National pilot audit of intermediate care.

PubMed

Hutchinson, Tom; Young, John; Forsyth, Duncan

2011-04-01

The National Service Framework for Older People resulted in the widespread introduction of intermediate care (IC) services. However, although these services have shared common aims, there has been considerable diversity in their staffing, organisation and delivery. Concerns have been raised regarding the clinical governance of IC with a paucity of data to evaluate the effectiveness, quality and safety of these services. This paper presents the results of a national pilot audit of IC services focusing particularly on clinical governance issues. The results confirm these concerns and provide support for a larger scale national audit of IC services to monitor and improve care quality.

7 CFR 4280.196 - Servicing energy audit and renewable energy development assistance grants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Servicing energy audit and renewable energy... AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.196 Servicing energy audit and renewable energy development assistance...

7 CFR 4280.196 - Servicing energy audit and renewable energy development assistance grants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Servicing energy audit and renewable energy... AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.196 Servicing energy audit and renewable energy development assistance...

7 CFR 4280.196 - Servicing energy audit and renewable energy development assistance grants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Servicing energy audit and renewable energy... AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.196 Servicing energy audit and renewable energy development assistance...

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

National stroke audit: a tool for change?

PubMed Central

Rudd, A; Lowe, D; Irwin, P; Rutledge, Z; Pearson, M

2001-01-01

Objectives—To describe the standards of care for stroke patients in England, Wales and Northern Ireland and to determine the power of national audit, coupled with an active dissemination strategy to effect change. Design—A national audit of organisational structure and retrospective case note audit, repeated within 18 months. Separate postal questionnaires were used to identify the types of change made between the first and second round and to compare the representativeness of the samples. Setting—157 trusts (64% of eligible trusts in England, Wales, and Northern Ireland) participated in both rounds. Participants—5589 consecutive patients admitted with stroke between 1 January 1998 and 31 March 1998 (up to 40 per trust) and 5375 patients admitted between 1 August 1999 and 31 October 1999 (up to 40 per trust). Audit tool—Royal College of Physicians Intercollegiate Working Party stroke audit. Results—The proportion of patients managed on stroke units rose between the two audits from 19% to 26% with the proportion managed on general wards falling from 60% to 55% and those managed on general rehabilitation wards falling from 14% to 11%. Standards of assessment, rehabilitation, and discharge planning improved equally on stroke units and general wards, but in many aspects remained poor (41% formal cognitive assessment, 46% weighed once during admission, 67% physiotherapy assessment within 72 hours, 24% plan documented for mood disturbance, 36% carers' needs assessed separately). Conclusions—Nationally conducted audit linked to a comprehensive dissemination programme was effective in stimulating improvements in the quality of care for patients with stroke. More patients are being managed on stroke units and multidisciplinary care is becoming more widespread. There remain, however, many areas where standards of care are low, indicating a need for investment of skills and resources to achieve acceptable levels. Key Words: stroke; clinical audit PMID:11533421

Energy Alert 78-1, National Energy Act: A Special Report on the National Energy Conservation Policy Act of 1978.

ERIC Educational Resources Information Center

Association of Physical Plant Administrators of Universities and Colleges, Washington, DC.

This Energy Alert deals specifically with Public Law 95-619, the National Energy Conservation Policy Act of 1978 (NECPA). Title III, Part 1 of NECPA authorizes $900 million over a three-year period for grants to schools and hospitals for energy audits, technical assistance and energy conservation projects. This publication attempts to inform…

Sault Tribe Building Efficiency Energy Audits

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

Holt, Jeffrey W.

2013-09-26

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

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

An Audit of the Irish National Intellectual Disability Database

ERIC Educational Resources Information Center

Dodd, Philip; Craig, Sarah; Kelly, Fionnola; Guerin, Suzanne

2010-01-01

This study describes a national data audit of the National Intellectual Disability Database (NIDD). The NIDD is a national information system for intellectual disability (ID) for Ireland. The purpose of this audit was to assess the overall accuracy of information contained on the NIDD, as well as collecting qualitative information to support the…

Successful implementation of diabetes audits in Australia: the Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative.

PubMed

Lee, A S; Colagiuri, S; Flack, J R

2018-04-06

We developed and implemented a national audit and benchmarking programme to describe the clinical status of people with diabetes attending specialist diabetes services in Australia. The Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative was established as a quality audit activity. De-identified data on demographic, clinical, biochemical and outcome items were collected from specialist diabetes services across Australia to provide cross-sectional data on people with diabetes attending specialist centres at least biennially during the years 1998 to 2011. In total, 38 155 sets of data were collected over the eight ANDIAB audits. Each ANDIAB audit achieved its primary objective to collect, collate, analyse, audit and report clinical diabetes data in Australia. Each audit resulted in the production of a pooled data report, as well as individual site reports allowing comparison and benchmarking against other participating sites. The ANDIAB initiative resulted in the largest cross-sectional national de-identified dataset describing the clinical status of people with diabetes attending specialist diabetes services in Australia. ANDIAB showed that people treated by specialist services had a high burden of diabetes complications. This quality audit activity provided a framework to guide planning of healthcare services. © 2018 Diabetes UK.

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.

Dutch Lung Surgery Audit: A National Audit Comprising Lung and Thoracic Surgery Patients.

PubMed

Berge, Martijn Ten; Beck, Naomi; Heineman, David Jonathan; Damhuis, Ronald; Steup, Willem Hans; van Huijstee, Pieter Jan; Eerenberg, Jan Peter; Veen, Eelco; Maat, Alexander; Versteegh, Michel; van Brakel, Thomas; Schreurs, Wilhemina Hendrika; Wouters, Michel Wilhelmus

2018-04-21

The nationwide Dutch Lung Surgery Audit (DLSA) started in 2012 to monitor and evaluate the quality of lung surgery in the Netherlands as an improvement tool. This outline describes the establishment, structure and organization of the audit by the Dutch Society of Lung Surgeons (NVvL) and the Dutch Society of Cardiothoracic Surgeons (NVT), in collaboration with the Dutch Institute for Clinical Auditing (DICA). In addition, first four-year results are presented. The NVvL and NVT initiated a web-based registration including weekly updated online feedback for participating hospitals. Data verification by external data managers is performed on regular basis. The audit is incorporated in national quality improvement programs and participation in the DLSA is mandatory by health insurance organizations and the National Healthcare Inspectorate. Between 1 January 2012 and 31 December 2015, all hospitals performing lung surgery participated and a total of 19,557 patients were registered from which almost half comprised lung cancer patients. Nationwide the guideline adherence increased over the years and 96.5% of lung cancer patients were discussed in preoperative multidisciplinary teams. Overall postoperative complications and mortality after non-small cell lung cancer surgery were 15.5% and 2.0%, respectively. The audit provides reliable benchmarked information for caregivers and hospital management with potential to start local, regional or national improvement initiatives. Currently, the audit is further completed with data from non-surgical lung cancer patients including treatment data from pulmonary oncologists and radiation oncologists. This will ultimately provide a comprehensive overview of lung cancer treatment in The Netherlands. Copyright © 2018. Published by Elsevier Inc.

National stroke audit: a tool for change?

PubMed

Rudd, A G; Lowe, D; Irwin, P; Rutledge, Z; Pearson, M

2001-09-01

To describe the standards of care for stroke patients in England, Wales and Northern Ireland and to determine the power of national audit, coupled with an active dissemination strategy to effect change. A national audit of organisational structure and retrospective case note audit, repeated within 18 months. Separate postal questionnaires were used to identify the types of change made between the first and second round and to compare the representativeness of the samples. 157 trusts (64% of eligible trusts in England, Wales, and Northern Ireland) participated in both rounds. 5589 consecutive patients admitted with stroke between 1 January 1998 and 31 March 1998 (up to 40 per trust) and 5375 patients admitted between 1 August 1999 and 31 October 1999 (up to 40 per trust). Audit tool-Royal College of Physicians Intercollegiate Working Party stroke audit. The proportion of patients managed on stroke units rose between the two audits from 19% to 26% with the proportion managed on general wards falling from 60% to 55% and those managed on general rehabilitation wards falling from 14% to 11%. Standards of assessment, rehabilitation, and discharge planning improved equally on stroke units and general wards, but in many aspects remained poor (41% formal cognitive assessment, 46% weighed once during admission, 67% physiotherapy assessment within 72 hours, 24% plan documented for mood disturbance, 36% carers' needs assessed separately). Nationally conducted audit linked to a comprehensive dissemination programme was effective in stimulating improvements in the quality of care for patients with stroke. More patients are being managed on stroke units and multidisciplinary care is becoming more widespread. There remain, however, many areas where standards of care are low, indicating a need for investment of skills and resources to achieve acceptable levels.

7 CFR 4280.188 - Grant funding for energy audit and renewable energy development assistance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Grant funding for energy audit and renewable energy... AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.188 Grant funding for energy audit and renewable energy development assistance. (a...

7 CFR 4280.188 - Grant funding for energy audit and renewable energy development assistance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Grant funding for energy audit and renewable energy... AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.188 Grant funding for energy audit and renewable energy development assistance. (a...

7 CFR 4280.188 - Grant funding for energy audit and renewable energy development assistance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Grant funding for energy audit and renewable energy... AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.188 Grant funding for energy audit and renewable energy development assistance. (a...

75 FR 29706 - Notice of Funding Availability (NOFA) for Energy Audits and Renewable Energy Development...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-27

...) for Energy Audits and Renewable Energy Development Assistance Under the Rural Energy for America... energy audits; grants for conducting renewable energy development assistance; and grants for conducting... efficiency improvement grants and guaranteed loans; Energy audit and renewable energy development assistance...

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

Energy Audit . . . Here's How.

ERIC Educational Resources Information Center

American School and University, 1983

1983-01-01

After establishing building use patterns and complaints, a consulting engineer's walkthrough energy audit begins with the exterior. Then heating/cooling system efficiency is checked with a flue gases kit. Efficient use of water heaters, lighting, teacher lounges, and food preparation and eating areas saves energy. Most effective conservation…

7 CFR 4280.195 - Awarding and administering energy audit and renewable energy development assistance grants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 7 Agriculture 15 2014-01-01 2014-01-01 false Awarding and administering energy audit and renewable... OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.195 Awarding and administering energy audit and renewable...

7 CFR 4280.195 - Awarding and administering energy audit and renewable energy development assistance grants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 15 2012-01-01 2012-01-01 false Awarding and administering energy audit and renewable... OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable Energy Development Assistance Grants § 4280.195 Awarding and administering energy audit and renewable...

Roles For Thermography In Utility Company Residential Energy Audits

NASA Astrophysics Data System (ADS)

Schott, William A.

1981-01-01

Basin Electric Power Cooperative, Bismarck, North Dakota, provides wholesale electricity to more than 100 rural electric cooperatives of the Missouri Pasin Region. The Cooperative, in cooperation with Aadland*Hoffmann*Pieri Energy Associates, Inc., Minneapolis, MN has developed a three-fold program which involves the analytical approach, the instructional approach and the motivational approach (A'IsM) to an energy audit. This three-fold program utilizes infrared thermography to pinpoint where heat loss is occurring in the home. The auditor can motivate the homeowner to initiate energy conserving improvements and practices by showing where money can be saved. Infrared thermography is a most valuable tool in helping the rural electrics conserve energy and the nation's natural resources. Over 180 energy auditors have been trained through this program in this area and 5,000 trained in the nation.

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

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

Code of Federal Regulations, 2013 CFR

2013-01-01

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

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...

Development of Next Generation Energy Audit Protocols for the Rapid and Advanced Analysis of Building Energy Use

NASA Astrophysics Data System (ADS)

Hartley, Christopher Ahlvin

Current building energy auditing techniques are outdated and lack targeted, actionable information. These analyses only use one year's worth of monthly electricity and gas bills to define energy conservation and efficiency measures. These limited data sets cannot provide robust, directed energy reduction recommendations. The need is apparent for an overhaul of existing energy audit protocols to utilize all data that is available from the building's utility provider, installed energy management system (EMS), and sub-metering devices. This thesis analyzed the current state-of-the-art in energy audits, generated a next generation energy audit protocol, and conducted both audits types on four case study buildings to find out what additional information can be obtained from additional data sources and increased data gathering resolutions. Energy data from each case study building were collected using a variety of means including utility meters, whole building energy meters, EMS systems, and sub-metering devices. In addition to conducting an energy analysis for each case study building using the current and next generation energy audit protocols, two building energy models were created using the programs eQuest and EnergyPlus. The current and next generation energy audit protocol results were compared to one another upon completion. The results show that using the current audit protocols, only variations in season are apparent. Results from the developed next generation energy audit protocols show that in addition to seasonal variations, building heating, ventilation and air conditioning (HVAC) schedules, occupancy schedules, baseline and peak energy demand levels, and malfunctioning equipment can be found. This new protocol may also be used to quickly generate accurate building models because of the increased resolution that yields scheduling information. The developed next generation energy auditing protocol is scalable and can work for many building types across the

Improving clinical practice in stroke through audit: results of three rounds of National Stroke Audit.

PubMed

Irwin, P; Hoffman, A; Lowe, D; Pearson, M; Rudd, A G

2005-08-01

The results of three rounds of National Stroke Audit in England, Wales and Northern Ireland are compared. Audit of the organization of stroke services and retrospective case-note audit of up to 40 consecutive cases admitted per hospital over a 3-month period was conducted in each of 1998, 1999 and 2001/02. The changes in the organizational, case-mix and process results of the hospitals that had participated in all three rounds were analysed. 60% of all eligible trusts from England, Wales and Northern Ireland took part in all three audits in 1998, 1999 and 2001/02. Total numbers of cases were 4996, 4841 and 5152, respectively. Case-mix variables were similar over the three rounds. Mortality at 7 and 30 days fell by 3% and 5%, respectively. The proportion of hospitals with a stroke unit rose from 48% to 77%. The proportion of patients spending most of their stay in a stroke unit rose from 17% in 1998 to 26% in 1999 and 29% in 2001/02. Improvements achieved in process standards of care between 1998 and 1999 (median change was a gain of 9%) failed to improve further by 2001/02 (median change was 0%). In all three rounds process standards of care tended to be better in stroke units. Three rounds of national audit of stroke care have shown standards of care on stroke units were notably higher than on general wards. Slowing in the rise of the proportion managed on stroke units mirrors the slow down in improvement to overall national standards of care. To further improve outcomes and national standards of stroke care a much higher proportion of patients needs to be managed in stroke units.

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

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 3 2013-01-01 2013-01-01 false Weatherization materials standards and energy audit procedures. 440.21 Section 440.21 Energy DEPARTMENT OF ENERGY ENERGY CONSERVATION WEATHERIZATION ASSISTANCE FOR LOW-INCOME PERSONS § 440.21 Weatherization materials standards and energy audit procedures. (a...

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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

Code of Federal Regulations, 2014 CFR

2014-01-01

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

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

Code of Federal Regulations, 2012 CFR

2012-01-01

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

7 CFR 4280.195 - Awarding and administering energy audit and renewable energy development assistance grants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 15 2013-01-01 2013-01-01 false Awarding and administering energy audit and renewable energy development assistance grants. 4280.195 Section 4280.195 Agriculture Regulations of the Department... OF AGRICULTURE LOANS AND GRANTS Rural Energy for America Program General Energy Audit and Renewable...

HIV testing in dermatology - a national audit.

PubMed

Esson, Gavin A; Holme, S A

2018-05-01

Forty percent of individuals have late-stage HIV at the time of diagnosis, resulting in increased morbidity. Identifying key diseases which may indicate HIV infection can prompt clinicians to trigger testing, which may result in more timely diagnosis. The British HIV Association has published guidelines on such indicator diseases in dermatology. We audited the practice of HIV testing in UK dermatologists and General Practitioners (GPs) and compared results with the national guidelines. This audit showed that HIV testing in key indicator diseases remains below the standard set out by the national guidelines, and that GPs with special interest in dermatology have a lower likelihood for testing, and lower confidence when compared to consultants, registrars and associate specialists. Large proportions of respondents believed further training in HIV testing would be beneficial.

Auditing Orthopaedic Audit

PubMed Central

Guryel, E; Acton, K; Patel, S

2008-01-01

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

Auditing orthopaedic audit.

PubMed

Guryel, E; Acton, K; Patel, S

2008-11-01

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

Emergency recompression: clinical audit of service delivery at a national level.

PubMed

Ross, John As; Sayer, Martin Dj

2009-03-01

Clinical audit is an essential element to the maintenance or improvement of delivery of any medical service. During the development phase of a National Recompression Registration Service for Scotland, clinical audit was initiated to provide a standardised tool to monitor the quality of outcome with respect to the severity of presentation. A functional audit process was an essential consideration for planned future measurement of treatment efficacy at local (single hyperbaric unit) and national (multiple hyperbaric units) scales. The audit process was designed to be undemanding, robust and informative, irrespective of the experience of treatment centre and of the clinician in charge of treatment. The clinical records from 104 cases of divers with decompression illness were used to derive and evaluate measures of severity and clinical outcome that could be used for audit and quality assurance. The various measures of disease severity were examined against clinical outcome and days spent in care after admission to a hyperbaric unit. An initial version of the clinical audit format that was developed from this process is presented.

Energy audit in small wastewater treatment plants: methodology, energy consumption indicators, and lessons learned.

PubMed

Foladori, P; Vaccari, M; Vitali, F

2015-01-01

Energy audits in wastewater treatment plants (WWTPs) reveal large differences in the energy consumption in the various stages, depending also on the indicators used in the audits. This work is aimed at formulating a suitable methodology to perform audits in WWTPs and identifying the most suitable key energy consumption indicators for comparison among different plants and benchmarking. Hydraulic-based stages, stages based on chemical oxygen demand, sludge-based stages and building stages were distinguished in WWTPs and analysed with different energy indicators. Detailed energy audits were carried out on five small WWTPs treating less than 10,000 population equivalent and using continuous data for 2 years. The plants have in common a low designed capacity utilization (52% on average) and equipment oversizing which leads to waste of energy in the absence of controls and inverters (a common situation in small plants). The study confirms that there are several opportunities for reducing energy consumption in small WWTPs: in addition to the pumping of influent wastewater and aeration, small plants demonstrate low energy efficiency in recirculation of settled sludge and in aerobic stabilization. Denitrification above 75% is ensured through intermittent aeration and without recirculation of mixed liquor. Automation in place of manual controls is mandatory in illumination and electrical heating.

The first national clinical audit for rheumatoid arthritis.

PubMed

Firth, J; Snowden, N; Ledingham, J; Rivett, A; Galloway, J; Dennison, E M; MacPhie, E; Ide, Z; Rowe, I; Kandala, N; Jameson, K

The first national audit for rheumatoid and early inflammatory arthritis has benchmarked care for the first 3 months of follow-up activity from first presentation to a rheumatology service. Access to care, management of early rheumatoid arthritis and support for self care were measured against National Institute for Health and Care Excellence quality standards; impact of early arthritis and experience of care were measured using patient-reported outcome and experience measures. The results demonstrate delays in referral and accessing specialist care and the need for service improvement in treating to target, suppression of high levels of disease activity and support for self-care. Improvements in patient-reported outcomes within 3 months and high levels of overall satisfaction were reported but these results were affected by low response rates. This article presents a summary of the national data from the audit and discusses the implications for nursing practice.

Stroke units: research and reality. Results from the National Sentinel Audit of Stroke

PubMed Central

Rudd, A; Hoffman, A; Irwin, P; Pearson, M; Lowe, D; on, b

2005-01-01

Objectives: To use data from the 2001–2 National Stroke Audit to describe the organisation of stroke units in England, Wales and Northern Ireland, and to see if key characteristics deemed effective from the research literature were present. Design: Data were collected as part of the National Sentinel Audit of Stroke in 2001, both on the organisation and structure of inpatient stroke care and the process of care to hospitals managing stroke patients. Setting: 240 hospitals from England, Wales and Northern Ireland took part in the 2001–2 National Stroke Audit, a response rate of over 95%. These sites audited a total of 8200 patients. Audit tool: Royal College of Physicians Intercollegiate Working Party Stroke Audit Tool. Results: 73% of hospitals participating in the audit had a stroke unit but only 36% of stroke admissions spent any time on one. Only 46% of all units describing themselves as stroke units had all five organisational characteristics that previous research literature had identified as being key features, while 26% had four and 28% had three or less. Better organisation was associated with better process of care for patients, with patients managed on stroke units receiving better care than those managed in other settings. Conclusion: The National Service Framework for Older People set a target for all hospitals treating stroke patients to have a stroke unit by April 2004. This study suggests that in many hospitals this is being achieved without adequate resource and expertise. PMID:15691997

The importance of a supportive environment in clinical audit: a pilot study of doctors' engagement with the NHS National PET-CT audit programme.

PubMed

Ross, Peter; Hubert, Jane; Saunders, Mike; Wong, Wai Lup

2014-10-01

The NHS National PET-CT Audit Programme was launched in 2008 as part of a national NHS programme to widen patient access to PET-computed tomography (CT) imaging in England. However, to implement clinical audit effectively, healthcare professionals need to be fully engaged with the process. The purpose of the pilot study was to identify and explore the different factors that influence doctors' engagement with the National NHS PET-CT Audit Programme. A single embedded case study was undertaken, which centred on the NHS National PET-CT Audit Programme. Seven theoretical propositions drawn from a review of the literature were tested and their influence evaluated. A purposeful sample of 13 semistructured interviews with consultant doctors was taken from different hospitals over a 6-month period. The data were analysed using directed thematic content analysis, with the themes compared against the study's propositions. Doctors' perspectives of clinical audit changed in response to the way in which the audit was implemented. The main barriers to engagement were the lack of a common vision and poor communication, which contributed to poor interprofessional relationships and a perceived culture of blame. In contrast, factors that facilitated engagement centred on the adoption of a more supportive and collaborative approach, which in turn facilitated higher levels of trust between professionals. The dissemination of performance data was found to be a key influencing factor. The study makes use of a unique data set and to the best of our knowledge is one of the first studies to document how the dissemination of doctors' performance data positively influences engagement with clinical audit in England. In addition, the study also shows how, contrary to some studies in the literature, clinical audit can reduce professional anxiety by providing a validation of professional competence. The study supports the premise that clinical audit will be fully embraced by doctors only if they

78 FR 75366 - 30-Day Notice of Proposed Information Collection: Public Housing Energy Audits and Utility...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-11

... Information Collection: Public Housing Energy Audits and Utility Allowances AGENCY: Office of the Chief... Title of Information Collection: Public Housing Energy Audits and Utility Allowances. OMB Approval... C, Energy Audit and Energy Conservation Measures, requires PHAs to complete energy audits once every...

The second national audit of intermediate care.

PubMed

Young, John; Gladman, John R F; Forsyth, Duncan R; Holditch, Claire

2015-03-01

Intermediate care services have developed internationally to expedite discharge from hospital and to provide an alternative to an emergency hospital admission. Inconsistencies in the evidence base and under-developed governance structures led to concerns about the care quality, outcomes and provision of intermediate care in the NHS. The National Audit of Intermediate Care was therefore established by an interdisciplinary group. The second national audit reported in 2013 and included crisis response teams, home-based and bed-based services in approximately a half of the NHS. The main findings were evidence of weak local strategic planning, considerable under-provision, delays in accessing the services and lack of mental health involvement in care. There was a very high level of positive patient experience reported across all types of intermediate care, though reported involvement with care decisions was less satisfactory. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The National Falls and Bone Health Audit: implications for UK emergency care.

PubMed

Banerjee, Jay; Benger, Jonathan; Treml, Jonathan; Martin, Finbarr C; Grant, Rob; Lowe, Derek; Potter, Jonathan; Husk, Janet

2012-10-01

The National Clinical Audit of Falls and Bone Health, coordinated by the Royal College of Physicians, assesses progress in implementing integrated falls services across the UK against national standards and enables benchmarking between service providers. Nationally, falls are a leading contributor towards mortality and morbidity in older people and account for 700,000 visits to emergency departments and 4 million annual bed days in England alone. Two rounds of national organisational audit in 2005 and 2008 and one national clinical audit in 2006 were carried out based on indicators developed by a multidisciplinary group. These showed that management of falls and bone health in older people remains suboptimal in emergency departments and minor injury units and opportunities are being missed in carrying out evidence-based risk assessment and management. Older people attending emergency departments in the UK following a fall are receiving a poor deal. There is an urgent need to ensure more effective assessment and management to prevent further falls and fractures.

Health and Safety Audit Design Manual

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

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

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

National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK

PubMed Central

Dixon, Peter A; Kirkham, Jamie J; Marson, Anthony G; Pearson, Mike G

2015-01-01

Objectives About 100 000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013. Setting 154 emergency departments (EDs) across the UK. Participants Data from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure. Primary and secondary outcome measures Details were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level. Results Of those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability. Conclusions These results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients. PMID:25829372

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.

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.

78 FR 59049 - 60-Day Notice of Proposed Information Collection: Public Housing Energy Audits and Utility...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-25

... Information Collection: Public Housing Energy Audits and Utility Allowances AGENCY: Office of the Assistant.... Overview of Information Collection Title of Information Collection: Public Housing Energy Audits and... proposed use: 24 CFR 965.301, Subpart C, Energy Audit and Energy Conservation Measures, requires PHAs to...

Energy Efficiency, Water Efficiency, and Renewable Energy Site Assessment: San Juan National Forest - Dolores Ranger District, Colorado

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

Kandt, Alicen J.; Kiatreungwattana, Kosol

This report summarizes the results from an energy efficiency, water efficiency, and renewable energy site assessment of the Dolores Ranger District in the San Juan National Forest in Colorado. A team led by the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) conducted the assessment with United States Forest Service (USFS) personnel on August 16-17, 2016, as part of ongoing efforts by USFS to reduce energy and water use and implement renewable energy technologies. The assessment is approximately an American Society of Heating, Refrigerating, and Air-Conditioning Engineers Level 2 audit and meets Energy Independence and Security Act requirements.

National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK.

PubMed

Dixon, Peter A; Kirkham, Jamie J; Marson, Anthony G; Pearson, Mike G

2015-03-31

About 100,000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013. 154 emergency departments (EDs) across the UK. Data from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure. Details were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level. Of those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability. These results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Energy Detectives! Introduce Students to a Promising Career in Energy Auditing

ERIC Educational Resources Information Center

Helmholdt, Nick

2012-01-01

The growing field of energy assessment for buildings presents opportunities for teachers to engage students in topics related to current issues, science, technology, and communication skills. Students who find satisfaction in energy auditing can expand their interests into careers as the demand to stop wasteful practices in homes and businesses…

Terminating the Audit of the National Flood Insurance Program’s Fiscal 1980 Financial Statements.

DTIC Science & Technology

1981-09-21

7 AD-A107 188 GENERAL ACCOUNTING OFFICE WASHINGTON DC ACCOUNTING A ETC F/G 5/1 TERMINATING THE AUDIT OF THE NATIONAL FLOOD INSURANCE PROGRAN S-,-ETC...Management Agency Dear Mr. Giuffrida: A Subject: Terminating the Audit of the National Floodr .) Insurance Program’s Fiscal 1980 Financial...objective of the audit was to express an opinion on the NFIP’s < fiscal 1980 financial statements. We will not meet this objec- tive, however, because

Development of an automated energy audit protocol for office buildings

NASA Astrophysics Data System (ADS)

Deb, Chirag

This study aims to enhance the building energy audit process, and bring about reduction in time and cost requirements in the conduction of a full physical audit. For this, a total of 5 Energy Service Companies in Singapore have collaborated and provided energy audit reports for 62 office buildings. Several statistical techniques are adopted to analyse these reports. These techniques comprise cluster analysis and development of prediction models to predict energy savings for buildings. The cluster analysis shows that there are 3 clusters of buildings experiencing different levels of energy savings. To understand the effect of building variables on the change in EUI, a robust iterative process for selecting the appropriate variables is developed. The results show that the 4 variables of GFA, non-air-conditioning energy consumption, average chiller plant efficiency and installed capacity of chillers should be taken for clustering. This analysis is extended to the development of prediction models using linear regression and artificial neural networks (ANN). An exhaustive variable selection algorithm is developed to select the input variables for the two energy saving prediction models. The results show that the ANN prediction model can predict the energy saving potential of a given building with an accuracy of +/-14.8%.

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.

From prevention to nursing home care: a comprehensive national audit of stroke care.

PubMed

Horgan, Frances; McGee, Hannah; Hickey, Anne; Whitford, David L; Murphy, Sean; Royston, Maeve; Cowman, Seamus; Shelley, Emer; Conroy, Ronan M; Wiley, Miriam; O'Neill, Desmond

2011-01-01

Many countries are developing national audits of stroke care. However, these typically focus on stroke care from acute event to hospital discharge rather than the full spectrum from prevention to long-term care. We report on a comprehensive national audit of stroke care in the community and hospitals in the Republic of Ireland. The findings provide insights into the wider needs of people with stroke and their families, a basis for developing stroke-appropriate health strategies, and a global model for the evaluation of stroke services. Six national surveys were completed: general practitioners (prevention and primary care), hospital organisational and clinical audit of 2,570 consecutive stroke admissions (acute and hospital care), allied health professionals and public health nurses (discharge to community care), nursing homes (needs of patients discharged to long-term care), and patient and carers (post-hospital phase of rehabilitation and ongoing care). The audit identified substantial deficits in a number of areas including primary prevention, emergency assessment/investigation and treatment in hospital, discharge planning, rehabilitation and ongoing secondary prevention, and communication with patients and families. There was a lack of coordination and communication between the acute and community services, with a dearth of therapy services in both home and nursing home settings. This multi-faceted national stroke audit facilitated multiple perspectives on the continuum of stroke prevention and care. An overall synthesis of surveys supports the development of a multidisciplinary perspective in planning the development of comprehensive stroke services at the national level, and may assist in regional and global development of stroke strategies. Copyright © 2011 S. Karger AG, Basel.

Identifying Low Cost Energy Improvements for School Buildings: An Energy Audit Manual.

ERIC Educational Resources Information Center

Minnesota State Dept. of Energy and Economic Development, St. Paul.

This manual is a guide for performing energy audits in school buildings using low- and no-cost measures found effective in Minnesota. The manual helps school maintenance and administrative personnel conduct walk-through inspections of school buildings, focusing on the energy efficiency of their equipment and operations. The measures recommended…

Audit of the Federal Energy Regulatory Commission`s Office of Chief Accountant

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

NONE

1995-04-07

The Federal Energy Regulatory Commission`s (Commission) mission is to oversee America`s natural gas and oil pipeline transportation, electric utility, and hydroelectric power industries to ensure that consumers receive adequate energy supplies at just and reasonable rates. To carry out this mission, the Commission issues regulations covering the accounting, reporting, and rate-making requirements of the regulated utility companies. The Commission`s Office of Chief Accountant performs financial related audits at companies to ensure compliance with these regulations. The purpose of this audit was to evaluate the office of Chief Accountant`s audit performance. Specifically, the objectives were to determine if the most appropriatemore » audit approach was used and if a quality assurance process was in place to ensure reports were accurate and supported by the working papers.« less

National audit of continence care for older people: management of urinary incontinence.

PubMed

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

2008-01-01

the Department of Health report 'Good practice in continence services' highlights the need for proper assessment and management of urinary incontinence. The National Service Framework for Older People required service providers to establish integrated continence services by April 2004. A national audit was conducted to assess the quality of continence care for older people and whether these requirements have been met. the audit studied incontinent individuals of 65 years and over. Each site returned data on organisational structure and the process of 20 patients' care. Data were submitted via the internet, and all were anonymous. the national audit was conducted across England, Wales and Northern Ireland. Data on the care of patients/residents with bladder problems were returned by 141/326 (43%) of primary care trusts (PCT), by 159/196 (81%) of secondary care trusts (involving 198 hospitals) and by 29/309 (9%) of invited care homes. In all 58% of PCT, 48% of hospitals and 74% of care homes reported that integrated continence services existed in their area. Whilst basic provision of care appeared to be in place, the audit identified deficiencies in the organisation of services, and in the assessment and management of urinary incontinence in the elderly. the results of this audit indicate that the requirement for integrated continence services has not yet been met. Assessment and care by professionals directly looking after the older person were often lacking. There is an urgent need to re-establish the fundamentals of continence care into the practice of medical and nursing staff and action needs to be taken with regard to the establishment of truly integrated, quality services in this neglected area of practice.

Energy drink consumption and the risk of alcohol use disorder among a national sample of adolescents and young adults.

PubMed

Emond, Jennifer A; Gilbert-Diamond, Diane; Tanski, Susanne E; Sargent, James D

2014-12-01

To assess the association between energy drink use and hazardous alcohol use among a national sample of adolescents and young adults. Cross-sectional analysis of 3342 youth aged 15-23 years recruited for a national survey about media and alcohol use. Energy drink use was defined as recent use or ever mixed-use with alcohol. Outcomes were ever alcohol use and 3 hazardous alcohol use outcomes measured with the Alcohol Use Disorders Identification Test (AUDIT): ever consuming 6 or more drinks at once (6+ binge drinking) and clinical criteria for hazardous alcohol use as defined for adults (8+AUDIT) and for adolescents (4+AUDIT). Among 15-17 year olds (n = 1508), 13.3% recently consumed an energy drink, 9.7% ever consumed an energy drink mixed with alcohol, and 47.1% ever drank alcohol. Recent energy drink use predicted ever alcohol use among 15-17-year-olds only (OR 2.58; 95% CI 1.77-3.77). Of these 15-17-year-olds, 17% met the 6+ binge drinking criteria, 7.2% met the 8+AUDIT criteria, and 16.0% met the 4+AUDIT criteria. Rates of energy drink use and all alcohol use outcomes increased with age. Ever mixed-use with alcohol predicted 6+ binge drinking (OR 4.69; 95% CI 3.70-5.94), 8+AUDIT (OR 3.25; 95% CI 2.51-4.21), and 4+AUDIT (OR 4.15; 95% CI 3.27-5.25) criteria in adjusted models among all participants, with no evidence of modification by age. Positive associations between energy drink use and hazardous alcohol use behaviors are not limited to youth in college settings. Copyright © 2014 Elsevier Inc. All rights reserved.

Energy drink consumption and the risk of alcohol use disorder among a national sample of adolescents and young adults

PubMed Central

Emond, Jennifer A.; Gilbert-Diamond, Diane; Tanski, Susanne E.; Sargent, James D.

2014-01-01

Objective To assess the association between energy drink use and hazardous alcohol use among a national sample of adolescents and young adults. Study design Cross-sectional analysis of 3,342 youth aged 15-23 years recruited for a national survey about media and alcohol use. Energy drink use was defined as recent use or ever mixed-use with alcohol. Outcomes were ever alcohol use and three hazardous alcohol use outcomes measured with the Alcohol Use Disorders Identification Test (AUDIT): ever consuming 6 or more drinks at once (6+ binge drinking) and clinical criteria for hazardous alcohol use as defined for adults (8+AUDIT) and for adolescents (4+AUDIT). Results Among 15-17 year olds (n=1,508), 13.3% recently consumed an energy drink, 9.7% ever consumed an energy drink mixed with alcohol, and 47.1% ever drank alcohol. Recent energy drink use predicted ever alcohol use among 15-17 years olds only (OR: 2.58; 95% CI: 1.77-3.77). Of these 15-17 year olds, 17% met the 6+ binge drinking criteria, 7.2% met the 8+AUDIT criteria, and 16.0% met the 4+AUDIT criteria. Rates of energy drink use and all alcohol use outcomes increased with age. Ever mixed-use with alcohol predicted 6+ binge drinking (OR 4.69; 95% CI: 3.70-5.94), 8+AUDIT (OR 3.25; 95% CI: 2.51-4.21), and 4+AUDIT (OR 4.15; 95% CI: 3.27-5.25) criteria in adjusted models among all participants, with no evidence of modification by age. Conclusions Positive associations between energy drink use and hazardous alcohol use behaviors are not limited to youth in college settings. PMID:25294603

ECT practices in Iraq: a national audit.

PubMed

Alhemiary, Nesif; Ali, Zainab; Abbas, Mohammed J

2015-12-01

Aims and method This national audit examined practice of electroconvulsive therapy (ECT) in Iraq against local standards. Data were collected by a questionnaire sent to heads of departments or medical directors in the 10 Iraqi hospitals which provide ECT and by examining case notes of all patients who had ECT in the first 6 months of 2013. Results Of the 26 psychiatric hospitals in Iraq, 10 provide ECT. There were some resource shortcomings in the ECT clinics (e.g. only 2 had a minimum of 2 rooms and all had no EEG monitoring). During the audit period, 251 patients had ECT. The mean age was 36.2 years and 51.8% were males. Bilateral ECT was used in all cases, general anaesthesia in 77.15%. The main indication for ECT was schizophrenia, followed by severe depression, resistant mania, catatonia and others. Clinical implications More work is needed to ensure all patients receive modified ECT. ECT is still used widely for schizophrenia. This needs further exploration and training.

A national trainee-led audit of inguinal hernia repair in Scotland.

PubMed

O'Neill, S; Robertson, A G; Robson, A J; Richards, C H; Nicholson, G A; Mittapalli, D

2015-10-01

This audit assessed inguinal hernia surgery in Scotland and measured compliance with British Hernia Society Guidelines (2013), specifically regarding management of bilateral and recurrent inguinal hernias. It also assessed the feasibility of a national trainee-led audit, evaluated regional variations in practise and gauged operative exposure of trainees. A prospective audit of adult inguinal hernia repairs across every region in Scotland (30 hospitals in 14 NHS boards) over 2-weeks was co-ordinated by the Scottish Surgical Research Group (SSRG). 235 patients (223 male, median age 61) were identified and 96 % of cases were elective. Anaesthesia was 91 % general, 5 % spinal and 3 % local. Prophylactic antibiotics were administered in 18 %. Laparoscopic repair was used in 33 % (30 % trainee-performed). Open repair was used in 67 % (42 % trainee-performed). Elective primary bilateral hernia repairs were laparoscopic in 97 % while guideline compliance for an elective recurrence was 77 %. For elective primary unilateral hernias, the use of laparoscopic repair varied significantly by region (South East 43 %, North 14 %, East 7 % and West 6 %, p < 0.001) as did repair under local anaesthesia for open cases (North 21 %, South East 4 %, West 2 % and East 0 %, p = 0.001). Trainees independently performed 9 % of procedures. There were no significant differences in trainee or unsupervised trainee operator rates between laparoscopic and open cases. Mean hospital stay was 0.7-days with day case surgery performed in 69 %. This trainee-lead audit provides a contemporary view of inguinal hernia surgery in Scotland. Increased compliance on recurrent cases appears indicated. National re-audit could ensure improved adherence and would be feasible through the SSRG.

75 FR 32494 - Energy Conservation for PHA-Owned or Leased Project-Audits, Utility Allowances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

...-Owned or Leased Project-Audits, Utility Allowances AGENCY: Office of the Chief Information Officer, HUD... complete energy audits, benefit/cost analyses for individual vs. master metering. PHAs review tenant...-Audits, Utility Allowances. OMB Approval Number: 2577-0062. Form Numbers: HUD-50078. Description of the...

The Myocardial Ischaemia National Audit Project (MINAP)

PubMed Central

Smeeth, Liam; Walker, Lynne; Weston, Clive

2010-01-01

Aims of MINAP To audit the quality of care of patients with acute coronary syndrome and provide a resource for academic research. Quality of care interventions Feedback to hospitals, ambulance services and cardiac networks regarding benchmarking of performance against national standards and targets. Setting All 230 acute hospitals in England and Wales. Years: 2000-present. Population Consecutive patients, unconsented. Current number of records: 735 000. Startpoints Any acute coronary syndrome, including non-ST-elevation myocardial infarction, ST-elevation myocardial infarction and unstable angina. Baseline data 123 fields covering demographic factors, co-morbid conditions and treatment in hospital. No blood resource. Data capture Manual entry by clerks, nurses or doctors onto Lotus Notes; non-financial incentives at hospital level. Data quality Hospitals perform an annual data validation study, where data are re-entered from the case notes in 20 randomly selected records that are held on the server. In 2008 data were >90% complete for 20 key fields, with >80% completeness for all but four of the remaining fields. Endpoints and linkages to other data All-cause mortality is obtained through linkage with Office for National Statistics. No other linkages exist at present. Access to data Available for research and audit by application to the MINAP Academic Group. http://www.rcplondon.ac.uk/CLINICAL-STANDARDS/ORGANISATION/PARTNERSHIP/Pages/MINAP-.aspx. PMID:20659944

National surgical mortality audit may be associated with reduced mortality after emergency admission.

PubMed

Kiermeier, Andreas; Babidge, Wendy J; McCulloch, Glenn A J; Maddern, Guy J; Watters, David A; Aitken, R James

2017-10-01

The Western Australian Audit of Surgical Mortality was established in 2002. A 10-year analysis suggested it was the primary driver in the subsequent fall in surgeon-related mortality. Between 2004 and 2010 the Royal Australasian College of Surgeons established mortality audits in other states. The aim of this study was to examine national data from the Australian Institute of Health and Welfare (AIHW) to determine if a similar fall in mortality was observed across Australia. The AIHW collects procedure and outcome data for all surgical admissions. AIHW data from 2005/2006 to 2012/2013 was used to assess changes in surgical mortality. Over the 8 years surgical admissions increased by 23%, while mortality fell by 18% and the mortality per admission fell by 33% (P < 0.0001). A similar decrease was seen in all regions. The mortality reduction was overwhelmingly observed in elderly patients admitted as an emergency. The commencement of this nation-wide mortality audit was associated with a sharp decline in perioperative mortality. In the absence of any influences from other changes in clinical governance or new quality programmes it is probable it had a causal effect. The reduced mortality was most evident in high-risk patients. This study adds to the evidence that national audits are associated with improved outcomes. © 2017 Royal Australasian College of Surgeons.

Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit

PubMed Central

2012-01-01

Background Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. Methods The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. Results The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. Conclusions The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable. PMID:22971539

Dosimetric verification of radiotherapy treatment planning systems in Serbia: national audit.

PubMed

Rutonjski, Laza; Petrović, Borislava; Baucal, Milutin; Teodorović, Milan; Cudić, Ozren; Gershkevitsh, Eduard; Izewska, Joanna

2012-09-12

Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT) workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT) and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs). The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.

National audit of cerebrospinal fluid testing.

PubMed

Holbrook, Ian; Beetham, Robert; Cruickshank, Anne; Egner, William; Fahie-Wilson, Mike; Keir, Geoff; Patel, Dina; Watson, Ian; White, Peter

2007-09-01

UK National External Quality Assessment Service (NEQAS) Specialist Advisory Group for EQA of CSF Proteins and Biochemistry was interested in current practice for the biochemical investigation of cerebrospinal fluid (CSF) in the UK. A questionnaire was sent to laboratories via regional audit committees and the results collated. Most laboratories were analysing CSF in a satisfactory manner. There was some variation in the reference ranges used for glucose, protein and lactate. There was concern about the rejection policies of some laboratories on these unrepeatable samples and the wavelengths used to measure bilirubin. The survey revealed the lack of spectrophotometric scanning for haem pigments and bilirubin in some hospitals. The current practice for the measurement of CSF samples in the UK is satisfactory in most laboratories responding to the questionnaire. National agreement on reference ranges for glucose, protein and lactate should be achievable. Those performing spectrophotometric scanning of the CSF were doing so in concordance with the national guidelines. Some hospitals in the UK may not have responded to the questionnaire because they did not offer spectrophotometric scanning.

32 CFR 37.1325 - Periodic audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

History on Trial: Evaluating Learning Outcomes through Audit and Accreditation in a National Standards Environment

ERIC Educational Resources Information Center

Brawley, Sean; Clark, Jennifer; Dixon, Chris; Ford, Lisa; Nielsen, Erik; Ross, Shawn; Upton, Stuart

2015-01-01

This paper uses a trial audit of history programs undertaken in 2011-­2012 to explore issues surrounding the attainment of Threshold Learning Outcomes (TLOs) in an emerging Australian national standards environment for the discipline of history. The audit sought to ascertain whether an accreditation process managed by the discipline under the…

United Kingdom national paediatric bilateral cochlear implant audit: preliminary results.

PubMed

Cullington, Helen; Bele, Devyanee; Brinton, Julie; Lutman, Mark

2013-11-01

Prior to 2009, United Kingdom (UK) public funding was mainly only available for children to receive unilateral cochlear implants. In 2009, the National Institute for Health and Care Excellence published guidance for cochlear implantation following their review. According to these guidelines, all suitable children are eligible to have simultaneous bilateral cochlear implants or a sequential bilateral cochlear implant if they had received the first before the guidelines were published. Fifteen UK cochlear implant centres formed a consortium to carry out a multi-centre audit. The audit involves collecting data from simultaneously and sequentially implanted children at four intervals: before bilateral cochlear implants or before the sequential implant, 1, 2, and 3 years after bilateral implants. The measures include localization, speech recognition in quiet and background noise, speech production, listening, vocabulary, parental perception, quality of life, and surgical data including complications. The audit has now passed the 2-year point, and data have been received on 850 children. This article provides a first view of some data received up until March 2012.

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.

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...

Cotton gin electrical energy use trends and 2009 audit results

USDA-ARS?s Scientific Manuscript database

Cotton gin energy costs have risen more than other operating costs. Energy audits were conducted in twenty US cotton gins representing a range of capacities in six states. The average participating saw gin used 39.5 kWh to process a bale. The average roller gin used 62.6 kWh. Gins have become la...

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

PubMed

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-01-30

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

10 CFR 950.41 - Monitoring/Auditing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Monitoring/Auditing. 950.41 Section 950.41 Energy DEPARTMENT OF ENERGY STANDBY SUPPORT FOR CERTAIN NUCLEAR PLANT DELAYS Audit and Investigations and Other Provisions § 950.41 Monitoring/Auditing. The Department has the right to audit any and all costs associated...

National audit of continence care: adherence to National Institute for Health and Clinical Excellence (NICE) guidance in older versus younger adults with faecal incontinence.

PubMed

Harari, Danielle; Husk, Janet; Lowe, Derek; Wagg, Adrian

2014-11-01

previous UK National Audits of Continence Care showed low rates of assessment and treatment of faecal incontinence (FI) in older people. the 2009 audit assessed adherence to the National Institute for Health and Clinical Excellence guidelines on management of FI and compared care in older versus younger patients. fifteen older (65+) and 15 younger (18-65) patients with FI were to be audited in hospital (inpatient or outpatient), primary care (PC) and care home sites. data were submitted for n = 2,930 cases from 133 hospitals, n = 1,729 from 97 PC surgeries and n = 693 from 63 care homes. Bowel history was not documented in 41% older versus 24% younger patients in hospitals and 27 versus 19% in PC (both P < 0.001). In older people, there was no documented focused examination in one-third in hospitals, one-half in PC and three-quarters in care homes. Overall, <50% had documented treatment for an identified bowel-related cause of FI. FI was frequently attributed to co-morbidity. Few patients received copies of their treatment plan. Quality-of-life impact was poorly documented particularly in hospitals. this national audit shows deficits in documented assessment, diagnosis and treatment for adults with FI despite availability of clinical guidance. Overall care is significantly poorer for older people. Clinicians, including geriatricians, need to lead on improving care in older people including comprehensive assessment where needed. Improvement in some indicators in older people with successive audits suggests that ongoing national audit with linked information resources can be useful as both monitor and agent for change. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

National education program for energy efficient illumination engineering

NASA Astrophysics Data System (ADS)

Walker, Constance E.; Pompea, Stephen M.

2011-05-01

About one-third of outdoor lighting escapes unused into the sky, wasting energy and causing sky glow. Because of excessive sky glow around astronomical facilities, the National Optical Astronomy Observatory has a strong motivation to lead light pollution education efforts. While our original motivation of preserving the dark skies near observatories is still important, energy conservation is a critical problem that needs to be addressed nationwide. To address this problem we have created an extensive educational program on understanding and measuring light pollution. A set of four learning experiences introduces school students at all grade levels to basic energy-responsive illumination engineering design principles that can minimize light pollution. We created and utilize the GLOBE at Night citizen science light pollution assessment campaign as a cornerstone activity. We also utilize educational activities on light shielding that are introduced through a teaching kit. These two components provide vocabulary, concepts, and visual illustrations of the causes of light pollution. The third, more advanced component is the school outdoor lighting audit, which has students perform an audit and produce a revised master plan for compliant lighting. These learning experiences provide an integrated learning unit that is highly adaptable for U.S. and international education efforts in this area.

Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit.

PubMed

Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

2018-01-01

Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Clinical audit of cancer diagnosis in general practices in England. Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15-86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0-27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. © British Journal of General Practice 2018.

National policy on physical activity: the development of a policy audit tool.

PubMed

Bull, Fiona C; Milton, Karen; Kahlmeier, Sonja

2014-02-01

Physical inactivity is a leading risk factor for noncommunicable disease worldwide. Increasing physical activity requires large scale actions and relevant, supportive national policy across multiple sectors. The policy audit tool (PAT) was developed to provide a standardized instrument to assess national policy approaches to physical activity. A draft tool, based on earlier work, was developed and pilot-tested in 7 countries. After several rounds of revisions, the final PAT comprises 27 items and collects information on 1) government structure, 2) development and content of identified key policies across multiple sectors, 3) the experience of policy implementation at both the national and local level, and 4) a summary of the PAT completion process. PAT provides a standardized instrument for assessing progress of national policy on physical activity. Engaging a diverse international group of countries in the development helped ensure PAT has applicability across a wide range of countries and contexts. Experiences from the development of the PAT suggests that undertaking an audit of health enhancing physical activity (HEPA) policy can stimulate greater awareness of current policy opportunities and gaps, promote critical debate across sectors, and provide a catalyst for collaboration on policy level actions. The final tool is available online.

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.

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.

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

PubMed Central

2014-01-01

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

Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit

PubMed Central

Swann, Ruth; McPhail, Sean; Witt, Jana; Shand, Brian; Abel, Gary A; Hiom, Sara; Rashbass, Jem; Lyratzopoulos, Georgios; Rubin, Greg

2018-01-01

Background Continual improvements in diagnostic processes are needed to minimise the proportion of patients with cancer who experience diagnostic delays. Clinical audit is a means of achieving this. Aim To characterise key aspects of the diagnostic process for cancer and to generate baseline measures for future re-audit. Design and setting Clinical audit of cancer diagnosis in general practices in England. Method Information on patient and tumour characteristics held in the English National Cancer Registry was supplemented by information from GPs in participating practices. Data items included diagnostic timepoints, patient characteristics, and clinical management. Results Data were collected on 17 042 patients with a new diagnosis of cancer during 2014 from 439 practices. Participating practices were similar to non-participating ones, particularly regarding population age, urban/rural location, and practice-based patient experience measures. The median diagnostic interval for all patients was 40 days (interquartile range [IQR] 15–86 days). Most patients were referred promptly (median primary care interval 5 days [IQR 0–27 days]). Where GPs deemed diagnostic delays to have occurred (22% of cases), patient, clinician, or system factors were responsible in 26%, 28%, and 34% of instances, respectively. Safety netting was recorded for 44% of patients. At least one primary care-led investigation was carried out for 45% of patients. Most patients (76%) had at least one existing comorbid condition; 21% had three or more. Conclusion The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer. PMID:29255111

32 CFR 22.825 - Closeout audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Closeout audits. 22.825 Section 22.825 National... GRANTS AND AGREEMENTS-AWARD AND ADMINISTRATION Post-Award Administration § 22.825 Closeout audits. (a) Purpose. This section establishes DoD policy for obtaining audits at closeout of individual grants and...

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

PubMed Central

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

1994-01-01

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

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...

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 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...

Obstetric audit: the Bradford way.

PubMed

Lodge, Virginia; Lomas, Karen; Jaworskyj, Suzanne; Thomson, Heidi

2014-08-01

Ultrasound is widely used as a screening tool in obstetrics with the aim of reducing maternal and foetal morbidity. However, to be effective it is recommended that scanning services follow standard protocols based on national guidelines and that scanning practice is audited to ensure consistency. Bradford has a multi-ethnic population with one of the highest rates of birth defects in the UK and it requires an effective foetal anomaly screening service. We implemented a rolling programme of audits of dating scans, foetal anomaly scans and growth scans carried out by sonographers in Bradford. All three categories of scan were audited using measurable parameters based on national guidelines. Following feedback and re-training to address issues identified, re-audits of dating and foetal anomaly scans were carried out. In both cases, sonographers being re-audited had a marked improvement in their practice. Analysis of foetal abnormality detection rates showed that as a department, we were reaching the nationally agreed detection rates for the Fetal Anomaly Screening Programme auditable conditions. Audit has been shown to be a useful and essential process in achieving consistent scanning practices and high quality images and measurements.

Obstetric audit: the Bradford way

PubMed Central

Lomas, Karen; Jaworskyj, Suzanne; Thomson, Heidi

2014-01-01

Ultrasound is widely used as a screening tool in obstetrics with the aim of reducing maternal and foetal morbidity. However, to be effective it is recommended that scanning services follow standard protocols based on national guidelines and that scanning practice is audited to ensure consistency. Bradford has a multi-ethnic population with one of the highest rates of birth defects in the UK and it requires an effective foetal anomaly screening service. We implemented a rolling programme of audits of dating scans, foetal anomaly scans and growth scans carried out by sonographers in Bradford. All three categories of scan were audited using measurable parameters based on national guidelines. Following feedback and re-training to address issues identified, re-audits of dating and foetal anomaly scans were carried out. In both cases, sonographers being re-audited had a marked improvement in their practice. Analysis of foetal abnormality detection rates showed that as a department, we were reaching the nationally agreed detection rates for the Fetal Anomaly Screening Programme auditable conditions. Audit has been shown to be a useful and essential process in achieving consistent scanning practices and high quality images and measurements. PMID:27433213

British Orthodontic Society national audit of temporary anchorage devices (TADs): report of the first thousand TADs placed.

PubMed

Bearn, David R; Alharbi, Fahad

2015-09-01

To provide data from the British Orthodontic Society (BOS) national clinical audit on temporary anchorage device (TAD) use following the recommendations of the National Institute for Health and Clinical Excellence (NIHCE) Design and setting: The Audit commenced on 1 January 2008 and is still ongoing. This article reports the data for TADs placed from 1 January 2008 to 1 November 2013. Audit data was collected from participants using a system of both on-line data entry and hard copy forms. The criteria and standards for the audit were set following the NIHCE report in conjunction with the Development and Standards Committee of the BOS. Virtually all participants used the on-line data entry available on the BOS website. The data submitted was checked and entered manually into an Excel spreadsheet, and transferred to SPSS for analysis. Written information and documented discussion of risks were provided in over 90% of TADs placed, but 17.4% were placed without a specific signed consent form. Temporary anchorage device failure rate was 24.2% overall. Among failed TADs, 93.1% were lost or removed due to excess mobility. Infection or inflammation resulting in loss or removal was reported in 6% of TADs. The only audit standard that was met was failures due to infection of inflammation. The rest of the audit standards were not met. Recommendations are made to address these issues.

Implementing Major Trauma Audit in Ireland.

PubMed

Deasy, Conor; Cronin, Marina; Cahill, Fiona; Geary, Una; Houlihan, Patricia; Woodford, Maralyn; Lecky, Fiona; Mealy, Ken; Crowley, Philip

2016-01-01

There are 27 receiving trauma hospitals in the Republic of Ireland. There has not been an audit system in place to monitor and measure processes and outcomes of care. The National Office of Clinical Audit (NOCA) is now working to implement Major Trauma Audit (MTA) in Ireland using the well-established National Health Service (NHS) UK Trauma Audit and Research Network (TARN). The aim of this report is to highlight the implementation process of MTA in Ireland to raise awareness of MTA nationally and share lessons that may be of value to other health systems undertaking the development of MTA. The National Trauma Audit Committee of the Royal College of Surgeons in Ireland, consisting of champions and stakeholders in trauma care, in 2010 advised on the adaptation of TARN for Ireland. In 2012, the Emergency Medicine Program endorsed TARN and in setting up the National Emergency Medicine Audit chose MTA as the first audit project. A major trauma governance group was established representing stakeholders in trauma care, a national project co-ordinator was recruited and a clinical lead nominated. Using Survey Monkey, the chief executives of all trauma receiving hospitals were asked to identify their hospital's trauma governance committee, trauma clinical lead and their local trauma data co-ordinator. Hospital Inpatient Enquiry systems were used to identify to hospitals an estimate of their anticipated trauma audit workload. There are 25 of 27 hospitals now collecting data using the TARN trauma audit platform. These hospitals have provided MTA Clinical Leads, allocated data co-ordinators and incorporated MTA reports formally into their clinical governance, quality and safety committee meetings. There has been broad acceptance of the NOCA escalation policy by hospitals in appreciation of the necessity for unexpected audit findings to stimulate action. Major trauma audit measures trauma patient care processes and outcomes of care to drive quality improvement at hospital and

Dosimetry quality audit of high energy photon beams in greek radiotherapy centers.

PubMed

Hourdakis, Constantine J; Boziari, A

2008-04-01

Dosimetry quality audits and intercomparisons in radiotherapy centers is a useful tool in order to enhance the confidence for an accurate therapy and to explore and dissolve discrepancies in dose delivery. This is the first national comprehensive study that has been carried out in Greece. During 2002--2006 the Greek Atomic Energy Commission performed a dosimetry quality audit of high energy external photon beams in all (23) Greek radiotherapy centers, where 31 linacs and 13 Co-60 teletherapy units were assessed in terms of their mechanical performance characteristics and relative and absolute dosimetry. The quality audit in dosimetry of external photon beams took place by means of on-site visits, where certain parameters of the photon beams were measured, calculated and assessed according to a specific protocol and the IAEA TRS 398 dosimetry code of practice. In each radiotherapy unit (Linac or Co-60), certain functional parameters were measured and the results were compared to tolerance values and limits. Doses in water under reference and non reference conditions were measured and compared to the stated values. Also, the treatment planning systems (TPS) were evaluated with respect to irradiation time calculations. The results of the mechanical tests, dosimetry measurements and TPS evaluation have been presented in this work and discussed in detail. This study showed that Co-60 units had worse performance mechanical characteristics than linacs. 28% of all irradiation units (23% of linacs and 42% of Co-60 units) exceeded the acceptance limit at least in one mechanical parameter. Dosimetry accuracy was much worse in Co60 units than in linacs. 61% of the Co60 units exhibited deviations outside +/-3% and 31% outside +/-5%. The relevant percentages for the linacs were 24% and 7% respectively. The results were grouped for each hospital and the sources of errors (functional and human) have been investigated and discussed in details. This quality audit proved to be a

12 CFR 715.7 - Supervisory Committee audit alternatives to a financial statement audit.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Supervisory Committee audit alternatives to a financial statement audit. 715.7 Section 715.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS SUPERVISORY COMMITTEE AUDITS AND VERIFICATIONS § 715.7 Supervisory...

APA national audit of pediatric opioid infusions.

PubMed

Morton, Neil S; Errera, Agata

2010-02-01

A prospective audit of neonates, infants, and children receiving opioid infusion techniques managed by pediatric acute pain teams from across the United Kingdom and Eire was undertaken over a period of 17 months. The aim was to determine the incidence, nature, and severity of serious clinical incidents (SCIs) associated with the techniques of continuous opioid infusion, patient-controlled analgesia, and nurse-controlled analgesia in patients aged 0-18. The audit was funded by the Association of Paediatric Anaesthetists (APA) and performed by the acute pain services of 18 centers throughout the United Kingdom. Data were submitted weekly via a web-based return form designed by the Document Capture Company that documented data on all patients receiving opioid infusions and any SCIs. Eight categories of SCI were identified in advance, and the reported SCIs were graded in terms of severity (Grade 1 (death/permanent harm); Grade 2 (harm but full recovery and resulting in termination of the technique or needing significant intervention); Grade 3 (potential but no actual harm). Data were collected over a period of 17 months (25/06/07-25/11/08) and stored on a secure server for analysis. Forty-six SCIs were reported in 10 726 opioid infusion techniques. One Grade 1 incident (1 : 10,726) of cardiac arrest occurred and was associated with aspiration pneumonitis and the underlying neurological condition, neurocutaneous melanosis. Twenty-eight Grade 2 incidents (1 : 383) were reported of which half were respiratory depression. The seventeen Grade 3 incidents (1 : 631) were all drug errors because of programming or prescribing errors and were all reported by one center. The overall incidence of 1 : 10,000 of serious harm with opioid infusion techniques in children is comparable to the risks with pediatric epidural infusions and central blocks identified by two recent UK national audits (1,2). Avoidable factors were identified including prescription and pump programming errors

10 CFR 603.1115 - Single audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Single audits. 603.1115 Section 603.1115 Energy DEPARTMENT... Administration § 603.1115 Single audits. For audits of for-profit participant's systems, under §§ 603.640 through 603.660, the contracting officer is the focal point for ensuring that participants submit audit...

Treatment planning systems dosimetry auditing project in Portugal.

PubMed

Lopes, M C; Cavaco, A; Jacob, K; Madureira, L; Germano, S; Faustino, S; Lencart, J; Trindade, M; Vale, J; Batel, V; Sousa, M; Bernardo, A; Brás, S; Macedo, S; Pimparel, D; Ponte, F; Diaz, E; Martins, A; Pinheiro, A; Marques, F; Batista, C; Silva, L; Rodrigues, M; Carita, L; Gershkevitsh, E; Izewska, J

2014-02-01

The Medical Physics Division of the Portuguese Physics Society (DFM_SPF) in collaboration with the IAEA, carried out a national auditing project in radiotherapy, between September 2011 and April 2012. The objective of this audit was to ensure the optimal usage of treatment planning systems. The national results are presented in this paper. The audit methodology simulated all steps of external beam radiotherapy workflow, from image acquisition to treatment planning and dose delivery. A thorax CIRS phantom lend by IAEA was used in 8 planning test-cases for photon beams corresponding to 15 measuring points (33 point dose results, including individual fields in multi-field test cases and 5 sum results) in different phantom materials covering a set of typical clinical delivery techniques in 3D Conformal Radiotherapy. All 24 radiotherapy centers in Portugal have participated. 50 photon beams with energies 4-18 MV have been audited using 25 linear accelerators and 32 calculation algorithms. In general a very good consistency was observed for the same type of algorithm in all centres and for each beam quality. The overall results confirmed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy is generally acceptable with no major causes for concern. This project contributed to the strengthening of the cooperation between the centres and professionals, paving the way to further national collaborations. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

10 CFR 71.137 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 2 2010-01-01 2010-01-01 false Audits. 71.137 Section 71.137 Energy NUCLEAR REGULATORY COMMISSION (CONTINUED) PACKAGING AND TRANSPORTATION OF RADIOACTIVE MATERIAL Quality Assurance § 71.137 Audits... planned and periodic audits to verify compliance with all aspects of the quality assurance program and to...

Promoting research and audit at medical school: evaluating the educational impact of participation in a student-led national collaborative study.

PubMed

Chapman, Stephen J; Glasbey, James C D; Khatri, Chetan; Kelly, Michael; Nepogodiev, Dmitri; Bhangu, Aneel; Fitzgerald, J Edward F

2015-03-13

Medical students often struggle to engage in extra-curricular research and audit. The Student Audit and Research in Surgery (STARSurg) network is a novel student-led, national research collaborative. Student collaborators contribute data to national, clinical studies while gaining an understanding of audit and research methodology and ethical principles. This study aimed to evaluate the educational impact of participation. Participation in the national, clinical project was supported with training interventions, including an academic training day, an online e-learning module, weekly discussion forums and YouTube® educational videos. A non-mandatory, online questionnaire assessed collaborators' self-reported confidence in performing key academic skills and their perceptions of audit and research prior to and following participation. The group completed its first national clinical study ("STARSurgUK") with 273 student collaborators across 109 hospital centres. Ninety-seven paired pre- and post-study participation responses (35.5%) were received (male = 51.5%; median age = 23). Participation led to increased confidence in key academic domains including: communication with local research governance bodies (p < 0.001), approaching clinical staff to initiate local collaboration (p < 0.001), data collection in a clinical setting (p < 0.001) and presentation of scientific results (p < 0.013). Collaborators also reported an increased appreciation of research, audit and study design (p < 0.001). Engagement with the STARSurg network empowered students to participate in a national clinical study, which increased their confidence and appreciation of academic principles and skills. Encouraging active participation in collaborative, student-led, national studies offers a novel approach for delivering essential academic training.

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

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...

10 CFR 600.316 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Audits. 600.316 Section 600.316 Energy DEPARTMENT OF... Grants and Cooperative Agreements With For-Profit Organizations Post-Award Requirements § 600.316 Audits. (a) Any recipient that expends $500,000 or more in a year under Federal awards must have an audit...

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...

Ideas That Work! The Midnight Audit

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

Parker, Steven A.

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

[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.

Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania.

PubMed

Makubi, Abel N; Meda, Collins; Magesa, Alex; Minja, Peter; Mlalasi, Juliana; Salum, Zubeda; Kweka, Rumisha E; Rwehabura, James; Quaresh, Amrana; Magesa, Pius M; Robert, David; Makani, Julie; Kaaya, Ephata

2012-10-01

In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive cross-sectional study which audited laboratory practice in haematology and blood transfusion at Muhimbili National Hospital (MNH) aimed at assessing the pre-analytical stage of laboratory investigations including laboratory request forms and handling specimen processing in the haematology laboratory and assessing the chain from donor selection, blood component processing to administration of blood during transfusion. A national standard checklist was used to audit the laboratory request forms (LRF), phlebotomists' practices on handling and assessing the from donor selection to administration 6f blood during transfusion. Both interview and observations were used. A total of 195 LRF were audited and 100% of had incomplete information such as patients' identification numbers, time sample ordered, reason for request, summary of clinical assessment and differential diagnoses. The labelling of specimens was poorly done by phlebotomists/clinicians in 82% of the specimens. Also 65% (132/202) of the blood samples delivered in the haematology laboratory did not contain the recommended volume of blood. There was no laboratory request form specific for ordering blood and there were no guidelines for indication of blood transfusion in the wards/ clinics. The blood transfusion laboratory section was not participating in external quality assessment and the hospital transfusion committee was not in operation. It is recommended that a referral hospital like MNH should have a transfusion committee to provide an active forum to facilitate communication between those involved with transfusion, monitor, coordinate and audit blood transfusion practices as per national

Impact of NICE guidance on rates of haemorrhage after tonsillectomy: an evaluation of guidance issued during an ongoing national tonsillectomy audit.

PubMed

Audit, National Prospective Tonsillectomy

2008-08-01

The National Institute for Health and Clinical Excellence (NICE) issued guidance on surgical techniques for tonsillectomy during a national audit of surgical practice and postoperative complications. To assess the impact of the guidance on tonsillectomy practice and outcomes. An interrupted time-series analysis of routinely collected Hospital Episodes Statistics data, and an analysis of longitudinal trends in surgical technique using data from the National Prospective Tonsillectomy Audit. Patients undergoing tonsillectomy in English NHS hospitals between January 2002 and December 2004. Postoperative haemorrhage within 28 days. The rate of haemorrhage increased by 0.5% per year from 2002, reaching 6.4% when the guidance was published. After publication, the rate of haemorrhage fell immediately to 5.7% (difference 0.7%: 95% CI -1.3% to 0.0%) and the rate of increase appeared to have stopped. Data from the National Prospective Tonsillectomy Audit showed that the fall coincided with a shift in surgical techniques, which was consistent with the guidance. NICE guidance influenced surgical tonsillectomy technique and in turn produced an immediate fall in postoperative haemorrhage. The ongoing national audit and strong support from the surgical specialist association may have aided its implementation.

Audit Report, "Fire Protection Deficiencies at Los Alamos National Laboratory"

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

None

2009-06-01

The Department of Energy's Los Alamos National Laboratory (Los Alamos) maintains some of the Nation's most important national security assets, including nuclear materials. Many of Los Alamos' facilities are located in close proximity to one another, are occupied by large numbers of contract and Federal employees, and support activities ranging from nuclear weapons design to science-related activities. Safeguarding against fires, regardless of origin, is essential to protecting employees, surrounding communities, and national security assets. On June 1, 2006, Los Alamos National Security, LLC (LANS), became the managing and operating contractor for Los Alamos, under contract with the Department's National Nuclearmore » Security Administration (NNSA). In preparation for assuming its management responsibilities at Los Alamos, LANS conducted walk-downs of the Laboratory's facilities to identify pre-existing deficiencies that could give rise to liability, obligation, loss or damage. The walk-downs, which identified 812 pre-existing fire protection deficiencies, were conducted by subject matter professionals, including fire protection experts. While the Los Alamos Site Office has overall responsibility for the effectiveness of the fire protection program, LANS, as the Laboratory's operating contractor, has a major, day-to-day role in minimizing fire-related risks. The issue of fire protection at Los Alamos is more than theoretical. In May 2000, the 'Cerro Grande' fire burned about 43,000 acres, including 7,700 acres of Laboratory property. Due to the risk posed by fire to the Laboratory's facilities, workforce, and surrounding communities, we initiated this audit to determine whether pre-existing fire protection deficiencies had been addressed. Our review disclosed that LANS had not resolved many of the fire protection deficiencies that had been identified in early 2006: (1) Of the 296 pre-existing deficiencies we selected for audit, 174 (59 percent) had not been

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...

30-days mortality in patients with perforated peptic ulcer: A national audit

PubMed Central

Nakano, Anne; Bendix, Jørgen; Adamsen, Sven; Buck, Daniel; Mainz, Jan; Bartels, Paul; Nørgård, Bente

2008-01-01

Background In 2005, The Danish National Indicator Project (DNIP) reported findings on patients hospitalized with perforated ulcer. The indicator “30-days mortality” showed major discrepancy between the observed mortality of 28% and the chosen standard (10%). Rationale An audit committee was appointed to examine quality problems linked to the high mortality. The purpose was to (i) examine patient characteristics, (ii) evaluate the appropriateness of the standard, and (iii) audit all cases of deaths within 30 days after surgery. Methods Four hundred and twelve consecutive patients were included and used for the analyses of patient characteristics. The evaluation of the standard was based on a literature review, and a structured audit was performed according to the 115 deaths that occurred. Results The mean age was 69.1 years, 42.0% had one co-morbid disease and 17.7% had two co-morbid diseases. 45.9% had an American Association of Anaesthetists score of 3–4. We found no results on mortality in studies similar to ours. The audit process indicated that the postoperative observation of patients was insufficient. Discussion As a result of this study, the standard for mortality was increased to 20%, and the new indicators for postoperative monitoring were developed. The DNIP continues to evaluate if these initiatives will improve the results on mortality. PMID:22312201

Audit Report on "The Department's Management of the ENERGY STAR Program"

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

None

2009-10-01

The American Recovery and Reinvestment Act (Recovery Act) authorized about $300 million in consumer rebate incentives for purchases of products rated under the 'ENERGY STAR' Program. ENERGY STAR, a voluntary labeling program established in 1992, provides consumers with energy efficiency data for a range of products so that they can make informed purchase judgments. The overall goal of the program is to encourage consumers to choose energy efficient products, advancing the nationwide goal of reducing energy consumption. The U.S. Environmental Protection Agency (EPA) managed the ENERGY STAR Program on a stand-alone basis until 1996 when it joined forces with themore » Department of Energy (Department). A Memorandum of Cooperation expanded the ENERGY STAR product categories, giving the Department responsibility for overseeing eight product categories such as windows, dishwashers, clothes washers, and refrigerators, while EPA retained responsibility for electronic product categories and heating, ventilating, and cooling equipment. Each agency is responsible for setting product efficiency specifications for those items under its control and for ensuring the proper use of the ENERGY STAR label in the marketplace. In August 2007, the EPA Office of Inspector General issued an audit report identifying significant control weaknesses in EPA's management of ENERGY STAR. The Department, concerned by the findings at EPA and eager to improve its own program, developed an approach to verify adherence to product specifications, ensure proper use of the ENERGY STAR label in the marketplace, and improve the establishment of product specifications. As evidenced by the commitment of $300 million in Recovery Act funds, the ENERGY STAR Program plays an important role in the U.S. efforts to reduce energy consumption. We initiated this audit to determine whether the Department had implemented the actions it announced in 2007 to strengthen the Program. The Department had not implemented

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

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

NASA Astrophysics Data System (ADS)

Kauppinen, Timo

2007-04-01

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

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

28 CFR 115.193 - Audits of standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audits of standards. 115.193 Section 115.193 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Audits § 115.193 Audits of standards. The agency shall conduct audits...

28 CFR 115.193 - Audits of standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audits of standards. 115.193 Section 115.193 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Audits § 115.193 Audits of standards. The agency shall conduct audits...

28 CFR 115.193 - Audits of standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audits of standards. 115.193 Section 115.193 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Lockups Audits § 115.193 Audits of standards. The agency shall conduct audits...

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.

76 FR 79168 - U.S. Department of Energy Audit Guidance: For-Profit Recipients

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... Federal eRulemaking Portal at http:[sol][sol]www.regulations.gov. Follow the instructions for submitting... access the guidance at: http:[sol][sol]energy.gov/management/downloads/ draft-profit-audit-guidance-fy...

National Beef Quality Audit-2011: Survey of instrument grading assessments of beef carcass characteristics

USDA-ARS?s Scientific Manuscript database

The instrument grading assessments for the 2011 National Beef Quality Audit evaluated seasonal trends of beef carcass quality and yield attributes over the course of the year. One week of instrument grading data, HCW, gender, USDA quality grade (QG), and yield grade (YG) factors, were collected ever...

Development of a national audit tool for juvenile idiopathic arthritis: a BSPAR project funded by the Health Care Quality Improvement Partnership

PubMed Central

McErlane, Flora; Foster, Helen E; Armitt, Gillian; Bailey, Kathryn; Cobb, Joanna; Davidson, Joyce E; Douglas, Sharon; Fell, Andrew; Friswell, Mark; Pilkington, Clarissa; Strike, Helen; Smith, Nicola; Thomson, Wendy; Cleary, Gavin

2018-01-01

Abstract Objective Timely access to holistic multidisciplinary care is the core principle underpinning management of juvenile idiopathic arthritis (JIA). Data collected in national clinical audit programmes fundamentally aim to improve health outcomes of disease, ensuring clinical care is equitable, safe and patient-centred. The aim of this study was to develop a tool for national audit of JIA in the UK. Methods A staged and consultative methodology was used across a broad group of relevant stakeholders to develop a national audit tool, with reference to pre-existing standards of care for JIA. The tool comprises key service delivery quality measures assessed against two aspects of impact, namely disease-related outcome measures and patient/carer reported outcome and experience measures. Results Eleven service-related quality measures were identified, including those that map to current standards for commissioning of JIA clinical services in the UK. The three-variable Juvenile Arthritis Disease Activity Score and presence/absence of sacro-iliitis in patients with enthesitis-related arthritis were identified as the primary disease-related outcome measures, with presence/absence of uveitis a secondary outcome. Novel patient/carer reported outcomes and patient/carer reported experience measures were developed and face validity confirmed by relevant patient/carer groups. Conclusion A tool for national audit of JIA has been developed with the aim of benchmarking current clinical practice and setting future standards and targets for improvement. Staged implementation of this national audit tool should facilitate investigation of variability in levels of care and drive quality improvement. This will require engagement from patients and carers, clinical teams and commissioners of JIA services. PMID:29069424

Development of a national audit tool for juvenile idiopathic arthritis: a BSPAR project funded by the Health Care Quality Improvement Partnership.

PubMed

McErlane, Flora; Foster, Helen E; Armitt, Gillian; Bailey, Kathryn; Cobb, Joanna; Davidson, Joyce E; Douglas, Sharon; Fell, Andrew; Friswell, Mark; Pilkington, Clarissa; Strike, Helen; Smith, Nicola; Thomson, Wendy; Cleary, Gavin

2018-01-01

Timely access to holistic multidisciplinary care is the core principle underpinning management of juvenile idiopathic arthritis (JIA). Data collected in national clinical audit programmes fundamentally aim to improve health outcomes of disease, ensuring clinical care is equitable, safe and patient-centred. The aim of this study was to develop a tool for national audit of JIA in the UK. A staged and consultative methodology was used across a broad group of relevant stakeholders to develop a national audit tool, with reference to pre-existing standards of care for JIA. The tool comprises key service delivery quality measures assessed against two aspects of impact, namely disease-related outcome measures and patient/carer reported outcome and experience measures. Eleven service-related quality measures were identified, including those that map to current standards for commissioning of JIA clinical services in the UK. The three-variable Juvenile Arthritis Disease Activity Score and presence/absence of sacro-iliitis in patients with enthesitis-related arthritis were identified as the primary disease-related outcome measures, with presence/absence of uveitis a secondary outcome. Novel patient/carer reported outcomes and patient/carer reported experience measures were developed and face validity confirmed by relevant patient/carer groups. A tool for national audit of JIA has been developed with the aim of benchmarking current clinical practice and setting future standards and targets for improvement. Staged implementation of this national audit tool should facilitate investigation of variability in levels of care and drive quality improvement. This will require engagement from patients and carers, clinical teams and commissioners of JIA services. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology.

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.

28 CFR 115.405 - Audit appeals.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audit appeals. 115.405 Section 115.405 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.405 Audit appeals. (a) An agency may lodge an appeal with the...

28 CFR 115.405 - Audit appeals.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audit appeals. 115.405 Section 115.405 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.405 Audit appeals. (a) An agency may lodge an appeal with the...

28 CFR 115.405 - Audit appeals.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audit appeals. 115.405 Section 115.405 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.405 Audit appeals. (a) An agency may lodge an appeal with the...

10 CFR 603.660 - Other audit requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Other audit requirements. 603.660 Section 603.660 Energy... Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters § 603.660 Other audit requirements. If an expenditure-based TIA provides for audits of a for-profit participant by an IPA, the...

AUDIT OF THE AUDITS.

PubMed

Alam, Malik Mahmood

2015-01-01

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

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

PubMed Central

Iqbal, H.J; Pidikiti, P

2010-01-01

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

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.

The Dutch surgical colorectal audit.

PubMed

Van Leersum, N J; Snijders, H S; Henneman, D; Kolfschoten, N E; Gooiker, G A; ten Berge, M G; Eddes, E H; Wouters, M W J M; Tollenaar, R A E M; Bemelman, W A; van Dam, R M; Elferink, M A; Karsten, Th M; van Krieken, J H J M; Lemmens, V E P P; Rutten, H J T; Manusama, E R; van de Velde, C J H; Meijerink, W J H J; Wiggers, Th; van der Harst, E; Dekker, J W T; Boerma, D

2013-10-01

In 2009, the nationwide Dutch Surgical Colorectal Audit (DSCA) was initiated by the Association of Surgeons of the Netherlands (ASN) to monitor, evaluate and improve colorectal cancer care. The DSCA is currently widely used as a blueprint for the initiation of other audits, coordinated by the Dutch Institute for Clinical Auditing (DICA). This article illustrates key elements of the DSCA and results of three years of auditing. Key elements include: a leading role of the professional association with integration of the audit in the national quality assurance policy; web-based registration by medical specialists; weekly updated online feedback to participants; annual external data verification with other data sources; improvement projects. In two years, all Dutch hospitals participated in the audit. Case-ascertainment was 92% in 2010 and 95% in 2011. External data verification by comparison with the Netherlands Cancer Registry (NCR) showed high concordance of data items. Within three years, guideline compliance for diagnostics, preoperative multidisciplinary meetings and standardised reporting increased; complication-, re-intervention and postoperative mortality rates decreased significantly. The success of the DSCA is the result of effective surgical collaboration. The leading role of the ASN in conducting the audit resulted in full participation of all colorectal surgeons in the Netherlands. By integrating the audit into the ASNs' quality assurance policy, it could be used to set national quality standards. Future challenges include reduction of administrative burden; expansion to a multidisciplinary registration; and addition of financial information and patient reported outcomes to the audit data. Copyright © 2013 Elsevier Ltd. All rights reserved.

28 CFR 115.403 - Audit contents and findings.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audit contents and findings. 115.403 Section 115.403 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.403 Audit contents and findings. (a) Each audit...

28 CFR 115.403 - Audit contents and findings.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audit contents and findings. 115.403 Section 115.403 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.403 Audit contents and findings. (a) Each audit...

28 CFR 115.403 - Audit contents and findings.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audit contents and findings. 115.403 Section 115.403 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.403 Audit contents and findings. (a) Each audit...

Report on audit of Department of Energy`s contractor salary increase fund

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

NONE

1997-04-04

The Department of Energy (Department) uses contractors to operate its facilities and compensates contractor employees based on their skills, complexity of jobs, and work performance. Thirty-one of the Department`s major contractors reported a total payroll of $4.3 billion and $4.4 billion during 1994 and 1995, respectively. The 31 contractors also reported awarding salary increases of $18 million for 1994 and $200 million for 1995. The purpose of the audit was to review the process used to determine and approve the amount of salary increases for contractor employees. The specific audit objective was to determine whether salary increases received by contractormore » employees were in accordance with Departmental policies and procedures. The Department of Energy Acquisition Regulation (DEAR) requires that contractor salary actions be within specific limitations, supportable, and approved prior to incurrence of costs. In addition, the Secretary of Energy imposed a 1 year salary freeze on the merit portion of management and operating contractor employee salaries for each contractor`s Fiscal Year 1994 compensation year. However, a fund for promotions and adjustments was approved but limited to 0.5 percent of payroll for the year. A review of eight major contractors showed that six complied with the Department`s policies on salary increases. The other two gave salary increases that were not always in accordance with Departmental policies. This resulted in both contractors not fully complying with the pay freeze in 1994 and exceeding their salary increase fund budgets in 1995. If these two contractors had implemented Department and contract requirements and contracting officers had properly performed their contract administrative responsibilities concerning salary increase funds, both contractors would have frozen salary increases and would not have exceeded their annual budgets.« less

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.

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

A national house-staff audit of medical prophylaxis in medical patients for the PREVENTion of Venous ThromboEmbolism (PREVENT-VTE).

PubMed

Adamali, H; Suliman, A M; Zaid, H; O'Donoghue, E; Burke, A; Suliman, A W; Salem, M; O'Toole, A; Yearoo, A Ibrahim; Javid, S; Ullah, I; Bolger, K; Dunican, E; McCullagh, B; Curtin, D; Lonergan, M T; Dillon, L; Murphy, A W; Gaine, S

2013-01-01

We established a national audit to assess the thromboprophylaxis rate for venous thromoembolism (VTE) in at risk medical patients in acute hospitals in the Republic of Ireland and to determine whether the use of stickers to alert physicians regarding thromboprophylaxis would double the rate prophylaxis in a follow-up audit. 651 acute medical admission patients in the first audit and 524 in the second re-audit were recruited. The mean age was 66.5 yrs with similar numbers of male and female patients and 265 (22.6%) patients were active smokers. The first and second audits identified 549 (84%) and 487 (93%) of patients at-risk for VTE respectively. Of the at-risk patients, 163 (29.7%) and 132 (27.1%) received LMWH in the first and second audit respectively. Mechanical thromboprophylaxis was instigated in 75 (13.6%) patients in the first and 86 (17.7%) patients in the second audit. The placement of stickers in patient charts didn't produce a significant increase in the number of at risk patients treated in the second audit. There is unacceptably low adherence to the ACCP guidelines in Ireland and more complex intervention than chart reminders are required to improve compliance.

28 CFR 115.293 - Audits of standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audits of standards. 115.293 Section 115.293 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Community Confinement Facilities Audits § 115.293 Audits of standards. The agency...

28 CFR 115.293 - Audits of standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audits of standards. 115.293 Section 115.293 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Community Confinement Facilities Audits § 115.293 Audits of standards. The agency...

28 CFR 115.293 - Audits of standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audits of standards. 115.293 Section 115.293 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Community Confinement Facilities Audits § 115.293 Audits of standards. The agency...

28 CFR 115.393 - Audits of standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audits of standards. 115.393 Section 115.393 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Juvenile Facilities Audits § 115.393 Audits of standards. The agency shall conduct...

28 CFR 115.393 - Audits of standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audits of standards. 115.393 Section 115.393 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Juvenile Facilities Audits § 115.393 Audits of standards. The agency shall conduct...

28 CFR 115.393 - Audits of standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audits of standards. 115.393 Section 115.393 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Standards for Juvenile Facilities Audits § 115.393 Audits of standards. The agency shall conduct...

National audit of the sensitivity of double-contrast barium enema for colorectal carcinoma, using control charts For the Royal College of Radiologists Clinical Radiology Audit Sub-Committee.

PubMed

Tawn, D J; Squire, C J; Mohammed, M A; Adam, E J

2005-05-01

To audit the sensitivity of double-contrast barium enema (DCBE) for colorectal carcinoma, as currently practised in UK departments of radiology. As part of its programme of national audits, the Royal College of Radiologists Clinical Radiology Audit Sub-Committee undertook a retrospective audit of the sensitivity of DCBE for colorectal carcinoma during 2002. The following targets were set: demonstration of a lesion > or =95%; correct identification as a carcinoma > or =90%. Across the UK, 131 departments took part in the audit, involving 5454 examinations. The mean demonstration rate was 92.9% and the diagnosis rate was 85.9%, slightly below the targets set. The equivocal rate (lesion demonstrated, but not defined as malignant) was 6.9%, the perception failure rate was 2.8% and the technical failure rate was 4.4%. Control-chart methodology was used to analyze the data and to identify any departments whose performance was consistent with special-cause variation. When compared with the diagnosis rate (84.6%) and demonstration rate (92.7%) reported in the Wessex Audit 1995, [Thomas RD, Fairhurst JJ, Frost RA. Wessex regional audit: barium enema in colo-rectal carcinoma. Clin Radiol 1995;50:647-50.] a similar level of performance was observed in the NHS today, implying that the basic process for undertaking and reporting DCBE has remained relatively unchanged over the last few years. Improvement in the future will require fundamental changes to the process of reporting DCBE, in order to minimize the perception failure rate and accurately to describe lesions, so reducing the equivocal rate. Control-chart methodology has a useful role in identifying strategies to deliver continual improvement.

Photovoltaic system criteria documents. Volume 6: Criteria for auditing photovoltaic system applications and experiments. Revision A

NASA Technical Reports Server (NTRS)

Koenig, John C.; Billitti, Joseph W.; Tallon, John M.

1980-01-01

The criteria is defined for auditing photovoltaic system applications and experiments. The purpose of the audit is twofold: to see if the application is meeting its stated objectives and to measure the application's progress in terms of the National Photovoltaic Program's goals of performance, cost, reliability, safety, and socio-environmental acceptance. The information obtained from an audit will be used to assess the status of an application and to provide the Department of Energy with recommendations on the future conduct of the application. Those aspects are covered of a site audit necessary to produce a systematic method for the gathering of qualitative and quantitative data to measure the success of an application. A sequence of audit events and guidelines for obtaining the required information is presented.

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

PubMed

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

1995-12-01

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

National BTS bronchiectasis audit 2012: is the quality standard being adhered to in adult secondary care?

PubMed

Hill, Adam T; Routh, Chris; Welham, Sally

2014-03-01

A significant step towards improving care of patients with non-cystic fibrosis bronchiectasis was the creation of the British Thoracic Society (BTS) national guidelines and the quality standard. A BTS bronchiectasis audit was conducted between 1 October and 30 November 2012, in adult patients with bronchiectasis attending secondary care, against the BTS quality standard. Ninety-eight institutions took part, submitting a total of 3147 patient records. The audit highlighted the variable adoption of the quality standard. It will allow the host institutions to benchmark against UK figures and drive quality improvement programmes to promote the quality standard and improve patient care.

Surgical audit in the developing countries.

PubMed

Bankole, J O; Lawal, O O; Adejuyigbe, O

2003-01-01

Audit assures provision of good quality health service at affordable cost. To be complete therefore, surgical practice in the young developing countries, as elsewhere, must incorporate auditing. Peculiarities of the developing countries and insufficient understanding of auditing may be, however, responsible for its been little practised. This article, therefore, reviews the objectives, the commonly evaluated aspects, and the method of audit, and includes a simple model of audit cycle. It is hoped that it will kindle the idea of regular practice of quality assurance by surgeons working in the young developing nations and engender a sustainable interest.

NCQA implements new outcomes audit standards.

PubMed

1997-06-01

Faulty data gathering and auditing techniques have put in question the comparability of HEDIS outcomes standards. The National Center for Quality Assurance has moved to shore up its data's credibility with new auditing standards. A new class of certified auditors must be trained. Until then, the Health Care Financing Administration will have Medicare managed care organizations audited by independent firms.

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

PubMed

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

2016-07-01

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

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.

An audit of the use of isolation facilities in a UK National Health Service trust.

PubMed

Damji, S; Barlow, G D; Patterson, L; Nathwani, D

2005-07-01

To aid the ongoing battle against hospital-acquired infection in the UK, all acute National Health Service (NHS) trusts should have audit data about how dedicated isolation beds within the trust are being used. In a previously published audit, we demonstrated that one-third of patients admitted to a dedicated isolation room in Tayside were not thought to be an infection risk by experienced healthcare staff. Since this audit, Tayside's isolation facilities have moved from a small peripheral 'fever' hospital to a large central teaching hospital site. At the time of this move, and using the above audit data, we designed and implemented a guideline for general practitioners and hospital doctors regarding the admission of patients to an isolation bed. The aim of this study was to compare the use of isolation beds before and after the move to the new facilities, which we anticipated would increase the demand for isolation. The results show that by all three criteria used, the utilization of isolation beds has deteriorated following the move, mainly due to the increased admission of general medical 'boarders' and low-risk infection patients. At a time when hospital-acquired infections are increasing, NHS trusts should ensure that dedicated isolation beds are used appropriately.

Time trends, improvements and national auditing of rectal cancer management over an 18-year period.

PubMed

Kodeda, K; Johansson, R; Zar, N; Birgisson, H; Dahlberg, M; Skullman, S; Lindmark, G; Glimelius, B; Påhlman, L; Martling, A

2015-09-01

The main aims were to explore time trends in the management and outcome of patients with rectal cancer in a national cohort and to evaluate the possible impact of national auditing on overall outcomes. A secondary aim was to provide population-based data for appraisal of external validity in selected patient series. Data from the Swedish ColoRectal Cancer Registry with virtually complete national coverage were utilized in this cohort study on 29 925 patients with rectal cancer diagnosed between 1995 and 2012. Of eligible patients, nine were excluded. During the study period, overall, relative and disease-free survival increased. Postoperative mortality after 30 and 90 days decreased to 1.7% and 2.9%. The 5-year local recurrence rate dropped to 5.0%. Resection margins improved, as did peri-operative blood loss despite more multivisceral resections being performed. Fewer patients underwent palliative resection and the proportion of non-operated patients increased. The proportions of temporary and permanent stoma formation increased. Preoperative radiotherapy and chemoradiotherapy became more common as did multidisciplinary team conferences. Variability in rectal cancer management between healthcare regions diminished over time when new aspects of patient care were audited. There have been substantial changes over time in the management of patients with rectal cancer, reflected in improved outcome. Much indirect evidence indicates that auditing matters, but without a control group it is not possible to draw firm conclusions regarding the possible impact of a quality control registry on faster shifts in time trends, decreased variability and improvements. Registry data were made available for reference. Colorectal Disease © 2015 The Association of Coloproctology of Great Britain and Ireland.

24 CFR 300.17 - Audits and reports.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Audits and reports. 300.17 Section...) GOVERNMENT NATIONAL MORTGAGE ASSOCIATION, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT GENERAL § 300.17 Audits and reports. The Association and its designees may at any reasonable time audit the books and examine...

Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit.

PubMed

van Bommel, Annelotte C M; Spronk, Pauline E R; Vrancken Peeters, Marie-Jeanne T F D; Jager, Agnes; Lobbes, Marc; Maduro, John H; Mureau, Marc A M; Schreuder, Kay; Smorenburg, Carolien H; Verloop, Janneke; Westenend, Pieter J; Wouters, Michel W J M; Siesling, Sabine; Tjan-Heijnen, Vivianne C G; van Dalen, Thijs

2017-03-01

In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation-wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty-two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals. The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre- and post-operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast-conserving surgery for invasive cancer requiring re-operation were consistently low (∼5%). Other indicators, for example, the use of an MRI-scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation. Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243-249. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Completing the audit cycle: the outcomes of audits in mental health services.

PubMed

Balogh, R; Bond, S

2001-04-01

To assess how far those UK National Health Service mental health settings that tested, and prior to publication, used the Newcastle Clinical Audit Toolkit for Mental Health (NCAT) completed the audit cycle. Twelve clinical audit project reports, each focused on one of the five modules in the NCAT, from four rounds of activity over a 2-year period; clinical and managerial staff in the settings where audit projects had taken place. Interviews with audit project team members about the recommendations of the 12 audit project reports and about contextual issues; all projects had reported at least 2 years previously. In analysing the audit project outcomes, five categories of inaction were discernible and five further categories were needed to describe varying states of progress. It was necessary to discriminate between actions attributed to the NCAT audit projects and actions attributed mainly to other initiatives. In total, 26.4% of audit recommendations were still under discussion or in progress. A relatively low proportion of recommendations from audit report findings (34.7%) had been implemented, and these were divided almost equally between recommendations attributed to the NCAT projects (38) and those attributed to other initiatives in the organization (37). Investigation of the medium-term outcomes of clinical audit projects has provided an insight into what might usefully be termed the process of completing the audit cycle. The time-scales required to reach the point at which action is deemed to have been implemented or not may be as long as 3 years. Conceptualizing the action stage of the cycle as a single discrete event fails to do justice to the complexity of the process, and attributing the implementation of change in clinical settings to single causes such as individual audit projects is problematic.

32 CFR Appendix C to Part 37 - What Is the Desired Coverage for Periodic Audits of For-Profit Participants To Be Audited by IPAs?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false What Is the Desired Coverage for Periodic Audits of For-Profit Participants To Be Audited by IPAs? C Appendix C to Part 37 National Defense Department... INVESTMENT AGREEMENTS Pt. 37, App. C Appendix C to Part 37—What Is the Desired Coverage for Periodic Audits...

Web-based mammography audit feedback.

PubMed

Geller, Berta M; Ichikawa, Laura; Miglioretti, Diana L; Eastman, David

2012-06-01

Interpreting screening mammography accurately is challenging and requires ongoing education to maintain and improve interpretative skills. Recognizing this, many countries with organized breast screening programs have developed audit and feedback systems using national performance data to help radiologists assess and improve their skills. We developed and tested an interactive Website to provide screening and diagnostic mammography audit feedback with comparisons to national and regional benchmarks. Radiologists who participate in three Breast Cancer Surveillance Consortium registries in the United States were invited during 2009 and 2010 to use a Website that provides tabular and graphical displays of mammography audit reports with comparisons to national and regional performance measures. We collected data about the use and perceptions of the Website. Thirty-five of 111 invited radiologists used the Website from one to five times in a year. The most popular measure was sensitivity for both screening and diagnostic mammography, whereas a table with all measures was the most visited page. Of the 13 radiologists who completed the postuse survey, all found the Website easy to use and navigate, 11 found the benchmarks useful, and nine reported that they intended to improve a specific outcome measure that year. An interactive Website to provide customized mammography audit feedback reports to radiologists has the potential to be a powerful tool in improving interpretive performance. The conceptual framework of customized audit feedback reports can also be generalized to other imaging tests.

Audit of dental practice record-keeping: a PCT-coordinated clinical audit by Worcestershire dentists.

PubMed

Cole, Andrew; McMichael, Alan

2009-07-01

A collaborative audit of clinical record-keeping standards was performed among Worcestershire dentists. Its aims were to improve the quality of National Health Service (NHS) patient care and to assist dentists to perform well during Dental Reference Service practice visits. Worcestershire dentists with NHS contracts were invited to take part in this audit. Each dentist audited a random selection of 30 of their dental clinical records against a common framework comprising eight domains. Record-keeping, and the presence or absence of key diagnostic and treatment planning details were recorded. Grading was applied in four categories, in which grades 1 and 2 were good (1) and adequate (2), captured on data-collection sheets and centrally analysed for frequency of each grade. Out of a total of 184 Worcestershire general dental practitioners, 161 (87.5%) submitted usable responses. The audit revealed wide variation between dentists in clinical record-keeping. The recording of soft tissues (36% below grade 2), periodontal status (30%), radiographic review (27%), and note-taking (25%) all fell below the standard that had been set (brackets show proportion not meeting the standard). The results provided baseline information about the standard of record-keeping in NHS dental practices in Worcestershire. The collaborative nature of the audit enabled dissemination of individual results to participants, to facilitate comparison (anonymously) against their peers. The audit provided impetus for the Primary Care Trust (PCT) to arrange postgraduate education on record-keeping and to raise awareness among local dentists about record-keeping. The subsequent report to dentists explored the record-keeping standards expected during practice inspections undertaken by the Dental Reference Service. Worcestershire PCT's method of collaborative dental audit could potentially replace the previous national programme of dental audit, formerly coordinated locally.

Picatinny Arsenal 3000 Area Laboratory Complex Energy Analysis

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

Brown, Daryl R.; Goddard, James K.

2010-05-01

In response to a request by Picatinny Arsenal, the Pacific Northwest National Laboratory (PNNL) was asked by the Army to conduct an energy audit of the Arsenal’s 3000 Area Laboratory Complex. The objective of the audit was to identify life-cycle cost-effective measures that the Arsenal could implement to reduce energy costs. A “walk-through” audit of the facilities was conducted on December 7-8, 2009. Findings and recommendations are included in this document.

Feasibility study of glass dosimeter postal dosimetry audit of high-energy radiotherapy photon beams.

PubMed

Mizuno, Hideyuki; Kanai, Tatsuaki; Kusano, Yohsuke; Ko, Susumu; Ono, Mari; Fukumura, Akifumi; Abe, Kyoko; Nishizawa, Kanae; Shimbo, Munefumi; Sakata, Suoh; Ishikura, Satoshi; Ikeda, Hiroshi

2008-02-01

The characteristics of a glass dosimeter were investigated for its potential use as a tool for postal dose audits. Reproducibility, energy dependence, field size and depth dependence were compared to those of a thermoluminescence dosimeter (TLD), which has been the major tool for postal dose audits worldwide. A glass dosimeter, GD-302M (Asahi Techno Glass Co.) and a TLD, TLD-100 chip (Harshaw Co.) were irradiated with gamma-rays from a (60)Co unit and X-rays from a medical linear accelerator (4, 6, 10 and 20 MV). The dosimetric characteristics of the glass dosimeter were almost equivalent to those of the TLD, in terms of utility for dosimetry under the reference condition, which is a 10 x 10 cm(2) field and 10 cm depth. Because of its reduced fading, compared to the TLD, and easy quality control with the ID number, the glass dosimeter proved to be a suitable tool for postal dose audits. Then, we conducted postal dose surveys of over 100 facilities and got good agreement, with a standard deviation of about 1.3%. Based on this study, postal dose audits throughout Japan will be carried out using a glass dosimeter.

A UK national audit of hereditary and acquired angioedema

PubMed Central

Jolles, S; Williams, P; Carne, E; Mian, H; Huissoon, A; Wong, G; Hackett, S; Lortan, J; Platts, V; Longhurst, H; Grigoriadou, S; Dempster, J; Deacock, S; Khan, S; Darroch, J; Simon, C; Thomas, M; Pavaladurai, V; Alachkar, H; Herwadkar, A; Abinun, M; Arkwright, P; Tarzi, M; Helbert, M; Bangs, C; Pastacaldi, C; Phillips, C; Bennett, H; El-Shanawany, T

2014-01-01

Hereditary angioedema (HAE) and acquired angioedema (AAE) are rare life-threatening conditions caused by deficiency of C1 inhibitor (C1INH). Both are characterized by recurrent unpredictable episodes of mucosal swelling involving three main areas: the skin, gastrointestinal tract and larynx. Swelling in the gastrointestinal tract results in abdominal pain and vomiting, while swelling in the larynx may be fatal. There are limited UK data on these patients to help improve practice and understand more clearly the burden of disease. An audit tool was designed, informed by the published UK consensus document and clinical practice, and sent to clinicians involved in the care of HAE patients through a number of national organizations. Data sets on 376 patients were received from 14 centres in England, Scotland and Wales. There were 55 deaths from HAE in 33 families, emphasizing the potentially lethal nature of this disease. These data also show that there is a significant diagnostic delay of on average 10 years for type I HAE, 18 years for type II HAE and 5 years for AAE. For HAE the average annual frequency of swellings per patient affecting the periphery was eight, abdomen 5 and airway 0·5, with wide individual variation. The impact on quality of life was rated as moderate or severe by 37% of adult patients. The audit has helped to define the burden of disease in the UK and has aided planning new treatments for UK patients. PMID:23786259

28 CFR 115.404 - Audit corrective action plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audit corrective action plan. 115.404 Section 115.404 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.404 Audit corrective action plan. (a) A finding of...

28 CFR 115.404 - Audit corrective action plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audit corrective action plan. 115.404 Section 115.404 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.404 Audit corrective action plan. (a) A finding of...

28 CFR 115.404 - Audit corrective action plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audit corrective action plan. 115.404 Section 115.404 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.404 Audit corrective action plan. (a) A finding of...

simuwatt - A Tablet Based Electronic Auditing Tool

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

Macumber, Daniel; Parker, Andrew; Lisell, Lars

2014-05-08

'simuwatt Energy Auditor' (TM) is a new tablet-based electronic auditing tool that is designed to dramatically reduce the time and cost to perform investment-grade audits and improve quality and consistency. The tool uses the U.S. Department of Energy's OpenStudio modeling platform and integrated Building Component Library to automate modeling and analysis. simuwatt's software-guided workflow helps users gather required data, and provides the data in a standard electronic format that is automatically converted to a baseline OpenStudio model for energy analysis. The baseline energy model is calibrated against actual monthly energy use to ASHRAE Standard 14 guidelines. Energy conservation measures frommore » the Building Component Library are then evaluated using OpenStudio's parametric analysis capability. Automated reporting creates audit documents that describe recommended packages of energy conservation measures. The development of this tool was partially funded by the U.S. Department of Defense's Environmental Security Technology Certification Program. As part of this program, the tool is being tested at 13 buildings on 5 Department of Defense sites across the United States. Results of the first simuwatt audit tool demonstration are presented in this paper.« less

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

PubMed

Gilheany, Mark; Baarini, Omar; Samaras, Dean

2015-01-01

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

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

PubMed Central

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

2016-01-01

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

A national dosimetry audit for stereotactic ablative radiotherapy in lung.

PubMed

Distefano, Gail; Lee, Jonny; Jafari, Shakardokht; Gouldstone, Clare; Baker, Colin; Mayles, Helen; Clark, Catharine H

2017-03-01

A UK national dosimetry audit was carried out to assess the accuracy of Stereotactic Ablative Body Radiotherapy (SABR) lung treatment delivery. This mail-based audit used an anthropomorphic thorax phantom containing nine alanine pellets positioned in the lung region for dosimetry, as well as EBT3 film in the axial plane for isodose comparison. Centres used their local planning protocol/technique, creating 27 SABR plans. A range of delivery techniques including conformal, volumetric modulated arc therapy (VMAT) and Cyberknife (CK) were used with six different calculation algorithms (collapsed cone, superposition, pencil-beam (PB), AAA, Acuros and Monte Carlo). The mean difference between measured and calculated dose (excluding PB results) was 0.4±1.4% for alanine and 1.4±3.4% for film. PB differences were -6.1% and -12.9% respectively. The median of the absolute maximum isodose-to-isodose distances was 3mm (-6mm to 7mm) and 5mm (-10mm to +19mm) for the 100% and 50% isodose lines respectively. Alanine and film is an effective combination for verifying dosimetric and geometric accuracy. There were some differences across dose algorithms, and geometric accuracy was better for VMAT and CK compared with conformal techniques. The alanine dosimetry results showed that planned and delivered doses were within ±3.0% for 25/27 SABR plans. Copyright © 2017 Elsevier B.V. All rights reserved.

THE U.S. EPA NATIONAL HEALTH AND ENVIRONMENTAL EFFECTS RESEARCH LABORATORY'S APPROACH TO AUDITING HEALTH EFFECTS STUDIES

EPA Science Inventory

This is an abstract of a proposed presentation and does not necessarily reflect EPA policy.

The Health Divisions of the US EPA National Health and Environmental Effects Research Laboratory have a guideline for conducting technical systems audits. As part of the guideline ...

ENT audit and research in the era of trainee collaboratives.

PubMed

Smith, Matthew E; Hardman, John; Ellis, Matthew; Williams, Richard J

2018-05-26

Large surgical audits and research projects are complex and costly to deliver, but increasingly surgical trainees are delivering these projects within formal collaboratives and research networks. Surgical trainee collaboratives are now recognised as a valuable part of the research infrastructure, with many perceived benefits for both the trainees and the wider surgical speciality. In this article, we describe the activity of ENT trainee research collaboratives within the UK, and summarise how INTEGRATE, the UK National ENT Trainee Research Network, successfully delivered a national audit of epistaxis management. The prospective audit collected high-quality data from 1826 individuals, representing 94% of all cases that met the inclusion criteria at the 113 participating sites over the 30-day audit period. It is hoped that the audit has provided a template for subsequent high-quality and cost-effective national studies, and we discuss the future possibilities for ENT trainee research collaboratives.

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

UK national clinical audit: management of pregnancies in women with HIV.

PubMed

Raffe, S; Curtis, H; Tookey, P; Peters, H; Freedman, A; Gilleece, Y

2017-02-20

The potential for HIV transmission between a pregnant woman and her unborn child was first recognized in 1982. Since then a complex package of measures to reduce risk has been developed. This project aims to review UK management of HIV in pregnancy as part of the British HIV Association (BHIVA) audit programme. The National Study of HIV in Pregnancy and Childhood (NSHPC), a population-based surveillance study, provided data for pregnancies with an expected delivery date from 1/1/13 - 30/6/14. Services also completed a survey on local management policies. Data were audited against the 2012 BHIVA pregnancy guidelines. During the audit period 1483 pregnancies were reported and 112 services completed the survey. Use of dedicated multidisciplinary teams was reported by 99% although 26% included neither a specialist midwife nor nurse. 17% of services reported delays >1 week for HIV specialist review of women diagnosed antenatally. Problematic urgent HIV testing had been experienced by 9% of services although in a further 49% the need for urgent testing had not arisen. Delays of >2 h in obtaining urgent results were common. Antiretroviral therapy (ART) was started during pregnancy in 37% women with >94% regimens in accordance with guidelines. Late ART initiation was common, particularly in those with a low CD4 count or high viral load. Eleven percent of services reported local policy contrary to guidelines regarding delivery mode for women with a VL <50 copies/mL at ≥36 weeks. According to NSHPC reports 27% of women virologically eligible for vaginal delivery planned to deliver by CS. Pregnant women in the UK are managed largely in accordance with BHIVA guidelines. Improvements are needed to ensure timely referral and ART initiation to ensure the best possible outcomes.

When are circular lesions square? A national clinical education skin lesion audit and study.

PubMed

Miranda, Benjamin H; Herman, Katie A; Malahias, Marco; Juma, Ali

2014-09-01

Skin cancer is the most prevalent cancer by organ type and referral accuracy is vital for diagnosis and management. The British Association of Dermatologists (BAD) and literature highlight the importance of accurate skin lesion examination, diagnosis and educationally-relevant studies. We undertook a review of the relevant literature, a national audit of skin lesion description standards and a study of speciality training influences on these descriptions. Questionnaires (n=200), with pictures of a circular and an oval lesion, were distributed to UK dermatology/plastic surgery consultants and speciality trainees (ST), general practitioners (GP), and medical students (MS). The following variables were analysed against a pre-defined 95% inclusion accuracy standard: site, shape, size, skin/colour, and presence of associated scars. There were 250 lesion descriptions provided by 125 consultants, STs, GPs, and MSs. Inclusion accuracy was greatest for consultants over STs (80% vs. 68%; P<0.001), GPs (57%) and MSs (46%) (P<0.0001), for STs over GPs (P<0.010) and MSs (P<0.0001) and for GPs over MSs (P<0.010), all falling below audit standard. Size description accuracy sub-analysis according to circular/oval dimensions was as follows: consultants (94%), GPs (80%), STs (73%), MSs (37%), with the most common error implying a quadrilateral shape (66%). Addressing BAD guidelines and published requirements for more empirical performance data to improve teaching methods, we performed a national audit and studied skin lesion descriptions. To improve diagnostic and referral accuracy for patients, healthcare professionals must strive towards accuracy (a circle is not a square). We provide supportive evidence that increased speciality training improves this process and propose that greater focus is placed on such training early on during medical training, and maintained throughout clinical practice.

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

PubMed

Paton, Carol; Barnes, Thomas R E

2014-06-01

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

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

28 CFR 115.401 - Frequency and scope of audits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Frequency and scope of audits. 115.401 Section 115.401 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.401 Frequency and scope of audits. (a) During the...

28 CFR 115.401 - Frequency and scope of audits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Frequency and scope of audits. 115.401 Section 115.401 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.401 Frequency and scope of audits. (a) During the...

28 CFR 115.401 - Frequency and scope of audits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Frequency and scope of audits. 115.401 Section 115.401 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) PRISON RAPE ELIMINATION ACT NATIONAL STANDARDS Auditing and Corrective Action § 115.401 Frequency and scope of audits. (a) During 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

National dosimetric audit network finds discrepancies in AAA lung inhomogeneity corrections.

PubMed

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

2015-07-01

This work presents the Australian Clinical Dosimetry Service's (ACDS) findings of an investigation of systematic discrepancies between treatment planning system (TPS) calculated and measured audit doses. Specifically, a comparison between the Anisotropic Analytic Algorithm (AAA) and other common dose-calculation algorithms in regions downstream (≥2cm) from low-density material in anthropomorphic and slab phantom geometries is presented. Two measurement setups involving rectilinear slab-phantoms (ACDS Level II audit) and anthropomorphic geometries (ACDS Level III audit) were used in conjunction with ion chamber (planar 2D array and Farmer-type) measurements. Measured doses were compared to calculated doses for a variety of cases, with and without the presence of inhomogeneities and beam-modifiers in 71 audits. Results demonstrate a systematic AAA underdose with an average discrepancy of 2.9 ± 1.2% when the AAA algorithm is implemented in regions distal from lung-tissue interfaces, when lateral beams are used with anthropomorphic phantoms. This systemic discrepancy was found for all Level III audits of facilities using the AAA algorithm. This discrepancy is not seen when identical measurements are compared for other common dose-calculation algorithms (average discrepancy -0.4 ± 1.7%), including the Acuros XB algorithm also available with the Eclipse TPS. For slab phantom geometries (Level II audits), with similar measurement points downstream from inhomogeneities this discrepancy is also not seen. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

ENVIRONMENTAL AUDITING: Environmental Auditing in Hospitals: First Results in a University Hospital.

PubMed

Dettenkofer; Kuemmerer; Schuster; Mueller; Muehlich; S; Daschner

2000-01-01

/ While medical audit in infection control today is one important element in the quality assurance of health care, environmental auditing, approved in 1993 by the Council of the European Communities for the industrial sector, so far has not been used as a tool to control and reduce environmental pollution caused by medical care. The aim of this study was to investigate whether environmental auditing according to the European Eco-Management and Audit Scheme (EMAS) can be implemented in hospitals as a process of improvement in protection of the environment. In a prior publication the methodological issues and the organizational steps that had to be taken were described. An environmental review of the activities of the Freiburg University Hospital and an ecoanalysis of the input and output were performed. The results of this analysis, published in an environmental report, provide a fundamental data set for the consumption of energy, water, materials, and the burdens of major pollutants and waste. Regarding the organizational structure of the hospital, the first steps towards an integrating environmental management system as demanded by EMAS could be taken. Beside supporting advantages, e.g., improvement of environmental safety, public image and staff contentment, and potential economic benefits such as less cost to be paid for energy and water consumption, there are important restrictions of environmental auditing in hospitals. Examples are the lack of basic environmental data, staff motivation (especially of physicians), cooperation of the organizational substructures, and funds for prefinancing urgently needed improvements in ecology. Based on the study findings, a textbook on environmental auditing in hospitals, including checklists covering all important environmental objectives, has been published to support hospitals in their efforts to achieve an optimized and sustainable practice of providing health care.

Can trainees design and deliver a national audit of epistaxis management? A pilot of a secure web-based audit tool and research trainee collaboratives.

PubMed

Mehta, N; Williams, R J; Smith, M E; Hall, A; Hardman, J C; Cheung, L; Ellis, M P; Fussey, J M; Lakhani, R; McLaren, O; Nankivell, P C; Sharma, N; Yeung, W; Carrie, S; Hopkins, C

2017-06-01

To investigate the feasibility of a national audit of epistaxis management led and delivered by a multi-region trainee collaborative using a web-based interface to capture patient data. Six trainee collaboratives across England nominated one site each and worked together to carry out this pilot. An encrypted data capture tool was adapted and installed within the infrastructure of a university secure server. Site-lead feedback was assessed through questionnaires. Sixty-three patients with epistaxis were admitted over a two-week period. Site leads reported an average of 5 minutes to complete questionnaires and described the tool as easy to use. Data quality was high, with little missing data. Site-lead feedback showed high satisfaction ratings for the project (mean, 4.83 out of 5). This pilot showed that trainee collaboratives can work together to deliver an audit using an encrypted data capture tool cost-effectively, whilst maintaining the highest levels of data quality.

From Energy Audits to Home Performance: 30 Years of Articles in Home Energy Magazine

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

Meier, Alan

Home Energy Magazine has been publishing articles about residential energy efficiency for 30 years. Its goal has been to disseminate technically reliable and neutral information to the practitioners, that is, professionals in the business of home energy efficiency. The articles, editorials, letters, and advertisements are a kind of window on the evolution of energy conservation technologies, policies, and organizations. Initially, the focus was on audits and simple retrofits, such as weatherstripping and insulation. Instrumentation was sparse sometimes limited to a ruler to measure depth of attic insulation and a blower door was exotic. CFLs were heavy, awkward bulbs which might,more » or might not, fit in a fixture. Saving air conditioning energy was not a priority. Solar energy was only for the most adventurous. Thirty years on, the technologies and business have moved beyond just insulating attics to the larger challenge of delivering home performance and achieving zero net energy. This shift reflects the success in reducing space heating energy and the need to create a profitable industry by providing more services. The leading edge of the residential energy services market is becoming much more sophisticated, offering both efficiency and solar systems. The challenge is to continue providing relevant and reliable information in a transformed industry and a revolutionized media landscape.« less

32 CFR Appendix D to Part 290 - Audit Working Papers

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Audit Working Papers D Appendix D to Part 290 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF INFORMATION ACT PROGRAM DEFENSE CONTRACT AUDIT AGENCY (DCAA) FREEDOM OF INFORMATION ACT PROGRAM Pt...

32 CFR Appendix D to Part 290 - Audit Working Papers

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Audit Working Papers D Appendix D to Part 290 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF INFORMATION ACT PROGRAM DEFENSE CONTRACT AUDIT AGENCY (DCAA) FREEDOM OF INFORMATION ACT PROGRAM Pt...

32 CFR Appendix D to Part 290 - Audit Working Papers

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Audit Working Papers D Appendix D to Part 290 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF INFORMATION ACT PROGRAM DEFENSE CONTRACT AUDIT AGENCY (DCAA) FREEDOM OF INFORMATION ACT PROGRAM Pt...

32 CFR Appendix D to Part 290 - Audit Working Papers

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Audit Working Papers D Appendix D to Part 290 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF INFORMATION ACT PROGRAM DEFENSE CONTRACT AUDIT AGENCY (DCAA) FREEDOM OF INFORMATION ACT PROGRAM Pt...

32 CFR Appendix D to Part 290 - Audit Working Papers

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Audit Working Papers D Appendix D to Part 290 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED) FREEDOM OF INFORMATION ACT PROGRAM DEFENSE CONTRACT AUDIT AGENCY (DCAA) FREEDOM OF INFORMATION ACT PROGRAM Pt...

45 CFR 602.26 - Non-Federal audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 602.26 Section 602.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION UNIFORM... Requirements § 602.26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining...

Initial Results from the Royal College of Radiologists' UK National Audit of Anal Cancer Radiotherapy 2015.

PubMed

Muirhead, R; Drinkwater, K; O'Cathail, S M; Adams, R; Glynne-Jones, R; Harrison, M; Hawkins, M A; Sebag-Montefiore, D; Gilbert, D C

2017-03-01

UK guidance was recently developed for the treatment of anal cancer using intensity-modulated radiotherapy (IMRT). We audited the current use of radiotherapy in UK cancer centres for the treatment of anal cancer against such guidance. We describe the acute toxicity of IMRT in comparison with patient population in the audit treated with two-phase conformal radiotherapy and the previous published data from two-phase conformal radiotherapy, in the UK ACT2 trial. A Royal College of Radiologists' prospective national audit of patients treated with radiotherapy in UK cancer centres was carried out over a 6 month period between February and July 2015. Two hundred and forty-two cases were received from 40/56 cancer centres (71%). In total, 231 (95%) underwent full dose radiotherapy with prophylactic nodal irradiation. Of these, 180 (78%) received IMRT or equivalent, 52 (22%) two-phase conformal (ACT2) technique. The number of interruptions in radiotherapy treatment in the ACT2 trial was 15%. Interruptions were noted in 7% (95% confidence interval 0-14%) of courses receiving two-phase conformal and 4% (95% confidence interval 1-7%) of those receiving IMRT. The percentage of patients completing the planned radiotherapy dose, irrelevant of gaps, was 90% (95% confidence interval 82-98%) and 96% (95% confidence interval 93-99%), in two-phase conformal and IMRT respectively. The toxicity reported in the ACT2 trial, in patients receiving two-phase conformal in the audit and in patients receiving IMRT in the audit was: any toxic effect 71%, 54%, 48%, non-haematological 62%, 49%, 40% and haematological 26%, 13%, 18%, respectively. IMRT implementation for anal cancer is well underway in the UK with most patients receiving IMRT delivery, although its usage is not yet universal. This audit confirms that IMRT results in reduced acute toxicity and minimised treatment interruptions in comparison with previous two-phase conformal techniques. Copyright © 2016 The Royal College of

10 CFR 26.41 - Audits and corrective action.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Audits and corrective action. 26.41 Section 26.41 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.41 Audits and corrective action. (a) General. Each licensee and other entity who is subject to this subpart is responsible for the...

10 CFR 26.41 - Audits and corrective action.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Audits and corrective action. 26.41 Section 26.41 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.41 Audits and corrective action. (a) General. Each licensee and other entity who is subject to this subpart is responsible for the...

10 CFR 26.41 - Audits and corrective action.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Audits and corrective action. 26.41 Section 26.41 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.41 Audits and corrective action. (a) General. Each licensee and other entity who is subject to this subpart is responsible for the...

10 CFR 26.41 - Audits and corrective action.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Audits and corrective action. 26.41 Section 26.41 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.41 Audits and corrective action. (a) General. Each licensee and other entity who is subject to this subpart is responsible for the...

10 CFR 26.41 - Audits and corrective action.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Audits and corrective action. 26.41 Section 26.41 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.41 Audits and corrective action. (a) General. Each licensee and other entity who is subject to this subpart is responsible for the...

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

A national quality registers as a tool to audit items of the fundamentals of care to older patients with hip fractures.

PubMed

Hommel, Ami; Bååth, Carina

2016-06-01

The Swedish healthcare system has a unique resource in the national quality registers. A national quality registry contains individualised data concerning patient problems, medical interventions and outcomes after treatment, within all healthcare settings. Many healthcare settings face challenges related to the way they deliver the fundamentals of care, therefore, it is important to audit the outcome. It is estimated that the number of people aged 80 years or older will have almost quadrupled between 2000 and 2050. Hip fracture has been recognised as the most serious consequence of osteoporosis because of the risk of its complications, which include pain, acute confusional state, pressure ulcers, infections, disability, diminished quality of life and mortality. The aim of this study was therefore to explore if and how a national quality register can be used as an audit tool for the fundamentals of care when it concerns older patients suffering from a hip fracture. For this study we retrospectively selected and audited variables retrieved from the national quality hip fracture register. The audit included 1083 patients 80 years and older, consecutively admitted to a university hospital in the south of Sweden, in 2011-2013. Nearly half of the patients were admitted from their own homes and were living alone. Almost half of the patients could walk outdoors before the fracture occurred. After 4 months, 28.5% of the patients walked outdoors. Additionally, after 4 months about 30% of the patients were still suffering from pain after hip fracture surgery and still using analgesics. There was a reduction in length of stay between 2011 and 2013. As a part of the national quality register the questions from EQ5D were used before surgery and after 4 months. Before discharge from hospital there were less registered complications in 2012 and 2013 compared with 2011. The national hip fracture quality register allows healthcare staff to analyse nursing outcomes and to

Newborn infants with bilious vomiting: a national audit of neonatal transport services.

PubMed

Ojha, Shalini; Sand, Laura; Ratnavel, Nandiran; Kempley, Stephen Terence; Sinha, Ajay Kumar; Mohinuddin, Syed; Budge, Helen; Leslie, Andrew

2017-11-01

The precautionary approach to urgently investigate infants with bilious vomiting has increased the numbers referred to transport teams and tertiary surgical centres. The aim of this national UK audit was to quantify referrals and determine the frequency of surgical diagnoses with the purpose to inform the consequent inclusion of these referrals in the national 'time-critical' data set. A prospective, multicentre UK-wide audit was conducted between 1 August, 2015 and 31 October, 2015. Term infants aged ≤7 days referred for transfer due to bilious vomiting were included. Data at the time of transport and outcomes at 7 days after transfer were collected by the local teams and transferred anonymously for analysis. Sixteen teams contributed data on 165 cases. Teams that consider such transfers as 'time-critical' responded significantly faster than those that do not classify bilious vomiting as time-critical. There was a surgical diagnosis in 22% cases, and 7% had a condition where delayed treatment may have caused bowel loss. Most surgical problems could be predicted by clinical and/or X-ray findings, but two infants with normal X-ray features were found to have a surgical problem. The results support the need for infants with bilious vomiting to be investigated for potential surgical pathologies, but the data do not provide evidence for the default designation of such referrals as 'time-critical.' Decisions should be made by clinical collaboration between the teams and, where appropriate, swift transfer provided. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

10 CFR Appendix B to Part 600 - Audit Report Distributees

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Audit Report Distributees B Appendix B to Part 600 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Pt. 600, App. B Appendix B to Part 600—Audit Report Distributees Distributee: Manager, Eastern Region, Office of Inspector...

Achievement of NICE quality standards for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

PubMed

Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian

2017-02-01

A national audit was performed assessing the early management of suspected inflammatory arthritis by English and Welsh rheumatology units. The aim of this audit was to measure the performance of rheumatology services against National Institute for Health and Care Excellence (NICE) quality standards (QSs) for the management of early inflammatory arthritis benchmarked to regional and national comparators for the first time in the UK. All individuals >16 years of age presenting to rheumatology services in England and Wales with suspected new-onset inflammatory arthritis were included in the audit. Information was collected against six NICE QSs that pertain to early inflammatory arthritis management. We present national data for the 6354 patients recruited from 1 February 2014 to 31 January 2015; 97% of trusts and health boards in England and Wales participated in this audit. Only 17% of patients were referred by their general practitioner within 3 days of first presentation. Specialist rheumatology assessment occurred within 3 weeks of referral in 38% of patients. The target of DMARD initiation within 6 weeks of referral was achieved in 53% of RA patients; 36% were treated with combination DMARDs and 82% with steroids within the first 3 months of specialist care. Fifty-nine per cent of patients received structured education on their arthritis within 1 month of diagnosis. In total, 91% of patients had a treatment target set; the agreed target was achieved within 3 months of specialist review in only 27% of patients. Access to urgent advice via a telephone helpline was reported to be available in 96% of trusts. The audit has highlighted gaps between NICE standards and delivery of care, as well as substantial geographic variability. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

18 CFR 349.1 - Notice to audited person.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Notice to audited person. 349.1 Section 349.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE INTERSTATE COMMERCE ACT DISPOSITION OF CONTESTED AUDIT FINDINGS AND PROPOSED REMEDIES § 349.1 Notice to...

Audit, guidelines and standards: clinical governance for hip fracture care in Scotland.

PubMed

Currie, Colin T; Hutchison, James D

To report on experience of national-level audit, guidelines and standards for hip fracture care in Scotland. Scottish Hip Fracture Audit (from 1993) documents case-mix, process and outcomes of hip fracture care in Scotland. Evidence-based national guidelines on hip fracture care are available (1997, updated 2002). Hip fracture serves as a tracer condition by the health quality assurance authority for its work on older people, which reported in 2004. Audit data are used locally to document care and support and monitor service developments. Synergy between the guidelines and the audit provides a means of improving care locally and monitoring care nationally. External review by the quality assurance body shows to what extent guideline-based standards relating to A&E care, pre-operative delay, multidisciplinary care and audit participation are met. Three national-level initiatives on hip fracture care have delivered: Reliable and large-scale comparative information on case-mix, care and outcomes; evidence-based recommendations on care; and nationally accountable standards inspected and reported by the national health quality assurance authority. These developments are linked and synergistic, and enjoy both clinical and managerial support. They provide an evolving framework for clinical governance, with casemix-adjusted outcome assessment for hip fracture care as a next step.

Assessment of national dosimetry quality audits results for teletherapy machines from 1989 to 2015.

PubMed

Muhammad, Wazir; Ullah, Asad; Mahmood, Khalid; Matiullah

2016-01-01

The purpose of this study was to ensure accuracy in radiation dose delivery, external dosimetry quality audit has an equal importance with routine dosimetry performed at clinics. To do so, dosimetry quality audit was organized by the Secondary Standard Dosimetry Laboratory (SSDL) of Pakistan Institute of Nuclear Science and Technology (PINSTECH) at the national level to investigate and minimize uncertainties involved in the measurement of absorbed dose, and to improve the accuracy of dose measurement at different radiotherapy hospitals. A total of 181 dosimetry quality audits (i.e., 102 of Co-60 and 79 of linear accelerators) for teletherapy units installed at 22 different sites were performed from 1989 to 2015. The percent deviation between users’ calculated/stated dose and evaluated dose (in the result of on-site dosimetry visits) were calculated and the results were analyzed with respect to the limits of ± 2.5% (ICRU "optimal model") ± 3.0% (IAEA on-site dosimetry visits limit) and ± 5.0% (ICRU minimal or "lowest acceptable" model). The results showed that out of 181 total on-site dosimetry visits, 20.44%, 16.02%, and 4.42% were out of acceptable limits of ± 2.5% ± 3.0%, and ± 5.0%, respectively. The importance of a proper ongoing quality assurance program, recommendations of the followed protocols, and properly calibrated thermometers, pressure gauges, and humidity meters at radiotherapy hospitals are essential in maintaining consistency and uniformity of absorbed dose measurements for precision in dose delivery.

The National Health Service Breast Screening Programme and British Association of Surgical Oncology audit of quality assurance in breast screening 1996-2001.

PubMed

Sauven, P; Bishop, H; Patnick, J; Walton, J; Wheeler, E; Lawrence, G

2003-01-01

The National Health Service Breast Screening Programme (NHSBSP) is an example of a nationally coordinated quality assurance programme in which all the professional groups involved participate. Surgeons, radiologists and pathologists defined the clinical outcome measures against which they would subsequently be audited. The NHSBSP and the Association of Breast Surgery at BASO are jointly responsible for coordinating an annual audit of all surgical activities undertaken within the NHSBSP. The trends for key outcome measures between 1996 and 2001 are provided. The preoperative diagnosis rate (minimum standard 70 per cent or more) improved from 63 to 87 per cent. This rise was mirrored by an increase in the use of core biopsy in preference to fine-needle cytology. The proportion of patients in whom lymph node status was recorded improved from 81 to 93 per cent. There was no significant change in the number of women treated by low case-load surgeons and waiting times for surgery increased through the study interval. The BASO-NHSBSP Breast Audit has recorded major changes in clinical practice over 5 years. A key feature has been the dissemination of good practice through feedback of the results at local and national level. Copyright 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd

Cyber Security Audit and Attack Detection Toolkit

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

Peterson, Dale

2012-05-31

This goal of this project was to develop cyber security audit and attack detection tools for industrial control systems (ICS). Digital Bond developed and released a tool named Bandolier that audits ICS components commonly used in the energy sector against an optimal security configuration. The Portaledge Project developed a capability for the PI Historian, the most widely used Historian in the energy sector, to aggregate security events and detect cyber attacks.

Routine monitoring and assessment of adults living with HIV: results of the British HIV Association (BHIVA) national audit 2015.

PubMed

Molloy, A; Curtis, H; Burns, F; Freedman, A

2017-09-13

The clinical care of people living with HIV changed fundamentally as a result of the development of effective antiretroviral therapy (ART). HIV infection is now a long-term treatable condition. We report a national audit to assess adherence to British HIV Association guidelines for the routine investigation and monitoring of adult HIV-1-infected individuals. All UK sites known as providers of adult HIV outpatient services were invited to complete a case-note review and a brief survey of local clinic practices. Participating sites were asked to randomly select 50-100 adults, who attended for specialist HIV care during 2014 and/or 2015. Each site collected data electronically using a self-audit spreadsheet tool. This included demographic details (gender, ethnicity, HIV exposure, and age) and whether 22 standardised and pre-defined clinical audited outcomes had been recorded. Data were collected on 8258 adults from 123 sites, representing approximately 10% of people living with HIV reported in public health surveillance as attending UK HIV services. Sexual health screening was provided within 96.4% of HIV services, cervical cytology and influenza vaccination within 71.4% of HIV services. There was wide variation in resistance testing across sites. Only 44.9% of patients on ART had a documented 10-year CVD risk within the past three years and fracture risk had been assessed within the past three years for only 16.7% patients aged over 50 years. There was high participation in the national audit and good practice was identified in some areas. However improvements can be made in monitoring of cardiovascular risk, bone and sexual health.

Mobile Building Energy Audit and Modeling Tools: Cooperative Research and Development Final Report, CRADA Number CRD-11-00441

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

Brackney, L.

Broadly accessible, low cost, accurate, and easy-to-use energy auditing tools remain out of reach for managers of the aging U.S. building population (over 80% of U.S. commercial buildings are more than 10 years old*). concept3D and NREL's commercial buildings group will work to translate and extend NREL's existing spreadsheet-based energy auditing tool for a browser-friendly and mobile-computing platform. NREL will also work with concept3D to further develop a prototype geometry capture and materials inference tool operable on a smart phone/pad platform. These tools will be developed to interoperate with NREL's Building Component Library and OpenStudio energy modeling platforms, and willmore » be marketed by concept3D to commercial developers, academic institutions and governmental agencies. concept3D is NREL's lead developer and subcontractor of the Building Component Library.« less

Institutional Manager's Guide to Energy Conservation.

ERIC Educational Resources Information Center

Department of Energy, Washington, DC. Office of State and Local Programs.

The information provided in this guidebook is based on a field evaluation of grantees in the Institutional Conservation Program (ICP). The ICP, authorized by the National Energy Conservation Policy Act of 1978 and administered by the Department of Energy, provides energy audits and 50 percent matching grants for detailed energy analyses and for…

Tuberculosis screening in patients with HIV: An audit against UK national guidelines to assess current practice and the effectiveness of an electronic tuberculosis-screening prompt.

PubMed

Fox-Lewis, A; Brima, N; Muniina, P; Grant, A D; Edwards, S G; Miller, R F; Pett, S L

2016-09-01

A retrospective clinical audit was performed to assess if the British HIV Association 2011 guidelines on routine screening for tuberculosis in HIV are being implemented in a large UK urban clinic, and if a tuberculosis-screening prompt on the electronic patient record for new attendees was effective. Of 4658 patients attending during the inclusion period, 385 were newly diagnosed first-time attendees and routine tuberculosis screening was recommended in 165. Of these, only 6.1% of patients had a completed tuberculosis screening prompt, and 12.1% underwent routine tuberculosis screening. This audit represents the first published UK data on routine screening rates for tuberculosis in HIV and demonstrates low rates of tuberculosis screening despite an electronic screening prompt designed to simplify adherence to the national guideline. Reasons why tuberculosis screening rates were low, and the prompt ineffective, are unclear. A national audit is ongoing, and we await the results to see if our data reflect a lack of routine tuberculosis screening in HIV-infected patients at a national level. © The Author(s) 2016.

Adherence to UK national guidance for discharge information: an audit in primary care

PubMed Central

Hammad, Eman A; Wright, David John; Walton, Christine; Nunney, Ian; Bhattacharya, Debi

2014-01-01

Aims Poor communication of clinical information between healthcare settings is associated with patient harm. In 2008, the UK National Prescribing Centre (NPC) issued guidance regarding the minimum information to be communicated upon hospital discharge. This study evaluates the extent of adherence to this guidance and identifies predictors of adherence. Methods This was an audit of discharge summaries received by medical practices in one UK primary care trust of patients hospitalized for 24 h or longer. Each discharge summary was scored against the applicable NPC criteria which were organized into: ‘patient, admission and discharge’, ‘medicine’ and ‘therapy change’ information. Results Of 3444 discharge summaries audited, 2421 (70.3%) were from two teaching hospitals and 906 (26.3%) from three district hospitals. Unplanned admissions accounted for 2168 (63.0%) of the audit sample and 74.6% (2570) of discharge summaries were electronic. Mean (95% CI) adherence to the total NPC minimum dataset was 71.7% [70.2, 73.2]. Adherence to patient, admission and discharge information was 77.3% (95% CI 77.0, 77.7), 67.2% (95% CI 66.3, 68.2) for medicine information and 48.9% (95% CI 47.5, 50.3) for therapy change information. Allergy status, co-morbidities, medication history and rationale for therapy change were the most frequent omissions. Predictors of adherence included quality of the discharge template, electronic discharge summaries and smaller numbers of prescribed medicines. Conclusions Despite clear guidance regarding the content of discharge information, omissions are frequent. Adherence to the NPC minimum dataset might be improved by using comprehensive electronic discharge templates and implementation of effective medicines reconciliation at both sides of the health interface. PMID:25041244

Adherence to UK national guidance for discharge information: an audit in primary care.

PubMed

Hammad, Eman A; Wright, David John; Walton, Christine; Nunney, Ian; Bhattacharya, Debi

2014-12-01

Poor communication of clinical information between healthcare settings is associated with patient harm. In 2008, the UK National Prescribing Centre (NPC) issued guidance regarding the minimum information to be communicated upon hospital discharge. This study evaluates the extent of adherence to this guidance and identifies predictors of adherence. This was an audit of discharge summaries received by medical practices in one UK primary care trust of patients hospitalized for 24 h or longer. Each discharge summary was scored against the applicable NPC criteria which were organized into: 'patient, admission and discharge', 'medicine' and 'therapy change' information. Of 3444 discharge summaries audited, 2421 (70.3%) were from two teaching hospitals and 906 (26.3%) from three district hospitals. Unplanned admissions accounted for 2168 (63.0%) of the audit sample and 74.6% (2570) of discharge summaries were electronic. Mean (95% CI) adherence to the total NPC minimum dataset was 71.7% [70.2, 73.2]. Adherence to patient, admission and discharge information was 77.3% (95% CI 77.0, 77.7), 67.2% (95% CI 66.3, 68.2) for medicine information and 48.9% (95% CI 47.5, 50.3) for therapy change information. Allergy status, co-morbidities, medication history and rationale for therapy change were the most frequent omissions. Predictors of adherence included quality of the discharge template, electronic discharge summaries and smaller numbers of prescribed medicines. Despite clear guidance regarding the content of discharge information, omissions are frequent. Adherence to the NPC minimum dataset might be improved by using comprehensive electronic discharge templates and implementation of effective medicines reconciliation at both sides of the health interface. © 2014 The British Pharmacological Society.

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…

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.

Audit Report on "Protection of the Department of Energy's Unclassified Sensitive Electronic Information"

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

None

The Department of Energy and its contractors store and process massive quantities of sensitive information to accomplish national security, energy, science, and environmental missions. Sensitive unclassified data, such as personally identifiable information (PII), official use only, and unclassified controlled nuclear information require special handling and protection to prevent misuse of the information for inappropriate purposes. Industry experts have reported that more than 203 million personal privacy records have been lost or stolen over the past three years, including information maintained by corporations, educational institutions, and Federal agencies. The loss of personal and other sensitive information can result in substantial financialmore » harm, embarrassment, and inconvenience to individuals and organizations. Therefore, strong protective measures, including data encryption, help protect against the unauthorized disclosure of sensitive information. Prior reports involving the loss of sensitive information have highlighted weaknesses in the Department's ability to protect sensitive data. Our report on Security Over Personally Identifiable Information (DOE/IG-0771, July 2007) disclosed that the Department had not fully implemented all measures recommended by the Office of Management and Budget (OMB) and required by the National Institute of Standards and Technology (NIST) to protect PII, including failures to identify and encrypt PII maintained on information systems. Similarly, the Government Accountability Office recently reported that the Department had not yet installed encryption technology to protect sensitive data on the vast majority of laptop computers and handheld devices. Because of the potential for harm, we initiated this audit to determine whether the Department and its contractors adequately safeguarded sensitive electronic information. The Department had taken a number of steps to improve protection of PII. Our review, however

The impact of a national clinician-led audit initiative on care and mortality after hip fracture in England: an external evaluation using time trends in non-audit data.

PubMed

Neuburger, Jenny; Currie, Colin; Wakeman, Robert; Tsang, Carmen; Plant, Fay; De Stavola, Bianca; Cromwell, David A; van der Meulen, Jan

2015-08-01

Hip fracture is the most common serious injury of older people. The UK National Hip Fracture Database (NHFD) was launched in 2007 as a national collaborative, clinician-led audit initiative to improve the quality of hip fracture care, but has not yet been externally evaluated. We used routinely collected data on 471,590 older people (aged 60 years and older) admitted with a hip fracture to National Health Service (NHS) hospitals in England between 2003 and 2011. The main variables of interest were the use of early surgery (on day of admission, or day after) and mortality at 30 days from admission. We compared time trends in the periods 2003-2007 and 2007-2011 (before and after the launch of the NHFD), using Poisson regression models to adjust for demographic changes. The number of hospitals participating in the NHFD increased from 11 in 2007 to 175 in 2011. From 2007 to 2011, the rate of early surgery increased from 54.5% to 71.3%, whereas the rate had remained stable over the period 2003-2007. Thirty-day mortality fell from 10.9% to 8.5%, compared with a small reduction from 11.5% to 10.9% previously. The annual relative reduction in adjusted 30-day mortality was 1.8% per year in the period 2003-2007, compared with 7.6% per year over 2007-2011 (P<0.001 for the difference). The launch of a national clinician-led audit initiative was associated with substantial improvements in care and survival of older people with hip fracture in England.

Staff, associate specialist and specialty doctors' national audit on the management of gonorrhoea in the United Kingdom, 2015.

PubMed

Mullan, Helen; Richards, Jane; Lee, John

2017-12-01

The British Association for Sexual Health and HIV (BASHH) revised United Kingdom national guideline for the management of gonorrhoea in adults, 2011, identified five auditable outcome measures, namely, that all patients should receive first-line treatment, be screened or treated for chlamydial infection, have a test of cure (TOC), be offered written information and have partner notification carried out. The UK National Guideline for Gonorrhoea Testing, Clinical Effectiveness Group, BASHH, 2012, recommended in addition that all reactive nucleic acid amplification tests (NAATs) from pharynx and rectum should be confirmed by supplementary testing, using a second NAAT which detects a different nucleic acid target, all those with a positive NAAT for gonorrhoea should have culture and antimicrobial susceptibility testing and that TOC should be done by two weeks. Staff, associate specialist and specialty doctors performed a national audit against these standards. Data from 3233 cases were submitted; 8% of cases of gonorrhoea diagnosed in England, Scotland and Wales over this period. We found that 83% patients received first-line treatment with a reason for not doing so provided for 11%. TOC was documented for 62% and written information was offered to 41%. Results about supplementary testing were inconsistent. The results for the other outcomes were satisfactory.

25 CFR 225.26 - Auditing and accounting.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Auditing and accounting. 225.26 Section 225.26 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.26 Auditing and accounting. The Secretary may...

25 CFR 225.26 - Auditing and accounting.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Auditing and accounting. 225.26 Section 225.26 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS OIL AND GAS, GEOTHERMAL, AND SOLID MINERALS AGREEMENTS Minerals Agreements § 225.26 Auditing and accounting. The Secretary may...

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

PubMed

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

2015-04-01

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

Analysis of electrical audit and energy efficiency in building Hotel BC, North Jakarta

NASA Astrophysics Data System (ADS)

Wahyudi Biantoro, Agung

2018-03-01

The Hotel BC is using power source from PLN with capacity of 4300 kVA which is divided into 3 units of 2000 kVA transformer. Transformers are used to supply the load of Mall tenants, and Utility loads, such as Chiller, pumps and others. Problems found in the field are complaints from the hotel regarding the safety of electrical installations and wasteful, inefficient electrical costs. The purpose of this study is to check the electrical installation in the building and determine the Energy Use Intensity (EUI) and the cost of payment according to usage based on historical data of the building then compare it with the EUI standard of Ministry of Energy and Mineral Resources of Indonesia. The method used is survey measurement method and quantitative descriptive analysis by comparing in general condition of energy consumption of this building with standard issued by Ministry of Energy and Mineral Resources of Indonesia. The EUI is average 645.58 kWh/m2/year, or 53.79 kWh/m2/month, this is inefficient category, because its EUI value is > 24 kWh / m2 / month. For Electrical audit on imaging thermal test at Panel Out Going of chiller pump, 200 ampere, the highest temperature is 97.3° C, at 200 ampere phase S termination, and this is included in the major category. The numbers of hot spots on the Capacitor bank panels are 10 major points and Chiller panel has 10 major. There are many major points and they are quite dangerous because they can cause fire hazard on the panel. The AC average temperature and humidity distribution did not meet the standard of SNI (Indonesia National Standard).

Energy audit data for a resort island in the South China Sea.

PubMed

Basir Khan, M Reyasudin; Jidin, Razali; Pasupuleti, Jagadeesh

2016-03-01

The data consists of actual generation-side auditing including the distribution of loads, seasonal load profiles, and types of loads as well as an analysis of local development planning of a resort island in the South China Sea. The data has been used to propose an optimal combination of hybrid renewable energy systems that able to mitigate the diesel fuel dependency on the island. The resort island selected is Tioman, as it represents the typical energy requirements of many resort islands in the South China Sea. The data presented are related to the research article "Optimal Combination of Solar, Wind, Micro-Hydro and Diesel Systems based on Actual Seasonal Load Profiles for a Resort Island in the South China Sea" [1].

Energy audit data for a resort island in the South China Sea

PubMed Central

Basir Khan, M. Reyasudin; Jidin, Razali; Pasupuleti, Jagadeesh

2015-01-01

The data consists of actual generation-side auditing including the distribution of loads, seasonal load profiles, and types of loads as well as an analysis of local development planning of a resort island in the South China Sea. The data has been used to propose an optimal combination of hybrid renewable energy systems that able to mitigate the diesel fuel dependency on the island. The resort island selected is Tioman, as it represents the typical energy requirements of many resort islands in the South China Sea. The data presented are related to the research article “Optimal Combination of Solar, Wind, Micro-Hydro and Diesel Systems based on Actual Seasonal Load Profiles for a Resort Island in the South China Sea” [1]. PMID:26900590

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

PubMed

Swaffield, J

1995-09-01

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

A survey of audit activity in general practice.

PubMed Central

Hearnshaw, H; Baker, R; Cooper, A

1998-01-01

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

BASHH 2016 UK national audit and survey of HIV testing, risk assessment and follow-up: case note audit.

PubMed

Bhaduri, Sumit; Curtis, Hilary; McClean, Hugo; Sullivan, Ann K

2018-01-01

This national audit demonstrated discrepancies between actual practice and that indicated by clinic policies following enquiry about alcohol, recreational drugs and chemsex use. Clinics were more likely to enquire about risk behaviour if this was clinic policy or routine practice. Previous testing was the most common reason for refusing HIV testing, although 33% of men who have sex with men had a prior test of more than three months ago. Of the group declining due to recent exposure in the window period, 21/119 cases had an exposure within the four weeks prior to presentation, but had a previous risk not covered by previous testing. Recommendations include provision of risk assessments for alcohol, recreational drug use and chemsex, documenting reasons for HIV test refusal, provision of HIV point-of-care testing, follow-up for cases at higher risk of HIV and advice about community testing or self-sampling/testing.

Building Energy Audit Report, for Hickam AFB, HI

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

Chvala, William D.; De La Rosa, Marcus I.; Brown, Daryl R.

2010-09-30

A building energy assessment was performed by a team of engineers from Pacific Northwest National Laboratory (PNNL) under contract to the Department of Energy/Federal Energy Management program (FEMP). The effort used the Facility Energy Decision System (FEDS) model to determine how energy is consumed at Hickam AFB, identify the most cost-effective energy retrofit measures, and calculate the potential energy and cost savings. This documents reports the results of that assessment.

Building Energy Audit Report for Camp Smith, HI

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

Chvala, William D.; De La Rosa, Marcus I.; Brown, Daryl R.

2010-09-30

A detailed energy assessment was performed by a team of engineers from Pacific Northwest National Laboratory (PNNL) under contract to the Department of Energy/Federal Energy Management program (FEMP). The effort used the Facility Energy Decision System (FEDS) model to determine how energy is consumed at Camp Smith, identify the most cost-effective energy retrofit measures, and calculate the potential energy and cost savings. This report documents the results of that assessment.

Influencing the practice and outcome in acute upper gastrointestinal haemorrhage. Steering Committee of the National Audit of Acute Upper Gastrointestinal Haemorrhage.

PubMed

Rockall, T A; Logan, R F; Devlin, H B; Northfield, T C

1997-11-01

To assess changes in practice and outcome in acute upper gastrointestinal haemorrhage following the feedback of data, the reemphasis of national guidelines, and specific recommendations following an initial survey. A prospective, multicentre, audit cycle. Forty five hospitals from three health regions participated in two phases of the audit cycle. Phase I: 2332 patients with acute upper gastrointestinal haemorrhage; phase II: 1625 patients with upper gastrointestinal haemorrhage. Patients were evaluated with respect to management (with reference to the recommendations in the national guidelines), mortality, and length of hospital stay. Following the distribution of data from the first phase of the National Audit and the formulation of specific recommendations for improving practice, the proportion of hospitals with local guidelines or protocols for the management of upper gastrointestinal haemorrhage rose from 71% (32/45) to 91% (41/45); 12 of the 32 hospitals with guidelines during the first phase revised their guidelines following the initial survey. There was a small but significant increase in the proportion of all patients who underwent endoscopy (from 81% to 86%), the proportion who underwent endoscopy within 24 hours of admission (from 50% to 56%), and the use of central venous pressure monitoring in patients with organ failure requiring blood transfusion or those with profound shock (from 30% to 43%). There was, however, no change in the use of high dependency beds or joint medical/surgical management in high risk cases. There was no significant change in crude or risk standardised mortality (13.4% in the first phase and 14.4% in the second phase). Although many of the participating hospitals have made efforts to improve practice by producing or updating guidelines or protocols, there has been only a small demonstrable change in some areas of practice during the National Audit. The failure to detect any improvement in mortality may reflect this lack of

10 CFR 603.655 - Frequency of periodic audits of for-profit participants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... audit, unless the participant already had a systems audit due to other Federal awards within the past... to verify that the participant's systems continue to be reliable (the audit then would cover the two... 10 Energy 4 2010-01-01 2010-01-01 false Frequency of periodic audits of for-profit participants...

Determination of Energy of a Clinical Electron Beam as Part of a Routine Quality Assurance and Audit System

NASA Astrophysics Data System (ADS)

Hernández-Bello, Jimmy; D'Souza, Derek; Rossenberg, Ivan

2002-08-01

A method to determine the electron beam energy and an electron audit based on the current IPEM electron Code of Practice has been devised. During the commissioning on the new Varian 2100CD linear accelerator in The Middlesex Hospital, two methods were devised for the determination of electron energy. The first method involves the use of a two-depth method, whereby the ratio of ionisation (presented as a percentage) measured by an ion chamber at two depths in solid water is used to compare against the baseline ionisation depth value for that energy. The second method involves the irradiation of an X-ray film in solid water to obtain a depth dose curve and, hence determine the half value depth and practical range of the electrons. The results showed that the two-depth method has a better accuracy, repeatability, reliability and consistency than the X-ray method. The results for the electron audit showed that electron absolute outputs are obtained from ionisation measurements in solid water, where the energy-range parameters such as practical range and the depth at which ionisation is 50% of that at the maximum for the depth-ionisation curve are determined.

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

45 CFR 1157.26 - Non-Federal audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE ARTS UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE... Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations,” have met the audit...

32 CFR 37.1115 - What are my responsibilities related to participants' single audits?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Department of Defense for ensuring that participants submit audit reports and for resolving any findings in... 32 National Defense 1 2013-07-01 2013-07-01 false What are my responsibilities related to participants' single audits? 37.1115 Section 37.1115 National Defense Department of Defense OFFICE OF THE...

32 CFR 37.1115 - What are my responsibilities related to participants' single audits?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Department of Defense for ensuring that participants submit audit reports and for resolving any findings in... 32 National Defense 1 2010-07-01 2010-07-01 false What are my responsibilities related to participants' single audits? 37.1115 Section 37.1115 National Defense Department of Defense OFFICE OF THE...

32 CFR 37.1115 - What are my responsibilities related to participants' single audits?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Department of Defense for ensuring that participants submit audit reports and for resolving any findings in... 32 National Defense 1 2012-07-01 2012-07-01 false What are my responsibilities related to participants' single audits? 37.1115 Section 37.1115 National Defense Department of Defense OFFICE OF THE...

32 CFR 37.1115 - What are my responsibilities related to participants' single audits?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Department of Defense for ensuring that participants submit audit reports and for resolving any findings in... 32 National Defense 1 2011-07-01 2011-07-01 false What are my responsibilities related to participants' single audits? 37.1115 Section 37.1115 National Defense Department of Defense OFFICE OF THE...

Notification: Cancellation of Audit on Status of Corrective Actions to Address Operational Deficiencies at the EPA’s National Center for Radiation Field Operations

EPA Pesticide Factsheets

Project #OA-FY16-0179, September 20, 2016. The EPA OIG is canceling its audit on status of corrective actions to address operational deficiencies at the EPA’s National Center for Radiation Field Operations.

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.

National Beef Quality Audit-2011: Harvest-floor assessments of targeted characteristics that affect quality and value of cattle, carcasses, and byproducts

USDA-ARS?s Scientific Manuscript database

The National Beef Quality Audit-2011(NBQA-2011) was conducted to assess targeted characteristics on the harvest floor that affect the quality and value of cattle, carcasses, and byproducts. Survey teams evaluated approximately 18,000 cattle/carcasses between May and November 2011 in 8 beef processin...

Sandia National Laboratories: Working with Sandia: Contract Audit

Science.gov Websites

Government Auditing Standards. Electronic Cost Claims Electronic Cost Claim (ECC) An Electronic Cost Claim is ) ECC-Cost Reimbursable Template and Instructions (MS Excel) ECC-University Template (MS Excel) ECC -Indirect Rates (Indirect Rate Cost Claim) (MS Excel) Electronic Cost Proposals Electronic Cost Proposal

Clinical Implications of TiGRT Algorithm for External Audit in Radiation Oncology.

PubMed

Shahbazi-Gahrouei, Daryoush; Saeb, Mohsen; Monadi, Shahram; Jabbari, Iraj

2017-01-01

Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. Nonhomogeneous phantom as quality dose verification phantom, Farmer ionization chambers, and PC-electrometer (Sun Nuclear, USA) as a reference class electrometer was employed throughout the audit in linear accelerators 6 and 18 MV energies (Siemens ONCOR Impression Plus, Germany). Seven test cases were performed using semi CIRS phantom. In homogeneous regions and simple plans for both energies, there was a good agreement between measured and treatment planning system calculated dose. Their relative error was found to be between 0.8% and 3% which is acceptable for audit, but in nonhomogeneous organs, such as lung, a few errors were observed. In complex treatment plans, when wedge or shield in the way of energy is used, the error was in the accepted criteria. In complex beam plans, the difference between measured and calculated dose was found to be 2%-3%. All differences were obtained between 0.4% and 1%. A good consistency was observed for the same type of energy in the homogeneous and nonhomogeneous phantom for the three-dimensional conformal field with a wedge, shield, asymmetric using the TiGRT treatment planning software in studied center. The results revealed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy was globally within acceptable standards with no major causes for concern.

AUDIT OF OXYGEN PRESCRIBING IN A CHILDREN'S HOSPITAL.

PubMed

Wheeler, Lucy; James, Janet; Byrne, Sarah; Forton, Julian

2016-09-01

To audit oxygen prescribing in a children's hospital following the introduction of a new paediatric medication chart, which incorporates an oxygen prescription section. In June 2015 a 1-day snapshot audit was carried out across all wards in the children's hospital. All patients receiving oxygen on that day were included:▸ The audit was repeated in July 2015.▸ The standards for the audit were set at 100% in accordance with our local guidelines.1 ▸ All patients receiving oxygen should have a prescription. Of these:▸ All patients should have target saturations identified.▸ All patients should have an administration device identified.▸ All patients should have a nurse signature on the chart within the last 12 hrs. In June, 13 patients were receiving oxygen on the audit day. 0/14 had a prescription.In July, 18 patients were receiving oxygen on the audit day. (14 critical care, 4 medicine).4/18 had an oxygen prescription (22%). These were all medical patients. Of these, 4 patients had a target saturation identified (100%), 1 had a device prescribed (25%), and 4 had a nurse signature within the last 12 hrs (100%). The initial audit showed no compliance with either local or national guidance for oxygen prescribing.1 2 The re-audit showed improved prescribing on the medical wards but not within critical care. The new paediatric medication chart was launched early in 2015, along with a training package for doctors, nurses and pharmacists. This was in response to the National Patient Safety Agency (NPSA) rapid response report on oxygen safety in hospitals.3 There was a gap between the training and the new charts being available which may have led to the poor results in the first audit. Increased awareness of the charts and the initial audit results probably helped improve prescribing in the re-audit. For medical patients, prescribing and monitoring was good, although device was infrequently prescribed. Critical care have not engaged with the new chart

A model for national outcome audit in vascular surgery.

PubMed

Prytherch, D R; Ridler, B M; Beard, J D; Earnshaw, J J

2001-06-01

The aim was to model vascular surgical outcome in a national study using POSSUM scoring. One hundred and twenty-one British and Irish surgeons completed data questionnaires on patients undergoing arterial surgery under their care (mean 12 patients, range 1-49) in May/June 1998. A total of 1480 completed data records were available for logistic regression analysis using P-POSSUM methodology. Information collected included all POSSUM data items plus other factors thought to have a significant bearing on patient outcome: "extra items". The main outcome measures were death and major postoperative complications. The data were checked and inconsistent records were excluded. The remaining 1313 were divided into two sets for analysis. The first "training" set was used to obtain logistic regression models that were applied prospectively to the second "test" dataset. using POSSUM data items alone, it was possible to predict both mortality and morbidity after vascular reconstruction using P-POSSUM analysis. The addition of the "extra items" found significant in regression analysis did not significantly improve the accuracy of prediction. It was possible to predict both mortality and morbidity derived from the preoperative physiology components of the POSSUM data items alone. this study has shown that P-POSSUM methodology can be used to predict outcome after arterial surgery across a range of surgeons in different hospitals and could form the basis of a national outcome audit. It was also possible to obtain accurate models for both mortality and major morbidity from the POSSUM physiology scores alone. Copyright 2001 Harcourt Publishers Limited.

The national one week prevalence audit of universal meticillin-resistant Staphylococcus aureus (MRSA) admission screening 2012.

PubMed

Fuller, Christopher; Robotham, Julie; Savage, Joanne; Hopkins, Susan; Deeny, Sarah R; Stone, Sheldon; Cookson, Barry

2013-01-01

The English Department of Health introduced universal MRSA screening of admissions to English hospitals in 2010. It commissioned a national audit to review implementation, impact on patient management, admission prevalence and extra yield of MRSA identified compared to "high-risk" specialty or "checklist-activated" screening (CLAS) of patients with MRSA risk factors. National audit May 2011. Questionnaires to infection control teams in all English NHS acute trusts, requesting number patients admitted and screened, new or previously known MRSA; MRSA point prevalence; screening and isolation policies; individual risk factors and patient management for all new MRSA patients and random sample of negatives. 144/167 (86.2%) trusts responded. Individual patient data for 760 new MRSA patients and 951 negatives. 61% of emergency admissions (median 67.3%), 81% (median 59.4%) electives and 47% (median 41.4%) day-cases were screened. MRSA admission prevalence: 1% (median 0.9%) emergencies, 0.6% (median 0.4%) electives, 0.4% (median 0%) day-cases. Approximately 50% all MRSA identified was new. Inpatient MRSA point prevalence: 3.3% (median 2.9%). 104 (77%) trusts pre-emptively isolated patients with previous MRSA, 63 (35%) pre-emptively isolated admissions to "high-risk" specialties; 7 (5%) used PCR routinely. Mean time to MRSA positive result: 2.87 days (±1.33); 37% (219/596) newly identified MRSA patients discharged before result available; 55% remainder (205/376) isolated post-result. In an average trust, CLAS would reduce screening by 50%, identifying 81% of all MRSA. "High risk" specialty screening would reduce screening by 89%, identifying 9% of MRSA. Implementation of universal screening was poor. Admission prevalence (new cases) was low. CLAS reduced screening effort for minor decreases in identification, but implementation may prove difficult. Cost effectiveness of this and other policies, awaits evaluation by transmission dynamic economic modelling, using data from

18 CFR 37.7 - Auditing Transmission Service Information.

Code of Federal Regulations, 2011 CFR

2011-04-01

... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT OPEN ACCESS SAME-TIME INFORMATION... time stamped. (b) Audit data must remain available for download on the OASIS for 90 days, except ATC/TTC postings that must remain available for download on the OASIS for 20 days. The audit data are to...

18 CFR 37.7 - Auditing Transmission Service Information.

Code of Federal Regulations, 2010 CFR

2010-04-01

... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT OPEN ACCESS SAME-TIME INFORMATION... time stamped. (b) Audit data must remain available for download on the OASIS for 90 days, except ATC/TTC postings that must remain available for download on the OASIS for 20 days. The audit data are to...

18 CFR 37.7 - Auditing Transmission Service Information.

Code of Federal Regulations, 2012 CFR

2012-04-01

... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT OPEN ACCESS SAME-TIME INFORMATION... time stamped. (b) Audit data must remain available for download on the OASIS for 90 days, except ATC/TTC postings that must remain available for download on the OASIS for 20 days. The audit data are to...

18 CFR 37.7 - Auditing Transmission Service Information.

Code of Federal Regulations, 2014 CFR

2014-04-01

... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT OPEN ACCESS SAME-TIME INFORMATION... time stamped. (b) Audit data must remain available for download on the OASIS for 90 days, except ATC/TTC postings that must remain available for download on the OASIS for 20 days. The audit data are to...

18 CFR 37.7 - Auditing Transmission Service Information.

Code of Federal Regulations, 2013 CFR

2013-04-01

... COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT OPEN ACCESS SAME-TIME INFORMATION... time stamped. (b) Audit data must remain available for download on the OASIS for 90 days, except ATC/TTC postings that must remain available for download on the OASIS for 20 days. The audit data are to...

48 CFR 925.901 - Omission of the audit clause.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Omission of the audit clause. 925.901 Section 925.901 Federal Acquisition Regulations System DEPARTMENT OF ENERGY SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Additional Foreign Acquisition Clauses 925.901 Omission of the audit clause...

National Energy Outlook: 1976 Executive Summary.

ERIC Educational Resources Information Center

Federal Energy Administration, Washington, DC.

This brochure begins with findings and conclusions of the 1975 NATIONAL ENERGY OUTLOOK. Discussions of national energy topics follow, including: What Are the Roots of Our Energy Problem? How Did We Become So Vulnerable to Oil Imports?; How Much Energy Will the Nation Consume?; How Will the National Meet Its Growing Energy Demands by 1985; How Much…

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

Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study.

PubMed

Ross, P; Hubert, J; Wong, W L

2017-02-01

To identify the barriers and facilitators of doctors' engagement with clinical audit and to explore how and why these factors influenced doctors' decisions to engage with the NHS National Clinical Audit Programme. A single-embedded case study. Mixed methods sequential approach with explorative pilot study and follow-up survey. Pilot study comprised 13 semi-structured interviews with purposefully selected consultant doctors over a six-month period. Interview data coded and analysed using directed thematic content analysis with themes compared against the study's propositions. Themes derived from the pilot study informed the online survey question items. Exploratory factor analysis using STATA and descriptive statistical methods applied to summarise findings. Data triangulation techniques used to corroborate and validate findings across the different methodological techniques. NHS National PET-CT Clinical Audit Programme. Doctors reporting on the Audit Programme. Extent of engagement with clinical audit, factors that influence engagement with clinical audit. Online survey: 58/59 doctors responded (98.3%). Audit was found to be initially threatening (79%); audit was reassuring (85%); audit helped validate professional competence (93%); participation in audit improved reporting skills (76%). Three key factors accounted for 97.6% of the variance in survey responses: (1) perception of audit's usefulness, (2) a common purpose, (3) a supportive blame free culture of trust. Factor 1 influenced medical engagement most. The study documents performance feedback as a key facilitator of medical engagement with clinical audit. It found that medical engagement with clinical audit was associated with reduced levels of professional anxiety and higher levels of perceived self-efficacy.

28 CFR 901.4 - Audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Audits. 901.4 Section 901.4 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL FINGERPRINT SUBMISSION REQUIREMENTS § 901.4... must include mechanisms to determine whether fingerprints were submitted within the time frame...

28 CFR 901.4 - Audits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Audits. 901.4 Section 901.4 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL FINGERPRINT SUBMISSION REQUIREMENTS § 901.4... must include mechanisms to determine whether fingerprints were submitted within the time frame...

28 CFR 901.4 - Audits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Audits. 901.4 Section 901.4 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL FINGERPRINT SUBMISSION REQUIREMENTS § 901.4... must include mechanisms to determine whether fingerprints were submitted within the time frame...

28 CFR 901.4 - Audits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Audits. 901.4 Section 901.4 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL FINGERPRINT SUBMISSION REQUIREMENTS § 901.4... must include mechanisms to determine whether fingerprints were submitted within the time frame...

28 CFR 901.4 - Audits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Audits. 901.4 Section 901.4 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL FINGERPRINT SUBMISSION REQUIREMENTS § 901.4... must include mechanisms to determine whether fingerprints were submitted within the time frame...

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

PubMed

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

2000-03-01

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

Childhood obesity in secondary care: national prospective audit of Australian pediatric practice.

PubMed

Campbell, Michele; Bryson, Hannah E; Price, Anna M H; Wake, Melissa

2013-01-01

In many countries, pediatricians offer skilled secondary care for children with conditions more challenging than can readily be managed in the primary care sector, but the extent to which this sector engages with the detection and management of obesity remains largely unexplored. This study aimed to audit the prevalence, diagnosis, patient, and consultation characteristics of obesity in Australian pediatric practices. This was a national prospective patient audit in Australia. During the course of 2 weeks, members of the Australian Paediatric Research Network prospectively recorded consecutive outpatient consultations by using a brief standardized data collection form. Measures included height, weight, demographics, child and parent health ratings, diagnoses, referrals, investigations, and consultation characteristics. We compared the prevalence of pediatrician-diagnosed and measured obesity (body mass index ≥95th percentile) and top-ranked diagnoses, patient, and consultation characteristics in (a) obese and nonobese children, and (b) obese children with and without a diagnosis. A total of 198 pediatricians recorded 5466 consultations with 2-17 year olds, with body mass index z-scores calculated for 3436 (62.9%). Of the 12.6% obese children, only one-third received an "overweight/obese" diagnosis. Obese children diagnosed as overweight/obese were heavier, older, and in poorer health than those not diagnosed and incurred more Medicare (government-funded health system) cost and referrals. Obesity is infrequently clinically diagnosed by Australian pediatricians and measurement practices vary widely. Further research could focus on supporting and normalizing clinical obesity activities from which pediatricians and parents could see clear benefits. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit.

PubMed

Nolan, Jerry P; Soar, Jasmeet; Smith, Gary B; Gwinnutt, Carl; Parrott, Francesca; Power, Sarah; Harrison, David A; Nixon, Edel; Rowan, Kathryn

2014-08-01

To report the incidence, characteristics and outcome of adult in-hospital cardiac arrest in the United Kingdom (UK) National Cardiac Arrest Audit database. A prospectively defined analysis of the UK National Cardiac Arrest Audit (NCAA) database. 144 acute hospitals contributed data relating to 22,628 patients aged 16 years or over receiving chest compressions and/or defibrillation and attended by a hospital-based resuscitation team in response to a 2222 call. The main outcome measures were incidence of adult in-hospital cardiac arrest and survival to hospital discharge. The overall incidence of adult in-hospital cardiac arrest was 1.6 per 1000 hospital admissions with a median across hospitals of 1.5 (interquartile range 1.2-2.2). Incidence varied seasonally, peaking in winter. Overall unadjusted survival to hospital discharge was 18.4%. The presenting rhythm was shockable (ventricular fibrillation or pulseless ventricular tachycardia) in 16.9% and non-shockable (asystole or pulseless electrical activity) in 72.3%; rates of survival to hospital discharge associated with these rhythms were 49.0% and 10.5%, respectively, but varied substantially across hospitals. These first results from the NCAA database describing the current incidence and outcome of adult in-hospital cardiac arrest in UK hospitals will serve as a benchmark from which to assess the future impact of changes in service delivery, organisation and treatment for in-hospital cardiac arrest. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Energy audits of boiler chiller plants, Energy Engineering Analysis Program, Fort Bragg, North Carolina, volume 1: Narrative report

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

NONE

1991-03-01

This document constitutes the Pre-Final Submittal for Contract DACA21-84-C-0603, Energy Audits of Boiler/Chiller Plants, Ft. Bragg, North Carolina. The purpose of this report is to indicate the work accomplished to date, show samples of field data collected, illustrate the methods and justifications of the approaches taken, outline the present conditions, and make recommendations for the potential energy efficiency improvements to the central energy plants of Fort Bragg. The specific buildings analyzed are: (1) Building C-1432 82nd Heating Plant; (2) Building D-3529 JFK Heating Cooling Plant, and (3) Building C-6039 82nd Chiller Plant. The following buildings were part of the originalmore » scope of work, but were deleted for reasons explained further in Section 1.0 of this report: (1) Building C-7549 Standby Plant for C-1432; (2) Building N-6002 New EM Barracks Complex; and (3) Building H-6240 `H` Area Chiller Plant.« less

National Energy Legislation

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

NONE

1992-12-31

The impact of state regulation of nuclear power, since PG&E and Silkwood, on the implementation of national energy policy on nuclear power is evident in the debates on federal legislation required for such implementation. The political demands that confront some states for an expanded role in the regulation of commercial nuclear power plants also confront Congress, which is responsible for the legislative implementation of the strategy proposed in the Report. The expansion of state and local regulation of nuclear plants, however, will complicate and possibly frustrate the efforts of Congress to enact the strategy for nuclear power into law. Themore » debates on Senate Bill 1220, the National Energy Security Act of 1991, indicate that the expansion of state regulation of nuclear power will frustrate the implementation of the national energy policy on nuclear power. Senate Bill 1220 would enact a comprehensive national energy policy. For example, Title XI would further deregulate the production of natural gas; Title XIV is concerned with secure supplies, and the use of coal in the future. Senate Bill 1220 would also amend PUHCA. Of particular significance for nuclear power, however, are Titles VIII and IX. The House and Senate debates on House Bill 1301 and Senate Bill 1220 are summarized.« less

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

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

PubMed

Hughes, Rhidian

2005-01-01

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

What We Are Really Doing with ICT in Physical Education: A National Audit of Equipment, Use, Teacher Attitudes, Support, and Training

ERIC Educational Resources Information Center

Thomas, Andrew; Stratton, Gareth

2006-01-01

This paper reports on the results from a detailed national audit of information communication technology (ICT) in physical education (PE), examining attitudes, training, numbers of pieces of equipment and hardware owned, and its employment and use across nine Local Education Authorities, six types of schools, and four types of Specialist College.…

National energy policy

NASA Technical Reports Server (NTRS)

1973-01-01

The efforts of the U.S. government to cope with the national energy crisis are discussed. The provisions of several legislative actions to implement the actions for energy conservation are examined. Immediate conservation measures and the long range planning for energy resources are reported.

32 CFR 32.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Non-Federal audits. 32.26 Section 32.26 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS...

10 CFR 600.126 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Non-Federal audits. 600.126 Section 600.126 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Uniform Administrative Requirements for Grants and Cooperative Agreements With Institutions of Higher Education, Hospitals, and Other Nonprofit Organizations Post-Award...

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

NASA Astrophysics Data System (ADS)

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

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

Clinical Implications of TiGRT Algorithm for External Audit in Radiation Oncology

PubMed Central

Shahbazi-Gahrouei, Daryoush; Saeb, Mohsen; Monadi, Shahram; Jabbari, Iraj

2017-01-01

Background: Performing audits play an important role in quality assurance program in radiation oncology. Among different algorithms, TiGRT is one of the common application software for dose calculation. This study aimed to clinical implications of TiGRT algorithm to measure dose and compared to calculated dose delivered to the patients for a variety of cases, with and without the presence of inhomogeneities and beam modifiers. Materials and Methods: Nonhomogeneous phantom as quality dose verification phantom, Farmer ionization chambers, and PC-electrometer (Sun Nuclear, USA) as a reference class electrometer was employed throughout the audit in linear accelerators 6 and 18 MV energies (Siemens ONCOR Impression Plus, Germany). Seven test cases were performed using semi CIRS phantom. Results: In homogeneous regions and simple plans for both energies, there was a good agreement between measured and treatment planning system calculated dose. Their relative error was found to be between 0.8% and 3% which is acceptable for audit, but in nonhomogeneous organs, such as lung, a few errors were observed. In complex treatment plans, when wedge or shield in the way of energy is used, the error was in the accepted criteria. In complex beam plans, the difference between measured and calculated dose was found to be 2%–3%. All differences were obtained between 0.4% and 1%. Conclusions: A good consistency was observed for the same type of energy in the homogeneous and nonhomogeneous phantom for the three-dimensional conformal field with a wedge, shield, asymmetric using the TiGRT treatment planning software in studied center. The results revealed that the national status of TPS calculations and dose delivery for 3D conformal radiotherapy was globally within acceptable standards with no major causes for concern. PMID:28989910

National energy strategy to be devised

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

Not Available

Secretary of Energy James D. Watkins has announced the Department of Energy's plans to develop a national energy strategy. Leaders of three national associations voiced concern that organizers of the U.S. Department of Energy hearings made no contract with the American Wind Energy Association, (AWEA) and National Wood Energy Association (NWEA) or the Solar Energy Industries Association (SEIA). All three representatives urged the DOE to address the problems of acid rain, global climate change and continued reliance on imported fuel. The renewable energy industry groups expressed hope that a future DOE meeting with Watkins and the renewable energy industries willmore » be held to discuss the components of a national energy strategy encouraging the use of renewable energy sources.« less

What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review.

PubMed

Foy, R; Eccles, M P; Jamtvedt, G; Young, J; Grimshaw, J M; Baker, R

2005-07-13

Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care. We selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised. National guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently. Audit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward.

32 CFR 203.16 - Record retention and audits.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Record retention and audits. 203.16 Section 203.16 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... preserve detailed records in connection with the contract reflecting acquisitions, work progress, reports...

32 CFR 203.16 - Record retention and audits.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Record retention and audits. 203.16 Section 203.16 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... preserve detailed records in connection with the contract reflecting acquisitions, work progress, reports...

32 CFR 203.16 - Record retention and audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Record retention and audits. 203.16 Section 203.16 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... preserve detailed records in connection with the contract reflecting acquisitions, work progress, reports...

32 CFR 203.16 - Record retention and audits.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Record retention and audits. 203.16 Section 203.16 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... preserve detailed records in connection with the contract reflecting acquisitions, work progress, reports...

32 CFR 203.16 - Record retention and audits.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Record retention and audits. 203.16 Section 203.16 National Defense Department of Defense (Continued) OFFICE OF THE SECRETARY OF DEFENSE (CONTINUED... preserve detailed records in connection with the contract reflecting acquisitions, work progress, reports...

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

Reducing the blame culture through clinical audit in nuclear medicine: a mixed methods study

PubMed Central

Ross, P; Hubert, J

2017-01-01

Objectives To identify the barriers and facilitators of doctors’ engagement with clinical audit and to explore how and why these factors influenced doctors’ decisions to engage with the NHS National Clinical Audit Programme. Design A single-embedded case study. Mixed methods sequential approach with explorative pilot study and follow-up survey. Pilot study comprised 13 semi-structured interviews with purposefully selected consultant doctors over a six-month period. Interview data coded and analysed using directed thematic content analysis with themes compared against the study’s propositions. Themes derived from the pilot study informed the online survey question items. Exploratory factor analysis using STATA and descriptive statistical methods applied to summarise findings. Data triangulation techniques used to corroborate and validate findings across the different methodological techniques. Setting NHS National PET-CT Clinical Audit Programme. Participants Doctors reporting on the Audit Programme. Main Outcome measures Extent of engagement with clinical audit, factors that influence engagement with clinical audit. Results Online survey: 58/59 doctors responded (98.3%). Audit was found to be initially threatening (79%); audit was reassuring (85%); audit helped validate professional competence (93%); participation in audit improved reporting skills (76%). Three key factors accounted for 97.6% of the variance in survey responses: (1) perception of audit’s usefulness, (2) a common purpose, (3) a supportive blame free culture of trust. Factor 1 influenced medical engagement most. Conclusions The study documents performance feedback as a key facilitator of medical engagement with clinical audit. It found that medical engagement with clinical audit was associated with reduced levels of professional anxiety and higher levels of perceived self-efficacy. PMID:28210493

The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis.

PubMed

Hopkins, C; Browne, J P; Slack, R; Lund, V; Topham, J; Reeves, B; Copley, L; Brown, P; van der Meulen, J

2006-10-01

This study summarises the results of a National Audit of sino-nasal surgery carried out in England and Wales. It describes patient and operative characteristics as well as patient outcomes up to 36 months after surgery. Prospective cohort study. NHS hospitals in England and Wales. Consecutive patients undergoing surgery for nasal polyposis and/or chronic rhinosinusitis. The total score derived from a 22-item version of the Sino-Nasal Outcome Test (SNOT-22). Lower scores represent better health-related quality of life. A total of 3128 consecutive patients at 87 NHS hospitals were enrolled. There is a large improvement in SNOT-22 scores from the pre-operative period (mean = 42.0) to 3 months after surgery (mean = 25.5). The scores for patients undergoing nasal polypectomy improved from 41.0 before surgery to 23.1 at 3 months after surgery, while the scores for patients undergoing surgery for chronic rhinosinusitis alone improved from 44.2 to 31.2. The SNOT-22 scores reported at 12 and 36 months after surgery were similar to those reported at 3 months. Excessive bleeding occurred in 5% of patients during the operation and in 1% of patients after the operation. Intra-orbital complications were reported in 0.2%. Of those patients undergoing primary surgery for bilateral grade I or II polyposis, 18% had not received a pre-operative course of steroid treatment. At the 36-month follow-up, 11.4% of patients had undergone revision surgery. The audit confirms that sino-nasal surgery is generally safe and effective. There is some evidence that patient selection for surgery could be improved.

Benchmarking against the National Emergency Laparotomy Audit recommendations.

PubMed

Ho, Yiu Ming; Cappello, Julie; Kousary, Ramin; McGowan, Brian; Wysocki, Arkadiusz P

2018-05-01

The Royal College of Anaesthetists published the National Emergency Laparotomy Audit (NELA) to describe and compare inpatient care and outcomes of major emergency abdominal surgery in England and Wales in 2015 and 2016. The purpose of this article is to compare emergency abdominal surgical care and mortality in a regional hospital (Logan Hospital, Queensland, Australia) with NELA results. Data were extracted from two databases. All deaths from May 2010 to April 2015 were reviewed and patients who had an emergency abdominal operation within 30 days of death were identified. The health records of all patients who underwent abdominal surgery were extracted and those who had an emergency laparotomy were identified for analysis. Three hundred and fifty patients underwent emergency laparotomy and were included in the analysis. The total 30-day mortality during this 5-year period was 9.7%. Factors affecting mortality included age, Portsmouth-Physiological and Operative Severity Score (P-POSSUM) and admission source. Timing of antibiotic administration, use of perioperative medical service and frequency of intensive care admission were the same in patients who died and survived. Mortality in patients following emergency laparotomy at Logan Hospital compares favourably with 11.1% reported by NELA. This may be partly attributable to case mix distribution as for each P-POSSUM risk Logan Hospital mortality was at the upper end of that reported by NELA. Further Australia data are required. Improved compliance with NELA recommendations may improve outcomes. © 2017 Royal Australasian College of Surgeons.

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.

32 CFR 37.655 - Must I specify the frequency of IPAs' periodic audits of for-profit participants?

Code of Federal Regulations, 2010 CFR

2010-07-01

... had a systems audit due to other Federal awards within the past two years. The frequency thereafter...'s systems are reliable (the audit then would cover the two or three-year period between audits). The... audits of for-profit participants? 37.655 Section 37.655 National Defense Department of Defense OFFICE OF...

40 CFR 141.808 - Audits and inspections.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Aircraft Drinking Water Rule § 141.808 Audits and..., disinfection and flushing, and general maintenance and self-inspections of aircraft water system. (b) Air... delivery of safe drinking water. ...

Pawnee Nation Energy Option Analyses

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

Matlock, M.; Kersey, K.; Riding In, C.

2009-07-21

Pawnee Nation of Oklahoma Energy Option Analyses In 2003, the Pawnee Nation leadership identified the need for the tribe to comprehensively address its energy issues. During a strategic energy planning workshop a general framework was laid out and the Pawnee Nation Energy Task Force was created to work toward further development of the tribe’s energy vision. The overarching goals of the “first steps” project were to identify the most appropriate focus for its strategic energy initiatives going forward, and to provide information necessary to take the next steps in pursuit of the “best fit” energy options. Description of Activities Performedmore » The research team reviewed existing data pertaining to the availability of biomass (focusing on woody biomass, agricultural biomass/bio-energy crops, and methane capture), solar, wind and hydropower resources on the Pawnee-owned lands. Using these data, combined with assumptions about costs and revenue streams, the research team performed preliminary feasibility assessments for each resource category. The research team also reviewed available funding resources and made recommendations to Pawnee Nation highlighting those resources with the greatest potential for financially-viable development, both in the near-term and over a longer time horizon. Findings and Recommendations Due to a lack of financial incentives for renewable energy, particularly at the state level, combined mediocre renewable energy resources, renewable energy development opportunities are limited for Pawnee Nation. However, near-term potential exists for development of solar hot water at the gym, and an exterior wood-fired boiler system at the tribe’s main administrative building. Pawnee Nation should also explore options for developing LFGTE resources in collaboration with the City of Pawnee. Significant potential may also exist for development of bio-energy resources within the next decade. Pawnee Nation representatives should closely

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

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

What do we know about how to do audit and feedback? Pitfalls in applying evidence from a systematic review

PubMed Central

Foy, R; Eccles, MP; Jamtvedt, G; Young, J; Grimshaw, JM; Baker, R

2005-01-01

Background Improving the quality of health care requires a range of evidence-based activities. Audit and feedback is commonly used as a quality improvement tool in the UK National Health Service [NHS]. We set out to assess whether current guidance and systematic review evidence can sufficiently inform practical decisions about how to use audit and feedback to improve quality of care. Methods We selected an important chronic disease encountered in primary care: diabetes mellitus. We identified recommendations from National Institute for Clinical Excellence (NICE) guidance on conducting audit and generated questions which would be relevant to any attempt to operationalise audit and feedback in a healthcare service setting. We explored the extent to which a systematic review of audit and feedback could provide practical guidance about whether audit and feedback should be used to improve quality of diabetes care and, if so, how audit and feedback could be optimised. Results National guidance suggests the importance of securing the right organisational conditions and processes. Review evidence suggests that audit and feedback can be effective in changing healthcare professional practice. However, the available evidence says relatively little about the detail of how to use audit and feedback most efficiently. Conclusion Audit and feedback will continue to be an unreliable approach to quality improvement until we learn how and when it works best. Conceptualising audit and feedback within a theoretical framework offers a way forward. PMID:16011811

Identifying acute myocardial infarction: effects on treatment and mortality, and implications for National Service Framework audit.

PubMed

Sapsford, R J; Lawrance, R A; Dorsch, M F; Das, R; Jackson, B M; Morrell, C; Robinson, M B; Hall, A S

2003-03-01

The National Service Framework (NSF) for Coronary Heart Disease requires annual clinical audit of the care of patients with myocardial infarction, with little guidance on how to achieve these standards and monitor practice. To assess which method of identification of acute myocardial infarction (AMI) cases is most suitable for NSF audit, and to determine the effect of the definition of AMI on the assessment of quality of care. Observational study. Over a 3-month period, 2153 consecutive patients from 20 hospitals across the Yorkshire region, with confirmed AMI, were identified from coronary care registers, biochemistry records and hospital coding systems. The sensitivity and positive predictive value of AMI patient identification using clinical coding, biochemistry and coronary care registers were compared to a 'gold standard' (the combination of all three methods). Of 3685 possible cases of AMI singled out by one or more methods, 2153 patients were identified as having a final diagnosis of AMI. Hospital coding revealed 1668 (77.5%) cases, with a demographic profile similar to that of the total cohort. Secondary preventative measures required for inclusion in NSF were also of broadly similar distribution. The sensitivities and positive predictive values for patient identification were substantially less in the cohorts identified through biochemistry and coronary care unit register. Patients fulfilling WHO criteria (n=1391) had a 30-day mortality of 15.9%, vs. 24.2% for the total cohort. Hospital coding misses a substantial proportion (22.5%) of AMI cases, but without any apparent systematic bias, and thus provides a suitably representative and robust basis for NSF-related audit. Better still would be the routine use of multiple methods of case identification.

Pawnee Nation Energy Option Analyses

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

Matlock, M.; Kersey, K.; Riding In, C.

2009-07-31

In 2003, the Pawnee Nation leadership identified the need for the tribe to comprehensively address its energy issues. During a strategic energy planning workshop a general framework was laid out and the Pawnee Nation Energy Task Force was created to work toward further development of the tribe’s energy vision. The overarching goals of the “first steps” project were to identify the most appropriate focus for its strategic energy initiatives going forward, and to provide information necessary to take the next steps in pursuit of the “best fit” energy options. Based on the request of Pawnee Nation’s Energy Task Force themore » research team, consisting Tribal personnel and Summit Blue Consulting, focused on a review of renewable energy resource development potential, funding sources and utility organizational along with energy savings options. Elements of the energy demand forecasting and characterization and demand side options review remained in the scope of work, but were only addressed at a high level. Description of Activities Performed Renewable Energy Resource Development Potential The research team reviewed existing data pertaining to the availability of biomass (focusing on woody biomass, agricultural biomass/bio-energy crops, and methane capture), solar, wind and hydropower resources on the Pawnee-owned lands. Using these data, combined with assumptions about costs and revenue streams, the research team performed preliminary feasibility assessments for each resource category. The research team also reviewed available funding resources and made recommendations to Pawnee Nation highlighting those resources with the greatest potential for financially-viable development, both in the near-term and over a longer time horizon. Energy Efficiency Options While this was not a major focus of the project, the research team highlighted common strategies for reducing energy use in buildings. The team also discussed the benefits of adopting a building energy

[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.

10 CFR 603.665 - Periodic audits of nonprofit participants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Periodic audits of nonprofit participants. 603.665 Section 603.665 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters...

10 CFR 603.665 - Periodic audits of nonprofit participants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Periodic audits of nonprofit participants. 603.665 Section 603.665 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters...

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

PubMed

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

2015-02-01

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

Scholastic Audits. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2009-01-01

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

National Beef Quality Audit-2011: In-plant survey of targeted carcass characteristics related to quality, quantity, value, and marketing of fed steers and heifers

USDA-ARS?s Scientific Manuscript database

The National Beef Quality Audit – 2011 (NBQA-2011) assessed the current status of quality and consistency of fed steers and heifers. Beef carcasses (n = 9,802), representing approximately 10 percent of each production lot in 28 beef processing facilities, were selected randomly for the survey. Car...

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.

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

To what extent are national guidelines for the management of urinary incontinence in women adhered? Data from a national audit.

PubMed

Wagg, A; Duckett, J; McClurg, D; Harari, D; Lowe, D

2011-12-01

OBJECTIVE  To assess the degree of adherence to the current National Institute for Health and Clinical Excellence (NICE) guidelines on the management of urinary incontinence (UI) in women. Retrospective survey of consecutive female inpatients and outpatients with UI as part of a national audit. NHS hospital and primary care (PC) trusts. Twenty-five women <65 years old and 25 women ≥ 65 years old from each participating site. All NHS trusts in England, Wales and Northern Ireland were eligible to participate. A web-based data collection form aligned to the NICE guidelines was constructed for the study. All data submitted to the audit were anonymous and access to the web-tool was password-protected for confidentiality. Data were returned by 128 acute and 75 PC trusts on 7846 women. No diagnosis was documented in 6.8% (153/2254) of younger and 28% (571/2011) of older women in hospitals (P < 0.001), and by 8.6% (123/1435) of younger and 21% (380/1786) of older women in PC trusts. In hospitals, 26% (396/1524) of younger women and 15% (182/1231) of older women (P < 0.001) and in PC trusts 8.2% (77/934) of younger and 4.7% (46/975) of older women underwent multichannel cystometry before conservative therapy. Documentation of discussion of causes and treatment of UI occurred in 76% (1717/2254) of younger and 44% (884/2011) of older women in hospitals (P < 0.001) and in 75% (1080/1435) of younger and 53% (948/1786) of older women in PC trusts (P < 0.001). CONCLUSION Older women are less likely to receive NICE compliant management. Adherence varies according to recommendation. There needs to be concentration on evidence-based community provision of care by competent and interested clinicians before the aims of the NICE guidelines are met. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Changes in NHS organization of care and management of hospital admissions with COPD exacerbations between the national COPD audits of 2003 and 2008.

PubMed

George, P M; Stone, R A; Buckingham, R J; Pursey, N A; Lowe, D; Roberts, C M

2011-10-01

The 2003 UK Chronic Obstructive Pulmonary Disease (COPD) audit revealed wide variability between hospital units in care delivered. To assess whether processes of care, patient outcomes and organization of care have improved since 2003. A UK national audit was performed in 2008 to survey the organization and delivery of clinical care provided to patients admitted to hospital with COPD. All UK acute hospital Trusts (units) were invited to participate. Each unit completed cross-sectional resource and organization questionnaires and a prospective clinical audit comprising up to 60 consecutively admitted cases of COPD exacerbation. Comparison between 2003 and 2008 includes aggregated statistics for units participating in both audit rounds. A total of 192 units participated in both audit rounds (6197 admissions in 2003 and 8170 in 2008). In 2008, patients were older and of a poorer functional class. Overall mortality was unchanged but adjusting for age and performance status, inpatient mortality (P = 0.05) and 90-day mortality (P = 0.001) were both reduced in 2008. More patients were discharged under a respiratory specialist (P < 0.01), treated with non-invasive ventilation if acidotic (P < 0.001) and accepted onto early discharge schemes (P < 0.01) while median length of stay fell from 6 to 5 days (P < 0.001). Within these mean data, however, there remains considerable inter-unit variation in organization, resources and outcomes. Overall improvements in resources and organization are accompanied by reduced mortality, shorter admissions and greater access to specialist services. There remains, however, considerable variation in the quality of secondary care provided between units.

77 FR 45721 - Consolidated Audit Trail

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-01

...The Securities and Exchange Commission (``Commission'') is adopting Rule 613 under the Securities Exchange Act of 1934 (``Exchange Act'' or ``Act'') to require national securities exchanges and national securities associations (``self-regulatory organizations'' or ``SROs'') to submit a national market system (``NMS'') plan to create, implement, and maintain a consolidated order tracking system, or consolidated audit trail, with respect to the trading of NMS securities, that would capture customer and order event information for orders in NMS securities, across all markets, from the time of order inception through routing, cancellation, modification, or execution.

UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.

PubMed

McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D

2012-10-01

A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting.

Patient and clinician reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis

PubMed Central

Ledingham, JM; Snowden, N; Rivett, A; Galloway, J; Firth, J; Ide, Z; MacPhie, E; Kandala, N; Dennison, EM; Rowe, I

2017-01-01

Objectives Our aim was to conduct a national audit assessing the impact and experience of early management of inflammatory arthritis by English and Welsh rheumatology units. The audit enables rheumatology services to measure for the first time their performance, patient outcomes and experience, benchmarked to regional and national comparators. Methods All individuals >16 years of age presenting to English and Welsh rheumatology services with suspected new-onset inflammatory arthritis were included in the audit. Clinician- and patient-derived outcome and patient-reported experience measures were collected. Results Data are presented for the 6354 patients recruited from 1 February 2014 to 31 January 2015. Ninety-seven per cent of English and Welsh trusts participated. At the first specialist assessment, the 28-joint DAS (DAS28) was calculated for 2659 (91%) RA patients [mean DAS28 was 5.0 and mean Rheumatoid Arthritis Impact of Disease (RAID) score was 5.6]. After 3 months of specialist care, the mean DAS28 was 3.5 and slightly >60% achieved a meaningful DAS28 reduction. The average RAID score and reduction in RAID score were 3.6 and 2.4, respectively. Of the working patients ages 16–65 years providing data, 7, 5, 16 and 37% reported that they were unable to work, needed frequent time off work, occasionally and rarely needed time off work due to their arthritis, respectively; only 42% reported being asked about their work. Seventy-eight per cent of RA patients providing data agreed with the statement ‘Overall in the last 3 months I have had a good experience of care for my arthritis’; <2% disagreed. Conclusion This audit demonstrates that most RA patients have severe disease at the time of presentation to rheumatology services and that a significant number continue to have high disease activity after 3 months of specialist care. There is a clear need for the National Health Service to develop better systems for capturing, coding and integrating information from

34 CFR 668.23 - Compliance audits and audited financial statements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... this section, a government auditor must meet the Government Auditing Standards qualification and... Accounting Office's (GAO's) Government Auditing Standards. (This publication is available from the... generally accepted accounting principles, and audited by an independent auditor in accordance with generally...

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

PubMed Central

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

2011-01-01

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

40 CFR 141.808 - Audits and inspections.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., disinfection and flushing, and general maintenance and self-inspections of aircraft water system. (b) Air... Section 141.808 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Aircraft Drinking Water Rule § 141.808 Audits and...

40 CFR 141.808 - Audits and inspections.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., disinfection and flushing, and general maintenance and self-inspections of aircraft water system. (b) Air... Section 141.808 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Aircraft Drinking Water Rule § 141.808 Audits and...

40 CFR 141.808 - Audits and inspections.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., disinfection and flushing, and general maintenance and self-inspections of aircraft water system. (b) Air... Section 141.808 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Aircraft Drinking Water Rule § 141.808 Audits and...

40 CFR 141.808 - Audits and inspections.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., disinfection and flushing, and general maintenance and self-inspections of aircraft water system. (b) Air... Section 141.808 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS (CONTINUED) NATIONAL PRIMARY DRINKING WATER REGULATIONS Aircraft Drinking Water Rule § 141.808 Audits and...

Preoperative assessment of lung cancer patients: evaluating guideline compliance (re-audit).

PubMed

Jayia, Parminderjit Kaur; Mishra, Pankaj Kumar; Shah, Raajul R; Panayiotou, Andrew; Yiu, Patrick; Luckraz, Heyman

2015-03-01

Guidelines have been issued for the management of lung cancer patients in the United Kingdom. However, compliance with these national guidelines varies in different thoracic units in the country. We set out to evaluate our thoracic surgery practice and compliance with the national guidelines. An initial audit in 2011 showed deficiencies in practice, thus another audit was conducted to check for improvements in guideline compliance. A retrospective study was carried out over a 12-month period from January 2013 to January 2014 and included all patients who underwent radical surgical resection for lung cancer. Data were collected from computerized records. Sixty-eight patients had radical surgery for lung cancer between January 2013 and January 2014. Four patients were excluded from the analysis due to incomplete records. Our results showed improvements in our practice compared to our initial audit. More patients underwent surgery within 4 weeks of computed tomography and positron-emission tomography scanning. An improvement was noticed in carbon monoxide transfer factor measurements. Areas for improvement include measurement of carbon monoxide transfer factor in all patients, a cardiology referral in patients at risk of cardiac complications, and the use of a global risk stratification model such as Thoracoscore. Guideline-directed service delivery provision for lung cancer patients leads to improved outcomes. Our results show improvement in our practice compared to our initial audit. We aim to liaise with other thoracic surgery units to get feedback about their practice and any audits regarding adherence to the British Thoracic Society and National Institute for Health and Care Excellence guidelines. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Audits Made Simple

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

Belangia, David Warren

A company just got notified there is a big external audit coming in 3 months. Getting ready for an audit can be challenging, scary, and full of surprises. This Gold Paper describes a typical audit from notification of the intent to audit through disposition of the final report including Best Practices, Opportunities for Improvement (OFI), and issues that must be fixed. Good preparation can improve the chances of success. Ensuring the auditors understand the environment and requirements is paramount to success. It helps the auditors understand that the enterprise really does think that security is important. Understanding and following amore » structured process ensures a smooth audit process. Ensuring follow-up on OFIs and issues in a structured fashion will also make the next audit easier. It is important to keep in mind that the auditors will use the previous report as a starting point. Now the only worry is the actual audit and subsequent report and how well the company has done.« less

Energy and National Security

ERIC Educational Resources Information Center

Abelson, Philip H.

1973-01-01

Discussed in this editorial is the need for a broad and detailed government policy on energy use. Oil companies can not be given complete responsibility to demonstrate usage of different energy sources. The government should construct plants because energy is connected with national security. (PS)

The Effect of an Energy Audit Service Learning Project on Student Perceptions of STEM Related Disciplines, Personal Behaviors/Actions towards the Environment, and Stewardship Skills

NASA Astrophysics Data System (ADS)

Gullo, Michael

The purpose of this study was to investigate whether or not service learning could be considered an alternative teaching method in an environmental science classroom. In particular, the results of this research show whether an energy audit service learning project influenced student environmental awareness (knowledge of environmental issues, problems, and solutions), student personal actions/behaviors towards the environment, student perceptions and attitudes of science related careers, and community partnerships. Haines (2010) defines service learning as “a teaching and learning strategy that integrates meaningful community service with instruction and reflection to enrich the learning experience, teach civic responsibility, and strengthen communities” (p. 16). Moreover, service learning opportunities can encourage students to step out of their comfort zone and learn from hands-on experiences and apply knowledge obtained from lectures and classroom activities to real life situations. To add to the growing body of literature, the results of this study concluded that an energy audit service learning project did not have a measureable effect on student perceptions and attitudes of science related careers as compared to a more traditional teaching approach. However, the data from this study did indicate that an energy audit service learning project increased students personal actions/behaviors towards the environment more than a direct teaching approach.

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.

Current standards for infection control: audit assures compliance.

PubMed

Flanagan, Pauline

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

[Medical audits contribute to good and comparable health services].

PubMed

Arntzen, Elisabeth; Mikkelsen, Bente

2007-01-04

In 2004, the board of Eastern Norwegian Regional Health Authority (HelseØst RHF) decided that medical audits should be carried out in the treatment of cerebral stroke and breast cancer and in the mental health services. The objective was to establish to what extent the best practice is followed, to learn from each other, and to obtain help and advice. The medical audits were based on guidelines in ISO and were carried out under the leadership of external medical audit leaders, medical experts and medical auditors from the region. The results show that, on the whole, the patients are offered satisfactory treatment, but improvement is needed. The number of breast-preserving operations could be increased, treatment should be offered in a cerebral stroke unit to all those with acute cerebral stroke and suicide assessments should be improved. Most improvement measures were started quickly and were followed up by directors and local boards. HelseØst RHF followed up the general improvement suggestions. The medical audits were well received by health enterprises. In order to carry out medical audits the following is needed; national medical standards or summarized information on the best practice where standards are not defined. The regional health enterprises can use medical audits to assess the standard of treatment in risk zones, thus ensuring that uniform services are available for the population. Medical audits provide a good tool for preserving quality.

Audit Guidelines for 1989-90: Single Audit Act of 1984.

ERIC Educational Resources Information Center

South Carolina State Dept. of Education, Columbia.

Single Audit Act of 1984 was passed to provide guidelines for organizationwide audits of federally funded programs. Explanatory notes for Educational Improvement Act (EIA) summer school accounting are given. Section 1 outlines audit requirements established for state and local governments that receive and administer federal assistance. 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

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.

34 CFR 668.23 - Compliance audits and audited financial statements.

Code of Federal Regulations, 2011 CFR

2011-07-01

...” refers to an independent certified public accountant or a government auditor. To conduct an audit under... to records, audit work papers, or other documents necessary to review that audit, including the right to obtain copies of those records, work papers, or documents. (2) An institution must give the...

34 CFR 668.23 - Compliance audits and audited financial statements.

Code of Federal Regulations, 2013 CFR

2013-07-01

...” refers to an independent certified public accountant or a government auditor. To conduct an audit under... to records, audit work papers, or other documents necessary to review that audit, including the right to obtain copies of those records, work papers, or documents. (2) An institution must give the...

34 CFR 668.23 - Compliance audits and audited financial statements.

Code of Federal Regulations, 2014 CFR

2014-07-01

...” refers to an independent certified public accountant or a government auditor. To conduct an audit under... to records, audit work papers, or other documents necessary to review that audit, including the right to obtain copies of those records, work papers, or documents. (2) An institution must give the...

34 CFR 668.23 - Compliance audits and audited financial statements.

Code of Federal Regulations, 2012 CFR

2012-07-01

...” refers to an independent certified public accountant or a government auditor. To conduct an audit under... to records, audit work papers, or other documents necessary to review that audit, including the right to obtain copies of those records, work papers, or documents. (2) An institution must give the...

Never audit alone--the case for audit teams.

PubMed

Adams, N H

1999-01-01

On-site audits, conducted by technical and quality assurance (QA) experts at the data-gathering location, are the core of an effective QA program. However, inadequate resources for such audits are the bane of a QA program and, frequently, the proposed solution is to send only one auditor to the study site. There are several reasons why audits should be performed by more than one person: 1. Audits of EPA projects frequently involve hazardous chemicals or other environmental hazards. They also often involve working after normal work hours in remote locations with dangerous equipment. It is unsafe to work alone under such conditions. 2. Skills: Many of EPA's projects are multidisciplinary, involving multiple measurements systems, several environmental media, and complex automated data collection and analysis systems. It is unlikely that one auditor would have the requisite skills to assess all of these operations. 3. Separateness: Two auditors can provide two (sometimes differing) perspectives on problems encountered during an audit. Two auditors can provide complementary expertise and work experience. Two auditors can provide twice the surveillance power. 4. Support: The operations that need to be assessed are sometimes in different parts of a site, requiring two auditing devices or considerable commuting time. Also, auditors are occasionally diverted by managers wishing to show their best efforts rather than the whole operation; if two auditors are on-site, one can interview managers while the other talks with technical staff. If there is a dispute, one auditor can support the other in verifying observations. 5. Savings: Although sending one auditor is perceived to be a cost-saving measure, it may be more economical to send two auditors. Time on site (lodging, food) is decreased, more of the project is assessed in one visit, less pre-audit training is required, and report preparation is accelerated. In summary, sending more than one auditor on a field audit is

Insights: Future of the national laboratories. National Renewable Energy Laboratory. [The future of the National Renewable Energy (Sources) Laboratory

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

Sunderman, D.

Psychologists tell us that people are born with certain personality traits, such as shyness or boldness, which their environment can encourage, subdue, or even alter. National labs have somewhat similar characteristics. They were created for particular missions and staffed by people who built organizations in which those missions could be fulfilled. As a result, the Department of Energy's (DOE) national labs are among the world's finest repositories of technology and scientific talent, especially in the fields of defense, nuclear weapons, nuclear power, and basic energy. Sunderman, director of the National Renewable Energy Laboratory, discusses the history of the laboratory andmore » its place in the future, both in terms of technologies and nurturing.« less

Environmental management assessment of the National Institute for Petroleum and Energy Research

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

NONE

1994-08-01

This report documents the results of the environmental management assessment of the National Institute for Petroleum and Energy Research (NIPER), located in Bartlesville, Oklahoma. The assessment was conducted August 15-26, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health. The assessment included reviews of documents and reports, as well as inspections and observations of selected facilities and operations. Further, the team conducted interviews with management and staff from the Bartlesville Project Office (BPO), the Office of Fossil Energy (FE), the Pittsburgh Energy Technology Center (PETC), state and local regulatory agencies, andmore » BDM Oklahoma (BDM-OK), which is the management and operating (M&O) contractor for NIPER. Because of the transition from a cooperative agreement to an M&O contract in January 1994, the scope of the assessment was to evaluate (1) the effectiveness of BDM-OK management systems being developed and BPO systems in place and under development to address environmental requirements; (2) the status of compliance with DOE Orders, guidance, and directives; and (3) conformance with accepted industry management practices. An environmental management assessment was deemed appropriate at this time in order to identify any systems modifications that would provide enhanced effectiveness of the management systems currently under development.« less

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

10 CFR 603.670 - Flow down audit requirements to subrecipients.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Flow down audit requirements to subrecipients. 603.670 Section 603.670 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters...

10 CFR 603.670 - Flow down audit requirements to subrecipients.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Flow down audit requirements to subrecipients. 603.670 Section 603.670 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters...

18 CFR 41.1 - Notice to audited person.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Notice to audited person. 41.1 Section 41.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF...

18 CFR 41.1 - Notice to audited person.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Notice to audited person. 41.1 Section 41.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF...

18 CFR 41.1 - Notice to audited person.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Notice to audited person. 41.1 Section 41.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF...

18 CFR 41.1 - Notice to audited person.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Notice to audited person. 41.1 Section 41.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF...

18 CFR 41.1 - Notice to audited person.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Notice to audited person. 41.1 Section 41.1 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS UNDER THE FEDERAL POWER ACT ACCOUNTS, RECORDS, MEMORANDA AND DISPOSITION OF...

Issues in Humanoid Audition and Sound Source Localization by Active Audition

NASA Astrophysics Data System (ADS)

Nakadai, Kazuhiro; Okuno, Hiroshi G.; Kitano, Hiroaki

In this paper, we present an active audition system which is implemented on the humanoid robot "SIG the humanoid". The audition system for highly intelligent humanoids localizes sound sources and recognizes auditory events in the auditory scene. Active audition reported in this paper enables SIG to track sources by integrating audition, vision, and motor movements. Given the multiple sound sources in the auditory scene, SIG actively moves its head to improve localization by aligning microphones orthogonal to the sound source and by capturing the possible sound sources by vision. However, such an active head movement inevitably creates motor noises.The system adaptively cancels motor noises using motor control signals and the cover acoustics. The experimental result demonstrates that active audition by integration of audition, vision, and motor control attains sound source tracking in variety of conditions.onditions.

Computerizing Audit Studies

PubMed Central

Lahey, Joanna N.; Beasley, Ryan A.

2014-01-01

This paper briefly discusses the history, benefits, and shortcomings of traditional audit field experiments to study market discrimination. Specifically it identifies template bias and experimenter bias as major concerns in the traditional audit method, and demonstrates through an empirical example that computerization of a resume or correspondence audit can efficiently increase sample size and greatly mitigate these concerns. Finally, it presents a useful meta-tool that future researchers can use to create their own resume audits. PMID:24904189

Health plan auditing: 100-percent-of-claims vs. random-sample audits.

PubMed

Sillup, George P; Klimberg, Ronald K

2011-01-01

The objective of this study was to examine the relative efficacy of two different methodologies for auditing self-funded medical claim expenses: 100-percent-of-claims auditing versus random-sampling auditing. Multiple data sets of claim errors or 'exceptions' from two Fortune-100 corporations were analysed and compared to 100 simulated audits of 300- and 400-claim random samples. Random-sample simulations failed to identify a significant number and amount of the errors that ranged from $200,000 to $750,000. These results suggest that health plan expenses of corporations could be significantly reduced if they audited 100% of claims and embraced a zero-defect approach.

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

[Evaluation auditing of the quality of health care in accreditation of health facilities].

PubMed

Paim, Chennyfer da Rosa Paino; Zucchi, Paola

2011-01-01

This article shows how many health insurance companies operating in the Greater São Paulo have been performing auditing of the quality of their health care services, professionals, and which criteria are being employed to do so. Because of the legislation decreeing that health insurance companies have legal co-responsibility for the health care services and National Health Agency control the health services National Health Agency, auditing evaluations have been implemented since then. The survey was based on electronic forms e-mailed to all health insurance companies operating in the Greater São Paulo. The sample consisted of 125 health insurance companies; 29 confirmed that had monitoring and evaluation processes; 26 performed auditing of their services regularly; from those, 20 used some type of form or protocol for technical visits; all evaluation physical and administrative structure and 22 included functional structure. Regarding the professionals audited 21 were nurses, 13 administrative assistants; 04 managers and 02 doctors. Regarding criteria for accreditation the following were highlighted: region analysis (96%), localization (88.88%) and cost (36%). We conclude that this type of auditing evaluation is rather innovative and is being gradually implemented by the health insurance companies, but is not a systematic process.

Experiences of using the GMP audit preparation tool in pharmaceutical contract manufacturer audits.

PubMed

Linna, Anu; Korhonen, Mirka; Airaksinen, Marja; Juppo, Anne Mari

2010-06-01

Use of external contractors is nowadays inevitable in the pharmaceutical industry. Therefore the amount of current good manufacturing practice audits has been increasing. During the audit, a large amount of items should be covered in a limited amount of time. Consequently, pharmaceutical companies should have systematic and effective ways to manage and prepare for the audits. This study is a continuation to the earlier study, where a tool for the preparation of cGMP audit was developed and its content was validated. The objective of this study was to evaluate the usefulness of the developed tool in audit preparation and during the actual cGMP audit. Three qualitative research methods were used in this study (observation, interviews, and opinion survey). First, the validity of the information given through the tool was examined by comparing the responses to the actual conditions observed during the contract manufacturer audits (n = 15). Additionally the opinions of the contract manufacturers of the tool were gathered (n = 10) and the auditors were interviewed (n = 2). The developed tool was proven to be useful in audit preparation phase from both the auditor's and the contract manufacturers' point of view. Furthermore, using the tool can also save some time when performing the audit. The results show that using the tool can give significant support in audit preparation phase and also during the actual audit.

Management of gout by UK rheumatologists: a British Society for Rheumatology national audit.

PubMed

Roddy, Edward; Packham, Jon; Obrenovic, Karen; Rivett, Ali; Ledingham, Joanna M

2018-05-01

To assess the concordance of gout management by UK rheumatologists with evidence-based best-practice recommendations. Data were collected on patients newly referred to UK rheumatology out-patient departments over an 8-week period. Baseline data included demographics, method of diagnosis, clinical features, comorbidities, urate-lowering therapy (ULT), prophylaxis and blood tests. Twelve months later, the most recent serum uric acid level was collected. Management was compared with audit standards derived from the 2006 EULAR recommendations, 2007 British Society for Rheumatology/British Health Professionals in Rheumatology guideline and the National Institute for Health and Care Excellence febuxostat technology appraisal. Data were collected for 434 patients from 91 rheumatology departments (mean age 59.8 years, 82% male). Diagnosis was crystal-proven in 13%. Of 106 taking a diuretic, this was reduced/stopped in 29%. ULT was continued/initiated in 76% of those with one or more indication for ULT. One hundred and fifty-eight patients started allopurinol: the starting dose was most commonly 100 mg daily (82%); in those with estimated glomerular filtration rate <60 ml/min the highest starting dose was 100 mg daily. Of 199 who started ULT, prophylaxis was co-prescribed for 94%. Fifty patients started a uricosuric or febuxostat: 84% had taken allopurinol previously. Of 44 commenced on febuxostat, 18% had a history of heart disease. By 12 months, serum uric acid levels ⩽360 and <300 μmol/l were achieved by 45 and 25%, respectively. Gout management by UK rheumatologists concords well with guidelines for most audit standards. However, fewer than half of patients achieved a target serum uric level over 12 months. Rheumatologists should help ensure that ULT is optimized to achieve target serum uric acid levels to benefit patients.

45 CFR 1183.26 - Non-Federal audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1183.26 Section 1183.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE... Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations,” have met...

45 CFR 1174.26 - Non-Federal audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1174.26 Section 1174.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE... Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations,” have met...

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

The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors.

PubMed

Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M

2014-10-01

We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030-9700), and without it was ~1:135 900 (1:78 600-299 000). The cases of accidental awareness during general anaesthesia reported to 5th National Audit Project were overwhelmingly cases of unintended awareness during neuromuscular blockade. The incidence of accidental awareness during caesarean section was ~1:670 (1:380-1300). Two thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental; rapid sequence induction; obesity; difficult airway management; neuromuscular blockade; and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, most due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex; age (younger adults, but not children); obesity; anaesthetist seniority (junior trainees); previous awareness; out-of-hours operating; emergencies; type of surgery (obstetric, cardiac, thoracic); and use of neuromuscular blockade. The following factors were

Energy Department Announces National Bioenergy Center

Science.gov Websites

Department of Energy's National Renewable Energy Laboratory (NREL) in Golden, Colo., and Oak Ridge National Laboratories (ORNL) in Oak Ridge, Tenn. will lead the Bioenergy Center. The center will link DOE-funded biomass

36 CFR 1207.26 - Non-Federal audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Non-Federal audit. 1207.26 Section 1207.26 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION GENERAL RULES UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND COOPERATIVE AGREEMENTS TO STATE AND LOCAL GOVERNMENTS Post-Award Requirements Financial...

Data audit as a way to prevent/contain misconduct.

PubMed

Shamoo, Adil E

2013-01-01

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

10 CFR Appendix B to Part 600 - Audit Report Distributees

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Audit Report Distributees B Appendix B to Part 600 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Pt. 600, App. B Appendix B... General, U.S. Department of Energy, P.O. Box 1328, Oak Ridge, Tennessee 37831-1328. For recipients in...

10 CFR Appendix B to Part 600 - Audit Report Distributees

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Audit Report Distributees B Appendix B to Part 600 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS FINANCIAL ASSISTANCE RULES Pt. 600, App. B Appendix B... General, U.S. Department of Energy, P.O. Box 1328, Oak Ridge, Tennessee 37831-1328. For recipients in...

Patient- and clinician-reported outcomes for patients with new presentation of inflammatory arthritis: observations from the National Clinical Audit for Rheumatoid and Early Inflammatory Arthritis.

PubMed

Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian

2017-02-01

Our aim was to conduct a national audit assessing the impact and experience of early management of inflammatory arthritis by English and Welsh rheumatology units. The audit enables rheumatology services to measure for the first time their performance, patient outcomes and experience, benchmarked to regional and national comparators. All individuals >16 years of age presenting to English and Welsh rheumatology services with suspected new-onset inflammatory arthritis were included in the audit. Clinician- and patient-derived outcome and patient-reported experience measures were collected. Data are presented for the 6354 patients recruited from 1 February 2014 to 31 January 2015. Ninety-seven per cent of English and Welsh trusts participated. At the first specialist assessment, the 28-joint DAS (DAS28) was calculated for 2659 (91%) RA patients [mean DAS28 was 5.0 and mean Rheumatoid Arthritis Impact of Disease (RAID) score was 5.6]. After 3 months of specialist care, the mean DAS28 was 3.5 and slightly >60% achieved a meaningful DAS28 reduction. The average RAID score and reduction in RAID score were 3.6 and 2.4, respectively. Of the working patients ages 16-65 years providing data, 7, 5, 16 and 37% reported that they were unable to work, needed frequent time off work, occasionally and rarely needed time off work due to their arthritis, respectively; only 42% reported being asked about their work. Seventy-eight per cent of RA patients providing data agreed with the statement 'Overall in the last 3 months I have had a good experience of care for my arthritis'; <2% disagreed. This audit demonstrates that most RA patients have severe disease at the time of presentation to rheumatology services and that a significant number continue to have high disease activity after 3 months of specialist care. There is a clear need for the National Health Service to develop better systems for capturing, coding and integrating information from outpatient clinics, including measures of

Dosimetric audit in brachytherapy

PubMed Central

Bradley, D A; Nisbet, A

2014-01-01

Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace. PMID:24807068

The Legal Audit: Preventing Problems.

ERIC Educational Resources Information Center

Perlman, Daniel H.

1987-01-01

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

Do federal and state audits increase compliance with a grant program to improve municipal infrastructure (AUDIT study): study protocol for a randomized controlled trial.

PubMed

De La O, Ana L; Martel García, Fernando

2014-09-03

Poor governance and accountability compromise young democracies' efforts to provide public services critical for human development, including water, sanitation, health, and education. Evidence shows that accountability agencies like superior audit institutions can reduce corruption and waste in federal grant programs financing service infrastructure. However, little is know about their effect on compliance with grant reporting and resource allocation requirements, or about the causal mechanisms. This study protocol for an exploratory randomized controlled trial tests the hypothesis that federal and state audits increase compliance with a federal grant program to improve municipal service infrastructure serving marginalized households. The AUDIT study is a block randomized, controlled, three-arm parallel group exploratory trial. A convenience sample of 5 municipalities in each of 17 states in Mexico (n=85) were block randomized to be audited by federal auditors (n=17), by state auditors (n=17), and a control condition outside the annual program of audits (n=51) in a 1:1:3 ratio. Replicable and verifiable randomization was performed using publicly available lottery numbers. Audited municipalities were included in the national program of audits and received standard audits on their use of federal public service infrastructure grants. Municipalities receiving moderate levels of grant transfers were recruited, as these were outside the auditing sampling frame--and hence audit program--or had negligible probabilities of ever being audited. The primary outcome measures capture compliance with the grant program and markers for the causal mechanisms, including deterrence and information effects. Secondary outcome measure include differences in audit reports across federal and state auditors, and measures like career concerns, political promotions, and political clientelism capturing synergistic effects with municipal accountability systems. The survey firm and research

Improved sexual history taking in the 2012 BASHH asymptomatic screening re-audit.

PubMed

Menon-Johansson, A S; McClean, H; Carne, C A; Estreich, S; Knapper, C; Sethi, G; Smith, A; Sullivan, A K

2014-04-01

Effective asymptomatic screening for sexually transmitted infections is an important public health service because a significant proportion of sexually transmitted infections do not present with symptoms. In 2009, the National Audit Group of the British Association of Sexual Health and HIV (BASHH) audited the management of asymptomatic patients and recommended increased documentation about oral and anal sex, regional strategies for nucleic acid amplification test (NAAT) use for gonorrhoea, improved screening for hepatitis B in men who have sex with men and an increase in screening for HIV. The 2012 audit used web-based forms to collect submissions from 180 consultant-led centres (65% response rate) that included episodes of care from 6669 asymptomatic patients. An improvement was demonstrated for all the areas measured during the 2009 audit. A doubling of gonorrhoea testing using NAATs was seen and yet 10% of asymptomatic patients continued to have microscopy despite these tests not being recommended by BASHH guidelines. This audit recommends universal adoption of gonorrhoea NAATs across the United Kingdom.

National Comparative Audit of Blood Transfusion: report on the 2014 audit of patient information and consent.

PubMed

Booth, C; Grant-Casey, J; Lowe, D; Court, E L; Allard, S

2017-11-28

The aim of this study was to assess current practices around obtaining consent for blood transfusion and provision of patient information in hospitals across the UK and identify areas for improvement. Recommendations from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) (2011) state that valid consent should be obtained for blood transfusion and documented in clinical records. A standardised source of information should be available to patients. Practices in relation to this have historically been inconsistent. The consent process was studied in hospitals across the UK over a 3-month period in 2014 by means of an audit of case notes and simultaneous surveys of patients and staff. In total, 2784 transfusion episodes were reviewed across 164 hospital sites. 85% of sites had a policy on consent for transfusion. Consent was documented in 43% of case notes. 68% of patients recalled being given information on benefits of transfusion, 38% on risks and 8% on alternatives and 28% reported receiving an information leaflet. In total, 85% of staff stated they had explained the reason for transfusion, but only 65% had documented this. 41% of staff had received training specifically on transfusion consent in the last 2 years. There is a need to improve clinical practice in obtaining valid consent for transfusion in line with existing national guidelines and local Trust policies, with emphasis on documentation within clinical records. Provision of patient information is an area particularly highlighted for action, and transfusion training for clinicians should be strengthened. © 2017 British Blood Transfusion Society.

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...

46 CFR Sec. 12 - Audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

Unpredictable Feelings: Academic Women under Research Audit

ERIC Educational Resources Information Center

Grant, Barbara M.; Elizabeth, Vivienne

2015-01-01

Academic research is subject to audit in many national settings. In Aotearoa/New Zealand, the government regulates the flow of publicly funded research income into tertiary institutions through the Performance-Based Research Fund (PBRF). This article enquires into the effects of the PBRF by exploring data collected from 16 academic women of…

Remote auditing of radiotherapy facilities using optically stimulated luminescence dosimeters

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

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

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

20 CFR 655.24 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 655.24 Section 655.24 Employees...) § 655.24 Audits. (a) Discretion. OFLC will conduct audits of H-2B temporary labor certification applications. The applications selected for audit will be chosen within the sole discretion of OFLC. (b) Audit...

Prenatal screening for major congenital heart disease: assessing performance by combining national cardiac audit with maternity data.

PubMed

Gardiner, Helena M; Kovacevic, Alexander; van der Heijden, Laila B; Pfeiffer, Patricia W; Franklin, Rodney Cg; Gibbs, John L; Averiss, Ian E; Larovere, Joan M

2014-03-01

Determine maternity hospital and lesion-specific prenatal detection rates of major congenital heart disease (mCHD) for hospitals referring prenatally and postnatally to one Congenital Cardiac Centre, and assess interhospital relative performance (relative risk, RR). We manually linked maternity data (3 hospitals prospectively and another 16 retrospectively) with admissions, fetal diagnostic and surgical cardiac data from one Congenital Cardiac Centre. This Centre submits verified information to National Institute for Cardiovascular Outcomes Research (NICOR-Congenital), which publishes aggregate antenatal diagnosis data from infant surgical procedures. We included 120 198 unselected women screened prospectively over 11 years in 3 maternity hospitals (A, B, C). Hospital A: colocated with fetal medicine, proactive superintendent, on-site training, case-review and audit, hospital B: on-site training, proactive superintendent, monthly telemedicine clinics, and hospital C: sonographers supported by local obstetrician. We then studied 321 infants undergoing surgery for complete transposition (transposition of the great arteries (TGA), n=157) and isolated aortic coarctation (CoA, n=164) screened in hospitals A, B, C prospectively, and 16 hospitals retrospectively. 385 mCHD recorded prospectively from 120 198 (3.2/1000) screened women in 3 hospitals. Interhospital relative performance (RR) in Hospital A:1.68 (1.4 to 2.0), B:0.70 (0.54 to 0.91), C:0.65 (0.5 to 0.8). Standardised prenatal detection rates (funnel plots) demonstrating inter-hospital variation across 19 hospitals for TGA (37%, 0.00 to 0.81) and CoA (34%, 0.00 to 1.06). Manually linking data sources produced hospital-specific and lesion-specific prenatal mCHD detection rates. More granular, rather than aggregate, data provides meaningful feedback to improve screening performance. Automatic maternal and infant record linkage on a national scale, requires verified, prospective maternity audit and integration of

20 CFR 655.1312 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

30 CFR 735.22 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

16 CFR 703.7 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

NEVER AUDIT ALONE--THE CASE FOR AUDIT TEAMS