequences and may go undetected. Consequently, health care workers need brief screening tools to be able to routinely identify and manage excessive alcohol use among their patients. Various brief versions of the valid and reliable 10-item Alcohol Use Disorders Identification Test (AUDIT) (i.e., the AUDIT-C, AUDIT-3, AUDIT-QF, AUDIT-PC, AUDIT-4, and m-FAST) may potentially replace the full AUDIT in busy HIV care settings. This study aims to assess the utility of these six brief versions of the AUDIT relative to the full AUDIT for identifying excessive alcohol use among patients in HIV care settings in South Africa. Participants were 188 (95 women) patients from three ART clinics within district hospitals in the City of Tshwane Metropolitan Municipality who reported past-12-month alcohol use. Performance of each brief AUDIT measure for identifying excessive alcohol use was evaluated against that of the full AUDIT (with a cutoff score of ≥6 for women and ≥8 for men) as the gold standard. We used receiver-operating characteristic (ROC) analysis. Most brief AUDIT measures had an area under the receiver operating curve (AUROC) above .90 when compared with the full AUDIT (five of six for women and three of six for men). The AUDIT-PC, AUDIT-4, and m-FAST had the highest AUROCs, whereas the three brief measures comprising only consumption items had low specificities at the most optimal cutoff levels. Various brief versions of the AUDIT may be appropriate substitutes for the full AUDIT for screening for excessive alcohol use in HIV clinics in sub-Saharan Africa.

Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

PubMed

Lyon, Cheryl

2007-12-01

Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they are unable to communicate wishes. The post-implementation audit showed a clear improvement as compliance ranged from 15-100% for the five audit criteria. Strong leadership by the project team was effective in engaging staff in this quality improvement program. Conclusion  The outcomes of the project were extremely positive and demonstrate a genuine improvement in practice. All audit criteria indicate that the Manningham Centre is now positively working towards improved practice based on the best available evidence. It is hoped that as the expertise developed during this project is shared, other areas of gerontological practice will be similarly improved and more facilities caring for the older person will embrace evidence-based practice.

Audit: Auditing Service in the Department of the Army

DTIC Science & Technology

1991-12-16

Organizations2 AAA/IR Notes: 1 Functional refers to Multilocation Audits conducted by U.S. Army Audit Agency and Internal Review. 2 Private Organizations...Army Regulation 36–5 Audit Auditing Service in the Department of the Army Headquarters Department of the Army Washington, DC 16 December 1991...FROM - TO) xx-xx-1997 to xx-xx-1997 4. TITLE AND SUBTITLE Auditing Service in the Department of the Army Unclassified 5a. CONTRACT NUMBER 5b. GRANT

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.

Communication of Audit Risk to Students.

ERIC Educational Resources Information Center

Alderman, C. Wayne; Thompson, James H.

1986-01-01

This article focuses on audit risk by examining it in terms of its components: inherent risk, control risk, and detection risk. Discusses applying audit risk, a definition of audit risk, and components of audit risk. (CT)

Assessing the dosimetric and geometric accuracy of stereotactic radiosurgery

NASA Astrophysics Data System (ADS)

Dimitriadis, Alexis

Stereotactic radiosurgery (SRS) is a non-invasive treatment predominantly used for the management of malignant and benign brain tumours. The treatment can be delivered by various platforms in a single fraction where a high dose of radiation is delivered to the target whilst the surrounding healthy tissue is spared. This requires a high degree of accuracy in terms of the dose level delivered but also in terms of geometric precision. The purpose of this work was to identify the variations of SRS practice in the UK and develop a novel method compatible with all practices, capable of assessing the accuracy of delivery. The motivation behind this effort was to contribute to safety in SRS delivery, provide confidence through a quality assurance audit and form a basis to support standardisation in SRS. A national survey was performed to investigate SRS practices in the UK and to help guide the methodology of this thesis. This resulted to the development of a method for an end-to-end audit of SRS. This was based on an anthropomorphic head phantom with a medium sized target located centrally in the brain, in close proximity to the brainstem. This realistic patient scenario was presented to all 26 radiosurgery centres in the UK who were asked to treat it with SRS. The dose delivered was assessed using two novel commercially available radiation detectors, a plastic scintillator and radiochromic film. These detectors were characterised for measuring the dose delivered in SRS. Another established dosimetry system, alanine, was also used alongside these detectors to assess the accuracy of each delivery. The results allowed the assessment of SRS practices in the UK and the comparison of all centres that participated in the audit. The results were also used to evaluate the performance of the dosimeters used for the purposes of quality assurance measurements and audit.

77 FR 26824 - Agency Information Collection; Activity Under OMB Review; Submission of Audit Reports-Part 248

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... RITA 2008-0002] Agency Information Collection; Activity Under OMB Review; Submission of Audit Reports.... SUPPLEMENTARY INFORMATION: OMB Approval No. 2138-0004. Title: Submission of Audit Reports--Part 248. Form No... having an annual audit must file a statement that no such audit has been performed. In lieu of the audit...

Facilities Audit Workbook: A Self-Evaluation for Higher Education.

ERIC Educational Resources Information Center

Kaiser, Harvey H.

The purpose and scope of a facilities audit and steps in conducting an audit are outlined, and facility ratings forms that can be used in the process are included. The audit is presented as a part of the comprehensive facilities management approach, and the users and different audit uses are also addressed. The audit design phase includes deciding…

Internal Audit Manual.

DTIC Science & Technology

1985-11-01

multilocation audits because of the significant amount of planning, resources, and time they require, coordination of all review efforts shall be the...similar to the multilocation audits of the internal audit activities. f. The Military Department audit agencies and the Military Department criminal...34 -.° -.- . . °- . .. ?.. . .. . .. .. . .. . .. . .. . .. .. . .. . .. . .. .. . . .. :2 DOD 7600.7-M DEPARTMENT OF DEFENSE( %INTERNAL AUDIT ~MANUAL Jq- OFFICE OF L- INSPECTOR GENERAL

A silver coated dressing reduces the incidence of early burn wound cellulitis and associated costs of inpatient treatment: comparative patient care audits.

PubMed

Fong, J; Wood, F; Fowler, B

2005-08-01

In 2000 and 2002, the Royal Perth Hospital (RPH) Burn Unit, Western Australia, conducted two 'before and after' patient care audits comparing the effectiveness and cost of Silvazine (silver sulphadiazine and chlorhexidine digluconate cream) and Acticoat, a new dressing product for in-patient treatment of early burn wounds. The main outcome variables were: burn wound cellulitis, antibiotic use and cost of treatment. Two patient care audits and a comparative sample were used. The two regimes audited were, 'standard treatment' of twice daily showers or washes with 4% chlorhexidine soap and Silvazine cream as a topical dressing (2000, n=51), compared with the 'new treatment' of daily showers of the burn wound with 4% chlorhexidine soap and the application of an Acticoat dressing (2002, n=19). In 2002, costs were also examined using a sample of matched pairs (n=8) of current and previous patients. The main findings were: when using Acticoat the incidence of infection and antibiotic use fell from 55% (28/51) and 57% (29/51) in 2000 to 10.5% (2/19) and 5.2% (1/19) in 2002. The total costs (excluding antibiotics, staffing and surgery) for those treated with Silvazine were US$ 109,357 and those treated with Acticoat were US$ 78,907, demonstrating a saving of US$ 30,450 with the new treatment. The average length of stay (LOS) in hospital was 17.25 days for the Silvazine group and 12.5 days for the Acticoat group-a difference of 4.75 days. These audits demonstrate that Acticoat results in a reduced incidence of burn wound cellulitis, antibiotic use and overall cost compared to Silvazine in the treatment of early burn wounds.

Translating the evidence for emergency equipment and supplies into practice among healthcare providers in a tertiary mental health institution: a best practice implementation project.

PubMed

Lu, Qiufen; Ng, Hui Chin; Xie, Huiting

2015-05-15

In the mental health care setting, patients are more vulnerable to choking and the risk of cardiac and respiratory problems due to behavioral problems and use of rapid tranquilization. Poorly maintained, incomplete or damaged equipment in emergency trolleys have previously been documented in various articles as a major contributing factor to deaths and delayed response to resuscitation attempts. This project aimed to examine the current practices for managing emergency equipment. An evidence implementation project was undertaken by utilizing the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research Into Practice programs. Pre- and post-implementation audits were conducted in a mental health institution over 25 months. Strategies were implemented between audits to enhance adoption of the best available evidence regarding the checking and maintenance of emergency equipment. The baseline audit data showed that adherence was lowest in ensuring the functional status of emergency equipment (53%), followed by conducting regular checks for functional status, using inventory, and documenting these checks (60%). In line with the Getting Research Into Practice module, barriers such as the lack of knowledge and skills regarding emergency equipment were addressed with town hall meetings, code blue drills and education sessions. Follow-up audit results showed improvement in all areas. The greatest improvement was in documentation of emergency equipment checks, which improved by 18%, from 80% to 98%. Audits enabled the timely identification of potential lapses in the management of emergency equipment so that the barriers could be addressed, and strategies in line with the best available evidence regarding the checking and maintenance of emergency equipment were adopted. The Joanna Briggs Institute.

Antenatal services for Aboriginal women: the relevance of cultural competence.

PubMed

Reibel, Tracy; Walker, Roz

2010-01-01

Due to persistent significantly poorer Aboriginal perinatal outcomes, the Women's and Newborns' Health Network, Western Australian Department of Health, required a comprehensive appraisal of antenatal services available to Aboriginal women as a starting point for future service delivery modelling. A services audit was conducted to ascertain the usage frequency and characteristics of antenatal services used by Aboriginal women in Western Australia (WA). Telephone interviews were undertaken with eligible antenatal services utilising a purpose specific service audit tool comprising questions in five categories: 1) general characteristics; 2) risk assessment; 3) treatment, risk reduction and education; 4) access; and 5) quality of care. Data were analysed according to routine antenatal care (e.g. risk assessment, treatment and risk reduction), service status (Aboriginal specific or non-specific) and application of cultural responsiveness. Significant gaps in appropriate antenatal services for Aboriginal women in metropolitan, rural and remote regions in WA were evident. Approximately 75% of antenatal services used by Aboriginal women have not achieved a model of service delivery consistent with the principles of culturally responsive care, with few services incorporating Aboriginal specific antenatal protocols/programme, maintaining access or employing Aboriginal Health Workers (AHWs). Of 42 audited services, 18 Aboriginal specific and 24 general antenatal services reported utilisation by Aboriginal women. Of these, nine were identified as providing culturally responsive service delivery, incorporating key indicators of cultural security combined with highly consistent delivery of routine antenatal care. One service was located in the metropolitan area and eight in rural or remote locations. The audit of antenatal services in WA represents a significant step towards a detailed understanding of which services are most highly utilised and their defining characteristics. The cultural responsiveness indicators used in the audit establish benchmarks for planning culturally appropriate antenatal services that may encourage Aboriginal women to more frequently attend antenatal visits.

Remote auditing of radiotherapy facilities using optically stimulated luminescence dosimeters

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

Lye, Jessica, E-mail: jessica.lye@arpansa.gov.au; Dunn, Leon; Kenny, John

Purpose: On 1 July 2012, the Australian Clinical Dosimetry Service (ACDS) released its Optically Stimulated Luminescent Dosimeter (OSLD) Level I audit, replacing the previous TLD based audit. The aim of this work is to present the results from this new service and the complete uncertainty analysis on which the audit tolerances are based. Methods: The audit release was preceded by a rigorous evaluation of the InLight® nanoDot OSLD system from Landauer (Landauer, Inc., Glenwood, IL). Energy dependence, signal fading from multiple irradiations, batch variation, reader variation, and dose response factors were identified and quantified for each individual OSLD. The detectorsmore » are mailed to the facility in small PMMA blocks, based on the design of the existing Radiological Physics Centre audit. Modeling and measurement were used to determine a factor that could convert the dose measured in the PMMA block, to dose in water for the facility's reference conditions. This factor is dependent on the beam spectrum. The TPR{sub 20,10} was used as the beam quality index to determine the specific block factor for a beam being audited. The audit tolerance was defined using a rigorous uncertainty calculation. The audit outcome is then determined using a scientifically based two tiered action level approach. Audit outcomes within two standard deviations were defined as Pass (Optimal Level), within three standard deviations as Pass (Action Level), and outside of three standard deviations the outcome is Fail (Out of Tolerance). Results: To-date the ACDS has audited 108 photon beams with TLD and 162 photon beams with OSLD. The TLD audit results had an average deviation from ACDS of 0.0% and a standard deviation of 1.8%. The OSLD audit results had an average deviation of −0.2% and a standard deviation of 1.4%. The relative combined standard uncertainty was calculated to be 1.3% (1σ). Pass (Optimal Level) was reduced to ≤2.6% (2σ), and Fail (Out of Tolerance) was reduced to >3.9% (3σ) for the new OSLD audit. Previously with the TLD audit the Pass (Optimal Level) and Fail (Out of Tolerance) were set at ≤4.0% (2σ) and >6.0% (3σ). Conclusions: The calculated standard uncertainty of 1.3% at one standard deviation is consistent with the measured standard deviation of 1.4% from the audits and confirming the suitability of the uncertainty budget derived audit tolerances. The OSLD audit shows greater accuracy than the previous TLD audit, justifying the reduction in audit tolerances. In the TLD audit, all outcomes were Pass (Optimal Level) suggesting that the tolerances were too conservative. In the OSLD audit 94% of the audits have resulted in Pass (Optimal level) and 6% of the audits have resulted in Pass (Action Level). All Pass (Action level) results have been resolved with a repeat OSLD audit, or an on-site ion chamber measurement.« less

Inspector General, DoD, Oversight of the Air Force Audit Agency Audit of the FY 1996 Air Force Consolidated Financial Statements.

DTIC Science & Technology

1997-04-10

financial statements . We delegated the audit of the FY 1996 Air Force consolidated financial statements to the Air Force Audit Agency on May 17, 1996...This report provides our endorsement of the Air Force Audit Agency disclaimer of opinion on the Air Force consolidated financial statements for FY...1996, along with the Air Force Audit Agency Report of Audit, ’Opinion on Fiscal Year 1996 Air Force Consolidated Financial Statements .’

The Impact of Agency Audits on the Buy Our Spares Smart (BOSS) Program

DTIC Science & Technology

1988-06-01

MULTILOCATION DOD-WODE FOLLOW- UP AUDIT OF SPARE’ PARTS PROCUREMENT NAVY T 48185 13 53 TABLE III (PAGE 2 OF 3) AUDITS AND RECOMMENDATIONS CLASSIFICATION S... Audit agency/number: GAO/NSIAD 85-119 111 7. Multilocation DOD-wide Follow-up Audit of Spare Parts Procurement. Date completed: 19 November 1985 Audit ...SFILE NAVAL POSTGRADUATE SCHOOL 0_ Monterey, California DTIC AUG 3 0 1988 DCO THESIS UIMPA T OF AGMY AUDITS BJY OUR SPARES S6AR (BOSS) PRGRAM by

Improved quality of management of eclampsia patients through criteria based audit at Muhimbili National Hospital, Dar es Salaam, Tanzania. Bridging the quality gap.

PubMed

Kidanto, Hussein Lesio; Wangwe, Peter; Kilewo, Charles D; Nystrom, Lennarth; Lindmark, Gunnila

2012-11-21

Criteria-based audits (CBA) have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania. The prevalence of eclampsia in MNH is high (≈6%) with the majority of cases arriving after start of convulsions. In 2004-2005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base). A criteria-based audit (CBA) was used to evaluate the quality of care for eclamptic mothers admitted at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania after implementation of recommendations of a previous audit. A CBA of eclampsia cases was conducted at MNH. Management practices were evaluated using evidence-based criteria for appropriate care. The Ministry of Health (MOH) guidelines, local management guidelines, the WHO manual supplemented by the WHO Reproductive Health Library, standard textbooks, the Cochrane database and reviews in peer reviewed journals were adopted. At the initial audit in 2006, 389 case notes were assessed and compared with the standards, gaps were identified, recommendations made followed by implementation. A re-audit of 88 cases was conducted in 2009 and compared with the initial audit. There was significant improvement in quality of patient management and outcome between the initial and re-audit: Review of management plan by senior staff (76% vs. 99%; P=0.001), urine for albumin test (61% vs. 99%; P=0.001), proper use of partogram to monitor labour (75% vs. 95%; P=0.003), treatment with steroids for lung maturity (2.0% vs. 24%; P=0.001), Caesarean section within 2 hours of decision (33% vs. 61%; P=0.005), full blood count (28% vs. 93%; P=0.001), serum urea and creatinine (44% vs. 86%; P=0.001), liver enzymes (4.0% vs. 86%; P=0.001), and specialist review within 2 hours of admission (25% vs. 39%; P=0.018). However, there was no significant change in terms of delivery within 24 hours of admission (69% vs. 63%; P=0.33). There was significant reduction of maternal deaths (7.7% vs. 0%; P=0.001). CBA is applicable in low resource setting and can help to improve quality of care in obstetrics including management of pre-eclampsia and eclampsia.

Aviation's Normal Operations Safety Audit: a safety management and educational tool for health care? Results of a small-scale trial.

PubMed

Bennett, Simon A

2017-01-01

A National Health Service (NHS) contingent liability for medical error claims of over £26 billion. To evaluate the safety management and educational benefits of adapting aviation's Normal Operations Safety Audit (NOSA) to health care. In vivo research, a NOSA was performed by medical students at an English NHS Trust. After receiving training from the author, the students spent 6 days gathering data under his supervision. The data revealed a threat-rich environment, where errors - some consequential - were made (359 threats and 86 errors were recorded over 2 weeks). The students claimed that the exercise improved their observational, investigative, communication, teamworking and other nontechnical skills. NOSA is potentially an effective safety management and educational tool for health care. It is suggested that 1) the UK General Medical Council mandates that all medical students perform a NOSA in fulfillment of their degree; 2) the participating NHS Trusts be encouraged to act on students' findings; and 3) the UK Department of Health adopts NOSA as a cornerstone risk assessment and management tool.

Assuring optimal trauma care: the role of trauma centre accreditation

PubMed Central

Simons, Richard; Kirkpatrick, Andrew

2002-01-01

Optimal care of the injured patient requires the delivery of appropriate, definitive care shortly after injury. Over the last 30 to 40 years, civilian trauma systems and trauma centres have been developed in the United States based on experience gained in military conflicts, particularly in Korea and Vietnam. A similar process is evolving in Canada. National trauma committees in the US and Canada have defined optimal resources to meet the goal of rapid, appropriate care in trauma centres. They have introduced programs (verification or accreditation) to externally audit trauma centre performance based on these guidelines. It is generally accepted that implementing trauma systems results in decreased preventable death and improved survival after trauma. What is less clear is the degree to which each facet of trauma system development contributes to this improvement. The relative importance of national performance guidelines and trauma centre audit as integral steps toward improved outcomes following injury are reviewed. Current Trauma Association of Canada guidelines for trauma centres are presented and the process of trauma centre accreditation is discussed. PMID:12174987

The use of alcohol use disorders identification test (AUDIT) in detecting alcohol use disorder and risk drinking in the general population: validation of AUDIT using schedules for clinical assessment in neuropsychiatry.

PubMed

Lundin, Andreas; Hallgren, Mats; Balliu, Natalja; Forsell, Yvonne

2015-01-01

The alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) are commonly used in population surveys but there are few validations studies in the general population. Validity should be estimated in samples close to the targeted population and setting. This study aims to validate AUDIT and AUDIT-C in a general population sample (PART) in Stockholm, Sweden. We used a general population subsample age 20 to 64 that answered a postal questionnaire including AUDIT who later participated in a psychiatric interview (n = 1,093). Interviews using Schedules for Clinical Assessment in Neuropsychiatry was used as criterion standard. Diagnoses were set according to the fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Agreement between the diagnostic test and criterion standard was measured with area under the receiver operator characteristics curve (AUC). A total of 1,086 (450 men and 636 women) of the interview participants completed AUDIT. There were 96 individuals with DSM-IV-alcohol dependence, 36 DSM-IV-Alcohol Abuse, and 153 Risk drinkers. AUCs were for DSM-IV-alcohol use disorder 0.90 (AUDIT-C 0.85); DSM-IV-dependence 0.94 (AUDIT-C 0.89); risk drinking 0.80 (AUDIT-C 0.80); and any criterion 0.87 (AUDIT-C 0.84). In this general population sample, AUDIT and AUDIT-C performed outstanding or excellent in identifying dependency, risk drinking, alcohol use disorder, any disorder, or risk drinking. Copyright © 2015 by the Research Society on Alcoholism.

7 CFR 735.402 - Providers of other electronic documents.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and maximum deductible amounts and applicability of other forms of financial assurances as set forth...) Submit a current review or an audit level financial statement prepared according to generally accepted...) Financial requirements; (9) Terms of insurance policies or assurances; (10) Provider's integrity statement...

7 CFR 37.10 - Official assessment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... ASSESS ORGANIC CERTIFYING AGENCIES § 37.10 Official assessment. Official assessment of an applicant's certification program shall be granted upon successful completion of a two-step review process, as provided for... completion of an adequacy audit by the auditors. (b) Program assessment. Assessment of a certification...

7 CFR 3406.27 - Other Federal statutes and regulations that apply.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Education, Hospitals, and Other Nonprofit Organizations. 7 CFR Part 3051—Audits of Institutions of Higher...) COOPERATIVE STATE RESEARCH, EDUCATION, AND EXTENSION SERVICE, DEPARTMENT OF AGRICULTURE 1890 INSTITUTION... policy requirements applicable to recipients of Departmental financial assistance. 7 CFR Part 3017...

Financial Reporting of Government Property in the Custody of Contractors

DTIC Science & Technology

1997-08-04

financial reporting of Government property, and we assessed compliance with applicable laws and regulations. This report addresses the use of the Contract...Property Management System for financial reporting of Government property. Issuance of this report does not complete our announced audit objectives. We

Rearchitecting IT: Simplify. Simplify

ERIC Educational Resources Information Center

Panettieri, Joseph C.

2006-01-01

Simplifying and securing an IT infrastructure is not easy. It frequently requires rethinking years of hardware and software investments, and a gradual migration to modern systems. Even so, writes the author, universities can take six practical steps to success: (1) Audit software infrastructure; (2) Evaluate current applications; (3) Centralize…

47 CFR 54.705 - Committees of the Administrator's Board of Directors.

Code of Federal Regulations, 2010 CFR

2010-10-01

... decisions concerning: (i) How the Administrator projects demand for the schools and libraries support... libraries support mechanism; (iii) Administration of the application process, including activities to ensure... be applied to services purchased by eligible schools and libraries; (x) Performance of audits of...

First-order reliability application and verification methods for semistatic structures

NASA Astrophysics Data System (ADS)

Verderaime, V.

1994-11-01

Escalating risks of aerostructures stimulated by increasing size, complexity, and cost should no longer be ignored in conventional deterministic safety design methods. The deterministic pass-fail concept is incompatible with probability and risk assessments; stress audits are shown to be arbitrary and incomplete, and the concept compromises the performance of high-strength materials. A reliability method is proposed that combines first-order reliability principles with deterministic design variables and conventional test techniques to surmount current deterministic stress design and audit deficiencies. Accumulative and propagation design uncertainty errors are defined and appropriately implemented into the classical safety-index expression. The application is reduced to solving for a design factor that satisfies the specified reliability and compensates for uncertainty errors, and then using this design factor as, and instead of, the conventional safety factor in stress analyses. The resulting method is consistent with current analytical skills and verification practices, the culture of most designers, and the development of semistatic structural designs.

41 CFR 102-118.385 - What must a waiver request include?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services Waivers from Mandatory Prepayment Audit... a prepayment audit increases costs over a postpayment audit, decreases efficiency, involves a...

24 CFR 1000.548 - Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA...

Code of Federal Regulations, 2011 CFR

2011-04-01

... DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.548 Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA activities be... audit pursuant to the Single Audit Act relating to NAHASDA activities be submitted to HUD? 1000.548...

24 CFR 1000.548 - Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA...

Code of Federal Regulations, 2013 CFR

2013-04-01

... DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.548 Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA activities be... audit pursuant to the Single Audit Act relating to NAHASDA activities be submitted to HUD? 1000.548...

24 CFR 1000.548 - Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA...

Code of Federal Regulations, 2014 CFR

2014-04-01

... DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.548 Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA activities be... audit pursuant to the Single Audit Act relating to NAHASDA activities be submitted to HUD? 1000.548...

24 CFR 1000.548 - Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA...

Code of Federal Regulations, 2010 CFR

2010-04-01

... DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.548 Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA activities be... audit pursuant to the Single Audit Act relating to NAHASDA activities be submitted to HUD? 1000.548...

24 CFR 1000.548 - Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA...

Code of Federal Regulations, 2012 CFR

2012-04-01

... DEVELOPMENT NATIVE AMERICAN HOUSING ACTIVITIES Recipient Monitoring, Oversight and Accountability § 1000.548 Must a copy of the recipient's audit pursuant to the Single Audit Act relating to NAHASDA activities be... audit pursuant to the Single Audit Act relating to NAHASDA activities be submitted to HUD? 1000.548...

Inspector General, DoD, Oversight of the Army Audit Agency Audit of the U.S. Army Corps of Engineers, Civil Works Program, FY 1996 Financial Statements

DTIC Science & Technology

1997-04-10

The audit objective was to determine the accuracy and completeness of the audit of the U.S. Army Corps of Engineers, Civil Works Program, FY 1996...financial statements conducted by the Army Audit Agency. See Appendix C for a discussion of the audit process.

Special Inspector General for Afghanistan Reconstruction (SIGAR)

DTIC Science & Technology

2015-01-30

enhanced if the supreme audit institution were to audit the budget, including all line ministries.” Source: State, 2014 Fiscal Transparency Report, 1/14...accordance with GAGAS, which includes both require- ments contained in the American Institute of Certified Public Accountants Statements on Auditing ...performance audits , financial audits , alert letters, and other reports examining the reconstruction effort. One performance audit reported on a key

[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.

Analysis of regional radiotherapy dosimetry audit data and recommendations for future audits

PubMed Central

Palmer, A; Mzenda, B; Kearton, J; Wills, R

2011-01-01

Objectives Regional interdepartmental dosimetry audits within the UK provide basic assurances of the dosimetric accuracy of radiotherapy treatments. Methods This work reviews several years of audit results from the South East Central audit group including megavoltage (MV) and kilovoltage (kV) photons, electrons and iodine-125 seeds. Results Apart from some minor systematic errors that were resolved, the results of all audits have been within protocol tolerances, confirming the long-term stability and agreement of basic radiation dosimetric parameters between centres in the audit region. There is some evidence of improvement in radiation dosimetry with the adoption of newer codes of practice. Conclusion The value of current audit methods and the limitations of peer-to-peer auditing is discussed, particularly the influence of the audit schedule on the results obtained, where no “gold standard” exists. Recommendations are made for future audits, including an essential requirement to maintain the monitoring of basic fundamental dosimetry, such as MV photon and electron output, but audits must also be developed to include new treatment technologies such as image-guided radiotherapy and address the most common sources of error in radiotherapy. PMID:21159805

Developments in environmental auditing by supreme audit institutions.

PubMed

Van Leeuwen, Sylvia

2004-02-01

At the end of the 1980s, Supreme Audit Institutions (SAIs) became aware of their responsibility towards the environment and environmental policy. In this article, the development of environmental auditing by SAIs during the last 10 years is presented, as well as the current state of the art. The description is based on the results of three questionnaire surveys held in 1994, 1997, and 2000 by the INTOSAI Working Group in Environmental Auditing. In most countries, the government has stipulated some form of environmental policy, and the SAI has a mandate to carry out regularity and/or performance audits. The activities of SAIs have developed substantially since 1993. Nowadays, environmental auditing is a substantial and regular part of the audit work of more than half of the SAIs. Environmental problems are often transboundary in nature. SAIs can contribute to international environmental cooperation by auditing the compliance of their national government with international environmental obligations and commitments. The INTOSAI Working Group on environmental auditing wants to enhance this type of audit and has provided guidelines for the audit process and the selection of international agreements. Moreover, cooperation between SAIs is a good method to exchange experiences and to learn from each other.

Corporate governance and proactive environmental management in Novo Hamburgo and neighbouring cities, Brazil.

PubMed

Naime, R; Spilki, F R; Nascimento, C A

2015-05-01

This study compiled data on environmental auditing and voluntary certification of environment-friendly businesses of the Commercial and Industrial Association of Novo Hamburgo, Campo Bom and Estância Velha and analysed them according to classical environmental management principles: sustainable development and corporate governance. It assessed the level of application of the concepts of corporate governance to everyday business in companies and organisations and estimated how the interconnection and vertical permeability of these concepts might help to make bureaucratic environmental management systemic, proactive and evaluative, changes that may add great value to the operations evaluated. Results showed that, when analysing only audited items not directly defined in legislation, no significant changes were identified. The inclusion of more advanced indices may promote the transition from bureaucratic management, which meets regulated environmental standards only satisfactorily, into proactive and systemic environmental management, which adds value to companies and helps to perpetuate them. Audited and analysed data did not reveal actions that depend on the internal redistribution of power and the interconnection or verticality of attitudes that may materialize concepts of corporate governance.