[Internal audit in medical laboratory: what means of control for an effective audit process?].

PubMed

Garcia-Hejl, Carine; Chianéa, Denis; Dedome, Emmanuel; Sanmartin, Nancy; Bugier, Sarah; Linard, Cyril; Foissaud, Vincent; Vest, Philippe

2013-01-01

To prepare the French Accreditation Committee (COFRAC) visit for initial certification of our medical laboratory, our direction evaluated its quality management system (QMS) and all its technical activities. This evaluation was performed owing an internal audit. This audit was outsourced. Auditors had an expertise in audit, a whole knowledge of biological standards and were independent. Several nonconformities were identified at that time, including a lack of control of several steps of the internal audit process. Hence, necessary corrective actions were taken in order to meet the requirements of standards, in particular, the formalization of all stages, from the audit program, to the implementation, review and follow-up of the corrective actions taken, and also the implementation of the resources needed to carry out audits in a pre-established timing. To ensure an optimum control of each step, the main concepts of risk management were applied: process approach, root cause analysis, effects and criticality analysis (FMECA). After a critical analysis of our practices, this methodology allowed us to define our "internal audit" process, then to formalize it and to follow it up, with a whole documentary system.

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.

Improving the Business Communication Skills of Postgraduate Internal Audit Students: A South African Teaching Innovation

ERIC Educational Resources Information Center

Plant, Kato; Slippers, Jana

2015-01-01

This article reports on the introduction of a business communication course in the curriculum of postgraduate internal audit students at a higher education institution in South Africa. Internal auditors should have excellent verbal and written communication skills in performing value-adding assurance and consulting services to their engagement…

An Examination of the Interrelationship between the Structure of Financial Management and the Internal Audit Function within the Department of Defense.

DTIC Science & Technology

1986-03-01

sites at activities such as system commands and other large commands; 2. Multilocation audits (T audits ): performed vertically throughout Navy to provide...34 of time devoted to multilocation audits and the flexibility gained from generating audit issues vice audit topics. This ’..~ ’. . flexibility...Education College degree College degree in in accounting accounting or equiva- or equivalent lent experience experience Multilocation audits 18 90 Scope

Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?

PubMed

Maina, Robert N; Mengo, Doris M; Mohamud, Abdikher D; Ochieng, Susan M; Milgo, Sammy K; Sexton, Connie J; Moyo, Sikhulile; Luman, Elizabeth T

2014-01-01

Kenya has implemented the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme to facilitate quality improvement in medical laboratories and to support national accreditation goals. Continuous quality improvement after SLMTA completion is needed to ensure sustainability and continue progress toward accreditation. Audits were conducted by qualified, independent auditors to assess the performance of five enrolled laboratories using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. End-of-programme (exit) and one year post-programme (surveillance) audits were compared for overall score, star level (from zero to five, based on scores) and scores for each of the 12 Quality System Essential (QSE) areas that make up the SLIPTA checklist. All laboratories improved from exit to surveillance audit (median improvement 38 percentage points, range 5-45 percentage points). Two laboratories improved from zero to one star, two improved from zero to three stars and one laboratory improved from three to four stars. The lowest median QSE scores at exit were: internal audit; corrective action; and occurrence management and process improvement (< 20%). Each of the 12 QSEs improved substantially at surveillance audit, with the greatest improvement in client management and customer service, internal audit and information management (≥ 50 percentage points). The two laboratories with the greatest overall improvement focused heavily on the internal audit and corrective action QSEs. Whilst all laboratories improved from exit to surveillance audit, those that focused on the internal audit and corrective action QSEs improved substantially more than those that did not; internal audits and corrective actions may have acted as catalysts, leading to improvements in other QSEs. Systematic identification of core areas and best practices to address them is a critical step toward strengthening public medical laboratories.

Progressing beyond SLMTA: Are internal audits and corrective action the key drivers of quality improvement?

PubMed Central

Mengo, Doris M.; Mohamud, Abdikher D.; Ochieng, Susan M.; Milgo, Sammy K.; Sexton, Connie J.; Moyo, Sikhulile; Luman, Elizabeth T.

2014-01-01

Background Kenya has implemented the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme to facilitate quality improvement in medical laboratories and to support national accreditation goals. Continuous quality improvement after SLMTA completion is needed to ensure sustainability and continue progress toward accreditation. Methods Audits were conducted by qualified, independent auditors to assess the performance of five enrolled laboratories using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist. End-of-programme (exit) and one year post-programme (surveillance) audits were compared for overall score, star level (from zero to five, based on scores) and scores for each of the 12 Quality System Essential (QSE) areas that make up the SLIPTA checklist. Results All laboratories improved from exit to surveillance audit (median improvement 38 percentage points, range 5–45 percentage points). Two laboratories improved from zero to one star, two improved from zero to three stars and one laboratory improved from three to four stars. The lowest median QSE scores at exit were: internal audit; corrective action; and occurrence management and process improvement (< 20%). Each of the 12 QSEs improved substantially at surveillance audit, with the greatest improvement in client management and customer service, internal audit and information management (≥ 50 percentage points). The two laboratories with the greatest overall improvement focused heavily on the internal audit and corrective action QSEs. Conclusion Whilst all laboratories improved from exit to surveillance audit, those that focused on the internal audit and corrective action QSEs improved substantially more than those that did not; internal audits and corrective actions may have acted as catalysts, leading to improvements in other QSEs. Systematic identification of core areas and best practices to address them is a critical step toward strengthening public medical laboratories. PMID:29043193

Report on the Audit of Performnce and Reliability of Cobra Helicopter Rotor Blades

DTIC Science & Technology

1991-05-21

We are providing this final report for your information and use. The audit was made from January to March 1991. The audit objective was to evaluate...internal controls. The audit was made in response to concerns raised by personnel at the Sharpe Army Depot about the K747 blade’s performance, maintenance, and reliability.

Nuclear materials control and accountability (NMC and A) auditors in the 90's

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

Barham, M.A.; Abbott, R.R.

1991-01-01

The increase in emphasis on the adequacy of the NMC and A internal control systems requires that management define what type of training and experience is needed by NMC and A Internal Audit Program. At Martin Marietta Energy Systems, inc. (the prime contractor for the Department of Energy at Oak Ridge, Tenn.), the Central NMC and A Manager has developed a comprehensive set of NMC and A Internal Audit policies that defines performance standards, methods of conducting audits, mechanisms for ensuring appropriate independence for NMC and A auditors, structure for standardized audit reports and working papers, and a section thatmore » addresses the development of training plans for individual NMC and A auditors. The training requirements reflect the unique combination of skills necessary to be an effective NMC and A Internal Auditor- a combination of the operational auditing skills of a Certified Internal Auditor, the accounting auditing capabilities of a Certified Public Accountant, and the specific technical knowledge base associated with nuclear materials. This paper presents a mechanism for identifying an individual training program for NMC and A auditors that considers the above requirements and the individual's long-range career goals.« less

Inspector General, DOD, Oversight of the Audit of the FY 2000 Military Retirement Fund Financial Statements

DTIC Science & Technology

2001-02-28

statements and to report on the adequacy of internal controls and compliance with laws and regulations. We contracted the audit of the FY 2000 Military...performed on the oversight of the audit of the FY 2000 Military Retirement Fund Financial Statements.

77 FR 64374 - Petition for Waiver of Compliance

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... internal safety audits to evaluate compliance with SSPP and measure its effectiveness. An annual report identifying the audits performed and any corrective action must be submitted to the New Jersey Department of... audit. In addition, NJDOT conducts a safety review a minimum of once every 3 years to evaluate the...

Pro: Boards Need Independent, Impartial Experts to Audit Administrative Performance.

ERIC Educational Resources Information Center

Boonin, Tobyann; Neuwirth, Paul

1983-01-01

Argues that school boards should use outside "management auditors" to help assess operational effectiveness, especially in five areas: internal financial auditing, personnel and payroll, purchasing, construction and repairs, and data processing. Suggests guidelines for hiring management auditors and lists 11 firms that perform management…

Financial Statement Audit: U.S. Department of Education, Federal Direct Student Loan Program for the Year Ended September 30, 1994. Audit Control Number 17-48320.

ERIC Educational Resources Information Center

Office of Inspector General (ED), Washington, DC.

An independent audit was done of the principal financial statements of the William D. Ford Federal Direct Loan Program of the Department of Education for the year ending September 30, 1994. In planning and performing the review the auditors considered the internal control structure of the program in order to determine auditing procedures. The…

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.

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...

Internal Auditing for School Districts.

ERIC Educational Resources Information Center

Cuzzetto, Charles

This book provides guidelines for conducting internal audits of school districts. The first five chapters provide an overview of internal auditing and describe techniques that can be used to improve or implement internal audits in school districts. They offer information on the definition and benefits of internal auditing, the role of internal…

48 CFR 970.5232-3 - Accounts, records, and inspection.

Code of Federal Regulations, 2010 CFR

2010-10-01

... subcontracts, both pre-award and post-award; and (viii) The schedule for peer review of internal audits by... be undertaken by the internal audit organization during the next fiscal year that is designed to test...) Internal audit. The Contractor agrees to design and maintain an internal audit plan and an internal audit...

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.

Simulating and stimulating performance: introducing distributed simulation to enhance musical learning and performance.

PubMed

Williamon, Aaron; Aufegger, Lisa; Eiholzer, Hubert

2014-01-01

Musicians typically rehearse far away from their audiences and in practice rooms that differ significantly from the concert venues in which they aspire to perform. Due to the high costs and inaccessibility of such venues, much current international music training lacks repeated exposure to realistic performance situations, with students learning all too late (or not at all) how to manage performance stress and the demands of their audiences. Virtual environments have been shown to be an effective training tool in the fields of medicine and sport, offering practitioners access to real-life performance scenarios but with lower risk of negative evaluation and outcomes. The aim of this research was to design and test the efficacy of simulated performance environments in which conditions of "real" performance could be recreated. Advanced violin students (n = 11) were recruited to perform in two simulations: a solo recital with a small virtual audience and an audition situation with three "expert" virtual judges. Each simulation contained back-stage and on-stage areas, life-sized interactive virtual observers, and pre- and post-performance protocols designed to match those found at leading international performance venues. Participants completed a questionnaire on their experiences of using the simulations. Results show that both simulated environments offered realistic experience of performance contexts and were rated particularly useful for developing performance skills. For a subset of 7 violinists, state anxiety and electrocardiographic data were collected during the simulated audition and an actual audition with real judges. Results display comparable levels of reported state anxiety and patterns of heart rate variability in both situations, suggesting that responses to the simulated audition closely approximate those of a real audition. The findings are discussed in relation to their implications, both generalizable and individual-specific, for performance training.

Simulating and stimulating performance: introducing distributed simulation to enhance musical learning and performance

PubMed Central

Williamon, Aaron; Aufegger, Lisa; Eiholzer, Hubert

2014-01-01

Musicians typically rehearse far away from their audiences and in practice rooms that differ significantly from the concert venues in which they aspire to perform. Due to the high costs and inaccessibility of such venues, much current international music training lacks repeated exposure to realistic performance situations, with students learning all too late (or not at all) how to manage performance stress and the demands of their audiences. Virtual environments have been shown to be an effective training tool in the fields of medicine and sport, offering practitioners access to real-life performance scenarios but with lower risk of negative evaluation and outcomes. The aim of this research was to design and test the efficacy of simulated performance environments in which conditions of “real” performance could be recreated. Advanced violin students (n = 11) were recruited to perform in two simulations: a solo recital with a small virtual audience and an audition situation with three “expert” virtual judges. Each simulation contained back-stage and on-stage areas, life-sized interactive virtual observers, and pre- and post-performance protocols designed to match those found at leading international performance venues. Participants completed a questionnaire on their experiences of using the simulations. Results show that both simulated environments offered realistic experience of performance contexts and were rated particularly useful for developing performance skills. For a subset of 7 violinists, state anxiety and electrocardiographic data were collected during the simulated audition and an actual audition with real judges. Results display comparable levels of reported state anxiety and patterns of heart rate variability in both situations, suggesting that responses to the simulated audition closely approximate those of a real audition. The findings are discussed in relation to their implications, both generalizable and individual-specific, for performance training. PMID:24550856

78 FR 68853 - International Medical Device Regulators Forum; Medical Device Single Audit Program International...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-15

...] International Medical Device Regulators Forum; Medical Device Single Audit Program International Coalition Pilot... Drug Administration (FDA) is announcing participation in the Medical Device Single Audit Program International Coalition Pilot Program. The Medical Device Single Audit Program (MDSAP) was designed and...

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

10 CFR 835.102 - Internal audits.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of program...

10 CFR 835.102 - Internal audits.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of program...

10 CFR 835.102 - Internal audits.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of program...

10 CFR 835.102 - Internal audits.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of program...

10 CFR 835.102 - Internal audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Internal audits. 835.102 Section 835.102 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.102 Internal audits. Internal audits of the radiation protection program, including examination of program...

77 FR 24538 - Sunshine Act; Audit Committee Meeting of the Board of Directors

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... NEIGHBORHOOD REINVESTMENT CORPORATION Sunshine Act; Audit Committee Meeting of the Board of.... Executive Session with Internal Audit Director IV. Executive Session with Officers: Pending Litigation V. Internal Audit Report with Management's Response VI. Amendment to the FY 2012 Internal Audit Plan VII. FY...

78 FR 54925 - Audit Committee Meeting of The Board of Directors; Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

... NEIGHBORHOOD REINVESTMENT CORPORATION Audit Committee Meeting of The Board of Directors; Sunshine.... Executive Session With Internal Audit Director III. Title Change of the Internal Audit Director IV. Executive Session With Officers: Pending Litigation V. FY14 Risk Assessment & Internal Audit Plan VI...

Implementation of Quality Systems in Nuclear Medicine: Why It Matters. An Outcome Analysis (Quality Management Audits in Nuclear Medicine Part III).

PubMed

Dondi, Maurizio; Paez, Diana; Torres, Leonel; Marengo, Mario; Delaloye, Angelika Bischof; Solanki, Kishor; Van Zyl Ellmann, Annare; Lobato, Enrique Estrada; Miller, Rodolfo Nunez; Giammarile, Francesco; Pascual, Thomas

2018-05-01

The International Atomic Energy Agency (IAEA) developed a comprehensive program-Quality Management Audits in Nuclear Medicine (QUANUM). This program covers all aspects of nuclear medicine practices including, but not limited to, clinical practice, management, operations, and services. The QUANUM program, which includes quality standards detailed in relevant checklists, aims at introducing a culture of comprehensive quality audit processes that are patient oriented, systematic, and outcome based. This paper will focus on the impact of the implementation of QUANUM on daily routine practices in audited centers. Thirty-seven centers, which had been externally audited by experts under IAEA auspices at least 1 year earlier, were invited to run an internal audit using the QUANUM checklists. The external audits also served as training in quality management and the use of QUANUM for the local teams, which were responsible of conducting the internal audits. Twenty-five out of the 37 centers provided their internal audit report, which was compared with the previous external audit. The program requires that auditors score each requirement within the QUANUM checklists on a scale of 0-4, where 0-2 means nonconformance and 3-4 means conformance to international regulations and standards on which QUANUM is based. Our analysis covering both general and clinical areas assessed changes on the conformance status on a binary manner and the level of conformance scores. Statistical analysis was performed using nonparametric statistical tests. The evaluation of the general checklists showed a global improvement on both the status and the levels of conformances (P < 0.01). The evaluation of the requirements by checklist also showed a significant improvement in all, with the exception of Hormones and Tumor marker determinations, where changes were not significant. Of the 25 evaluated institutions, 88% (22 of 25) and 92% (23 of 25) improved their status and levels of conformance, respectively. Fifty-five requirements, on average, increased from nonconformance to conformance status. In 8 key areas, the number of improved requirements was well above the average: Administration & Management (checklist 2); Radiation Protection & Safety (checklist 4); General Quality Assurance system (checklist 6); Imaging Equipment Quality Assurance or Quality Control (checklist 7); General Diagnostic (checklist 9); General Therapeutic (checklist 12); Radiopharmacy Level 1 (checklist 14); and Radiopharmacy Level 2 (checklist 15). Analysis of results related to clinical activities showed an overall positive impact on both the status and the level of conformance to international standards. Similar results were obtained for the most frequently performed clinical imaging and therapeutic procedures. Our study shows that the implementation of a comprehensive quality management system through the IAEA QUANUM program has a positive impact on nuclear medicine practices. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

12 CFR 917.7 - Audit committees.

Code of Federal Regulations, 2010 CFR

2010-01-01

... internal auditor and that the internal auditor may be removed only with the approval of the audit committee; (ii) Provide that the internal auditor shall report directly to the audit committee on substantive matters and that the internal auditor is ultimately accountable to the audit committee and board of...

12 CFR 917.7 - Audit committees.

Code of Federal Regulations, 2011 CFR

2011-01-01

... internal auditor and that the internal auditor may be removed only with the approval of the audit committee; (ii) Provide that the internal auditor shall report directly to the audit committee on substantive matters and that the internal auditor is ultimately accountable to the audit committee and board of...

A Critical Evaluation of Academic Internal Audit

ERIC Educational Resources Information Center

Blackmore, Jacqueline Ann

2004-01-01

This account of internal audit is set within the context of higher education in the UK and a fictitiously named Riverbank University. The study evaluates the recent introduction of "Internal Academic Audit" to the University and compares the process with that of the internationally recognized ISO 19011 Guidelines for Auditing Quality…

CTEPP STANDARD OPERATING PROCEDURE FOR CONDUCTING INTERNAL FIELD AUDITS AND QUALITY CONTROL (SOP-2.25)

EPA Science Inventory

This SOP describes the method for conducting internal field audits and quality control procedures. Internal field audits will be conducted to ensure the collection of high quality data. Internal field audits will be conducted by Field Auditors (the Field QA Officer and the Field...

21 CFR 1304.06 - Records and reports for electronic prescriptions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) The internal audit trail and any auditable event identified by the internal audit as required by... auditable event identified by the internal audit as required by § 1311.215 of this chapter. (d) A registrant... Note: At 75 FR 16306, Mar. 31, 2010, § 1304.06 was added, effective June 1, 2010. Inventory...

The Internal Control System and Control Programs: A Reference Guide

DTIC Science & Technology

1990-06-01

multilocation audits . [Ref. 27:Ch. 8, p. 4] 3. Verification Staqe The actual audit field work occurs during this phase. The audit team provides an entrance...number) ;E, GUO.)P SuB GROUP Internal Control; Internal Control System; Audits ; Reviews; Ccamand Evaluation Program; EconnTy & Efficiency Reviews...general overview of the inter- nal control system and discusses the various external and internal audits , inspections, reviews and investiaative

48 CFR 970.5232-3 - Accounts, records, and inspection.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subcontracts, both pre-award and post-award; and (viii) The schedule for peer review of internal audits by... be undertaken by the internal audit organization during the next fiscal year that is designed to test.... (i) Internal audit. The Contractor agrees to design and maintain an internal audit plan and an...

48 CFR 970.5232-3 - Accounts, records, and inspection.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subcontracts, both pre-award and post-award; and (viii) The schedule for peer review of internal audits by... be undertaken by the internal audit organization during the next fiscal year that is designed to test.... (i) Internal audit. The Contractor agrees to design and maintain an internal audit plan and an...

48 CFR 970.5232-3 - Accounts, records, and inspection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subcontracts, both pre-award and post-award; and (viii) The schedule for peer review of internal audits by... be undertaken by the internal audit organization during the next fiscal year that is designed to test.... (i) Internal audit. The Contractor agrees to design and maintain an internal audit plan and an...

48 CFR 970.5232-3 - Accounts, records, and inspection.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subcontracts, both pre-award and post-award; and (viii) The schedule for peer review of internal audits by... be undertaken by the internal audit organization during the next fiscal year that is designed to test.... (i) Internal audit. The Contractor agrees to design and maintain an internal audit plan and an...

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.

A comprehensive survey of government auditors' self-efficacy and professional development for improving audit quality.

PubMed

Lee, Shue-Ching; Su, Jau-Ming; Tsai, Sang-Bing; Lu, Tzu-Li; Dong, Weiwei

2016-01-01

Government audit authorities supervise the implementation of government budgets and evaluate the use of administrative resources to ensure that funding is used wisely, economically, and effectively. A quality audit involves reviewing policies according to international standards and perspectives, and provides insight, predictions, and warnings to related organizations. Such practice can reflect the effectiveness of a government. Professional development and self-efficacy have strong influence upon the performance of auditors. To further understand the factors that may enhance their performance and to ultimately provide practical recommendations for the audit authorities, we have surveyed about 50 % of all the governmental auditors in Taiwan using the stratified random sampling method. The result showed that any auditing experience and professionalization can positively influence the professional awareness. Also, acquired knowledge and skillset of an auditor can effectively improve ones professional judgment. We also found that professional development (including organizational culture and training opportunities) and self-efficacy (including profession and experience as well as trends and performance) may significantly impact audit quality. We concluded that to retain auditors, audit authorities must develop an attractive future outlook emphasizing feedback and learning within an organization. Our study provides a workable management guidelines for strengthening the professional development and self-efficacy of audit authorities in Taiwan.

The relational underpinnings of quality internal auditing in medical clinics in Israel.

PubMed

Carmeli, Abraham; Zisu, Malka

2009-03-01

Internal auditing is a key mechanism in enhancing organizational reliability. However, research on the ways quality internal auditing is enabled through learning, deterrence, motivation and process improvement is scant. In particular, the relational underpinnings of internal auditing have been understudied. This study attempts to address this need by examining how organizational trust, perceived organizational support and psychological safety enable internal auditing. Data collected from employees in medical clinics of one of the largest healthcare organizations in Israel at two points in time six months apart. Our results show that organizational trust and perceived organizational support are positively related to psychological safety (measured at time 1), which, in turn, is associated with internal auditing (measured at time 2).

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...

Auditing the Records of Student-Athletes.

ERIC Educational Resources Information Center

Riggs, Robert O.; Hedden, Carole R.

1985-01-01

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

NASA Audit Follow-up Handbook

NASA Technical Reports Server (NTRS)

1990-01-01

This NASA Audit Follow-up Handbook is issued pursuant to the requirements of the Office of Management and Budget (OMB) Circular A-50, Audit Follow-up, dated September 29, 1982. It sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for use when considering reports issued by the Office of Inspector General (OIG), other executive branch audit organizations, the Defense Contract Audit Agency (DCAA), and the General Accounting Office (GAO). It is intended to: specify principal roles; strengthen the procedures for management decisions (resolution) on audit findings and corrective action on audit report recommendations; emphasize the importance of monitoring agreed upon corrective actions to assure actual accomplishment; and foster the use of audit reports as effective tools of management. A flow chart depicting the NASA audit and management decision process is in Appendix A. This handbook is a controlled handbook issued in loose-leaf form and will be revised by page changes. Additional copies for internal use may be obtained through normal distribution channels.

77 FR 56238 - Audit Committee Meeting of the Board of Directors; Sunshine Act

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

... NEIGHBORHOOD REINVESTMENT CORPORATION Audit Committee Meeting of the Board of Directors; Sunshine... Secretary, (202) 220-2376; [email protected] . AGENDA: I. Call to Order II. Executive Session with Internal Audit... to the Audit Committee Charter VI. Internal Audit Response with Management's Response VII. FY 2013...

78 FR 24438 - Board of Directors Audit Committee; Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

... NEIGHBORHOOD REINVESTMENT CORPORATION Board of Directors Audit Committee; Sunshine Act Meeting... Secretary (202) 220-2376; [email protected] . AGENDA: I. CALL TO ORDER II. Executive Session with Internal Audit... Policy VI. External 3rd Party Audit Communication VII. FY 2014 Risk Assessment & Draft Internal Audit...

What can we learn from a decade of database audits? The Duke Clinical Research Institute experience, 1997--2006.

PubMed

Rostami, Reza; Nahm, Meredith; Pieper, Carl F

2009-04-01

Despite a pressing and well-documented need for better sharing of information on clinical trials data quality assurance methods, many research organizations remain reluctant to publish descriptions of and results from their internal auditing and quality assessment methods. We present findings from a review of a decade of internal data quality audits performed at the Duke Clinical Research Institute, a large academic research organization that conducts data management for a diverse array of clinical studies, both academic and industry-sponsored. In so doing, we hope to stimulate discussions that could benefit the wider clinical research enterprise by providing insight into methods of optimizing data collection and cleaning, ultimately helping patients and furthering essential research. We present our audit methodologies, including sampling methods, audit logistics, sample sizes, counting rules used for error rate calculations, and characteristics of audited trials. We also present database error rates as computed according to two analytical methods, which we address in detail, and discuss the advantages and drawbacks of two auditing methods used during this 10-year period. Our review of the DCRI audit program indicates that higher data quality may be achieved from a series of small audits throughout the trial rather than through a single large database audit at database lock. We found that error rates trended upward from year to year in the period characterized by traditional audits performed at database lock (1997-2000), but consistently trended downward after periodic statistical process control type audits were instituted (2001-2006). These increases in data quality were also associated with cost savings in auditing, estimated at 1000 h per year, or the efforts of one-half of a full time equivalent (FTE). Our findings are drawn from retrospective analyses and are not the result of controlled experiments, and may therefore be subject to unanticipated confounding. In addition, the scope and type of audits we examine here are specific to our institution, and our results may not be broadly generalizable. Use of statistical process control methodologies may afford advantages over more traditional auditing methods, and further research will be necessary to confirm the reliability and usability of such techniques. We believe that open and candid discussion of data quality assurance issues among academic and clinical research organizations will ultimately benefit the entire research community in the coming era of increased data sharing and re-use.

75 FR 59331 - Public Company Accounting Oversight Board; Notice of Filing of Proposed Rules on Auditing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... risk is a function of the effectiveness of the design and operation of internal control. 8. Inherent... integrated audit of financial statements and internal control over financial reporting, the requirements in Auditing Standard No. 5, An Audit of Internal Control Over Financial Reporting That Is Integrated with An...

Time to audit.

PubMed

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

2012-09-01

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

Quality control and assurance in hematopoietic stem cell transplantation data registries in Japan and other countries.

PubMed

Kuwatsuka, Yachiyo

2016-01-01

Observational studies from national and international registries with large volumes of patients are commonly performed to identify superior strategies for hematopoietic stem cell transplantation. Major international and national stem cell transplant registries collect outcome data using electronic data capture systems, and a systematic study support process has been developed. Statistical support for studies is available from some major international registries, and international and national registries also mutually collaborate to promote stem cell transplant outcome studies and transplant-related activities. Transplant registries additionally take measures to improve data quality to further improve the quality of outcome studies by utilizing data capture systems and manual data management. Data auditing can potentially even further improve data quality; however, human and budgetary resources can be limiting factors in system construction and audits of the Japanese transplant registry are not currently performed.

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

PubMed

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

2010-01-01

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

HSE auditing

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

Herwaarden, A.J.F. van; Sykes, R.M.

1996-12-31

Shell International Exploration and Production (SIEP) commenced a programme of Health Safety and Environmental (HSE) auditing in its Operating Companies (Opcos) in the late 1970s. Audits in the initial years focused on safety aspects with environmental and occupational aspects being introduced as the process matured. Part of the audit programme is performed by SIEP auditors, external to the Opcos. The level of SIEP-led audit activity increased linearly until the late 1980s, since when a level of around 40 Audits per year has been maintained in roughly as many companies. For the last 15 years each annual programme has included structuredmore » audits of all facets of EP operations. The frequency and duration of these audits have the principle objective of auditing all HSE critical processes of each Opco`s activity, within each five-year cycle. Durations vary from 8-10 days with a 4 person team to 18-20 days with a 6-8 person team. Each audit returns a satisfactory or unsatisfactory rating based on analysis of the effectiveness of the so-called eleven principles of Enhanced Safety Management (ESM) required to be applied throughout the Group. Independence is maintained by the SIEP audit leader, who carries ultimate responsibility for the content and wording of each report, where necessary backed-up by senior management in SIEP. These SIEP-led audits have been successful in the following areas: (1) Provision of early warning in areas where facilities integrity or HSE management was likely to be compromised. (2) Aiding the establishment of an internal HSE auditing process in many Opcos. (3) Training, through participation in audits, not only auditors, but also prospective line managers in the effective management of HSE. With the recent introduction of HSE Management Systems (HSE-MS) in many Opcos, auditing is now in the process of controlled evolution from ESM to HSE-MS based.« less

Multicentre dose audit for clinical trials of radiation therapy in Asia

PubMed Central

Fukuda, Shigekazu; Fukumura, Akifumi; Nakamura, Yuzuru-Kutsutani; Jianping, Cao; Cho, Chul-Koo; Supriana, Nana; Dung, To Anh; Calaguas, Miriam Joy; Devi, C.R. Beena; Chansilpa, Yaowalak; Banu, Parvin Akhter; Riaz, Masooma; Esentayeva, Surya; Kato, Shingo; Karasawa, Kumiko; Tsujii, Hirohiko

2017-01-01

Abstract A dose audit of 16 facilities in 11 countries has been performed within the framework of the Forum for Nuclear Cooperation in Asia (FNCA) quality assurance program. The quality of radiation dosimetry varies because of the large variation in radiation therapy among the participating countries. One of the most important aspects of international multicentre clinical trials is uniformity of absolute dose between centres. The National Institute of Radiological Sciences (NIRS) in Japan has conducted a dose audit of participating countries since 2006 by using radiophotoluminescent glass dosimeters (RGDs). RGDs have been successfully applied to a domestic postal dose audit in Japan. The authors used the same audit system to perform a dose audit of the FNCA countries. The average and standard deviation of the relative deviation between the measured and intended dose among 46 beams was 0.4% and 1.5% (k = 1), respectively. This is an excellent level of uniformity for the multicountry data. However, of the 46 beams measured, a single beam exceeded the permitted tolerance level of ±5%. We investigated the cause for this and solved the problem. This event highlights the importance of external audits in radiation therapy. PMID:27864507

Identification of Classified Information in Unclassified DoD Systems During the Audit of Internal Controls and Data Reliability in the Deployable Disbursing System

DTIC Science & Technology

2009-02-17

Identification of Classified Information in Unclassified DoD Systems During the Audit of Internal Controls and Data Reliability in the Deployable...TITLE AND SUBTITLE Identification of Classified Information in Unclassified DoD Systems During the Audit of Internal Controls and Data Reliability...Systems During the Audit ofInternal Controls and Data Reliability in the Deployable Disbursing System (Report No. D-2009-054) Weare providing this

Effects of patient safety auditing in hospital care: results of a mixed-method evaluation (part 1).

PubMed

Hanskamp-Sebregts, Mirelle; Zegers, Marieke; Westert, Gert P; Boeijen, Wilma; Teerenstra, Steven; van Gurp, Petra J; Wollersheim, Hub

2018-06-15

To evaluate the effectiveness of internal auditing in hospital care focussed on improving patient safety. A before-and-after mixed-method evaluation study was carried out in eight departments of a university medical center in the Netherlands. Internal auditing and feedback focussed on improving patient safety. The effect of internal auditing was assessed 15 months after the audit, using linear mixed models, on the patient, professional, team and departmental levels. The measurement methods were patient record review on adverse events (AEs), surveys regarding patient experiences, safety culture and team climate, analysis of administrative hospital data (standardized mortality rate, SMR) and safety walk rounds (SWRs) to observe frontline care processes on safety. The AE rate decreased from 36.1% to 31.3% and the preventable AE rate from 5.5% to 3.6%; however, the differences before and after auditing were not statistically significant. The patient-reported experience measures regarding patient safety improved slightly over time (P < 0.001). The SMR, patient safety culture and team climate remained unchanged after the internal audit. The SWRs showed that medication safety and information security were improved (P < 0.05). Internal auditing was associated with improved patient experiences and observed safety on wards. No effects were found on adverse outcomes, safety culture and team climate 15 months after the internal audit.

76 FR 72220 - Board of Directors Audit Committee Meeting; Sunshine Act

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... NEIGHBORHOOD REINVESTMENT CORPORATION Board of Directors Audit Committee Meeting; Sunshine Act... Secretary, (202) 220-2376; [email protected] . AGENDA: I. Call To Order II. Executive Session with Internal Audit Director III. Executive Session Related to Pending Litigation IV. Internal Audit Report with Management's...

7 CFR 277.17 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

'Correction:'Peer chart audits: A tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement

PubMed Central

Staton, Lisa J; Kraemer, Suzanne M; Patel, Sangnya; Talente, Gregg M; Estrada, Carlos A

2007-01-01

Background The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. Methods A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided. Results Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%–72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components – neurological, vascular and skin foot exam – increased over time (6% to 24%, p < 0.001). Conclusion Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial. PMID:17662124

Peer chart audits: a tool to meet Accreditation Council on Graduate Medical Education (ACGME) competency in practice-based learning and improvement.

PubMed

Staton, Lisa J; Kraemer, Suzanne M; Patel, Sangnya; Talente, Gregg M; Estrada, Carlos A

2007-07-27

The Accreditation Council on Graduate Medical Education (ACGME) supports chart audit as a method to track competency in Practice-Based Learning and Improvement. We examined whether peer chart audits performed by internal medicine residents were associated with improved documentation of foot care in patients with diabetes mellitus. A retrospective electronic chart review was performed on 347 patients with diabetes mellitus cared for by internal medicine residents in a university-based continuity clinic from May 2003 to September 2004. Residents abstracted information pertaining to documentation of foot examinations (neurological, vascular, and skin) from the charts of patients followed by their physician peers. No formal feedback or education was provided. Significant improvement in the documentation of foot exams was observed over the course of the study. The percentage of patients receiving neurological, vascular, and skin exams increased by 20% (from 13% to 33%) (p = 0.001), 26% (from 45% to 71%) (p < 0.001), and 18% (51%-72%) (p = 0.005), respectively. Similarly, the proportion of patients receiving a well-documented exam which includes all three components - neurological, vascular and skin foot exam - increased over time (6% to 24%, p < 0.001). Peer chart audits performed by residents in the absence of formal feedback were associated with improved documentation of the foot exam in patients with diabetes mellitus. Although this study suggests that peer chart audits may be an effective tool to improve practice-based learning and documentation of foot care in diabetic patients, evaluating the actual performance of clinical care was beyond the scope of this study and would be better addressed by a randomized controlled trial.

Dosimetric inter-institutional comparison in European radiotherapy centres: Results of IAEA supported treatment planning system audit.

PubMed

Gershkevitsh, Eduard; Pesznyak, Csilla; Petrovic, Borislava; Grezdo, Joseph; Chelminski, Krzysztof; do Carmo Lopes, Maria; Izewska, Joanna; Van Dyk, Jacob

2014-05-01

One of the newer audit modalities operated by the International Atomic Energy Agency (IAEA) involves audits of treatment planning systems (TPS) in radiotherapy. The main focus of the audit is the dosimetry verification of the delivery of a radiation treatment plan for three-dimensional (3D) conformal radiotherapy using high energy photon beams. The audit has been carried out in eight European countries - Estonia, Hungary, Latvia, Lithuania, Serbia, Slovakia, Poland and Portugal. The corresponding results are presented. The TPS audit reviews the dosimetry, treatment planning and radiotherapy delivery processes using the 'end-to-end' approach, i.e. following the pathway similar to that of the patient, through imaging, treatment planning and dose delivery. The audit is implemented at the national level with IAEA assistance. The national counterparts conduct the TPS audit at local radiotherapy centres through on-site visits. TPS calculated doses are compared with ion chamber measurements performed in an anthropomorphic phantom for eight test cases per algorithm/beam. A set of pre-defined agreement criteria is used to analyse the performance of TPSs. TPS audit was carried out in 60 radiotherapy centres. In total, 190 data sets (combination of algorithm and beam quality) have been collected and reviewed. Dosimetry problems requiring interventions were discovered in about 10% of datasets. In addition, suboptimal beam modelling in TPSs was discovered in a number of cases. The TPS audit project using the IAEA methodology has verified the treatment planning system calculations for 3D conformal radiotherapy in a group of radiotherapy centres in Europe. It contributed to achieving better understanding of the performance of TPSs and helped to resolve issues related to imaging, dosimetry and treatment planning.

Development of a brachytherapy audit checklist tool.

PubMed

Prisciandaro, Joann; Hadley, Scott; Jolly, Shruti; Lee, Choonik; Roberson, Peter; Roberts, Donald; Ritter, Timothy

2015-01-01

To develop a brachytherapy audit checklist that could be used to prepare for Nuclear Regulatory Commission or agreement state inspections, to aid in readiness for a practice accreditation visit, or to be used as an annual internal audit tool. Six board-certified medical physicists and one radiation oncologist conducted a thorough review of brachytherapy-related literature and practice guidelines published by professional organizations and federal regulations. The team members worked at two facilities that are part of a large, academic health care center. Checklist items were given a score based on their judged importance. Four clinical sites performed an audit of their program using the checklist. The sites were asked to score each item based on a defined severity scale for their noncompliance, and final audit scores were tallied by summing the products of importance score and severity score for each item. The final audit checklist, which is available online, contains 83 items. The audit scores from the beta sites ranged from 17 to 71 (out of 690) and identified a total of 7-16 noncompliance items. The total time to conduct the audit ranged from 1.5 to 5 hours. A comprehensive audit checklist was developed which can be implemented by any facility that wishes to perform a program audit in support of their own brachytherapy program. The checklist is designed to allow users to identify areas of noncompliance and to prioritize how these items are addressed to minimize deviations from nationally-recognized standards. Copyright © 2015 American Brachytherapy Society. All rights reserved.

Accuracy of a smartphone to test laryngoscope's light and an audit to our laryngoscopes using an ISO standard.

PubMed

Machado, Diogo Alcino de Abreu Ribeiro Carvalho; Esteves, Dina da Assunção Azevedo; Branca, Pedro Manuel Araújo de Sousa

Laryngoscope is a key tool in anesthetic practice. Direct laryngoscopy is a crucial moment and inadequate laryngoscope's light can lead to catastrophic consequences. From our experience laryngoscope's light is assessed in a subjective manner and we believe a more precise evaluation should be used. Our objective is to compare the accuracy of a smartphone compared to a lux meter. Secondly we audited our Operating Room laryngoscopes. We designed a pragmatic study, using as primary outcome the accuracy of a smartphone compared to the lux meter. Further we audited with both the lux meter and the smartphone all laryngoscopes and blades ready to use in our Operating Rooms, using the International Standard form the International Organization for Standardization. For primary outcome we found no significant difference between devices. Our audit showed that only 2 in 48 laryngoscopes complied with the ISO norm. When comparing the measurements between the lux meter and the smartphone we found no significant difference. Ideally every laryngoscope should perform as required. We believe all laryngoscopes should have a practical but reliable and objective test prior to its utilization. Our results suggest the smartphone was accurate enough to be used as a lux meter to test laryngoscope's light. Audit results showing only 4% comply with the ISO standard are consistent with other studies. The tested smartphone has enough accuracy to perform light measurement in laryngoscopes. We believe this is a step further to perform an objective routine check to laryngoscope's light. Copyright © 2016. Published by Elsevier Editora Ltda.

What can we learn from a decade of database audits? The Duke Clinical Research Institute experience, 1997–2006

PubMed Central

Rostami, Reza; Nahm, Meredith; Pieper, Carl F.

2011-01-01

Background Despite a pressing and well-documented need for better sharing of information on clinical trials data quality assurance methods, many research organizations remain reluctant to publish descriptions of and results from their internal auditing and quality assessment methods. Purpose We present findings from a review of a decade of internal data quality audits performed at the Duke Clinical Research Institute, a large academic research organization that conducts data management for a diverse array of clinical studies, both academic and industry-sponsored. In so doing, we hope to stimulate discussions that could benefit the wider clinical research enterprise by providing insight into methods of optimizing data collection and cleaning, ultimately helping patients and furthering essential research. Methods We present our audit methodologies, including sampling methods, audit logistics, sample sizes, counting rules used for error rate calculations, and characteristics of audited trials. We also present database error rates as computed according to two analytical methods, which we address in detail, and discuss the advantages and drawbacks of two auditing methods used during this ten-year period. Results Our review of the DCRI audit program indicates that higher data quality may be achieved from a series of small audits throughout the trial rather than through a single large database audit at database lock. We found that error rates trended upward from year to year in the period characterized by traditional audits performed at database lock (1997–2000), but consistently trended downward after periodic statistical process control type audits were instituted (2001–2006). These increases in data quality were also associated with cost savings in auditing, estimated at 1000 hours per year, or the efforts of one-half of a full time equivalent (FTE). Limitations Our findings are drawn from retrospective analyses and are not the result of controlled experiments, and may therefore be subject to unanticipated confounding. In addition, the scope and type of audits we examine here are specific to our institution, and our results may not be broadly generalizable. Conclusions Use of statistical process control methodologies may afford advantages over more traditional auditing methods, and further research will be necessary to confirm the reliability and usability of such techniques. We believe that open and candid discussion of data quality assurance issues among academic and clinical research organizations will ultimately benefit the entire research community in the coming era of increased data sharing and re-use. PMID:19342467

Screening for alcohol use disorders and at-risk drinking in the general population: psychometric performance of three questionnaires.

PubMed

Rumpf, Hans-Jürgen; Hapke, Ulfert; Meyer, Christian; John, Ulrich

2002-01-01

Most screening questionnaires are developed in clinical settings and there are few data on their performance in the general population. This study provides data on the area under the receiver-operating characteristic (ROC) curve, sensitivity, specificity, and internal consistency of the Alcohol Use Disorders Identification Test (AUDIT), the consumption questions of the AUDIT (AUDIT-C) and the Lübeck Alcohol Dependence and Abuse Screening Test (LAST) among current drinkers (n = 3551) of a general population sample in northern Germany. Alcohol dependence and misuse according to DSM-IV and at-risk drinking served as gold standards to assess sensitivity and specificity and were assessed with the Munich-Composite Diagnostic Interview (M-CIDI). AUDIT and LAST showed insufficient sensitivity for at-risk drinking and alcohol misuse using standard cut-off scores, but satisfactory detection rates for alcohol dependence. The AUDIT-C showed low specificity in all criterion groups with standard cut-off. Adjusted cut-points are recommended. Among a subsample of individuals with previous general hospital admission in the last year, all questionnaires showed higher internal consistency suggesting lower reliability in non-clinical samples. In logistic regression analyses, having had a hospital admission increased the sensitivity in detecting any criterion group of the LAST, and the number of recent general practice visits increased the sensitivity of the AUDIT in detecting alcohol misuse. Women showed lower scores and larger areas under the ROC curves. It is concluded that setting specific instruments (e.g. primary care or general population) or adjusted cut-offs should be used.

The evolution of clinical audit as a tool for quality improvement.

PubMed

Berk, Michael; Callaly, Thomas; Hyland, Mary

2003-05-01

Clinical auditing practices are recognized universally as a useful tool in evaluating and improving the quality of care provided by a health service. External auditing is a regular activity for mental health services in Australia but internal auditing activities are conducted at the discretion of each service. This paper evaluates the effectiveness of 6 years of internal auditing activities in a mental health service. A review of the scope, audit tools, purpose, sampling and design of the internal audits and identification of the recommendations from six consecutive annual audit reports was completed. Audit recommendations were examined, as well as levels of implementation and reasons for success or failure. Fifty-seven recommendations were identified, with 35% without action, 28% implemented and 33.3% still pending or in progress. The recommendations were more likely to be implemented if they relied on activity, planning and action across a selection of service areas rather than being restricted to individual departments within a service, if they did not involve non-mental health service departments and if they were not reliant on attitudinal change. Tools used, scope and reporting formats have become more sophisticated as part of the evolutionary nature of the auditing process. Internal auditing in the Barwon Health Mental Health Service has been effective in producing change in the quality of care across the organization. A number of evolutionary changes in the audit process have improved the efficiency and effectiveness of the audit.

Academic Culture, Business Culture, and Measuring Achievement Differences: Internal Auditing Views

ERIC Educational Resources Information Center

Roth, Benjamin S.

2012-01-01

This study explored whether university internal audit directors' views of culture and measuring achievement differences between their institutions and a business were related to how they viewed internal auditing priorities and uses. The Carnegie Classification system's 283 Doctorate-granting Universities were the target population.…

Recommended Procedures for the Internal Financial Auditing of University Libraries.

ERIC Educational Resources Information Center

Kurth, William H.; Zubatsky, David S.

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

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.

Internal Audit in Higher Education.

ERIC Educational Resources Information Center

Holmes, Alison, Ed.; Brown, Sally, Ed.

This book describes a range of examples of internal audit in higher education as part of a process of the exchange of good practice. The book recognizes well-established links with audit theory from other contexts and makes use of theoretical perspectives explored in the financial sector. The chapters are: (1) "Quality Audit Issues"…

A Brief Background of the ICA (International Communication Association) Audit.

ERIC Educational Resources Information Center

Krivonos, Paul D.

This paper examines the International Communication Association (ICA) audit, the aim of which is to establish an integrated communication audit system and a multimethod approach to the auditing of the communication of an organization. Many of an organization's communication variables and concepts are examined so that strengths and weaknesses in…

Multicentre dose audit for clinical trials of radiation therapy in Asia.

PubMed

Mizuno, Hideyuki; Fukuda, Shigekazu; Fukumura, Akifumi; Nakamura, Yuzuru-Kutsutani; Jianping, Cao; Cho, Chul-Koo; Supriana, Nana; Dung, To Anh; Calaguas, Miriam Joy; Devi, C R Beena; Chansilpa, Yaowalak; Banu, Parvin Akhter; Riaz, Masooma; Esentayeva, Surya; Kato, Shingo; Karasawa, Kumiko; Tsujii, Hirohiko

2017-05-01

A dose audit of 16 facilities in 11 countries has been performed within the framework of the Forum for Nuclear Cooperation in Asia (FNCA) quality assurance program. The quality of radiation dosimetry varies because of the large variation in radiation therapy among the participating countries. One of the most important aspects of international multicentre clinical trials is uniformity of absolute dose between centres. The National Institute of Radiological Sciences (NIRS) in Japan has conducted a dose audit of participating countries since 2006 by using radiophotoluminescent glass dosimeters (RGDs). RGDs have been successfully applied to a domestic postal dose audit in Japan. The authors used the same audit system to perform a dose audit of the FNCA countries. The average and standard deviation of the relative deviation between the measured and intended dose among 46 beams was 0.4% and 1.5% (k = 1), respectively. This is an excellent level of uniformity for the multicountry data. However, of the 46 beams measured, a single beam exceeded the permitted tolerance level of ±5%. We investigated the cause for this and solved the problem. This event highlights the importance of external audits in radiation therapy. © The Author 2016. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

A risk-based auditing process for pharmaceutical manufacturers.

PubMed

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

2014-01-01

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

Internal Audit: Does it Enhance Governance in the Australian Public University Sector?

ERIC Educational Resources Information Center

Christopher, Joe

2015-01-01

This study seeks to confirm if internal audit, a corporate control process, is functioning effectively in Australian public universities. The study draws on agency theory, published literature and best-practice guidelines to develop an internal audit evaluation framework. A survey instrument is thereafter developed from the framework and used as a…

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

PubMed Central

2013-01-01

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

The Second Stroke Audit of Catalonia shows improvements in many, but not all quality indicators.

PubMed

Abilleira, Sònia; Ribera, Aida; Sánchez, Emília; Tresserras, Ricard; Gallofré, Miquel

2012-01-01

Periodic audits allow monitoring of healthcare quality by comparing performances at different time points. Aims To assess quality of in-hospital stroke care in Catalonia in 2007 and compare it with 2005 (post-/preguidelines delivery, respectively). Data on 13 evidence-based performance measures were collected by a retrospective review of medical records of consecutive stroke admissions (January-December 2007) to 47 acute hospitals in Catalonia. Adherence was calculated according to the ratio (patients with documented performance measures' compliance) (valid cases for that measure). Sampling weights were applied to produce estimates of compliance. The proportions of compliance with performance measures in both audits were compared using random-effects logistic regressions, with each performance measure as the dependent variable and audit edition as the explanatory variable to determine whether changes in stroke care quality occurred along time. We analyzed 1767 events distributed among 47 hospitals. In 2007, there was an increase in tissue plasminogen activator administrations (2·8% vs. 5·9%) and stroke unit admissions (16·6% vs. 22·6%) and a reduction in seven-day mortality (9·5% vs. 6·8%). Logistic regression models provided evidence of improved adherences to seven performance measures (screening of dysphagia, management of hyperthermia, baseline computed tomography scan, baseline glycemia, rehabilitation needs, early mobilization, and anticoagulants for atrial fibrillation), but worsening of management of hypertension, dyslipidemia, and antithrombotics at discharge. The remaining three performance measures showed no changes. The Second Stroke Audit showed improvements in most dimensions of care, although unexpectedly a few but relevant performance measures became worse. Therefore, periodic stroke audits are needed to check changes in quality of care over time. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

Comparative dosimetry study of three UK centres implementing total skin electron treatment through external audit.

PubMed

Misson-Yates, S; Gonzalez, R; McGovern, M; Greener, A

2015-05-01

This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth-dose curve in water (R50,D) value. Clinical simulation using TLDs) showed an agreement of -1.6% and -6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation.

Comparative dosimetry study of three UK centres implementing total skin electron treatment through external audit

PubMed Central

Gonzalez, R; McGovern, M; Greener, A

2015-01-01

Objective: This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Methods: Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Results: Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth–dose curve in water (R50,D) value. Clinical simulation using TLDs) showed an agreement of −1.6% and −6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. Conclusion: This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. Advances in knowledge: TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation. PMID:25761213

Report on the Audit of Internal Controls Over DoD Major Suggestion Awards

DTIC Science & Technology

1992-01-22

This final report on the Audit of Major Suggestion Awards is provided for your information and use. The audit was requested by the Assistant...suggestions. If adopted, the revision could substantially increase the number of cases with awards over $10,000. The audit was made from September through...October 1991. The overall objective of the audit was to determine whether existing internal controls ensured the integrity of major suggestion awards

76 FR 23861 - Corporate Credit Unions

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-29

... statements, Financial statement audit, Generally accepted auditing standards, Independent public accountant... public accountant undermines the IPA's independence. The Board is delaying the effective date of this ERM... accepted auditing standards, Independent public accountant, Internal control, Internal control framework...

Comparing Resident Self-Report to Chart Audits for Quality Improvement Projects: Accurate Reflection or Cherry-Picking?

PubMed Central

Kuperman, Ethan F.; Tobin, Kristen; Kraschnewski, Jennifer L.

2014-01-01

Background Resident engagement in quality improvement is a requirement for graduate medical education, but the optimal means of instruction and evaluation of resident progress remain unknown. Objective To determine the accuracy of self-reported chart audits in measuring resident adherence to primary care clinical practice guidelines. Methods During the 2010–2011 academic year, second- and third-year internal medicine residents at a single, university hospital–based program performed chart audits on 10 patients from their primary care clinic to determine adherence to 16 US Preventive Services Task Force primary care guidelines. We compared residents' responses to independent audits of randomly selected patient charts by a single external reviewer. Results Self-reported data were collected by 18 second-year and 15 third-year residents for 330 patients. Independently, 70 patient charts were randomly selected for review by an external auditor. Overall guideline compliance was significantly higher on self-reported audits compared to external audits (82% versus 68%, P < .001). Of 16 guidelines, external audits found significantly lower rates of adherence for 5 (tetanus vaccination, osteoporosis screening, colon cancer screening, cholesterol screening, and obesity screening). Chlamydia screening was more common in audited charts than in self-reported data. Although third-year residents self-reported higher guideline adherence than second-year residents (86% versus 78%, P < .001), external audits for third-year residents found lower overall adherence (64% versus 72%, P  =  .040). Conclusions Residents' self-reported chart audits may significantly overestimate guideline adherence. Increased supervision and independent review appear necessary to accurately evaluate resident performance. PMID:26140117

Comparing Resident Self-Report to Chart Audits for Quality Improvement Projects: Accurate Reflection or Cherry-Picking?

PubMed

Kuperman, Ethan F; Tobin, Kristen; Kraschnewski, Jennifer L

2014-12-01

Resident engagement in quality improvement is a requirement for graduate medical education, but the optimal means of instruction and evaluation of resident progress remain unknown. To determine the accuracy of self-reported chart audits in measuring resident adherence to primary care clinical practice guidelines. During the 2010-2011 academic year, second- and third-year internal medicine residents at a single, university hospital-based program performed chart audits on 10 patients from their primary care clinic to determine adherence to 16 US Preventive Services Task Force primary care guidelines. We compared residents' responses to independent audits of randomly selected patient charts by a single external reviewer. Self-reported data were collected by 18 second-year and 15 third-year residents for 330 patients. Independently, 70 patient charts were randomly selected for review by an external auditor. Overall guideline compliance was significantly higher on self-reported audits compared to external audits (82% versus 68%, P < .001). Of 16 guidelines, external audits found significantly lower rates of adherence for 5 (tetanus vaccination, osteoporosis screening, colon cancer screening, cholesterol screening, and obesity screening). Chlamydia screening was more common in audited charts than in self-reported data. Although third-year residents self-reported higher guideline adherence than second-year residents (86% versus 78%, P < .001), external audits for third-year residents found lower overall adherence (64% versus 72%, P  =  .040). Residents' self-reported chart audits may significantly overestimate guideline adherence. Increased supervision and independent review appear necessary to accurately evaluate resident performance.

Impact of Pharmacists' audit on improving the quality of prescription of dabigatran etexilate methanesulfonate: a retrospective study.

PubMed

Shimizu, Teppei; Momose, Yoshio; Ogawa, Ryuichi; Takahashi, Masahiro; Echizen, Hirotoshi

2017-01-01

Appropriate prescription of dabigatran etexilate methanesulfonate (JAN) is more complicated than assumed, because there are totally 10 items of contraindications and instructions for dosage reduction depending on patients' characteristics. We aimed to study whether the routine audit of first-time prescriptions of dabigatran performed by pharmacists is effective in improving the quality of prescription. A retrospective re-audit was performed on all the prescriptions of dabigatran issued at Kitahara International Hospital, Tokyo between March 2011 and February 2014, by evaluating the prescriptions rigorously against the approved prescribing information of the drug. The original routine audit of the prescriptions for inpatients was performed by hospital pharmacists using electronic medical records (EMR), whereas the audit for ambulant patients receiving external prescriptions was performed by community pharmacists using information obtained mainly by questioning patients. The frequencies of inappropriate prescriptions detected by the re-audit in the two groups were compared. Two hundred and twenty-eight patients (131 ambulant patients and 97 inpatients) were prescribed dabigatran for the first time during the study period. All patients met the approved indications. While 33% of the prescriptions for ambulant patients showed at least one violation of the approved usage, only 11% of the prescriptions for inpatients showed violations ( p  < 0.001). Two ambulant patients with creatinine clearance < 30 mL/min were dispensed dabigatran, whereas no such case was found among inpatients. A significantly greater proportion of ambulant patients aged ≥70 years showed violation of the instruction for dosage reduction compared to inpatients of the same age group (18 and 4%, respectively). The present study suggests that pharmacists may achieve better performance in auditing prescriptions of dabigatran when medical records are fully available than when information is available mainly by questioning patients. Further large-scale studies are required to clarify whether the audit of dabigatran prescriptions improves ultimate therapeutic outcomes or complications.

Enhancing compliance at Department of Defense facilities: comparison of three environmental audit tools.

PubMed

Hepler, Jeff A; Neumann, Cathy

2003-04-01

To enhance environmental compliance, the U.S. Department of Defense (DOD) recently developed and implemented a standardized environmental audit tool called The Environmental Assessment and Management (TEAM) Guide. Utilization of a common audit tool (TEAM Guide) throughout DOD agencies could be an effective agent of positive change. If, however, the audit tool is inappropriate, environmental compliance at DOD facilities could worsen. Furthermore, existing audit systems such as the U.S. Environmental Protection Agency's (U.S. EPA's) Generic Protocol for Conducting Environmental Audits of Federal Facilities and the International Organization for Standardization's (ISO's) Standard 14001, "Environmental Management System Audits," may be abandoned even if they offer significant advantages over TEAM Guide audit tool. Widespread use of TEAM Guide should not take place until thorough and independent evaluation has been performed. The purpose of this paper is to compare DOD's TEAM Guide audit tool with U.S. EPA's Generic Protocol for Conducting Environmental Audits of Federal Facilities and ISO 14001, in order to assess which is most appropriate and effective for DOD facilities, and in particular those operated by the U.S. Army Corps of Engineers (USACE). USACE was selected as a result of one author's recent experience as a district environmental compliance coordinator responsible for the audit mission at this agency. Specific recommendations for enhancing the quality of environmental audits at all DOD facilities also are given.

Developing and implementing a computerized nursing quality control system in a tertiary general medical center in Israel.

PubMed

Kagan, Ilya; Cohen, Rachel; Fish, Miri; Mezare, Henia Perry

2014-01-01

This article describes the development and implementation of the Nursing Quality Indicators Scale and a quality control system for hospital nursing care, which allows universal access to all external and internal audit results, thus ensuring complete data transparency. Standardized indicators make departments' performance comparable. Key to the new system is nurses' self-audit and responsibility for making quality improvements at the ward level.

Best Practices for Audit and Financial Advisory Committees Within the Department of Defense

DTIC Science & Technology

2007-12-06

oversight of an organization’s annual financial statement audit, risk management plan, internal control framework, and compliance with external...is generally responsible for providing independent oversight of an organization’s annual financial statement audit, risk management plan, internal...achieving financial management objectives and identify areas of risk or concern. 40 11.2. Systems of Internal Controls

Knowledge Acquisition and Memory Effects Involving an Expert System Designed as a Learning Tool for Internal Control Assessment

ERIC Educational Resources Information Center

Lenard, Mary Jane

2003-01-01

The assessment of internal control is a consideration in all financial statement audits, as stressed by the Statement on Auditing Standards (SAS) No. 78. According to this statement, "the auditor should obtain an understanding of internal control sufficient to plan the audit" (Accounting Standards Board, 1995, p. 1). Therefore, an…

A direct observation method for auditing large urban centers using stratified sampling, mobile GIS technology and virtual environments.

PubMed

Lafontaine, Sean J V; Sawada, M; Kristjansson, Elizabeth

2017-02-16

With the expansion and growth of research on neighbourhood characteristics, there is an increased need for direct observational field audits. Herein, we introduce a novel direct observational audit method and systematic social observation instrument (SSOI) for efficiently assessing neighbourhood aesthetics over large urban areas. Our audit method uses spatial random sampling stratified by residential zoning and incorporates both mobile geographic information systems technology and virtual environments. The reliability of our method was tested in two ways: first, in 15 Ottawa neighbourhoods, we compared results at audited locations over two subsequent years, and second; we audited every residential block (167 blocks) in one neighbourhood and compared the distribution of SSOI aesthetics index scores with results from the randomly audited locations. Finally, we present interrater reliability and consistency results on all observed items. The observed neighbourhood average aesthetics index score estimated from four or five stratified random audit locations is sufficient to characterize the average neighbourhood aesthetics. The SSOI was internally consistent and demonstrated good to excellent interrater reliability. At the neighbourhood level, aesthetics is positively related to SES and physical activity and negatively correlated with BMI. The proposed approach to direct neighbourhood auditing performs sufficiently and has the advantage of financial and temporal efficiency when auditing a large city.

Audit Report on "The Department's Management of Nuclear Materials Provided to Domestic Licensees"

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

None

The objective if to determine whether the Department of Energy (Department) was adequately managing its nuclear materials provided to domestic licensees. The audit was performed from February 2007 to September 2008 at Department Headquarters in Washington, DC, and Germantown, MD; the Oak Ridge Office and the Oak Ridge National Laboratory in Oak Ridge, TN. In addition, we visited or obtained data from 40 different non-Departmental facilities in various states. To accomplish the audit objective, we: (1) Reviewed Departmental and Nuclear Regulatory Commission (NRC) requirements for the control and accountability of nuclear materials; (2) Analyzed a Nuclear Materials Management and Safeguardsmore » System (NMMSS) report with ending inventory balances for Department-owned nuclear materials dated September 30, 2007, to determine the amount and types of nuclear materials located at non-Department domestic facilities; (3) Held discussions with Department and NRC personnel that used NMMSS information to determine their roles and responsibilities related to the control and accountability over nuclear materials; (4) Selected a judgmental sample of 40 non-Department domestic facilities; (5) Met with licensee officials and sent confirmations to determine whether their actual inventories of Department-owned nuclear materials were consistent with inventories reported in the NMMSS; and, (6) Analyzed historical information related to the 2004 NMMSS inventory rebaselining initiative to determine the quantity of Department-owned nuclear materials that were written off from the domestic licensees inventory balances. This performance audit was conducted in accordance with generally accepted Government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objective. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives. The audit included tests of controls and compliance with laws and regulations related to managing the Department-owned nuclear materials provided to non-Departmental domestic licensees. Because our review was limited it would not necessarily have disclosed all internal control deficiencies that may have existed at the time of our audit. We examined the establishment of performance measures in accordance with Government Performance and Results Act of 1993, as they related to the audit objective. We found that the Department had established performance measures related to removing or disposing of nuclear materials and radiological sources around the world. We utilized computer generated data during our audit and performed procedures to validate the reliability of the information as necessary to satisfy our audit objective. As noted in the report, we questioned the reliability of the NMMSS data.« less

[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.

Measuring Data Quality Through a Source Data Verification Audit in a Clinical Research Setting.

PubMed

Houston, Lauren; Probst, Yasmine; Humphries, Allison

2015-01-01

Health data has long been scrutinised in relation to data quality and integrity problems. Currently, no internationally accepted or "gold standard" method exists measuring data quality and error rates within datasets. We conducted a source data verification (SDV) audit on a prospective clinical trial dataset. An audit plan was applied to conduct 100% manual verification checks on a 10% random sample of participant files. A quality assurance rule was developed, whereby if >5% of data variables were incorrect a second 10% random sample would be extracted from the trial data set. Error was coded: correct, incorrect (valid or invalid), not recorded or not entered. Audit-1 had a total error of 33% and audit-2 36%. The physiological section was the only audit section to have <5% error. Data not recorded to case report forms had the greatest impact on error calculations. A significant association (p=0.00) was found between audit-1 and audit-2 and whether or not data was deemed correct or incorrect. Our study developed a straightforward method to perform a SDV audit. An audit rule was identified and error coding was implemented. Findings demonstrate that monitoring data quality by a SDV audit can identify data quality and integrity issues within clinical research settings allowing quality improvement to be made. The authors suggest this approach be implemented for future research.

31 CFR Appendix B to Subpart C of... - Internal Revenue Service

Code of Federal Regulations, 2010 CFR

2010-07-01

... investigation, audit, or collection activity. Accordingly, individuals should contact the Internal Revenue Service employee conducting an audit or effecting the collection of tax liabilities to gain access to such... individual desires information or records not in connection with an investigation, audit, or collection...

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

Quality Control Review of the Defense Finance and Accounting Service Internal Audit Organization

DTIC Science & Technology

2014-12-01

Executive documented a threat to independence because they provided direction in a nonaudit service (IR End-to-End Assessment of DFAS Texarkana Operations...effect the lack of segregation of duties and system management controls has on the DFAS Texarkana Vendor Pay and Payroll functions.” Based on our...Infrastructure Management, February 10, 2014 Performance CO12PRC010TX Columbus Audit of DFAS Texarkana Vendor Pay and Payroll, November 19, 2013

The ICA Communication Audit: Process, Status, Critique

ERIC Educational Resources Information Center

Goldhaber, Gerald M.; Krivonos, Paul D.

1977-01-01

Explores the International Communication Association (ICA) Audit process including goals, products, instruments, audit logistics and timetable, feedback of results and follow-up, costs, current status and audits conducted to date. (ED.)

Alaska Power Administration combined financial statements, schedules and supplemental reports, September 30, 1995 and 1994

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

NONE

1995-12-31

This report presents the results of the independent certified public accountant`s audit of the Department of Energy`s Alaska Power Administration`s (Alaska) financial statements as of September 30, 1995. The auditors have expressed an unqualified opinion on the 1995 statements. Their reports on Alaska`s internal control structure and on compliance with laws and regulations are also provided. The Alaska Power Administration operates and maintains two hydroelectric projects that include five generator units, three power tunnels and penstocks, and over 88 miles of transmission line. Additional information about Alaska Power Administration is provided in the notes to the financial statements. The 1995more » financial statement audit was made under the provisions of the Inspector General Act (5 U.S.C. App.), as amended, the Chief Financial Officers (CFO) Act (31 U.S.C. 1500), and Office of Management and Budget implementing guidance to the CFO Act. The auditor`s work was conducted in accordance with generally accepted government auditing standards. To fulfill the audit responsibilities, the authors contracted with the independent public accounting firm of KPMG Peat Marwick (KPMG) to conduct the audit for us, subject to review. The auditor`s report on Alaska`s internal control structure disclosed no reportable conditions that could have a material effect on the financial statements. The auditor also considered the overview and performance measure data for completeness and material consistency with the basic financial statements, as noted in the internal control report. The auditor`s report on compliance with laws and regulations disclosed no instances of noncompliance by Alaska.« less

7 CFR 3052.510 - Audit findings.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 3052.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a... programs. The auditor's determination of whether a deficiency in internal control is a reportable condition...

A Comparative Analysis of Internal Communication and Public Relations Audits. State of the Art.

ERIC Educational Resources Information Center

Dozier, David M.; Hellweg, Susan A.

A review of current literature regarding the state of the art in the conduct of internal communication and public relations audits by public relations practitioners reveals that these two related measurement activities are of considerable importance to the practice of public relations. Public relations audits are concerned with exploratory…

77 FR 63872 - Senior Executive Service; Appointment of Members to the Performance Review Board

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-17

... Resources--Kim L.H. Green. Rotating Membership ASP Kathleen E. Franks, Director, Office of Regulatory and... OLMS Stephen J. Willertz, Director, Office of Enforcement and International Union Audits--appointment...

29 CFR 99.510 - Audit findings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a... programs. The auditor's determination of whether a deficiency in internal control is a reportable condition...

The ICA Communication Audit and Perceived Communication Effectiveness Changes in 16 Audited Organizations.

ERIC Educational Resources Information Center

Brooks, Keith; And Others

1979-01-01

Discusses the benefits of the International Communication Association Communication Audit as a methodology for evaluation of organizational communication processes and outcomes. An "after" survey of 16 audited organizations confirmed the audit as a valid diagnostic methodology and organization development intervention technique which…

Quality assurance and the need to evaluate interventions and audit programme outcomes.

PubMed

Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian

2017-06-01

Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.

Clinical audit teaching in record-keeping for dental undergraduates at International Medical University, Kuala Lumpur, Malaysia.

PubMed

Chong, Jun A; Chew, Jamie K Y; Ravindranath, Sneha; Pau, Allan

2014-02-01

This study investigated the impact of clinical audit training on record-keeping behavior of dental students and students' perceptions of the clinical audit training. The training was delivered to Year 4 and Year 5 undergraduates at the School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. It included a practical audit exercise on patient records. The results were presented by the undergraduates, and guidelines were framed from the recommendations proposed. Following this, an audit of Year 4 and Year 5 students' patient records before and after the audit training was carried out. A total of 100 records were audited against a predetermined set of criteria by two examiners. An email survey of the students was also conducted to explore their views of the audit training. Results showed statistically significant improvements in record-keeping following audit training. Responses to the email survey were analyzed qualitatively. Respondents reported that the audit training helped them to identify deficiencies in their record-keeping practice, increased their knowledge in record-keeping, and improved their record-keeping skills. Improvements in clinical audit teaching were also proposed.

Findings From a Nursing Care Audit Based on the Nursing Process: A Descriptive Study.

PubMed

Poortaghi, Sarieh; Salsali, Mahvash; Ebadi, Abbas; Rahnavard, Zahra; Maleki, Farzaneh

2015-09-01

Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. This study aimed to audit nursing care based on a nursing process model. This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses' compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses' age (r = 0.26, P = 0.001) and work experience (r = 0.273, P = 0.001). Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools.

Next-generation audit and feedback for inpatient quality improvement using electronic health record data: a cluster randomised controlled trial.

PubMed

Patel, Sajan; Rajkomar, Alvin; Harrison, James D; Prasad, Priya A; Valencia, Victoria; Ranji, Sumant R; Mourad, Michelle

2018-03-05

Audit and feedback improves clinical care by highlighting the gap between current and ideal practice. We combined best practices of audit and feedback with continuously generated electronic health record data to improve performance on quality metrics in an inpatient setting. We conducted a cluster randomised control trial comparing intensive audit and feedback with usual audit and feedback from February 2016 to June 2016. The study subjects were internal medicine teams on the teaching service at an urban tertiary care hospital. Teams in the intensive feedback arm received access to a daily-updated team-based data dashboard as well as weekly inperson review of performance data ('STAT rounds'). The usual feedback arm received ongoing twice-monthly emails with graphical depictions of team performance on selected quality metrics. The primary outcome was performance on a composite discharge metric (Discharge Mix Index, 'DMI'). A washout period occurred at the end of the trial (from May through June 2016) during which STAT rounds were removed from the intensive feedback arm. A total of 40 medicine teams participated in the trial. During the intervention period, the primary outcome of completion of the DMI was achieved on 79.3% (426/537) of patients in the intervention group compared with 63.2% (326/516) in the control group (P<0.0001). During the washout period, there was no significant difference in performance between the intensive and usual feedback groups. Intensive audit and feedback using timely data and STAT rounds significantly increased performance on a composite discharge metric compared with usual feedback. With the cessation of STAT rounds, performance between the intensive and usual feedback groups did not differ significantly, highlighting the importance of feedback delivery on effecting change. The trial was registered with ClinicalTrials.gov (NCT02593253). © 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.

Singapore Pre-Service Secondary Mathematics Teachers' Content Knowledge: Findings from an International Comparative Study

ERIC Educational Resources Information Center

Toh, Tin Lam; Kaur, Berinderjeet; Koay, Phong Lee

2013-01-01

In this article, we explore the mathematical content knowledge of one entire cohort of pre-service teachers (N = 107) through analysing their performance in a Secondary Mathematics Audit that was developed for the International Comparative Studies in Mathematics Teacher Training that was initiated by the University of Plymouth. We study how their…

Spasmodic dysphonia: a seven-year audit of dose titration and demographics in the Indian population.

PubMed

Nerurkar, N K; Banu, T P

2014-07-01

This study aimed to evaluate the demographics of spasmodic dysphonia in the Indian population and to analyse the optimum dose titration of botulinum toxin type A in this group. A comparative analysis with international studies was also performed. The study involved a retrospective analysis and audit of botulinum toxin type A dose titration in spasmodic dysphonia patients who visited our voice clinic between January 2005 and January 2012. The average total therapeutic dose required for patients with adductor spasmodic dysphonia was 4.2 U per patient per vocal fold (total 8.4 U per patient), and for patients with abductor spasmodic dysphonia, it was 4.6 U per patient. Our audit revealed that 80 per cent of the spasmodic dysphonia patients were male, which contrasts dramatically with international studies, wherein around 80 per cent of spasmodic dysphonia patients were female. Our study also revealed a higher dose titration of botulinum toxin for the Indian spasmodic dysphonia population in both adductor and abductor spasmodic dysphonia cases.

[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

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.

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.

76 FR 20336 - Defense Audit Advisory Committee (DAAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Audit Advisory Committee (DAAC) AGENCY... following Federal advisory committee meeting of the Defense Audit Advisory Committee will be held. DATES... management to include financial reporting processes, systems of internal controls, audit processes, and...

Making a 403(b) Checklist--and Checking It Twice

ERIC Educational Resources Information Center

Blinn, Linda Segal

2013-01-01

The prospect of an IRS 403(b) audit can be daunting, but as the old saying goes, knowing is half the battle. Understanding what to expect during the audit process and having the proper internal controls are the keys to avoiding stress. As part of a traditional IRS 403(b) plan audit, the Internal Revenue Service has requested that plan sponsors…

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 2 2013-04-01 2013-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.22 - What are the minimum internal control standards for internal audit for Tier A gaming operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false What are the minimum internal control standards for internal audit for Tier A gaming operations? 542.22 Section 542.22 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.22 What are the minimum internal control standards for...

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 2 2011-04-01 2011-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2012 CFR

2012-04-01

... 25 Indians 2 2012-04-01 2012-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

25 CFR 542.32 - What are the minimum internal control standards for internal audit for Tier B gaming operations?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 2 2014-04-01 2014-04-01 false What are the minimum internal control standards for internal audit for Tier B gaming operations? 542.32 Section 542.32 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS § 542.32 What are the minimum internal control standards for...

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.

76 FR 33377 - In The Matter of: Artfest International, Inc; Order of Suspension of Trading

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-08

..., an independent audit of Artfest's financial statements for the fiscal year ended December 31, 2010, which was not performed, and financial statements for the 2010 period that are referenced in the filings...

48 CFR 242.7501 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEFENSE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Accounting Systems and..., shall maintain an accounting system and related internal controls throughout contract performance which... accounting system and cost data are reliable; (c) Risk of misallocations and mischarges are minimized; and (d...

TU-G-BRD-06: The Imaging and Radiation Oncology Core Houston (IROC Houston) QA Center International Activities Outside North America

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

Followill, D; Kry, S; Molineu, A

Purpose: To describe the extent of IROC Houston’s (formerly the RPC) QA activities and audit results for radiotherapy institutions outside of North America (NA). Methods: The IROC Houston’s QA program components were designed to audit the radiation dose calculation chain from the NIST traceable reference beam calibration, to inclusion of dosimetry parameters used to calculate tumor doses, to the delivery of the radiation dose. The QA program provided to international institutions includes: 1) remote TLD/OSLD audit of machine output, 2) credentialing for advanced technologies, and 3) review of patient treatment records. IROC Houston uses the same standards and acceptance criteriamore » for all of its audits whether for North American or international sites. Results: IROC Houston’s QA program has reached out to radiotherapy sites in 43 different countries since 2013 through their participation in clinical trials. In the past two years, 2,778 international megavoltage beam outputs were audited with OSLD/TLD. While the average IROC/Inst ratio is near unity for all sites monitored, there are international regions whose results are significantly different from the NA region. In the past 2 years, 477 and 87 IMRT H&N phantoms were irradiated at NA and international sites, respectively. Regardless of the OSLD beam audit results, the overall pass rate (87 percent) for all international sites (no region separation) is equal to the NA sites. Of the 182 international patient charts reviewed, 10.7 percent of the dose calculation points did not meet our acceptance criterion as compared to 13.6 percent for NA sites. The lower pass rate for NA sites results from a much larger brachytherapy component which has been shown to be more error prone. Conclusion: IROC Houston has expanded its QA services worldwide and continues a long history of improving radiotherapy dose delivery in many countries. Funding received for QA audit services from the Korean GOG, DAHANCA, EORTC, ICON and CMIC Group.« less

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.

Internal Audit Service | Internal Audit Service

Science.gov Websites

Book Newsroom Newsroom News and features Press releases Photo gallery Fact sheets and brochures Media Home Contact Phone Book Fermilab at Work For Industry Jobs Interact Facebook Twitter Instagram Google

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

PubMed

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

2017-07-01

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

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

38 CFR 41.510 - Audit findings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 41.510 Audit findings. (a) Audit findings reported. The auditor shall report the following as audit findings in a schedule of... auditor's determination of whether a deficiency in internal control is a reportable condition for the...

22 CFR 226.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT ADMINISTRATION OF ASSISTANCE AWARDS TO U.S. NON-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Financial and Program Management § 226.26 Non-Federal audits... organizations (including hospitals) shall be subject to the audit requirements contained in the Single Audit Act...

32 CFR 34.16 - Audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... independent audit is intended to ascertain the adequacy of the recipient's internal financial management... of the recipient's financial statements. However, it may be more economical in some cases to have the...; and (2) When requesting an additional audit, shall: (i) Limit the scope of such additional audit to...

32 CFR 34.16 - Audits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... independent audit is intended to ascertain the adequacy of the recipient's internal financial management... of the recipient's financial statements. However, it may be more economical in some cases to have the...; and (2) When requesting an additional audit, shall: (i) Limit the scope of such additional audit to...

76 FR 72186 - Defense Audit Advisory Committee (DAAC); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-22

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Audit Advisory Committee (DAAC); Notice of... announces the following Federal advisory committee meeting of the Defense Audit Advisory Committee (DAAC... of internal controls, audit processes, and processes for monitoring compliance with relevant laws and...

77 FR 34940 - Defense Audit Advisory Committee (DAAC); Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-12

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Audit Advisory Committee (DAAC); Notice of... following Federal advisory committee meeting of the Defense Audit Advisory Committee (DAAC) will be held... reporting processes, systems of internal controls, audit processes, and processes for monitoring compliance...

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...

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

PubMed

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

1998-06-01

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

Nationwide prospective audit of pancreatic surgery: design, accuracy, and outcomes of the Dutch Pancreatic Cancer Audit.

PubMed

van Rijssen, L Bengt; Koerkamp, Bas G; Zwart, Maurice J; Bonsing, Bert A; Bosscha, Koop; van Dam, Ronald M; van Eijck, Casper H; Gerhards, Michael F; van der Harst, Erwin; de Hingh, Ignace H; de Jong, Koert P; Kazemier, Geert; Klaase, Joost; van Laarhoven, Cornelis J; Molenaar, I Quintus; Patijn, Gijs A; Rupert, Coen G; van Santvoort, Hjalmar C; Scheepers, Joris J; van der Schelling, George P; Busch, Olivier R; Besselink, Marc G

2017-10-01

Auditing is an important tool to identify practice variation and 'best practices'. The Dutch Pancreatic Cancer Audit is mandatory in all 18 Dutch centers for pancreatic surgery. Performance indicators and case-mix factors were identified by a PubMed search for randomized controlled trials (RCT's) and large series in pancreatic surgery. In addition, data dictionaries of two national audits, three institutional databases, and the Dutch national cancer registry were evaluated. Morbidity, mortality, and length of stay were analyzed of all pancreatic resections registered during the first two audit years. Case ascertainment was cross-checked with the Dutch healthcare inspectorate and key-variables validated in all centers. Sixteen RCT's and three large series were found. Sixteen indicators and 20 case-mix factors were included in the audit. During 2014-2015, 1785 pancreatic resections were registered including 1345 pancreatoduodenectomies. Overall in-hospital mortality was 3.6%. Following pancreatoduodenectomy, mortality was 4.1%, Clavien-Dindo grade ≥ III morbidity was 29.9%, median (IQR) length of stay 12 (9-18) days, and readmission rate 16.0%. In total 97.2% of >40,000 variables validated were consistent with the medical charts. The Dutch Pancreatic Cancer Audit, with high quality data, reports good outcomes of pancreatic surgery on a national level. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Evaluating Internal Communication: The ICA Communication Audit.

ERIC Educational Resources Information Center

Goldhaber, Gerald M.

1978-01-01

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

Meta-audit of laboratory ISO accreditation inspections: measuring the old emperor's clothes.

PubMed

Wilson, Ian G; Smye, Michael; Wallace, Ian J C

2016-02-01

Accreditation to ISO/IEC 17025 is required for EC official food control and veterinary laboratories by Regulation (EC) No. 882/2004. Measurements in hospital laboratories and clinics are increasingly accredited to ISO/IEC 15189. Both of these management standards arose from command and control military standards for factory inspection during World War II. They rely on auditing of compliance and have not been validated internally as assessment bodies require of those they accredit. Neither have they been validated to criteria outside their own ideology such as the Cochrane principles of evidence-based medicine which might establish whether any benefit exceeds their cost. We undertook a retrospective meta-audit over 14 years of internal and external laboratory audits that checked compliance with ISO 17025 in a public health laboratory. Most noncompliances arose solely from clauses in the standard and would not affect users. No effect was likely from 91% of these. Fewer than 1% of noncompliances were likely to have consequences for the validity of results or quality of service. The ISO system of compliance auditing has the performance characteristics of a poor screening test. It adds substantially to costs and generates more noise (false positives) than informative signal. Ethical use of resources indicates that management standards should not be used unless proven to deliver the efficacy, effectiveness, and value required of modern healthcare interventions. © 2015 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.

Using Communication Audits To Teach Organizational Communication to Students and Employees.

ERIC Educational Resources Information Center

Scott, Craig R.; Shaw, Sandra Pride; Timmerman, C. Erik; Frank, Volker; Quinn, Laura

1999-01-01

Discusses how communication audits serve well as educational tools for both student auditors and employees of organizations. Describes how teachers need to gain access to organizations, especially through internal audit departments; negotiate the exchange of essentially free audit findings for a learning experience and research data; and secure…

Validation of Organizational Communication Audit Instruments.

ERIC Educational Resources Information Center

DeWine, Sue; And Others

Based on a review of the literature, this paper examines criticisms leveled against the communication audit developed by the International Communication Association (ICA) and then offers a modified version of the audit designed to meet those criticisms. Following a brief introduction, the first section of the paper reviews criticisms of the audit,…

75 FR 68329 - Meeting of the Defense Audit Advisory Committee (DAAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... DEPARTMENT OF DEFENSE Office of the Secretary Meeting of the Defense Audit Advisory Committee... Defense Audit Advisory Committee will be held. DATES: Monday, November 22, 2010 beginning at 3 p.m. and... of internal controls, audit processes, and processes for monitoring compliance with relevant laws and...

Findings From a Nursing Care Audit Based on the Nursing Process: A Descriptive Study

PubMed Central

Poortaghi, Sarieh; Salsali, Mahvash; Ebadi, Abbas; Rahnavard, Zahra; Maleki, Farzaneh

2015-01-01

Background: Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. Objectives: This study aimed to audit nursing care based on a nursing process model. Patients and Methods: This was a cross-sectional descriptive study in which a nursing audit checklist was designed and validated for assessing nurses’ compliance with nursing process. A total of 300 nurses from various clinical settings of Tehran university of medical sciences were selected. Data were analyzed using descriptive and inferential statistics, including frequencies, Pearson correlation coefficient and independent samples t-tests. Results: The compliance rate of nursing process indicators was 79.71 ± 0.87. Mean compliance scores did not significantly differ by education level and gender. However, overall compliance scores were correlated with nurses’ age (r = 0.26, P = 0.001) and work experience (r = 0.273, P = 0.001). Conclusions: Nursing process indicators can be used to audit nursing care. Such audits can be used as quality assurance tools. PMID:26576448

Expanding the Navy’s Managers Internal Control Program’s (MICP) Capability to Prepare for External Financial Audits

DTIC Science & Technology

2015-06-01

adequate documentation to substantiate transactions , and effective internal controls surrounding business processes along with the verification that...organization, such as its personnel, processes, and objectives. The internal auditing profession brings a composite of in-depth knowledge and best business ...with internal auditors. Organizations should keep internal auditors abreast of changes in expectations as the business evolves. Doing so helps

Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania.

PubMed

Mgaya, Andrew H; Litorp, Helena; Kidanto, Hussein L; Nyström, Lennarth; Essén, Birgitta

2016-11-08

In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited. Two registered nurses under supervision of a nurse midwife, a specialist obstetrician and a consultant obstetrician, reviewed the case files. Criteria for standard diagnosis and management of foetal distress were developed based on international and national guidelines, and literature reviews, and then, stepwise applied, in an audit cycle. During the baseline audit, substandard care was identified, and recommendations for improvement of care were proposed and implemented. The effect of the implementations was assessed by the differences in percentage of standard diagnosis and management between the baseline and re-audit, using Chi-square test or Fisher's exact test, when appropriate. In the baseline audit and re-audit, 248 and 251 deliveries with a diagnosis of foetal distress were identified and audited, respectively. The standard of diagnosis increased significantly from 52 to 68 % (p < 0.001). Standards of management improved tenfold from 0.8 to 8.8 % (p < 0.001). Improved foetal heartbeat monitoring using a Fetal Doppler was the major improvement in diagnoses, while change of position of the mother and reduced time interval from decision to perform caesarean section to delivery were the major improvements in management (all p < 0.001). Percentage of cases with substandard diagnosis and management was significantly reduced in both referred public and non-referred private patients (all p ≤ 0.01) but not in non-referred public and referred private patients. The criteria-based audit was able to detect substandard diagnosis and management of foetal distress and improved care using feedback and available resources.

48 CFR 225.872-6 - Audit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Defense Procurement and Acquisition Policy (Contract Policy and International Contracting), ((703) 697... DEFENSE SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Other International Agreements and Coordination 225.872... for reciprocal “no-cost” audits of contracts and subcontracts (pre- and post-award). (b) To determine...

Critique of the Communication Audit from the Academic Researcher's Perspective.

ERIC Educational Resources Information Center

Sincoff, Michael Z.; Goyer, Robert S.

The history of the International Communication Association's Communication Audit is briefly reviewed, and possible benefits and pitfalls of the approach are discussed. Certain assumptions and methods underlying the Communicaton Audit are critiqued. (AA)

Financial statement analysis, internal controls, and audit readiness: Bestpractices for Pakistan army financial management officers

DTIC Science & Technology

2017-06-01

2012). Noland and Metrejean (2013) emphasize the importance of the internal control environment and cite the June 2010 case of a non -existent...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA MBA PROFESSIONAL REPORT FINANCIAL STATEMENT ANALYSIS, INTERNAL CONTROLS , AND...FINANCIAL STATEMENT ANALYSIS, INTERNAL CONTROLS , AND AUDIT READINESS: BEST PRACTICES FOR PAKISTAN ARMY FINANCIAL MANAGEMENT OFFICERS 5. FUNDING NUMBERS 6

The Perceived Impact of Quality Audit on the Work of Academics

ERIC Educational Resources Information Center

Cheng, Ming

2011-01-01

Quality audit has become the dominant means of assessing the quality of university teaching and learning. This paper addresses this international trend through the analysis of academics' perception of quality audit. It presents a new way to understand quality audit through the interpretation of how frontline academics in England perceived and…

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...

Report: Follow-Up Audit - EPA Needs to Strengthen Internal Controls Over Retention Incentives

EPA Pesticide Factsheets

Report #17-P-0407, September 26, 2017. Additional actions are needed to strengthen internal controls over monitoring and to effectively resolve the cause of the prior audit findings. We question $1,605 of irregular payments.

25 CFR 543.23 - What are the minimum internal control standards for audit and accounting?

Code of Federal Regulations, 2014 CFR

2014-04-01

... supervision, bingo cards, bingo card sales, draw, prize payout; cash and equivalent controls, technologic aids... 25 Indians 2 2014-04-01 2014-04-01 false What are the minimum internal control standards for audit... INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS FOR CLASS II GAMING § 543.23 What are the...

25 CFR 543.23 - What are the minimum internal control standards for audit and accounting?

Code of Federal Regulations, 2013 CFR

2013-04-01

... supervision, bingo cards, bingo card sales, draw, prize payout; cash and equivalent controls, technologic aids... 25 Indians 2 2013-04-01 2013-04-01 false What are the minimum internal control standards for audit... INTERIOR HUMAN SERVICES MINIMUM INTERNAL CONTROL STANDARDS FOR CLASS II GAMING § 543.23 What are the...

An Empirical Investigation of the Impact of the Anchor and Adjustment Heuristic on the Audit Judgment Process

DTIC Science & Technology

1988-01-01

Pe ~ ** . . . ’ S .- ..% - - -- - - An Empirical Investigation of the Impact of the Anchor and Adjustment Heuristic on the Audit Judgment Process A...1 Introduction ....... ............... 1 Audit Opinion Process ... ............ 2 Professional Judgment ..... ........... 5 Heuristics in the Audit Process...to evaluating the results of analytic reviews and internal control compliance tests (Felix and Kinney 1982, also Libby 1981). Decomposing the audit opinion

Southwestern Power Administration Combined Financial Statements, 2006-2009

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

None

2009-09-01

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

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

[Internal audit--the foundation of healthcare quality management in health care].

PubMed

Smiianov, V A

2014-01-01

The paper proved the need for internal audit as the basis for quality control of medical care in a health facility, developed the project milestones and explains what needs to be taken into account at every stage during its implementation.

22 CFR 211.5 - Obligations of cooperating sponsor.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Standards promulgated by the International Organization of Supreme Audit Institutions or International... provisions of this regulation. (c) Audits—(1) By nongovernmental cooperating sponsors. A nongovernmental cooperating sponsor shall arrange for periodic audits to be conducted in accordance with OMB Circular A-133...

22 CFR 211.5 - Obligations of cooperating sponsor.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Standards promulgated by the International Organization of Supreme Audit Institutions or International... provisions of this regulation. (c) Audits—(1) By nongovernmental cooperating sponsors. A nongovernmental cooperating sponsor shall arrange for periodic audits to be conducted in accordance with OMB Circular A-133...

22 CFR 211.5 - Obligations of cooperating sponsor.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Standards promulgated by the International Organization of Supreme Audit Institutions or International... provisions of this regulation. (c) Audits—(1) By nongovernmental cooperating sponsors. A nongovernmental cooperating sponsor shall arrange for periodic audits to be conducted in accordance with OMB Circular A-133...

22 CFR 211.5 - Obligations of cooperating sponsor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Standards promulgated by the International Organization of Supreme Audit Institutions or International... provisions of this regulation. (c) Audits—(1) By nongovernmental cooperating sponsors. A nongovernmental cooperating sponsor shall arrange for periodic audits to be conducted in accordance with OMB Circular A-133...

22 CFR 211.5 - Obligations of cooperating sponsor.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Standards promulgated by the International Organization of Supreme Audit Institutions or International... provisions of this regulation. (c) Audits—(1) By nongovernmental cooperating sponsors. A nongovernmental cooperating sponsor shall arrange for periodic audits to be conducted in accordance with OMB Circular A-133...

Audit and internal quality control in immunohistochemistry

PubMed Central

Maxwell, P; McCluggage, W

2000-01-01

Aims—Although positive and negative controls are performed and checked in surgical pathology cases undergoing immunohistochemistry, internal quality control procedures for immunohistochemistry are not well described. This study, comprising a retrospective audit, aims to describe a method of internal quality control for immunohistochemistry. A scoring system that allows comparison between cases is described. Methods—Two positive tissue controls for each month over a three year period (1996–1998) of the 10 antibodies used most frequently were evaluated. All test cases undergoing immunohistochemistry in the months of April in this three year period were also studied. When the test case was completely negative for a given antibody, the corresponding positive tissue control from that day was examined. A marking system was devised whereby each immunohistochemical slide was assessed out of a possible score of 8 to take account of staining intensity, uniformity, specificity, background, and counterstaining. Using this scoring system, cases were classified as showing optimal (7–8), borderline (5–6), or unacceptable (0–4) staining. Results—Most positive tissue controls showed either optimal or borderline staining with the exception of neurone specific enolase (NSE), where most slides were unacceptable or borderline as a result of a combination of low intensity, poor specificity, and excessive background staining. All test cases showed either optimal or borderline staining with the exception of a single case stained for NSE, which was unacceptable. Conclusions—This retrospective audit shows that immunohistochemically stained slides can be assessed using this scoring system. With most antibodies, acceptable staining was achieved in most cases. However, there were problems with staining for NSE, which needs to be reviewed. Laboratories should use a system such as this to evaluate which antibodies regularly result in poor staining so that they can be excluded from panels. Routine evaluation of immunohistochemical staining should become part of everyday internal quality control procedures. Key Words: immunohistochemistry • audit • internal quality control PMID:11265178

Financial Audit: Financial Reporting and Internal Controls at the Air Force Systems Command

DTIC Science & Technology

1991-01-01

As part of GAO’S audits of the Air Force’s financial management and operations for fiscal years 1988 and 1989, GAO evaluated the Air Force Systems Command’s internal accounting controls and financial reporting systems. For fiscal year 1988 and 1989, the Systems Command received about $26.7 billion and $32.4 billion, respectively, in appropriated funds. This report discusses the results of our audits of the Systems Command.

Psychometric properties of the Alcohol Use Disorders Identification Test (AUDIT) and prevalence of alcohol use among Iranian psychiatric outpatients.

PubMed

Noorbakhsh, Simasadat; Shams, Jamal; Faghihimohamadi, Mohamadmahdi; Zahiroddin, Hanieh; Hallgren, Mats; Kallmen, Hakan

2018-01-30

Iran is a developing and Islamic country where the consumption of alcoholic beverages is banned. However, psychiatric disorders and alcohol use disorders are often co-occurring. We used the Alcohol Use Disorders Identification Test (AUDIT) to estimate the prevalence of alcohol use and examined the psychometric properties of the test among psychiatric outpatients in Teheran, Iran. AUDIT was completed by 846 consecutive (sequential) patients. Descriptive statistics, internal consistency (Cronbach alpha), confirmatory and exploratory factor analyses were used to analyze the prevalence of alcohol use, reliability and construct validity. 12% of men and 1% of women were hazardous alcohol consumers. Internal reliability of the Iranian version of AUDIT was excellent. Confirmatory factor analyses showed that the construct validity and the fit of previous factor structures (1, 2 and 3 factors) to data were not good and seemingly contradicted results from the explorative principal axis factoring, which showed that a 1-factor solution explained 77% of the co-variances. We could not reproduce the suggested factor structure of AUDIT, probably due to the skewed distribution of alcohol consumption. Only 19% of men and 3% of women scored above 0 on AUDIT. This could be explained by the fact that alcohol is illegal in Iran. In conclusion the AUDIT exhibited good internal reliability when used as a single scale. The prevalence estimates according to AUDIT were somewhat higher among psychiatric patients compared to what was reported by WHO regarding the general population.

Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module.

PubMed

Boggan, Joel C; Swaminathan, Aparna; Thomas, Samantha; Simel, David L; Zaas, Aimee K; Bae, Jonathan G

2017-04-01

Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback. Residents performed audits of ambulatory patients requiring laboratory or radiologic testing by means of a shared online interface. The intervention consisted of an educational module viewed with initial audits, development of a personalized improvement plan after Phase 1, and repeated real-time feedback of individual relative performance compared at clinic and program levels. Outcomes included results communicated within 14 days and prespecified "significant" results communicated within 72 hours. A total of 76 of 86 eligible residents (88%) reviewed 1713 individual ambulatory patients' charts in Phase 1, and 73 residents (85%) reviewed 1509 charts in Phase 2. Follow-up rates were higher in Phase 2 than Phase 1 for communicating results within 14 days and significant results within 72 hours (85% versus 78%, P  < .001; and 82% versus 70%, P  = .002, respectively). Communication of "significant" results was more likely to occur via telephone, compared with communication of nonsignificant results. Participation in a shared audit and feedback quality improvement project can improve rates of resident follow-up and communication of results, although communication gaps remained.

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

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.

77 FR 20871 - Audit and Financial Management Advisory (AFMAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-06

... Agency's financial management, including the financial reporting process, systems of internal controls... the meeting is to discuss the SBA's Financial Reporting, Audit Findings Remediation, Ongoing OIG... SMALL BUSINESS ADMINISTRATION Audit and Financial Management Advisory (AFMAC) AGENCY: U.S. Small...

77 FR 74834 - Office of the Secretary

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-18

... DEPARTMENT OF DEFENSE Office of the Secretary Defense Audit Advisory Committee (DAAC); Notice of... Defense announces the following Federal advisory committee meeting of the Defense Audit Advisory Committee... financial management to include financial reporting processes, systems of internal controls, audit processes...

Criteria for internal auditing.

PubMed

Holder, W W; Clay, R J

1979-01-01

An effective, inclusive internal auditing endeavor should help assure hospital managements that (1) an adequate system of internal control exists to assure the safeguarding of assets and the reliability of data produced by the financial information system, (2) uneconomic operating practices are detected promptly so they can be remedied, and (3) program results and effectiveness levels are of sufficiently high quality to demonstrate managerial competence.

[Validation of the AUDIT test for identifying risk consumption and alcohol use disorders in women].

PubMed

Pérula de Torres, L A; Fernández-García, J A; Arias-Vega, R; Muriel-Palomino, M; Márquez-Rebollo, E; Ruiz-Moral, R

2005-11-30

To validate the AUDIT test for identifying women with excess alcohol consumption and/or dependency syndrome (DS). Descriptive study to validate a test. Two primary care centres and a county drug-dependency centre. 414 women from 18 to 75 recruited at the clinic. Interventions. Social and personal details were obtained through personal interview, their alcohol consumption was quantified and the AUDIT and MALT questionnaires were filled in. Then the semi-structured SCAN interview was conducted (gold standard; DSM-IV and CIE-10 criteria), and analyses were requested (GGT, GOT, GPT, VCM). 186 patients were given a follow-up appointment three-four weeks later (retest). Intra-observer reliability was evaluated with the Kappa index, internal consistency with Cronbach s alpha, and the validity of criteria with indexes of sensitivity and specificity, predictive values and probability quotients. To evaluate the diagnostic performance of the test and the most effective cut-off point, a ROC analysis was run. 11.4% (95% CI, 8.98-13.81) were diagnosed with alcohol abuse (0.5%) or DS (10.9%). The Kappa coefficients of the AUDIT items ranged between 0.685 and 0.795 (P<.001). Internal reliability, with Cronbach s alpha, was 0.932 (95% CI, 0.921-0.941). Test sensitivity was 89.6% (95% CI,76.11-96.02) and specificity was 95.07% (95% CI, 92.18-96.97). The most effective cut-off point was at 6 points. The AUDIT is a questionnaire with good psycho-measurement properties. It is reliable and valid for the detection of risk consumption and DS in women.

48 CFR 52.216-7 - Allowable Cost and Payment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... last disclosure of internal audit reports to the Government. (J) Annual internal audit plan of...-contract cost allowability limitations, and billing limitations. (v) The Contractor shall update the billings on all contracts to reflect the final settled rates and update the schedule of cumulative direct...

Medical Record Documentation Among Interns: A Prospective Quality Improvement Study.

PubMed

Owen, Jm; Conway, R; Silke, B; O'Riordan, D

2015-06-01

Comprehensive record keeping is a key aspect of medical practice. The National Hospitals Office (NHO) and Irish Medical Council (IMC) have published guidelines in this area. A prospective audit of 100 patients assessed by interns was performed to quantify adherence with these guidelines followed by an educational session and email reminders. Adherence was reassessed in an incidental manner. Compliance was recorded in a number of areas including the reason for review and documentation of a plan both 98 (98%). However less than half of interns recorded the patient's name, background history or their impression of the case. Only 31(31%) noted the patient's MRN and only 1(1%) the information they gave to the patient. Significant improvements following the intervention were found, however significant deficits remained in a number of areas including the noting of an impression of the case 62(62%) and information given to patients 18(18%). Suboptimal documentation can be improved through education and clinical auditing.

Report on the Audit of Foreign Military Sales Trust Fund Disbursement Reporting

DTIC Science & Technology

1991-09-11

This is our final report on the Audit of Foreign Military Sales Trust Fund Disbursement Reporting, provided for your information and use. The audit was...made from August 1990 through March 1991. The overall objective of the audit was to determine whether disbursements from the Foreign Military Sales...implementation of the internal management control program required by the Federal Managers’ Financial Integrity Act (FMFIA) as it pertained to the audit objectives.

Financial Management: Extending the Financial Statements Audit Requirement of the CFO Act to Additional Federal Agencies

DTIC Science & Technology

2002-05-14

Defense Nuclear Facilities Safety Board has balance-sheet-only audits every 3 to 5 years, most recently for fiscal year 1997. It did not prepare fiscal...associated with the agency’s operations were the most important factors to Have had financial statements audits Defense Nuclear Facilities Safety...audits, the International Trade Commission and the Defense Nuclear Facilities Safety Board, did not have financial statements audits for fiscal year

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...

Entrepreneurship through Strategic Planning, Management, and Evaluation.

ERIC Educational Resources Information Center

Groff, Warren H.

A process to assess a college's external environment and audit its internal environment in order to pursue options available to postsecondary education is described. Essentially the concept is one of matching opportunities in the external environment with institutional strengths as determined by an internal audit. Strategic planning must consider…

Audit in public administration’s information systems - External or internal?

NASA Astrophysics Data System (ADS)

Drljača, D.; Latinović, B.

2017-05-01

Audit of the information system, thanks to the increased use of ICT and related cyber-crime, becomes a very important process in modern companies and institutions. It is usual to engage or outsource a third party for independent financial audit. But what about auditing of the information system of public administration institutions? This paper gives an introduction to possible aspects of information system’s audit with the aim to discuss possible answer on the question in the title.

Final Report on the Audit of the Administration of the Contract Closeout Process at the Defense Contract Management Region, Dallas

DTIC Science & Technology

1990-09-18

This is our final report on the Audit of the Administration of the Contract Closeout Process at the Defense Contract Management Region, Dallas (DCMR... audit was made from January to October 1989. The objectives of the audit were to determine the timeliness of the contract closeout process, the validity...As part of the audit , we also evaluated internal controls over the contract closeout process. As of December 31, 1988, the Contract Administration

Internal Controls for the Military Sealift Command Portion of the Transportation Business Area of the FY 1994 Defense Business Operations Fund Financial Statements

DTIC Science & Technology

1995-06-28

Secondary Reports Dilution Unit, Audit Planning and Technical Support Directorate, at (703) 604-8937 (DSN 664-8937) or FAX (703) 604-8932. Suggestions...for Future Audits To suggest ideas for or to request future audits , contact the Planning and Coordination Branch, Audit Planning and Technical...Defense OAIG-AUD (ATTN: APTS Audit Suggestions) 400 Army Navy Drive (Room 801) Arlington, Virginia 22202-2884 DoD Hotline To report fraud, waste

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.

U.S. Government Financial Statements: Results of GAO’s Fiscal Year 1997 Audit

DTIC Science & Technology

1998-04-01

Our audit of the federal government’s consolidated financial statements and the Inspectors General (IG) audits of agencies’ financial statements have...fiscal year 1997 consolidated financial statements , (2) internal controls weaknesses, and (3) serious difficulties complying with financial systems

The implementation of unit-based perinatal mortality audit in perinatal cooperation units in the northern region of the Netherlands.

PubMed

van Diem, Mariet Th; Timmer, Albertus; Bergman, Klasien A; Bouman, Katelijne; van Egmond, Nico; Stant, Dennis A; Ulkeman, Lida H M; Veen, Wenda B; Erwich, Jan Jaap H M

2012-07-09

Perinatal (mortality) audit can be considered to be a way to improve the careprocess for all pregnant women and their newborns by creating an opportunity to learn from unwanted events in the care process. In unit-based perinatal audit, the caregivers involved in cases that result in mortality are usually part of the audit group. This makes such an audit a delicate matter. The purpose of this study was to implement unit-based perinatal mortality audit in all 15 perinatal cooperation units in the northern region of the Netherlands between September 2007 and March 2010. These units consist of hospital-based and independent community-based perinatal caregivers. The implementation strategy encompassed an information plan, an organization plan, and a training plan. The main outcomes are the number of participating perinatal cooperation units at the end of the project, the identified substandard factors (SSF), the actions to improve care, and the opinions of the participants. The perinatal mortality audit was implemented in all 15 perinatal cooperation units. 677 different caregivers analyzed 112 cases of perinatal mortality and identified 163 substandard factors. In 31% of cases the guidelines were not followed and in 23% care was not according to normal practice. In 28% of cases, the documentation was not in order, while in 13% of cases the communication between caregivers was insufficient. 442 actions to improve care were reported for 'external cooperation' (15%), 'internal cooperation' (17%), 'practice organization' (26%), 'training and education' (10%), and 'medical performance' (27%). Valued aspects of the audit meetings were: the multidisciplinary character (13%), the collective and non-judgmental search for substandard factors (21%), the perception of safety (13%), the motivation to reflect on one's own professional performance (5%), and the inherent postgraduate education (10%). Following our implementation strategy, the perinatal mortality audit has been successfully implemented in all 15 perinatal cooperation units. An important feature was our emphasis on the delicate character of the caregivers evaluating the care they provided. However, the actual implementation of the proposed actions for improving care is still a point of concern.

The User Perspective in Performance Auditing--A Case Study of Norway

ERIC Educational Resources Information Center

Arthur, Arnfrid; Rydland, Lars Tore; Amundsen, Kristin

2012-01-01

The user perspective is an important contextual factor for Supreme Audit Institutions (SAIs). This article provides examples from performance audits in Norway and explores why the user perspective has become important in performance audit practices. It shows that user satisfaction can be employed as a key performance indicator of effectiveness of…

Supplementary Report on Audit of Internal Control Systems Related to the Office of the Secretary of Transportation's Financial Statements for Fiscal Years 1994 and 1995

DOT National Transportation Integrated Search

1997-01-24

The internal controlrelated objectives for our audits of the Office of the Secretary of Transportation's (OST) Financial Statements for Fiscal Years (FY) 1994 and 1995 were to determine whether OST and the Federal Transit Administration (FTA) (i) had...

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.

The On-Line Audit Revisited: Yale University.

ERIC Educational Resources Information Center

Weldon, Albert R., Jr.; And Others

1984-01-01

Yale University's on-line examination of accounting and administrative systems is discussed. Program goals are to review financial management systems at the university to identify weaknesses in internal controls, and to fulfill all audit requirements of federal grants and contracts. After outlining the quarterly audit cycle, advantages of the…

Audit of the Bloodhound Education Programme, 2012-2013

ERIC Educational Resources Information Center

Straw, Suzanne; Jeffes, Jennifer; Dawson, Anneka; Lord, Pippa

2015-01-01

The National Foundation for Educational Research (NFER) was commissioned by the "Bloodhound Education Programme" (BEP) to conduct an audit of its activities throughout 2012 and early 2013. The audit included: telephone consultations with a range of stakeholders; analysis of monitoring and internal evaluation data; and attendance at two…

Behavioural Constraints on Practices of Auditing in Nigeria (BCPAN)

ERIC Educational Resources Information Center

Akpomi, Margaret E.; Amesi, Joy

2009-01-01

This research was conducted to determine the behavioural constraints on practices of auditing (BCPAN) in Nigeria and to proffer strategies for making incidence of auditing (internal and external auditors) more effective. Thirty-seven administrators drawn from some public limited liability companies, private companies and tertiary institutions were…

ICA Communication Audit Survey Instrument: 1977 Organizational Norms.

ERIC Educational Resources Information Center

Goldhaber, Gerald M.; And Others

Section one of this paper describes the history and development of the "communicaton audit," a system for assessing communication effectiveness in organizations, by the International Communication Association. Section two describes the 16 audits conducted so far and the overall demographic characteristics of the current survey data bank.…

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

PubMed

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

2013-01-01

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

Audit in forensic pathology.

PubMed

Burke, M P; Opeskin, K

2000-09-01

Autopsy numbers in Australian hospitals have declined markedly during the past decade despite evidence of a relatively static rate of demonstrable clinical misdiagnosis during this time. The reason for this decrease in autopsy numbers is multifactorial and may include a general lack of clinical and pathologic interest in the autopsy with a possible decline in autopsy standard, a lack of clinicopathologic correlation after autopsies, and an increased emphasis on surgical biopsy reporting within hospital pathology departments. Although forensic autopsies are currently maintaining their numbers, it is incumbent on forensic pathologists to demonstrate the wealth of important information a carefully performed postmortem examination can reveal. To this end, the Pathology Division of the Victorian Institute of Forensic Medicine has instituted a program of minimum standards in varied types of coroner cases and commenced a system of internal and external audit. The minimum standard for a routine, sudden, presumed natural death is presented and the audit system is discussed.

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

Clinical audit of ectopic pregnancy.

PubMed

Hamid, Alaa Aldin Abdel; Yousry, Almraghy; El Radi, Safwat Abd; Shabaan, Omar Mamdouh; Mazen, Elzahry; Nabil, Halal

2017-03-01

The aim of this study was to determine the risk factors of ectopic pregnancy in cases presented to the Woman's Health Hospital (WHH) in Assuit University, and to perform clinical audit on strategies for management of ectopic pregnancy in the WHH. This descriptive hospital based study was conducted at the Woman's Health Hospital (WHH) of Assuit University (Egypt). There were 210 patients who were admitted to the WHH with the diagnosis of ectopic pregnancy in the period between February 1, 2015 through the end of October 2015. Data were analyzed by SPSS version 21, using descriptive statistics, Mann-Whitney U test, and Chi square. Ectopic pregnancy affects woman in the reproductive age. There are many risk factors that increase the chance of its occurrence; however, it may also occur in the absence of any risk factors (14.0%). Internal VD (72.5%) is the most frequent risk factor; other risk factors include history of abortion, previous CS, ovulation induction, history of infertility, or previous history of EP. Clinical audit is an important item of any adequate health care. As regards to the clinical audit of EP management, we are not adhering to the guidelines.

[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.

40 CFR 63.8 - Monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... with conducting performance tests under § 63.7. Verification of operational status shall, at a minimum... 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...

40 CFR 63.8 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... with conducting performance tests under § 63.7. Verification of operational status shall, at a minimum... 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...

Service to the Nation, Strength for the Future. Fiscal Year 2013 United States Army Annual Financial Report

DTIC Science & Technology

2013-01-01

implementing several internal monthly controls testing initiatives, and other similar accomplishments geared to achieving a full audit-ready financial report...existence and completeness of assets, internal controls, and other critical functions required to meet audit readiness goals. The Army is on-track...ensure the integrity of their reporting systems, programs, and operations. This section focuses on the Army’s system of internal controls to

Development and reliability of an audit tool to assess the school physical activity environment across 12 countries

PubMed Central

Broyles, S T; Drazba, K T; Church, T S; Chaput, J-P; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Olds, T; Onywera, V; Sarmiento, O L; Standage, M; Tremblay, M S; Tudor-Locke, C; Zhao, P; Katzmarzyk, P T

2015-01-01

Objectives: Schools are an important setting to enable and promote physical activity. Researchers have created a variety of tools to perform objective environmental assessments (or ‘audits') of other settings, such as neighborhoods and parks; yet, methods to assess the school physical activity environment are less common. The purpose of this study is to describe the approach used to objectively measure the school physical activity environment across 12 countries representing all inhabited continents, and to report on the reliability and feasibility of this methodology across these diverse settings. Methods: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) school audit tool (ISAT) data collection required an in-depth training (including field practice and certification) and was facilitated by various supporting materials. Certified data collectors used the ISAT to assess the environment of all schools enrolled in ISCOLE. Sites completed a reliability audit (simultaneous audits by two independent, certified data collectors) for a minimum of two schools or at least 5% of their school sample. Item-level agreement between data collectors was assessed with both the kappa statistic and percent agreement. Inter-rater reliability of school summary scores was measured using the intraclass correlation coefficient. Results: Across the 12 sites, 256 schools participated in ISCOLE. Reliability audits were conducted at 53 schools (20.7% of the sample). For the assessed environmental features, inter-rater reliability (kappa) ranged from 0.37 to 0.96; 18 items (42%) were assessed with almost perfect reliability (κ=0.80–0.96), and a further 24 items (56%) were assessed with substantial reliability (κ=0.61–0.79). Likewise, scores that summarized a school's support for physical activity were highly reliable, with the exception of scores assessing aesthetics and perceived suitability of the school grounds for sport, informal games and general play. Conclusions: This study suggests that the ISAT can be used to conduct reliable objective audits of the school physical activity environment across diverse, international school settings. PMID:27152183

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

PubMed Central

Howe, A

1998-01-01

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

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

PubMed

Howe, A

1998-01-01

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

NINJA: a noninvasive framework for internal computer security hardening

NASA Astrophysics Data System (ADS)

Allen, Thomas G.; Thomson, Steve

2004-07-01

Vulnerabilities are a growing problem in both the commercial and government sector. The latest vulnerability information compiled by CERT/CC, for the year ending Dec. 31, 2002 reported 4129 vulnerabilities representing a 100% increase over the 2001 [1] (the 2003 report has not been published at the time of this writing). It doesn"t take long to realize that the growth rate of vulnerabilities greatly exceeds the rate at which the vulnerabilities can be fixed. It also doesn"t take long to realize that our nation"s networks are growing less secure at an accelerating rate. As organizations become aware of vulnerabilities they may initiate efforts to resolve them, but quickly realize that the size of the remediation project is greater than their current resources can handle. In addition, many IT tools that suggest solutions to the problems in reality only address "some" of the vulnerabilities leaving the organization unsecured and back to square one in searching for solutions. This paper proposes an auditing framework called NINJA (acronym for Network Investigation Notification Joint Architecture) for noninvasive daily scanning/auditing based on common security vulnerabilities that repeatedly occur in a network environment. This framework is used for performing regular audits in order to harden an organizations security infrastructure. The framework is based on the results obtained by the Network Security Assessment Team (NSAT) which emulates adversarial computer network operations for US Air Force organizations. Auditing is the most time consuming factor involved in securing an organization's network infrastructure. The framework discussed in this paper uses existing scripting technologies to maintain a security hardened system at a defined level of performance as specified by the computer security audit team. Mobile agents which were under development at the time of this writing are used at a minimum to improve the noninvasiveness of our scans. In general, noninvasive scans with an adequate framework performed on a daily basis reduce the amount of security work load as well as the timeliness in performing remediation, as verified by the NINJA framework. A vulnerability assessment/auditing architecture based on mobile agent technology is proposed and examined at the end of the article as an enhancement to the current NINJA architecture.

7 CFR Appendix B to Part 3015 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2010 CFR

2010-01-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... regulations. a. Internal control review. In order to provide this assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and...

7 CFR Appendix B to Part 3015 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2011 CFR

2011-01-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... regulations. a. Internal control review. In order to provide this assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and...

7 CFR Appendix B to Part 3015 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2014 CFR

2014-01-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... regulations. a. Internal control review. In order to provide this assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and...

Corrosion Prevention for Wheeled Vehicle Systems

DTIC Science & Technology

1993-08-13

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

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.

30 CFR 1227.300 - What audit functions may a State perform?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 3 2011-07-01 2011-07-01 false What audit functions may a State perform? 1227.300 Section 1227.300 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT... Delegated Functions § 1227.300 What audit functions may a State perform? An audit consists of an examination...

Auditing of clinical research ethics in a children's and women's academic hospital.

PubMed

Bortolussi, Robert; Nicholson, Diann

2002-06-01

Canadian and international guidelines for research ethics practices have advocated that research ethics boards (REBs) should implement mechanisms to review and monitor human research. Despite this, few Canadian REBs fulfil this expectation. The objective of this report is to summarize the results of 6 audits of clinical research ethics conducted between 1992 and 2000 in a children's and women's academic hospital in Canada in an effort to guide other academic centres planning a similar process. Research audits were conducted by members of a research audit review committee made up of REB volunteers. With use of random and selective processes, approximately 10% of research protocols were audited through interviews with research investigators and research coordinators and by sampling research records. Predetermined criteria were used to assess evidence of good record keeping, data monitoring, adherence to protocol, consents and the recording of adverse events during the research study. An estimate of time required to undertake an audit was made by recall of participants and records. Thirty-five research studies were reviewed including 16 multicentre clinical trials and 19 single-site clinical studies. Review of record keeping and research practice revealed some deficiencies: researchers failed to maintain original authorization (7%) or renewal documentation (9%); there was 1 instance of improper storage of medication; in 5% of 174 participants for whom consent was reviewed, an outdated consent form had been used, and in 4% the signature of the enrolee was not properly shown. Other deficiencies in consent documentation occurred in less than 2% of cases. Nineteen recommendations were made with respect to deficiencies and process issues. A total of 9 to 20 person-hours are required to review each protocol in a typical audit of this type. Information from research audits has been useful to develop educational programs to correct deficiencies identified through the audits. The research audit is a valuable tool in improving research ethics performance but requires considerable resources.

76 FR 24489 - Sunshine Act Notice

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-02

... Meeting of April 7, 2011. Proposed Final Audit Report on the Service Employees International Union. Committee on Political Education (SEIU COPE) (A09-28). Audit Division Recommendation Memorandum on Freedom's...

Determinants of environmental audit frequency: the role of firm organizational structure.

PubMed

Earnhart, Dietrich; Leonard, J Mark

2013-10-15

This study empirically examines the extent of environmental management practiced by US chemical manufacturing facilities, as reflected in the number of environmental internal audits conducted annually. As its focus, this study analyzes the effects of firm-level organizational structure on facility-level environmental management practices. For this empirical analysis, the study exploits unique data from a survey distributed to all U.S. chemical manufacturing permitted to discharge wastewater in 2001; the data reflect internal audits conducted during the years 1999-2001. Empirical results reveal differences in auditing behavior based on whether facilities are owned by publicly held or non-publicly held firms, owned by U.S.-based or non-U.S.-based firms, and owned by larger or smaller firms. Copyright © 2013 Elsevier Ltd. All rights reserved.

Audit and feedback using the Robson classification to reduce caesarean section rates: a systematic review.

PubMed

Boatin, A A; Cullinane, F; Torloni, M R; Betrán, A P

2018-01-01

In most regions worldwide, caesarean section (CS) rates are increasing. In these settings, new strategies are needed to reduce CS rates. To identify, critically appraise and synthesise studies using the Robson classification as a system to categorise and analyse data in clinical audit cycles to reduce CS rates. Medline, Embase, CINAHL and LILACS were searched from 2001 to 2016. Studies reporting use of the Robson classification to categorise and analyse data in clinical audit cycles to reduce CS rates. Data on study design, interventions used, CS rates, and perinatal outcomes were extracted. Of 385 citations, 30 were assessed for full text review and six studies, conducted in Brazil, Chile, Italy and Sweden, were included. All studies measured initial CS rates, provided feedback and monitored performance using the Robson classification. In two studies, the audit cycle consisted exclusively of feedback using the Robson classification; the other four used audit and feedback as part of a multifaceted intervention. Baseline CS rates ranged from 20 to 36.8%; after the intervention, CS rates ranged from 3.1 to 21.2%. No studies were randomised or controlled and all had a high risk of bias. We identified six studies using the Robson classification within clinical audit cycles to reduce CS rates. All six report reductions in CS rates; however, results should be interpreted with caution because of limited methodological quality. Future trials are needed to evaluate the role of the Robson classification within audit cycles aimed at reducing CS rates. Use of the Robson classification in clinical audit cycles to reduce caesarean rates. © 2017 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

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

PubMed

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

1999-01-01

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

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.

Criteria-based audit of caesarean section in a referral hospital in rural Tanzania.

PubMed

Heemelaar, S; Nelissen, E; Mdoe, P; Kidanto, H; van Roosmalen, J; Stekelenburg, J

2016-04-01

WHO uses the Caesarean section (CS) rate to monitor implementation of emergency obstetric care (EmOC). Although CS rates are rising in sub-Saharan Africa, maternal outcome has not improved. We audited indications for CS and related complications among women with severe maternal morbidity and mortality in a referral hospital in rural Tanzania. Cross-sectional study was from November 2009 to November 2011. Women with severe maternal morbidity and mortality were identified and those with CS were included in this audit. Audit criteria were developed based on the literature review and (inter)national guidelines. Tanzanian and Dutch doctors reviewed hospital notes. The main outcome measured was prevalence of substandard quality of care leading to unnecessary CS and delay in performing interventions to prevent CS. A total of 216 maternal near misses and 32 pregnancy-related deaths were identified, of which 82 (33.1%) had a CS. Indication for CS was in accordance with audit criteria for 36 of 82 (44.0%) cases without delay. In 20 of 82 (24.4%) cases, the indication was correct; however, there was significant delay in providing standard obstetric care. In 16 of 82 (19.5%) cases, the indication for CS was not in accordance with audit criteria. During office hours, CS was more often correctly indicated than outside office hours (60.0% vs. 36.0%, P < 0.05). Caesarean section rate is not an useful indicator to monitor quality of EmOC as a high rate of unnecessary and potentially preventable CS was identified in this audit. © 2016 John Wiley & Sons Ltd.

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

30 CFR 1227.300 - What audit functions may a State perform?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 3 2012-07-01 2012-07-01 false What audit functions may a State perform? 1227.300 Section 1227.300 Mineral Resources OFFICE OF NATURAL RESOURCES REVENUE, DEPARTMENT OF THE INTERIOR... § 1227.300 What audit functions may a State perform? An audit consists of an examination of records to...

Digital Mapping, Charting and Geodesy Data Standardization

DTIC Science & Technology

1994-12-19

The primary objective of the audit was to evaluate DMA’s implementation of the Defense Standardization Program. Specifically, the audit determined...interoperability of digital MC&G data. The audit also evaluated DMA’s implementation of the DoD Internal Management Control Program as it pertains to DMA’S implementation of the Defense Standardization Program.

Expediting the Quest for Quality: The Role of IQAC in Academic Audit

ERIC Educational Resources Information Center

Nitonde, Rohidas

2016-01-01

Academic Audit is an important tool to control and maintain standards in academic sector. It has been found highly relevant by the experts across the world. Academic audit helps institutions to introspect and improve their quality. The present paper intends to probe into the possible role of Internal Quality Assurance Cell (IQAC) in Academic Audit…

78 FR 58589 - Final Listing of Audit and Other Reports Issued by SIGIR on Reconstruction Spending in Iraq

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-24

... Taken Action on Most Open Audit Recommendations 10/27/2011 12-003 Status of International Narcotics... Requirements for Changes in Reconstruction Activities in Iraq 4/27/2011 11-011 Quick Response Fund: Management... Data 1/28/2011 11-009 Iraqi Government Support for the Iraq International Academy 1/ 26/2011 11-007...

The Adoption of Internal Audit as a Governance Control Mechanism in Australian Public Universities--Views from the CEOs

ERIC Educational Resources Information Center

Christopher, Joe

2012-01-01

This study draws on the multi-theoretical approach to governance and the views of university chief executive officers (CEOs) to examine the extent to which internal auditing as a control mechanism is adopted in Australian public universities under an environment of change management. The findings highlight negative consequences of change and their…

75 FR 26304 - Self-Regulatory Organizations; Notice of Filing of Proposed Rule Change by NYSE Arca, Inc...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

..., independence and performance of the Company's independent auditor, (d) the process relating to internal risk... independent auditors, and (f) the Company's tax policy. It also prepares the Audit Committee report to... are (i) to conduct an annual review with the independent auditors, to determine the scope of their...

Information Systems: Opportunities Exist to Strengthen SEC’s Oversight of Capacity and Security

DTIC Science & Technology

2001-07-01

Strengthen SEC’s Oversight of Capacity and Security 5 . FUNDING NUMBERS 6. AUTHOR(S) GAO 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING...ANSI Std. Z39-18 298-102 Page i GAO-01-863 Information Systems Letter 1 Results in Brief 2 Background 4 Scope and Methodology 5 SEC Uses a Wide Range...or external organizations to conduct the independent reviews. These internal audits are performed cyclically based on an annual risk analysis. SEC

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.

Prolonged labour as indication for emergency caesarean section: a quality assurance analysis by criterion-based audit at two Tanzanian rural hospitals.

PubMed

Maaløe, N; Sorensen, B L; Onesmo, R; Secher, N J; Bygbjerg, I C

2012-04-01

To audit the quality of obstetric management preceding emergency caesarean sections for prolonged labour. A quality assurance analysis of a retrospective criterion-based audit supplemented by in-depth interviews with hospital staff. Two Tanzanian rural mission hospitals. Audit of 144 cases of women undergoing caesarean sections for prolonged labour; in addition, eight staff members were interviewed. Criteria of realistic best practice were established, and the case files were audited and compared with these. Hospital staff were interviewed about what they felt might be the causes for the audit findings. Prevalence of suboptimal management and themes emerging from an analysis of the transcripts. Suboptimal management was identified in most cases. Non-invasive interventions to potentially avoid operative delivery were inadequately used. When deciding on caesarean section, in 26% of the cases labour was not prolonged, and in 16% the membranes were still intact. Of the women with genuine prolonged labour, caesarean sections were performed with a fully dilated cervix in 36% of the cases. Vacuum extraction was not considered. Amongst the hospital staff interviewed, the awareness of evidence-based guidelines was poor. Word of mouth, personal experience, and fear, especially of HIV transmission, influenced management decisions. The lack of use and awareness of evidence-based guidelines led to misinterpretation of clinical signs, fear of simple interventions, and an excessive rate of emergency caesarean sections. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Improving quality in an internal medicine residency program through a peer medical record audit.

PubMed

Asao, Keiko; Mansi, Ishak A; Banks, Daniel

2009-12-01

This study examined the effectiveness of a quality improvement project of a limited didactic session, a medical record audit by peers, and casual feedback within a residency program. Residents audited their peers' medical records from the clinic of a university hospital in March, April, August, and September 2007. A 24-item quality-of-care score was developed for five common diagnoses, expressed from 0 to 100, with 100 as complete compliance. Audit scores were compared by month and experience of the resident as an auditor. A total of 469 medical records, audited by 12 residents, for 80 clinic residents, were included. The mean quality-of-care score was 89 (95% CI = 88-91); the scores in March, April, August, and September were 88 (95% CI = 85-91), 94 (95% CI = 90-96), 87 (95% CI = 85-89), and 91 (95% CI = 89-93), respectively. The mean score of 58 records of residents who had experience as auditors was 94 (95% CI = 89-96) compared with 89 (95% CI = 87-90) for those who did not. The score significantly varied (P = .0009) from March to April and from April to August, but it was not significantly associated with experience as an auditor with multivariate analysis. Residents' compliance with the standards of care was generally high. Residents responded to the project well, but their performance dropped after a break in the intervention. Continuation of the audit process may be necessary for a sustained effect on quality.

Quick-Reaction Report on the Audit of Defense Base Realignment and Closure Budget Data for Naval Station Treasure Island, California

DTIC Science & Technology

1994-05-19

the audit of two projects: P-608T, Building Modifications, valued at...Island, California, to the Naval Training Center Great Lakes, Illinois. The audit also evaluated the implementation of the DoD Internal Management...related to the two projects in this report and is discussed in Report No. 94-109, Quick-Reaction Report on the Audit of Defense Base Realignment and Closure Budget Data for the Naval Training Center Great Lakes, Illinois, May 19,

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.

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

Division of Legislative Audit

Science.gov Websites

Reviews - Performance Review of the Department of Corrections, 2014 - Performance Review of the Department of Health and Social Services, 2015 - A Performance Review of the Department of Education and Early Statewide Audits Sunset Audits Performance Reviews Performance Review of the Department of Corrections, 2014

Operative blood transfusion quality improvement audit.

PubMed

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

2014-01-01

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

Using national hip fracture registries and audit databases to develop an international perspective.

PubMed

Johansen, Antony; Golding, David; Brent, Louise; Close, Jacqueline; Gjertsen, Jan-Erik; Holt, Graeme; Hommel, Ami; Pedersen, Alma B; Röck, Niels Dieter; Thorngren, Karl-Göran

2017-10-01

Hip fracture is the commonest reason for older people to need emergency anaesthesia and surgery, and leads to prolonged dependence for many of those who survive. People with this injury are usually identified very early in their hospital care, so hip fracture is an ideal marker condition with which to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries. The national audits provide a consistent picture of typical patients - an average age of 80 years, with less than a third being men, and a third of all patients having cognitive impairment - but there was surprising variation in the type of fracture, of operation and of anaesthesia and hospital length of stay in different countries. These national audits provide a unique opportunity to compare how health care systems of different countries are responding to the same clinical challenge. This review will encourage the development and reporting of a standardised dataset to support international collaboration in healthcare audit. Copyright © 2017 Elsevier Ltd. All rights reserved.

DOD Financial Management: Greater Visibility Needed to Better Assess Audit Readiness for Property, Plant, and Equipment

DTIC Science & Technology

2016-05-01

with U.S. generally accepted accounting principles and establish and maintain effective internal control over financial reporting and compliance with... Accountability Office Highlights of GAO-16-383, a report to congressional committees May 2016 DOD FINANCIAL MANAGEMENT Greater Visibility... Accounting Standards Advisory Board FIAR Financial Improvement and Audit Readiness IUS internal-use software NDAA National Defense Authorization Act

The European general thoracic surgery database project.

PubMed

Falcoz, Pierre Emmanuel; Brunelli, Alessandro

2014-05-01

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

2012 financial outlook: physicians and podiatrists.

PubMed

Schaum, Kathleen D

2012-04-01

Although the nationally unadjusted average Medicare allowable rates have not increased or decreased significantly, the new codes, the new coding regulations, the NCCI edits, and the Medicare contractors' local coverage determinations (LCDs) will greatly impact physicians' and podiatrists' revenue in 2012. Therefore, every wound care physician and podiatrist should take the time to update their charge sheets and their data entry systems with correct codes, units, and appropriate charges (that account for all the resources needed to perform each service or procedure). They should carefully read the LCDs that are pertinent to the work they perform. If the LCDs contain language that is unclear or incorrect, physicians and podiatrists should contact the Medicare contractor medical director and request a revision through the LCD Reconsideration Process. Medicare has stabilized the MPFS allowable rates for 2012-now physicians and podiatrists must do their part to implement the new coding, payment, and coverage regulations. To be sure that the entire revenue process is working properly, physicians and podiatrists should conduct quarterly, if not monthly, audits of their revenue cycle. Healthcare providers will maintain a healthy revenue cycle by conducting internal audits before outside auditors conduct audits that result in repayments that could have been prevented.

41 CFR 102-118.425 - Is my agency allowed to perform a postpayment audit on our transportation bills?

Code of Federal Regulations, 2010 CFR

2010-07-01

... perform a postpayment audit on our transportation bills? 102-118.425 Section 102-118.425 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...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

41 CFR 102-118.285 - What options for performing a prepayment audit does my agency have?

Code of Federal Regulations, 2010 CFR

2010-07-01

... performing a prepayment audit does my agency have? 102-118.285 Section 102-118.285 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services...

40 CFR 63.7 - Performance testing requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) program. Data quality objectives are the pretest expectations of precision, accuracy, and completeness of... test data bias. Gaseous audit samples are designed to audit the performance of the sampling system as... just as the compliance samples are collected. If a liquid or solid audit sample is designed to audit...

40 CFR 63.7 - Performance testing requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) program. Data quality objectives are the pretest expectations of precision, accuracy, and completeness of... test data bias. Gaseous audit samples are designed to audit the performance of the sampling system as... just as the compliance samples are collected. If a liquid or solid audit sample is designed to audit...

40 CFR 63.7 - Performance testing requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) program. Data quality objectives are the pretest expectations of precision, accuracy, and completeness of... test data bias. Gaseous audit samples are designed to audit the performance of the sampling system as... just as the compliance samples are collected. If a liquid or solid audit sample is designed to audit...

40 CFR 63.7 - Performance testing requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) program. Data quality objectives are the pretest expectations of precision, accuracy, and completeness of... test data bias. Gaseous audit samples are designed to audit the performance of the sampling system as... just as the compliance samples are collected. If a liquid or solid audit sample is designed to audit...

[Validity of AUDIT test for detection of disorders related with alcohol consumption in women].

PubMed

Pérula-de Torres, Luis Angel; Fernández-García, José Angel; Arias-Vega, Raquel; Muriel-Palomino, María; Márquez-Rebollo, Encarnación; Ruiz-Moral, Roger

2005-11-26

Early detection of patients with alcohol problems is important in clinical practice. The AUDIT (Alcohol Use Disorders Identification Test) questionnaire is a valid tool for this aim, especially in the male population. The objective of this study was to validate how useful is this questionnaire in females patients and to assess their test cut-off point for the diagnosis of alcohol problems in women. 414 woman were recruited in 2 health center and specialized center for addiction treatment. The AUDIT test and a semistructured interview (SCAN as gold standard) were performed to all patients. Internal consistency and criteria validity was assessed. Cronbach alpha was 0.93 (95% confidence interval [CI], 0.921-0.941). When the DSM-IV was taken as reference the most useful cut-off point was 6 points, with 89.6% (95% CI, 76.11-96.02) sensitivity and 95.07% (95% CI, 92.18-96.97) specificity. When CIE-10 was taken as reference the sensitivity was 89.58% (95% CI, 76.56-96.10) and the specificity was 95.33% (95% CI, 92.48-97.17). AUDIT is a questionnaire with good psychometrics properties and is valid for detecting dependence and risk alcohol consumption in women.

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...

Psychometric properties of the AUDIT among men in Goa, India.

PubMed

Endsley, Paige; Weobong, Benedict; Nadkarni, Abhijit

2017-10-01

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening questionnaire used to detect alcohol use disorders. The AUDIT has been validated in only two studies in India and although it has been previously used in Goa, India, it has yet to be validated in that setting. In this paper, we aim to report data on the validity of the AUDIT for the screening of AUDs among men in Goa, India. Concurrent and convergent validity of the AUDIT were assessed against the Mini International Neuropsychiatric Interview (MINI) and World Health Organisation Disability Assessment Scale (WHODAS) for alcohol abuse, alcohol dependence, and functional status respectively through the secondary analysis of data from a community cohort of men from Goa, India. The AUDIT showed high internal reliability and acceptable criterion validity with adequate psychometric properties for the detection of alcohol abuse and dependence. However, all of the optimal cut-off points from ROC analyses were lower than the WHO recommended for identification of risk of all AUDs, with a score of 6-12 detecting alcohol abuse and 13 and higher alcohol dependence. In order to optimize the utility of the AUDIT, a lowered cut-off point for alcohol abuse and dependence is recommended for Goa, India. Further validation studies for the AUDIT should be conducted for continued validation of the tool in other parts of India. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

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...

Pilot of the Modern Army Recordkeeping System (MARKS) at Headquarters, U.S. Army Armor Center and Fort Knox, Fort Knox, Kentucky, January-December 1984.

DTIC Science & Technology

1985-05-01

Clothing and Textile Materiel 341 Standardization 36 Audit 37 Financial Administration 410 Medical Services 50 Nuclear and Chemical Weapons and Materiel 55...Transaction Files 314-18 210-60b NAF Report of Audit Files 314-27 36-5a NAF Payroll Control Files 36-75a 316-01 36-2a GAO Audit Reporting Files 36-5b 316-02...ll-7a Internal Review Files 316-03 36-5c AAA Audit Reporting Files 316-15 36-5d DAS Audit Reporting Files 319-12 37-107a Commercial Account Claim

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...

Performance Audit of the U.S. Geological Survey, Energy Resource Program Inorganic Geochemistry Laboratory

USGS Publications Warehouse

Luppens, James A.; Janke, Louis G.; McCord, Jamey D.; Bullock, John H.; Brazeau, Lisa; Affronter, Ronald H.

2007-01-01

A performance audit of the U.S. Geological Survey (USGS), Energy Resource Program (ERP) Inorganic Geochemistry Laboratory (IGL) was conducted between August, 2003 and October, 2005. The goals were to ensure that a high level of analytical performance was maintained and identify any areas that could be enhanced. The audit was subdivided into three phases. Phase 1 was a preliminary assessment of current performance based on recent performance on CANSPEX samples. IGL performance was also compared to laboratories world-wide with similar scope. Phase 2 consisted of the implementation of the recommended changes made in Phase 1. Phase 3 of the audit consisted of a reassessment effort to evaluate the effectiveness of the recommendations made in the Phase 1 and an on-site audit of the laboratory facilities. Phases 1 and 3 required summary reports that are included in Appendices A and B of this report. The audit found that the IGL was one of the top two laboratories compared for trace element analyses. Several recommendations to enhance performance on major and minor elemental parameters were made and implemented. Demonstrated performance improvements as a result of the recommended changes were documented. Several initiatives to sustain the performance improvements gained from the audit have been implemented.

Eye dose to staff involved in interventional and procedural fluoroscopy

NASA Astrophysics Data System (ADS)

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

2016-03-01

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

Auditing Safety of Compounding and Reconstituting of Intravenous Medicines on Hospital Wards in Finland.

PubMed

Suvikas-Peltonen, Eeva; Palmgren, Joni; Häggman, Verner; Celikkayalar, Ercan; Manninen, Raija; Airaksinen, Marja

2017-01-01

On the hospital wards in Finland, nurses generally reconstitute intravenous medicines, such as antibiotics, analgesics, and antiemetics prescribed by doctors. Medicine reconstitution is prone to many errors. Therefore, it is important to identify incorrect practices in the reconstitution of medicine to improve patient safety in hospitals. The aim of this study was to audit the compounding and reconstituting of intravenous medicines on hospital wards in a secondary-care hospital in Finland by using an assessment tool and microbiological testing for identifying issues posing patient safety risks. A hospital pharmacist conducted an external audit by using a validated 65-item assessment tool for safe-medicine compounding practices on 20 wards of the selected hospital. Also, three different microbiological samples were collected to assure the aseptics. Practices were evaluated using a four-point rating scale of "never performed," "rarely performed," "often performed," and "always performed," and were based on observation and interviews with nurses or ward pharmacists. In addition, glove-, settle plate-, and media fill-tests were collected. Associations between microbial sample results and audit-tool results were discussed. Altogether, only six out of the 65 items were fully implemented in all wards; these were related to logistic practices and quality assurance. More than half of the wards used incorrect practices ("rarely performed" or "never performed") for five items. Most of these obviated practices related to aseptic practices. All media-fill tests were clean but the number of colony forming units in glove samples and settle- plate samples varied from 0 to >100. More contamination was found in wards where environmental conditions were inadequate or the use of gloves was incorrect. Compounding practices were [mostly] quite well adapted, but the aseptic practices needed improvement. Attention should have been directed particularly to good aseptic techniques and compounding environment on the wards. These results can be used for updating the guidelines and for training nurses involved in compounding. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

12 CFR 19.242 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., Suspension, and Debarment of Accountants From Performing Audit Services § 19.242 Definitions. As used in this... services. (b) Audit services means any service required to be performed by an independent public accountant... accountant (accountant) means any individual who performs or participates in providing audit services. ...

12 CFR 19.242 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., Suspension, and Debarment of Accountants From Performing Audit Services § 19.242 Definitions. As used in this... services. (b) Audit services means any service required to be performed by an independent public accountant... accountant (accountant) means any individual who performs or participates in providing audit services. ...

12 CFR 19.242 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., Suspension, and Debarment of Accountants From Performing Audit Services § 19.242 Definitions. As used in this... services. (b) Audit services means any service required to be performed by an independent public accountant... accountant (accountant) means any individual who performs or participates in providing audit services. ...

12 CFR 19.242 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., Suspension, and Debarment of Accountants From Performing Audit Services § 19.242 Definitions. As used in this... services. (b) Audit services means any service required to be performed by an independent public accountant... accountant (accountant) means any individual who performs or participates in providing audit services. ...

A Comparative Study of Financial Data Sources for Critical Access Hospitals: Audited Financial Statements, the Medicare Cost Report, and the Internal Revenue Service Form 990

ERIC Educational Resources Information Center

Ozmeral, Alisha Bhadelia; Reiter, Kristin L.; Holmes, George M.; Pink, George H.

2012-01-01

Purpose: Medicare Cost Reports (MCR), Internal Revenue Service Form 990s (IRS 990), and Audited Financial Statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across…

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.

Clinical audit training improves undergraduates' performance in root canal therapy.

PubMed

Fong, J Y M; Tan, V J H; Lee, J R; Tong, Z G M; Foong, Y K; Tan, J M E; Parolia, A; Pau, A

2017-12-20

To evaluate the effectiveness of clinical audit-feedback cycle as an educational tool in improving the technical quality of root canal therapy (RCT) and compliance with record keeping performed by dental undergraduates. Clinical audit learning was introduced in Year 3 of a 5-year curriculum for dental undergraduates. During classroom activities, students were briefed on clinical audit, selected their audit topics in groups of 5 or 6 students, and prepared and presented their audit protocols. One chosen topic was RCT, in which 3 different cohorts of Year 3 students conducted retrospective audits of patients' records in 2012, 2014 and 2015 for their compliance with recommended record keeping criteria and their performance in RCT. Students were trained by and calibrated against an endodontist (κ ≥ 0.8). After each audit, the findings were reported in class, and recommendations were made for improvement in performance of RCT and record keeping. Students' compliance with published guidelines was presented and their RCT performances in each year were compared using the chi-square test. Overall compliance with of record keeping guidelines was 44.1% in 2012, 79.6% in 2014 and 94.6% in 2015 (P = .001). In the 2012 audit, acceptable extension, condensation and the absence of mishap were observed in 72.4, 75.7% and 91.5%; in the 2014 audit, 95.1%, 64.8% and 51.4%; and in 2015 audit, 96.4%, 82.1% and 92.8% of cases, respectively. In 2015, 76.8% of root canal fillings met all 3 technical quality criteria when compared to 48.6% in 2014 and 44.7% in 2012 (P = .001). Clinical audit-feedback cycle is an effective educational tool for improving dental undergraduates' compliance with record keeping and performance in the technical quality of RCT. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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.

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...

The Implications of Using Integrated Software Support Environment for Design of Guidance and Control Systems Software

DTIC Science & Technology

1990-02-01

inspections are performed before each formal review of each software life cycle phase. * Required software audits are performed . " The software is acceptable... Audits : Software audits are performed bySQA consistent with thegeneral audit rules and an auditreportis prepared. Software Quality Inspection (SQI...DSD Software Development Method 3-34 DEFINITION OF ACRONYMS Acronym Full Name or Description MACH Methode d’Analyse et de Conception Flierarchisee

The changing role of internal auditors in health care.

PubMed

Edwards, D E; Kusel, J; Oxner, T H

2000-08-01

Two surveys of directors of internal auditing in health care conducted in 1990 and 1998 found that healthcare internal auditors are spending proportionately more time on management and operational improvement activities and less time on traditional financial/compliance activities. The average staff size has remained relatively constant, but salaries at all levels of experience have risen. More importantly, the tenure of healthcare internal auditors has increased significantly since 1990. The profile of the healthcare internal auditing director also has changed. The director is older, more experienced, and has held the position for twice as long as was the case in 1990. On the other hand, the director is more stressed and less satisfied with compensation.

77 FR 6595 - Notice of Sunshine Act Meeting; Audit Committee of the Board of Directors

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-08

..., Assistant Corporate Secretary (202) 220-2376; [email protected] . AGENDA: I. CALL TO ORDER II. External Auditor's Presentation III. Executive Session with External Auditors IV. Executive Session with Internal Audit Director V...

Towards an integration of affiliated companies energy audit process system at P.T Astra International

NASA Astrophysics Data System (ADS)

Telaga, Abdi Suryadinata; Hartanto, Indra Dwi; Audina, Debby Rizky; Prabowo, Fransiscus Dimas

2017-06-01

Environmental awareness, stringent regulation and soaring energy costs, together make energy efficiency as an important pillar for every company. Particularly, in 2020, the ministry of energy and mineral resources of Indonesia has set a target to reduce carbon emission by 26%. For that reason, companies in Indonesia have to comply with the emission target. However, there is trade-off between company's productivity and carbon emission. Therefore, the companies' productivity must be weighed against the environmental effect such as carbon emission. Nowadays, distinguish excessive energy in a company is still challenging. The company rarely has skilled person that capable to audit energy consumed in the company. Auditing energy consumption in a company is a lengthy and time consuming process. As PT Astra International (AI) have 220 affiliated companies (AFFCOs). Occasionally, direct visit to audit energy consumption in AFFCOs is inevitable. However, capability to conduct on-site energy audit was limited by the availability of PT AI energy auditors. For that reason, PT AI has developed a set of audit energy tools or Astra green energy (AGEn) tools to aid the AFFCOs auditor to be able to audit energy in their own company. Fishbone chart was developed as an analysis tool to gather root cause of audit energy problem. Following the analysis results, PT AI made an improvement by developing an AGEn web-based system. The system has capability to help AFFCOs to conduct energy audit on-site. The system was developed using prototyping methodology, object-oriented system analysis and design (OOSAD), and three-tier architecture. The implementation of system used ASP.NET, Microsoft SQL Server 2012 database, and web server IIS 8.

Financial Audit. Federal Family Education Loan Program's Financial Statements for Fiscal Years 1993 and 1992. Report to the Congress and the Secretary of Education.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC.

This report presents findings of an audit of the Principal Statements of the Department of Education's (ED) Federal Family Education Loan Program (FFELP) and its internal controls and compliance with laws and regulations for the fiscal years ending September 30, 1993, and September 30, 1992. The audit investigated whether the Principal Statements…

The Brazilian Audit Tribunal's role in improving the federal environmental licensing process

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

Lima, Luiz Henrique, E-mail: luizhlima@terra.com.b; Magrini, Alessandra, E-mail: ale@ppe.ufrj.b; Centro de Tecnologia - Bloco C Sala 211, Ilha do Fundao, 21949-900 - Rio de Janeiro, Caixa-Postal: 68565, RJ

This article describes the role played by the Brazilian Audit Tribunal (Tribunal de Contas da Uniao - TCU) in the external auditing of environmental management in Brazil, highlighting the findings of an operational audit conducted in 2007 of the federal environmental licensing process. Initially, it records the constitutional and legal framework of Brazilian environmental licensing, describing the powers and duties granted to federal, state and municipal institutions. In addition, it presents the responsibilities of the TCU in the environmental area, comparing these with those of other Supreme Audit Institutions (SAI) that are members of the International Organization of Supreme Auditmore » Institutions (INTOSAI). It also describes the work carried out in the operational audit of the Brazilian environmental licensing process and its main conclusions and recommendations. Finally, it draws a parallel between the findings and recommendations made in Brazil with those of academic studies and audits conducted in other countries.« less

Is Alcohol Use Disorder Identification Test (AUDIT) or Its Shorter Versions More Useful to Identify Risky Drinkers in a Chinese Population? A Diagnostic Study

PubMed Central

Yip, Benjamin H. K.; Chung, Roger Y.; Chung, Vincent C. H.; Kim, Jean; Chan, Iris W. T.; Wong, Martin C. S.; Wong, Samuel Y. S.; Griffiths, Sian M.

2015-01-01

Objective To examine the diagnostic performance of shorter versions of Alcohol Use Disorder Identification Test (AUDIT), including Alcohol Consumption (AUDIT-C), in identifying risky drinkers in primary care settings using conventional performance measures, supplemented by decision curve analysis and reclassification table. Study design and Setting A cross-sectional study of adult males in general outpatient clinics in Hong Kong. The study included only patients who reported at least sometimes drinking alcoholic beverages. Timeline follow back alcohol consumption assessment method was used as the reference standard. A Chinese translated and validated 10-item AUDIT (Ch-AUDIT) was used as a screening tool of risky drinking. Results Of the participants, 21.7% were classified as risky drinkers. AUDIT-C has the best overall performance among the shorter versions of Ch-AUDIT. The AUC of AUDIT-C was comparable to Ch-AUDIT (0.898 vs 0.901, p-value = 0.959). Decision curve analysis revealed that when the threshold probability ranged from 15–30%, the AUDIT-C had a higher net-benefit than all other screens. AUDIT-C improved the reclassification of risky drinking when compared to Ch-AUDIT (net reclassification improvement = 0.167). The optimal cut-off of AUDIT-C was at ≥5. Conclusion Given the rising levels of alcohol consumption in the Chinese regions, this Chinese translated 3-item instrument provides convenient and time-efficient risky drinking screening and may become an increasingly useful tool. PMID:25756353

12 CFR 513.8 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2010 CFR

2010-01-01

... independent public accountants and accounting firms performing audit services. 513.8 Section 513.8 Banks and... Removal, suspension, or debarment of independent public accountants and accounting firms performing audit... of independent public accountants and their accounting firms from performing independent audit and...

12 CFR 390.97 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2012 CFR

2012-01-01

... independent public accountants and accounting firms performing audit services. 390.97 Section 390.97 Banks and... debarment of independent public accountants and accounting firms performing audit services. (a) Scope. This... accountants and their accounting firms from performing independent audit and attestation services required by...

12 CFR 513.8 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2014 CFR

2014-01-01

... public accountants and accounting firms performing audit services. 513.8 Section 513.8 Banks and Banking..., suspension, or debarment of independent public accountants and accounting firms performing audit services. (a... independent public accountants and their accounting firms from performing independent audit and attestation...

12 CFR 390.97 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2014 CFR

2014-01-01

... independent public accountants and accounting firms performing audit services. 390.97 Section 390.97 Banks and... debarment of independent public accountants and accounting firms performing audit services. (a) Scope. This... accountants and their accounting firms from performing independent audit and attestation services required by...

12 CFR 390.97 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2013 CFR

2013-01-01

... independent public accountants and accounting firms performing audit services. 390.97 Section 390.97 Banks and... debarment of independent public accountants and accounting firms performing audit services. (a) Scope. This... accountants and their accounting firms from performing independent audit and attestation services required by...

12 CFR 513.8 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2013 CFR

2013-01-01

... public accountants and accounting firms performing audit services. 513.8 Section 513.8 Banks and Banking..., suspension, or debarment of independent public accountants and accounting firms performing audit services. (a... independent public accountants and their accounting firms from performing independent audit and attestation...

12 CFR 513.8 - Removal, suspension, or debarment of independent public accountants and accounting firms...

Code of Federal Regulations, 2012 CFR

2012-01-01

... independent public accountants and accounting firms performing audit services. 513.8 Section 513.8 Banks and... Removal, suspension, or debarment of independent public accountants and accounting firms performing audit... of independent public accountants and their accounting firms from performing independent audit and...

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...

Screening for At-Risk Drinking in a Population Reporting Symptoms of Depression: A Validation of the AUDIT, AUDIT-C, and AUDIT-3.

PubMed

Levola, Jonna; Aalto, Mauri

2015-07-01

Excessive alcohol use is common in patients presenting with symptoms of depression. The aim of this study was to evaluate how the Alcohol Use Disorders Identification Test (AUDIT) and its most commonly used abbreviated versions perform in detecting at-risk drinking among subjects reporting symptoms of depression. A subsample (n = 390; 166 men, 224 women) of a general population survey, the National FINRISK 2007 Study, was used. Symptoms of depression were measured with the Beck Depression Inventory-Short Form and alcohol consumption with the Timeline Follow-back (TLFB). At-risk drinking was defined as ≥280 g weekly or ≥60 g on at least 1 occasion in the previous 28 days for men, 140 and 40 g, respectively, for women. The AUDIT, AUDIT-C, and AUDIT-3 were tested against the defined gold standard, that is, alcohol use calculated from the TLFB. An optimal cutoff was designated as having a sensitivity and specificity of over 0.75, with emphasis on specificity. The AUDIT and its abbreviations were compared with carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase. At-risk drinking was common. The AUDIT and AUDIT-C performed quite consistently. Optimal cutoffs for men were ≥9 for the AUDIT and ≥6 for AUDIT-C. The optimal cut-offs for women with mild symptoms of depression were ≥5 for the AUDIT and ≥4 for AUDIT-C. Optimal cutoffs could not be determined for women with moderate symptoms of depression (specificity <0.75). A nearly optimal cutoff for women was ≥5 for the AUDIT. The AUDIT-3 failed to perform in women, but in men, a good level of sensitivity and specificity was reached at a cutoff of ≥2. With standard threshold values, the biochemical markers demonstrated very low sensitivity (9 to 28%), but excellent specificity (83 to 98%). Screening for at-risk drinking among patients presenting with symptoms of depression using the full AUDIT is recommended, although the AUDIT-C performed almost equally well. Cut-offs should be adjusted according to gender, but not according to the severity of depressive symptoms. The AUDIT and its abbreviations were superior to biochemical markers. Copyright © 2015 by the Research Society on Alcoholism.

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…

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

PubMed

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

2003-10-01

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

Effective model development of internal auditors in the village financial institution

NASA Astrophysics Data System (ADS)

Arsana, I. M. M.; Sugiarta, I. N.

2018-01-01

Designing an effective audit system is complex and challenging, and a focus on examining how internal audit drive improvement in three core performance dimensions ethicality, efficiency, and effectiveness in organization is needed. The problem of research is how the desain model and peripheral of supporter of effective supervation Village Credit Institution? Research of objectives is yielding the desain model and peripheral of supporter of effective supervation Village Credit Institution. Method Research use data collecting technique interview, observation and enquette. Data analysis, data qualitative before analysed to be turned into quantitative data in the form of scale. Each variable made to become five classificat pursuant to scale of likert. Data analysed descriptively to find supervation level, Structural Equation Model (SEM) to find internal and eksternal factor. So that desain model supervation with descriptive analysis. Result of research desain model and peripheral of supporter of effective supervation Village Credit Institution. The conclusion desain model supported by three sub system: sub system institute yield body supervisor of Village Credit Institution, sub system standardization and working procedure yield standard operating procedure supervisor of Village Credit Institution, sub system education and training yield supervisor professional of Village Credit Institution.

Twelve months of implementation of health care performance-based financing in Burkina Faso: A qualitative multiple case study.

PubMed

Ridde, Valéry; Yaogo, Maurice; Zongo, Sylvie; Somé, Paul-André; Turcotte-Tremblay, Anne-Marie

2018-01-01

To improve health services' quantity and quality, African countries are increasingly engaging in performance-based financing (PBF) interventions. Studies to understand their implementation in francophone West Africa are rare. This study analysed PBF implementation in Burkina Faso 12 months post-launch in late 2014. The design was a multiple and contrasted case study involving 18 cases (health centres). Empirical data were collected from observations, informal (n = 224) and formal (n = 459) interviews, and documents. Outside the circle of persons trained in PBF, few in the community had knowledge of it. In some health centres, the fact that staff were receiving bonuses was intentionally not announced to populations and community leaders. Most local actors thought PBF was just another project, but the majority appreciated it. There were significant delays in setting up agencies for performance monitoring, auditing, and contracting, as well as in the payment. The first audits led rapidly to coping strategies among health workers and occasionally to some staging beforehand. No community-based audits had yet been done. Distribution of bonuses varied from one centre to another. This study shows the importance of understanding the implementation of public health interventions in Africa and of uncovering coping strategies. © 2017 The Authors. The International Journal of Health Planning and Management Published by John Wiley & Sons Ltd.

Mental models of audit and feedback in primary care settings.

PubMed

Hysong, Sylvia J; Smitham, Kristen; SoRelle, Richard; Amspoker, Amber; Hughes, Ashley M; Haidet, Paul

2018-05-30

Audit and feedback has been shown to be instrumental in improving quality of care, particularly in outpatient settings. The mental model individuals and organizations hold regarding audit and feedback can moderate its effectiveness, yet this has received limited study in the quality improvement literature. In this study we sought to uncover patterns in mental models of current feedback practices within high- and low-performing healthcare facilities. We purposively sampled 16 geographically dispersed VA hospitals based on high and low performance on a set of chronic and preventive care measures. We interviewed up to 4 personnel from each location (n = 48) to determine the facility's receptivity to audit and feedback practices. Interview transcripts were analyzed via content and framework analysis to identify emergent themes. We found high variability in the mental models of audit and feedback, which we organized into positive and negative themes. We were unable to associate mental models of audit and feedback with clinical performance due to high variance in facility performance over time. Positive mental models exhibit perceived utility of audit and feedback practices in improving performance; whereas, negative mental models did not. Results speak to the variability of mental models of feedback, highlighting how facilities perceive current audit and feedback practices. Findings are consistent with prior research  in that variability in feedback mental models is associated with lower performance.; Future research should seek to empirically link mental models revealed in this paper to high and low levels of clinical performance.

AGU Committees

NASA Astrophysics Data System (ADS)

Administrative Committees are responsible for those functions required for the overall performance or well-being of AGU as an organization. These committees are Audit and Legal Affairs, Budget and Finance*, Development, Nominations*, Planning, Statutes and Bylaws*, Tellers.Operating Committees are responsible for the policy direction and operational oversight of AGU's primary programs. The Operating Committees are Education and Human Resources, Fellows*, Information Technology, International Participation*, Meetings, Public Affairs, Public Information, Publications*.

Preanalytical Nonconformity Management Regarding Primary Tube Mixing in Brazil.

PubMed

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

2017-01-01

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

Value of audits in breast cancer screening quality assurance programmes.

PubMed

Geertse, Tanya D; Holland, Roland; Timmers, Janine M H; Paap, Ellen; Pijnappel, Ruud M; Broeders, Mireille J M; den Heeten, Gerard J

2015-11-01

Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading units. During audits, screening outcomes like recall rates and detection rates are assessed and a radiological review is performed. This study investigates and compares the results of four audit series: 1996-2000, 2001-2005, 2003-2007 and 2010-2013. The analysis shows increased recall rates (from 0.66%, 1.07%, 1.22% to 1.58%), increased detection rates (from 3.3, 4.5, 4.8 to 5.4 per 1000) and increased sensitivity (from 64.5%, 68.7%, 70.5% to 71.6%), over the four audit series. The percentage of 'missed cancers' among interval cancers and advanced screen-detected cancers did not change (p = 0.4). Our audits not only provide an opportunity for assessing screening outcomes, but also provide moments of self-reflection with peers. For radiologists, an accurate understanding of their performance is essential to identify points of improvement. We therefore recommend a radiological review of screening examinations and immediate feedback as part of an audit. • Radiological review and immediate feedback are recommended as part of an audit. • For breast screening radiologists, audits provide moments of self-reflection with peers. • Radiological review of screening examinations provides insights in recall behaviour. • Accurate understanding of radiologists' performance is essential to identify points of improvement.

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

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...

The ADIPS pilot National Diabetes in Pregnancy Audit Project.

PubMed

Simmons, David; Cheung, N Wah; McIntyre, H David; Flack, Jeff R; Lagstrom, Janet; Bond, Dianne; Johnson, Elizabeth; Wolmarans, Louise; Wein, Peter; Sinha, Ashim K

2007-06-01

Limited resources are available to compare outcomes of pregnancies complicated by diabetes across different centres. To compare the use of paper, stand alone and networked electronic processes for a sustainable, systematic international audit of diabetes in pregnancy care. Development of diabetes in pregnancy minimum dataset using nominal group technique, email user survey of difficulties with audit tools and collation of audit data from nine pilot sites across Australia and New Zealand. Seventy-nine defined data items were collected: 33 were for all women, nine for those with gestational diabetes (GDM) and 37 for women with pregestational diabetes. After the pilot, four new fields were requested and 18 fields had queries regarding utility or definition. A range of obstacles hampered the implementation of the audit including Medical Records Committee processes, other medical/non-medical staff not initially involved, temporary staff, multiple clinical records used by different parts of the health service, difficulty obtaining the postnatal test results and time constraints. Implementation of electronic audits in both the networked and the stand-alone settings had additional problems relating to the need to nest within pre-existing systems. Among the 496 women (45 type 1; 43 type 2; 399 GDM) across the nine centres, there were substantial differences in key quality and outcome indicators between sites. We conclude that an international, multicentre audit and benchmarking program is feasible and sustainable, but can be hampered by pre-existing processes, particularly in the initial introduction of electronic methods.

Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

PubMed

Marshall, Nina L; Spooner, Muirne; Galvin, P Leo; Ti, Joanna P; McElvaney, N Gerald; Lee, Michael J

2011-01-01

A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

Auditing as Institutional Research: A Qualitative Focus.

ERIC Educational Resources Information Center

Fetterman, David M.

1991-01-01

Internal institutional auditing can improve effectiveness and efficiency and protect an institution's assets. Many of the concepts and techniques used to analyze higher education institutions are qualitative in nature and suited to institutional research, including fiscal, operational, data-processing, investigative, management consulting,…

Three lines of defence model and the role of internal audit activities as the response to the global economic crisis

NASA Astrophysics Data System (ADS)

Dragičević Radičević, T.; Stojanović Trivanović, M.; Stanojević, Lj

2017-05-01

The existing framework of corporate governance has shown a number of weaknesses, and the result was a new economic crisis at the global level. The main problems were identified as: increased risk of investors, non-transparency of information, conflict of interest between corporation subjects. European Institute of Internal Auditors in response to the strengthening the trust in information, shareholders activism, better communication, which all will lead to the reduction of risks and restore investors confidence, proposed the Model Three Lines of Defence, where the key role has internal audit.

[Standard of integration management at company level and its auditing].

PubMed

Flach, T; Hetzel, C; Mozdzanowski, M; Schian, H-M

2006-10-01

Responsibility at company level for the employment of workers with health-related problems or disabilities has increased, inter alia because of integration management at company level according to section 84 (2) of the German Social Code Book IX. Although several recommendations exist, no standard is available for auditing and certification. Such a standard could be a basis for granting premiums according to section 84 (3) of Book IX of the German Social Code. AUDIT AND CERTIFICATION: One product of the international "disability management" movement is the "Consensus Based Disability Management Audit" (CBDMA). The Audit is a systematic and independent measurement of the effectiveness of integration management at company level. CBDMA goals are to give evidence of the quality of the integration management implemented, to identify opportunities for improvement and recommend appropriate corrective and preventive action. In May 2006, the integration management of Ford-Werke GmbH Germany with about 23 900 employees was audited and certified as the first company in Europe. STANDARD OF INTEGRATION MANAGEMENT AT COMPANY LEVEL: In dialogue with corporate practitioners, the international standard of CBDMA has been adapted, completed and verified concerning its practicability. Process orientation is the key approach, and the structure is similar to DIN EN ISO 9001:2000. Its structure is as follows: (1) management-labour responsibility (goals and objectives, program planning, management-labour review), (2) management of resources (disability manager and DM team, employees' participation, cooperation with external partners, infrastructure), (3) communication (internal and external public relations), (4) case management (identifying cases, contact, situation analysis, planning actions, implementing actions and monitoring, process and outcome evaluation), (5) analysis and improvement (analysis and program evaluation), (6) documentation (manual, records).

Risk of future trauma based on alcohol screening scores: A two-year prospective cohort study among US veterans

PubMed Central

2012-01-01

Background Severe alcohol misuse as measured by the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) is associated with increased risk of future fractures and trauma-related hospitalizations. This study examined the association between AUDIT-C scores and two-year risk of any type of trauma among US Veterans Health Administration (VHA) patients and assessed whether risk varied by age or gender. Methods Outpatients (215, 924 male and 9168 female) who returned mailed AUDIT-C questionnaires were followed for 24 months in the medical record for any International Statistical Classification of Diseases and Related Health Problems (ICD-9) code related to trauma. The two-year prevalence of trauma was examined as a function of AUDIT-C scores, with low-level drinking (AUDIT-C 1–4) as the reference group. Men and women were examined separately, and age-stratified analyses were performed. Results Having an AUDIT-C score of 9–12 (indicating severe alcohol misuse) was associated with increased risk for trauma. Mean (SD) ages for men and women were 68.2 (11.5) and 57.2 (15.8), respectively. Age-stratified analyses showed that, for men ≤50 years, those with AUDIT-C scores ≥9 had an increased risk for trauma compared with those with AUDIT-C scores in the 1–4 range (adjusted prevalence, 25.7% versus 20.8%, respectively; OR = 1.24; 95% confidence interval [CI], 1.03–1.50). For men ≥65 years with average comorbidity and education, those with AUDIT-C scores of 5–8 (adjusted prevalence, 7.9% versus 7.4%; OR = 1.16; 95% CI, 1.02–1.31) and 9–12 (adjusted prevalence 11.1% versus 7.4%; OR = 1.68; 95% CI, 1.30–2.17) were at significantly increased risk for trauma compared with men ≥65 years in the reference group. Higher AUDIT-C scores were not associated with increased risk of trauma among women. Conclusions Men with severe alcohol misuse (AUDIT-C 9–12) demonstrate an increased risk of trauma. Men ≥65 showed an increased risk for trauma at all levels of alcohol misuse (AUDIT-C 5–8 and 9–12). These findings may be used as part of an evidence-based brief intervention for alcohol use disorders. More research is needed to understand the relationship between AUDIT-C scores and risk of trauma in women. PMID:22966411

Local audit of diagnostic surgical pathology as a tool for quality assurance.

PubMed

Malami, Sani Abubakar; Iliyasu, Yawale

2008-01-01

Internal audit has been rarely done for quality assurance of histology laboratories in Nigeria. We reviewed the steps involved in the production of reports with a view to assessing the performance of the histopathology laboratory of Aminu Kano Teaching Hospital, Nigeria. A randomly selected 2 per cent sample of the total histology workload of the center for the year ending December 2005 amounting to 2877 cases was systematically reviewed. Analysis of the accumulated data showed a concordance rate of 94.8% between the original and review histological diagnoses, comparable to other published studies. Significant defects were observed to be due to missing demographic information on request forms (22.8%), poor technical quality of slide sections (18.4%) and typographical errors by typists (12.3%) In a minority of cases microscopic description was inadequate or inappropriate (7.0%) and some were inaccurate (2.7%). The turnaround time ranged from 2 to 16 days (mean 6.2 days) with results of 75.8 per cent of the specimens completed within 7 days. From the study we have shown that local audit is feasible in Nigerian laboratories and is an excellent method for detecting errors and improving performance in Surgical Pathology to optimize the scarce resources available to patient care in our country.

30 CFR 227.301 - What are a State's responsibilities if it performs audits?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Audit Strategy, which MMS will develop in consultation with States having delegated audit authority; (c) Agree to undertake special audit initiatives MMS identifies targeting specific royalty issues, such as...

The implementation of unit-based perinatal mortality audit in perinatal cooperation units in the northern region of the Netherlands

PubMed Central

2012-01-01

Background Perinatal (mortality) audit can be considered to be a way to improve the careprocess for all pregnant women and their newborns by creating an opportunity to learn from unwanted events in the care process. In unit-based perinatal audit, the caregivers involved in cases that result in mortality are usually part of the audit group. This makes such an audit a delicate matter. Methods The purpose of this study was to implement unit-based perinatal mortality audit in all 15 perinatal cooperation units in the northern region of the Netherlands between September 2007 and March 2010. These units consist of hospital-based and independent community-based perinatal caregivers. The implementation strategy encompassed an information plan, an organization plan, and a training plan. The main outcomes are the number of participating perinatal cooperation units at the end of the project, the identified substandard factors (SSF), the actions to improve care, and the opinions of the participants. Results The perinatal mortality audit was implemented in all 15 perinatal cooperation units. 677 different caregivers analyzed 112 cases of perinatal mortality and identified 163 substandard factors. In 31% of cases the guidelines were not followed and in 23% care was not according to normal practice. In 28% of cases, the documentation was not in order, while in 13% of cases the communication between caregivers was insufficient. 442 actions to improve care were reported for ‘external cooperation’ (15%), ‘internal cooperation’ (17%), ‘practice organization’ (26%), ‘training and education’ (10%), and ‘medical performance’ (27%). Valued aspects of the audit meetings were: the multidisciplinary character (13%), the collective and non-judgmental search for substandard factors (21%), the perception of safety (13%), the motivation to reflect on one’s own professional performance (5%), and the inherent postgraduate education (10%). Conclusion Following our implementation strategy, the perinatal mortality audit has been successfully implemented in all 15 perinatal cooperation units. An important feature was our emphasis on the delicate character of the caregivers evaluating the care they provided. However, the actual implementation of the proposed actions for improving care is still a point of concern. PMID:22776712

Validating dose rate calibration of radiotherapy photon beams through IAEA/WHO postal audit dosimetry service.

PubMed

Jangda, Abdul Qadir; Hussein, Sherali

2012-05-01

In external beam radiation therapy (EBRT), the quality assurance (QA) of the radiation beam is crucial to the accurate delivery of the prescribed dose to the patient. One of the dosimetric parameters that require monitoring is the beam output, specified as the dose rate on the central axis under reference conditions. The aim of this project was to validate dose rate calibration of megavoltage photon beams using the International Atomic Energy Agency (IAEA)/World Health Organisation (WHO) postal audit dosimetry service. Three photon beams were audited: a 6 MV beam from the low-energy linac and 6 and 18 MV beams from a dual high-energy linac. The agreement between our stated doses and the IAEA results was within 1% for the two 6 MV beams and within 2% for the 18 MV beam. The IAEA/WHO postal audit dosimetry service provides an independent verification of dose rate calibration protocol by an international facility.

Imminent Danger Pay: Actions Needed Regarding Pay Designations in the U.S. Central Command Area of Responsibility

DTIC Science & Technology

2014-01-30

results of previous audits conducted on the data systems 1The source of this review is the Senate...locations within the CENTCOM area of responsibility. We conducted this performance audit from December 2012 to January 2014 in accordance with...generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to

AICPA standard can help improve audit committee performance.

PubMed

Reinstein, A; Luecke, R W

2001-08-01

The AICPA's Auditing Standards Board issued Statement on Auditing Standards (SAS) No. 90, Improving the Effectiveness of Corporate Audit Committees, in response to a related Securities and Exchange Commission (SEC) rule change. Under the standard, audit committees of publicly traded organizations must enter into discussions with their organization's auditors regarding the quality and the acceptability of the accounting principles that have been applied in the organization's financial statements. Although SAS No. 90 is intended for publicly traded entities, the standard has significant implications for all healthcare organizations in defining what constitutes an effective audit committee. To comply with the standard, audit committees should have independent directors who are rotated on and off the committee, training for committee members on the effective performance of their duties, a charter specifying committee responsibilities and membership requirements, meetings at least four times annually, and responsibility for retaining services of CPA firms to conduct the organization's annual audits.

Physician Self-Audit: A Scoping Review

ERIC Educational Resources Information Center

Gagliardi, Anna R.; Brouwers, Melissa C.; Finelli, Antonio; Campbell, Craig E.; Marlow, Bernard A.; Silver, Ivan L.

2011-01-01

Introduction: Self-audit involves self-collection of personal performance data, reflection on gaps between performance and standards, and development and implementation of learning or quality improvement plans by individual care providers. It appears to stimulate learning and quality improvement, but few physicians engage in self-audit. The…

Computer assisted audit techniques for UNIX (UNIX-CAATS)

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

Polk, W.T.

1991-12-31

Federal and DOE regulations impose specific requirements for internal controls of computer systems. These controls include adequate separation of duties and sufficient controls for access of system and data. The DOE Inspector General`s Office has the responsibility to examine internal controls, as well as efficient use of computer system resources. As a result, DOE supported NIST development of computer assisted audit techniques to examine BSD UNIX computers (UNIX-CAATS). These systems were selected due to the increasing number of UNIX workstations in use within DOE. This paper describes the design and development of these techniques, as well as the results ofmore » testing at NIST and the first audit at a DOE site. UNIX-CAATS consists of tools which examine security of passwords, file systems, and network access. In addition, a tool was developed to examine efficiency of disk utilization. Test results at NIST indicated inadequate password management, as well as weak network resource controls. File system security was considered adequate. Audit results at a DOE site indicated weak password management and inefficient disk utilization. During the audit, we also found improvements to UNIX-CAATS were needed when applied to large systems. NIST plans to enhance the techniques developed for DOE/IG in future work. This future work would leverage currently available tools, along with needed enhancements. These enhancements would enable DOE/IG to audit large systems, such as supercomputers.« less

Computer assisted audit techniques for UNIX (UNIX-CAATS)

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

Polk, W.T.

1991-01-01

Federal and DOE regulations impose specific requirements for internal controls of computer systems. These controls include adequate separation of duties and sufficient controls for access of system and data. The DOE Inspector General's Office has the responsibility to examine internal controls, as well as efficient use of computer system resources. As a result, DOE supported NIST development of computer assisted audit techniques to examine BSD UNIX computers (UNIX-CAATS). These systems were selected due to the increasing number of UNIX workstations in use within DOE. This paper describes the design and development of these techniques, as well as the results ofmore » testing at NIST and the first audit at a DOE site. UNIX-CAATS consists of tools which examine security of passwords, file systems, and network access. In addition, a tool was developed to examine efficiency of disk utilization. Test results at NIST indicated inadequate password management, as well as weak network resource controls. File system security was considered adequate. Audit results at a DOE site indicated weak password management and inefficient disk utilization. During the audit, we also found improvements to UNIX-CAATS were needed when applied to large systems. NIST plans to enhance the techniques developed for DOE/IG in future work. This future work would leverage currently available tools, along with needed enhancements. These enhancements would enable DOE/IG to audit large systems, such as supercomputers.« less

External quality-assurance programs managed by the U.S. Geological Survey in support of the National Atmospheric Deposition Program/National Trends Network

USGS Publications Warehouse

Latysh, Natalie E.; Wetherbee, Gregory A.

2005-01-01

The U.S. Geological Survey, Branch of Quality Systems, operates the external quality-assurance programs for the National Atmospheric Deposition Program/National Trends Network (NADP/NTN). Beginning in 1978, six different programs have been implemented?the intersite-comparison program, the blind-audit program, the sample-handling evaluation program, the field-audit program, the interlaboratory-comparison program, and the collocated-sampler program. Each program was designed to measure error contributed by specific components in the data-collection process. The intersite-comparison program, which was discontinued in 2004, was designed to assess the accuracy and reliability of field pH and specific-conductance measurements made by site operators. The blind-audit and sample-handling evaluation programs, which also were discontinued in 2002 and 2004, respectively, assessed contamination that may result from sampling equipment and routine handling and processing of the wet-deposition samples. The field-audit program assesses the effects of sample handling, processing, and field exposure. The interlaboratory-comparison program evaluates bias and precision of analytical results produced by the contract laboratory for NADP, the Illinois State Water Survey, Central Analytical Laboratory, and compares its performance with the performance of international laboratories. The collocated-sampler program assesses the overall precision of wet-deposition data collected by NADP/NTN. This report documents historical operations and the operating procedures for each of these external quality-assurance programs. USGS quality-assurance information allows NADP/NTN data users to discern between actual environmental trends and inherent measurement variability.

Comparison Between Manual Auditing and a Natural Language Process With Machine Learning Algorithm to Evaluate Faculty Use of Standardized Reports in Radiology.

PubMed

Guimaraes, Carolina V; Grzeszczuk, Robert; Bisset, George S; Donnelly, Lane F

2018-03-01

When implementing or monitoring department-sanctioned standardized radiology reports, feedback about individual faculty performance has been shown to be a useful driver of faculty compliance. Most commonly, these data are derived from manual audit, which can be both time-consuming and subject to sampling error. The purpose of this study was to evaluate whether a software program using natural language processing and machine learning could accurately audit radiologist compliance with the use of standardized reports compared with performed manual audits. Radiology reports from a 1-month period were loaded into such a software program, and faculty compliance with use of standardized reports was calculated. For that same period, manual audits were performed (25 reports audited for each of 42 faculty members). The mean compliance rates calculated by automated auditing were then compared with the confidence interval of the mean rate by manual audit. The mean compliance rate for use of standardized reports as determined by manual audit was 91.2% with a confidence interval between 89.3% and 92.8%. The mean compliance rate calculated by automated auditing was 92.0%, within that confidence interval. This study shows that by use of natural language processing and machine learning algorithms, an automated analysis can accurately define whether reports are compliant with use of standardized report templates and language, compared with manual audits. This may avoid significant labor costs related to conducting the manual auditing process. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

49 CFR 385.313 - Who will conduct the safety audit?

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Oversight of the Air Force - What is the Audit Component and How Can Air Force Managers Deal with It Effectively?

DTIC Science & Technology

1988-05-01

This report discusses authority, mission, and responsibilities of the audit organizations that perform oversight of Air Force operations. A...the discussion of the major audit organizations. The audit oversight function is here to stay. Auditors and audit organizations can be beneficial to Air

48 CFR 701.602-1 - Authority of contracting officers in resolving audit recommendations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Authority of contracting officers in resolving audit recommendations. 701.602-1 Section 701.602-1 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT GENERAL FEDERAL ACQUISITION REGULATION SYSTEM Career...

Effect of a population-level performance dashboard intervention on maternal-newborn outcomes: an interrupted time series study.

PubMed

Weiss, Deborah; Dunn, Sandra I; Sprague, Ann E; Fell, Deshayne B; Grimshaw, Jeremy M; Darling, Elizabeth; Graham, Ian D; Harrold, JoAnn; Smith, Graeme N; Peterson, Wendy E; Reszel, Jessica; Lanes, Andrea; Walker, Mark C; Taljaard, Monica

2018-06-01

To assess the effect of the Maternal Newborn Dashboard on six key clinical performance indicators in the province of Ontario, Canada. Interrupted time series using population-based data from the provincial birth registry covering a 3-year period before implementation of the Dashboard and 2.5 years after implementation (November 2009 through March 2015). All hospitals in the province of Ontario providing maternal-newborn care (n=94). A hospital-based online audit and feedback programme. Rates of the six performance indicators included in the Dashboard. 2.5 years after implementation, the audit and feedback programme was associated with statistically significant absolute decreases in the rates of episiotomy (decrease of 1.5 per 100 women, 95% CI 0.64 to 2.39), induction for postdates in women who were less than 41 weeks at delivery (decrease of 11.7 per 100 women, 95% CI 7.4 to 16.0), repeat caesarean delivery in low-risk women performed before 39 weeks (decrease of 10.4 per 100 women, 95% CI 9.3 to 11.5) and an absolute increase in the rate of appropriately timed group B streptococcus screening (increase of 2.8 per 100, 95% CI 2.2 to 3.5). The audit and feedback programme did not significantly affect the rates of unsatisfactory newborn screening blood samples or formula supplementation at discharge. No statistically significant effects were observed for the two internal control outcomes or the four external control indicators-in fact, two external control indicators (episiotomy and postdates induction) worsened relative to before implementation. An electronic audit and feedback programme implemented in maternal-newborn hospitals was associated with clinically relevant practice improvements at the provincial level in the majority of targeted indicators. © 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.

Transforming an EPA QA/R-2 quality management plan into an ISO 9002 quality management system.

PubMed

Kell, R A; Hedin, C M; Kassakhian, G H; Reynolds, E S

2001-01-01

The Environmental Protection Agency's (EPA) Office of Emergency and Remedial Response (OERR) requires environmental data of known quality to support Superfund hazardous waste site projects. The Quality Assurance Technical Support (QATS) Program is operated by Shaw Environmental and Infrastructure, Inc. to provide EPA's Analytical Operations Center (AOC) with performance evaluation samples, reference materials, on-site laboratory auditing capabilities, data audits (including electronic media data audits), methods development, and other support services. The new QATS contract awarded in November 2000 required that the QATS Program become ISO 9000 certified. In a first for an EPA contractor, the QATS staff and management successfully transformed EPA's QA/R-2 type Quality Management Plan into a Quality Management System (QMS) that complies with the requirements of the internationally recognized ISO 9002 standard and achieved certification in the United States, Canada, and throughout Europe. The presentation describes how quality system elements of ISO 9002 were implemented on an already existing quality system. The psychological and organizational challenges of the culture change in QATS' day-to-day operations will be discussed for the benefit of other ISO 9000 aspirants.

Your Audit and Financial Controls.

ERIC Educational Resources Information Center

Hatch, Mary B.; And Others

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

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

DTIC Science & Technology

2013-03-07

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

Benchmarking and audit of breast units improves quality of care

PubMed Central

van Dam, P.A.; Verkinderen, L.; Hauspy, J.; Vermeulen, P.; Dirix, L.; Huizing, M.; Altintas, S.; Papadimitriou, K.; Peeters, M.; Tjalma, W.

2013-01-01

Quality Indicators (QIs) are measures of health care quality that make use of readily available hospital inpatient administrative data. Assessment quality of care can be performed on different levels: national, regional, on a hospital basis or on an individual basis. It can be a mandatory or voluntary system. In all cases development of an adequate database for data extraction, and feedback of the findings is of paramount importance. In the present paper we performed a Medline search on “QIs and breast cancer” and “benchmarking and breast cancer care”, and we have added some data from personal experience. The current data clearly show that the use of QIs for breast cancer care, regular internal and external audit of performance of breast units, and benchmarking are effective to improve quality of care. Adherence to guidelines improves markedly (particularly regarding adjuvant treatment) and there are data emerging showing that this results in a better outcome. As quality assurance benefits patients, it will be a challenge for the medical and hospital community to develop affordable quality control systems, which are not leading to excessive workload. PMID:24753926

The 5S lean method as a tool of industrial management performances

NASA Astrophysics Data System (ADS)

Filip, F. C.; Marascu-Klein, V.

2015-11-01

Implementing the 5S (seiri, seiton, seiso, seiketsu, and shitsuke) method is carried out through a significant study whose purpose to analyse and deployment the management performance in order to emphasize the problems and working mistakes, reducing waste (stationary and waiting times), flow transparency, storage areas by properly marking and labelling, establishing standards work (everyone knows exactly where are the necessary things), safety and ergonomic working places (the health of all employees). The study describes the impact of the 5S lean method implemented to storing, cleaning, developing and sustaining a production working place from an industrial company. In order to check and sustain the 5S process, it is needed to use an internal audit, called “5S audit”. Implementing the 5S methodology requires organization and safety of the working process, properly marking and labelling of the working place, and audits to establish the work in progress and to maintain the improved activities.

The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians.

PubMed

Kalanithi, Lucy; Coffey, Charles E; Mourad, Michelle; Vidyarthi, Arpana R; Hollander, Harry; Ranji, Sumant R

2013-01-01

This article reports on a resident-led quality improvement program to improve communication between inpatient internal medicine residents and their patients' primary care physicians (PCPs). The program included education on care transitions, standardization of documentation, audit and feedback of documented PCP communication rates with public reporting of performance, rapid-cycle data analysis and improvement projects, and a financial incentive. At baseline, PCP communication was documented in 55% of patients; after implementation of the intervention, communication was documented in 89.3% (2477 of 2772) of discharges during the program period. The program was associated with a significant increase in referring PCP satisfaction with communication at hospital admission (baseline, 27.7% "satisfied" or "very satisfied"; postintervention, 58.2%; P < .01) but not at discharge (baseline, 14.9%; postintervention, 21.8%; P = .41). Residents cited the importance of PCP communication for patient care and audit and feedback of their performance as the principal drivers of their engagement in the project.

J&K Fitness Supply Company: Auditing Inventory

ERIC Educational Resources Information Center

Clikeman, Paul M.

2012-01-01

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

Complete internal audit of a mammography service in a reference institution for breast imaging.

PubMed

Badan, Gustavo Machado; Roveda Júnior, Décio; Ferreira, Carlos Alberto Pecci; de Noronha Junior, Ozeas Alves

2014-01-01

Undertaking of a complete audit of the service of mammography, as recommended by BI-RADS(®), in a private reference institution for breast cancer diagnosis in the city of São Paulo, SP, Brazil, and comparison of results with those recommended by the literature. Retrospective, analytical and cross-sectional study including 8,000 patients submitted to mammography in the period between April 2010 and March 2011, whose results were subjected to an internal audit. The patients were followed-up until December 2012. The radiological classification of 7,249 screening mammograms, according to BI-RADS, was the following: category 0 (1.43%), 1 (7.82%), 2 (80.76%), 3 (8.35%), 4 (1.46%), 5 (0.15%) and 6 (0.03%). The breast cancer detection ratio was 4.8 cases per 1,000 mammograms. Ductal carcinoma in situ was found in 22.8% of cases. Positive predictive values for categories 3, 4 and 5 were 1.3%, 41.3% and 100%, respectively. In the present study, the sensitivity of the method was 97.1% and specificity, 97.4%. The complete internal audit of a service of mammography is essential to evaluate the quality of such service, which reflects on an early breast cancer detection and reduction of mortality rates.

The role of field auditing in environmental quality assurance management.

PubMed

Claycomb, D R

2000-01-01

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

Higher Education as an International Commodity: Ensuring Quality in Partnerships.

ERIC Educational Resources Information Center

Hodson, Peter J.; Thomas, Harold G.

2001-01-01

Describes how overseas collaborative activity has been particularly popular with many United Kingdom higher education institutions over the past decade, with the Quality Assurance Agency creating an audit agenda to measure the quality of such partnerships. Asserts that existing collaborative audit approaches lack cultural sensitivity and are open…

76 FR 9057 - Capital International, Inc., et al.;

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-16

... Partnership will send its Limited Partners an annual financial statement audited by independent accountants as... for federal and state income tax purposes. \\4\\ ``Audit'' will have the meaning defined in rule 1-02(d... request an exemption from the rule 17f-1(b)(4) requirement that an independent accountant periodically...

75 FR 9638 - Surface Transportation Project Delivery Pilot Program; Caltrans Audit Report

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-03

... practice on a case- by-case basis. The FHWA recommends that Caltrans develop a departmentwide, holistic corrective action management approach and system that will develop and implement an internal process review... the Pilot Program. During the on-site audit, Caltrans staff and management continued to express...

A Library Communication Audit for the Twenty-First Century

ERIC Educational Resources Information Center

Chalmers, Mardi; Liedtka, Theresa; Bednar, Carol

2006-01-01

This article describes a case study relating to an internal communication audit conducted in a large academic library that assessed existing information channels during a period of organizational change in order to recommend improvements. A communications task force developed and administered a survey instrument and then analyzed data and reported…

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.

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

PubMed

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

2015-01-01

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

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

PubMed Central

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

2015-01-01

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

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

Audit filters for improving processes of care and clinical outcomes in trauma systems.

PubMed

Evans, Christopher; Howes, Daniel; Pickett, William; Dagnone, Luigi

2009-10-07

Traumatic injuries represent a considerable public health burden with significant personal and societal costs. The care of the severely injured patient in a trauma system progresses along a continuum that includes numerous interventions being provided by a multidisciplinary group of healthcare personnel. Despite the recent emphasis on quality of care in medicine, there has been little research to direct trauma clinicians and administrators on how optimally to monitor and improve upon the quality of care delivered within a trauma system. Audit filters are one mechanism for improving quality of care and are defined as specific clinical processes or outcomes of care that, when they occur, represent unfavorable deviations from an established norm and which prompt review and feedback. Although audit filters are widely utilized for performance improvement in trauma systems they have not been subjected to systematic review of their effectiveness. To determine the effectiveness of using audit filters for improving processes of care and clinical outcomes in trauma systems. Our search strategy included an electronic search of the Cochrane Injuries Group Specialized Register, the Cochrane EPOC Group Specialized Register, CENTRAL (The Cochrane Library 2008, Issue 4), MEDLINE, PubMed, EMBASE, CINAHL, and ISI Web of Science: (SCI-EXPANDED and CPCI-S). We handsearched the Journal of Trauma, Injury, Annals of Emergency Medicine, Academic Emergency Medicine, and Injury Prevention. We searched two clinical trial registries: 1) The World Health Organization International Clinical Trials Registry Platform and, 2) Clinical Trials.gov. We also contacted content experts for further articles. The most recent electronic search was completed in December 2008 and the handsearch was completed up to February 2009. We searched for randomized controlled trials, controlled clinical trials, controlled before-and-after studies, and interrupted time series studies that used audit filters as an intervention for improving processes of care, morbidity, or mortality for severely injured patients. Two authors independently screened the search results, applied inclusion criteria, and extracted data. There were no studies identified that met the inclusion criteria for this review. We were unable to identify any studies of sufficient methodological quality to draw conclusions regarding the effectiveness of audit filters as a performance improvement intervention in trauma systems. Future research using rigorous study designs should focus on the relative effectiveness of audit filters in comparison to alternative quality improvement strategies at improving processes of care, functional outcomes, and mortality for injured patients.

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

[Pharmaceutical revision of hospital drug administration].

PubMed

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

2002-01-20

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

48 CFR 809.406-1 - General.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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.

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

32 CFR 37.645 - Must I require periodic audits, as well as award-specific audits, of for-profit participants?

Code of Federal Regulations, 2010 CFR

2010-07-01

... amounts or adjusts performance outcomes. The periodic audit provides some assurance that the reported... 32 National Defense 1 2010-07-01 2010-07-01 false Must I require periodic audits, as well as award-specific audits, of for-profit participants? 37.645 Section 37.645 National Defense Department of Defense...

Practical Comptrollership Course

DTIC Science & Technology

1987-03-01

variables that drive selection of "significant" areas. " Multilocation audits investigate specific functions. In 1985, for example, the NAS performed... audits of health care functions, and of supply departments, focusing on spare parts. These two audits were part of DoD-wide multilocation audit ...should have included more practical examples. Evaluator A questioned the inclusion of Chapter IIIE, addressing auditing , in the comptrollership course

40 CFR 63.11224 - What are my monitoring, installation, operation, and maintenance requirements?

Code of Federal Regulations, 2014 CFR

2014-07-01

... include a daily calibration drift assessment, a quarterly performance audit, and an annual zero alignment... performance audit, or an annual zero alignment audit. (7) You must calculate and record 6-minute averages from... absolute particulate matter loadings. (5) The bag leak detection system must be equipped with a device to...

40 CFR 63.11224 - What are my monitoring, installation, operation, and maintenance requirements?

Code of Federal Regulations, 2013 CFR

2013-07-01

... include a daily calibration drift assessment, a quarterly performance audit, and an annual zero alignment... performance audit, or an annual zero alignment audit. (7) You must calculate and record 6-minute averages from... absolute particulate matter loadings. (5) The bag leak detection system must be equipped with a device to...

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.

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.

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.

Assessment of cardiovascular risk and target organ damage among adult patients with primary hypertension in Thika Level 5 Hospital, Kenya: a criteria-based clinical audit.

PubMed

Mwita, Clifford Chacha; Akello, Walter; Sisenda, Gloria; Ogoti, Evans; Tivey, David; Munn, Zachary; Mbogo, David

2013-06-01

Appropriate management of hypertension reduces the risk of death from stroke and cardiac disease and includes routine assessment for target organ damage and estimation of cardiovascular risk. However, implementation of evidence-based hypertension management guidelines is unsatisfactory. We explore the use of audit and feedback as a quality improvement (QI) strategy for reducing the knowledge practice gap in hypertension care in a resource poor setting. The aim of this study is to determine the level of compliance to evidence-based guidelines on assessment of cardiovascular risk and target organ damage among patients with hypertension in Thika Level 5 Hospital in central Kenya and to implement best practice with regard to evidence utilisation among clinicians in the hospital. A retrospective clinical audit done in three phases spread over 5 months. Phase one involved identifying five audit criteria on assessment of cardiovascular risk and target organ damage in patients with hypertension and conducting a baseline audit in which compliance to audit criteria, blood pressure control and drug prescription practices were assessed. Phase two involved identifying barriers to compliance to audit criteria and strategies to overcoming these barriers. The third phase was a follow-up audit. There was no use of a cardiovascular risk assessment tool in both audits (0% vs. 0%; P = 1.00). Testing urine for haematuria and proteinuria reduced from 13% to 8% (P = 0.230) while taking a blood sample for measuring blood glucose, electrolytes and creatinine levels improved from 11% to 17% (P = 0.401). Performance of fundoscopy and electrocardiography remained unchanged at 2% and 8%, respectively (P = 0.886 and P = 0.898). High patient load was identified as the biggest barrier to implementation of best practice. Blood pressure control improved from 33% to 70% (P ≤ 0.001), whereas the proportion of patients on two or more recommended antihypertensive drugs rose from 59% to 72% (P = 0.158). In Thika Level 5 Hospital, audit and feedback has a poor impact on assessment of cardiovascular risk and target organ damage but positive impact on blood pressure control and prescription practices. Time and sample size may have affected observed results. Additional audits and alternative QI strategies are warranted. © 2013 The Authors. International Journal of Evidence-Based Healthcare © 2013 The Joanna Briggs Institute.

A Proposed Supplemental Teaching Model for Enhancing Students' Understanding of Sarbanes Oxley

ERIC Educational Resources Information Center

Specht, James; Kagan, Albert; Maanum, Scott D.

2009-01-01

The Sarbanes Oxley Act of 2002 brought about major changes in how accounting firms conduct audits of publicly traded companies. Corporate officials have additional responsibilities in the areas of internal controls and financial reports. In addition there is a new organization responsible for established auditing standards for publicly traded…

77 FR 23305 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing and Immediate...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... Organizations Report to the Order Audit Trail System Information Barriers Put Into Place by the Member... Rule 5320 to require that member organizations report to the Order Audit Trail System (``OATS... implements and uses an effective system of internal controls--such as appropriate information barriers--that...

Nineteenth-Century World's Fairs as Accountability Systems: Scopic Systems, Audit Practices and Educational Data

ERIC Educational Resources Information Center

Sobe, Noah W.; Boven, David T.

2014-01-01

Late-19th century World's Fairs constitute an important chapter in the history of educational accountability. International expositions allowed for educational systems and practices to be "audited" by lay and expert audiences. In this article we examine how World's Fair exhibitors sought to make visible educational practices and…

State University of New York Maritime College: Selected Financial Management Practices.

ERIC Educational Resources Information Center

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

This report presents audit findings of the financial management practices at the State University of New York (SUNY) Maritime College, which trains students to become licensed officers in the U.S. Merchant Marines. Specifically, the audit examined whether SUNY Maritime maintains an adequate internal control environment and adequate internal…

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

ERIC Educational Resources Information Center

Kucharski, Walter J.

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

76 FR 20731 - RINO International Corporation; Order of Suspension of Trading

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-13

..., because the company has failed to disclose that: (i) The outside law firm and forensic accountants hired by the audit committee to investigate allegations of financial fraud at the company resigned on or...; (ii) the chairman of its audit committee resigned on March 31, 2011; and (iii) the company's remaining...

40 CFR Appendix A to Part 31 - Audit Requirements for State and Local Government Recipients

Code of Federal Regulations, 2014 CFR

2014-07-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

40 CFR Appendix A to Part 31 - Audit Requirements for State and Local Government Recipients

Code of Federal Regulations, 2011 CFR

2011-07-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

40 CFR Appendix A to Part 31 - Audit Requirements for State and Local Government Recipients

Code of Federal Regulations, 2010 CFR

2010-07-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

40 CFR Appendix A to Part 31 - Audit Requirements for State and Local Government Recipients

Code of Federal Regulations, 2012 CFR

2012-07-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

40 CFR Appendix A to Part 31 - Audit Requirements for State and Local Government Recipients

Code of Federal Regulations, 2013 CFR

2013-07-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

41 CFR 105-55.018 - Exemptions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... under, the Internal Revenue Code of 1986, as amended (26 U.S.C. 1 et seq.); the Social Security Act (42... arising from the audit of transportation accounts pursuant to 31 U.S.C. 3726 will be determined, collected.... 3726 (see 41 CFR part 101-41, administered by the Director, Office of Transportation Audits) and are...

41 CFR 105-55.018 - Exemptions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... under, the Internal Revenue Code of 1986, as amended (26 U.S.C. 1 et seq.); the Social Security Act (42... arising from the audit of transportation accounts pursuant to 31 U.S.C. 3726 will be determined, collected.... 3726 (see 41 CFR part 101-41, administered by the Director, Office of Transportation Audits) and are...

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

[Integrate the surgical hand disinfection as a quality indicator in an operating room of urology].

PubMed

Francois, M; Girard, R; Mauranne, C C; Ruffion, A; Terrier, J E

2017-12-01

The surgical hand disinfection by friction (SDF) helps to reduce the risk of surgical site infections. For this purpose and in order to promote good compliance to quality care, the urology service of Centre Hospitalier Lyon Sud achieved a continuous internal audit to improve the quality of the SDF. An internal audit executed by the medical students of urology was established in 2013. The study population was all operators, instrumentalists and operating aids of urology operating room (OR). Each student realized 5-10 random observations, of all types of professionals. The criteria measured by the audit were criteria for friction. The evolution of indicators was positive. Particularly, the increasing duration of the first and second friction was statistically significant during follow-up (P=0.001). The total duration of friction shows a similar trend for all professionals. The surgical hand disinfection by friction in the urology OR of the Centre Hospitalier Lyon Sud has gradually improved over the iterative audits. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

7 CFR 246.20 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN... by OIG to be necessary. In performing such audits, OIG will rely to the extent feasible on audit work...

Experience with Adaptive Security Policies.

DTIC Science & Technology

1998-03-01

3.1 Introduction r: 3.2 Logical Groupings of audited permission checks 29 3.3 Auditing of system servers via microkernel snooping 31 3.4...performed by servers other than the microkernel . Since altering each server to audit events would complicate the integration of new servers, a...modification to the microkernel was implemented to allow the microkernel to audit the requests made of other servers. Both methods for enhancing audit

12 CFR 263.400 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of independent public accountants and their accounting firms from performing independent audit and... PRACTICE FOR HEARINGS Removal, Suspension, and Debarment of Accountants From Performing Audit Services...

12 CFR 263.400 - Scope.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PRACTICE FOR HEARINGS Removal, Suspension, and Debarment of Accountants From Performing Audit Services... of independent public accountants and their accounting firms from performing independent audit and...

10 CFR 72.176 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... RADIOACTIVE WASTE, AND REACTOR-RELATED GREATER THAN CLASS C WASTE Quality Assurance § 72.176 Audits. The... assurance program and to determine the effectiveness of the program. The audits must be performed in... 10 Energy 2 2010-01-01 2010-01-01 false Audits. 72.176 Section 72.176 Energy NUCLEAR REGULATORY...

Contracting for Audit Services.

ERIC Educational Resources Information Center

Heifetz, Harry S.

1987-01-01

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

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

DTIC Science & Technology

2012-08-07

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

49 CFR 1511.9 - Accounting and auditing requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... and remitting the fees. The accountant's working papers with respect to the audit must accompany this... air carrier must submit an audit performed by an independent certified public accountant of the... cost of the audit will be borne by the carrier. The accountant must express an opinion as to the...

49 CFR 1511.9 - Accounting and auditing requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and remitting the fees. The accountant's working papers with respect to the audit must accompany this... air carrier must submit an audit performed by an independent certified public accountant of the... cost of the audit will be borne by the carrier. The accountant must express an opinion as to the...

49 CFR 1511.9 - Accounting and auditing requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and remitting the fees. The accountant's working papers with respect to the audit must accompany this... air carrier must submit an audit performed by an independent certified public accountant of the... cost of the audit will be borne by the carrier. The accountant must express an opinion as to the...

Steps in Performing a Communication Audit.

ERIC Educational Resources Information Center

Sincoff, Michael Z.; And Others

This paper develops the step-by-step processes necessary to conduct a communication audit in order to determine the communication effectiveness of an organization. The authors stress the responsibilities of both the audit team and the organization's top management as they interact during progressive phases of the audit. Emphasis is placed on…

10 CFR 26.415 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Audits. 26.415 Section 26.415 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS FFD Program for Construction § 26.415 Audits. (a) Licensees and other entities who implement an FFD program under this subpart shall ensure that audits are performed to assure...

76 FR 15981 - Sunshine Act; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

... Investment Performance Report; c. Legislative Report. 3. Communication Awards. 4. Audit Report Discussion. 5. Audit Findings Summary Report. 6. Department of Labor Audit Briefing. 7. Roth Project Update. Parts...

An Empirical Analysis of Practitioners' Perceptions of the Introductory Course in Auditing.

ERIC Educational Resources Information Center

Kanter, Howard A.

1987-01-01

The study rated importance of 50 auditing topics to the job performance of first-year staff auditors and to successful completion of the Certified Public Accountant examination. Data were gathered from 449 respondents. A significant number of topics taught in auditing courses are important neither to job performance nor to success on the…

External audit of clinical practice and medical decision making in a new Asian oncology center: Results and implications for both developing and developed nations

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

Shakespeare, Thomas P.; Back, Michael F.; Lu, Jiade J.

2006-03-01

Purpose: The external audit of oncologist clinical practice is increasingly important because of the incorporation of audits into national maintenance of certification (MOC) programs. However, there are few reports of external audits of oncology practice or decision making. Our institution (The Cancer Institute, Singapore) was asked to externally audit an oncology department in a developing Asian nation, providing a unique opportunity to explore the feasibility of such a process. Methods and Materials: We audited 100 randomly selected patients simulated for radiotherapy in 2003, using a previously reported audit instrument assessing clinical documentation/quality assurance and medical decision making. Results: Clinical documentation/qualitymore » assurance, decision making, and overall performance criteria were adequate 74.4%, 88.3%, and 80.2% of the time, respectively. Overall 52.0% of cases received suboptimal management. Multivariate analysis revealed palliative intent was associated with improved documentation/clinical quality assurance (p = 0.07), decision making (p 0.007), overall performance (p = 0.003), and optimal treatment rates (p 0.07); non-small-cell lung cancer or central nervous system primary sites were associated with better decision making (p = 0.001), overall performance (p = 0.03), and optimal treatment rates (p = 0.002). Conclusions: Despite the poor results, the external audit had several benefits. It identified learning needs for future targeting, and the auditor provided facilitating feedback to address systematic errors identified. Our experience was also helpful in refining our national revalidation audit instrument. The feasibility of the external audit supports the consideration of including audit in national MOC programs.« less

Report on the Audit of the Acquisition of the Tactical Air Operations Center/Modular Control Equipment

DTIC Science & Technology

1991-06-06

This is our final report on the Audit of the Acquisition of the Tactical Air Operations Center/Modular Control Equipment (TAOC/MCE) for your...matters of concern that could affect the acquisition of the TAOC/MCE. We performed the audit from March through December 1990. The audit objective was...controls related to the audit objectives. The audit was made in accordance with the Inspector General’s critical program management element approach

Venous thromboembolism management in Northeast Melbourne: how does it compare to international guidelines and data?

PubMed

Lim, Hui Y; Chua, Chong C; Tacey, Mark; Sleeman, Matthew; Donnan, Geoffrey; Nandurkar, Harshal; Ho, Prahlad

2017-09-01

Venous thromboembolism (VTE) is a major cause of morbidity and mortality with significant heterogeneity in its management, both within our local practice and in international guidelines. To provide a holistic evaluation of 'real-world' Australian experience in the warfarin era, including how we compare to international guidelines. Retrospective evaluation of VTE from July 2011 to December 2012 at two major hospitals in Melbourne, Australia. These results were compared to recommendations in the international guidelines. A total of 752 episodes involving 742 patients was identified. Contrary to international guidelines, an unwarranted heritable thrombophilia screen was performed in 22.0% of patients, amounting to a cost of AU$29 000. The duration of anticoagulation was longer compared to international recommendations, although the overall recurrence (3.2/100 person-years) and clinically significant bleeding rates (2.4/100 person-years) were comparable to 'real-world' data. Unprovoked VTE (hazard ratio 2.06; P = 0.01) was a risk factor for recurrence, and there was no difference in recurrence between major VTE (proximal deep vein thrombosis (DVT) and/or pulmonary embolism) and isolated distal DVT (3.02 vs 3.94/100 person-years; P = 0.25). Fourteen patients were subsequently diagnosed with malignancy, and patients with recurrent VTE had increased risk of prospective cancer diagnosis (relative risk 6.68; P < 0.001). While our 'real-world' VTE experience during the warfarin era largely correlates with international guidelines, there remains heterogeneity in the management strategies, including excessive thrombophilia screening and longer duration of anticoagulation. This audit highlights the need for national VTE guidelines, as well as prospective auditing of VTE management, in the direct oral anticoagulant era for future comparison. © 2017 Royal Australasian College of Physicians.

12 CFR 263.400 - Scope.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) RULES OF PRACTICE FOR HEARINGS Removal, Suspension, and Debarment of Accountants From Performing Audit... debarment of independent public accountants and their accounting firms from performing independent audit and...

12 CFR 263.400 - Scope.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) RULES OF PRACTICE FOR HEARINGS Removal, Suspension, and Debarment of Accountants From Performing Audit... debarment of independent public accountants and their accounting firms from performing independent audit and...

12 CFR 263.400 - Scope.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) RULES OF PRACTICE FOR HEARINGS Removal, Suspension, and Debarment of Accountants From Performing Audit... debarment of independent public accountants and their accounting firms from performing independent audit and...

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.

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

PubMed

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

2018-06-01

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

Clinical audit and national survey on the assessment of collateral circulation before radial forearm free flap harvest.

PubMed

Abdullakutty, Anwer; Bajwa, Mandeep S; Patel, Sonum; D'Souza, Jacob

2017-01-01

Controversy exists regarding the use of Duplex Ultrasound (DUS) in addition to the Modified Allen's Test (MAT) for the assessment of collateral circulation prior to elevation of the Radial Forearm Free Flap (RFFF). A survey amongst members of BAOMS Head & Neck Oncology Subspecialty Interest Group and a completed local audit was undertaken to assess the need for DUS. Data for the initial audit was collected retrospectively between 2010 and 2013. Both MAT and DUS was performed routinely during this period. The results of the survey and initial audit led to a change in practice and DUS was no longer requested. The re-audit was performed prospectively between 2013 and 2015. The results of the survey showed that all respondents performed MAT. DUS was performed 'always' by 40%, 'sometimes' by 13.3% and 'never' by 46.7%. A total of 41 patients were included in the initial audit, 6 had an abnormal DUS but only 1 had an abnormal MAT. Five cases had an abnormal DUS but normal MAT and went on to have their ipsilateral RFFF raised without ischaemic complications. The patient with an abnormal MAT had their contralateral RFFF raised. No patients suffered ischaemic complications during the initial audit. A total of 48 patients were included in the re-audit 2 of which had an abnormal MAT and their contralateral RFFF raised. No patients suffered ischaemic complications during the re-audit. In conclusion, routine use of DUS did not provide any additional information above the MAT in identifying patients at risk of ischaemic complications. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. All rights reserved.

DoD Actions Were Not Adequate to Reduce Improper Travel Payments

DTIC Science & Technology

2016-03-10

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

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.

Field Audit Checklist Tool (FACT)

EPA Pesticide Factsheets

Download EPA's The Field Audit Checklist Tool (FACT). FACT is intended to help auditors perform field audits, to easily view monitoring plan, quality assurance and emissions data and provides access to data collected under MATS.

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...

The Effect of Software Features on Software Adoption and Training in the Audit Profession

ERIC Educational Resources Information Center

Kim, Hyo-Jeong

2012-01-01

Although software has been studied with technology adoption and training research, the study of specific software features for professional groups has been limited. To address this gap, I researched the impact of software features of varying complexity on internal audit (IA) professionals. Two studies along with the development of training…

77 FR 23303 - Self-Regulatory Organizations; NYSE Arca, Inc.; Notice of Filing and Immediate Effectiveness of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

... the Order Audit Trail System Information Barriers Put Into Place by the ETP Holder in Reliance on... report to the Order Audit Trail System (``OATS'') information barriers put into place by the ETP Holder... uses an effective system of internal controls--such as appropriate information barriers--that operate...

FY 2012 Audit Plan

DTIC Science & Technology

2011-10-01

September 30, 2012 and 2011 Objective: Determine whether KPMG complied, in all material respects, with U.S. generally accepted government auditing...reported the same 13 material internal control weaknesses as the previous year. These pervasive and longstanding financial management issues...Defense Contract Management Agency’s Investigation and Control of Nonconforming Materials (D2011-D000CD-0264.000) Objective: Examine the Defense

Streamlining the Acquisition Process: A DCAA Field-Grade Perspective

DTIC Science & Technology

2014-03-01

Initial Capabilities Document IFRS International Financial Reporting Standards IPT Integrated Product Team IRR Independent Reference Review...the responsibilities, programmed focus, strategic plan and recent events impacting the organization. B. DEFENSE CONTRACT AUDIT AGENCY 1. DCAA...material misstatements, whether caused by error or fraud. The type of audit requested by the contracting officer will directly impact both the

SUNY College of Agriculture and Technology at Morrisville: Selected Financial Management Practices.

ERIC Educational Resources Information Center

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

This audit report of the State University of New York (SUNY) College of Agriculture and Technology at Morrisville addresses the question of whether the college management has established an effective system of internal control over its revenue, equipment, and student work-study payroll. The audit makes a number of observations and conclusions.…

21 CFR Appendix A to Part 1403 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2010 CFR

2010-04-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

21 CFR Appendix A to Part 1403 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2013 CFR

2013-04-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

21 CFR Appendix A to Part 1403 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2014 CFR

2014-04-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

21 CFR Appendix A to Part 1403 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2011 CFR

2011-04-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

21 CFR Appendix A to Part 1403 - OMB Circular A-128, “Audits of State and Local Governments”

Code of Federal Regulations, 2012 CFR

2012-04-01

... operations. A series of audits of individual departments, agencies, and establishments for the same fiscal... assurance the auditor must make a study and evaluation of internal control systems used in administering Federal assistance programs. The study and evaluation must be made whether or not the auditor intends to...

Systematic review of tonsil surgery quality registers and introduction of the Nordic Tonsil Surgery Register Collaboration.

PubMed

Ruohoalho, Johanna; Østvoll, Eirik; Bratt, Mette; Bugten, Vegard; Bäck, Leif; Mäkitie, Antti; Ovesen, Therese; Stalfors, Joacim

2018-06-01

Surgical quality registers provide tools to measure and improve the outcome of surgery. International register collaboration creates an opportunity to assess and critically evaluate national practices, and increases the size of available datasets. Even though millions of yearly tonsillectomies and tonsillotomies are performed worldwide, clinical practices are variable and inconsistency of evidence regarding the best clinical practice exists. The need for quality improvement actions is evident. We aimed to systematically investigate the existing tonsil surgery quality registers found in the literature, and to provide a thorough presentation of the planned Nordic Tonsil Surgery Register Collaboration. A systematic literature search of MEDLINE and EMBASE databases (from January 1990 to December 2016) was conducted to identify registers, databases, quality improvement programs or comprehensive audit programs addressing tonsil surgery. We identified two active registers and three completed audit programs focusing on tonsil surgery quality registration. Recorded variables were fairly similar, but considerable variation in coverage, number of operations included and length of time period for inclusion was discovered. Considering tonsillectomies and tonsillotomies being among the most commonly performed surgical procedures in otorhinolaryngology, it is surprising that only two active registers could be identified. We present a Nordic Tonsil Surgery Register Collaboration-an international tonsil surgery quality register project aiming to provide accurate benchmarks and enhance the quality of tonsil surgery in Denmark, Finland, Norway and Sweden.

Do code of conduct audits improve chemical safety in garment factories? Lessons on corporate social responsibility in the supply chain from Fair Wear Foundation.

PubMed

Lindholm, Henrik; Egels-Zandén, Niklas; Rudén, Christina

2016-10-01

In managing chemical risks to the environment and human health in supply chains, voluntary corporate social responsibility (CSR) measures, such as auditing code of conduct compliance, play an important role. To examine how well suppliers' chemical health and safety performance complies with buyers' CSR policies and whether audited factories improve their performance. CSR audits (n = 288) of garment factories conducted by Fair Wear Foundation (FWF), an independent non-profit organization, were analyzed using descriptive statistics and statistical modeling. Forty-three per cent of factories did not comply with the FWF code of conduct, i.e. received remarks on chemical safety. Only among factories audited 10 or more times was there a significant increase in the number of factories receiving no remarks. Compliance with chemical safety requirements in garment supply chains is low and auditing is statistically correlated with improvements only at factories that have undergone numerous audits.

Audit and feedback by medical students to improve the preventive care practices of general practice supervisors.

PubMed

Gilkes, Lucy A; Liira, Helena; Emery, Jon

Medical students benefit from their contact with clinicians and patients in the clinical setting. However, little is known about whether patients and clinicians also benefit from medical students. We developed an audit and feedback intervention activity to be delivered by medical students to their general practice supervisors. We tested whether the repeated cycle of audit had an effect on the preventive care practices of general practitioners (GPs). The students performed an audit on topics of preventive medicine and gave feedback to their supervisors. Each supervisor in the study had more than one student performing the audit over the academic year. After repetitive cycles of audit and feedback, the recording of social history items by GPs improved. For example, recording alcohol history increased from 24% to 36%. This study shows that medical students can be effective auditors, and their repeated audits may improve their general practice supervisors' recording of some aspects of social history.

Do code of conduct audits improve chemical safety in garment factories? Lessons on corporate social responsibility in the supply chain from Fair Wear Foundation

PubMed Central

2016-01-01

Background In managing chemical risks to the environment and human health in supply chains, voluntary corporate social responsibility (CSR) measures, such as auditing code of conduct compliance, play an important role. Objectives To examine how well suppliers’ chemical health and safety performance complies with buyers’ CSR policies and whether audited factories improve their performance. Methods CSR audits (n = 288) of garment factories conducted by Fair Wear Foundation (FWF), an independent non-profit organization, were analyzed using descriptive statistics and statistical modeling. Results Forty-three per cent of factories did not comply with the FWF code of conduct, i.e. received remarks on chemical safety. Only among factories audited 10 or more times was there a significant increase in the number of factories receiving no remarks. Conclusions Compliance with chemical safety requirements in garment supply chains is low and auditing is statistically correlated with improvements only at factories that have undergone numerous audits. PMID:27611103

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

PubMed

Hindley, Jenny

2014-09-01

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

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.

Reliability of a self-report Italian version of the AUDIT-C questionnaire, used to estimate alcohol consumption by pregnant women in an obstetric setting.

PubMed

Bazzo, Stefania; Battistella, Giuseppe; Riscica, Patrizia; Moino, Giuliana; Dal Pozzo, Giuseppe; Bottarel, Mery; Geromel, Mariasole; Czerwinsky, Loredana

2015-01-01

Alcohol consumption during pregnancy can result in a range of harmful effects on the developing foetus and newborn, called Fetal Alcohol Spectrum Disorders (FASD). The identification of pregnant women who use alcohol enables to provide information, support and treatment for women and the surveillance of their children. The AUDIT-C (the shortened consumption version of the Alcohol Use Disorders Identification Test) is used for investigating risky drinking with different populations, and has been applied to estimate alcohol use and risky drinking also in antenatal clinics. The aim of the study was to investigate the reliability of a self-report Italian version of the AUDIT-C questionnaire to detect alcohol consumption during pregnancy, regardless of its use as a screening tool. The questionnaire was filled in by two independent consecutive series of pregnant women at the 38th gestation week visit in the two birth locations of the Local Health Authority of Treviso (Italy), during the years 2010 and 2011 (n=220 and n=239). Reliability analysis was performed using internal consistency, item-total score correlations, and inter-item correlations. The "discriminatory power" of the test was also evaluated. Results. Overall, about one third of women recalled alcohol consumption at least once during the current pregnancy. The questionnaire had an internal consistency of 0.565 for the group of the year 2010, of 0.516 for the year 2011, and of 0.542 for the overall group. The highest item total correlations' coefficient was 0.687 and the highest inter-item correlations' coefficient was 0.675. As for the discriminatory power of the questionnaire, the highest Ferguson's delta coefficient was 0.623. These findings suggest that the Italian self-report version of the AUDIT-C possesses unsatisfactory reliability to estimate alcohol consumption during pregnancy when used as self-report questionnaire in an obstetric setting.

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2013 CFR

2013-01-01

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

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2012 CFR

2012-01-01

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

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

7 CFR 1773.38 - Scope of engagement.

Code of Federal Regulations, 2014 CFR

2014-01-01

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

Long-term stability of GOES-8 and -9 attitude control

NASA Astrophysics Data System (ADS)

Carr, James L.

1996-10-01

An independent audit of the in-orbit behavior of the GOES-8 and GOES-9 satellites has been conducted for the NASA/GSFC. This audit utilized star and landmark observations from the GOES imager to determine long-term histories for spacecraft attitude, orbital position, and instrument internal misalignments. The paper presents results from this audit. Long-term drifts are found in the attitude histories, whereas the misalignment histories are shown to be diurnally stable. The GOES image navigation and registration system is designed to compensate for instrument internal misalignments, and both the diurnally repeatable and drift components of the attitude. Correlations between GOES-8 and GOES-9 long-term roll and pitch drifts implicate the Earth sensor as the origin of these observed drifts. This results clearly demonstrates the enhanced registration stability to be obtained with stellar inertial attitude determination replacing or supplementing Earth sensor control on future GOES missions.

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

PubMed

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

2001-02-01

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

Report on the Audit of the Joint Civilian Orientation Conference Fund

DTIC Science & Technology

1991-01-31

This is our final report on the audit of the Joint Civilian Orientation Conference (JCOC) Fund (the Fund). We performed the audit from June to July...1990. The Director, Budget and Finance, Washington Headquarters Services, requested the audit because a new Treasurer had been appointed. The overall...Instruction No. 48, Joint Civilian Orientation Conference Fund, May 31, 1983, and with DoD policy and guidelines. In addition, the audit evaluated

Brent Olson - Director, Office of Internal Audit | NREL

Science.gov Websites

improve the effectiveness and efficiency of governance, risk management, and control processes. Using this the Treadway Commission's 2013 Internal Control Framework, Standards for Internal Control in the additional certifications from IIA including Certified Internal Auditor (CIA); Certification in Control Self

Piloting laboratory quality system management in six health facilities in Nigeria.

PubMed

Mbah, Henry; Ojo, Emmanuel; Ameh, James; Musuluma, Humphrey; Negedu-Momoh, Olubunmi Ruth; Jegede, Feyisayo; Ojo, Olufunmilayo; Uwakwe, Nkem; Ochei, Kingsley; Dada, Michael; Udah, Donald; Chiegil, Robert; Torpey, Kwasi

2014-01-01

Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality) Improvement Process Towards Accreditation (WHO/AFRO- SLIPTA) in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria. Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO- SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects. At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4%) and occurrence/incidence management (15%) improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise. This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO- SLIPTA implementation in Nigeria.

Corruption and air pollution in Europe.

PubMed

Ivanova, Kate

2011-01-01

This paper examines how the effectiveness of regulatory framework influences levels of sulphur emissions in a scenario where, to reduce its (emission-) tax payments, a polluting firm may under-report emissions level at the risk of being audited and fined. First, a model to explain how changes in regulatory framework (e.g., audit effectiveness) and transboundary spillovers affect both actual and reported emissions is developed. Then the theoretical predictions using data for 39 European countries from 1999 to 2003 are tested and inferences about true emission levels are made. The empirical analysis supports the theoretical predictions with significant implications for the interpretation of pollution data reported to international monitoring agencies. Countries with effective regulation are likely to have relatively high reported emissions of sulphur. But this should not automatically be interpreted as weak environmental performance, because their actual pollution levels are likely to be lower than in nations with less effective regulation.

12 CFR 715.10 - Audit report and working paper maintenance and access.

Code of Federal Regulations, 2010 CFR

2010-01-01

... that the audit was performed and reported in accordance with the terms of the engagement letter... a summary of the results of the audit to the members of the credit union orally or in writing at the...”) so requests, the Supervisory Committee shall provide NCUA a copy of each of the audit reports it...

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

PubMed

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

2018-06-01

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

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

Code of Federal Regulations, 2011 CFR

2011-07-01

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

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

Code of Federal Regulations, 2012 CFR

2012-07-01

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

Report on International Education Review

ERIC Educational Resources Information Center

Ministry of Advanced Education, 2005

2005-01-01

The Ministry of Advanced Education (Ministry) provides overall funding and policy direction for British Columbia's public post-secondary education system. The Student and Strategic Services Division, Ministry of Advanced Education requested Internal Audit & Advisory Services to conduct a review of the international education programs at…

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

Media audit reveals inappropriate promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes in South-East Asia.

PubMed

Vinje, Kristine Hansen; Phan, Linh Thi Hong; Nguyen, Tuan Thanh; Henjum, Sigrun; Ribe, Lovise Omoijuanfo; Mathisen, Roger

2017-06-01

To review regulations and to perform a media audit of promotion of products under the scope of the International Code of Marketing of Breast-milk Substitutes ('the Code') in South-East Asia. We reviewed national regulations relating to the Code and 800 clips of editorial content, 387 advertisements and 217 Facebook posts from January 2015 to January 2016. We explored the ecological association between regulations and market size, and between the number of advertisements and market size and growth of milk formula. Cambodia, Indonesia, Myanmar, Thailand and Vietnam. Regulations on the child's age for inappropriate marketing of products are all below the Code's updated recommendation of 36 months (i.e. 12 months in Thailand and Indonesia; 24 months in the other three countries) and are voluntary in Thailand. Although the advertisements complied with the national regulations on the age limit, they had content (e.g. stages of milk formula; messages about the benefit; pictures of a child) that confused audiences. Market size and growth of milk formula were positively associated with the number of newborns and the number of advertisements, and were not affected by the current level of implementation of breast-milk substitute laws and regulations. The present media audit reveals inappropriate promotion and insufficient national regulation of products under the scope of the Code in South-East Asia. Strengthened implementation of regulations aligned with the Code's updated recommendation should be part of comprehensive strategies to minimize the harmful effects of advertisements of breast-milk substitutes on maternal and child nutrition and health.

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.

A survey of Australasian obstetric anaesthesia audit.

PubMed

Smith, S J; Cyna, A M; Simmons, S W

1999-08-01

In order to develop a minimal obstetric anaesthesia dataset based on current Australasian clinical audit best practice, we carried out a postal survey of 69 Australasian anaesthetic departments covering an obstetric service. We asked about data being collected, specifically concerning the high risk obstetric patient, epidural analgesia and postoperative anaesthetic review. Examples of any data collection forms were requested. Of the 66 responses, 35 departments (53%) were not collecting any audit data. Twenty-six of the 31 departments (84%) performing obstetric anaesthesia audit responded to our follow-up telephone survey. Eighteen departments believed that there had been an improvement in patient care as a result of their audit and 13 felt that the benefits outweighed the costs involved. However, only six departments (9%) had performed an audit cycle. The importance of feedback to patients or hospital staff and the incidence of post dural puncture headache (PDPH) were cited by some as priorities for obstetric anaesthesia audit. There was however no consistency as to what data should be collected. Many responses suggested a perceived need to collect clinical data without knowing what to do with it. Our survey has highlighted confusion between three distinct objectives; a dataset for obstetric anaesthesia record keeping, data required for continuing patient management in hospital and, a specific minimal dataset for clinical audit purposes. We conclude that current Australasian obstetric anaesthesia audit strategies are inadequate to develop a minimal dataset for cost-effective clinical audit.

Independent Auditors Report on the Examination of DoD Execution of Afghanistan National Army Trust Fund Donations to the Afghanistan Security Forces Fund

DTIC Science & Technology

2015-07-31

conducted this attestation engagement in accordance with examination engagement standards established by the American Institute of Certified Public...Accountants and with generally accepted government auditing standards. We appreciate the courtesies extended to the staff. Please direct questions to me at...2015-154 Contents Audit Opinion __________________________________________________________________________1 Internal Controls

State University of New York College at Old Westbury: Selected Financial Management Practices. Report 95-S-52.

ERIC Educational Resources Information Center

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

This audit report of State University of New York College at Old Westbury (OW) examined internal controls over cash, accounts receivable, student accounts, payroll checks, equipment and computer systems and whether these controls provided adequate safeguards and accurate records. The study audited the period April 1, 1993 through February 28, 1995…

A New Tool for Quality: The Internal Audit.

PubMed

Haycock, Camille; Schandl, Annette

As health care systems aspire to improve the quality and value for the consumers they serve, quality outcomes must be at the forefront of this value equation. As organizations implement evidence-based practices, electronic records to standardize processes, and quality improvement initiatives, many tactics are deployed to accelerate improvement and care outcomes. This article describes how one organization utilized a formal clinical audit process to identify gaps and/or barriers that may be contributing to underperforming measures and outcomes. This partnership between quality and audit can be a powerful tool and produce insights that can be scaled across a large health care system.

49 CFR 1.15 - OST Structure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Office of Audit Relations, (2) The Office of Human Resource Management, (3) The Office of Hearings, (4... Assistant Secretary for Aviation and International Affairs, which includes: (i) The Office of International Transportation and Trade, (ii) The Office of International Aviation, and (iii) The Office of Aviation Analysis...

49 CFR 1.15 - OST Structure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Office of Audit Relations, (2) The Office of Human Resource Management, (3) The Office of Hearings, (4... Assistant Secretary for Aviation and International Affairs, which includes: (i) The Office of International Transportation and Trade, (ii) The Office of International Aviation, and (iii) The Office of Aviation Analysis...

49 CFR 1.15 - OST Structure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Office of Audit Relations, (2) The Office of Human Resource Management, (3) The Office of Hearings, (4... Assistant Secretary for Aviation and International Affairs, which includes: (i) The Office of International Transportation and Trade, (ii) The Office of International Aviation, and (iii) The Office of Aviation Analysis...

Evaluation of a fungal collection as certified reference material producer and as a biological resource center.

PubMed

Forti, Tatiana; Souto, Aline da S S; do Nascimento, Carlos Roberto S; Nishikawa, Marilia M; Hubner, Marise T W; Sabagh, Fernanda P; Temporal, Rosane Maria; Rodrigues, Janaína M; da Silva, Manuela

2016-01-01

Considering the absence of standards for culture collections and more specifically for biological resource centers in the world, in addition to the absence of certified biological material in Brazil, this study aimed to evaluate a Fungal Collection from Fiocruz, as a producer of certified reference material and as Biological Resource Center (BRC). For this evaluation, a checklist based on the requirements of ABNT ISO GUIA34:2012 correlated with the ABNT NBR ISO/IEC17025:2005, was designed and applied. Complementing the implementation of the checklist, an internal audit was performed. An evaluation of this Collection as a BRC was also conducted following the requirements of the NIT-DICLA-061, the Brazilian internal standard from Inmetro, based on ABNT NBR ISO/IEC 17025:2005, ABNT ISO GUIA 34:2012 and OECD Best Practice Guidelines for BRCs. This was the first time that the NIT DICLA-061 was applied in a culture collection during an internal audit. The assessments enabled the proposal for the adequacy of this Collection to assure the implementation of the management system for their future accreditation by Inmetro as a certified reference material producer as well as its future accreditation as a Biological Resource Center according to the NIT-DICLA-061. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

A Study of Criteria for the Evaluation of Secondary School Instrumentalists When Auditioning for Festival Bands. Final Report.

ERIC Educational Resources Information Center

Owen, Curtis D., Jr.

This study purposed to develop a means of evaluating student performance in auditions for festival bands which would minimize the inconsistencies of subjective judgment. Tape recordings of student auditions were played three times to judges. During the first audition, evaluators rated students on a continuum scale with numerical divisions, and…

Audits of radiopharmaceutical formulations

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

Castronovo, F.P. Jr.

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

The pre-audit assessment: A homework assignment for auditors

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

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to ``give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by ``total quality management` have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

The pre-audit assessment: A homework assignment for auditors

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

Marschman, S.C.

1993-02-01

The role of the quality assurance audit is evolving from compliance verification to a much broader assessment of programmatic and management performance. In the past, audits were poorly understood and caused fear and trepidation. Auditees turned an audit into a cat-and-mouse game using coverup strategies and decoy discrepancies. These games were meant to give the auditors what they want, namely a few findings that could later be easily corrected. At Pacific Northwest Laboratory (PNL), I observed auditing become a spectator sport. Matching a compliance-oriented auditor against a crafty group of scientists provided hours of entertainment. As a program manager, itmore » was clear these games were neither productive useful nor cost effective. Fortunately, over the past few years several concepts embraced by total quality management' have begun to emerge at PNL. These concepts are being adopted by most successful organizations, and based on these concepts new tools and ideas are emerging to help organizations improve productivity and quality. Successful organizations have been and are continuing to develop management strategies that rely on participative approaches to their operations. These approaches encourage the empowerment of organization staff at all levels, with the goal of instilling ownership of quality in every staff member. As management philosophies are changing, so are the responsibilities and expectations of managers. Managers everywhere are experimenting with new tools to help them improve their operations and competitiveness. As the quality audit evolves, managers and other customers of the audit process have developed expectations for the auditing process that never existed in years past. These expectations have added complexity to the audit process. It is no longer adequate to prepare a checklist, perform the audit, and document the results. When viewed as a tool for verifying performance, a quality audit becomes more than a compliance checklist.« less

Evaluation of Defense Hotline Allegations at the Defense Contract Audit Agency Santa Barbara Suboffice

DTIC Science & Technology

2014-10-08

and suspected fraud were not reported; • time and material vouchers were excluded from a paid voucher review; • a supervisor did not support an...6 Requirements for Identification of Potential Fraud __________________________________________6 Audit Deficiencies and Performance Metrics...officer and DCAA auditor an incurred cost submission six months after the end of the contractor’s fiscal year. Incurred cost audits are usually performed

Navy Ship Maintenance: Action Needed to Maximize New Contracting Strategys Potential Benefits

DTIC Science & Technology

2016-11-01

published product may be reproduced and distributed in its entirety without further permission from GAO. However, because this work may contain...ports. See appendix I for more information about our scope and methodology. We conducted this performance audit from September 2015 to November 2016 in...accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient

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…

Audit of the support for breastfeeding mothers in Fife maternity hospitals using adapted 'Baby Friendly Hospital' materials.

PubMed

Campbell, H; Gorman, D; Wigglesworth, A

1995-12-01

The objective of this study was to assess the level of support given to breastfeeding mothers during their stay in maternity hospitals. The audit was carried out in maternity hospitals in Fife with the co-ordination of the Fife Joint Breastfeeding initiative. The subjects consisted of ten maternity hospital staff (medical and midwifery), and 12 antenatal and 21 postnatal women. The design of the study consisted of an audit of hospital policies and practices in comparison with ten internationally recognized standards. This was carried out by adapting the external evaluation instruments from the WHO-UNICEF "Baby Friendly Hospital" materials. Methods relied not only on reported practices but also on direct observation and enquiry. Action was taken to address areas of practice which fell below the WHO-UNICEF standards: supplementary feeding of breastfed babies, particularly overnight, was reduced; discharge "bounty packs" advertising baby milk manufacturer products were discontinued; a hospital breastfeeding support group was established; the hypoglycaemia policy was revised; and the need for an orientation session on breastfeeding policies for medical staff was recognized. This audit approach using "Baby Friendly Hospital' materials has helped to define policy, measure performance against recognized standards, identify quality specifications for maternity service agreements and has improved hospital support for breastfeeding mothers. This approach is suitable for maternity hospitals whose breastfeeding rates make them ineligible for "Baby Friendly Hospital" accreditation, and has the potential to be extended to encompass wider "health-promoting hospital" issues such as promotion of infant car seats.

Crisis management can leave residual effects.

PubMed

Margolis, G L; DeMuro, P R

1991-10-01

A healthcare organization that once suffered from poor financial performance may fail to correct recovery methods that can cause lingering legal and accounting problems. A crisis management style is prone to creating problems with an organization's debt structure, Medicare and Medicaid payment, tax issues, labor relations, licensing and accreditation, compliance with fraud and abuse rules, and accounting for charity care. After stabilizing a worrisome financial situation, a healthcare organization should conduct an internal audit to ensure that its legal and accounting practices remain above board.

Methodology to Assess No Touch Audit Software Using Simulated Building Utility Data

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

Cheung, Howard; Braun, James E.; Langner, M. Rois

This report describes a methodology developed for assessing the performance of no touch building audit tools and presents results for an available tool. Building audits are conducted in many commercial buildings to reduce building energy costs and improve building operation. Because the audits typically require significant input obtained by building engineers, they are usually only affordable for larger commercial building owners. In an effort to help small building and business owners gain the benefits of an audit at a lower cost, no touch building audit tools have been developed to remotely analyze a building's energy consumption.

Report on the Audit ot the Acquisition of the Tacit Rainbow Anti-Radiation Missile System

DTIC Science & Technology

1991-06-24

This is our final report on the audit of the Tacit Rainbow Anti-Radiation Missile System (Tacit Rainbow) for your information and use. We performed... the audit from March through December 1990. The audit objective was to evaluate the acquisition management of the air-launched Tacit Rainbow system to...contains no recommendations because DoD took action to cancel the Tacit Rainbow system in FY 1992. We are bringing the issues identified during the audit to

Inter-departmental dosimetry audits – development of methods and lessons learned

PubMed Central

Eaton, David J.; Bolton, Steve; Thomas, Russell A. S.; Clark, Catharine H.

2015-01-01

External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. In the United Kingdom, such audits have been performed for almost 30 years. From the start, they included clinically relevant conditions, as well as reference machine output. Recently, national audits have tested new or complex techniques, but these methods are then used in regional audits by a peer-to-peer approach. This local approach builds up the radiotherapy community, facilitates communication, and brings synergy to medical physics. PMID:26865753

Causes and temporal changes in nationally collected stillbirth audit data in high-resource settings.

PubMed

Norris, Tom; Manktelow, Bradley N; Smith, Lucy K; Draper, Elizabeth S

2017-06-01

Few high-income countries have an active national programme of stillbirth audit. From the three national programmes identified (UK, New Zealand, and the Netherlands) steady declines in annual stillbirth rates have been observed over the audit period between 1993 and 2014. Unexplained stillbirth remains the largest group in the classification of stillbirths, with a decline in intrapartum-related stillbirths, which could represent improvements in intrapartum care. All three national audits of stillbirths suggest that up to half of all reviewed stillbirths have elements of care that failed to follow standards and guidance. Variation in the classification of stillbirth, cause of death and frequency of risk factor groups limit our ability to draw meaningful conclusions as to the true scale of the burden and the changing epidemiology of stillbirths in high-income countries. International standardization of these would facilitate direct comparisons between countries. The observed declines in stillbirth rates over the period of perinatal audit, a possible consequence of recommendations for improved antenatal care, should serve to incentivise other countries to implement similar audit programmes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

The Internal Audit.

ERIC Educational Resources Information Center

Kuhn, Robert H.

1981-01-01

Internal control comprises the plan of organization and all the coordinate methods and measures adopted within a school system to safeguard its assets, check the reliability of its accounting data, promote operational efficiency, and encourage adherence to prescribed policies. (Author)

30 CFR 1229.123 - Standards for audit activities.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Qualifications. The auditors assigned to perform the audit must collectively possess adequate professional proficiency for the tasks required, including a knowledge of accounting, auditing, agency regulations, and... shall maintain an independent attitude and appearance. (iii) Due professional care. Due professional...

30 CFR 1229.123 - Standards for audit activities.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Qualifications. The auditors assigned to perform the audit must collectively possess adequate professional proficiency for the tasks required, including a knowledge of accounting, auditing, agency regulations, and... shall maintain an independent attitude and appearance. (iii) Due professional care. Due professional...

30 CFR 1229.123 - Standards for audit activities.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Qualifications. The auditors assigned to perform the audit must collectively possess adequate professional proficiency for the tasks required, including a knowledge of accounting, auditing, agency regulations, and... shall maintain an independent attitude and appearance. (iii) Due professional care. Due professional...

Energy Audit of the Boston and Maine Railroad

DOT National Transportation Integrated Search

1981-04-01

This report documents an energy audit of the Boston and Maine (B&M) Railroad performed in support of a joint Government/industry program to determine means of conserving energy on railroads without reducing safety or service quality. The audit was pe...

Detecting, reporting, and analysis of priority diseases for routine public health surveillance in Liberia.

PubMed

Frimpong, Joseph Asamoah; Amo-Addae, Maame Pokuah; Adewuyi, Peter Adebayo; Hall, Casey Daniel; Park, Meeyoung Mattie; Nagbe, Thomas Knue

2017-01-01

Public health officials depend on timely, complete, and accurate surveillance data for decision making. The quality of data generated from surveillance is highly dependent on external and internal factors which may either impede or enhance surveillance activities. One way of identifying challenges affecting the quality of data generated is to conduct a data quality audit. This case study, based on an audit conducted by residents of the Liberia Frontline Field Epidemiology Training Program, was designed to be a classroom simulation of a data quality audit in a health facility. It is suited to enforce theoretical lectures in surveillance data quality and auditing. The target group is public health trainees, who should be able to complete this exercise in approximately 2 hours and 30 minutes.

Importance of primary indication and liver function between stages: results of a multicenter Italian audit of ALPPS 2012-2014.

PubMed

Serenari, Matteo; Zanello, Matteo; Schadde, Erik; Toschi, Elena; Ratti, Francesca; Gringeri, Enrico; Masetti, Michele; Cillo, Umberto; Aldrighetti, Luca; Jovine, Elio

2016-05-01

Posthepatectomy liver failure is one of the most feared complications in extended hepatic resections. In 2012, a novel two-stage liver resection was developed, able to induce rapid and extensive hypertrophy by portal vein ligation and in situ liver splitting - Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS). The technique became more widely employed but its use remained controversial due to reporting of high complication and mortality rates. A national audit was performed to gather information about the safety of the procedure and to better understand the complications. The audit was offered to all high-volume hepatobiliary centers in Italy. Of all Italian centers approached in January 2012, 12 centers with experience in ALPPS enrolled and participated in collection of data. Fifty patients underwent ALPPS between 2012 and 2014. In 48/50 patients completion of hepatectomy was performed successfully. Major morbidity occurred in 54% with a 20% 90-day mortality. Uni- and multivariate analysis showed that ALPPS for cholangiocarcinoma and a peak of bilirubin over 5 mg/dl between stages was associated with increase of 90-day mortality and worse survival. It is proposed that a moratorium be introduced for classic ALPPS in cholangiocarcinoma and to abort ALPPS in patients who develop an interstage increase in bilirubin, due to the high risk of liver failure and mortality. Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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.

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2011 CFR

2011-04-01

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

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2013 CFR

2013-04-01

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

23 CFR 140.803 - Policy.

Code of Federal Regulations, 2014 CFR

2014-04-01

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

Fourth consensus of the International Society for Premenstrual Disorders (ISPMD): auditable standards for diagnosis and management of premenstrual disorder.

PubMed

Ismaili, Elgerta; Walsh, Sally; O'Brien, Patrick Michael Shaughn; Bäckström, Torbjorn; Brown, Candace; Dennerstein, Lorraine; Eriksson, Elias; Freeman, Ellen W; Ismail, Khaled M K; Panay, Nicholas; Pearlstein, Teri; Rapkin, Andrea; Steiner, Meir; Studd, John; Sundström-Paromma, Inger; Endicott, Jean; Epperson, C Neill; Halbreich, Uriel; Reid, Robert; Rubinow, David; Schmidt, Peter; Yonkers, Kimberley

2016-12-01

Whilst professional bodies such as the Royal College and the American College of Obstetricians and Gynecologists have well-established standards for audit of management for most gynaecology disorders, such standards for premenstrual disorders (PMDs) have yet to be developed. The International Society of Premenstrual Disorders (ISPMD) has already published three consensus papers on PMDs covering areas that include definition, classification/quantification, clinical trial design and management (American College Obstetricians and Gynecologists 2011; Brown et al. in Cochrane Database Syst Rev 2:CD001396, 2009; Dickerson et al. in Am Fam Physician 67(8):1743-1752, 2003). In this fourth consensus of ISPMD, we aim to create a set of auditable standards for the clinical management of PMDs. All members of the original ISPMD consensus group were invited to submit one or more auditable standards to be eligible in the inclusion of the consensus. Ninety-five percent of members (18/19) responded with at least one auditable standard. A total of 66 auditable standards were received, which were returned to all group members who then ranked the standards in order of priority, before the results were collated. Proposed standards related to the diagnosis of PMDs identified the importance of obtaining an accurate history, that a symptom diary should be kept for 2 months prior to diagnosis and that symptom reporting demonstrates symptoms in the premenstrual phase of the menstrual cycle and relieved by menstruation. Regarding treatment, the most important standards were the use of selective serotonin reuptake inhibitors (SSRIs) as a first line treatment, an evidence-based approach to treatment and that SSRI side effects are properly explained to patients. A set of comprehensive standards to be used in the diagnosis and treatment of PMD has been established, for which PMD management can be audited against for standardised and improved care.

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.

Impact of audit of routine second-trimester cardiac images using a novel image-scoring method.

PubMed

Sairam, S; Awadh, A M A; Cook, K; Papageorghiou, A T; Carvalho, J S

2009-05-01

To assess the impact of using an objective scoring method to audit cardiac images obtained as part of the routine 21-23-week anomaly scan. A prospective audit and re-audit (6 months later) were conducted on cardiac images obtained by sonographers during the routine anomaly scan. A new image-scoring method was devised based on expected features in the four-chamber and outflow tract views. For each patient, scores were awarded for documentation and quality of individual views. These were called 'Documentation Scores' and 'View Scores' and were added to give a 'Patient Score' which represented the quality of screening provided by the sonographer for that particular patient (maximum score, 15). In order to assess the overall performance of sonographers, an 'Audit Score' was calculated for each by averaging his or her Patient Scores. In addition, to assess each sonographer's performance in relation to particular aspects of the various views, each was given their own 'Sonographer View Scores', derived from image documentation and details of four-chamber view (magnification, valve offset and septum) and left and right outflow tract views. All images were scored by two reviewers, jointly in the primary audit and independently in the re-audit. The scores from primary and re-audit were compared to assess the impact of feedback from the primary audit. Eight sonographers participated in the study. The median Audit Score increased significantly (P < 0.01), from 10.8 (range, 9.8-12.4) in the primary audit to 12.4 (range, 10.4-13.6) in the re-audit. Scores allocated by the two reviewers in the re-audit were not significantly different (P = 0.08). Objective scoring of fetal heart images is feasible and has a positive impact on the quality of cardiac images acquired at the time of the routine anomaly scan. This audit tool has the potential to be applied in every obstetric scanning unit and may improve the effectiveness of screening for congenital heart defects.

DOD and Coast Guard: Actions Needed to Increase Oversight and Management Information on Hazing Incidents Involving Servicemembers

DTIC Science & Technology

2016-02-01

The published product may be reproduced and distributed in its entirety without further permission from GAO. However, because this work may contain...We conducted this performance audit from April 2015 to February 2016 in accordance with generally accepted government auditing standards. These...standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and

A clinical audit cycle of post-operative hypothermia in dogs.

PubMed

Rose, N; Kwong, G P S; Pang, D S J

2016-09-01

Use of clinical audits to assess and improve perioperative hypothermia management in client-owned dogs. Two clinical audits were performed. In Audit 1 data were collected to determine the incidence and duration of perioperative hypothermia (defined as rectal temperatures <37·0°C). The results from Audit 1 were used to reach consensus on changes to be implemented to improve temperature management, including re-defining hypothermia as rectal temperature <37·5°C. Audit 2 was performed after 1 month with changes in place. Audit 1 revealed a high incidence of post-operative hypothermia (88·0%) and prolonged time periods (7·5 hours) to reach normothermia. Consensus changes were to use a forced air warmer on all dogs and measure rectal temperatures hourly post-operatively until temperature ≥37·5°C. After 1 month with the implemented changes, Audit 2 identified a significant reduction in the time to achieve a rectal temperature of ≥37·5°C, with 75% of dogs achieving this goal by 3·5 hours. The incidence of hypothermia at tracheal extubation remained high in Audit 2 (97·3% with a rectal temperature <37·5°C). Post-operative hypothermia was improved through simple changes in practice, showing that clinical audit is a useful tool for monitoring post-operative hypothermia and improving patient care. Overall management of perioperative hypothermia could be further improved with earlier intervention. © 2016 British Small Animal Veterinary Association.

DOD Financial Management: Improvement Needed in DOD Components’ Implementation of Audit Readiness Effort

DTIC Science & Technology

2011-09-01

DOD Financial Management Abbreviations AFB Air Force Base COSO Committee of Sponsoring Organizations of the Treadway... Management and mismanagement.11 All of DOD’s programs on GAO’s High- Risk List relate to its business operations, including systems and processes... Management maintains audit readiness through risk -based periodic testing of internal controls utilizing the OMB Circular No. A-123, Appendix A

40 CFR 56.7 - State agency performance audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... which grantees use Federal monies, to assure that an adequate evaluation of each State's performance in... 40 Protection of Environment 5 2010-07-01 2010-07-01 false State agency performance audits. 56.7 Section 56.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED...

Auditing chronic disease care: Does it make a difference?

PubMed

Essel, Vivien; van Vuuren, Unita; De Sa, Angela; Govender, Srini; Murie, Katie; Schlemmer, Arina; Gunst, Colette; Namane, Mosedi; Boulle, Andrew; de Vries, Elma

2015-06-26

An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. To determine whether clinical audits improve chronic disease care in health districts over time. Western Cape Province, South Africa. Internal audits were conducted of primary healthcare facility processes and equipment availability as well as a folder review of 10 folders per chronic condition per facility. Random systematic sampling was used to select the 10 folders for the folder review. Combined data for all facilities gave a provincial overview and allowed for comparison between districts. Analysis was done comparing districts that have been participating in the audit process from 2009 to 2010 ('2012 old') to districts that started auditing recently ('2012 new'). The number of facilities audited has steadily increased from 29 in 2009 to 129 in 2012. Improvements between different years have been modest, and the overall provincial average seemed worse in 2012 compared to 2011. However, there was an improvement in the '2012 old' districts compared to the '2012 new' districts for both the facility audit and the folder review, including for eight clinical indicators, with '2012 new' districts being less likely to record clinical processes (OR 0.25, 95% CI 0.21-0.31). These findings are an indication of the value of audits to improve care processes over the long term. It is hoped that this improvement will lead to improved patient outcomes.

Auditing chronic disease care: Does it make a difference?

PubMed Central

van Vuuren, Unita; De Sa, Angela; Govender, Srini; Murie, Katie; Schlemmer, Arina; Gunst, Colette; Namane, Mosedi; Boulle, Andrew; de Vries, Elma

2015-01-01

Background An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. Aim To determine whether clinical audits improve chronic disease care in health districts over time. Setting Western Cape Province, South Africa. Methods Internal audits were conducted of primary healthcare facility processes and equipment availability as well as a folder review of 10 folders per chronic condition per facility. Random systematic sampling was used to select the 10 folders for the folder review. Combined data for all facilities gave a provincial overview and allowed for comparison between districts. Analysis was done comparing districts that have been participating in the audit process from 2009 to 2010 (‘2012 old’) to districts that started auditing recently (‘2012 new’). Results The number of facilities audited has steadily increased from 29 in 2009 to 129 in 2012. Improvements between different years have been modest, and the overall provincial average seemed worse in 2012 compared to 2011. However, there was an improvement in the ‘2012 old’ districts compared to the ‘2012 new’ districts for both the facility audit and the folder review, including for eight clinical indicators, with ‘2012 new’ districts being less likely to record clinical processes (OR 0.25, 95% CI 0.21–0.31). Conclusion These findings are an indication of the value of audits to improve care processes over the long term. It is hoped that this improvement will lead to improved patient outcomes. PMID:26245615

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

PubMed Central

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

1981-01-01

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

Strategies for increasing house staff management of cholesterol with inpatients.

PubMed

Boekeloo, B O; Becker, D M; Levine, D M; Belitsos, P C; Pearson, T A

1990-01-01

This study tested the effectiveness of two conceptually different chart audit-based approaches to modifying physicians' clinical practices to conform with quality-assurance standards. The objective was to increase intern utilization of cholesterol management opportunities in the inpatient setting. Using a clinical trial study design, 29 internal medicine interns were randomly assigned to four intervention groups identified by the intervention they received: control, reminder checklists (checklists), patient-specific feedback (feedback), or both interventions (combined). Over a nine-month period, intern management of high blood cholesterol levels in internal medicine inpatients (n = 459) was monitored by postdischarge chart audit. During both a baseline and subsequent intervention period, interns documented significantly more cholesterol management for inpatients with coronary artery disease (CAD) than without CAD. During baseline, 27.3%, 24.3%, 21.7%, 12.4%, 5.4%, and 2.7% of all inpatient charts had intern documentation concerning a low-fat hospital diet, cholesterol history, screening blood cholesterol level assessment, follow-up lipid profile, nutritionist consult, and preventive cardiology consult, respectively. The feedback intervention significantly increased overall intern-documented cholesterol management among inpatients with CAD. The checklists significantly decreased overall intern-documented cholesterol management. Feedback appears to be an effective approach to increasing intern cholesterol management in inpatients.

A comprehensive survey of the relationship between self-efficacy and performance for the governmental auditors.

PubMed

Su, Jau-Ming; Lee, Shue-Ching; Tsai, Sang-Bing; Lu, Tzu-Li

2016-01-01

As governmental auditing is involved in evaluating the legitimacy, economy, efficiency, and effectiveness of how the various administrative branches use their allocated resources to optimize the government's functions, it is expected that the performance of the auditors in charge are strongly influenced by their respective qualities such as self-efficacy and experience, etc. To further understand the factors that may enhance their performance and to ultimately provide practical recommendations for the audit authorities, we have surveyed about 50 % of all the governmental auditors in Taiwan. The result showed that any auditing experience and professionalization do positively influence the professional awareness, and acquired knowledge and skillset of an auditor can effectively improve his or her professional judgment. We also found that perceived ability, problem-solving skills, and resource sharing may significantly impact any performance involved. Our study provides a workable management guidelines for strengthening the self-efficacy of audit authorities in Taiwan.

Methodology of Systems' Development for the Internal Audit: The Case of the SME

NASA Astrophysics Data System (ADS)

Gountaras, George

2009-08-01

Recent changes in regulations of the most important institutions and Enterprises of USA, UK and Greece due to the Sarbanes-Oxley Act of 2002 are modified the vision about the enterprises activities' inspection. This article investigates the role of the applied instruments in the successful realization of internal audit in the Small and Medium Enterprises in Greece. The hindered development of this kind of enterprises related to the intensive market competition is taken in consideration. The most important analyzed factors are the operations effectiveness and efficiency, the reliability of economic statements, and the adaptation to the legal frame of business development.

Project Cerberus: tobacco industry strategy to create an alternative to the Framework Convention on Tobacco Control.

PubMed

Mamudu, Hadii M; Hammond, Ross; Glantz, Stanton A

2008-09-01

Between 1999 and 2001, British American Tobacco, Philip Morris, and Japan Tobacco International executed Project Cerberus to develop a global voluntary regulatory regime as an alternative to the Framework Convention on Tobacco Control (FCTC). They aimed to develop a global voluntary regulatory code to be overseen by an independent audit body and to focus attention on youth smoking prevention. The International Tobacco Products Marketing Standards announced in September 2001, however, did not have the independent audit body. Although the companies did not stop the FCTC, they continue to promote the International Tobacco Products Marketing Standards youth smoking prevention as an alternative to the FCTC. Public health civil society groups should help policymakers and governments understand the importance of not working with the tobacco industry.

Project Cerberus: Tobacco Industry Strategy to Create an Alternative to the Framework Convention on Tobacco Control

PubMed Central

Mamudu, Hadii M.; Hammond, Ross; Glantz, Stanton A.

2008-01-01

Between 1999 and 2001, British American Tobacco, Philip Morris, and Japan Tobacco International executed Project Cerberus to develop a global voluntary regulatory regime as an alternative to the Framework Convention on Tobacco Control (FCTC). They aimed to develop a global voluntary regulatory code to be overseen by an independent audit body and to focus attention on youth smoking prevention. The International Tobacco Products Marketing Standards announced in September 2001, however, did not have the independent audit body. Although the companies did not stop the FCTC, they continue to promote the International Tobacco Products Marketing Standards youth smoking prevention as an alternative to the FCTC. Public health civil society groups should help policymakers and governments understand the importance of not working with the tobacco industry. PMID:18633079

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