34 CFR Appendix A to Subpart B of... - Standards for Audit of Governmental Organizations, Programs, Activities, and Functions (GAO)

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Standards for Audit of Governmental Organizations... Programs Pt. 668, Subpt. B, App. A Appendix A to Subpart B of Part 668—Standards for Audit of Governmental... standard for governmental auditing is: In matters relating to the audit work, the audit organization and...

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

NASA Astrophysics Data System (ADS)

Jianping, Wang; Min, Chen; Xianwen, Wu

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

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

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

DTIC Science & Technology

1986-03-01

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

Internal audit consider the implications.

PubMed

Baumgartner, Grant D; Hamilton, Angela

2004-06-01

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

Identifying best practices for audit committees.

PubMed

Burke, J V; Luecke, R W; Meeting, D

1996-06-01

Most healthcare organizations have an audit committee of the governing board, or a finance committee, that fulfills the audit oversight function. Financial managers play a key role in shaping the content, agency, and operation of the audit committee. The findings of a recent research study conducted by Arthur Anderson & Co., SC, into the best practices of audit committees have implications for healthcare organizations.

Measuring use of electronic health record functionality using system audit information.

PubMed

Bowes, Watson A

2010-01-01

Meaningful and efficient methods for measuring Electronic Health Record (EHR) adoption and functional usage patterns have recently become important for hospitals, clinics, and health care networks in the United State due to recent government initiatives to increase EHR use. To date, surveys have been the method of choice to measure EHR adoption. This paper describes another method for measuring EHR adoption which capitalizes on audit logs, which are often common components of modern EHRs. An Audit Data Mart is described which identified EHR functionality within 836 Departments, within 22 Hospitals and 170 clinics at Intermountain Healthcare, a large integrated delivery system. The Audit Data Mart successfully identified important and differing EHR functional usage patterns. These patterns were useful in strategic planning, tracking EHR implementations, and will likely be utilized to assist in documentation of "Meaningful Use" of EHR functionality.

21 CFR 1311.215 - Internal audit trail.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

Report on the Audit of Materials Technology

DTIC Science & Technology

1990-01-25

We are providing this report on the Audit of Materials Technology for your information and use. No comments were required or received on the draft...report. The audit was made from July through September 1989. The objectives of the audit were to evaluate the missions and functions assigned to DOD

77 FR 14042 - Notice of Proposed Audit Delegation Renewal for the State of New Mexico

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-08

... of Proposed Audit Delegation Renewal for the State of New Mexico AGENCY: Office of Natural Resources... of Natural Resources Revenue (ONRR) renew current delegations of audit and investigation authority... royalty management functions of conducting audits and investigations. The State requests delegation of...

28 CFR 64.2 - Designated officers and employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., perform audit functions, or perform other investigative or enforcement functions in administering the..., inspection or audit functions of the Office of Inspector General of an “establishment” or a “designated... functions; (x) Employees of the Social Security Administration assigned to Administration field offices...

28 CFR 64.2 - Designated officers and employees.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., perform audit functions, or perform other investigative or enforcement functions in administering the..., inspection or audit functions of the Office of Inspector General of an “establishment” or a “designated... functions; (x) Employees of the Social Security Administration assigned to Administration field offices...

Diagnostic image quality in gynaecological ultrasound: Who should measure it, what should we measure and how?

PubMed Central

Knapp, Karen

2013-01-01

Assessment of diagnostic image quality in gynaecological ultrasound is an important aspect of imaging department quality assurance. This may be addressed through audit, but who should undertake the audit, what should be measured and how, remains contentious. The aim of this study was to identify whether peer audit is a suitable method of assessing the diagnostic quality of gynaecological ultrasound images. Nineteen gynaecological ultrasound studies were independently assessed by six sonographers utilising a pilot version of an audit tool. Outcome measures were levels of inter-rater agreement using different data collection methods (binary scores, Likert scale, continuous scale), effect of ultrasound study difficulty on study score and whether systematic differences were present between reviewers of different clinical grades and length of experience. Inter-rater agreement ranged from moderate to good depending on the data collection method. A continuous scale gave the highest level of inter-rater agreement with an intra-class correlation coefficient of 0.73. A strong correlation (r = 0.89) between study difficulty and study score was yielded. Length of clinical experience between reviewers had no effect on the audit scores, but individuals of a higher clinical grade gave significantly lower scores than those of a lower grade (p = 0.04). Peer audit is a promising tool in the assessment of ultrasound image quality. Continuous scales seem to be the best method of data collection implying a strong element of heuristically driven decision making by reviewing ultrasound practitioners. PMID:27433192

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

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

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

Assurance: the power behind PCASSO security.

PubMed Central

Baker, D. B.; Masys, D. R.; Jones, R. L.; Barnhart, R. M.

1999-01-01

The need for security protection in Internet-based healthcare applications is generally acknowledged. Most healthcare applications that use the Internet have at least implemented some kind of encryption. Most applications also enforce user authentication and access control policies, and many audit user actions. However, most fall short on providing strong assurances that the security mechanisms are behaving as expected and that they cannot be subverted. While no system can claim to be totally "bulletproof," PCASSO provides assurance of correct operation through formal, disciplined design and development methodologies, as well as through functional and penetration testing. Through its security mechanisms, backed by strong system assurances, PCASSO is demonstrating "safe" use of public data networks for health care. PMID:10566443

Reliability of the School Food Checklist for in-school audits and photograph analysis of children's packed lunches.

PubMed

Mitchell, S A; Miles, C L; Brennan, L; Matthews, J

2010-02-01

Assessment of children's diets is problematic, typically relying on error-prone parent or child recall or reporting, or resource intensive direct observation. The School Food Checklist (SFC) is an objective instrument comprising of 20 food and beverage categories designed to measure the foods contained in children's packed lunches. The present study aimed to assess intra-rater and inter-rater reliability of each of the food and beverage categories of the SFC for both in-school audits and photograph analysis of children's school lunches. Participants comprised 176 children aged 5-8 years from five primary schools in Northern Metropolitan Melbourne. The SFC was used to measure the foods contained in children's packed lunches in the school setting and using photographs. Photograph analysis was conducted by the auditors 2-3 months after completion of in-school audits. Both intra-rater [intra-class correlation coefficient (ICC) = 0.78-1] and inter-rater (ICC = 0.50-0.95) reliability analysis indicated strong agreement for in-school auditing. With the exception of the food category titled 'leftovers', there was strong intra-rater reliability for auditors' live audits and their analysis of photographs [ICC = 0.57-0.98 (Auditor 1); ICC = 0.72-0.90 (Auditor 2)], and strong inter-rater reliability for photograph analysis (ICC = 0.68-0.92). The SFC is a reliable method of measuring the foods and beverages contained in children's packed lunches when used in the school setting or for photograph analysis. This finding has broad implications, particularly for the use of photograph analysis, because this approach offers a convenient and cost effective method of measuring what food and beverages children bring to school in home packed lunches.

76 FR 17973 - Self-Regulatory Organizations; C2 Options Exchange, Incorporated; Order Approving Proposed Rule...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... office of the Vice Chairman.\\5\\ The primary function of the Vice Chairman's office was to facilitate... Permit Holder committees.\\6\\ The Exchange believes that C2 management is able to perform these functions... eliminate its Audit Committee because its functions are duplicative of the functions performed by the Audit...

Research and audit in effective health services.

PubMed

Thomas, B

This article explores the role of research and audit in the pursuit of effective health services, the differences between the audit and research function, the importance of a multidisciplinary approach to evaluating a service and the impact of an evidence-based approach on patients.

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

PubMed

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

2011-11-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

76 FR 17974 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

...\\ Historically, the Vice Chairman's primary function was to facilitate communication between the Exchange and its... proposes to amend its Bylaws to eliminate its Audit Committee because its functions are duplicative of the functions performed by the Audit Committee of its parent company, CBOE Holdings, Inc. (``CBOE Holdings...

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

PubMed

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

2016-01-01

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

75 FR 80947 - Conflict Minerals

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

... require any issuer for which conflict minerals are necessary to the functionality or production of a... measures would include, but would not be limited to, an independent private sector audit of the issuer's... obtained an independent private sector audit of its report, provide the audit report, and make its reports...

[Nursing audit as a professional marketing strategy].

PubMed

Costa, Maria Suêuda; Forte, Benedita Pessoa; Alves, Maria Dalva Santos; Viana, Jamille Forte; Oriá, Mônica Oliveira Batista

2004-01-01

This study relates an audit experience with an interdisciplinary team in public health services at Fortaleza-CE and aims to describe the functional dimension of these audit actions and the its importance for nursing; to define a model with a professional marketing strategy for the nurse. Theoretical bases of contemporary Administration were used to converge with the audit practice experiences. One proposes a new audit nursing strategy in favor of the professional significance, because the nurse currently conducts actions with a scientific marketing identity, but at the unconscious level.

Flexible Audit Trailing in Interactive Courseware.

ERIC Educational Resources Information Center

Judd, Terry; Kennedy, Gregor

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

78 FR 19246 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-29

... the system have been updated to include use in law enforcement, audits and oversight activities, and..., organization, or individual for the purpose of performing audit or oversight operations as authorized by law, but only such information as is necessary and relevant to such audit or oversight function. (4...

42 CFR 455.232 - Medicaid integrity audit program contractor functions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

42 CFR 455.232 - Medicaid integrity audit program contractor functions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

42 CFR 455.232 - Medicaid integrity audit program contractor functions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

42 CFR 455.232 - Medicaid integrity audit program contractor functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid integrity audit program contractor functions. 455.232 Section 455.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS PROGRAM INTEGRITY: MEDICAID Medicaid...

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

ERIC Educational Resources Information Center

Christopher, Joe

2015-01-01

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

Defense Logistical Support Contracts in Iraq and Afghanistan: Issues for Congress

DTIC Science & Technology

2010-09-20

Services Committee on April 14, 2010. The bill was amended by the HASC on April 21, 2010, discharged by the House Oversight and Government Reform Committee...Afghanistan; • Section 852 calls for the Army Audit Agency, the Navy Audit Services, and the Air Force Audit Agency to each conduct a comprehensive audit of...security functions in areas of combat operations and are involved in the discharge of a weapon or other active, non-lethal countermeasures; and

Defense Contracting in Iraq and Afghanistan: Issues and Options for Congress

DTIC Science & Technology

2009-02-19

Afghanistan; • Section 852 calls for the Army Audit Agency, the Navy Audit Services, and the Air Force Audit Agency to each conduct a comprehensive audit of...perform security functions in areas of combat operations and are involved in the discharge of a weapon or other active, non-lethal countermeasures; and...strengthen the government’s hand in dealing with industry. As an example, Secretary of the Navy Donald C. Winter and Chief of Naval Operations Adm

Cross-Cultural Adaptation and Psychometric Properties of the AUDIT and CAGE Questionnaires in Tanzanian Swahili for a Traumatic Brain Injury Population.

PubMed

Vissoci, Joao Ricardo Nickenig; Hertz, Julian; El-Gabri, Deena; Andrade Do Nascimento, José Roberto; Pestillo De Oliveira, Leonardo; Mmbaga, Blandina Theophil; Mvungi, Mark; Staton, Catherine A

2018-01-01

To develop Swahili versions of the Alcohol Use Disorders Identification Test (AUDIT) and CAGE questionnaires and evaluate their psychometric properties in a traumatic brain injury (TBI) population in Tanzania. Swahili versions of the AUDIT and CAGE were developed through translation and back-translation by a panel of native speakers of both English and Swahili. The translated instruments were administered to a sample of Tanzanian adults from a TBI registry. The validity and reliability were analyzed using standard statistical methods. The translated versions of both the AUDIT and CAGE questionnaires were found to have excellent language clarity and domain coherence. Reliability was acceptable (>0.85) for all tested versions. Confirmatory factor analysis of one, two and three factor solution for the AUDIT and one factor solution for the CAGE showed adequate results. AUDIT and CAGE scores were strongly correlated to each other (R > 0.80), and AUDIT scores were significantly lower in non-drinkers compared to drinkers. This article presents the first Swahili and Tanzanian adaptations of the AUDIT and CAGE instruments as well as the first validation of these questionnaires with TBI patients. Both instruments were found to have acceptable psychometric properties, resulting in two new useful tools for medical and social research in this setting. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Managing Productivity.

DTIC Science & Technology

1985-01-01

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

Management and Operations Auditing: A Business Oriented Management Structure For a Unified School District.

ERIC Educational Resources Information Center

Conway, Ernest J.; And Others

An operations audit was conducted for a school district. The purpose of the audit was to determine the organization of the central office and reorganize its structure and staff as appropriate to clearly define goals and objectives, specify roles and responsibilities, eliminate wasted or duplicated efforts, and functionally define operational work…

Toward an HRD Auditing Protocol: Assessing HRD Risk Management Practices

ERIC Educational Resources Information Center

Clardy, Alan

2004-01-01

Even though HRD-related programs and activities carry risks that should be monitored and assessed, there is little literature on how auditing applies to the HRD function; the existing literature on the topic defines HRD auditing in widely different ways. The nature of risk for organizational process is discussed, followed by a review of the…

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

PubMed

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

2016-01-01

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

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

PubMed Central

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

2018-01-01

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

A review of the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-C, and USAUDIT for screening in the United States: Past issues and future directions.

PubMed

Higgins-Biddle, John C; Babor, Thomas F

2018-05-03

The US Preventive Services Task Force recommends that clinicians screen all adults for alcohol misuse and provide brief counseling to those engaged in risky or hazardous drinking. The World Health Organization's (WHO's) Alcohol Use Disorders Identification Test (AUDIT) is the most widely tested instrument for screening in primary health care. This paper describes the structural and functional features of the AUDIT and methodological problems with the validation of the alcohol consumption questions (AUDIT-C). The content, scoring, and rationale for a new version of the AUDIT (called the USAUDIT), adapted to US standard drink size and hazardous drinking guidelines, is presented. Narrative review focusing on the consumption elements of the AUDIT. Four studies of the AUDIT-C are reviewed and evaluated. The AUDIT has been used extensively in many countries without making the changes in the first three consumption questions recommended in the AUDIT User's Manual. As a consequence, the original WHO version is not compatible with US guidelines and AUDIT scores are not comparable with those obtained in countries that have different drink sizes, consumption units, and safe drinking limits. Clinical and Scientific Significance. The USAUDIT has adapted the WHO AUDIT to a 14 g standard drink, and US low-risk drinking guidelines. These changes provide greater accuracy in measuring alcohol consumption than the AUDIT-C.

Audio-visual temporal perception in children with restored hearing.

PubMed

Gori, Monica; Chilosi, Anna; Forli, Francesca; Burr, David

2017-05-01

It is not clear how audio-visual temporal perception develops in children with restored hearing. In this study we measured temporal discrimination thresholds with an audio-visual temporal bisection task in 9 deaf children with restored audition, and 22 typically hearing children. In typically hearing children, audition was more precise than vision, with no gain in multisensory conditions (as previously reported in Gori et al. (2012b)). However, deaf children with restored audition showed similar thresholds for audio and visual thresholds and some evidence of gain in audio-visual temporal multisensory conditions. Interestingly, we found a strong correlation between auditory weighting of multisensory signals and quality of language: patients who gave more weight to audition had better language skills. Similarly, auditory thresholds for the temporal bisection task were also a good predictor of language skills. This result supports the idea that the temporal auditory processing is associated with language development. Copyright © 2017. Published by Elsevier Ltd.

76 FR 58315 - Self-Regulatory Organizations; EDGA Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... internal controls, and do not necessarily require internal auditors to perform the internal audit function... clarify the Exchange's current ability to retain a third party auditor through codification in the By... undertaken by a third-party auditor retained to perform all or a portion of the Exchange's audit function. 2...

76 FR 58317 - Self-Regulatory Organizations; EDGX Exchange, Inc.; Notice of Filing and Immediate Effectiveness...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-20

... internal controls, and do not necessarily require internal auditors to perform the internal audit function... clarify the Exchange's current ability to retain a third party auditor through codification in the By... undertaken by a third-party auditor retained to perform all or a portion of the Exchange's audit function. 2...

Marketing audit reveals holes and opportunities.

PubMed

Pearson, E

1990-07-01

The marketing department is an essential function of the hospital. But do you know if your marketing efforts are meeting your institution's objectives? An audit of the department is as essential as any other part of the marketing plan. The author tells you "how" and "why" you should seek the services of an auditor to examine your marketing function.

A quality assurance audit: phase III trial of maximal androgen deprivation in prostate cancer (TROG 96.01).

PubMed

Steigler, A; Mameghan, H; Lamb, D; Joseph, D; Matthews, J; Franklin, I; Turner, S; Spry, N; Poulsen, M; North, J; Kovacev, O; Denham, J

2000-02-01

In 1997 the Trans-Tasman Radiation Oncology Group (TROG) performed a quality assurance (QA) audit of its phase III randomized clinical trial investigating the effectiveness of different durations of maximal androgen deprivation prior to and during definitive radiation therapy for locally advanced carcinoma of the prostate (TROG 96.01). The audit reviewed a total of 60 cases from 15 centres across Australia and New Zealand. In addition to verification of technical adherence to the protocol, the audit also incorporated a survey of centre planning techniques and a QA time/cost analysis. The present report builds on TROG's first technical audit conducted in 1996 for the phase III accelerated head and neck trial (TROG 91.01) and highlights the significant progress TROG has made in the interim period. The audit provides a strong validation of the results of the 96.01 trial, as well as valuable budgeting and treatment planning information for future trials. Overall improvements were detected in data quality and quantity, and in protocol compliance, with a reduction in the rate of unacceptable protocol violations from 10 to 4%. Audit design, staff education and increased data management resources were identified as the main contributing factors to these improvements. In addition, a budget estimate of $100 per patient has been proposed for conducting similar technical audits. The next major QA project to be undertaken by TROG during the period 1998-1999 is an intercentre dosimetry study. Trial funding and staff education have been targeted as the key major issues essential to the continued success and expansion of TROG's QA programme.

Quality improvement in New Zealand healthcare. Part 3: achieving effective care through clinical audit.

PubMed

Seddon, Mary; Buchanan, John

2006-08-04

In this third article in the Series on quality improvement, we examine the effectiveness of dimension of healthcare quality. To satisfy this dimension, two equally important facets must be attended to. First the best available evidence must be sought through research, and second that evidence must be applied--this second function is the domain of quality improvement activities generally and clinical audit in particular. Clinical audit is one of the main tools to establish whether the best evidence is being used in practice, as it compares actual practice to a standard of practice. Clinical audit identifies any gaps between what is done and what should be done, and rectifies any deficiencies in the actual processes of care. In this article, the steps involved in a clinical audit, how it is different to research, and the question of whether clinical audit requires ethical approval are explored.

Renal function monitoring in patients prescribed dabigatran in the Compass Health Primary Health Organisation: a quality improvement audit.

PubMed

McBain, Lynn; Kyle, Anna

2018-03-09

To assess annual renal function monitoring and clinical indications for use in patients prescribed dabigatran. A quality improvement activity included all patients in the Compass Health Primary Health Organisation (PHO) prescribed dabigatran. Information recorded: demographics; indication for use; daily dose; height; weight; serum creatinine; and estimated glomerular filtration rate (eGFR). The first audit occurred during July 2013 - May 2014, the second during May 2014 - October 2016. Across the PHO, all patients prescribed dabigatran were reviewed: 941 patients and 1,564 respectively. At the time of the second pass audit, renal function monitoring improved from 88% to 90%, and 96% were prescribed dabigatran for an approved indication. Results showed a continuing high level of renal function monitoring across the PHO in 90% of patients prescribed dabigatran. Practitioners were reminded to use creatinine clearance as a marker of renal function. Dabigatran was prescribed for an approved indication in 96% of patients. Our results are in line with recommended best practice and clinical guidelines.

Audits of oncology units - an effective and pragmatic approach.

PubMed

Abratt, Raymond Pierre; Eedes, David; Bailey, Belinda; Salmon, Chris; Govender, Yogi; Oelofse, Ivan; Burger, Henriette

2017-05-24

Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Staff in oncology units who were part of the audit process completed the audit self-assessment form for the unit. This was followed by a visit to each unit by an assessor, and then subsequent personal contact, usually via telephone. The audit self-assessment document listed quality-assurance measures or items in the physical and functional areas of the oncology unit. There were a total of 153 items included in the audit. The online survey took place in October 2016. The invitation to participate was sent to 59 oncology units at which staff members had completed the audit process. The online survey was completed by 54 (41%) of the 132 potential respondents. The online survey found that the audit was very or extremely useful in maintaining personal professional standards in 89% of responses. The audit process and feedback was rated as very or extremely satisfactory in 80% and 81%, respectively. The self-assessment audit document was scored by survey respondents as very or extremely practical in 63% of responses. The feedback on the audit was that it was very or extremely helpful in formulating improvement plans in oncology units in 82% of responses. Major and minor changes that occurred as a result of the audit process were reported as 8% and 88%, respectively. The survey findings show that the audit process and its self- assessment document meet the aims of being helpful and pragmatic.

Audit Cultures and Quality Assurance Mechanisms in England: A Study of Their Perceived Impact on the Work of Academics

ERIC Educational Resources Information Center

Cheng, Ming

2010-01-01

Proponents of the concept of the audit culture in UK higher education argue that from the late 1990s onward audit functioned as a form of power control and had a profound effect on academics and their work. Such arguments continued to be made into the early 2000s. Since then, however, the level of external scrutiny surrounding UK academics'…

Development of a pedestrian audit tool to assess rural neighborhood walkability.

PubMed

Scanlin, Kathleen; Haardoerfer, Regine; Kegler, Michelle C; Glanz, Karen

2014-08-01

Recently, investigators have begun to refine audit instruments for use in rural areas. However, no studies have developed a walkability summary score or have correlated built environment characteristics with physical activity behavior. The Rural Pedestrian Environmental Audit Instrument was developed specifically for use in rural areas. Segments surrounding participant's homes were selected to represent neighborhood streets (N = 116). Interrater reliability was conducted on a subset of streets (N = 42). Rural-specific domain and walkability scores were developed and correlated with individual-level data on perceptions of the neighborhood and self-reported physical activity behavior. Interrater reliability for the instrument was substantial and all domains had high agreement. Walkability in the audited area was low with even the best segments demonstrating only moderate support for walking. There were no significant correlations between the neighborhood walkability score and self-reported neighborhood walkability, time spent walking, sedentary behavior, or BMI; however, a few correlations within the social/dynamic domain were significant. This study expands recent research refining audit instruments for rural areas. Findings suggest the usefulness of summarizing environmental data at the domain level and linking it to physical activity behavior to identify aspects of the neighborhood environment that are most strongly correlated with actual behavior.

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.

Department of the Navy FY 1992/FY 1993 Budget Estimates Descriptive Summaries Submitted to Congress February 1991, Research, Development, Test and Evaluation, Navy

DTIC Science & Technology

1991-02-01

FY 1990 ACCOMPLISHMENTS: a. (U) Completed physical functional and operational audit of system, subcomponents and interfaces related to digital...receiver hardware. b. (U) Developed system specification reflecting audit results. c. (U) Established reliability assessment and recommended changes and/or...interoperability testing and demonstrations. d. (U) Updated joint terminal specifications and standards. e. (U) Audited Army/Navy/Air Force terminal designs. f. (U

Defense Logistical Support Contracts in Iraq and Afghanistan: Issues for Congress

DTIC Science & Technology

2009-06-24

on Wartime Contracting in Iraq and Afghanistan; • Section 852 calls for the Army Audit Agency, the Navy Audit Services, and the Air Force Audit...reporting requirements for contractors that perform security functions in areas of combat operations and are involved in the discharge of a weapon or other...hand in dealing with industry. As an example, Secretary of the Navy Donald C. Winter and Chief of Naval Operations Adm. Michael G. Mullen have reported

Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.

PubMed

Donovan, Dennis M; Kivlahan, Daniel R; Doyle, Suzanne R; Longabaugh, Richard; Greenfield, Shelly F

2006-12-01

To examine among alcohol-dependent out-patient clients the concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) total score and 'zones' suggested by the World Health Organization for defining levels of severity of alcohol use problems. Participants were classified into AUDIT zones (AUDIT total score = 8-15, 16-19, 20-40) and compared on measures of demographics, treatment goals, alcohol consumption, alcohol-related consequences, severity of dependence, physiological dependence, tolerance, withdrawal and biomarkers of alcohol use. Eleven out-patient academic clinical research centers across the United States. Participants Alcohol dependent individuals (n = 1335) entering out-patient treatment in the Combined Pharmacotherapies and Behavioral Interventions (COMBINE) study. The AUDIT was administered as part of an initial screening. Baseline measures used for concurrent validation included the Structured Clinical Interview for Diagnostic and Statistical Manual, 4th edition (DSM-IV) Disorders, the Alcohol Dependence Scale, the Drinker Inventory of Consequences, the Obsessive-Compulsive Drinking Scale, the University of Rhode Island Change Assessment, the Thoughts about Abstinence Scale, the Form-90, %carbohydrate-deficient transferrin and gamma-glutamyl transferase. Findings Indicators of severity of dependence and alcohol-related problems increased linearly with total score and differed significantly across AUDIT zones. The highest zone, with scores of 20 and above, was markedly different with respect to severity from the other two zones and members of this group endorsed an abstinence goal more strongly. The AUDIT total score is a brief measure that appears to provide an index of severity of dependence in a sample of alcohol-dependent individuals seeking out-patient treatment, extending its potential utility beyond its more traditional role as a screening instrument in general populations.

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.

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

PubMed

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

2010-01-01

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

A centrally generated primary care physician audit report does not improve colonoscopy uptake after a positive result on a fecal occult blood test in Ontario's ColonCancerCheck program.

PubMed

Stock, D; Rabeneck, L; Baxter, N N; Paszat, L F; Sutradhar, R; Yun, L; Tinmouth, J

2017-02-01

Timely follow-up of fecal occult blood screening with colonoscopy is essential for achieving colorectal cancer mortality reduction. In the present study, we evaluated the effectiveness of centrally generated, physician-targeted audit and feedback to improve colonoscopy uptake after a positive fecal occult blood test (fobt) result within Ontario's population-wide ColonCancerCheck Program. This prospective cohort study used data sets from Ontario's ColonCancerCheck Program (2008-2011) that were linked to provincial administrative health databases. Cox proportional hazards regression was used to estimate the effect of centralized, physician-targeted audit and feedback on colonoscopy uptake in an Ontario-wide fobt-positive cohort. A mailed physician audit and feedback report identifying individuals outstanding for colonoscopy for 3 or more months after a positive fobt result did not increase the likelihood of colonoscopy uptake (hazard ratio: 0.95; 95% confidence interval: 0.79 to 1.13). Duration of positive fobt status was strongly inversely associated with the hazard of follow-up colonoscopy ( p for linear trend: <0.001). In a large population-wide setting, centralized tracking in the form of physician-targeted mailed audit and feedback reports does not improve colonoscopy uptake for screening participants with a positive fobt result outstanding for 3 or more months. Mailed physician-targeted screening audit and feedback reports alone are unlikely to improve compliance with follow-up colonoscopy in Ontario. Other interventions such as physician audits or automatic referrals, demonstrated to be effective in other jurisdictions, might be warranted.

When is audit and feedback effective in dementia care? A systematic review.

PubMed

Sykes, Michael J; McAnuff, Jennifer; Kolehmainen, Niina

2018-03-01

Evidence-based care for people with dementia is a priority for patients, carers and clinicians and a policy priority. There is evidence that people with dementia do not always receive such care. Audit and feedback, also known as clinical audit, is an extensively-used intervention to improve care. However, there is uncertainty about the best way to use it. To investigate whether audit and feedback is effective for improving health professionals' care of people with dementia. To investigate whether the content and delivery of audit and feedback affects its effectiveness in the context of health professionals' care for people with dementia. Systematic review DATA SOURCES: The Cochrane Central Register of Controlled Trials, Prospero, Medline (1946-December week 1 2016), PsycInfo (1967-January 2017), Cinahl (1982-January 2017), HMIC (1979-January 2017), Embase (1974-2017 week 1) databases and the Science Citation Index and Social Science Citation Index were searched combining terms for audit and feedback, health personnel, and dementia. Following screening, the data were extracted using the Template for Intervention Description and Replication (TIDieR), and synthesised graphically using harvest plots and narratively. Thirteen studies met the inclusion criteria. Published studies of audit and feedback in dementia rarely described more than one cycle. None of the included studies had a comparison group: 12 were before and after designs and one was an interrupted time series without a comparison group. The median absolute improvement was greater than in studies beyond dementia which have used stronger designs with fewer risks of bias. Included studies demonstrated large variation in the effectiveness of audit and feedback. Whilst methodological and reporting limitations in the included studies hinder the ability to draw strong conclusions on the effectiveness of audit and feedback in dementia care, the large interquartile range indicates further work is needed to understand the factors which affect the effectiveness of this much-used intervention. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

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

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

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

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

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

PubMed

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

2015-07-01

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

Building the community voice into planning: 25 years of methods development in social audit

PubMed Central

2011-01-01

Health planners and managers make decisions based on their appreciation of causality. Social audits question the assumptions behind this and try to improve quality of available evidence. The method has its origin in the follow-up of Bhopal survivors in the 1980s, where “cluster cohorts” tracked health events over time. In social audit, a representative panel of sentinel sites are the framework to follow the impact of health programmes or reforms. The epidemiological backbone of social audit tackles causality in a calculated way, balancing computational aspects with appreciation of the limits of the science. Social audits share findings with planners at policy level, health services providers, and users in the household, where final decisions about use of public services rest. Sharing survey results with sample communities and service workers generates a second order of results through structured discussions. Aggregation of these evidence-based community-led solutions across a representative sample provides a rich substrate for decisions. This socialising of evidence for participatory action (SEPA) involves a different skill set but quality control and rigour are still important. Early social audits addressed settings without accepted sample frames, the fundamentals of reproducible questionnaires, and the logistics of data turnaround. Feedback of results to stakeholders was at CIET insistence – and at CIET expense. Later social audits included strong SEPA components. Recent and current social audits are institutionalising high level research methods in planning, incorporating randomisation and experimental designs in a rigorous approach to causality. The 25 years have provided a number of lessons. Social audit reduces the arbitrariness of planning decisions, and reduces the wastage of simply allocating resources the way they were in past years. But too much evidence easily exceeds the uptake capacity of decision takers. Political will of governments often did not match those of donors with interest conditioned by political cycles. Some reforms have a longer turnaround than the political cycle; short turnaround interventions can develop momentum. Experience and specialisation made social audit seem more simple than it is. The core of social audit, its mystique, is not easily taught or transferred. Yet teams in Mexico, Nicaragua, Canada, southern Africa, and Pakistan all have more than a decade of experience in social audit, their in-service training supported by a customised Masters programme. PMID:22376121

Building the community voice into planning: 25 years of methods development in social audit.

PubMed

Andersson, Neil

2011-12-21

Health planners and managers make decisions based on their appreciation of causality. Social audits question the assumptions behind this and try to improve quality of available evidence. The method has its origin in the follow-up of Bhopal survivors in the 1980s, where "cluster cohorts" tracked health events over time. In social audit, a representative panel of sentinel sites are the framework to follow the impact of health programmes or reforms. The epidemiological backbone of social audit tackles causality in a calculated way, balancing computational aspects with appreciation of the limits of the science.Social audits share findings with planners at policy level, health services providers, and users in the household, where final decisions about use of public services rest. Sharing survey results with sample communities and service workers generates a second order of results through structured discussions. Aggregation of these evidence-based community-led solutions across a representative sample provides a rich substrate for decisions. This socialising of evidence for participatory action (SEPA) involves a different skill set but quality control and rigour are still important.Early social audits addressed settings without accepted sample frames, the fundamentals of reproducible questionnaires, and the logistics of data turnaround. Feedback of results to stakeholders was at CIET insistence--and at CIET expense. Later social audits included strong SEPA components. Recent and current social audits are institutionalising high level research methods in planning, incorporating randomisation and experimental designs in a rigorous approach to causality.The 25 years have provided a number of lessons. Social audit reduces the arbitrariness of planning decisions, and reduces the wastage of simply allocating resources the way they were in past years. But too much evidence easily exceeds the uptake capacity of decision takers. Political will of governments often did not match those of donors with interest conditioned by political cycles. Some reforms have a longer turnaround than the political cycle; short turnaround interventions can develop momentum. Experience and specialisation made social audit seem more simple than it is. The core of social audit, its mystique, is not easily taught or transferred. Yet teams in Mexico, Nicaragua, Canada, southern Africa, and Pakistan all have more than a decade of experience in social audit, their in-service training supported by a customised Masters programme.

Conducting a Technology Audit

ERIC Educational Resources Information Center

Flaherty, William

2011-01-01

Technology is a critical component in the success of any high-functioning school district, thus it is important that education leaders should examine it closely. Simply put, the purpose of a technology audit is to assess the effectiveness of the technology for administrative or instructional use. Rogers Public Schools in Rogers, Arkansas, recently…

Auditing the Quality of Management in the Community College.

ERIC Educational Resources Information Center

Hammons, James O.; Murry, John W. Jr.

1998-01-01

Provides an evaluation of the Community College Management Audit, a system designed to assess the abilities of administrative personnel to perform certain key functions of a manager regardless of their areas of responsibility. Argues that the principles underlying organizational effectiveness apply to both businesses and educational organizations.…

Evaluation of a Nutrition Care Process-based audit instrument, the Diet-NCP-Audit, for documentation of dietetic care in medical records.

PubMed

Lövestam, Elin; Orrevall, Ylva; Koochek, Afsaneh; Karlström, Brita; Andersson, Agneta

2014-06-01

Adequate documentation in medical records is important for high-quality health care. Documentation quality is widely studied within nursing, but studies are lacking within dietetic care. The aim of this study was to translate, elaborate and evaluate an audit instrument, based on the four-step Nutrition Care Process model, for documentation of dietetic care in medical records. The audit instrument includes 14 items focused on essential parts of dietetic care and the documentation's clarity and structure. Each item is to be rated 0-1 or 0-2 points, with a maximum total instrument score of 26. A detailed manual was added to facilitate the interpretation and increase the reliability of the instrument. The instrument is based on a similar tool initiated 9 years ago in the United States, which in this study was translated to Swedish and further elaborated. The translated and further elaborated instrument was named Diet-NCP-Audit. Firstly, the content validity of the Diet-NCP-Audit instrument was tested by five experienced dietitians. They rated the relevance and clarity of the included items. After a first rating, minor improvements were made. After the second rating, the Content Validity Indexes were 1.0, and the Clarity Index was 0.98. Secondly, to test the reliability, four dietitians reviewed 20 systematically collected dietetic notes independently using the audit instrument. Before the review, a calibration process was performed. A comparison of the reviews was performed, which resulted in a moderate inter-rater agreement with Krippendorff's α = 0.65-0.67. Grouping the audit results in three levels: lower, medium or higher range, a Krippendorff's α of 0.74 was considered high reliability. Also, an intra-rater reliability test-retest with a 9 weeks interval, performed by one dietitian, showed strong agreement. To conclude, the evaluated audit instrument had high content validity and moderate to high reliability and can be used in auditing documentation of dietetic care. © 2013 Nordic College of Caring Science.

Evaluating Shortened Versions of the AUDIT as Screeners for Alcohol Use Problems in a General Population Study.

PubMed

Nayak, Madhabika B; Bond, Jason C; Greenfield, Thomas K

2015-01-01

Efficient alcohol screening measures are important to prevent or treat alcohol use disorders (AUDs). We studied different versions of the Alcohol Use Disorders Identification Test (AUDIT) comparing their performance to the full AUDIT and an AUD measure as screeners for alcohol use problems in Goa, India. Data from a general population study on 743 male drinkers aged 18-49 years are reported. Drinkers completed the AUDIT and an AUD measure. We created shorter versions of the AUDIT by (a) collapsing AUDIT item responses into three and two categories and (b) deleting two items with the lowest factor loadings. Each version was evaluated using factor, reliability and validity, and differential item functioning (DIF) analysis by age, education, standard of living index (SLI), and area of residence. A single factor solution was found for each version with lower factor loadings for items on guilt and concern. There were no significant differences among the different AUDIT versions in predicting AUD. No significant DIF was found by education, SLI or area of residence. DIF was observed for the alcohol frequency item by age. The AUDIT may be used with dichotomized response options without loss of predictive validity. A shortened eight-item dichotomized scale can adequately screen for AUDs in Goa when brevity is of paramount importance, although with lower predictive validity. Although the frequency item was endorsed more by older men, there is no evidence that the AUDIT items perform differently in other groups of male drinkers in Goa.

34 CFR Appendix A to Subpart B of... - Standards for Audit of Governmental Organizations, Programs, Activities, and Functions (GAO)

Code of Federal Regulations, 2010 CFR

2010-07-01

... the individual auditors shall maintain an independent attitude. (b) This standard places upon the auditor and the audit organization the responsibility for maintaining sufficient independence so that their opinions, conclusions, judgments, and recommendations will be impartial. If the auditor is not...

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

PubMed

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

2011-06-06

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

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

PubMed Central

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

2011-01-01

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

How previous experience shapes perception in different sensory modalities

PubMed Central

Snyder, Joel S.; Schwiedrzik, Caspar M.; Vitela, A. Davi; Melloni, Lucia

2015-01-01

What has transpired immediately before has a strong influence on how sensory stimuli are processed and perceived. In particular, temporal context can have contrastive effects, repelling perception away from the interpretation of the context stimulus, and attractive effects (TCEs), whereby perception repeats upon successive presentations of the same stimulus. For decades, scientists have documented contrastive and attractive temporal context effects mostly with simple visual stimuli. But both types of effects also occur in other modalities, e.g., audition and touch, and for stimuli of varying complexity, raising the possibility that context effects reflect general computational principles of sensory systems. Neuroimaging shows that contrastive and attractive context effects arise from neural processes in different areas of the cerebral cortex, suggesting two separate operations with distinct functional roles. Bayesian models can provide a functional account of both context effects, whereby prior experience adjusts sensory systems to optimize perception of future stimuli. PMID:26582982

Improving Standards of Care in Obstructed Labour: A Criteria-Based Audit at a Referral Hospital in a Low-Resource Setting in Tanzania

PubMed Central

2016-01-01

Objective In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting. Methods A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care. The implemented interventions included but were not limited to introducing standard guidelines for diagnosis and management of obstructed labour, agreeing on mandatory review by specialist for cases that are assigned caesarean section, re-training and supervision on use and interpretation of partograph and, strengthening team work between doctors, mid-wives and theatre staff. After implementing these interventions in March, a re-audit was performed from July 2015 to November, 2015, and the results were compared to those of the baseline audit. Results Two hundred and sixty deliveries in the baseline survey and 250 deliveries in the follow-up survey were audited. Implementing the new criteria improved the diagnosis from 74% to 81% (p = 0.049) and also the management of obstructed labour from 4.2% at baseline audit to 9.2% at re-audit (p = 0.025). Improved detection of prolonged labour through heightened observation of regular contractions, protracted cervical dilatation, protracted descent of presenting part, arrested cervical dilation, and severe moulding contributed to improved standards of diagnosis (all p < 0.04). Patient reviews by senior obstetricians increased from 34% to 43% (p = 0.045) and reduced time for caesarean section intervention from the median time of 120 to 90 minutes (p = 0.001) improved management (all p < 0.05). Perinatal outcomes, neonatal distress and fresh stillbirths, were reduced from 16% to. 8.8% (p = 0.01). Conclusion A criteria-based audit proved to be a feasible and useful tool in improving diagnosis and management of obstructed labour using available resources. Some of the observed changes in practice were of modest magnitude implying demand for further improvements, while sustaining those already put in place. PMID:27893765

Improving Standards of Care in Obstructed Labour: A Criteria-Based Audit at a Referral Hospital in a Low-Resource Setting in Tanzania.

PubMed

Mgaya, Andrew H; Kidanto, Hussein L; Nystrom, Lennarth; Essén, Birgitta

2016-01-01

In low-resource settings, obstructed labour is strongly associated with severe maternal morbidity and intrapartum asphyxia, and consequently maternal and perinatal deaths. This study evaluated the impact of a criteria-based audit of the diagnosis and management of obstructed labour in a low-resource setting. A baseline criteria-based audit was conducted from October 2013 to March 2014, followed by a workshop in which stakeholders gave feedback on interventions agreed upon to improve obstetric care. The implemented interventions included but were not limited to introducing standard guidelines for diagnosis and management of obstructed labour, agreeing on mandatory review by specialist for cases that are assigned caesarean section, re-training and supervision on use and interpretation of partograph and, strengthening team work between doctors, mid-wives and theatre staff. After implementing these interventions in March, a re-audit was performed from July 2015 to November, 2015, and the results were compared to those of the baseline audit. Two hundred and sixty deliveries in the baseline survey and 250 deliveries in the follow-up survey were audited. Implementing the new criteria improved the diagnosis from 74% to 81% (p = 0.049) and also the management of obstructed labour from 4.2% at baseline audit to 9.2% at re-audit (p = 0.025). Improved detection of prolonged labour through heightened observation of regular contractions, protracted cervical dilatation, protracted descent of presenting part, arrested cervical dilation, and severe moulding contributed to improved standards of diagnosis (all p < 0.04). Patient reviews by senior obstetricians increased from 34% to 43% (p = 0.045) and reduced time for caesarean section intervention from the median time of 120 to 90 minutes (p = 0.001) improved management (all p < 0.05). Perinatal outcomes, neonatal distress and fresh stillbirths, were reduced from 16% to. 8.8% (p = 0.01). A criteria-based audit proved to be a feasible and useful tool in improving diagnosis and management of obstructed labour using available resources. Some of the observed changes in practice were of modest magnitude implying demand for further improvements, while sustaining those already put in place.

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

PubMed

Jiang, Keyuan; Cao, Xiang

2011-10-01

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

Degree Audit Systems: Are They Worth It?

ERIC Educational Resources Information Center

Johns, Virginia

2006-01-01

A lot of various degree audit systems are available on the market and most often they have similar features such as the functionality they each provide, the technical platforms upon which they operate, their requirements for interfacing with the local SIS, the ease of use, and the level of effort required to implement and operate. However, the…

Contrasting olfaction, vision, and audition as predictors of cognitive change and impairment in non-demented older adults.

PubMed

MacDonald, Stuart W S; Keller, Connor J C; Brewster, Paul W H; Dixon, Roger A

2018-05-01

This study examines the relative utility of a particular class of noninvasive functional biomarkers-sensory functions-for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether (a) olfactory function, vision, and audition exhibited significant longitudinal declines in nondemented older adults; (b) multiwave change for these sensory function indicators predicted risk of mild cognitive impairment (MCI); and (c) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. A longitudinal sample (n = 408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively, single-assessment MCI, and multiple-assessment MCI. We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multistep screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Evaluating shortened versions of the AUDIT as screeners for alcohol use problems in a general population study

PubMed Central

Nayak, Madhabika B.; Bond, Jason C.; Greenfield, Thomas K.

2015-01-01

Background Efficient alcohol screening measures are important to prevent or treat alcohol use disorders (AUDs). Objectives We studied different versions of the Alcohol Use Disorders Identification Test (AUDIT) comparing their performance to the full AUDIT and an AUD measure as screeners for alcohol use problems in Goa, India. Methods Data from a general population study on 743 male drinkers aged 18 to 49 years are reported. Drinkers completed the AUDIT and an AUD measure. We created shorter versions of the AUDIT by a) collapsing AUDIT item responses into 3 and 2 categories and b) deleting 2 items with the lowest factor loadings. Each version was evaluated using factor, reliability and validity, and differential item functioning (DIF) analysis by age, education, standard of living index (SLI), and area of residence. Results A single factor solution was found for each version with lower factor loadings for items on guilt and concern. There were no significant differences among the different AUDIT versions in predicting AUD. No significant DIF was found by education, SLI or area of residence. DIF was observed for the alcohol frequency item by age. Conclusions/Importance The AUDIT may be used with dichotomized response options without loss of predictive validity. A shortened 8-item dichotomized scale can adequately screen for AUDs in Goa when brevity is of paramount importance, although with lower predictive validity. Although the frequency item was endorsed more by older men, there is no evidence that the AUDIT items perform differently in other groups of male drinkers in Goa. PMID:26549791

Comparison between a multicentre, collaborative, closed-loop audit assessing management of supracondylar fractures and the British Orthopaedic Association Standard for Trauma 11 (BOAST 11) guidelines.

PubMed

Goodall, R; Claireaux, H; Hill, J; Wilson, E; Monsell, F; Boast Collaborative; Tarassoli, P

2018-03-01

Aims Supracondylar fractures are the most frequently occurring paediatric fractures about the elbow and may be associated with a neurovascular injury. The British Orthopaedic Association Standards for Trauma 11 (BOAST 11) guidelines describe best practice for supracondylar fracture management. This study aimed to assess whether emergency departments in the United Kingdom adhere to BOAST 11 standard 1: a documented assessment, performed on presentation, must include the status of the radial pulse, digital capillary refill time, and the individual function of the radial, median (including the anterior interosseous), and ulnar nerves. Materials and Methods Stage 1: We conducted a multicentre, retrospective audit of adherence to BOAST 11 standard 1. Data were collected from eight hospitals in the United Kingdom. A total of 433 children with Gartland type 2 or 3 supracondylar fractures were eligible for inclusion. A centrally created data collection sheet was used to guide objective analysis of whether BOAST 11 standard 1 was adhered to. Stage 2: We created a quality improvement proforma for use in emergency departments. This was piloted in one of the hospitals used in the primary audit and was re-audited using equivalent methodology. In all, 102 patients presenting between January 2016 and July 2017 were eligible for inclusion in the re-audit. Results Stage 1: Of 433 patient notes audited, adherence to BOAST 11 standard 1 was between 201 (46%) and 232 (54%) for the motor and sensory function of the individual nerves specified, 318 (73%) for radial pulse, and 247 (57%) for digital capillary refill time. Stage 2: Of 102 patient notes audited, adherence to BOAST 11 standard 1 improved to between 72 (71%) and 80 (78%) for motor and sensory function of the nerves, to 84 (82%) for radial pulse, and to 82 (80%) for digital capillary refill time. Of the 102 case notes reviewed in stage 2, only 44 (43%) used the quality improvement proforma; when the proforma was used, adherence improved to between 40 (91%) and 43 (98%) throughout. Conclusion Adherence to BOAST 11 standard 1 is poor in hospitals across the country. This is concerning as neurovascular deficit may be an indication for emergent surgery, and missed neurovascular injury can cause long-term, or even permanent, functional impairment. We present a simple proforma that improves adherence to this standard, can easily be implemented into emergency departments, and may improve patient safety. Cite this article: Bone Joint J 2018;100-B:346-51.

The Mass Function of Cosmic Structures

NASA Astrophysics Data System (ADS)

Audit, E.; Teyssier, R.; Alimi, J.-M.

We investigate some modifications to the Press and Schechter (1974) (PS) prescription resulting from shear and tidal effects. These modifications rely on more realistic treatments of the collapse process than the standard approach based on the spherical model. First, we show that the mass function resulting from a new approximate Lagrangian dynamic (Audit and Alimi, A&A 1996), contains more objects at high mass, than the classical PS mass function and is well fitted by a PS-like function with a threshold density of deltac ≍ 1.4. However, such a Lagrangian description can underestimate the epoch of structure formation since it defines it as the collapse of the first principal axis. We therefore suggest some analytical prescriptions, for computing the collapse time along the second and third principal axes, and we deduce the corresponding mass functions. The collapse along the third axis is delayed by the shear and the number of objects of high mass then decreases. Finally, we show that the shear also strongly affects the formation of low-mass halos. This dynamical effect implies a modification of the low-mass slope of the mass function and allows the reproduction of the observed luminosity function of field galaxies.

The Australian and New Zealand Audit of Surgical Mortality-birth, deaths, and carriage.

PubMed

Raju, R S; Guy, G S; Majid, A J; Babidge, W; Maddern, G J

2015-02-01

This article outlines the formation of the Australian and New Zealand Audit of Surgical Mortality (ANZASM) and describes its objectives, governance, functioning and challenges. A nationwide audit of surgical mortality provides an overview of the leading causes of death in patients who require surgical care. It identifies system or process errors, trends in deficiency of care and helps develop strategies to reduce deaths in the surgical arena. A standardized tool is used to systematically collect data after every surgical death. Patient details are reviewed by a peer surgeon (and in certain cases a second) to identify issues with patient management and hospital processes. The treating surgeon is then offered confidential feedback and alternate views on patient management. From January 2009 to December 2012, 19,096 deaths were reported to the ANZASM. Eighty-six percent of the audited deaths occurred in patients requiring an emergency admission. Significant criticism of patient care was reported in 13% of cases with 16% of clinical issues perceived to be preventable. Western Australia, which first began the audit process, has shown a 30% reduction in surgical deaths. Nationwide mortality audits are a useful and worthwhile exercise. Recommendations identified in the audit reports direct educational workshops and seminars to address these issues. They allow Departments of Health to make informed decisions in their hospitals. Through this model, and the lessons learnt, we would encourage other countries planning to set up their own audits to follow a similar concept.

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

PubMed

Endsley, Paige; Weobong, Benedict; Nadkarni, Abhijit

2017-10-01

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

[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.

Philosophy of clinical psychopharmacology.

PubMed

Aragona, Massimiliano

2013-03-01

The renewal of the philosophical debate in psychiatry is one exciting news of recent years. However, its use in psychopharmacology may be problematic, ranging from self-confinement into the realm of values (which leaves the evidence-based domain unchallenged) to complete rejection of scientific evidence. In this paper philosophy is conceived as a conceptual audit of clinical psychopharmacology. Its function is to criticise the epistemological and methodological problems of current neopositivist, ingenuously realist and evidence-servant psychiatry from within the scientific stance and with the aim of aiding psychopharmacologists in practicing a more self-aware, critical and possibly useful clinical practice. Three examples are discussed to suggest that psychopharmacological practice needs conceptual clarification. At the diagnostic level it is shown that the crisis of the current diagnostic system and the problem of comorbidity strongly influence psychopharmacological results, new conceptualizations more respondent to the psychopharmacological requirements being needed. Heterogeneity of research samples, lack of specificity of psychotropic drugs, difficult generalizability of results, need of a phenomenological study of drug-induced psychopathological changes are discussed herein. At the methodological level the merits and limits of evidence-based practice are considered, arguing that clinicians should know the best available evidence but that guidelines should not be constrictive (due to several methodological biases and rhetorical tricks of which the clinician should be aware, sometimes respondent to extra-scientific, economical requests). At the epistemological level it is shown that the clinical stance is shaped by implicit philosophical beliefs about the mind/body problem (reductionism, dualism, interactionism, pragmatism), and that philosophy can aid physicians to be more aware of their beliefs in order to choose the most useful view and to practice coherently. In conclusion, psychopharmacologists already use methodological audit (e.g. statistical audit); similarly, conceptual clarification is needed in both research planning/evaluation and everyday psychopharmacological practice.

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

PubMed

Miettunen, Kirsi; Metsälä, Eija

2017-06-01

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

Physical activity and healthy eating environmental audit tools in youth care settings: A systematic review.

PubMed

Ajja, Rahma; Beets, Michael W; Chandler, Jessica; Kaczynski, Andrew T; Ward, Dianne S

2015-08-01

There is a growing interest in evaluating the physical activity (PA) and healthy eating (HE) policy and practice environment characteristics in settings frequented by youth (≤18years). This review evaluates the measurement properties of audit tools designed to assess PA and HE policy and practice environment characteristics in settings that care for youth (e.g., childcare, school, afterschool, summer camp). Three electronic databases, reference lists, educational department and national health organizations' web pages were searched between January 1980 and February 2014 to identify tools assessing PA and/or HE policy and practice environments in settings that care for youth (≤18years). Sixty-five audit tools were identified of which 53 individual tools met the inclusion criteria. Thirty-three tools assessed both the PA and HE domains, 6 assessed the PA domain and 14 assessed the HE domain solely. The majority of the tools were self-assessment tools (n=40), and were developed to assess the PA and/or HE environment in school settings (n=33), childcare (n=12), and after school programs (n=4). Four tools assessed the community at-large and had sections for assessing preschool, school and/or afterschool settings within the tool. The majority of audit tools lacked validity and/or reliability data (n=42). Inter-rater reliability and construct validity were the most frequently reported reliability (n=7) and validity types (n=5). Limited attention has been given to establishing the reliability and validity of audit tools for settings that care for youth. Future efforts should be directed towards establishing a strong measurement foundation for these important environmental audit tools. Published by Elsevier Inc.

Dosimetry audits and intercomparisons in radiotherapy: A Malaysian profile

NASA Astrophysics Data System (ADS)

M. Noor, Noramaliza; Nisbet, A.; Hussein, M.; Chu S, Sarene; Kadni, T.; Abdullah, N.; Bradley, D. A.

2017-11-01

Quality audits and intercomparisons are important in ensuring control of processes in any system of endeavour. Present interest is in control of dosimetry in teletherapy, there being a need to assess the extent to which there is consistent radiation dose delivery to the patient. In this study we review significant factors that impact upon radiotherapy dosimetry, focusing upon the example situation of radiotherapy delivery in Malaysia, examining existing literature in support of such efforts. A number of recommendations are made to provide for increased quality assurance and control. In addition to this study, the first level of intercomparison audit i.e. measuring beam output under reference conditions at eight selected Malaysian radiotherapy centres is checked; use being made of 9 μm core diameter Ge-doped silica fibres (Ge-9 μm). The results of Malaysian Secondary Standard Dosimetry Laboratory (SSDL) participation in the IAEA/WHO TLD postal dose audit services during the period between 2011 and 2015 will also been discussed. In conclusion, following review of the development of dosimetry audits and the conduct of one such exercise in Malaysia, it is apparent that regular periodic radiotherapy audits and intercomparison programmes should be strongly supported and implemented worldwide. The programmes to-date demonstrate these to be a good indicator of errors and of consistency between centres. A total of ei+ght beams have been checked in eight Malaysian radiotherapy centres. One out of the eight beams checked produced an unacceptable deviation; this was found to be due to unfamiliarity with the irradiation procedures. Prior to a repeat measurement, the mean ratio of measured to quoted dose was found to be 0.99 with standard deviation of 3%. Subsequent to the repeat measurement, the mean distribution was 1.00, and the standard deviation was 1.3%.

Contrasting Olfaction, Vision, and Audition as Predictors of Cognitive Change and Impairment in Non-Demented Older Adults

PubMed Central

MacDonald, Stuart W.S.; Keller, Connor J.C.; Brewster, Paul W.H.; Dixon, Roger A.

2017-01-01

Objective This study examines the relative utility of a particular class of non-invasive functional biomarkers -- sensory functions -- for detecting those at risk of cognitive decline and impairment. Three central research objectives were examined including whether: (1) olfactory function, vision, and audition exhibited significant longitudinal declines in non-demented older adults, (2) multi-wave change for these sensory function indicators predicted risk of mild cognitive impairment, and (3) change within persons for each sensory measure shared dynamic time-varying associations with within-person change in cognitive functioning. Method A longitudinal sample (n=408) from the Victoria Longitudinal Study was assembled. Three cognitive status subgroups were identified: not impaired cognitively (NIC), single assessment mild cognitive impairment (SA-MCI), and multiple assessment mild cognitive impairment (MA-MCI). Results We tested independent predictive associations, contrasting change in sensory function as predictors of cognitive decline and impairment, utilizing both linear mixed models and logistic regression analysis. Olfaction and, to a lesser extent, vision were identified as the most robust predictors of cognitive status and decline; audition showed little predictive influence. Conclusions These findings underscore the potential utility of deficits in olfactory function, in particular, as an early marker of age- and pathology-related cognitive decline. Functional biomarkers may represent potential candidates for use in the early stages of a multi-step screening approach for detecting those at risk of cognitive impairment, as well as for targeted intervention. PMID:29809033

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

ERIC Educational Resources Information Center

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

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

Multi-centre audit of VMAT planning and pre-treatment verification.

PubMed

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

Role of Large Clinical Datasets From Physiologic Monitors in Improving the Safety of Clinical Alarm Systems and Methodological Considerations: A Case From Philips Monitors.

PubMed

Sowan, Azizeh Khaled; Reed, Charles Calhoun; Staggers, Nancy

2016-09-30

Large datasets of the audit log of modern physiologic monitoring devices have rarely been used for predictive modeling, capturing unsafe practices, or guiding initiatives on alarm systems safety. This paper (1) describes a large clinical dataset using the audit log of the physiologic monitors, (2) discusses benefits and challenges of using the audit log in identifying the most important alarm signals and improving the safety of clinical alarm systems, and (3) provides suggestions for presenting alarm data and improving the audit log of the physiologic monitors. At a 20-bed transplant cardiac intensive care unit, alarm data recorded via the audit log of bedside monitors were retrieved from the server of the central station monitor. Benefits of the audit log are many. They include easily retrievable data at no cost, complete alarm records, easy capture of inconsistent and unsafe practices, and easy identification of bedside monitors missed from a unit change of alarm settings adjustments. Challenges in analyzing the audit log are related to the time-consuming processes of data cleaning and analysis, and limited storage and retrieval capabilities of the monitors. The audit log is a function of current capabilities of the physiologic monitoring systems, monitor's configuration, and alarm management practices by clinicians. Despite current challenges in data retrieval and analysis, large digitalized clinical datasets hold great promise in performance, safety, and quality improvement. Vendors, clinicians, researchers, and professional organizations should work closely to identify the most useful format and type of clinical data to expand medical devices' log capacity.

National Machine Guarding Program: Part 2. Safety management in small metal fabrication enterprises.

PubMed

Parker, David L; Yamin, Samuel C; Brosseau, Lisa M; Xi, Min; Gordon, Robert; Most, Ivan G; Stanley, Rodney

2015-11-01

Small manufacturing businesses often lack important safety programs. Many reasons have been set forth on why this has remained a persistent problem. The National Machine Guarding Program (NMGP) was a nationwide intervention conducted in partnership with two workers' compensation insurers. Insurance safety consultants collected baseline data in 221 business using a 33-question safety management audit. Audits were completed during an interview with the business owner or manager. Most measures of safety management improved with an increasing number of employees. This trend was particularly strong for lockout/tagout. However, size was only significant for businesses without a safety committee. Establishments with a safety committee scored higher (55% vs. 36%) on the safety management audit compared with those lacking a committee (P < 0.0001). Critical safety management programs were frequently absent. A safety committee appears to be a more important factor than business size in accounting for differences in outcome measures. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Improving preventive health care in Aboriginal and Torres Strait Islander primary care settings.

PubMed

Bailie, Jodie; Matthews, Veronica; Laycock, Alison; Schultz, Rosalie; Burgess, Christopher P; Peiris, David; Larkins, Sarah; Bailie, Ross

2017-07-14

Like other colonised populations, Indigenous Australians experience poorer health outcomes than non-Indigenous Australians. Preventable chronic disease is the largest contributor to the health differential between Indigenous and non-Indigenous Australians, but recommended best-practice preventive care is not consistently provided to Indigenous Australians. Significant improvement in health care delivery could be achieved through identifying and minimising evidence-practice gaps. Our objective was to use clinical audit data to create a framework of the priority evidence-practice gaps, strategies to address them, and drivers to support these strategies in the delivery of recommended preventive care. De-identified preventive health clinical audit data from 137 primary health care (PHC) centres in five jurisdictions were analysed (n = 17,108 audited records of well adults with no documented major chronic disease; 367 system assessments; 2005-2014), together with stakeholder survey data relating to interpretation of these data, using a mixed-methods approach (n = 152 responses collated in 2015-16). Stakeholders surveyed included clinicians, managers, policy officers, continuous quality improvement (CQI) facilitators and academics. Priority evidence-practice gaps and associated barriers, enablers and strategies to address the gaps were identified and reported back through two-stages of consultation. Further analysis and interpretation of these data were used to develop a framework of strategies and drivers for health service improvement. Stakeholder identified priorities were: following-up abnormal test results; completing cardiovascular risk assessments; timely recording of results; recording enquiries about living conditions, family relationships and substance use; providing support for clients identified with emotional wellbeing risk; enhancing systems to enable team function and continuity of care. Drivers identified for improving care in these areas included: strong Indigenous participation in the PHC service; appropriate team structure and function to support preventive care; meaningful use of data to support quality of care and CQI; and corporate support functions and structures. The framework should be useful for guiding development and implementation of barrier-driven, tailored interventions for primary health care service delivery and policy contexts, and for guiding further research. While specific strategies to improve the quality of preventive care need to be tailored to local context, these findings reinforce the requirement for multi-level action across the system. The framework and findings may be useful for similar purposes in other parts of the world, with appropriate attention to context in different locations.

34 CFR Appendix B to Subpart B of... - Appendix I, Standards for Audit of Governmental Organizations, Programs, Activities, and...

Code of Federal Regulations, 2013 CFR

2013-07-01

... Organizations, Programs, Activities, and Functions (GAO) B Appendix B to Subpart B of Part 668 Education... Programs Pt. 668, Subpt. B, App. B Appendix B to Subpart B of Part 668—Appendix I, Standards for Audit of... required for the practice of public accountancy by the regulatory authorities of the States.” 1 1 Letter (B...

34 CFR Appendix B to Subpart B of... - Appendix I, Standards for Audit of Governmental Organizations, Programs, Activities, and...

Code of Federal Regulations, 2014 CFR

2014-07-01

... Organizations, Programs, Activities, and Functions (GAO) B Appendix B to Subpart B of Part 668 Education... Programs Pt. 668, Subpt. B, App. B Appendix B to Subpart B of Part 668—Appendix I, Standards for Audit of... required for the practice of public accountancy by the regulatory authorities of the States.” 1 1 Letter (B...

34 CFR Appendix B to Subpart B of... - Appendix I, Standards for Audit of Governmental Organizations, Programs, Activities, and...

Code of Federal Regulations, 2012 CFR

2012-07-01

... Organizations, Programs, Activities, and Functions (GAO) B Appendix B to Subpart B of Part 668 Education... Programs Pt. 668, Subpt. B, App. B Appendix B to Subpart B of Part 668—Appendix I, Standards for Audit of... required for the practice of public accountancy by the regulatory authorities of the States.” 1 1 Letter (B...

Patient-focused goal planning process and outcome after spinal cord injury rehabilitation: quantitative and qualitative audit.

PubMed

Byrnes, Michelle; Beilby, Janet; Ray, Patricia; McLennan, Renee; Ker, John; Schug, Stephan

2012-12-01

To evaluate the process and outcome of a multidisciplinary inpatient goal planning rehabilitation programme on physical, social and psychological functioning for patients with spinal cord injury. Clinical audit: quantitative and qualitative analyses. Specialist spinal injury unit, Perth, Australia. Consecutive series of 100 newly injured spinal cord injury inpatients. MAIN MEASURE(S): The Needs Assessment Checklist (NAC), patient-focused goal planning questionnaire and goal planning progress form. The clinical audit of 100 spinal cord injured patients revealed that 547 goal planning meetings were held with 8531 goals stipulated in total. Seventy-five per cent of the goals set at the first goal planning meeting were achieved by the second meeting and the rate of goal achievements at subsequent goal planning meetings dropped to 56%. Based on quantitative analysis of physical, social and psychological functioning, the 100 spinal cord injury patients improved significantly from baseline to discharge. Furthermore, qualitative analysis revealed benefits consistently reported by spinal cord injury patients of the goal planning rehabilitation programme in improvements to their physical, social and psychological adjustment to injury. The findings of this clinical audit underpin the need for patient-focused goal planning rehabilitation programmes which are tailored to the individual's needs and involve a comprehensive multidisciplinary team.

National Energy Audit Tool for Multifamily Buildings Development Plan

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

Malhotra, Mini; MacDonald, Michael; Accawi, Gina K

The U.S. Department of Energy's (DOE's) Weatherization Assistance Program (WAP) enables low-income families to reduce their energy costs by providing funds to make their homes more energy efficient. In addition, the program funds Weatherization Training and Technical Assistance (T and TA) activities to support a range of program operations. These activities include measuring and documenting performance, monitoring programs, promoting advanced techniques and collaborations to further improve program effectiveness, and training, including developing tools and information resources. The T and TA plan outlines the tasks, activities, and milestones to support the weatherization network with the program implementation ramp up efforts. Weatherizationmore » of multifamily buildings has been recognized as an effective way to ramp up weatherization efforts. To support this effort, the 2009 National Weatherization T and TA plan includes the task of expanding the functionality of the Weatherization Assistant, a DOE-sponsored family of energy audit computer programs, to perform audits for large and small multifamily buildings This report describes the planning effort for a new multifamily energy audit tool for DOE's WAP. The functionality of the Weatherization Assistant is being expanded to also perform energy audits of small multifamily and large multifamily buildings. The process covers an assessment of needs that includes input from national experts during two national Web conferences. The assessment of needs is then translated into capability and performance descriptions for the proposed new multifamily energy audit, with some description of what might or should be provided in the new tool. The assessment of needs is combined with our best judgment to lay out a strategy for development of the multifamily tool that proceeds in stages, with features of an initial tool (version 1) and a more capable version 2 handled with currently available resources. Additional development in the future is expected to be needed if more capabilities are to be added. A rough schedule for development of the version 1 tool is presented. The components and capabilities described in this plan will serve as the starting point for development of the proposed new multifamily energy audit tool for WAP.« less

Practical Shipbuilding Standards for Surface Preparation and Coatings

DTIC Science & Technology

1979-07-01

strong solvent and apply over last coat of epoxy within 48 hours. *Minimum Dry Film Thickness 12.0 SAFETY AND POLUTION CONTROL 12.5 Safety solvents shall...Owner Inspec ion (3) QA/QC Dept. Inspectors. (4) Craft Inspectors (5) Craft Supervision Inspection Only (6) QA/QC Dept. Audit Only (7) Are

Phosphatidylethanol Levels Are Elevated and Correlate Strongly with AUDIT Scores in Young Adult Binge Drinkers.

PubMed

Piano, Mariann R; Tiwari, Stephanie; Nevoral, Lauren; Phillips, Shane A

2015-09-01

To compare levels of phosphatidylethanol (PEth) to self-reported alcohol intake among young adult binge drinkers (18-30 years). Abstainers (n = 23), moderate (n = 22), and binge drinkers (n = 58) completed an alcohol consumption questionnaire and the AUDIT. PEth was measured in whole blood and dried blood spots via high-performance liquid chromatography with tandem mass spectrometry. Also measured was mean corpuscular volume (MCV) and gamma glutamyl transpeptidase (GGT). Most subjects were female (65%) and Caucasian (73%). Among binge drinkers, past-month average number of binge episodes was 7.2 ± 4; average duration of binge drinking behavior was 4.3 ± 3 years. AUDIT scores and PEth levels (ng/ml) in whole blood or dried blood spots were significantly (P < 0.001) greater in binge drinkers (13 ± 4, 186 ± 170, and 65 ± 53, respectively) compared to moderate drinkers (6 ± 3, 24 ± 29, and 11 ± 13, respectively) and abstainers (0.6 ± 0.89, 0, and 0, respectively). No differences were found in MCV and GGT among groups. There were significant correlations between whole blood and dried blood spot PEth levels and AUDIT scores (Spearman's r = 0.745 and 0.738, P < 0.0001, respectively), and whole blood and dried blood spot PEth levels were significantly correlated (0.899, P < 0.0001). PEth levels measured in whole blood and dried blood spots were significantly greater in binge drinkers compared to abstainers and moderate drinkers, and these levels were positively correlated with AUDIT scores. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

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

PubMed Central

2012-01-01

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

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

DTIC Science & Technology

2013-01-01

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

Maintenance Audit through Value Analysis Technique: A Case Study

NASA Astrophysics Data System (ADS)

Carnero, M. C.; Delgado, S.

2008-11-01

The increase in competitiveness, technological changes and the increase in the requirements of quality and service have forced a change in the design and application of maintenance, as well as the way in which it is considered within the managerial strategy. There are numerous maintenance activities that must be developed in a service company. As a result the maintenance functions as a whole have to be outsourced. Nevertheless, delegating this subject to specialized personnel does not exempt the company from responsibilities, but rather leads to the need for control of each maintenance activity. In order to achieve this control and to evaluate the efficiency and effectiveness of the company it is essential to carry out an audit that diagnoses the problems that could develop. In this paper a maintenance audit applied to a service company is developed. The methodology applied is based on the expert systems. The expert system by means of rules uses the weighting technique SMART and value analysis to obtain the weighting between the decision functions and between the alternatives. The expert system applies numerous rules and relations between different variables associated with the specific maintenance functions, to obtain the maintenance state by sections and the general maintenance state of the enterprise. The contributions of this paper are related to the development of a maintenance audit in a service enterprise, in which maintenance is not generally considered a strategic subject and to the integration of decision-making tools such as the weighting technique SMART with value analysis techniques, typical in the design of new products, in the area of the rule-based expert systems.

Assessing achievement in nephrology training: using clinic chart audits to quantitatively screen competency.

PubMed

Yuan, Christina M; Prince, Lisa K; Zwettler, Amy J; Nee, Robert; Oliver, James D; Abbott, Kevin C

2014-11-01

Entrustable professional activities (EPAs) are complex tasks representing vital physician functions in multiple competencies, used to demonstrate trainee development along milestones. Managing a nephrology outpatient clinic has been proposed as an EPA for nephrology fellowship training. Retrospective cohort study of nephrology fellow outpatient clinic performance using a previously validated chart audit tool. Outpatient encounter chart audits for training years 2008-2009 through 2012-2013, corresponding to participation in the Nephrology In-Training Examination (ITE). A median of 7 auditors (attending nephrologists) audited a mean of 1,686±408 (SD) charts per year. 18 fellows were audited; 12, in both of their training years. Proportion of chart audit and quality indicator deficiencies. Longitudinal deficiency and ITE performance. Among fellows audited in both their training years, chart audit deficiencies were fewer in the second versus the first year (5.4%±2.0% vs 17.3%±7.0%; P<0.001) and declined between the first and second halves of the first year (22.2%±6.4% vs 12.3%±9.5%; P=0.002). Most deficiencies were omission errors, regardless of training year. Quality indicator deficiencies for hypertension and chronic kidney disease-associated anemia recognition and management were fewer during the second year (P<0.001). Yearly audit deficiencies ≥5% were associated with an ITE score less than the 25th percentile for second-year fellows (P=0.03), with no significant association for first-year fellows. Auditor-reported deficiencies declined between the first and second halves of the year (17.0% vs 11.1%; P<0.001), with a stable positive/neutral comment rate (17.3% vs 17.8%; P=0.6), suggesting that the decline was not due to auditor fatigue. Retrospective design and small trainee numbers. Managing a nephrology outpatient clinic is an EPA. The chart audit tool was used to assess longitudinal fellow performance in managing a nephrology outpatient clinic. Failure to progress may be quantitatively identified and remediated. The tool identifies deficiencies in all 6 competencies, not just medical knowledge, the primary focus of the ITE and the nephrology subspecialty board examination. Published by Elsevier Inc.

The reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a German general practice population sample.

PubMed

Dybek, Inga; Bischof, Gallus; Grothues, Janina; Reinhardt, Susa; Meyer, Christian; Hapke, Ulfert; John, Ulrich; Broocks, Andreas; Hohagen, Fritz; Rumpf, Hans-Jürgen

2006-05-01

Our goal was to analyze the retest reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a primary-care setting and recommend a cut-off value for the different alcohol-related diagnoses. Participants recruited from general practices (GPs) in two northern German cities received the AUDIT, which was embedded in a health-risk questionnaire. In total, 10,803 screenings were conducted. The retest reliability was tested on a subsample of 99 patients, with an intertest interval of 30 days. Sensitivity and specificity at a number of different cut-off values were estimated for the sample of alcohol consumers (n=8237). For this study, 1109 screen-positive patients received a diagnostic interview. Individuals who scored less than five points in the AUDIT and also tested negative in a second alcohol-related screen were defined as "negative" (n=6003). This definition was supported by diagnostic interviews of 99 screen-negative patients from which no false negatives could be detected. As the gold standard for detection of an alcohol-use disorder (AUD), we used the Munich-Composite International Diagnostic Interview (MCIDI), which is based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria. On the item level, the reliability, measured by the intraclass correlation coefficient (ICC), ranged between .39 (Item 9) and .98 (Item 10). For the total score, the ICC was .95. For cut-off values of eight points and five points, 87.5% and 88.9%, respectively, of the AUDIT-positives, and 98.9% and 95.1%, respectively, of the AUDIT-negatives were identically identified at retest, with kappa = .86 and kappa = .81. At the cut-off value of five points, we determined good combinations of sensitivity and specificity for the following diagnoses: alcohol dependence (sensitivity and specificity of .97 and .88, respectively), AUD (.97 and .92), and AUD and/or at-risk consumption (.97 and .91). Embedded in a health-risk questionnaire in primary-care settings, the AUDIT is a reliable and valid screening instrument to identify at-risk drinkers and patients with an AUD. Our findings strongly suggest a lowering of the recommended cut-off value of eight points.

Fundamental frequency development in typically developing infants and infants with severe-to-profound hearing loss

PubMed Central

Iyer, Suneeti Nathani; Oller, D. Kimbrough

2010-01-01

Little research has been conducted on the development of suprasegmental characteristics of vocalizations in typically developing infants (TDI) and the role of audition in the development of these characteristics. The purpose of the present study was to examine the longitudinal development of fundamental frequency (F0) in eight TDI and eight infants with severe-to-profound hearing loss matched for level of vocal development. Results revealed no significant changes in F0 with advances in pre-language vocal development for TDI. Infants with hearing loss, however, showed a statistically reliable higher variability of F0 than TDI, when age was accounted for as a covariate. The results suggest development of F0 may be strongly influenced by audition. PMID:19031191

Addressing Antibiotic Abuse in China: An Experimental Audit Study☆

PubMed Central

Currie, Janet; Lin, Wanchuan; Meng, Juanjuan

2016-01-01

China has high rates of antibiotic abuse and antibiotic resistance but the causes are still a matter for debate. Strong physician financial incentives to prescribe are likely to be an important cause. However, patient demand (or physician beliefs about patient demand) is often cited and may also play a role. We use an audit study to examine the effect of removing financial incentives, and to try to separate out the effects of patient demand. We implement a number of different experimental treatments designed to try to rule out other possible explanations for our findings. Together, our results suggest that financial incentives are the main driver of antibiotic abuse in China, at least in the young and healthy population we draw on in our study. PMID:26949284

Cross-Cultural Impression Management: A Cultural Knowledge Audit Model

ERIC Educational Resources Information Center

Spong, Abigail; Kamau, Caroline

2012-01-01

Purpose: Many people moving into a new culture for work or study do so without prior cross-cultural training, yet successful cultural adaptation has important ramifications. The purpose of this paper is to focus on cross-cultural impression management as an element of cultural adaptation. Does cultural adaptation begin by paying strong attention…

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

DTIC Science & Technology

2014-12-01

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

DOD Competitive Sourcing: Questions About Goals, Pace, and Risks of Key Reform Initiative.

DTIC Science & Technology

1999-02-01

internal audit , and the function being studied. To the extent existing in-house resources are limited, if resources need to be shifted to meet new...contractor support costs and $24 million for existing in-house staff—to compete 4,000 positions in a multifunction, multilocation study, at least $7,000...competitions and of personnel separation costs on their installations. Army officials, based on work by the Army Audit Agency, have expressed concern that

The role of field auditing in environmental quality assurance management.

PubMed

Claycomb, D R

2000-01-01

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

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

PubMed

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

2015-05-15

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

National machine guarding program: Part 2. Safety management in small metal fabrication enterprises

PubMed Central

Yamin, Samuel C.; Brosseau, Lisa M.; Xi, Min; Gordon, Robert; Most, Ivan G.; Stanley, Rodney

2015-01-01

Background Small manufacturing businesses often lack important safety programs. Many reasons have been set forth on why this has remained a persistent problem. Methods The National Machine Guarding Program (NMGP) was a nationwide intervention conducted in partnership with two workers' compensation insurers. Insurance safety consultants collected baseline data in 221 business using a 33‐question safety management audit. Audits were completed during an interview with the business owner or manager. Results Most measures of safety management improved with an increasing number of employees. This trend was particularly strong for lockout/tagout. However, size was only significant for businesses without a safety committee. Establishments with a safety committee scored higher (55% vs. 36%) on the safety management audit compared with those lacking a committee (P < 0.0001). Conclusions Critical safety management programs were frequently absent. A safety committee appears to be a more important factor than business size in accounting for differences in outcome measures. Am. J. Ind. Med. 58:1184–1193, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26345591

Southwestern Power Administration Combined Financial Statements, 2006-2009

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

None

2009-09-01

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

Neurobiological roots of language in primate audition: common computational properties.

PubMed

Bornkessel-Schlesewsky, Ina; Schlesewsky, Matthias; Small, Steven L; Rauschecker, Josef P

2015-03-01

Here, we present a new perspective on an old question: how does the neurobiology of human language relate to brain systems in nonhuman primates? We argue that higher-order language combinatorics, including sentence and discourse processing, can be situated in a unified, cross-species dorsal-ventral streams architecture for higher auditory processing, and that the functions of the dorsal and ventral streams in higher-order language processing can be grounded in their respective computational properties in primate audition. This view challenges an assumption, common in the cognitive sciences, that a nonhuman primate model forms an inherently inadequate basis for modeling higher-level language functions. Copyright © 2014 Elsevier Ltd. All rights reserved.

A primary care audit of familial risk in patients with a personal history of breast cancer.

PubMed

Nathan, Paul; Ahluwalia, Aneeta; Chorley, Wendy

2014-12-01

Breast cancer is the most common cancer diagnosed in women, both in the UK and worldwide. A small proportion of women are at very high risk of breast cancer, having a particularly strong family history. The National Institute for Health and Clinical Excellence (NICE) has advised that practitioners should not, in most instances, actively seek to identify women with a family history of breast cancer. An audit was undertaken at an urban primary care practice of 15,000 patients, using a paper-based, self-administered questionnaire sent to patients identified with a personal history of breast cancer. The aim of this audit was to determine whether using targeted screening of relatives of patients with breast cancer to identify familial cancer risk is worthwhile in primary care. Since these patients might already expected to have been risk assessed following their initial diagnosis, this audit acts as a quality improvement exercise. The audit used a validated family history questionnaire and risk assessment tool as a screening approach for identifying and grading familial risk in line with the NICE guidelines, to guide referral to the familial cancer screening service. The response rate to family history questionnaires was 54 % and the majority of patients responded positively to their practitioner seeking to identify familial cancer risks in their family. Of the 57 returned questionnaires, over a half (54 %) contained pedigrees with individuals eligible for referral. Patients and their relatives who are often registered with the practice welcome the discussion. An appropriate referral can therefore be made. The findings suggest a role for primary care practitioners in the identification of those at higher familial risk. However integrated systems and processes need designing to facilitate this work.

UK Renal Registry 15th annual report: Chapter 8 UK multisite peritoneal dialysis access catheter audit for first PD catheters 2011.

PubMed

Briggs, Victoria; Pitcher, David; Braddon, Fiona; Fogarty, Damian; Wilkie, Martin

2013-01-01

The central paradigm of effective peritoneal dialysis (PD) is an appropriate standard of PD catheter function. The aim of the project was to develop an effective national PD access audit which would identify an 'appropriate standard' of PD catheter function. The UK Renal Registry collected centre specific information on various PD access outcome measures including catheter functionality and post-insertion complications. The first PD access audit covering England, Northern Ireland and Wales was conducted during April to June 2012 looking at incident dialysis patients in 2011. Forty three data collection spreadsheets were returned from a total of 65 centres describing 917 PD catheter placements. The median age of PD patients was 61 years and 61.5% were male. The proportion of patients initiated on PD in comparison to HD was lower in socially deprived areas. There was a relationship between the timing of nephrology referral and the likelihood of surgical assessment regarding PD catheter placement. Patients with diabetes did not have higher rates of PD catheter failure or of early peritonitis. A comparative PD catheter audit has the potential to provide valuable information on an important patient related outcome measure and lead to an improvement in patient experience. There was wide variation between centres of PD catheter use for late presenting patients. Overall patients were more likely to get a PD catheter if they had been known to the service for more than 1 year. The percutaneous insertion technique was associated with a higher early (less than 2 week) peritonitis rate and more catheter flow problems. Copyright © 2013 S. Karger AG, Basel.

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

PubMed

Taylor, L; Jones, S

2006-04-01

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

Fernando's Long Journey Home

ERIC Educational Resources Information Center

Reclaiming Children and Youth, 2013

2013-01-01

This article describes how use of the "Developmental Audit" tool and related court documents shaped the outcome of the life of a young Mexican man who lived a remarkable saga of resilience, in his struggle to come to the United Stated (USA) to be reunited with his mother. As a small child, strong work ethics and support of family were…

Educational Accounting Procedures.

ERIC Educational Resources Information Center

Tidwell, Sam B.

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

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

PubMed

Szymaniak, Samara

2015-09-01

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

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

PubMed

Lyon, Cheryl

2007-12-01

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

Health governance--its introduction in Lanarkshire Health Board.

PubMed

Wrench, J G; Moir, D C

2002-01-01

To describe an approach to implementing the principles of clinical governance in a Health Board setting. Using guidance from the Scottish Executive and The Faculty of Public Health Medicine to set up a health governance structure at Health Board level. Auditing current work to identify areas that required to be progressed. Lanarkshire Health Board. A Health Governance Committee and a Health Governance Advisory Group, to support the work of the main committee, were set up at Board level. The Scottish Executive Governance Monitoring Template has been adapted to cover the main public health functions. Topics considered in the first year include qualifications, registration and CPD activity of Consultants in Public Health Medicine, audit of public health advice on gastro-intestinal illness, audit of DPH Annual Report and audit of items of business on Health Board agenda. The model developed in Lanarkshire has a Health Governance Advisory Group which works in support of the main Health Governance Committee. This model works well in practice with much of the routine work being done by the Advisory Group. This has streamlined the work of the Health Governance Committee and facilitated its introduction.

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.

The use of audit to identify maternal mortality in different settings: is it just a difference between the rich and the poor?

PubMed

van Dillen, Jeroen; Stekelenburg, Jelle; Schutte, Joke; Walraven, Gijs; van Roosmalen, Jos

2007-01-01

To illustrate how maternal mortality audit identifies different causes of and contributing factors to maternal deaths in different settings in low- and high-income countries and how this can lead to local solutions in reducing maternal deaths. Descriptive study of maternal mortality from different settings and review of data on the history of reducing maternal mortality in what are now high-income countries. Kalabo district in Zambia, Farafenni division in The Gambia, Onandjokwe district in Namibia, and the Netherlands. Population of rural areas in Zambia and The Gambia, peri-urban population in Namibia and nationwide data from the Netherlands. Data from facility-based maternal mortality audits from three African hospitals and data from the latest confidential enquiry in the Netherlands. Maternal mortality ratio (MMR), causes (direct and indirect) and characteristics. MMR ranged from 10 per 100,000 (the Netherlands) to 1,540 per 100,000 (The Gambia). Differences in causes of deaths were characterized by HIV/AIDS in Namibia, sepsis and HIV/AIDS in Zambia, (pre-)eclampsia in The Netherlands and obstructed labour in The Gambia. Differences in maternal mortality are more than just differences between the rich and poor. Acknowledging the magnitude of maternal mortality and harnessing a strong political will to tackle the issues are important factors. However, there is no single, general solution to reduce maternal mortality, and identification of problems needs to be promoted through audit, both national and local.

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

PubMed

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

2003-01-01

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

76 FR 7610 - Self-Regulatory Organizations; Chicago Board Options Exchange, Incorporated; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-10

...). Historically, the Vice Chairman's primary functions were to take a lead role in facilitating communication... limited role, focused solely on CBOE. Under its charter, the primary functions of the CBOE Audit Committee... management will perform these functions. Section 2.3 of the Bylaws is proposed to be amended to delete the...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

PubMed

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

2007-12-01

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

Rash impulsiveness and reward sensitivity in relation to risky drinking by university students: potential roles of frontal systems.

PubMed

Lyvers, Michael; Duff, Helen; Basch, Vanessa; Edwards, Mark S

2012-08-01

Two forms of impulsivity, rash impulsiveness and reward sensitivity, have been proposed to reflect aspects of frontal lobe functioning and promote substance use. The present study examined these two forms of impulsivity as well as frontal lobe symptoms in relation to risky drinking by university students. University undergraduates aged 18-26years completed the Alcohol Use Disorders Identification Test (AUDIT), Barratt Impulsiveness Scale (BIS-11), Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ), Frontal Systems Behavior Scale (FrSBe), and a demographics questionnaire assessing age, gender, and age of onset of weekly drinking (AOD). AUDIT-defined harmful drinkers reported earlier AOD and scored higher on BIS-11, the Sensitivity to Reward (SR) scale of the SPSRQ, and the Disinhibition and Executive Dysfunction scales of the FrSBe compared to lower risk groups. Differences remained significant after controlling for duration of alcohol exposure. Path analyses indicated that the influence of SR on AUDIT was mediated by FrSBe Disinhibition, whereas the influence of BIS-11 on AUDIT was mediated by both Disinhibition and Executive Dysfunction scales of the FrSBe. Findings tentatively suggest that the influence of rash impulsiveness on drinking may reflect dysfunction in dorsolateral prefrontal and orbitofrontal systems, whereas the influence of reward sensitivity on drinking may primarily reflect orbitofrontal dysfunction. Irrespective of the underlying functional brain systems involved, results appear to be more consistent with a pre-drinking trait interpretation than effects of alcohol exposure. Copyright © 2012 Elsevier Ltd. All rights reserved.

Software Assists in Extensive Environmental Auditing

NASA Technical Reports Server (NTRS)

Callac, Christopher; Matherne, Charlie

2002-01-01

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

Software Assists in Extensive Environmental Auditing

NASA Technical Reports Server (NTRS)

Callac, Christopher; Matherne, Charlie

2003-01-01

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

Software Assists in Extensive Environmental Auditing

NASA Technical Reports Server (NTRS)

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

2002-01-01

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

Designing Academic Audit: Lessons Learned in Europe and Asia.

ERIC Educational Resources Information Center

Dill, David D.

2000-01-01

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

38 CFR 41.215 - Relation to other audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

Comparing Accessibility Auditing Methods for Ebooks: Crowdsourced, Functionality-Led Versus Web Content Methodologies.

PubMed

James, Abi; Draffan, E A; Wald, Mike

2017-01-01

This paper presents a gap analysis between crowdsourced functional accessibility evaluations of ebooks conducted by non-experts and the technical accessibility standards employed by developers. It also illustrates how combining these approaches can provide more appropriate information for a wider group of users with print impairments.

The Essential Need for Research Misconduct Allegation Audits.

PubMed

Loikith, Lisa; Bauchwitz, Robert

2016-08-01

Nearly 90 % of allegations of biomedical research misconduct in the United States are dismissed by responsible institutions without any faculty assessment or auditable record. Recently, members of the U.S. Congress have complained that the penalties for those against whom findings of research misconduct are made are too light and that too few grant funds associated with research misconduct have been recovered for use by other researchers and taxpayers. Here we discuss the laws that empower federal agencies that can oversee investigations of biomedical research misconduct: the Office of Research Integrity (ORI) and the Office of the Inspector General (OIG), both located within the Department of Health and Human Services (HHS). Research misconduct investigations pertaining to U.S. physical sciences funded through the National Science Foundation (NSF) are overseen by the NSF's OIG. While OIGs may provide some improvement over the ORI in the handling of research misconduct, we have found that a much more serious flaw exists which undermines an ability to conduct performance audits of the effectiveness by which allegations of research misconduct are handled in the United States. Specifically, sufficient data do not need to be retained by U.S. research institutions funded by HHS or NSF to allow effective audit of why allegations of research misconduct are dismissed before being seen by faculty inquiry or investigative committees. U.S. federal Generally Accepted Government Auditing Standards (GAGAS/Yellow Book), if applied to the research misconduct oversight process, would allow a determination of whether the handling of allegations of biomedical research misconduct actually functions adequately, and if not, how it might be improved. In particular, we propose that independent, external peer review under GAGAS audit standards should be instituted without delay in assessing the performance of ORI, or any other similarly tasked federal agency, in handling allegations of research misconduct.

User compliance with documenting on a track and trigger-based observation and response chart: a two-phase multi-site audit study.

PubMed

Elliott, Doug; Allen, Emily; McKinley, Sharon; Perry, Lin; Duffield, Christine; Fry, Margaret; Gallagher, Robyn; Iedema, Rick; Roche, Michael

2017-12-01

To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated. Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required. Two-phase audit. Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1; 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2; 2012). Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart. User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected. © 2017 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

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.

Development of a data entry auditing protocol and quality assurance for a tissue bank database.

PubMed

Khushi, Matloob; Carpenter, Jane E; Balleine, Rosemary L; Clarke, Christine L

2012-03-01

Human transcription error is an acknowledged risk when extracting information from paper records for entry into a database. For a tissue bank, it is critical that accurate data are provided to researchers with approved access to tissue bank material. The challenges of tissue bank data collection include manual extraction of data from complex medical reports that are accessed from a number of sources and that differ in style and layout. As a quality assurance measure, the Breast Cancer Tissue Bank (http:\\\\www.abctb.org.au) has implemented an auditing protocol and in order to efficiently execute the process, has developed an open source database plug-in tool (eAuditor) to assist in auditing of data held in our tissue bank database. Using eAuditor, we have identified that human entry errors range from 0.01% when entering donor's clinical follow-up details, to 0.53% when entering pathological details, highlighting the importance of an audit protocol tool such as eAuditor in a tissue bank database. eAuditor was developed and tested on the Caisis open source clinical-research database; however, it can be integrated in other databases where similar functionality is required.

Implementing best practice into the emergency department triage process.

PubMed

Burgess, Luke; Kynoch, Kathryn; Hines, Sonia

2018-05-17

Triage is the process by which emergency departments (EDs) sort patients presenting for medical treatment. The Australasian Triage Scale, validated to measure urgency, answers the question 'This patient should wait for medical assessment and treatment no longer than…' Multiple patients may present within short time frames, and some will have conditions that have outcomes directly related to timeliness of treatment such as stroke, sepsis and myocardial infarction. The safety of patients within the ED is thus directly related to the triage system. This project aimed to compare current triage practice within a metropolitan ED with evidence-based practice guidelines produced by the Australasian College for Emergency Medicine and College of Emergency Nurses Australasia. The clinical audit project was undertaken in an ED in a large metropolitan hospital. Two hundred episodes of triage were audited, 100 in the preimplementation and 100 in the postimplementation phase. Current practice was compared with triage guidelines, barriers to adherence to evidence-based practice identified, and interventions were planned and implemented to address these. The audits of practice focused on five key areas and were assessed against 12 criteria: arrival and triage, documentation, compliance with policy, communication, and triage staff. Overall five criteria showed improvement, with reassessment of patients waiting for treatment, and the time taken for each triage episode achieving the greatest amount of improvement. Four criteria showed no improvement or a decline, and two achieved 100% adherence in both audits. The project sought to undertake a clinical audit of triage practice to evaluate the adherence of practice to evidence-based guidelines. The project has provided strong support for the implementation of a formal nursing role to support the care of waiting room patients, and act as a second triage nurse during periods of high activity. The physical triage environment has been identified as a barrier to optimal adherence to evidence-based practice guidelines. Using effective communication to manage the waiting experience of patients can have positive benefits for both patients and staff.

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

DTIC Science & Technology

2009-05-22

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

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

29 CFR 99.215 - Relation to other audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

PubMed

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

2000-12-01

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

The Birmingham pituitary database: auditing the outcome of the treatment of acromegaly.

PubMed

Jenkins, D; O'Brien, I; Johnson, A; Shakespear, R; Sheppard, M C; Stewart, P M

1995-11-01

Reduction of GH concentrations in acromegalic subjects may improve the increased mortality associated with the condition. Audit of the biochemical outcome of the management of acromegaly is, therefore, important. (1) To audit the biochemical 'cure' rate of acromegalic patients treated by surgery and/or radiotherapy under the care of the South Birmingham Endocrine Clinic. (2) To assess the correlation between random or basal GH with IGF-I and nadir GH during an oral glucose tolerance test. Ascertainment of acromegalic patients from a pituitary database. Mode of therapy, pretreatment GH, pretreatment tumour size, post-treatment GH, post-treatment IGF-I and post-treatment nadir GH were recorded. Biochemical cure was defined as a most recent random or basal GH < 5 mU/l. Cure rates were determined. Eighty-nine acromegalic patients were identified as having received surgery and/or radiotherapy. In 35/89 (39%) the most recent GH was < 5 mU/l. The cure rate following surgery was 26/78 (33%). This was not significantly associated with tumour size, but was associated with pretreatment GH concentration (chi 2 = 7.1, 2d.f., P < 0.05). Random/basal GH showed a log-linear association with IGF-I, r = 0.72, and a linear association with nadir GH, r = 0.93. Biochemical cure of acromegaly was more strongly associated with pretreatment GH than with tumour size. Random/basal GH measurements are useful and convenient for the audit of treatment outcome in acromegaly. Ways of improving the biochemical outcome of acromegaly should be sought.

18 CFR 286.103 - Notice to audited person.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

18 CFR 158.1 - Notice to audited person.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

A survey of community child health audit.

PubMed

Spencer, N J; Penlington, E

1993-03-01

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

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

DTIC Science & Technology

1987-01-01

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

ACTS data center

NASA Technical Reports Server (NTRS)

Syed, Ali; Vogel, Wolfhard J.

1993-01-01

Viewgraphs on ACTS Data Center status report are included. Topics covered include: ACTS Data Center Functions; data flow overview; PPD flow; RAW data flow; data compression; PPD distribution; RAW Data Archival; PPD Audit; and data analysis.

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

PubMed

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

2017-06-01

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

A survey of audit activity in general practice.

PubMed Central

Hearnshaw, H; Baker, R; Cooper, A

1998-01-01

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

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.

PUVA and methotrexate therapy of psoriasis: how closely do dermatology departments follow treatment guidelines? Psoriasis Audit Workgroup of the British Association of Dermatologists.

PubMed

Bilsland, D J; Rhodes, L E; Zaki, I; Wilkinson, S M; McKenna, K E; Handfield-Jones, S E; Williams, R E

1994-08-01

Following publication of treatment guidelines for patients with psoriasis, a six-centre audit was undertaken to assess current therapeutic practice for two second-line treatments, PUVA and methotrexate. The audit consisted of random sampling of casenotes by external auditors from a paired dermatology department, and assessment by questionnaire. One hundred and eight PUVA and 118 methotrexate casenotes were audited. The commonest indications for treatment were: (a) failure of tropical therapy--PUVA (mean 81% of casenotes), methotrexate (84%); (b) repeated hospital admissions--PUVA (16%), methotrexate (25%). For both PUVA and methotrexate, some aspects of treatment were well documented: PUVA--psoralen dosage (91%), response to PUVA (89%), cumulative lifetime UVA dosage (81%); methotrexate--pretreatment assessment of full blood count (91%), urea and electrolytes (85%), liver function tests (84%). For other aspects documentation was less complete: PUVA--no documentation of presence/absence of skin cancer history (66%), note of photoactive drugs (32%); methotrexate--concurrent medication (69%), history of presence/absence of liver disease (36%). Another aspect which was poorly documented in both PUVA and methotrexate notes was whether advice on contraception/fertility had been given. There was no indication in 29 of 32 casenotes of females of child-bearing age receiving PUVA, and 52 of 63 case notes of relevant patients on methotrexate. This project has demonstrated that formal, multicentre audit based on published guidelines is a practical proposition.

Auditing Orthopaedic Audit

PubMed Central

Guryel, E; Acton, K; Patel, S

2008-01-01

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

Auditing orthopaedic audit.

PubMed

Guryel, E; Acton, K; Patel, S

2008-11-01

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

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

PubMed Central

Iqbal, H.J; Pidikiti, P

2010-01-01

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

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.

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

PubMed

Hughes, Rhidian

2005-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-01-01

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

10 CFR 603.1295 - Periodic audit.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

Scholastic Audits. Research Brief

ERIC Educational Resources Information Center

Walker, Karen

2009-01-01

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

Getting Down to Business.

ERIC Educational Resources Information Center

Wood, Lonnie

1998-01-01

A dozen schools in Colorado opened their doors to professional performance auditors to evaluate their effectiveness and efficiency. The audit reports recommended finding precise costs of functions, programs, and operations; minimizing duplication; and increasing accountability. (MLF)

76 FR 58540 - Proposed Information Collection Request of the ETA 581, Contribution Operations Report; Extension...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... resources) is minimized, collection instruments are clearly understood, and the impact of collection...), report delinquency, collections (accounts receivable), the audit function, and the detection of employer...

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

77 FR 26798 - Self-Regulatory Organizations; NYSE Amex LLC; Notice of Filing of Proposed Rule Change to List...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

... the NFA. The Commodity Sub-Advisor is also registered with the SEC as an investment adviser. Nuveen... as an investment adviser. Commodity Investments. The Fund's investment strategy will utilize the... the audit committee and nominating committee functions for the Fund, those functions required under...

Audit Technical of Kori Rubber Dam in the River of Keyang District of Ponorogo East Java Province

NASA Astrophysics Data System (ADS)

Murnianto, E.; Suprapto, M.; Ikhsan, C.

2018-03-01

The development of science and technology for the utilization and protection of rivers has embodied various types of river infrastructure. Without proper maintenance, rapid river sediments undergo physical degradation and function. Problems that occur in Kori Rubber Dam, among others, the damage to the body of the rubber dam that is made of rubber, so that the function of flower deflection is not optimal. This happens because of limited operational and maintenance activities (OM). A technical audit is a process of identifying problems, analyzing, and evaluating ones conducted independently, objectively and professionally on the basis of examination, to assess the truth, accuracy, credibility, and reliability of information about a job. In this case an assessment of the Kori Rubber Dam, which is basically a benchmarking activity. Assessment of rubber dam components includes the physical conditions and functions that affect the weir. This research is expected to know the performance of Kori rubber Dam as a recommendation material in the implementation of OM Rubber Dam activities.

Identifying harmful drinking using a single screening question in a psychiatric consultation-liaison population.

PubMed

Massey, Suena H; Norris, Lorenzo; Lausin, Melissa; Nwaneri, Chinyere; Lieberman, Daniel Z

2011-01-01

Harmful drinking is common in medical inpatients, yet commonly missed due in part to time pressures. A screening question about past year heavy drinking recommended by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) has been validated in primary care and emergency room settings. We tested the psychometric properties of a modified single screening question (SSQ) in hospitalized patients referred to a consultation-liaison service. A psychiatry attending (n = 40), a psychiatry resident (n = 30) and a medical student (n = 30) administered the SSQ, followed by a self-report 10-item Alcohol Use Disorders Identification Test (AUDIT) to a sample of 100 consultation-liaison patients who were able to give informed consent for participation. Using the AUDIT as a reference, the sensitivity and specificity of the SSQ to detect harmful drinking in this sample were .96 and .82, respectively. Gender differences in specificity were not found. The single question also had a strong correlation with dependence (r(b) = .457, p < .001), and harmful use (r(b) = .620, p < .001) subscales of the AUDIT. The SSQ about past year heavy drinking can rapidly identify harmful drinking in alert nonpsychotic consultation-liaison patients. Copyright © 2011 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

An Orthopedic Performance Improvement Initiative at a Small Military Treatment Facility.

PubMed

McGee, John Christopher; Bise, Christopher G; Stevens, Joel M

2017-03-01

The scientific literature demonstrates a cost-benefit associated with early access to physical therapy. The purpose of this case study is to report the results of an orthopedic performance improvement initiative (OPII) at a small military treatment facility (approximately 4.5K active duty beneficiaries). The OPII was introduced to (1) limit variation by ensuring that all active duty orthopedic consults were audited ensuring proper timing of appropriate services and (2) establish contractual agreement for shared resources with the U.S. Naval Jacksonville Orthopedic Department. OPII was accomplished through consensus development and strong leadership support. All orthopedic referrals (n = 260) were audited for 6 months. Appropriate recommendations were provided to either continue with orthopedic care or to redirect to a physical therapy first approach. Orthopedic referrals decreased 27% with concomitant 32% increase in physical therapy referrals producing overall savings of $462K (33%). Meanwhile, surgical throughput improved 45%. Seventy percent of the savings were attributed to improved utilization translating to a relative value unit savings per beneficiary of $17.64 (23.7%). Our results support the value of a conservative physical therapy first approach for musculoskeletal conditions and shared mil-to-mil resourcing agreements. Success requires an iterative audit/feedback process balanced with stakeholder consensus. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

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

ERIC Educational Resources Information Center

Dill, David D.

2000-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

PubMed Central

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

2011-01-01

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

Safety Auditing and Assessments

NASA Technical Reports Server (NTRS)

Goodin, James Ronald (Ronnie)

2005-01-01

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

Safety Auditing and Assessments

NASA Astrophysics Data System (ADS)

Goodin, Ronnie

2005-12-01

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

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.

Nurses' participation in audit: a regional study.

PubMed

Cheater, F M; Keane, M

1998-03-01

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

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

PubMed

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

2014-09-01

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

Controls Over Copyrighted Computer Software

DTIC Science & Technology

1993-02-19

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

Correspondent Functional Topography of the Human Left Inferior Parietal Lobule at Rest and Under Task Revealed Using Resting-State fMRI and Coactivation Based Parcellation.

PubMed

Wang, Jiaojian; Xie, Sangma; Guo, Xin; Becker, Benjamin; Fox, Peter T; Eickhoff, Simon B; Jiang, Tianzi

2017-03-01

The human left inferior parietal lobule (LIPL) plays a pivotal role in many cognitive functions and is an important node in the default mode network (DMN). Although many previous studies have proposed different parcellation schemes for the LIPL, the detailed functional organization of the LIPL and the exact correspondence between the DMN and LIPL subregions remain unclear. Mounting evidence indicates that spontaneous fluctuations in the brain are strongly associated with cognitive performance at the behavioral level. However, whether a consistent functional topographic organization of the LIPL during rest and under task can be revealed remains unknown. Here, they used resting-state functional connectivity (RSFC) and task-related coactivation patterns separately to parcellate the LIPL and identified seven subregions. Four subregions were located in the supramarginal gyrus (SMG) and three subregions were located in the angular gyrus (AG). The subregion-specific networks and functional characterization revealed that the four anterior subregions were found to be primarily involved in sensorimotor processing, movement imagination and inhibitory control, audition perception and speech processing, and social cognition, whereas the three posterior subregions were mainly involved in episodic memory, semantic processing, and spatial cognition. The results revealed a detailed functional organization of the LIPL and suggested that the LIPL is a functionally heterogeneous area. In addition, the present study demonstrated that the functional architecture of the LIPL during rest corresponds with that found in task processing. Hum Brain Mapp 38:1659-1675, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

23 CFR 140.805 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

The Legal Audit: Preventing Problems.

ERIC Educational Resources Information Center

Perlman, Daniel H.

1987-01-01

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

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

DTIC Science & Technology

1996-04-18

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

How-Tos of Financial Management.

ERIC Educational Resources Information Center

Kokenge, Carolyn

1982-01-01

The article is intended to help rehabilitation agency directors and board members understand functional fund accounting and a good financial management information system. The author stresses the advantages of a regular audit done by certified public accountants. (Author)

45 CFR 310.10 - What are the functional requirements for the Model Tribal IV-D System?

Code of Federal Regulations, 2010 CFR

2010-10-01

... Number; and (E) Participant Identification Number; (ii) Delinquency and enforcement activities; (iii... operations and to assess program performance through the audit of financial and statistical data maintained...

40 CFR 63.8 - Monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

ERIC Educational Resources Information Center

Pfeffer, Eileen; Kester, Donald L.

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

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

PubMed

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

2012-05-01

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

46 CFR 272.42 - Audit requirements and procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-27

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

46 CFR Sec. 12 - Audit.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

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

PubMed Central

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

2015-01-01

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

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

PubMed

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

2015-01-01

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

24 CFR 84.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

45 CFR 2543.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

28 CFR 70.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

The Communication Audit: A Framework for Teaching Management Communication.

ERIC Educational Resources Information Center

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

1996-01-01

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

38 CFR 41.200 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

20 CFR 655.1312 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

30 CFR 735.22 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

16 CFR 703.7 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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...

23 CFR 172.7 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

PubMed

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-02-08

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

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

DTIC Science & Technology

1988-02-24

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

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

PubMed

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

2018-07-01

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

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

PubMed Central

2014-01-01

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

Contribution of Streetscape Audits to Explanation of Physical Activity in Four Age Groups Based on the Microscale Audit of Pedestrian Streetscapes (MAPS)

PubMed Central

Cain, Kelli L.; Millstein, Rachel A.; Sallis, James F.; Conway, Terry L.; Gavand, Kavita A.; Frank, Lawrence D.; Saelens, Brian E.; Geremia, Carrie M.; Chapman, James; Adams, Marc A.; Glanz, Karen; King, Abby C.

2014-01-01

Ecological models of physical activity emphasize the effects of environmental influences. “Microscale” streetscape features that may affect pedestrian experience have received less research attention than macroscale walkability (e.g., residential density). The Microscale Audit of Pedestrian Streetscapes (MAPS) measures street design, transit stops, sidewalk qualities, street crossing amenities, and features impacting aesthetics. The present study examined associations of microscale attributes with multiple physical activity (PA) measures across four age groups. Areas in the San Diego, Seattle, and the Baltimore metropolitan areas, USA, were selected that varied on macro-level walkability and neighborhood income. Participants (n=3677) represented four age groups (children, adolescents, adults, older adults). MAPS audits were conducted along a 0.25 mile route along the street network from participant residences toward the nearest non-residential destination. MAPS data were collected in 2009–2010. Subscale and overall summary scores were created. Walking/biking for transportation and leisure/neighborhood PA were measured with age-appropriate surveys. Objective PA was measured with accelerometers. Mixed linear regression analyses were adjusted for macro-level walkability. Across all age groups 51.2%, 22.1%, and 15.7% of all MAPS scores were significantly associated with walking/biking for transport, leisure/neighborhood PA, and objectively-measured PA, respectively. Supporting the ecological model principle of behavioral specificity, destinations and land use, streetscape, street segment, and intersection variables were more related to transport walking/biking, while aesthetic variables were related to leisure/neighborhood PA. The overall score was related to objective PA in children and older adults. Present findings provide strong evidence that microscale environment attributes are related to PA across the lifespan. Improving microscale features may be a feasible approach to creating activity-friendly environments. PMID:24983701

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

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

PubMed Central

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

2014-01-01

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

42 CFR 420.203 - Disclosure of hiring of intermediary's former employees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... employment, was employed in a managerial, accounting, auditing, or similar capacity by an agency or... functions as those of a manager, accountant, or auditor even though the individual is not so designated by...

45 CFR 310.10 - What are the functional requirements for the Model Tribal IV-D System?

Code of Federal Regulations, 2011 CFR

2011-10-01

... plan, including: (1) Identifying information such as Social Security numbers, names, dates of birth... operations and to assess program performance through the audit of financial and statistical data maintained...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

... postpayment audit when using the GSA Audit Division? 102-118.445 Section 102-118.445 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Postpayment Transportation Audits § 102-118...

30 CFR 725.19 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

32 CFR 37.1325 - Periodic audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

29 CFR 99.220 - Frequency of audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

29 CFR 99.230 - Audit costs.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

PubMed

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

2000-03-01

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

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

PubMed

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

2017-01-01

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

Communication of Audit Risk to Students.

ERIC Educational Resources Information Center

Alderman, C. Wayne; Thompson, James H.

1986-01-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-07

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

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

ERIC Educational Resources Information Center

Kaiser, Harvey H.

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

Internal Audit Manual.

DTIC Science & Technology

1985-11-01

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

Remote auditing of radiotherapy facilities using optically stimulated luminescence dosimeters

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

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

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

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

PubMed

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

2016-02-26

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

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

PubMed

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

2016-04-01

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

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

DTIC Science & Technology

1997-04-10

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

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

DTIC Science & Technology

1988-06-01

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

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

PubMed

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

2015-01-01

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

Improving energy audit process and report outcomes through planning initiatives

NASA Astrophysics Data System (ADS)

Sprau Coulter, Tabitha L.

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

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Code of Federal Regulations, 2011 CFR

2011-04-01

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

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

Code of Federal Regulations, 2013 CFR

2013-04-01

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

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

Code of Federal Regulations, 2014 CFR

2014-04-01

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

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

Code of Federal Regulations, 2012 CFR

2012-04-01

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

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

DTIC Science & Technology

1997-04-10

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

Special Inspector General for Afghanistan Reconstruction (SIGAR)

DTIC Science & Technology

2015-01-30

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

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

PubMed

Wen, Jing; Xiao, Jiangyi; Wang, Aijun

2018-01-30

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

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

PubMed Central

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

2011-01-01

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

Developments in environmental auditing by supreme audit institutions.

PubMed

Van Leeuwen, Sylvia

2004-02-01

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

Audibility and visual biasing in speech perception

NASA Astrophysics Data System (ADS)

Clement, Bart Richard

Although speech perception has been considered a predominantly auditory phenomenon, large benefits from vision in degraded acoustic conditions suggest integration of audition and vision. More direct evidence of this comes from studies of audiovisual disparity that demonstrate vision can bias and even dominate perception (McGurk & MacDonald, 1976). It has been observed that hearing-impaired listeners demonstrate more visual biasing than normally hearing listeners (Walden et al., 1990). It is argued here that stimulus audibility must be equated across groups before true differences can be established. In the present investigation, effects of visual biasing on perception were examined as audibility was degraded for 12 young normally hearing listeners. Biasing was determined by quantifying the degree to which listener identification functions for a single synthetic auditory /ba-da-ga/ continuum changed across two conditions: (1)an auditory-only listening condition; and (2)an auditory-visual condition in which every item of the continuum was synchronized with visual articulations of the consonant-vowel (CV) tokens /ba/ and /ga/, as spoken by each of two talkers. Audibility was altered by presenting the conditions in quiet and in noise at each of three signal-to- noise (S/N) ratios. For the visual-/ba/ context, large effects of audibility were found. As audibility decreased, visual biasing increased. A large talker effect also was found, with one talker eliciting more biasing than the other. An independent lipreading measure demonstrated that this talker was more visually intelligible than the other. For the visual-/ga/ context, audibility and talker effects were less robust, possibly obscured by strong listener effects, which were characterized by marked differences in perceptual processing patterns among participants. Some demonstrated substantial biasing whereas others demonstrated little, indicating a strong reliance on audition even in severely degraded acoustic conditions. Listener effects were not correlated with lipreading performance. The large effect of audibility suggests that conclusions regarding an increased reliance on vision among hearing- impaired listeners were premature, and that accurate comparisons only can be made after equating audibility. Further, if after such control, individual hearing- impaired listeners demonstrate the processing differences that were demonstrated in the present investigation, then these findings have the potential to impact aural rehabilitation strategies.

47 CFR 0.111 - Functions of the Bureau.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Engineering and Technology has shared responsibility for radiofrequency equipment and device complaints. (5...); subpart C (Federal-State/Local Relationships [Reserved]; subpart D (carriage of television broadcast... information, conduct investigations, conduct external audits and collect information, including pursuant to...

45 CFR 307.10 - Functional requirements for computerized support enforcement systems in operation by October 1...

Code of Federal Regulations, 2011 CFR

2011-10-01

... information such as social security numbers, names, dates of birth, home addresses and mailing addresses... enable the Office to monitor State operations and assess program performance through the audit conducted...

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...

41 CFR 102-118.265 - What is a prepayment audit?

Code of Federal Regulations, 2010 CFR

2010-07-01

... audit? 102-118.265 Section 102-118.265 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services Agency Requirements for Prepayment Audits...

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

PubMed

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

2014-02-01

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

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.

Risk-based audit selection of dairy farms.

PubMed

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

2014-02-01

Dairy farms are audited in the Netherlands on numerous process standards. Each farm is audited once every 2 years. Increasing demands for cost-effectiveness in farm audits can be met by introducing risk-based principles. This implies targeting subpopulations with a higher risk of poor process standards. To select farms for an audit that present higher risks, a statistical analysis was conducted to test the relationship between the outcome of farm audits and bulk milk laboratory results before the audit. The analysis comprised 28,358 farm audits and all conducted laboratory tests of bulk milk samples 12 mo before the audit. The overall outcome of each farm audit was classified as approved or rejected. Laboratory results included somatic cell count (SCC), total bacterial count (TBC), antimicrobial drug residues (ADR), level of butyric acid spores (BAB), freezing point depression (FPD), level of free fatty acids (FFA), and cleanliness of the milk (CLN). The bulk milk laboratory results were significantly related to audit outcomes. Rejected audits are likely to occur on dairy farms with higher mean levels of SCC, TBC, ADR, and BAB. Moreover, in a multivariable model, maxima for TBC, SCC, and FPD as well as standard deviations for TBC and FPD are risk factors for negative audit outcomes. The efficiency curve of a risk-based selection approach, on the basis of the derived regression results, dominated the current random selection approach. To capture 25, 50, or 75% of the population with poor process standards (i.e., audit outcome of rejected), respectively, only 8, 20, or 47% of the population had to be sampled based on a risk-based selection approach. Milk quality information can thus be used to preselect high-risk farms to be audited more frequently. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

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.

ASERNIP-S: international trend setting.

PubMed

Maddern, Guy; Boult, Margaret; Ahern, Eleanor; Babidge, Wendy

2008-10-01

The Australian Safety and Efficacy Register of New Interventional Procedures--Surgical (ASERNIP-S) came into being 10 years ago to provide health technology assessments specifically tailored towards new surgical techniques and technologies. It was and remains the only organisation in the world to focus on this area of research. Most funding has been provided by the Australian Government Department of Health, and assessments have helped inform the introduction of new surgical techniques into Australia. ASERNIP-S is a project of the Royal Australasian College of Surgeons. The ASERNIP-S program employs a diverse range of methods including systematic reviews, technology overviews, assessments of new and emerging surgical technologies identified by horizon scanning, and audit. Support and guidance for the program is provided by Fellows of the Royal Australasian College of Surgeons. ASERNIP-S works closely with consumers to produce health technology assessments and audits, as well as consumer information to keep patients fully informed of research. Since its inception, the ASERNIP-S program has developed a strong international profile through the production of over 60 reports on evidence-based surgery, surgical technologies and audit. The work undertaken by ASERNIP-S has evolved from assessments of the safety and efficacy of procedures to include guidance on policies and surgical training programs. ASERNIP-S needs to secure funding so that it can continue to play an integral role in the improvement of quality of care both in Australia and internationally.

Endometriosis education in schools: A New Zealand model examining the impact of an education program in schools on early recognition of symptoms suggesting endometriosis.

PubMed

Bush, Deborah; Brick, Emily; East, Michael C; Johnson, Neil

2017-08-01

Menstrual morbidity plays a significant role in adolescent females' lives. There are no studies to date reporting such data from menstrual health education programs in schools. The aim of our study was to report results from an audit of a menstrual health and endometriosis education program in secondary schools and observe age patterns of young women presenting for menstrual morbidity care. Audit data from education in secondary schools and audit data of patients from an Endometriosis and Pelvic Pain Coaching clinic operating in a private endometriosis specialised centre are reported. In a region of consistent delivery of the education program, student awareness of endometriosis was 32% in 2015. Overall in 2015, 13% of students experienced distressing menstrual symptoms and 27% of students sometimes or always missed school due to menstrual symptoms. Further, in one region of consistent delivery of the menstrual health education program, data show an increase in younger patients attending for specialised endometriosis care. There is strong suggestive evidence that consistent delivery of a menstrual health education program in schools increases adolescent student awareness of endometriosis. In addition, there is suggestive evidence that in a geographical area of consistent delivery of the program, a shift in earlier presentation of young women to a specialised health service is observed. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Prospective audit to evaluate the potential of the coronial system to increase solid organ donation

PubMed Central

Twamley, Huw; Haigh, Andrew; Williment, Claire; Hudson, Cara; Whitney, Julie; Neuberger, James

2016-01-01

Objectives Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process. Design Prospective audit. Setting All acute National Health Service Hospitals in the UK where deceased organ donation was considered. Participants 1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF. Main outcome measures Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice. Results Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant. Conclusions Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants. PMID:27401356

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

PubMed Central

2014-01-01

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

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

PubMed Central

2013-01-01

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

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

PubMed

Levola, Jonna; Aalto, Mauri

2015-07-01

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

7 CFR 3052.510 - Audit findings.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

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...

Eight years' experience of regional audit: an assessment of its value as a clinical governance tool.

PubMed

John, H; Paskins, Z; Hassell, A; Rowe, I F

2010-02-01

Strengthening clinical audit is crucial for improving the quality of healthcare provision. The West Midlands Rheumatology Service and Training Committee coordinates an innovative programme of regional audits and the experience of rheumatology healthcare professionals involved was surveyed. This was a questionnaire-based study in which respondents rated statements relating to regional audit on Likert scales. Out of 105 staff, 70 replied. There was consensus that results of regional audit have been robust, valid and reliable; regional audits benefit patients and units; provide educational opportunities for specialist registrars (SpRs); and are more efficient than local audit by allowing comparison between units. Opinion was divided about how well informed respondents were and how effective they are at closing the audit loop. Many units reported changes in practice. Regional audit is widely perceived to be a valuable clinical governance tool supporting significant changes to clinical practice, and an excellent training opportunity for SpRs. Recommendations for a successful regional audit scheme are described in this article.

Function in job seekers with mental illness and drug and alcohol problems who access community based disability employment services.

PubMed

Matthews, Lynda R; Harris, Lynne M; Jaworski, Alison; Alam, Ashraful; Bozdag, Gokcen

2013-03-01

This study identified functioning, health, and social needs in jobseekers with mental disorders independently assessed as having capacity to work and referred to disability employment services. Differences in function between jobseekers with mental illness alone and with additional drug and alcohol problems were examined with view to identifying interventions for vocational rehabilitation. A convenience sample of 116 jobseekers completed BASIS-32, CANSAS, AUDIT, DAST-10 and 6 items from the EXIT interview and were divided into two groups: mental illness only, and additional drug and alcohol issues (AUDIT total score >8 and/or DAST total score >3). Analysis of variance was used to determine group differences. Jobseekers reported low-moderate problems with function. Over 40% of the sample reported unresolved psychological distress, physical health needs, and social/daytime activity needs. Thirty-five jobseekers (30%) had additional drug and alcohol problems and reported significantly greater difficulty with impulsive/addictive behavior and poorer memory and executive function than the mental illness only group. No significant differences were identified in past work functioning. Screening all job seekers for psychological, physical, and social needs to identify suitable treatment and rehabilitation strategies and providing interventions that improve emotional regulation and executive function for job seekers with additional drug and alcohol problems may improve employability of job seekers accessing disability employment services.

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.

Evaluation of the organisation and effectiveness of internal audits to govern patient safety in hospitals: a mixed-methods study

PubMed Central

van Gelderen, Saskia C; Zegers, Marieke; Boeijen, Wilma; Westert, Gert P; Robben, Paul B; Wollersheim, Hub C

2017-01-01

Objectives Hospital boards are legally responsible for safe healthcare. They need tools to assist them in their task of governing patient safety. Almost every Dutch hospital performs internal audits, but the effectiveness of these audits for hospital governance has never been evaluated. The aim of this study is to evaluate the organisation of internal audits and their effectiveness for hospitals boards to govern patient safety. Design and setting A mixed-methods study consisting of a questionnaire regarding the organisation of internal audits among all Dutch hospitals (n=89) and interviews with stakeholders regarding the audit process and experienced effectiveness of audits within six hospitals. Results Response rate of the questionnaire was 76% and 43 interviews were held. In every responding hospital, the internal audits followed the plan–do–check–act cycle. Every hospital used interviews, document analysis and site visits as input for the internal audit. Boards stated that effective aspects of internal audits were their multidisciplinary scope, their structured and in-depth approach, the usability to monitor improvement activities and to change hospital policy and the fact that results were used in meetings with staff and boards of supervisors. The qualitative methods (interviews and site visits) used in internal audits enable the identification of soft signals such as unsafe culture or communication and collaboration problems. Reported disadvantages were the low frequency of internal audits and the absence of soft signals in the actual audit reports. Conclusion This study shows that internal audits are regarded as effective for patient safety governance, as they help boards to identify patient safety problems, proactively steer patient safety and inform boards of supervisors on the status of patient safety. The description of the Dutch internal audits makes these audits replicable to other healthcare organisations in different settings, enabling hospital boards to complement their systems to govern patient safety. PMID:28698328

The Interpretive Auditor: Reframing the Communication Audit.

ERIC Educational Resources Information Center

Jones, Deborah

2002-01-01

Suggests communication auditors should be thought of as skilled and committed listeners to and within organizational communication processes. Distinguishes between functionalism and interpretivism in organizational communication. Describes a project based on a collaboration between scholars in sociolinguistics and organizational communication.…

Crescent evaluation : appendix E : crescent demonstration office : evaluation report

DOT National Transportation Integrated Search

1994-02-01

The purpose of this review was to conduct a limited audit to determine how well the Crescent Demonstration Office functions perform from the user perspective and what enhancements might be considered desirable or required in a long-term, system-wide ...

30 CFR 227.300 - What audit functions may a State perform?

Code of Federal Regulations, 2010 CFR

2010-07-01

... royalty reports and payments accurately reflect actual production, sales, revenues and costs, and...; (2) Examining royalty and production reports; (3) Examining lessee production and sales records, including contracts, payments, invoices, and transportation and processing costs to substantiate production...

29 CFR 99.510 - Audit findings.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

12 CFR 621.31 - Non-audit services.

Code of Federal Regulations, 2010 CFR

2010-01-01

... provided by a qualified public accountant during the period of an audit engagement which are not connected to an audit or review of an institution's financial statements. (a) A qualified public accountant... external audit work. (b) A qualified public accountant engaged to conduct a Farm Credit institution's audit...

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...

29 CFR 95.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... higher education or other non-profit organizations (including hospitals) shall be subject to the audit... governments shall be subject to the audit requirements contained in the Single Audit Act Amendments of 1996...-Profit Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB...

7 CFR 3019.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... higher education or other non-profit organizations (including hospitals) shall be subject to the audit... governments shall be subject to the audit requirements contained in the Single Audit Act Amendments of 1996...-Profit Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB...

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

ERIC Educational Resources Information Center

Brooks, Keith; And Others

1979-01-01

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

20 CFR 655.180 - Audit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 655.180 Section 655.180 Employees... United States (H-2A Workers) Integrity Measures § 655.180 Audit. The CO may conduct audits of applications for which certifications have been granted. (a) Discretion. The applications selected for audit...

20 CFR 601.9 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

42 CFR 430.33 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 430.33 Section 430.33 Public Health CENTERS... ASSISTANCE PROGRAMS GRANTS TO STATES FOR MEDICAL ASSISTANCE PROGRAMS Grants; Reviews and Audits; Withholding... § 430.33 Audits. (a) Purpose. The Department's Office of Inspector General (OIG) periodically audits...

38 CFR 41.230 - Audit costs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Audit costs. 41.230 Section 41.230 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 41.230 Audit costs. (a) Allowable...

Internal Auditing for School Districts.

ERIC Educational Resources Information Center

Cuzzetto, Charles

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

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…

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...

14 CFR 1260.126 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

...-profit organizations (including hospitals) shall be subject to the audit requirements contained in the... subject to the audit requirements contained in the Single Audit Act Amendments of 1966 (31 U.S.C. 7501... Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB Circular A-133 shall...

41 CFR 102-118.310 - Must my agency prepayment audit program establish appeal procedures whereby a TSP may appeal any...

Code of Federal Regulations, 2010 CFR

2010-07-01

... prepayment audit program establish appeal procedures whereby a TSP may appeal any reduction in the amount... Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services Agency Requirements for Prepayment Audits...

12 CFR 1273.9 - Audit Committee.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 9 2012-01-01 2012-01-01 false Audit Committee. 1273.9 Section 1273.9 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS OFFICE OF FINANCE § 1273.9 Audit Committee. (a) Composition. The Independent Directors shall serve as the Audit Committee. The Audit...

12 CFR 1273.9 - Audit Committee.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 9 2013-01-01 2013-01-01 false Audit Committee. 1273.9 Section 1273.9 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS OFFICE OF FINANCE § 1273.9 Audit Committee. (a) Composition. The Independent Directors shall serve as the Audit Committee. The Audit...

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...

49 CFR 663.39 - Post-delivery audit review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the contract or at law. (b) This provision does not preclude the recipient and manufacturer from..., DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES Post-Delivery Audits § 663.39 Post-delivery audit review. (a) If a recipient cannot complete a post-delivery audit...

49 CFR 663.39 - Post-delivery audit review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the contract or at law. (b) This provision does not preclude the recipient and manufacturer from..., DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES Post-Delivery Audits § 663.39 Post-delivery audit review. (a) If a recipient cannot complete a post-delivery audit...

Inspector General, DOD, Oversight of the Air Force Audit Agency Audit of the FY 1999 Air Force General Fund Financial Statements

DTIC Science & Technology

2000-02-14

Consolidated Financial Statements . Our objective was to determine the accuracy and completeness of the Air Force Audit Agency audit of the FY 1999 Air Force General Fund financial statements. See Appendix A for a discussion of the audit

40 CFR 63.8 - Monitoring requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... with conducting performance tests under § 63.7. Verification of operational status shall, at a minimum... in the relevant standard; or (B) The CMS fails a performance test audit (e.g., cylinder gas audit), relative accuracy audit, relative accuracy test audit, or linearity test audit; or (C) The COMS CD exceeds...

40 CFR 63.8 - Monitoring requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... with conducting performance tests under § 63.7. Verification of operational status shall, at a minimum... in the relevant standard; or (B) The CMS fails a performance test audit (e.g., cylinder gas audit), relative accuracy audit, relative accuracy test audit, or linearity test audit; or (C) The COMS CD exceeds...

30 CFR 204.201 - Who may obtain accounting and auditing relief?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Who may obtain accounting and auditing relief... MINERALS REVENUE MANAGEMENT ALTERNATIVES FOR MARGINAL PROPERTIES Accounting and Auditing Relief § 204.201 Who may obtain accounting and auditing relief? (a) You may obtain accounting and auditing relief under...

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...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-12

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

30 CFR 208.15 - Audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

28 CFR 33.51 - Audit.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 33.51 Section 33.51 Judicial... Additional Requirements § 33.51 Audit. Pursuant to Office of Management and Budget Circular A-128 “Audits of State and Local Governments,” all grantees and subgrantees must provide for an independent audit of...

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...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-25

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

42 CFR 457.236 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Audits. 457.236 Section 457.236 Public Health...-Reviews and Audits; Withholding for Failure to Comply; Deferral and Disallowance of Claims; Reduction of Federal Medical Payments § 457.236 Audits. The CHIP agency must assure appropriate audit of records on...

20 CFR 627.481 - Audit resolution.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit resolution. 627.481 Section 627.481... PROGRAMS UNDER TITLES I, II, AND III OF THE ACT Administrative Standards § 627.481 Audit resolution. (a) Federal audit resolution. When the OIG issues an audit report to the Employment and Training...

31 CFR 50.60 - Audit authority.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

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

7 CFR 210.22 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

49 CFR 663.9 - Audit limitations.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

20 CFR 632.33 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

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

30 CFR 217.200 - Audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Audits. 217.200 Section 217.200 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR MINERALS REVENUE MANAGEMENT AUDITS AND INSPECTIONS Coal § 217.200 Audits. An audit of the accounts and books of operators/lessees for the purpose of...

24 CFR 236.901 - Audit.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Audit. 236.901 Section 236.901... AND INTEREST REDUCTION PAYMENT FOR RENTAL PROJECTS Audits § 236.901 Audit. Where a State or local... mortgagor of a mortgage insured or held by the Commissioner under this part, it shall conduct audits in...

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

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-06

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

7 CFR 3570.83 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Audits. 3570.83 Section 3570.83 Agriculture... COMMUNITY PROGRAMS Community Facilities Grant Program § 3570.83 Audits. (a) Audits will be conducted in... submit an audit report will, within 60 days following the end of the fiscal year in which any grant funds...

49 CFR 663.39 - Post-delivery audit review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Post-delivery audit review. 663.39 Section 663.39 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES Post-Delivery Audits § 663.39 Post-delivery audit...

49 CFR 663.21 - Pre-award audit requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Pre-award audit requirements. 663.21 Section 663.21 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION PRE-AWARD AND POST-DELIVERY AUDITS OF ROLLING STOCK PURCHASES Pre-Award Audits § 663.21 Pre-award audit...

44 CFR 304.5 - Audits and records.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Audits and records. 304.5 Section 304.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS CONSOLIDATED GRANTS TO INSULAR AREAS § 304.5 Audits and records. (a) Audits. FEMA will maintain adequate auditing,...

29 CFR 99.200 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 99.200 Section 99.200 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 99.... Guidance on determining Federal awards expended is provided in § 99.205. (b) Single audit. Non-Federal...

24 CFR 965.302 - Requirements for energy audits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 24 Housing and Urban Development 4 2014-04-01 2014-04-01 false Requirements for energy audits. 965... URBAN DEVELOPMENT PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Energy Audits and Energy Conservation Measures § 965.302 Requirements for energy audits. All PHAs shall complete an energy audit for each PHA...

24 CFR 965.302 - Requirements for energy audits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 24 Housing and Urban Development 4 2011-04-01 2011-04-01 false Requirements for energy audits. 965... URBAN DEVELOPMENT PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Energy Audits and Energy Conservation Measures § 965.302 Requirements for energy audits. All PHAs shall complete an energy audit for each PHA...

24 CFR 965.302 - Requirements for energy audits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 24 Housing and Urban Development 4 2012-04-01 2012-04-01 false Requirements for energy audits. 965... URBAN DEVELOPMENT PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Energy Audits and Energy Conservation Measures § 965.302 Requirements for energy audits. All PHAs shall complete an energy audit for each PHA...

24 CFR 965.302 - Requirements for energy audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Requirements for energy audits. 965... URBAN DEVELOPMENT PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Energy Audits and Energy Conservation Measures § 965.302 Requirements for energy audits. All PHAs shall complete an energy audit for each PHA...

24 CFR 965.302 - Requirements for energy audits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 24 Housing and Urban Development 4 2013-04-01 2013-04-01 false Requirements for energy audits. 965... URBAN DEVELOPMENT PHA-OWNED OR LEASED PROJECTS-GENERAL PROVISIONS Energy Audits and Energy Conservation Measures § 965.302 Requirements for energy audits. All PHAs shall complete an energy audit for each PHA...

7 CFR 1948.96 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Program § 1948.96 Audit requirements. (a) Audit requirements for Site Development and Acquisition Grants will be made in accordance with FmHA Instruction 1942-G. (b) Audits for planning grants made in... 7 Agriculture 13 2010-01-01 2009-01-01 true Audit requirements. 1948.96 Section 1948.96...

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

PubMed Central

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

2015-01-01

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

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

PubMed

Berk, Michael; Callaly, Thomas; Hyland, Mary

2003-05-01

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

Adolescents as perpetrators of aggression within the family.

PubMed

Kuay, Hue San; Lee, Sarah; Centifanti, Luna C M; Parnis, Abigail C; Mrozik, Jennifer H; Tiffin, Paul A

2016-01-01

Although family violence perpetrated by juveniles has been acknowledged as a potentially serious form of violence for over 30years, scientific studies have been limited to examining the incidence and form of home violence. The present study examined the prevalence of family aggression as perpetrated by youths; we examined groups drawn from clinic-referred and forensic samples. Two audits of case files were conducted to systematically document aggression perpetrated by referred youths toward their family members. The purpose of the first audit was fourfold: i) to identify the incidence of the perpetration of family aggression among clinical and forensic samples; ii) to identify whether there were any reports of weapon use during aggressive episodes; iii) to identify the target of family aggression (parents or siblings); and iv) to identify the form of aggression perpetrated (verbal or physical). The second audit aimed to replicate the findings and to show that the results were not due to differences in multiple deprivation indices, clinical diagnosis of disruptive behavior disorders, and placement into alternative care. A sampling strategy was designed to audit the case notes of 25 recent forensic Child and Adolescent Mental Health Service (CAMHS) cases and 25 demographically similar clinic-referred CAMHS cases in the first audit; and 35 forensic cases and 35 demographically similar clinic-referred CAMHS cases in the second audit. Using ordinal chi-square, the forensic sample (audit 1=64%; audit 2=82.9%) had greater instances of family violence than the clinical sample (audit 1=32%; audit 2=28.6%). They were more likely to use a weapon (audit 1=69%; audit 2=65.5%) compared to the clinical sample (audit 1 and 2=0%). Examining only the aggressive groups, there was more perpetration of aggression toward parents (audit 1, forensic=92%, clinical=75%; audit 2, forensic=55.17%, clinical=40%) than toward siblings (audit 1, forensic=43%, clinical=50%; audit 2, forensic=27.58%, clinical=30%). Based on these findings, we would urge professionals who work within the child mental health, particularly the forensic area, to systematically collect reports of aggression perpetrated toward family members. Copyright © 2016 Elsevier Ltd. All rights reserved.

Electronic Implementation of Integrated End-of-life Care: A Local Approach

PubMed Central

Schlieper, Daniel; Altreuther, Christiane; Schallenburger, Manuela; Neukirchen, Martin; Schmitz, Andrea

2017-01-01

Introduction: The Liverpool Care Pathway for the Dying Patient is an instrument to deliver integrated care for patients in their last hours of life. Originally a paper-based system, this study investigates the feasibility of an electronic version. Methods: An electronic Liverpool Care Pathway was implemented in a specialized palliative care unit of a German university hospital. Its use is exemplified by means of auditing and analysis of the proportion of recorded items. Results: In the years 2013 and 2014 the electronic Liverpool Care Pathway was used for the care of 159 patients. The uptake of the instrument was high (67%). Most items were recorded. Apart from a high usability, the fast data retrieval allows fast analysis for auditing and research. Conclusions and discussion: The electronic instrument is feasible in a computerized ward and has strong advantages for retrospective analysis. Trial registration: Internal Clinical Trial Register of the Medical Faculty, Heinrich Heine University Düsseldorf, No. 2015124683 (7 December 2015). PMID:28970746

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

PubMed

Kester, Lucy; Stoller, James K

2013-05-01

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

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

DTIC Science & Technology

2002-08-21

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

[Medical audit: a modern undervalued management tool].

PubMed

Osorio, Guido; Sayes, Nilda; Fernández, Lautaro; Araya, Ester; Poblete, Dennis

2002-02-01

Medical audit is defined as the critical and periodical assessment of the quality of medical care, through the revision on medical records and hospital statistics. This review defines the work of the medical auditor and shows the fields of action of medical audit, emphasizing its importance and usefulness as a management tool. The authors propose that every hospital should create an audit system, should provide the necessary tools to carry out medical audits and should form an audit committee.

Audit Oversight: DoD Hotline Allegations Concerning Postaward Audits at the Defense Contract Audit Agency Boeing Huntington Beach Resident Office

DTIC Science & Technology

2005-05-04

should be filed or issue a memorandum clarifying the existing guidance and revise the DCAA Management Information System (DMIS) to allow defective...APO Response. The DCAA comments were not responsive. In the past, we have found inaccuracies in the DCAA management information system . Neither...Audit Agency Management Information System to only allow defective pricing audit assignments to be closed by issuing an audit report or canceling the

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

PubMed

Hepler, Jeff A; Neumann, Cathy

2003-04-01

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

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.

21 CFR 1304.06 - Records and reports for electronic prescriptions.

Code of Federal Regulations, 2010 CFR

2010-04-01

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

49 CFR 385.313 - Who will conduct the safety audit?

Code of Federal Regulations, 2010 CFR

2010-10-01

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

47 CFR 53.213 - Audit analysis and evaluation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... auditor shall submit a draft of the audit report to the Federal/State joint audit team. (1) The Federal... auditor. Exceptions of the Federal/State joint audit team to the finding and conclusions of the independent auditor that remain unresolved shall be included in the final audit report. (2) Within 15 days...

45 CFR 305.64 - Audit procedures and State comments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Audit procedures and State comments. (a) Prior to the start of the actual audit, Federal auditors will hold an audit entrance conference with the IV-D agency. At that conference, the auditors will explain... fieldwork, Federal auditors will afford the State IV-D agency an opportunity for an audit exit conference at...

41 CFR 105-72.306 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... education or other non-profit organizations (including hospitals) shall be subject to the audit requirements... be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 U.S.C... Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB Circular A-133 shall...

49 CFR 19.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... education or other non-profit organizations (including hospitals) shall be subject to the audit requirements... be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 U.S.C... Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB Circular A-133 shall...

36 CFR 1210.26 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-07-01

... education or other non-profit organizations (including hospitals) shall be subject to the audit requirements... be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 U.S.C... Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB Circular A-133 shall...

43 CFR 12.926 - Non-Federal audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... education or other non-profit organizations (including hospitals) shall be subject to the audit requirements... be subject to the audit requirements contained in the Single Audit Act Amendments of 1996 (31 U.S.C... Organizations.” (c) For-profit hospitals not covered by the audit provisions of revised OMB Circular A-133 shall...

Report on the Audit of Architect-Engineer Contracting at U.S. Army Engineer Division, Europe

DTIC Science & Technology

1991-02-13

This is our final report on the Audit of Architect-Engineer Contracting at U.S. Army Engineer Division1 Europe, for your information and use...our ongoing audit of architect-engineer contracting. The Contract Management Directorate made the audit from March 1989 through February 1990. The audit covered

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

40 CFR Appendix A to Subpart E of... - Plans for Selective Enforcement Auditing

Code of Federal Regulations, 2010 CFR

2010-07-01

... Auditing A Appendix A to Subpart E of Part 1068 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Auditing Pt. 1068, Subpt. E, App. A Appendix A to Subpart E of Part 1068—Plans for Selective Enforcement Auditing The following tables describe sampling plans for selective enforcement audits, as described in...

45 CFR 305.64 - Audit procedures and State comments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Audit procedures and State comments. (a) Prior to the start of the actual audit, Federal auditors will hold an audit entrance conference with the IV-D agency. At that conference, the auditors will explain... fieldwork, Federal auditors will afford the State IV-D agency an opportunity for an audit exit conference at...

47 CFR 53.213 - Audit analysis and evaluation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... auditor shall submit a draft of the audit report to the Federal/State joint audit team. (1) The Federal... auditor. Exceptions of the Federal/State joint audit team to the finding and conclusions of the independent auditor that remain unresolved shall be included in the final audit report. (2) Within 15 days...

50 CFR 401.23 - Audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Audits. 401.23 Section 401.23 Wildlife and... ENHANCEMENT § 401.23 Audits. The State is required to conduct an audit at least every two years in accordance with the provisions of Attachment P OMB Circular A-102. Failure to conduct audits as required may...

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

Code of Federal Regulations, 2010 CFR

2010-04-01

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

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

ERIC Educational Resources Information Center

Hargie, Owen; Tourish, Dennis; Wilson, Noel

2002-01-01

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

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

Code of Federal Regulations, 2010 CFR

2010-10-01

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

45 CFR 2521.45 - What are the limitations on the Federal government's share of program costs?

Code of Federal Regulations, 2014 CFR

2014-10-01

... under § 2522.240(b)(1), and 85 percent of other member support costs. (2) If you are a professional... volunteers to your organizations for organizational functions such as accounting, audit, and training of...

45 CFR 2521.45 - What are the limitations on the Federal government's share of program costs?

Code of Federal Regulations, 2012 CFR

2012-10-01

... under § 2522.240(b)(1), and 85 percent of other member support costs. (2) If you are a professional... volunteers to your organizations for organizational functions such as accounting, audit, and training of...

45 CFR 2521.45 - What are the limitations on the Federal government's share of program costs?

Code of Federal Regulations, 2013 CFR

2013-10-01

... under § 2522.240(b)(1), and 85 percent of other member support costs. (2) If you are a professional... volunteers to your organizations for organizational functions such as accounting, audit, and training of...

45 CFR 2521.45 - What are the limitations on the Federal government's share of program costs?

Code of Federal Regulations, 2011 CFR

2011-10-01

... under § 2522.240(b)(1), and 85 percent of other member support costs. (2) If you are a professional... volunteers to your organizations for organizational functions such as accounting, audit, and training of...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

14 CFR 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

10 CFR 26.37 - Protection of information.

Code of Federal Regulations, 2012 CFR

2012-01-01

... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.37 Protection of information... program, including determinations of fitness, FFD program audits, or some human resources functions; (6... test results, MRO reviews, determinations of fitness, and management actions pertaining to the subject...

10 CFR 26.37 - Protection of information.

Code of Federal Regulations, 2014 CFR

2014-01-01

... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.37 Protection of information... program, including determinations of fitness, FFD program audits, or some human resources functions; (6... test results, MRO reviews, determinations of fitness, and management actions pertaining to the subject...

10 CFR 26.37 - Protection of information.

Code of Federal Regulations, 2013 CFR

2013-01-01

... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.37 Protection of information... program, including determinations of fitness, FFD program audits, or some human resources functions; (6... test results, MRO reviews, determinations of fitness, and management actions pertaining to the subject...

10 CFR 26.37 - Protection of information.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.37 Protection of information... program, including determinations of fitness, FFD program audits, or some human resources functions; (6... test results, MRO reviews, determinations of fitness, and management actions pertaining to the subject...

10 CFR 26.37 - Protection of information.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Program Elements § 26.37 Protection of information... program, including determinations of fitness, FFD program audits, or some human resources functions; (6... test results, MRO reviews, determinations of fitness, and management actions pertaining to the subject...

Psychology in Action: Psychology in China

ERIC Educational Resources Information Center

Hsiao, Sigmund

1977-01-01

"Psychologists in the People's Republic of China are engaged in research concerning theory, Chinese language, child development, vision, audition, and areas of physiological psychology including acupuncture, pain, memory, and central nervous system functioning. The Institute of Psychology within the Chinese Academy of Sciences represents the…

42 CFR 421.304 - Medicare integrity program contractor functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... services for which Medicare payment may be made either directly or indirectly. (b) Auditing, settling and.... 421.304 Section 421.304 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM MEDICARE CONTRACTING Medicare Integrity Program...

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

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.

Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory.

PubMed

Jeffries, Mark; Phipps, Denham; Howard, Rachel L; Avery, Anthony; Rodgers, Sarah; Ashcroft, Darren

2017-05-10

Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care. This is a qualitative study informed by strong structuration theory. The analysis was thematic, using a template approach. An a priori set of thematic codes, based on strong structuration theory, was developed from the literature and applied to the transcripts. The coding template was then modified through successive readings of the data. Clinical commissioning group in the south of England. Four focus groups and five semi-structured interviews were conducted with 18 participants purposively sampled from a range of stakeholder groups (general practitioners, pharmacists, patients and commissioners). Using the system could lead to improved medication safety, but use was determined by broad institutional contexts; by the perceptions, dispositions and skills of users; and by the structures embedded within the technology. These included perceptions of the system as new and requiring technical competence and skill; the adoption of the system for information gathering; and interactions and relationships that involved individual, shared or collective use. The dynamics between these external, internal and technological structures affected the adoption and implementation of the system. Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation. © 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.

Piloting a Structured Practice Audit to Assess ACGME Milestones in Written Handoff Communication in Internal Medicine

PubMed Central

Martin, Shannon K.; Farnan, Jeanne M.; McConville, John F.; Arora, Vineet M.

2015-01-01

Background Written communication skills are integral to patient care handoffs. Residency programs require feasible assessment tools that provide timely formative and summative feedback, ideally linked to the Accreditation Council for Graduate Medical Education Milestones. Objective We describe the use of 1 such tool—UPDATED—to assess written handoff communication skills in internal medicine interns. Methods During 2012–2013, the authors piloted a structured practice audit at 1 academic institution to audit written sign-outs completed by 45 interns, using the UPDATED tool, which scores 7 aspects of sign-out communication linked to milestones. Intern sign-outs were audited by trained faculty members throughout the year. Results were incorporated into intern performance reviews and Clinical Competency Committees. Results A total of 136 sign-outs were audited (averaging 3.1 audits per intern). In the first trimester, 14 interns (31%) had satisfactory audit results. Five interns (11%) had critical deficiencies and received immediate feedback, and the remaining 26 (58%) were assigned future audits due to missing audits or unsatisfactory scores. In the second trimester, 21 interns (68%) had satisfactory results, 1 had critical deficiencies, and 9 (29%) required future audits. Nine of the 10 remaining interns in the final trimester had satisfactory audits. Faculty time was estimated at 10 to 15 minutes per sign-out audited. Conclusions The UPDATED audit is a milestone-based tool that can be used to assess written sign-out communication skills in internal medicine residency programs. Future work is planned to adapt the tool for use by senior supervisory residents to appraise sign-outs in real time. PMID:26221442

Diagnostic efficiency of the AUDIT-C in U.S. veterans with military service since September 11, 2001.

PubMed

Crawford, Eric F; Fulton, Jessica J; Swinkels, Cindy M; Beckham, Jean C; Calhoun, Patrick S

2013-09-01

Alcohol screening with the 3-item alcohol use disorders identification test (AUDIT-C) has been implemented throughout the U.S. Veterans Health Administration. Validation of the AUDIT-C, however, has been conducted with samples of primarily older veterans. This study examined the diagnostic efficiency of the AUDIT-C in a younger cohort of veterans who served during Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF). Veteran participants (N=1775) completed the alcohol use disorders identification test (AUDIT) and underwent the structured clinical interview for DSM-IV-TR for Axis I disorders (SCID) in research settings within four VA medical Centers. Areas under receiver operating characteristic curves (AUCs) measured the effiency of the full AUDIT and AUDIT-C in identifying SCID-based diagnoses of past year alcohol abuse or dependence. Both measures performed well in detecting alcohol use disorders. In the full sample, the AUDIT had a better AUC (.908; .881-.935) than the AUDIT-C (.859; .826-.893; p<.0001). It is notable that this same result was found among men but not women, perhaps due to reduced power. Diagnostic efficiency statistics for the AUDIT and AUDIT-C were consistent with results from older veteran samples. The diagnostic efficiency of both measures did not vary with race or age. Both the AUDIT and AUDIT-C appear to be valid instruments for identifying alcohol abuse or dependence among the most recent cohort of U.S. veterans with service during OEF/OIF within research settings. Published by Elsevier Ireland Ltd.

Piloting a Structured Practice Audit to Assess ACGME Milestones in Written Handoff Communication in Internal Medicine.

PubMed

Martin, Shannon K; Farnan, Jeanne M; McConville, John F; Arora, Vineet M

2015-06-01

Written communication skills are integral to patient care handoffs. Residency programs require feasible assessment tools that provide timely formative and summative feedback, ideally linked to the Accreditation Council for Graduate Medical Education Milestones. We describe the use of 1 such tool-UPDATED-to assess written handoff communication skills in internal medicine interns. During 2012-2013, the authors piloted a structured practice audit at 1 academic institution to audit written sign-outs completed by 45 interns, using the UPDATED tool, which scores 7 aspects of sign-out communication linked to milestones. Intern sign-outs were audited by trained faculty members throughout the year. Results were incorporated into intern performance reviews and Clinical Competency Committees. A total of 136 sign-outs were audited (averaging 3.1 audits per intern). In the first trimester, 14 interns (31%) had satisfactory audit results. Five interns (11%) had critical deficiencies and received immediate feedback, and the remaining 26 (58%) were assigned future audits due to missing audits or unsatisfactory scores. In the second trimester, 21 interns (68%) had satisfactory results, 1 had critical deficiencies, and 9 (29%) required future audits. Nine of the 10 remaining interns in the final trimester had satisfactory audits. Faculty time was estimated at 10 to 15 minutes per sign-out audited. The UPDATED audit is a milestone-based tool that can be used to assess written sign-out communication skills in internal medicine residency programs. Future work is planned to adapt the tool for use by senior supervisory residents to appraise sign-outs in real time.

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

PubMed

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

2009-10-07

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

A re-audit of the management of gonorrhoea.

PubMed

Ekanayaka, Ratna; Challenor, Rachel

2016-08-01

A re-audit of the management of gonorrhoea was undertaken in 2014. Six out of nine auditable outcomes were met in the second audit (2014) compared with three out of eight in the first audit (2012). The new measures that were introduced following the original audit may have helped to improve outcomes. However, electronic patient records were introduced in December 2012. Documentation was much improved with the use of patient record templates and this has contributed considerably to the improved outcomes. © The Author(s) 2016.

John F. Kennedy Space Center, Safety, Reliability, Maintainability and Quality Assurance, Survey and Audit Program

NASA Technical Reports Server (NTRS)

1994-01-01

This document is the product of the KSC Survey and Audit Working Group composed of civil service and contractor Safety, Reliability, and Quality Assurance (SR&QA) personnel. The program described herein provides standardized terminology, uniformity of survey and audit operations, and emphasizes process assessments rather than a program based solely on compliance. The program establishes minimum training requirements, adopts an auditor certification methodology, and includes survey and audit metrics for the audited organizations as well as the auditing organization.

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

DTIC Science & Technology

1991-06-06

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

Maintenance Manual for AUDIT. A System for Analyzing SESCOMP Software. Volume 4: Appendix D. Listings of the AUDIT Software for the IBM 360.

DTIC Science & Technology

1977-08-01

The AUDIT documentation provides the maintenance programmer personnel with the information to effectively maintain and use the AUDIT software. The ...SESCOMPSPEC’s) and produces reports detailing the deviations from those standards. The AUDIT software also examines a program unit to detect and report...changes in word length on the output of computer programs. This report contains the listings of the AUDIT software for the IBM 360. (Author)

Maintenance Manual for AUDIT. A System for Analyzing SESCOMP Software. Volume 3: Appendix C - Listings of the AUDIT Software for the UNIVAC 1108.

DTIC Science & Technology

1977-08-01

The AUDIT documentation provides the maintenance programmer personnel with the information to effectively maintain and use the AUDIT software. The ...SESCOMPSPEC’s) and produces reports detailing the deviations from those standards. The AUDIT software also examines a program unit to detect and report...changes in word length on the output of computer programs. This report contains the listings of the AUDIT software for the UNIVAC 1108. (Author)

Maintenance Manual for AUDIT. A System for Analyzing SESCOMP Software. Volume 2: Appendix B. Listings of the Audit Software for the CDC 6000.

DTIC Science & Technology

1977-08-01

The AUDIT documentation provides the maintenance programmer personnel with the information to effectively maintain and use the AUDIT software. The ...SESCOMPSPEC’s) and produces reports detailing the deviations from those standards. The AUDIT software also examines a program unit to detect and report...changes in word length on the output of computer programs. This report contains the listings of the AUDIT software for the CDC 6000. (Author)

The ICA Communication Audit: Process, Status, Critique

ERIC Educational Resources Information Center

Goldhaber, Gerald M.; Krivonos, Paul D.

1977-01-01

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

Evaluation of the organisation and effectiveness of internal audits to govern patient safety in hospitals: a mixed-methods study.

PubMed

van Gelderen, Saskia C; Zegers, Marieke; Boeijen, Wilma; Westert, Gert P; Robben, Paul B; Wollersheim, Hub C

2017-07-10

Hospital boards are legally responsible for safe healthcare. They need tools to assist them in their task of governing patient safety. Almost every Dutch hospital performs internal audits, but the effectiveness of these audits for hospital governance has never been evaluated. The aim of this study is to evaluate the organisation of internal audits and their effectiveness for hospitals boards to govern patient safety. A mixed-methods study consisting of a questionnaire regarding the organisation of internal audits among all Dutch hospitals (n=89) and interviews with stakeholders regarding the audit process and experienced effectiveness of audits within six hospitals. Response rate of the questionnaire was 76% and 43 interviews were held. In every responding hospital, the internal audits followed the plan-do-check-act cycle. Every hospital used interviews, document analysis and site visits as input for the internal audit. Boards stated that effective aspects of internal audits were their multidisciplinary scope, their structured and in-depth approach, the usability to monitor improvement activities and to change hospital policy and the fact that results were used in meetings with staff and boards of supervisors. The qualitative methods (interviews and site visits) used in internal audits enable the identification of soft signals such as unsafe culture or communication and collaboration problems. Reported disadvantages were the low frequency of internal audits and the absence of soft signals in the actual audit reports. This study shows that internal audits are regarded as effective for patient safety governance, as they help boards to identify patient safety problems, proactively steer patient safety and inform boards of supervisors on the status of patient safety. The description of the Dutch internal audits makes these audits replicable to other healthcare organisations in different settings, enabling hospital boards to complement their systems to govern patient safety. © 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.

[Clinical audit of screening for gestational diabetes among 848 pregnant women in 23 maternity units of the Pays de la Loire, 2014].

PubMed

Branger, B; Velupillai, C; François, S; Coutin, A S; Paumier, A; Gillard, P; Collin, R; Sentilhes, L; Winer, N

2016-10-01

Guidelines for screening for gestational diabetes mellitus (GDM) were published in 2010. An audit of the maternity units of the Pays de la Loire network sought to determine the adherence rate and to study the factors affecting it in order to propose corrective measures to improve it. The perinatal network in Pays de la Loire provided obstetricians of the 23 participating maternity units with a set of criteria to be collected from the files of women giving birth. The methodology of the audit was designed to enable calculation of the adherence rate overall and according to indications (risk factors, hyperglycemia, and macrosomia): adherence, non-adherence, and over-adherence (screening in the absence of an indication). To obtain around 900 pregnancies, the audit was planned to cover a week of deliveries in June 2014. The analysis included 848 pregnancies and 872 newborns. Risk factors were found for 46.6% of the women (43.2 to 49.9): 13.2% for maternal age≥35years and 30.8% for BMI≥25kg/m 2 . GDM was diagnosed for 14.6% (12.4 to 17.2). The adherence rate for screening was 45.5% (42.2 to 49.9), the non-adherence rate 27.6% (24.7 to 30.7), and the over-adherence rate 26.9% (24.0 to 30.0). Among the factors potentially associated with adherence, we observed only the second-trimester factor (macrosomia); there was no "professional" effect on adherence criteria. No evidence of overmanagement was observed for the pregnancies/deliveries/newborns with overdiagnosis. Oral glucose tolerance tests were performed in accordance with the guidelines (95.9%). Follow-up of women with GDM by specialists was satisfactory (84.6%). This audit showed that adherence to the guidelines was insufficient in the Pays de la Loire network. The reasons for this are numerous: ignorance of the guidelines, in part due to their relative recency, the change in the blood sugar levels defining GDM (perceived as too low), and the absence of strong evidence about these thresholds from publications and practices in other countries, the need to select women for risk factors, and sometimes the late onset of prenatal care at the maternity unit. In view of this audit, the Perinatal Network of Pays de la Loire must work to improve the knowledge and screening practices for GDM among its professionals, by the repeated dissemination of these guidelines and chart review sessions. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

7 CFR 1291.11 - Audit requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROGRAM-FARM BILL § 1291.11 Audit requirements. Each year that a State receives a grant under the SCBGP-FB, the State is required to conduct an audit of the expenditures of SCBGP-FB funds. If the Single Audit... audit of all SCBGP-FB funds no later than 60 days after the end date of the grant agreement. The State...

7 CFR 1291.11 - Audit requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROGRAM-FARM BILL § 1291.11 Audit requirements. Each year that a State receives a grant under the SCBGP-FB, the State is required to conduct an audit of the expenditures of SCBGP-FB funds. If the Single Audit... audit of all SCBGP-FB funds no later than 60 days after the end date of the grant agreement. The State...

7 CFR 1291.11 - Audit requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROGRAM-FARM BILL § 1291.11 Audit requirements. Each year that a State receives a grant under the SCBGP-FB, the State is required to conduct an audit of the expenditures of SCBGP-FB funds. If the Single Audit... audit of all SCBGP-FB funds no later than 60 days after the end date of the grant agreement. The State...

7 CFR 1291.11 - Audit requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PROGRAM-FARM BILL § 1291.11 Audit requirements. Each year that a State receives a grant under the SCBGP-FB, the State is required to conduct an audit of the expenditures of SCBGP-FB funds. If the Single Audit... audit of all SCBGP-FB funds no later than 60 days after the end date of the grant agreement. The State...

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...

20 CFR 627.480 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audits. 627.480 Section 627.480 Employees... UNDER TITLES I, II, AND III OF THE ACT Administrative Standards § 627.480 Audits. (a) Non-Federal Audits... Single Audit Act of 1984 (31 U.S.C. 7501-7) and 29 CFR part 96, the Department of Labor regulations which...

7 CFR 285.4 - Audits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 4 2010-01-01 2010-01-01 false Audits. 285.4 Section 285.4 Agriculture Regulations of... PUERTO RICO § 285.4 Audits. (a) The Commonwealth of Puerto Rico shall provide an audit of expenditures in... such audit shall be reported to FNS no later than 120 days from the end of each fiscal year in which...

NASA Audit Follow-up Handbook

NASA Technical Reports Server (NTRS)

1990-01-01

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

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

A multihospital medication allergy audit: a means to quality assurance.

PubMed

Hoffmann, R P; Ellerbrock, M C; Lovett, J E

1982-04-01

Seventeen community hospitals within the 16 division of the Sisters of Mercy Health Corporation cooperatively participated in a medication allergy audit program. Initial and follow-up audits were conducted at each hospital to determine whether allergy information for penicillin- or aspirin-sensitive patients was appropriately communicated to the pharmacist. A total of 483 patient records were reviewed during each audit which corresponded to 12% of each hospital's average patient census. In the initial audit, the overall acceptance rate for the combined hospitals was 62.3%. Following the first audit, each hospital undertook corrective follow-up measures in an attempt to improve its results. In the second audit, the overall acceptance rate improved significantly to 78.9%. It is concluded that this auditing process followed by corrective follow-up measures was an effective mechanism for improving the communication of patient allergy information and is a means to quality assurance. Future audits will be necessary to determine whether the beneficial effects produced will be sustained or improved.

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 useful tool for the improvement of quality in radiotherapy. It succeeded to disseminate the IAEA TRS-398 protocol in nearly all radiotherapy centers achieving homogenization and consistency of dosimetry within the country. Also, it detected discrepancies in dosimetry and provided guidance and recommendations to eliminate sources of errors. Finally, it proved that quality assurance programs, periodic quality control tests, maintenance and service play an important role for achieving accuracy and safe operation in radiotherapy.

7 CFR 4284.18 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Grant Programs § 4284.18 Audit requirements. Grantees must comply with the audit requirements of 7 CFR part 3052. The audit requirements apply to the years in which grant funds are received and years in...

Auditing the Records of Student-Athletes.

ERIC Educational Resources Information Center

Riggs, Robert O.; Hedden, Carole R.

1985-01-01

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

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

Code of Federal Regulations, 2011 CFR

2011-01-01

... INVESTMENT AGREEMENTS Award Terms Affecting Participants' Financial, Property, and Purchasing Systems Financial Matters § 603.645 Periodic audits and award-specific audits of for-profit participants. The...

12 CFR 9.9 - Audit of fiduciary activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... discrete audit (by internal or external auditors) of each significant fiduciary activity (i.e., on an... system shall note the results of all discrete audits performed since the last audit report (including...

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.

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.

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

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.

A comprehensive audit of nursing record keeping practice.

PubMed

Griffiths, Paul; Debbage, Samantha; Smith, Alison

Good quality record keeping is essential to safe and effective patient care. To ensure that high standards of record keeping are maintained, regular clinical audit should be undertaken. This article describes an audit and re-audit of nursing record keeping at Sheffield Teaching Hospital NHS Foundation Trust. The article demonstrates improving audit data in 2005 and 2006 and describes how audit and the resulting recommendations and action plans can result in real improvements in the quality of record keeping. The keys to success in this ongoing audit programme are identified as stakeholder involvement, support from the senior nurses in the organization and the use of the data for both local and trust-wide purposes.

Internal audit in a microbiology laboratory.

PubMed Central

Mifsud, A J; Shafi, M S

1995-01-01

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

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...

An Exploration of the Effectiveness of an Audit Simulation Tool in a Classroom Setting

ERIC Educational Resources Information Center

Zelin, Robert C., II

2010-01-01

The purpose of this study was to examine the effectiveness of using an audit simulation product in a classroom setting. Many students and professionals feel that a disconnect exists between learning auditing in the classroom and practicing auditing in the workplace. It was hoped that the introduction of an audit simulation tool would help to…

12 CFR 550.480 - How do I report the results of the audit?

Code of Federal Regulations, 2010 CFR

2010-01-01

... board of directors. (b) Continuous audit. If you adopt a continuous audit system, you must note the... 12 Banks and Banking 5 2010-01-01 2010-01-01 false How do I report the results of the audit? 550... FIDUCIARY POWERS OF SAVINGS ASSOCIATIONS Exercising Fiduciary Powers Audit Requirements § 550.480 How do I...

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...

Semi-Annual Report to Congress: October 1, 1981-March 31, 1982. No. 4. (Submitted Pursuant to Public Law 95-452).

ERIC Educational Resources Information Center

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

The Office of Inspector General (OIG) describes its provision of audit, investigation, fraud detection and prevention, and certain security services to the U.S. Department of Education (ED). Audit activities are reviewed in the first section, which discusses audit accomplishments, OIG audits by government and independent auditors, audits on…

42 CFR 137.168 - May the Secretary require audit or accounting standards other than those specified in § 137.167?

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false May the Secretary require audit or accounting... SERVICES TRIBAL SELF-GOVERNANCE Operational Provisions Audits and Cost Principles § 137.168 May the Secretary require audit or accounting standards other than those specified in § 137.167? No, no other audit...

Factors influencing the effectiveness of audit and feedback: nurses' perceptions.

PubMed

Christina, Venessa; Baldwin, Kathryn; Biron, Alain; Emed, Jessica; Lepage, Karine

2016-11-01

To explore the perceptions of nurses in an acute care setting on factors influencing the effectiveness of audit and feedback. Audit and feedback is widely used and recommended in nursing to promote evidence-based practice and to improve care quality. Yet the literature has shown a limited to modest effect at most. Audit and feedback will continue to be unreliable until we learn what influences its effectiveness. A qualitative study was conducted using individual, semi-structured interviews with 14 registered nurses in an acute care teaching hospital in Montreal, Canada. Three themes were identified: the relevance of audit and feedback, particularly understanding the purpose of audit and feedback and the prioritisation of audit criteria; the audit and feedback process, including its timing and feedback characteristics; and individual factors, such as personality and perceived accountability. According to participants, they were likely to have a better response to audit and feedback when they perceived that it was relevant and that the process fitted their preferences. This study benefits nursing leaders and managers involved in quality improvement by providing a better understanding of nurses' perceptions on how best to use audit and feedback as a strategy to promote evidence-based practice. © 2016 John Wiley & Sons Ltd.

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.

Impact of clinical audits on cesarean section rate.

PubMed

Peng, Fu-Shiang; Lin, Hsien-Ming; Lin, Ho-Hsiung; Tu, Fung-Chao; Hsiao, Chin-Fen; Hsiao, Sheng-Mou

2016-08-01

Many countries have noted a substantial increase in the cesarean section rate (CSR). Several methods for lowering the CSR have been described. Understanding the impact of clinical audits on the CSR may aid in lowering CSR. Thus, our aim is to elucidate the effect of clinical audits on the CSR. We retrospectively analyzed 3781 pregnant women who gave birth in a medical center between January 2008 and January 2011. Pregnant women who delivered between January 2008 and July 2009 were enrolled as the pre-audit group (n = 1592). After August 2009, all cesarean section cases that were audited were enrolled in the audit group (n = 2189). The CSR was compared between groups. The overall CSR (34.5% vs. 31.1%, adjusted odds ratio [OR] = 0.83, p = 0.008) and the cesarean section rate due to dystocia (9.6% vs. 6.2%, p < 0.001) were significantly lower in the audit group than the pre-audit group. However, there was no significant difference in the rate of operative vaginal delivery between groups. Consensus on the unnecessity for cesarean section was achieved in 16 (8.2%) of 195 audit cases in the monthly audit conference. In nulliparous pregnant women (n = 2148), multivariate analysis revealed that clinical audit (OR = 0.78), maternal age (OR = 1.10), gestational age at delivery (OR = 0.80), and fetal body weight at birth (OR = 1.0005) were independent predictors of cesarean section (all p < 0.05). Most variables of maternal and perinatal morbidity and mortality did not differ before and after audits were implemented. Clinical audits appear to be an effective strategy for reducing the CSR. Therefore, we recommend strict monitoring of the indications in dystocia for cesarean section to reduce the CSR. Copyright © 2016. Published by Elsevier B.V.

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

PubMed

Cameron, Michaella; Jones, Stacey; Adedeji, Olufunso

2015-07-01

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

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

Audio in Courseware: Design Knowledge Issues.

ERIC Educational Resources Information Center

Aarntzen, Diana

1993-01-01

Considers issues that need to be addressed when incorporating audio in courseware design. Topics discussed include functions of audio in courseware; the relationship between auditive and visual information; learner characteristics in relation to audio; events of instruction; and audio characteristics, including interactivity and speech technology.…

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

29 CFR 95.51 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-Award Requirements Reports and Records § 95.51 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award. Recipients shall monitor subawards to ensure subrecipients have met the audit...

14 CFR § 1260.151 - Monitoring and reporting program performance.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Records § 1260.151 Monitoring and reporting program performance. (a) Recipients are responsible for managing and monitoring each project, program, subcontract, function or activity supported by the award. Recipients shall monitor subcontracts to ensure subcontractors have met the audit requirements as delineated...

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

Code of Federal Regulations, 2010 CFR

2010-07-01

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

7 CFR 400.203 - Financial statement and certification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... shall be audited by a CPA (CPA Audit); or if a CPA audited financial statement is not available, the... Treasurer, partner, or owner is submitted, a CPA audited financial statement must be submitted if...

7 CFR 400.203 - Financial statement and certification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... shall be audited by a CPA (CPA Audit); or if a CPA audited financial statement is not available, the... Treasurer, partner, or owner is submitted, a CPA audited financial statement must be submitted if...

7 CFR 400.203 - Financial statement and certification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... shall be audited by a CPA (CPA Audit); or if a CPA audited financial statement is not available, the... Treasurer, partner, or owner is submitted, a CPA audited financial statement must be submitted if...

7 CFR 400.203 - Financial statement and certification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... shall be audited by a CPA (CPA Audit); or if a CPA audited financial statement is not available, the... Treasurer, partner, or owner is submitted, a CPA audited financial statement must be submitted if...

7 CFR 400.203 - Financial statement and certification.

Code of Federal Regulations, 2010 CFR

2010-01-01

... shall be audited by a CPA (CPA Audit); or if a CPA audited financial statement is not available, the... Treasurer, partner, or owner is submitted, a CPA audited financial statement must be submitted if...

7 CFR 1290.10 - Audit requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 10 2010-01-01 2010-01-01 false Audit requirements. 1290.10 Section 1290.10 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... audit, a copy of the audit results. ...

Addictive behavior among young people in Ukraine: a pilot study.

PubMed

Linskiy, Igor V; Minko, Aleksandr I; Artemchuk, Anatoliy Ph; Grinevich, Eugenia G; Markova, Marianna V; Musienko, Georgiy A; Shalashov, Valeriy V; Markozova, Lyubov M; Samoilova, Elena S; Kuzminov, Valeriy N; Shalashova, Ilona V; Ponomarev, Vladimir I; Baranenko, Aleksey V; Minko, Aleksey A; Goltsova, Svetlana V; Sergienko, Oksana V; Linskaya, Ekaterina I; Vyglazova, Olga V; Zhabenko, Nataliya; Zhabenko, Olena

2012-08-01

The AUDIT-like tests system was created for complex assessment and evaluation of the addictive status of adolescents in a Ukrainian population. The AUDIT-like tests system has been created from the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. The AUDIT-like tests were minimally modified from the original AUDIT. Attention was brought to similarities between stages of different addictions (TV, computer games, the Internet, etc.) and alcohol addiction. Seventeen AUDIT-like tests were created to detect the different types of chemical and non-chemical addictions.

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.

Audit and Feedback-Focused approach to Evidence-based Care in Treating patients with pneumonia in hospital (AFFECT Study).

PubMed

Halpape, Katelyn; Sulz, Linda; Schuster, Brenda; Taylor, Ron

2014-01-01

Pneumonia is the eighth leading cause of death in Canada. Use of guideline-concordant therapy tempers the development of resistance, decreases health care costs, and reduces morbidity and mortality. The purpose of this study was to optimize the treatment of patients with pneumonia under hospitalist care by focusing on best practice and local antibiogram data. The objectives were to collaborate with a hospitalist representative to optimize in-hospital treatment of patients with community-acquired, hospital-acquired, and health care-associated pneumonia; to complete a baseline audit to determine the proportion of antibiotic orders adhering to the strategy; to present the strategy and baseline audit findings to the hospitalists; to perform a post-intervention audit, with comparison to baseline, and to present results to the hospitalists; to expedite de-escalation to a narrower-spectrum antibiotic; to expedite parenteral-to-oral step-down therapy and promote appropriate duration of therapy; and to determine if a pneumonia scoring system was used. An audit and feedback intervention focusing on pre- and post-intervention retrospective chart audits was completed. Review of pneumonia guidelines and the local antibiogram assisted in identifying the study strategy. A presentation to the hospitalists outlined antimicrobial stewardship principles and described the findings of the baseline audit. Pre- and post-intervention audit results were compared. Local best-practice treatment algorithms were developed for community-acquired pneumonia and for hospital-acquired and health care-associated pneumonia. The pre-intervention audit covered the period December 2011 to January 2012, with subsequent education and audit results presented to the hospitalists in November 2012. The post-intervention audit covered the period December 2012 to January 2013. Adherence to the treatment algorithms increased from 10% (2/21) in the pre-intervention audit to 38% (5/13) in the post-intervention audit. There was a trend to reduced duration of therapy in the post-intervention group. An audit and feedback intervention related to hospitalists' prescribing for pneumonia increased adherence to local best practice.

Factors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania.

PubMed

Nyamtema, Angelo S; Urassa, David P; Pembe, Andrea B; Kisanga, Felix; van Roosmalen, Jos

2010-06-03

Effective maternal and perinatal audits are associated with improved quality of care and reduction of severe adverse outcome. Although audits at the level of care were formally introduced in Tanzania around 25 years ago, little information is available about their existence, performance, and practical barriers to their implementation. This study assessed the structure, process and impacts of maternal and perinatal death audit systems in clinical practice and presents a detailed account on how they could be improved. A cross sectional descriptive study was conducted in eight major hospitals in Dar es Salaam in January 2009. An in-depth interview guide was used for 29 health managers and members of the audit committees to investigate the existence, structure, process and outcome of such audits in clinical practice. A semi-structured questionnaire was used to interview 30 health care providers in the maternity wards to assess their awareness, attitude and practice towards audit systems. The 2007 institutional pregnancy outcome records were reviewed. Overall hospital based maternal mortality ratio was 218/100,000 live births (range: 0 - 385) and perinatal mortality rate was 44/1000 births (range: 17 - 147). Maternal and perinatal audit systems existed only in 4 and 3 hospitals respectively, and key decision makers did not take part in audit committees. Sixty percent of care providers were not aware of even a single action which had ever been implemented in their hospitals because of audit recommendations. There were neither records of the key decision points, action plan, nor regular analysis of the audit reports in any of the facilities where such audit systems existed. Maternal and perinatal audit systems in these institutions are poorly established in structure and process; and are less effective to improve the quality of care. Fundamental changes are urgently needed for successful audit systems in these institutions.

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

PubMed

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

2014-10-01

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

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

PubMed

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

2009-05-01

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

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

PubMed

Houston, Lauren; Probst, Yasmine; Humphries, Allison

2015-01-01

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

Holding services to account.

PubMed

Clegg, J

2008-07-01

Recently, the frequency of audit inspections of health services for people with intellectual disability (ID) in the UK has increased, from occasional inquiries to a systematic audit of all services. From 2008, a process of continuous audit 'surveillance' of specialist health services is to be introduced. Similar regimes of inspection are in place for social care services. To explore the conceptual positions which inform audit, through detailed examination of the investigation into the learning disability service at Sutton and Merton. Audit is distinct from evaluation because it neither provides opportunities for service staff to give an account of their work nor represents a search for knowledge. Audit investigates adherence to government policy. In ID, audits measure aspirations derived from normalisation, despite research showing that some of these aspirations have not been achieved by any service. As audit consumes significant public resource, it is questionable whether the dominant finding of the Healthcare Commission's investigation into Sutton and Merton, that the ID service was chronically under-funded, represents value for money. While basic checks on minimum standards will always be necessary, service excellence requires not audit but research-driven evaluation. Audits inhibit rather than open-up debate about improving support to people with ID. They impose an ideology, squander resource, and demoralise carers and staff. Evaluations challenge the implicit management-versus-professional binary enacted by audit, and can inform new care systems which make effective use of all those engaged with people with ID.

Best practice in clinical audit document.

PubMed

2016-12-01

A guide to best practice in clinical audit has been published by the Healthcare Quality Improvement Partnership. It outlines updated criteria for best practice to support clinicians and clinical audit staff with planning, designing and carrying out audits.

AICPA standard can help improve audit committee performance.

PubMed

Reinstein, A; Luecke, R W

2001-08-01

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

Experience with Adaptive Security Policies.

DTIC Science & Technology

1998-03-01

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

Financial Accounting for New Jersey School Districts, 1984. The Audit Program. Draft.

ERIC Educational Resources Information Center

1984

Background information for the auditing of New Jersey School Districts is given. Included are chapters on the following: (1) a digest of the School Audit Law, Title 18A:23-1 to 18A:23-11; (2) directives to the Boards of Education; (3) school district bookkeeping; (4) scope of funds to be audited; (5) conducting the school audit; and (6) sample of…

DoD Generally Effective at Correcting Causes of Antideficiency Act Violations in Military Personnel Accounts, But Vulnerabilities Remain

DTIC Science & Technology

2012-11-30

U.S. Army Audit Agency Report No. A-2010-0143- FFM , “Follow-up Audit of FY 05 Subsistence Charges,” July 29, 2010 U.S. Army Audit Agency Report...2009 U.S. Army Audit Agency Report No. A-2008-0108- FFM , “Miscellaneous Credits for Reserve Component Pay,” April 29, 2008 Navy Naval Audit Service

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

PubMed Central

Howe, A

1998-01-01

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

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

PubMed

Howe, A

1998-01-01

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

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

PubMed

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

2018-03-01

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

Different versions of the Alcohol Use Disorders Identification Test (AUDIT) as screening instruments for underage binge drinking.

PubMed

Cortés-Tomás, María-Teresa; Giménez-Costa, José-Antonio; Motos-Sellés, Patricia; Sancerni-Beitia, María-Dolores

2016-01-01

The changes experienced in recent years in the conceptualization of binge drinking (BD) make it necessary to revise the usefulness of the existing instruments for its detection among minors. The AUDIT and its abbreviated versions have shown their utility in different populations and consumption ranges, but there has been little research into their use in the detection of BD among adolescents. This study tests the capacity of the AUDIT, AUDIT-C and AUDIT-3 to identify BD adolescents, indicating the optimal cut-off points for each sex. High school students self-administered the AUDIT and completed a weekly self-report of their alcohol intake. BD is classified into different groups according to parameters like the quantity consumed and its frequency in the past six months, adjusting the cut-off points for each case. The results obtained with a sample of 634 adolescents (15-17 years old/52.2% female) indicate that cut-off points of 4 on the AUDIT and 3 on the AUDIT-C show the best fit. Dividing the sample by sexes, the AUDIT and the AUDIT-C would detect BD males with scores of 5 and 4, respectively (with the AUDIT-C being more sensitive), and BD females with a score of 3 on both (the more sensitive being the AUDIT). All three versions are adequate to classify BD adolescents but none of them made it possible to safely differentiate binge drinkers with different consumption intensities. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Novel Process Audit for Standardized Perioperative Handoff Protocols.

PubMed

Pallekonda, Vinay; Scholl, Adam T; McKelvey, George M; Amhaz, Hassan; Essa, Deanna; Narreddy, Spurthy; Tan, Jens; Templonuevo, Mark; Ramirez, Sasha; Petrovic, Michelle A

2017-11-01

A perioperative handoff protocol provides a standardized delivery of communication during a handoff that occurs from the operating room to the postanestheisa care unit or ICU. The protocol's success is dependent, in part, on its continued proper use over time. A novel process audit was developed to help ensure that a perioperative handoff protocol is used accurately and appropriately over time. The Audit Observation Form is used for the Audit Phase of the process audit, while the Audit Averages Form is used for the Data Analysis Phase. Employing minimal resources and using quantitative methods, the process audit provides the necessary means to evaluate the proper execution of any perioperative handoff protocol. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

47 CFR 54.707 - Audit controls.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Audit controls. 54.707 Section 54.707 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.707 Audit controls. The Administrator shall have authority to audit...

47 CFR 54.707 - Audit controls.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 3 2011-10-01 2011-10-01 false Audit controls. 54.707 Section 54.707 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.707 Audit controls. The Administrator shall have authority to audit...

47 CFR 54.707 - Audit controls.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Audit controls. 54.707 Section 54.707 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.707 Audit controls. The Administrator shall have authority to audit...

47 CFR 54.707 - Audit controls.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 3 2010-10-01 2010-10-01 false Audit controls. 54.707 Section 54.707 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Administration § 54.707 Audit controls. The Administrator shall have authority to audit...

43 CFR 426.25 - Reclamation audits.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Reclamation audits. 426.25 Section 426.25... INTERIOR ACREAGE LIMITATION RULES AND REGULATIONS § 426.25 Reclamation audits. Reclamation will conduct... reviews; (b) In-depth reviews; and (c) Audits. ...

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

PubMed

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

2017-12-01

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

Final Technical Report. Training in Building Audit Technologies

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

Brosemer, Kathleen

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

Quantifying and improving the efficiency of Gamma Knife treatment plans for brain metastases: results of a 1-year audit.

PubMed

Wright, Gavin; Hatfield, Paul; Loughrey, Carmel; Reiner, Beatrice; Bownes, Peter

2014-12-01

A method for quantifying the efficiency of Gamma Knife treatment plans for metastases was previously implemented by the authors to retrospectively identify the least efficient plans and has provided insights into improved planning strategies. The aim of the current work was to ascertain whether those insights led to improved treatment plans. Following completion of the initial study, a 1-year audit of metastasis plans created at St. James's Institute of Oncology was carried out. Audited recent plans were compared with the earlier plans of the initial study, in terms of their efficiency and dosimetric quality. The statistical significance of any differences between relevant plan parameters was quantified by Mann-Whitney U-tests. Comparisons were made between all plans and repeated for a reduced set of plans from which the smallest lesions treated with a single 4-mm shot were excluded. The plan parameters compared were a plan efficiency index (PEI), the number of shots, Paddick conformity index (PCI), gradient index (GI), and percent coverage (of the lesion by the prescription isodose). A total of 157 metastatic lesions were included in the audit and were compared with 241 in the initial study. In a comparison of all cases, the audited plans achieved a higher median PEI score than did the earlier plans from the initial study (1.08 vs 1.02), indicating improved efficiency of the audited plans. When the smallest lesions (for which there was little scope for varying plan strategy) were discounted, the improvement in median PEI score was greater (1.23 vs 1.03, p < 0.001). This improvement in efficiency corresponds to an estimated mean (maximum) time saving of 15% (66%) per lesion (11 minutes [64 minutes] on the day of treatment). The modified planning strategy yielding these efficiency improvements did not rely on the use of significantly fewer shots (median 11 vs 11 shots, p = 0.924), nor did it result in significant detriment to dosimetric quality (median coverage 99% vs 99%, median PCI 0.84 vs 0.83, p = 0.449, and median GI 2.72 vs 2.67, p = 0.701, audited plans vs initial plans, respectively). Choice of planning strategy can substantially affect plan efficiency and thus strongly influence treatment time. Through increased emphasis on efficiency, resulting from the introduction of PEI combined with a modified planning strategy informed by previous work, it has been possible to reduce times for metastatic plans without compromising their dosimetric quality. Although the average time savings achieved per lesion are moderate, the potential benefits per patient are greater for those with multiple metastases. Reducing treatment times has clear benefits with regard to patient comfort and throughput. In addition, optimization of plan efficiency may potentially affect the biologically effective dose from Gamma Knife treatments and offers opportunity for further work.

Prospective audit to evaluate the potential of the coronial system to increase solid organ donation.

PubMed

Twamley, Huw; Haigh, Andrew; Williment, Claire; Hudson, Cara; Whitney, Julie; Neuberger, James

2016-07-08

Anecdotal evidence suggests that organ donation from deceased donors referred to the Coroner/Procurator Fiscal (PF) could be increased if all followed best practice. The aim of this prospective audit was to establish how referrals affected organ donation and to develop evidence-based guidelines to ensure that organ donation can be facilitated safely without interfering in the Coroner/PF's investigative process. Prospective audit. All acute National Health Service Hospitals in the UK where deceased organ donation was considered. 1437 deceased patients who met the eligibility criteria for organ donation and were referred to Coroner/PF. Number of cases where permission for transplantation was given, number of organs where permission was refused and number of organs which might have been transplanted if all had followed best practice. Full permission for organ retrieval was given in 87% cases and partial permission in 9%. However, if full permission had been given where no autopsy was performed or restrictions seemed unjustified, up to 77 organs (22 lungs, 22 kidneys, 9 pancreases, 9 livers, 8 hearts and 7 small bowels) could have been available for transplant. Coroners/PFs and their officers show strong support for transplantation but improvement in practice could result in a small but significant increase in life-saving and life-enhancing transplants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

75 FR 26262 - Center for Scientific Review; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

...: Learning, Cognition, and Audition. Date: May 27, 2010. Time: 1 p.m. to 3 p.m. Agenda: To review and...: Brain Disorders and Clinical Neuroscience Integrated Review Group; Pathophysiological Basis of [email protected] . Name of Committee: Integrative, Functional and Cognitive Neuroscience Integrated Review...

Teller Training Module: Off-Line Banking System. High-Technology Training Module.

ERIC Educational Resources Information Center

Lund, Candyce J.

This teller training module on offline banking systems is intended to be part of a postsecondary financial applications course. The module contains the following sections: module objective; specific objective; content--electronic audit machine key functions, practice packet--sample bank transactions and practicing procedures, and…

REGIONAL AIR POLLUTION STUDY, QUALITY ASSURANCE AUDITS

EPA Science Inventory

RAPS Quality Assurance audits were conducted under this Task Order in continuation of the audit program previously conducted under Task Order No. 58. Quantitative field audits were conducted of the Regional Air Monitoring System (RAMS) Air Monitoring Stations, Local Air Monitorin...

48 CFR 842.101 - Contract audit responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Contract audit responsibilities. 842.101 Section 842.101 Federal Acquisition Regulations System DEPARTMENT OF VETERANS AFFAIRS CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contract Audit Services 842.101 Contract...

20 CFR 416.1027 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Audits. 416.1027 Section 416.1027 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determinations of Disability Administrative Responsibilities and Requirements § 416.1027 Audits. (a) Audits...

20 CFR 404.1627 - Audits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Audits. 404.1627 Section 404.1627 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determinations of Disability Administrative Responsibilities and Requirements § 404.1627 Audits. (a) Audits...

20 CFR 404.1627 - Audits.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Audits. 404.1627 Section 404.1627 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND DISABILITY INSURANCE (1950- ) Determinations of Disability Administrative Responsibilities and Requirements § 404.1627 Audits. (a) Audits...

76 FR 20336 - Defense Audit Advisory Committee (DAAC)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-12

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

20 CFR 416.1027 - Audits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Audits. 416.1027 Section 416.1027 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Determinations of Disability Administrative Responsibilities and Requirements § 416.1027 Audits. (a) Audits...

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

DTIC Science & Technology

1988-01-01

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

Evaluation of Subcontract Price Proposals

DTIC Science & Technology

1990-04-09

This is the final report on the Audit of the Evaluation of Subcontract Price Proposals. Comments on a draft of this report were considered in...preparing the final report. We made the audit from October 1987 through May 198% The initial objectives of the audit were to evaluate procedures used by...assist audit reports were used by procurement contracting officers in negotiating contract prices. During the audit , we expanded our objectives to

DoD Actions Were Not Adequate to Reduce Improper Travel Payments

DTIC Science & Technology

2016-03-10

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

The Internal Control System and Control Programs: A Reference Guide

DTIC Science & Technology

1990-06-01

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

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.

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

PubMed

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

2015-01-01

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

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

PubMed

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

2012-12-01

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

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

PubMed Central

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

2015-01-01

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

Audit in general practice: factors influencing participation.

PubMed Central

Baker, R.; Robertson, N.; Farooqi, A.

1995-01-01

OBJECTIVE--To identify the factors influencing participation in a single topic audit initiated by a medical audit advisory group. DESIGN--Interview and questionnaire survey of general practitioners who had been invited to take part in an audit of vitamin B-12. SETTING--All 147 general practices in Leicestershire. MAIN OUTCOME MEASURES--Aspects of structure, attitude, and behaviour that influenced participation or non-participation. RESULTS--75 practices completed the audit, 49 withdrew after initial agreement, and 23 refused to take part at the outset. Participants were more likely than those who refused to view the advisory group as useful or a threat and to have positive thoughts about audit but less likely to have previously undertaken audit entailing implementation of change. Participants were more likely than those who withdrew to have positive thoughts about audit and to have discussed whether to take part within the practice but were less likely to view the advisory group as useful. The most common reason given for withdrawal was lack of time. CONCLUSIONS--Participation was influenced by attitudes towards audit in general and the advisory group in particular and by aspects of behaviour such as communication within the practice. Practical support and resources may help some practices undertake audit, but advisory groups must also deal with attitudes and unsatisfactory communication in practice teams. PMID:7613323

['Clinical auditing', a novel tool for quality assessment in surgical oncology].

PubMed

van Leersum, Nicoline J; Kolfschoten, Nikki E; Klinkenbijl, Jean H G; Tollenaar, Rob A E M; Wouters, Michel W J M

2011-01-01

To determine whether systematic audit and feedback of information about the process and outcomes improve the quality of surgical care. Systematic literature review. Embase, PubMed, and Web of Science databases were searched for publications on 'quality assessment' and 'surgery'. The references of the publications found were examined as well. Publications were included in the review if the effect of auditing on the quality of surgical care had been investigated. In the databases 2415 publications were found. After selection, 28 publications describing the effect of auditing, whether or not combined with a quality improvement project, on guideline adherence or indications of outcomes of care were included. In 21 studies, a statistically significant positive effect of auditing was reported. In 5 studies a positive effect was found, but this was either not significant or statistical significance was not determined. In 2 studies no effect was observed. 5 studies compared the combination of auditing with a quality improvement project with auditing alone; 4 of these reported an additional effect of the quality improvement project. Audit and feedback of quality information seem to have a positive effect on the quality of surgical care. The use of quality information from audits for the purpose of a quality improvement project can enhance the positive effect of the audit.

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

PubMed

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

2017-02-16

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

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.

Intrathecal baclofen therapy in paediatrics: a study protocol for an Australian multicentre, 10-year prospective audit

PubMed Central

Stewart, Kirsty; Hutana, Gavin; Kentish, Megan

2017-01-01

Introduction Increasing clinical use of Intrathecal baclofen (ITB) in Australian tertiary paediatric hospitals, along with the need for standardised assessment and reporting of adverse events, saw the formation of the Australian Paediatric ITB Research Group (APIRG). APIRG developed a National ITB Audit tool designed to capture clinical outcomes and adverse events data for all Australian children and adolescents receiving ITB therapy. Methods and analysis The Australian ITB Audit is a 10 year, longitudinal, prospective, clinical audit collecting all adverse events and assessment data across body functions and structure, participation and activity level domains of the ICF. Data will be collected at baseline, 6 and 12 months with ongoing capture of all adverse event data. This is the first Australian study that aims to capture clinical and adverse event data from a complete population of children with neurological impairment receiving a specific intervention between 2011 and 2021. This multi-centre study will inform ITB clinical practice in children and adolescents, direct patient selection, record and aid decision making regarding adverse events and investigate the impact of ITB therapy on family and patient quality of life. Ethics and dissemination This project was approved by the individual Human Research Ethics committees at the six Australian tertiary hospitals involved in the study. Results will be published in various peer reviewed journals and presented at national and international conferences. Trial registration number ACTRN 12610000323022; Pre-results. PMID:28637739

Contribution of streetscape audits to explanation of physical activity in four age groups based on the Microscale Audit of Pedestrian Streetscapes (MAPS).

PubMed

Cain, Kelli L; Millstein, Rachel A; Sallis, James F; Conway, Terry L; Gavand, Kavita A; Frank, Lawrence D; Saelens, Brian E; Geremia, Carrie M; Chapman, James; Adams, Marc A; Glanz, Karen; King, Abby C

2014-09-01

Ecological models of physical activity emphasize the effects of environmental influences. "Microscale" streetscape features that may affect pedestrian experience have received less research attention than macroscale walkability (e.g., residential density). The Microscale Audit of Pedestrian Streetscapes (MAPS) measures street design, transit stops, sidewalk qualities, street crossing amenities, and features impacting aesthetics. The present study examined associations of microscale attributes with multiple physical activity (PA) measures across four age groups. Areas in the San Diego, Seattle, and the Baltimore metropolitan areas, USA, were selected that varied on macro-level walkability and neighborhood income. Participants (n = 3677) represented four age groups (children, adolescents, adults, older adults). MAPS audits were conducted along a 0.25 mile route along the street network from participant residences toward the nearest non-residential destination. MAPS data were collected in 2009-2010. Subscale and overall summary scores were created. Walking/biking for transportation and leisure/neighborhood PA were measured with age-appropriate surveys. Objective PA was measured with accelerometers. Mixed linear regression analyses were adjusted for macro-level walkability. Across all age groups 51.2%, 22.1%, and 15.7% of all MAPS scores were significantly associated with walking/biking for transport, leisure/neighborhood PA, and objectively-measured PA, respectively. Supporting the ecological model principle of behavioral specificity, destinations and land use, streetscape, street segment, and intersection variables were more related to transport walking/biking, while aesthetic variables were related to leisure/neighborhood PA. The overall score was related to objective PA in children and older adults. Present findings provide strong evidence that microscale environment attributes are related to PA across the lifespan. Improving microscale features may be a feasible approach to creating activity-friendly environments. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.