WorldWideScience

Sample records for national audit programme

  1. Audit of the Bloodhound Education Programme, 2012-2013

    Science.gov (United States)

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

    2015-01-01

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

  2. Auditing as method of QA programme evaluation

    International Nuclear Information System (INIS)

    Wilhelm, H.

    1980-01-01

    The status and adequacy of a quality assurance programme should be regularly reviewed by the cognizant management. The programme audit is an independent review to determine the compliance with respective quality assurance requirements and to determine the effectiveness of that programme. This lecture gives an introduction of the method to perform audits under the following topics: 1. Definition and purpose of quality audits. 2. Organization of the quality audit function. 3. Unique requirements for auditors. 4. Audit preparation and planning. 5. Conduct of the audit. 6. Reporting the audit results. 7. Follow-up activities. (RW)

  3. Manual on quality assurance programme auditing

    International Nuclear Information System (INIS)

    1984-01-01

    The objective of this Manual is to provide guidance and illustrative examples of the methodology and techniques of internal and external audits that are consistent with the requirements and recommendations of the Code and the Safety Guide. The methodology and techniques are based on the practices of Member States having considerable experience in auditing QA programmes. This Manual is directed primarily towards QA programme auditors and managers and presents methods and techniques considered appropriate for the preparation and performance of audits and the evaluation of results. Its scope includes the techniques and methods used to carry out QA programme audits variously described as 'System', 'Product' and 'Process' audits. The techniques and methods described here may be used as one approach to the evaluation of suppliers' QA capabilities as defined in 50-SG-QA10. Although the Manual is primarily directed towards purchasers and suppliers, it is also relevant to regulatory organizations, such as government offices responsible for quality assurance, which carry out external audits independent of purchasers and suppliers. In such cases similar methods, procedures and techniques may be used

  4. Results of a national quality audit programme for radiotherapy centers in Iran

    International Nuclear Information System (INIS)

    Solimanian, A.; Ghafoori, M.

    1998-01-01

    The SSDL of Iran has established a quality audit programme for radiotherapy centers in the country. Most of the radiotherapy departments are now audited annually by the SSDL dosimetry team. During the site visits, beam characteristics of the teletherapy units are determined or tested. This report presents the results of the on-site output measurements conducted during the period 1985-1996 and demonstrates the role of traceability of absorbed dose to water determinations in hospitals to the SSDL standard. (author)

  5. Results of the national audit in radiotherapy

    International Nuclear Information System (INIS)

    Alonso Samper, Jose Luis; Dominguez, Lourdes; Alert Silva, Jose; Alfonso Laguardia, Rodolfo; Larrinaga Cortina, Eduardo; Garcia Yip, Fernando; Rodriguez Machado, Jorge; Morales Lopez, Jorge Luis; Silvestre Patallo, Ileana

    2009-01-01

    The National Audit Programme in Radiotherapy in Cuba working for 8 years regularly visiting each country's radiotherapy service at least once every two years, during the visit involving two medical physicists and radiation oncologist. This paper presents the main features of the program and its main results. Early detection deficiencies in the work of the Radiation Therapy Services that may cause radiological risk situations for both patients and workers and the general public. Help with their comments to the continuous improvement of quality of care. During audit visits is reviewed the whole process of radiotherapy, since the patient comes to the monitoring service. This is done by dividing the audits into three groups or aspects: Clinical Aspects, Aspects of Safety and Quality Control Aspects of the equipment. Methodological guidelines have been established for conducting audits and they serve as standards of quality in radiation therapy, these guidelines also allow the quantification of results. It has identified the main gaps in services that affect the quality of care. After each visit, leave recommendations may be directed to the service itself, to the direction of the provincial hospital or health. Conclusions. We believe that the National Audit Programme in Radiotherapy is an effective tool in controlling the quality of the treatments offered and at the same time with its recommendations helps services to continually improve quality. (Author)

  6. Results of the national audits radiotherapy program

    International Nuclear Information System (INIS)

    Alonso Samper, Jose Luis; Alert Silva, Jose; Alfonso Laguardia, Rodolfo

    2009-01-01

    The National Audit Programme in Radiotherapy in Cuba works regularly 8 years visiting each country's radiotherapy service at least once every two years, during the visit involving two physicists and an oncologist radiation therapist. This paper presents the main features of the program and its main . Early detection deficiencies in the work of the Radiation Therapy Services to may cause radiological risk situations for both patients and workers and the general public. Help with their comments to the continuous improvement of quality treatments. During audit visits is reviewed throughout the process of radiation from that the patient comes to the monitoring service. This is done by dividing the audits into three groups or aspects Clinical Aspects, Aspects of Safety and Quality Control Aspects of the equipment. Methodological guidelines have been established for conducting audits and they serve as standards of quality in radiation therapy, these guidelines also allow quantification of the . It has identified the main gaps in services that affect quality treatments. After each visit, leave recommendations may be directed to service itself, to the direction of the provincial hospital or health. We believe that the National Audit Programme in Radiotherapy is a efficient tool in controlling the quality of treatments given and at the same time with its recommendations to help improve services of continuous quality. (author)

  7. External quality audit programmes for radiotherapy dosimetry and equipment

    International Nuclear Information System (INIS)

    Thwaites, D.I.

    1997-01-01

    It is widely accepted that individual radiotherapy centres should have in place a comprehensive quality assurance programme on all the necessary steps for the delivery of safe accurate treatment. As regards the performance of radiotherapy equipment and dosimetry, the most widely used process of external checking has been dosimetry intercomparison, comparing independently measured doses to locally stated doses in a variety of conditions. These have been at a number of different levels: from basic beam calibration; up to and including exercises employing anatomic or pseudo-anatomic phantoms and incorporating tests of treatment planning equipment and procedures. Some of these have been one-off exercises, whilst others are continuing, or have given rise to on-going quality audit programmes on a national (or wider) basis. A number of these have evolved, or are evolving, into audits which include external checking of the achievement of standards in performance of treatment equipment, as well as in the dosimetry in each institution involved. The principles and methodologies of the various types of external checking programmes for treatment equipment and dosimetry are reviewed, covering the experimental approaches and the tolerances applied. What is included in a given programme will, of necessity, depend on the resources available and the purpose of the exercise. Methods and tolerances must be matched to endpoint. Tolerance levels must take into account the experimental uncertainties of the measurement methods employed. Finally, external audit can only be used to complement, and in conjunction with, institutional quality assurance programmes and not as a substitute for them

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

    Science.gov (United States)

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

    2003-01-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

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

    Science.gov (United States)

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

    2018-04-06

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

  11. Preliminary results of a national quality audit programme in radiotherapy services in Cuba

    International Nuclear Information System (INIS)

    Dominguez Hung, L.; Larrinaga Cortina, E.F.; Campa Menendez, R.; Morales Lopez, J.L.; Garcia Yip, A.F.

    2001-01-01

    The current state of radiotherapy in Cuba has allowed to pass to a superior stage in the process of quality assurance, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices, as national regulator entity for the control and supervision of the medical devices of the National Health System, is responsible for the implementation of this program. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of 60 Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audited, such as: the installation and unit's safety, mechanical and dosimetric aspects of the treatment unit and organizational aspects of the institution quality assurance program. Also carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institutions' program of quality assurance and a feedback for the setting about to the PNAC. (author)

  12. Preliminary results of a national quality audit programme in radiotherapy services in Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez Hung, L; Larrinaga Cortina, E F [Centro de Control Estatal de Equipos Medicos, Havana (Cuba); Campa Menendez, R [Centro de Proteccion e Higiene de las Radiaciones, Havana (Cuba); Morales Lopez, J L; Garcia Yip, A F [Instituto Nacional de Oncologia y Radiobiologia, Havana (Cuba)

    2001-03-01

    The current state of radiotherapy in Cuba has allowed to pass to a superior stage in the process of quality assurance, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices, as national regulator entity for the control and supervision of the medical devices of the National Health System, is responsible for the implementation of this program. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of {sup 60}Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audited, such as: the installation and unit's safety, mechanical and dosimetric aspects of the treatment unit and organizational aspects of the institution quality assurance program. Also carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institutions' program of quality assurance and a feedback for the setting about to the PNAC. (author)

  13. Audit Programmes in a Diagnostic Radiological Facility (invited paper)

    International Nuclear Information System (INIS)

    Moores, B.M.; Connolly, P.A.; Cole, P.R.

    1998-01-01

    The effective implementation of optimisation strategies for radiation protection in diagnostic radiology including nuclear medicine requires mechanisms for ongoing audit of all relevant factors. The Quality Criteria of the Commission of European Communities highlights clearly the three aspects of a radiological examination which needed to be considered, which are: (i) radiographic technique, (ii) patient dose, and (iii) image quality. Therefore, it is important that the choice of a known and acceptable radiographic technique provides a known outcome in terms of patient dose and image quality. This requirement should be capable of being achieved throughout Europe and capable of being updated as new radiological strategies are developed. Audit programmes aimed at monitoring that this situation exists may be considered at three levels: Level 1 involves routine, periodic, assessment of patient doses on a representative sample of patients undergoing a particular type of examination. Results from this audit are then compared with acceptable and clearly defined diagnostic reference levels or reference dose values which provides a framework for guidance on acceptable practice. A summary of such level 1 programmes which are being pursued in Europe is presented. Level 2 audit programmes, beside patient dose assessment, will also involve an assessment of all those parameters relevant to an X ray examination which may have a bearing on the actual dose delivered to the patient. Such level 2 audit programmes provide the basis for implementation of optimisation strategies for radiation protection in terms of risk reduction, one of the fundamental tenets of radiation protection philosophy. Level 3 audit programmes also include assessment and verification of image quality requirements for particular examinations. This latter aspect is a necessary basis for overall optimisation of radiation protection in diagnostic radiology. (author)

  14. Auditing emergency management programmes: Measuring leading indicators of programme performance.

    Science.gov (United States)

    Tomsic, Heather

    Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

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

    DEFF Research Database (Denmark)

    Johansen, Antony; Golding, David; Brent, Louise

    2017-01-01

    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....... 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....... a consistent picture of typical patients - an average age of 80 years, with less than a third being men, and a third of all patients having cognitive impairment - but there was surprising variation in the type of fracture, of operation and of anaesthesia and hospital length of stay in different countries...

  16. Quality audit programme for {sup 99m}Tc and {sup 131}I radioactivity measurements with radionuclide calibrators

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, Leena [Radiation Safety Systems Division, Bhabha Atomic Research Centre, Mumbai 400 085 (India)], E-mail: leena@barc.gov.in; Anuradha, R.; Kulkarni, D.B. [Radiation Safety Systems Division, Bhabha Atomic Research Centre, Mumbai 400 085 (India)

    2008-06-15

    The use of radiopharmaceuticals in nuclear medicine for diagnosis and therapy has increased over the years with {sup 99m}Tc and {sup 131}I being most widely used. Quality audit programmes for radioactivity measurements of {sup 131}I have been ongoing and the 12th audit was recently conducted among seventy nuclear medicine centres (NMC) in India. An audit for the activity measurements of {sup 99m}Tc was conducted for the first time among ten NMCs in Mumbai, India. These programmes for radioactivity measurements have become very important to establish traceability of measurements to national and international standards and ensure accurate calibration of radionuclide calibrators. The results of both the audits are very encouraging. Ninety-four percent of the NMCs for {sup 131}I activity measurements were within a window of {+-}10% and for {sup 99m}Tc one NMC was deviating more than {+-}10%. The methodology adopted for the audit and results are discussed in detail in this paper.

  17. Value of audits in breast cancer screening quality assurance programmes

    NARCIS (Netherlands)

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

    2015-01-01

    Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading

  18. Development of National Technology Audit Policy

    Directory of Open Access Journals (Sweden)

    Subiyanto Subiyanto

    2017-07-01

    Full Text Available The Laws have mandated implementation of technology audit, nevertheless such implementation needs an additional policy that is more technical. The concept of national audit technology policy shall make technology audit as a tool to ensure the benefit of technology application for society and technology advance for nation independency. This article discusses on technology audit policy concept especially infrastructure requirement, with emphasis on regulation, implementation tools, and related institution. The development of technology audit policy for national interest requires provision of mandatory audit implementation, accompanied by tools for developing technology auditor’s competence and technology audit institutional’s mechanism. To guide technology auditor’s competence, concept of national audit technology policy shall classify object of technology audit into product technology, production technology, and management of technology, accompanied by related parameters of technology performance evaluation.

  19. Fraud Risk Factors and Audit Programme Modifications: Evidence from Jordan

    Directory of Open Access Journals (Sweden)

    Modar Abdullatif

    2013-03-01

    Full Text Available This study explores how audit firms in Jordan deal with the presence of fraud risk factors in audit clients. In doing so, the study seeks to explore which fraud risk factors are more important to Jordanianauditors, and how Jordanian auditors consider modifying their audit programmes when fraud risk factors are present in clients. The study uses a structured questionnaire that was administered to seniorlevel auditors in the largest Jordanian audit firms. The findings show that almost all of the 20 fraud risk factors included in the questionnaire were only slightly important (if not unimportant, a finding that is arguably alarming. The perceived importance of modifying the audit programme in the presence of each fraud risk factor was related to the perceived importance of the fraud risk factor itself. However, changes in the nature and extent of audit procedures were more important than changes in the timing of the procedures or the members of the audit team. The most important fraud risk factors were related to the characteristics of management and its attitude towards the audit, while the least important fraud risk factors were related to the difficulties in the client’s financial performance. Factor analysis found that the fraud risk factors could be classified into four separate groups. Possible interpretations of the findings were discussed, such as considering the Jordanian business environment characteristics, and the findings were compared to those of extant international studies.

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

    Science.gov (United States)

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

    2017-10-01

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

  1. Development of National Technology Audit Policy

    OpenAIRE

    Subiyanto Subiyanto

    2017-01-01

    The Laws have mandated implementation of technology audit, nevertheless such implementation needs an additional policy that is more technical. The concept of national audit technology policy shall make technology audit as a tool to ensure the benefit of technology application for society and technology advance for nation independency. This article discusses on technology audit policy concept especially infrastructure requirement, with emphasis on regulation, implementation tools, and related ...

  2. Quality assurance programme at the National Calibration Laboratory in Tanzania

    International Nuclear Information System (INIS)

    Muhogora, W.E.; Yoloye, O.; Ngaile, J.; Lema, U.S.

    2000-01-01

    A quality assurance programme at the National Calibration Laboratory for ionizing radiation in Tanzania is described. The programme focuses mainly on regular stability check source and reference output measurements, performance testing of TLD systems as well as some external audit checks. It is found that the stability check source measurements are within ± 1%. Similarly, the air kerma rate measurements agree well with calibration uncertainties, that is ± 2% for protection level measurements and ± 1.5% for clinical dosimetry. The results of comparison of dose measurements done on site and those obtained from some external audit checks are also within requirements. This shows that the working standards have been kept with good care, and that the traceability to the international measurement system is adequately maintained. Some examples on calibration transfer activities are briefly discussed

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

    Science.gov (United States)

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

    2016-04-01

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

  4. How Democratic is Latvia? Audit of Democracy 2005–2014

    OpenAIRE

    2015-01-01

    The Audit of Democracy 2014 prepared within the scope of National Research ProgrammeNational Identity”. Audit preparation and publication supported by the Friedrich Ebert Foundation and the United States Embassy in Latvia.

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

    Science.gov (United States)

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

    2017-10-01

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

  6. Value of audits in breast cancer screening quality assurance programmes.

    Science.gov (United States)

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

    2015-11-01

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

  7. UK National Audit of Sexual History-taking: case-notes audit.

    Science.gov (United States)

    Carne, C; McClean, H; Bhaduri, S; Gokhale, R; Sethi, G; Daniels, D

    2009-05-01

    A national audit of sexual history-taking was conducted in genitourinary medicine clinics in the UK in 2008. Data were aggregated by region and clinic, allowing practice to be compared between regions, as well as to national averages and against national Guidelines. In this paper the case-notes of 4121 patients were audited. A high proportion of the case-notes were deemed to be completely legible. In other respects there is considerable inter-regional variation in the adherence to national Guidelines. Interventions are especially required to improve documentation of practice in discussing condom use, HIV risk assessment, offer of a chaperone and assessment for hepatitis B vaccination and hepatitis C testing, and issues concerning sexual contacts.

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

    OpenAIRE

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

    2012-01-01

    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 conducte...

  9. A closer look at cervical smear uptake and results pre- and post- introduction of the national screening programme.

    LENUS (Irish Health Repository)

    Gallagher, F

    2012-02-01

    Prior to the introduction of a national cervical screening programme, death rates from cervical cancer in the Republic of Ireland were greater than the death rates in all other regions in Britain and Northern Ireland. The following audit compares the impact of the national cervical screening programme, established on 1 September \\'08, on uptake and results per age group screened before and after its implementation. This retrospective audit was carried out in a four-doctor practice with approximately 1554 GMS and 5000 private patients. Data over a ten month period in \\'08\\/\\'09 was collected from the practice record of cervical smears and compared to the same period in \\'07\\/\\'08. A cohort of 534 Irish urban women was included. A total number of 148 women were screened between October 2007 and July 2008 compared with 386 women screened over the same months in 2008\\/2009. Increase in uptake was most marked in the 25-44 years age group, 100 (\\'07-\\'08) vs. 303 (\\'08-\\'09). The majority of results for both time periods were negative (85% 07\\/08, 81% 08\\/09). There was a higher number of HSIL in \\'08-\\'09 (an increase from 1% to 3.37% of the total screened). This audit clearly supports the introduction of the national cervical screening programme showing both an increase in uptake and a increased pick-up of high grade lesions.

  10. National audit of radioactivity measurements in Nuclear Medicine Centres

    International Nuclear Information System (INIS)

    Ravindra, Anuradha; Kulkarni, D.B.; Joseph, Leena; Babu, D.A.R.

    2014-01-01

    Routine activity measurements of radiopharmaceutical solutions in Nuclear Medicine Centres (NMC) are carried out with the help of radionuclide calibrators (RC). These solutions are either ingested or injected to the patient for diagnosis or therapy. However, for the realization of an optimized examination, the activity of these radiopharmaceuticals must be determined accurately before administering it to patients. The primary standards are maintained by Radiation Standards Section, Radiological Physics and Advisory Division. National audit programmes of Iodine -131 activity measurements with RCs are conducted biannually to establish traceability to national standards and to check the status of nuclear medicine practice followed at the NMC. The results of fifteenth audit of 131 I activity measurements with RC are presented in this paper. Questionnaires were sent to two hundred and thirty three NMCs in-the country. One hundred and nine NMC's agreed for participation and accordingly, glass vials containing radioactive 131 I solution of nominal activity of 100 MBq were procured from Board of Radiation and Isotope Technology, Mumbai. The radioactivity in each vial was determined with high pressure re-entrant gamma ionisation chamber (GIC), a secondary standard maintained by this laboratory. The sensitivity coefficient of GIC is traceable to the primary standard. The standardized radioactive solution of 131 I in glass vial was sent to each participant. Measurements results were reported in the reporting form sent. This audit was conducted in four schedules in Jan 2013. One hundred and sixty six results were received from one hundred and nine participants as many participants took measurements on more than one isotope calibrator

  11. The development of an interdepartmental audit as part of a physics quality assurance programme for external beam therapy

    International Nuclear Information System (INIS)

    Bonnett, D.E.; Jaukett, R.J.; Mills, J.A.; Martin-Smith, P.

    1994-01-01

    A cost-effective audit system has been developed that will both detect systematic error in data and procedures, and evaluate the quality assurance programme provided by a physics department for radiotherapy. The audit has been developed for external beam radiotherapy and assesses one modality and one treatment machine per year. The method of assessing the quality assurance programme and the schedule of measurements are described. The process is illustrated using the results of trial audits between the medical physics department at Coventry and Leicester. (author)

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

    Science.gov (United States)

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

    2014-03-01

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

  13. How does a quality audits work in national harmonization of activity measurement over nuclear medicine measurement in Cuba

    International Nuclear Information System (INIS)

    Varela, C.

    2006-01-01

    The National Control Center for Medical Devices (CCEEM) is a regulatory agency, belongs to the Cuban Ministry of Public Heath. It works to guarantee the safety and effectiveness of medical devices used into the National Health System (NHS) and the patient, and user protection. Quality Control assures that particular aspect will be satisfied, so since several years ago a national programme for the quality control of nuclear medicine instruments has been organized and established. A service was created in order to control periodically the state of the instrumentation in all the nuclear medicine departments, it is making annual quality control audits and participating in comparisons exercises organises by CCEEM. 3 comparisons exercises with CENTIS and services of NHS were made and eleven nuclear medicine departments were audited in order to perform a practical evaluation of this service, giving the two new regulations and general instructions to dose administration. The objects of the present work is shows, by those results, how does a quality audits work in National Harmonization of Activity Measurement over Nuclear Medicine Measurement in Cuba

  14. MAAGs (Medical Audit Advisory Groups): the Eli Lilly National Clinical Audit Centre.

    Science.gov (United States)

    Baker, R; Fraser, R

    1993-01-01

    Outlines the framework for promoting audit in general practice, created as one part of the health service reforms. Medical Audit Advisory Groups (MAAGs) were set up in each district with the aim of participation in audit of all general practitioners by April 1992. The activities undertaken have included those recommended by the Department of Health; the most significant of these being the appointment of lay facilitators who are able to assist general practitioners and primary care teams co-operate over efforts to improve the quality of care, and may offer one means of introducing some of the methods of total quality management into general practice. Discusses the problems which remain: audit is not yet sufficiently systematic, interface audit with secondary care is at a very early stage, the ways to involve managers and patients in audit remain to be clarified, and there is little evidence of the consequences of audit in terms of improved care. The Eli Lilly National Clinical Audit Centre has been set up within the Department of General Practice, University of Leicester, in order to address these issues.

  15. Stages of change: A qualitative study on the implementation of a perinatal audit programme in South Africa

    Directory of Open Access Journals (Sweden)

    Pattinson Robert C

    2011-09-01

    Full Text Available Abstract Background Audit and feedback is an established strategy for improving maternal, neonatal and child health. The Perinatal Problem Identification Programme (PPIP, implemented in South African public hospitals in the late 1990s, measures perinatal mortality rates and identifies avoidable factors associated with each death. The aim of this study was to elucidate the processes involved in the implementation and sustainability of this programme. Methods Clinicians' experiences of the implementation and maintenance of PPIP were explored qualitatively in two workshop sessions. An analytical framework comprising six stages of change, divided into three phases, was used: pre-implementation (create awareness, commit to implementation; implementation (prepare to implement, implement and institutionalisation (integrate into routine practice, sustain new practices. Results Four essential factors emerged as important for the successful implementation and sustainability of an audit system throughout the different stages of change: 1 drivers (agents of change and team work, 2 clinical outreach visits and supervisory activities, 3 institutional perinatal review and feedback meetings, and 4 communication and networking between health system levels, health care facilities and different role-players. During the pre-implementation phase high perinatal mortality rates highlighted the problem and indicated the need to implement an audit programme (stage 1. Commitment to implementing the programme was achieved by obtaining buy-in from management, administration and health care practitioners (stage 2. Preparations in the implementation phase included the procurement and installation of software and training in its use (stage 3. Implementation began with the collection of data, followed by feedback at perinatal review meetings (stage 4. The institutionalisation phase was reached when the results of the audit were integrated into routine practice (stage 5 and

  16. An Audit of the Irish National Intellectual Disability Database

    Science.gov (United States)

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

    2010-01-01

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

  17. National audit of continence care: laying the foundation.

    Science.gov (United States)

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

    2005-12-01

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

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

    Science.gov (United States)

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

    2018-04-21

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

  19. A clinical audit programme for diagnostic radiology: The Approach adopted by the international atomic energy agency

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2010-01-01

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

  1. External quality audits in radiotherapy in Poland

    International Nuclear Information System (INIS)

    Bulski, W.; Rostkowska, J.; Kania, M.; Gwiazdowska, B.

    2002-01-01

    The Secondary Standard Dosimetry Laboratory (SSDL) of the Medical Physics Department of the Centre of Oncology in Warsaw is a continuation of the Radiation Measurements Laboratory created in 1937, following the suggestions of Marie Curie, the founder of the Institute. The present SSDL is a member of the WHO/IAEA international network and is periodically audited by the International Atomic Energy Agency. The SSDL is in charge of the calibration of all radiotherapy dosimeters in Poland, and it also co-ordinates all activities carried out in radiotherapy quality assurance programmes nation-wide. The External Audit Group (EAG) was set-up according to the recommendations of the IAEA, as a part of the SSDL. The EAG is in charge of the management of the project and organization of the TLD measurements. The SSDL takes the responsibilities of the metrological aspects of the programme. The results of the efforts, aimed at the development of a quality audit programme and methodology in radiotherapy, are presented

  2. National audit of a system for rectal contact brachytherapy

    Directory of Open Access Journals (Sweden)

    Laia Humbert-Vidan

    2017-01-01

    Full Text Available Background and purpose: Contact brachytherapy is used for the treatment of early rectal cancer. An overview of the current status of quality assurance of the rectal contact brachytherapy systems in the UK, based on a national audit, was undertaken in order to assist users in optimising their own practices. Material and methods: Four UK centres using the Papillon 50 contact brachytherapy system were audited. Measurements included beam quality, output and radiation field size and uniformity. Test frequencies and tolerances were reviewed and compared to both existing recommendations and published reviews on other kV and electronic brachytherapy systems. External validation of dosimetric measurements was provided by the National Physical Laboratory. Results: The maximum host/audit discrepancy in beam quality determination was 6.5%; this resulted in absorbed dose variations of 0.2%. The host/audit agreement in absorbed dose determination was within 2.2%. The median of the radiation field uniformity measurements was 2.7% and the host/audit agreement in field size was within 1 mm. Test tolerances and frequencies were within the national recommendations for kV units. Conclusions: The dosimetric characterisation of the Papillon 50 was validated by the audit measurements for all participating centres, thus providing reassurance that the implementation had been performed within the standards stated in previously published audit work and recommendations for kV and electronic brachytherapy units. However, optimised and standardised quality assurance testing could be achieved by reducing some methodological differences observed. Keywords: Contact brachytherapy, Electronic brachytherapy, Audit

  3. Energy audit practices in China: National and local experiences and issues

    International Nuclear Information System (INIS)

    Shen Bo; Price, Lynn; Lu Hongyou

    2012-01-01

    China set an ambitious goal of reducing its energy use per unit of GDP by 20% between 2006 and 2010. Much of the country’s effort is focused on improving the energy efficiency of the industrial sector, which consumes about two-thirds of China’s primary energy. Industrial energy audits are an important part of China’s efforts to improve its energy intensity. Such audits are employed to help enterprises identify energy-efficiency improvement opportunities and serve as a means to collect critical energy-consuming information. Information about energy audit practices in China is, however, little known to the outside world. This study combines a review of China’s national policies and programs on energy auditing with information collected from surveying a variety of Chinese institutions involved in energy audits. A key goal of the study is to conduct a gap analysis to identify how current practices in China related to energy auditing differ from energy auditing practices found around the world. This article presents our findings on the study of China’s energy auditing practices at the national and provincial levels. It discusses key issues related to the energy audits conducted in China and offers policy recommendations that draw upon international best practices. - Highlights: ► We examine China’s national and regional energy auditing practices in the 11th FYP. ► Energy audits have helped China achieve its energy efficiency target. ► Issues still remain preventing energy auditing from achieving its full potential. ► Gap analysis is conducted to compare with other international auditing program. ► We offer recommendations for the development of best energy audit practices.

  4. Transposition of the new European Union audit regulation into the Croatian national law

    Directory of Open Access Journals (Sweden)

    Sanja Sever Mališ

    2016-11-01

    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?

  5. National Energy Audit (NEAT) Users Manual Version 7

    Energy Technology Data Exchange (ETDEWEB)

    Gettings, M.

    2001-05-10

    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.

  6. TLD audit in the radiotherapy at the national level

    International Nuclear Information System (INIS)

    Kroutilikova, D.; Zackova, H.; Novotny, J.; Pridal, I.

    1998-01-01

    Czech legislation requires that all radiotherapy departments undertake quality independent audit annually. An authorized auditing group was created as a body of the National Radiation Protection Institute. It has been decided that TLD postal audit combined with film dosimetry would alternate with in situ audit every two or three years. For this, a local TLD measuring network has been established. The methods applied in the TLD audit were taken from EROPAQ and EURAQA projects in 1996 and modified to comply with Czech local circumstances. First TLD audits were started in February 1997. During the February to September period, 60 beams were checked: 26 Co-60 beams, 10 Cs-137 beams, 15 X-ray beams, and 9 electron beams. Details of the measurements and their results are given. (P.A.)

  7. Energy Audit Practices in China: National and Local Experiences and Issues

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Bo; Price, Lynn; Lu, Hongyou

    2010-12-21

    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.

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

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  10. Interobserver agreement between primary graders and an expert grader in the Bristol and Weston diabetic retinopathy screening programme: a quality assurance audit.

    Science.gov (United States)

    Patra, S; Gomm, E M W; Macipe, M; Bailey, C

    2009-08-01

    To assess the quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and to set standards for future interobserver agreement reports. A prospective audit of 213 image sets from six fully trained primary graders in the Bristol and Weston diabetic retinopathy screening programme was carried out over a 4-week period. All the images graded by the primary graders were regraded by an expert grader blinded to the primary grading results and the identity of the primary grader. The interobserver agreement between primary graders and the blinded expert grader and the corresponding Kappa coefficient was determined for overall grading, referable, non-referable and ungradable disease. The audit standard was set at 80% for interobserver agreement with a Kappa coefficient of 0.7. The interobserver agreement bettered the audit standard of 80% in all the categories. The Kappa coefficient was substantial (0.7) for the overall grading results and ranged from moderate to substantial (0.59-0.65) for referable, non-referable and ungradable disease categories. The main recommendation of the audit was to provide refresher training for the primary graders with focus on ungradable disease. The audit demonstrated an acceptable level of quality and accuracy of primary grading in the Bristol and Weston diabetic retinopathy screening programme and provided a standard against which future interobserver agreement can be measured for quality assurance within a screening programme. Diabet. Med. 26, 820-823 (2009).

  11. National Energy AudiT (NEAT) user`s manual

    Energy Technology Data Exchange (ETDEWEB)

    Krigger, J.K.; Adams, N. [Saturn Resource Management, Helena, MT (United States); Gettings, M. [Oak Ridge National Lab., TN (United States). Energy Div.

    1997-10-01

    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.

  12. Epistaxis 2016: national audit of management.

    Science.gov (United States)

    2017-12-01

    Epistaxis is a common condition that can be associated with significant morbidity, and it places a considerable burden on our healthcare system. This national audit of management sought to assess current practice against newly created consensus recommendations and to expand our current evidence base. The management of epistaxis patients who met the inclusion criteria, at 113 registered sites across the UK, was compared with audit standards during a 30-day window. Data were further utilised for explorative analysis. Data for 1826 cases were uploaded to the database, representing 94 per cent of all cases that met the inclusion criteria at participating sites. Sixty-two per cent of patients were successfully treated by ENT clinicians within 24 hours. The 30-day recurrent presentation rate across the dataset was 13.9 per cent. Significant event analysis revealed an all-cause 30-day mortality rate of 3.4 per cent. Audit findings demonstrate a varying alignment with consensus guidance, with explorative analysis countering some previously well-established tenets of management.

  13. HIV testing in dermatology - a national audit.

    Science.gov (United States)

    Esson, Gavin A; Holme, S A

    2018-05-01

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

  14. Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique's SLMTA story.

    Science.gov (United States)

    Masamha, Jessina; Skaggs, Beth; Pinto, Isabel; Mandlaze, Ana Paula; Simbine, Carolina; Chongo, Patrina; de Sousa, Leonardo; Kidane, Solon; Yao, Katy; Luman, Elizabeth T; Samogudo, Eduardo

    2014-01-01

    Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH) laboratory structure. This article outlines the steps followed to establish a national framework for quality improvement and embedding the SLMTA programme within existing MOH laboratory systems. The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and seven from partner organisations) conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist), workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented. The six laboratories demonstrated substantial improvement in audit scores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation. Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that country leadership, ownership and institutionalisation can set the stage for

  15. National Energy Audit (NEAT) Users Manual Version 7; TOPICAL

    International Nuclear Information System (INIS)

    Gettings, M.

    2001-01-01

    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

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

    Science.gov (United States)

    Ross, John As; Sayer, Martin Dj

    2009-03-01

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

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

    Science.gov (United States)

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

    2017-06-01

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

  18. An IAEA Survey of Dosimetry Audit Networks for Radiotherapy

    International Nuclear Information System (INIS)

    Grochowska, Paulina; Izewska, Joanna

    2013-01-01

    A Survey: In 2010, the IAEA undertook a task to investigate and review the coverage and operations of national and international dosimetry audit programmes for radiotherapy. The aim was to organize the global database describing the activities of dosimetry audit networks in radiotherapy. A dosimetry audit questionnaire has been designed at an IAEA consultants' meeting held in 2010 for organizations conducting various levels of dosimetry audits for radiotherapy. Using this questionnaire, a survey was conducted for the first time in 2010 and repeated in 2011. Request for information on different aspects of the dosimetry audit was included, such as the audit framework and resources, its coverage and scope, the dosimetry system used and the modes of audit operation, i.e. remotely and through on-site visits. The IAEA questionnaire was sent to over 80 organizations, members of the IAEA/WHO Network of Secondary Standards Dosimetry Laboratories (SSDLs) and other organizations known for having operated dosimetry audits for radiotherapy in their countries or internationally. Survey results and discussion: In response to the IAEA survey, 53 organizations in 45 countries confirmed that they operate dosimetry audit services for radiotherapy. Mostly, audits are conducted nationally, however there are five organizations offering audits abroad, with two of them operating in various parts of the world and three of them at the regional level, auditing radiotherapy centres in neighbouring countries. The distribution of dosimetry audit services in the world is given. (author)

  19. An audit of a cervical smear screening programme.

    Science.gov (United States)

    Moodie, P J; Kljakovic, M; McLeod, D K

    1989-07-26

    An audit of a computer based screening and recall programme in a Wellington group general practice is reported (practice population 13,866). The records of all women aged between 20 and 59 years (4133 women) were checked to determine if they had had a cervical smear test in the previous two years. A random sample of women who had a cervical smear result recorded in the notes (107 women called "responders") showed that 71% gave "familiarity with the family doctor" and "acting in response to a recall letter" as reasons for choosing the place of their last smear. Satisfaction with the service was indicated by 95% of these women stating they would have their next smear at the medical centre. In the audit of all the records, a group of 667 women who had been sent a letter inviting them to have a smear done and who had apparently declined the procedure was identified (called "nonresponders"). A random sample of this group (168 women) was taken and an attempt made to interview them. In fact only 38 women could be identified as requiring a smear and even if those who refused to be interviewed (13) and those unable to be contacted (23) are added, then less than half of this sample were "true nonresponders". This suggests that the percentage of women in the practice who have been offered a smear and have refused to have one is less than 8%.

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

    NARCIS (Netherlands)

    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; Verloop, Janneke; Westenend, Pieter J.; Wouters, Michel W.J.M.; Siesling, Sabine; Tjan-Heijnen, Vivianne C.G.; van Dalen, Thijs

    2017-01-01

    Background 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. Methods Clinical and pathological

  1. Routine environmental audit of the Sandia National Laboratories, California, Livermore, California

    Energy Technology Data Exchange (ETDEWEB)

    1994-03-01

    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.

  2. National audit of provision of MRI services 2006/07

    Energy Technology Data Exchange (ETDEWEB)

    Barter, S. [Royal College of Radiologists, London (United Kingdom)], E-mail: sue.barter@addenbrookes.nhs.uk; Drinkwater, K.; Remedios, D. [Royal College of Radiologists, London (United Kingdom)

    2009-03-15

    In 2003 the Royal College of Radiologists Clinical Radiology Audit Sub-Committee began an audit process evaluating the standards of provision of magnetic resonance imaging (MRI) services. This was prompted by the publication of the 2002 Audit Commission Report, which had identified that lack of MRI provision was responsible for more than half of the total waiting times for diagnostic imaging investigations. The audit found that the time from request to report did not meet the standard for cancer staging examinations, but nationally, was within the target set for routine orthopaedic examinations. However, national mean waiting times were longer than recommended for both cancer and orthopaedic MRI. Since then, there has been massive investment in MRI capacity, both from installation of MRI systems in NHS Trusts, and in England, from outsourcing of routine MRI cases through the Department of Health contract with an independent provider. A re-audit in 2006/7 shows that there has been a significant improvement in waiting times for routine orthopaedic examinations, but the position with cancer staging examinations has deteriorated. Control chart methodology shows that underperformance is due to common cause variation, i.e., improvements need to be made to the overall process from receiving the request for MRI to the issue of the report. Follow-up with participating departments demonstrated there were some common themes for underperformance, and suggestions for improvement are made from departments with best performance.

  3. National audit of provision of MRI services 2006/07

    International Nuclear Information System (INIS)

    Barter, S.; Drinkwater, K.; Remedios, D.

    2009-01-01

    In 2003 the Royal College of Radiologists Clinical Radiology Audit Sub-Committee began an audit process evaluating the standards of provision of magnetic resonance imaging (MRI) services. This was prompted by the publication of the 2002 Audit Commission Report, which had identified that lack of MRI provision was responsible for more than half of the total waiting times for diagnostic imaging investigations. The audit found that the time from request to report did not meet the standard for cancer staging examinations, but nationally, was within the target set for routine orthopaedic examinations. However, national mean waiting times were longer than recommended for both cancer and orthopaedic MRI. Since then, there has been massive investment in MRI capacity, both from installation of MRI systems in NHS Trusts, and in England, from outsourcing of routine MRI cases through the Department of Health contract with an independent provider. A re-audit in 2006/7 shows that there has been a significant improvement in waiting times for routine orthopaedic examinations, but the position with cancer staging examinations has deteriorated. Control chart methodology shows that underperformance is due to common cause variation, i.e., improvements need to be made to the overall process from receiving the request for MRI to the issue of the report. Follow-up with participating departments demonstrated there were some common themes for underperformance, and suggestions for improvement are made from departments with best performance

  4. Approach the National Quality Audit System for Radiotherapy in Latvia

    OpenAIRE

    Dehtjars, J; Popovs, S; Plaude, S

    2008-01-01

    It is very important to make National Quality Audit to ensure accurate conformal RT delivery. It is necessary to develop an Audit system to inspect all Conformal RT and IMRT delivery chain including the Quality checks of linear accelerator, Multileaf Collimator (MLC), Computer Tomography (CT) scanner or simulator, target and tissue delineation, plan evaluation, and delivery.

  5. Routine environmental audit of the Sandia National Laboratories, California, Livermore, California

    International Nuclear Information System (INIS)

    1994-03-01

    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

  6. A national survey of cardiac rehabilitation services in New Zealand: 2015.

    Science.gov (United States)

    Kira, Geoff; Doolan-Noble, Fiona; Humphreys, Grace; Williams, Gina; O'Shaughnessy, Helen; Devlin, Gerry

    2016-05-27

    Guidelines for cardiac rehabilitation (CR) programmes inform best practice. In Aotearoa NewZealand, little information exists about the structure and services provided by CR programmes and there is a poor understanding of how existing CR programmes are delivered with respect to evidence-based national guidelines. All 46 CR providers in New Zealand were invited to participate in a national survey in 2015. The survey sought information on the following: unit structure; referral processes; patient assessment; audit (including quality assurance activity); Phase 2 CR content; and support for special populations. Simple descriptive analysis of the responses was conducted, involving forming counts and percentages. Thirty-six distinct units completed the survey and 94% provided Phase 2. Assessment tools, Phase 2 educational components, and the methods of providing the exercise component varied. Most units audited their services, 25% audited their programme six-monthly or more frequently. Just over half of the units (56%) reported key performance indicators. The survey identified variations in delivery and content of CR in New Zealand, with poor understanding of the impact on patient outcomes. This is likely due to the absence of standardised audit practices and routine collection of key performance indicators on a national basis.

  7. National Energy Audit Tool for Multifamily Buildings Development Plan

    Energy Technology Data Exchange (ETDEWEB)

    Malhotra, Mini [ORNL; MacDonald, Michael [Sentech, Inc.; Accawi, Gina K [ORNL; New, Joshua Ryan [ORNL; Im, Piljae [ORNL

    2012-03-01

    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

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

    Directory of Open Access Journals (Sweden)

    S. Raffe

    2017-02-01

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

  9. National and regional asthma programmes in Europe

    OpenAIRE

    Olof Selroos; Maciej Kupczyk; Piotr Kuna; Piotr Łacwik; Jean Bousquet; David Brennan; Susanna Palkonen; Javier Contreras; Mark FitzGerald; Gunilla Hedlin; Sebastian L. Johnston; Renaud Louis; Leanne Metcalf; Samantha Walker; Antonio Moreno-Galdó

    2015-01-01

    This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorse...

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

    Science.gov (United States)

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

    2008-08-01

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

  11. Suggestions in maternal and child health for the National Technology Assessment Programme: a consideration of consumer and professional priorities.

    Science.gov (United States)

    Johanson, R; Rigby, C; Newburn, M; Stewart, M; Jones, P

    2002-03-01

    In North Staffordshire, the Achieving Sustainable Quality in Maternity (ASQUAM) meetings provide the programme for clinical guidelines and audit over the following year. The ASQUAM clinical effectiveness programme has attempted to address a number of the issues identified as obstacles to informed democratic prioritization. For example, it became clear that a number of topics raised were actually research questions. The organizers therefore decided to split the fourth ASQUAM day into an 'audit' morning and a 'research' afternoon. The meeting organized by RJ, CR and PJ in partnership with the Midwives Information and Resource Service and the National Childbirth Trust, was timed to allow the research ideas to feed into the national Health Technology Assessment (HTA) programme. This meeting was designed to increase the profile of ASQUAM amongst consumers and to increase their representation at the meeting. Objectives were to choose a new set of research priorities for the year 2000, and to ascertain the voting pattern of comparison to health professionals. There was overall agreement in terms of priorities, with the consumer group prioritizing 8 of the 10 topics chosen by the professionals (or 10 of the 11). No significant differences between the proportions of voted cast for each topic by professionals and consumers were found apart from topic 20. The numbers of consumers were small which does limit the number the validity of statistical comparisons. Nevertheless, it is clear that voting patterns were similar. Overall the process suggests that democratic prioritization is a viable option and one that may become essential within the framework of clinical and research governance.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Science.gov (United States)

    Swaffield, J

    1995-09-01

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

  14. The theoretical and practical principles of determining doses and carrying out dosimetric audit programmes in radiotherapy units in Poland (adjustment to the European Union Council Directive 97/43 EURATOM)

    International Nuclear Information System (INIS)

    Bulski, W.

    2011-01-01

    This project was aimed at developing research and organizational programmes to implement in Poland the Council Directive 97143 EURATOM in the field of dosimetric audits. The project included two types of research in detail: (1) the preparation of precise and reproducible standards of radiation doses, or, in other words, the investigation, development and determination of exact and effective principles of the standardization of ionization chambers used in carrying out dosimetric audit programmes, (2) the investigation of TL detectors used in audits, with the aim of obtaining the best possible measurement accuracy as well as analysis of available results of audits under reference conditions, and the development and implementation of audits for non-reference conditions, including computer-assisted treatment planning systems (TPS) indispensable in present-day radiotherapy practices. (author)

  15. An external dosimetry audit programme to credential static and rotational IMRT delivery for clinical trials quality assurance.

    Science.gov (United States)

    Eaton, David J; Tyler, Justine; Backshall, Alex; Bernstein, David; Carver, Antony; Gasnier, Anne; Henderson, Julia; Lee, Jonathan; Patel, Rushil; Tsang, Yatman; Yang, Huiqi; Zotova, Rada; Wells, Emma

    2017-03-01

    External dosimetry audits give confidence in the safe and accurate delivery of radiotherapy. The RTTQA group have performed an on-site audit programme for trial recruiting centres, who have recently implemented static or rotational IMRT, and those with major changes to planning or delivery systems. Measurements of reference beam output were performed by the host centre, and by the auditor using independent equipment. Verification of clinical plans was performed using the ArcCheck helical diode array. A total of 54 measurement sessions were performed between May 2014 and June 2016 at 28 UK institutions, reflecting the different combinations of planning and delivery systems used at each institution. Average ratio of measured output between auditor and host was 1.002±0.006. Average point dose agreement for clinical plans was -0.3±1.8%. Average (and 95% lower confidence intervals) of gamma pass rates at 2%/2mm, 3%/2mm and 3%/3mm respectively were: 92% (80%), 96% (90%) and 98% (94%). Moderately significant differences were seen between fixed gantry angle and rotational IMRT, and between combination of planning systems and linac manufacturer, but not between anatomical treatment site or beam energy. An external audit programme has been implemented for universal and efficient credentialing of IMRT treatments in clinical trials. Good agreement was found between measured and expected doses, with few outliers, leading to a simple table of optimal and mandatory tolerances for approval of dosimetry audit results. Feedback was given to some centres leading to improved clinical practice. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  16. Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique’s SLMTA story

    Directory of Open Access Journals (Sweden)

    Jessina Masamha

    2014-11-01

    Full Text Available Background: Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH laboratory structure. Objective: This article outlines the steps followed to establish a national framework for quality improvement and embed the SLMTA programme within existing MOH laboratory systems. Methods: The MOH adopted SLMTA as the national laboratory quality improvement strategy, hired a dedicated coordinator and established a national laboratory quality technical working group comprising mostly personnel from key MOH departments. The working group developed an implementation framework for advocacy, training, mentorship, supervision and audits. Emphasis was placed on building local capacity for programme activities. After receiving training, a team of 25 implementers (18 from the MOH and sevenfrom partner organisations conducted baseline audits (using the Stepwise Laboratory Quality Improvement Process Towards Accreditation [SLIPTA] checklist, workshops and site visits in six reference and two central hospital laboratories. Exit audits were conducted in six of the eight laboratories and their results are presented. Results: The six laboratories demonstrated substantial improvement in SLIPTA checklistscores; median scores increased from 35% at baseline to 57% at exit. It has been recommended that the National Tuberculosis Reference Laboratory apply for international accreditation. Conclusion: Successful implementation of SLMTA requires partnership between programme implementers, whilst effectiveness and long-term viability depend on country leadership, ownership and commitment. Integration of SLMTA into the existing MOH laboratory system will ensure durability beyond initial investments. The Mozambican model holds great promise that

  17. Quality audit of dosimetry in radiotherapy centers using postal dose TLD intercomparison in India

    International Nuclear Information System (INIS)

    Ramanathan, G.; Kadam, V.D.; Vinatha, S.P.; Soman, A.T.; Vijayam, M.; Shaha, V.V.; Abani, M.C.

    2001-01-01

    The national quality audit of dosimetry in radiation therapy centers using mailed TLDs is being carried out by RSS/ASSD of BARC since 1976, in collaboration with IAEA/WHO for India and neighbouring countries such as Mayanmar, Sri Lanka and Nepal. The importance of the programme comes from the fact that consistent, high accuracy ( 60 Co machines ∼35 linear accelerators are being covered by the programme. This paper brings out the materials and methods used in the intercomparison. The results of intercomparison are analyzed to find the steps to improve the performance in quality audit of those centers whose results are outside the limit of acceptable deviation

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

    Science.gov (United States)

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

    2015-03-31

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

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

    Science.gov (United States)

    1981-09-21

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

  20. National energy efficiency programme

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    This paper focusses on energy conservation and specifically on energy efficiency which includes efficiency in the production, delivery and utilisation of energy as part of the total energy system of the economy. A National Energy Efficiency Programme is being launched in the Eighth Plan that will take into account both macro level and policy and planning considerations as well as micro level responses for different category of users in the industry, agriculture, transport and domestic sectors. The need for such a National Energy Efficiency Programme after making an assessment of existing energy conservation activities in the country is discussed. The broad framework and contents of the National Energy Efficiency Programme have been outlined and the Eighth Plan targets for energy conservation and their break-up have been given. These targets, as per the Eighth Plan document are 5000 MW in electricity installed capacity and 6 million tonnes of petroleum products by the terminal year of the Eighth Plan. The issues that need to be examined for each sector for achieving the above targets for energy conservation in the Eighth Plan are discussed briefly. They are: (a) policy and planning, (b) implementation arrangements which include the institutional setup and selective legislation, (c) technological requirements, and (d) resource requirements which include human resources and financial resources. (author)

  1. Quality assurance auditing for nuclear power plants

    International Nuclear Information System (INIS)

    1980-01-01

    This Safety Guide provides requirements and recommendations for establishing and implementing a system of internal and external audits during the design, manufacture, construction, commissioning and operation of nuclear power plants. It provides for the planning, performance, reporting and follow-up of the quality assurance audit activity. It defines in general terms the responsibilities of the auditing and audited organizations. The Guide also covers auditing in the context of supplier evaluation; it does not include inspection for the sole purpose of process control or product acceptance. Like the Code, the present Guide was prepared as part of the IAEA's programme, referred to as the NUSS programme, for establishing Codes of Practice and Safety Guides relating to land-based stationary thermal neutron power plants

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rutonjski Laza

    2012-09-01

    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.

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

    Science.gov (United States)

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

    2012-09-12

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

  5. National and regional asthma programmes in Europe.

    Science.gov (United States)

    Selroos, Olof; Kupczyk, Maciej; Kuna, Piotr; Łacwik, Piotr; Bousquet, Jean; Brennan, David; Palkonen, Susanna; Contreras, Javier; FitzGerald, Mark; Hedlin, Gunilla; Johnston, Sebastian L; Louis, Renaud; Metcalf, Leanne; Walker, Samantha; Moreno-Galdó, Antonio; Papadopoulos, Nikolaos G; Rosado-Pinto, José; Powell, Pippa; Haahtela, Tari

    2015-09-01

    This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe. Copyright ©ERS 2015.

  6. National and regional asthma programmes in Europe

    Directory of Open Access Journals (Sweden)

    Olof Selroos

    2015-09-01

    Full Text Available This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.

  7. Outline of the transition from national to international audit regulation in Denmark

    DEFF Research Database (Denmark)

    Holm, Claus; Warming-Rasmussen, Bent

    2004-01-01

    ) 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......Seen in a historic perspective, the development of audit regulation in Denmark reflects a few but very influential business scandals causing changes in law-regulation, and a profession which have reacted to confidence crises through an increasing level of selfregulation. Audit regulation also...... 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...

  8. Supplier's evaluation - internal and external audits and surveillance

    International Nuclear Information System (INIS)

    Fowler, J.L.; Derrick, R.

    1976-01-01

    The quality programme for SGHWR type reactors places responsibility upon all purchasers to evaluate potential suppliers' quality systems and to conduct audits and surveillance on the implementation of suppliers' quality assurance programmes during contract performance. This will be carried out in accordance with the requirements of Central Electricity Board standard QA42. It also places a responsibilty on every supplier to conduct in-house audits and surveillance of the effectiveness of his own quality assurance programmes. These procedures are discussed. (U.K.)

  9. ADS National Programmes: China

    International Nuclear Information System (INIS)

    2015-01-01

    In China the conceptual study of an ADS concept which lasted for about five years ended in 1999. As one project of the National Basic Research Programme of China (973 Programme) in energy domain, which is sponsored by the China Ministry of Science and Technology (MOST), a five year programme of fundamental research of ADS physics and related technology was launched in 2000 and passed national review at the end of 2005. From 2007, another five year 973 Programme Key Technology Research of Accelerator Driven Subcritical System for Nuclear waste Transmutation started. The research activities were focused on HPPA physics and technology, reactor physics of external source driven subcritical assembly, nuclear data base and material study. For HPPA, a high current injector consisting of an ECR ion source, LEBT and an RFQ accelerating structure of 3.5 MeV has been built and were being improved. In reactor physics study, a series of neutron multiplication experimental study has been carrying out. The VENUS I facility has been constructed as the basic experimental platform for neutronics study in ADS blanket. VENUS I a zero power subcritical neutron multiplying assembly driven by external neutron produced by a pulsed neutron generator or 252Cf neutron source. The theoretical, experimental and simulation studies on nuclear data, material properties and nuclear fuel circulation related to ADS are carried out in order to provide the database for ADS system analysis. China Institute of Atomic Energy (CIAE), Institute of High Energy Physics (IHEP) and other Chinese institutes carried out the MOST project together. Besides CIAE, China Academy of Science (CAS) pays more and more attention to Advanced Nuclear Fuel Cycles (ANFC). A large programme of ANFC, including ADS and Th based nuclear fuel cycle, has been launched by CAS

  10. Guidelines for the preparation of a quality manual for external audit groups on dosimetry in radiotherapy

    International Nuclear Information System (INIS)

    Izewska, Joanna; Arib, M.; Saravi, M.

    2002-01-01

    This document has been prepared within the framework of a Co-ordinated Research Programme (CRP) on Development of Quality Assurance Programme for Radiation Therapy Dosimetry in Developing Countries, during two Meetings at the IAEA Headquarters in Vienna (11-14 November 1996 and 6-10 October 1997). It is based on the recommendations of ISO 9000 series and ISO/IEC guide No. 25. The document can be used as a guide on how to prepare a quality manual for national External Audit Groups (EAG), i.e., a nationally recognised group in charge of operating external quality audits for radiotherapy dosimetry. The EAG of a given country includes the SSDL, a Measuring Group and a Medical Physics Group, who work in close co-operation at all steps of the audit. The content herein should be considered as a suggestion and additions or deletions can be made in accordance with the specific conditions in each country. It is preferable that the manual itself be as concise as possible, limiting it to the core scope. Detailed working sheets describing the procedures should be included in Appendices together with data sheets, questionnaires and reporting forms. The quality manual of each country should be carefully reviewed by all members of the EAG and, as far as possible, should be approved by relevant professional bodies and supported by health authorities. It has long been recognised that accurate knowledge of the dose in radiotherapy is vital to ensure safe and effective radiation treatments. To achieve this goal, comprehensive quality assurance programmes should be established to cover all steps from dose prescription to dose delivery. These programmes should include internal checks performed by the radiotherapy centres and external audits made by independent external bodies. It is estimated that not more than 50% of radiotherapy facilities world-wide have participated in some level of dose quality audit by an independent expert. Genuine concern exists that some, or even many

  11. National programme for prevention of burn injuries

    Directory of Open Access Journals (Sweden)

    Gupta J

    2010-10-01

    Full Text Available The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.

  12. A quality assurance programme for radiation therapy dosimetry: Report of a consultants' meeting to review the status and to plant the development

    International Nuclear Information System (INIS)

    Izewska, J.; Andreo, P.

    1996-01-01

    Four national External Audit Groups (EAG) in charge of operating quality audits for radiotherapy dosimetry have been created through a Co-ordinated Research Programme ''Development of a Quality Assurance Programme for Radiation Therapy Dosimetry in Developing Countries'' (E2-40-07). The present status of the development of the measuring systems and measuring procedures for the EAGs has been compared to the methodology established by Quality Audit Networks operating at present in Europe. To harmonize different EAG procedures, a document entitled ''Guidelines to prepare a Quality Manual for External Audit Groups on Dosimetry in Radiotherapy '' has been outlined and a first draft prepared. The ''Guidelines...'' covers quality policy, quality systems and quality structures including process control following the recommendations of ISO 9000 series and ISO/IEC guide No. 25. When completed, this document can be used as a guide on how to prepare the quality manual for national EAGs in developing countries. Due to increased interest in the project three new participants have been admitted. (author)

  13. External audit in radiotherapy dosimetry

    International Nuclear Information System (INIS)

    Thwaites, D.I.; Western General Hospital, Edinburgh

    1996-01-01

    Quality audit forms an essential part of any comprehensive quality assurance programme. This is true in radiotherapy generally and in specific areas such as radiotherapy dosimetry. Quality audit can independently test the effectiveness of the quality system and in so doing can identify problem areas and minimize their possible consequences. Some general points concerning quality audit applied to radiotherapy are followed by specific discussion of its practical role in radiotherapy dosimetry, following its evolution from dosimetric intercomparison exercises to routine measurement-based on-going audit in the various developing audit networks both in the UK and internationally. Specific examples of methods and results are given from some of these, including the Scottish+ audit group. Quality audit in radiotherapy dosimetry is now well proven and participation by individual centres is strongly recommended. Similar audit approaches are to be encouraged in other areas of the radiotherapy process. (author)

  14. Auditing of environmental management system

    Directory of Open Access Journals (Sweden)

    Čuchranová Katarína

    2001-12-01

    Full Text Available Environmental auditing has estabilished itself as a valueable instrument to verify and help to improve the environmental performance.Organizations of all kinds may have a need to demonstrate the environmental responsibility. The concept of environmental management systems and the associated practice of environmental auditing have been advanced as one way to satisfy this need.These system are intended to help an organization to establish and continue to meet its environmental policies, objectives, standards and other requirements.Environmental auditing is a systematic and documented verification process of objectively obtaining and evaluating audit evidence to determine whether an organizations environmental management system conforms to the environmental management system audit criteria set by the organization and for the communication of the results of this process to the management.The following article intercepts all parts of preparation environmental auditing.The audit programme and procedures should cover the activities and areas to be considered in audits, the frequency of audits, the responsibilities associated with managing and conducting audits, the communication of audit results, auditor competence, and how audits will be conducted.The International Standard ISO 140011 estabilishes the audit procedures that determine conformance with EMS audit criteria.

  15. Development of dose audits for complex treatment techniques in radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M., E-mail: stefanic@cae.cnea.gov.ar [Centro Regional de Referencia con Patrones Secundarios para Dosimetria - CNEA, Presbitero Juan Gonzalez y Aragon 15, B1802AYA Ezeiza (Argentina)

    2014-08-15

    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)

  16. Development of dose audits for complex treatment techniques in radiotherapy

    International Nuclear Information System (INIS)

    Stefanic, A. M.; Molina, L.; Vallejos, M.; Montano, G.; Zaretzky, A.; Saravi, M.

    2014-08-01

    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)

  17. The ambiguous identity of auditing

    DEFF Research Database (Denmark)

    Lindeberg, Tobias

    2007-01-01

    This paper analyses the identity of auditing by comparing performance auditing to financial auditing and programme evaluation. Based on an analysis of textbooks, it is concluded that these evaluative practices are situated on a continuum. This implies that studies that rely on ‘audit’ as a label...... to attribute identity to a distinct evaluative practice become insensitive to issues concerning the relevance of their results to evaluative practices in general and their relation to specific characteristic of certain evaluative practices...

  18. Methodology of the Auditing Measures to Civil Airport Security and Protection

    Directory of Open Access Journals (Sweden)

    Ján Kolesár

    2016-10-01

    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.

  19. NDA National Graduate Programme 'nucleargraduates'

    International Nuclear Information System (INIS)

    Dawson, Carl

    2010-01-01

    The aim of this paper is to outline the NDA National Graduate Programme (nuclear graduates). The NDA has a remit under the Energy Act (2004) 'to maintain and develop the skills for decommissioning and nuclear clean-up'. Although current research is now being reviewed, there is significant evidence to suggest that the age profile in the Site Licence Companies is skewed towards older workers and there is likely to be a skill shortage in 3-5 years. As nuclear clean-up is a national issue; skill shortages also become a national issue in a very real sense. In addition, evidence suggests that the industry needs to be constantly challenged in order to achieve its targets for decommissioning. The NDA has a unique position under the Act. It is both a strategic overseer and direct employer. To this end the 'National Graduate Programme' is aligned to both the NDA's previous succession plans and the needs of the industry. Industry needs leadership that challenges the status quo and moves the UK nuclear industry to become best in class; Industry needs a dedicated to programme to address skills shortages and difficult to recruit areas such as, but not exclusively, estimators, schedulers, contract managers, site engineers, decommissioning technicians, safety monitors; The NDA has indicated a 'commercial and politically savvy' cohort is required to meet its own internal challenges and to ensure sustainability in its own workforce, and to be sensitive to the needs of customers and suppliers alike; Need to create a more diversified workforce in the nuclear industry and also plan for new skills evolving from research and development breakthroughs; Need to ensure that Tier 1, 2, 3 and 4 contractors invest in the leadership and skills for the future. World Class - delivery will be benchmarked against UK based multinational companies who operate in a global graduate attraction and development marketplace. The graduates targeted will be from leading institutions and will have a blend of

  20. 30-days mortality in patients with perforated peptic ulcer: A national audit

    Directory of Open Access Journals (Sweden)

    Anne Nakano

    2008-11-01

    Full Text Available Anne Nakano1,4, Jørgen Bendix2, Sven Adamsen3, Daniel Buck4, Jan Mainz5, Paul Bartels1, Bente Nørgård4,61The Danish National Indicator Project, Regionshuset Aarhus, Aarhus, Denmark; 2Department of Gastrointestinal Surgery L, Aarhus University Hospital, Denmark; 3Digestive Disease Center, Section for Gastrointestinal Surgery, Copenhagen, Denmark; University Hospital Herlev, Denmark; 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 5Department of Psychiatry Region North, Denmark and Institute of Public Health, University of Southern Denmark, Odense, Denmark; 6Center for National Clinical Databases, South, Odense University Hospital, and Epidemiology, Institute of Public Health, University of Southern Denmark, Odense, DenmarkBackground: In 2005, The Danish National Indicator Project (DNIP reported findings on patients hospitalized with perforated ulcer. The indicator “30-days mortality” showed major discrepancy between the observed mortality of 28% and the chosen standard (10%.Rationale: An audit committee was appointed to examine quality problems linked to the high mortality. The purpose was to (i examine patient characteristics, (ii evaluate the appropriateness of the standard, and (iii audit all cases of deaths within 30 days after surgery.Methods: Four hundred and twelve consecutive patients were included and used for the analyses of patient characteristics. The evaluation of the standard was based on a literature review, and a structured audit was performed according to the 115 deaths that occurred.Results: The mean age was 69.1 years, 42.0% had one co-morbid disease and 17.7% had two co-morbid diseases. 45.9% had an American Association of Anaesthetists score of 3–4. We found no results on mortality in studies similar to ours. The audit process indicated that the postoperative observation of patients was insufficient.Discussion: As a result of this study, the standard for mortality was increased to

  1. A qualitative evaluation of foundation dentists' and training programme directors' perceptions of clinical audit in general dental practice.

    Science.gov (United States)

    Thornley, P; Quinn, A; Elley, K

    2015-08-28

    This study reports on an investigation into clinical audit (CA) educational and service delivery outcomes in a dental foundation training (DFT) programme. The aim was to investigate CA teaching, learning and practice from the perspective of foundation dentists (FDs) and to record suggestions for improvement. A qualitative research methodology was used. Audio recordings of focus group interviews with FDs were triangulated by an interview with a group of training programme directors (TPDs). The interviews were transcribed and thematically analysed using a 'Framework' approach within Nvivo Data Analysis Software. FDs report considerable learning and behaviour change. However, TPDs have doubts about the long-term effects on service delivery. There can be substantial learning in the clinical, managerial, communication and professionalism domains, and in the development of time management, organisational and team-working skills. Information is provided about use of resources and interaction with teachers and colleagues. CA provides learning opportunities not produced by other educational activities including 'awkward conversations' with team-members in the context of change management and providing feedback. This is relevant when applying the recommendations of the Francis report. This paper should be useful to any dentist conducting audit or team training. Suggestions are made for improvements to resources and support including right touch intervention. Trainers should teach in the 'Goldilocks Zone'.

  2. 32 CFR 37.1325 - Periodic audit.

    Science.gov (United States)

    2010-07-01

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

  3. The national clinical audit of falls and bone health-secondary prevention of falls and fractures: a physiotherapy perspective.

    Science.gov (United States)

    Goodwin, Victoria; Martin, Finbarr C; Husk, Janet; Lowe, Derek; Grant, Robert; Potter, Jonathan

    2010-03-01

    To establish current physiotherapy practice in the secondary management of falls and fragility fractures compared with national guidance. Web-based national clinical audit. Acute trusts (n=157) and primary care trusts (n=146) in England, Wales and Northern Ireland. Data were collected on 5642 patients with non-hip fragility fractures and 3184 patients with a hip fracture. Those patients who were bedbound or who declined assessment or rehabilitation were excluded from the analysis. Results indicate that of those with non-hip fractures, 28% received a gait and balance assessment, 22% participated in an exercise programme, and 3% were shown how to get up from the floor. For those with a hip fracture, the results were 68%, 44% and 7%, respectively. Physiotherapists have a significant role to play in the secondary prevention of falls and fractures. However, along with managers and professional bodies, more must be done to ensure that clinical practice reflects the evidence base and professional standards.

  4. PILLARS OF THE AUDIT ACTIVITY: MATERIALITY AND AUDIT RISK

    OpenAIRE

    ANA MARIA JOLDOŞ; IONELA CORNELIA STANCIU; GABRIELA GREJDAN

    2010-01-01

    The purpose of this article is to present the issues of materiality and audit risk within the activity of financial audit. The concepts of materiality and audit risk are described from a theoretical perspective, providing approaches found within the national and international literature and within the specific legislation. A case study on the calculation of materiality and audit risk for an entity is presented in the last part of the article. Through the theoretical approach and the case stud...

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

    Science.gov (United States)

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

    2013-11-01

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

  6. Preliminary results of the national program of audit of quality in radiotherapy services in the Republic of Cuba

    International Nuclear Information System (INIS)

    Dominguez Hung, Lourdes; Larrinaga Cortina, Eduardo F.; Morales Lopez, Jorge L.; Garcia Yip, Fernando; Campa Menendez, Raudel

    2001-01-01

    The current state of the radiotherapy in Cuba has allowed to pass to a superior stage, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices as national regulator entity for the control and supervision of the medical devices of the National Health System is the responsible for it implementation. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of 60 Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audit, such as: the installation and unit's security, treatment unit's mechanical and dosimetric aspects and organizational aspects of the institution quality assurance program. Also were carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institution's program of quality assurance and a feedback for the setting about to the PNAC. (author)

  7. A National Framework for Energy Audit Ordinances

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Cody; Costa, Marc; Long, Nicholas; Antonoff, Jayson

    2016-08-26

    A handful of U.S. cities have begun to incorporate energy audits into their building energy performance policies. Cities are beginning to recognize an opportunity to use several information tools to bring to real estate markets both motivation to improve efficiency and actionable pointers on how to improve. Care is necessary to combine such tools as operational ratings, energy audits, asset ratings, and building retro-commissioning in an effective policy regime that maximizes market impact. In this paper, the authors focus on energy audits and consider both the needs of the policies' implementers in local governments and the emerging standards and federal tools to improve data collection and practitioner engagement. Over the past two years, we have compared several related data formats such as New York City's existing audit reporting spreadsheet, ASHRAE guidance on building energy auditing, and the DOE Building Energy Asset Score, to identify a possible set of required and optional fields for energy audit reporting programs. Doing so revealed tensions between the ease of data collection and the value of more detailed information, which had implications for the effort and qualifications needed to complete the energy audit. The resulting list of data fields is now feeding back into the regulatory process in several cities currently working on implementing or developing audit policies. Using complementary policies and standardized tools for data transmission, the next generation of policies and programs will be tailored to local building stock and can more effectively target improvement opportunities through each building's life.

  8. Innovative strategies for a successful SLMTA country programme: The Rwanda story

    Directory of Open Access Journals (Sweden)

    Innocent Nzabahimana

    2014-11-01

    Objectives: This study describes the achievements of Rwandan laboratories four years after the introduction of SLMTA in the country, using the SLIPTA scoring system to measure laboratory progress. Methods: Three cohorts of five laboratories each were enrolled in the SLMTA programme in 2010, 2011 and 2013. The cohorts used SLMTA workshops, improvement projects, mentorship and quarterly performance-based financing incentives to accelerate laboratory quality improvement. Baseline, exit and follow-up audits were conducted over a two-year period from the time of enrolment. Audit scores were used to categorise laboratory quality on a scale of zero (< 55% to five (95% – 100% stars. Results: At baseline, 14 of the 15 laboratories received zero stars with the remaining laboratory receiving a two-star rating. At exit, five laboratories received one star, six received two stars and four received three stars. At the follow-up audit conducted in the first two cohorts approximately one year after exit, one laboratory scored two stars, five laboratories earned three stars and four laboratories, including the National Reference Laboratory, achieved four stars. Conclusion: Rwandan laboratories enrolled in SLMTA showed improvement in quality management systems. Sustaining the gains and further expansion of the SLMTA programme to meet country targets will require continued programme strengthening.

  9. Environmental auditing: Theory and applications

    Science.gov (United States)

    Thompson, Dixon; Wilson, Melvin J.

    1994-07-01

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

  10. The role of the National Physical Laboratory in monitoring and improving dosimetry in UK radiotherapy

    International Nuclear Information System (INIS)

    Thomas, R.A.S.; Duane, S.; McEwen, M.R.; Rosser, K.E.

    2002-01-01

    In the UK, the National Physical Laboratory, in collaboration with the Institute for Physics and Engineering in Medicine operates an audit programme to ensure national consistency in radiotherapy dosimetry. The present programme covers dosimetry of megavoltage photons and electrons (3-19 MeV) and low and medium energy (10-300 kV) photons. The aim of each audit is to verify the local measurement of absorbed dose at the radiotherapy centre. The audit measurements - principally beam quality and linac output - are made following the same protocol as the clinic but using different equipment. The audit is not an absolute measurement of the absorbed dose but amounts to a check that the equipment used by the centre is operating as expected and that the Code of Practice is being followed correctly. The protocols used in the UK are IPSM 1990 for high-energy photons, IPEMB 1996 for electrons and IPEMB 1996 for low energy photons. For the purpose of these audits, NPL maintains a set of calibrated ionisation chambers

  11. 12 CFR 715.7 - Supervisory Committee audit alternatives to a financial statement audit.

    Science.gov (United States)

    2010-01-01

    ... financial statement audit. 715.7 Section 715.7 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION... Committee audit alternatives to a financial statement audit. A credit union which is not required to obtain a financial statement audit may fulfill its supervisory committee responsibility by any one of the...

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

    Science.gov (United States)

    1977-08-01

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

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

    Science.gov (United States)

    1977-08-01

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

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

    Science.gov (United States)

    1977-08-01

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

  15. Prevention of mother-to-child transmission in HIV audit in Xhosa clinic, Mahalapye, Botswana

    Directory of Open Access Journals (Sweden)

    Stephane Tshitenge

    2014-01-01

    Full Text Available Background: The Mahalapye district health management team (DHMT conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme.Aim: This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines.Setting: This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana.Methods: This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013.Results: One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19% knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of the 115 pregnant women (69% were seen at a gestational age of between 14 and 28 weeks. About two-thirds of the pregnant women (67% took antiretroviral drugs. Of the 44 HIV-exposed infants, 39 (89% were HIV DNA PCR negative at 6 weeks. Thirty-two (73% children were given cotrimoxazole prophylaxis between 6 and 8 weeks.Conclusion: The PMTCT programme service delivery was still suboptimal and could potentially increase the mother-to-child transmission of HIV. Daily monitoring mechanism to track those eligible could help to close the gap.

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

    Science.gov (United States)

    Wen, Jing; Xiao, Jiangyi; Wang, Aijun

    2018-01-30

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

  17. Sandia National Laboratories: Working with Sandia: Contract Audit

    Science.gov (United States)

    Defense Systems & Assessments About Defense Systems & Assessments Program Areas Accomplishments Audit Sandia's Economic Impact Licensing & Technology Transfer Browse Technology Portfolios Audit iSupplier Account Accounts Payable Contract Information Construction and Facilities Contract Audit

  18. The IAEA/WHO TLD postal programme for radiotherapy hospitals

    International Nuclear Information System (INIS)

    Izewska, J.; Andreo, P.

    2000-01-01

    Since 1969 the International Atomic Energy Agency (IAEA), together with the World Health Organization (WHO), has performed postal TLD audits to verify the calibration of radiotherapy beams in developing countries. A number of changes have recently been implemented to improve the efficiency of the IAEA/WHO TLD programme. The IAEA has increased the number of participants and reduced significantly the total turn-around time to provide results to the hospitals within the shortest possible time following the TLD irradiations. The IAEA has established a regular follow-up programme for hospitals with results outside acceptance limits of ±5%. The IAEA has, over 30 years, verified the calibration of more than 3300 clinical photon beams at approximately 1000 radiotherapy hospitals. Only 65% of those hospitals who receive TLDs for the first time have results within the acceptance limits, while more than 80% of the users that have benefited from a previous TLD audit are successful. The experience of the IAEA in TLD audits has been transferred to the national level. The IAEA offers a standardized TLD methodology, provides Guidelines and gives technical back-up to the national TLD networks. The unsatisfactory status of the dosimetry for radiotherapy, as noted in the past, is gradually improving however, the dosimetry practices in many hospitals in developing countries need to be revised in order to reach adequate conformity to hospitals that perform modern radiotherapy in Europe, USA and Australia. (author)

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

    Science.gov (United States)

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

    2018-01-01

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

  20. Operational programs for national radioactive waste and spent fuel management programme in Slovenia

    International Nuclear Information System (INIS)

    Zeleznik, Nadja; Kralj, Metka; Mele, Irena

    2007-01-01

    The first separate National Radioactive Waste and Spent Fuel Management Programme (National Programme) was prepared in Slovenia in 2005 as a supplementary part of the National Environmental Action Programme and was adopted in February 2006 by the Slovenian Parliament. The new National Programme includes all topics being relevant for the management of the radioactive waste and spent fuel which are produced in Slovenia, from the legislation and identification of different waste streams, to the management of radioactive waste and spent fuel, the decommissioning of nuclear facilities and management of (TE)NORM in the near future from 2006 up to the 2015. The National Programme identified the existing and possible future problems and proposed the technical solutions and action plans for two distinctive periods: 2006-2009 and 2010- 2015. According to the requirement of Act on Protection against Ionising Radiation and Nuclear Safety the national Agency for Radwaste Management (ARAO) prepared the operational programmes for the four year period with technical details on implementation of the National programme. ARAO gained the detailed plans of different involved holders and proposed 9 operational programmes with aims, measures, individual organizations in charge, expenses and resources for each of the programmes. The Operational programmes were already reviewed by the Ministry of Environment and Physical Planning and are under acceptance. The orientation of the radioactive waste management according to the National Programme and operational activities within additional limitations based on the strategical decisions of Slovenian Government is presented in the paper. (authors)

  1. Record Management Audit: Nuclear Malaysia’s Experience

    International Nuclear Information System (INIS)

    Adnan, H.; Yusof, M. H.; Ngadiron, N.; Ismail, R.M.

    2016-01-01

    Full text: The Malaysian Nuclear Agency (Nuclear Malaysia) is heavily reliant on information in order to accomplish its strategic research and development, and commercialization (R&D&C) outcomes. Since its beginning in 1972, the activity of Information Management (IM) – Records Management (RM) is always integrated in the process of knowledge repository. The Division of Information Management (DIM) is the custodian for the agency’s knowledge repository and also responsible to ensure its compliance with the National Archive of Malaysian Act 2003 (Act 629), as well as to address the needs of 3s: Safety, Security and Safeguards outlined by IAEA. In 2013, Nuclear Malaysia has launched KM Nuclear Policy which includes KM audit committee, to oversee and provide checks and balances for KM initiative programmes. The first KM audit conducted was the Record Management Audit (RMA), started in 2014. The journey faced some challenges from people, process and technology and later completed in 2015 with accumulation of new knowledge derived for the KM improvement. RMA is a unique process which needs to be shared with others because it offers example and experience from the perspective of nuclear R&D agency. (author

  2. Time to audit.

    Science.gov (United States)

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

    2012-09-01

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

  3. Postal audit in dental radiodiagnostics

    International Nuclear Information System (INIS)

    Novak, L.; Kroutilikova, D.

    2001-01-01

    According to Czech laws dental intraoral X-ray machines are classified as s imple sources of ionizing radiation . Consequently , their use is licensed on condition that an adequate quality assurance program is realized. In general, the programme is based on acceptance tests, status tests and constancy tests. The particular methods are specified in the recommendation [1] published by State Office for Nuclear Safety .Both the acceptance and status tests involve in situ measurements to control parameters of the X-ray machine and the developing process. Only persons who were licensed for such handling can do these measurements. The yearly status tests are very detailed and several years ' experience showed it might be advantageous to have a simpler method additionally available for purposes of the state supervision. Such a method is supposed as a postal audit. It should be simple enough to make the operation of the state supervision more effective but it also should provide sufficient information on radiation protection of the patients. Besides it should enable to prolong the period for the status tests ultimately .As for the postal audit, a small package containing a proper dosimetric set would be sent directly to the dentist who would treat it according to instructions. This paper describes such method that was developed in the National Radiation Protection Institute (NRPI) and results of pilot study that was carried out to test the method. The described method will be a helpful tool for the operation of the state supervision in the dental radiodiagnostics. The method will be implemented into the existing system of controls from 2002. Due to its simplicity and a quite rich content of information allows to check a big amount of the dental workplaces at once. It is supposed that one half of all Czech X-ray units will be checked in this way every year performed on state costs. It means 175 audits per month approximately. In this way, the operation of the quality

  4. National infection prevention and control programmes: Endorsing quality of care.

    Science.gov (United States)

    Stempliuk, Valeska; Ramon-Pardo, Pilar; Holder, Reynaldo

    2014-01-01

    Core components Health care-associated infections (HAIs) are a major cause of morbidity and mortality. In addition to pain and suffering, HAIs increase the cost of health care and generates indirect costs from loss of productivity for patients and society as a whole. Since 2005, the Pan American Health Organization has provided support to countries for the assessment of their capacities in infection prevention and control (IPC). More than 130 hospitals in 18 countries were found to have poor IPC programmes. However, in the midst of many competing health priorities, IPC programmes are not high on the agenda of ministries of health, and the sustainability of national programmes is not viewed as a key point in making health care systems more consistent and trustworthy. Comprehensive IPC programmes will enable countries to reduce the mobility, mortality and cost of HAIs and improve quality of care. This paper addresses the relevance of national infection prevention and control (NIPC) programmes in promoting, supporting and reinforcing IPC interventions at the level of hospitals. A strong commitment from national health authorities in support of national IPC programmes is crucial to obtaining a steady decrease of HAIs, lowering health costs due to HAIs and ensuring safer care.

  5. National Leprosy Eradication Programme (NLEP

    Directory of Open Access Journals (Sweden)

    Shetty Sushant

    1997-01-01

    Full Text Available This article traces the history of the growth and development of our National Leprosy Eradication Programme (NLEP. The aims, strategy, means of eradication, the organizational structure have been discussed. Since the beginning of this programme, the prevalence rate and disability rate have shown a sharp decline. The number of cases detected and under treatment have also increased. The achievement made has been possible due to an excellent organization of leprosy relief work under NLEP with the active cooperation of the non- governmental organizations. Now that leprosy is on the decline, the need of education and rehabilitation of patients assumes a greater importance.

  6. Radiation safety audit

    International Nuclear Information System (INIS)

    Kadadunna, K.P.I.K.; Mod Ali, Noriah

    2008-01-01

    Audit has been seen as one of the effective methods to ensure harmonization in radiation protection. A radiation safety audit is a formal safety performance examination of existing or future work activities by an independent team. Regular audit will assist the management in its mission to maintain the facilities environment that is inherently safe for its employees. The audits review the adequacy of facilities for the type of use, training, and competency of workers, supervision by authorized users, availability of survey instruments, security of radioactive materials, minimization of personnel exposure to radiation, safety equipment, and the required record keeping. All approved areas of use are included in these periodic audits. Any deficiency found in the audit shall be corrected as soon as possible after they are reported. Radiation safety audit is a proactive approach to improve radiation safety practices and identify and prevent any potential radiation accident. It is an excellent tool to identify potential problem to radiation users and to assure that safety measures to eliminate or reduce the problems are fully considered. Radiation safety audit will help to develop safety culture of the facility. It is intended to be the cornerstone of a safety program designed to aid the facility, staff and management in maintaining a safe environment in which activities are carried out. The initiative of this work is to evaluate the need of having a proper audit as one of the mechanism to manage the safety using ionizing radiation. This study is focused on the need of having a proper radiation safety audit to identify deviations and deficiencies of radiation protection programmes. It will be based on studies conducted on several institutes/radiation facilities in Malaysia in 2006. Steps will then be formulated towards strengthening radiation safety through proper audit. This will result in a better working situation and confidence in the radiation protection community

  7. A comprehensive audit of nursing record keeping practice.

    Science.gov (United States)

    Griffiths, Paul; Debbage, Samantha; Smith, Alison

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

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

    Science.gov (United States)

    2014-01-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  10. Comprehensive monitoring system - essential tool to show the results of the energy audit and voluntary agreement programmes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    Without visible results political support to an energy efficiency programme will dissolve in a few years. Therefore high-quality monitoring and reporting systems are essential to maintain a long-term commitment. Both in Finnish Energy Audit Programme (EAP), began in 1992, and in Voluntary Agreement Scheme (VA), began in 1997, bottom-up monitoring systems have been in place almost since the beginning. These policy measures and their monitoring systems are integrated. For the EAP monitoring system data is collected in three phases: subsidies granted; the energy auditing volumes in different sectors submitted EA reports; proposed measures and saving potentials. VA annual reporting; status of implementation of the proposed measures in EA reports and implementing rate for saving potentials. In VA scheme the companies and communities report annually on their energy consumption and on energy efficiency measures they have implemented or have decided to implement. Information on energy savings in energy units and energy costs as well as the required investment is reported in connection to the presented measures. The collected data is based on engineering calculations by the energy auditors. Since the companies have no incentives to submit exaggerated savings, the reported savings are equal to those figures the companies have used as criteria when deciding on the implementation of the measures. By 2005 these two policy measures have generated about 7 TWh annual savings, representing over 2 % of Finland's total energy end-use. In relation to the magnitude of savings brought in daylight, the investment on monitoring has really paid back.

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

    Science.gov (United States)

    Bearn, David R; Alharbi, Fahad

    2015-09-01

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

  12. Poverty alleviation programmes in India: a social audit.

    Science.gov (United States)

    K Yesudian, C A

    2007-10-01

    The review highlights the poverty alleviation programmes of the government in the post-economic reform era to evaluate the contribution of these programmes towards reducing poverty in the country. The poverty alleviation programmes are classified into (i) self-employment programmes; (ii) wage employment programmes; (iii) food security programmes; (iv) social security programmes; and (v) urban poverty alleviation programmes. The parameter used for evaluation included utilization of allocated funds, change in poverty level, employment generation and number or proportion of beneficiaries. The paper attempts to go beyond the economic benefit of the programmes and analyzes the social impact of these programmes on the communities where the poor live, and concludes that too much of government involvement is actually an impediment. On the other hand, involvement of the community, especially the poor has led to better achievement of the goals of the programmes. Such endeavours not only reduced poverty but also empowered the poor to find their own solutions to their economic problems. There is a need for decentralization of the programmes by strengthening the panchayat raj institutions as poverty is not merely economic deprivation but also social marginalization that affects the poor most.

  13. Temporal Changes in the Quality of Acute Stroke Care in Five National Audits across Europe

    Directory of Open Access Journals (Sweden)

    Steffi Hillmann

    2015-01-01

    Full Text Available Background. Data on potential variations in delivery of appropriate stroke care over time are scarce. We investigated temporal changes in the quality of acute hospital stroke care across five national audits in Europe over a period of six years. Methods. Data were derived from national stroke audits in Germany, Poland, Scotland, Sweden, and England/Wales/Northern Ireland participating within the European Implementation Score (EIS collaboration. Temporal changes in predefined quality indicators with comparable information between the audits were investigated. Multivariable logistic regression analyses were performed to estimate adherence to quality indicators over time. Results. Between 2004 and 2009, individual data from 542,112 patients treated in 538 centers participating continuously over the study period were included. In most audits, the proportions of patients who were treated on a SU, were screened for dysphagia, and received thrombolytic treatment increased over time and ranged from 2-fold to almost 4-fold increase in patients receiving thrombolytic therapy in 2009 compared to 2004. Conclusions. A general trend towards a better quality of stroke care defined by standardized quality indicators was observed over time. The association between introducing a specific measure and higher adherence over time might indicate that monitoring of stroke care performance contributes to improving quality of care.

  14. PILLARS OF THE AUDIT ACTIVITY: MATERIALITY AND AUDIT RISK

    Directory of Open Access Journals (Sweden)

    ANA MARIA JOLDOŞ

    2010-01-01

    Full Text Available The purpose of this article is to present the issues of materiality andaudit risk within the activity of financial audit. The concepts of materiality and audit risk aredescribed from a theoretical perspective, providing approaches found within the national andinternational literature and within the specific legislation. A case study on the calculation ofmateriality and audit risk for an entity is presented in the last part of the article. Through thetheoretical approach and the case study, it was concluded that materiality has an importantrole in determining the type of report to be issued, that is why it can be considered helpful forthose involved in the audit process.

  15. National Programme for Radiological Protection in Medical Exposures

    International Nuclear Information System (INIS)

    2013-07-01

    A national programme on radiation protection of patients can only be effective and sustainable if there is a joint effort between the regulatory body and the health authorities, and a cooperation with educational institutions, professional bodies and representatives of the industry. The regulatory body needs to promote a strategy of cooperation, and to identify obstacles that may prevent compliance with regulatory requirements and to address them. Not of least is the need for a continuous self-evaluation on the efficacy of the programme. Radiation safety of the patients is a responsibility of the users of the radiation sources involved in diagnostic and treatment. In particular, they are responsible for compliance with regulatory requirements. But safety depends also on aspects that are beyond the capabilities of those authorized to conduct practices. These aspects include educational programmes and institutions to implement them, calibration facilities, national protocols, professional bodies for the establishment of reference levels and contributions from the industry. Neither the users nor the regulatory body alone can achieve that these elements are in place. It needs a network of institutions and cooperation arrangements that involve educational and health authorities, laboratory facilities, professional bodies and the industry. A national programme has to include a strategy of cooperation, identification of obstacles that may prevent compliance with regulatory requirements and address them. Not of least is the need for a continuous self-evaluation on the efficacy of the programme. A group of regulatory agencies belonging to the Ibero American Forum of Nuclear and Radiation Regulatory Agency have exchanged experiences, lessons learned and good practices over three years. This exchange included extensive collaboration with the health authorities. The result of this work is this document containing a self-evaluation approach for the regulatory programme on

  16. Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP).

    Science.gov (United States)

    Lindsay, Geoff; Strand, Steve

    2013-10-19

    Evidence based parenting programmes can improve parenting skills and the behaviour of children exhibiting, or at risk of developing, antisocial behaviour. In order to develop a public policy for delivering these programmes it is necessary not only to demonstrate their efficacy through rigorous trials but also to determine that they can be rolled out on a large scale. The aim of the present study was to evaluate the UK government funded national implementation of its Parenting Early Intervention Programme, a national roll-out of parenting programmes for parents of children 8-13 years in all 152 local authorities (LAs) across England. Building upon our study of the Pathfinder (2006-08) implemented in 18 LAs. To the best of our knowledge this is the first comparative study of a national roll-out of parenting programmes and the first study of parents of children 8-13 years. The UK government funded English LAs to implement one or more of five evidence based programmes (later increased to eight): Triple P, Incredible Years, Strengthening Families Strengthening Communities, Families and Schools Together (FAST), and the Strengthening Families Programme (10-14). Parents completed measures of parenting style (laxness and over-reactivity), and mental well-being, and also child behaviour at three time points: pre- and post-course and again one year later. 6143 parents from 43 LAs were included in the study of whom 3325 provided post-test data and 1035 parents provided data at one-year follow up. There were significant improvements for each programme, with effect sizes (Cohen's d) for the combined sample of 0.72 parenting laxness, 0.85 parenting over-reactivity, 0.79 parent mental well-being, and 0.45 for child conduct problems. These improvements were largely maintained one year later. All four programmes for which we had sufficient data for comparison were effective. There were generally larger effects on both parent and child measures for Triple P, but not all between

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

    International Nuclear Information System (INIS)

    Shakespeare, Thomas P.; Back, Michael F.; Lu, Jiade J.; Lee, Khai Mun; Mukherjee, Rahul K.

    2006-01-01

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

  18. The UK radiotherapy dosimetry audit network

    International Nuclear Information System (INIS)

    Thwaites, D.I.

    2002-01-01

    Full text: Radiotherapy dosimetry intercomparison in the UK has been carried out in limited studies since the 1960s. However the first national dosimetry intercomparison involving all radiotherapy centres was conducted in the late 1980s. This was based on visits to each centre, using ionisation chamber dosimetry. It audited megavoltage photon beam calibration and other single field parameters. It also measured doses in a three-field 'treatment' in a trapezoidal phantom constructed from epoxy-resin water-equivalent material and compared these to locally planned doses. This included off-axis points, oblique incidence, inhomogeneities, etc. The study found mean measured beam calibration doses close to stated values (ratio 1.003), with a standard deviation (sd) of the distribution of 1.5% and 97% of doses within the pro-set 3% tolerance. For the planned multi-field irradiations, mean dose ratios (measured/stated) were 1.01 (sd 3%, 90% of results within 5%). A number of discrepancies were identified, leading to improved practice. A follow up study (mid-1990s) for electron beam audit also repeated the megavoltage photon calibration audit. For photons, an improvement was noted (mean ratio 1.003, sd 1.0%, 100% within 3%), whilst for electron beams, the mean ratio of measured/stated dose was 0.994 (sd 1.8%, 94% within 3%, 99% within 5%). In parallel with - and growing out of - this, a national audit network began to develop in 1991/2. It utilised similar methodology to the intercomparison and a network approach to allow parallel developments of the scope of the system. The network has eight regional groups, each with up to 10 radiotherapy centres, serving average populations of 7-8 million. Each group organises audits of its own centres and has developed at its own pace. Most have piloted methodology, phantoms, etc. for new audits which can then be used by other groups. All 65 UK centres are included. The network is co-ordinated by an IPEM Steering Committee (current chair

  19. National programme: Finland

    International Nuclear Information System (INIS)

    Forsten, J.

    1986-01-01

    Finland's programmes in the field of reactor pressure components are presented in this paper. The following information on each of these programmes is given: the brief description of the programme; the programme's schedule and duration; the name of the project manager

  20. NOVANA. National Monitering and Assessment Programme for the Aquatic and Terrestrial Environments

    DEFF Research Database (Denmark)

    Svendsen, L. M.; Bijl, L. van der; Boutrup, S.

    This report is Part 2 of the Programme Description of NOVANA - the National Monitoring and Assessment Programme for the Aquatic and Terrestrial Environments. Part 2 comprises a de-tailed description of the nine NOVANA subprogrammes: Background monitoring of air......This report is Part 2 of the Programme Description of NOVANA - the National Monitoring and Assessment Programme for the Aquatic and Terrestrial Environments. Part 2 comprises a de-tailed description of the nine NOVANA subprogrammes: Background monitoring of air...

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

    Science.gov (United States)

    Audit, National Prospective Tonsillectomy

    2008-08-01

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

  2. NDA National Graduate Programme 'nucleargraduates'

    Energy Technology Data Exchange (ETDEWEB)

    Dawson, Carl

    2010-07-01

    The aim of this paper is to outline the NDA National Graduate Programme (nuclear graduates). The NDA has a remit under the Energy Act (2004) 'to maintain and develop the skills for decommissioning and nuclear clean-up'. Although current research is now being reviewed, there is significant evidence to suggest that the age profile in the Site Licence Companies is skewed towards older workers and there is likely to be a skill shortage in 3-5 years. As nuclear clean-up is a national issue; skill shortages also become a national issue in a very real sense. In addition, evidence suggests that the industry needs to be constantly challenged in order to achieve its targets for decommissioning. The NDA has a unique position under the Act. It is both a strategic overseer and direct employer. To this end the 'National Graduate Programme' is aligned to both the NDA's previous succession plans and the needs of the industry. Industry needs leadership that challenges the status quo and moves the UK nuclear industry to become best in class; Industry needs a dedicated to programme to address skills shortages and difficult to recruit areas such as, but not exclusively, estimators, schedulers, contract managers, site engineers, decommissioning technicians, safety monitors; The NDA has indicated a 'commercial and politically savvy' cohort is required to meet its own internal challenges and to ensure sustainability in its own workforce, and to be sensitive to the needs of customers and suppliers alike; Need to create a more diversified workforce in the nuclear industry and also plan for new skills evolving from research and development breakthroughs; Need to ensure that Tier 1, 2, 3 and 4 contractors invest in the leadership and skills for the future. World Class - delivery will be benchmarked against UK based multinational companies who operate in a global graduate attraction and development marketplace. The graduates targeted will be from leading

  3. Evaluation of the national roll-out of parenting programmes across England: the parenting early intervention programme (PEIP)

    Science.gov (United States)

    2013-01-01

    Background Evidence based parenting programmes can improve parenting skills and the behaviour of children exhibiting, or at risk of developing, antisocial behaviour. In order to develop a public policy for delivering these programmes it is necessary not only to demonstrate their efficacy through rigorous trials but also to determine that they can be rolled out on a large scale. The aim of the present study was to evaluate the UK government funded national implementation of its Parenting Early Intervention Programme, a national roll-out of parenting programmes for parents of children 8–13 years in all 152 local authorities (LAs) across England. Building upon our study of the Pathfinder (2006–08) implemented in 18 LAs. To the best of our knowledge this is the first comparative study of a national roll-out of parenting programmes and the first study of parents of children 8–13 years. Methods The UK government funded English LAs to implement one or more of five evidence based programmes (later increased to eight): Triple P, Incredible Years, Strengthening Families Strengthening Communities, Families and Schools Together (FAST), and the Strengthening Families Programme (10–14). Parents completed measures of parenting style (laxness and over-reactivity), and mental well-being, and also child behaviour at three time points: pre- and post-course and again one year later. Results 6143 parents from 43 LAs were included in the study of whom 3325 provided post-test data and 1035 parents provided data at one-year follow up. There were significant improvements for each programme, with effect sizes (Cohen’s d) for the combined sample of 0.72 parenting laxness, 0.85 parenting over-reactivity, 0.79 parent mental well-being, and 0.45 for child conduct problems. These improvements were largely maintained one year later. All four programmes for which we had sufficient data for comparison were effective. There were generally larger effects on both parent and child measures

  4. Behavior of audit fees in the audit firm or partner changes

    Directory of Open Access Journals (Sweden)

    Marcelo Antonio Pierri Junior

    2016-09-01

    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.

  5. 30-days mortality in patients with perforated peptic ulcer: A national audit

    Science.gov (United States)

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

    2008-01-01

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

  6. An audit of tuberculosis health services in prisons and immigration removal centres.

    Science.gov (United States)

    Mehay, Anita; Raj, Thara; Altass, Lynn; Newton, Autilia; O'Moore, Eamonn; Railton, Cathie; Tan, Hong; Story, Al; Frater, Alison

    2017-06-01

    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. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Quality control programme for radiotherapy

    International Nuclear Information System (INIS)

    Campos de Araujo, A.M.; Viegas, C.C.B.; Viamonte, A.M.

    2002-01-01

    A 3 years pilot programme started in January 2000 with 33 philanthropic cancer institutions that provides medical services to 60% of the patients from the national social security system. Brazil has today 161 radiotherapy services (144 operating with megavoltage equipment). These 33 institutions are distributed over 19 Brazilian states. The aim of this programme is: To create conditions to allow the participants to apply the radiotherapy with quality and efficacy; To promote up dating courses for the physicians, physicists and technicians of these 33 Institutions. With the following objectives: To recommend dosimetric and radiological protection procedures in order to guarantee the tumor prescribed dose and safe working conditions; To help in establishing and implementing these procedures. The main activities are: local quality control evaluations, postal TLD audits in reference conditions, postal TLD audits in off axis conditions and training. The local quality control program has already evaluated 22 institutions with 43 machines (25 Co-60 and 18 linear accelerators). In these visits we perform dosimetric, electrical, mechanical and safety tests. As foreseen, we found more problems among the old Co-60 machines i.e., field flatness, size, symmetry and relative output factors; lasers positioning system alignment; optical distance indicator; radiation and light field coincidence; optical and mechanical distance indicators agreement, than among the linear accelerators i.e., field flatness and size; lasers positioning system alignment; tray interlocking and wedge filter factors

  8. The Strategic Options of Supreme Audit Institutions

    DEFF Research Database (Denmark)

    Klarskov Jeppesen, Kim; Carrington, Thomas; Catasús, Bino

    2017-01-01

    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...

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kaurai E. Masanganise

    2013-06-01

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

  11. Status of national programmes on fast reactors

    International Nuclear Information System (INIS)

    1994-04-01

    Based on the International Working Group on Fast reactors (IWGFR) members' request, the IAEA organized a special meeting on Fast Reactor Development and the Role of the IAEA in May 1993. The purpose of the meeting was to review and discuss the status and recent development, to present major changes in fast reactor programmes and to recommend future activities on fast reactors. The IWGFR took note that in some Member States large prototypes have been built or are under construction. However, some countries, due to their current budget constraints, have reduced the level of funding for research and development programmes on fast reactors. The IWGFR noted that in this situation the international exchange of information and cooperation on the development of fast reactors is highly desirable and stressed the importance of the IAEA's programme on fast reactors. These proceedings contain important and useful information on national programmes and new developments in sodium cooled fast reactors in Member States. Refs, figs and tabs

  12. CONVERGENCE OF INTERNATIONAL AUDIT STANDARDS AND AMERICAN AUDIT STANDARDS REGARDING SAMPLING

    Directory of Open Access Journals (Sweden)

    Chis Anca Oana

    2013-07-01

    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.

  13. A national programme for mastitis control in Australia: Countdown Downunder

    Directory of Open Access Journals (Sweden)

    Brightling PB

    2009-04-01

    Full Text Available Abstract In 1998, Countdown Downunder, Australia's national mastitis and cell count control programme, was created. With funding from the country's leading dairy organisation, Dairy Australia, this programme was originally intended to run for three years but is now in its tenth year. As it was the first time Australia had attempted a national approach to mastitis control on the farm, the first three years of the programme were largely concerned with the development of resources to be used by farmers and service providers. The second three years were devoted to training with both groups. Since that time, Countdown Downunder has entered into a second resource development phase. The goal of the programme was to achieve a reduction in the bulk milk somatic cell count from the Australian dairy herd. To achieve this, the programme had to develop resources with clear and consistent messages around mastitis and somatic cell count control on farms. It was determined that progress toward the goals would be made more rapidly if service providers were trained in the use of these resources prior to farmers. This paper reviews the Countdown Downunder programme from 1998 to 2007.

  14. Health, safety, and environmental auditing in the E and P industry

    International Nuclear Information System (INIS)

    Sexton, K.; Visser, K.

    1991-01-01

    This paper gives an overview of the development of auditing within the field of Health, Safety and Environmental (HSE) management in the E and P industry. Auditing of these aspects of the business is relatively recent, and the adoption of formal audit programmes is increasingly regarded as an essential element of the HSE management program. Auditing provides assurance that internal controls are working effectively, and provides vital information for system improvement. An overview will be given of the transitional phases that the HSE auditing process has been through; the factors that have influenced those developments; and some views on potential future developments

  15. QA programme in external radiotherapy in Romania - status and perspective

    International Nuclear Information System (INIS)

    Dumitrescu, A.; Milu, C.

    2008-01-01

    Full text: Recognizing the importance of quality assurance in radiotherapy and the need to make access to radiation standards traceable to the international measurement system for every radiotherapy center, the Romanian national secondary standard dosimetry laboratory (SSDL) has started in 1999 - together with IAEA - a national quality audit programme in all the centers for external radiotherapy from Romania. At present, there are 17 radiotherapy centers in Romania, and a total of 19 teletherapy units and 4 LINCs. The programme has 3 phases: the first phase was to organize a survey in all radiotherapy centers, to collect general information on their radio therapists, medical physicists, type of equipment, dosimeters, etc. Following the survey, a quality assurance network was set up, and on-site dosimetry reviews were arranged according to a suitable timetable. The second phase consisted in performing the reference dosimetry and the calibration of the equipment. Then, a quality audit system based on mailed TLDs has been applied to all radiation beams produced by cobalt-60 therapy units and medical accelerators, in order to identify discrepancies in dosimetry larger than ± 3%. At the same time, the beam calibration performed by the SSDLs was verified. The results of the first survey were analyzed, and corrective actions were taken. A second survey was then organized, based on the mailed TLDs. This paper presents in detail the entire QA programme, its results, and the actions that are to be taken in order to improve the accuracy and consistency of the dosimetry in clinical radiotherapy in Romania. (author)

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

    Directory of Open Access Journals (Sweden)

    Thomas Angela N

    2009-09-01

    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.

  17. High performance cloud auditing and applications

    CERN Document Server

    Choi, Baek-Young; Song, Sejun

    2014-01-01

    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...

  18. The National Institute for Health Research Leadership Programme

    Science.gov (United States)

    Jones, Molly Morgan; Wamae, Watu; Fry, Caroline Viola; Kennie, Tom; Chataway, Joanna

    2012-01-01

    Abstract RAND Europe evaluated the National Institute for Health Research (NIHR) Leadership Programme in an effort to help the English Department of Health consider the extent to which the programme has helped to foster NIHR's aims, extract lessons for the future, and develop plans for the next phase of the leadership programme. Successful delivery of high-quality health research requires not only an effective research base, but also a system of leadership supporting it. However, research leaders are not often given the opportunity, nor do they have the time, to attend formal leadership or management training programmes. This is unfortunate because research has shown that leadership training can have a hugely beneficial effect on an organisation. Therefore, the evaluation has a particular interest in understanding the role of the programme as a science policy intervention and will use its expertise in science policy analysis to consider this element alongside other, more traditional, measures of evaluation. PMID:28083231

  19. Could clinical audit improve the diagnosis of pulmonary tuberculosis in Cuba, Peru and Bolivia?

    Science.gov (United States)

    Siddiqi, Kamran; Volz, Anna; Armas, L; Otero, L; Ugaz, R; Ochoa, E; Gotuzzo, E; Torrico, F; Newell, James N; Walley, J; Robinson, Mike; Dieltiens, G; Van der Stuyft, P

    2008-04-01

    To assess the effectiveness of clinical audit in improving the quality of diagnostic care provided to patients suspected of tuberculosis; and to understand the contextual factors which impede or facilitate its success. Twenty-six health centres in Cuba, Peru and Bolivia were recruited. Clinical audit was introduced to improve the diagnostic care for patients attending with suspected TB. Standards were based on the WHO and TB programme guidelines relating to the appropriate use of microscopy, culture and radiological investigations. At least two audit cycles were completed over 2 years. Improvement was determined by comparing the performance between two six-month periods pre- and post-intervention. Qualitative methods were used to ascertain facilitating and limiting contextual factors influencing change among healthcare professionals' clinical behaviour after the introduction of clinical audit. We found a significant improvement in 11 of 13 criteria in Cuba, in 2 of 6 criteria in Bolivia and in 2 of 5 criteria in Peru. Twelve out of 24 of the audit criteria in all three countries reached the agreed standards. Barriers to quality improvement included conflicting objectives for clinicians and TB programmes, poor coordination within the health system and patients' attitudes towards illness. Clinical audit may drive improvements in the quality of clinical care in resource-poor settings. It is likely to be more effective if integrated within and supported by the local TB programmes. We recommend developing and evaluating an integrated model of quality improvement including clinical audit.

  20. Audits of oncology units – an effective and pragmatic approach ...

    African Journals Online (AJOL)

    Background. Audits of oncology units are part of all quality-assurance programmes. However, they do not always come across as pragmatic and helpful to staff. Objective. To report on the results of an online survey on the usefulness and impact of an audit process for oncology units. Methods. Staff in oncology units who ...

  1. Effective quality auditing

    International Nuclear Information System (INIS)

    Sivertsen, Terje

    2004-01-01

    The present report focuses on how to improve the effectiveness of quality audits and organization-wide quality management. It discusses several concepts related to internal quality auditing, includes guidelines on how to establish auditing as a key process of the organization, and exemplifies its application in the management of quality, strategy, and change. The report follows a line of research documented previously in the reports 'Continuous Improvement of Software Quality' (HWR-584) and 'ISO 9000 Quality Systems for Software Development' (HWR-629). In particular, the concepts of measurement programmes and process improvement cycles, discussed in HWR-584, form the basis for the approach advocated in the present report to the continual improvement of the internal quality audit process. Internal auditing is an important ingredient in ISO 9000 quality systems, and continual improvement of this process is consistent with the process-oriented view of the 2000 revision of the ISO 9000 family (HWR-629). The overall aim of the research is to provide utilities and their system vendors with better tools for quality management in digital I and C projects. The research results are expected to provide guidance to the choice of software engineering practices to obtain a system fulfilling safety requirements at an acceptable cost. For licensing authorities, the results are intended to make the review process more efficient through the use of appropriate measures (metrics), and to be of help in establishing requirements to software quality assurance in digital I and C projects. (Author)

  2. Development of national immunoassay reagent programmes

    International Nuclear Information System (INIS)

    Sufi, S.B.; Micallef, J.V.; Ahsan, R.; Goncharov, N.P.

    1992-01-01

    Despite the existence of networks of fully equipped laboratories with well-trained staff, the availability of immunodiagnostic services in developing countries is often limited by the high cost of imported kits. There are a number of ways of tackling this problem, ranging from bulk purchase of kits or reagents to local development and production of assay systems. Argentina/Chile, China, Cuba/Mexico, and Thailand are amongst the countries which have established local immunoassay reagent programmes to manufacture low cost, high quality immunoassay reagents. Kits from these projects are now beginning to become available, and it is hoped that they will promote national diagnostic services and research, as well as stimulating the development of reagent programmes for other analytes. (author). 4 refs, 1 tab

  3. A method of quality audit for treatment planning system for intracavitary HDR brachytherapy

    International Nuclear Information System (INIS)

    Sharma, S.D.; Vandana, S.; Philomina, A.; Kannan, S.; Rituraj, U.

    2007-01-01

    High dose rate brachytherapy is a multipurpose modality. Quality audit (QAu) is an independent examination and evaluation of quality assurance activities and results of an institution. Both clinical and physical aspects of patient treatments must be subjected to careful control and planning to achieve a high degree of accuracy in radiation therapy treatments. Comprehensive quality assurance (QA) programmes should be established to cover all steps from dose prescription to dose delivery. These programmes should include detailed internal checks performed by the radiotherapy centres and external audits made by independent bodies. A systematic and independent examination and evaluation to determine whether quality activities and results comply with planned arrangements and whether the arrangements are implemented effectively and are suitable to achieve objectives is called quality audit. One purpose of a quality audit (QAu) is to evaluate the need for improvement or corrective action

  4. A national dosimetric audit of IMRT

    International Nuclear Information System (INIS)

    Budgell, Geoff; Berresford, Joe; Trainer, Michael; Bradshaw, Ellie; Sharpe, Peter; Williams, Peter

    2011-01-01

    Background and purpose: A dosimetric audit of IMRT has been carried out within the UK between June 2009 and March 2010 in order to provide an independent check of safe implementation and to identify problems in the modelling and delivery of IMRT. Methods and materials: A mail based audit involving film and alanine dosimeters was utilized. Measurements were made for each individual field in an IMRT plan isocentrically in a flat water-equivalent phantom at a depth of 5 cm. The films and alanine dosimeters were processed and analysed centrally; additional ion chamber measurements were made by each participating centre. Results: 57 of 62 centres participated, with a total of 78 plans submitted. For the film measurements, all 176 fields from the less complex IMRT plans (including prostate and breast plans) achieved over 95% pixels passing a gamma criterion of 3%/3 mm within the 20% isodose. For the more complex IMRT plans (mainly head and neck) 8/245 fields (3.3%) achieved less than 95% pixels passing a 4%/4 mm gamma criterion. Of the alanine measurements, 4/78 (5.1%) of the measurements differed by >5% from the dose predicted by the treatment planning system. Three of these were large deviations of -77.1%, -29.1% and 14.1% respectively. Excluding the three measurements outside 10%, the mean difference was 0.05% with a standard deviation of 1.5%. The out of tolerance results have been subjected to further investigations. Conclusions: A dosimetric audit has been successfully carried out of IMRT implementation by over 90% of UK radiotherapy departments. The audit shows that modelling and delivery of IMRT is accurate, suggesting that the implementation of IMRT has been carried out safely.

  5. Four African Nations Agree to Water Management Programme

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: Seeking to improve their management of water resources, four northeast African nations today agreed at the International Atomic Energy Agency (IAEA) to establish a long-term framework for utlizing a key underground water system. Chad, Egypt, Libya and Sudan signed a Strategic Action Programme (SAP) that aims to optimize the equitable use of the Nubian Sandstone Aquifer System, a huge water resource that lies beneath the four nations. The SAP also commits the countries to strengthen and build upon a previously existing regional coordination mechanism, in part by establishing a new Joint Authority for the Nubian Aquifer System. The Programme lays the groundwork for improving cooperation among the four arid nations and for strengthening their capacity to monitor and manage the aquifer effectively. With growing populations and decreasing water availability from other sources in the region, the aquifer is under mounting pressure. Removing water without a clear understanding of transboundary and other implications threatens water quality and has the potential to harm biodiversity and accelerate land degradation. The agreement resulted from a joint Technical Cooperation project of the United Nations Development Programme (UNDP) and the Global Environment Facility (GEF), the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the IAEA. ''I congratulate all involved on this significant achievement,'' said IAEA Director General Yukiya Amano. ''Water is a key resource, and effective management and use of such water resources is essential for the future. The agreement of the Strategic Action Programme is the result of real cooperation between the four States, the Agency and UNDP-GEF. I am confident that this Programme will be a success and will benefit the people of the region. This positive project experience benefits strengthened and expanded cooperation between the IAEA and the UNDP-GEF.'' ''UNDP would like to congratulate the

  6. Comprehensive audits of radiotherapy practices: A tool for quality improvement: Quality Assurance Team for Radiation Oncology (QUATRO)

    International Nuclear Information System (INIS)

    2007-10-01

    As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and at various levels, either reviewing critical parts of the radiotherapy process (partial audits) or assessing the whole process (comprehensive audits). The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimetry (TLD) to verify the calibration of radiotherapy beams since 1969. Furthermore, it has developed a set of procedures for experts undertaking missions to radiotherapy hospitals in Member States for on-site review of dosimetry equipment, data and techniques, measurements and training of local staff. This methodology involves dosimetry and medical radiation physics aspects of the radiotherapy process without entering into clinical areas. The IAEA, through its technical cooperation programme, has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process. including aspects such as organization, infrastructure, and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate thc quality of all of the components of the practice of radiotherapy at an institution, including its professional competence, with a view to quality improvement. A multidisciplinary team, comprising a radiation oncologist, a medical physicist and a radiotherapy technologist, carries out the audit. The present publication has been field tested by IAEA teams performing audits in radiotherapy programmes in hospitals in Africa, Asia, Europe and Latin America. Their comments, corrections and feedback have been taken

  7. Comprehensive audits of radiotherapy practices: A tool for quality improvement: Quality Assurance Team for Radiation Oncology (QUATRO)

    International Nuclear Information System (INIS)

    2008-08-01

    As part of a comprehensive approach to quality assurance (QA) in the treatment of cancer by radiation, an independent external audit (peer review) is important to ensure adequate quality of practice and delivery of treatment. Quality audits can be of various types and at various levels, either reviewing critical parts of the radiotherapy process (partial audits) or assessing the whole process (comprehensive audits). The IAEA has a long history of providing assistance for dosimetry (partial) audits in radiotherapy to its Member States. Together with the World Health Organization (WHO), it has operated postal audit programmes using thermoluminescence dosimetry (TLD) to verify the calibration of radiotherapy beams since 1969. Furthermore, it has developed a set of procedures for experts undertaking missions to radiotherapy hospitals in Member States for on-site review of dosimetry equipment, data and techniques, measurements and training of local staff. This methodology involves dosimetry and medical radiation physics aspects of the radiotherapy process without entering into clinical areas. The IAEA, through its technical cooperation programme, has received numerous requests from developing countries to perform comprehensive audits of radiotherapy programmes to assess the whole process. including aspects such as organization, infrastructure, and clinical and medical physics components. The objective of a comprehensive clinical audit is to review and evaluate thc quality of all of the components of the practice of radiotherapy at an institution, including its professional competence, with a view to quality improvement. A multidisciplinary team, comprising a radiation oncologist, a medical physicist and a radiotherapy technologist, carries out the audit. The present publication has been field tested by IAEA teams performing audits in radiotherapy programmes in hospitals in Africa, Asia, Europe and Latin America. Their comments, corrections and feedback have been taken

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

    Science.gov (United States)

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

    2017-10-01

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

  9. Preparation of the National Radioactive Waste and Spent Fuel Management Programme in Slovenia

    International Nuclear Information System (INIS)

    Kralj, M.; Zeleznik, N.; Mele, I.; Veselic, M.

    2006-01-01

    The first separate National Radioactive Waste and Spent Fuel Management Programme (National Programme) was prepared in Slovenia in 2005, as a separate part of the National Environmental Action Programme that was adopted in June 2005. In the previous National Environmental Action Programme from the year 1999, the radioactive waste and spent fuel management was mentioned only briefly in the paragraph on radiation and nuclear safety with two main objectives: to provide an effective management of radioactive waste, and to keep the environmental ionising radiation under control. The new National Programme from 2005 includes all topics being relevant for the management of the radioactive waste and spent fuel, from the legislation and identification of different waste streams in Slovenia, to the management of radioactive waste and spent fuel, the decommissioning of nuclear facilities and management of (TE)NORM. It deals also with the relevant actors in the radioactive waste management, communication and information activities, and the financial aspects of the radioactive waste and spent fuel management. The National Programme was already adopted by the Slovenian Government in October 2005 and will go to Parliament proceedings. The Technical bases for the National Programme was prepared by ARAO and presented to the government in the beginning of 2005. The frames for this document were taken from relevant strategic documents: the Programme of decommissioning the nuclear power plant Krsko and the radioactive waste and spent fuel management, prepared in 2004 by Slovenian and Croatian experts (ARAO and APO), the Proposal of LILW Management Strategy (1999), the Strategy of Spent Fuel Management (1996), and the Resolution on the National Energy Programme (2004). ARAO made a detailed study on the amount and types of radioactive waste produced in Slovenia and future arising with emphasis on the minimization on radioactive waste production. It considered all producers of LILW and

  10. Assessment of paediatric clinical audit.

    LENUS (Irish Health Repository)

    Perrem, L M

    2012-02-01

    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.

  11. Development of a quality assurance programme for radiation therapy dosimetry in development countries. Report of the second research co-ordination meeting - RCM-650.2 on the CRP E2 40 07, 4-8 December 2000, IAEA DMRP Section, Vienna

    International Nuclear Information System (INIS)

    2001-01-01

    The aim of the Co-ordinated Research Programme ''Development of a Quality Assurance Programme for Radiation Therapy Dosimetry in Developing Countries'' (E2-40-07) is to establish national Quality Assurance (QA) networks for external quality audits for radiotherapy hospitals in developing countries. This is done by setting-up national External Audit Groups (EAG) with laboratory backup for operating TLD audits for radiotherapy dosimetry. The CRP offers a standardized methodology, the same for all participating countries, provides guidelines and gives technical support to the national EAG activities. In 1995-1998, the national EAGs were established in Algeria, Argentina, China, Czech Republic, India, Israel and Malaysia. At present five countries have joined the project: Colombia, Cuba, Philippines, Poland and Viet Nam. The current status of the development of methodology and procedures for QA audits in the participating countries was presented and discussed at length. Each participant has submitted the status report regarding the TLD system, measuring procedures, structure of the national EAG and relations with other relevant national organizations or bodies. The new participants are in the process of adapting the procedures developed by the IAEA and revised by the previous group in this CRP. The participants have received information on state of the art of the quality audit networks in Europe presented by Prof. Dutreix. Further discussions followed the presentations of the results of testing of the EAG measuring systems and operational procedures for audits. Special emphasis was given to issues related to legislation and national regulations in the different countries and confidentiality in reporting the audit results. Procedural problems related to endorsement of the EAGs by the relevant national bodies were noted. The composition of the national EAGs was discussed and optimal structures for the individual countries recommended. The contents of the QA manuals for

  12. The National Youth Service Corps Programme and Growing Security Threat in Nigeria

    Directory of Open Access Journals (Sweden)

    Chukwuemeka Okafor

    2014-06-01

    Full Text Available The National Youth Service Corps (NYSC was established in 1973 after the Nigerian civil war to involve Nigerian university graduates below the age of thirty in nation building. Gradually, the scheme was opened-up for polytechnic graduates.  The article presents the objectives and deployment policy of the programme. It shows that the early phase of the programme recorded the problems of corruption, ghost corps members, accommodation, language barriers as well as hostile culture. However, the contemporary Nigerian society has been overtaken by the destructive wind of insecurity. The article reveals that the various waves of political violence in the country, including Boko Haram terrorism, hostage crises, and geographical threats have turned into a collection of overwhelming menace to the programme, thereby leading to massive agitation for itabrogation. The article recommends for multiple series of reforms in order to protect the lives of many Nigerian graduates that are building the nation through this admirable development programme.

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

    Science.gov (United States)

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

    2013-01-01

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

  14. United Nations Environment Programme. Annual Review 1981.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    This edition of the United Nations Environment Programme (UNEP) annual report is structured in three parts. Part 1 focuses on three contemporary problems (ground water, toxic chemicals and human food chains and environmental economics) and attempts to solve them. Also included is a modified extract of "The Annual State of the Environment…

  15. Report of the first research coordination meeting (RCM) for the co-ordinated research project (CRP E2 40 07) on development of a quality assurance programme for radiation therapy dosimetry in developing countries. IAEA, Vienna, 6-10 October 1997

    International Nuclear Information System (INIS)

    Izewska, J.

    1998-01-01

    In 1994, a group of consultants was asked to advice the Agency on the expansion of the IAEA/WHO TLD postal dose check service for radiotherapy hospitals by transfer of know-how to national level. The consultants advised the Agency to initiate the Co-ordinated Research Programme (CRP) to transfer the IAEA well established TLD methodology to the countries where existing resources enable set up of the External Audit Groups - nationally recognised groups in charge of operating external quality audits for radiotherapy dosimetry. The External Audit Groups (EAG) include the SSDL, a Measuring Centre (MC) and a Medical Physics Group (MPG), and these groups work in close co-operation during all steps of the TLD audits

  16. Enhanced recovery from surgery in the UK: an audit of the enhanced recovery partnership programme 2009-2012.

    Science.gov (United States)

    Simpson, J C; Moonesinghe, S R; Grocott, M P W; Kuper, M; McMeeking, A; Oliver, C M; Galsworthy, M J; Mythen, M G

    2015-10-01

    The UK Department of Health Enhanced Recovery Partnership Programme collected data on 24 513 surgical patients in the UK from 2009-2012. Enhanced Recovery is an approach to major elective surgery aimed at minimizing perioperative stress for the patient. Previous studies have shown Enhanced Recovery to be associated with reduced hospital length of stay and perioperative morbidity. In this national clinical audit, National Health Service hospitals in the UK were invited to submit patient-level data. The data regarding length of stay and compliance with each element of Enhanced Recovery protocols for colorectal, orthopaedic, urological and gynaecological surgery patients were analysed. The relationship between Enhanced Recovery protocol compliance and length of stay was measured. From 16 267 patients from 61 hospital trusts, three out of four surgical specialties showed Enhanced Recovery, compliance being weakly associated with shorter length of stay (correlation coefficients -0.18, -0.14, -0.25 in colorectal, orthopaedics and gynaecology respectively). At a cut-off of 80% compliance, good compliance was associated with two, one and three day reductions in median length of stay respectively in colorectal, orthopaedic and urological surgeries, with no saving in gynaecology. This study is the largest assessment of the relationship between Enhanced Recovery protocol compliance and outcome in four surgical specialties. The data suggest that higher compliance with an Enhanced Recovery protocol has a weak association with shorter length of stay. This suggests that changes in process, resulting from highly protocolised pathways, may be as important in reducing perioperative length of stay as any individual element of Enhanced Recovery protocols in isolation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Foresight and strategy in national research councils and research programmes

    DEFF Research Database (Denmark)

    Andersen, Per Dannemand; Borup, Mads

    2009-01-01

    This paper addresses the issue of foresight and strategy processes of national research councils and research programmes. It is based on a study of strategy processes in national research councils and programmes and the challenges faced by their strategy activities. We analysed the strategy...... processes of two organisations: the Danish Technical Research Council and the Danish Energy Research Programme. We analysed the mechanisms of the strategy processes and studied the actors involved. The actors’ understanding of strategy was also included in the analysis. Based on these analyses we argue...... that the impact of foresight exercises can be improved if we have a better understanding of the traditions and new challenges faced by the research councils. We also argue that a more formal use of foresight elements might improve the legitimacy and impact of the strategic considerations of research councils...

  18. Small Satellites and the Nigerian National Space Programme

    Science.gov (United States)

    Borroffice, Robert; Chizea, Francis; Sun, Wei; Sweeting, Martin, , Sir

    2002-01-01

    Space technology and access to space have been elusive to most developing countries over the last half of the 21st century, which is attributed to very low par capital income and the lack of awareness of policy/decision makers about the role of space technology in national development. Space technology was seen as very expensive and prestigious, meant only for the major industrialized countries, while the developing countries should focus on building their national economy and providing food, shelter and other social amenities for their ever-growing populations. In the last decade, the trend has changed with many developing countries embracing spaced technology as one of the major ways of achieving sustainable development. The present trend towards the use of small satellites in meeting national needs has aided this transition because, apart from the small size, they are cheaper to build and to launch, with shorter development time, lower complexity, improved effectiveness and reduced operating costs. This in turn has made them more affordable and has opened up new avenues for the acquisition of satellite technology. The collaborative work between National Space Research and Development Agency of Nigeria (NASRDA) and Surrey Satellite and Technology Limited (SSTL) is a programme aimed at building two small satellites as a way of kick- starting the national space programme. The first project, NigeriaSAT-1, is an enhanced microsatellite carrying Earth observation payloads able to provide 32 metre GSD 3 band multispectral images with a 600km swath width. NigeriaSAT-1 is one of six microsatellites forming the Disaster Monitoring Constellation (DMC) alongside microsatellites contributed by Algeria, China, Turkey, Thailand and UK. Through participation in this international constellation, Nigeria will be able to receive images with a daily revisit worldwide. The EO images generated by NigeriaSAT-1 and the partner microsatellites will be used for providing rapid coverage

  19. A survey to assess audit mechanisms practised by skeletal reporting radiographers

    International Nuclear Information System (INIS)

    Jones, H.C.; Manning, D.

    2008-01-01

    Purpose: This study investigates the role of plain film reporting radiographers and the methods they employ to evaluate the quality of their performance. Method: The survey was conducted in 2003. Questionnaires were sent, via the universities, to radiographers who had registered on a post-graduate musculoskeletal image interpretation course at a University in England since their introduction (9 years earlier). Results: The response rate was 37% (n = 112). Sixty-four percent of the trained reporting radiographers surveyed are creating independent reports on musculoskeletal images and an additional 15% contribute to a double reporting system. Twenty-one percent of the reporting radiographers in this study are not undertaking audit of their practice. Of the 79% who are participating in audit programmes the variety of methods being used are widespread. In order to protect against litigation, 19% of reporting radiographers have a portfolio of evidence supporting their competency; 71% have a specific job description for their advanced role; 73% of reporting radiographers are members of a trade union; and 82% of reporting radiographers work to a departmental protocol. Conclusion: The majority of reporting radiographers are participating in some form of audit. However, it is imperative that the sizeable minority who are not should initiate this process promptly. It is important that national standards are set so that these audit processes become embedded into practice for the protection of both the patient and radiographer. The inconsistency shown with regard to audit processes and protection against litigation suggests that further clarification is required from the professional bodies

  20. A survey to assess audit mechanisms practised by skeletal reporting radiographers

    Energy Technology Data Exchange (ETDEWEB)

    Jones, H.C. [Directorate of Radiology, Royal Liverpool University Hospital Trust, Prescot Street, Liverpool L7 8XP (United Kingdom)], E-mail: helen.jones@rlbuht.nhs.uk; Manning, D. [School of Medical Imaging Sciences, St. Martin' s College, Lancaster LA1 3JD (United Kingdom)

    2008-08-15

    Purpose: This study investigates the role of plain film reporting radiographers and the methods they employ to evaluate the quality of their performance. Method: The survey was conducted in 2003. Questionnaires were sent, via the universities, to radiographers who had registered on a post-graduate musculoskeletal image interpretation course at a University in England since their introduction (9 years earlier). Results: The response rate was 37% (n = 112). Sixty-four percent of the trained reporting radiographers surveyed are creating independent reports on musculoskeletal images and an additional 15% contribute to a double reporting system. Twenty-one percent of the reporting radiographers in this study are not undertaking audit of their practice. Of the 79% who are participating in audit programmes the variety of methods being used are widespread. In order to protect against litigation, 19% of reporting radiographers have a portfolio of evidence supporting their competency; 71% have a specific job description for their advanced role; 73% of reporting radiographers are members of a trade union; and 82% of reporting radiographers work to a departmental protocol. Conclusion: The majority of reporting radiographers are participating in some form of audit. However, it is imperative that the sizeable minority who are not should initiate this process promptly. It is important that national standards are set so that these audit processes become embedded into practice for the protection of both the patient and radiographer. The inconsistency shown with regard to audit processes and protection against litigation suggests that further clarification is required from the professional bodies.

  1. Sustainability of recurrent expenditure on public social welfare programmes: expenditure analysis of the free maternal care programme of the Ghana National Health Insurance Scheme.

    Science.gov (United States)

    Ankrah Odame, Emmanuel; Akweongo, Patricia; Yankah, Ben; Asenso-Boadi, Francis; Agyepong, Irene

    2014-05-01

    Sustainability of public social welfare programmes has long been of concern in development circles. An important aspect of sustainability is the ability to sustain the recurrent financial costs of programmes. A free maternal care programme (FMCP) was launched under the Ghana National Health Insurance Scheme (NHIS) in 2008 with a start-up grant from the British Government. This article examines claims expenditure under the programme and the implications for the financial sustainability of the programme, and the lessons for donor and public financing of social welfare programmes. Records of reimbursement claims for services and medicines by women benefitting from the policy in participating facilities in one sub-metropolis in Ghana were analysed to gain an understanding of the expenditure on this programme at facility level. National level financial inflow and outflow (expenditure) data of the NHIS, related to implementation of this policy for 2008 and 2009, were reviewed to put the facility-based data in the national perspective. A total of US$936 450.94 was spent in 2009 by the scheme on FMCP in the sub-metropolis. The NHIS expenditure on the programme for the entire country in 2009 was US$49.25 million, exceeding the British grant of US$10.00 million given for that year. Subsequently, the programme has been entirely financed by the National Health Insurance Fund. The rapidly increasing, recurrent demands on this fund from the maternal delivery exemption programme-without a commensurate growth on the amounts generated annually-is an increasing threat to the sustainability of the fund. Provision of donor start-up funding for programmes with high recurrent expenditures, under the expectation that government will take over and sustain the programme, must be accompanied by clear long-term analysis and planning as to how government will sustain the programme.

  2. Embedding operational research into national disease control programme: lessons from 10 years of experience in Indonesia

    Directory of Open Access Journals (Sweden)

    Yodi Mahendradhata

    2014-10-01

    Full Text Available There is growing recognition that operational research (OR should be embedded into national disease control programmes. However, much of the current OR capacity building schemes are still predominantly driven by international agencies with limited integration into national disease control programmes. We demonstrated that it is possible to achieve a more sustainable capacity building effort across the country by establishing an OR group within the national tuberculosis (TB control programme in Indonesia. Key challenges identified include long-term financial support, limited number of scientific publications, and difficulties in documenting impact on programmatic performance. External evaluation has expressed concerns in regard to utilisation of OR in policy making. Efforts to address this concern have been introduced recently and led to indications of increased utilisation of research evidence in policy making by the national TB control programme. Embedding OR in national disease control programmes is key in establishing an evidence-based disease control programme.

  3. 45 CFR 1174.26 - Non-Federal audit.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1174.26 Section 1174.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE....26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits...

  4. 45 CFR 1183.26 - Non-Federal audit.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 3 2010-10-01 2010-10-01 false Non-Federal audit. 1183.26 Section 1183.26 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE....26 Non-Federal audit. (a) Basic rule. Grantees and subgrantees are responsible for obtaining audits...

  5. 45 CFR 1157.26 - Non-Federal audit.

    Science.gov (United States)

    2010-10-01

    ... 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...

  6. The French national programme of bovine hypodermosis eradication

    International Nuclear Information System (INIS)

    Amouroux, Isabelle

    2000-01-01

    The National Federation of Sanitary Defence Organisations (FNGDS) is a professional organisation which brings together more than 95% cattle breeders within its departmental structures (GDS). Working closely with breeders within their local structures, the GDS maintains a high level of efficiency in communicating and informing farmers about sanitary programmes as well as rally them to participate in these programmes. FNGDS has built a solid cooperation with the veterinary administration and private veterinarians in the fight against the most serious animal diseases. In the 1980s, new sanitary guidelines regarding export emphasised the necessity of fighting against the warble fly. As parasitic hypodermosis causes a major decrease in zootechnic performances, as well as is an important immuno depression, the GDS from different regions began the fight against it. Taking into account the fly biology, it was deemed necessary to establish a concerted fight in order to avoid recontamination in their regions as well as improve sanitary conditions. In 1989, FNGDS proposed and implemented a national scheme for the eradication of hypodermis in collaboration with other professional and industrial organisations, scientists, veterinarians and the Ministry of Agriculture. In 1994, a law against the warble fly was enacted. This law required every region to fight against the fly beginning 1 July 1998. Before this deadline, all regions were encouraged to begin regional plans on a voluntary basis, which, nevertheless, had to be approved by a national committee. Under the national scheme which was based on parasitic biology, each region had to build its own programme. It had to be in charge of the details of operation, e.g., regarding topography and the presence of Hypoderma lineatum. Cooperation between animal health partners was greatly encouraged

  7. Surgical audit in the developing countries.

    Science.gov (United States)

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

    2003-01-01

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

  8. Establishment of the Auditing National Service of quality to the instrumentation of Nuclear medicine in Cuba

    International Nuclear Information System (INIS)

    Varela C, C.; Diaz B, M.; Lopez B, G.M.; Torres A, L.A.; Coca P, M.A.

    2006-01-01

    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)

  9. Individual-level outcomes from a national clinical leadership development programme.

    Science.gov (United States)

    Patton, Declan; Fealy, Gerard; McNamara, Martin; Casey, Mary; Connor, Tom O; Doyle, Louise; Quinlan, Christina

    2013-08-01

    A national clinical leadership development programme was instituted for Irish nurses and midwives in 2010. Incorporating a development framework and leadership pathway and a range of bespoke interventions for leadership development, including workshops, action-learning sets, mentoring and coaching, the programme was introduced at seven pilot sites in the second half of 2011. The programme pilot was evaluated with reference to structure, process and outcomes elements, including individual-level programme outcomes. Evaluation data were generated through focus groups and group interviews, individual interviews and written submissions. The data provided evidence of nurses' and midwives' clinical leadership development through self and observer-reported behaviours and dispositions including accounts of how the programme participants developed and displayed particular clinical leadership competencies. A key strength of the new programme was that it involved interventions that focussed on specific leadership competencies to be developed within the practice context.

  10. 12 CFR 9.9 - Audit of fiduciary activities.

    Science.gov (United States)

    2010-01-01

    ... commensurate with the nature and risk of that activity. Thus, certain fiduciary activities may receive audits... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Audit of fiduciary activities. 9.9 Section 9.9... NATIONAL BANKS Regulations § 9.9 Audit of fiduciary activities. (a) Annual audit. At least once during each...

  11. Do Auditing and Reporting Standards Affect Firms’ Ethical Behaviours? The Moderating Role of National Culture

    NARCIS (Netherlands)

    Zengin Karaibrahimoglu, Yasemin; Guneri Cangarli, Burcu

    2016-01-01

    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

  12. Impact of antimicrobial stewardship programme on hospitalized patients at the intensive care unit: a prospective audit and feedback study.

    Science.gov (United States)

    Khdour, Maher R; Hallak, Hussein O; Aldeyab, Mamoon A; Nasif, Mowaffaq A; Khalili, Aliaa M; Dallashi, Ahamad A; Khofash, Mohammad B; Scott, Michael G

    2018-04-01

    Inappropriate use of antibiotics is one of the most important factors contributing to the emergence of drug resistant pathogens. The purpose of this study was to measure the clinical impact of antimicrobial stewardship programme (ASP) interventions on hospitalized patients at the Intensive care unit at Palestinian Medical Complex. A prospective audit with intervention and feedback by ASP team within 48-72 h of antibiotic administration began in September 2015. Four months of pre-ASP data were compared with 4 months of post-ASP data. Data collected included clinical and demographic data; use of antimicrobials measured by defined daily doses, duration of therapy, length of stay, readmission and all-cause mortality. Overall, 176 interventions were made the ASP team with an average acceptance rate of 78.4%. The most accepted interventions were dose optimization (87.0%) followed by de-escalation based on culture results with an acceptance rate of 84.4%. ASP interventions significantly reduces antimicrobial use by 24.3% (87.3 defined daily doses/100 beds vs. 66.1 defined daily doses/100 beds P < 0.001). The median (interquartile range) of length of stay was significantly reduced post ASP [11 (3-21) vs. 7 (4-19) days; P < 0.01]. Also, the median (interquartile range) of duration of therapy was significantly reduced post-ASP [8 (5-12) days vs. 5 (3-9); P = 0.01]. There was no significant difference in overall 30-day mortality or readmission between the pre-ASP and post-ASP groups (26.9% vs. 23.9%; P = 0.1) and (26.1% vs. 24.6%; P = 0.54) respectively. Our prospective audit and feedback programme was associated with positive impact on antimicrobial use, duration of therapy and length of stay. © 2017 The British Pharmacological Society.

  13. The United Kingdom's radiotherapy dosimetry audit network

    International Nuclear Information System (INIS)

    Thwaites, D.I.; Allahverdi, M.; Powley, S.K.; Nisbet, A.

    2003-01-01

    The first comprehensive national dosimetry intercomparison in the United Kingdom involving all UK radiotherapy centres was carried out in the late 1980s. Out of this a regular radiotherapy dosimetry audit network evolved in the early 1990s. The network is co-ordinated by the Institute of Physics and Engineering in Medicine and comprises eight co-operative regional groups. Audits are based on site visits using ionization chambers and epoxy resin water substitute phantoms. The basic audit methodology and phantom design follows that of the original national intercomparison exercise. However, most of the groups have evolved more complex methods, to extend the audit scope to include other parameters, other parts of the radiotherapy process and other treatment modalities. A number of the groups have developed phantoms to simulate various clinical treatment situations, enabling the sharing of phantoms and expertise between groups, but retaining a common base. Besides megavoltage external beam photon dosimetry, a number of the groups have also included the audit of kilovoltage X ray beams, electron beams and brachytherapy dosimetry. The National Physical Laboratory is involved in the network and carries out basic beam calibration audits to link the groups. The network is described and the methods and results are illustrated using the Scottish+ group as an example. (author)

  14. The continuous improvement of the Internal Audits Process assurance the effective compliance of ISO 17025:2005 requirements

    Directory of Open Access Journals (Sweden)

    Carina Di Candia

    2011-04-01

    Full Text Available Continuous Improvement Process started in LATU in 1996. The Impact was so important that covered all the organization. Nowadays LATU has almost all its processes certificated and most than 200 tests accredited. The Internal Audits process began in 1996 with an annual planning for all the laboratory's areas. For the UKAS accreditation in 1998, LATU improves the internal audits planning auditing not only the system but also the tests. In 1999 LATU was certified by SQS and accredited the calibrations by DKD. Since 2004 internal audits was managed as a process; in order to that was defined objectives, indicators, achievements and the necessary resources of the internal audit programme and process. The internal audit programme has a pre defined tri annual planning that includes all the laboratory areas. The results of the measures obtained till now demonstrate the improvement in the internal audit and all the laboratory processes. Auditors final staff increase their technical competence. As a consequence of managing the internal audits as a process, the internal communication has an important relevance to feedback the continuous improvement of the laboratory. This was evidence in a decrease of the documentaries non conformities, improvement of the calibrations and maintenance programme, optimization trainings and qualifications of the staff, common internal trainings, creation of a quality assurance team to improvement the tests control, improvement in the relationship with the support areas. Most of this requirements are included in ISO 17025:2005; that assurance the effective compliance of this standard.

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

    Science.gov (United States)

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

    2015-09-01

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

  16. 24 CFR 300.17 - Audits and reports.

    Science.gov (United States)

    2010-04-01

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

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

    Science.gov (United States)

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

    2017-03-01

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

  18. There are calls for a national screening programme for prostate cancer: what is the evidence to justify such a national screening programme?

    Science.gov (United States)

    Green, A; Tait, C; Aboumarzouk, O; Somani, B K; Cohen, N P

    2013-05-01

    Prostate cancer is the commonest cancer in men and a major health issue worldwide. Screening for early disease has been available for many years, but there is still no national screening programme established in the United Kingdom. To assess the latest evidence regarding prostate cancer screening and whether it meets the necessary requirements to be established as a national programme for all men. Electronic databases and library catalogues were searched electronically and manual retrieval was performed. Only primary research results were used for the analysis. In recent years, several important randomised controlled trials have produced varied outcomes. In Europe the largest study thus far concluded that screening reduced prostate cancer mortality by 20%. On the contrary, a large American trial found no reduction in mortality after 7-10 years follow-up. Most studies comment on the adverse effects of screening - principally those of overdiagnosis and subsequent overtreatment. Further information about the natural history of prostate cancer and accuracy of screening is needed before a screening programme can be truly justified. In the interim, doctors and patients should discuss the risks, benefits and sequelae of taking part in voluntary screening for prostate cancer.

  19. The national immunisation programme in the Netherlands: current status and potential future developments

    NARCIS (Netherlands)

    Abbink F; Al MJ; Berbers GAM; Binnendijk RS van; Boot HJ; Duynhoven YTHP van; Gageldonk-Lafeber AB van; Greeff SC de; Kimman TG; Meijer LA; Mooi FR; Oosten M van; Plas SM van der; Schouls LM; Soolingen D van; Vermeer-de Bondt PE; Vliet JA van; Melker HE de; Hahne SJM; Boer IM de; CIE

    2005-01-01

    The national immunisation programme in the Netherlands is very effective and safe. To improve the success and effectiveness of the immunisation programme, vaccination of other (age)groups is indicated. Extension of the programme with new target diseases can result in considerable health gain for

  20. Technical risk audit method (tram): development and application to the auditing of major hazard sites

    International Nuclear Information System (INIS)

    Maddison, T.; Kirk, P.; Stansfield, R.

    1998-01-01

    The Technical Risk Audit Method (TRAM) has been developed by the UK Health and Safety Executive (UK HSE) as a risk-based auditing and inspection tool for application to Major Hazard process plant covered by the Seveso-I/Seveso-II directives. The objective of TRAM is to provide a framework in which plant inspection or audit can be undertaken and results collated. TRAM comprises a paper audit procedure and a software tool which is used to analyse the results. TRAM includes a semi-quantitative risk model, which may be used to rank risks both within and between similar facilities, using qualitative data collected during the inspection. The results of this qualitative analysis may be used to identify where inspector resources would be best deployed. To date, TRAM has been applied to a number of LPG storage and processing facilities in the UK, and the lessons learnt are being used to develop a robust version suitable for use by inspectors. The methodology will be made consistent with the risk model included in IEC 61508 'Functional safety of electrical/electronic/programmable electronic safety-related systems' to permit its application to a wide range of process plant and other hazardous facilities. (authors)

  1. The role of national consultant services industries to support the first nuclear power plant programme in Indonesia

    International Nuclear Information System (INIS)

    Dharu Dewi; Sahala Lumbanraja; Sriyana

    2007-01-01

    Study has been done which concerning the role of Indonesian National Consultant Services Industries to support the First Nuclear Power Plant (NPP) Programme in Indonesia. NPP programme activities will be success if the studies should be started with good planning. To obtain the optimal results, the opportunity and the role of national consultants should be considered to the localization of NPP Programme to be bigger. Utilizing of national consultants services can be expected to become second opinion which is to play important role in socialization of NPP Programme. The Government and NPP Project Owner's candidate should analysis, plan and implement the Nuclear Power Plant Programme activities, started from identification of the available national consultants, considering the national consults procurement process, definition of scope of works of national consultants activities, carry out the selection of national consultants, evaluation, monitoring and supervision so that the utilizing of national consultants will give benefit more effective, efficient, economic appropriate objectives and good quality. This study to assess the structure and type of national consultants, works package which can be done by national consultants, selection methods of national consultants, constraints of national consultants and enhancing of the role of national consultants to involve and support in the nuclear power plant programme in Indonesia. The research methods are literature study, consultation with resource person and exploring of website/internet. (author)

  2. Dosimetry audits and intercomparisons in radiotherapy: A Malaysian profile

    International Nuclear Information System (INIS)

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

    2017-01-01

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

  3. Computer Assisted Audit Techniques

    Directory of Open Access Journals (Sweden)

    Eugenia Iancu

    2007-01-01

    Full Text Available From the modern point of view, audit takes intoaccount especially the information systems representingmainly the examination performed by a professional asregards the manner for developing an activity by means ofcomparing it to the quality criteria specific to this activity.Having as reference point this very general definition ofauditing, it must be emphasized that the best known segmentof auditing is the financial audit that had a parallel evolutionto the accountancy one.The present day phase of developing the financial audithas as main trait the internationalization of the accountantprofessional. World wide there are multinational companiesthat offer services in the financial auditing, taxing andconsultancy domain. The auditors, natural persons and auditcompanies, take part at the works of the national andinternational authorities for setting out norms in theaccountancy and auditing domain.The computer assisted audit techniques can be classified inseveral manners according to the approaches used by theauditor. The most well-known techniques are comprised inthe following categories: testing data techniques, integratedtest, parallel simulation, revising the program logics,programs developed upon request, generalized auditsoftware, utility programs and expert systems.

  4. Building energy efficiency labeling programme in Singapore

    International Nuclear Information System (INIS)

    Lee, Siew Eang; Rajagopalan, Priyadarsini

    2008-01-01

    The use of electricity in buildings constitutes around 16% of Singapore's energy demand. In view of the fact that Singapore is an urban city with no rural base, which depends heavily on air-conditioning to cool its buildings all year round, the survival as a nation depends on its ability to excel economically. To incorporate energy efficiency measures is one of the key missions to ensure that the economy is sustainable. The recently launched building energy efficiency labelling programme is such an initiative. Buildings whose energy performance are among the nation's top 25% and maintain a healthy and productive indoor environment as well as uphold a minimum performance for different systems can qualify to attain the Energy Smart Office Label. Detailed methodologies of the labelling process as well as the performance standards are elaborated. The main strengths of this system namely a rigorous benchmarking database and an independent audit conducted by a private accredited Energy Service Company (ESCO) are highlighted. A few buildings were awarded the Energy Smart Office Label during the launching of the programme conducted in December 2005. The labeling of other types of buildings like hotels, schools, hospitals, etc. is ongoing

  5. The use of enhanced recovery after surgery (ERAS) principles in Scottish orthopaedic units--an implementation and follow-up at 1 year, 2010-2011: a report from the Musculoskeletal Audit, Scotland.

    Science.gov (United States)

    Scott, Nicholas B; McDonald, David; Campbell, Jane; Smith, Richard D; Carey, A Kate; Johnston, Ian G; James, Kate R; Breusch, Steffen J

    2013-01-01

    To establish whether a nationally guided programme can lead to more widespread implementation of enhanced recovery after surgery (ERAS), a well-established optimised care pathway for lower limb arthroplasty. In 2010, National Services Scotland's Musculoskeletal Audit was asked to perform a 'snapshot' audit of the current peri-operative management of patients undergoing total hip and knee arthroplasty in all 22 Scottish orthopaedic units with an identical follow-up audit in 2011 after input and support from the national steering group. Audit 1 and audit 2 involved 1,345 and 1,278 patients, respectively. The number of Scottish units that developed an ERAS programme increased from 8 (36 %) to 15 (68 %). Units that included more ERAS patients had earlier mobilisation rates (146/474, 36 % ERAS patients mobilised same day vs. 34/873, 4 % non-ERAS; n = 22 units, r = 0.55, p = 0.008) and shorter post-operative length of stay (median 4 days vs. ERAS, 5 days non-ERAS, n = 22 units, r = -0.64, p = 0.001). ERAS knee arthroplasty patients had lower blood transfusion rates (5/205, 2 % vs. 51/399, 13 %, n = 22 units, r = -0.62, p = 0.002). Units that restricted the use of IV fluids post-operatively had higher early mobilisation rates (n = 22 units, r = 0.48, p = 0.03) and shorter post-operative length of stay (n = 22 units, r = -0.56, p = 0.007). Reduced use of patient-controlled analgesia was also associated with earlier mobilisation (n = 22 units, r = 0.49, p = 0.02) and shorter length of stay (n = 22 units, r = -0.39, p = 0.07). Urinary catheterisation rates also dropped from 468/1,345 (35 %) in 2010 to 337/1,278 (26 %) in 2011 (n = 22 units, z = 2.19, p = 0.03). A clinically guided and nationally supported process has proven highly successful in achieving a further uptake of enhanced recovery principles after lower limb arthroplasty in Scotland, which has resulted in clinical benefits to patients and reduced length of hospital stay.

  6. Current practice of antiplatelet and anticoagulation management in post-cardiac surgery patients: a national audit.

    Science.gov (United States)

    Hosmane, Sharath; Birla, Rashmi; Marchbank, Adrian

    2012-04-01

    The Audit and Guidelines Committee of the European Association for Cardio-Thoracic Surgery recently published a guideline on antiplatelet and anticoagulation management in cardiac surgery. We aimed to assess the awareness of the current guideline and adherence to it in the National Health Service through this National Audit. We designed a questionnaire consisting of nine questions covering various aspects of antiplatelet and anticoagulation management in post-cardiac surgery patients. A telephonic survey of the on-call cardiothoracic registrars in all the cardiothoracic centres across the UK was performed. All 37 National Health Service hospitals in the UK with 242 consultants providing adult cardiac surgical service were contacted. Twenty (54%) hospitals had a unit protocol for antiplatelet and anticoagulation management in post-cardiac surgery. Only 23 (62.2%) registrars were aware of current European Association for Cardio-Thoracic Surgery guidelines. Antiplatelet therapy is variable in the cardiac surgical units across the country. Low-dose aspirin is commonly used despite the recommendation of 150-300 mg. The loading dose of aspirin within 24 h as recommended by the guideline is followed only by 60.7% of surgeons. There was not much deviation from the guideline with respect to the anticoagulation therapy.

  7. Bioenergy in the national forestry programme

    International Nuclear Information System (INIS)

    Heikurainen, M.

    1998-01-01

    The objective of the national forestry programme is to develop the treatment, utilization and protection of forests in order to increase the employment level in the forestry sector as well as enhance the utilization of the forests for recreation purposes. Increment of the utilization of wood energy is one of the means for meeting the objective of the programme. In addition to the silvicultural reasons, one of the main reasons for increasing of the utilization of energy wood is the possibilities of energywood-related small and medium-sized entrepreneurship to employ people. The emission reduction requirements of the Kyoto summit offer also a reason for the increment of the utilization of wood energy, because the carbon dioxide emissions of biofuels are not included in the emission share of the country. The techno-economically viable unutilized wood energy potential of clearcuts has been estimated to 3.7 million m 3 and that of the integrated harvesting of first thinnings 2.3 million m 3 . On the basis of these figures the latest objective of the programme has been set to increase the energy wood harvesting and utilization to 5.0 million m 3 /a up to the year 2010. The main means listed in the programme are: Development of integrated harvesting methods, by which it is possible to produce energy wood economically (price less than 45 FIM/MWh) as a byproduct of commercial timber; The environmental support paid to the forest chips purchasers; Bioenergy capacity developed in the forest industry; Social support for product development and entrepreneurhip in the field of bioenergy; Reduction of the value added taxes of the end users of split firewood and wood briquettes

  8. Clinical audit in the final year of undergraduate medical education: towards better care of future generations.

    Science.gov (United States)

    Mak, Donna B; Miflin, Barbara

    2012-01-01

    In Australia, in an environment undergoing rapidly changing requirements for health services, there is an urgent need for future practitioners to be knowledgeable, skilful and self-motivated in ensuring the quality and safety of their practice. Postgraduate medical education and vocational programs have responded by incorporating training in quality improvement into continuing professional development requirements, but undergraduate medical education has been slower to respond. This article describes the clinical audit programme undertaken by all students in the final year of the medical course at the University of Notre Dame, Fremantle, Australia, and examines the educational worth of this approach. Data were obtained from curricular documents, including the clinical audit handbook, and from evaluation questionnaires administered to students and supervisors. The clinical audit programme is based on sound educational principles, including situated and participatory learning and reflective practice. It has demonstrated multi-dimensional benefits for students in terms of learning the complexities of conducting an effective audit in professional practice, and for health services in terms of facilitating quality improvement. Although this programme was developed in a medical course, the concept is readily transferable to a variety of other health professional curricula in which students undertake clinical placements.

  9. Clinical audits: who does control what? European guide lines;Audits cliniques: qui controle quoi? Lignes directrices europeennes

    Energy Technology Data Exchange (ETDEWEB)

    Jarvinen, H. [Ingenieur es Sciences, Expert en chef pour l' Utilisation des Rayonnements Ionisants A des fins medicales, Autorite de Surete Nucleaire et de Radioprotection (STUK), Helsinki (Finland)

    2009-12-15

    The E.C. directive 97/43/EURATOM (M.E.D.-directive) introduced the concept of Clinical Audit for the assessment of medical radiological practices (diagnostic radiology, nuclear medicine and radiotherapy). The European Commission started in June 2007 a special project to review in detail the status of implementation of Clinical audits in Member States and to prepare European Guidance on Clinical Audits for diagnostic radiology, nuclear medicine and radiotherapy. The purpose of this E.C. project is to provide clear and comprehensive information and guidance on the procedures and criteria for clinical audits in all radiological practices, in order to improve the implementation of Article 6.4 of the M.E.D.-directive. The guidance should be flexible and enable the member States to adopt the model of clinical audit with respect to their national legislation and administrative provisions. By definition, clinical audit is a systematic examination or review of medical radiological procedures. It seeks to improve the quality and the outcome of patient care through structured review whereby radiological practices, procedures and results are examined against agreed standards for good medical radiological procedures. Modifications of the practices are implemented where indicated and new standards applied if necessary. The general objectives of clinical audit should be: to improve the quality of patient care, to promote the effective use of resources, to enhance the provision and organization of clinical services, to further professional education and training. Clinical audits must be at the same time internal (set by the management of the department) and external (set by external auditors at the department). It must not be confused with other evaluation activities such inspections, accreditation or quality system certifications. Clinical audits should address structure, process and outcome such the unit mission, quality assurance, dosimetry and treatments follow-up. The recent

  10. National Radiobiology Archives distributed access programmer's guide

    International Nuclear Information System (INIS)

    Prather, J.C.; Smith, S.K.; Watson, C.R.

    1991-12-01

    The National Radiobiology Archives is a comprehensive effort to gather, organize, and catalog original data, representative specimens, and supporting materials related to significant radiobiology studies. This provides researchers with information for analyses which compare or combine results of these and other studies and with materials for analysis by advanced molecular biology techniques. This Programmer's Guide document describes the database access software, NRADEMO, and the subset loading script NRADEMO/MAINT/MAINTAIN, which comprise the National Laboratory Archives Distributed Access Package. The guide is intended for use by an experienced database management specialist. It contains information about the physical and logical organization of the software and data files. It also contains printouts of all the scripts and associated batch processing files. It is part of a suite of documents published by the National Radiobiology Archives

  11. Expanding Global Language Education in Public Primary Schools: The National English Programme in Mexico

    Science.gov (United States)

    Sayer, Peter

    2015-01-01

    The paper examines the recent national programme of English language instruction in the Mexican public primary schools, called the "Programa Nacional de Inglés en Educación Básica" (PNIEB). The programme, initiated in 2009 by the Ministry of Education as part of the national curriculum, represents the largest expansion of English…

  12. Brand new eyes: Thematic audits as a QA-tool for learning

    DEFF Research Database (Denmark)

    Silleborg, Ellen; Bendixen, Carsten; Jacobsen, Jens Christian

    2014-01-01

    What set of eyes do you put forward when you array a thematic audit trail – e.g. the eyes of a judge, a listener or a negotiator? A preliminary answer to this could be: “What we learn from an audit depends on our methodology”. Yes – so let’s work with it! The workshop is dedicated to questions li...... to programme theory. Afterwards we invite you to share your experiences and points of views about audits. The goal is to strengthen our use of audits as a tool for learning and QA in higher education.......What set of eyes do you put forward when you array a thematic audit trail – e.g. the eyes of a judge, a listener or a negotiator? A preliminary answer to this could be: “What we learn from an audit depends on our methodology”. Yes – so let’s work with it! The workshop is dedicated to questions like...

  13. ENT audit and research in the era of trainee collaboratives.

    Science.gov (United States)

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

    2018-05-26

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

  14. TTVP Audit Database

    Data.gov (United States)

    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....

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

    Science.gov (United States)

    Levola, Jonna; Aalto, Mauri

    2015-07-01

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

  16. Vendor audits: A cooperative program

    International Nuclear Information System (INIS)

    White, S.C.

    1989-01-01

    The litany of recent problems with substandard, fraudulent, or counterfeit materials has led to much scrutiny regarding the adequacy and effectiveness of licensee-performed vendor audits. To address these problems in the audit process, most licensees have dedicated significant additional technical and qualitative resources. In response to the limited availability of sufficient resources and expertise to perform more comprehensive and effective vendor audits, many licensees have recognize the advantages of cooperative programs to perform joint audits with other licensees on a regional basis. The Nuclear Procurement Issues Council (NUPIC) provides such a program on a national level, which has proven to be of significant benefit not only to licensees but also to vendors of nuclear safety-related items and services

  17. Developing a national programme of flood risk management measures: Moldova

    Directory of Open Access Journals (Sweden)

    Ramsbottom David

    2016-01-01

    Full Text Available A Technical Assistance project funded by the European Investment Bank has been undertaken to develop a programme of flood risk management measures for Moldova that will address the main shortcomings in the present flood management system, and provide the basis for long-term improvement. Areas of significant flood risk were identified using national hydraulic and flood risk modelling, and flood hazard and flood risk maps were then prepared for these high risk areas. The flood risk was calculated using 12 indicators representing social, economic and environmental impacts of flooding. Indicator values were combined to provide overall estimates of flood risk. Strategic approaches to flood risk management were identified for each river basin using a multi-criteria analysis. Measures were then identified to achieve the strategic approaches. A programme of measures covering a 20-year period was developed together with a more detailed Short-Term Investment Plan covering the first seven years of the programme. Arrangements are now being made to implement the programme. The technical achievements of the project included national hydrological and hydraulic modelling covering 12,000 km of river, the development of 2-dimensional channel and floodplain hydraulic models from a range of topographic and bathymetric data, and an integrated flood risk assessment that takes account of both economic and non-monetary impacts.

  18. Clinical Audit for Referral Guidelines: A Problem Solving Tool

    International Nuclear Information System (INIS)

    Remedios, D.

    2011-01-01

    In the United Kingdom, the Health Act of 1999 places the responsibility of monitoring and improving the quality of health care with hospital and primary care trusts. All National Health Service employees must perform audits, and in some cases pay progression is limited if there is no evidence that a clinical audit has been carried out. An audit cycle or spiral facilitates a continuing system for quality improvement. About 40 local internal clinical audits are contained in the Royal College of Radiologists' AuditLive, which encourages participation in clinical audits. (author)

  19. United Nations programme for the assistance in Uruguay mining exploration

    International Nuclear Information System (INIS)

    1976-01-01

    The Uruguay government asked for the United Nations for the development of technical assistance programme in geological considerations of the Valentines iron deposits. This agreement was signed as Mining prospect ion assistance in Uruguay.

  20. When Are Circular Lesions Square? A National Clinical Education Skin Lesion Audit and Study

    Directory of Open Access Journals (Sweden)

    Benjamin H Miranda

    2014-09-01

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

  1. Governmental point of view on the Dutch National Cooperative Programme for Air Quality

    International Nuclear Information System (INIS)

    2008-06-01

    Dutch air quality does not yet meet the European standards throughout the Netherlands. The Dutch National Cooperative Programme for Air Quality (NSL) is expected to realize improvements. This publication explains the Dutch plans for meeting the European standards for air quality in the coming years. It addresses the following subjects: the Dutch National Cooperative Programme for Air Quality (NSL); legal framework; historical development; current situation and autonomous development for PM10 and NO2; spatial projects; measure packages and financial means. [mk] [nl

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

    Science.gov (United States)

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

    2017-06-01

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

  3. 77 FR 24538 - Sunshine Act; Audit Committee Meeting of the Board of Directors

    Science.gov (United States)

    2012-04-24

    .... Internal Audit Report with Management's Response VI. Amendment to the FY 2012 Internal Audit Plan VII. FY.... Internal Audit Status Reports X. External Audit Updates XI. National Foreclosure Mitigation Counseling... NEIGHBORHOOD REINVESTMENT CORPORATION Sunshine Act; Audit Committee Meeting of the Board of...

  4. Dosimetry audits and intercomparisons in radiotherapy: A Malaysian profile

    Science.gov (United States)

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

    2017-11-01

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

  5. Clinical audit: Development of the criteria of good practices

    International Nuclear Information System (INIS)

    Soimakallio, S.; Alanen, A.; Jaervinen, H.; Ahonen, A.; Ceder, K.; Lyyra-Laitinen, T.; Paunio, M.; Sinervo, T.; Wigren, T.

    2011-01-01

    Clinical audit is a systematic review of the procedures in order to improve the quality and the outcome of patient care, whereby the procedures are examined against agreed standards for good medical Radiological procedures. The criteria of good procedures (i.e. the good practice) are thus the cornerstones for development of clinical audits: these should be the basis of assessments regardless of the type of the audit-external, internal, comprehensive or partial. A lot of criteria for good practices are available through the recommendations and publications by international and national professional societies and other relevant organisations. For practical use in clinical audits, the criteria need to be compiled, sorted out and agreed on for the particular aims of an audit (comprehensive or partial, external or internal). The national professional and scientific societies can provide valuable contribution to this development. For examination-or treatment-specific criteria- preliminary consensus needs to be obtained with the help of clinical experts, while clinical audits can be useful as a benchmarking tool to improve the criteria. (authors)

  6. Great Expectations: Teacher Learning in a National Professional Development Programme

    Science.gov (United States)

    Armour, Kathleen M.; Makopoulou, Kyriaki

    2012-01-01

    This paper reports findings from an evaluation of a national continuing professional development (CPD) programme for teachers in England. Data showed that the localised implementation, opportunities for interactive learning, and "collective participation" were positive factors. Research participants reported difficulties, however, in…

  7. 45 CFR 602.26 - Non-Federal audit.

    Science.gov (United States)

    2010-10-01

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

  8. STATUTORY AUDIT AND PERFORMANCE AUDIT

    Directory of Open Access Journals (Sweden)

    Suciu Gheorghe

    2012-06-01

    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.

  9. United Nations Environment Programme. Annual Report of the Executive Director, 1985.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    This report to the Governing Council of the United Nations Environment Programme (UNEP) was prepared to provide the governments of member nations with information on what UNEP had done during 1985, and to serve as a communications mechanism to replace the usual meeting of the Governing Council in 1986. It contains chapters on: (1) the year in…

  10. The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

    Science.gov (United States)

    Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

    2016-09-22

    A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring

  11. Scoping the impact of the national child measurement programme feedback on the child obesity pathway: study protocol

    Directory of Open Access Journals (Sweden)

    Falconer Catherine

    2012-09-01

    Full Text Available Abstract Background The National Child Measurement Programme was established to measure the height and weight of children at primary school in England and provides parents with feedback about their child’s weight status. In this study we will evaluate the impact of the National Child Measurement Programme feedback on parental risk perceptions of overweight, lifestyle behaviour and health service use. Methods The study will be a prospective cohort study of parents of children enrolled in the National Child Measurement Programme and key service providers from 5 primary care trusts (administrative bodies responsible for providing primary and secondary care services. We will conduct baseline questionnaires, followed by provision of weight feedback and 3 follow up questionnaires over the course of a year. Questionnaires will measure change in parental risk perception of overweight, health behaviours and health service use. Qualitative interviews will be used to identify barriers and facilitators to change. This study will produce preliminary data on National Health Service costs associated with weight feedback and determine which feedback approach (letter and letter plus telephone is more effective. Discussion This study will provide the first large scale evaluation of the National Child Measurement Programme feedback. Findings from this evaluation will inform future planning of the National Child Measurement Programme.

  12. The National Singing Programme for Primary Schools in England: An Initial Baseline Study

    Science.gov (United States)

    Welch, G. F.; Himonides, E.; Papageorgi, I.; Saunders, J.; Rinta, T.; Stewart, C.; Preti, C.; Lani, J.; Vraka, M.; Hill, J.

    2009-01-01

    The "Sing Up" National Singing Programme for primary schools in England was launched in November 2007 under the UK government's "Music Manifesto". "Sing Up" is a four-year programme whose overall aim is to raise the status of singing and increase opportunities for children throughout the country to enjoy singing as…

  13. Audits of oncology units – an effective and pragmatic approach

    Directory of Open Access Journals (Sweden)

    Raymond Pierre Abratt

    2017-06-01

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

  14. The UK's National Programme for IT: Why was it dismantled?

    Science.gov (United States)

    Justinia, Taghreed

    2017-02-01

    This paper discusses the UK's National Programme for IT (NPfIT), which was an ambitious programme launched in 2002 with an initial budget of some £6.2 billion. It attempted to implement a top-down digitization of healthcare in England's National Health Service (NHS). The core aim of the NPfIT was to bring the NHS' use of information technology into the 21st century, through the introduction of an integrated electronic patient record systems, and reforming the way that the NHS uses information, and hence to improve services and the quality of patient care. The initiative was not trusted by doctors and appeared to have no impact on patient safety. The project was marred by resistance due to the inappropriateness of a centralized authority making top-down decisions on behalf of local organizations. The NPfIT was officially dismantled in September 2011. Deemed the world's largest civil IT programme, its failure and ultimate demise sparked a lot of interest as to the reasons why. This paper summarises the underlying causes that lead to dismantling the NPfIT. At the forefront of those circumstances were the lack of adequate end user engagement, the absence of a phased change management approach, and underestimating the scale of the project.

  15. IAEA/WHO TLD postal dose audit service and high precision measurements for radiotherapy level dosimetry

    International Nuclear Information System (INIS)

    Izewska, J.; Bera, P.; Vatnitsky, S.

    2002-01-01

    Since 1969 the International Atomic Energy Agency, together with the World Health Organization, has performed postal TLD audits to verify calibration of radiotherapy beams in developing countries. The TLD programme also monitors activities of Secondary Standard Dosimetry Laboratories (SSDLs). The programme has checked approximately 4000 clinical beams in over 1100 hospitals, and in many instances significant errors have been detected in the beam calibration. Subsequent follow-up actions help to resolve the discrepancies, thus preventing further mistreatment of patients. The audits for SSDLs check the implementation of the dosimetry protocol in order to assure proper dissemination of dosimetry standards to the end-users. The TLD audit results for SSDLs show good consistency in the basic dosimetry worldwide. New TLD procedures and equipment have recently been introduced by the IAEA that include a modified TLD calibration methodology and computerised tools for automation of dose calculation from TLD readings. (author)

  16. Health and Safety Audit Design Manual

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2017-10-01

    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.

  17. Environmental Audit of the Alaska Power Administration

    International Nuclear Information System (INIS)

    1992-10-01

    This report documents the results of the Comprehensive Baseline Environmental Audit of the Alaska Power Administration (APA) headquartered in Juneau, Alaska. This Audit was conducted by the US Department of Energy's (DOE's) Office of Environmental Audit (EH-24) from August 24 to December 8, 1992. The scope of the Audit was comprehensive, covering all environmental programs and activities with the exception of those relating to the National Environmental Policy Act (NEPA). Specifically considered was the compliance status of APA regarding Federal, state, and local statutes and regulations, DOE Orders and Directives, and best management practices. The technical disciplines addressed by the Audit were: air, surface water/drinking water, groundwater, waste management, toxic and chemical materials, quality assurance, inactive waste sites, and environmental management. Due to the nature of the activities carried out at the two Federal hydroelectric projects operated by APA, the area of radiation was not investigated during the Audit

  18. Implementing and sustaining a hand hygiene culture change programme at Auckland District Health Board.

    Science.gov (United States)

    Roberts, Sally A; Sieczkowski, Christine; Campbell, Taima; Balla, Greg; Keenan, Andrew

    2012-05-11

    In January 2009 Auckland District Health Board commenced implementation of the Hand Hygiene New Zealand (HHNZ) programme to bring about a culture change and to improve hand hygiene compliance by healthcare workers. We describe the implementation process and assess the effectiveness of this programme 36 months after implementation. In keeping with the HHNZ guideline the implementation was divided into five steps: roll-out and facility preparation, baseline evaluation, implementation, follow-up evaluation and sustainability. The process measure was improvement in hand hygiene compliance and the outcome measure was Staphylococcus aureus clinical infection and bacteraemia rates. The mean (95% CI; range) baseline compliance rates for the national reporting wards was 35% (95% CI 24-46%, 25-61%). The overall compliance by the 7th audit period was 60% (95% CI 46-74; range 47-91). All healthcare worker groups had improvement in compliance. The reduction in healthcare-associated S. aureus bacteraemia rates following the implementation was statistically significant (p=0.027). Compliance with hand hygiene improved following implementation of a culture change programme. Sustaining this improvement requires commitment and strong leadership at a senior level both nationally and within each District Health Board.

  19. National energy programmes and plans of the USA

    International Nuclear Information System (INIS)

    Fri, R.W.

    1977-01-01

    Following President Carter's direction, the United States of America has developed a major new national energy policy which places greater emphasis on energy conservation as well as the intensified use of alternate technologies to reduce US dependence on petroleum and natural gas. The President's programme includes a multi-pronged coal conversion effort, the goal of installing two-and-a-half million US solar-equipped homes by 1985, and continued US execution of a wide-ranging programme of research and development. Nuclear power also continues to figure prominently in the US energy programme, with significant reliance being placed on the light water reactor which has proven its safety and value through years of reliable experience. The US Government is taking major steps to facilitate further the wide-scale domestic use of light water reactors by seeking major simplifications in the domestic licensing process; by expanding US enrichment capacity; by conducting a major effort to exploit its resources of natural uranium feed and by moving decisively to resolve effectively the problem of waste disposal by targeting to install a prototypical long-term waste repository by 1985. The USA, however, recognizes that uranium reserves ultimately may run out and to this end it is launching a comprehensive assessment of the type of second-generation facilities that it should construct, giving higher priority than ever before to the investigation of alternate systems that may be more attractive from a non-proliferation standpoint. (This includes an examination of the feasibility of options that might serve to reduce or avoid access to weapons-usable materials.) The USA is approaching this evaluation without preconceptions and believes its review can occur on a timely basis without adversely impacting on continued timely use of light water systems. The USA, however, recognizes that, depending on their energy circumstances, various nations have differing views as to how best to

  20. 42 CFR 137.171 - Where do Self-Governance Tribes send their audit reports?

    Science.gov (United States)

    2010-10-01

    ... Provisions Audits and Cost Principles § 137.171 Where do Self-Governance Tribes send their audit reports? (a) For fiscal years ending on or before June 30, 1996, the audit report must be sent to: National... years, beginning after June 30, 1996, the audit report must be sent to: Single Audit Clearinghouse, 1201...

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

    Science.gov (United States)

    Currie, Colin T; Hutchison, James D

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

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

    Science.gov (United States)

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

    2016-01-01

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

  3. Status of national programmes on fast breeder reactors

    International Nuclear Information System (INIS)

    1989-07-01

    The twenty-second Annual Meeting of the International Working Group on Fast Reactors took place in Vienna, 18-21 April 1989. Nineteen representatives from twelve Member States and International Organizations attended the Meeting. This publication is a collection of presentations in which the participants reported the status of their national programmes on fast breeder reactors. A separate abstract was prepared for each of the twelve papers from this collections. Refs, figs, tabs and 1 graph

  4. INFOMAR - Ireland's National Seabed Mapping Programme: A Tool For Marine Spatial Planning

    Science.gov (United States)

    Furey, T. M.

    2016-02-01

    INFOMAR is Ireland's national seabed mapping programme and is a key action in the national integrated marine plan, Harnessing Our Ocean Wealth. It comprises a multi-platform approach to delivering marine integrated mapping in 2 phases, over a projected 20 year timeline (2006-2026). The programme has three work strands; Data Acquisition, Data Exchange and Integration, and Value Added Exploitation. The Data Acquisition strand includes collection of hydrographic, oceanographic, geological, habitat and heritage datasets that will underpin future sustainable development and management of Ireland's marine resource. INFOMAR outputs are delivered through the Data Exchange and Integration strand. Uses of these outputs are wide ranging and multipurpose, from management plans for fisheries, aquaculture and coastal protection works, to environmental impact assessments, ocean renewable development and integrated coastal zone management. In order to address the evolution and diversification of maritime user requirements, the programme has realigned and developed outputs and new products, in part, through an innovative research funding initiative. Development is also fostered through the Value Added Exploitation strand. INFOMAR outputs and products serve to underpin delivery of Ireland's statutory obligations and enhance compliance with EU and national legislation. This is achieved through co-operation with the agencies responsible for supporting Ireland's international obligations and for the implementation of marine spatial planning. A strategic national seabed mapping programme such as INFOMAR, provides a critical baseline dataset which underpins development of the marine economy, and improves our understanding of the response of marine systems to pressures, and the effect of cumulative impacts. This paper will focus on the evolution and scope of INFOMAR, and look at examples of outputs being harnessed to serve approaches to the management of activities having an impact on the

  5. Report on the Observance of Standards and Codes, Accounting and Auditing : Module B - Institutional Framework for Corporate Financial Reporting, B.9 Auditing Standard-setting

    OpenAIRE

    World Bank

    2017-01-01

    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....

  6. Adaptation of the QUANUM platform for internal audits in Nuclear Medicine in Brazil

    International Nuclear Information System (INIS)

    Paula, V.M.; Andrade, E.R. de; Sá, L.V. de

    2017-01-01

    Audit is an ongoing review of all processes involving a particular service to ensure that each process is developed systematically and in accordance with specific regulations. The IAEA developed an internal audit process named QUANUM - Quality Management Audits in Nuclear Medicine and available in their website. This tool offers support to management quality audits, assisting teams in the evaluation of quality management system. QUANUM tool was developed based on the European Community guidelines and international recommendations. In order to be better applied in a country, national regulations should be followed not to generate non-conformities. Based on the current legal framework a review was performed under light of the normative items from national regulators which should be in compliance with the international recommendations. Also, national requirements not addressed by international recommendations were considered. Therefore, a single model was designed to meet both requirements, national and international standards and regulations. An Internal Audit model was elaborated helping to quantify risk levels concerned to the process as a whole demonstrating that national regulations meet 0,63 % of the international QUANUM requirements This tool systematizes and improves the quality management policy and, at last, be able to attend the Regulatory Audit, minimizing non-conformities. (author)

  7. Adaptation of the QUANUM platform for internal audits in Nuclear Medicine in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Paula, V.M.; Andrade, E.R. de, E-mail: vitor_moura06@hotmail.com [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil); Sá, L.V. de, E-mail: lidia@ird.gov.br, E-mail: fisica.dna@gmail.com [Instituto de Radioproteção e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2017-07-01

    Audit is an ongoing review of all processes involving a particular service to ensure that each process is developed systematically and in accordance with specific regulations. The IAEA developed an internal audit process named QUANUM - Quality Management Audits in Nuclear Medicine and available in their website. This tool offers support to management quality audits, assisting teams in the evaluation of quality management system. QUANUM tool was developed based on the European Community guidelines and international recommendations. In order to be better applied in a country, national regulations should be followed not to generate non-conformities. Based on the current legal framework a review was performed under light of the normative items from national regulators which should be in compliance with the international recommendations. Also, national requirements not addressed by international recommendations were considered. Therefore, a single model was designed to meet both requirements, national and international standards and regulations. An Internal Audit model was elaborated helping to quantify risk levels concerned to the process as a whole demonstrating that national regulations meet 0,63 % of the international QUANUM requirements This tool systematizes and improves the quality management policy and, at last, be able to attend the Regulatory Audit, minimizing non-conformities. (author)

  8. The impact of the Hand Hygiene New Zealand programme on hand hygiene practices in New Zealand's public hospitals.

    Science.gov (United States)

    Freeman, Joshua; Dawson, Louise; Jowitt, Deborah; White, Margo; Callard, Hayley; Sieczkowski, Christine; Kuriyan, Ron; Roberts, Sally

    2016-10-14

    To detail the progress made by Hand Hygiene New Zealand (HHNZ) since 2011 and also describe the challenges experienced along the way and the factors required for delivery of a successful hand hygiene programme at a national level. HHNZ is a multimodal culture-change programme based on the WHO '5 moments for hand hygiene' approach. The key components of the programme include clinical leadership, auditing of hand hygiene compliance with thrice yearly reporting of improvement in hand hygiene practice, biannual reporting of the outcome marker, healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB), effective communication with key stakeholders and the use of the front-line ownership (FLO) principles for quality improvement. The nationally aggregated hand hygiene compliance has increased from 62% in June 2012 to 81% in March 2016. There has been improvement across all 'moments', all healthcare worker groups and a range of different clinical specialties. The rate of HA-SAB has remained stable. The HHNZ programme has led to significant improvements in hand hygiene practice in DHBs throughout New Zealand. The principles of FLO are now widely used to drive hand hygiene improvement in New Zealand DHBs.

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

    Science.gov (United States)

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

    2017-09-13

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

  10. 78 FR 72718 - NASA Advisory Council; Audit, Finance and Analysis Committee; Meeting

    Science.gov (United States)

    2013-12-03

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice: (13-139)] NASA Advisory Council; Audit... amended, the National Aeronautics and Space Administration announces a meeting of the Audit, Finance and... includes briefings on the following topics: Finance Update Budget Update NASA Strategic Planning and...

  11. Internal Audit Service | Internal Audit Service

    Science.gov (United States)

    their internal auditing function in the areas of professional excellence, quality of service and Students and teachers Media Internal Audit Service Navbar Toggle Home About the Staff Risk Assessment and Planning Internal Audit Process Search for Search Home The mission of the Fermilab Internal Audit Service

  12. The West Midlands breast cancer screening status algorithm - methodology and use as an audit tool.

    Science.gov (United States)

    Lawrence, Gill; Kearins, Olive; O'Sullivan, Emma; Tappenden, Nancy; Wallis, Matthew; Walton, Jackie

    2005-01-01

    To illustrate the ability of the West Midlands breast screening status algorithm to assign a screening status to women with malignant breast cancer, and its uses as a quality assurance and audit tool. Breast cancers diagnosed between the introduction of the National Health Service [NHS] Breast Screening Programme and 31 March 2001 were obtained from the West Midlands Cancer Intelligence Unit (WMCIU). Screen-detected tumours were identified via breast screening units, and the remaining cancers were assigned to one of eight screening status categories. Multiple primaries and recurrences were excluded. A screening status was assigned to 14,680 women (96% of the cohort examined), 110 cancers were not registered at the WMCIU and the cohort included 120 screen-detected recurrences. The West Midlands breast screening status algorithm is a robust simple tool which can be used to derive data to evaluate the efficacy and impact of the NHS Breast Screening Programme.

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

    Science.gov (United States)

    Andersson, Neil

    2011-12-21

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

  14. Audit of high energy therapy beams in hospital oncology departments by the National Radiation Laboratory

    International Nuclear Information System (INIS)

    Smyth, V.G.

    1994-02-01

    In 1993 the output of every high energy radiotherapy beam used clinically in New Zealand was measured by National Radiation Laboratory (NRL) staff using independent dosimetry equipment. The purpose of this was to audit the dosimetry that is used by hospital physicists for the basis of patient treatments, and to uncover any errors that may be clinically significant. This report analyses the uncertainties involved in comparing the NRL and hospital measurements, and presents the results of the 1993 audit. The overall uncertainty turns out to be about 1.5%. The results for linear accelerator photon beams are consistent with a purely random variation within this uncertainty. Electron beams show some small errors beyond the expected uncertainty. Gamma beams have the potential to be the most accurately measured, but in practice are less accurately measured than linear accelerator beams. None of the disagreements indicated an error of clinical significance. 8 refs., 3 figs., 2 tabs

  15. Impact of the national special programme for food security on ...

    African Journals Online (AJOL)

    Impact of the national special programme for food security on poverty alleviation among women in Oyo State, Nigeria. ... In addition, majority (60.2%) of the participants were literate and participated more in cassava and maize production, while insufficient loan ranked first among the problems encountered by the ...

  16. BRIEF INCURSION IN THE EVOLUTION OF INTERN AUDIT

    Directory of Open Access Journals (Sweden)

    DUTESCU MIHAELA

    2014-02-01

    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 .

  17. Scope of the Spanish Marine Sciences National Programme from 1995 to 2003

    Directory of Open Access Journals (Sweden)

    Beatriz Morales-Nin

    2004-06-01

    Full Text Available Marine Research in Spain was funded mainly by the National Plans of the Ministry of Science and Technology. These have four-year duration and comprise priority research areas addressed by Research and Development Programmes. Marine Sciences has been identified as a Programme since 1995, and forms part of two National Plans. The Programme made annual invitations to tender with the following objectives: global change, ecosystems, sustainable fisheries, coastal zone, pollution and new technologies. Each objective had several sub-objectives. In the first period (1995-1999 Aquaculture was one of the objectives, and it had its own Programme in the second. The 1995-1999 Programme approved 189 projects (47% of the proposals submitted with a budget of 9.14 M€ and a participation of 550 persons/year. In the 2000-2003 Programme 175 projects were approved (51% of the proposals submitted corresponding to €12.42 M and 780 persons/year. The universities were the principal actors (58% of the projects, followed by the Science Council (25% of the projects. Catalonia is the region with the greatest participation both in projects and in funding, followed by Galicia and Andalusia. Considering that in the first period there were five invitations to tender and Aquaculture was the main objective (63 projects and €2.26 M, the increase in participation and funding is considerable. This trend is also confirmed by the increase in success rate (approval of proposals rose from 47% in the first invitation to tender to 51% in the second and the increase in the mean budget per project (from €48.300 to €70.900 respectively.

  18. Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

    Directory of Open Access Journals (Sweden)

    Erna Pasanda

    2013-12-01

    Full Text Available This study aims to examine the influence of gender and audit experience toward audit judgment and to examine gender and audit experience towards audit judgment when moderated by client credibility. The research was conducted on auditors who worked on KAP in Makassar South Sulawesi using survey. Sampling technique in this study was random sampling based on judgment. Data collected and then analyzed by employing regression method and Moderated Regression Analysis (MRA. The result indicates that gender does not significantly influence audit judgment while audit experience significantly influences audit judgment. Client credibility does not moderate the influence of gender and audit experience on the audit judgment.

  19. Pilot postal audits in radiotherapy for 60Co in non-reference conditions in Cuba: practical consideration and preliminary results

    International Nuclear Information System (INIS)

    Gutierrez Lores, S.; Walwyn Salas, G.; Alonso Villanueva, G.

    2008-01-01

    Discusses the practical consideration and preliminary results of the Cuban's SSDL in Pilot Postal Audit in Radiotherapy for Co-60 in non-reference conditions under IAEA Coordinated Research Project E2.40.12. A strategy for national TLD audit programmes has been developed by the international Atomic Energy Agency (IAEA). It involves progression through three sequential dosimetry audit steps. The first step audits are for the beam output in reference conditions for photon beams. The second step audits are for the dose in reference and non-reference conditions on the beam axis for photon beams. The third step audits involve measurements of the dose in reference, and non-reference conditions off-axis for open and wedged symmetric and symmetric fields for photon beams. Under coordinated research project E2.40.12 were characterized 100 micro rods. All of these rods were identified individually with a consecutive number made over one of its sides, using a fine tip of graphite. The method used to determinate the individual sensibility of the TL detectors was: irradiating a group of them, with the same history of irradiation and readout. The TLD signal was read using HARSHAW 2000C/B reader. Based on the IAEA standard TLD holder for photon beams, a TLD holder was developed with horizontal arm to enable measurements 5 cm off the central axis. Successful results in two external trial carried out using the IAEA TLD service in the years 2003 - 2004 were obtained. Five 5 facilities were considered to be included in the Pilot Audit Audits in Radiotherapy for Co-60 in non reference conditions (on-axis) in the year 2003, according to recommendation of External Audit Group (EAG). For the year 2004 were considered only 3 facilities in the Pilot Audit Audits in Radiotherapy for Co-60 in non reference conditions (off-axis). Extend the postal dose audits to the rest of the institutions around the country. The participation in these audits promotes a major understanding of the physicists

  20. Bangladesh. National Studies. Asia-Pacific Programme of Education for All.

    Science.gov (United States)

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This study examines the work of the Asia-Pacific Programme of Education for All (APPEAL) since its 1987 inception. Efforts to assess educational achievement at the local, regional, and national levels in Bangladesh are examined with a view to achieving universal primary education; eradicating illiteracy; and providing continuing education in…

  1. India. National Studies. Asia-Pacific Programme of Education for All.

    Science.gov (United States)

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This study examines the work of the Asia-Pacific Programme of Education for All (APPEAL) since its 1987 inception. Efforts to assess educational achievement at the local, regional, and national levels in India are examined with a view to achieving universal primary education (UPE); eradicating illiteracy; and providing continuing education in…

  2. United Nations International Drug Control Programme responds

    Directory of Open Access Journals (Sweden)

    Michael Platzer

    2002-01-01

    Full Text Available [First paragraph] We would like to reply to the article written by Axel Klein entitled, "Between the Death Penalty and Decriminalization: New Directions for Drug Control in the Commonwealth Caribbean" published in NWIG 75 (3&4 2001. We have noted a number of factual inaccuracies as well as hostile comments which portray the United Nations International Drug Control Programme in a negative light. This reply is not intended to be a critique of the article, which we find unbalanced and polemical, but rather an alert to the tendentious statements about UNDCP, which we feel should be corrected.

  3. Aktivitas Komite Audit, Kepemilikan Institusional dan Biaya Audit

    Directory of Open Access Journals (Sweden)

    Linda Kusumaning Wedari

    2015-01-01

    Full Text Available This study investigates the influence of the audit committee activities and institutional ownership to the audit fees in Indonesia public companies. The research samples are manufacturing companies listed in Indonesia Stock Exchange for the period 2010 – 2013. There are 124 observations that meet the sample criteria, data are analyzed using Eviews 6.0. The results show that the audit committee activities which measured by the number of audit committee meetings have significant positive effect on the audit fees. Meanwhile, institutional ownership, diffused and blockholders institutional ownership do not significantly affect to the audit fees. However some of the control variables such as the number of wholly-owned subsidiaries, subsidiaries abroad, and audit quality have significant positive effect on audit fees, whereas leverage, loss and audit opinion have no significant effect on the audit fee.

  4. Development of a national injury prevention/safe community programme in Vietnam.

    Science.gov (United States)

    Luau, H C; Svanström, L; Ekman, R; Duong, H L; Nguyen, O C; Dahlgren, G; Hoang, P

    2001-03-01

    The aim of this study is to describe the initiation of a national programme on injury prevention/safe community (IP/SC). Market economy, Doi Moi, was introduced in Vietnam in 1986, and since then the injury pattern has been reported to have changed. The number of traffic injury deaths has increased three-fold from 1980 to 1996 and traffic injuries more than four-fold. Injuries are now the leading cause of mortality in hospitals. There are difficulties in obtaining a comprehensive picture of the injury pattern from official statistics and, in conjunction with the work initiated by the Ministry of Health, a number of local reporting systems have already been developed. Remarkable results have been achieved within the IP/SC in a very short time, based on 20 years of experience. An organizational construction system has been built from province to local community areas. Management is based on administrative and legislative documents. IP/SC implementation is considered the duty of the whole community, local authorities and people committees, and should be incorporated into local action plans. The programme is a significant contribution towards creating a safe environment in which everybody may live and work, allowing the stability for society to develop. Implementation of the programme in schools is a special characteristic. The programme will be developed in 800 schools with a large number of pupils (25% of the population). This model for safer schools is considerably concerned and is a good experience to disseminate. The recommendations are that more pilot models of IP/SC should be conducted in other localities and that the programme should be expanded to a national scale. Furthermore, co-operation between sectors and mass organizations should be encouraged and professional skills of key SC members at all levels should be raised.

  5. Clinical audits: who does control what? European guide lines

    International Nuclear Information System (INIS)

    Jarvinen, H.

    2009-01-01

    The E.C. directive 97/43/EURATOM (M.E.D.-directive) introduced the concept of Clinical Audit for the assessment of medical radiological practices (diagnostic radiology, nuclear medicine and radiotherapy). The European Commission started in June 2007 a special project to review in detail the status of implementation of Clinical audits in Member States and to prepare European Guidance on Clinical Audits for diagnostic radiology, nuclear medicine and radiotherapy. The purpose of this E.C. project is to provide clear and comprehensive information and guidance on the procedures and criteria for clinical audits in all radiological practices, in order to improve the implementation of Article 6.4 of the M.E.D.-directive. The guidance should be flexible and enable the member States to adopt the model of clinical audit with respect to their national legislation and administrative provisions. By definition, clinical audit is a systematic examination or review of medical radiological procedures. It seeks to improve the quality and the outcome of patient care through structured review whereby radiological practices, procedures and results are examined against agreed standards for good medical radiological procedures. Modifications of the practices are implemented where indicated and new standards applied if necessary. The general objectives of clinical audit should be: to improve the quality of patient care, to promote the effective use of resources, to enhance the provision and organization of clinical services, to further professional education and training. Clinical audits must be at the same time internal (set by the management of the department) and external (set by external auditors at the department). It must not be confused with other evaluation activities such inspections, accreditation or quality system certifications. Clinical audits should address structure, process and outcome such the unit mission, quality assurance, dosimetry and treatments follow-up. The recent

  6. Audit

    OpenAIRE

    1991-01-01

    Audit has long been a feature of good general practice. The literature is full of examples of audit by general practitioners and this Occasional Paper quotes many examples of audit which have produced valuable results. This chapter gives some advice to doctors wishing to audit their prescribing.

  7. The Danish National Reform Programme 2005 and the gender aspect of the Danish Employment Strategy

    DEFF Research Database (Denmark)

    Emerek, Ruth

    This assessment of the gender aspect of the Danish Employment Strategy in the National Reform Programme 2005 form along with assessments from the other European-member states the basis for the synthesis report The National Reform programme 2005 and the gender aspect of the European Employment...... Strategy prepared for the Equality Unit in the European Commission by Jill Rubery et al. It is part of the work of the EU expert group on Gender, Social Inclusion and Employment (EGGSIE)....

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

    Science.gov (United States)

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

    2015-04-01

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

  9. 75 FR 17437 - NASA Advisory Council; Audit, Finance and Analysis Committee; Meeting

    Science.gov (United States)

    2010-04-06

    ... NATIONAL AERONAUTICS AND SPACE ADMINISTRATION [Notice (10-040)] NASA Advisory Council; Audit... amended, the National Aeronautics and Space Administration announces a meeting of the Audit, Finance and... topic: GAO High Risk List The meeting will be open to the public up to the seating capacity of the room...

  10. The Malawi National Tuberculosis Programme: an equity analysis

    Directory of Open Access Journals (Sweden)

    Chimzizi Rhehab

    2007-12-01

    Full Text Available Abstract Background Until 2005, the Malawi National Tuberculosis Control Programme had been implemented as a vertical programme. Working within the Sector Wide Approach (SWAp provides a new environment and new opportunities for monitoring the equity performance of the programme. This paper synthesizes what is known on equity and TB in Malawi and highlights areas for further action and advocacy. Methods A synthesis of a wide range of published and unpublished reports and studies using a variety of methodological approaches was undertaken and complemented by additional analysis of routine data on access to TB services. The analysis and recommendations were developed, through consultation with key stakeholders in Malawi and a review of the international literature. Results The lack of a prevalence survey severely limits the epidemiological knowledge base on TB and vulnerability. TB cases have increased rapidly from 5,334 in 1985 to 28,000 in 2006. This increase has been attributed to HIV/AIDS; 77% of TB patients are HIV positive. The age/gender breakdown of TB notification cases mirrors the HIV epidemic with higher rates amongst younger women and older men. The WHO estimates that only 48% of TB cases are detected in Malawi. The complexity of TB diagnosis requires repeated visits, long queues, and delays in sending results. This reduces poor women and men's ability to access and adhere to services. The costs of seeking TB care are high for poor women and men – up to 240% of monthly income as compared to 126% of monthly income for the non-poor. The TB Control Programme has attempted to increase access to TB services for vulnerable groups through community outreach activities, decentralising DOT and linking with HIV services. Conclusion The Programme of Work which is being delivered through the SWAp is a good opportunity to enhance equity and pro-poor health services. The major challenge is to increase case detection, especially amongst the poor

  11. Aspects of audit. 4: Acceptability of audit.

    OpenAIRE

    Shaw, C D

    1980-01-01

    Whether or not audit is accepted in Britain will be determined principally by how it is controlled, how much it costs, and how effective it is. The objectives of audit have been defined as education, planning, evaluation, research, and anticipatory diplomacy--that is, starting internal audit before external audit is imposed on the medical profession. Published reports suggest that in Britain internal audit would be more effective andless expensive than the complex professional standards revie...

  12. National Radiobiology Archives distributed access programmer's guide

    Energy Technology Data Exchange (ETDEWEB)

    Prather, J. C. [Linfield Coll., McMinnville, OR (United States); Smith, S. K.; Watson, C. R. [Pacific Northwest Lab., Richland, WA (United States)

    1991-12-01

    The National Radiobiology Archives is a comprehensive effort to gather, organize, and catalog original data, representative specimens, and supporting materials related to significant radiobiology studies. This provides researchers with information for analyses which compare or combine results of these and other studies and with materials for analysis by advanced molecular biology techniques. This Programmer's Guide document describes the database access software, NRADEMO, and the subset loading script NRADEMO/MAINT/MAINTAIN, which comprise the National Laboratory Archives Distributed Access Package. The guide is intended for use by an experienced database management specialist. It contains information about the physical and logical organization of the software and data files. It also contains printouts of all the scripts and associated batch processing files. It is part of a suite of documents published by the National Radiobiology Archives.

  13. Treatment planning systems dosimetry auditing project in Portugal.

    Science.gov (United States)

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

    2014-02-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  15. FEATURES OF ACCOUNTING AND AUDIT OF INSURANCE ORGANIZATIONS IN UKRAINE

    Directory of Open Access Journals (Sweden)

    А. Sholoiko

    2015-04-01

    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.

  16. Op weg naar de landelijke invoering van perinatale audit

    NARCIS (Netherlands)

    Leeman LD; Waelput AJM; Eskes M; Achterberg PW; VTV

    2007-01-01

    In the near future perinatal audit will start in the Netherlands, with a systematic critical analysis of the quality of care of perinatal mortality. The National Institute for Public Health and the Environment designed a plan for the implementation of perinatal audit. The slower decline of perinatal

  17. CHALLENGES OF INTERNAL AUDIT IN THE CURRENT CRISIS

    Directory of Open Access Journals (Sweden)

    Popa Adriana Florina

    2013-07-01

    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

  18. Establishment and development of the National Tuberculosis Control Programme in Vietnam

    NARCIS (Netherlands)

    Huong, N. T.; Duong, B. D.; Co, N. V.; Quy, H. T.; Tung, L. B.; Bosman, M.; Gebhardt, A.; Velema, J. P.; Broekmans, J. F.; Borgdorff, M. W.

    2005-01-01

    OBJECTIVE: To describe the establishment and development of the National Tuberculosis Control Programme (NTP) of Vietnam. METHODS: Data were obtained from the surveillance system established by the new NTP in 1986 and based on the principles now described as the WHO DOTS strategy. RESULTS: The

  19. Impact of a national QI programme on reducing electronic health record notifications to clinicians.

    Science.gov (United States)

    Shah, Tina; Patel-Teague, Shilpa; Kroupa, Laura; Meyer, Ashley N D; Singh, Hardeep

    2018-03-05

    Emerging evidence suggests electronic health record (EHR)-related information overload is a risk to patient safety. In the US Department of Veterans Affairs (VA), EHR-based 'inbox' notifications originally intended for communicating important clinical information are now cited by 70% of primary care practitioners (PCPs) to be of unmanageable volume. We evaluated the impact of a national, multicomponent, quality improvement (QI) programme to reduce low-value EHR notifications. The programme involved three steps: (1) accessing daily PCP notification load data at all 148 facilities operated nationally by the VA; (2) standardising and restricting mandatory notification types at all facilities to a recommended list; and (3) hands-on training for all PCPs on customising and processing notifications more effectively. Designated leaders at each of VA's 18 regional networks led programme implementation using a nationally developed toolkit. Each network supervised technical requirements and data collection, ensuring consistency. Coaching calls and emails allowed the national team to address implementation challenges and monitor effects. We analysed notification load and mandatory notifications preintervention (March 2017) and immediately postintervention (June-July 2017) to assess programme impact. Median number of mandatory notification types at each facility decreased significantly from 15 (IQR: 13-19) to 10 (IQR: 10-11) preintervention to postintervention, respectively (Pmanage them. Nevertheless, our project suggests feasibility of using large-scale 'de-implementation' interventions to reduce unintended safety or efficiency consequences of well-intended electronic communication systems. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Worldwide QA networks for radiotherapy dosimetry

    International Nuclear Information System (INIS)

    Izewska, J.; Svensson, H.; Ibbott, G.

    2002-01-01

    A number of national or international organizations have developed various types and levels of external audits for radiotherapy dosimetry. There are three major programmes who make available external audits, based on mailed TLD (thermoluminescent dosimetry), to local radiotherapy centres on a regular basis. These are the IAEA/WHO TLD postal dose audit service operating worldwide, the European Society for Therapeutic Radiology and Oncology (ESTRO) system, EQUAL, in European Union (EU) and the Radiological Physics Center (RPC) in North America. The IAEA, in collaboration with WHO, was the first organization to initiate TLD audits on an international scale in 1969, using mailed system, and has a well-established programme for providing dose verification in reference conditions. Over 32 years, the IAEA/WHO TLD audit service has checked the calibration of more than 4300 radiotherapy beams in about 1200 hospitals world-wide. Only 74% of those hospitals who receive TLDs for the first time have results with deviation between measured and stated dose within acceptance limits of ±5%, while approximately 88% of the users that have benefited from a previous TLD audit are successful. EQUAL, an audit programme set up in 1998 by ESTRO, involves the verification of output for high energy photon and electron beams, and the audit of beam parameters in non-reference conditions. More than 300 beams are checked each year, mainly in the countries of EU, covering approximately 500 hospitals. The results show that although 98% of the beam calibrations are within the tolerance level of ±5%, a second check was required in 10% of the participating centres, because a deviation larger than ±5% was observed in at least one of the beam parameters in non-reference conditions. EQUAL has been linked to another European network (EC network) which tested the audit methodology prior to its application. The RPC has been funded continuously since 1968 to monitor radiation therapy dose delivery at

  1. Results from a survey of national immunization programmes on home-based vaccination record practices in 2013

    OpenAIRE

    Young, Stacy L.; Gacic-Dobo, Marta; Brown, David W.

    2015-01-01

    Background Data on home-based records (HBRs) practices within national immunization programmes are non-existent, making it difficult to determine whether current efforts of immunization programmes related to basic recording of immunization services are appropriately focused. Methods During January 2014, WHO and the United Nations Children's Fund sent a one-page questionnaire to 195 countries to obtain information on HBRs including type of record used, number of records printed, whether record...

  2. Contribution of records management to audit opinions and accountability in government

    Directory of Open Access Journals (Sweden)

    Rodreck David

    2017-05-01

    Full Text Available Background: Auditing can support national democratic processes, national development and government good will. Supreme Audit Institutions (SAI, such as offices of Auditor General, publish consolidated reports on audit outcomes for local authorities, government departments, parastatals and related public entities. These reports identify broad areas analysed during audit exercises that often include financial management, governance, asset management, risk management, revenue collection and debt recovery. They highlight trends that were detected during audit exercises at the end of a financial year. The reports further show how records and records management affect audit exercises as well as financial management within the audited institutions. Objectives: The intention of the research was to ascertain the contribution of records management to audit opinions and accountability in financial management in Zimbabwean government entities. Method: A document analysis of Comptroller and Auditor General of Zimbabwe (CAGZ’s reports was used to identify the types of decisions and recommendations (audit opinions issued, in juxtaposition to the records management issues raised. Results and Conclusion: This study shows that there is a strong correlation between records management concerns and audit opinions raised by the CAGZ’s narrative audit reports. Inadequate records management within government entities was associated with adverse and qualified opinions and, in some cases, unqualified opinions that had emphases of matter. There was a causal loop in which lack of documentary evidence of financial activities was the source cause of poor accounting and poor audit reports. Errors resulting from incomplete or inaccurate records meant that government entities were not showing a true picture of their financial status and their financial statements could be materially misstated. As an important monitoring and control system, records management should be

  3. A Practical Model to Perform Comprehensive Cybersecurity Audits

    Directory of Open Access Journals (Sweden)

    Regner Sabillon

    2018-03-01

    Full Text Available These days organizations are continually facing being targets of cyberattacks and cyberthreats; the sophistication and complexity of modern cyberattacks and the modus operandi of cybercriminals including Techniques, Tactics and Procedures (TTP keep growing at unprecedented rates. Cybercriminals are always adopting new strategies to plan and launch cyberattacks based on existing cybersecurity vulnerabilities and exploiting end users by using social engineering techniques. Cybersecurity audits are extremely important to verify that information security controls are in place and to detect weaknesses of inexistent cybersecurity or obsolete controls. This article presents an innovative and comprehensive cybersecurity audit model. The CyberSecurity Audit Model (CSAM can be implemented to perform internal or external cybersecurity audits. This model can be used to perform single cybersecurity audits or can be part of any corporate audit program to improve cybersecurity controls. Any information security or cybersecurity audit team has either the options to perform a full audit for all cybersecurity domains or by selecting specific domains to audit certain areas that need control verification and hardening. The CSAM has 18 domains; Domain 1 is specific for Nation States and Domains 2-18 can be implemented at any organization. The organization can be any small, medium or large enterprise, the model is also applicable to any Non-Profit Organization (NPO.

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

    Science.gov (United States)

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

    2012-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Andersson Neil

    2011-12-01

    Full Text Available Abstract Health planners and managers make decisions based on their appreciation of causality. Social audits question the assumptions behind this and try to improve quality of available evidence. The method has its origin in the follow-up of Bhopal survivors in the 1980s, where “cluster cohorts” tracked health events over time. In social audit, a representative panel of sentinel sites are the framework to follow the impact of health programmes or reforms. The epidemiological backbone of social audit tackles causality in a calculated way, balancing computational aspects with appreciation of the limits of the science. Social audits share findings with planners at policy level, health services providers, and users in the household, where final decisions about use of public services rest. Sharing survey results with sample communities and service workers generates a second order of results through structured discussions. Aggregation of these evidence-based community-led solutions across a representative sample provides a rich substrate for decisions. This socialising of evidence for participatory action (SEPA involves a different skill set but quality control and rigour are still important. Early social audits addressed settings without accepted sample frames, the fundamentals of reproducible questionnaires, and the logistics of data turnaround. Feedback of results to stakeholders was at CIET insistence – and at CIET expense. Later social audits included strong SEPA components. Recent and current social audits are institutionalising high level research methods in planning, incorporating randomisation and experimental designs in a rigorous approach to causality. The 25 years have provided a number of lessons. Social audit reduces the arbitrariness of planning decisions, and reduces the wastage of simply allocating resources the way they were in past years. But too much evidence easily exceeds the uptake capacity of decision takers. Political

  6. Quality Audits In Radiotherapy. Chapter 20

    International Nuclear Information System (INIS)

    Izewska, J.

    2017-01-01

    It is widely recognized that quality audits constitute a vital component of quality management in radiotherapy [20.1–20.3]. The main reason why quality audits are considered an important activity is that they help to review the quality of radiotherapy services and improve them. Quality audits check whether radiotherapy practices are adequate, i.e. that what should be done is being done; and in case it is not, audits provide recommendations to encourage improvements to be made. Without some form of auditing, it would be difficult to determine whether radiotherapy services are safe and effective for cancer treatment. In other words, a quality audit in radiotherapy is a method of reviewing whether the quality of activities in a radiotherapy department adheres to the standards of good practices to ensure that the treatment to the cancer patient is optimal. Overall, audits lead to improvements of professional practices and the general quality of services delivered. There are many recommendations regarding quality in radiotherapy practice, both national and international. Practices vary depending on the economic level of States, including specific procedures, equipment and facilities, as well as available resources. Good practices evolve with research developments, including new clinical trial results, progress in evidence based medicine and developments in radiotherapy technology. Quality audits involve the process of fact finding and comparing the findings against criteria for good practices in radiotherapy. Various issues and gaps may be identified by the auditors in the audit process, for example insufficiencies in structure, inadequacies in technology or deviations in procedures. This way the weak points or areas of concern are documented and recommendations for the audited centre are formulated that address these areas with the purpose of improving quality.

  7. Exploring audit assistants decision to leave the audit profession

    OpenAIRE

    Gertsson, Nellie; Sylvander, Johanna; Broberg, Pernilla; Friberg, Josefine

    2017-01-01

    Purpose - The purpose of this paper is to explore why audit assistants leave the audit profession. By including both the perceptions held by audit assistants that left the audit profession and the perceptions of audit assistants still working in the audit profession, this study aims to explore how determinants of job satisfaction are associated with decisions to leave the audit profession. Design/methodology/approach - To explore the association between determinants of job satisfaction and de...

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

    Science.gov (United States)

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

    1997-11-01

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

  9. Federally Chartered Corporation: Review of the Financial Statement Audit Reports for the National Federation of Music Clubs for Fiscal Years 1999 and 1998

    National Research Council Canada - National Science Library

    Steinhoff, Jeffrey

    2000-01-01

    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...

  10. Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

    Science.gov (United States)

    McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

    2016-07-28

    Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative

  11. The State of the World Environment, 1987. United Nations Environment Programme.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    One of the main activities assigned to the Governing Council of the United Nations Environment Programme (UNEP) is to review the world environmental situation to insure that emerging environmental problems of wide international significance receive appropriate and adequate consideration by governments. Accordingly, UNEP has assessed the state of…

  12. Developing a framework for audit quality management in audit firms

    Directory of Open Access Journals (Sweden)

    Darius Vaicekauskas, Jonas Mackevičius

    2014-02-01

    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

  13. National programme for weather, climate and atmosphere research. Annual report 1984/85

    CSIR Research Space (South Africa)

    Louw, CW

    1984-12-01

    Full Text Available This report reviews the activities of the National Programme for Weather, Climate and Atmosphere Research (NPWCAR) for 1984/85, highlights the findings and also discusses future developments and general needs regarding research within the framework...

  14. Implementation of the quality assurance programmes for radiotherapy at the national level

    International Nuclear Information System (INIS)

    Jaervinen, H.

    1997-01-01

    In Finland, the general principles and objectives of the QA are being more and more incorporated in the basic curricula of radiotherapy professionals: radiotherapists, radiation technologists (nurses), and the physicists, in particular. The medical physicists are identified as an independent specialty which, after the general studies in physics requires a special examination and five years practicing in various aspects of radiotherapy clinical work. Specific meetings organized both occasionally and regularly by national societies, hospitals and the authorities collect together different specialists in the field, thus providing opportunities for continuous up-keeping of knowledge and the exchange of experiences in QA. The Finnish Centre for Radiation and nuclear Safety (STUK), operating under the Ministry of Social Affairs and Health, is the national authority for radiation protection covering all fields of the application of radiation. Besides its supervisory role, i.e. to control that the safety of various applications meets the requirements et by legislation, considerable amount of the resources are devoted to research in support of the supervisory activities. For radiotherapy, the leading principle is to ensure the safety of patients, personnel and the public, the good accuracy of the dose to the patient being one of the main objectives. In essence, this leading principle manifests itself through the maintenance of standards, measurement techniques and calibration services traceable to the international measurement system, and through the legal inspections as well as independent reviews and measurements to assess the QA systems of hospitals (i.e. through Dosimetry Audits or Quality Audits)

  15. UK intussusception audit: A national survey of practice and audit of reduction rates

    International Nuclear Information System (INIS)

    Hannon, Edward; Williams, Rhianydd; Allan, Rosemary; Okoye, Bruce

    2014-01-01

    Aim: To define current UK reduction practice and the reductions rates achieved. Materials and methods: Electronic surveys were sent to radiologists at 26 UK centres. This assessed methods of reduction, equipment, personnel, and protocol usage. Standardized audit proforma were also sent to evaluate all reductions performed in 2011. Results: Twenty-two of 26 centres (85%) replied. All used air enema under fluoroscopic guidance. Equipment was not standardized but could be broadly categorized into hand-pumped air-supply systems (seven centres) and pressurized air systems (15 centres). Seventeen centres followed a protocol based on British Society of Paediatric Radiologists (BSPR) guidelines. In 21 of the 22 centres a consultant paediatric radiologist led reductions and only 12 centres reported a surgeon being present. Three hundred and ten cases were reported across 22 centres. Cases per centre ranged from 0–31 (median 14). Reduction rates varied from 38–90% (median 71%). The overall perforation rate was 2.5%. Caseload did not significantly correlate with reduction rate, and there was no significant difference between the two types of equipment used. Median reduction rates were 15% higher in centres with a surgeon present at reduction (p < 0.05). Conclusion: Intussusception care in the UK lacks standardization of equipment and personnel involved. National reduction rates are lower than in current international literature. Improved standardization may lead to an improvement in reduction rates and a surgeon should always be present at reduction

  16. Cardiovascular risk assessment: audit findings from a nurse clinic--a quality improvement initiative.

    Science.gov (United States)

    Waldron, Sarah; Horsburgh, Margaret

    2009-09-01

    Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice. A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average). Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had afive-year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period. The recently available 'heart health' trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends. Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health.

  17. Deviations outside the acceptance limits in the IAEA/WHO TLD audits for radiotherapy hospitals

    International Nuclear Information System (INIS)

    Vatnitsky, S.; Izewska, J.

    2002-01-01

    The main purpose of the IAEA/WHO TLD postal dose audit programme for dosimetry in radiotherapy is to provide an independent verification of the dose delivered by treatment machines in radiotherapy hospitals. The results of the TLD audit are considered acceptable if the relative deviation between the participant's stated dose and the TLD determined dose is within ±5%. The goal of this note is to draw the attention of participants of the TLD programme to some of the common reasons for deviations outside the acceptance limits. Armed with this knowledge, other participants may avoid similar problems in the future. The analysis of deviations presented here is based on the results of TLD audits of the calibration of approximately 1000 Co-60 beams and 600 high-energy X-ray beams performed in the period 1996-2001. A total of 259 deviations outside the ±5% limits have been detected, including 204 deviations for Co-60 beams (20% of all Co-60 beams checked) and 55 for high-energy X-ray beams (10% of all X-ray beams checked). It is worth mentioning that the percentage of large deviations (beyond 10%) is also higher for Co-60 beams than for high-energy X-ray beams. Some problems may be caused by obsolete dosimetry equipment or poor treatment machine conditions. Other problems may be due to insufficient training of staff working in radiotherapy. The clinical relevance of severe TLD deviations detected in the audit programme was confirmed in many cases, but, fortunately, not all-poor dosimetric results reflect deficiencies in the calibration of clinical beams or machine faults. Sometime it happens, that the TLDs are irradiated with an incorrect dose due to misunderstanding of the instructions on how to perform the TLD irradiation. Such dosimetry errors would have no direct impact on actual dose delivered to a patient

  18. China's national climate change programme

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-06-15

    The National Climate Change Program identifies China's basic stand, current achievements and challenges as well as its goals, principles and key areas of efforts in the coming years on the issue of climate change. Contents of the document are: climate change and corresponding efforts in China; Impacts and challenges of climate change on China; Guidelines, principles and objectives of China to address climate change; China's policies and measures to address climate change; and China's position on key climate change issues and needs for international cooperation. Measures to mitigate greenhouse gases include: to expedite the constitution and amendment of laws and regulations that are favourable to greenhouse gas mitigation (including amending the Law on the Coal Industry and Electric Power of the People's Republic of China); to prepare or improve national energy programmes and programmes for coal, electricity etc.; to develop 600 MW or above supercritical units and large combined-cycle units and other with efficient and clean power generation technologies; to develop heat and power cogeneration; to develop coal-bed methane and coal-mine methane industry; to develop technologies for the clean and efficient development and utilisation of coal. Emphasis will be on the research and development of highly-efficient coal mining technologies, efficient power generation technologies such as heavy-duty gas turbines, integrated gasification combined cycle, high-pressure, high-temperature ultra supercritical unit and large-scale supercritical circulation fluid bed boilers; vigorously develop coal liquefaction, gasification and coal-chemistry and other technologies for coal conversion, coal gasification based multi-generation systems technology, and carbon dioxide capture, utilization and storage technologies. In the iron and steel industry many technological improvements are recommended to be made.

  19. 75 FR 41240 - NASA Advisory Council; Audit, Finance and Analysis Committee; Meeting.

    Science.gov (United States)

    2010-07-15

    ... amended, the National Aeronautics and Space Administration announces a meeting of the Audit, Finance and... building (West Lobby-- Visitor Control Center), and must state that they are attending the Audit, Finance...

  20. 76 FR 20717 - NASA Advisory Council; Audit, Finance and Analysis Committee; Meeting

    Science.gov (United States)

    2011-04-13

    ... amended, the National Aeronautics and Space Administration announces a meeting of the Audit, Finance and... Center), and must state that they are attending the Audit, Finance, and Analysis Committee meeting in...

  1. Strategic environmental audit for the national waste disposal program; Strategische Umweltpruefung zum Nationalen Entsorgungsprogramm. Umweltbericht fuer die Oeffentlichkeitsbeteiligung

    Energy Technology Data Exchange (ETDEWEB)

    Steinhoff, Mathias; Kallenbach-Herbert, Beate; Claus, Manuel [Oeko-Institut e.V., Darmstadt (Germany); and others

    2015-03-27

    The report on the strategic environmental audit for the national waste disposal program covers the following issues: aim of the study, active factors, environmental objectives; description and evaluation of environmental impact including site selection criteria for final repositories of heat generating radioactive waste, intermediate storage of spent fuel elements and waste from reprocessing plants, disposal of wastes retrieved from Asse II; hypothetical zero variants.

  2. Quality Determinants of Independent Audits of Banks

    Directory of Open Access Journals (Sweden)

    José Alves Dantas

    2015-04-01

    Full Text Available Since DeAngelo's study (1981 on audit quality, the latter has been a topic well discussed in the international accounting literature; however, there is little evidence about audit quality in the financial market. In Brazil, studies on audit quality began only in the 2000s, although without a specific focus on banks. The purpose of this study was to identify the quality determinants of audit work in Brazilian banking institutions. Using the practice of earnings management as a proxy for audit quality - more specifically, the discretionary accruals related to the process of the constitution of the Loan Loss Provision (LLP - tests were performed based on the quarterly information of commercial and multipleservice banks and savings banks from 2001 to 2012. Empirical tests have shown that the quality of audit work has several types of relationships as follows: negative with the client importance level for the auditor; negative with the works after the sixth year of the contract; positive with the establishment of the Audit Committee by the banks; positive with the judgment of punitive administrative proceedings against independent auditors; and positive with the level of rigor of the regulatory environment. Of the tested hypotheses, three were not confirmed empirically. The first hypothesis predicted an association between audit quality and the auditor degree of specialization in the banking industry. The second hypothesis predicted that audit quality would be negatively correlated with the degree of concentration of audit activity within the National Financial System (Sistema Financeiro Nacional - SFN. The third hypothesis predicted that audit quality would be lower when the auditorclient relationship is of a short term. The results of the study contribute to the debate concerning the role of auditors in the transparency and solidity of the financial system, including their role as a complementary or auxiliary supervisor.

  3. Auditing the Auditors: Has the Establishment of the Audit Oversight Board Affected Audit Quality?

    OpenAIRE

    Ismail, Hashanah; Theng, Ung Chui

    2015-01-01

    This paper reports on the results of a research into the relationship between audit quality during the years before and after the incorporation of the Audit Oversight Board (AOB) in Malaysia in 2010. As the AOB only audits auditors of listed companies this study is based on 50 companies’ audited financial statements 2 years before and after AOB was established. A total of 200 firm years were observed. Using reported companies’ earnings to proxy for earnings and audit quality the data collecte...

  4. An analysis of two separate quality audits in UK radiotherapy centres

    International Nuclear Information System (INIS)

    Aird, E G A

    1995-01-01

    The CHART quality assurance programme has been used to audit 2 groups of radiotherapy centres for the delivery of radiotherapy: 1. those involved in the CHART Clinical Trial (1991-1995) 2. all London radiotherapy centres (1994-1996) Machinery Tests This paper will seek to illustrate improvements in meeting the criteria set by the QA programme as older linear accelerators are replaced. Phantom Tests The residual errors between measured and calculated doses in anatomical phantoms will be analysed to demonstrate where there are still weaknesses in treatment planning and delivery of radiotherapy

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

    Science.gov (United States)

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

  6. The South African National Accelerator Centre and its research programme

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Y. [Kyushu Univ., Fukuoka (Japan)

    1997-03-01

    An overview of the South African National Accelerator Centre and its research activities is given with emphasis on medium energy nuclear physics and nuclear data measurements for medical use. Also presented is a preliminary result of {sup 40}Ca(p,p`x) spectrum measurement for 392 MeV which has been carried out at RCNP, Osaka University, under the South Africa-Japan collaborative programme. (author)

  7. Kingdom of Morocco : Accounting and Auditing

    OpenAIRE

    World Bank

    2002-01-01

    This report provides an assessment of Moroccan accounting and auditing standards and practices, and the institutional capacity necessary to ensure high-quality financial reporting. The law gives accounting standard-setting responsibility to the National Accounting Council (Conseil National de la Comptabilité). Since the Council was established in 1989, Moroccan accounting standards have im...

  8. Program of TLD audits for quality control in radiotherapy

    International Nuclear Information System (INIS)

    Alvarez, P.; Feld, D.; Gomez, C.; Kessler, C.; Montano, R.G.; Lindner, C.; Peretti, M.; Saravi, M.; Miguez, V.; Paidon, S.; Raslawski, E.

    1998-01-01

    Full text: It is known that a high precision in radiotherapy is essential to ensure a successful radiation treatment. To reach this goal it is necessary to detect and minimise many errors, which can be done through a periodic program of quality control, not only internal checks but also participating in external audits that attempt to control the absorbed dose delivered and detect any source of error, coming from the machine itself or from human mistakes. Under the frame of the International Quality Assurance Network for Dosimetry in Radiotherapy proposed by the International Atomic Energy Agency, a National External Audit Group (EAG) has been created in our country, composed by the Secondary Standard Dosimetry Laboratory (SSDL), 2 Medical Physics and 1 Medical Radiotherapist. The SSDL and one of the Medical Physics belong to the National Atomic Energy Agency, meanwhile the rest of the group belong to the National Pediatric Hospital P rof. J.P.Garrahan . This EAG performs external audits to Radiation Therapy Centres with a thermoluminescence system, which is checked periodically by the IAEA. The audits are performed to the 60 Co γ-ray and high energy X-ray beams that are being used for medical application in the whole country. The SSDL is the responsible of the thermoluminescence measurements; deviation of the absorbed dose determined by the TLD system from the one informed by the Responsible of the Center within the interval ± 5% are considered acceptable while deviations out of this interval require the intervention of the Medical Physic Group and the Radiotherapist in order to determine the cause of the discrepancies. In 1997, 4 audits performed in reference conditions were carried out 68 60 Co units participated in the audits, 61 of them with deviation within the acceptable interval in their first participation, meanwhile 1 got this deviation in repeated audits, after the follow up performed by the Medical Physic Group. Regarding high energy X-ray beams

  9. Evaluation of the Dutch National Research Programme on Global Air Pollution and Climate Change. Final Report

    International Nuclear Information System (INIS)

    Guy, K.; Boekholt, P.; Kaellen, E.; Downing, T.; Verbruggen, A.

    2002-02-01

    During 2001, the second phase of the National Research Programme on Global Air Pollution and Climate Change (NOP2) has been evaluated. In the period 1995-2001 the budget for NOP was 47 million Dutch guilders, which supported over 30 organisations in 100 projects and studies spanning four main themes: (1) dynamics of the climate system and its component parts; (2) vulnerability of natural and societal systems to climate change; (3) societal causes and solutions; (4) integration and assessment. Later in the life of the programme, two themes were added to widen the scope of the programme and add value to existing activities. These covered projects concerned with 'cross-cutting' or 'over-arching' issues and those dealing with 'internationalisation', i.e. projects specifically designed to support various initiatives in the development of international programmes. A further proportion of the research budget was dedicated to direct policy support. The evaluation was primarily intended to: Assess the scientific quality of the work undertaken in the programme and the attainment of scientific and technical goals. Also attention was paid to the relevancy of projects and project outputs to national and international policy formulation (policy relevance); the structure and operation of the programme to see if it promoted coherence and synergy between the constituent parts (synergy); and recommendations concerning the form, content and direction of a new programme in the area (new directions)

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

    Directory of Open Access Journals (Sweden)

    Christopher Fuller

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

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

    Science.gov (United States)

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

    2013-01-01

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

  12. Are joint audits a proper instrument for increased audit quality?

    OpenAIRE

    Velte, Patrick; Azibi, Jamel

    2015-01-01

    Joint audits are recently controversial discussed to increase audit quality and decrease Audit market concentration in Europe, complementing the existing and future rotation rules by the 8th EC directive. First, this article presents a theoretical foundation of joint audits. In this context, the main influences on low balling are presented. The link between joint audits and audit quality is stillcontroversial. Then, the main results of empirical research on joint audit are focused. A clear po...

  13. Environmental management audit, Uranium Mill Tailings Remedial Action Project (UMTRA)

    International Nuclear Information System (INIS)

    1993-01-01

    The Office of Environment, Safety and Health (EH) has established, as part of the internal oversight responsibilities within Department of Energy (DOE), a program within the Office of Environmental Audit (EH-24), to conduct environmental audits at DOE's operating facilities. This document contains the results of the Environmental Management Audit of the Uranium Mill Tailings Remedial Action (UMTRA) Project. This Environmental Management Audit was conducted by the DOE's Office of Environmental Audit from October 26 through November 6, 1992. The audit's objective is to advise the Secretary as to the adequacy of UMTRA's environmental programs, and management organization in ensuring environmental protection and compliance with Federal, state, and DOE environmental requirements. This Environmental Management Audit's scope was comprehensive and covered all areas of environmental management with the exception of environmental programs pertaining to the implementation of the requirements of the National Environmental Policy Act (NEPA), which is the responsibility of the DOE Headquarters Office of NEPA Oversight

  14. Wider participation in the EU Eco Management and Audit Scheme; Das Gemeinschaftssystem der EG-Oeko-Audit-Verordnung oeffnet sich

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, U. [Institut fuer Management und Umwelt, Augsburg (Germany); Blaha, A.

    1998-04-01

    Within the framework of the EU Eco Management and Audit Scheme, which addresses primarily industry, member states can make provisions at the national level to permit trade and service firms as well as public enterprises to participate in the scheme. With the ordinance extending the eco audit ordinance which came into force in February 1998, questions of environmental management and environmental auditing are now also becoming interesting for the non-industrial sector in Germany. Unresolved issues concern, for instance, site delimitation, product ecology, and indirect environmental effects. (orig./AKF) [Deutsch] Im Rahmen des EG-Oeko-Audits, das sich in erster Linie an gewerbliche Unternehmen richtet, koennen die Mitgliedslaender im Rahmen nationaler Regelungen Handels- und Dienstleistungsunternehmen sowie oeffentliche Einrichtungen in das Gemeinschaftssystem einbeziehen. Mit der im Februar 1998 in Kraft getretenen Erweiterungsverordnung zum Umweltauditgesetz werden in Deutschland jetzt auch fuer nichtgewerbliche Bereiche Fragen des Umweltmanagements und des Oeko-Audits interessant. Eine Reihe von Fragen ergibt sich, beispielsweise nach der Standortabgrenzung, nach der Produktoekologie und nach den indirekten Umweltauswirkungen. (orig./AKF)

  15. AN AUDIT OF THE SUDDEN-INFANT-DEATH-SYNDROME PREVENTION PROGRAM IN THE AUCKLAND REGION

    NARCIS (Netherlands)

    Obdeijn, M. C.; Tonkin, S.; Mitchell, E. A.

    1995-01-01

    Aim. An audit of the sudden infant death syndrome (SIDS) prevention programme in the Auckland region. Methods. 107 health professionals working in antenatal classes, postnatal wards, domiciliary midwifery and the Plunket Society were interviewed. Results. Maternal smoking and infant sleeping

  16. High-dosage dosimetry programme of the IAEA

    International Nuclear Information System (INIS)

    Mehta, K.

    1999-01-01

    The high-dose dosimetry programme was initiated by the International Atomic Energy Agency in 1977. Like any other Agency programme, this one has various activities. These cover: research contracts and research agreements, co-ordinated research projects (CRP), training courses, and laboratory-based activities. The Agency's dose quality audit service (International Dose Assurance Service, IDAS), initiated in 1985, is one of the key elements of the programme. At earlier times, the technical part was operated through a laboratory in Germany. However, after purchasing the Bruker ESR spectrometer, the entire service has been operated from the Agency since 1992. This audit service has served well the needs of various institutes around the world involved with radiation processing. We have had two Co-ordinated Research Projects (the second one is in its last year) over the last several years. Both were/are aimed at standardization of dosimetry for radiation processing. Nine or ten participants of each CRP were about evenly distributed between the developed and developing Member States. In collaboration with the Food and Environmental Protection Section and the Industrial Applications and Chemistry Section, the Dosimetry and Medical Radiation Physics Section has participated in several training courses; these have been mainly regional courses. This collaboration has worked well since such courses combine specific radiation processing applications with the needs of good dosimetry and process control. Also, the Agency has organised several dose intercomparisons in recent time. The activities of the high-dose dosimetry programme since the last symposium (November 1990) are reviewed here. (author)

  17.  Developing a framework for audit quality management in audit firms

    Directory of Open Access Journals (Sweden)

    Darius Vaicekauskas

    2014-04-01

    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.

  18. Preliminary results of the national program of audit of quality in radiotherapy services in the Republic of Cuba; Resultados preliminares del programa nacional de auditoria de calidad en servicios de radioterapia en la Republica de Cuba

    Energy Technology Data Exchange (ETDEWEB)

    Dominguez Hung, Lourdes; Larrinaga Cortina, Eduardo F. [Centro de Control Estatal de Equipos Medicos, La Habana (Cuba); Morales Lopez, Jorge L.; Garcia Yip, Fernando [Instituto Nacional de Oncologia y Radiobiologia, La Habana (Cuba); Campa Menendez, Raudel [Centro de Proteccion y Higiene de las Radiaciones, La Habana (Cuba)

    2001-07-01

    The current state of the radiotherapy in Cuba has allowed to pass to a superior stage, the establishment of a National Quality Audit Program (PNAC). The National Control Center for Medical Devices as national regulator entity for the control and supervision of the medical devices of the National Health System is the responsible for it implementation. This paper presents the preliminary results of the execution of the PNAC in teletherapy services with isotopic units of {sup 60} Co. The audits were carried out according to the methodology settled down in the normalized procedure of operation of the PNAC. The physical aspects related with the treatment were audit, such as: the installation and unit's security, treatment unit's mechanical and dosimetric aspects and organizational aspects of the institution quality assurance program. Also were carried out, in the clinical aspect, verifications of cases type planned by the qualified personnel of the service. The results corresponding to the determination of the reference dose for each institution were compared with those obtained in a postal audit with the International Atomic Energy Agency. These first audits allowed to evaluate the performance of the institution's program of quality assurance and a feedback for the setting about to the PNAC. (author)

  19. Analisis Pengaruh Keahlian, Independensi, Perencanaan Audit dan Supervisi Audit terhadap Kualitas Audit pada Inspektorat Provinsi Sumatera Utara

    OpenAIRE

    Pohan, Nur Aisah

    2015-01-01

    The objective of the research was to analyze the influence of skill, independence, audit planning, and audit supervision on audit quality simultaneously and partially and to find out that motivation could moderate the correlation of skill, independence, audit planning, and audit supervision with audit quality at the Inspectorate of North Sumatera Province office. The research used causal research method. The population and the samples consisted of 66 supervision officials at the Inspectorate ...

  20. United Nations Environment Programme. Annual Report of the Executive Director, 1983.

    Science.gov (United States)

    United Nations Environment Programme, Nairobi (Kenya).

    This report provides a comprehensive overview of the major activities, programs, events, and developments within the United Nations Environment Programme (UNEP) in 1983. Its purpose is to provide a broad understanding of what UNEP is, how it functions, and what it does with the money it has at its disposal. Chapter I summarizes 1983 in terms of…

  1. Cuban experience in dosimetry quality audit program in radiotherapy

    International Nuclear Information System (INIS)

    Alonso-Samper, J.L.; Dominguez, L.; Yip, F.G.; Laguardia, R.A.; Morales, J.L.; Larrinaga, E.

    2002-01-01

    Full text: Five years ago we started a National Program of Quality Assurance in Radiotherapy. This program was possible thanks to the cooperation between the Cuban Ministry of Health and the International Atomic Energy Agency (IAEA) in the Projects ARCAL XXX and CUB/6/011. In the framework of these projects a total of ten complete dosimetry set were acquired and a large number of medical physicists were trained. At the same time, the Cuban side signed a contract for nine cobalt units, which have been gradually installed and all of them are running at the moment. During more than 20 years Cuba has taken part in the IAEA/WHO TLD postal dose audit programs and our results have been inside the (+/-)5 % acceptance limit. Cuba also joined the IAEA Coordinated Research Program E2 40 07, to extend at a national level the experience of the TLD based audits, using the capability of our SSDL to measure TLD. At the same time the work of the already existing External Audit Group was consolidated. The National Program of Quality Assurance in Radiotherapy works on base of external on-site visits. The main objective is to avoid any accident and to improve the quality of the RT treatments. Every year each Radiotherapy service is visited by a qualified team of physicists with the objective to check the physical aspects of the quality of the RT treatment, it includes: Documents and Records, safety, mechanical and dosimetric aspects, treatment planning, also we use the fixed depth phantom to simulate and verify several techniques. Although the TLD postal audit results are acceptable, in our QA audits we have detected some problems that may deviate the dose delivery to patients in more than 5%, examples of which are: Not all the clinical plans are redundantly checked by an independent person; Not all the controls (daily, monthly and annual) are performed according to the protocols approved by the National QA Committee. In some cases the controls are not well recorded; Clinical

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Enhancing energy efficiency in public buildings: The role of local energy audit programmes

    International Nuclear Information System (INIS)

    Annunziata, Eleonora; Rizzi, Francesco; Frey, Marco

    2014-01-01

    In the objective of reaching the “nearly zero-energy buildings” target set by the European Union, municipalities cover a crucial role in advocating and implementing energy-efficient measures on a local scale. Based on a dataset of 322 municipalities in Northern Italy, we carried out a statistical analysis to investigate which factors influence the adoption of energy efficiency in municipal buildings. In particular, the analysis focuses on four categories of factors: (i) capacity building for energy efficiency, (ii) existing structure and competences for energy efficiency, (iii) technical and economic support for energy efficiency, and (iv) spill-over effect caused by adoption of “easier” energy-efficient measures. Our results show that capacity building through training courses and technical support provided by energy audits affect positively the adoption of energy efficiency in municipal buildings. The size of the municipal authority, the setting of local energy policies for residential buildings and funding for energy audits are not correlated with energy efficiency in public buildings, where the “plucking of low hanging fruit” often prevails over more cost-effective but long-term strategies. Finally, our results call for the need to promote an efficient knowledge management and a revision of the Stability and Growth Pact. - Highlights: • Public procurement supports the deployment of the energy efficiency of buildings. • Energy audits and other factors influence energy efficiency in public buildings. • Econometric analysis applied to data from 322 municipalities in Northern Italy. • Municipalities need to overtake the “plucking of low-hanging fruit”. • Knowledge management should be associated with removal of budget constraints

  4. Implementing SLMTA in the Kenya National Blood Transfusion Service: lessons learned

    Directory of Open Access Journals (Sweden)

    Eric N. Wakaria

    2017-04-01

    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.

  5. FINANCIAL AUDIT -RISKS IDENTIFIED IN THE AUDIT PLANNING STAGE

    Directory of Open Access Journals (Sweden)

    Stelian Selisteanu

    2015-09-01

    Full Text Available The general objective of the audit activity is to currently present, under all significant aspects, a financial situation and to state an opinion according to which all economic operations are indeed correct and pursuant the law. As any activity that involves the human factor, the audit activity is subject to the influence of certain risks, risks that emerge, firstly, from an organizational level of the audited entity. In audit, risk is a very important influence element, whose ignorance can generate major implications in achieving the final goal to create an evidences database on which a pertinent and objective opinion can be founded, concerning the audited financial situations. In this context, one of the main objectives, that takes place during the planning phase of the audit, is represented by assessing risks to which the audited activity is subjected to, evaluation that helps the determining the work volume implied by the audit.

  6. National programmes for validating physician competence and fitness for practice: a scoping review.

    Science.gov (United States)

    Horsley, Tanya; Lockyer, Jocelyn; Cogo, Elise; Zeiter, Jeanie; Bursey, Ford; Campbell, Craig

    2016-04-15

    To explore and categorise the state of existing literature for national programmes designed to affirm or establish the continuing competence of physicians. Scoping review. MEDLINE, ERIC, Sociological Abstracts, web/grey literature (2000-2014). Included when a record described a (1) national-level physician validation system, (2) recognised as a system for affirming competence and (3) reported relevant data. Using bibliographic software, title and abstracts were reviewed using an assessment matrix to ensure duplicate, paired screening. Dyads included both a methodologist and content expert on each assessment, reflective of evidence-informed best practices to decrease errors. 45 reports were included. Publication dates ranged from 2002 to 2014 with the majority of publications occurring in the previous six years (n=35). Country of origin--defined as that of the primary author--included the USA (N=32), the UK (N=8), Canada (N=3), Kuwait (N=1) and Australia (N=1). Three broad themes emerged from this heterogeneous data set: contemporary national programmes, contextual factors and terminological consistency. Four national physician validation systems emerged from the data: the American Board of Medical Specialties Maintenance of Certification Program, the Federation of State Medical Boards Maintenance of Licensure Program, the Canadian Revalidation Program and the UK Revalidation Program. Three contextual factors emerged as stimuli for the implementation of national validation systems: medical regulation, quality of care and professional competence. Finally, great variation among the definitions of key terms was identified. There is an emerging literature focusing on national physician validation systems. Four major systems have been implemented in recent years and it is anticipated that more will follow. Much of this work is descriptive, and gaps exist for the extent to which systems build on current evidence or theory. Terminology is highly variable across programmes

  7. Quality audit service of the IAEA for radiation processing dosimetry

    International Nuclear Information System (INIS)

    Mehta, K.; Girzikowsky, R.

    1996-01-01

    The mandate of the International Atomic Energy Agency includes assistance to Member States to establish nuclear technologies safely and effectively. In pursuit of this, a quality audit service for dosimetry relevant to radiation processing was initiated as a key element of the High-Dose Standardization Programme of the IAEA. The standardization of dosimetry for radiation processing provides a justification for the regulatory approval of irradiated products and their unrestricted international trade. In recent times, the Agency's Dosimetry Laboratory has placed concentrated effort towards establishing a quality assurance programme based on the ISO 9000 series documents. The need for reliable and accurate dosimetry for radiation processing is increasing in Member States and we can envisage a definite role for the SSDLs in such a programme. (author). 10 refs, 3 figs

  8. Home audit program: management manual

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    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)

  9. CONSIDERATIONS REGARDING THE AUDIT OF FINANCIAL SITUATIONS

    OpenAIRE

    Maria-Madalina SALOMIA

    2012-01-01

    In a business world situated on a market that is becoming more and more active both on an international and national level, the audit of financial situations embodies a veritable varied research domain and with favorable advantages for the Romanian business society, as well as for the interest of the business society located outside the Romanian space. From the result of the auditing of financial situations of a entity, various information may be obtained which is used by different groups tha...

  10. On the nature of auditing: The audit partner effect : Research on the effect of individual audit partners on audit quality and the information dynamics of accounting data

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    This doctoral thesis is about whether auditing is ‘static and mechanic’ of nature or the opposite: ‘dynamic and organic’. If auditing is considered ‘static and mechanic’ of nature, this implies that standard audit solutions are available and can uniformly be applied by the audit partners. Moreover, it suggests that the level of audit quality can be guaranteed to a large extent by the audit firm’s control and governance structures. In such an environment, audit firm size and the actual audit q...

  11. Main Problems and Prospects of Audit Development in Ukraine

    Directory of Open Access Journals (Sweden)

    Sobolev Volodymyr M.

    2013-11-01

    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.

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

    Science.gov (United States)

    Hughes, Rhidian

    2005-01-01

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

  13. The National Security Agency (NSA eavesdropping on Americans
    A programme that is neither legal nor necessary

    Directory of Open Access Journals (Sweden)

    Zmarak Khan

    2006-12-01

    Full Text Available On 16 December 2005, the New York Times reported that the President had authorized the National Security Agency (NSA to spy on Americans, inside the United States, without first obtaining a warrant from the secret FISA court. Although the President has described the NSA activities to be legal and critical to our national security, the programme has started a national controversy, raising questions over its legality and necessity. Consequently, there have been pending legal challenges, congressional investigations, and public outcry over the use of such expansive presidential authority. The legal community, including the American Bar Association, considers the programme illegal. The only district court that has addressed the issue has held it to be an unconstitutional programme that violates FISA. This comment highlights several reasons for why warrantless wiretapping is illegal and unnecessary. The comment also notes public policy reasons against presidential power that is not subject to any checks from Congress or review from the judiciary. Finally, it argues that the President needs to immediately cease the programme; asks Congress to take its oversight responsibility more seriously; and reasons that the judicial review protects against abuse.

  14. INCODE-DK 2014. Classification of cause of intrauterine fetal death – a new approach to perinatal audit

    DEFF Research Database (Denmark)

    Maroun, Lisa Leth; Ramsing, Mette; Olsen, Tina Elisabeth

    on a national level as described in the national guideline for IUFD. Multidisciplinary perinatal audit is an important tool in the evaluation of stillbirth, however, the establishment of the C-IUFD has until now been hampered by the lack of a recommended classification system. Material and methods...... on the perinatal audit system in use as introduced by K. Vitting Andersen. The scheme is adapted to INCODE in main categories and allows grading and coding of C-IUFD. INCODE –DK and INCODE perinatal audittabel are available in an updated version of the IUFD guideline 2014, as well as in a separate excel file...... of the working group that the new audit scheme in combination with the new national classification system will improve the uniformity and quality of perinatal audits on a national level....

  15. INFOMAR, Ireland's National Seabed Mapping Programme; Sharing Valuable Insights.

    Science.gov (United States)

    Judge, M. T.; McGrath, F.; Cullen, S.; Verbruggen, K.

    2017-12-01

    Following the successful high-resolution deep-sea mapping carried out as part of the Irish National Seabed Survey (INSS), a strategic, long term programme was established: INtegrated mapping FOr the sustainable development of Ireland MArine Resources (INFOMAR). Funded by Ireland's Department of Communication, Climate Action and Environment, INFOMAR comprises a multi-platform approach to completing Ireland's marine mapping, and is a key action in the integrated marine plan, Harnessing Our Ocean Wealth. Co-managed by Geological Survey Ireland and the Marine Institute, the programme has three work strands: Data Acquisition; Data Exchange and Integration; Value Added Exploitation.The Data Acquisition strand includes collection of geological, hydrographic, oceanographic, habitat and heritage datasets that underpin sustainable development and management of Ireland's marine resources. INFOMAR operates a free data policy; data and outputs are delivered online through the Data Exchange and Integration strand. Uses of data and outputs are wide-ranging and multipurpose. In order to address the evolution and diversification of user requirements, further data product development is facilitated through the Value Added Exploitation strand.Ninety percent of Ireland's territory lies offshore. Therefore, strategic national seabed mapping continues to provide critical, high-resolution baseline datasets for numerous economic sectors and societal needs. From these we can glean important geodynamic knowledge of Ireland's vast maritime territory. INFOMAR remains aligned with national and European policies and directives. Exemplified by our commitment to EMODnet, a European Commission funded project that supports the collection, standardisation and sharing of available marine information, data and data products across all European Seas. As EMODnet Geology Minerals leaders we have developed a framework for mapping marine minerals. Furthermore, collaboration with the international research

  16. Developing a framework for audit quality management in audit firms

    OpenAIRE

    Darius Vaicekauskas, Jonas Mackevičius

    2014-01-01

    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...

  17. Inventory of Dutch National Research on Global Climate Change: Inside and outside the National Research Programme

    International Nuclear Information System (INIS)

    Smythe, K.D.; Bernabo, C.; Kingma, J.; Vrakking, W.

    1993-04-01

    This summary of Dutch research on global climate change was compiled from a survey of the major research organisations in the Netherlands. The scope and structure of the survey and this report were based on a request for information from the World Meteorological Organisation for an intergovernmental meeting on the World Climate Programme (WCP) held (from 14 to 16 April 1993). The WMO request emphasized activities related to the WCP and its associated programmes. To extend the usefulness of the exercise, an attempt has been made to broaden the focus to give additional attention to the Intergovernmental Geosphere-Biosphere Programme (IGBP) and the Human Dimensions Programme (HDP). This was the first attempt to inventory the research projects on global climate change underway in the Netherlands - both inside and outside the National Research Programme. Other surveys on Dutch climate-related research have been conducted. The most extensive effort was a cataloging of publications from climate research in the Netherlands from 1981 to 1991, which was conducted by the Netherlands Royal Academy of Sciences (KNAW). That inventory is being updated to include publications through 1992. The database resulting from this exercise will be a useful tool for organisations sponsoring and conducting global climate change research in their efforts to stimulate cooperation and promote coordination among research groups in the Netherlands and abroad. There are plans to update the inventory in the future and to provide the information to participating Dutch organisations as well as research organisations in other countries. An overview of the current research is provided in Volume 1 with a list of projects

  18. THE EFFECT OF AUDIT FOLLOW-UP AND SIZES ON THE AUDIT QUALITY

    OpenAIRE

    Mahpiansyah Mahpiansyah

    2017-01-01

    ABSTRAK Penelitian ini mengukur pengaruh ukuran audit dan tindak lanjut hasil audit terhadap kualitas audit di Indonesia. Pemerintah Indonesia memiliki dua institusi audit: eksternal dan internal audit. Tindak lanjut audit adalah perkembangan pelaksanaan rekomendasi audit dari audit eksternal untuk memperbaiki laporan keuangan auditee. Penelitian ini menganalisa data 33 provinsi dari tahun 2009 sampai dengan tahun 2013 dari Ikhtisar Laporan Hasil Pemeriksaan Badan Pemeriksa Keuangan (ILHP ...

  19. The National Coordinated Research Programme for Air Quality. Another choice for clean air

    International Nuclear Information System (INIS)

    Van Giezen, M.; Havinga, A.; De Boer, H.

    2009-01-01

    On August 1st 2009 the National Coordinated Research Programme for Air quality (NSL in Dutch) entered into operation. This programme must help improve air quality such that it meets the European standards. At the same time the deadlock between environment and space is also solved. A special approach has been chosen for this purpose, which is based on a common interest of the State, provinces and local authorities. It was an intensive and interesting process. The annual monitoring will have to show whether or not the NSL will meet its objectives. [nl

  20. Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

    OpenAIRE

    Erna Pasanda; Natalia Paranoan

    2013-01-01

    This study aims to examine the influence of gender and audit experience toward audit judgment and to examine gender and audit experience towards audit judgment when moderated by client credibility. The research was conducted on auditors who worked on KAP in Makassar South Sulawesi using survey. Sampling technique in this study was random sampling based on judgment. Data collected and then analyzed by employing regression method and Moderated Regression Analysis (MRA). The result indicates tha...

  1. Conservative management of CIN2: National Audit of British Society for Colposcopy and Cervical Pathology members' opinion.

    Science.gov (United States)

    Macdonald, Madeleine; Smith, John H F; Tidy, John A; Palmer, Julia E

    2018-04-01

    There is no doubt that organised cervical screening programmes have significantly reduced the rates of cervical cancer by detection and treatment of high-grade cervical intraepithelial neoplasia (CIN2, CIN3). National UK guidelines do not differentiate between CIN2 and CIN3 as separate entities and recommend treatment for both, although a degree of uncertainty exists regarding the natural history of CIN2. This national survey of British Society for Colposcopy and Cervical Pathology members aimed to assess attitudes towards conservative management (CM) of CIN2 in the UK and identify potential selection criteria. In total, 511 members responded (response rate 32%); 55.6% offered CM for selective cases; 12.4% for all cases; 16.4% had formal guidelines. Most agreed age group was >40yrs (83%), HPV 16/18 positive (51.4%), smoking (60%), immuno-compromise (74.2%), and large lesion size (80.8%) were relative contraindications for CM. 75.9% favoured six-monthly monitoring, with 80.2% preferring excisional treatment for persistent high-grade disease. Many UK colposcopists manage CIN2 conservatively without formal guidelines. Potential selection criteria should be investigated by a multicentre study. Impact statement Although anecdotally some colposcopists manage many women with CIN2 conservatively, this National Audit of British Society for Colposcopy and Cytopathology members, we believe, is the first time this has been formally recorded. The survey assesses current attitudes towards conservative management (CM) of CIN2 and seeks to identify potential selection criteria that could be used to identify suitable women. It received over 500 responses and significantly, identified many colposcopists recommending CM of CIN2 for patients despite the lack of any formal guidance regarding this approach. The greater majority of respondents were keen to consider participating in a multicentre trial on CM of CIN2 targeting the UK screening population (25-64 years). The paper has

  2. An audit cycle of consent form completion: A useful tool to improve junior doctor training.

    Science.gov (United States)

    Leng, Catherine; Sharma, Kavita

    2016-01-01

    Consent for surgical procedures is an essential part of the patient's pathway. Junior doctors are often expected to do this, especially in the emergency setting. As a result, the aim of our audit was to assess our practice in consenting and institute changes within our department to maintain best medical practice. An audit of consent form completion was conducted in March 2013. Standards were taken from Good Surgical Practice (2008) and General Medical Council guidelines. Inclusion of consent teaching at a formal consultant delivered orientation programme was then instituted. A re-audit was completed to reassess compliance. Thirty-seven consent forms were analysed. The re-audit demonstrated an improvement in documentation of benefits (91-100%) and additional procedures (0-7.5%). Additional areas for improvement such as offering a copy of the consent form to the patient and confirmation of consent if a delay occurred between consenting and the procedure were identified. The re-audit demonstrated an improvement in the consent process. It also identified new areas of emphasis that were addressed in formal teaching sessions. The audit cycle can be a useful tool in monitoring, assessing and improving clinical practice to ensure the provision of best patient care.

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

    Science.gov (United States)

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

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

  4. Reasons for deviations outside the acceptance limits in the IAEA/WHO TLD audits for radiotherapy hospitals

    International Nuclear Information System (INIS)

    Vatnitsky, Stanislav; Izewska, Joanna

    2002-01-01

    The main purpose of the IAEA/WHO TLD postal dose audit programme for dosimetry in radiotherapy [1] is to provide an independent verification of the dose delivered by treatment machines in radiotherapy hospitals. The results of the TLD audit are considered acceptable if the relative deviation between the participant's stated dose and the TLD determined dose is within ±5%. The goal of this note is to draw the attention of participants of the TLD programme to some of the common reasons for deviations outside the acceptance limits. Armed with this knowledge, other participants may avoid similar problems in the future. The analysis of deviations presented here is based on the results of TLD audits of the calibration of approximately 1000 Co-60 beams and 600 high-energy X-ray beams performed in the period 1996-2001. A total of 259 deviations outside the ±5% limits have been detected, including 204 deviations for Co-60 beams (20% of all Co-60 beams checked) and 55 for high-energy X-ray beams (10% of all X-ray beams checked). It is worth mentioning that the percentage of large deviations (beyond 10%) is also higher for Co-60 beams than for highenergy X-ray beams. Some problems may be caused by obsolete dosimetry equipment or poor treatment machine conditions. Other problems may be due to insufficient training of staff working in radiotherapy. The clinical relevance of severe TLD deviations detected in the audit programme was confirmed in many cases, but, fortunately, not all-poor dosimetric results reflect deficiencies in the calibration of clinical beams or machine faults. Sometime it happens, that the TLDs are irradiated with an incorrect dose due to misunderstanding of the instructions on how to perform the TLD irradiation. Such dosimetry errors would have no direct impact on actual dose delivered to a patient

  5. Medical audit: threat or opportunity for the medical profession. A comparative study of medical audit among medical specialists in general hospitals in The Netherlands and England, 1970-1999

    NARCIS (Netherlands)

    van Herk, R.; Klazinga, N. S.; Schepers, R. M.; Casparie, A. F.

    2001-01-01

    Medical audit has been introduced among hospital specialists in both the Netherlands and England. In the Netherlands following some local experiments, medical audit was promoted nationally as early as 1976 by the medical profession itself and became a mandatory activity under the Hospital Licensing

  6. Audit and Evaluation of Computer Security. Computer Science and Technology.

    Science.gov (United States)

    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…

  7. Implementation of a web-based national child health-care programme in a local context: A complex facilitator role.

    Science.gov (United States)

    Tell, Johanna; Olander, Ewy; Anderberg, Peter; Berglund, Johan Sanmartin

    2018-02-01

    The aim of this study was to investigate child health-care coordinators' experiences of being a facilitator for the implementation of a new national child health-care programme in the form of a web-based national guide. The study was based on eight remote, online focus groups, using Skype for Business. A qualitative content analysis was performed. The analysis generated three categories: adapt to a local context, transition challenges and led by strong incentives. There were eight subcategories. In the latent analysis, the theme 'Being a facilitator: a complex role' was formed to express the child health-care coordinators' experiences. Facilitating a national guideline or decision support in a local context is a complex task that requires an advocating and mediating role. For successful implementation, guidelines and decision support, such as a web-based guide and the new child health-care programme, must match professional consensus and needs and be seen as relevant by all. Participation in the development and a strong bottom-up approach was important, making the web-based guide and the programme relevant to whom it is intended to serve, and for successful implementation. The study contributes valuable knowledge when planning to implement a national web-based decision support and policy programme in a local health-care context.

  8. AUDIT INFORMATION CONTENT

    OpenAIRE

    Ioan Rus

    2012-01-01

    The audit of computer systems shows at least two features that make the auditwork not includable in other audit processes such as internal audit and financial audit. Thesetwo particularities refer to the specific software used in information systems auditing and reallevels of information systems audit. This paper presents the specific levels of a system ofauditing and specific techniques available for their implementation in practice. In the end theauthor suggests proposals for improving spec...

  9. A cost-outcome approach to pre and post-implementation of national sports injury prevention programmes.

    Science.gov (United States)

    Gianotti, Simon; Hume, Patria A

    2007-12-01

    In New Zealand (NZ), the Accident Compensation Corporation (ACC) has developed a pre and post-implementation cost-outcome formulae for sport injury prevention to provide information regarding the success of a prevention programme. The ACC provides for the cost of all personal injuries in NZ and invests in prevention programmes to offset 1.6 million annual claims that cost $NZD 1.9 billion. The ACC invests in nine national community sport injury prevention programmes that represent 40% of sport claims and costs. Pre-implementation is used to determine the decision whether to invest in implementation and to determine the level of such investment for the injury prevention programme. Post-implementation is calculated two ways: unadjusted, assuming ceteris paribus; and adjusted assuming no prevention programme was in place. Post-implementation formulae provide a return on investment (ROI) for each dollar invested in the programme and cost-savings. The cost-outcome formulae approach allows ACC to manage expectations of the prevention programme as well as when it will provide a ROI, allowing it to take a long-term view for investment in sport injury prevention. Originally developed for its sport injury prevention programmes, the cost-outcome formulae have now been applied to the other prevention programmes ACC invests in such as home, road and workplace injury prevention.

  10. Environmental Audit of the Environmental Measurements Laboratory (EML)

    International Nuclear Information System (INIS)

    1992-02-01

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

  11. ISO 14000 - the International Environmental Management Standard: Potential impacts on environmental management and auditing in the electric power generation industry

    International Nuclear Information System (INIS)

    Gauntlett, S.B.; Pierce, J.L.; Pierce, J.L.

    1995-01-01

    In the framework of environmental management, the concept of voluntary environmental compliance auditing is not in itself a new development. Environmentally conscious firms have for more than a decade, undertaken voluntary audits to help achieve and maintain compliance with environmental regulations and to help identify and correct unregulated or poorly regulated environmental hazard. The firms undertaking the audits were motivated by a desire to mitigate legal and financial risks and/or the desire to be a highly responsible member of the corporate community. Much of the early attention to environmental auditing was in the chemical process industries. Today, there are four current trends affecting environmental auditing: (1) the practice is becoming widespread in all industry groups in both large and small firms; (2) environmental management and audit methodolgies and approaches are being codified in the form of written national and International standards; (3) environmental management programs and in-house audits are increasingly being certified by independent auditors (who are not associated with regulatory agencies); and (4) the certifications are being viewed as marketing and public relations tools. The adoption of ISO 14000 is destined to become the most significant development in international environmental management and auditing. International standards for the development of Environmental Management Systems and the execution of environmental audits do not currently exist. Individual countries, such as England and France, have national standards. One multi-national standard currently exists--the European Economic Community's Eco-Management and Audit Scheme (EMAS). The United States does not have a national environmental management and auditing standard

  12. Benchmarking against the National Emergency Laparotomy Audit recommendations.

    Science.gov (United States)

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

    2018-05-01

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

  13. Strategic environmental assessment of the national programme for the safe management of spent fuel and radioactive waste

    Energy Technology Data Exchange (ETDEWEB)

    Steinhoff, Mathias; Kallenbach-Herbert, Beate; Claus, Manuel [Oeko-Institut e.V. Darmstadt (Germany); and others

    2015-03-27

    The report on the strategic environmental audit for the national waste disposal program covers the following issues: aim of the study, active factors, environmental objectives; description and evaluation of environmental impact including site selection criteria for final repositories of heat generating radioactive waste, intermediate storage of spent fuel elements and waste from reprocessing plants, disposal of wastes retrieved from Asse II; hypothetical zero variants.

  14. Strategic environmental assessment of the national programme for the safe management of spent fuel and radioactive waste

    International Nuclear Information System (INIS)

    Steinhoff, Mathias; Kallenbach-Herbert, Beate; Claus, Manuel

    2015-01-01

    The report on the strategic environmental audit for the national waste disposal program covers the following issues: aim of the study, active factors, environmental objectives; description and evaluation of environmental impact including site selection criteria for final repositories of heat generating radioactive waste, intermediate storage of spent fuel elements and waste from reprocessing plants, disposal of wastes retrieved from Asse II; hypothetical zero variants.

  15. Collaborative Framework for Designing a Sustainability Science Programme: Lessons Learned at the National Autonomous University of Mexico

    Science.gov (United States)

    Charli-Joseph, Lakshmi; Escalante, Ana E.; Eakin, Hallie; Solares, Ma. José; Mazari-Hiriart, Marisa; Nation, Marcia; Gómez-Priego, Paola; Pérez-Tejada, César A. Domínguez; Bojórquez-Tapia, Luis A.

    2016-01-01

    Purpose: The authors describe the challenges and opportunities associated with developing an interdisciplinary sustainability programme in an emerging economy and illustrate how these are addressed through the approach taken for the development of the first postgraduate programme (MSc and PhD) in sustainability science at the National Autonomous…

  16. CONSIDERATIONS REGARDING THE AUDIT OF FINANCIAL SITUATIONS

    Directory of Open Access Journals (Sweden)

    Maria-Madalina, Salomia

    2012-01-01

    Full Text Available In a business world situated on a market that is becoming more and more active both on an international and national level, the audit of financial situations embodies a veritable varied research domain and with favorable advantages for the Romanian business society, as well as for the interest of the business society located outside the Romanian space.From the result of the auditing of financial situations of a entity, various information may be obtained which is used by different groups that present opinions, knowledge and divergent interests such as:managers, investors, financial creditors, commercial creditors, clients, suppliers, employees, the government and its institutions, bankers, financial analysts, the public, the business community and other entities who base themselves on the objectivity and integrity of the financial situations audited.

  17. Assessing the Higher National Diploma Chemical Engineering programme in Ghana: students' perspective

    Science.gov (United States)

    Boateng, Cyril D.; Cudjoe Bensah, Edem; Ahiekpor, Julius C.

    2012-05-01

    Chemical engineers have played key roles in the growth of the chemical and allied industries in Ghana but indigenous industries that have traditionally been the domain of the informal sector need to be migrated to the formal sector through the entrepreneurship and innovation of chemical engineers. The Higher National Diploma Chemical Engineering programme is being migrated from a subject-based to a competency-based curriculum. This paper evaluates the programme from the point of view of students. Data were drawn from a survey conducted in the department and were analysed using SPSS. The survey involved administering questionnaires to students at all levels in the department. Analysis of the responses indicated that the majority of the students had decided to pursue chemical engineering due to the career opportunities available. Their knowledge of the programme learning outcomes was, however, poor. The study revealed that none of the students was interested in developing indigenous industries.

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

    Science.gov (United States)

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

    2015-01-01

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

  19. TLD audit in radiotherapy in the Czech Republic

    International Nuclear Information System (INIS)

    Kroutilikova, D.; Zackova, H.; Judas, L.

    1998-01-01

    National Radiation Protection Institute in Prague organizes the TLD audit. The aim of the TLD postal audit is to provide control of the clinical dosimetry in the Czech Republic for purposes of state supervision in radiotherapy, to investigate and to reduce uncertainties involved in the measurements of absorbed dose and to improve consistency in dose determination in the regional radiotherapy centers. TLD audit covers absorbed dose measurements under reference conditions for 60 Co and 137 Cs beams, high-energy X-ray and electron beams of of linear accelerators and betatrons. The thermo-luminescence dosemeters are sent regularly to all radiotherapy centers. Absorbed dose measures by the TLD is compared to absorbed dose stated by radiotherapy center. Encapsulated LiF:Mg, Ti powder is used for the measurement. Deviation of 3% between stated and TLD measured dose is considered for photons and ±5% for electron beams. First TLD audit was started in 1997. A total of 135 beams was checked. There were found seven major deviations (more than ±6%), which were very carefully investigated. Medical Physicists from these departments reported a set-up mistake. However, at most of those hospitals with major deviations, an in situ audit in details was made soon after TLD audit. There were found discrepancies of clinical dosimetry but also bad technical state of some of the irradiation units. In 1998, second course TLD audit was started. No major deviation was found. Regular TLD audit seems to be a good way to eliminate big mistakes in the basic clinical dosimetry. Repeated audit in the regional radiotherapy centers that had major deviation during the first audit exhibited improvement of their dosimetry. It is intended to broaden the method and to control also beam parameters by means of a multi-purpose phantom. (authors)

  20. Audit of the introduction of CT colonography for detection of colorectal carcinoma in a non-academic environment and its implications for the national bowel cancer screening programme

    International Nuclear Information System (INIS)

    Thomas, S.; Atchley, J.; Higginson, A.

    2009-01-01

    Aim: To compare the sensitivity of double-contrast barium enema (DCBE) with computed tomography colonography (CTC) to determine whether CTC is superior for the detection of colorectal cancer (CRC) locally, and to compare the results to those of a national barium enema audit. Materials and methods: All patients undergoing diagnostic DCBE or CTC between January 2003 and December 2005 were identified from the picture archiving communication system (PACS). Patients with a confirmed diagnosis of CRC were identified from the local cancer registry. Patients who were not diagnosed as having CRC on imaging were assumed true negatives if they were not listed in the cancer registry by December 2007, giving a minimum of 2 years follow-up. DCBE and CTC reports of all patients with CRC were analysed, and cancer detection was considered to have occurred (positive test result) if the report stated the definite presence of CRC or possible CRC requiring further investigation. Results: 2520 DCBEs and 604 CTCs were included. Twenty-one of 33 patients with CRC were detected using DCBE (incidence 1.31%, sensitivity 63.7%). Thirty-two of 33 patients with CRC were -detected using CTC (incidence 5.46%, sensitivity 97.7%). Conclusion: CTC is more sensitive for the detection of CRC, and its introduction in a district general hospital is justified. However, there has been a consequent decline in DCBE sensitivity, which, if reflected nationally, suggests CTC is the preferential screening test for CRC

  1. Audit of the introduction of CT colonography for detection of colorectal carcinoma in a non-academic environment and its implications for the national bowel cancer screening programme

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, S. [Department of Radiology, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO3 6AD (United Kingdom)], E-mail: Susan.Thomas@porthosp.nhs.uk; Atchley, J.; Higginson, A. [Department of Radiology, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth PO3 6AD (United Kingdom)

    2009-02-15

    Aim: To compare the sensitivity of double-contrast barium enema (DCBE) with computed tomography colonography (CTC) to determine whether CTC is superior for the detection of colorectal cancer (CRC) locally, and to compare the results to those of a national barium enema audit. Materials and methods: All patients undergoing diagnostic DCBE or CTC between January 2003 and December 2005 were identified from the picture archiving communication system (PACS). Patients with a confirmed diagnosis of CRC were identified from the local cancer registry. Patients who were not diagnosed as having CRC on imaging were assumed true negatives if they were not listed in the cancer registry by December 2007, giving a minimum of 2 years follow-up. DCBE and CTC reports of all patients with CRC were analysed, and cancer detection was considered to have occurred (positive test result) if the report stated the definite presence of CRC or possible CRC requiring further investigation. Results: 2520 DCBEs and 604 CTCs were included. Twenty-one of 33 patients with CRC were detected using DCBE (incidence 1.31%, sensitivity 63.7%). Thirty-two of 33 patients with CRC were -detected using CTC (incidence 5.46%, sensitivity 97.7%). Conclusion: CTC is more sensitive for the detection of CRC, and its introduction in a district general hospital is justified. However, there has been a consequent decline in DCBE sensitivity, which, if reflected nationally, suggests CTC is the preferential screening test for CRC.

  2. 40 CFR 141.808 - Audits and inspections.

    Science.gov (United States)

    2010-07-01

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

  3. ADAKAH KANDUNGAN INFORMASI LAPORAN AUDIT WTP DENGAN PARAGRAF PENJELAS DAN LAPORAN AUDIT WDP?

    Directory of Open Access Journals (Sweden)

    Arie Wicaksono

    2012-03-01

    Full Text Available Penelitian ini bertujuan untuk menyelidiki konten informasi modified audit opinion pada penilaian pasar. Modified audit opinion dianggap sebagai titik awal laporan standar. Modified audit opinion mengacu pada laporan audit wajar tanpa pengecualian dengan paragraf penjelasan dan laporan audit wajar dengan pengecualian pada reaksi pasar. Penelitian ini dilakukan dengan menggunakan metode studi peristiwa. Sampelnya adalah perusahaan yang memiliki laporan audit wajar tanpa pengecualian dengan paragraf penjelasan dan laporan audit wajar dengan pengecualian yang terdaftar di Bursa Efek Indonesia pada periode 2004-2009. Hasil penelitian menunjukkan bahwa pe-ngumuman laporan audit wajar tanpa pengecualian dengan paragraf penjelasan dan laporan audit wajar dengan pengecualian tidak secara signifikan mempengaruhi abnormal return. This study aims to investigate the information content of modified audit opinion on market valuation. Modified audit opinions are considered the least departure of standard report. The term modified audit opinion refers to both unqualified audit report with explanatory paragraph and qualified audit report on market reaction. The research was done by using event study method. The sample are companies that have unqualified audit report with explanatory paragraph and qualified audit report that listed in Indonesia Stock Exchange in the period of 2004-2009.The results show that the announcement of unqualified audit report with explanatory paragraph and qualified audit report did not significantly affect the abnormal return.

  4. Audit of accuracy of clinical coding in oral surgery.

    Science.gov (United States)

    Naran, S; Hudovsky, A; Antscherl, J; Howells, S; Nouraei, S A R

    2014-10-01

    We aimed to study the accuracy of clinical coding within oral surgery and to identify ways in which it can be improved. We undertook did a multidisciplinary audit of a sample of 646 day case patients who had had oral surgery procedures between 2011 and 2012. We compared the codes given with their case notes and amended any discrepancies. The accuracy of coding was assessed for primary and secondary diagnoses and procedures, and for health resource groupings (HRGs). The financial impact of coding Subjectivity, Variability and Error (SVE) was assessed by reference to national tariffs. The audit resulted in 122 (19%) changes to primary diagnoses. The codes for primary procedures changed in 224 (35%) cases; 310 (48%) morbidities and complications had been missed, and 266 (41%) secondary procedures had been missed or were incorrect. This led to at least one change of coding in 496 (77%) patients, and to the HRG changes in 348 (54%) patients. The financial impact of this was £114 in lost revenue per patient. There is a high incidence of coding errors in oral surgery because of the large number of day cases, a lack of awareness by clinicians of coding issues, and because clinical coders are not always familiar with the large number of highly specialised abbreviations used. Accuracy of coding can be improved through the use of a well-designed proforma, and standards can be maintained by the use of an ongoing data quality assurance programme. Copyright © 2014. Published by Elsevier Ltd.

  5. Developing an online collaborative system within the domain of financial auditing

    Directory of Open Access Journals (Sweden)

    Pavel Năstase

    2015-05-01

    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.

  6.  Developing a framework for audit quality management in audit firms

    OpenAIRE

    Darius Vaicekauskas; Jonas Mackevičius

    2014-01-01

     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 th...

  7. Audit quality and the audit partner effect : Evidence from European listed companies

    OpenAIRE

    Buuren, van, J.P.

    2009-01-01

    The main objective of this study is to provide evidence on the differences in audit quality amongst audit partners. I attribute these dissimilarities to (i) differences in the audit risk perception and the risk appetite of individual audit partners and (ii) to differences in the personal business case of audit partners. As a result, three audit partner archetypes have been identified: liberal, high quality and conservative. This paper will provide evidence that 50% of the audit partners (53% ...

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

    Directory of Open Access Journals (Sweden)

    Puja Seth

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

  9. Environmental audit: Fossil energy sites in Wyoming

    International Nuclear Information System (INIS)

    1992-08-01

    This report documents the results of the Comprehensive Baseline Environmental Audit completed for Selected Fossil Energy Sites in Wyoming. During this Audit, facilities, field sites, and activities were investigated and inspected in several areas of Wyoming that are considered to be representative of offsite work falling under the purview of the Morgantown Energy Technology Center (METC) in Morgantown, West Virginia. Department of Energy (DOE) personnel at METC and at the Liquid Fuels Technology Branch (LFTB) in Laramie, Wyoming were interviewed as were DOE contractors and Federal and state regulators. Extensive document review was also a key part of this Audit. The on-site portion of the Audit occurred in Morgantown from May 18 to 22, 1992, and throughout Wyoming from May 26 through June 10, 1992. EH-24 carries out independent assessments of DOE facilities and DOE-funded off-site activities as part of the Assistant Secretary's Environmental Audit Program. That program is designed to evaluate the status of facilities and activities regarding compliance with environmental laws, regulations, DOE Directives, formal written procedures, compliance agreements, and Best Management Practices (BMPs). This internal oversight function plays an important role in improving the compliance status of DOE operations. The Audit stresses the fact that it is the responsibility of line management to conduct operations in an environmentally sound and safe manner. The scope of this Environmental Audit was comprehensive, covering all areas of environmental activities and waste management operations with the exception of the National Environmental Policy Act (NEPA), which is beyond the purview of EH-24. Specifically included within this Audit were Air, Soils/Sediment/Biota, Surface Water/Drinking Water, Groundwater, Waste Management, Toxic and Chemical Materials, Quality Assurance, Radiation, Inactive Waste Sites, and Environmental Management

  10. The effects of placing an operational research fellow within the Viet Nam National Tuberculosis Programme.

    Science.gov (United States)

    Hoa, N B; Nhung, N V; Kumar, A M V; Harries, A D

    2016-12-21

    In April 2009, an operational research fellow was placed within the Viet Nam National Tuberculosis Control Programme (NTP). Over the 6 years from 2010 to 2015, the OR fellow co-authored 21 tuberculosis research papers (as principal author in 15 [71%]). This constituted 23% of the 91 tuberculosis papers published in Viet Nam during this period. Of the 21 published papers, 16 (76%) contributed to changes in policy ( n = 8) and practice ( n = 8), and these in turn improved programme performance. Many papers also contributed important evidence for better programme planning. Highly motivated OR fellows embedded within NTPs can facilitate high-quality research and research uptake.

  11. Audit diabetes-dependent quality of life questionnaire: usefulness in diabetes self-management education in the Slovak population.

    Science.gov (United States)

    Holmanová, Elena; Ziaková, Katarína

    2009-05-01

    This paper reports a study to test validity and internal consistency of the audit diabetes-dependent quality of life questionnaire in the Slovak population and to evaluate its usefulness in the context of education of people with diabetes. The individualised instruments designed to measure individuals' perceptions of the impact of diabetes on their quality of life may be helpful to identify individuals' preferences, motivational deficits in diabetes management and to tailor individual treatment strategies. Survey. After linguistic validation, the structure of the questionnaire was tested using factor analysis on 104 patients who were recruited from the National Institute of Endocrinology and Diabetology in Lubochna. Internal consistency was evaluated by computing Cronbach's alpha. Clinical variables related to the quality of life were analysed using one-way ANOVA, multifactor ANOVA, Pearson's and Spearman's rank correlation coefficients. A one-dimensional scale structure was supported and internal consistency was high (alpha = 0.93). Variance in impact of diabetes on quality of life was explained by age, presence of late complications and type of insulin regimen. The audit diabetes-dependent quality of life is culturally appropriate, valid and reliable in the sample of Slovak patients attending the educational programme. Our results agreed with previous European and Asian studies supporting its usefulness in the context of diabetes self-management education. Individualised diabetes-specific quality of life measures allow better understanding of patients' treatment preferences and, consequently, more effective prioritizing and targeting of appropriate educational interventions. This instrument may be useful in routine clinical practice and as an outcome measure for international clinical research trials evaluating effectiveness of educational programmes.

  12. Man-rem audit - a tool for exposure ALARA at Madras Atomic Power Station

    International Nuclear Information System (INIS)

    Shivaramakrishnan, N.R.; Eswaran, G.; Gangamohan, M.; Sathish, A.V.; Ramasubramanian, K.V.; Gandhimathinathan, S.; Selvam, S.; Moolya, L.L.

    2012-01-01

    ALARA - acronym for As Low As Reasonably Achievable, which means making every reasonable effort to maintain exposures to radiation as far below the dose limits as is practical. ICRP has recommended ALARA to be implemented as a formal practice into the System of Dose Limitation, which contains three parts, 1) Justification of practice 2) Optimization 3) Dose Limits. As with the human endeavor, there is always room for improvement. Keeping this in mind, ALARA program is being practiced in our Nuclear Power Plants over the years. There has been a gradual reduction of collective dose in our Nuclear Power Plants due to successful implementation of the ALARA programs. This was possible due to the rigorous application of O and M experience, feedback and active participation of workforce towards ALARA. Furthermore, ALARA is an ongoing continual improvement programme towards collective dose reduction and has enough scope for improvement at any point of time. In order to substantiate the gains of ALARA programme and to improve it further, first time Mam-rem Audit was conducted at MAPS during the month of Sep-Oct 2010. This paper gives the brief outline about the method man-rem audit, its findings, corrective action implementation and the benefits derived from it. Man-rem audit similar to financial audit, serves as a tool for finding out grey areas where improvements is required so that station collective dose can be further optimized. It is one of the identified missions to achieve excellence in area of reducing station collective dose, unplanned exposures and RPP deviation. The scope of this audit is to bring further improvements in the reduction in station collective dose, create more awareness among the employees about ALARA principles and seek valuable suggestions for improvements. Audit team consisting of senior HP persons had one to one interaction with the individuals of the respective section in the field and tried to gather the information from the individual and

  13. Health system changes under pay-for-performance: the effects of Rwanda's national programme on facility inputs.

    Science.gov (United States)

    Ngo, Diana K L; Sherry, Tisamarie B; Bauhoff, Sebastian

    2017-02-01

    Pay-for-performance (P4P) programmes have been introduced in numerous developing countries with the goal of increasing the provision and quality of health services through financial incentives. Despite the popularity of P4P, there is limited evidence on how providers achieve performance gains and how P4P affects health system quality by changing structural inputs. We explore these two questions in the context of Rwanda's 2006 national P4P programme by examining the programme's impact on structural quality measures drawn from international and national guidelines. Given the programme's previously documented success at increasing institutional delivery rates, we focus on a set of delivery-specific and more general structural inputs. Using the programme's quasi-randomized roll-out, we apply multivariate regression analysis to short-run facility data from the 2007 Service Provision Assessment. We find positive programme effects on the presence of maternity-related staff, the presence of covered waiting areas and a management indicator and a negative programme effect on delivery statistics monitoring. We find no effects on a set of other delivery-specific physical resources, delivery-specific human resources, delivery-specific operations, general physical resources and general human resources. Using mediation analysis, we find that the positive input differences explain a small and insignificant fraction of P4P's impact on institutional delivery rates. The results suggest that P4P increases provider availability and facility operations but is only weakly linked with short-run structural health system improvements overall. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia.

    Science.gov (United States)

    Nguyen, Thuong T; McKinney, Barbara; Pierson, Antoine; Luong, Khue N; Hoang, Quynh T; Meharwal, Sandeep; Carvalho, Humberto M; Nguyen, Cuong Q; Nguyen, Kim T; Bond, Kyle B

    2014-01-01

    The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme. However, the paper-based format of the checklist makes administration cumbersome and limits timely analysis and communication of results. In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors' feedback about usability. The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries.

  15. SLIPTA e-Tool improves laboratory audit process in Vietnam and Cambodia

    Directory of Open Access Journals (Sweden)

    Thuong T. Nguyen

    2014-11-01

    Full Text Available Background: The Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA checklist is used worldwide to drive quality improvement in laboratories in developing countries and to assess the effectiveness of interventions such as the Strengthening Laboratory Management Toward Accreditation (SLMTA programme. However, the paperbased format of the checklist makes administration cumbersome and limits timely analysis and communication of results. Development of e-Tool: In early 2012, the SLMTA team in Vietnam developed an electronic SLIPTA checklist tool. The e-Tool was pilot tested in Vietnam in mid-2012 and revised. It was used during SLMTA implementation in Vietnam and Cambodia in 2012 and 2013 and further revised based on auditors’ feedback about usability. Outcomes: The SLIPTA e-Tool enabled rapid turn-around of audit results, reduced workload and language barriers and facilitated analysis of national results. Benefits of the e-Tool will be magnified with in-country scale-up of laboratory quality improvement efforts and potential expansion to other countries.

  16. KEPUASAN KLIEN DAN KEGUNAAN LAPORAN AUDIT EKSTERNAL STAKE HOLDER (PERSPEKTIF KLIEN AUDIT

    Directory of Open Access Journals (Sweden)

    Tubagus Ismail

    2015-05-01

    Full Text Available The purpose of the paper is to test a structural equation model (SEM of client satisfaction with the audit, and of client perception of the usefulness of the audit to external stakeholders. A questionnaire was mailed to audit clients, i.e. of manufacturing go public companies in the province of Banten; 57 useable questionnaires were returned. Data were processed using the SEM software Partial Least Square (PLS. The data suggest that auditors face difficulties in handling divided loyalties, as audit clients perceive a strong relationship between client satisfaction and usefulness to external stakeholders. The higher auditors competence is perceived to be by the clients, the more satisfied they are with the audit and the more useful they believe the audit is to external stakeholders. The more skeptical the auditor is perceived to be by the clients, the less satisfied they are with the audit and the moreuseful they believe the audit is to external stakeholders. The findings extend previous results, the better the relationship with the auditor is perceived to be by the clients, the more satisfied they are with the audit and the less useful they believe the audit is to external stakeholders. The study addresses an issue most auditing research has not explicitly considered: the distinction between client satisfaction with the audit and client perceptions of the usefulness of the audit to external stakeholders. Tujuan dari artikel ini adalah untuk menguji model persamaan struktural (SEM atas kepuasan klien, audit, dan persepsi klien tentang kegunaan audit kepada pemangku kepentingan eksternal. Responden penelititan ini adalah 57 klien audit, yang bekerja di perusahaan manufaktur go public di Provinsi Banten. Data diolah dengan menggunakan software SEM Partial Least Square (PLS. Hasil penelitian menunjukkan bahwa auditor menghadapi kesulitan dalam menangani kesetiaan yang terbagi bagi, antara harus berada pada posisi kepuasan klien dan kegunaan kepada

  17. Energy audit role in building planning

    Science.gov (United States)

    Sipahutar, Riman; Bizzy, Irwin

    2017-11-01

    An energy audit is one way to overcome the excessive use of energy in buildings. The increasing growth of population, economy, and industry will have an impact on energy demand and the formation of greenhouse gas emissions. Indonesian National Standard (SNI) concerning the building has not been implemented optimally due to the socialization process by a government not yet been conducted. An energy audit of buildings has been carried out at offices and public services. Most electrical energy in buildings used for air refresher equipment or air conditioning. Calculation of OTTV has demonstrated the importance of performing since the beginning of the planning of a building to get energy-efficient buildings.

  18. 78 FR 21631 - NASA Advisory Council; Audit, Finance and Analysis Committee; Meeting

    Science.gov (United States)

    2013-04-11

    ... the Audit, Finance and Analysis Committee of the NASA Advisory Council have been revised. The revised... 92-463, as amended, the National Aeronautics and Space Administration announces a meeting of the Audit, Finance and Analysis Committee of the NASA Advisory Council. DATES: Monday, April 22, 2013, 9:00...

  19. Continuos Online Auditing Dan Continuous Assurance : Evolusi Jasa Audit Masa Mendatang

    OpenAIRE

    Ariston; Handoko, Jesica

    2006-01-01

    The advent of computer has affected numerous aspects of accounting and auditing. Computerassisted auditing has became commonplace, leading to a significant increase in efficiency of auditing (Kogan dkk., 1999). This improvements enabled management and reporting (internal and external) of finer information sets at progressively narrower time frames. This article describes continuous online auditing and continuous assurance as emerging future audit services evolution. They have three impo...

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

    Science.gov (United States)

    Wen, Jing; Xiao, Jiangyi; Wang, Aijun

    2018-02-08

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

  1. IAEA/WHO postal dose audits for radiotherapy hospitals in Eastern and South-Eastern Europe

    International Nuclear Information System (INIS)

    Izewska, J.; Vatnitsky, S.; Shortt, K.R.

    2004-01-01

    The IAEA/WHO TLD programme has been in operation for 34 years. In this period the calibration of approximately 5200 high-energy photon beams in over 1300 radiotherapy hospitals in 115 countries worldwide was checked. Of these, 18% of the audits were performed in Eastern and South-Eastern Europe. There are large contrasts in the region; while the results are very good for most countries, a few countries struggle with basic problems in dosimetry. The hospitals operating radiotherapy services without qualified medical physicists or dosimetry equipment have poorer results than those properly equipped and staffed. Only about 2/3 of TLD audit participants in Eastern Europe have the appropriate dosimetry equipment. To achieve consistency of the audit results within Eastern and South-Eastern Europe, strengthening of radiotherapy infrastructure in a few countries would be necessary. (authors)

  2. Auditing hazardous waste incineration

    International Nuclear Information System (INIS)

    Jayanty, R.K.M.; Allen, J.M.; Sokol, C.K.; von Lehmden, D.J.

    1990-01-01

    This paper reports that audit standards consisting of volatile and semivoltile organics have been established by the EPA to be provided to federal, state, and local agencies or their contractors for use in performance audits to assess the accuracy of measurement methods used during hazardous waste trial burns. The volatile organic audit standards currently total 29 gaseous organics in 5, 6, 7, 9, and 18-component mixtures at part-per-billion (ppb) levels (1 to 10 000 ppb) in compressed gas cylinders in a balance gas of nitrogen. The semivoltile organic audit standards currently total six organics which are spiked onto XAD-2 cartridges for auditing analysis procedures. Studies of all organic standards have been performed to determine the stability of the compounds and the feasibility of using them as performance audit materials. Results as of July 1987 indicate that all of the selected organic compounds are adequately stabile for use as reliable audit materials. Performance audits have been conducted with the audit materials to assess the accuracy of the measurement methods. To date, 160 performance audits have been initiated with the ppb-level audit gases. The audit results obtained with audit gases during hazardous waste trial burn tests were generally within ±50% of the audit concentrations. A limited number of audit results have been obtained with spiked XAD-2 cartridges, and the results have generally been within ±35% of the audit concentrations

  3. National Programme for Radiological Protection in Medical Exposures; Programa nacional de Proteccion radiologica en las exposiciones medicas

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-07-15

    A national programme on radiation protection of patients can only be effective and sustainable if there is a joint effort between the regulatory body and the health authorities, and a cooperation with educational institutions, professional bodies and representatives of the industry. The regulatory body needs to promote a strategy of cooperation, and to identify obstacles that may prevent compliance with regulatory requirements and to address them. Not of least is the need for a continuous self-evaluation on the efficacy of the programme. Radiation safety of the patients is a responsibility of the users of the radiation sources involved in diagnostic and treatment. In particular, they are responsible for compliance with regulatory requirements. But safety depends also on aspects that are beyond the capabilities of those authorized to conduct practices. These aspects include educational programmes and institutions to implement them, calibration facilities, national protocols, professional bodies for the establishment of reference levels and contributions from the industry. Neither the users nor the regulatory body alone can achieve that these elements are in place. It needs a network of institutions and cooperation arrangements that involve educational and health authorities, laboratory facilities, professional bodies and the industry. A national programme has to include a strategy of cooperation, identification of obstacles that may prevent compliance with regulatory requirements and address them. Not of least is the need for a continuous self-evaluation on the efficacy of the programme. A group of regulatory agencies belonging to the Ibero American Forum of Nuclear and Radiation Regulatory Agency have exchanged experiences, lessons learned and good practices over three years. This exchange included extensive collaboration with the health authorities. The result of this work is this document containing a self-evaluation approach for the regulatory programme on

  4. Can virtual streetscape audits reliably replace physical streetscape audits?

    Science.gov (United States)

    Badland, Hannah M; Opit, Simon; Witten, Karen; Kearns, Robin A; Mavoa, Suzanne

    2010-12-01

    There is increasing recognition that the neighborhood-built environment influences health outcomes, such as physical activity behaviors, and technological advancements now provide opportunities to examine the neighborhood streetscape remotely. Accordingly, the aims of this methodological study are to: (1) compare the efficiencies of physically and virtually conducting a streetscape audit within the neighborhood context, and (2) assess the level of agreement between the physical (criterion) and virtual (test) audits. Built environment attributes associated with walking and cycling were audited using the New Zealand Systematic Pedestrian and Cycling Environment Scan (NZ-SPACES) in 48 street segments drawn from four neighborhoods in Auckland, New Zealand. Audits were conducted physically (on-site) and remotely (using Google Street View) in January and February 2010. Time taken to complete the audits, travel mileage, and Internet bandwidth used were also measured. It was quicker to conduct the virtual audits when compared with the physical audits (χ = 115.3 min (virtual), χ = 148.5 min (physical)). In the majority of cases, the physical and virtual audits were within the acceptable levels of agreement (ICC ≥  0.70) for the variables being assessed. The methodological implication of this study is that Google Street View is a potentially valuable data source for measuring the contextual features of neighborhood streets that likely impact on health outcomes. Overall, Google Street View provided a resource-efficient and reliable alternative to physically auditing the attributes of neighborhood streetscapes associated with walking and cycling. Supplementary data derived from other sources (e.g., Geographical Information Systems) could be used to assess the less reliable streetscape variables.

  5. Performing of quality audits

    International Nuclear Information System (INIS)

    Rausch, W.P.

    1980-01-01

    A discussion of the need for Quality Audits both from the practical and regulatory point of view will be followed by presentation of the required steps of audit preparation, auditor assignment, checklist development, review of prior audits, notification, logistics, etc. The various examination steps of auditing, including pre-audit conference, checklist usage, interview, and objective evidence review, will be discussed as will the techniques used in finding development, post audit conference, audit report writing, and follow-up. An overview of organization for auditing, including training and certification, will be presented. (RW)

  6. The A.P.I. ECO Project. Pilot demonstration project in small and medium enterprises implementing the eco-management and audit scheme; Progetto A.P.I.ECO. Azioni pilota in favore dell`attuazione nelle piccole e medie industrie del sistema comunitario di ecogestione e audit

    Energy Technology Data Exchange (ETDEWEB)

    Brunetti, Nicola [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Ambiente; Casciani, Michele; Galotti, Giorgio; Peruzzi, Augusto [IGEAM Srl, Rome (Italy)

    1997-09-01

    During a 18 months period in 1995/1996 a pilot demonstration project, on behalf of the Commission the European Communities, was undertaken to investigate the experience of 8 small and medium-sized enterprises (SMEs), in Lazio Region, implementing the Eco-management and audit scheme (EMAS). The promoters of A.P.I.ECO project are: IGEAM Srl (environmental consulting company); ENEA (the National Agency for New Technology, Energy and the Environment) and FEDERLAZIO (Regional SMEs association). The principal direct targets of the project have been: backing up 8 SMEs of different sectors and characteristics, by conducting a deep initial environmental review and implementing the EMAS, with the goal of leading them to the environmental certification according to the 1836/93 EC Regulation; preparation and utilization of guidelines, procedures and protocols for the several steps of EMAS; promoting and divulgating principles and techniques of environmental management and eco-auditing, as much as possible, especially on a regional scale via SMEs association; training and opportunity of a practical experience of environmental analysis and auditing in SMEs to a large group of technicians of different backgrounds in the environmental field. A step by step procedure program was utilized for implementing EMAS in the 8 SMEs: environmental review; policy, objectives and programmes; environmental management system (Organization and Personnel, Environmental Management Manual, Operating Systems and Controls and Register of Environmental Effects and Regulation, Environmental Audit); Environmental statement. The project has been completed with the drafting of guideline for environmental statement for each of the 8 companies and the disseminating the results achieved.

  7. Targets and criteria for the effective participation of national industry in a domestic nuclear power programme

    International Nuclear Information System (INIS)

    Py, J.P.

    1986-01-01

    The interest in maximum use of national resource is common to all countries, the highly industrialized as well as the developing ones. Although benefits can be expected from national participation in a domestic nuclear power programme and may not be limited to this programme, such national participation is restricted by constraining factors: economic, financial, technical and political. Considering the various natures of activities - design, procurement, manufacturing, erection -, their technical difficulties, their potential spin-off effects on the overall industrial development of a country, the paper reviews the materials and components of a nuclear power plants which can be selected as targets for domestic production. The paper also reviews criteria which must be considered in setting these Target materials and components in order to overcome restricting factors to national participation such as cost of national products, financing, investment capability, adequate market size, availability of qualified manpower, industrial capability and quality standards, availability of technology and know-how, conflicts of interests. Some concrete examples drawn from previous experience will illustrate France efforts to overcome these limiting factors [fr

  8. IT auditing

    NARCIS (Netherlands)

    Fijneman, R.; Ho, K.H.; Roos Lindgreen, E.; Veltman, P.

    2008-01-01

    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

  9. Mentoring, coaching and action learning: interventions in a national clinical leadership development programme.

    Science.gov (United States)

    McNamara, Martin S; Fealy, Gerard M; Casey, Mary; O'Connor, Tom; Patton, Declan; Doyle, Louise; Quinlan, Christina

    2014-09-01

    To evaluate mentoring, coaching and action learning interventions used to develop nurses' and midwives' clinical leadership competencies and to describe the programme participants' experiences of the interventions. Mentoring, coaching and action learning are effective interventions in clinical leadership development and were used in a new national clinical leadership development programme, introduced in Ireland in 2011. An evaluation of the programme focused on how participants experienced the interventions. A qualitative design, using multiple data sources and multiple data collection methods. Methods used to generate data on participant experiences of individual interventions included focus groups, individual interviews and nonparticipant observation. Seventy participants, including 50 programme participants and those providing the interventions, contributed to the data collection. Mentoring, coaching and action learning were positively experienced by participants and contributed to the development of clinical leadership competencies, as attested to by the programme participants and intervention facilitators. The use of interventions that are action-oriented and focused on service development, such as mentoring, coaching and action learning, should be supported in clinical leadership development programmes. Being quite different to short attendance courses, these interventions require longer-term commitment on the part of both individuals and their organisations. In using mentoring, coaching and action learning interventions, the focus should be on each participant's current role and everyday practice and on helping the participant to develop and demonstrate clinical leadership skills in these contexts. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2015-02-01

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

  11. Motivating consumers for National Programme on Immunization (NPI) and Oral Rehydration Therapy (ORT) in Nigeria.

    Science.gov (United States)

    Ekerete, P P

    1997-01-01

    The Expanded Programme on Immunization (EPI) (changed to National Programme on Immunization (NPI) in 1996) and Oral Rehydration Therapy (ORT) were launched in Nigeria in 1979. The goal of EPI was Universal Childhood Immunization (UCI) 1990, that is, to vaccinate 80% of all children age 0-2 years by 1990, and 80% of all pregnant women were also expected to be vaccinated with Tetanus Toxoid Vaccine. The Oral Rehydration Therapy was designed to teach parents with children age 0-5 years how to prepare and use a salt-sugar solution to rehydrate children dehydrated by diarrhoea. Nigeria set up Partners-in-Health to mobilize and motivate mothers to accept the programme. In 1990 a National coverage survey was conducted to assess the level of attainment. The results show that some states were able to reach the target and some were not. It therefore became necessary to evaluate the contribution of those promotional elements adopted by Partners-in-Health to motivate mothers to accept the programme. The respondents were therefore asked to state the degree to which these elements motivated them to accept the programme. The data were collected and processed through a Likert rating scale and t-test procedure for test of significance between two sample means. The study revealed that some elements motivated mothers very strongly, others strongly, and most moderately or low, with health workers as major sources of motivation. The study also revealed that health workers alone can not sufficiently motivate mothers without the help of religious leaders, traditional leaders and mass media, etc. It was therefore recommended that health workers should be intensively used along with other promotional elements to promote the NPI/ORT programme in Nigeria.

  12. The Transparency Programme of the Swedish National Council for Nuclear Waste. A Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Kjell (Karita Research AB, Taeby (Sweden)), E-Mail: kjell.andersson@karita.se

    2009-12-15

    In this paper the activities of the Transparency Programme of the Swedish National Council for Nuclear Waste have been explored. Comparisons have been made with other activities using the same transparency approach and observations made from different reports that deal with the programme or parts of it have been taken into account. Obviously, to make firm conclusions to what extent the aims of the Transparency Programme have been achieved a formal review should be done. It seems evident however that the programme has vitalized the overall dialogue about the Swedish nuclear waste management programme and that the hearings held have raised the awareness about issues that have been dealt with such as value-laden aspects of disposals methods, feasibility of certain alternatives, the need for clarification of how regulatory criteria can be applied and the use of research on governance processes. Stakeholders seem to have appreciated the overall organization and the stretching that took place during the hearings held. For possible future activities, the observations made about the antagonism between certain parties which has existed since a long time ago and the common language and culture need to be taken into account. The core problem, however, is to reach out to the political decision makers at the national level, especially since the time distance between hearings held so far and critical government decisions is at least six years which put a high demand on the reporting system. Taking the experiences from other transparency projects into account, the Council might consider the possibility to establish a reference group with participation from different stakeholders and politicians who could have a role for conveying results to wider groups. One observer has concluded that the reporting from the Transparency Programme should be open in the sense that it should not make conclusions on the issues as such (e.g. if a certain disposal method is to prefer or not). Instead

  13. The Transparency Programme of the Swedish National Council for Nuclear Waste. A Status Report

    International Nuclear Information System (INIS)

    Andersson, Kjell

    2009-12-01

    In this paper the activities of the Transparency Programme of the Swedish National Council for Nuclear Waste have been explored. Comparisons have been made with other activities using the same transparency approach and observations made from different reports that deal with the programme or parts of it have been taken into account. Obviously, to make firm conclusions to what extent the aims of the Transparency Programme have been achieved a formal review should be done. It seems evident however that the programme has vitalized the overall dialogue about the Swedish nuclear waste management programme and that the hearings held have raised the awareness about issues that have been dealt with such as value-laden aspects of disposals methods, feasibility of certain alternatives, the need for clarification of how regulatory criteria can be applied and the use of research on governance processes. Stakeholders seem to have appreciated the overall organization and the stretching that took place during the hearings held. For possible future activities, the observations made about the antagonism between certain parties which has existed since a long time ago and the common language and culture need to be taken into account. The core problem, however, is to reach out to the political decision makers at the national level, especially since the time distance between hearings held so far and critical government decisions is at least six years which put a high demand on the reporting system. Taking the experiences from other transparency projects into account, the Council might consider the possibility to establish a reference group with participation from different stakeholders and politicians who could have a role for conveying results to wider groups. One observer has concluded that the reporting from the Transparency Programme should be open in the sense that it should not make conclusions on the issues as such (e.g. if a certain disposal method is to prefer or not). Instead

  14. The diversity of the Brazilian regional Audit Courts on government auditing

    Directory of Open Access Journals (Sweden)

    André Feliciano Lino

    2017-11-01

    Full Text Available ABSTRACT Currently, the 33 regional audit courts are responsible to monitor the public financial management cycle for states and municipalities and to judge the compliance of governors’ acts to the laws regarding procurement and civil servants’ employment from more than 20,000 governmental entities under their jurisdiction. This article aims to analyze the diversity of internal configuration of these regional audit courts and to discuss the potential associations with the financial auditing quality their teams usually run. We conducted interviews with external auditors and IT directors from 18 courts, followed by triangulation to official documents from the audit courts, such as audit manuals and activities reports. The audit quality drivers were identified within the governmental auditing literature, supporting the evidences collected by the interviews content analysis. Despite all regional auditing bodies in Brazil were based on the Napoleonic model, the analysis indicates the identified configurations vary according to the team’s organization and size, auditor rotation and use of data reporting systems. The discussion shows that dissimilarities on the courts’ configurations, as they are responsible to audit a specific country area, will contribute to a different coercion level on fiscal and accounting issues to state and municipalities, due a combination of characteristics which could mitigate or improve the audit quality. This paper additionally suggests some precautions, based on the organization alignment literature, for the use of proxies to control audit quality effects in the public finance studies in Brazil.

  15. Service impact of a national clinical leadership development programme: findings from a qualitative study.

    Science.gov (United States)

    Fealy, Gerard M; McNamara, Martin S; Casey, Mary; O'Connor, Tom; Patton, Declan; Doyle, Louise; Quinlan, Christina

    2015-04-01

    The study reported here was part of a larger study, which evaluated a national clinical leadership development programme with reference to resources, participant experiences, participant outcomes and service impact. The aim of the present study was to evaluate the programme's service impact. Clinical leadership development develops competencies that are expressed in context. The outcomes of clinical leadership development occur at individual, departmental and organisational levels. The methods used to evaluate the service impact were focus groups, group interviews and individual interviews. Seventy participants provided data in 18 separate qualitative data collection events. The data contained numerous accounts of service development activities, initiated by programme participants, which improved service and/or improved the culture of the work setting. Clinical leadership development programmes that incorporate a deliberate service impact element can result in identifiable positive service outcomes. The nuanced relationship between leader development and service development warrants further investigation. This study demonstrates that clinical leadership development can impact on service in distinct and identifiable ways. Clinical leadership development programmes should focus on the setting in which the leadership competencies will be demonstrated. © 2013 John Wiley & Sons Ltd.

  16. The national bowel cancer audit project: the impact of organisational structure on outcome in operative bowel cancer within the United Kingdom.

    Science.gov (United States)

    Cornish, J A; Tekkis, P P; Tan, E; Tilney, H S; Thompson, M R; Smith, J J

    2011-06-01

    To investigate the relationship between organisational structure, process and surgical outcomes for bowel cancer surgery. An e-survey was sent to the members of the Association of Coloproctology of Great Britain and Ireland to determine the organisational structure of their Trusts. Responses were combined with the National Bowel Cancer Audit (NBOCAP) data. Items investigated included; number of consultants, nurse specialists, volume of cases and intensive care facilities. Main outcome measures included: 30-day risk-adjusted mortality, length of stay (LOS), lymph node yield and circumferential margin involvement (CRM). One hundred and seventeen Trusts responded (65.8%), matched to 7666 patient episodes (NBOCAP data) from 54 (62.8%)Trusts who submitted data to the audit. Trusts treating 0.001), 0.001), 0001) and 0001) were more likely to have a 30-day-risk-adjusted mortality twice that of the national mean. Sixty five percent (n = 1603) of Trusts treating ≥ 190 cases/annum harvested ≥ 12 lymph nodes vs. 58.3% (n = 1435) in Trusts organisational infrastructure of hospitals appears to have as great an impact on patient outcomes as the volume of cases performed by hospital Trusts. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

  18. Safety Auditing and Assessments

    Science.gov (United States)

    Goodin, James Ronald (Ronnie)

    2005-01-01

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

  19. Op weg naar de landelijke invoering van perinatale audit

    OpenAIRE

    Leeman LD; Waelput AJM; Eskes M; Achterberg PW; VTV

    2007-01-01

    In the near future perinatal audit will start in the Netherlands, with a systematic critical analysis of the quality of care of perinatal mortality. The National Institute for Public Health and the Environment designed a plan for the implementation of perinatal audit. The slower decline of perinatal mortality in the Netherlands in comparison to surrounding countries gave cause to this plan. There are suggestions that improvement of (preventive) care can lead to perinatal health gains. Perinat...

  20. Audit Fee Determinants and Audit Quality in Ethiopian Commercial ...

    African Journals Online (AJOL)

    However, among the factors considered important by the regulatory bank, credit risk is found to be insignificant. 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 ...

  1. Audit Fee Determinants and Audit Quality in Ethiopian Commercial ...

    African Journals Online (AJOL)

    user

    Secondly, the presence of vigilant regulation places a countervailing effect in the audit ... market and the stiff competition (partly triggered by the bidding system) ... accounting profession, and lower audit quality concern afforded in the country, ..... those earnings and give it a better audit opinion than the facts merit (Xie et al.

  2. Reaching national consensus on the core clinical skill outcomes for family medicine postgraduate training programmes in South Africa.

    Science.gov (United States)

    Akoojee, Yusuf; Mash, Robert

    2017-05-26

    Family physicians play a significant role in the district health system and need to be equipped with a broad range of clinical skills in order to meet the needs and expectations of the communities they serve. A previous study in 2007 reached national consensus on the clinical skills that should be taught in postgraduate family medicine training prior to the introduction of the new speciality. Since then, family physicians have been trained, employed and have gained experience of working in the district health services. The national Education and Training Committee of the South African Academy of Family Physicians, therefore, requested a review of the national consensus on clinical skills for family medicine training. A Delphi technique was used to reach national consensus in a panel of 17 experts: family physicians responsible for training, experienced family physicians in practice and managers responsible for employing family physicians. Consensus was reached on 242 skills from which the panel decided on 211 core skills, 28 elective skills and 3 skills to be deleted from the previous list. The panel was unable to reach consensus on 11 skills. The findings will guide training programmes on the skills to be addressed and ensure consistency across training programmes nationally. The consensus will also guide formative assessment as documented in the national portfolio of learning and summative assessment in the national exit examination. The consensus will be of interest to other countries in the region where training programmes in family medicine are developing.

  3. TAX AUDIT AS A SEPARATE ITEM IN THE SYSTEM OF GENERAL AUDIT

    Directory of Open Access Journals (Sweden)

    Aleksey F. Akhmetshin

    2014-01-01

    Full Text Available The article describes General concepts of the audit, the purpose and the essence of the tax audit, determines the methods of calculation of the tax burden, describes the ratio of the total and tax audit. Comparative analysis with the purpose of definition of tax audit as a separate element of the system of General audit is given. Conclusion about expediency of holding events for tax audit for the purpose of reduction of tax risks of economic entities is made.

  4. Audit mode change, corporate governance

    Directory of Open Access Journals (Sweden)

    Limei Cao

    2015-12-01

    Full Text Available This study investigates changes in audit strategy in China following the introduction of risk-based auditing standards rather than an internal control-based audit mode. Specifically, we examine whether auditors are implementing the risk-based audit mode to evaluate corporate governance before distributing audit resources. The results show that under the internal control-based audit mode, the relationship between audit effort and corporate governance was weak. However, implementation of the risk-based mode required by the new auditing standards has significantly enhanced the relationship between audit effort and corporate governance. Since the change in audit mode, the Big Ten have demonstrated a significantly better grasp of governance risk and allocated their audit effort accordingly, relative to smaller firms. The empirical evidence indicates that auditors have adjusted their audit strategy to meet the regulations, risk-based auditing is being achieved to a degree, reasonable and effective corporate governance helps to optimize audit resource allocation, and smaller auditing firms in particular should urgently strengthen their risk-based auditing capability. Overall, our findings imply that the mandatory switch to risk-based auditing has optimized audit effort in China.

  5. On the nature of auditing: The audit partner effect : Research on the effect of individual audit partners on audit quality and the information dynamics of accounting data

    NARCIS (Netherlands)

    Buuren, van J.P.

    2009-01-01

    This doctoral thesis is about whether auditing is ‘static and mechanic’ of nature or the opposite: ‘dynamic and organic’. If auditing is considered ‘static and mechanic’ of nature, this implies that standard audit solutions are available and can uniformly be applied by the audit partners. Moreover,

  6. Changing Methodologies in Financial Audit and Their Impact on Information Systems Audit

    Directory of Open Access Journals (Sweden)

    Daniel VILSANOIU

    2010-01-01

    Full Text Available This paper tries to provide a better understanding of the relation between financial audit and information systems audit and to assess the influence the change in financial audit methodologies had on IS audit. We concluded that the COSO Internal Control – Integrated Framework was the starting point for fundamental changes in both financial and IS audit and that the Sarbanes-Oxley Act should be viewed as an enabler rather than an enforcer in establishing strong governance models. Finally, our research suggests that there is a direct causality effect between the employment of BRA (business risk audit methodologies and the growing importance of IS audit.

  7. Increased auditor independence by external rotation and separating audit and non audit duties? - A note on the European audit regulation

    Directory of Open Access Journals (Sweden)

    Patrick Velte

    2015-05-01

    Full Text Available The European audit reform contains the implementation of an external mandatory auditor rotation (audit firm rotation and a separation of audit and non audit duties to increase auditor independence. The central question is, whether these regulation measures are connected with an increased accounting and audit quality. First, this article presents an agency theoretical foundation of auditor independence. Then, a state of the art analysis of empirical research illustrates these ambivalent results, so that the economic need for the audit market regulation in Europe is controversial

  8. Features partnership in auditing

    Directory of Open Access Journals (Sweden)

    V.P. Bondar

    2015-06-01

    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.

  9. GREAT BRITAIN AND GERMANY SUPREME AUDIT INSTITUTIONS

    Directory of Open Access Journals (Sweden)

    Dobre Cornelia

    2012-07-01

    this material have been followed the official sites of the Federal Court of Audit of Germany and of the National Audit Office of United Kindom, including consulting on hypothetical case studies submitted by the specialists of the two institutions on the occasion of seminars held at the Romanian Court of Auditors. This work focuses on developing institutional development,role, experience and traditions performed in the field of external public audit, as well as their relationship with the Parliament, including the measures taken as a result of recovery audit reports. Thus, the supreme institutions analysed may constitute "models" for Romania's economic reality. In our opinion, any "model" should be adapted to the situation on the field and in this case the model becomes the solution. An assessment of the current business of the supreme audit institutions, we ask where is heading and how they will look in the future. Perhaps the future will provide this response.

  10. 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.

    Science.gov (United States)

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

    2012-10-01

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

  11. Study of the Factors Responsible for the Dropouts from the BSc Programme of Indira Gandhi National Open University

    Directory of Open Access Journals (Sweden)

    Bharat Inder Fozdar

    2006-12-01

    Full Text Available This paper presents a report on students who decided to drop out of the BSc programme offered by Indira Gandhi National Open University (IGNOU. This study was designed to determine the reasons leading to students’ decisions to withdraw from the programme. Identified in this study are nine major reasons for dropouts. Results of this study lead to several suggestions for improving current instructional and delivery strategies of IGNOU’s BSc Programme. Following such suggestions could help to reduce students’ dropout rate for this particular programme through implementation of timely interventions at different critical stages of their learning journey.

  12. Towards Cooling Tower Efficiency-An Energy Audit Approach

    Directory of Open Access Journals (Sweden)

    Long Su Weng Alwin

    2017-01-01

    Full Text Available This research studied the power generation trends from national grid and gas for a period of 4 years. Energy audit of critical systems like this is needful for optimal energy utilization. An energy audit was carried outon 6 industrial cooloing towers and their annual operating cost calculated. Variable speed drive suggested was installed and corresponding annual energy savings of 114,900 kWh/year cost saving of RM30,000 was achieved at a case study plant located in Malaysia. Cooling towers with smart systems was recommended for higher energy savings.

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

    Science.gov (United States)

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

    2015-03-01

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

  14. Increased auditor independence by external rotation and separating audit and non audit duties? - A note on the European audit regulation

    OpenAIRE

    Patrick Velte; Marc Eulerich

    2015-01-01

    The European audit reform contains the implementation of an external mandatory auditor rotation (audit firm rotation) and a separation of audit and non audit duties to increase auditor independence. The central question is, whether these regulation measures are connected with an increased accounting and audit quality. First, this article presents an agency theoretical foundation of auditor independence. Then, a state of the art analysis of empirical research illustrates these ambivalent resul...

  15. Establishment of audit committees in government ministries of a developing country

    Directory of Open Access Journals (Sweden)

    Ndeshipewa Johanna Akwenye

    2016-11-01

    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

  16. Audits Made Simple

    Energy Technology Data Exchange (ETDEWEB)

    Belangia, David Warren [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-04-09

    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.

  17. Evidence for a link between mortality in acute COPD and hospital type and resources

    OpenAIRE

    Roberts, C; Barnes, S; Lowe, D; Pearson, M

    2003-01-01

    Background: The 1997 BTS/RCP national audit of acute care of chronic obstructive pulmonary disease (COPD) found wide variations in mortality between hospitals which were only partially explained by known audit indicators of outcome. It was hypothesised that some of the unexplained variation may result from differences in hospital type, organisation and resources. This pilot study examined the hypothesis as a factor to be included in a future national audit programme.

  18. Technical meeting to 'Review of national programmes on fast reactors and accelerator driven systems (ADS)'. Working material

    International Nuclear Information System (INIS)

    2003-01-01

    36th Annual Meeting of the Technical Working Group on Fast Reactors, the IAEA Technical Meeting (TM) on 'Review of National Programmes on Fast Reactors and Accelerator Driven Systems (ADS)', hosted by the Korean Atomic Energy Research Institute (KAERI) was attended by TWG-FR Members and Advisers from the following Member States (MS) and International Organizations: Brazil, France, Germany, India, Japan, the Republic of Kazakhstan, the Republic of Korea, the Russian Federation, the United Kingdom, the United States of America, and the OECD/NEA. The objectives of the meeting were to: 1) exchange information on the national programmes on Fast Reactors (FR) and Accelerator Driven Systems (ADS); 2) review the progress since the 35th TWG-FR Annual Meeting, including the status of the actions; 3) consider meeting arrangements for 2003 and 2004; 4) review the Agency's co-ordinated research activities in the field of FRs and ADS, as well as co-ordination of the TWG-FR's activities with other organizations. The participants made presentations on the status of the respective national programmes on FR and ADS development. A summary of the highlights for the period since the 35th TWG-FR Annual Meeting

  19. Line Program Environmental Management Audit: Formerly Utilized Sites Remedial Action Program

    International Nuclear Information System (INIS)

    1992-05-01

    This report documents the results of the Line Program Environmental Management Audit completed for the Formerly Utilized Sites Remedial Action Program (FUSRAP). During this Audit, activities and records were reviewed and personnel interviewed at Oak Ridge, Tennessee. Additionally, since FUSRAP falls under the responsibility of the Office of the Assistant Secretary for Environmental Restoration and Waste Management, selected individuals from this office were interviewed in Washington, DC and Germantown, Maryland. The onsite portion of the FUSRAP Audit was conducted from March 16 through 27, 1992, by the US Department of Energy's Office of Environmental Audit (EH-24) located within the Office of the Assistant Secretary for Environment, Safety and Health (EH-1). The scope of the FUSRAP Line Program Environmental Management Audit was comprehensive and included all areas of environmental management with the exception of the National Environmental Policy Act (NEPA). Since the subject of compliance with and implementation of the requirements of NEPA is the responsibility of the DOE Headquarters Office of NEPA Oversight, management issues pertaining to NEPA were not investigated as part of this Audit

  20. The Client Risk and The Audit Planning: Influence of Acceptance of Audit Engagement

    Directory of Open Access Journals (Sweden)

    Deby Suryani

    2018-03-01

    Full Text Available This study briefly aims to extend the relationship between client risks with the audit planning by proposes the acceptance of audit engagement as a mediate variable to fill a gap research, furthermore to determine the effect of client risk toward the audit planning in Public Accounting Firm in Jakarta, Indonesia. This research is a quantitative causal with primary data obtained by questionnaires. The population of this study is the auditors of Public Accounting Firm registered in the Directory Indonesian Institute of Accountants (Certified 2016 in Jakarta and to obtain the sample used purposive sampling technique and obtained samples of 197 respondents from 45 Public Accounting Firms spread in Jakarta. The analysis of data is using Structural Equation Modeling. The results of this research shows; (1. The Client risks directly may affect the audit planning in a positive but not significantly, (2. The Client risk directly affects the acceptance of audit positively and significantly, (3. The acceptance of audit engagement has positively and significantly influence on audit planning. Therefore the acceptance of audit engagement perfectly can act as mediate variable between client's risks with the audit planning, whereas the acceptance of audit engagement indicated by Time Budget Pressure, Audit Fee. Letter of Auditing and all indicator have a high loading factor.

  1. Current standards for infection control: audit assures compliance.

    Science.gov (United States)

    Flanagan, Pauline

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

  2. The healthy device and the definition of health: The example of the National Programme for a Healthy Life

    Directory of Open Access Journals (Sweden)

    Federico Andrés De Francisco

    2010-11-01

    Full Text Available The National Programme for a Healthy Life emerges from the creation of three other programmes that encourage the so-called healthy habits among individuals. Due to be implemented by the National Ministry of Health between 2007 and 2010, it is not a unique case in its group, as the National Programme for a Healthy Life presents the opportunity to think about the importance of health in modern society. In the modern context of a transition that migrates from medicine as curative medicine to a conception of medicine as a preventive science, and from the perspective of the concept of biopolitics, developed by the French philosopher Michel Foucault, it is inferred the existence of a healthy mechanism which organizes the discourses on health and builds truthful discourses about it. The presence of this mechanism could be a possible explanation of the omnipresence of health in modern society, the constant concern to prolong life and the instigation of self-control, care and improvement of an individual's health

  3. Pengaruh Anggaran Waktu Audit, Kompleksitas Dokumen Audit dan Pengalaman Auditor terhadap Pertimbangan Audit Sampling pada Badan Pemeriksaan Keuangan (Bpk) Republik Indonesia Perwakilan Provinsi Aceh

    OpenAIRE

    Nadirsyah, Nadirsyah; Indriani, Mirna; Usman, Iskandar

    2011-01-01

    This research is done at BPK branch office Aceh Province which aim to know the influence of time budget audit, complexsity of audit document and audit experience toward judgement audit sampling either simultaneously or partially. Responden of this research is auditors at BPK branch office Aceh Province. The objective of this research is to be able to seek the causality between the time budget audit, complexsity of audit document and audit experience toward judgement audit sampling wi...

  4. Confidence and authority through new knowledge: An evaluation of the national educational programme in paediatric oncology nursing in Sweden.

    Science.gov (United States)

    Pergert, Pernilla; Af Sandeberg, Margareta; Andersson, Nina; Márky, Ildikó; Enskär, Karin

    2016-03-01

    There is a lack of nurse specialists in many paediatric hospitals in Sweden. This lack of competence is devastating for childhood cancer care because it is a highly specialised area that demands specialist knowledge. Continuing education of nurses is important to develop nursing practice and also to retain them. The aim of this study was to evaluate a Swedish national educational programme in paediatric oncology nursing. The nurses who participated came from all of the six paediatric oncology centres as well as from general paediatric wards. At the time of the evaluation, three groups of registered nurses (n=66) had completed this 2year, part-time educational programme. A study specific questionnaire, including closed and open-ended questions was sent to the 66 nurses and 54 questionnaires were returned. Answers were analysed using descriptive statistics and qualitative content analysis. The results show that almost all the nurses (93%) stayed in paediatric care after the programme. Furthermore, 31% had a position in management or as a consultant nurse after the programme. The vast majority of the nurses (98%) stated that the programme had made them more secure in their work. The nurses were equipped, through education, for paediatric oncology care which included: knowledge generating new knowledge; confidence and authority; national networks and resources. They felt increased confidence in their roles as paediatric oncology nurses as well as authority in their encounters with families and in discussions with co-workers. New networks and resources were appreciated and used in their daily work in paediatric oncology. The programme was of importance to the career of the individual nurse and also to the quality of care given to families in paediatric oncology. The national educational programme for nurses in Paediatric Oncology Care meets the needs of the highly specialised care. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Does Audit Quality Improve After the Implementation of Mandatory Audit Partner Rotation?

    OpenAIRE

    Gary MONROE; Sarowar HOSSAIN

    2013-01-01

    We investigate whether audit partner tenure and audit quality associations remain significant after the implementation of mandatory audit partner rotation. Carey and Simnett (2006) report a significant negative association between long audit partner tenure and the propensity to issue qualified going-concern opinions for financially distressed companies. However, their study uses data from a period when there was no restriction on the length of audit partner tenure, i.e., from a period before ...

  6. Audit quality and the audit partner effect : Evidence from European listed companies

    NARCIS (Netherlands)

    Buuren, van J.P.

    2009-01-01

    The main objective of this study is to provide evidence on the differences in audit quality amongst audit partners. I attribute these dissimilarities to (i) differences in the audit risk perception and the risk appetite of individual audit partners and (ii) to differences in the personal business

  7. The Future of Audit

    Directory of Open Access Journals (Sweden)

    Danielle Lombardi

    2014-10-01

    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.

  8. Results from an audit feedback strategy for chronic obstructive pulmonary disease in-hospital care: a joint analysis from the AUDIPOC and European COPD audit studies.

    Science.gov (United States)

    Lopez-Campos, Jose Luis; Asensio-Cruz, M Isabel; Castro-Acosta, Ady; Calero, Carmen; Pozo-Rodriguez, Francisco

    2014-01-01

    Clinical audits have emerged as a potential tool to summarize the clinical performance of healthcare over a specified period of time. However, the effectiveness of audit and feedback has shown inconsistent results and the impact of audit and feedback on clinical performance has not been evaluated for COPD exacerbations. In the present study, we analyzed the results of two consecutive nationwide clinical audits performed in Spain to evaluate both the in-hospital clinical care provided and the feedback strategy. The present study is an analysis of two clinical audits performed in Spain that evaluated the clinical care provided to COPD patients who were admitted to the hospital for a COPD exacerbation. The first audit was performed from November-December 2008. The feedback strategy consisted of personalized reports for each participant center, the presentation and discussion of the results at regional, national and international meetings and the creation of health-care quality standards for COPD. The second audit was part of a European study during January and February 2011. The impact of the feedback strategy was evaluated in term of clinical care provided and in-hospital survival. A total of 94 centers participated in the two audits, recruiting 8,143 admissions (audit 1∶3,493 and audit 2∶4,650). The initially provided clinical care was reasonably acceptable even though there was considerable variability. Several diagnostic and therapeutic procedures improved in the second audit. Although the differences were significant, the degree of improvement was small to moderate. We found no impact on in-hospital mortality. The present study describes COPD hospital care in Spanish hospitals and evaluates the impact of peer-benchmarked, individually written and group-oral feedback strategy on the clinical outcomes for treating COPD exacerbations. It describes small to moderate improvements in the clinical care provided to COPD patients with no impact on in

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

    Science.gov (United States)

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

    2018-07-01

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

  10. Status of national gas cooled reactor programmes

    International Nuclear Information System (INIS)

    1991-08-01

    This report has been compiled as a central source of summary-level information on the present status of High Temperature Gas-Cooled Reactor (HTGR) programmes in the world and on future plans for the continued development and deployment of HTGRs. Most of the information concerns the programmes in the United States, Germany, Japan and the Soviet Union, countries that have had large programmes related to HTGR technology for several years. Summary-level information is also provided in the report on HTGR-related activities in several other countries who either have an increasing interest in the technology and/or who are performing some development efforts related to HTGR technology. The report contains a summary-level update on the MAGNOX and AGR programmes. This is the twelfth issue of the document, the first of which was issued in March, 1979. The report has been prepared in the IAEA Nuclear Power Technology Development Section. Figs and tabs

  11. Radiographer-led plan selection for bladder cancer radiotherapy: initiating a training programme and maintaining competency.

    Science.gov (United States)

    McNair, H A; Hafeez, S; Taylor, H; Lalondrelle, S; McDonald, F; Hansen, V N; Huddart, R

    2015-04-01

    The implementation of plan of the day selection for patients receiving radiotherapy (RT) for bladder cancer requires efficient and confident decision-making. This article describes the development of a training programme and maintenance of competency. Cone beam CT (CBCT) images acquired on patients receiving RT for bladder cancer were assessed to establish baseline competency and training needs. A training programme was implemented, and observers were asked to select planning target volumes (PTVs) on two groups of 20 patients' images. After clinical implementation, the PTVs chosen were reviewed offline, and an audit performed after 3 years. A mean of 73% (range, 53-93%) concordance rate was achieved prior to training. Subsequent to training, the mean score decreased to 66% (Round 1), then increased to 76% (Round 2). Six radiographers and two clinicians successfully completed the training programme. An independent observer reviewed the images offline after clinical implementation, and a 91% (126/139) concordance rate was achieved. During the audit, 125 CBCT images from 13 patients were reviewed by a single observer and concordance was 92%. Radiographer-led selection of plan of the day was implemented successfully with the use of a training programme and continual assessment. Quality has been maintained over a period of 3 years. The training programme was successful in achieving and maintaining competency for a plan of the day technique.

  12. Environmental Audit, Rifle, Gunnison and Grand Junction UMTRA Project Sites

    International Nuclear Information System (INIS)

    1991-08-01

    This report documents the results of the comprehensive baseline Environmental Audit completed for the Uranium Mill Tailings Remedial Action (UMTRA) sites at Grand Junction, Rifle, and Gunnison, Colorado. Included in the Audit were the actual abandoned mill sites, associated transportation and disposal cell facilities, and representative examples of the more than 4,000 known vicinity properties. Sites investigated include: Climax Mill Site, Truck/Train Haul Route, Cotter Transfer Station, Cheney Disposal Cell, Rifle Mill Sites (Old and New Rifle), Gunnison Mill Site, Vicinity Properties, and Estes Gulch and Proposed Landfill Site No. 1 Disposal Cells. The UMTRA Audit was a comprehensive baseline audit which considered all environmental programs and the activities associated with ongoing and planned remediation at the UMTRA sites listed above. Compliance with the National Environmental Policy Act (NEPA) was not considered during this investigation. The Audit Team looked at the following technical disciplines: air, surface water/drinking water, groundwater, soil/sediment/biota, waste management, toxic and chemical materials, quality assurance, radiation, inactive waste sites, and environmental management. 6 figs., 12 tabs

  13. Environmental Audit, Rifle, Gunnison and Grand Junction UMTRA Project Sites

    Energy Technology Data Exchange (ETDEWEB)

    None

    1991-08-01

    This report documents the results of the comprehensive baseline Environmental Audit completed for the Uranium Mill Tailings Remedial Action (UMTRA) sites at Grand Junction, Rifle, and Gunnison, Colorado. Included in the Audit were the actual abandoned mill sites, associated transportation and disposal cell facilities, and representative examples of the more than 4,000 known vicinity properties. Sites investigated include: Climax Mill Site, Truck/Train Haul Route, Cotter Transfer Station, Cheney Disposal Cell, Rifle Mill Sites (Old and New Rifle), Gunnison Mill Site, Vicinity Properties, and Estes Gulch and Proposed Landfill Site No. 1 Disposal Cells. The UMTRA Audit was a comprehensive baseline audit which considered all environmental programs and the activities associated with ongoing and planned remediation at the UMTRA sites listed above. Compliance with the National Environmental Policy Act (NEPA) was not considered during this investigation. The Audit Team looked at the following technical disciplines: air, surface water/drinking water, groundwater, soil/sediment/biota, waste management, toxic and chemical materials, quality assurance, radiation, inactive waste sites, and environmental management. 6 figs., 12 tabs.

  14. The impact of global financial crisis on audit and non-audit fees

    OpenAIRE

    Alexeyeva, Irina; Svanström, Tobias

    2015-01-01

    This is the accepted and refereed manuscript to the article Purpose - The paper aims to investigate audit and non-audit fees during the global financial crisis (GFC) in an environment that is relatively sparsely regulated with regard to the provision of non-audit services. Design/methodology/approach - Audit and non-audit fees were studied during pre-GFC (2006-2007), GFC (2008-2009) and post-GFC (2010-2011) periods. Findings - During the GFC Swedish companies benefited from an increa...

  15. The National Hip Fracture Database (NHFD) - Using a national clinical audit to raise standards of nursing care.

    Science.gov (United States)

    Johansen, Antony; Boulton, Christopher; Hertz, Karen; Ellis, Michael; Burgon, Vivienne; Rai, Sunil; Wakeman, Rob

    2017-08-01

    The National Hip Fracture Database (NHFD) is a key clinical governance programme for staff working in trauma wards across England, Wales and Northern Ireland. It uses prospectively collected information about the 65,000 people who present with hip fracture each year, and links these with information about the quality of care and outcome for each individual. The NHFD can, therefore, provide a picture of the care offered to frail older people with this injury - people who, between them, occupy nearly half of inpatient trauma beds. The NHFD uses its website (www.nhfd.co.uk) to feed back live information to each of the countries' 180 trauma units - allowing them to bench mark their performance against national standards, and against that in other hospitals. This helps to develop a consensus over the best care for frail older people in areas where national guidance is not yet available. This article shows how the NHFD is contributing to four key aspects of patient safety and nursing care: the prevention of pressure ulcers and post-operative delirium, the monitoring of falls incidence across hospitals and nutritional assessment of patients with hip fracture. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Energy audit: potential of energy - conservation in Jordanian ceramic industry

    International Nuclear Information System (INIS)

    Adas, H.; Taher, A.

    2005-01-01

    This paper represents the findings of the preliminary energy-audits performed by the Rational Use of Energy Division at the National Energy Research Center (NERC), as well as the findings of a detailed energy-audit carried out in the largest Ceramic plant in Jordan (Jordan Ceramic industries).These studies were preceded by a survey of the ceramic factories in Jordan. The survey was carried out in 1997. The performed preliminary energy-audits showed that an average saving-potential in most of theses plants is about 25 % of the total energy-bills in these plants, which constitutes a considerable portion of the total production-cost. This fact was verified through the detailed energy-audit performed by NERC team for the largest Ceramic Plant in Jordan in June 2003, which showed an energy-saving potential of about 30 %. This saving can be achieved by some no-cost or low-cost measures, in addition to some measures that need reasonable investments with an average pay-back period of about two years. This detailed energy-audit covered electrical systems, refrigeration systems, compressed-air systems, and kilns. The results of the detailed energy-audit can be disseminated to other Ceramic plant, because of the similarity in the production process between these plants and the plant where the detailed energy-audit was carried out. (author)

  17. Oversight Institutions Within the United Nations

    DEFF Research Database (Denmark)

    Pontoppidan, Caroline Aggestam

    2015-01-01

    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...

  18. Changing Methodologies in Financial Audit and Their Impact on Information Systems Audit

    OpenAIRE

    Daniel VILSANOIU; Mihaela SERBAN

    2010-01-01

    This paper tries to provide a better understanding of the relation between financial audit and information systems audit and to assess the influence the change in financial audit methodologies had on IS audit. We concluded that the COSO Internal Control – Integrated Framework was the starting point for fundamental changes in both financial and IS audit and that the Sarbanes-Oxley Act should be viewed as an enabler rather than an enforcer in establishing strong governance models. Finally, ou...

  19. [Surgery for colorectal cancer since the introduction of the Netherlands national screening programmeInvestigations into changes in number of resections and waiting times for surgery].

    Science.gov (United States)

    de Neree Tot Babberich, M P M; van der Willik, E M; van Groningen, J T; Ledeboer, M; Wiggers, T; Wouters, M W J M

    2017-01-01

    To investigate the impact of the Netherlands national colorectal cancer screening programme on the number of surgical resections for colorectal carcinoma and on waiting times for surgery. Descriptive study. Data were extracted from the Dutch Surgical Colorectal Audit. Patients with primary colorectal cancer surgery between 2011-2015 were included. The volume and median waiting times for the years 2011-2015 are described. Waiting times from first tumor positive biopsy until the operation (biopsy-operation) and first preoperative visit to the surgeon until the operation (visit-operation) are analyzed with a univariate and multivariate linear regression analysis. Separate analysis was done for visit-operation for academic and non-academic hospitals and for screening compared to non-screening patients. In 2014 there was an increase of 1469 (15%) patients compared to 2013. In 2015 this increase consisted of 1168 (11%) patients compared to 2014. In 2014 and 2015, 1359 (12%) and 3111 (26%) patients were referred to the surgeon through screening, respectively. The median waiting time of biopsy-operation significantly decreased (ß: 0.94, 95%BI) over the years 2014-2015 compared to 2011-2013. In non-academic hospitals, the waiting time visit-operation also decreased significantly (ß: 0.89, 95%BI 0.87-0.90) over the years 2014-2015 compared to 2011-2013. No difference was found in waiting times between patients referred to the surgeon through screening compared to non-screening. There is a clear increase in volume since the introduction of the colorectal cancer screening programme without an increase in waiting time until surgery.

  20. 34 CFR 668.23 - Compliance audits and audited financial statements.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Compliance audits and audited financial statements. 668... purpose financial statements. (3) Third-party servicers. Except as provided under this part or 34 CFR part... financial statements no later than six months after the last day of the institution's fiscal year. (5) Audit...

  1. PENGARUH KONDISI KEUANGAN, PERTUMBUHAN DAN OPINI AUDIT TAHUN SEBELUMNYA TERHADAP OPINI AUDIT GOING CONCERN

    Directory of Open Access Journals (Sweden)

    Badingatus Solikhah

    2012-03-01

    Full Text Available Penelitian tentang going concern ditujukan untuk menguji secara empiris dampak kondisi keuangan corporate, perkembangan corporate dan opini audit tahun lalu terhadap opini audit going concern Data dikumpulkan dengan menggunakan content analysis dan metode dokumentasi dan diproses dengan Logistic Regression. Berdasarkan hasil penelitian, bukti empiris yang ditemukan adalah bahwa kondisi keuangan corporate opini audit tahun lalu berdampak signifikan terhadap penerimaan opini audit going concern. Namun sebaliknya variabel pertumbuhan corporate terbukti tidak signifikan terhadap penerimaan opini audit going concern. AbstractThe going concern research has a goal for testing empirically the effect of corporate financial condition, corporate growth, and last year audit opinion towards going concern audit opinion The data were collected by using content analysis and documentation methods, and processed by means of Logistic Regression. Based on the result of the study, empirical evidence is found that corporate financial condition and last year audit opinion has significant effect towards going concern audit opinion acceptance. In the contrary, corporate growth variable is proven insignificant towards going concern audit opinion acceptance.Keywords: audit opinion; going concern; logistic regression

  2. Audit mode change, corporate governance

    OpenAIRE

    Limei Cao; Wanfu Li; Limin Zhang

    2015-01-01

    This study investigates changes in audit strategy in China following the introduction of risk-based auditing standards rather than an internal control-based audit mode. Specifically, we examine whether auditors are implementing the risk-based audit mode to evaluate corporate governance before distributing audit resources. The results show that under the internal control-based audit mode, the relationship between audit effort and corporate governance was weak. However, implementation of the ri...

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

    Science.gov (United States)

    Sillup, George P; Klimberg, Ronald K

    2011-01-01

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

  4. From joint to single audits

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2018-01-01

    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 ...

  5. The Risk of Electronic Audit and its Impact on The Quality Audit

    Directory of Open Access Journals (Sweden)

    Zainab Jabbar Yousif

    2018-05-01

    Full Text Available The auditing profession faces a challenge referred to as information technology ,Information technology has set the profession of auditing in constant challenge because it has made the world an open - limited system through communication technology . The importance of this research stems from the need to identify the nature of the  risks of electronic auditing  after turned  from manual checking to electronic auditing due to developments in technologies  in all sectors.  The risk of electronic auditing  the risk of information technology infrastructure and the risks of applications and other  related to communication processes, several conclusions have been reached, implementation of programs with goods specifications in the electronic auditing  process will lead to safety of work and  reduce the risk of electronic auditing . The research highlights these  risks and their impact on the quality of auditing .                                  

  6. Patient experience of CT colonography and colonoscopy after fecal occult blood test in a national screening programme

    OpenAIRE

    Plumb, Andrew A.; Ghanouni, Alex; Rees, Colin J.; Hewitson, Paul; Nickerson, Claire; Wright, Suzanne; Taylor, Stuart A.; Halligan, Steve; von Wagner, Christian

    2016-01-01

    Objective To investigate patient experience of CT colonography (CTC) and colonoscopy in a national screening programme. Methods Retrospective analysis of patient experience postal questionnaires. We included screenees from a fecal occult blood test (FOBt) based screening programme, where CTC was performed when colonoscopy was incomplete or deemed unsuitable. We analyzed questionnaire responses concerning communication of test risks, test-related discomfort and post-test pain, as well as compl...

  7. Patient experience of CT colonography and colonoscopy after fecal occult blood test in a national screening programme

    OpenAIRE

    Plumb, A. A.; Ghanouni, A.; Rees, C. J.; Hewitson, P.; Nickerson, C.; Wright, S.; Taylor, S. A.; Halligan, S.; von Wagner, C.

    2017-01-01

    OBJECTIVE: To investigate patient experience of CT colonography (CTC) and colonoscopy in a national screening programme. METHODS: Retrospective analysis of patient experience postal questionnaires. We included screenees from a fecal occult blood test (FOBt) based screening programme, where CTC was performed when colonoscopy was incomplete or deemed unsuitable. We analyzed questionnaire responses concerning communication of test risks, test-related discomfort and post-test pain, as well as com...

  8. The validity and reliability of the cross-national comparison of degree programme levels in European countries : What have students learnt?

    NARCIS (Netherlands)

    Rexwinkel, Trudy; Haenen, Jacques; Pilot, Albert

    2017-01-01

    A cross-national comparison of degree programme levels became relevant when the borders of European countries opened for students and graduates, and higher education institutions were restructured into bachelor’s and master’s programmes. This new situation foregrounded the questions of what students

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

    Science.gov (United States)

    Paim, Chennyfer da Rosa Paino; Zucchi, Paola

    2011-01-01

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

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

    Science.gov (United States)

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

    2010-06-01

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

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

    Science.gov (United States)

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

    2018-05-01

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

  12. The Neighborhood Auditing Tool: A Hybrid Interface for Auditing the UMLS

    OpenAIRE

    Morrey, C. Paul; Geller, James; Halper, Michael; Perl, Yehoshua

    2009-01-01

    The UMLS’s integration of more than 100 source vocabularies, not necessarily consistent with one another, causes some inconsistencies. The purpose of auditing the UMLS is to detect such inconsistencies and to suggest how to resolve them while observing the requirement of fully representing the content of each source in the UMLS. A software tool, called the Neighborhood Auditing Tool (NAT), that facilitates UMLS auditing is presented. The NAT supports “neighborhood-based” auditing, where, at a...

  13. Delivery of antiretroviral treatment services in India: Estimated costs incurred under the National AIDS Control Programme.

    Science.gov (United States)

    Agarwal, Reshu; Rewari, Bharat Bhushan; Shastri, Suresh; Nagaraja, Sharath Burugina; Rathore, Abhilakh Singh

    2017-04-01

    Competing domestic health priorities and shrinking financial support from external agencies necessitates that India's National AIDS Control Programme (NACP) brings in cost efficiencies to sustain the programme. In addition, current plans to expand the criteria for eligibility for antiretroviral therapy (ART) in India will have significant financial implications in the near future. ART centres in India provide comprehensive services to people living with HIV (PLHIV): those fulfilling national eligibility criteria and receiving ART and those on pre-ART care, i.e. not on ART. ART centres are financially supported (i) directly by the NACP; and (ii) indirectly by general health systems. This study was conducted to determine (i) the cost incurred per patient per year of pre-ART and ART services at ART centres; and (ii) the proportion of this cost incurred by the NACP and by general health systems. The study used national data from April 2013 to March 2014, on ART costs and non-ART costs (human resources, laboratory tests, training, prophylaxis and management of opportunistic infections, hospitalization, operational, and programme management). Data were extracted from procurement records and reports, statements of expenditure at national and state level, records and reports from ART centres, databases of the National AIDS Control Organisation, and reports on use of antiretroviral drugs. The analysis estimates the cost for ART services as US$ 133.89 (?8032) per patient per year, of which 66% (US$ 88.66, ?5320) is for antiretroviral drugs and 34% (US$ 45.23, ?2712) is for non-ART recurrent expenditure, while the cost for pre-ART care is US$ 33.05 (?1983) per patient per year. The low costs incurred for patients in ART and pre-ART care services can be attributed mainly to the low costs of generic drugs. However, further integration with general health systems may facilitate additional cost saving, such as in human resources.

  14. Mobile phones to support adherence to antiretroviral therapy: what would it cost the Indian National AIDS Control Programme?

    Science.gov (United States)

    Rodrigues, Rashmi; Bogg, Lennart; Shet, Anita; Kumar, Dodderi Sunil; De Costa, Ayesha

    2014-01-01

    Adherence to antiretroviral treatment (ART) is critical to maintaining health and good clinical outcomes in people living with HIV/AIDS. To address poor treatment adherence, low-cost interventions using mobile communication technology are being studied. While there are some studies that show an effect of mobile phone reminders on adherence to ART, none has reported on the costs of such reminders for national AIDS programmes. This paper aims to study the costs of mobile phone reminder strategies (mHealth interventions) to support adherence in the context of India's National AIDS Control Program (NACP). The study was undertaken at two tertiary level teaching hospitals that implement the NACP in Karnataka state, South India. Costs for a mobile phone reminder application to support adherence, implemented at these sites (i.e. weekly calls, messages or both) were studied. Costs were collected based on the concept of avoidable costs specific to the application. The costs that were assessed were one-time costs and recurrent costs that included fixed and variable costs. A sequential procedure for costing was used. Costs were calculated at national-programme level, individual ART-centre level and individual patient level from the NACP's perspective. The assessed costs were pooled to obtain an annual cost per patient. The type of application, number of ART centres and number of patients on ART were varied in a sensitivity analysis of costs. The Indian NACP would incur a cost of between 79 and 110 INR (USD 1.27-1.77) per patient per year, based on the type of reminder, the number of patients on ART and the number of functioning ART centres. The total programme costs for a scale-up of the mHealth intervention to reach the one million patients expected to be on treatment by 2017 is estimated to be 0.36% of the total five-year national-programme budget. The cost of the mHealth intervention for ART-adherence support in the context of the Indian NACP is low and is facilitated by

  15. Auditing Quality in China

    OpenAIRE

    Ding, Shengyan

    2012-01-01

    In the research area of Chinese auditing market, few studies have been conducted on the effects that auditor-related characteristics have on auditing quality. Thus, the paper is to examine the influences auditor-related attributes have on auditing quality, including size of the auditing firm, its income, and whether it is Big 4 or not. In addition to that, research topic on relationship between relationship between market concentration level and auditing quality is also an attractive one amon...

  16. Standard operating procedures for quality audits of 60Co external beam radiotherapy facilities

    International Nuclear Information System (INIS)

    Larrinaga Cortina, E.F.; Dominguez Hung, L.; Campa Menendez, R.

    2001-01-01

    The use of radiotherapy implies the necessity of rigorous quality standards in its different components, aimed to provide the best possible treatment and avoid potential patients' risks, that could even cause him death. Projects of technical cooperation developed in Cuba and supported by the International Atomic Energy Agency address the implementation of Programs of Quality Assurance (PGC) in radiotherapy services. The establishment of the National Quality Audit Program (PNAC) is a superior stage. The National Control Center for Medical Devices, as the national regulator entity for the control and supervision of medical devices in the National Health System, is responsible for the making and execution of the PNAC. The audit modality selected was the inspection visit in situ due to its intrinsic advantages, our geographical extension and the number of radiotherapy services. This paper presents the methodology for the execution of the PNAC, in form of a Normalized Procedure of Operation (PNO) that defines the objectives, scope, terms and definitions, responsibilities, composition and selection of the auditor team, security's conditions, materials and equipment, steps of the audit execution, results calculation and interpretation, records, etc. (author)

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

    Science.gov (United States)

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

    2014-10-01

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

  18. Audit result and its users

    Directory of Open Access Journals (Sweden)

    Shalimova Nataliya S.

    2014-01-01

    Full Text Available The article identifies essence of the “audit result” and “users of audit result” notions and characteristics of the key audit results user. It shows that in order to give a wide characteristic of users it is expedient to unite all objects, which could be used (audit report, fact of refusal to conduct audit and information that is submitted to managers in the process of audit with the term “audit result” and classify it depending on the terms of submission by final and intermediate result. The article offers to define audit results user as a person, persons or category of persons for whom the auditor prepares the audit report and, in cases, envisaged by international standards of the audit and domestic legislative and regulatory acts, provides other additional information concerning audit issues. In order to identify the key audit results user the article distributes all audit tasks into two groups depending on possibilities of identification of users. The article proves that the key user should be identified especially in cases of a mandatory audit and this process should go in interconnection with the mechanism of allocation of a key user of financial reports. It offers to consider external users with direct financial interests, who cannot request economic subjects directly to provide information and who should rely on general financial reports and audit report when receiving significant portion of information they need, as the key user. The article makes proposals on specification of the categorical mechanism in the sphere of audit, which are the basis for audit quality assessment, identification of possibilities and conditions of appearance of the necessary and sufficient trust to the auditor opinion.

  19. Service audit of a forensic rehabilitation ward.

    Science.gov (United States)

    Young, Susan; Gudjonsson, Gisli H; Needham-Bennett, Humphrey; Chick, Kay

    2009-10-01

    An open forensic rehabilitation ward provides an important link bridging the gap between secure and community provisions. This paper provides an audit of such a service by examining the records of an open forensic rehabilitation ward over a five-year period from 1 June 2000 until 31 May 2005. During the audit period there were 51 admissions, involving 45 different patients, and 50 discharges. The majority of the patients came from secure unit facilities, acute psychiatric wards or home. Thirty-nine patients were discharged either into hostels (66%) or their home (12%). The majority of patients (80%) had on admission a primary diagnosis of either schizophrenia or schizoaffective disorder. Most had an extensive forensic history. The focus of their admission was to assess and treat their mental illness/disorder and offending behaviour and this was successful as the majority of patients were transferred to a community placement after a mean of 15 months. It is essential that there is a well-integrated care pathway for forensic patients, involving constructive liaison with generic services and a well-structured treatment programme which integrates the key principles of the 'recovery model' approach to care.

  20. CRITERIA AND FACTORS THAT INSURE THE QUALITY IN PROVISION OF AUDIT SERVICES, DIFFERENT FROM AUDIT

    Directory of Open Access Journals (Sweden)

    Antoniuk O.

    2018-03-01

    Full Text Available Introduction. Quality management of audit services requires further theoretical research and development in the field of audit activity and quality of audit, continuous improvement of the organization and methodology in providing audit services. Purpose. The article deals with the theoretical and practical questions of assessing the quality of audit services that are different from the audit in order to identify ways to improve the methodological quality assurance in the provision of these services. Results. It is proved that factors (economic, methodological, organizational and conditions have an impact on the quality of audit services. This, in general, affects the content of audit services regulation and their social and economic significance. The terms of quality assurance, which are considered in the article, have a decisive influence on the implementation of those specific factors that directly change the properties of the audit services and create the services of the required quality. Assurance of the quality of audit services is considered as the creation of the necessary conditions for the implementation of all factors that affect the quality of audit services, maintanence of the given level of quality of audit services in accordance with the requirements of legal acts and market needs. Conclusions. The issue of identifying criteria, factors and indicators for assessing the quality in audit services is raised. In the generalized form, the matrix of quality assurance of audit services is presented, which indicates the interconnection of various conditions, factors, quality indicators in audit services.

  1. A study of the National Physical Laboratory microdosimetry research programme in collaboration with the University of Leeds

    International Nuclear Information System (INIS)

    Menzel, H.G.

    1987-11-01

    A study of the present programme of work carried out by the National Physical Laboratory and the University of Leeds, has been carried out. The study is based on the use of the tissue-equivalent proportional counter in microdosimetic techniques in radiation protection for monoenergetic neutrons or reference radionuclide neutron sources. This report comments on the programme as a whole and provides recommendations for future research work, taking into account the research programmes carried out at other institutions. It also attempts to summarise the present state of knowledge and experience associated with the application of this technique to radiation fields met in routine radiation protection. (author)

  2. Rethinking The Future of Auditing: How an Integrated Continuous Auditing Approach Can Leverage the Full Potential of Continuous Auditing

    OpenAIRE

    Weins, Sebastian; Alm, Bastian; Wang, Tawei

    2016-01-01

    The concept of Continuous Auditing has been around for more than three decades. The ongoing discussion on the benefits and models on adoption has made Continuous Auditing become a more critical issue. Although a lot of progress has been made in previous years, we argue that the entire potential of Continuous Auditing still remains unrevealed. This paper provides a new conceptual framework on how to bring Continuous Auditing to the next level. It goes beyond the existing technical concepts and...

  3. Former Audit Partners on Audit Committees: Implications for Russian Corporate Governance

    Directory of Open Access Journals (Sweden)

    Genevieve Scalan

    2017-04-01

    Full Text Available The Moscow Exchange in conjunction with the Organization for Economic Cooperation and Development (OECD continues to address improvements in Russian corporate governance by conducting annual roundtables (OECD, 2017.  My research relates to corporate governance provided by audit committees. I examine relationships between former audit partner (FAP audit committee members and auditors, via a network similar to the interlocking directorate.  Using a dataset of U.S. auditor dismissals, I construct unique network variables measuring the relational ties between FAP audit committees and auditors.  I find some evidence suggesting ties created by former audit partners may increase auditor switching possibly indicating impaired auditor independence. This outcome suggests implications for Russian corporate governance because it is likely Russian Boards of Directors would experience similar circumstances as their U.S. counterparts.  As the Moscow Exchange continues its partnership with the OECD to improve corporate governance, audit quality and auditor independence should be considered in the dialogue.

  4. Corporate social responsibility audit: Theoretical aspects

    Directory of Open Access Journals (Sweden)

    Artem Koldovskyi

    2015-08-01

    Full Text Available This paper puts a conceptual framework to outline research for corporate social responsibility (CSR audit based on the analysis of current CRS literature and audit models as implementation of CSR. It is intended to make clear the phenomena about the relationship between audit, implementation of business ethics principles and corporate governance. However, most studies do not take into account modify CSR audit. This paper reports part of a research we carried out on the theoretical interpretation of the corporate social responsibility audit. This paper examines the corporate social responsibility audit as a composition of four categories - management system audits, on-site audits, verbal probability expressions (VPE audits and technology audits. The paper concludes suggests to systematize multiple audits so that they can be conduct in three types of audits - environmental management audits covering in-house companies, environmental technology audits of products, and environmental audits of sites, including non-manufacturing sites and non-consolidated subsidiaries.

  5. 36 CFR 1207.26 - Non-Federal audit.

    Science.gov (United States)

    2010-07-01

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

  6. Diffusion of an e-learning programme among Danish General Practitioners: A nation-wide prospective survey

    Directory of Open Access Journals (Sweden)

    Nielsen Bente

    2008-04-01

    Full Text Available Abstract Background We were unable to identify studies that have considered the diffusion of an e-learning programme among a large population of general practitioners. The aim of this study was to investigate the uptake of an e-learning programme introduced to General Practitioners as part of a nation-wide disseminated dementia guideline. Methods A prospective study among all 3632 Danish GPs. The GPs were followed from the launching of the e-learning programme in November 2006 and 6 months forward. Main outcome measures: Use of the e-learning programme. A logistic regression model (GEE was used to identify predictors for use of the e-learning programme. Results In the study period, a total of 192 different GPs (5.3% were identified as users, and 17% (32 had at least one re-logon. Among responders at first login most have learnt about the e-learning programme from written material (41% or from the internet (44%. A total of 94% of the users described their ability of conducting a diagnostic evaluation as good or excellent. Most of the respondents used the e-learning programme due to general interest (90%. Predictors for using the e-learning programme were Males (OR = 1.4, 95% CI 1.1; 2.0 and members of Danish College of General Practice (OR = 2.2, 95% CI 1.5; 3.1, whereas age, experience and working place did not seem to be influential. Conclusion Only few Danish GPs used the e-learning programme in the first 6 months after the launching. Those using it were more often males and members of Danish College of General Practice. Based on this study we conclude, that an active implementation is needed, also when considering electronic formats of CME like e-learning. Trial Registration ClinicalTrials.gov Identifier: NCT00392483.

  7. Audit Validation Using Ontologies

    Directory of Open Access Journals (Sweden)

    Ion IVAN

    2015-01-01

    Full Text Available Requirements to increase quality audit processes in enterprises are defined. It substantiates the need for assessment and management audit processes using ontologies. Sets of rules, ways to assess the consistency of rules and behavior within the organization are defined. Using ontologies are obtained qualifications that assess the organization's audit. Elaboration of the audit reports is a perfect algorithm-based activity characterized by generality, determinism, reproducibility, accuracy and a well-established. The auditors obtain effective levels. Through ontologies obtain the audit calculated level. Because the audit report is qualitative structure of information and knowledge it is very hard to analyze and interpret by different groups of users (shareholders, managers or stakeholders. Developing ontology for audit reports validation will be a useful instrument for both auditors and report users. In this paper we propose an instrument for validation of audit reports contain a lot of keywords that calculates indicators, a lot of indicators for each key word there is an indicator, qualitative levels; interpreter who builds a table of indicators, levels of actual and calculated levels.

  8. Analisis Pengaruh Ukuran Kantor Akuntan Publik, Audit Fee, Audittenure, Dan Karakteristik Komite Audit Terhadap Audit Quality Pada Perusahaan Manufaktur Yang Terdaftar Di Bursa Efek Indonesia

    OpenAIRE

    William, Richi

    2017-01-01

    130503129 Penelitian ini bertujuan untuk mengetahui dan menganalisis pengaruh ukuran kantor akuntan publik, audit fee, audit tenure, dan karakteristik komite audit terhadap kualitas audit pada perusahaan manufaktur yang terdaftar di Bursa Efek Indonesia. Indikator karakteristik komite audit yaitu gender dan usia komite audit. Populasi penelitian ini sebanyak 151 perusahaan manufaktur. Metode pengambilan sampel yang digunakan adalah purposive sampling, sehingga diperoleh 27 perusahaan s...

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

    Science.gov (United States)

    De La O, Ana L; Martel García, Fernando

    2014-09-03

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

  10. Audit Expectation Gap: Perspectives of Auditors and Audited ...

    African Journals Online (AJOL)

    This study empirically examined Audit Expectation Gap: Perspectives of Auditors and Audited Account Users. For the purpose of this study primary and secondary data were used. Data were sourced through the examination of vast array of relevant literature like journals, standard textbooks, magazine and questionnaires.

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

    Science.gov (United States)

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

    2017-11-28

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

  12. The Internal Audit Outsourcing

    Directory of Open Access Journals (Sweden)

    Grzegorz Gołębiowski

    2010-06-01

    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.

  13. Review of national research programmes on the microbiology of radioactive waste disposal

    International Nuclear Information System (INIS)

    Rosevear, A.

    1991-06-01

    Published results on the microbial effects of relevance to radioactive waste disposal are reviewed. The subjects covered by each of the various national programmes are considered in turn and the important themes that emerge from these are summarised. Finally the relevance of this microbiological research to the Nirex Safety case is discussed in brief. All references to research papers that deal with microbial aspects of radioactive waste disposal are listed and the key publications identified. (author)

  14. Quality audits of the remote-controlled automatically-driven gamma ray afterloading equipment used in brachytherapy in the Czech Republic

    International Nuclear Information System (INIS)

    Zackova, H.; Horakova, I.

    2001-01-01

    To reach safety and precise application of ionisation radiation to patients Atomic act declares, in its Article no. 7, requirements for medical exposure. There are also given -among others -the demands to i nstall the quality assurance programmes (QA) for medical actions and functions . Since 1997, when the act has been adopted, a set of five Recommendations of State Office for Nuclear Safety (SONS ) for radiotherapy has been prepared to instruct users how to prepare quality control system (i.e. system of tests required by of the regulation no.184/1997 Sb. -acceptance, status and constancy tests) for main types of sources used in radiotherapy for treatment of the patients. Among them also the Recommendation on QA in brachytherapy has been issued by SONS in 1998. National Radiation Protection Institute (NRPI) has been performing the regular in situ quality audits in which the chosen parameters (which could seriously influence the dose to the patients -i.e. absorbed dose, main geometrical and radiation parameters etc ) are independently checked by the NRPI experts. System of Quality Audits on the sources used in teletherapy has been introduced in 1997 and at present time they are smoothly carried out according the SONS's demands. This work describes the process of installing of the Quality Audit system on brachytherapy. The work described here forms the only part of the activities, which have been carrying out by the department of dosimetry gamma and X-rays of NRPI to support supervisions of SONS in the field of radiation protection in radiotherapy .Quality audits in brachytherapy will extend the possibilities of NRPI. The Methods NRPI 43-01.30 prepared by NRPI could be used as documentation for all types of test which are at present time required by Czech legislation for the remote-controlled automatically-driven gamma-ray afterloading equipment used in brachytherapy. (authors)

  15. Creation of Auditing Knowledge:

    DEFF Research Database (Denmark)

    Liempd, Dennis van

      Even though auditing research could play a role in understanding the many challenges that are threatening the profession, and in providing possible solutions, it seems to have failed in adequately doing so. This is for a major part because of a lack of research into auditing's basic assumptions......, 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...

  16. Research in auditing: main themes

    Directory of Open Access Journals (Sweden)

    Marcelo Porte

    Full Text Available ABSTRACT The passage of the Sarbanes-Oxley Act (SOX was a turning point in auditing and in auditors practice for the academic world. Research concerning the characterization of academic production related to auditing is in its third decade. Its analysis is accomplished by means of definition of keywords, abstracts or title, and information on thematic association within the academic production itself in auditing is undisclosed. In order to revise this gap in auditing literature, this study identified the main themes in auditing and their association in post-SOX era by analyzing the content of objectives and hypothesis of 1,650 publications in Web of Science (2002-2014. The findings in this study extended those from the study by Lesage and Wechtler (2012 from 16 auditing thematic typologies to 22. The results demonstrate that the themes audit report & financial statement users, corporate governance, audit market, external audit, socio-economic data of the company, international regulation, and fraud risk & audit risk were the most addressed in the publications about auditing. Corporate governance has a broader association with the other themes in the area. Future researches may use these themes and relate them to the methodologies applied to audit studies.

  17. Leaving a joint audit system

    DEFF Research Database (Denmark)

    Holm, Claus; Thinggaard, Frank

    2014-01-01

    determinants model and an audit fee change model and include interaction terms. Findings: The authors find short-term fee reductions in companies switching to single audits, but only where the former joint audit contained a dominant auditor. The authors argue that in this situation bargaining power is more...... with the auditors than in a equally shared joint audit, and that the auditors' incentives to offer an initial fee discount are bigger. Research limitations/implications: The number of observations is constrained by the small Danish capital market. Future research could take a more qualitative research approach......, to examine whether the use of a single audit firm rather than two has an effect on audit quality. The area calls for further theory development covering audit fee and audit quality in joint audit settings. Practical implications: Comapnies should consider their relationship with their auditors before...

  18. 46 CFR Sec. 12 - Audit.

    Science.gov (United States)

    2010-10-01

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

  19. Unpredictable Feelings: Academic Women under Research Audit

    Science.gov (United States)

    Grant, Barbara M.; Elizabeth, Vivienne

    2015-01-01

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

  20. Limiting Civil Liability in the Sphere of Business Auditing

    Directory of Open Access Journals (Sweden)

    Carmen COSTULEANU

    2011-09-01

    Full Text Available The statutory audit of business entities is represented by the audit of annual financial accounts or consolidated financial accounts, according to the Community legislation transposed in national regulations. Negligence or imprudence in performing the activities related to this type of audit entail special consequences. It is to some of the elements derived from this context that we refer in this paper, especially as there is often the underlying risk for the auditor to be held liable. It is worth noting that one cannot claim several compensations for the same action. Then, the auditor is not jointly liable with the other authors of the illicit actions which have caused damages. On the other hand, limited liability does not apply to the situations when it has been proven that the auditor has breached his professional duties with direct intent.

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

    Science.gov (United States)

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

    2014-03-01

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

  2. The effects of audit value added on audit survival: Evidence from CPAs of Thailand

    Directory of Open Access Journals (Sweden)

    Seerungrat Sudsomboon

    2016-03-01

    Full Text Available The purposes of this study are to investigate the relationship between antecedents and consequences of audit value added (AVA. AVA is performance of the auditors who work with dedication and commitment to quality work and usefulness for user. AVA composes three dimensions as well as audit best practice, audit continuous learning, and professional ethic awareness. The results from the questionnaire survey of 135 CPAs in Thailand. The findings identified that only two dimensions of AVA has positive relationship with all consequences as well as audit continuous learning and professional ethic awareness. Which the consequences of this study are financial information transparency, stakeholder acceptance, and audit survival. In addition, the finding shows the relationship between antecedence and audit value added are positive significant. Which the antecedence of this study are Stakeholder pressure, audit regulation change, and business environment climate. Surprisingly, have not significant the relationship between audit best practice that dimensions of audit value added and consequences. The summary of this paper not only provides theoretical and managerial contributions but also suggestions and directions of the future research are elaborate.

  3. 11 CFR 9038.1 - Audit.

    Science.gov (United States)

    2010-01-01

    ... 11 Federal Elections 1 2010-01-01 2010-01-01 false Audit. 9038.1 Section 9038.1 Federal Elections... EXAMINATIONS AND AUDITS § 9038.1 Audit. (a) General. (1) The Commission will conduct an audit of the qualified... primary matching funds. The audit may be conducted at any time after the date of the candidate's...

  4. 30 CFR 735.22 - Audit.

    Science.gov (United States)

    2010-07-01

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

  5. NEVER AUDIT ALONE--THE CASE FOR AUDIT TEAMS

    Science.gov (United States)

    On-site audits conducted by technical and quality assurance (QA) experts at the data-gathering location are the core of an effective QA program. However, inadequate resources for such audits are the bane of a QA program, and the proposed solution frequently is to send only one au...

  6. Software Assists in Extensive Environmental Auditing

    Science.gov (United States)

    Callac, Christopher; Matherne, Charlie

    2003-01-01

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

  7. CRITERIA AND FACTORS THAT INSURE THE QUALITY IN PROVISION OF AUDIT SERVICES, DIFFERENT FROM AUDIT

    OpenAIRE

    Antoniuk O.

    2018-01-01

    Introduction. Quality management of audit services requires further theoretical research and development in the field of audit activity and quality of audit, continuous improvement of the organization and methodology in providing audit services. Purpose. The article deals with the theoretical and practical questions of assessing the quality of audit services that are different from the audit in order to identify ways to improve the methodological quality assurance in the provision of thes...

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

    Science.gov (United States)

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

    2012-11-21

    Criteria-based audits (CBA) have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania. The prevalence of eclampsia in MNH is high (≈6%) with the majority of cases arriving after start of convulsions. In 2004-2005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base). A criteria-based audit (CBA) was used to evaluate the quality of care for eclamptic mothers admitted at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania after implementation of recommendations of a previous audit. A CBA of eclampsia cases was conducted at MNH. Management practices were evaluated using evidence-based criteria for appropriate care. The Ministry of Health (MOH) guidelines, local management guidelines, the WHO manual supplemented by the WHO Reproductive Health Library, standard textbooks, the Cochrane database and reviews in peer reviewed journals were adopted. At the initial audit in 2006, 389 case notes were assessed and compared with the standards, gaps were identified, recommendations made followed by implementation. A re-audit of 88 cases was conducted in 2009 and compared with the initial audit. There was significant improvement in quality of patient management and outcome between the initial and re-audit: Review of management plan by senior staff (76% vs. 99%; P=0.001), urine for albumin test (61% vs. 99%; P=0.001), proper use of partogram to monitor labour (75% vs. 95%; P=0.003), treatment with steroids for lung maturity (2.0% vs. 24%; P=0.001), Caesarean section within 2 hours of decision (33% vs. 61%; P=0.005), full blood count (28% vs. 93%; P=0.001), serum urea and creatinine (44% vs. 86%; P=0.001), liver enzymes (4.0% vs. 86%; P=0.001), and specialist review within 2 hours of

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

    Science.gov (United States)

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

    2014-05-01

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

  10. 30 CFR 725.19 - Audit.

    Science.gov (United States)

    2010-07-01

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

  11. Non-small cell lung cancer in young adults: presentation and survival in the English National Lung Cancer Audit.

    Science.gov (United States)

    Rich, A L; Khakwani, A; Free, C M; Tata, L J; Stanley, R A; Peake, M D; Hubbard, R B; Baldwin, D R

    2015-11-01

    Non-small cell lung cancer (NSCLC) in young adults is a rare but devastating illness with significant socioeconomic implications, and studies of this patient subgroup are limited. This study employed the National Lung Cancer Audit to compare the clinical features and survival of young adults with NSCLC with the older age groups. A retrospective cohort review using a validated national audit dataset. Data were analysed for the period between 1 January 2004 and 31 December 2011. Young adults were defined as between 18 and 39 years, and all others were divided into decade age groups, up to the 80 years and above group. We performed logistic and Cox regression analyses to assess clinical outcomes. Of a total of 1 46 422 patients, 651 (0.5%) were young adults, of whom a higher proportion had adenocarcinoma (48%) than in any other age group. Stage distribution of NSCLC was similar across the age groups and 71% of young patients had stage IIIb/IV. Performance status (PS) was 0-1 for 85%. Young adults were more likely to have surgery and chemotherapy compared with the older age groups and had better overall and post-operative survival. The proportion with adenocarcinoma, better PS and that receiving surgery or chemotherapy diminished progressively with advancing decade age groups. In our cohort of young adults with NSCLC, the majority had good PS despite the same late-stage disease as older patients. They were more likely to have treatment and survive longer than older patients. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. Optimising measurement of health-related characteristics of the built environment: Comparing data collected by foot-based street audits, virtual street audits and routine secondary data sources.

    Science.gov (United States)

    Pliakas, Triantafyllos; Hawkesworth, Sophie; Silverwood, Richard J; Nanchahal, Kiran; Grundy, Chris; Armstrong, Ben; Casas, Juan Pablo; Morris, Richard W; Wilkinson, Paul; Lock, Karen

    2017-01-01

    The role of the neighbourhood environment in influencing health behaviours continues to be an important topic in public health research and policy. Foot-based street audits, virtual street audits and secondary data sources are widespread data collection methods used to objectively measure the built environment in environment-health association studies. We compared these three methods using data collected in a nationally representative epidemiological study in 17 British towns to inform future development of research tools. There was good agreement between foot-based and virtual audit tools. Foot based audits were superior for fine detail features. Secondary data sources measured very different aspects of the local environment that could be used to derive a range of environmental measures if validated properly. Future built environment research should design studies a priori using multiple approaches and varied data sources in order to best capture features that operate on different health behaviours at varying spatial scales. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    OpenAIRE

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

    2015-01-01

    Background Although using the nursing process improves nursing care quality, few studies have evaluated nursing performance in accordance with nursing process steps either nationally or internationally. Objectives This study aimed to audit nursing care based on a nursing process model. Patients and Methods This was a cross-sectional descriptive study in which a nursing audit checkl...

  14. Performance Audit in Public Sector Entities - A New Challenge for Eastern European Countries

    Directory of Open Access Journals (Sweden)

    Adriana TIRON TUDOR

    2007-02-01

    Full Text Available Performance measurement provides an objective basis for evaluating how efficiently public resources are being used and how effectively public service outcomes are being achieved. It is a process used to support government selfanalysis and provide a basis for more informed and publicly defensible decision-making. In this context an important role is reserved to performance external audit performed by external audit institutions. The performance audit analyses the quality of financial administration from the point of view of the three elements of performance: economy, efficiency and effectiveness. We intend to realize a comparative study for some Eastern European countries regarding the performance audit, knowing the fact that since countries differ at the level of individual reforms, there is no single model of reform. Nonetheless, reform strategies have many points in common emphasizing the international character of public management reform. By cross-national comparisons we intend to analyze the impact of implementing the new performance audit in certain Eastern European Countries, and in Romania, focused on the external audit institutions.

  15. The role of tax audit as a component of restaurants` financial state audit

    Directory of Open Access Journals (Sweden)

    T.M. Omelianchuk

    2015-06-01

    Full Text Available The necessity of tax audit in the process of audit the financial state the enterprises of restaurant economy arises through accumulation in the balance sheet information about the state of fiscal discipline in such forms like the debt on payment taxes, fees and other payments to the budget. In connection with the widespread scientific pluralism views, the purpose of the article is an analysis the role of the tax audit of the company in restaurant facilities today. Dialectical method of cognition of the essence of the tax audit and methods of comparison, generalization, systematization and synthesis of the study of the peculiarities of tax audit of the company in restaurant facilities were used for achievement the purpose of research. Discovered the features of realization the tax audit оn the company of the restaurant facilities. Studied the state the market development of the external audit of taxes and tax audit in Ukraine. Have been identified the features of the system of taxation of business entities in the restaurant industry. The scope of results’ application are the participants’ assessment of the financial state and fiscal capacity of the enterprise restaurant economy.

  16. Finnish Research Programme on Nuclear Waste Management (KYT). Framework Programme for 2002-2005

    International Nuclear Information System (INIS)

    Rasilainen, K.

    2002-12-01

    The new Finnish research programme on nuclear waste management (KYT) will be conducted in 2002 - 2005. This framework programme describes the starting point, the basic aims and the organisation of the research programme. The starting point of the KYT programme is derived from the present state and future challenges of Finnish nuclear waste management. The research programme is funded mainly by the Ministry of Trade and Industry (KTM), the Radiation and Nuclear Safety Authority (STUK), Posiva Oy, Fortum Oyj, Teollisuuden Voima Oy (TVO), and the National Technology Agency (Tekes). As both regulators and implementors are involved, the research programme concentrates on neutral research topics that must be studied in any case. Methods and tools for experimental and theoretical studies fall in this category. State of the art -reviews on relevant topics also create national know-how. Topics that directly belong to licensing activities of nuclear waste management are excluded from the research programme. KYT carries out technical studies that increase national know-how in the area of nuclear waste management. The aim is to maintain and develop basic expertise needed in the operations derived from the national nuclear waste management plan. The studies have been divided into strategic studies and studies enhancing the long-term safety of spent nuclear fuel disposal. Strategic studies support the overall feasibility of Finnish nuclear waste management. These studies include basic options and overall safety principles related to nuclear fuel cycle and nuclear waste management. In addition, general cost estimates as well as general safety considerations related to transportations, low- and medium level wastes, and decommissioning are included in strategic studies. Studies supporting the long-term safety of spent fuel disposal include issues related to performance assessment methodology, release of radionuclides from the repository, behaviour of bedrock and groundwater

  17. A new quality assurance package for hospital palliative care teams: the Trent Hospice Audit Group model.

    Science.gov (United States)

    Hunt, J; Keeley, V L; Cobb, M; Ahmedzai, S H

    2004-07-19

    Cancer patients in hospitals are increasingly cared for jointly by palliative care teams, as well as oncologists and surgeons. There has been a considerable growth in the number and range of hospital palliative care teams (HPCTs) in the United Kingdom. HPCTs can include specialist doctors and nurses, social workers, chaplains, allied health professionals and pharmacists. Some teams work closely with existing cancer multidisciplinary teams (MDTs) while others are less well integrated. Quality assurance and clinical governance requirements have an impact on the monitoring of such teams, but so far there is no standardised way of measuring the amount and quality of HPCTs' workload. Trent Hospice Audit Group (THAG) is a multiprofessional research group, which has been developing standards and audit tools for palliative care since the 1990s. These follow a format of structure-process-outcome for standards and measures. We describe a collaborative programme of work with HPCTs that has led to a new set of standards and audit tools. Nine HPCTs participated in three rounds of consultation, piloting and modification of standard statements and tools. The final pack of HPCT quality assurance tools covers: policies and documentation; medical notes review; questionnaires for ward-based staff. The tools measure the HPCT workload and casemix; the views of ward-based staff on the supportive role of the HPCT and the effectiveness of HPCT education programmes, particularly in changing practice. The THAG HPCT quality assurance pack is now available for use in cancer peer review.

  18. Associations between AUDIT-C and mortality vary by age and sex.

    Science.gov (United States)

    Harris, Alex H S; Bradley, Katharine A; Bowe, Thomas; Henderson, Patricia; Moos, Rudolf

    2010-10-01

    We sought to determine the sex- and age-specific risk of mortality associated with scores on the 3-item Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire using data from a national sample of Veterans Health Administration (VHA) patients. Men (N = 215,924) and women (N = 9168) who completed the AUDIT-C in a patient survey were followed for 24 months. AUDIT-C categories (0, 1-4, 5-8, 9-12) were evaluated as predictors of mortality in logistic regression models, adjusted for age, race, education, marital status, smoking, depression, and comorbidities. For women, AUDIT-C scores of 9-12 were associated with a significantly increased risk of death compared to the AUDIT-C 1-4 group (odds ratio [OR] 7.09; 95% confidence interval [CI] = 2.67, 18.82). For men overall, AUDIT-C scores of 5-8 and 9-12 were associated with increased risk of death compared to the AUDIT-C 1-4 group (OR 1.13, 95% CI = 1.05, 1.21, and OR 1.63, 95% CI = 1.45, 1.84, respectively) but these associations varied by age. These results provide sex- and age-tailored risk information that clinicians can use in evidence-based conversations with patients about the health-related risks of their alcohol consumption. This study adds to the growing literature establishing the AUDIT-C as a scaled marker of alcohol-related risk or "vital sign" that might facilitate the detection and management of alcohol-related risks and problems.

  19. The Role of NMAC Audits in Euratom Safeguards - Development of an audit framework

    Energy Technology Data Exchange (ETDEWEB)

    Alique Moya, O.; Hill, C.; Kahnmeyer, W.; Koutsoyannopoulos, C.; Boella, M. [European Commission, DG ENERGY, Unit DDG2.E.1, Design, Planning and Evaluation of inspections, Logistical support, Luxembourg (Luxembourg)

    2011-12-15

    The use of audits of nuclear facility operators' nuclear material accountancy and control (NMAC) systems has evolved since the idea was launched some years ago. The European Commission has developed a framework that enables the use of NMAC system audits as an effective and efficient tool in nuclear safeguards. The framework includes elements like audit definition and concept, a procedure, audit criteria and the approach for using audits. The main elements of this framework have been built upon ESARDA working group recommendations and were widely consulted with Member States and nuclear operators. The framework and experience from its application are presented.

  20. THE AUDIT OF RECEPTION PROCESS

    Directory of Open Access Journals (Sweden)

    Dorina MOCUŢA

    2013-01-01

    Full Text Available The object of study case is to analyze the quality of the logistics department, focusing on the audit process. Purpose of this paper is to present the advantages resulting from the systematic audit processes and methods of analysis and improvement of nonconformities found. The case study is realised at SC Miele Tehnica SRL Brasov, twelfth production line, and the fourth from outside Germany. The specific objectives are: clarifying the concept of audit quality, emphasizing requirements ISO 19011:2003 "Guidelines for auditing quality management systems and / or environment" on audits; cchieving quality audit and performance analysis; improved process performance reception materials; compliance with legislation and auditing standards applicable in EU and Romania.