Sapsford, R J; Lawrance, R A; Dorsch, M F; Das, R; Jackson, B M; Morrell, C; Robinson, M B; Hall, A S
The National Service Framework (NSF) for Coronary Heart Disease requires annual clinical audit of the care of patients with myocardial infarction, with little guidance on how to achieve these standards and monitor practice. To assess which method of identification of acute myocardial infarction (AMI) cases is most suitable for NSF audit, and to determine the effect of the definition of AMI on the assessment of quality of care. Observational study. Over a 3-month period, 2153 consecutive patients from 20 hospitals across the Yorkshire region, with confirmed AMI, were identified from coronary care registers, biochemistry records and hospital coding systems. The sensitivity and positive predictive value of AMI patient identification using clinical coding, biochemistry and coronary care registers were compared to a 'gold standard' (the combination of all three methods). Of 3685 possible cases of AMI singled out by one or more methods, 2153 patients were identified as having a final diagnosis of AMI. Hospital coding revealed 1668 (77.5%) cases, with a demographic profile similar to that of the total cohort. Secondary preventative measures required for inclusion in NSF were also of broadly similar distribution. The sensitivities and positive predictive values for patient identification were substantially less in the cohorts identified through biochemistry and coronary care unit register. Patients fulfilling WHO criteria (n=1391) had a 30-day mortality of 15.9%, vs. 24.2% for the total cohort. Hospital coding misses a substantial proportion (22.5%) of AMI cases, but without any apparent systematic bias, and thus provides a suitably representative and robust basis for NSF-related audit. Better still would be the routine use of multiple methods of case identification.
Egner, W; Cook, T; Harper, N; Garcez, T; Marinho, S; Kong, K L; Nasser, S; Thomas, M; Warner, A; Hitchman, J; Floss, K
Guidelines for investigation of perioperative drug allergy exist, but the quality of services is unknown. Specialist perioperative anaphylaxis services were surveyed through the Royal College of Anaesthetists 6th National Audit Project. We compare self-declared UK practice in specialist perioperative allergy services with national recommendations. A SurveyMonkey™ questionnaire was distributed to providers of allergy services in the UK. Responses were assessed for adherence to the best practice recommendations of the British Society for Allergy and Clinical Immunology (BSACI), the Association of Anaesthetists of Great Britain and Ireland and the National Institute for Health and Care Excellence (NICE) Guidance on Drug Allergy-CG183. Over 1200 patients were evaluated in 44 centres annually. Variation in workload, waiting times, access, staffing and diagnostic approach was noted. Paediatric centres had the longest routine waiting times (most wait >13 weeks) in contrast to adult centres (most wait clinic and 5/44 (11%) sign-posted support groups]. Most centres were able to provide diagnostic challenges to antibiotics [40/44 (91%]) and local anaesthetics [41/44 (93%)]. Diagnostic testing is not harmonized, with marked variability in the NMBA panels used to identify safe alternatives. Chlorhexidine and latex are not part of routine testing in many centres. Poor access to services and patient information provision require attention. Harmonization of diagnostic approach is desirable, particularly with regard to a minimum NMBA panel for identification of safe alternatives. © 2017 John Wiley & Sons Ltd.
Ross, Elliot M; Harper, Stephen A; Cunningham, Cord; Walrath, Benjamin D; DeMers, Gerard; Kharod, Chetan U
As part of a Military Emergency Medical Services (EMS) system process improvement initiative, the authors sought to objectively evaluate the U.S. military EMS system for the island of Okinawa. They applied a program evaluation tool currently utilized by the U.S. National Park Service (NPS). A comprehensive needs assessment was conducted to evaluate the current Military EMS system in Okinawa, Japan. The NPS EMS Program Audit Worksheet was used to get an overall "score" of our assessment. After all the data had been collected, a joint committee of Military EMS physicians reviewed the findings and made formal recommendations. From 2011 to 2014, U.S. military EMS on Okinawa averaged 1,345 ± 137 patient transports annually. An advanced life support (ALS) provider would have been dispatched on 558 EMS runs (38%) based on chief complaint in 2014 had they been available. Over 36,000 man-hours were expended during this period to provide National Registry Emergency Medical Technician (EMT)-accredited instruction to certify 141 Navy Corpsman as EMT Basics. The NPS EMS Program Audit Worksheet was used and the program scored a total of 31, suggesting the program is well planned and operating within standards. This evaluation of the Military EMS system on Okinawa using the NPS program assessment and audit worksheet demonstrates the NPS evaluation instruments may offer a useful assessment tool for the evaluation of Military EMS systems. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.
The object of the doctoral dissertation is financial audit service quality (further – audit service quality). The aim of the doctoral dissertation is to conceptualize audit service quality and based on the conceptual model to analyse and evaluate audit service quality in Lithuania while providing recommendations for quality improvements. The aim is achieved while applying following research methods: analysis of scientific literature, content analysis, questionnaire survey, expert judgement. ...
Reynolds, C M E; Egan, B; Cawley, S; Kennedy, R; Sheehan, S R; Turner, M J
There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.
There is international consensus that smoking cessation in the first half of pregnancy improves foetal outcomes. We surveyed all 19 maternity units nationally about their antenatal smoking cessation practices. All units recorded details on maternal smoking at the first antenatal visit. Only one unit validated the self-reported smoking status of pregnant women using a carbon monoxide breath test. Twelve units (63%) recorded timing of smoking cessation. In all units women who reported smoking were given verbal cessation advice. This was supported by written advice in 12 units (63%), but only six units (32%) had all midwives trained to provide this advice. Only five units (26%) reported routinely revisiting smoking status later in pregnancy. Although smoking is an important modifiable risk factor for adverse pregnancy outcomes, smoking cessation services are inadequate in the Irish maternity services and there are variations in practices between hospitals.
The study is done as a part of a bachelor’s study in Marketing at Laurea University of Applied Sciences. Marketing as a science appeared more than 50 years ago and is still developing. The purpose of the thesis work is to collect knowledge via marketing research, to understand how marketing is implemented by the case company–provider and compare the result to professional services marketing theory. Marketing professional services is difficult because services differ from goods. Marketing ...
Alexander, C L; Currie, S; Pollock, K; Smith-Palmer, A; Jones, B L
Giardia duodenalis and Cryptosporidium species are protozoan parasites capable of causing gastrointestinal disease in humans and animals through the ingestion of infective faeces. Whereas Cryptosporidium species can be acquired locally or through foreign travel, there is the mis-conception that giardiasis is considered to be largely travel-associated, which results in differences in laboratory testing algorithms. In order to determine the level of variation in testing criteria and detection methods between diagnostic laboratories for both pathogens across Scotland, an audit was performed. Twenty Scottish diagnostic microbiology laboratories were invited to participate with questions on sample acceptance criteria, testing methods, testing rates and future plans for pathogen detection. Reponses were received from 19 of the 20 laboratories representing each of the 14 territorial Health Boards. Detection methods varied between laboratories with the majority performing microscopy, one using a lateral flow immunochromatographic antigen assay, another using a manually washed plate-based enzyme immunoassay (EIA) and one laboratory trialling a plate-based EIA automated with an EIA plate washer. Whereas all laboratories except one screened every stool for Cryptosporidium species, an important finding was that significant variation in the testing algorithm for detecting Giardia was noted with only four laboratories testing all diagnostic stools. The most common criteria were 'travel history' (11 laboratories) and/or 'when requested' (14 laboratories). Despite only a small proportion of stools being examined in 15 laboratories for Giardia (2%-18% of the total number of stools submitted), of interest is the finding that a higher positivity rate was observed for Giardia than Cryptosporidium in 10 of these 15 laboratories. These findings highlight that the underreporting of Giardia in Scotland is likely based on current selection and testing algorithms.
Reid, Daniel Brooks; Parsons, Shaun R; Gill, Stephen D; Hughes, Andrew J
To audit written medical discharge summary procedure and practice against Standard Six (clinical handover) of the Australian National Safety and Quality Health Service Standards at a major regional Victorian health service. Department heads were invited to complete a questionnaire about departmental discharge summary practices. Twenty-seven (82%) department heads completed the questionnaire. Seven (26%) departments had a documented discharge summary procedure. Fourteen (52%) departments monitored discharge summary completion and 13 (48%) departments monitored the timeliness of completion. Seven (26%) departments informed the patient of the content of the discharge summary and six (22%) departments provided the patient with a copy. Seven (26%) departments provided training for staff members on how to complete discharge summaries. Completing discharge summaries was usually delegated to the medical intern. The introduction of the National Service Standards prompted an organisation-wide audit of discharge summary practices against the external criterion. There was substantial variation in the organisation's practices. The Standards and the current audit results highlight an opportunity for the organisation to enhance and standardise discharge summary practices and improve communication with general practice.
The aim of the article. Aim of the article is to characterize the logistics audit essence, to form main stages of the logistic service audit and to observe informational providing of these stages, to characterize behavior model concerning logistic service factors analysis. The results of the analysis. The given work deals with logistic audit value and its essence, which is determined as representing sources of the spare logistic expenses and investigates plan for further actions concerning...
Liviu Adrian COTFAS
Full Text Available The Service Oriented Architecture (SOA approach enables the development of flexible distributed applications. Auditing such applications implies several specific challenges related to interoperability, performance and security. The service oriented architecture model is described and the advantages of this approach are analyzed. We also highlight several quality attributes and potential risks in SOA applications that an architect should be aware when designing a distributed system. Key risk factors are identified and a model for risk evaluation is introduced. The top reasons for auditing SOA applications are presented as well as the most important standards. The steps for a successful audit process are given and discussed.
Schelleman, C.C.M.; Maijoor, S.J.
To compete effectively in an increasingly competitive audit market audit firms need information on the efficiency of the audit services they offer. This study reports on the cost and labor efficiency for a sample of 114 audit engagements conducted by one of the (then) Big 6 audit firms. Estimating the efficiency of audit engagements is a form of benchmarking, of which economics oriented research has seen many applications. The application to auditing however is, as far as we know, relatively ...
Johansen, Antony; Golding, David; Brent, Louise
. These national audits provide a unique opportunity to compare how health care systems of different countries are responding to the same clinical challenge. This review will encourage the development and reporting of a standardised dataset to support international collaboration in healthcare audit....... to audit the care offered to older people by health services around the world. We have reviewed the reports of eight national audit programmes, to examine the approach used in each, and highlight differences in case mix, management and outcomes in different countries. The national audits provide...
Berkovitz, Saul; Cummings, Mike; Perrin, Chris; Ito, Rieko
Recent research has established the efficacy, effectiveness and cost effectiveness of acupuncture for some forms of chronic musculoskeletal pain. However, there are practical problems with delivery which currently prevent its large scale implementation in the National Health Service. We have developed a delivery model at our hospital, a 'high volume' acupuncture clinic (HVAC) in which patients are treated in a group setting for single conditions using standardised or semi-standardised electroacupuncture protocols by practitioners with basic training. We discuss our experiences using this model for chronic knee pain and present an outcome audit for the first 77 patients, demonstrating satisfactory initial (eight week) clinical results. Longer term (one year) data are currently being collected and the model should next be tested in primary care to confirm its feasibility.
Morton, Neil S; Errera, Agata
A prospective audit of neonates, infants, and children receiving opioid infusion techniques managed by pediatric acute pain teams from across the United Kingdom and Eire was undertaken over a period of 17 months. The aim was to determine the incidence, nature, and severity of serious clinical incidents (SCIs) associated with the techniques of continuous opioid infusion, patient-controlled analgesia, and nurse-controlled analgesia in patients aged 0-18. The audit was funded by the Association of Paediatric Anaesthetists (APA) and performed by the acute pain services of 18 centers throughout the United Kingdom. Data were submitted weekly via a web-based return form designed by the Document Capture Company that documented data on all patients receiving opioid infusions and any SCIs. Eight categories of SCI were identified in advance, and the reported SCIs were graded in terms of severity (Grade 1 (death/permanent harm); Grade 2 (harm but full recovery and resulting in termination of the technique or needing significant intervention); Grade 3 (potential but no actual harm). Data were collected over a period of 17 months (25/06/07-25/11/08) and stored on a secure server for analysis. Forty-six SCIs were reported in 10 726 opioid infusion techniques. One Grade 1 incident (1 : 10,726) of cardiac arrest occurred and was associated with aspiration pneumonitis and the underlying neurological condition, neurocutaneous melanosis. Twenty-eight Grade 2 incidents (1 : 383) were reported of which half were respiratory depression. The seventeen Grade 3 incidents (1 : 631) were all drug errors because of programming or prescribing errors and were all reported by one center. The overall incidence of 1 : 10,000 of serious harm with opioid infusion techniques in children is comparable to the risks with pediatric epidural infusions and central blocks identified by two recent UK national audits (1,2). Avoidable factors were identified including prescription and pump programming errors
Laing, Gregory Kenneth
There is a growing demand in higher education for universities to introduce teaching methods that achieve the learning outcomes of vocational education. The need for vocational educational outcomes was met in this study involving a service learning activity designed to provide basic professional auditing competencies. The details of the design and…
Zhang, Yu (Elli); Hay, David; Holm, Claus
We examine the effect on auditor independence of auditors providing non-audit services in the Norwegian audit market. We report the results of three tests of independence of mind and one test of independence in appearance. These tests find that there is a positive relationship between audit fees......-audit services and the frequency with which auditors issue modified audit opinions. There is no association between non-audit services and audit tenure. Finally, we examine the relationship between unexpected or excess non-audit fees and cost of capital. There is no relationship. Our findings fail to find any...... evidence for loss of independence of mind or loss of independence of appearance as a result of providing non-audit services....
Шигун, Марія Михайлівна; Гаргола, Ю. Г.
The necessity of setting qualification requirements to the experts of audit firms who are not auditors by profession but are engaged in the process of rendering audit services has been grounded. The specificity of evaluating labor-intensity while rendering audit services has been disclosed.
Underwood, P; Beck, P
To assess local uptake of treatments for secondary prevention of myocardial infarction and compare with targets in the National Service Framework (NSF) for coronary heart disease. Retrospective audit of case notes with follow up questionnaire at 1 year. Teaching hospital and community. 100 patients alive in December 1998 who had been admitted with an acute myocardial infarction between October 1997 and October 1998. Local use of aspirin, beta blockers, ACE inhibitors, and statins. Unless contraindicated, discharge aspirin use was 100%, beta blocker use 84%, statin prescription and/or provision of dietetic advice 66% and ACE inhibitors where any heart failure was found was 97%. 1-2 years later total cholesterol remained greater than 5.0 mmol/l in 25% of patients, 24% had stopped beta blockers, and ACE inhibitors remained at a low dose in half of those surveyed. The NSF for coronary heart disease states that by April 2002 80-90% of patients should be prescribed appropriate secondary prevention. This had nearly been achieved at hospital discharge in 1999. However, follow up indicated problems in ongoing care with cholesterol targets not always being achieved, beta blockers often being stopped, and ACE inhibitors frequently remaining at low doses. Gaining maximum benefit from treatment depends on these secondary targets also being achieved. In these aspects of secondary prevention the NSF represents only an initial step towards effective prevention of coronary heart disease; perhaps the most difficult and expensive steps are yet to be fully realised.
... directory. 42.103 Section 42.103 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION... audit services directory. (a) DCAA maintains and distributes the Directory of Federal Contract Audit Offices. The directory identifies cognizant audit offices and the contractors over which they have...
Bolden, R.; O Regan, N
This interview with Lord Michael Bichard, one of the most distinguished public sector leaders in the UK, explores his ideas around the relationship between leadership, creativity and innovation. A champion of place-based approaches to public services, where citizens are actively involved in service design, delivery and appraisal, Bichard advocates the need for inclusive and supportive leadership that enables the emergence of the kinds of creativity required to respond to the financial challen...
Patrick Krauss; Henning Zülch
.... Using a sample of 1,008 firm observations of major German listed companies for the sample period 2004-2011, our study is one of the first to thoroughly analyze this issue empirically for the German audit market...
Establishment of the Auditing National Service of quality to the instrumentation of Nuclear medicine in Cuba; Establecimiento del Servicio Nacional de Auditorias de calidad a la instrumentacion de medicina nuclear en Cuba
Varela C, C.; Diaz B, M. [Centro de Control Estatal de Equipos Medicos (CCEEM), Calle 4 No. 455 (altos) e/ 19 y 21 Vedado, Ciudad Habana (Cuba); Lopez B, G.M. [CPHR, Calle 20 No. 4113 e/ 41 y 47, Playa, Ciudad Habana (Cuba); Torres A, L.A.; Coca P, M.A. [Centro de Investigaciones Clinicas, Calle 34 No. 4501, e/ 45 y 47, Roto Kohly, Playa, Ciudad Habana (Cuba)]. e-mail: email@example.com
Next to the vertiginous development of the technology in the Nuclear Medicine field, the possibility of early diagnosis of pathological processes without anatomical alterations, as well as its application with therapeutic purposes in the cancer treatment has grown. To assure a diagnosis and adapted therapy, it is vital to establish quality guarantee programs to the instrumentation. The State Medical Equipment Control Center (CCEEM), as regulator organ attributed to the Public Health Ministry of Cuba, it has licensed the Service of Quality Audits to the Nuclear medicine services, fulfilling all the technical and legal requirements to such effect. As base of these, the National Protocol for the Quality Control of the Instrumentation in Nuclear Medicine has been implemented, put out in vigour 2 national regulations, and an inter-institutional and multidisciplinary auditor equipment has been licensed. The different followed steps, as well as the realization of the first quality audits, its show not only a better execution of the tests and bigger professionalism of the involved specialists, but an increment in the taking of conscience to apply adequately the quality concepts for achieving a better service to the patient. On the other hand, the necessity of incorporating the clinical aspects to the audits, fomenting an integral harmonized advance of the quality guarantee programs is evidenced. (Author)
.... AR 36-7 was issued 20 June 1985 (para 7d). Adds U.S. Army Criminal Investigation Command, DOD Inspector General and the General Accounting Office to the section on coordination of audit programs and schedules (para 8a...
Sanja Sever Mališ
Full Text Available The audit reform in the EU had as a consequence the adoption of the new regulatory framework. The European Parliament adopted Directive 2014/56/EU amending the Directive 2006/43/EC on statutory audit in the EU and the EU Regulation No. 537/2014 containing requirements that relate specifically to the statutory audit of public interest entities. Each Member State needs to transpose the Directive into its national legislation and also ensure its implementation. Within the framework of transposing the Directive into the national regulation, each Member State had many options that allows them to tailor the provisions of the national law according to their needs and specific aspects of the national audit markets. However, the number of options brings risks that are connected to additional audit procedures and inefficiencies in the process of performing audit with the potential effects on the quality and cost of audits. The aim of this article is to analyse the most important (not used options of the Directive and Regulation according to the Croatian national legislation. In that sense, the article provides information about the definition of statutory audit and the subjects of statutory audit as well as the definition of public interest entities in Croatia. In addition, the audit profession in Croatia is analysed in the context of the “European audit passport”. The results of this research can be a base for future comparisons between Croatia and the other EU Member States. Finally, the implementation of this provisions will answer the question: Does the implementation of different options bring convergence or divergence within the single EU audit services market?
Purpose: The individual EU Member States have options on how they implement the new statutory audit framework in Europe. They may introduce stricter rules or apply certain exemptions where deemed appropriate. Denmark exemplifies Member States with a traditionally high level of non-audit services...... Member States, but for certain countries like Denmark, there will be greater effects on the future provision of non-audit services....... provided by its auditors. The aim of this study is to contrast the minimum implementation rationale observed in the Danish implementation process with an ex ante examination of fee dependency. Design/methodology/approach: The audit reform introduces a cap on non-audit fees which implies a regulator...
Full Text Available Tax audit is an important part of tax control. It’s aimed to control the observance of tax legislation on taxes and fees. The purpose of the research is to generalize the method of performance of tax audits of individual taxpayers by State Fiscal Service of Ukraine. The subject of research is the methods of audit by State Fiscal Service of Ukraine. Methods. It was used general and specific methods of research, including: analysis and synthesis, system and process approaches, induction and deduction, etc. Results. The problem of tax auditing process in Ukraine is the absence of integrated and systematic approach for its implementation. Unfortunately, the practice of the tax audit is not yet examined clearly. Today the basic principles of tax audit are considered by the scientists only in theory. Apart from the existence of guidelines on verification of a particular type of taxes, other obligatory payments that are designed fiscal service, the formation of evidence, procedure for using certain methods and techniques for auditing, information sources are ignored legislators and scientists. Apart from the existence of guidelines on verification of a particular type of taxes, other obligatory payments which are designed by fiscal service, the formation of evidence base, procedure of usage of certain methods and techniques for audit, information sources and other issues are ignored by legislators and scientists. Despite this, today the tax audit is a tool to fully examine and reduce the tax risks of the organization. Another problem of tax audit is that legislation doesn’t fix the notion of tax audit so there is no exact interpretation of it. Tax audit engages more efficient flow of taxes and fees to the state budget. Although there is increase of the efficiency of the national tax auditing mechanism now, but there are some problems which need be resolved in order to ensure rational tax revenues in the budget under the present conditions of socio
Full Text Available A auditoria, na saúde, verifica os processos e resultados da prestação de serviços, pressupondo o desenvolvimento de um modelo de atenção adequado, de acordo com as legislações vigentes. Nesta pesquisa, objetivou-se analisar as atividades da auditoria no Sistema Único de Saúde no serviço de saúde bucal, buscando demonstrar as ações e a sua inserção nas três esferas de governo. Foram realizadas análise documental e levantamentos bibliográficos sobre os sistemas de auditoria e o papel do auditor no serviço odontológico desde 1969. Os resultados mostraram que foram encontrados seis artigos sobre auditoria odontológica no SUS e que a atuação do auditor odontológico é abrangente no gerenciamento do sistema, consistindo no controle, na avaliação, na supervisão e na orientação, bem como na garantia da participação social e acesso aos serviços. Na saúde bucal o auditor analisa, monitora e fiscaliza o planejamento das estratégias e os procedimentos efetuados; realiza o cadastramento dos profissionais, das unidades de saúde e a programação física orçamentária; viabiliza os dados para o sistema de informação e o pagamento dos serviços prestados; examina o cumprimento das pactuações, dando um enfoque educativo e não mais policialesco à resolubilidade dos problemas. Conclui-se que existem poucos estudos sobre auditoria odontológica no SUS e que o sistema de auditoria é um instrumento administrativo confiável e essencial para os gestores no desenvolvimento das ações de saúde.Auditing in health verifies processes and results in the provision of services, assuming the development of an adequate care model in accordance with the current legislation. In this research, the goal was to analyze the auditing activities within the Brazilian National Health System, in the oral health service, aiming to demonstrate the actions and their inclusion in the three governmental spheres. Documental analyses were undertaken
Clinical Audit plays an important role in the evaluation of care and clinical outcomes for all patients. In conjunction with the respiratory nurse specialist a retrospective chart audit of the regional lung cancer service was undertaken at the Midlands Regional Hospital Mullingar (MRHM). The lung cancer service has been established for four years and has set its standards in line with NICE guidelines and Irish guidelines for the clinical management of lung cancer. An audit tool was developed by the audit facilitator in conjunction with the respiratory nurse specialist and key department personnel. The tool aimed to measure length of time taken for key steps in the patients care pathway. A pilot audit was carried out and the tool was evaluated. The audit tool provided accurate recording of information at key points in the patient’s care which allows for a thorough service evaluation. The data collected and analysed gives vital information on the quality of service, and showed where there are deficits in service provision that need to be addressed.
Full Text Available A road safety audit is a formal analysis that seeks to guarantee that an existing or future road fulfills optimal safety criteria, conducted by a team of experts who se members are independent of the road project. It can be carried out in one, several or all of the stages of the project (planning, design, construction, before opening the road to traffic, and operation. The development and implementation of a road safety audit process is one of the strategies that have been applied in Mexico in recent years to reduce road accidents and their associated consequences. The objective of this work is to present the procedures that have been developed and applied in Mexico, as well as the benefits and problems that have been encountered. The application of those procedures to a specific case is also shown. Emphasis is made in the audit of high ways in the operation stage, which is the type that greater application and development has had in Mexico.
Welcome to the U.S. Department of Energy's (DOE's) energy auditing tool, called ''NEAT.'' NEAT, an acronym for National Energy Audit Tool, a program for personal computers that was designed for use by local agencies in the Weatherization Assistance Program. It is an approved alternative audit that meets all auditing requirements set forth by the Program. NEAT is easy to use. It applies engineering and economic calculations to evaluate energy conservation measures for single-family, detached houses or small multifamily buildings. You can use it to rank measures for each individual house, or to establish a priority list of conservation measures for nearly identical housing types. NEAT was written for the Weatherization Assistance Program by Oak Ridge National Laboratory. Many building energy consumption algorithms are taken from Lawrence Berkeley Laboratory's Computerized Instrumented Residential Audit (CIRA), published in 1982 for the Department of Energy. Equipment retrofit conservation measures are based on published reports on various heating retrofits. Heating and cooling system replacement conservation measures are based on the energy ratings of new heating and cooling equipment. The Weatherization Program anticipates that this computer-based energy audit will offer substantial performance improvements to many states who choose to incorporate it into their programs. When conservation measures are evaluated locally according to climate, fuel cost, measure cost, and existing house conditions, the Program will be closer to its goal of assuring the maximum return for every federal dollar spent.
The Model Audit is a free technical assistance resource for voluntary use by utilities. The manual contains procedures for customer interviews, residence inspections, and cost and saving calculations. Data forms, calculation aids, weather and other data, and a section on presenting results to the customer are included. This revision incorporates updates issued on the original February 1980 version: improved calculational procedures for cooling load, replacement air conditioners, solar domestic hot water, thermosiphon air panels, sunspaces, and new procedures for several state-added measures.
Sarah Putri Ramadhani
Full Text Available SubDirektorat Layanan Teknologi dan Sistem Informasi pada Direktorat Pengembangan Teknologi dan Sistem Informasi (DPTSI sebagai penyedia layanan TI di lingkungan Institut Teknologi Sepuluh Nopember (ITS tidak sedikit mengalami gangguan atau insiden yang mengakibatkan menurunnya kualitas pelayanan yang diberikan. Oleh karena itu terdapat unit service desk yang bertugas menangani berbagai macam keluhan insiden dan memenuhi permintaan layanan TI. Namun DPTSI belum pernah mengadakan pengendalian internal terhadap prosesnya. Untuk memastikan pengelolaan telah diterapkan dalam kontrolnya maka perlu sebuah metode yaitu audit internal. Salah satu hal yang perlu disiapkan dalam melaksanakan audit adalah perangkat audit karena menyediakan serangkaian instruksi dari proses yang harus dilakukan service desk sehingga membantu seorang auditor dalam menjalankan audit sesuai dengan tujuan dan memastikan seluruh proses telah dilakukan. Berdasarkan permasalahan tersebut, penelitian ini mengembangkan perangkat audit pada service desk DPTSI yang dibuat berdasarkan control objective pada Service Desk Standard yang dipetakan dengan proses pada best practice COBIT 5 domain DSS02. Ruang lingkup perangkat audit juga ditetapkan melalui control objective yang dipetakan dengan risiko TI pada service desk yang dianalisis menggunakan pendekatan best practice COBIT 5 for Risk APO12 Manage Risk. Hasil dari penelitian ini adalah sebuah dokumen perangkat audit beserta panduan penggunaannya, yang nantinya diharapkan dapat membantu DPTSI untuk melakukan audit pada service desk..
Humphreys, Clare; Railton, Cathie; O'Moore, Éamonn; Lombard, Martin; Newton, Autilia
Prisons are an important setting to address prevention, testing and treatment of hepatitis C virus (HCV) and other blood-borne viruses. This audit examined current practice against national standards in a representative sample of prisons in England. The audit tool was developed based on best practice guidelines and piloted in one prison. In December 2012, the audit was conducted in a further 20 prisons, which were chosen to represent different types, sizes and geographical spread across England. Testing for HCV was offered in the majority of prisons audited (20 of 21), but only two-thirds had a written policy on testing and treatment; less than a third had a steering group to oversee the process. The nature of services varied greatly. There were inconsistencies across data sources on testing. This audit found that while there were many areas of good practice, the quality and content of hepatitis C service provision varied. It highlighted the need to provide appropriate guidance for prisons in delivering a high-quality service, ensuring that relevant training is available for different staff and that adequate psychosocial support is provided to patients. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
A pre- and post-intevention randomized cross-sectional study was carried out from January to February and April to May 2001, respectively, to audit and intervene in the timeliness of health services delivery in an Emergency Paediatric Unit (EPU) of Jos University Teaching Hospital. A structured questionnaire was used to ...
Aim. To audit the community psychiatric services in southern Gauteng with a view to determining whether the objectives of the country\\'s mental health legislation and policies are being achieved. Results. Although southern Gauteng\\'s community psychiatric clinics are situated in a primary health setting, primary health ...
Full Text Available Purpose of the research is to ensure the securities of information system asset and to ensure if informa-tion system support the operational and data collected was valid. Research method that used in this research were library studies and field studies. Field studies such an observation, questioner, and inter-view. the expected result are founding the weakness of security management control, operational man-agement control, input control, and output control of risk happened in the company. Conclusion of this research are the system on the company work good and there’s no potential risk happened and make an impact to the delivery process of information system.Index Terms - Auditing Information system, Delivery product process.
Ladislav Kareš; Petra Krišková
The article dealt with institutional aspects of auditing profession, mostly their impact on international harmonization concept of auditing services. The authors of the article mention on importance and tasks of the institution - the IAASB - The International Auditing and Assurance Standards Board, by compiling of strategy of auditing services behavior and development, mostly in context of providing the auditing services. The authors mention on the IAASB priorities in this area set for period...
Full Text Available Questions of energetic audit realization of housing and communal services and small enterprises are examined in the paper. Particular details of each stage of energetic audit implementation are discussed. The methodology of power audit on an example of a small enterprise is shown. Priorities at formation power consuming objects audit stages are proved. Results and recommendations about energy-saving and resource-saving actions based on performed audit are shown as well.
INTOSAI) Code of Ethics and Auditing Standards (2001), performance auditing is an audit of the economy, efficiency and effectiveness with which the audited entity uses its resources in carrying out its responsibilities. Larsson (2004) asserts that the ...
.... The Government Auditing Standards (GAS) require that an audit organization performing audits and/or attestation engagements in accordance with GAS should have an appropriate internal quality control system in place and undergo an external...
Krigger, J.K.; Adams, N. [Saturn Resource Management, Helena, MT (United States); Gettings, M. [Oak Ridge National Lab., TN (United States). Energy Div.
Welcome to the US Department of Energy`s (DOE`s) energy auditing tool called ``NEAT``. NEAT, an acronym for National Energy AudiT, is a program for personal computers that was designed for use by local agencies in the Weatherization Assistance Program. It is an approved alternative audit that meets all auditing requirements set forth by the program as well as those anticipated from new regulations pertaining to waiver of the 40% materials requirements. NEAT is easy to use. It applies engineering and economic calculations to evaluate energy conservation measures for single-family, detached houses or small multifamily buildings. You can use it to rank measured for each individual house, or to establish a priority list of conservation measures for nearly identical housing types. NEAT was written for the Weatherization Assistance Program by Oak Ridge National Laboratory. Many buildings energy consumption algorithms are taken from Lawrence Berkeley Laboratory`s to the computerized Instrumented Residential Audit (CIRA), published in 1982 for the Department of energy. Equipment retrofit conservation measures are based on published reports on various heating retrofits. Heating and cooling system replacement conservation measures are based on the energy ratings of new heating and cooling equipment. The Weatherization Program anticipates that this computer-based energy audit will offer substantial performance improvements to many states who choose to incorporate it into their programs. When conservation measures are evaluated locally according to climate, fuel cost, measure cost, and existing house conditions, the Program will be closer to its goal of assuring the maximum return for every federal dollar spent.
Full Text Available Single gene tests to predict whether cancers respond to specific targeted therapies are performed increasingly often. Advances in sequencing technology, collectively referred to as next generation sequencing (NGS, mean the entire cancer genome or parts of it can now be sequenced at speed with increased depth and sensitivity. However, translation of NGS into routine cancer care has been slow. Healthcare stakeholders are unclear about the clinical utility of NGS and are concerned it could be an expensive addition to cancer diagnostics, rather than an affordable alternative to single gene testing.We validated a 46-gene hotspot cancer panel assay allowing multiple gene testing from small diagnostic biopsies. From 1 January 2013 to 31 December 2013, solid tumour samples (including non-small-cell lung carcinoma [NSCLC], colorectal carcinoma, and melanoma were sequenced in the context of the UK National Health Service from 351 consecutively submitted prospective cases for which treating clinicians thought the patient had potential to benefit from more extensive genetic analysis. Following histological assessment, tumour-rich regions of formalin-fixed paraffin-embedded (FFPE sections underwent macrodissection, DNA extraction, NGS, and analysis using a pipeline centred on Torrent Suite software. With a median turnaround time of seven working days, an integrated clinical report was produced indicating the variants detected, including those with potential diagnostic, prognostic, therapeutic, or clinical trial entry implications. Accompanying phenotypic data were collected, and a detailed cost analysis of the panel compared with single gene testing was undertaken to assess affordability for routine patient care. Panel sequencing was successful for 97% (342/351 of tumour samples in the prospective cohort and showed 100% concordance with known mutations (detected using cobas assays. At least one mutation was identified in 87% (296/342 of tumours. A locally
Hamblin, Angela; Wordsworth, Sarah; Fermont, Jilles M; Page, Suzanne; Kaur, Kulvinder; Camps, Carme; Kaisaki, Pamela; Gupta, Avinash; Talbot, Denis; Middleton, Mark; Henderson, Shirley; Cutts, Anthony; Vavoulis, Dimitrios V; Housby, Nick; Tomlinson, Ian; Taylor, Jenny C; Schuh, Anna
Single gene tests to predict whether cancers respond to specific targeted therapies are performed increasingly often. Advances in sequencing technology, collectively referred to as next generation sequencing (NGS), mean the entire cancer genome or parts of it can now be sequenced at speed with increased depth and sensitivity. However, translation of NGS into routine cancer care has been slow. Healthcare stakeholders are unclear about the clinical utility of NGS and are concerned it could be an expensive addition to cancer diagnostics, rather than an affordable alternative to single gene testing. We validated a 46-gene hotspot cancer panel assay allowing multiple gene testing from small diagnostic biopsies. From 1 January 2013 to 31 December 2013, solid tumour samples (including non-small-cell lung carcinoma [NSCLC], colorectal carcinoma, and melanoma) were sequenced in the context of the UK National Health Service from 351 consecutively submitted prospective cases for which treating clinicians thought the patient had potential to benefit from more extensive genetic analysis. Following histological assessment, tumour-rich regions of formalin-fixed paraffin-embedded (FFPE) sections underwent macrodissection, DNA extraction, NGS, and analysis using a pipeline centred on Torrent Suite software. With a median turnaround time of seven working days, an integrated clinical report was produced indicating the variants detected, including those with potential diagnostic, prognostic, therapeutic, or clinical trial entry implications. Accompanying phenotypic data were collected, and a detailed cost analysis of the panel compared with single gene testing was undertaken to assess affordability for routine patient care. Panel sequencing was successful for 97% (342/351) of tumour samples in the prospective cohort and showed 100% concordance with known mutations (detected using cobas assays). At least one mutation was identified in 87% (296/342) of tumours. A locally actionable
Mehay, Anita; Raj, Thara; Altass, Lynn; Newton, Autilia; O'Moore, Eamonn; Railton, Cathie; Tan, Hong; Story, Al; Frater, Alison
Tuberculosis (TB) is the second leading cause of death worldwide due to a single infectious agent. Rates of active TB in places of prescribed detention (PPD), which include Prisons, Young Offender Institutions and Immigration Removal Centres, are high compared with the general population. PPD therefore present an opportunity to develop targeted health programmes for TB control. This audit aims to assess current service provisions and identify barriers to achieving best practice standards in PPD across London. Twelve healthcare teams within PPD commissioned by NHS England (London Region) were included in the audit. Services were evaluated against the National Institute for Health and Care Excellence standards for TB best practice. None of the health providers with a digital X-ray machine were conducting active case finding in new prisoners and no health providers routinely conduct Latent TB infection testing and preventative treatment. Barriers to implementing standards include the lack of staff skills and staff skills mix, structural and technical barriers, and demands of custodial and health services. This audit restates the importance of national public health TB strategies to consider healthcare provisions across PPD.
Malhotra, Mini [ORNL; MacDonald, Michael [Sentech, Inc.; Accawi, Gina K [ORNL; New, Joshua Ryan [ORNL; Im, Piljae [ORNL
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. Weatherization 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
Provision of non-audit services is of increasing economic importance for audit firms Especially provision to non-audit clients Wide range of offered services From detection to prevention, from bribery to fraud to violation of code of conduct Small, but growing market with Big 4 as clear leaders Wide variety of backgrounds of forensic services professionals Consequently, diverse portfolio of methods Most research focuses on fraud with some high-quality publications Miss...
The Brain and Spine Foundation (BSF) has produced a web based information access toolkit for health and social care professionals and primary care trust service commissioners to support implementation of the national service framework for long term neurological conditions.
Full Text Available Tightening the requirements for the audit profession and improving the quality of non-audit services led to best practice sharing of such services. The article analyzes the key trends in the provision of non-audit services in Ukraine in the context of implementing global experience. The comparative analysis of the requirements for separation of audit and non-audit services is conducted. The need for harmonization to ensure the independence of auditors in Ukraine is grounded. The author gives the particular attention to contemporary approaches to the regulation of such services in the EU and the US. So, the deep analysis of Directive 2014/56/EU «On statutory audits of annual accounts and consolidated accounts», Directive 2014/95/EU «Оn disclosure of non-financial and diversity information» and Sarbanes-Oxley Act is used by authors. In this regard, the gaps in regulatory control of audit and non-audit services in Ukraine are identified and the ways of their solution in the context of the reform of audit and convergence of accounting and auditing standards are underlined.
Al-Abri, Mohammed A; Al-Hashmi, Khamis M; Jaju, Deepali; Al-Rawas, Omar A; Al-Riyami, Bazdawi M; Hassan, Mohammed O
To audit the sleep service at Sultan Qaboos University Hospital (SQUH), Muscat, Oman, and to explore deficiencies to introduce new measures of improvement. Polysomnography (PSG) reports and SQUH medical records of all patients who underwent sleep studies from January 1995 to December 2006 in the sleep laboratory at SQUH were reviewed and analyzed. Out of a total of 1042 sleep studies conducted in the specified period, 768 PSG recordings were valid for analysis. The audit showed that the Otolaryngology Department was the main referring specialty for PSG (43%). Snoring was the main symptom for 33% of the subjects referred, but suspicion of obstructive sleep apnea was the main reason for referral (38%). Three quarters of the patients were males who were also younger, and with lower body mass index compared to females (p=0.0001 for all). Despite large number of patients with an apnea-hypopnea index of >15 (n=261), only 94 (36%) patients received continuous positive airway pressure titrations and treatment. The sleep medicine service in SQUH provided the basic service, and raised the awareness of the importance of this specialty. However, substantial effort is required to bring it to international standards.
Osberger, Mary Joe
This article reviews normal processes of hearing and speech perception, including developmental stages involved in audition. A historical review of nonelectronic and electronic amplification systems, including cochlear implants and vibrotactile aids, auditory assessment procedures, and acoustic and multisensory auditory training methodologies and…
An audit was undertaken in 2009 to determine the success of the new national orthodontic referral protocol introduced to the Health Service Executive (HSE) in 2007 and operated in the Dublin Mid-Leinster HSE region. It was repeated in 2011 to determine if the HSE austerity measures have had a bearing on the orthodontic service performance in the Dublin Mid-Leinster HSE region. The audit also measured the success of referring practitioners in identifying the correct Index of Orthodontic Treatment Need (IOTN) classification of the patient. In the 2011 audit, the figures were broken down to identify the occlusal variables that caused dental practitioners most difficulties in identification. The audit demonstrates a good referral to assessment timeframe in 2009 (85-80% compliance for IOTN 5 and 4 within three to six months, respectively), which deteriorates significantly in 2011 (26-4% for IOTN 5 and 4 within three to six months, respectively). The ability of dentists to identify the correct IOTN classification was better in 2009 (60% correct) compared to 2011 (51% correct), but both figures fell below the audit standard of 75% of referrals with correct IOTN classifications. The IOTN occlusal dental health components most readily identified by referring practitioners and meeting audit standards were 5a (overjet >9mm), 5i (impacted teeth) and 5h (extensive hypodontia). The remaining occlusal dental health components in the HSE IOTN fell below the audit standard. The audit clearly identifies a requirement for a continued educational effort to maintain the HSE IOTN skill base in primary care, and a need for additional resources to manage the demand for orthodontic assessments.
Project #OA-FY12-0570, November 29, 2012. The EPA Office of Inspector General (OIG) plans to begin the fieldwork phase of our audit of EPA’s customer service help desks, hotlines, and clearinghouses (customer service lines).
Corporation for National and Community Service, 2017
The Corporation for National and Community Service (CNCS) is a federal agency that annually engages millions of Americans in service and volunteering at more than 50,000 sites across the country. Senior Corps and AmeriCorps members play a vital role in helping communities design and implement locally determined, results-driven, cost-effective…
Samson A. Adediran; Mary Josiah; Clement E. Ozele; Sule U. Veronica
Small businesses are important to the Nigerian economy. As a developing economy, the investment of vast wealth and resources in small businesses and the auditing of their business are very crucial to the financial growth and prosperity of the economy. The aim of this study is to present the results of a systematic inquiry about the state of demand and supply of accounting and audit services for small businesses in Nigeria particularly Edo State using a sample of small businesses and audit fir...
Anderson, Peter; Fee, Peter; Shulman, Rob; Bellingan, Geoffrey; Howell, David
A comprehensive review of the clinical audit programme in a teaching hospital intensive care unit. A retrospective analysis of the clinical audit projects undertaken within the intensive care unit over the preceding 2 years and compared with published national guidelines for clinical audit. A 27-bedded teaching hospital intensive care unit in the UK. Each audit project was reviewed independently by two assessors. The following questions were assessed. 1. Were the projects true audits? 2. Were they prospective of retrospective? 3. Did the projects have input from appropriate members of the multidisciplinary team. 4. How many of the audit projects were re-audits? 5. Of the re-audits how many showed evidence of service improvement? each audit project was also scored against the Audit Project Assessment Tool produced by the UK Clinical Governance Support Team. Of the twenty five audit projects reviewed twenty two were considered to be true audits. All of the projects used only retrospective data. Audit projects were contributed from all sections of the multidisciplinary critical care team but there were few truly multidisciplinary projects. Four of the audit projects were re-audits, of these three showed service improvement and one showed deterioration. Of the twenty two true audit projects reviewed, eleven were classified as good quality projects using the Audit Project Assessment Tool. Despite the clinical audit programme being active and well supported, objective evidence of clinical governance benefit was lacking. The overall clinical audit programme has been revitalised by a series of improvements since undertaking this review and this approach is recommended to other organizations who are interested in improving their clinical audit performance.
Background: Community mental health services (CMHS) are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an ...
Beck, Tanja; Diaz del Castillo, Patricia; Fovet, Frederic; Mole, Heather; Noga, Brodie
This article presents out an outcome analysis of a Universal Design (UD) audit to the various professional facets of a disability service (DS) provider's office on a large North American campus. The context of the audit is a broad campus-wide drive to implement Universal Design for Learning (UDL) in teaching practices. In an effort for consistency…
This article reports on records management findings emanating from performance audits conducted by the Office of the Auditor General (OAG) at selected offices covering the financial years 2003-04 to 2007-08. The performance audits were conducted at the Ministryof Trade and Industry (MTI), Kgatleng Land Board (KLB), ...
The aim of this study was to audit the availability of GI facilities in the provincial sector, which provides care for the majority of people in the Western Cape. Method. All hospitals in the Western Cape providing endoscopy were evaluated by means of a hands-on audit, to identify available organisational infrastructure.
Carter, L M; Layton, S
Local studies have shown an increase in cervicofacial infections of dental origin presenting to oral and maxillofacial surgery units in the UK. A lack of access to National Health Service (NHS) primary care dental services has been implicated as a root cause. Cross-sectional national audit.Method Oral and maxillofacial surgery units in the UK were asked to report details of severe cervicofacial infection of dental origin presenting in October and November 2006. Data were collected regarding: patient demographics, referral source, management in primary care, management by maxillofacial surgery, and outcome. Two hundred and sixty-six episodes of cervicofacial infection of dental origin were reported during the audit period. At the time of presentation, 56.4% of patients were registered with a general dental practitioner (GDP). One hundred and forty (52.6%) patients sought treatment from primary care dental services for their episode of cervicofacial infection and only 20 patients were unsuccessful in obtaining treatment. Forty-seven percent of patients did not seek treatment from primary care dental services. Fifty percent of patients were referred by accident and emergency. Sixty-six percent of patients were prescribed oral antibiotics without operative intervention by primary dental care services. Eighty-one percent of patients required hospital admission and 46% of patients required a surgical procedure under general anaesthesia. Eighty-nine percent of patients made a full recovery and 3% recovered with complications. There were no deaths reported during the audit period. This audit provides a benchmark from which future comparisons can be made and by design cannot prove an increase in the presentation of cervicofacial infection of dental origin. Lack of access to NHS primary care dental services may be less significant than originally thought. A significant proportion of patients preferentially present to primary care medical services rather than dental services
This report documents the results of the Routine Environmental Audit of the Sandia National Laboratories, Livermore, California (SNL/CA). During this audit the activities the Audit Team conducted included reviews of internal documents and reports from preview audits and assessments; interviews with US Department of Energy (DOE), State of California regulators, and contractor personnel; and inspections and observations of selected facilities and operations. The onsite portion of the audit was conducted from February 22 through March 4, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety, and Health (EH). The audit evaluated the status of programs to ensure compliance with Federal, state, and local environmental laws and regulations; compliance with DOE Orders, guidance, and directives; and conformance with accepted industry practices and standards of performance. The audit also evaluated the status and adequacy of the management systems developed to address environmental requirements. The audit`s functional scope was comprehensive and included all areas of environmental management and a programmatic evaluation of NEPA and inactive waste sites.
PURPOSE: The purpose of this paper is to examine an audit that was performed of all patients referred to a liaison psychiatry inpatient consultation service which sought to establish a baseline for demographics, type of referral, and management of referrals, with a view to introducing improved evidence-based treatments. It also aims to examine timeliness of response to referrals benchmarked against published standards. DESIGN\\/METHODOLOGY\\/APPROACH: All inpatient referrals to a liaison psychiatry service were recorded over a six-month period, including demographics, diagnosis, management and timeliness of response to referrals. The data were retrospectively analysed and compared against international standards. FINDINGS: A total of 172 referrals were received in the six months. Commonest referral reasons included assessments regarding depressive disorders (23.8 per cent), delirium\\/other cognitive disorders (19.2 per cent), alcohol-related disorders (18.6 per cent), anxiety disorders (14.5 per cent), and risk management (12.2 per cent). Evidence-based practices were not utilised effectively for a number of different types of presentations. A total of 40.1 per cent of referrals were seen on the same day, 75.4 per cent by the end of the next day, and 93.4 per cent by the end of the following day. PRACTICAL IMPLICATIONS: Use of a hospital protocol for management of delirium may improve outcomes for these patients. Evidence-based techniques, such as brief intervention therapies, may be beneficial for referrals involving alcohol dependence. Referrals were seen reasonably quickly, but there is room for improvement when compared with published standards. ORIGINALITY\\/VALUE: This paper provides valuable information for those involved in management of liaison psychiatry consultation services, providing ideas for development and implementation of evidence based practices.
Fu, Hwai-Hui; Tsai, Hsien-Tang; Lin, Ching-Wei; Wei, Duan
National Health Insurance (NHI) has been implemented in Taiwan for nearly a decade. Owing to growing demand for medical-care, effective sampling auditing is a key factor in obtaining reasonably priced medical-care services. This investigation proposes a conceptual framework "medical-claim payment auditing (MCPA) procedure" based on the "Military Standard 105E (MIL-STD-105E) single sampling plan" for establishing an objective criterion for making medical-claim payments fairly. The MCPA procedure contributes to the following: (1) meeting international standards of sampling technology; (2) reducing the sampling ratio and consequently auditing costs; and (3) encouraging healthcare providers to honestly apply their medical-claim payments thus avoid wasting medical resources.
Full Text Available The Author analyses his over years experiences and results with audits in brand car ´s service and sale areas. He acted on behalf of TÜV SÜD Automotive GmbH Munich - Germany. He hits of audit ´s consecution in compliance with ISO 9001 and above standard requirement car ´s producers. He withal adverts to effects implementation the Quality management systems at these services.
Shen, Bo; Price, Lynn; Lu, Hongyou
China has set an ambitious goal of reducing its energy use per unit of GDP by 20% between 2006 and 2010. Since the industrial sector consumes about two-thirds of China's primary energy, many of the country's efforts are focused on improving the energy efficiency of this sector. Industrial energy audits have become an important part of China's efforts to improve its energy intensity. In China, industrial energy audits have been employed to help enterprises indentify energy-efficiency improvement opportunities for achieving the energy-saving targets. These audits also serve as a mean to collect critical energy-consuming information necessary for governments at different levels to supervise enterprises energy use and evaluate their energy performance. To better understand how energy audits are carried out in China as well as their impacts on achieving China's energy-saving target, researchers at the Lawrence Berkeley National Laboratory (LBNL) conducted an in-depth study that combines a review of China's national policies and guidelines on energy auditing and a series of discussions with a variety of Chinese institutions involved in energy audits. This report consists of four parts. First, it provides a historical overview of energy auditing in China over the past decades, describing how and why energy audits have been conducted during various periods. Next, the report reviews current energy auditing practices at both the national and regional levels. It then discusses some of the key issues related to energy audits conducted in China, which underscore the need for improvement. The report concludes with policy recommendations for China that draw upon international best practices and aim to remove barriers to maximizing the potential of energy audits.
Booth, C; Grant-Casey, J; Lowe, D; Court, E L; Allard, S
The aim of this study was to assess current practices around obtaining consent for blood transfusion and provision of patient information in hospitals across the UK and identify areas for improvement. Recommendations from the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) (2011) state that valid consent should be obtained for blood transfusion and documented in clinical records. A standardised source of information should be available to patients. Practices in relation to this have historically been inconsistent. The consent process was studied in hospitals across the UK over a 3-month period in 2014 by means of an audit of case notes and simultaneous surveys of patients and staff. In total, 2784 transfusion episodes were reviewed across 164 hospital sites. 85% of sites had a policy on consent for transfusion. Consent was documented in 43% of case notes. 68% of patients recalled being given information on benefits of transfusion, 38% on risks and 8% on alternatives and 28% reported receiving an information leaflet. In total, 85% of staff stated they had explained the reason for transfusion, but only 65% had documented this. 41% of staff had received training specifically on transfusion consent in the last 2 years. There is a need to improve clinical practice in obtaining valid consent for transfusion in line with existing national guidelines and local Trust policies, with emphasis on documentation within clinical records. Provision of patient information is an area particularly highlighted for action, and transfusion training for clinicians should be strengthened. © 2017 British Blood Transfusion Society.
Full Text Available This article presents three factors affecting the development of auditing services market and its oligopoly. The binding provisions of law concerning discretionary powers of auditing companies’ proprietary rights, to some extent, petrify the current auditing market structure. By means of numerous capital access deterrents they make it impossible to compete with the most influential entities on the market. Bearing in mind the vital influence of statutory auditors on companies’ functioning, and allowing the companies access to capital, it is advisable to abolish all binding restrictions and simultaneously strengthen the internal control mechanisms facilitating high quality of financial review and statutory auditors’ independence. The auditing services market is, most of all, subject to price competition. The binding requisition of statutory auditors’ (including auditing companies salary disclosure intensifies mutual chain of audit pricing dependence and restricts competition. Properly utilized rotation principle, by strengthening the competence, might positively influence functioning of the auditing services market. It increases an opportunity of collaborating with new entities, while enforcing constant improvement of qualifications required to perform financial reviews. Hence its wider use should be postulated.
Full Text Available The importance of internal audit education is more than obviously, being in the same time, emphasized by thesettlements of Code of Ethics issued by The Institute of Internal Auditors (I IA. The Code of Ethics states the principlesand expectations governing behavior of individuals and organizations in the conduct of internal auditing, describingthe minimum requirements for conducting internal audit activities, and one of these requireme nts being the professionalcompetence. According to this requirement internal auditors apply the knowledge, skills, and experience needed in theperformance of internal audit services. In the same time, it is absolutely necessary that internal auditors mus t have apermanent preoccupation for the increasing quality of their internal audit education and so the performance of internalaudit services offered. Starting from these premises, our research objectives were focused on the analyzing the contextof the evolution of internal audit education from international to national perspectives. Using the method of literaturereview we made an analysis of internal audit education in the international context, followed by a critical analysis ofthe internal audit education in the Romanian context. Our results show there are some problematic areas that arelooking for quickly solutions in order to assure a good quality of internal audit education, and so a good quality ofinternal audit services, in that way being accomplished the necessary context so internal audit to be able to add valueto the organization.
Timmons, Suzanne; O'Shea, Emma; O'Neill, Desmond; Gallagher, Paul; de Siún, Anna; McArdle, Denise; Gibbons, Patricia; Kennelly, Sean
Admission to an acute hospital can be distressing and disorientating for a person with dementia, and is associated with decline in cognitive and functional ability. The objective of this audit was to assess the quality of dementia care in acute hospitals in the Republic of Ireland. Across all 35 acute public hospitals, data was collected on care from admission through discharge using a retrospective chart review (n = 660), hospital organisation interview with senior management (n = 35), and ward level organisation interview with ward managers (n = 76). Inclusion criteria included a diagnosis of dementia, and a length of stay greater than 5 days. Most patients received physical assessments, including mobility (89 %), continence (84 %) and pressure sore risk (87 %); however assessment of pain (75 %), and particularly functioning (36 %) was poor. Assessment for cognition (43 %) and delirium (30 %) was inadequate. Most wards have access at least 5 days per week to Liaison Psychiatry (93 %), Geriatric Medicine (84 %), Occupational Therapy (79 %), Speech & Language (81 %), Physiotherapy (99 %), and Palliative Care (89 %) Access to Psychology (9 %), Social Work (53 %), and Continence services (34 %) is limited. Dementia awareness training is provided on induction in only 2 hospitals, and almost half of hospitals did not offer dementia training to doctors (45 %) or nurses (48 %) in the previous 12 months. Staff cover could not be provided on 62 % of wards for attending dementia training. Most wards (84 %) had no dementia champion to guide best practice in care. Discharge planning was not initiated within 24 h of admission in 72 % of cases, less than 40 % had a single plan for discharge recorded, and 33 % of carers received no needs assessment prior to discharge. Length of stay was significantly greater for new discharges to residential care (p < .001). Dementia care relating to assessment, access to certain specialist services
Dowling, P A
This initial audit of 600 recently assessed Eastern Health Board orthodontic patients suggests that a large number of them (47 per cent) requires referral for routine restorative and preventive dental care. Closer links are needed with general dental practitioners and community dental surgeons to resolve these needs. The trend for a high referral of females and Class 11 Division 1 malocclusion type correlated well with studies in other countries.
Lesley J. Robertson
Full Text Available Background: Community mental health services (CMHS are a central objective of the National Mental Health Policy Framework and Strategic Plan. Three core components are described: residential facilities, day care and outpatient services. Primary mental health care with specialist support is required according to an intervention pyramid. Staffing norms provide for a minimum mental health service coverage of 2.7% of the population for adults and 1.5% for children and adolescents. Aim: The aim of this study was to describe the existing CMHS in Southern Gauteng in terms of the National Mental Health Policy. Methods: The CMHS of the City of Johannesburg, Ekurhuleni, Sedibeng and West Rand districts were studied. Information regarding service organisation and staffing was obtained via the Gauteng Directorate of Mental Health. Routinely collected District Health Information Systems data for the 2014/2015 year were analysed. Results: The organisation of services was not consistent with that recommended by the Mental Health Policy, and specialist CMHS were inappropriately situated within primary care. Only 2.23% of clinic visits were for mental health, and 80% of these were at specialist CMHS. Overall mental health coverage was approximately 0.3% of the population for adults and 0.02% for children and adolescents. Staffing, residential facilities and day care were far below the cited norms for minimal cover. Conclusion: Our audit revealed that the CMHS in Southern Gauteng did not meet any of the norms cited by the Mental Health Policy. Barriers to implementation of this aspect of the Mental Health Policy need to be explored.
Kiertzner, Lars; Thinggaard, Frank
that having two independent auditors reduces total audit fees (most likely due to competitive pressure), but only for larger companies. We have used the core audit fee determinants model, which is a result of international research, with generic proxy variables for client size, complexity, risk profile...... international findings of a positive association between other fees and audit fees.......This paper adds to the scarce evidence on the determinants of audit fees in European countries outside the UK. The paper examines audit fees paid by companies listed on the Copenhagen Stock Exchange in 2002, which is the first year in which the disclosure of both audit fees and other fees paid...
Thinggaard, Frank; Kiertzner, Lars
that having two independent auditors reduces total audit fees (most likely due to competitive pressure), but only for larger companies. We have used the core audit fee determinants model, which is a result of international research, with generic proxy variables for client size, complexity, risk profile...... international findings of a positive association between other fees and audit fees. ......This paper adds to the scarce evidence on the determinants of audit fees in European countries outside the UK. The paper examines audit fees paid by companies listed on the Copenhagen Stock Exchange in 2002, which is the first year in which the disclosure of both audit fees and other fees paid...
Guha, Kaushik; Allen, Christopher J; Chawla, Sumir; Pryse-Hawkins, Hayley; Fallon, Laura; Chambers, Vicki; Vazir, Ali; Lyon, Alex R; Cowie, Martin R; Sharma, Rakesh
The National Institute for Health and Care Excellence (NICE) updated its guidelines for chronic heart failure (HF) in 2010. This re-audit assessed interim improvement as compared with an audit in 2011. Patients with HF (preserved and reduced ejection fraction) attending a tertiary cardiac centre over a 2-year period (January 2013-December 2014) were audited. The data collected included demographics, HF aetiology, medications, clinical parameters and cardiac rehabilitation. In total, 513 patients were audited. Compared with 2011, male preponderance (71%) and age (68±14 years, (Mean ± SD)) were similar. 73% of patients lived outside of London. HF aetiologies included ischaemic heart disease (37% versus 40% in 2011), dilated cardiomyopathy (26% versus 20%) primary valve disease (13% versus 12%). For patients with left ventricular systolic dysfunction (n=434, 85% of patients audited) 89% were taking beta-blockers (compared with 77% in 2011), 91% an angiotensin converting enzyme inhibitor or angiotensin receptor blocker (86% in 2011) and 56% a mineralocorticoid receptor antagonist (44% in 2011); 6% were prescribed ivabradine. All patients were reviewed at least 6-monthly. Although 100% of patients were educated about exercise, only 21 (4%) enrolled in a supervised exercise programme. This audit demonstrated high rates of documentation, follow-up and compliance with guideline-based medical therapies. A consistent finding was poor access to cardiac rehabilitation. © Royal College of Physicians 2016. All rights reserved.
Banks, Merrilyn; Hannan-Jones, Mary; Ross, Lynda; Buckley, Ann; Ellick, Jennifer; Young, Adrienne
To develop and test the reliability of a Meal Quality Audit Tool (MQAT) to audit the quality of hospital meals to assist food service managers and dietitians in identifying areas for improvement. The MQAT was developed using expert opinion and was modified over time with extensive use and feedback. A phased approach was used to assess content validity and test reliability: (i) trial with 60 dietetic students, (ii) trial with 12 food service dietitians in practice and (iii) interrater reliability study. Phases 1 and 2 confirmed content validity and informed minor revision of scoring, language and formatting of the MQAT. To assess reliability of the final MQAT, eight separate meal quality audits of five identical meals were conducted over several weeks in the hospital setting. Each audit comprised an 'expert' team and four 'test' teams (dietitians, food services and ward staff). Interrater reliability was determined using intra-class correlation analysis. There was statistically significant interrater reliability for dimensions of Temperature and Accuracy (P food service-led teams scoring higher on these dimensions. 'Test' teams reported that MQAT was clear and easy to use. MQAT was found to be reliable for Temperature and Accuracy domains, with further work required to improve the reliability of the Appearance and Sensory dimensions. The systematic use of the tool, used in conjunction with patient satisfaction, could provide pertinent and useful information regarding the quality of food services and areas for improvement. © 2017 Dietitians Association of Australia.
Community Based Social Audit of Health Services in Two Districts of Afghanistan. The health system in Afghanistan has been chronically neglected during decades of war and conflict. As the country emerges from this situation, it is overwhelmed by a long list of priorities in almost every sector. Scarce health resources ...
This article examines the relationship between the standardized service quality survey LibQUAL+ and the rise of audit culture. Recent scholarship examining assessment and accountability systems and the ideological principles driving their implementation in higher education raises concerns about the impact these systems have on teaching, learning,…
Norris, Tom; Manktelow, Bradley N; Smith, Lucy K; Draper, Elizabeth S
Few high-income countries have an active national programme of stillbirth audit. From the three national programmes identified (UK, New Zealand, and the Netherlands) steady declines in annual stillbirth rates have been observed over the audit period between 1993 and 2014. Unexplained stillbirth remains the largest group in the classification of stillbirths, with a decline in intrapartum-related stillbirths, which could represent improvements in intrapartum care. All three national audits of stillbirths suggest that up to half of all reviewed stillbirths have elements of care that failed to follow standards and guidance. Variation in the classification of stillbirth, cause of death and frequency of risk factor groups limit our ability to draw meaningful conclusions as to the true scale of the burden and the changing epidemiology of stillbirths in high-income countries. International standardization of these would facilitate direct comparisons between countries. The observed declines in stillbirth rates over the period of perinatal audit, a possible consequence of recommendations for improved antenatal care, should serve to incentivise other countries to implement similar audit programmes. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Iqbal, H J; Pidikiti, P
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. 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. 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. 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.
An economic model by DeAngelo shows that the existence of client-specific quasi-rents impairs auditor independence. The provison of non-audit advisory services (NAS) increases quasi-rents, and thus it is a threat to independence. Recently, a number of changes have been made not only to the relevent...... international and US regulations, but also to the German regulations related to NAS. A large number of empirical studies have investigated the influence of NAS on the perceived auditor independence. Most of these studies were performed in Anglo-Saxon countries, particularly in the US, and a majority found...... by a seperate department of the audit firm....
Thomas, Franklin A.
This 1983 speech by the president of the Ford Foundation addresses the problem of youth unemployment and examines the case for adoption of a system of "National Service." The widening effects of structural unemployment are cited; and economic, demographic, and technological reasons for this phenomenon are outlined. National Service is…
McErlane, Flora; Foster, Helen E; Armitt, Gillian; Bailey, Kathryn; Cobb, Joanna; Davidson, Joyce E; Douglas, Sharon; Fell, Andrew; Friswell, Mark; Pilkington, Clarissa; Strike, Helen; Smith, Nicola; Thomson, Wendy; Cleary, Gavin
Timely access to holistic multidisciplinary care is the core principle underpinning management of juvenile idiopathic arthritis (JIA). Data collected in national clinical audit programmes fundamentally aim to improve health outcomes of disease, ensuring clinical care is equitable, safe and patient-centred. The aim of this study was to develop a tool for national audit of JIA in the UK. A staged and consultative methodology was used across a broad group of relevant stakeholders to develop a national audit tool, with reference to pre-existing standards of care for JIA. The tool comprises key service delivery quality measures assessed against two aspects of impact, namely disease-related outcome measures and patient/carer reported outcome and experience measures. Eleven service-related quality measures were identified, including those that map to current standards for commissioning of JIA clinical services in the UK. The three-variable Juvenile Arthritis Disease Activity Score and presence/absence of sacro-iliitis in patients with enthesitis-related arthritis were identified as the primary disease-related outcome measures, with presence/absence of uveitis a secondary outcome. Novel patient/carer reported outcomes and patient/carer reported experience measures were developed and face validity confirmed by relevant patient/carer groups. A tool for national audit of JIA has been developed with the aim of benchmarking current clinical practice and setting future standards and targets for improvement. Staged implementation of this national audit tool should facilitate investigation of variability in levels of care and drive quality improvement. This will require engagement from patients and carers, clinical teams and commissioners of JIA services.
... Education Resources Glossary JetStream NWS Training Portal NOAA Library For Students, Parents and Teachers Brochures ABOUT Organization Strategic Plan For NWS Employees International National Centers ...
Objective. To determine the national distribution of intensive care unit (ICU)/high care (HC) units and beds. Design and setting. A descriptive, non-interventive, observational study design was used. An audit of all public and private sector ICU and high care units in South Africa was undertaken. Results. A 100% sample was ...
This article provides an in-depth description of the methodology that was followed and the quality control measures that were implemented during the audit of national critical care resources in South Africa. South African Medical Journal Vol. 97 (12) 2007: pp. 1308-1310 ...
Zengin Karaibrahimoglu, Yasemin; Guneri Cangarli, Burcu
This paper aims to examine the impact of national cultural values on the relation between auditing and reporting standards and ethical behaviours of firms. Based on a regression analysis using data regarding 54 countries between the years 2007 and 2012, we found that the impact of the perceived
Van Diem, Mariet; De Reu, Paul; Eskes, Martine; Brouwers, Hens; Holleboom, Cas; Slagter-Roukema, Tineke; Merkus, Hans
Objective. To explore the feasibility of a national perinatal audit organization. Design. Validation study. Setting. Three regions in the Netherlands. Population. 228 cases of perinatal mortality. Methods. Narratives of perinatal mortality cases were assessed by a panel of representatives of all
Thomas Angela N
Full Text Available Abstract Background Perinatal death is a devastating experience for the mother and of concern in clinical practice. Regular perinatal audit may identify suboptimal care related to perinatal deaths and thus appropriate measures for its reduction. The aim of this study was to perform a qualitative perinatal audit of intrapartum and early neonatal deaths and propose means of reducing the perinatal mortality rate (PMR. Methods From 1st August, 2007 to 31st December, 2007 we conducted an audit of perinatal deaths (n = 133 with birth weight 1500 g or more at Muhimbili National Hospital (MNH. The audit was done by three obstetricians, two external and one internal auditors. Each auditor independently evaluated the cases narratives. Suboptimal factors were identified in the antepartum, intrapartum and early neonatal period and classified into three levels of delay (community, infrastructure and health care. The contribution of each suboptimal factor to adverse perinatal outcome was identified and the case graded according to possible avoidability. Degree of agreement between auditors was assessed by the kappa coefficient. Results The PMR was 92 per 1000 total births. Suboptimal factors were identified in 80% of audited cases and half of suboptimal factors were found to be the likely cause of adverse perinatal outcome and were preventable. Poor foetal heart monitoring during labour was indirectly associated with over 40% of perinatal death. There was a poor to fair agreement between external and internal auditors. Conclusion There are significant areas of care that need improvement. Poor monitoring during labour was a major cause of avoidable perinatal mortality. This type of audit was a good starting point for quality assurance at MNH. Regular perinatal audits to identify avoidable causes of perinatal deaths with feed back to the staff may be a useful strategy to reduce perinatal mortality.
Statutory audit is conducted by an financial auditor in accordance with international auditing standards. Unlike the statutory audit, financial audit covers the full range of services within the IAASB: audit services, review services, services upon agreed procedures development services (compilation) of information. Therefore, global perspective on statutory audits ia looked upon as a part of the whole.
Holm, Claus; Warming-Rasmussen, Bent
reflects international developments in corporate regulation initiatives often in the wake of corporate failures with global impetus on the lost of trust in listed companies and their financial reporting. The purpose of this paper is to examine the transition from national (though international inspired......) regulation to a predominately international orientation in audit regulation. The most central changes in audit regulations in the last years have concerned the auditor's independence. Denmark has for instance repealed the demand for general independence, according to which auditors were not allowed to have...... for quality control. This reflects a series of initiatives with the aim to strengthen the control and sanction against unacceptable quality in an auditor's work. In the future, Danish accounting and audit regulation will be largely identical to international norms for the issuing of financial statements...
Doherty, Patrick; Salman, Ahmad; Furze, Gill; Dalal, Hasnain M; Harrison, Alexander
To assess the extent by which programmes meet national minimum standards for the delivery of cardiac rehabilitation (CR) as part of the National Certification Programme for Cardiovascular Rehabilitation (NCP_CR). The analysis used UK National Audit of Cardiac Rehabilitation (NACR) data extracted and validated for the period 2013-2014 set against six NCP_CR measures deemed as important for the delivery of high-quality CR programmes. Each programme that achieved a single minimum standard was given a score of 1. The range of the scoring for meeting the minimum standards is between 1 and 6. The performance of CR programmes was categorised into three groups: high (score of 5-6), middle (scores of 3-4) and low (scores of 1-2). If a programme did not meet any of the six criteria, they were considered to have failed. Data from 170 CR programmes revealed statistically significant differences among UK CR programmes. The principal findings were that, based on NCP_CR criteria, 30.6% were assessed as high performance with 45.9% as mid-level performance programmes, 18.2% were in the lower-level and 5.3% failed to meet any of the minimum criteria. This study shows that high levels of performance is achievable in the era of modern cardiology and that many CR programmes are close to meeting high performance standards. However, substantial variation, below the recommended minimum standards, exists throughout the UK. National certification should be seen as a positive step to ensure that patients, irrespective of where they live, are accessing quality services.
Ryan, Alexandra; Uppal, Meenakshi; Cunning, Imelda; Buckley, Claire M
The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the 'Guidelines on prevention & management of foot problems in Type 2 Diabetes' by the National Institute of Clinical Excellence (NICE). Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot). Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.
Full Text Available Objective: The purpose of this study was to evaluate the impact of the employment of additional podiatry staff on patients with diabetes attending a community-based podiatry service. Methods: An audit was conducted to evaluate the intervention of two additional podiatry staff. All patients with diabetes referred to and attending community podiatry services in a specified area in the Republic of Ireland between June 2011 and June 2012 were included. The service was benchmarked against the UK gold standard outlined in the ‘Guidelines on prevention & management of foot problems in Type 2 Diabetes’ by the National Institute of Clinical Excellence (NICE. Process of care measures addressed were the number of patients with diabetes receiving treatment and the waiting times of patients with diabetes from referral to initial review. Results: An increase in the number of patients with diabetes receiving treatment was seen in all risk categories (ranging from low risk to the emergency foot. Waiting times for patients with diabetes decreased post-intervention but did not reach the targets outlined in the NICE guidelines. The average time from referral to initial review of patients with an emergency diabetic foot was 37 weeks post-intervention. NICE guidelines recommend that these patients are seen within 24 hours. Discussion: During the life cycle of this audit, increased numbers of patients were treated and waiting times for patients with diabetes were reduced. An internal re-organisation of the services coincided with the commencement of the additional staff. The improvements observed were due to the effects of a combination of additional staff and service re-organisation. Efficient organisation of services is key to optimal performance. Continued efforts to improve services are required to reach the standards outlined in the NICE guidelines.
Exton, L S; Cheung, S T; Brain, A G; Mohd Mustapa, M F; de Berker, D A R
In 2010, the British Association of Dermatologists (BAD) published clinical guidelines for the safe introduction and continued use of isotretinoin in patients with acne in the UK. The BAD provides UK dermatologists with a facility for national audit, and it undertook an audit on compliance with these guidelines in 2012. To determine current clinical practices relating to use of isotretinoin among dermatologists in the UK (including geographical variations) as measured against BAD standards, and to ascertain any improvement since the 2012 audit. The 2012 isotretinoin audit proforma was used, with additional questions on clinical setting, complaints and litigation. A web-based survey tool was used for data entry and submission, with email invitation to working, UK-based BAD members (n = 1226) in December 2013 and weekly reminders during the 8.5-week data collection period. Responders were requested to enter data for the three most recent consecutive patients (including one male and one female patient) who had completed treatment within the previous 6 months. In total, 338 (27.6%) respondents provided data on 1013 patients. Serum lipids were checked in 93.4% of patients and documentation of mental health and/or mood state was recorded in 82.1%. Regarding the Pregnancy Prevention Programme (PPP), 91.6% of female patients of childbearing potential had signed the PPP information form, while 93.3% who had followed the PPP had taken pregnancy tests both before and during treatment, and 54.7% had taken a pregnancy test 5 weeks post-treatment. Overall, there is currently good compliance with standards. Certain aspects of care that are less frequently preformed, such as pregnancy testing post-treatment, are highlighted. © 2017 British Association of Dermatologists.
This plan outlines the audie strategies that the Deputy Inspector General for Audit Services intends to implement and execute in Fiscal Year (FY) 1998. The plan also includes the details of efforts to improve customer service and to implement the Inspector General`s streamlining initiatives. The FY 1997/1998 Strategic Plan emphasizes six key issue areas: Financial Management, Contract Administration, Program Management, Environmental Quality, Infrastructure and Administrative Safeguards. These issue areas were chosen to ensure that the Inspector General`s audit, inspection, and investigative functions are focused to assist the Department to reach its goals, pursue its strategies, and monitor its success indicators. This plan also establishes goals, objectives, and performance measures, which are discussed in detail in Appendix I.
Full Text Available In 2014, the method of data collection from NHS trusts in England for the National Lung Cancer Audit (NLCA was changed from a bespoke dataset called LUCADA (Lung Cancer Data. Under the new contract, data are submitted via the Cancer Outcome and Service Dataset (COSD system and linked additional cancer registry datasets. In 2014, trusts were given opportunity to submit LUCADA data as well as registry data. 132 NHS trusts submitted LUCADA data, and all 151 trusts submitted COSD data. This transitional year therefore provided the opportunity to compare both datasets for data completeness and reliability. We linked the two datasets at the patient level to assess the completeness of key patient and treatment variables. We also assessed the interdata agreement of these variables using Cohen's kappa statistic, κ. We identified 26 001 patients in both datasets. Overall, the recording of sex, age, performance status and stage had more than 90% agreement between datasets, but there were more patients with missing performance status in the registry dataset. Although levels of agreement for surgery, chemotherapy and external-beam radiotherapy were high between datasets, the new COSD system identified more instances of active treatment. There seems to be a high agreement of data between the datasets, and the findings suggest that the registry dataset coupled with COSD provides a richer dataset than LUCADA. However, it lagged behind LUCADA in performance status recording, which needs to improve over time.
Khakwani, Aamir; Jack, Ruth H; Vernon, Sally; Dickinson, Rosie; Wood, Natasha; Harden, Susan; Beckett, Paul; Woolhouse, Ian; Hubbard, Richard B
In 2014, the method of data collection from NHS trusts in England for the National Lung Cancer Audit (NLCA) was changed from a bespoke dataset called LUCADA (Lung Cancer Data). Under the new contract, data are submitted via the Cancer Outcome and Service Dataset (COSD) system and linked additional cancer registry datasets. In 2014, trusts were given opportunity to submit LUCADA data as well as registry data. 132 NHS trusts submitted LUCADA data, and all 151 trusts submitted COSD data. This transitional year therefore provided the opportunity to compare both datasets for data completeness and reliability. We linked the two datasets at the patient level to assess the completeness of key patient and treatment variables. We also assessed the interdata agreement of these variables using Cohen's kappa statistic, κ. We identified 26 001 patients in both datasets. Overall, the recording of sex, age, performance status and stage had more than 90% agreement between datasets, but there were more patients with missing performance status in the registry dataset. Although levels of agreement for surgery, chemotherapy and external-beam radiotherapy were high between datasets, the new COSD system identified more instances of active treatment. There seems to be a high agreement of data between the datasets, and the findings suggest that the registry dataset coupled with COSD provides a richer dataset than LUCADA. However, it lagged behind LUCADA in performance status recording, which needs to improve over time.
Full Text Available This paper uses a trial audit of history programs undertaken in 2011-2012 to explore issues surrounding the attainment of Threshold Learning Outcomes (TLOs in an emerging Australian national standards environment for the discipline of history. The audit sought to ascertain whether an accreditation process managed by the discipline under the auspices of the Australian Historical Association (AHA could be based on a limited-intervention, “light-touch” approach to assessing attainment of the TLOs. The results of the audit show that successful proof of TLO attainment would only be possible with more active intervention into existing history majors and courses. Assessments across all levels of history teaching would have to be designed, undertaken, and marked using a rubric matched to the TLOs. It proved unrealistic to expect students to demonstrate acquisition of the TLOs from existing teaching and assessment practices. The failure of the “light-touch” audit process indicates that demonstrating student attainment under a national standards regime would require fundamental redevelopment of the curriculum. With standards-based approaches to teaching and learning emerging as international phenomena, this case study resonates beyond Australia and the discipline under investigation.
O'Neill, S; Robertson, A G; Robson, A J; Richards, C H; Nicholson, G A; Mittapalli, D
This audit assessed inguinal hernia surgery in Scotland and measured compliance with British Hernia Society Guidelines (2013), specifically regarding management of bilateral and recurrent inguinal hernias. It also assessed the feasibility of a national trainee-led audit, evaluated regional variations in practise and gauged operative exposure of trainees. A prospective audit of adult inguinal hernia repairs across every region in Scotland (30 hospitals in 14 NHS boards) over 2-weeks was co-ordinated by the Scottish Surgical Research Group (SSRG). 235 patients (223 male, median age 61) were identified and 96 % of cases were elective. Anaesthesia was 91 % general, 5 % spinal and 3 % local. Prophylactic antibiotics were administered in 18 %. Laparoscopic repair was used in 33 % (30 % trainee-performed). Open repair was used in 67 % (42 % trainee-performed). Elective primary bilateral hernia repairs were laparoscopic in 97 % while guideline compliance for an elective recurrence was 77 %. For elective primary unilateral hernias, the use of laparoscopic repair varied significantly by region (South East 43 %, North 14 %, East 7 % and West 6 %, p Scotland. Increased compliance on recurrent cases appears indicated. National re-audit could ensure improved adherence and would be feasible through the SSRG.
Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian
A national audit was performed assessing the early management of suspected inflammatory arthritis by English and Welsh rheumatology units. The aim of this audit was to measure the performance of rheumatology services against National Institute for Health and Care Excellence (NICE) quality standards (QSs) for the management of early inflammatory arthritis benchmarked to regional and national comparators for the first time in the UK. All individuals >16 years of age presenting to rheumatology services in England and Wales with suspected new-onset inflammatory arthritis were included in the audit. Information was collected against six NICE QSs that pertain to early inflammatory arthritis management. We present national data for the 6354 patients recruited from 1 February 2014 to 31 January 2015; 97% of trusts and health boards in England and Wales participated in this audit. Only 17% of patients were referred by their general practitioner within 3 days of first presentation. Specialist rheumatology assessment occurred within 3 weeks of referral in 38% of patients. The target of DMARD initiation within 6 weeks of referral was achieved in 53% of RA patients; 36% were treated with combination DMARDs and 82% with steroids within the first 3 months of specialist care. Fifty-nine per cent of patients received structured education on their arthritis within 1 month of diagnosis. In total, 91% of patients had a treatment target set; the agreed target was achieved within 3 months of specialist review in only 27% of patients. Access to urgent advice via a telephone helpline was reported to be available in 96% of trusts. The audit has highlighted gaps between NICE standards and delivery of care, as well as substantial geographic variability. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: email@example.com.
Thinggaard, Frank; Kiertzner, Lars
. Our results indicate that the requirement to have two independent auditors reduces total audit fees, most likely because of competitive pressure, but only in the segment of larger companies. We have applied the core audit fee determinants model which has evolved in international research with generic...... are complexity of substance and general client risk thus indicating that the typical audit of such a large company to a greater extent is planned considering risk and materiality. In contrast to most prior international research, no general Big Four effect could be established by analyzing Danish data. However......, our results indicate that PWC is low balling in the segment of large companies and highballing in the segment of small companies. Finally our results confirm international findings of a positive association between other fees and audit fees....
Hall Alistair S
Full Text Available Abstract Background Clinical governance requires health care professionals to improve standards of care and has resulted in comparison of clinical performance data. The Myocardial Infarction National Audit Project (a UK cardiology dataset tabulates its performance. However funnel plots are the display method of choice for institutional comparison. We aimed to demonstrate that funnel plots may be derived from MINAP data and allow more meaningful interpretation of data. Methods We examined the attainment of National Service Framework standards for all hospitals (n = 230 and all patients (n = 99,133 in the MINAP database between 1st April 2003 and 31st March 2004. We generated funnel plots (with control limits at 3 sigma of Door to Needle and Call to Needle thrombolysis times, and the use of aspirin, beta-blockers and statins post myocardial infarction. Results Only 87,427 patients fulfilled criteria for analysis of the use of secondary prevention drugs and 15,111 patients for analysis by Door to Needle and Call to Needle times (163 hospitals achieved the standards for Door to Needle times and 215 were within or above their control limits. One hundred and sixteen hospitals fell outside the 'within 25%' and 'more than 25%' standards for Call to Needle times, but 28 were below the lower control limits. Sixteen hospitals failed to reach the standards for aspirin usage post AMI and 24 remained below the lower control limits. Thirty hospitals were below the lower CL for beta-blocker usage and 49 outside the standard. Statin use was comparable. Conclusion Funnel plots may be applied to a complex dataset and allow visual comparison of data derived from multiple health-care units. Variation is readily identified permitting units to appraise their practices so that effective quality improvement may take place.
.... The Government Auditing Standards (GAS) require that an audit organization performing Government audits have an appropriate internal quality control system and undergo an external quality control review every 3 years by an organization...
Cachia, Karl; Baldacchino, Peter J.;
The purpose of the paper is to gain insight into the changing role of the National Audit Office (NAO) in public accountability with the backdrop of the legal amendments that instituted the Office. The paper seeks to analyse the strength of the Office’s legal mandate, evaluate the understandability of NAO reports as well as discuss the Office’s bearing on public policy. The discussion draws upon semi-structured interviews conducted with three NAO Officers and thirteen m...
Full Text Available The article explores an issue of the internal audit outsourcing. It indicates the differences between internal audit, outsourcing and cosourcing of this service as well as their advantages and disadvantages. Drawing from the research on internal audit outsourcing the recent market trends were identified as well as motivations for choosing different forms of internal auditing.
Ziso, B; Dixon, P A; Marson, A G
Epilepsy is the third most common diagnosis in older people, however management in this group remains variable. National Audit of Seizure management in Hospitals (NASH) set out to assess care provided to patients attending hospitals in England following a seizure. 154 Emergency Departments (EDs) across the UK took part. 1256 patients aged 60 years or over were included for analysis (median age 74 years, 54% men). 51% were known to have epilepsy, 17% had history of previous seizure or blackout and 32% presented with a suspected first seizure. 14% of older patients with epilepsy were not on treatment, 59% were on monotherapy. Sodium valproate was the most commonly used antiepileptic, 28%. 35% of patients with epilepsy, aged 60 and over, had a CT during admission compared to only 17% of those under 60. 80% of patients aged 60 and over presenting with a likely first seizure were admitted to hospital, compared to 65% of those under 60. 34% of those with suspected first seizure were referred to a neurologist on discharge compared to 68% of patients under the age of 60. 52% of 60-69year olds with a suspected first seizure were referred to neurology compared to 25% of patients aged 80-89. Older patients presenting with seizures are more likely to be admitted to hospital and have imaging. They are less likely to be referred to specialist services on discharge. There appears to be significant disparity in patient age and rate of referral. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.
Government-funded weatherization assistance programs resulted from increased oil prices caused by the 1973 oil embargo. These programs were instituted to reduce US consumption of oil and help low-income families afford the increasing cost of heating their homes. In the summer of 1988, Oak Ridge National Laboratory (ORNL) began providing technical support to the Department of Energy (DOE) Weatherization Assistance Program (WAP). A preliminary study found no suitable means of cost-effectively selecting energy efficiency improvements (measures) for single-family homes that incorporated all the factors seen as beneficial in improving cost-effectiveness and usability. In mid-1989, ORNL was authorized to begin development of a computer-based measure selection technique. In November of 1992 a draft version of the program was made available to all WAP state directors for testing. The first production release, Version 4.3, was made available in october of 1993. The Department of Energy's Weatherization Assistance Program has continued funding improvements to the program increasing its user-friendliness and applicability. initial publication of this engineering manual coincides with availability of Version 6.1, November 1997, though algorithms described generally apply to all prior versions. Periodic updates of specific sections in the manual will permit maintaining a relevant document. This Engineering Manual delineates the assumptions used by NEAT in arriving at the measure recommendations based on the user's input of the building characteristics. Details of the actual data entry are available in the NEAT User's Manual (ORNL/Sub/91-SK078/1) and will not be discussed in this manual.
... 49 Transportation 9 2010-10-01 2010-10-01 false Officers-general superintendence; accounting, auditing and finance; management services and data processing; personnel and labor relations; legal and... PASSENGER SERVICE FOR RAILROADS 1 Operating Expenses § 1242.83 Officers—general superintendence; accounting...
Clarke, Rachel T; Warnick, Janine; Stretton, Kate; Littlewood, Tim J
Recent disquiet at inadequacies in the immediate management of neutropenic sepsis in the UK led to a new, gold standard 'door-to-needle' time of 1 h for the administration of intravenous antibiotics. The aim of this audit was to identify whether that target is being met nationally, the potential barriers to its achievement, and concrete recommendations for how to overcome these. We also sought to establish the degree of regional heterogeneity in current local management protocols. Questionnaires were sent to haematologists across the UK to determine their unit's immediate management of patients presenting from the community with possible neutropenic sepsis. Local protocols and audits were also requested. Data covering 95 different hospitals were received, covering a combined catchment area of nearly 30 million people. There were marked regional inconsistencies in the definition of 'neutropenic sepsis' and almost every aspect of its immediate management. Only 26% of audited patients (n=627) received intravenous antibiotics within the target time of 1 h. Median door-to-needle times ranged from 30 min to 4 h. Long delays of over 5 h were not uncommon. © 2011 Blackwell Publishing Ltd.
Likewati; W.O.; Kartini; D.; Ariawati; R.; Sari; D.
Abstract The purpose of this paper is to explain the marketing performance of stars hotel in Bandung city Indonesia through variables marketing environment audit Kotler et.al 1977 in which their effects are mediated through variable services marketing audit known as Index of Services Marketing ExcellenceISME BerryConant and Parasuraman 1991. The Population in this study consist of 73 hotels with various stars i.e 3 star hotels 4 and 5 in the city hotel in Bandung. From this population 30 star...
Full Text Available The notion of «institution partnerships in the audit» and its importance in Ukraine. Done overview of international experience in the Institute of partnerships in the audit business. Determined the nature of the audit, rights, duties and powers of the partnership during the audit. Done distribution of functions between the partner and the engagement partner in the synthesis of these blocks: taking on a new customer service or continued cooperation with existing customers (clients; familiarization with activities of customer audits, including an understanding of its internal control system; identification and assessment of risks of material misstatement of accounting; audit process and the audit and the formation of the final judgment. On the basis of the distribution of functions between the partner and the engagement partner, defined the overall structure of management system auditing firm. These conditions for implementation of partnerships in the audit business, and identified a number of advantages and disadvantages of partnerships for auditing.
Gonzalez-Padron, Tracy; Ferguson, Jeffery M.
Service-marketing education provides students customer service skills sought by employers who recognize the relationship between service and profit. Students in service marketing benefit from active-learning activities with actual organizations to apply customer service frameworks taught in the course. The purpose of this paper is to describe an…
Hussey, J; Mitchell, L; Hew, Y; Foster, K; Waldram, A
Genitourinary case records of 42 pregnant women with syphilis were reviewed as part of a regional audit following the re-emergence of congenital syphilis in the north east of England. National standards, from the British Association of Sexual Health and HIV guidelines on managing syphilis in pregnancy, were met in the majority of cases with 69% being treated according to national guidance and all cases completing treatment. Locally developed standards on multidisciplinary working and communication were met less well, with particular issues regarding the documentation of pregnancy outcomes in GUM records and communication between specialities being highlighted. A regional good practice guide has been developed and implemented to address standards not met, reduce adverse outcomes and prevent future cases of congenital syphilis.
Full Text Available Abstract The purpose of this paper is to explain the marketing performance of stars hotel in Bandung city Indonesia through variables marketing environment audit Kotler et.al 1977 in which their effects are mediated through variable services marketing audit known as Index of Services Marketing ExcellenceISME BerryConant and Parasuraman 1991. The Population in this study consist of 73 hotels with various stars i.e 3 star hotels 4 and 5 in the city hotel in Bandung. From this population 30 stars hotels ware collected ramdomly in which 15 of them are 3- stars hotel 11 are 4- stars hotel and 5 are 5- stars hotels. Other than that some informan were interviewed to formed a qualitative aspect of this study one informan from each stars hotel and one from hotel organization in Bandung. To analyzed the quantitative data we used Partial Least Squares using SmartPLS-2 and Maxqda-11 to anlyzed the qualitative data. The results of the study show that the influence of marketing audit services ISME to the hotels marketing performance is not significant both variable in marketing environment audit significanly affect the marketing performance but Macro Environment audit is not significantly affect the ISME whereas task environment audit significantly affect the ISME. Thus there is no indirect effect of Marketing Environment to the marketing Performance. Our finding give a special case of ISME aplication to hotel industry proposed by Berry 1991which is used in services industry in general. The model proposed in this paper related to the work of Wu 2011 in that we use ISME in addition to enviromental variables. Other benefit from this study implied that hotels must conduct a regular evaluation of their marketing activities and strategies comprehensively sistematicaly periodicaly and objectively.
van Bommel, Annelotte C M; Spronk, Pauline E R; Vrancken Peeters, Marie-Jeanne T F D; Jager, Agnes; Lobbes, Marc; Maduro, John H; Mureau, Marc A M; Schreuder, Kay; Smorenburg, Carolien H; Verloop, Janneke; Westenend, Pieter J; Wouters, Michel W J M; Siesling, Sabine; Tjan-Heijnen, Vivianne C G; van Dalen, Thijs
In 2011, the NABON Breast Cancer Audit (NBCA) was instituted as a nation-wide audit to address quality of breast cancer care and guideline adherence in the Netherlands. The development of the NBCA and the results of 4 years of auditing are described. Clinical and pathological characteristics of patients diagnosed with invasive breast cancer or in situ carcinoma (DCIS) and information regarding diagnosis and treatment are collected in all hospitals (n = 92) in the Netherlands. Thirty-two quality indicators measuring care structure, processes and outcomes were evaluated over time and compared between hospitals. The NBCA contains data of 56,927 patients (7,649 DCIS and 49,073 invasive cancers). Patients being discussed in pre- and post-operative multidisciplinary team meetings improved (2011: 83% and 91%; 2014: 98% and 99%, respectively) over the years. Tumour margin positivity rates after breast-conserving surgery for invasive cancer requiring re-operation were consistently low (∼5%). Other indicators, for example, the use of an MRI-scan prior to surgery or immediate breast reconstruction following mastectomy showed considerable hospital variation. Results shown an overall high quality of breast cancer care in all hospitals in the Netherlands. For most quality indicators improvement was seen over time, while some indicators showed yet unexplained variation. J. Surg. Oncol. 2017;115:243-249. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.
Full Text Available Background The licensure is an evaluation mechanism, which allows health centers or individuals to assess health services delivery based on minimum requirements. Objectives The present study aimed to audit the general practitioner (GP offices in Tabriz city to assess their compliance with national licensure standards in 2015. Methods This was across-sectional study, which audited 228 general practitioner offices randomly. The data from offices was collected based on researcher-made checklist, the validity of which was approved. Firstly, descriptively analysis of data was done and then, the relationship between clinics characteristics and compliance with standards was assessed using Analysis of Variance (ANOVA and Tukey’s test. To perform the analysis, the SPSS19 software was used, and P < 0.05 was considered significant. Results Based on the study results, the mean standards compliance in GP offices was 78.9%, with highest compliance dedicated to medical documents and informatics dimension with 99.1% compliance level and lowest compliance related to hygiene dimension with 56.2% compliance level. In the analysis of the statistical relationship between the offices characteristics and licensure standards, there was significant relationships, between daily admittance of patients in offices and standards compliance in human resources dimension; GPs’ job experience and standards compliance in medical and non-medical devices dimension; and urban district of office and standards compliance in physical environment dimension and medical and non-medical devices dimension. In addition, there was a significant difference between total score of standards compliance and offices of urban districts (P < 0.05. Conclusions Generally, the status of Tabriz general health clinics was relatively acceptable. Thus, evaluation authorities should pay attention especially to the hygiene dimension.
, in the context of assurance service. A case study was carried out with auditors affiliated with Danish subsidiaries of Big 4 audit firms to inspect the implementation and utilization of global audit methodology (GAM), which is the ICT-based platform that guides subordinate auditors through the audit process...
McAvoy, Brian Ramsay; Fletcher, Jane M; Elwood, Mark
Primary care professionals play a critical role in cancer care but relatively little is known about their education and training. This article presents the results of a national audit of education and training providers in relation to primary care and cancer. A semistructured telephone questionnaire. The response rate was very high (96%) with 210 organisations participating. Forty-two percent provided cancer education and training. Evidence of good adult education practice was demonstrated, and 95% of organisations ran accredited programs. Although pharmaceutical industry support was not favoured, the majority (78%) described this as their main source of funding. There is optimism and strong commitment among primary care cancer education and training providers. Their content seems appropriate and their approach is consistent with good adult learning principles and multidisciplinary care, but this could be enhanced with increased funding and improved collaboration and communication between organisations.
This is an abstract of a proposed presentation and does not necessarily reflect EPA policy.The Health Divisions of the US EPA National Health and Environmental Effects Research Laboratory have a guideline for conducting technical systems audits. As part of the guideline ...
Sakr, Yasser; Alhussami, Ilmi; Nanchal, Rahul; Wunderink, Richard G; Pellis, Tommaso; Wittebole, Xavier; Martin-Loeches, Ignacio; François, Bruno; Leone, Marc; Vincent, Jean-Louis; Kesecioglu, J
OBJECTIVE: To assess the effect of body mass index on ICU outcome and on the development of ICU-acquired infection. DESIGN: A substudy of the Intensive Care Over Nations audit. SETTING: Seven hundred thirty ICUs in 84 countries. PATIENTS: All adult ICU patients admitted between May 8 and 18, 2012,
Sakr, Y.; Alhussami, I.; Nanchal, R.; Wunderink, R.G.; Pellis, T.; Wittebole, X.; Martin-Loeches, I.; Francois, B.; Leone, M.; Vincent, J.L.; Pickkers, P.
OBJECTIVE: To assess the effect of body mass index on ICU outcome and on the development of ICU-acquired infection. DESIGN: A substudy of the Intensive Care Over Nations audit. SETTING: Seven hundred thirty ICUs in 84 countries. PATIENTS: All adult ICU patients admitted between May 8 and 18, 2012,
Akinyamoju, Akindayo O; Adeyemi, Bukola F; Adisa, Akinyele O; Okoli, Chidinma N
Biopsies are often essential for definitive diagnosis of oro-facial lesions and are a part of oral diagnostic procedures carried out in histopathology laboratories. At present, there is paucity of literature on the audit of oral histopathology services in Nigeria. The objectives of this study were to determine the prevalence of biopsied oral lesions in a Nigerian tertiary institution. Also to profile the usage of oral pathology service and to identify challenges that may be present in an oral histodiagnostic service. This was a retrospective study performed at the Oral Pathology Department of the University of Ibadan/ University College Hospital, Ibadan, Nigeria. Reports of all biopsies submitted at the Oral Pathology laboratory, for the period 1990-2014, were reviewed and data extracted. Descriptive analysis was done using SPSS software, version 20. The total number of reports was 1,998; invalid reports constituting 220(11%) were subsequently excluded leaving 1,778(89%) valid reports. The mean age of patients was 36.70±19.79, while the peak age of presentation was in the 3 rd decade. Male to female ratio was 1:1.1, and the mandible was the most common site of lesions 619(34.8%). These services were mainly utilized by oral surgeons (83.9%) and ameloblastoma (11.5%) was the most frequently diagnosed lesion. CD45 (16.7%) was the most frequently requested immuno-diagnostic test. Biopsied oral lesions were more prevalent in females, while oral and maxillofacial surgeons utilized these services the most. Inadequate biopsy specimens or unrepresentative specimens and deficient documentation were challenges identified in this study.
Ledingham, Joanna M; Snowden, Neil; Rivett, Ali; Galloway, James; Ide, Zoe; Firth, Jill; MacPhie, Elizabeth; Kandala, Ngianga; Dennison, Elaine M; Rowe, Ian
Our aim was to conduct a national audit assessing the impact and experience of early management of inflammatory arthritis by English and Welsh rheumatology units. The audit enables rheumatology services to measure for the first time their performance, patient outcomes and experience, benchmarked to regional and national comparators. All individuals >16 years of age presenting to English and Welsh rheumatology services with suspected new-onset inflammatory arthritis were included in the audit. Clinician- and patient-derived outcome and patient-reported experience measures were collected. Data are presented for the 6354 patients recruited from 1 February 2014 to 31 January 2015. Ninety-seven per cent of English and Welsh trusts participated. At the first specialist assessment, the 28-joint DAS (DAS28) was calculated for 2659 (91%) RA patients [mean DAS28 was 5.0 and mean Rheumatoid Arthritis Impact of Disease (RAID) score was 5.6]. After 3 months of specialist care, the mean DAS28 was 3.5 and slightly >60% achieved a meaningful DAS28 reduction. The average RAID score and reduction in RAID score were 3.6 and 2.4, respectively. Of the working patients ages 16-65 years providing data, 7, 5, 16 and 37% reported that they were unable to work, needed frequent time off work, occasionally and rarely needed time off work due to their arthritis, respectively; only 42% reported being asked about their work. Seventy-eight per cent of RA patients providing data agreed with the statement 'Overall in the last 3 months I have had a good experience of care for my arthritis'; <2% disagreed. This audit demonstrates that most RA patients have severe disease at the time of presentation to rheumatology services and that a significant number continue to have high disease activity after 3 months of specialist care. There is a clear need for the National Health Service to develop better systems for capturing, coding and integrating information from outpatient clinics, including measures of
Aggarwal, A; Nossiter, J; Cathcart, P; van der Meulen, J; Rashbass, J; Clarke, N; Payne, H
The National Prostate Cancer Audit (NPCA) started in April 2013 with the aim of assessing the process of care and its outcomes in men diagnosed with prostate cancer in England and Wales. One of the key aims of the audit was to assess the configuration and availability of specialist prostate cancer services in England. In 2014, the NPCA undertook an organisational survey of all 143 acute National Health Service (NHS) Trusts and 48 specialist multidisciplinary team (MDT) hubs cross England. Questionnaires established the availability and location of core diagnostic, treatment and patient-centred support services for the management of non-metastatic prostate cancer in addition to specific diagnostic and treatment procedures that reflect the continuing evolution of prostate cancer management, such as high-intensity focused ultrasound (HIFU) and stereotactic body radiotherapy. The survey received a 100% response rate. The results showed considerable geographical variation with respect to the availability of core treatment modalities, the size of the target population and catchment areas served by specialist MDT hubs, as well as in the uptake of additional procedures and services. Specifically there are gaps in the availability of core radiotherapy procedures; high dose rate and low dose rate brachytherapy are available in 44% and 75% of specialist MDTs, respectively. By comparison, there seems to be a relative 'over-penetration' of surgical innovation, with 67% of specialist MDTs providing robotic-assisted laparoscopic prostatectomy and 21% HIFU. There is also evidence of increased centralisation of core surgical procedures and regional inequity in the availability of surgical innovation across England. The organisational survey of the NPCA has provided a comprehensive assessment of the structure and function of specialist MDTs in England and the availability of prostate cancer procedures and services. As part of the prospective audit, the NPCA will assess the effect of
Harari, Danielle; Husk, Janet; Lowe, Derek; Wagg, Adrian
previous UK National Audits of Continence Care showed low rates of assessment and treatment of faecal incontinence (FI) in older people. the 2009 audit assessed adherence to the National Institute for Health and Clinical Excellence guidelines on management of FI and compared care in older versus younger patients. fifteen older (65+) and 15 younger (18-65) patients with FI were to be audited in hospital (inpatient or outpatient), primary care (PC) and care home sites. data were submitted for n = 2,930 cases from 133 hospitals, n = 1,729 from 97 PC surgeries and n = 693 from 63 care homes. Bowel history was not documented in 41% older versus 24% younger patients in hospitals and 27 versus 19% in PC (both P older people, there was no documented focused examination in one-third in hospitals, one-half in PC and three-quarters in care homes. Overall, older people. Clinicians, including geriatricians, need to lead on improving care in older people including comprehensive assessment where needed. Improvement in some indicators in older people with successive audits suggests that ongoing national audit with linked information resources can be useful as both monitor and agent for change. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains polygons corresponding to the County Warning Areas (CWAs) of each Weather Forecast Office (WFO) in the National Weather Service (NWS).
Eric N. Wakaria
Full Text Available Background: The Kenya National Blood Transfusion Service (KNBTS is mandated to provide safe and sufficient blood and blood components for the country. In 2013, the KNBTS National Testing Laboratory and the six regional blood transfusion centres were enrolled in the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. The process was supported by Global Communities with funding from the United States Centers for Disease Control and Prevention.Methods: The SLMTA implementation at KNBTS followed the standard three-workshop series, on-site mentorships and audits. Baseline, midterm and exit audits were conducted at the seven facilities, using a standard checklist to measure progress. Given that SLMTA was designed for clinical and public health laboratories, key stakeholders, guided by Global Communities, tailored SLMTA materials to address blood transfusion services, and oriented trainers, auditors and mentors on the same.Results: The seven facilities moved from an average of zero stars at baseline to an average of three stars at the exit audit. The average baseline audit score was 38% (97 points, midterm 71% (183 points and exit audit 79% (205 points. The Occurrence Management and Process Improvement quality system essential had the largest improvement (at 67 percentage points, from baseline to exit, whereas Facilities and Safety had the smallest improvement (at 31 percentage points.Conclusion: SLMTA can be an effective tool for preparing a blood transfusion service for accreditation. Key success factors included customising SLMTA to blood transfusion activities; sensitising trainers, mentors and auditors on operations of blood transfusion service; creating SLMTA champions in key departments; and integrating other blood transfusion-specific accreditation standards into SLMTA.
Harney, Anne-Marie; McClean, Rosaleen; Rawles, John; Stewart, David
The National Service Framework (NSF) for coronary heart disease requires that patients with acute myocardial infarction should start thrombolytic therapy within 60 min of the patient making contact with the National Health Service. In an audit of 700 patients with suspected acute myocardial infarction, patients' first contact was most commonly with a general practitioner (GP) (505/700; 72 per cent), who attended on 88 per cent (446/505) of occasions when they were called. In 93 per cent (255/284) of cases where both GP and an ambulance attended, the GP arrived first, by 25 min (median). In the final audit period, median call-to-thrombolysis time was 90 min (26 per cent < or = 60). We conclude that with existing physical and personnel resources in this semi-rural area of Northern Ireland, the NSF standard for thrombolytic treatment is unlikely to be met in a majority of cases unless GPs adopt prehospital thrombolysis.
van Leersum, N J; Snijders, H S; Wouters, M W J M; Henneman, D; Marijnen, C A M; Rutten, H R; Tollenaar, R A E M; Tanis, P J
Internationally, the use of preoperative radiotherapy (RT) for rectal cancer varies largely, related to different decision-making based on the harm-benefit ratio. In the Dutch guideline, RT is indicated in all cT2-4 tumours. We aimed to evaluate the use of RT in the Netherlands and to discuss Dutch practice in the context of current literature. Data of the Dutch Surgical Colorectal Audit (DSCA) were used and 6784 patients surgically treated for primary rectal cancer in 2009-2011 were included. The application and type of RT were described according to age, comorbidity, tumour localization and tumour stage at population level with analysis of hospital variation for specific subsets. In total, 85% of patients who underwent resection for rectal cancer received RT. Comorbidity (Charlson Comorbidity Index 2+) and older age (≥70 years) were associated with a slight decrease in application of RT (75 and 80% respectively). In stage I tumours, 77% of patients received RT, but large hospital variation existed (0-100%). The proportion chemoradiotherapy of the whole group of RT increased with increasing N-stage, increasing T-stage, decreasing distance from the anus, younger age and less comorbidity with hospital variation from 0 to 73%. From a European perspective, a high percentage of rectal cancer patients are treated with RT in the Netherlands. Considerable hospital variation was observed for RT in stage I and the proportion of chemoradiotherapy among all RT schemes. Data from clinical auditing enable evaluation of national practice and current standards from both a scientific and international perspective. Copyright © 2013 Elsevier Ltd. All rights reserved.
This is the third in a series of followup audits made to evaluate the corrective actions taken by the Defense Finance and Accounting Service, the Defense Information Systems Agency, and the Defense...
Clark, Michael; Semple, Martin J; Ivins, Nicola; Mahoney, Kirsten; Harding, Keith
Objective The Chief Nurse National Health Service Wales initiated a national survey of acute and community hospital patients in Wales to identify the prevalence of pressure ulcers and incontinence-associated dermatitis. Methods Teams of two nurses working independently assessed the skin of each inpatient who consented to having their skin observed. Results Over 28 September 2015 to 2nd October 2015, 8365 patients were assessed across 66 hospitals with 748 (8.9%) found to have pressure ulcers. Not all patients had their skin inspected with all mental health patients exempt from this part of the audit along with others who did not consent or were too ill. Of the patients with pressure ulcers, 593 (79.3%) had their skin inspected with 158 new pressure ulcers encountered that were not known to ward staff, while 152 pressure ulcers were incorrectly categorised by the ward teams. Incontinence-associated dermatitis was encountered in 360 patients (4.3%), while medical device-related pressure ulcers were rare (n=33). The support surfaces used while patients were in bed were also recorded to provide a baseline against which future changes in equipment procurement could be assessed. The presence of other wounds was also recorded with 2537 (30.3%) of all hospital patients having one or more skin wounds. Conclusions This survey has demonstrated that although complex, it is feasible to undertake national surveys of pressure ulcers, incontinence-associated dermatitis and other wounds providing comprehensive and accurate data to help plan improvements in wound care across Wales. PMID:28827240
Full Text Available Finding solutions to the problems faced by the Ukrainian education system require an adequate organizing structure for education system, enabling for transition to the principle of life-long education. The best option for this is the distance learning systems (DLS, which are considered by leading Ukrainian universities as high-performance information technologies in modern education, envisaged by the National Informatization Program, with the goals of reforming higher education in Ukraine in the context of joining the European educational area. The experience of implementing DLS “Prometheus” and Moodle and the main directions of distance learning development at the National Academy of Statistics, Accounting and Audit (NASAA are analyzed and summed up. The emphasis is made on the need to improve the skills of teachers with use of open distance courses and gradual preparation of students for the learning process in the new conditions. The structure of distance courses for different forms of education (full-time, part-time, and blended is built. The forms of learning (face-to-face, the driver complementary, rotation model; flex model, etc. are analyzed. The dynamic version of implementing blended learning models in NASAA using DLS “Prometheus” and Moodle is presented. It is concluded that the experience of NASAA shows that the blended form of distance learning based on Moodle platform is the most adequate to the requirements of Ukraine’s development within the framework of European education.
Lamb, M C; Cox, M A
This paper will outline the current changes being imposed on the National Health Service. The literature on change management will be employed to propose some guidelines for health service managers. The National Health Service (NHS) spent much of the 1980s and 1990s learning about the transition from administration to management and must now make the transition from management to leadership. The emphasis is now focused less on doing and more on being.
Milner, E C; Rowlands, P; Gardner, B; Ashby, F
The study aimed to develop and implement local audit standards for management and service engagement in the follow-up of patients suffering from a 'first episode of psychosis'. Audit standards, developed following a literature review and consultation with colleagues, were incorporated into a questionnaire for distribution to the community keyworkers of a 'first episode of psychosis' cohort at 1-2 years of follow-up. Most satisfied standards for engagement (91%) and maintenance medication (91%). Forty-two to sixty-three per cent had received psychological, family and educational interventions but these often lacked theoretical basis and detailed content. Admission, deliberate self-harm and forensic contacts were infrequent. Less than half had any structured daytime activity. Priorities identified for improving services for this group include adequate staff training in psychosocial interventions and more active planning and resourcing of day care and other constructive daytime activities. Simple locally-developed audit standards such as those described for a 'first episode of psychosis' population can offer a useful way of assessing service delivery and highlighting areas for development.
Full Text Available The environmental meteorological services in China are concerned with atmospheric environmental quality, which is directly related to human activities and affects human health. In recent years, air pollution and other environmental problems have attracted nationwide attention in China, so the environmental meteorological services have been developed rapidly. To provide better meteorological monitoring and forecasting services, the Environmental Meteorological Centre of China Meteorological Administration was established in March 2014 by integrating the resources of various national service units. We review the development of China’s national environmental meteorological services and highlight their current status including major technological capabilities. We also explore future trends of the national environmental meteorological services by analysing deficiencies, gaps in supply and demand, and capabilities of the current environmental meteorological services.
U.S. Department of Health & Human Services — The chart lists the overall audit score of each sponsor audited and provides additional detail on the number of audit elements tested during each audit, the number...
Department of Homeland Security — The NOAA Coastal Services Center's Legislative Atlas is a regional geographic information system (GIS) that provides spatial data for state and federal coastal and...
This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey. To assist personnel in the selection of analytical services, this catalog lists sample volume, required containers, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples.
This Services Catalog contains information about field supplies and analytical services available from the National Water Quality Laboratory in Denver, Colo., and field supplies available from the Quality Water Service Unit in Ocala, Fla., to members of the U.S. Geological Survey's Water Resources Division. To assist personnel in the selection of analytical services, this catalog lists sample volume, applicable concentration range, detection level, precision of analysis, and preservation requirements for samples. (USGS)
Deasy, Conor; Cronin, Marina; Cahill, Fiona; Geary, Una; Houlihan, Patricia; Woodford, Maralyn; Lecky, Fiona; Mealy, Ken; Crowley, Philip
There are 27 receiving trauma hospitals in the Republic of Ireland. There has not been an audit system in place to monitor and measure processes and outcomes of care. The National Office of Clinical Audit (NOCA) is now working to implement Major Trauma Audit (MTA) in Ireland using the well-established National Health Service (NHS) UK Trauma Audit and Research Network (TARN). The aim of this report is to highlight the implementation process of MTA in Ireland to raise awareness of MTA nationally and share lessons that may be of value to other health systems undertaking the development of MTA. The National Trauma Audit Committee of the Royal College of Surgeons in Ireland, consisting of champions and stakeholders in trauma care, in 2010 advised on the adaptation of TARN for Ireland. In 2012, the Emergency Medicine Program endorsed TARN and in setting up the National Emergency Medicine Audit chose MTA as the first audit project. A major trauma governance group was established representing stakeholders in trauma care, a national project co-ordinator was recruited and a clinical lead nominated. Using Survey Monkey, the chief executives of all trauma receiving hospitals were asked to identify their hospital's trauma governance committee, trauma clinical lead and their local trauma data co-ordinator. Hospital Inpatient Enquiry systems were used to identify to hospitals an estimate of their anticipated trauma audit workload. There are 25 of 27 hospitals now collecting data using the TARN trauma audit platform. These hospitals have provided MTA Clinical Leads, allocated data co-ordinators and incorporated MTA reports formally into their clinical governance, quality and safety committee meetings. There has been broad acceptance of the NOCA escalation policy by hospitals in appreciation of the necessity for unexpected audit findings to stimulate action. Major trauma audit measures trauma patient care processes and outcomes of care to drive quality improvement at hospital and
Kabiru Isa Dandago
means for ensuring auditor independence and high audit quality in the Malaysian banking industry. In the absence of statutory/mandatory requirement for auditor rotation, it is recommended that the Malaysian banking institutions should be carefully evaluating the impact auditor rotation would have on the quality of audit work on their current and future financial statements, as they decide whether to rotate their auditors or not.
Renante A. Egcas
Full Text Available Continual improvement and customer satisfaction are not simply mantras but become a culture of an organization that had its quality management system certified. Hence, this study aimed to assess the operation of the new accounts section of the select provincial branches of an ISO certified bank in the Philippines. A survey instrument using the CCC (characteristics-condition-challenges framework was employed. The respondents were the new accounts clerks (NACs, supervisors and clients of the branches. The result revealed that the most essential and helpful characteristics of the NAC to achieve maximum clients’ satisfaction are being accommodating, accurate, compliant, fast, facilitative, and pleasing. The result further revealed that the condition of the New Account Section (NAS as to the level of compliance and satisfaction in triangulated assessment was ‘very highly compliant/satisfactory’ in the different areas of operation, hence, conforming processes were evident. Furthermore, the result revealed that the challenges or the issues and problems encountered by the NACs are bulk of works, complaining clients, impatient clients, long processes, and overwhelming clients. Generally, the stakeholders of the bank, particularly the clients desired to be wellaccommodated and well-facilitated by a pleasing and efficient employee in a shortest possible time because for them this is ‘good service’. For continual improvement and business excellence, more procedural and service innovations on some aspects of operations are wanting.
The Department of Energy (Department) and Fluor Daniel Fernald (Fluor Daniel) implemented two work force restructurings at the Fernald Environmental Management Project between Fiscal Years (FY) 1994 and 1996. During the restructurings, the Department`s cost for temporary service subcontracts increased from $2.8 million to $9.8 million annually. The objective of this audit was to determine whether Fluor Daniel utilized temporary service agreements in an economical and efficient manner and in accordance with the policy and goals of the Department`s Work Force Restructuring Program.
Forshaw, Jennifer; Raybould, Stephanie; Lewis, Emilie; Muyingo, Mark; Weeks, Andrew; Reed, Kate; Manikam, Logan; Byamugisha, Josaphat
Mulago National Referral Hospital has the largest maternity unit in sub-Saharan Africa. It is situated in Uganda, where the maternal mortality ratio is 310 per 100,000 live births. In 2010 a 'Traffic Light System' was set up to rapidly triage the vast number of patients who present to the hospital every day. The aim of this study was to evaluate the effectiveness of the obstetric department's triage system at Mulago Hospital with regard to time spent in admissions and to identify urgent cases and factors adversely affecting the system. A prospective audit of the obstetric admissions department was carried out at the Mulago Hospital. Data were obtained from tagged patient journeys using two data collection tools and compiled using Microsoft Excel. StatsDirect was used to compose graphs to illustrate the results. Informal triage was occurring 46 % of the time at the first checkpoint in a woman's journey, but the 'Traffic Light System' was not being used and many of the patient's vital signs were not being recorded. It is hypothesised that the 'Traffic Light System' is not being used due to its focus on examination finding and diagnosis, implying that it is not suitable for an early stage in the patient's journey. Replacing it with a simple algorithm to categorise women into the urgency with which they need to be seen could rectify this.
As requested, we reviewed the audit reports covering the financial statements of the National Federation of Music Clubs, a federally chartered corporation, for the fiscal years ended June 30,1999 and 1998...
Cook, T. M; Andrade, J; Bogod, D. G; Hitchman, J. M; Jonker, W. R; Lucas, N; Mackay, J. H; Nimmo, A. F; O'Connor, K; O'Sullivan, E. P; Paul, R. G; Palmer, J. H. MacG; Plaat, F; Radcliffe, J. J; Sury, M. R. J; Torevell, H. E; Wang, M; Hainsworth, J; Pandit, J. J
The 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia yielded data...
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.
Klarskov Jeppesen, Kim; Carrington, Thomas; Catasús, Bino
Based on the theory of professional competition, this paper identifies and investigates four strategic options of supreme audit institutions (SAIs) through a case study of four Nordic national audit offices: a performance auditing strategy; a financial auditing strategy; a portfolio strategy...... options for public sector auditing....
UK national audit against the key performance indicators in the British Association for Sexual Health and HIV Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.
McClean, H; Sullivan, A K; Carne, C A; Warwick, Z; Menon-Johansson, A; Clutterbuck, D
A national audit of practice performance against the key performance indicators in the British Association for Sexual Health and HIV (BASHH) and HIV Medical Foundation for AIDS Sexual Health Standards for the Management of Sexually Transmitted Infections (STIs) was conducted in 2011. Approximately 60% and 8% of level 3 and level 2 services, respectively, participated. Excluding partner notification performance, the five lowest areas of performance for level 3 clinics were the STI/HIV risk assessment, care pathways linking care in level 2 clinics to local level 3 services, HIV test offer to patients with concern about STIs, information governance and receipt of chlamydial test results by clinicians within seven working days (the worst area of performance). The five lowest areas of performance for level 2 clinics were participating in audit, having an audit plan for the management of STIs for 2009-2010, the STI/HIV risk assessment, HIV test offer to patients with concern about STIs and information governance. The results are discussed with regard to the importance of adoption of the standards by commissioners of services because of their relevance to other national quality assurance drivers, and the need for development of a national system of STI management quality assurance measurement and reporting.
Boykin, C A; Eastwood, L C; Harris, M K; Hale, D S; Kerth, C R; Griffin, D B; Arnold, A N; Hasty, J D; Belk, K E; Woerner, D R; Delmore, R J; Martin, J N; VanOverbeke, D L; Mafi, G G; Pfeiffer, M M; Lawrence, T E; McEvers, T J; Schmidt, T B; Maddock, R J; Johnson, D D; Carr, C C; Scheffler, J M; Pringle, T D; Stelzleni, A M; Gottlieb, J; Savell, J W
The instrument grading assessment portion of the National Beef Quality Audit (NBQA) - 2016 allows the unique opportunity to evaluate beef carcass traits over the course of a year. One week of instrument grading data was collected each month from 5 beef processing corporations encompassing 18 facilities from January 2016 through December 2016 ( = 4,544,635 carcasses). Mean USDA yield grade (YG) was 3.1 with 1.37 cm fat thickness (FT), 88.9 cm LM area, 393.6 kg HCW, and 2.1% KPH. Frequency distribution of USDA YG was 9.5% YG 1, 34.6% YG 2, 38.8% YG 3, 14.6% YG 4, and 2.5% YG 5. Increases in HCW and FT since the NBQA-2011 were major contributors to differences in mean YG and the (numerically) increased frequency of YG 3, 4, and 5 carcasses found in the current audit. Mean marbling score was Small, and the distribution of USDA quality grades was 4.2% Prime, 71.4% Choice, 21.7% Select, and 2.7% other. Frequency of carcasses grading Prime on Monday (6.43%) was numerically higher than the average frequency of carcasses grading Prime overall (4.2%). Monthly HCW means were 397.6 kg in January, 397.2 kg in February, 396.5 kg in March, 389.3 kg in April, 384.8 kg in May, 385.0 kg in June, 386.1 kg in July, 394.1 kg in August, 399.1 kg in September, 403.9 kg in October, 406.5 kg in November, and 401.9 kg in December. Monthly mean marbling scores were Small in January, Small in February, Small in March, Small in April, Small in May, Small in June, Small in July, Small in August, Small in September, Small in October, Small in November, and Small in December. Both mean HCW and mean marbling score declined in the months of May and June. The month with the greatest numerical frequency of dark cutters was October (0.74%). Comparison of overall data from in-plant carcass and instrument grading assessments revealed close alignment of information, especially for YG (3.1 for in-plant assessment versus 3.1 for instrument grading) and marbling (Small for in-plant assessment versus Small
O'Neill, Eunan; Gallagher, Jennifer E; Kendall, Nick
Patients attending for primary dental care may require oral surgery procedures beyond the capability of a generalist and thus need to be treated by a dentist with greater expertise. In the United Kingdom, it is increasingly accepted that such care may be provided in primary care settings by specialists or dentists with a special interest. In response to local pressures, an intermediate minor oral surgery (IMOS) service has been established in Croydon, south west London, to provide oral surgery treatment for non-urgent patients on referral. To audit the appropriateness and quality of oral surgery referrals after triage to an IMOS service in Croydon and to set standards for future audits on this topic. An audit tool was developed in line with the local referral guidelines and agreed with local stakeholders. Information on 501 (10%) triaged referrals to IMOS practices over a 24-month period was obtained through the referral management centre. A 10% sample of referrals per month to each practice was calculated and IMOS providers randomly selected the relevant patient records. Using an agreed audit pro forma, information on the indications for referral, treatment provided, and dates relating to patient management, in addition to the age and sex of patients, was collected from the IMOS providers by one investigator. Descriptive analysis of the data was performed. Of the 501 patient records that were examined, 99% of patients were treated in IMOS practices, with only three (less than 1%) patients being referred on to hospital consultant services. The largest proportion (237; 40%) of referrals was for the extraction of teeth considered to have special difficulty, followed by lower third molars (154; 26%). Almost one-third (159; 32%) of patients were referred for more than one procedure. One in eight (72; 13%) teeth removed by the IMOS providers were recorded as a simple extraction without medical complications. In general, patients were referred appropriately to the
The nation’s ecosystems provide a vast array of services to humans from clean and abundant water to recreational opportunities. The benefits of nature or “ecosystem services” are often taken for granted and not considered in environmental decision-making. In some cases, decis...
Darius Vaicekauskas, Jonas Mackevičius
Full Text Available Over the last few decades audit quality has been investigated by many scholars, although it still hasn’t been properly conceptualized and lacks one common definition. This may be explained by the constant shifting of audit theory and practice, and the complexity of the audit service. The objective of the paper is to investigate the existing definitions of audit quality, identify its main elements and provide a framework for audit quality management in audit firms. The main contribution of the paper is a developed framework for audit quality management, covering both main stakeholders of auditing triangular relationships: third-party users, as well as audit clients. Due to a slump in audit prices, complex competition and a high degree of homogeneity, the authors of the paper focus not only on external users’ perceptions, as the existing large body of literature does, but also stress audit clients’ need for satisfaction in the comprehensive framework. The framework covers various audit firms and audit engagement team factors affecting audit quality and leading to quality audit outputs: an accurate and reliable auditor report and a value adding management letter. Based on the framework presented, recommendations for future audit quality research are provided
Institute of Museum and Library Services, 2004
The National Awards for Museum and Library Service give national recognition to institutions that play an integral and essential part in our learning society. The awards celebrate the efforts of libraries and museums of all sizes to connect with their increasingly diverse communities and to serve as centers of lifelong learning. As the pace of…
O'Kelly, R A
BACKGROUND: The Laboratory modernisation process in Ireland will include point of care testing (POCT) as one of its central tenets. However, a previous baseline survey showed that POCT was under-resourced particularly with respect to information technology (IT) and staffing. AIMS: An audit was undertaken to see if POCT services had improved since the publication of National Guidelines and if such services were ready for the major changes in laboratory medicine as envisaged by the Health Service Executive. METHODS: The 15 recommendations of the 2007 Guidelines were used as a template for a questionnaire, which was distributed by the Irish External Quality Assessment Scheme. RESULTS: Thirty-nine of a possible 45 acute hospitals replied. Only a quarter of respondent hospitals had POCT committees, however, allocation of staff to POCT had doubled since the first baseline survey. Poor IT infrastructure, the use of unapproved devices, and low levels of adverse incident reporting were still major issues. CONCLUSIONS: Point of care testing remains under-resourced, despite the roll out of such devices throughout the health service including primary care. The present high standards of laboratory medicine may not be maintained if the quality and cost-effectiveness of POCT is not controlled. Adherence to national Guidelines and adequate resourcing is essential to ensure patient safety.
Leonard K. Katalambula
Full Text Available Background. Colorectal cancer (CRC is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ2 tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06% and females (49.94%, although gender likelihood of diagnosis type (i.e., rectal or colon was significantly different (P=0.027. More than 60% of patients were between 40 and 69 years. Conclusions. Age (P=0.0183 and time (P=0.004 but not gender (P=0.0864 were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P=0.0405, age (P=0.0015, and time (P=0.0075 were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.
Ameratunga, Rohan; Steele, Richard; Jordan, Anthony; Preece, Kahn; Barker, Russell; Brewerton, Maia; Lindsay, Karen; Sinclair, Jan; Storey, Peter; Woon, See-Tarn
Primary immune deficiency disorders (PIDs) are rare conditions for which effective treatment is available. It is critical these patients are identified at an early stage to prevent unnecessary morbidity and mortality. Treatment of these disorders is expensive and expert evaluation and ongoing management by a clinical immunologist is essential. Until recently there has been a major shortage of clinical immunologists in New Zealand. While the numbers of trained immunologists have increased in recent years, most are located in Auckland. The majority of symptomatic PID patients require life-long immunoglobulin replacement. Currently there is a shortage of subcutaneous and intravenous immunoglobulin (SCIG/IVIG) in New Zealand. A recent audit by the New Zealand Blood Service (NZBS) showed that compliance with indications for SCIG/IVIG treatment was poor in District Health Boards (DHBs) without an immunology service. The NZBS audit has shown that approximately 20% of annual prescriptions for SCIG/IVIG, costing $6M, do not comply with UK or Australian guidelines. Inappropriate use may have contributed to the present shortage of SCIG/IVIG necessitating importation of the product. This is likely to have resulted in a major unnecessary financial burden to each DHB. Here we present the case for a national service responsible for the tertiary care of PID patients and oversight for immunoglobulin use for primary and non-haematological secondary immunodeficiencies. We propose that other PIDs, including hereditary angioedema, are integrated into a national PID service. Ancillary services, including the customised genetic testing service, and research are also an essential component of an integrated national PID service and are described in this review. As we show here, a hub-and-spoke model for a national service for PIDs would result in major cost savings, as well as improved patient care. It would also allow seamless transition from paediatric to adult services.
.... The mission of the Army Audit Agency is to provide an independent and objective internal audit service to the Department of the Army through an appropriate mix of financial and performance audits. Internal audits by the Army Audit Agency of military commands, installations, or activities are scheduled on a periodic basis determined by the Auditor General.
Robert Deal; Lisa Fong; Erin Phelps; Emily Weidner; Jonas Epstein; Tommie Herbert; Mary Snieckus; Nikola Smith; Tania Ellersick; Greg Arthaud
The ecosystem services concept describes the many benefits people receive from nature. It highlights the importance of managing public and private lands sustainably to ensure these benefits continue into the future, and it closely aligns with the U.S. Forest Service (USFS) mission to âsustain the health, diversity, and productivity of the Nationâs forests and...
Cleary, A; Walsh, F; Connolly, H; Hays, V; Oluwole, B; Macken, E; Dowling, M
This audit reviewed current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. A sample of 60 case files, care plans and prescriptions were audited, which is 31% of the total number of service users receiving depot injections in the mental health service region (n= 181). The sample audited had a range of diagnoses, including: schizophrenia, schizoaffective disorder, bipolar affective disorder, depression, alcoholic hallucinosis and autism. The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only five (8%) case notes examined had documentation recorded describing the condition of the injection site, and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded. In 57 (95%) of case notes, no documentation of recorded information on the depot and on side effects was given. The failure to monitor and record some blood tests was partly attributed to a lack of clarity regarding whose responsibility it was. A standardized checklist has been developed as a result of the audit and this will be introduced by all teams across the service. © 2011 Blackwell Publishing.
Full Text Available Abstract Background Independent external audits play an important role in quality assurance programme in radiation oncology. The audit supported by the IAEA in Serbia was designed to review the whole chain of activities in 3D conformal radiotherapy (3D-CRT workflow, from patient data acquisition to treatment planning and dose delivery. The audit was based on the IAEA recommendations and focused on dosimetry part of the treatment planning and delivery processes. Methods The audit was conducted in three radiotherapy departments of Serbia. An anthropomorphic phantom was scanned with a computed tomography unit (CT and treatment plans for eight different test cases involving various beam configurations suggested by the IAEA were prepared on local treatment planning systems (TPSs. The phantom was irradiated following the treatment plans for these test cases and doses in specific points were measured with an ionization chamber. The differences between the measured and calculated doses were reported. Results The measurements were conducted for different photon beam energies and TPS calculation algorithms. The deviation between the measured and calculated values for all test cases made with advanced algorithms were within the agreement criteria, while the larger deviations were observed for simpler algorithms. The number of measurements with results outside the agreement criteria increased with the increase of the beam energy and decreased with TPS calculation algorithm sophistication. Also, a few errors in the basic dosimetry data in TPS were detected and corrected. Conclusions The audit helped the users to better understand the operational features and limitations of their TPSs and resulted in increased confidence in dose calculation accuracy using TPSs. The audit results indicated the shortcomings of simpler algorithms for the test cases performed and, therefore the transition to more advanced algorithms is highly desirable.
To a great extent, the quality of financial reporting depends on the quality of the Accounting and Auditing standards on which the reporting and auditing requirements are based. The objective of the auditing standards analysis is to compare the national standards used to conduct audits of historical information with International Standards on Auditing (ISA) with a view to capturing signifi...
individual liberties not only owed a portion of his property (taxes), but his personal services (time and talents). With over 229.2 million adult ...criminal penalty for nonparticipation in the program.”4 Thus, if one chose not to participate in the national service program he/she could pay an...characteristics at an early age will help curb the recent increase in violent crimes11 and help fix the struggling education system in America.12 Finally
Cannell, P J
A mandatory scheme for clinical audit in the general dental services (GDS) was launched in April 2001. No evaluation of this mandatory scheme exists in the literature. This study provides an evaluation of this scheme. More recently a new dental contract was introduced in the general dental services (GDS) in April 2006. Responsibility for clinical audit activities was devolved to primary care trusts (PCTs) as part of their clinical governance remit. All GDPs within Essex were contacted by letter and invited to participate in the research. A qualitative research method was selected for this evaluation, utilising audio-taped semi-structured research interviews with eight general dental practitioners (GDPs) who had taken part in the GDS clinical audit scheme and who fitted the sampling criteria and strategy. The evaluation focused on dentists' experiences of the scheme. The main findings from the analysis of the GDS scheme data suggest that there is clear evidence of change following audit activities occurring within practices and for the benefit of patients. However, often it is the dentist only that undertakes a clinical audit project rather than the dental team, there is a lack of dissemination of project findings beyond the individual participating practices, very little useful feedback provided to participants who have completed a project and very limited use of formal re-auditing of a particular topic. This study provides evaluation of the GDS clinical audit scheme. Organisations who propose to undertake clinical audit activities in conjunction with dentistry in the future may benefit from incorporating and/or developing some findings from this evaluation into their project design and avoiding others.
Gray, G D; Moore, M C; Hale, D S; Kerth, C R; Griffin, D B; Savell, J W; Raines, C R; Lawrence, T E; Belk, K E; Woerner, D R; Tatum, J D; VanOverbeke, D L; Mafi, G G; Delmore, R J; Shackelford, S D; King, D A; Wheeler, T L; Meadows, L R; O'Connor, M E
The instrument grading assessments for the 2011 National Beef Quality Audit evaluated seasonal trends of beef carcass quality and yield attributes over the course of the year. One week of instrument grading data, HCW, gender, USDA quality grade (QG), and yield grade (YG) factors, were collected every other month (n = 2,427,074 carcasses) over a 13-mo period (November 2010 through November 2011) from 4 beef processing corporations, encompassing 17 federally inspected beef processing facilities, to create a "snapshot" of carcass quality and yield attributes and trends from carcasses representing approximately 8.5% of the U.S. fed steer and heifer population. Mean yield traits were YG (2.86), HCW (371.3 kg), fat thickness (1.19 cm.), and LM area (88.39 cm(2)). The YG distribution was YG 1, 15.7%; YG 2, 41.0%; YG 3, 33.8%; YG 4, 8.5%; and YG 5, 0.9%. Distribution of HCW was <272.2 kg, 1.6%; 272.2 to 453.6 kg, 95.1%; and ≥453.6 kg, 3.3%. Monthly HCW means were November 2010, 381.3 kg; January 2011, 375.9 kg; March 2011, 366.2 kg; May 2011, 357.9 kg; July 2011, 372.54 kg; September 2011, 376.1 kg; and November 2011, 373.5 kg. The mean fat thickness for each month was November 2010, 1.30 cm; January 2011, 1.22 cm; March 2011, 1.17 cm; May 2011, 1.12 cm; July 2011, 1.19 cm; September 2011, 1.22 cm; and November 2011, 1.22 cm. The overall average marbling score was Small(49). The USDA QG distribution was Prime, 2.7%; Top Choice, 22.9%; Commodity Choice, 38.6%; and Select, 31.5%. Interestingly, from November to May, seasonal decreases (P < 0.001) in HCW and fat thicknesses were accompanied by increases (P < 0.001) in marbling. These data present the opportunity to further investigate the entire array of factors that determine the value of beef. Data sets using the online collection of electronic data will likely be more commonly used when evaluating the U.S. fed steer and heifer population in future studies.
The Department of Energy (Department) and the National Institute of Environmental Health Sciences (NIEHS) entered into an interagency agreement in September 1992 to develop model safety and health training programs for workers involved in waste cleanup activities at Departmental facilities. Under the terms of the agreement, recipients of NIEHS training grants were to provide Hazardous Waste Operations and Emergency Response (HAZWOPER) training to Departmental sites. By June 1997, the Department had obligated over $40 million to the agreement. The objective of this audit was to determine whether the interagency agreement with NIEHS was the most cost-effective method of acquiring the training.
Léopold Djoutsa Wamba
Full Text Available La présente étude a pour ambition de vérifier s’il existe un lien empirique entre le comportement des audités et la qualité de l’audit au Cameroun. Nous avons à cet effet appréhendé la qualité de l’audit via les qualités de l’auditeur (sa compétence et son indépendance. En s’appuyant sur les analyses de classification et économétriques par la méthode de régression logistique sur des données recueillies par questionnaire auprès de 40 cabinets d’audits présents au Cameroun, les résultats montrent d’une part que la qualité de l’audit est plutôt altérée dans notre contexte. D’autre part, cette étude relève que la probabilité d’avoir un audit de qualité est d’autant plus grande lorsque les honoraires sont négociés à la hausse permanemment et, d’autant plus faible, si l’audité est absent lors du déroulement de la mission, ou s’il accuse des retards dans le paiement des honoraires ou encore, lorsqu’il n’a pas fourni à temps tous les documents nécessaires pour mener à bien la mission.
Chapman, Stephen J; Glasbey, James C D; Khatri, Chetan; Kelly, Michael; Nepogodiev, Dmitri; Bhangu, Aneel; Fitzgerald, J Edward F
Medical students often struggle to engage in extra-curricular research and audit. The Student Audit and Research in Surgery (STARSurg) network is a novel student-led, national research collaborative. Student collaborators contribute data to national, clinical studies while gaining an understanding of audit and research methodology and ethical principles. This study aimed to evaluate the educational impact of participation. Participation in the national, clinical project was supported with training interventions, including an academic training day, an online e-learning module, weekly discussion forums and YouTube® educational videos. A non-mandatory, online questionnaire assessed collaborators' self-reported confidence in performing key academic skills and their perceptions of audit and research prior to and following participation. The group completed its first national clinical study ("STARSurgUK") with 273 student collaborators across 109 hospital centres. Ninety-seven paired pre- and post-study participation responses (35.5%) were received (male = 51.5%; median age = 23). Participation led to increased confidence in key academic domains including: communication with local research governance bodies (p research, audit and study design (p study, which increased their confidence and appreciation of academic principles and skills. Encouraging active participation in collaborative, student-led, national studies offers a novel approach for delivering essential academic training.
Full Text Available The death of the English National Health Service (NHS has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented.
Corporation for National and Community Service, 2014
The Corporation for National and Community Service (CNCS) supports mentoring for children and youth from disadvantaged circumstances through several of their programs. CNCS believes that caring and capable adults can make a critical difference in the lives of children and youth in need. Mentoring is a proven method to ensure students complete…
Term Bank. Originally resorting under the Science and Technology Branch of the. Department of Arts, Culture, Science and Technology, the National Terminol- ogy Services .... as well as interpreters, translators, copywriters and journalists, i.e. all people in ..... "It should be an optional topic that students can take as part of.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false National service fellowships. 2534.10 Section 2534.10 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SPECIAL ACTIVITIES § 2534.10 National service fellowships. The Corporation may award national service fellowships on a competitive...
Sobolev Volodymyr M.
Full Text Available The article analyses influence of the world crisis phenomena upon the national economy, shows a significant necessity of using international reporting standards. It justifies a necessity of strengthening financial control, the goal of which is to detect shortcomings in financial reports and recommendations regarding their elimination in order to ensure trustworthiness of reports. It considers main problems of audit activity and identifies necessary measures and ways of their solution. It reveals and justifies possible directions of prospective development of audit in Ukraine with consideration of the process of transition of economic subjects to international standards of financial reporting and marks out a necessity of strengthening the role of the state institutions in further audit development. It analyses the insufficient control over the quality of audit services and statistical material regarding the number and specific features of operation of audit firms and private auditors in Ukraine.
Andon, P.; Free, C.; O'Dwyer, B.
Purpose - The purpose of this paper is to examine attempts at jurisdictional expansion in the audit field. Specifically, the authors critically analyse the professional implications of "new audit spaces", that is, novel auditing and assurance services that have emerged at intersections between audit
Andersen, John Sahl; Olivarius, Niels de Fine; Krasnik, Allan
Abstract Introduction: To describe the Danish National Health Service Register in relation to research. Content: The register contains data collected for administrative and scientific purposes from health contractors in primary health care. It includes information about citizens, providers......, and health services but minimal clinical information. Validity and coverage: The register covers everyone living in Denmark and data is available from 1990. No validity studies have been reported. Because the data is connected to reimbursement the coverage is assumed to be good. CONCLUSION: The strengths...
Full Text Available Abstract Background The aim of this study was to review evaluations and audits of primary care complementary therapy services to determine the impact of these services on improving health outcomes and reducing NHS costs. Our intention is to help service users, service providers, clinicians and NHS commissioners make informed decisions about the potential of NHS based complementary therapy services. Methods We searched for published and unpublished studies of NHS based primary care complementary therapy services located in England and Wales from November 2003 to April 2008. We identified the type of information included in each document and extracted comparable data on health outcomes and NHS costs (e.g. prescriptions and GP consultations. Results Twenty-one documents for 14 services met our inclusion criteria. Overall, the quality of the studies was poor, so few conclusions can be made. One controlled and eleven uncontrolled studies using SF36 or MYMOP indicated that primary care complementary therapy services had moderate to strong impact on health status scores. Data on the impact of primary care complementary therapy services on NHS costs were scarcer and inconclusive. One controlled study of a medical osteopathy service found that service users did not decrease their use of NHS resources. Conclusion To improve the quality of evaluations, we urge those evaluating complementary therapy services to use standardised health outcome tools, calculate confidence intervals and collect NHS cost data from GP medical records. Further discussion is needed on ways to standardise the collection and reporting of NHS cost data in primary care complementary therapy services evaluations.
National Oceanic and Atmospheric Administration, Department of Commerce — The data set contains information on retail market spot check audit purchases. Data are available from May 2001 to present with new data appended annually....
Full Text Available The research paper, focused on a rather technical approach, has the goal to design a system that brings together diverse audit stakeholders and investigates how an audit database available online can be implemented in SharePoint, as part of an on-line audit system which is collaborative and national. The online audit database covers various information needs for both financial auditors and the employees of the Chamber of Financial Auditors of Romania. For rapid deployment, we used various tools: Microsoft SQL Server 2008 R2, SharePoint Server 2010, SharePoint Designer 2010 and various implementation features: external content types, external lists, business data web parts etc. In this paper, we use two research methods: the first one is empiric, based on formulating a questionnaire and the interpretation of the results, while the second is the analysis of the implementation process by using a step-by-step approach. The online audit database stores information about the results of previous audits, the opinions issued as result of audits, the results of online electronic inspections, audit firms, audited entities, risks identified etc. The conclusion was that the online database, which is updated through Internet, is feasible to implement in SharePoint, for multiple audit stakeholders including financial auditors who can sell their financial audit services benefiting from the transparency that the system provides.
Ozmeral, Alisha Bhadelia; Reiter, Kristin L.; Holmes, George M.; Pink, George H.
Purpose: Medicare Cost Reports (MCR), Internal Revenue Service Form 990s (IRS 990), and Audited Financial Statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across…
Ozmeral, Alisha Bhadelia; Reiter, Kristin L; Holmes, George M; Pink, George H
Medicare cost reports (MCR), Internal Revenue Service form 990s (IRS 990), and audited financial statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across the MCR, IRS 990, and AFS for a sample of nonprofit critical access hospitals (CAHs). Line items from AFS of 47 CAHs were compared to data reported in the hospitals' MCR and IRS 990s. Line items were based on 9 financial indicators commonly used to assess hospital financial performance. Of the indicators examined, the equity financing ratio most frequently matched between the 3 reports, while salaries and benefits to total expenses and debt service coverage were often different. Variances were driven by differences in individual account balances used to construct the ratios. Relative to AFS, cash was frequently lower on the IRS 990 while marketable securities and unrestricted investments were often higher. Other revenue and net income were consistently lower on the MCR and IRS 990, and depreciation was often higher on the MCR. The majority of total assets and fund balance (equity) values matched across the 3 reports, suggesting differences in classification among detailed accounts were more common than variances between the component totals (total assets, total liabilities, and fund balance). Health policy researchers should consider the impact of these variances on study results and consider ways to improve the availability and quality of financial accounting information. © 2012 National Rural Health Association.
Pritt, Jeffrey; Jones, Berwyn E.
PREFACE This catalog provides information about analytical services available from the National Water Quality Laboratory (NWQL) to support programs of the Water Resources Division of the U.S. Geological Survey. To assist personnel in the selection of analytical services, the catalog lists cost, sample volume, applicable concentration range, detection level, precision of analysis, and preservation techniques for samples to be submitted for analysis. Prices for services reflect operationa1 costs, the complexity of each analytical procedure, and the costs to ensure analytical quality control. The catalog consists of five parts. Part 1 is a glossary of terminology; Part 2 lists the bottles, containers, solutions, and other materials that are available through the NWQL; Part 3 describes the field processing of samples to be submitted for analysis; Part 4 describes analytical services that are available; and Part 5 contains indices of analytical methodology and Chemical Abstract Services (CAS) numbers. Nomenclature used in the catalog is consistent with WATSTORE and STORET. The user is provided with laboratory codes and schedules that consist of groupings of parameters which are measured together in the NWQL. In cases where more than one analytical range is offered for a single element or compound, different laboratory codes are given. Book 5 of the series 'Techniques of Water Resources Investigations of the U.S. Geological Survey' should be consulted for more information about the analytical procedures included in the tabulations. This catalog supersedes U.S. Geological Survey Open-File Report 86-232 '1986-87-88 National Water Quality Laboratory Services Catalog', October 1985.
The purpose of this study was to investigate whether or not service learning could be considered an alternative teaching method in an environmental science classroom. In particular, the results of this research show whether an energy audit service learning project influenced student environmental awareness (knowledge of environmental issues, problems, and solutions), student personal actions/behaviors towards the environment, student perceptions and attitudes of science related careers, and community partnerships. Haines (2010) defines service learning as “a teaching and learning strategy that integrates meaningful community service with instruction and reflection to enrich the learning experience, teach civic responsibility, and strengthen communities” (p. 16). Moreover, service learning opportunities can encourage students to step out of their comfort zone and learn from hands-on experiences and apply knowledge obtained from lectures and classroom activities to real life situations. To add to the growing body of literature, the results of this study concluded that an energy audit service learning project did not have a measureable effect on student perceptions and attitudes of science related careers as compared to a more traditional teaching approach. However, the data from this study did indicate that an energy audit service learning project increased students personal actions/behaviors towards the environment more than a direct teaching approach.
Rozas Flores, Alan Errol; Facultad de Ciencias Contables, Universidad Nacional Mayor de San Marcos
The forensic audit is an audit specialist in obtaining evidence to turn them into tests, which are presented in the forum that is in the courts of justice, in order to check crime or settle legal disputes. Currently, major efforts are being carried out by compliance audits and comprehensive audits need to be retrofitted with legal research, to minimize the impunity that comes before economic and financial crimes, such as administrative corruption, corporate fraud and money laundering assets. ...
Hamid, Tahir; Harper, Luke; Rose, Samman; Petkar, Sanjive; Fienman, Richard; Athar, Syed M; Cushley, Michael
Medication error is a major source of iatrogenic illness. Error in prescription is the most common form of avoidable medication error. We present our study, performed at two, UK, National Health Services Hospitals. The prescription practice of junior doctor's working on general medical and surgical wards in National Health Service District General and University Teaching Hospitals in the UK was reviewed. Practice was assessed against standard hospital prescription charts, developed in accordance with local pharmacy guidance. A total of 407 prescription charts were reviewed in both initial audit and re-audit one year later. In the District General Hospital, documentation of allergy, weight and capital-letter prescription was achieved in 31, 5 and 40% of charts, respectively. Forty-nine per cent of discontinued prescriptions were properly deleted and signed for. In re-audit significant improvement was noted in documentation of the patient's name 100%, gender 54%, allergy status 51% and use of generic drug name 71%. Similarly, in the University Teaching Hospital, 82, 63 and 65% compliance was achieved in documentation of age, generic drug name prescription and capital-letter prescription, respectively. Prescription practice was reassessed one year later after recommendations and changes in the prescription practice, leading to significant improvement in documentation of unit number, generic drug name prescription, insulin prescription and documentation of the patient's ward. Prescription error remains an important, modifiable form of medical error, which may be rectified by introducing multidisciplinary assessment of practice, nationwide standardised prescription charts and revision of current prescribing clinical training. © The Author(s) 2016.
Fijneman, R.; Ho, K.H.; Roos Lindgreen, E.; Veltman, P.
This textbook on IT auditing (EDP auditing) is intended for ICT, IT auditing and accountancy professionals and students. It provides a consistent introduction to all topics with which an IT auditor is confronted in practice. It also refers of course to the major standards and norms adopted in
BACKGROUND: Ward-based patient-controlled epidural analgesia (PCEA) for postoperative pain control was introduced at our institution in 2006. We audited the efficacy and safety of ward-based PCEA from January 2006 to December 2008. METHOD: Data were collected from 928 patients who received PCEA in general surgical wards for postoperative analgesia using bupivacaine 0.125% with fentanyl 2 mug\\/mL. RESULTS: On the first postoperative day, the median visual analogue pain score was 2 at rest and 4 on activity. Hypotension occurred in 21 (2.2%) patients, excessive motor blockade in 16 (1.7%), high block in 5 (0.5%), nausea in 5 (0.5%) and pruritus in only 1 patient. Excessive sedation occurred in two (0.2%) patients but no intervention was required. There were no serious complications such as epidural abscess, infection or haematoma. CONCLUSION: Effective and safe postoperative analgesia can be provided with PCEA in a general surgical ward without recourse to high-dependency supervision.
Danckert, Rachael; Ryan, Anna; Plummer, Virginia; Williams, Cylie
Poor oral health has been associated with systemic diseases, morbidity and mortality. Many patients in hospital environments are physically compromised and rely upon awareness and assistance from health professionals for the maintenance or improvement of their oral health. This study aimed to identify whether common individual and environment factors associated with hospitalisation impacted on oral hygiene. Data were collected during point prevalence audits of patients in the acute and rehabilitation environments on three separate occasions. Data included demographic information, plaque score, presence of dental hygiene products, independence level and whether nurse assistance was documented in the health record. Data were collected for 199 patients. A higher plaque score was associated with not having a toothbrush (p = 0.002), being male (p = 0.007), being acutely unwell (p = 0.025) and requiring nursing assistance for oral hygiene (p = 0.002). There was fair agreement between the documentation of requiring assistance for oral care and the patient independently able to perform oral hygiene (ICC = 0.22). Oral hygiene was impacted by factors arising from hospitalisation, for those without a toothbrush and male patients of acute wards. Establishment of practices that increase awareness and promote good oral health should be prioritised. © 2015 Nordic College of Caring Science.
...; ] DEPARTMENT OF AGRICULTURE Animal and Plant Health Inspection Service National Wildlife Services Advisory... Wildlife Services Advisory Committee for a 2- year period. The Secretary has determined that the Committee...-7921. SUPPLEMENTARY INFORMATION: The purpose of the National Wildlife Services Advisory Committee (the...
The beginning of the 21st Century has been characterised by changed political and economic realities affecting the prevention, control and eradication of animal diseases and zoonoses and presenting new challenges to the veterinary profession. Veterinary Services (VS) need to have the capacity and capabilities to face these challenges and be able to detect, prevent, control and eradicate disease threats. Animal health and VS, being a public good, require global initiatives and collective international action to be able to implement global animal disease eradication. The application of the 'One World, One Health' strategy at the animal-human interface will strengthen veterinary capacity to meet this challenge. Good governance of VS at the national, regional and global level is at the heart of such a strategy. In this paper, the author lists the key elements comprising good veterinary governance and discusses the World Organisation for Animal Health (OIE) standards for the quality of VS. The OIE Tool for the Evaluation of the Performance of Veterinary Services (OIE PVS Tool) is introduced and its relevance in assessing compliance with OIE standards to prevent the spread of pathogens through trade is highlighted. A firm political commitment at the national, regional and international level, with provision of the necessary funding at all levels, is an absolute necessity in establishing good governance of VS to meet the ever-increasing threats posed by animal and human pathogens.
Melo, E Correa
The author describes the reasons why evaluation processes should be applied to the Veterinary Services of Member Countries, either for trade in animals and animal products and by-products between two...
Pontoppidan, Caroline Aggestam
This article will give a description of the role of internal audit and governance functions within the United Nations system. The United Nations has, during the last 10 years, worked to establish effective oversight services. Oversight, governance and hereunder the internal audit function has been...
Olsen, Angela; Majeed-Ariss, Rabiya; Teniola, Simonette; White, Catherine
Background: People with learning disabilities are more likely to experience sexual abuse and less likely to access support than the general population, this is due to a range of variables at the individual, societal and service-delivery level. This study presents a service evaluation of St Mary's Sexual Assault Referral Centre, Manchester to…
Dalal, Hasnain M; Evans, Philip H
Integrated care for patients who survive a myocardial infarction is lacking. Many patients are not offered cardiac rehabilitation, and secondary prevention is not optimal. 12 month audit of 106 patients who survived an acute myocardial infarction. Carrick Primary Care Trust in Cornwall (population 98 500) and one district general hospital. Proportion of patients who complete a cardiac rehabilitation programme after a myocardial infarction. Proportion of patients with optimal secondary prevention, as measured by smoking status, body mass index, cholesterol National service framework targets for cardiac rehabilitation and secondary prevention can be achieved in patients who survive a myocardial infarction by integrating rehabilitation services (home and hospital) with secondary prevention clinics in primary care. Nurse led clinics in primary care facilitate long term structured care and optimal secondary prevention.
Gray, C S; Drewitt, D J; Lewis, S J
Routine home visiting is a luxury not afforded to other medical specialties. The practice of routine home assessment visiting in geriatric medicine was evaluated in a prospective study of 110 consecutive referrals to determine whether; the response to general practitioners referrals could be predicted from the information given at the time of referral and; to identify where home visiting identified additional information of value in directing services more appropriately. Requests for admission were accurately predicted in 86-96% of cases by the visiting and a control doctor respectively. Additional information of value in directing services and patient management was gained from the home visit in 30% of admissions, 58% of day hospital cases and 80% of outpatients. It is possible to predict the outcome of home visits although implementation of such predictions without direct communication with general practitioners would result in a small number of unnecessary admissions and referrals to day hospital services.
The aim of this audit was to review current practice within a rural mental health service area on the monitoring and documentation of side effects of antipsychotic depot medication. Following a review of the literature on best practice internationally, an evidence based audit tool was adapted. A sample of 60 case files, care plans and prescriptions were audited between January and May 2010. This represented 31% of the total number of service users receiving depot injections in the mental health service region (n=181). The audit results revealed that most service users had an annual documented medical review and a documented prescription. However, only 5 (8%) case notes examined had documentation recorded describing the condition of the injection site and alternation of the injection site was recorded in only 28 (47%) case notes. No case notes examined had written consent to commence treatment recorded, and only 3 (5%) of case notes had documented that information on the depot injection and side effects was given. In 57 (95%) of case notes no documentation of recorded information on the depot and on side effects was given. Documentation of physical observations and tests revealed that 58% of cases had full blood count, liver function tests, thyroid function tests and fasting lipids recorded. All other tests (i.e. temperature, pulse, respirations, blood pressure, ECG) were recorded in less than 50% of cases. Prolactin levels were not recorded in any case. The lack of written consent was partly attributed to lack of recording of consent. The failure to monitor and record some\\r\
Bukhsh, F.A.; Weigand, H.
Whereas e-government used to be focused mainly on digitalizing documents, the attention is currently shifting to the question how the main governmental functions service, care and control can be realized in the best way in an information age. In this respect, e-customs is a case in point. Worldwide
Full Text Available The financial audit has two components: the statutory audit (mandatory for certain companies made by financial auditors and the optional audit which can be done by other professionals (chartered accountants, evaluators, and tax matters members. The statutory audit represents the examination done by an authorized and independent professional of the financial statement of a company, in order to express a motivated opinion regarding the position, situation and financial performance. The statutory audit is established by law for those companies which have a significant public impact. The financial statement represents the management’s statement through which the firm communicates with the stakeholders: shareholders, creditors, investors, clients, debtors, contractors, employees, state institutions and thepopulation. The objective of the performance audit is the efficiency and effectiveness with which the audited company uses its resources in order to accomplish its responsibilities. The audit committees have a greater responsibility especially after the scandals in the US (Enron, WorldCom, Adelphia, through the Sarbanes-Oxley act from 2002. The audit committee has the following attributions: it monitors the financial reports made by the executive management, helps internal investigations, monitors and evaluates the activity of the internal audit department, gives recommendations to the administration council regarding the problems encountered when communicating with the shareholders, replacing or extending the mandate of the external auditor and authorizes the approval of this person’s fees.
National Oceanic and Atmospheric Administration, Department of Commerce — Service Records and Retention System (SRRS) is historical digital data set DSI-9949, a collection of products created by the U.S. National Weather Service (NWS) and...
US Fish and Wildlife Service, Department of the Interior — The Visitor Services Plan covers background information, objectives, strategies and goals of the Visitor Services program at Seney NWR for the next 15 years. It...
Van Leeuwen, Sylvia
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.
Melo, E Correa
The author describes the reasons why evaluation processes should be applied to the Veterinary Services of Member Countries, either for trade in animals and animal products and by-products between two countries, or for establishing essential measures to improve the Veterinary Service concerned. The author also describes the basic elements involved in conducting an evaluation process, including the instruments for doing so. These basic elements centre on the following:--designing a model, or desirable image, against which a comparison can be made--establishing a list of processes to be analysed and defining the qualitative and quantitative mechanisms for this analysis--establishing a multidisciplinary evaluation team and developing a process for standardising the evaluation criteria.
Евгений Геннадьевич Панкратов
Full Text Available This article analyzes the existing methods of e-government systems audit, their shortcomings are examined. The approaches to improve existing techniques and adapt them to the specific characteristics of e-government systems are suggested. The paper describes the methodology, providing possibilities of integrated assessment of information systems. This methodology uses systems maturity models and can be used in the construction of e-government rankings, as well as in the audit of their implementation process. Maturity models are based on COBIT, COSO methodologies and models of e-government, developed by the relevant committee of the UN. The methodology was tested during the audit of information systems involved in the payment of temporary disability benefits. The audit was carried out during analysis of the outcome of the pilot project for the abolition of the principle of crediting payments for disability benefits.DOI: http://dx.doi.org/10.12731/2218-7405-2014-2-5
O'Connor, J; Youde, L S; Allen, J R; Hanson, R M; Baur, L A
To examine the process of anthropometric assessment of nutritional status in a tertiary paediatric hospital, to identify the barriers and to make recommendations for service improvement. The accuracy of height and weight scales in wards was checked. Dietitians measured height and weight of a representative sample of 245 inpatients and checked whether these measurements had been recorded on bed charts. Patients were classified as overweight, obese or under-nourished. Diagnoses and procedures were obtained for each patient. Funding implications were modelled for inappropriate coding of nutritional status. The barriers to nutritional assessment and management of nutritional comorbidities were: (i) inaccurate height scales in seven out of 12 wards; (ii) under-recording of height and weight on patient bed charts (73% height missing, 12% both height and weight missing); (iii) under-reporting of obesity and under-nutrition in medical notes (one of eight obese patients, and none of 28 undernourished patients, reported); and (iv) low referral rate of obese or under-nourished children to dietetic services (two of 42 overweight/obese patients referred, five of 28 undernourished patients referred). Funding simulation showed that if under-nourished patients were correctly diagnosed then the potential facility reimbursement would have increased by $A52 326. Barriers to nutritional assessment can lead to failure to diagnose and treat both over- and under-nutrition, thereby affecting quality of patient care, and may have financial implications for hospitals. Suggestions for service improvement include provision of accurate equipment, adequate training of staff undertaking nutritional assessments and clear definitions of staff responsibilities in all aspects of the process.
... HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National... retention resources, and partnerships. The public can join the meeting via audio conference call on the date... INFORMATION CONTACT: Njeri Jones, Bureau of Clinician Recruitment and Service, Health Resources and Services...
U.S. Department of Health & Human Services — The National Mental Health Services Survey (N-MHSS) is an annual survey designed to collect statistical information on the numbers and characteristics of all known...
US Fish and Wildlife Service, Department of the Interior — This Hunting Chapter precedes the overall Visitor Services Plan for Agassiz National Wildlife Refuge (Agassiz NWR). This chapter includes specific guidelines for...
Felker, Susan B.
Perry D. Martin of Newport, Va., assistant director of Virginia Tech's Service-Learning Center, was appointed by Governor Tim Kaine to serve on the Governor's Commission on National and Community Service.
Osborne, H. D.; Palmer, C. K.; Krone-Davis, P.; Melton, F. S.; Hobbins, M.
The National Weather Service (NWS), Weather Forecasting Offices (WFOs) are producing daily reference evapotranspiration (ETrc) forecasts or FRET across the Western Region and in other selected locations since 2009, using the Penman - Monteith Reference Evapotranspiration equation for a short canopy (12 cm grasses), adopted by the Environmental Water Resources Institute of the American Society of Civil Engineers (ASCE-EWRI, 2004). The sensitivity of these daily calculations to fluctuations in temperatures, humidity, winds, and sky cover allows forecasters with knowledge of local terrain and weather patterns to better forecast in the ETrc inputs. The daily FRET product then evolved into a suite of products, including a weekly ETrc forecast for better water planning and a tabular point forecast for easy ingest into local water management-models. The ETrc forecast product suite allows water managers, the agricultural community, and the public to make more informed water-use decisions. These products permit operational planning, especially with the impending drought across much of the West. For example, the California Department of Water Resources not only ingests the FRET into their soil moisture models, but uses the FRET calculations when determining the reservoir releases in the Sacramento and American Rivers. We will also focus on the expansion of FRET verification, which compares the daily FRET to the observations of ETo from the California Irrigation Management Information System (CIMIS) across California's Central Valley for the 2012 water year.
O'Shea, Emma; Timmons, Suzanne; Kennelly, Sean; de Siún, Anna; Gallagher, Paul; O'Neill, Desmond
As the prevalence of dementia increases, more people will need dementia palliative and end-of-life (EOL) care in acute hospitals. Published literature suggests that good quality care is not always provided. To evaluate the prescription of antipsychotics and performance of multidisciplinary assessments relevant to palliative care for people with dementia, including those at EOL, during hospital admission. As part of a national audit of dementia care, 660 case notes were reviewed across 35 acute hospitals. In the entire cohort, many assessments essential to dementia palliative care were not performed. Of the total sample, 76 patients died, were documented to be receiving EOL care, and/or were referred for specialist palliative care. In this cohort, even less symptom assessment was performed (eg, no pain assessment in 27%, no delirium screening in 68%, and no mood or behavioral and psychological symptoms of dementia in 93%). In all, 37% had antipsychotic drugs during their admission and 71% of these received a new prescription in hospital, most commonly for "agitation." This study suggests a picture of poor symptom assessment and possible inappropriate prescription of antipsychotic medication, including at EOL, hindering the planning and delivery of effective dementia palliative care in acute hospitals. © The Author(s) 2015.
Perrem, L M
Consultant paediatricians in Ireland were surveyed to evaluate their perceptions of the hospital audit environment and assess their involvement in the audit process. Eighty nine (77%) replied of whom 66 (74%) had an audit department and 23 (26%) did not. Sixteen (18%) felt their hospital was well resourced for audit and 25 (28%) felt the culture was very positive but only 1 (1%) had protected time. For 61 (69%) consultants audit was very important with 38 (43%) being very actively involved in the process. The most frequent trigger for audit was non consultant hospital doctor (NCHD) career development, cited by 77 (87%). The new Professional Competence Scheme and the National Quality and Risk Management Standards will require the deficiencies identified in this survey be addressed.
Full Text Available Over the last few decades audit quality has been investigated by many scholars, although it still hasn’t been properly conceptualized and lacks one common definition. This may be explained by the constant shifting of audit theory and practice, and the complexity of the audit service. The objective of the paper is to investigate the existing definitions of audit quality, identify its main elements and provide a framework for audit quality management in audit firms. The main contribution of the paper is a developed frame-work for audit quality management, covering both main stakeholders of auditing triangular relationships: third-party users, as well as audit clients. Due to a slump in audit prices, complex competition and a high degree of homogeneity, the authors of the paper focus not only on external users’ perceptions, as the existing large body of literature does, but also stress audit clients’ need for satisfaction in the comprehen-sive framework. The framework covers various audit firms and audit engagement team factors affecting audit quality and leading to quality audit outputs: an accurate and reliable auditor report and a value adding management letter. Based on the framework presented, recommendations for future audit quality research are provided.
Effective chronic disease management (CDM) requires the ready availability and communication of accurate, clinical disease specific information. Using epilepsy as a probe into CDM, we report on the availability and reliability of clinical information in the primary care records of people with epilepsy (PWE). The medical records of 374 PWE from 53 general practices in the Mid-West region of Ireland were examined. Confirmation of an epilepsy diagnosis by a neurologist was documented for 132 (35%) patients. 282 (75%) patients had no documented evidence of receiving specialist neurology review while 149 (40%) had not been reviewed by their GP in the previous two years for their epilepsy. Significant variation in documentation of epilepsy specific information together with an inadequacy and inconsistency of existing epilepsy services was highlighted.
Effective chronic disease management (CDM) requires the ready availability and communication of accurate, clinical disease specific information. Using epilepsy as a probe into CDM, we report on the availability and reliability of clinical information in the primary care records of people with epilepsy (PWE). The medical records of 374 PWE from 53 general practices in the Mid-West region of Ireland were examined. Confirmation of an epilepsy diagnosis by a neurologist was documented for 132 (35%) patients. 282 (75%) patients had no documented evidence of receiving specialist neurology review while 149 (40%) had not been reviewed by their GP in the previous two years for their epilepsy. Significant variation in documentation of epilepsy specific information together with an inadequacy and inconsistency of existing epilepsy services was highlighted.
U.S. Geological Survey, Department of the Interior — The USGS NAIP Plus service from The National Map consists of National Agriculture Imagery Program (NAIP) and high resolution orthoimagery (HRO) that combine the...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of air temperature. In...
Weigand, H.; Johannesson, P.; Andersson, B.; Bergholtz, M.; Bukhsh, F.A.; Deneckere, R.; Proper, H.
Compliance has become a strategic concern for many companies and organizations. To prove actual compliance, the organization must disclose itself (be auditable). A plethora of advanced tools has been developed to support compliance management and auditing processes. However, not all organizations
This report documents the identification and assessment of external service providers to the National Security Technology Incubator (NSTI) program for southern New Mexico. The NSTI is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant to Arrowhead Center, New Mexico State University. This report contains 1) a summary of the services to be provided by NSTI; 2) organizational descriptions of external service providers; and 3) a comparison of NSTI services and services offered by external providers.
Munro, Christina H; Henniker-Major, Ruth; Homfray, Virginia; Browne, Rita
The incidence of congenital syphilis remains low in the UK, but the morbidity and mortality to babies born to women who are untreated for the condition make testing for the disease antenatally one of the most cost-effective screening programmes. Women attending North Middlesex Hospital, UK with a positive syphilis test at their antenatal booking visit are referred to St Ann's Sexual Health Clinic, London, for management and contact tracing. We were concerned that our initial audit revealed that a large proportion of women referred to our service never attended and recorded partner notification was poor. Following the implementation of recommendations, specifically the introduction of an electronic referral system, re-audit showed an improvement in attendance, contact tracing, documentation and communication.
As increasing demand for organs is a challenge for transplant services worldwide it is essential to audit the process of organ donation. To address this, a national audit of potential organ donors was undertaken across hospitals with Intensive Care Units (N = 36). Questionnaires were returned on all patients (n = 2073) who died in these units from 1\\/9\\/07-31\\/8\\/08; 200 (10%) of these patients were considered for Brain Stem Testing (BST), 158 patients (79%) were diagnosed Brain Stem Dead (BSD) and 138 patients (87%) became potential donors. Consent for donation was given by 92 (69%) next of kin and 90 potential donors (65%) became organ donors. There was no evidence of a large number of potential organ donors being missed. Recommendations included completion of BSTs on all appropriate patients, development of support on BST, referral of all BSD patients to the Organ Procurement Service; enhanced co-ordination within hospitals and sustained information\\/education campaigns.
Madsen, A S; Laing, G L; Bruce, J L; Oosthuizen, G V; Clarke, D L
This study reviews and validates the practice of selective non-operative management (SNOM) of penetrating neck injury (PNI) in a South African trauma service and reviews the impact new imaging modalities have had on the management of this injury. This study was performed within the Pietermaritzburg Metropolitan Trauma Service, in the city of Pietermaritzburg, Kwazulu-Natal, South Africa. A prospectively maintained trauma registry was retrospectively interrogated. All patients with PNI treated over a 46-month period were included within the study. A total of 510 patients were included in the study. There were 452 stab wounds (SW) and 58 gunshot wounds (GSW). A total of 202 (40%) patients sustained isolated PNI, the remaining 308 (60%) patients sustained trauma to at least one additional anatomical region. An airway injury was identified in 29 (6%) patients; a pharyngo-oesophageal injury in 41 (8%) patients and a vascular injury in 86 (17%) patients. Associated injuries included three penetrating cardiac injuries (PCI) and 146 patients with haemo-pneumothoraces. Of the total cohort, 387 patients (76%) underwent CT Angiography (CTA), of which 70 (18%) demonstrated a vascular injury. Formal catheter directed angiogram (CDA) was performed on 16 patients with positive CTA but confirmed injury in only half of these patients. Of 212 patients (42%) who underwent water-soluble contrast swallow (WS-swallow), an injury was demonstrated in 29 (14%) cases. A total of 401 (79%) patients were successfully managed conservatively for PNI and 109 (21%) surgically or by endovascular intervention. Only five (1.2%) patients failed a trial of SNOM and required surgery. The in-hospital mortality rate was 2%. No deaths could be attributed to a failure of SNOM. SNOM of PNI is a safe and appropriate management strategy. The conservative management of isolated pharyngeal injuries is well supported by our findings but the role of conservative treatment of oesophageal injuries needs to be
Full Text Available Features of accounting and audit of insurance organizations in Ukraine that are based on the specific characteristics of the insurance activity and legislation are considered. The main of them are the next: the proper organization of accounting is a necessary condition of the activity of the financial institution; there are three groups of requirements to accounting of insurer, including: accounting of contracts; accounting of insurance reserves, formation financial reports in the Ukrainian insurance legislation; the use of IFRS instead of national accounting standards in preparing financial reports of insurance organizations in Ukraine is obligatory and despite of this compilation of primary documents and application of National Chart of Accounts by insurance organizations of Ukraine remains mandatory; it is necessary to follow the frequency of reporting according to national legislation; insurance companies are classified as institutions that must necessarily publish annual financial statements together with the auditor’s report about its accuracy, and this category of institutions are prohibited from using such form of organization of accounting and reporting as directly by the owner or the head of organization; audit of the annual financial statements and consolidated financial statements of insurance companies is mandatory and conducted in accordance with International quality control, auditing, review, other assurance, and related services pronouncements which adopted as national auditing standards by the Audit Chamber of Ukraine. These generalizations are done to make possible the further investigations of developing and improving in this field.
Garayoa, Roncesvalles; Yánez, Nathaly; Díez-Leturia, María; Bes-Rastrollo, Maira; Vitas, Ana Isabel
Prerequisite programs are considered the most efficient tool for a successful implementation of self-control systems to ensure food safety. The main objective of this study was to evaluate the implementation of these programs in 15 catering services located in Navarra and the Basque Country (regions in northern Spain), through on-site audits and microbiological analyses. The implementation of the prerequisite program was incomplete in 60% of the sample. The unobserved temperature control during both the storage and preparation of meals in 20% of the kitchens reveals misunderstanding in the importance of checking these critical control points. A high level of food safety and hygiene (absence of pathogens) was observed in the analyzed meals, while 27.8% of the tested surfaces exceeded the established limit for total mesophilic aerobic microorganisms (≤100 CFU/25 cm²). The group of hand-contact surfaces (oven door handles and aprons) showed the highest level of total mesophilic aerobic microorganisms and Enterobacteriaceae, and the differences observed with respect to the food-contact surfaces (work and distribution utensils) were statistically significant (P < 0.001). With regard to the food workers' hands, lower levels of microorganisms were observed in the handlers wearing gloves (that is, for Staphylococcus spp we identified 43 CFU/cm2 on average compared with 4 CFU/cm2 (P < 0.001) for those not wearing and wearing gloves, respectively). For a proper implementation of the prerequisites, it is necessary to focus on attaining a higher level of supervision of activities and better hygiene training for the food handlers, through specific activities such as informal meetings and theoretical-practical sessions adapted to the characteristics of each establishment. © 2016 Institute of Food Technologists®
National Park Service, Department of the Interior — This data set was developed in conjunction with the U.S. Department of Agriculture, Natural Resources Conservation Service, and meets the standards and...
Full Text Available Abstract Background Criteria-based audits (CBA have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania. Objective The prevalence of eclampsia in MNH is high (≈6% with the majority of cases arriving after start of convulsions. In 2004–2005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base. A criteria-based audit (CBA was used to evaluate the quality of care for eclamptic mothers admitted at Muhimbili National Hospital (MNH, Dar es Salaam, Tanzania after implementation of recommendations of a previous audit. Methods A CBA of eclampsia cases was conducted at MNH. Management practices were evaluated using evidence-based criteria for appropriate care. The Ministry of Health (MOH guidelines, local management guidelines, the WHO manual supplemented by the WHO Reproductive Health Library, standard textbooks, the Cochrane database and reviews in peer reviewed journals were adopted. At the initial audit in 2006, 389 case notes were assessed and compared with the standards, gaps were identified, recommendations made followed by implementation. A re-audit of 88 cases was conducted in 2009 and compared with the initial audit. Results There was significant improvement in quality of patient management and outcome between the initial and re-audit: Review of management plan by senior staff (76% vs. 99%; P=0.001, urine for albumin test (61% vs. 99%; P=0.001, proper use of partogram to monitor labour (75% vs. 95%; P=0.003, treatment with steroids for lung maturity (2.0% vs. 24%; P=0.001, Caesarean section within 2 hours of decision (33% vs. 61%; P=0.005, full blood count (28% vs. 93%; P=0.001, serum urea and creatinine (44% vs. 86%; P=0.001, liver enzymes (4.0% vs
Wiler, Jennifer L; Ross, Michael A; Ginde, Adit A
The objective was to describe patient and facility characteristics of emergency department (ED) observation services in the United States. The authors analyzed the 2007 National Hospital Ambulatory Medical Care Survey (NHAMCS). Characteristics of EDs with observation units (OUs) were compared to those without, and patients with a disposition of ED observation were compared to those with a "short-stay" (observational analysis. An estimated 1,746 U.S. EDs (36%) reported having OUs, of which 56% are administratively managed by ED staff. Fifty-two percent of hospitals with ED-managed OUs are in an urban location, and 89% report ED boarding, compared to 29 and 65% of those that do not have an OU. The admission rate is 38% at those with ED-managed OUs and 15% at those without OUs. Of the 15.1% of all ED patients who are kept in the hospital following an ED visit, one-quarter are kept for either a short-stay admission (1.8%) or an ED observation admission (2.1%). Most (82%) ED observation patients were discharged from the ED. ED observation patients were similar to short-stay admission patients in terms of age (median = 52 years for both, interquartile range = 36 to 70 years), self-pay (12% vs. 10%), ambulance arrival (37% vs. 36%), urgent/emergent triage acuity (77% vs. 74%), use of ≥1 ED medication (64% vs.76%), and the most common primary chief complaints and primary diagnoses. Over one-third of U.S. EDs have an OU. Short-stay admission patients have similar characteristics as ED observation patients and may represent an opportunity for the growth of OUs. © 2011 by the Society for Academic Emergency Medicine.
Full Text Available Approaching the Republic of Serbia the EU, an increasing number of operations of Management Company must comply with the laws and regulations of the EU. One of the most important task is to manage companies and do the job of auditing of financial reporting companies. There are two established types of audits. Internal audit work, done throughout the year and external, done by the end of the financial year. Both have an obligation to express opinions, which must have a background in the competence and independence. The scope of the audit, generally speaking depends on the legislation of national economies, then the law governing accounting, and at the end of the law that frames the audit functions. The auditor's opinion is necessary in order to ensure the credibility of financial statements. Considering the focus, audit can be seen as activity of audits essentially activities related to the financial statements that are subject to services performed by certified auditors. An opinion on the financial statements of companies are included in the audit reports. They are prepared and certified by independent auditors. The revision in the economic terminology means testing of accounting statements of business enterprises. Internal audit work is done throughout the year, but external to the end of the financial year. Both have an obligation to express opinions, which must have a background in competence. Auditing activities are performed independently, objectively and with a great deal of independence in the work, by internal and external authorized auditors, so that they can provide the necessary information to the users of audit reports. Internal auditing can be seen in the two main ranges. The first is within the company in which some processes are functioning the same. Another scope is wide level, including observation of the wider society and the state, and includes observation of the entire public sector of a country. This mode of operation of the
Popa Adriana Florina
Full Text Available Modern economic theories reject the generalization of theories concerning the economic and financial crises. Each financial crisis is unique, a historic accident, generated by specific factors in a certain socio-economic and political set-up. According to these theories, crises cannot be anticipated so as to minimize their negative effects. In spite of the fact that economic and financial crises are not identical and do not produce identical effects, history teaches us that they are strongly correlated with the cyclic nature of economic processes. The current economic recession, which shows in all fields of activity, is determining auditors to make evaluations which are a lot more precise, based on extensive procedures, as long as the presumption of activity continuity into the future is accurate. In this context, internal audit is individualized as an managerial assistance function, which allows a correct perception of the reality of the business as a whole and/or as predefined processes. The purpose of this paper is to create an overall picture of internal audit by collecting data and information from literature and showing the dimensions and the internal audit practices internationally. Therefore, we conducted a research based on the analysis of national and international publications, various articles and studies in the financial press, on the emergence and development of the internal audit function both internationally and nationally. Later we analyzed the position of internal audit in terms of global financial crisis, all these leading to the usage of a comparative study of twelve international companies in order to highlight the specific features of the internal audit function in each organization. Our intention is to emphasize aspects of internal audit departments, relations between them and the management, their role in companies based on studies provided by Protiviti, a global consulting and internal audit services company, having
... National Park Service Notice of Continuation of Visitor Services--Yosemite National Park AGENCY: National..., the National Park Service intends to request a continuation of visitor services in Yosemite National... Services Program, National Park Service, 1201 Eye Street, NW., 11th Floor, Washington, DC 20005; Telephone...
Tennant, Marc; Kruger, Estie
Australia is the sixth biggest (by area) country in the world, having a total area of about 7.5 million km(2) (3 million square miles). This study located every dental practice in the country (private and public) and mapped these practices against population. The total population of Australia (21.5 million) is distributed across 8,529 suburbs. On average about one-third of the population from each State lives in suburbs without practices and 46% live in suburbs with one to five dentists. Of those living within the study frameset, 86.6% live within 5 km of a private practice and 84.4% live within 10 km of a government practice. Australia's dental practices are distributed in a very uneven fashion across its vast area. Three-quarters of suburbs have no dental practice and over one-third of the population live in these suburbs. This research clearly identified that in a vast and uneven socio-geographically distributed country, service planning, if left to market forces, will end with a practice distribution that is fixed by economic drivers of scale and not that of disease burden. A more population health-driven approach to future design and construction of government safety net services is needed to address these disparities. © 2013 FDI World Dental Federation.
Verbeek Jos HAM
Full Text Available Abstract Background- The aim of the study was to develop quality indicators that can be used for quality assessment of registries of occupational diseases in relation to preventive policy on a national level. The research questions were: 1. Which indicators determine the quality of national registries of occupational diseases with respect to their ability to provide appropriate information for preventive policy? 2. What are the criteria that can distinguish low quality from high quality? Methods- First, we performed a literature search to assess which output of registries can be considered appropriate for preventive policy and to develop a set of preliminary indicators and criteria. Second, final indicators and criteria were assessed and their content validity was tested in a Delphi study, for which experts from the 25 EU Member States were invited. Results- The literature search revealed two different types of information output to be appropriate for preventive policy: monitor and alert information. For the evaluation of the quality of the monitor and alert function we developed ten indicators and criteria. Sixteen of the twenty-five experts responded in the first round of the Delphi study, and eleven in the second round. Based on their comments, we assessed the final nine indicators: the completeness of the notification form, coverage of registration, guidelines or criteria for notification, education and training of reporting physicians, completeness of registration, statistical methods used, investigation of special cases, presentation of monitor information, and presentation of alert information. Except for the indicator "coverage of registration" for the alert function, all the indicators met the preset requirements of content validity. Conclusion- We have developed quality indicators and criteria to evaluate registries for occupational diseases on the ability to provide appropriate information for preventive policy on a national level
Fuentes, Molly M; Thompson, Leah; Quistberg, D Alex; Haaland, Wren L; Rhodes, Karin; Kartin, Deborah; Kerfeld, Cheryl; Apkon, Susan; Rowhani-Rahbar, Ali; Rivara, Frederick P
To identify insurance-based disparities in access to outpatient pediatric neurorehabilitation services. Audit study with paired calls, where callers posed as a mother seeking services for a simulated child with history of severe traumatic brain injury and public or private insurance. Outpatient rehabilitation clinics. Sample of rehabilitation clinics (N=287): 195 physical therapy (PT) clinics, 109 occupational therapy (OT) clinics, 102 speech therapy (ST) clinics, and 11 rehabilitation medicine clinics. Not applicable. Acceptance of public insurance and the number of business days until the next available appointment. Therapy clinics were more likely to accept private insurance than public insurance (relative risk [RR] for PT clinics, 1.33; 95% confidence interval [CI], 1.22-1.44; RR for OT clinics, 1.40; 95% CI, 1.24-1.57; and RR for ST clinics, 1.42; 95% CI, 1.25-1.62), with no significant difference for rehabilitation medicine clinics (RR, 1.10; 95% CI, 0.90-1.34). The difference in median wait time between clinics that accepted public insurance and those accepting only private insurance was 4 business days for PT clinics and 15 days for ST clinics (P≤.001), but the median wait time was not significantly different for OT clinics or rehabilitation medicine clinics. When adjusting for urban and multidisciplinary clinic statuses, the wait time at clinics accepting public insurance was 59% longer for PT (95% CI, 39%-81%), 18% longer for OT (95% CI, 7%-30%), and 107% longer for ST (95% CI, 87%-130%) than that at clinics accepting only private insurance. Distance to clinics varied by discipline and area within the state. Therapy clinics were less likely to accept public insurance than private insurance. Therapy clinics accepting public insurance had longer wait times than did clinics that accepted only private insurance. Rehabilitation professionals should attempt to implement policy and practice changes to promote equitable access to care. Copyright © 2017
Debeck, Kora; Wood, Evan; Montaner, Julio; Kerr, Thomas
While there is mounting international acceptance of harm reduction approaches and growing support for policies that balance enforcement with more health-focused interventions, in many settings these developments are not reflected in policy. In October 2007, the Canadian federal government launched a new $64 million dollar 'National Anti-Drug Strategy' in which two-thirds of the new monies was reportedly directed towards drug prevention and treatment initiatives. However, contrary to the impression left by a host of federal politicians, including the Prime Minister, that this new strategy was investing significantly in drug prevention and drug treatment, this analysis finds that when base funding is considered additional monies provided through the new federal National Anti-Drug Strategy only marginally shifts the allocation of funds within each category. Specifically, law enforcement initiatives continue to receive the overwhelming majority of drug strategy funding (70%) while prevention (4%), treatment (17%) and harm reduction (2%) combined continue to receive less than a quarter of the overall funding. These findings suggest that the Canadian government is failing to invest resources in evidence-based drug policies.
Mar 26, 2013 ... Where “personal and confidential” materials are involved the Chief Audit Executive will consult with the President and the ... the principles of integrity, objectivity, confidentiality, and competency, and IDRC's Code of. Conduct and the Values and Ethics Code for the Public Service;. Informing management ...
Newell, Mark R.
As one of the cornerstones of the U.S. Geological Survey's (USGS) National Geospatial Program (NGP), The National Map is a collaborative effort among the USGS and other Federal, state, and local partners to improve and deliver topographic information for the Nation. It has many uses ranging from recreation to scientific analysis to emergency response. The National Map is easily accessible for display on the Web, as products, and as downloadable data. The geographic information available from The National Map includes orthoimagery (aerial photographs), elevation, geographic names, hydrography, boundaries, transportation, structures, and land cover. Other types of geographic information can be added to create specific types of maps. Of major importance, The National Map currently is being transformed to better serve the geospatial community. The USGS National Geospatial Program Office (NGPO) was established to provide leadership for placing geographic knowledge at the fingertips of the Nation. The office supports The National Map, Geospatial One-Stop (GOS), National Atlas of the United States®, and the Federal Geographic Data Committee (FGDC). This integrated portfolio of geospatial information and data supports the essential components of delivering the National Spatial Data Infrastructure (NSDI) and capitalizing on the power of place.
... 10 Energy 1 2010-01-01 2010-01-01 false Audits and corrective action. 26.41 Section 26.41 Energy... reports to identify any areas that were not covered by the shared or accepted audit. (2) Licensees and... relies are audited, if the program elements and services were not addressed in the shared audit. (3...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National... statements. FOR FURTHER INFORMATION CONTACT: Njeri Jones, Bureau of Clinician Recruitment and Service, Health...
Mamas, Mamas A; Kwok, Chun Shing; Kontopantelis, Evangelos; Fryer, Anthony A; Buchan, Iain; Bachmann, Max O; Zaman, M Justin; Myint, Phyo K
We aim to determine the prevalence of anemia in acute coronary syndrome (ACS) patients and compare their clinical characteristics, management, and clinical outcomes to those without anemia in an unselected national ACS cohort. The Myocardial Ischemia National Audit Project (MINAP) registry collects data on all adults admitted to hospital trusts in England and Wales with diagnosis of an ACS. We conducted a retrospective cohort study by analyzing patients in this registry between January 2006 and December 2010 and followed them up until August 2011. Multiple logistic regressions were used to determine factors associated with anemia and the adjusted odds of 30-day mortality with 1 g/dL incremental hemoglobin increase and the 30-day and 1-year mortality for anemic compared to nonanemic groups. Analyses were adjusted for covariates. Our analysis of 422 855 patients with ACS showed that 27.7% of patients presenting with ACS are anemic and that these patients are older, have a greater prevalence of renal disease, peripheral vascular disease, diabetes mellitus, and previous acute myocardial infarction, and are less likely to receive evidence-based therapies shown to improve clinical outcomes. Finally, our analysis suggests that anemia is independently associated with 30-day (OR 1.28, 95% CI 1.22-1.35) and 1-year mortality (OR 1.31, 95% CI 1.27-1.35), and we observed a reverse J-shaped relationship between hemoglobin levels and mortality outcomes. The prevalence of anemia in a contemporary national ACS cohort is clinically significant. Patients with anemia are older and multimorbid and less likely to receive evidence-based therapies shown to improve clinical outcomes, with the presence of anemia independently associated with mortality outcomes. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
Bridge, Pete; Dempsey, Shane; Giles, Eileen; Maresse, Sharon; McCorkell, Giulia; Opie, Craig; Wright, Caroline; Carmichael, Mary-Ann
This article presents the results of a single-day census of radiation therapy (RT) treatment and technology use in Australia. The primary aim of the study was to ascertain patterns of RT practice and technology in use across Australia. These data were primarily collated to inform curriculum development of academic programs, thereby ensuring that training is matched to workforce patterns of practice. The study design was a census method with all 59 RT centres in Australia being invited to provide quantitative summary data relating to patient case mix and technology use on a randomly selected but common date. Anonymous and demographic-free data were analysed using descriptive statistics. Overall data were provided across all six Australian States by 29 centres of a possible 59, yielding a response rate of 49% and representing a total of 2743 patients. Findings from this study indicate the increasing use of emerging intensity-modulated radiotherapy (IMRT), image fusion and image-guided radiation therapy (IGRT) technology in Australian RT planning and delivery phases. IMRT in particular was used for 37% of patients, indicating a high uptake of the technology in Australia when compared to other published data. The results also highlight the resource-intensive nature of benign tumour radiotherapy. In the absence of routine national data collection, the single-day census method offers a relatively convenient means of measuring and tracking RT resource utilisation. Wider use of this tool has the potential to not only track trends in technology implementation but also inform evidence-based guidelines for referral and resource planning.
... of Decision for the General Management Plan/Environmental Impact Statement for the Jefferson National... Jefferson National Expansion Memorial (Memorial), Missouri. On November 23, the NPS Midwest Region regional... FURTHER INFORMATION CONTACT: Copies of the ROD can be obtained by contacting Superintendent Thomas Bradley...
textabstractCorporate scandals during the last decade fostered many Corporate Governance reports. These reports aimed at restoring checks and balances in companies to prevent fraudulent behaviour and restore public trust. One of the functions active in many organizations is Internal Audit. This
Alsuhaibani, Adel; AlRajeh, Mohammed; Gikandi, Priscilla; Mousa, Ahmed
To improve the interventions provided for patients presenting with acute ophthalmic conditions to the ophthalmic emergency unit through applying the best available evidences from quality literature for managing such conditions. A retrospective cohort study at a tertiary eye care university hospital in Riyadh, Saudi Arabia, involving a two-phase audit of diagnosis-intervention was conducted. The first phase was done retrospectively for the duration from April 1 to May 30, 2014, after disseminating the results of the first phase to King Abdulaziz University Hospital ophthalmology department staff, and the second phase was done retrospectively for the duration from November 1 to December 30, 2015. The validity of outcomes was assessed through a literature search using Medline and the Cochrane Database of Systematic Reviews. The participants were masked on the study objectives to avoid Hawthorne's phenomenon (prescribing bias). In the first part of the audit, 73.2% out of 355 interventions were found to be evidence based. There was notable improvement of 80.9% in the number of evidence-based interventions in the second part of the audit. This improvement was statistically significant (p = 0.017). Evidence-based medicine audit can be a helpful tool to assess the performance and can lead to quality improve of the provided care by reducing the number of medical errors and refining medical decisions and interventions.
Projects #OA-FY16-0080 and #OA-FY16-0079, February 8, 2016. EPA OIG plan to begin audits of the EPA's fiscal year (FY) 2015 financial statements for the Pesticides Reregistration and Expedited Processing Fund (FIFRA) and Pesticide Registration Fund (PRIA).
National Oceanic and Atmospheric Administration, Department of Commerce — These data were created as part of the National Oceanic and Atmospheric Administration Coastal Services Center's efforts to create an online mapping viewer called...
National Oceanic and Atmospheric Administration, Department of Commerce — The Service Records Retention System (SRRS) was developed to store weather observations, summaries, forecasts, warnings, and advisories provided by the U.S. National...
The national economy agricultural sector development today is one of the key areas of the state support. Treasury servicing of budget funds intended for the support in agricultural sector is rendered by the State Treasury Service of Ukraine. This article deals with the study of current state treasury services in agricultural sector of Ukraine. In particular, the distribution and dynamics of the expenditures of the State Budget of Ukraine in financing public services and institutions in the fi...
De La O, Ana L; Martel García, Fernando
Poor governance and accountability compromise young democracies' efforts to provide public services critical for human development, including water, sanitation, health, and education. Evidence shows that accountability agencies like superior audit institutions can reduce corruption and waste in federal grant programs financing service infrastructure. However, little is know about their effect on compliance with grant reporting and resource allocation requirements, or about the causal mechanisms. This study protocol for an exploratory randomized controlled trial tests the hypothesis that federal and state audits increase compliance with a federal grant program to improve municipal service infrastructure serving marginalized households. The AUDIT study is a block randomized, controlled, three-arm parallel group exploratory trial. A convenience sample of 5 municipalities in each of 17 states in Mexico (n=85) were block randomized to be audited by federal auditors (n=17), by state auditors (n=17), and a control condition outside the annual program of audits (n=51) in a 1:1:3 ratio. Replicable and verifiable randomization was performed using publicly available lottery numbers. Audited municipalities were included in the national program of audits and received standard audits on their use of federal public service infrastructure grants. Municipalities receiving moderate levels of grant transfers were recruited, as these were outside the auditing sampling frame--and hence audit program--or had negligible probabilities of ever being audited. The primary outcome measures capture compliance with the grant program and markers for the causal mechanisms, including deterrence and information effects. Secondary outcome measure include differences in audit reports across federal and state auditors, and measures like career concerns, political promotions, and political clientelism capturing synergistic effects with municipal accountability systems. The survey firm and research
Heß, Benjamin; Stefani, Ulrike
In the ongoing discussions on audit regulation, the key issues of auditor independence and a high level of audit market concentration have become apparent. However, there is the concern that regulations intended to improve auditor independence (i.e., restrictions regarding the joint supply of audit and non-audit services, audit firm rotation, joint audits, etc.) might further increase audit market concentration. We address this issue with an empirical analysis. Based on a cross-country study ...
Full Text Available The services and specific documents for disabled persons require of investment and internal restructuring of libraries and document centers. The National Libraries should to face the same problem because the disabled persons are potential users. At the present the libraries web pages has been used to promote the products and services for all users, included disabled. By this reason, we have observed the existence of this services in ten National Libraries web pages, and the results showed that the electronic services and resources for this social group would be restructured to efficient access
Community information comprises of services offered by libraries and information centers to provide the people with information that is relevant to their daily life. The information helps the poor and marginalized groups to improve their standard of living and contribute in decisions that affect their lives. This paper highlights ...
Project #OA-FY16-0126, March 14, 2016. The EPA OIG plans to begin fieldwork for an audit of the EPA’s compliance with the mandated “Inspector General Report on Covered Systems,” as outlined in the Cybersecurity Act of 2015.
Gilby, E; Lloyd, G; Chan, L; Tosh, S; Brierley, S
The National Service Framework for coronary heart disease established clear standards for the management of patients with acute myocardial infarction in March 2000. This study evaluates an emergency department's thrombolysis performance in light of these standards. Inner city teaching hospital emergency department. The data were prospectively collected using a formal clinical pathway for all patients receiving thrombolysis in the emergency department between February 2000 and January 2001. Cases were reviewed at monthly multidisciplinary audit meetings. Regular feedback complemented routine teaching for both nursing and medical staff. 127 patients were thrombolysed, of whom 92 (72%) were immediately eligible. Some 77% of these had a door to needle time of less than 30 minutes and 38% less than 20 minutes. Twenty per cent of patients had a call to door time of less than 30 minutes. Some 84% of patients managed by the emergency department team had a door to needle time of less than 30 minutes compared with 53% of those patients seen by duty physicians. The thrombolysis target set by the National Service Framework for April 2002 is achievable. The target set for April 2003 remains an ambitious goal. Overall call to needle times are undermined by call to door times. Emergency department teams may be more efficient than duty physicians in processing patients needing thrombolysis.
Johnston, Vanessa; Smith, Le; Roydhouse, Heather
Accurate data on the health of refugees in primary care is vital to inform clinical practice, monitor disease prevalence, influence policy and promote coordination. We undertook a retrospective clinical audit of newly arrived refugees attending the Darwin refugee primary health service in its first 12 months of operation. Data were collected from the clinic files of refugee patients who attended for their initial health assessment from 1 July 2009 to 30 June 2010 and were analysed descriptively. Among 187 refugees who attended in 2009-2010, ~60% were from Asia and 42% were female. The most common diagnoses confirmed by testing were vitamin D deficiency (23%), hepatitis B carrier status (22%), tuberculosis infection (18%), schistosomiasis (17%) and anaemia (17%). The most common documented health conditions recorded by the GPs were vitamin D deficiency or insufficiency (66%), followed by schistosomiasis (24%) and dental disease (23%). This clinical audit adds to a limited evidence base suggesting a high prevalence of infectious disease, nutrient deficiency and dental disease among refugees arriving to Australia. GPs involved in the care of refugees must be aware of the epidemiology of disease in this group, as some diseases are rare among the general Australian population. Our results also highlight the ongoing need for advocacy to address service constraints such as limited public dental access for this population.
11 At provincial level, Provincial Growth and Development Strategies (PGDSs) were introduced as strategic plans to plan holistically for 'provincial space' and to guide provincial sector department and district-wide municipal planning, budgeting and implementation; at national level, this role was to be played by the Medium ...
Exceptional Parent, 1990
This article describes (1) IBM's National Support Center for Persons with Disabilities, a clearinghouse of information about adaptive devices, software, and support groups helping disabled persons use IBM computers; (2) special IBM products, including the Screen Reader, SpeechViewer, and PhoneCommunicator; and (3) an IBM-sponsored program whereby…
U.S. Geological Survey, Department of the Interior — The USGS Elevation Contours service from The National Map (TNM) consists of contours generated for the conterminous United States from 1- and 1/3 arc-second...
U.S. Geological Survey, Department of the Interior — The USGS NAIP Imagery service from The National Map (TNM) consists of high resolution images that combine the visual attributes of an aerial photograph with the...
U.S. Geological Survey, Department of the Interior — The USGS National Hydrography Dataset (NHD) service from The National Map (TNM) is a comprehensive set of digital spatial data that encodes information about...
Baechler, Michael C.
Energy audits are a powerful tool for uncovering operational and equipment improvements that will save energy, reduce energy costs, and lead to higher performance. Energy audits can be done as a stand-alone effort or as part of a larger analysis across a group of facilities, or across an owner's portfolio. The purpose of an energy audit (sometimes called an 'energy assessment' or 'energy study') is to determine where, when, why and how energy is used in a facility, and to identify opportunities to improve efficiency. Energy auditing services are offered by energy services companies (ESCOs), energy consultants and engineering firms. The energy auditor leads the audit process but works closely with building owners, staff and other key participants throughout to ensure accuracy of data collection and appropriateness of energy efficiency recommendation. The audit typically begins with a review of historical and current utility data and benchmarking of your building's energy use against similar buildings. This sets the stage for an onsite inspection of the physical building. The main outcome of an energy audit is a list of recommended energy efficiency measures (EEMs), their associated energy savings potential, and an assessment of whether EEM installation costs are a good financial investment.
...The Corporation for National and Community Service (the Corporation) is correcting a final rule to implement changes to the operation of the National Service Trust and the Senior Corps programs under the Serve America Act, that appeared in the Federal Register of August 20, 2010 (75 FR 51395). That document incorrectly failed to redesignate part 2533 as part 2534. This document corrects the final rule by revising the instruction.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false What is the National Service Trust? 2525.10 Section 2525.10 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE NATIONAL SERVICE TRUST: PURPOSE AND DEFINITIONS § 2525.10 What is the National Service Trust? The National Service Trust is an...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National... comment and questions. For Further Information Contact: Njeri Jones, Bureau of Clinician Recruitment and...
U.S. Geological Survey, Department of the Interior — The USGS Transportation service from The National Map (TNM) is based on TIGER/Line data provided through U.S. Census Bureau and road data from U.S. Forest Service....
McNulty, Cliodna A M; Verlander, Neville Q; Moore, Philippa C L; Larcombe, James; Dudley, Jan; Banerjee, Jaydip; Jadresic, Lyda
The National Institute of Care Excellence (NICE) 2007 guidance CG54, on urinary tract infection (UTI) in children, states that clinicians should use urgent microscopy and culture as the preferred method for diagnosing UTI in the hospital setting for severe illness in children under 3 years old and from the GP setting in children under 3 years old with intermediate risk of severe illness. NICE also recommends that all 'infants and children with atypical UTI (including non-Escherichia coli infections) should have renal imaging after a first infection'. We surveyed all microbiology laboratories in England with Clinical Pathology Accreditation to determine standard operating procedures (SOPs) for urgent microscopy, culture and reporting of children's urine and to ascertain whether the SOPs facilitate compliance with NICE guidance. We undertook a computer search in six microbiology laboratories in south-west England to determine urine submissions and urine reports in children under 3 years. Seventy-three per cent of laboratories (110/150) participated. Enterobacteriaceae that were not E. coli were reported only as coliforms (rather than non-E. coli coliforms) by 61% (67/110) of laboratories. Eighty-eight per cent of laboratories (97/110) provided urgent microscopy for hospital and 54% for general practice (GP) paediatric urines; 61% of laboratories (confidence interval 52-70%) cultured 1 μl volume of urine, which equates to one colony if the bacterial load is 106 c.f.u. l(-1). Only 22% (24/110) of laboratories reported non-E. coli coliforms and provided urgent microscopy for both hospital and GP childhood urines; only three laboratories also cultured a 5 μl volume of urine. Only one of six laboratories in our submission audit had a significant increase in urine submissions and urines reported from children less than 3 years old between the predicted pre-2007 level in the absence of guidance and the 2008 level following publication of the NICE guidance. Less than a
B.K. Reilly; Y. Reillly
Reilly B.K. and Y. Reilly. 2003. Auditing wildlife. Koedoe 46(2): 97–102. Pretoria. ISSN 0075-6458. Accountants and auditors are increasingly confronted with the problem of auditing wildlife populations on game ranches as their clients' asset base expands into this industry. This paper aims to provide guidelines on these actions based on case study data and research in the field of wildlife monitoring. Parties entering into dispute on numbers of animals on a property often resort to their au...
Full Text Available “I slept and dreamt that life was joy. I woke up and saw that life was service. I acted and behold, service was joy.”- Rabindranath TagoreNational Service Scheme popularly known as “NSS” was launched on Mahatma Gandhi’s birth centenary year, 1969 under Ministry of Youth affairs and Sports, in 37 universities, involving students, with the primary aim to establish meaningful linkage between the campus and the community.
This paper features the winners of this year's National Medals for Museum and Library Service, the nation's highest honor for libraries and museums. The award celebrates libraries and museums that make a difference for individuals, families, and communities. Medal winners are selected from nationwide nominations for institutions that demonstrate…
Dalmida, Safiya George; Amerson, Roxanne; Foster, Jennifer; McWhinney-Dehaney, Leila; Magowe, Mabel; Nicholas, Patrice K; Pehrson, Karen; Leffers, Jeanne
This article explores approaches to service involvement and provides direction to nurse leaders and others who wish to begin or further develop global (local and international) service or service learning projects. We review types of service involvement, analyze service-related data from a recent survey of nearly 500 chapters of the Honor Society of Nursing, Sigma Theta Tau International (STTI), make recommendations to guide collaborative partnerships and to model engagement in global and local service and service learning. This article offers a literature review and describes results of a survey conducted by the STTI International Service Learning Task Force. Results describe the types of service currently conducted by STTI nursing members and chapters, including disaster response, service learning, and service-related responses relative to the Millennium Development Goals (MDGs). The needs of chapter members for information about international service are explored and recommendations for promoting global service and sustainability goals for STTI chapters are examined. Before engaging in service, volunteers should consider the types of service engagement, as well as the design of projects to include collaboration, bidirectionality, sustainability, equitable partnerships, and inclusion of the United Nations Sustainable Development Goals. STTI supports the learning, knowledge, and professional development of nurses worldwide. International service and collaboration are key to the advancement of the nursing profession. Culturally relevant approaches to international service and service learning are essential to our global organization, as it aims to impact the health status of people globally. © 2016 Sigma Theta Tau International.
Di Pucchio, Alessandra; Pizzi, Enrica; Carosi, Giordano; Mazzola, Monica; Mattioli, Donatella; Pacifici, Roberta; Pichini, Simona
This investigation is aimed at providing information about structural and organizational characteristics of smoking cessation services (SCS) set up within the Italian National Health Service. Local health units and hospitals are the main institutions connected with SCS which are mainly located within the Department of Drug Addiction and the Department of Lung and Breath Care. SCS provide different tobacco-use cessation programs. Although pharmacotherapy is always used, a combination of therapeutic treatments is highly preferred. This study shows the importance of maintaining a national coordination among different SCS supporting their activity and encouraging the start up of additional services throughout the country. PMID:19440422
Bulbulia, R A; Poskitt, K R
Leg ulcers are common and costly to treat, and the quality of care provided to patients with this condition varies widely across the UK. The introduction of specialized community-based leg ulcer clinics in Gloucestershire has been associated with increased ulcer healing rates and decreased rates of ulcer recurrence, but this model of care has not been widely replicated. One way of ending this 'postcode lottery' is to produce a National Service Framework for leg ulcers, with the aim of delivering high-quality evidence-based care via such clinics under the supervision of local consultant vascular surgeons. Existing National Service Frameworks cover a range of common conditions that are, like leg ulceration, associated with significant morbidity, disability and resource use. These documents aim to raise quality and decrease regional variations in health care across the National Health Service, and leg ulceration fulfils all the necessary criteria for inclusion in a National Service Framework. Centrally defined standards of care for patients with leg ulceration, and the reorganization and restructuring of local services to allow the accurate assessment and treatment of such patients are required. Without a National Service Framework to drive up the quality of care across the country, the treatment of patients with leg ulcers will remain suboptimal for the majority of those who suffer from this common and debilitating condition.
Nisbet, Debbie L; Robertson, Ann C; Schluter, Philip J; McLennan, Andrew C; Hyett, Jon A
Nuchal translucency (NT) measurement is the ultrasound component of first trimester combined screening for Down syndrome. In 2002, a NT ultrasound education and monitoring program was established in Australia. Between 2002 and 2008, a total of 728,502 NT scans were audited through this process. OVERALL AIM: To audit the availability and performance of certified operators measuring NT following implementation of the Australian education and monitoring program in 2002. Retrospective review of the central database that is used to monitor performance of individuals and practices performing NT scans in both public and private practice settings throughout Australia between 2002 and 2008. The performance of operators was assessed by a widely used international standard - that 40-60% of NT measurements should be above the median value for gestational age. The number of certified operators has increased (from 184 in 2002 to 477 in 2008). There is wide variation between states in the number of operators per birth. The percentage of certified operators with a measurement distribution meeting the international standard has increased from 40% in 2002 to 55% in 2008. Greatest improvement has been seen in operators performing 30-199 scans per year. There has been no overall improvement in performance over the last three audit cycles. The number of operators certified to perform the NT scan has increased since 2002, although availability in some states remains low. An initial improvement in performance of operators appears to have reached a plateau. It is time to become more proactive in engaging operators in the audit cycle. © 2010 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Jan 6, 2010 ... Key performance indicators like major complications, readmissions, reoperations, transfers, incident reports, complaints and mortalities must also be included. Surgical audits bear very similar relationship to opera- tional research. There is a critical need for the results to be representative and accurate.
...; National Veterinary Services Laboratories Request Forms AGENCY: Animal and Plant Health Inspection Service... intention to request approval of an information collection associated with the National Veterinary Services... FURTHER INFORMATION CONTACT: For information on request forms associated with the National Veterinary...
Chis Anca Oana
Full Text Available Abstract: Sampling is widely used in market research, scientific analysis, market analysis, opinion polls and not least in the financial statement audit. We wonder what is actually sampling and how did it appear? Audit sampling involves the application of audit procedures to less than 100% of items within an account balance or class of transactions. Nowadays the technique is indispensable, the economic entities operating with sophisticated computer systems and large amounts of data. Economic globalization and complexity of capital markets has made possible not only the harmonization of international accounting standards with the national ones, but also the convergence of international accounting and auditing standards with the American regulations. International Standard on Auditing 530 and Statement on Auditing Standard 39 are the two main international and American normalized referentials referring to audit sampling. This article discusses the origin of audit sampling, mentioning a brief history of the method and different definitions from literature review. The two standards are studied using Jaccard indicators in terms of the degree of similarity and dissimilarity concerning different issues. The Jaccard coefficient measures the degree of convergence of international auditing standards (ISA 530 and U.S. auditing standards (SAS 39. International auditing standards and American auditing standards, study the sampling problem, both regulations presenting common points with regard to accepted sampling techniques, factors influencing the audit sample, treatment of identified misstatements and the circumstances in which sampling is appropriate. The study shows that both standards agree on application of statistical and non-statistical sampling in auditing, that sampling is appropriate for tests of details and controls, the factors affecting audit sampling being audit risk, audit objectives and population\\'s characteristics.
Audit Of The Prevalence Of Malnutrition Using The Modified Subjective Global Assessment Tool In Maintenance Peritoneal Dialysis Patients In The Top End Renal Service Of The Nortehrn Territory Australia
Full Text Available The objective of the audit is to determine the prevalence of malnutrition in maintenance peritoneal dialysis (MPD patients in the Top End of the Northern Territory, using the modified Subjective Global Assessment (SGA tool. Methods: The audit was conducted in an outpatients setting. Approximately 75% of PD patients in the Top End Renal service are represented by Aboriginal and Torres Strait Island people. The study population was MPD patients in the Top End Renal Service (TERS of the Northern Territory, from January 1st 2010 to December 31st 2010. Results were compared to malnutrition rates found in the 2008/09 the audit of MPD patients in the TERS. The SGA’s were performed by the renal Dietitian as part of the standard dietetic support of MPD patients. SGA scores were collected from patient medical charts. Results: Patients were classified into one of three categories, based on their SGA score (A Well-nourished; (B Mild- Moderate Malnutrition, (C Severe malnutrition. Malnutrition (B or C was detected in 10% of PD patients, compared to the 2008/09 audit where 76% of MPD patients had some degree of malnutrition. Summary: These results were much lower than malnutrition rates (76% in the MPD patients audited in 2008/09. A number of factors affecting the PD service after the 2008/09 audit could explain the decrease in malnutrition rates including the implementation of free oral nutrition supplements to MPD patients, development of service wide culturally appropriate education resources used in the pre-dialysis and dialysis stage. Future research into the correlation between improved peritonitis rates and decreased malnutrition rates in the population are warranted.
Chlamydial partner notification in the British Association for Sexual Health and HIV (BASHH) 2011 UK national audit against the BASHH Medical Foundation for AIDS and Sexual Health Sexually Transmitted Infections Management Standards.
McClean, H; Carne, C A; Sullivan, A K; Radcliffe, K W; Ahmed-Jushuf, I
This paper reports on chlamydial partner notification (PN) performance in the 2011 BASHH national audit against the British Association for Sexual Health and HIV (BASHH) Medical Foundation for AIDS Sexual Health (MedFASH) Sexually Transmitted Infection Management Standards (STIMS). There was wide regional variation in level 3 clinic PN performance against the current standard of index case-reported chlamydial PN, with 43% (regional range 0-80%) of clinics outside London meeting the ≥0.6 contacts seen per index standard, and 85% of clinics (regional range 82-88%) in London meeting the ≥0.4 standard. For level 2 clinics, 39% (regional range 0-100%) of clinics outside London met the ≥0.6 standard, and 43% (regional range 40-50%) of clinics in London met the ≥0.4 standard. Performance for health-care worker (HCW)-verified contact attendance is also reported. New standards for each of these performance measures are proposed for all level 3 clinics: ≥0.6 contacts seen per index case based on index case report, and ≥0.4 contacts seen per index case based on HCW verification, both within four weeks of the first partner notification interview. The results are discussed with regard to the importance of adoption of standards by commissioners of services, relevance to national quality agendas, and the need for development of a national system of PN quality assurance measurement and reporting.
Barratt, Paul A; Selfe, James
To improve outcomes of physiotherapy treatment for patients with Lateral Epicondylalgia. A systematic audit and quality improvement project over three phases, each of one year duration. Salford Royal NHS Foundation Trust Teaching Hospital Musculoskeletal Physiotherapy out-patients department. n=182. Phase one - individual discretion; Phase two - strengthening as a core treatment however individual discretion regarding prescription and implementation; Phase three - standardised protocol using high load isometric exercise, progressing on to slow combined concentric & eccentric strengthening. Global Rating of Change Scale, Pain-free grip strength, Patient Rated Tennis Elbow Evaluation, Tampa Scale of Kinesophobia-11. Phase three demonstrated a reduction in the average number of treatments by 42% whilst improving the number of responders to treatment by 8% compared to phase one. Complete cessation of non-evidence based treatments was also observed by phase three. Strengthening should be a core treatment for LE. Load setting needs to be sufficient. In phase three of the audit a standardised tendon loading programme using patient specific high load isometric exercises into discomfort/pain demonstrated a higher percentage of responders compared to previous phases. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
Hearnshaw, H; Baker, R; Cooper, A
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
... National Park Service Notice of Extension of Visitor Services--Mount Rainier National Park AGENCY: National..., the National Park Service intends to request an extension of visitor services in Mount Rainier National Park for a period not to exceed one year from the expiration date of the current contract. DATES...
... National Park Service National Park Service Benefits-Sharing Final Environmental Impact Statement Record of Decision AGENCY: National Park Service, Department of the Interior. ACTION: Notice of Availability of the...: Pursuant to the National Environmental Policy Act of 1969, 42 U.S.C. 4332(2)(C), the National Park Service...
Jun 27, 2006 ... The services that the IDRC's Audit Services function may provide are incorporated into the broad categories of assurance and advice. However, assurance and advisory services are not mutually exclusive, and many internal audit services may contain both an assurance and advice. Assurance services are ...
Yulius Jogi Cristiawan
Full Text Available The purpose of financial audit is to give opinion that the financial statement present fairly, in all material respect, the financial position, the result of operation and cash flow in conformity with generally accepted accounting principles. In this case, the focus of financial audit is financial statement. A Independent Auditor do not consider that the financial statement is the reflections of company business transaction that result from accounting process. In the accounting process, the distorsion information could be happened in business transaction. For examples the finished good must be presented at historical cost at financial statement, but if, the competitor could sell with the lower price or there are any substitutes, its presentation must be adjusted. A financial statement could not present the information about the competitors. Hence the auditor must be understand all aspects of client business. A conceptual framework for understanding client business will be presented in this article. Abstract in Bahasa Indonesia : Audit atas Laporan Keuangan (Financial Audit bertujuan untuk memberikan pendapat apakah laporan keuangan suatu entitas menyajikan sejara wajar atau tidak posisi keuangan, hasil operasi dan arus kas sesuai dengan prinsip akuntansi yang berlaku umum. Disini jelas terlihat bahwa fokus audit adalah laporan keuangan. Auditor lupa bahwa laporan keuangan merupakan suatu laporan transaksi bisnis perusahaan yang telah mengalami proses akuntansi (dengan suatu asumsi-asumsi tertentu sehingga menjadi laporan keuangan. Selama proses akuntansi tersebut suatu transaksi bisnis kadang mengalami distorsi informasi. Contoh: suatu persediaan barang jadi yang secara fisik masih baik akan dilaporkan di dalam laporan keuangan sebesar cost-nya, tetapi kalau secara bisnis bisa dibuktikan bahwa atas barang tersebut pesaing bisa menjual barang dengan harga lebih murah atau telah ada barang pengganti maka atas barang tersebut harus disesuaikan
Choi, Baek-Young; Song, Sejun
This book mainly focuses on cloud security and high performance computing for cloud auditing. The book discusses emerging challenges and techniques developed for high performance semantic cloud auditing, and presents the state of the art in cloud auditing, computing and security techniques with focus on technical aspects and feasibility of auditing issues in federated cloud computing environments. In summer 2011, the United States Air Force Research Laboratory (AFRL) CyberBAT Cloud Security and Auditing Team initiated the exploration of the cloud security challenges and future cloud auditing research directions that are covered in this book. This work was supported by the United States government funds from the Air Force Office of Scientific Research (AFOSR), the AFOSR Summer Faculty Fellowship Program (SFFP), the Air Force Research Laboratory (AFRL) Visiting Faculty Research Program (VFRP), the National Science Foundation (NSF) and the National Institute of Health (NIH). All chapters were partially suppor...
Kayiga, Herbert; Ajeani, Judith; Kiondo, Paul; Kaye, Dan K.
Background Obstructed labour remains a major cause of maternal morbidity and mortality whose complications can be reduced with improved quality of obstetric care. The objective was to assess whether criteria-based audit improves quality of obstetric care provided to women with obstructed labour in Mulago hospital, Uganda. Methods Using criteria-based audit, management of obstructed labour was analyzed prospectively in two audits. Six standards of care were compared. An initial audit of 180 pa...
Pandit, J J; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Cook, T M
We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700-23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030-9700), and without it was ~1:135 900 (1:78 600-299 000). The cases of accidental awareness during general anaesthesia reported to 5th National Audit Project were overwhelmingly cases of unintended awareness during neuromuscular blockade. The incidence of accidental awareness during caesarean section was ~1:670 (1:380-1300). Two thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental; rapid sequence induction; obesity; difficult airway management; neuromuscular blockade; and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, most due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex; age (younger adults, but not children); obesity; anaesthetist seniority (junior trainees); previous awareness; out-of-hours operating; emergencies; type of surgery (obstetric, cardiac, thoracic); and use of neuromuscular blockade. The following factors were
Thorseng, Anne; Jensen, Tina Blegind
initiative to provide such services to patients is the Danish national e-health portal, sundhed.dk, which is at the forefront of governmental initiatives and which serves as a unified hub between the various participants in the healthcare sector. Studying the evolution of sundhed.dk in light of information...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e......-health portal successfully managed to establish a solid foundation by means of providing direct usefulness and by building on existing information systems, routines, and governance structures in the healthcare sector. However, during this process, a number of unintended side effects appeared that have...
Gurgel Jr., Garibaldi D.; Carvalho de Sousa, Islâandia M.; de Araujo Oliveira, Sydia Rosana
In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles...... of universality, equity, and integrality. While the reform in Brazil aimed at improving equity and effectiveness, reforms in Europe aimed at improving efficiency in order to contain costs. The European reforms increased supply and utilization but never provided the large increase in efficiency that was hoped for......, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having...
Full Text Available Internal audit services are more and more needed within economic entities, because on one hand they are directly subordinated to the general manager, on the other hand there is an increase in credit to its recommendations, estimating that internal audit is more than just a simple compliance check based on an established referral system. Our research focuses on evaluating the impact of theory and practice in the application of internal audit process. The added value brought by internal audit function to the economic entity it is pretty difficult to establish and requires effective ways and criteria of measured. In this regard, we will try to present ways to analyze internal audit’s activity by reference to some performance indicators or other specific methods. We used as research techniques: literature review, applied research and constructive research.
Pybis, Jo; Saxon, David; Hill, Andy; Barkham, Michael
Cognitive Behaviour Therapy (CBT) is the front-line psychological intervention for step 3 within UK psychological therapy services. Counselling is recommended only when other interventions have failed and its effectiveness has been questioned. A secondary data analysis was conducted of data collected from 33,243 patients across 103 Improving Access to Psychological Therapies (IAPT) services as part of the second round of the National Audit of Psychological Therapies (NAPT). Initial analysis considered levels of pre-post therapy effect sizes (ESs) and reliable improvement (RI) and reliable and clinically significant improvement (RCSI). Multilevel modelling was used to model predictors of outcome, namely patient pre-post change on PHQ-9 scores at last therapy session. Counselling received more referrals from patients experiencing moderate to severe depression than CBT. For patients scoring above the clinical cut-off on the PHQ-9 at intake, the pre-post ES (95% CI) for CBT was 1.59 (1.58, 1.62) with 46.6% making RCSI criteria and for counselling the pre-post ES was 1.55 (1.52, 1.59) with 44.3% of patients meeting RCSI criteria. Multilevel modelling revealed a significant site effect of 1.8%, while therapy type was not a predictor of outcome. A significant interaction was found between the number of sessions attended and therapy type, with patients attending fewer sessions on average for counselling [M = 7.5 (5.54) sessions and a median (IQR) of 6 (3-10)] than CBT [M = 8.9 (6.34) sessions and a median (IQR) of 7 (4-12)]. Only where patients had 18 or 20 sessions was CBT significantly more effective than counselling, with recovery rates (95% CIs) of 62.2% (57.1, 66.9) and 62.4% (56.5, 68.0) respectively, compared with 44.4% (32.7, 56.6) and 42.6% (30.0, 55.9) for counselling. Counselling was significantly more effective at two sessions with a recovery rate of 34.9% (31.9, 37.9) compared with 22.2% (20.5, 24.0) for CBT. Outcomes for counselling and CBT in the
Carolina Aguiar da Rosa
Full Text Available O objetivo deste artigo é caracterizar os custos dos Serviços de Não-Auditoria – SNA das maiores empresas listadas na Bolsa de Valores de São Paulo – BM&FBOVESPA. Para a consecução deste trabalho foram utilizadas as informações divulgadas no Formulário de Referência – FR e no Relatório de Administração – RA, relativas ao ano de 2010, das 100 maiores empresas classificadas por valor de mercado, apresentadas na Revista Exame. Para identificar os elementos que caracterizam os grupos de empresas com diferentes custos de SNA evidenciados utilizou-se a análise de variância, avaliando-se a partir das variáveis ativo total, patrimônio líquido, resultado líquido e custos dos serviços de auditoria externa - SAE. Os resultados encontrados demonstram que os SNA mais utilizados pelas empresas são os de auditoria de impostos (31%. Por outro lado, os serviços de auditoria SOX detêm um custo expressivo, representando 16% do total de SNA, mas possuem uma baixa incidência, que pode ser justificada por uma preocupação recente com a governança corporativa. Uma preocupação com a evidenciação dos SNA pode surgir, pois 50% dos custos evidenciados pelas empresas compõem o grupo “outros serviços” e não são explicitados os tipos de serviços que fazem parte desse grupo. Além disso, foram encontradas incoerências de informações evidenciadas no FR e RA em 35% das empresas. Quanto às relações da variabilidade dos custos dos SNA, este estudo traz evidências de que os maiores custos dos SNA evidenciados pelas empresas da amostra estão naquelas em que os custos de SAE são maiores. The aim of this paper is to characterize the costs of Non-Audit Services - SNA of the largest companies listed at BM&FBOVESPA. To achieve this study, the Reference Form - FR and Management Report - RA were used to find information about SNAdisclosed in 2010 by the top 100 companies ranked by market value, which were listed at Exame magazine. To
Ndeshipewa Johanna Akwenye
Full Text Available The underlying study to this paper attempts to establish to what extent audit committees in government ministries in Namibia have been established as a requirement for enhanced quality of service delivery and accountability to taxpayers A qualitative approach was followed, where questionnaires or an interviews were conducted with accounting officers in government ministries. Content and thematic analyses were used to formulate narratives based on the understanding of similarities and differences in respondents’ experiences, views and perceptions. The study shows that from the 17 ministries that responded, only 2 ministries have established audit committees. Confirmatory, there is currently no legislature that makes it mandatory for government ministries in Namibia to establish audit committees within their respective constituencies. There are no formal audit committee terms and references or an audit committee charters are in place. Government ministries in Namibia seem to not have adopted best national and international governance practices with respect to the establishment of audit committees within their ministries. There is a need for a clear guidance as to how audit committees must be established; the composition of the committee members, the terms of office of committee members and remuneration, to mention a few
...The Corporation for National and Community Service (``the Corporation'') is issuing rules to implement changes to the operation of the National Service Trust as directed by the Edward M. Kennedy Serve America Act (``the Serve America Act'' or ``SAA''). In addition, this rule provides flexibility for exceptions to the 80 percent cost reimbursement requirement for Senior Companion and Foster Grandparent programs based on hardship. Finally, this rule reorders and renumbers certain parts of the existing regulations, adds new definitions, and makes several minor technical edits.
Cotter, S; McKee, M; Barber, N
OBJECTIVE--To investigate systematically participation in audit of NHS hospital pharmacists in the United Kingdom. DESIGN--Questionnaire census survey. SETTING--All NHS hospital pharmacies in the UK providing clinical pharmacy services. SUBJECTS--462 hospital pharmacies. MAIN MEASURES--Extent and nature of participation in medical, clinical, and pharmacy audits according to hospital management and teaching status, educational level and specialisation of pharmacists, and perceived availability of resources. RESULTS--416 questionnaires were returned (response rate 90%). Pharmacists contributed to medical audit in 50% (204/410) of hospitals, pharmacy audit in 27% (108/404), and clinical audit in only 7% (29/404). Many pharmacies (59% (235/399)) were involved in one or more types of audit but few (4%, (15/399)) in all three. Participation increased in medical and pharmacy audits with trust status (medical audit: 57% (65/115) trust hospital v 47% (132/281) non-trust hospital; pharmacy audit: 34% (39/114) v 24% (65/276)) and teaching status (medical audit: 58% (60/104) teaching hospital v 47% (130/279) non-teaching hospital; pharmacy audit 30% (31/104) v 25% (68/273)) and similarly for highly qualified pharmacists (MPhil or PhD, MSc, diplomas) (medical audit: 54% (163/302) with these qualifications v 38% (39/103) without; pharmacy audit: 32% (95/298) v 13% (13/102)) and specialists pharmacists (medical audit: 61% (112/184) specialist v 41% (90/221) non-specialist; pharmacy audit: 37% (67/182) v 19% (41/218)). Pharmacies contributing to medical audit commonly provided financial information on drug use (86% 169/197). Pharmacy audits often concentrated on audit of clinical pharmacy services. CONCLUSION--Pharmacists are beginning to participate in the critical evaluation of health care, mainly in medical audit. PMID:10132456
Gandecha, R; C Atkinson; Papazafeiropoulou, A; Stergioulas, L
This paper examines the use of Actor Network Theory (ANT) as a lens to get a better understanding of the implementation of the Integrated Care Record Service (ICRS) in the UK National Health Service (NHS). Actor Network Theory has been deployed in various environments to achieve a better understanding of the roles of not only the humans but also the artifacts that constitute, in this case, healthcare networks of services and organisations. The theory is used as a means of supporting real worl...
Marcelo Antonio Pierri Junior
Full Text Available The aim of this study was to identify if the behavior of audit fees are affected when the partner or audit firm change for the period 2010 to 2013. For this, an empirical model was developed and hypotheses based on the international and national literature about determinants of audit fees and audit firm rotation. The hypothesis of the study sought to observe the discount on the initial year relationship between the audited company and the audit firm, the fees in change of audit partner and the differences in the type of audit firm change, whether big- Four or non-Big Four. In addition to the variables incorporated to the assumptions, the model features eight control variables: total assets, subsidiaries, foreign subsidiaries, general liquidity, big-four, inherent risk, loss and restructuring operations. Data analysis technique used was the regression model with panel data. From the fixed effects model, it was observed that the company's asset size, liquidity and the type of firm that performs the audit contribute to increase the value of the fees paid by the audited companies. It wasn't possible to get significant evidence about discounted value of the audit fees, either in the audit firm or partner changes.
Cook, T M; Andrade, J; Bogod, D G; Hitchman, J M; Jonker, W R; Lucas, N; Mackay, J H; Nimmo, A F; O'Connor, K; O'Sullivan, E P; Paul, R G; Palmer, J H MacG; Plaat, F; Radcliffe, J J; Sury, M R J; Torevell, H E; Wang, M; Hainsworth, J; Pandit, J J
The 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland into accidental awareness during general anaesthesia yielded data related to psychological aspects from the patient, and the anaesthetist, perspectives; patients' experiences ranged from isolated auditory or tactile sensations to complete awareness. A striking finding was that 75% of experiences were for anaesthesia or at the time of report seemed beneficial. Quality of care before the event was judged good in 26%, poor in 39% and mixed in 31%. Three quarters of cases of accidental awareness during general anaesthesia (75%) were judged preventable. In 12% of cases of accidental awareness during general anaesthesia, care was judged good and the episode not preventable. The contributory and human factors in the genesis of the majority of cases of accidental awareness during general anaesthesia included medication, patient and education/training. The findings have implications for national guidance, institutional organisation and individual practice. The incidence of 'accidental awareness' during sedation (~1:15 000) was similar to that during general anaesthesia (~1:19 000). The project raises significant issues about information giving and consent for both sedation and anaesthesia. We propose a novel approach to describing sedation from the patient's perspective which could be used in communication and consent. Eight (6%) of the patients had resorted to legal action (12, 11%, to formal complaint) at the time of reporting. The 5th National Audit Project methodology provides a standardised template that might usefully inform the investigation of claims or serious incidents related to accidental awareness during general anaesthesia. © 2014 by the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland. This article is being published jointly in Anaesthesia and the British Journal of
Keli Regina DAL PRÁ
Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.
This survey study examined the inf ormation needs of National Youth Service Corps (NYSC) members and it is one of the few to do so. A purposive sample of 500 which is equal to about a fifth of the serving men and women from various parts of Ondo State, Nigeria answered to the questionnaire. Copies of this ...
Verhoef, Peter C.; Heijnsbroek, Martin; Bosma, Joost
Customer satisfaction is essential for public and railway services, because firms in these industries have contracts with governments requiring them to achieve specific customer satisfaction targets. In this paper, we describe a National Dutch Railways project in which we identify the major
U.S. Geological Survey, Department of the Interior — The USGS Map Indices service from The National Map (TNM) consists of 1x1 Degree, 30x60 Minute (100K), 15 Minute (63K), 7.5 Minute (24K), and 3.75 Minute grid...
The National Plant Germplasm System (NPGS) conserves plant genetic resources, not only for use by future generations, but for immediate use by scientists and educators around the world. With a great deal of interaction between genebank curators and users of plant genetic resources, customer service...
Frumkin, Peter; Jastrzab, JoAnn; Vaaler, Margaret; Greeney, Adam; Grimm, Robert T., Jr.; Cramer, Kevin; Dietz, Nathan
This study examines the short- and long-term impact of AmeriCorps participation on members' civic engagement, education, employment, and life skills. The analysis compares changes in the attitudes and behaviors of participants over time to those of individuals not enrolled in AmeriCorps, controlling for interest in national and community service,…
Diabetes is not simply a disorder of the metabolism but a chronic disease that affects every aspect of a person's body and life and is becoming increasingly common This paper outlines the National Service Framework for Diabetes standards and how they aim to reduce the incidence and the risks of complications of this condition.
The new dispensation in South Africa necessitated a paradigm shift at the National Terminology Services (NTS). Being part of the Central Government, the NTS has to implement policy as laid down by the government of the day. Former policy, processes and products are described as well as the vision and objectives for the ...
Rigbye, Jane; Griffiths, Mark D.
According to the latest British Gambling Prevalence Survey, there are approximately 300,000 adult problem gamblers in Great Britain. In January 2007, the "British Medical Association" published a report recommending that those experiencing gambling problems should receive treatment via the National Health Service (NHS). This study…
Describes the concept and purpose of the National Center for Service-Learning (Washington, D.C.) and outlines some of the resources available to people interested in pursuing the concepts (giving and getting, acting and reflecting, serving and learning) further. (ERB)
... 47 Telecommunication 3 2010-10-01 2010-10-01 false Audit planning. 53.211 Section 53.211 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) SPECIAL PROVISIONS CONCERNING BELL OPERATING COMPANIES Separate Affiliate; Safeguards § 53.211 Audit planning. (a...
Objective. To evaluate the role of the ICA (Identification,. Cause, Avoidable factor) Solution method of perinatal audit in reducing perinatal mortality. Design. Retrospective audit of 1 060 perinatal deaths between 1 January 1991 and 31 December 1992. Setting. Livingstone Hospital Maternity Service. Subjects. One thousand ...
Objective. To evaluate the role of the ICA (Identification, Cause, Avoidable factor) Solution method of perinatal audit in reducing perinatal mortality. Design. Retrospective audit of 1 060 perinatal deaths between 1 January 1991 and 31 December 1992. Setting. Livingstone Hospital Maternity Service. Subjects. One thousand ...
... the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS CHILD AND ADULT CARE FOOD PROGRAM State Agency Provisions § 226.8 Audits. (a) Unless... made once per each management evaluation, review, or audit per Program within a fiscal year. However...
Kandt, Alicen J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)
This presentation for the 2017 Energy Exchange in Tampa, Florida, offers information about advanced auditing technologies and techniques including alternative auditing approaches and considerations and caveats.
O'Donnell, Claire; Manché, Marioth; Kingsland, Charles; Haddad, Nabil; Brickwood, Paul
The variable nature of NHS provision of fertility services has again been highlighted by the response of commissioners to the recent guidance from the National Institute of Clinical Excellence. This paper describes an evidence-based model for policy aimed at minimising inequity across one Strategic Health Authority. The paper highlights the difficulties resulting from the current Department of Health guidance on targeting those in greatest need. A different way of describing this group is proposed, namely, defining childlessness in terms of parental status alone. This is clear to both patient and clinician at the outset, not subject to variable interpretation and because it is quantifiable for any given population, facilitates the commissioning of a level of service provision that reflects expressed need. A clinical audit suggests that the annual incidence of fertility problems prompting attendance at secondary care clinics is similar to levels observed nearly 20 years ago, at around 98 per 10,000 of the fertile population (proxy denominator, women aged 25 - 39). Our model further indicates that, for the more complex treatments, if both partners were required to be childless and treatments were to be delivered within 12 - 18 months of listing, commissioners would need to fund treatment for around 15 - 20 patients per 10,000 of the fertile population. If only one partner was required to be childless this figure would rise by 15 - 20%. We argue that despite the clinical guidelines, fertility treatments will remain a 'postcode lottery' unless central government addresses the priority to be given to fertility treatment on a national basis.
Full Text Available This article clarifies the impact of national culture in the after sales service in the automotive sector. Introduction and objectives: After-sales services have become paramount in the automobile industry. However, they are not sufficiently researched, particularly in emerging markets. Here an academic gap exists because, within the automotive research literature, culture is a widely neglected issue. Thus no explicit knowledge can be applied regarding emerging markets service demand behaviour, which might be a crucial point, as some of these countries culture is different to the western culture. Methods: The research is based in a survey carried out among Chinese premium brand automotive customers. Results: It shows which individual level values are causal and positively contribute to the perception of service quality and loyalty behaviour by customers. Conclusion: The article providing a guideline how the entire process chain of after-sales services could be researched and applies successfully the individual level value theory by Schwartz. Implications and research limitation: Brand loyalty is well explained by perceived service quality significantly leads to after-sales service satisfaction, which itself is a strong predictor of workshop loyalty. Moreover, workshop loyal customers are likewise significantly brand loyal. Finally, the influence of culture is empirically verified with the one exception of after-sales service satisfaction.
Ogah, J; Pring, D W
Consultant obstetricians and gynaecologists are often recalled from home back into hospital to attend emergencies. We audited their driving practices and compliance to motor traffic regulations on recall to these emergencies with the aid of a questionnaire survey. A total of 218 of the 300 UK consultants surveyed responded. Some 65% of those who owned a green warning light beacon (GWL) admitted to speeding on some journeys and 46% ignored red lights; 84% of non-owners of a GWL would speed and 28% would ignore a red light. A total of 37 consultants had been stopped for traffic violations, nine with a GWL and 28 without. Five consultants had been involved in accidents returning to hospital to attend an emergency. Obstetricians and gynaecologists are disregarding motor traffic regulations in order to attend emergencies.
...; National Veterinary Services Laboratories; Bovine Spongiform Encephalopathy Surveillance Program Documents... associated with National Veterinary Services Laboratories diagnostic support for the bovine spongiform... Veterinary Services Laboratories; Bovine Spongiform Encephalopathy Surveillance Program Documents. OMB Number...
... Information Collection; National Veterinary Services Laboratories; Bovine Spongiform Encephalopathy... information collection associated with National Veterinary Services Laboratories diagnostic support for the... Staff Veterinarian, Veterinary Services, APHIS, 4700 River Road Unit 43, Riverdale, MD 20737; (301) 851...
Full Text Available Indonesia is recognized as one of the most corrupting countries in the world. That can be seen by the facts that there are so many corruption cases handled by Prosecutor and Police Departments but no one case has been solved properly. Laws and Regulations have been created, controlling, and investigating institutions have been established and maintained but those still cannot touch the corruptors and put them behind bars. Public expects that accountants can improve their professional competences in detecting fraud. This article will overview about fraud auditing, condition causing fraud, characteristics and types of fraud, and the responsibility of auditor in detecting fraud.
De CECCO, Corrado; CETINĂ, Iuliana; RĂDULESCU, Violeta; DRĂGHICI, Mircea
Broadly speaking, the literature on the marketing audit and marketing of services has developed on a separate track. The prerequisite for a particular framework in developing the marketing audit of services is that it does not take sufficient account on the services features, even if the marketing audit is similar with the one in services, too. This thing does not allow the company of services to benefit from the advantages of the audit marketing.
Corrado De CECCO
Full Text Available Broadly speaking, the literature on the marketing audit and marketing of services has developed on a separate track. The prerequisite for a particular framework in developing the marketing audit of services is that it does not take sufficient account on the services features, even if the marketing audit is similar with the one in services, too. This thing does not allow the company of services to benefit from the advantages of the audit marketing.
... Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE SERVICE-LEARNING PROGRAM PURPOSES § 2515.10 What are the service-learning programs of the Corporation for National and Community... 45 Public Welfare 4 2010-10-01 2010-10-01 false What are the service-learning programs of the...
Silvia Blitzer Golombek
Full Text Available A growing number of studies show connections between youth participation in service and service-learning opportunities and positive behavior outcomes. Building on this data, the article presents National Youth Service Day (NYSD as a program that can be incorporated into ongoing activities to enhance youth development goals. The paper describes the program’s components– building a network of support organizations, offering project planning grants, providing service-learning materials, and developing a media and advocacy campaign. Examples of NYSD projects show how project planners are using the program to learn and practice academic and non-academic skills. A review of evaluations to date indicates the program is annually increasing its output measures. Participants’ responses show that the program is also contributing to positive behavioral changes, in particular related to young people’s increasing awareness about specific community issues and their own competency in addressing them.
Al Wattar BH
Full Text Available Bassel H Al Wattar,1,* Jennifer A Tamblyn,2,* William Parry-Smith,2,* Mathew Prior,3,* Helen Van Der Nelson4,* On behalf of UK Audit and Research trainee Collaborative in Obstetrics and Gynaecology (UKARCOG 1Women’s Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, UK; 2Institute of Metabolism and Systems Research (IMSR, University of Birmingham, Birmingham, UK; 3Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK; 4Academic Centre for Women’s Health, North Bristol NHS Trust, Bristol, UK *UKARCOG Background: Postpartum hemorrhage (PPH continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK.Methods: We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH. We used a standardized data collection tool and collected data on patients’ demographics, incidence of PPH, estimated blood loss (EBL, prophylactic and treatment measures, onset of labor, and mode of delivery.Results: We collected data from 98 obstetric units, including 3663 cases of primary PPH. Fifty percent of cases were minor PPH (EBL 500–1000 mL, n=1900/3613, 52.6% and the remaining were moderate PPH (EBL >1000 to <2000 mL, n=1424/3613, 39.4% and severe PPH (EBL >2000 mL, n=289/3613, 8%. The majority of women received active management of the third stage of labor (3504/3613, 97% most commonly with Syntometrine intramuscular (1479/3613, 40.9%. More than half required one additional uterotonic agent (2364/3613, 65.4% most commonly with Syntocinon intravenous infusion (1155/2364, 48.8%. There was a poor involvement of consultant obstetricians and anesthetists in
Sixsmith, Judith; Callender, Matthew; Hobbs, Georgina; Corr, Susan; Huber, Jörg W
This research explored the experiences of service users and providers during the implementation of the National Service Framework (NSF) for Long-Term (Neurological) Conditions (LTNCs). A participatory qualitative research design was employed. Data were collected using 50 semi-structured interviews with service users, 25 of whom were re-interviewed on three occasions. Forty-five semi-structured interviews were also conducted with service providers who worked with individuals with LTNCs. Interviews focused on health, well-being and quality of life in relation to service provision, access and delivery. Data were thematically analysed individually and collaboratively during two data analysis workshops. Three major themes were identified that related to the implementation of the NSF: "Diagnosis and treatment", "Better connected services" and "On-going rehabilitation". Service users reported that effective care was provided when in hospital settings but such treatments often terminated on return to their communities despite on-going need. In hospital and community settings, service providers indicated that they lacked the support and resources to provide continuous care, with patients reaching a crisis point before referral to specialist care. This research highlighted a range of issues concerning the recent UK-drive towards patient-centred approaches within healthcare, as service users were disempowered within the LTNC care pathway. Moreover, service providers indicated that resource constraints limited their ability to provide long-term, intensive and integrated service provision. Our research suggests that many service users with long-term neurological conditions experienced disconnections between services within their National Service Framework care pathway. For health and social care practitioners, a lack of continuity within a care pathway was suggested to be most pertinent following immediate care and moving to rehabilitative care. Our findings also indicate that
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false May a TSP appeal a... Service Provider (tsp) and Agency Appeal Procedures for Prepayment Audits § 102-118.580 May a TSP appeal a prepayment audit decision of the GSA Audit Division? (a) Yes, the TSP may appeal to the Civilian Board of...
Kennedy, Sherry; Young, Wendy; Schull, Michael J; Isaac, Winston
In February 2007, the Health Council of Canada, in its third annual report, emphasized the need for pan-Canadian data on our health care system. To date, no studies have examined the strengths and weaknesses of emergency health services (EHS) administrative databases, as perceived by researchers. We undertook a qualitative study to determine, from a researcher's perspective, the strengths and weaknesses of EHS administrative databases. The study also elicited researchers' suggestions to improve these databases. We conducted taped interviews with 4 Canadian health services researchers. The transcriptions were subsequently examined for common concepts, which were finalized after discussion with all the investigators. Five common themes emerged from the interviews: clinical detail, data quality, data linkage, data use and population coverage. Data use and data linkages were considered strengths. Clinical detail, data quality and population coverage were considered weaknesses. The 5 themes that emerged from this study all serve to reinforce the call from the Health Council of Canada for national data on emergency services, which could be readily captured through a national EHS administrative database. We feel that key stakeholders involved in emergency services across Canada should work together to develop a strategy to implement an accurate, clinically detailed, integrated and comprehensive national EHS database.
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1174.26 Section 1174.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE....26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits...
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1157.26 Section 1157.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE...-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits in accordance...
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1183.26 Section 1183.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE....26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits...
Turcsányi, István; Gohritz, Andreas; Fridén, Jan
Surgical restoration of upper extremity function in tetraplegia is acknowledged as beneficial, yet in many countries it is underused or absent. This study describes a 10-year review of a project to implement a tetraplegia upper extremity surgery service in Hungary. The main aims were to increase awareness among patients, the medical community and the public about the benefits of this rehabilitation. The process of implementing a national tetraplegia hand surgery service is described, together with a retrospective outcome study of upper extremity function after surgical reconstruction in this service. A total of 141 tetraplegic patients were assessed. Of these, 57 (40%) underwent a total of 126 reconstructions, including 366 procedures, between 2002 and 2012. Clinical parameters and patient-perceived results demonstrated improved functions and abilities. Considerable media attention and scientific presentations facilitated making this service permanent. In 2009, surgical rehabilitation in tetraplegia became a recognized part of the rehabilitation protocol in Hungary. These results suggest that the success of starting a national tetraplegia hand service relies on convincing postoperative outcomes, patient-to-patient contacts, and co- operation between rehabilitation specialists, therapists, health authorities and surgeons. The leadership of dedicated hand surgeons is necessary to provide and disseminate scientific support for the concept of tetraplegia hand surgery and to stimulate interdisciplinary communication and educational programmes.
The following article gives a brief overview of the new visual identity being adopted by the National Health Service in England. It looks at the thinking behind the identity, the identity's component parts and provides sources for obtaining further information on the identity's application. It is compiled from a presentation by Stephanie Hood from the corporate identity team of the NHS Executive communications unit given on 22nd October 1999 at the National Designers in Health Network seminar, Time-out '99, Sheffield. Supporting information was obtained from the NHS Communications website http:¿nww.doh.nhsweb.uk/commsnet.
National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of precipitation probabilities. In...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of precipitation probabilities. In...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Digital Forecast Database (NDFD) contains a seamless mosaic of the National Weather Service's (NWS) digital forecasts of precipitation probabilities. In...
... HUMAN SERVICES Health Resources and Services Administration National Practitioner Data Bank; Name Change... Administration, HHS. ACTION: Notice. SUMMARY: On March 7, 2007, the Health Resources and Services Administration... Data Banks, Bureau of Health Professions, Health Resources and Services Administration, Parklawn...
... Animal and Plant Health Inspection Service Notice of Availability of Biotechnology Quality Management... has developed an audit standard for its biotechnology compliance assistance program. The audit... Assistance Branch, Biotechnology Regulatory Services, APHIS, 4700 River Road Unit 91, Riverdale, MD 20737...
Sections report on: medical examinations and consultations; protection from health hazards, such as pneumoconiosis and other prescribed diseases; problems such as vitamin D in miners' blood, Legionnaires' disease, rehabilitation and physiotherapy, high pressure injection injuries, pump packing; National Coal Board (Coal Products) Ltd.; injuries and treatment; and nursing service. A list of staff and their publications and a supplement on occupational toxicology are included.
Barry, Angela; Wilkinson, Isabel; Halford, Victoria; Springett, Kate; McInnes, Alistair
Clinical assessment and management for anyone who has diabetes may be influenced by the development of the National Service Framework (NSF) for Diabetes. Through a case study, this article explains how the NSF for Diabetes and other recent NHS documentation has influenced our approach to managing a type 2 diabetic patient whose feet are categorised as 'high risk'. Some of the potential shortfalls of the NSF for Diabetes are also discussed in this context.
Brekke, Kurt Richard; Sørgard, Lars
This paper studies the interplay between public and private health care in a National Health Service. We consider a two-stage game, where at stage one a Health Authority sets the public sector wage and a subsidy to (or tax on) private provision. At stage two the physicians decide how much to work in the public and the private sector. We characterise different equilibria depending on whether physicians coordinate labour supply or not, the physicians’ job preferences, and t...
Maas, M.J.M.; Nijhuis-Van der Sanden, M.W.G.; Driehuis, F.; Heerkens, Y.F.; Vleuten, C.P.M. van der; Wees, P.J. van der
OBJECTIVES: To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation
... National Park Service Notice of Intent To Repatriate Cultural Items: USDA Forest Service, Coconino National Forest, Flagstaff, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The USDA Forest... believes itself to be culturally affiliated with the cultural items may contact the USDA Forest Service...
... National Park Service Notice of Intent To Repatriate Cultural Items: USDA Forest Service, Coconino National Forest, Flagstaff, AZ AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The USDA Forest... believes itself to be culturally affiliated ] with the cultural items may contact the USDA Forest Service...
... National Museum and Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH... National Museum and Library Services Board. This notice also describes the function of the Board. Notice of... National Museum and Library Service Board Meeting: 9:30 a.m.-11:30 a.m. Executive Session (Closed to the...
Edward W JohnstonDepartment of Hepatobiliary Surgery, Southampton General Hospital, Southampton, Hampshire, UKBackground: Clinical audit is a process used to improve the quality of care provided to patients. With an increasing body of evidence to question the effectiveness of audit, this study aims to evaluate the standard of surgical audits carried out in a large teaching hospital.Methods: All surgically orientated audits proposed to the hospital’s audit office over a 5-year period...
... National Park Service Notice of Inventory Completion: USDA Forest Service, Daniel Boone National Forest... Agriculture, Forest Service, Daniel Boone National Forest, has completed an inventory of human remains and... contact the Daniel Boone National Forest, Winchester, KY. Repatriation of the human remains to the Indian...
... National Framework? 86.101 Section 86.101 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE... INFRASTRUCTURE GRANT (BIG) PROGRAM Service Completion of the National Framework § 86.101 What is the Service schedule to adopt the National Framework? The Secretary of the Interior adopted the National Framework on...
INTRODUCTION: The National Health Service (NHS) Cancer Plan guidelines recommend a maximum 2-week wait from referral to first appointment, and 2 months from referral to treatment for primary cancers. However, there are currently no guidelines available for metastatic disease. In the UK, nearly half of all colorectal cancer patients develop hepatic metastases. Timely, surgical resection offers the potential for cure. The aim of this study was to audit current practice for colorectal liver metastases in a regional hepatobiliary unit, and compare this to the NHS Cancer Plan standards for primary disease. PATIENTS AND METHODS: A retrospective review of the unit\\'s database was performed for all hepatic metastases referrals from January 2006 to December 2008. The dates of referral, first appointment, investigations and initiation of treatment, along with patient\\'s age and sex, were recorded on Microsoft Excel and analysed. Time was expressed as mean +\\/- SD in days. RESULTS: A total of 102 patients with hepatic metastases were identified. Five were excluded due to incomplete data. The average time from referral to first appointment was 10.6 +\\/- 9.4 days and the average time from referral to treatment was 38.5 +\\/- 28.6 days. Seventy-five (72.7%) had surgical intervention, of whom 37 also had chemotherapy. CONCLUSIONS: The data compare favourably to the NHS Cancer Plan guidelines for primary malignancy, demonstrating that a regional hepatobiliary unit is capable of delivering a service for colorectal liver metastases that adheres to the NHS Cancer Plan. Therefore, the NHS Cancer Plan can be applied to this cohort.
Sury, M R J; Palmer, J H M G; Cook, T M; Pandit, J J
Details of current UK anaesthetic practice are unknown and were needed for interpretation of reports of accidental awareness during general anaesthesia (GA) within the 5th National Audit Project. We surveyed NHS anaesthetic activity to determine numbers of patients managed by anaesthetists and details of 'who, when, what, and where': activity included GA, local anaesthesia, sedation, or patients managed awake. Anaesthetists in NHS hospitals collected data on all patients for 2 days. Scaling enabled estimation of annual activity. Hospital response rate was 100% with 20,400 returns. The median return rate within departments was 98% (inter-quartile range 0.95-1). Annual numbers (% of total) of general anaesthetics, sedation, and awake cases were 2,766,600 (76.9%), 308,800 (8.6%), and 523,100 (14.5%), respectively. A consultant or career grade anaesthetist was present in more than 87% of cases. Emergency cases accounted for 23.1% of workload, 75% of which were undertaken out of hours. Specialties with the largest workload were orthopaedics/trauma (22.1%), general surgery (16.1%), and gynaecology (9.6%): 6.2% of cases were non-surgical. The survey data describe: who anaesthetized patients according to time of day, urgency, and ASA grade; when anaesthesia took place by day and by weekday; the distribution of patient types, techniques, and monitoring; where patients were anaesthetized. Nine patients out of 15 460 receiving GA died intraoperatively. Anaesthesia in the UK is currently predominantly a consultant-delivered service. The low mortality rate supports the safety of UK anaesthetic care. The survey data should be valuable for planning and monitoring anaesthesia services. © The Author 2014. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: email@example.com.
Jopson, Janet A; Reeder, Anthony I
To document the number and variety of indoor tanning facilities and services in New Zealand, and to analyse changes from 1992 to 2006. Hard copies of the Yellow Pages telephone directory listings of all 18 New Zealand regions for 1992, 1996, 2001 and 2006 were examined. Entries under solaria and sun bed headings were supplemented with entries where sun bed/indoor tanning services were explicitly advertised under hairdressing, beauty therapy/supplies, and health and fitness centre categories. Duplicate listings were eliminated. From 1992 to 2006, inclusive, there was a 241% increase in the number of businesses that advertised some form of indoor tanning service in the NZ Yellow Pages telephone directories. There was a 525% increase in the number of wholesale trade providers, indicative of expansion in the industry, overall. Hire services also increased. The reported findings are likely to represent an underestimate of the total numbers of facilities and providers. Substantial growth in indoor tanning facilities and services in New Zealand has occurred since 1992. The evidence of potential serious health risks from sunbed use, in conjunction with evidence of irresponsibility among some providers, suggests a need for regulatory controls to strengthen existing voluntary guidelines. With legislation recently introduced for the states of Victoria and South Australia, and proposed in Queensland and Western Australia before the end of 2008; it would be timely for New Zealand authorities to collaborate with those drafting that legislation.
Butterworth, C J; Baxter, A M; Shaw, M J; Bradnock, G
To assess the activity of consultants in restorative dentistry in the United Kingdom in the provision of osseointegrated dental implants within the National Health Service Hospital service and to evaluate their attitudes concerning the relevant medical and oral factors considered in patient selection for implant treatment. Anonymous postal questionnaire in the United Kingdom. Consultants in restorative dentistry. Out of the sample of 145, 109 consultants (75%) completed the questionnaire in 1999. 54 of the 109 consultants (49.5%) are involved in the provision of osseointegrated implant treatment, treating an average of 29 cases/year (range 2-150). However, over one third of the respondents treated 10 or less cases/year. 89% worked with oral surgeons as an implant team. 68% used Branemark (Nobel Biocare) implants as their main system. The majority of consultants felt that smoking, psychoses and previous irradiation were the most important medical factors that contra-indicated implant retained restorations whilst untreated periodontitis, poor oral hygiene and uncontrolled caries were the most important oral contra-indications. Many centres were experiencing significant problems with the funding of implant treatment with one centre receiving no funding. The implications for patient care and specialist training are discussed. There is a marked variation in the number of patients treated with endosseous dental implants within the United Kingdom National Health Service hospitals. Many consultants treat 10 or fewer patients each year. In the main, there is agreement about the factors that contra-indicate implant treatment; these are in line with national guidelines.
H. Kubra Kandemir
Full Text Available Auditors used to serve the interest of the shareholders only. However, there have been significant changes in terms of auditors’ role and their function. Auditors are now expected to verify financial statements, but at the same time give an assurance regarding the financial sustainability of the entity. Regarding the latter role, audit firms provide consulting services, including risk assessment and management services. However, the law does not assign the latter role to external auditors. This situation results in an expectations gap in relation to both the role of the auditors and the scope of the external auditing. In addition, the growing economic importance of consulting and the long years of auditor tenure is likely to impair auditor independence. This paper submits that the new form of auditing is not problematic but creates issues. First, the expectations between the users of the financial reports and auditors are wider. Second, auditors’ independence is damaged due to the long years of auditor tenure and dependence of non-audit fees generated from consultancy services that not related to audit. The recent law reforms issued by the European Commission has brought some important provisions in terms of filling the expectations gap, reinforcing auditor independence and reducing the familiarity threat. EU’s relatively strict rules on provision of non-audit services and audit firm rotation are expected to have an important impact in the audit market. A critical analysis of the new EU law is submitted with some policy recommendations.
.... FOR FURTHER INFORMATION CONTACT: Kim Huffman, Executive Secretary, National Advisory Council on the... administration, customer service, marketing, organizational partnerships, research, and clinical practice. We are.../or skills does the individual possess that would benefit the workings of NAC), and the nominee's...
2010, an STR is a record of all essential medical, mental health, and dental care received by service members during their military career . The STR is...care repository that contains results of annual health care assessments and information from private physicians and dentists . Although the Army
Lynford Graham; William F Messier Jr
The Statement on Auditing Standards No. 107 provides guidance on the auditor's consideration of audit risk and materiality when performing an audit of financial statements in accordance with generally accepted auditing standards...
Audit Fee Determinants and Audit Quality in Ethiopian Commercial Banks. ... revealed bank size, liquidity, efficiency, loan growth, capital adequacy and auditor size ... Keywords: audit fees, regulatory risks, audit quality, earning management, ...
Smith, George F.; Page, Donna
The National Weather Service River Forecast System (NWSRFS) consists of several major hydrometeorologic subcomponents to model the physics of the flow of water through the hydrologic cycle. The entire NWSRFS currently runs in both mainframe and minicomputer environments, using command oriented text input to control the system computations. As computationally powerful and graphically sophisticated scientific workstations became available, the National Weather Service (NWS) recognized that a graphically based, interactive environment would enhance the accuracy and timeliness of NWS river and flood forecasts. Consequently, the operational forecasting portion of the NWSRFS has been ported to run under a UNIX operating system, with X windows as the display environment on a system of networked scientific workstations. In addition, the NWSRFS Interactive Forecast Program was developed to provide a graphical user interface to allow the forecaster to control NWSRFS program flow and to make adjustments to forecasts as necessary. The potential market for water resources forecasting is immense and largely untapped. Any private company able to market the river forecasting technologies currently developed by the NWS Office of Hydrology could provide benefits to many information users and profit from providing these services.
Habrich, Heinz; Söhne, Wolfgang
The European Global Navigation System (GNSS) Galileo is going to be established in the near future. Currently, four satellites are in place forming the In-Orbit-Testing (IOT) phase. Within the next years, the constellation will be filled. Full Operational Capability (FOC) will be reached 2019. Beside the Open Service (OS) which is comparable to other OS of existing GNSS, e.g., GPS C/A, there is a so-called Public Regulated Service (PRS) included in the IOT satellites already. The PRS will have improved robustness, i.e. robust signals which will be resistant against involuntary interferences, jamming and spoofing. The PRS signal is encrypted and there will be a restricted access to authorized users, e.g. safety and emergency services, authorities with security task, critical infrastructure organizations etc. The access to the PRS which will be controlled through a special key management will be managed and supervised within the European Union (EU) Member States (MS) by national authorities, the Competent PRS Authority (CPA). But a set of Common Minimum Standards (CMS) will define the minimum requirements applicable to each PRS participant. Nevertheless, each MS is responsible for its national key management. This presentation will inform about the testing activities for Galileo PRS in Germany. The coarse concept for the testing is explained, the schedule is outlined. Finally, the paper will formulate some expectations to the Galileo PRS, e.g. for international cooperation.
Hassan, I A; Critten, P; Isalska, B; Denning, D W
Fungal infection is increasingly recognised as an important cause of morbidity and mortality, especially in immunocompromised patients. Little information exists on laboratory services available and the methods used by general microbiology laboratories to diagnose these important infections. To investigate the services microbiology laboratories in northwest England provide towards the diagnosis and management of superficial and deep fungal infections. A questionnaire was sent to laboratories to get a holistic view of the support given to clinicians looking after patients with fungal infections. The aim was not to investigate details of each laboratory's standard operating procedures. The completed questionnaires, which formed the basis of this report, were returned by all 21 laboratories which were recruited. This study was conducted between March 2004 and September 2004. Services were provided to District General Hospitals and to six tertiary centres, including eight teaching hospitals by 16 laboratories. Their bed capacity was 250-1300 beds. Total specimens (including bacterial and viral) processed annually were 42 000-500,000 whereas fungal ones were 560-5400. In most microbiology laboratories of northwest England, clinicians were aware of the potential of fungal pathogens to cause infections especially in immunocompromised patients. Additional measures such as prolonged incubation of samples were introduced to improve fungal yield from patients at high risk. It is necessary to train and educate laboratory and medical staff about the role of serology and molecular methods in diagnosis and management of patients with fungal infection.
Muhammad Malik Hakim
Full Text Available IT service providers often campaign for the importance of having a high level of IT maturity to its customers. However, not all IT companies have a high commitment to IT management within their own organisation. As a case study, this paper attempts to measure the IT maturity level of PT. XYZ that now is a growing IT services provider. Data collection is done by interview, document study, and direct field observation. The measurement of IT maturity level is conducted using 4 domains of COBIT 4.1 Framework, consists of Plan and Organize (PO, Deliver and Support (DS, Acquire and Implement (AI, and Monitor and Evaluate (ME. The result shows a value of 2.5 which indicates that IT maturity level is at level 2 (Repeatable but Intuitive which means low enough for companies that should have a high awareness of IT governance and commitment. This study shows that the level of IT maturity in IT service provider is not always as high as its campaign.
Alm, James; McKee, Michael
Strategies for reducing tax evasion include stricter enforcement, but taxpayer responses to increased enforcement are difficult to measure with field data. We use experimental methods to examine individual compliance responses to advance information on audit probability and productivity. Our design informs some individuals that their return will be audited prior to making their compliance decision, while other individuals receive information that they will not be audited; we also inform indiv...
Ternes, Mark P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Langley, Brandon R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Accawi, Gina K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Malhotra, Mini [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)
The Health and Safety Audit is an electronic audit tool developed by the Oak Ridge National Laboratory to assist in the identification and selection of health and safety measures when a home is being weatherized (i.e., receiving home energy upgrades), especially as part of the US Department of Energy (DOE) Weatherization Assistance Program, or during home energy-efficiency retrofit or remodeling jobs. The audit is specifically applicable to existing single-family homes (including mobile homes), and is generally applicable to individual dwelling units in low-rise multifamily buildings. The health and safety issues covered in the audit are grouped in nine categories: mold and moisture, lead, radon, asbestos, formaldehyde and volatile organic compounds (VOCs), combustion, pest infestation, safety, and ventilation. Development of the audit was supported by the US Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control and the DOE Weatherization Assistance Program.
Gutierrez L, S.; Walwyn S, G.; Alonso V, G. [CPHR, Calle 20 No. 4113 e/41 y 47, Playa, C.P. 11300, C. Habana (Cuba)]. e-mail: firstname.lastname@example.org
Purpose: To describe the methodology and experience of the Secondary Laboratory of Dosimetric Calibration of Cuba in the establishment of the TLD Postal Service for quality audits of beams of Co-60 in reference conditions. Materials and methods: Through the Coordinated Project of Research (Contract 10794) its was bought 200 solid thermoluminescent detectors of LiF: Mg, Ti (TLD-100) in micro bars form with dimensions of 6 x 1 x 1 mm and of the JR 1152F type manufactured in China. All these detectors were identified individually with a serial number on one of its faces, using a graphite fine sheet. Those detectors for its irradiation are introduced in cylindrical plastic capsules developed and used by the International Atomic Energy Agency (IAEA) in the Audit Postal Service of Dose IAEA/WHO, the capsules have one cavity equal to 3 mm for that is necessary to recover this cavity with a fine plastic tube so that the detectors remain immobile during the irradiation. The method used to determine the individual sensitivity of the thermoluminescent detectors is: to irradiate a detectors group (100 micro bars) 4 times in those same geometric conditions, with the same irradiation history and reading, then it is determine for each detector a sensitivity factor equal to the average of those readings obtained for the 4 irradiation cycles for each i detector among the average of all the reading values obtained during the 4 cycles. The thermoluminescent signal is obtained with a Harshaw 2000C/B reader manual. Results: The satisfactory results obtained in the verification of the calibration of the TLD system, using the reference irradiation service of the Seibersdorf Dosimetry Laboratory of the IAEA in three different years are shown. The results of the audits carried out to the different radiotherapy services of the country in different years are also presented. Conclusions: The experience with the detectors acquired in the project demonstrates that with an appropriate
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.
Kayiga, Herbert; Ajeani, Judith; Kiondo, Paul; Kaye, Dan K
Obstructed labour remains a major cause of maternal morbidity and mortality whose complications can be reduced with improved quality of obstetric care. The objective was to assess whether criteria-based audit improves quality of obstetric care provided to women with obstructed labour in Mulago hospital, Uganda. Using criteria-based audit, management of obstructed labour was analyzed prospectively in two audits. Six standards of care were compared. An initial audit of 180 patients was conducted in September/October 2013. The Audit results were shared with key stakeholders. Gaps in patient management were identified and recommendations for improving obstetric care initiated. Six standards of care (intravenous fluids, intravenous antibiotics, monitoring of maternal vital signs, bladder catheterization, delivery within two hours, and blood grouping and cross matching) were implemented. A re-audit of 180 patients with obstructed labour was conducted four months later to evaluate the impact of these recommendations. The results of the two audits were compared. In-depth interviews and focus group discussions were conducted among healthcare providers to identify factors that could have influenced the audit results. There was improvement in two standards of care (intravenous fluids and intravenous antibiotic administration) 58.9 % vs. 86.1 %; p audit. There was no improvement in vital sign monitoring, delivery within two hours or blood grouping and cross matching. There was a decline in bladder catheterization (94 % vs. 68.9 %; p audits was 55.1 and 48.2 % respectively, p = 0.19. Healthcare factors (negative attitude, low numbers, poor team work, low motivation), facility factors (poor supervision, stock-outs of essential supplies, absence of protocols) and patient factors (high patient load, poor compliance to instructions) contributed to poor quality of care. Introduction of criteria based audit in the management of obstructed labour led to measurable
Kim, Lois G; Caplin, Ben; Cleary, Faye; Hull, Sally A; Griffith, Kathryn; Wheeler, David C; Nitsch, Dorothea
Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing). GP practice prevalence of coded CKD stages 3-5 ranges from 0.04 to 7.8%. Practices differ considerably in coding of CKD in individuals where CKD is indicated following testing (ranging from 0 to 97% of those with and glomerular filtration rate Accounting for overdispersion is crucial in providing useful information about outlying practices for CKD prevalence.
... 45 Public Welfare 4 2010-10-01 2010-10-01 false How do I renew authority to use a national service insignia? 2540.560 Section 2540.560 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE GENERAL ADMINISTRATIVE PROVISIONS Restrictions on Use of National Service Insignia § 2540.560 How d...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false Who has authority to approve use of national service insignia? 2540.540 Section 2540.540 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE GENERAL ADMINISTRATIVE PROVISIONS Restrictions on Use of National Service Insignia § 2540.540 Who...
... 45 Public Welfare 4 2010-10-01 2010-10-01 false What are the restrictions on using national service insignia? 2540.510 Section 2540.510 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND COMMUNITY SERVICE GENERAL ADMINISTRATIVE PROVISIONS Restrictions on Use of National Service Insignia § 2540.510 What...
Fostering an ethic of active citizenship is typically a key goal for national service. However, national service advocates often assume that national service will act as civic education, paying insufficient attention to what this means and how different policy designs further or undermine different conceptions or aspects of citizenship. This paper…
... NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES Institute of Museum and Library Services Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and... the forthcoming meeting of the National Museum and Library Services Board. This notice also describes...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-seventh meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times... meeting will be open to the public. Purpose: The National Advisory Committee on Rural Health and Human...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-sixth meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times... meeting will be open to the public. Purpose: The National Advisory Committee on Rural Health and Human...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-fourth meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times.... Status: The meeting will be open to the public. Purpose: The National Advisory Committee on Rural Health...
... Office of Special Education and Rehabilitative Services; Overview Information; National Institute on... of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may change... period exceeding 60 months. The Assistant Secretary for Special Education and Rehabilitative Services may...
unique demands of the global war on terrorism, a volunteer national service program that calls for military or civilian service is needed, even though the...current political climate appears to offer little chance of its acceptance. A volunteer national service program could consist of four types of service: the military, AmeriCorps, homeland security, and the Peace Corps.
... ARTS AND THE HUMANITIES Institute of Museum and Library Services Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of Meeting. SUMMARY: The National Museum and Library Services Board, which advises the Director of...
... ARTS AND THE HUMANITIES Institute of Museum and Library Services Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of Meeting. SUMMARY: The National Museum and Library Services Board, which advises the Director of...
... 50 Wildlife and Fisheries 6 2010-10-01 2010-10-01 false How did the Service design the National Framework? 86.102 Section 86.102 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT... INFRASTRUCTURE GRANT (BIG) PROGRAM Service Completion of the National Framework § 86.102 How did the Service...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-second meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times... Advisory Committee on Rural Health and Human Services provides advice and recommendations to the Secretary...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health...-third meeting. Name: National Advisory Committee on Rural Health and Human Services. Dates and Times... delivery, research, development and administration of health and human services in rural areas. Agenda...
Cameron, Sharon T; Riddell, Julie; Brown, Audrey; Thomson, Andrew; Melville, Catriona; Flett, Gillian; Caird, Lucy; Laird, George
Women in Scotland who request an abortion (for non-medical reasons) within the legal gestational limit (up to 24 weeks) but beyond the gestational limit of all abortion facilities in Scotland (only up to 20 weeks) must travel to England if they wish to terminate the pregnancy. We wished to determine the number and characteristics of women presenting at ≥16 weeks' gestation for abortion, and compare the characteristics of those proceeding to abortion with those continuing the pregnancy. Over a period of 12 months we conducted a prospective audit of women presenting at ≥16 weeks' gestation to abortion services throughout Scotland. The characteristics of women proceeding to abortion and those continuing the pregnancy were compared. A total of 267 women presented for abortion at ≥16 weeks' gestation. Their median age was 22 years (range 14 to 47 years); 231 were from deprived areas (86.5%), 128 (47.9%) already had a child and 73 (27.3%) had previously undergone abortion. A total of 175 women (65.5%) proceeded to abortion, locally (n = 125; 46.8%) or in England (50; 18.7%). Those at ≥20 weeks' gestation were statistically more likely to continue the pregnancy than those at earlier gestations (p abortion in Scotland at ≥16 weeks' gestation. Those who are over 20 weeks' gestation and would need to travel to England for abortion are more likely to continue the pregnancy, suggesting that travel is a barrier to accessing legal abortion for this group of women. Provision of abortion services up to 24 weeks' gestation should be considered within Scotland.
Full Text Available The purpose of this study is to discuss the current state and future of auditing. Expert consensus is used as a basis to examine the current state of auditing and generate modifications both needed and likely to occur in the audit profession. This study contributes to the literature by using the Delphi method to develop predictions as to the direction of the audit industry and discuss the implications associated with these predictions. If auditors can better understand where the profession stands and where it is headed, then they can better prepare for the future. Some predictions emerging from this study relative to future audit practices include increasing automation of audit procedures, more predictive financial statements, continuous auditing of financial statements and transactions, and an increasingly global perspective regarding audit activities.
US Agency for International Development — USAID/OIG has initiated its new Audit Information Management System (AIMS) to track OIG's audit recommendations and USAID's management decisions. OIG's in-house...
Tucker, Sue; Baldwin, Robert; Hughes, Jane; Benbow, Susan; Barker, Andrew; Burns, Alistair; Challis, David
There is much variation in the services provided for older people with mental health problems. In England, the National Service Framework for Older People (NSFOP) sought to address these inconsistencies and improve care. This study describes the situation three years after its publication. A postal survey of old age psychiatrists collected data on the NSFOP mental health model: the range of specialist mental health provision, the nature of the specialist:generic service interface and the degree of interdisciplinary/interagency working. Three hundred and eighteen (72%) consultants responded. Considerable differences existed in the deployment of key professionals within community teams, with more than a third lacking ring-fenced social work time. Few services had dedicated rehabilitation beds and nearly a third lacked separate facilities for people with organic and functional illnesses. Increasing numbers of consultants had access to a memory clinic and there was some suggestion that liaison services were developing, but little indication of increased support for care homes. Several services had yet to agree protocols with primary care, or to implement measures promoting effective information-sharing and integrated care, and there was little evidence that the introduction of the Single Assessment Process (SAP) had significantly changed practice. Although just over half of consultants reported that mental health services were improving, less than a quarter considered community provision adequate. Three years after the publication of the NSFOP there remained significant gaps in services for older people with mental health problems and substantial variation in provision between districts. (c) 2006 John Wiley & Sons, Ltd.
Paige, Karen Schultz [Los Alamos National Laboratory; Gomez, Penelope E. [Los Alamos National Laboratory
This document describes the approach Waste and Environmental Services - Environmental Data and Analysis plans to take to resolve the issues presented in a recent audit of the WES-EDA Environmental Database relative to the RACER database. A majority of the issues discovered in the audit will be resolved in May 2011 when the WES-EDA Environmental Database, along with other LANL databases, are integrated and moved to a new vendor providing an Environmental Information Management (EIM) system that allows reporting capabilities for all users directly from the database. The EIM system will reside in a publicly accessible LANL cloud-based software system. When this transition occurs, the data quality, completeness, and access will change significantly. In the remainder of this document, this new structure will be referred to as the LANL Cloud System In general, our plan is to address the issues brought up in this audit in three ways: (1) Data quality issues such as units and detection status, which impinge upon data usability, will be resolved as soon possible so that data quality is maintained. (2) Issues requiring data cleanup, such as look up tables, legacy data, locations, codes, and significant data discrepancies, will be addressed as resources permit. (3) Issues associated with data feed problems will be eliminated by the LANL Cloud System, because there will be no data feed. As discussed in the paragraph above, in the future the data will reside in a publicly accessible system. Note that report writers may choose to convert, adapt, or simplify the information they receive officially through our data base, thereby introducing data discrepancies between the data base and the public report. It is not always possible to incorporate and/or correct these errors when they occur. Issues in the audit will be discussed in the order in which they are presented in the audit report. Clarifications will also be noted as the audit report was a draft document, at the time of this
Holm, Claus; Thinggaard, Frank
This study analyses audit quality differences between audits by a single big audit firm and joint audits with either one or two big audit firms. We exploit the unique situation in Denmark beginning on 1 January 2005, at which time a long-standing mandatory joint audit system for listed companies...... was replaced by a voluntary joint audit system. First, we report the results of a survey of Danish CFOs’ views on and their experiences with the choice of single or joint audits and their perceptions of audit quality. Second, based on data from the mandatory joint audit abolition year and the following two...... years, we test the audit quality differences using abnormal accruals. Most CFOs perceive that audit quality by a single big four audit firm is the same as it is in joint audits with either one or two big four audit firms. The results of our empirical analysis are in line with the perceptions. We find...
Study - Executive Summary In 2002, new corporate governance-related guidelines were introduced in Switzerland that included recommendations on the establishment, composition, structure and processes of audit committees. This study presents new evidence on audit committee patterns and trends at Swiss listed companies, as well as on audit committee effectiveness. The results of this study are important to individuals and organizations dealing with audit committees, incl...
El Taguri A
recognized location of choice for quality healthcare and an integrated centre of excellence for clinical and wellness services, medical education and research . An international medical travel conference (IMTC was held in December 2006 and some web sites such as ArabMedicare.com were established to accompany the needs of this growing market.In spite of the aforementioned rewards, medical tourism is not without risks . Medical tourism can do harm to national health services of the host as well as the country of origin. Besides cultural and language issues, there are risks inherent in traveling as accidents, exposure to different infectious diseases, risks from traveling soon after surgery, impossibility of treating chronic disease after a single consultation, the non familiarity of how a certain specialty applies to other communities, the on-off consultations, the limited possibility for follow up, the absence of record of the consultation , and most importantly fraud and abuse.The total amount of money spent by Libyans on both forms of medical tourism is difficult to estimate. It ranges between $100-200 millions per year for treatment abroad, but the accurate figures are not available. The form of medical tourism where doctors rather than patients travel, gained a momentum with the increased role of private practice in health service delivery. There is a real threat from the growing market of medical tourism in the region on the public health oriented national health system in Libya. The two neighboring countries that are mostly visited by Libyans have a lower performance of National Health Service in comparison to Libyan National Health services with an objective assessment as revealed by infant mortality rate, life expectancy at birth, maternal mortality ratio and proportion of low birth weight . Giving the non-popularity of tourism among the Libyan population, traveling in itself is an important event in one’s life. We should not deny that in many cases
... Emergency Nurses Hospital Administration Public Health Emergency Management State Homeland Security Director... National Highway Traffic Safety Administration Appointment/Reappointment to the National Emergency Medical... the National Emergency Medical Services Advisory Council (NEMSAC). SUMMARY: NHTSA is soliciting...
Rubin, G P; Saunders, C L; Abel, G A; McPhail, S; Lyratzopoulos, G; Neal, R D
Background: For patients with symptoms of possible cancer who do not fulfil the criteria for urgent referral, initial investigation in primary care has been advocated in the United Kingdom and supported by additional resources. The consequence of this strategy for the timeliness of diagnosis is unknown. Methods: We analysed data from the English National Audit of Cancer Diagnosis in Primary Care on patients with lung (1494), colorectal (2111), stomach (246), oesophagus (513), pancreas (327), and ovarian (345) cancer relating to the ordering of investigations by the General Practitioner and their nature. Presenting symptoms were categorised according to National Institute for Health and Care Excellence (NICE) guidance on referral for suspected cancer. We used linear regression to estimate the mean difference in primary-care interval by cancer, after adjustment for age, gender, and the symptomatic presentation category. Results: Primary-care investigations were undertaken in 3198/5036 (64%) of cases. The median primary-care interval was 16 days (IQR 5–45) for patients undergoing investigation and 0 days (IQR 0–10) for those not investigated. Among patients whose symptoms mandated urgent referral to secondary care according to NICE guidelines, between 37% (oesophagus) and 75% (pancreas) were first investigated in primary care. In multivariable linear regression analyses stratified by cancer site, adjustment for age, sex, and NICE referral category explained little of the observed prolongation associated with investigation. Interpretation: For six specified cancers, investigation in primary care was associated with later referral for specialist assessment. This effect was independent of the nature of symptoms. Some patients for whom urgent referral is mandated by NICE guidance are nevertheless investigated before referral. Reducing the intervals between test order, test performance, and reporting can help reduce the prolongation of primary-care intervals associated
... collects security services fees from more than 50,000 passengers annually must provide for an audit at least annually of its security service fee activities or accounts. (c) Audits pursuant to paragraph (b... carriers and foreign air carriers must establish and maintain an accounting system to account for the...
Sayinzoga, Felix; Bijlmakers, Leon; van Dillen, Jeroen; Mivumbi, Victor; Ngabo, Fidèle; van der Velden, Koos
Presenting the results of 5 years of implementing health facility-based maternal death audits in Rwanda, showing maternal death classification, identification of substandard (care) factors that have contributed to death, and conclusive recommendations for quality improvements in maternal and obstetric care. Nationwide facility-based retrospective cohort study. All cases of maternal death audited by district hospital-based audit teams between January 2009 and December 2013 were reviewed. Maternal deaths that were not subjected to a local audit are not part of the cohort. 987 audited cases of maternal death. Characteristics of deceased women, timing of onset of complications, place of death, parity, gravida, antenatal clinic attendance, reported cause of death, service factors and individual factors identified by committees as having contributed to death, and recommendations made by audit teams. 987 cases were audited, representing 93.1% of all maternal deaths reported through the national health management information system over the 5-year period. Almost 3 quarters of the deaths (71.6%) occurred at district hospitals. In 44.9% of these cases, death occurred in the post-partum period. Seventy per cent were due to direct causes, with post-partum haemorrhage as the leading cause (22.7%), followed by obstructed labour (12.3%). Indirect causes accounted for 25.7% of maternal deaths, with malaria as the leading cause (7.5%). Health system failures were identified as the main responsible factor for the majority of cases (61.0%); in 30.3% of the cases, the main factor was patient or community related. The facility-based maternal death audit approach has helped hospital teams to identify direct and indirect causes of death, and their contributing factors, and to make recommendations for actions that would reduce the risk of reoccurrence. Rwanda can complement maternal death audits with other strategies, in particular confidential enquiries and near-miss audits, so as to
Full Text Available Abstract Background National health strategies have called for an expansion of the role of primary care in England to increase access to sexual health services. However, there is little guidance for service planners and commissioners as to the public health impact of different combinations of specialist genitourinary medicine (GUM clinics and primary care based services for local populations. Service planning for infectious diseases like sexually transmitted infections (STI is further complicated because the goal of early detection and treatment is not only to improve the health of the individual, but to benefit the wider population and reduce future treatment costs by preventing onward transmission. Therefore, we are developing a survey tool that will enable service planners to better understand the needs of their local STI care-seeking population and which will help inform evidence-based decision-making about current and future service configurations. Here we describe the rationale and development of this survey tool. Methods/Design A pen-and-paper questionnaire asking about sociodemographics, reasons for attendance, care pathways, and recent sexual risk behaviours, is being developed for patients to complete in waiting rooms of diverse clinical services, including GUM clinics and primary-care based services in sociodemographically- and geographically-contrasting populations in England. The questionnaire was cognitively tested before being piloted. In the pilot, 67% of patients participated, of whom 84% consented to our linking their questionnaire to data on STI testing and diagnosis and partner notification outcomes from their clinical records. Discussion The pilot study suggests that both the questionnaire and its linkage to routinely-collected clinical data are likely to be acceptable to patients. By supplementing existing surveillance, data gathered by the survey tool will inform service planners' and providers' understanding of the needs
M F Tunde-Ayinmode
Full Text Available Objective . This study aimed to identify the socio-demographic characteristics, pattern of psychiatric disorders and management of children and adolescents before the setting up of a dedicated child and adolescent unit at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Method . A retrospective study, carried out at the Department of Behavioural Sciences of the hospital. Results . The age range of the 94 children seen was 7 - 19 years, with a mean of 16.38 years (standard deviation 2.49; 82% were aged 14 - 19 years and 17% 7 - 13 years, while only 1 child was under 7 years old. The majority of the children lived with their parents in monogamous families with 5 or more children. The majority of the parents were educated and gainfully employed. The major diagnoses were schizophrenia (50%, delirium (15% and seizure disorders (9%. Of the patients 64% were managed as outpatients and 36% as inpatients. Drug therapy was involved in the majority of cases, and the most frequently prescribed medication was haloperidol, atypical antipsychotics such as risperidone being used in only 8% of cases. Most of the patients were referred from the primary care- associated departments of the hospital, i.e. the general outpatient department (40% and the internal medicine and paediatrics departments (29%. Referrals from welfare, judicial and educational institutions were uncommon (3%. Conclusion . The pattern of patient presentation and management had not changed to any great extent over the past two decades. The introduction of a child and adolescent psychiatric unit is expected to improve consultation/liaison psychiatry and also child psychiatric service delivery and research. Understanding of the prevalence and pattern of presentation of mental disorders and their management is also expected to help improve the strategic planning and organisation of the new clinic.
Horst, B I; Jacobs, P C; Pierce, S M
This report describes Phase II of a project conducted for the Mechanical Utilities Division (UTel), Energy Management Program at Lawrence Livermore National Laboratory (LLNL) by Architectural Energy Corporation (AEC). The overall project covers energy efficiency and water conservation auditing services for 215 modular and prefabricated buildings at LLNL. The primary goal of this project is to demonstrate compliance with DOE Order 430.2A, Contractor Requirements Document section 2.d (2) Document, to demonstrate annual progress of at least 10 percent toward completing energy and water audits of all facilities. Although this project covers numerous buildings, they are all similar in design and use. The approach employed for completing audits for these facilities involves a ''model-similar building'' approach. In the model-similar building approach, similarities between groups of buildings are established and quantified. A model (or test case) building is selected and analyzed for each model-similar group using a detailed DOE-2 simulation. The results are extended to the group of similar buildings based on careful application of quantified similarities, or ''extension measures''. This approach leverages the relatively minor effort required to evaluate one building in some detail to a much larger population of similar buildings. The facility wide energy savings potential was calculated for a select set of measures that have reasonable payback based on the detailed building analysis and are otherwise desirable to the LLNL facilities staff. The selected measures are: (1) HVAC Tune-up. This is considered to be a ''core measure'', based on the energy savings opportunity and the impact on thermal comfort. All HVAC units in the study are assumed to be tuned up under this measure. See the Appendix for a detailed calculation by building and HVAC unit. (2) HVAC system scheduling. This is also considered to be a &apos
Full Text Available Audit is one of the basic issues in organisation and management. It consists of a number of constituent problems. One of them is the problem of research methodology. On the other hand, internal audit plays an increasingly important role in improvement of the functioning of an organisation . An attempt to apply the concept of internal audit for the purposes of diagnosing human resource management is the subject matter of this paper. Apart from the problems strictly related to the essence of methodology of personnel audit, an attempt was made to determine the problem range determined by this audit.
Liempd, Dennis van
, and a too one-sided view on the creation of auditing knowledge. The purpose of this paper is to call for more (diverse) research in this area. Earlier calls have been few and far between, and have not resulted in a lot of research. Within the last two decades though, the auditing universe has changed so...... much that high-quality auditing research never has been needed more. By reviewing available literature challenges to the auditing profession are explored, and the creation of knowledge in general and auditing knowledge in particular are discussed with respect to methodological approaches and operative...
Dr Joanne Gooding
Full Text Available This article considers the design and production of spectacles in Britain following the introduction of standardised frame styles under the National Health Service. NHS spectacles were provided as a functional, durable medical appliance to be delivered cost-effectively and there was no explicit concern for fashion or the patient experience. The actions of the government and professional bodies greatly affected the trade in eyewear and thus restricted opportunities for innovative design and consumer choice. Within the range of state regulation frames there was no active concern for ‘design’ in terms of appearance and it was only through the purchase of private frames that significant choice and variety in eyewear could be attained. The scope for the public to select a more fashionable frame whilst receiving an element of state aid was through the purchase of NHS hybrid private frames.
Camara, Gaoussou; Diallo, Al Hassim; Lo, Moussa; Tendeng, Jacques-Noël; Lo, Seynabou
In Senegal, great amounts of data are daily generated by medical activities such as consultation, hospitalization, blood test, x-ray, birth, death, etc. These data are still recorded in register, printed images, audios and movies which are manually processed. However, some medical organizations have their own software for non-standardized patient record management, appointment, wages, etc. without any possibility of sharing these data or communicating with other medical structures. This leads to lots of limitations in reusing or sharing these data because of their possible structural and semantic heterogeneity. To overcome these problems we have proposed a National Medical Information System for Senegal (SIMENS). As an integrated platform, SIMENS provides an EHR system that supports healthcare activities, a mobile version and a web portal. The SIMENS architecture proposes also a data and application integration services for supporting interoperability and decision making.
Fedaa Abd Almajid Sabbar Alaraji
Full Text Available The profession of quality auditing can have direct or indirect effects on the performance of accountants and auditors. Both particular research and professional recommendations provided evidence on measuring and evaluating service performance of audit profession by taking into account the relationship between quality and accountant performance. Applied research was developed in Republic of Iraq to reveal the function of bodies that regulate external audit for achieving the required level of audit quality and for identifying the obstacles that prevent the compliance with International Auditing Standards. Research focuses on the role of these bodies in order to achieve the quality of audit by implementing a quality control system. Its benefits reduce chances of criticisms and weaknesses, improving the auditing environment in Iraq.
Briggs, Victoria; Pitcher, David; Shaw, Catriona; Fluck, Richard; Wilkie, Martin
Dialysis access should be timely, minimise complications and maintain functionality. Good functional access is required for renal replacement therapy (RRT) to be successful. The aim of the combined vascular and peritoneal dialysis access audit was to examine practice patterns with respect to dialysis access and highlight variations in practice between renal centres. The UK Renal Registry collected centre-specific information on vascular and peritoneal access outcome measures including patient demographics, dialysis access type (at start of dialysis and three months after start of dialysis), surgical assessment and access functionality. The combined access audit covered incident haemodialysis (HD) and peritoneal dialysis (PD) patients in 2012 from England, Northern Ireland and Wales. Centres who had reported data on incident PD patients for the previous audit in 2011 were additionally asked to provide one year follow up data for this group. Fifty-one centres in England, Wales and Northern Ireland (representing 82% of all centres) returned data on first access from 3,720 incident HD patients and 1,018 incident PD patients. A strong relationship was seen between surgical assessment and the likelihood of starting HD with an arteriovenous fistula (AVF). Type of first access was related to the length of time known to renal services with higher numbers of AVFs and PD catheters used in patients known to renal services for at least one year. Three month and one year outcomes of HD and PD access were poorly reported. This audit provides information on important patient related outcome measures with the potential to lead to an improvement in access provision. This represents an important advance, however data collection remains suboptimal. There is wide practice variation across the England, Wales and Northern Ireland in provision of both HD and PD access which requires further exploration. © 2014 S. Karger AG, Basel.
Full Text Available Jill Dixon, Christopher JA Duncan Department of Infectious Diseases and Tropical Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK Abstract: Antimicrobials are an extremely valuable resource across the spectrum of modern medicine. Their development has been associated with dramatic reductions in communicable disease mortality and has facilitated technological advances in cancer therapy, transplantation, and surgery. However, this resource is threatened by the dwindling supply of new antimicrobials and the global increase in antimicrobial resistance. There is an urgent need for antimicrobial stewardship (AMS to protect our remaining antimicrobials for future generations. AMS emphasizes sensible, appropriate antimicrobial management for the benefit of the individual and society as a whole. Within the English National Health Service (NHS, a series of recent policy initiatives have focused on all aspects of AMS, including best practice guidelines for antimicrobial prescribing, enhanced surveillance mechanisms for monitoring antimicrobial use across primary and secondary care, and new prescribing competencies for doctors in training. Here we provide a concise summary to clarify the current position and importance of AMS within the NHS and review the evidence base for AMS recommendations. The evidence supports the impact of AMS strategies on modifying prescribing practice in hospitals, with beneficial effects on both antimicrobial resistance and the incidence of Clostridium difficile, and no evidence of increased sepsis-related mortality. There is also a promising role for novel diagnostic technologies in AMS, both in enhancing microbiological diagnosis and improving the specificity of sepsis diagnosis. More work is needed to establish an evidence base for interventions to improve public and patient education regarding the role of antibiotics in common clinical syndromes, such as respiratory tract infection. Future
Full Text Available The new building housing the National Service Center stands in a 40 Ha property in the outskirts of the city and it resembles more a university campus than an administrative centre. The building has only two levels above grade in an attempt to blend into the eminently rural surroundings, avoiding any architectural aggression to the natural environment. With a similar intention, earth hues were used in the precast concrete façade panels finish, completed by the horizontal emphasis of the dark bronze fenestration.
Interiorly, the building is outstanding by its flexible arrangement, creating open and integrated office spaces. The modular structure allows for future expansion that will eventually double its present size without affecting its architectural unity.
La nueva sede del National Service Center, situada en una parcela de más de 40 Há en el extrarradio de la ciudad, parece un campus universitario más que un centro administrativo. El edificio, que consta de sólo dos plantas sobre rasante, procura su integración en un paisaje marcadamente rural evitando la posible imposición agresiva de la arquitectura en el entorno natural. Con este fin se emplearon colores terrosos, en el acat>ado de los paneles prefabricados de cemento, complementados por una carpintería de marcado trazado horizontal en tonos bronce oscuro. Interiormente el edificio destaca por su flexibilidad, constituyendo espacios de oficinas abiertos e integrados. Su estructura modular permite la ampliación futura de la construcción, hasta duplicar su dimensión actual, sin alterar la unidad arquitectónica.
Macinati, Manuela S
Over the last decade, outsourcing has become one of the major issues in health care. Two major concerns are related to public health care outsourcing practice. The first one involves the suitability of the outsourcing strategy in the public sector, principally with reference to the outsourcing of essential clinical services. The second one relates to the actual benefits of the outsourcing practice in health care, in terms of cost reduction and increasing efficiency. This paper aims to contribute to the debate and literature on outsourcing through a national survey carried out in the Italian National Health Service. In order to achieve the research objective, a questionnaire was developed and, after a pilot test, it was mailed to all Italian public providers. The total response rate was around 42%. Results showed that outsourcing is a widespread phenomenon within health care, especially in the ancillary services area. Moreover, results showed many criticalities of the outsourcing practice in the Italian health-care sector. On the one hand, criticalities concerned the reasons for outsourcing, the characteristics of the outsourced services and the management of the relationship with the vendor. With reference to essential clinical service, outsourcing, as currently managed by health-care providers, may potentially weaken their ability to reach its own objectives. On the other hand, criticalities related to respondent-perceived benefits. Despite the overall positive outsourcing experience expressed in the survey, the results on perceived benefits showed that the effects of outsourcing did not always align to managers' expectations, especially in the cost containment and efficiency area.
Belangia, David Warren [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)
A company just got notified there is a big external audit coming in 3 months. Getting ready for an audit can be challenging, scary, and full of surprises. This Gold Paper describes a typical audit from notification of the intent to audit through disposition of the final report including Best Practices, Opportunities for Improvement (OFI), and issues that must be fixed. Good preparation can improve the chances of success. Ensuring the auditors understand the environment and requirements is paramount to success. It helps the auditors understand that the enterprise really does think that security is important. Understanding and following a structured process ensures a smooth audit process. Ensuring follow-up on OFIs and issues in a structured fashion will also make the next audit easier. It is important to keep in mind that the auditors will use the previous report as a starting point. Now the only worry is the actual audit and subsequent report and how well the company has done.
The objectives of certification and accreditation are the deployment and examination of quality improvement measures in health care services. The quality management system of the ISO 9001 is created to install measures and tools leading to assured and improved quality in health care. Only some experiences with certification fulfilling ISO 9001 criteria exist in the German health care system. Evidence-based clinical guidelines can serve as references for the development of standards in quality measurement. Only little data exists on the implementation strategy of guidelines and evaluation, respectively. A pilot quality management system in consistence with ISO 9001 criteria was developed for ambulatory, gastroenterological services. National guidelines of the German Society of Gastroenterology and Metabolism and the recommendations of the German Association of Physicians for quality assurance of gastrointestinal endoscopy were included in the documentation and internal auditing. This pilot quality management system is suitable for the first steps in the introduction of quality management in ambulatory health care. This system shows validity for accreditation and certification of gastrointestinal health care units as well.
The Diabetes National Service Framework (NSF) represents a new style of this relatively new policy instrument. It sets clear 10-year targets but leaves a large part of implementation decision-making to local teams. It is clear that the central priorities of people with diabetes are therapeutic partnership, expert guidance and integrated service provision. These underpinning themes transcend all of the more specific objectives of the NSF. Realising both the themes and the specific objectives will, in many localities, mean tackling quite challenging transformational programmes. They will probably need to include changed ways of working and information systems development, as well as constructive partnership between primary and secondary care and between many different healthcare disciplines. This may appear a formidable task but having diabetes firmly on the 'must do' healthcare agenda for the first time creates a tremendous opportunity. The way physician specialists in diabetes, the natural local leaders, rise to the challenge will be a key determinant of whether this NSF leads to real improvements in the experience and outcome of care for people with diabetes.
Carle, C; Alexander, P; Columb, M; Johal, J
We designed and internally validated an aggregate weighted early warning scoring system specific to the obstetric population that has the potential for use in the ward environment. Direct obstetric admissions from the Intensive Care National Audit and Research Centre's Case Mix Programme Database were randomly allocated to model development (n = 2240) or validation (n = 2200) sets. Physiological variables collected during the first 24 h of critical care admission were analysed. Logistic regression analysis for mortality in the model development set was initially used to create a statistically based early warning score. The statistical score was then modified to create a clinically acceptable early warning score. Important features of this clinical obstetric early warning score are that the variables are weighted according to their statistical importance, a surrogate for the FI O2 /Pa O2 relationship is included, conscious level is assessed using a simplified alert/not alert variable, and the score, trigger thresholds and response are consistent with the new non-obstetric National Early Warning Score system. The statistical and clinical early warning scores were internally validated using the validation set. The area under the receiver operating characteristic curve was 0.995 (95% CI 0.992-0.998) for the statistical score and 0.957 (95% CI 0.923-0.991) for the clinical score. Pre-existing empirically designed early warning scores were also validated in the same way for comparison. The area under the receiver operating characteristic curve was 0.955 (95% CI 0.922-0.988) for Swanton et al.'s Modified Early Obstetric Warning System, 0.937 (95% CI 0.884-0.991) for the obstetric early warning score suggested in the 2003-2005 Report on Confidential Enquiries into Maternal Deaths in the UK, and 0.973 (95% CI 0.957-0.989) for the non-obstetric National Early Warning Score. This highlights that the new clinical obstetric early warning score has an excellent ability to
Lobo, R; Lynch, K; Casserly, L F
The national early warning score (NEWS) was developed to detect the early signs of patient deterioration with a view to instituting higher levels of care. There is a concern about the sensitivity of the NEWS score in patients with chronic hypoxaemic conditions. This cross-sectional audit sought to determine the clinical relevance of a NEWS score of 7 or higher in medical patients by determining whether there was any change in clinical management. Patients with chronic hypoxaemic conditions had a modified early warning score applied retrospectively, the chronic respiratory early warning score (CREWS) to determine if it made a difference to the trigger threshold. The study also aimed to determine the discharge outcome of such patients. A NEWS score ≥7 did not result in a change in clinical management in 64.6% of cases; 94.1% of patients with no change in clinical management were subsequently discharged home. Oxygen supplementation and oxygen saturation were the primary determinants of elevated NEWS scores with 89.9 and 31.6% of cases having high scores, respectively; 19.7% of patients were receiving home oxygen therapy. Retrospective application of the CREWS scoring system in these patients would have reduced the number of reviews by 70.3%. In medical patients admitted to a Model 2 hospital with chronic respiratory illness, the 'respiratory variables' of the NEWS score are poor discriminators of patients who are clinically deteriorating. Better tools (such as the CREWS score) are required to distinguish acutely ill from chronically ill patients with respiratory disease in Model 2 hospitals.
With regard to audit quality, the study did not find significant relationship between the extent of earning management and abnormal audit fees, indicating that auditors do not seem to compromise audit quality to secure abnormally higher audit fees. The researcher recommends auditors to further align audit fee valuation with ...
provides direction for response to business risks among audit practitioners besides enriching the literature of audit risk and fee models with expanded variables and evidences from emerging economies. Key words: Business Risk Auditing, Audit firms, Kenya. Introduction. Auditing remains to be an important facet of financial ...
Full Text Available Airports similarly to other companies are certified in compliance with the International Standardization Organization (ISO standards of products and services (series of ISO 9000 Standards regarding quality management, to coordinate the technical side of standardizatioon and normalization at an international scale. In order for the airports to meet the norms and the certification requirements as by the ISO they are liable to undergo strict audits of quality, as a rule, conducted by an independent auditing organization. Focus of the audits is primarily on airport operation economics and security. The article is an analysis into the methodology of the airport security audit processes and activities. Within the framework of planning, the sequence of steps is described in line with the principles and procedures of the Security Management System (SMS and starndards established by the International Standardization Organization (ISO. The methodology of conducting airport security audit is developed in compliance with the national programme and international legislation standards (Annex 17 applicable to protection of civil aviation against acts of unlawful interference.
... ARTS AND THE HUMANITIES Sunshine Act Meeting of the National Museum and Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of meeting. SUMMARY: This notice sets forth the agenda of the forthcoming meeting of the National Museum and Library Services Board. This...
... ARTS AND THE HUMANITIES Sunshine Act Meeting; National Museum and Library Services Board AGENCY: Institute of Museum and Library Services (IMLS), NFAH. ACTION: Notice of meeting. SUMMARY: This notice sets forth the agenda of the forthcoming meeting of the National Museum and Library Services Board. This...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... meet during the month of September 2011. The National Advisory Committee on Rural Health will convene... Rural Health and Human Services. Dates and Time: September 26, 2011, 12:30 p.m.-5 p.m. September 27...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... meet during the month of February 2011. The National Advisory committee on Rural Health will convene... Rural Health and Human Services. Dates and Times: February 23, 2011, 8:45 a.m.-5 p.m. February 24, 2011...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... meet during the month of February 2012. The National Advisory Committee on Rural Health will convene... Rural Health and Human Services. Dates and Time: February 15, 2012, 2 p.m.-5 p.m. February 16, 2012, 8...
... Food and Nutrition Service 7 CFR Part 210 RIN 0584-AE11 National School Lunch Program: School Food Service Account Revenue Amendments Related to the Healthy, Hunger-Free Kids Act of 2010; Approval of... rule entitled ``National School Lunch Program: School Food Service Account Revenue Amendments Related...
Grove, A L; Meredith, J O; Macintyre, M; Angelis, J; Neailey, K
This paper presents the findings of a 13-month lean implementation in National Health Service (NHS) primary care health visiting services from May 2008 to June 2009. Lean was chosen for this study because of its reported success in other healthcare organisations. Value-stream mapping was utilised to map out essential tasks for the participating health visiting service. Stakeholder mapping was conducted to determine the links between all relevant stakeholders. Waste processes were then identified through discussions with these stakeholders, and a redesigned future state process map was produced. Quantitative data were provided through a 10-day time-and-motion study of a selected number of staff within the service. This was analysed to provide an indication of waste activity that could be removed from the system following planned improvements. The value-stream map demonstrated that there were 67 processes in the original health visiting service studied. Analysis revealed that 65% of these processes were waste and could be removed in the redesigned process map. The baseline time-and-motion data demonstrate that clinical staff performed on average 15% waste activities, and the administrative support staff performed 46% waste activities. Opportunities for significant waste reduction have been identified during the study using the lean tools of value-stream mapping and a time-and-motion study. These opportunities include simplification of standard tasks, reduction in paperwork and standardisation of processes. Successful implementation of these improvements will free up resources within the organisation which can be redirected towards providing better direct care to patients.
... 5 CFR Chapter IV RIN 3206-AM73 Designation of National Security Positions in the Competitive Service... issue regulations regarding designation of national security positions in the competitive service, and... procedures agencies should observe when designating, as national security positions, positions in the...
... From the Federal Register Online via the Government Publishing Office NATIONAL LABOR RELATIONS BOARD Public Availability of National Labor Relations Board's FY 2010 Service Contract Inventory AGENCY: National Labor Relations Board. ACTION: Notice of public availability of FY 2010 Service Contract...
... From the Federal Register Online via the Government Publishing Office NATIONAL LABOR RELATIONS BOARD Public Availability of National Labor Relations Board's FY 2011 Service Contract Inventory AGENCY: National Labor Relations Board. ACTION: Notice of public availability of FY 2011 Service Contract...
As discussed in the report we are releasing today, our work to review agency actions to ensure that recipients take timely and appropriate corrective actions to fix audit findings contained in single...
... of the Department of Agriculture (Continued) FOOD AND NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE CHILD NUTRITION PROGRAMS SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN...'s review upon request. The cost of these audits shall be considered a part of nutrition services and...
Cornes, Michelle; Peardon, John; Manthorpe, Jill
This article explores the involvement of older people in research and inspection, reflecting on the learning from the recent 'joint review' of the National Service Framework for Older People in England. Working in 10 different localities, the 'joint review' comprised a formal inspection of health and local council services (carried out by the Healthcare Commission, Commission for Social Care Inspection and the Audit Commission) and an externally commissioned university-led research project designed to ascertain the views and experiences of older people living in the 10 inspection sites. In total, 1839 older people were interviewed individually and through focus groups and an additional 4200 older people completed questionnaires. A distinctive feature of the research was the inclusion of a team of older researchers who had undertaken training in research methods in later life. Reflections of the older researchers and other members of the research team on undertaking this large-scale user involvement project were ascertained via a day-long seminar which was tape recorded and transcribed. While many espouse the principle of 'service user involvement' in research, there is a need to move beyond the rhetoric of participation and any blanket assumptions about what it means to be an 'older researcher', a 'service user researcher' or indeed, a 'professional researcher'. This means ensuring that within any given team (user-controlled or collaborative) there are clear lines of accountability and equal opportunities for individual appraisal, support, and personal or professional development. Such considerations are key to working with 'older researchers' and encouraging diversity in the research workforce more generally.
Smith, William Will R
The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers. The NPS developed a Tactical EMS (TEMS) program that closely integrated many principles from: 1) Tactical Combat Casualty Care (TCCC); 2) Tactical Emergency Casualty Care (TECC); 3) and other established federal and civilian TEMS programs. Combining these best practices into the NPS TEMS Program allowed for standardized training and implementation across not only the NPS, but also paralleled other military/federal/civilian TEMS programs. This synchronization is critical when an injury occurs in a joint tactical operation, either planned (drug interdiction) or unplanned (active shooter response), so that patient care can be uniform and efficient. The components identified for a sustainable TEMS program began with strong medical oversight, protocol development with defined phases of care, identifying specialized equipment, and organized implementation with trained TEMS instructors. Ongoing TEMS program management is continuously improving situationally appropriate training and integrating current best practices as new research, equipment, and tactics are developed. The NPS TEMS Program continues to provide ongoing training to ensure optimal patient care in tactical and other NPS settings. Copyright © 2017 Wilderness Medical Society. All rights reserved.
Prisciandaro, Joann; Hadley, Scott; Jolly, Shruti; Lee, Choonik; Roberson, Peter; Roberts, Donald; Ritter, Timothy
To develop a brachytherapy audit checklist that could be used to prepare for Nuclear Regulatory Commission or agreement state inspections, to aid in readiness for a practice accreditation visit, or to be used as an annual internal audit tool. Six board-certified medical physicists and one radiation oncologist conducted a thorough review of brachytherapy-related literature and practice guidelines published by professional organizations and federal regulations. The team members worked at two facilities that are part of a large, academic health care center. Checklist items were given a score based on their judged importance. Four clinical sites performed an audit of their program using the checklist. The sites were asked to score each item based on a defined severity scale for their noncompliance, and final audit scores were tallied by summing the products of importance score and severity score for each item. The final audit checklist, which is available online, contains 83 items. The audit scores from the beta sites ranged from 17 to 71 (out of 690) and identified a total of 7-16 noncompliance items. The total time to conduct the audit ranged from 1.5 to 5 hours. A comprehensive audit checklist was developed which can be implemented by any facility that wishes to perform a program audit in support of their own brachytherapy program. The checklist is designed to allow users to identify areas of noncompliance and to prioritize how these items are addressed to minimize deviations from nationally-recognized standards. Copyright © 2015 American Brachytherapy Society. All rights reserved.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services Funding Opportunity: National HIV Program for Enhanced HIV/AIDS Screening and Engagement in Care AGENCY: Indian Health Service...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... administration of health and human services in rural areas. Agenda: At 9:00 a.m. on June 18, the meeting will be... Resources and Services Administration, Parklawn Building, Room 5A-05, 5600 Fishers Lane, Rockville, MD 20857...
... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... Human Services, Health Resources and Services Administration, Parklawn Building, Room 5A-05, 5600... Secretary with respect to the delivery, research, development, and administration of health and human...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
U.S. Department of Health & Human Services — The National Survey of Substance Abuse Treatment Services (N-SSATS) is designed to collect information from all facilities in the United States, both public and...
US Fish and Wildlife Service, Department of the Interior — This Intra-Service Section 7 evaluation for the 2004 Hunting Plan concurs that activities associated with the proposed Hunting Plan for Crescent Lake National...
U.S. Geological Survey, Department of the Interior — The USGS Imagery Topo Large service from The National Map (TNM) is a dynamic topographic base map service that combines the best available data (Boundaries,...
US Fish and Wildlife Service, Department of the Interior — Diagnostic services case report for two Franklin's gull and two ring-billed gull carcasses collected from Long Lake National Wildlife Refuge to be tested for West...
US Fish and Wildlife Service, Department of the Interior — This environmental assessment outlines how the United States Fish and Wildlife Service proposes to open the Wallkill River National Wildlife Refuge for a managed...
The field of public health services and systems research (PHSSR) has emerged over the past decade to produce the evidence needed to address critical uncertainties about how best to organize, finance, and deliver effective public health strategies to all Americans. To advance these efforts, a national PHSSR research agenda-setting process was used to identify a broad inventory of information needs and uncertainties that public health stakeholders face in the domains of public health workforce, public health system structure and performance, public health financing, and public health information and technology. This paper presents the results of an expert review process used to transform the identified information needs into a concise set of research questions that can be pursued through new scientific inquiry in PHSSR. Established research frameworks were used to specify the contexts, mechanisms of action, and outcomes within the public health system that require further study. A total of 72 research questions were developed from the 113 original items in the PHSSR inventory of information needs. The questions include both persistent problems and newly emerging needs in public health practice and policy. The resulting research agenda provides a starting point for mobilizing the public health scientific enterprise around contemporary, high-priority uncertainties identified by broad cross sections of public health stakeholders. Regular updates to this agenda will be required to achieve continuous improvements in both the science and practice of public health. Copyright © 2012 American Journal of Preventive Medicine. All rights reserved.
In the need of renewing their system, the Internal Audit department has given a proposal for building a new one. Taking into consideration the problems of their system they elaborated a requirement's list with the functionalities and features they were expecting from the new management system. This new system would be primarily for the use of the Internal Audit staff but it would also support the follow-up of internal audit recommendations by potentially all CERN staff members.
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF TRANSPORTATION National Highway Traffic Safety Administration National Emergency Medical Services Advisory Council...) Progress Reports from Committee Chairs (4) Update on the Culture of Safety Project (5) Public Comment...
National Oceanic and Atmospheric Administration, Department of Commerce — The Shannon Index of diversity was calculated from National Marine Fisheries Service Groundfish Survey Program (NMFS GSP) fish trawl data. Data from 477 fishery...
U.S. Geological Survey, Department of the Interior — The USGS Shaded Relief Large service from The National Map (TNM) was created from the National Elevation Dataset (NED), a seamless dataset of best available raster...
National Oceanic and Atmospheric Administration, Department of Commerce — The National Weather Service (NWS) Storm Prediction Center uses RSS feeds to disseminate all watches, warnings and advisories for the United States that are...
U.S. Geological Survey, Department of the Interior — The USGS Imagery Only Large service from The National Map (TNM) consists of National Agriculture Imagery Program (NAIP) and high resolution orthoimagery (HRO) that...
National Oceanic and Atmospheric Administration, Department of Commerce — Fish benthic trawls were completed by the National Marine Fisheries Service Groundfish Survey Program (NMFS GSP). Data from 477 fishery independent trawls ranging...
National Oceanic and Atmospheric Administration, Department of Commerce — Grain size analyses produced by Robert Reid of the NOAA National Marine Fisheries Service for the NOAA/BLM Outer Continental Shelf Mid-Atlantic Project, Baltimore...
U.S. Geological Survey, Department of the Interior — The USGS Governmental Unit Boundaries service from The National Map (TNM) represents major civil areas for the Nation, including States or Territories, counties (or...
Full Text Available Complex logistics audit system is a tool for realization of logistical audit in the company. The current methods for logistics auditare based on “ad hok” analysis of logisticsl system. This paper describes system for complex logistics audit. It is a global diagnosticsof logistics processes and functions of enterprise. The goal of logistics audit is to provide comparative documentation for managementabout state of logistics in company and to show the potential of logistics changes in order to achieve more effective companyperformance.
Department of Transportation — This tool supports the cyclical financial audit process. Qlikview supports large volumes of financial transaction data that can be mined, summarized and presented to...
US Fish and Wildlife Service, Department of the Interior — The National Wildlife Refuge System’s 150 million acres in over 500 refuges representdiverse landscapes with different capacities to provide ecosystem goods and...
The United States Postal Service (USPS) in cooperation with EPA's National Risk Management Research Laboratory (NRMRL) is engaged in an effort to integrate waste prevention and recycling activities into the waste management programs at Postal facilities. This report describes the...
Evans, Julie; Turner, Sally; Bethell, Hugh
The National Service Framework (NSF) for Coronary Heart Disease (CHD) set standards, targets and milestones. In the case of acute myocardial infarction (AMI) or coronary revascularization, Milestone 3 of Standard 12 requires a 12 month audit of exercise and smoking habit and of body mass index (BMI) for patients who have attended cardiac rehabilitation (CR). The targets are that 50 per cent of patients should be exercising regularly, not smoking and have a BMI of <30 kg/m(2). The purpose of this study was to find out whether the targets are realistic and to measure the cost of retrieving the data. A postal questionnaire was used to follow up all the patients who attended our CR programme over a 12 month period. The project was costed. Four hundred and three CHD patients who had attended the programme between April 2001 and March 2002 were sent questionnaires 12 months after their index event. Their diagnoses were AMI in 147 (36.5 per cent), coronary artery surgery in 157 (39 per cent) and angioplasty in 99 (24.5 per cent). Completed questionnaires were received from 358 (89 per cent). Of the responders, 69 per cent were exercising regularly, 91.6 per cent were not smoking (73 per cent had been non-smokers before their index cardiac event) and 79 per cent had a BMI of <30 kg/m(2)(the figure at the start of rehabilitation had been 79 per cent). The cost of performing the audit was pounds sterling 1204. This audit is inexpensive. The targets for smoking and BMI set by the NSF were achieved by a very large margin before either the index cardiac event or starting CR.
Shah, Ajit; Bhat, Ravi
Elderly suicide rates may be influenced by mental health funding, service provision and national policy. A cross-national study examining the relationship between elderly suicide rates and (i) the presence of national policy on mental health, (ii) funding for mental health, and (iii) measures of mental health service provision was undertaken by utilizing data from the World Health Organization website. The main findings are: (i) there is no relationship between suicide rates in both sexes in both elderly age-bands and different measures of mental health policy, except they were increased in countries with a substance abuse policy; and (ii) suicide rates in both sexes in both elderly age-bands were higher in countries with greater provision of mental health services, including the number of psychiatric beds, psychiatrists, psychiatric nurses, and the availability of training in mental health for primary care professionals. Cross-national ecological studies using national-level aggregate data are not helpful in establishing a causal relationship (and the direction of this relationship) between elderly suicide rates and mental health funding, service provision and national policies. The impact of introducing national policies on mental health, increasing funding for mental health services and increasing mental health service provision on elderly suicide rates requires further examination in longitudinal within-country studies.
Moore, M C; Gray, G D; Hale, D S; Kerth, C R; Griffin, D B; Savell, J W; Raines, C R; Belk, K E; Woerner, D R; Tatum, J D; Igo, J L; VanOverbeke, D L; Mafi, G G; Lawrence, T E; Delmore, R J; Christensen, L M; Shackelford, S D; King, D A; Wheeler, T L; Meadows, L R; O'Connor, M E
The 2011 National Beef Quality Audit (NBQA-2011) assessed the current status of quality and consistency of fed steers and heifers. Beef carcasses (n = 9,802), representing approximately 10% of each production lot in 28 beef processing facilities, were selected randomly for the survey. Carcass evaluation for the cooler assessment of this study revealed the following traits and frequencies: sex classes of steer (63.5%), heifer (36.4%), cow (0.1%), and bullock (0.03%); dark cutters (3.2%); blood splash (0.3%); yellow fat (0.1%); calloused rib eye (0.05%); overall maturities of A (92.8%), B (6.0%), and C or greater (1.2%); estimated breed types of native (88.3%), dairy type (9.9%), and Bos indicus (1.8%); and country of origin of United States (97.7%), Mexico (1.8%), and Canada (0.5%). Certified or marketing program frequencies were age and source verified (10.7%), ≤A(40) (10.0%), Certified Angus Beef (9.3%), Top Choice (4.1%), natural (0.6%), and Non-Hormone-Treated Cattle (0.5%); no organic programs were observed. Mean USDA yield grade (YG) traits were USDA YG (2.9), HCW (374.0 kg), adjusted fat thickness (1.3 cm), LM area (88.8 cm2), and KPH (2.3%). Frequencies of USDA YG distributions were YG 1, 12.4%; YG 2, 41.0%; YG 3, 36.3%; YG 4, 8.6%; and YG 5, 1.6%. Mean USDA quality grade (QG) traits were USDA quality grade (Select(93)), marbling score (Small(40)), overall maturity (A(59)), lean maturity (A(54)), and skeletal maturity (A(62)). Frequencies of USDA QG distributions were Prime, 2.1%; Choice, 58.9%; Select, 32.6%; and Standard or less, 6.3%. Marbling score distribution was Slightly Abundant or greater, 2.3%; Moderate, 5.0%; Modest, 17.3%; Small, 39.7%; Slight, 34.6%; and Traces or less, 1.1%. Carcasses with QG of Select or greater and YG 3 or less represented 85.1% of the sample. This is the fifth benchmark study measuring targeted carcass characteristics, and information from this survey will continue to help drive progress in the beef industry. Results will
US Fish and Wildlife Service, Department of the Interior — This record contains two Diagnostic Services Case Updates, one from 8/7/2015 and one from 8/10/2015. The updates provide information about recent bird mortality...
U.S. Environmental Protection Agency — This EnviroAtlas web service supports research and online mapping activities related to EnviroAtlas (https://www.epa.gov/enviroatlas). This web service includes...
... Service, Dinosaur National Monument, Dinosaur, CO AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The U.S. Department of the Interior, National Park Service, Dinosaur National Monument, Dinosaur... culturally affiliated with the human remains may contact Dinosaur National Monument. Disposition of the human...
... 29 Labor 4 2010-07-01 2010-07-01 false Non-Federal audit. 1470.26 Section 1470.26 Labor Regulations Relating to Labor (Continued) FEDERAL MEDIATION AND CONCILIATION SERVICE UNIFORM ADMINISTRATIVE... Financial Administration § 1470.26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are...
... intent to audit the 2009, 2010, and 2011 statements of account submitted by Digitally Imported, Inc., and... Copyright Royalty Board Notice of Intent To Audit AGENCY: Copyright Royalty Board, Library of Congress... and statements of account submitted by eligible nonsubscription services such as, among others...
... intent to audit the 2010, 2011, and 2012 statements of account submitted by Saga Communications, Inc. and... Copyright Royalty Board Notice of Intent To Audit AGENCY: Copyright Royalty Board, Library of Congress... statements of account submitted by eligible nonsubscription services under the section 112 and 114 licenses...
Full Text Available , and especially to provide free basic services to the poor. (In terms of the "free basic services" policy, indigent households are not charged for services such as water, sanitation and electricity, provided that they stay within stated limits. In respect...
Ahmed S Bahammam
Conclusion: The sleep medicine services provided in the KSA have improved since the 2005 survey; however, these services are still below the level of service provided in developed countries. Organized efforts are needed to overcome the identified obstacles and challenges to the progress of sleep medicine in the KSA.
Heiser, John [Brookhaven National Lab. (BNL), Upton, NY (United States)
This document describes the Meteorological Services (Met Services) Calibration and Maintenance Schedule and Procedures, The purpose is to establish the frequency and mechanism for the calibration and maintenance of the network of meteorological instrumentation operated by Met Services. The goal is to maintain the network in a manner that will result in accurate, precise and reliable readings from the instrumentation.
Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M., E-mail: email@example.com [Centro Regional de Referencia con Patrones Secundarios para Dosimetria - CNEA, Presbitero Juan Gonzalez y Aragon 15, B1802AYA Ezeiza (Argentina)
This work was performed in the frame of a Coordinated Research Project (CRP) with IAEA whose objective was to extend the scope of activities carried out by national TLD-based networks from dosimetry audit for rectangular radiation fields to irregular and small fields relevant to modern radiotherapy. External audit is a crucial element in QA programmes for clinical dosimetry in radiotherapy, therefore a methodology and procedures were developed and were made available for dose measurement of complex radiotherapy parameters used for cancer treatment. There were three audit steps involved in this CRP: TLD based dosimetry for irregular MLC fields for conformal radiotherapy, dosimetry in the presence of heterogeneities and 2D MLC shaped fields relevant to stereotactic radiotherapy and applicable to dosimetry for IMRT. In addition, a new development of film-based 2D dosimetry for testing dose distributions in small field geometry was included. The plan for each audit step involved a pilot study and a trial audit run with a few local hospitals. The pilot study focused on conducting and evaluation of the audit procedures with all participants. The trial audit run was the running of the audit procedures by the participants to test them with a few local radiotherapy hospitals. This work intends to provide audits which are much nearer clinical practice than previous audits as they involve significant testing of Tps methods, as well as verifications to determinate whether hospitals can correctly calculate dose delivery in radiation treatments. (author)
De La O, Ana L; Martel García, Fernando
.... This study protocol for an exploratory randomized controlled trial tests the hypothesis that federal and state audits increase compliance with a federal grant program to improve municipal service...
Full Text Available Objective. To analyze organization and therapeutic procedures administered in tertiary outpatient pain clinics in Croatia. Methods. Data about organization of pain clinics, its personnel, equipment, continuing medical education, therapeutic procedures, research activities and relations with pharmaceutical industry were collected using questionnaires. Results. Twenty-two Croatian pain clinics were included in the study. Most of the pain clinics employ exclusively anesthesiologists and nurses. The most frequently prescribed therapeutic procedures in pain clinics were pharmacotherapy, transcutaneous electrical nerve stimulation, acupuncture and trigger point injections. Almost all pain clinics provide educational material for patients. Most of the pain clinics have regular interactions with pharmaceutical companies. Prescribing decisions were based mostly on information from scientific meetings, research articles and consultations with colleagues. Information sources which are considered to be the gold standard – the systematic reviews of The Cochrane Collaboration – were used less frequently (n=12; 57% than advertising materials from pharmaceutical companies (n=16; 76%. Few physicians and other pain clinics staff had scientific degrees or academic titles or were involved in a research project. Conclusion. The national study about pain clinics in Croatia pointed out that there is room for improvement of their organization and services. Pain clinics should employ health-care professionals with diverse backgrounds. They should offer treatments backed by the highest-level of scientific evidence. Since pain is a major public health issue, pain clinic staff should engage more in research to contribute to the growing field of pain research, to enhance capacities for pain research in Croatia, to incorporate scientific evidence into their daily decision-making and to enable evidence-based practice.
Ahmedani, Brian K; Vannoy, Steven
In 2012, the National Action Alliance for Suicide Prevention's Research Prioritization Task Force (RPTF) released a series of Aspirational Goals (AGs) to decrease suicide deaths and attempts. The RPTF asked experts to summarize what was known about particular AGs and to propose research pathways that would help reach them. This manuscript describes what is known about the benefits of access to health care (AG8) and continuity of care (AG9) for individuals at risk for suicide. Research pathways are proposed to address limitations in current knowledge, particularly in U.S. healthcare-based research. Using a three-step process, the expert panel reviewed available literature from electronic databases. For two AGs, the experts summarized the current state of knowledge, determined breakthroughs needed to advance the field, and developed a series of research pathways to achieve prevention goals. Several components of healthcare provision have been found to be associated with reduced suicide ideation, and in some cases they mitigated suicide deaths. Randomized trials are needed to provide more definitive evidence. Breakthroughs that support more comprehensive patient data collection (e.g., real-time surveillance, death record linkage, and patient registries) would facilitate the steps needed to establish research infrastructure so that various interventions could be tested efficiently within various systems of care. Short-term research should examine strategies within the current healthcare systems, and long-term research should investigate models that redesign the health system to prioritize suicide prevention. Evidence exists to support optimism regarding future suicide prevention, but knowledge is limited. Future research is needed on U.S. healthcare services and system enhancements to determine which of these approaches can provide empirical evidence for reducing suicide. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights
Full Text Available With the contemporary world, the internal audit activity is well organized , found in over 80 national institutes which are part of the Institute of Internal Auditors (IIA, whose headquarters is in the U.S., Orlando. This activity is conducted in accordance with the Internal Auditing Standards promoted by the Institute of Internal Auditors ( IIA. Internal auditing is an independent, objective assurance and consulting designed to increase value and improve an organization's operations. It helps the organization meet its objectives, assessing, through a systemic approach and methodical processes of risk management, control and management of the organization and making proposals to strengthen the effectiveness of the entity. [1 ] A review of the history audit provides a sound basis for understanding modern audit objectives and techniques of interpretation changes and its assimilation in detail all aspects characterizing the audit .
Ertl-Wagner, B; Steinbrucker, S
Quality management (QM) cannot be successfully implemented and performed without audits. The PDCA (Plan-Do-Check-Act) cycle is the core component of QM systems. In this cycle an audit represents the crucial step "check". Audits verify whether the performed actions and their results conform to the requirements. It is especially important to verify whether the principles of QM are omnipresent and fully implemented in a department or institution. The announcement of an audit may cause mixed feelings or even anxiety among the personnel to be audited. Without previous information and training the audit may be perceived as an act of control and intrusion into departmental affairs. The colleagues often fear sanctions if lapses are found or consider the audit to be a cross-examination. However, an audit is rather meant to be a helpful aid and a chance to continuously improve the departmental QM system by means of a constructive communication among colleagues. In the year 2009 the European Commission published guidelines for the performance of clinical audits in medical radiology, including diagnostic radiology, nuclear medicine and radiation therapy (Council Directive 97 / 43 / EURATOM). The aim is an optimal protection of the individual from the hazards of ionizing radiation and the directive expects radiological departments to perform clinical audits in accordance with national procedures.
Ruthberg, Zella G.
This is a collection of consensus reports, each produced at a session of an invitational workshop sponsored by the National Bureau of Standards. The purpose of the workshop was to explore the state-of-the-art and define appropriate subjects for future research in the audit and evaluation of computer security. Leading experts in the audit and…
Straw, Suzanne; Jeffes, Jennifer; Dawson, Anneka; Lord, Pippa
The National Foundation for Educational Research (NFER) was commissioned by the "Bloodhound Education Programme" (BEP) to conduct an audit of its activities throughout 2012 and early 2013. The audit included: telephone consultations with a range of stakeholders; analysis of monitoring and internal evaluation data; and attendance at two…
... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 602.26 Section 602.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION UNIFORM... Requirements § 602.26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining...
This report provides an assessment of accounting, financial reporting, and auditing requirements and practices within the enterprise and financial sectors in Hungary using International Financial Reporting Standards (IFRS),International Standards on Auditing (ISA), and the relevant portions of European Union (EU) law (also known as the acquis communautaire) as benchmarks. It also draws on ...
Bradley, D A; Nisbet, A
Dosimetric audit is required for the improvement of patient safety in radiotherapy and to aid optimization of treatment. The reassurance that treatment is being delivered in line with accepted standards, that delivered doses are as prescribed and that quality improvement is enabled is as essential for brachytherapy as it is for the more commonly audited external beam radiotherapy. Dose measurement in brachytherapy is challenging owing to steep dose gradients and small scales, especially in the context of an audit. Several different approaches have been taken for audit measurement to date: thimble and well-type ionization chambers, thermoluminescent detectors, optically stimulated luminescence detectors, radiochromic film and alanine. In this work, we review all of the dosimetric brachytherapy audits that have been conducted in recent years, look at current audits in progress and propose required directions for brachytherapy dosimetric audit in the future. The concern over accurate source strength measurement may be essentially resolved with modern equipment and calibration methods, but brachytherapy is a rapidly developing field and dosimetric audit must keep pace. PMID:24807068
The report provides an assessment of accounting, financial reporting, and auditing practices within the corporate sector in Peru, using International Financial Reporting Standards (IFRS), and International Standards on Auditing (ISA) as benchmarks, drawing on international experience and best practices in that field. This Report on the Observance of Standards and Codes (ROSC) Accounting & ...
... reporting (7 U.S.C. 3319a). (7) Cooperate and work with national and international institutions and other... official state and national estimates (7 U.S.C. 476, 951, and 2204). (2) Take such security precautions as... 7 Agriculture 1 2010-01-01 2010-01-01 false Administrator, National Agricultural Statistics...
... SPACE ADMINISTRATION Public Availability of the National Aeronautic and Space Administration FY 2010 Service Contract Inventory AGENCY: National Aeronautic and Space Administration. ACTION: Notice of public... Administration (NASA) is publishing this notice to advise the public of the availability of its FY 2010 Service...
... RECORDS ADMINISTRATION Public Availability of the National Archives and Records Administration FY 2011 Service Contract Inventory AGENCY: National Archives and Records Administration. ACTION: Notice of public... Administration (NARA) is publishing this notice to advise the public of the availability of its FY 2011 Service...
It is essential that the United States implement national service to reflect the balance between the people, the government and the military or more...the commitment of military forces. There are numerous benefits to be derived from mandatory national service , especially after events of 11 September
the integration of telemedicine to the national healthcare services on a business logic (functional) integration level. In this paper, (1) we identify the lack of business logic (functional) level integration opportunities for patient oriented telemedical applications with national healthcare services; (2) we...
Susan Martin-Williams; Steven Selin
Understanding the organizational development of National Heritage Areas (NHAs) and defining the National Park Service's (NPS) role within individual NHAs guided this qualitative study. Information gained during telephone interviews led to the development of an a priori model of the evolutionary stages of NHAs' organizational development and...
The purpose of this report is to gain an understanding of the governance arrangements, procedures, and capacity for setting auditing standards in a jurisdiction, covering: (a) the adoption of International Standards on Auditing (ISA) where applicable, and (b) national auditing standards. The questions are based on examples of good practice followed by international standard-setting bodies....
Full Text Available Local government councils (LGC rely on a number of funding sources including state and federal governments as well as their community constituents to enable them to provide a range of public services. Given the constraints on these funding sources councils need to have in place a range of strategies and policies capable of providing good governance and must appropriately discharge their financial accountabilities. To assist LGC with meeting their governance and accountability obligations they often seek guidance from their key stakeholders. For example, in the Australian State of New South Wales (NSW, the Office of Local Government has developed a set of guidelines, the Internal Audit Guidelines. In 2010 the NSW Office of Local Government issued revised guidelines emphasising that an internal audit committee is an essential component of good governance. In addition, the guidelines explained that to improve the governance and accountability of the councils, these committees should be composed of a majority of independent members. To maintain committee independence the guidelines indicated that the Mayor should not be a member of the committee. However these are only guidelines, not legislated requirements and as such compliance with the guidelines, before they were revised, has been demonstrated to be quite low (Jones & Bowrey 2013. This study, based on a review of NSW Local Government Councils’ 2012/2013 reports, including Annual Reportsrelation to internal audit committees, to determine if the guidelines are effective in improving local government council governance.
Full Text Available Palliative care in India has made enormous advances in providing better care for patients and families living with progressive disease, and many clinical services are well placed to begin quality improvement initiatives, including clinical audit. Clinical audit is recognized globally to be essential in all healthcare, as a way of monitoring and improving quality of care. However, it is not common in developing country settings, including India. Clinical audit is a cyclical activity involving: identification of areas of care in need of improvement, through data collection and analysis utilizing an appropriate questionnaire; setting measurable quality of care targets in specific areas; designing and implementing service improvement strategies; and then re-evaluating quality of care to assess progress towards meeting the targets. Outcome measurement is an important component of clinical audit that has additional advantages; for example, establishing an evidence base for the effectiveness of services. In resource limited contexts, outcome measurement in clinical audit is particularly important as it enables service development to be evidence-based and ensures resources are allocated effectively. Key success factors in conducting clinical audit are identified (shared ownership, training, managerial support, inclusion of all members of staff and a positive approach. The choice of outcome measurement tool is discussed, including the need for a culturally appropriate and validated measure which is brief and simple enough to incorporate into clinical practice and reflects the holistic nature of palliative care. Support for clinical audit is needed at a national level, and development and validation of an outcome measurement tool in the Indian context is a crucial next step.
Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)
... Office of Special Education and Rehabilitative Services; Overview Information; National Institute on... Special Education and Rehabilitative Services may change the maximum amount through a notice published in... Secretary for Special Education and Rehabilitative Services may change the maximum project period through a...
... Office of Special Education and Rehabilitative Services; Overview Information; National Institute on... budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may... call with NIDRR staff from the Office of Special Education and Rehabilitative Services between 1:00 p.m...
Some co-ordination of preventive health measures was achieved ... employee. It funher proposed the extension of district surgeon services in rural areas and the creation of a sep- arate medical service for blacks.20 But in the words of. Gluckman, 'the ..... Even this pro- posal met with resistance, and Gluckman was forced to.
Higher Education Funding Council for Wales, Cardiff.
This report, the seventh in a series from the Value for Money Steering Group, identifies the key management issues for governors, senior managers, and heads of security services at institutions of higher education in the United Kingdom in developing and reviewing security services to ensure that they are effective and provide value for money.…