Qualities of dental chart recording and coding.

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Chantravekin, Yosananda; Tasananutree, Munchulika; Santaphongse, Supitcha; Aittiwarapoj, Anchisa

2013-01-01

Chart recording and coding are the important processes in the healthcare informatics system, but there were only a few reports in the dentistry field. The objectives of this study are to study the qualities of dental chart recording and coding, as well as the achievement of lecture/workshop on this topic. The study was performed by auditing the patient's charts at the TU Dental Student Clinic from July 2011-August 2012. The chart recording mean scores ranged from 51.0-55.7%, whereas the errors in the coding process were presented in the coder part more than the doctor part. The lecture/workshop could improve the scores only in some topics.

Inaccurate Dental Charting in an Audit of 1128 General Dental Practice Records.

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Brown, Nathan L; Jephcote, Victoria E L

2017-03-01

Fourteen dentists at different practices in the UK assessed the dental charts of 1128 patients who were new to the dentist but not new to the practice; 44% of the dental charts were found to be inaccurate. Inaccuracy of the individual practice-based charts ranged between 16% for the best performing practices to 83% for the worst: 5% of dental charts had too many teeth charted and 5% had too few teeth charted; 13% of charts had missed amalgam restorations and 18% had missed tooth-coloured restorations; 5% of charts had amalgam restorations recorded but with the surfaces incorrect (eg an MO restoration charted but a DO restoration actually present); 9% of charts had tooth-coloured restoration surfaces incorrectly recorded. For 7.5% of charts, amalgams were charted but not actually present. Other inaccuracies were also noted. The authors reinforce the requirements of the GDC, the advice of defence organizations, and the forensic importance of accurate dental charts. Clinical relevance: Dental charting forms part of the patient’s dental records, and the GDC requires dentists to maintain complete and accurate dental records.

Are primary care practitioners in Barbados following diabetes guidelines? - a chart audit with comparison between public and private care sectors

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Carter Anne O

2011-06-01

Full Text Available Abstract Background Over 19% of the population ≥ 40 years of age in Barbados are diabetic. The quality of diabetes primary care is uncertain. Findings Charts of diabetic and hypertensive patients were randomly sampled at all public and 20 private sector primary care clinics. Charts of all diabetic patients ≥ 40 years of age were then selected. Processes of care, and quality targets for blood pressure (BP, fasting blood glucose (FBG and glycosylated haemoglobin (HbA1c were documented. 252 charts of diabetic patients (125 public and 127 private were audited. Patients had the following characteristics: mean age 64 years, female gender 61%, mean duration of diagnosis 9 years, and hypertension diagnosed 78%. Patients had an average of 4.7 clinic visits per year, 66% were prescribed metformin, 68% a sulphonylurea, 25% a statin, 21% insulin, 15% aspirin and 12% a glucosidase inhibitor. Public patients compared to private patients were more likely to be female (77% vs. 46%, p Conclusions Interventions such as body mass assessment, lifestyle advice, screening for retinopathy, monitoring blood glucose control, and achieving BP and glycaemic targets need improvement.

Research Electronic Data Capture (REDCap®) used as an audit tool with a built-in database.

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Kragelund, Signe H; Kjærsgaard, Mona; Jensen-Fangel, Søren; Leth, Rita A; Ank, Nina

2018-05-01

The aim of this study was to develop an audit tool with a built-in database using Research Electronic Data Capture (REDCap®) as part of an antimicrobial stewardship program at a regional hospital in the Central Denmark Region, and to analyse the need, if any, to involve more than one expert in the evaluation of cases of antimicrobial treatment, and the level of agreement among the experts. Patients treated with systemic antimicrobials in the period from 1 September 2015 to 31 August 2016 were included, in total 722 cases. Data were collected retrospectively and entered manually. The audit was based on seven flow charts regarding: (1) initiation of antimicrobial treatment (2) infection (3) prescription and administration of antimicrobials (4) discontinuation of antimicrobials (5) reassessment within 48 h after the first prescription of antimicrobials (6) microbiological sampling in the period between suspicion of infection and the first administration of antimicrobials (7) microbiological results. The audit was based on automatic calculations drawing on the entered data and on expert assessments. Initially, two experts completed the audit, and in the cases in which they disagreed, a third expert was consulted. In 31.9% of the cases, the two experts agreed on all elements of the audit. In 66.2%, the two experts reached agreement by discussing the cases. Finally, 1.9% of the cases were completed in cooperation with a third expert. The experts assessed 3406 flow charts of which they agreed on 75.8%. We succeeded in creating an audit tool with a built-in database that facilitates independent expert evaluation using REDCap. We found a large inter-observer difference that needs to be considered when constructing a project based on expert judgements. Our two experts agreed on most of the flow charts after discussion, whereas the third expert's intervention did not have any influence on the overall assessment. Copyright © 2018 Elsevier Inc. All rights reserved.

Pelvic floor physical therapy for lifelong vaginismus: a retrospective chart review and interview study.

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Reissing, Elke D; Armstrong, Heather L; Allen, Caroline

2013-01-01

Pelvic floor physical therapy is used in the treatment of sexual pain disorders; however, women with lifelong vaginismus have not yet been included in treatment studies or have not been differentiated from women with acquired vaginismus and/or dyspareunia. This retrospective chart review and interview study was intended to obtain initial information on physical therapy interventions, course, and outcome in women who have never been able to experience vaginal intercourse. The files of 53 women, consecutively treated at one physical therapy clinic, were included in the chart review; 13 of these women volunteered to be interviewed. The chart review revealed significant pelvic floor pathology and an average treatment course of 29 sessions. Internal manual techniques were found to be most effective, followed by patient education, dilatation exercises, and home exercises. Although participants were very satisfied with the physical therapy, some symptoms, such as pain, anxiety/fear, and pelvic floor tension remained and scores on the Female Sexual Distress Scale and Female Sexual Function Index indicated clinical levels of sexual distress and impaired sexual function after treatment. Although there appears to be no linear relation between symptom reduction and healthy sexual function, this initial information suggests that physical therapy may be a promising treatment option for some women with lifelong vaginismus and merits further evaluation.

How Accurately Do Consecutive Cohort Audits Predict Phase III Multisite Clinical Trial Recruitment in Palliative Care?

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McCaffrey, Nikki; Fazekas, Belinda; Cutri, Natalie; Currow, David C

2016-04-01

Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actual participating sites and recruitment to four Phase III multisite clinical RCTs. The proportion of potentially eligible study participants estimated from an inpatient chart review of people with life-limiting illnesses referred to six Australian specialist palliative care services was compared with recruitment data extracted from study prescreening information from three sites that participated fully in four Palliative Care Clinical Studies Collaborative RCTs. The predominant reasons for ineligibility in the audit and RCTs were analyzed. The audit overestimated the proportion of people referred to the palliative care services who could participate in the RCTs (pain 17.7% vs. 1.2%, delirium 5.8% vs. 0.6%, anorexia 5.1% vs. 0.8%, and bowel obstruction 2.8% vs. 0.5%). Approximately 2% of the referral base was potentially eligible for these effectiveness studies. Ineligibility for general criteria (language, cognition, and geographic proximity) varied between studies, whereas the reasons for exclusion were similar between the audit and pain and anorexia studies but not for delirium or bowel obstruction. The retrospective consecutive case note audit in participating sites did not predict realistic recruitment rates, mostly underestimating the impact of study-specific inclusion criteria. These findings have implications for the applicability of the results of RCTs. Prospective pilot studies are more likely to predict actual recruitment. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit

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Katy Robjant

2017-06-01

Full Text Available BackgroundHuman trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD have been found. Narrative exposure therapy (NET is an evidence-based treatment for PTSD.MethodsIn this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD.ResultsAll 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment.ConclusionAlthough limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population.

Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit.

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Robjant, Katy; Roberts, Jackie; Katona, Cornelius

2017-01-01

Human trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD) have been found. Narrative exposure therapy (NET) is an evidence-based treatment for PTSD. In this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD. All 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment. Although limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population.

Tuberculosis in Far North Queensland, Australia: a retrospective clinical audit.

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Wilson, Malcolm; Weston, Jana; Mullen, Annette; Knight, Trevor; Simpson, Graham

2018-06-05

Compared with global numbers, Australia has enjoyed relatively good tuberculosis control over the last thirty years with an annual incidence of 5.7 per 100,000 population. 1 Thanks to its unique geography and proximity to high-burden countries, such as Papua New Guinea (PNG), Far North Queensland (FNQ) has previously been shown to have higher rates of tuberculosis compared with both the state and national average. 2,3 AIMS: Document tuberculosis epidemiology in FNQ with comparison to two previous audits of the region. Retrospective clinical audit of all cases of tuberculosis notified to the Cairns Tuberculosis Control Unit between 2006 and 2016. 453 cases were identified, 374 with microbiological/histological confirmation. There were 312 cases of pulmonary tuberculosis; 155 extra-pulmonary; and 21 disseminated. Three-quarters (327/453) were identified in the overseas-born population. Of the remaining 126 cases, 40 were Torres Strait Islander and 19 Aboriginal Australians. Where drug susceptibility was known, two-thirds (247/368) were fully sensitive; 42 mono-resistant; 78 multidrug-resistant; and one extensively drug resistant. Rates of HIV co-infection were less than three percent (10/362). Tuberculosis remains a significant problem in FNQ. Case numbers have increased three-fold since the 1990s. Much of the increase comes from the overseas-born population. Although PNG accounts for the majority, the number of positive notifications amongst those born elsewhere abroad has increased five-fold since 2010. Tuberculosis amongst Aboriginal Australians has decreased following policy changes in response previous audits. Tuberculosis in Torres Strait residents, however, has increased from 12 cases (1993-2002) to 40 (2006-2016). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

A 5-year retrospective audit of prescribing by a critical care outreach team.

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Wilson, Mark

2018-05-01

UK prescribing legislation changes made in 2006 and 2012 enabled appropriately qualified nurses to prescribe any licensed medication, and all controlled drugs in schedule 2-5 of the Misuse of Drugs Regulations 2001, for any medical condition within their clinical competence. Critical Care Outreach nurses who are independent nurse prescribers are ideally placed to ensure that acutely ill patients receive treatment without delay. The perceived challenge was how Critical Care Outreach nurses would be able to safely prescribe for a diverse patient group. This study informs this developing area of nurse prescribing in critical care practice. The aims of the audit were to: identify which medications were prescribed; develop a critical care outreach formulary; identify the frequency, timing and number of prescribing decisions being made; identify if prescribing practice changed over the years and provide information for our continuing professional development. This article reports on data collected from a 5-year retrospective audit; of prescribing activity undertaken by nine independent nurse prescribers working in a 24/7 Critical Care Outreach team of a 600-bedded district general hospital in the UK. In total, 8216 medication items were prescribed, with an average of 2·6 prescribed per shift. The most commonly prescribed items were intravenous fluids and analgesia, which were mostly prescribed at night and weekends. The audit has shown that Critical Care Outreach nurse prescribing is feasible in a whole hospital patient population. The majority of prescribing occurred after 16:00 and at night. Further research would be beneficial, particularly looking at patient outcomes following reviews from prescribing critical care outreach nurses. The audit is one of the only long-term studies that describes prescribing practice in Critical Care Outreach teams in the UK. © 2017 British Association of Critical Care Nurses.

Inter-rater reliability of case-note audit: a systematic review.

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Lilford, Richard; Edwards, Alex; Girling, Alan; Hofer, Timothy; Di Tanna, Gian Luca; Petty, Jane; Nicholl, Jon

2007-07-01

The quality of clinical care is often assessed by retrospective examination of case-notes (charts, medical records). Our objective was to determine the inter-rater reliability of case-note audit. We conducted a systematic review of the inter-rater reliability of case-note audit. Analysis was restricted to 26 papers reporting comparisons of two or three raters making independent judgements about the quality of care. Sixty-six separate comparisons were possible, since some papers reported more than one measurement of reliability. Mean kappa values ranged from 0.32 to 0.70. These may be inflated due to publication bias. Measured reliabilities were found to be higher for case-note reviews based on explicit, as opposed to implicit, criteria and for reviews that focused on outcome (including adverse effects) rather than process errors. We found an association between kappa and the prevalence of errors (poor quality care), suggesting alternatives such as tetrachoric and polychoric correlation coefficients be considered to assess inter-rater reliability. Comparative studies should take into account the relationship between kappa and the prevalence of the events being measured.

Guideline implementation in clinical practice: use of statistical process control charts as visual feedback devices.

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Al-Hussein, Fahad A

2009-01-01

To use statistical control charts in a series of audits to improve the acceptance and consistant use of guidelines, and reduce the variations in prescription processing in primary health care. A series of audits were done at the main satellite of King Saud Housing Family and Community Medicine Center, National Guard Health Affairs, Riyadh, where three general practitioners and six pharmacists provide outpatient care to about 3000 residents. Audits were carried out every fortnight to calculate the proportion of prescriptions that did not conform to the given guidelines of prescribing and dispensing. Simple random samples of thirty were chosen from a sampling frame of all prescriptions given in the two previous weeks. Thirty six audits were carried out from September 2004 to February 2006. P-charts were constructed around a parametric specification of non-conformities not exceeding 25%. Of the 1081 prescriptions, the most frequent non-conformity was failure to write generic names (35.5%), followed by the failure to record patient's weight (16.4%), pharmacist's name (14.3%), duration of therapy (9.1%), and the use of inappropriate abbreviations (6.0%). Initially, 100% of prescriptions did not conform to the guidelines, but within a period of three months, this came down to 40%. A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

Gender Variance Among Youth with Autism Spectrum Disorders: A Retrospective Chart Review.

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Janssen, Aron; Huang, Howard; Duncan, Christina

2016-01-01

Purpose: Increasing clinical evidence suggests an overrepresentation of gender variance (GV) among patients with autism spectrum disorders (ASDs). This retrospective chart review aims to contribute to the existing literature on co-occurring ASD and gender dysphoria (GD). We compare the rate of parent-reported GV in patients with an ASD diagnosis to that of parent-reported GV in a normative nonreferred data set. Methods: Child Behavior Checklist (CBCL) charts were collected from 492 children and adolescents (409 natal males and 83 natal females) aged 6-18 years who have received a diagnosis of ASD at the New York University Child Study Center. Parent-reported GV was determined through endorsement of CBCL sex item 110, which assesses the presence of gender-related issues. We calculated the odds ratio of endorsement of item 110 between our ASD sample and the CBCL sample data. Results: The subjects diagnosed with ASD were 7.76 times more likely to report GV than the CBCL sample. This finding was statistically significant. About 5.1% of the patients in the ASD group and 0.7% of the CBCL nonreferred group endorsed sex item 110. 5.1% of natal males and 4.8% of natal females endorsed sex item 110. Neither gender nor age influenced the rate of endorsement. Conclusion: This finding supports the growing research suggesting a heightened co-occurrence rate of ASD and GD. Focus should be placed upon improving our understanding of the nature of this co-occurrence and on gender identity development within the atypical development of ASD.

The effect of rapid response teams on end-of-life care: A retrospective chart review

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Tam, Benjamin; Salib, Mary; Fox-Robichaud, Alison

2014-01-01

BACKGROUND: A subset of critically ill patients have end-of-life (EOL) goals that are unclear. Rapid response teams (RRTs) may aid in the identification of these patients and the delivery of their EOL care. OBJECTIVES: To characterize the impact of RRT discussion on EOL care, and to examine how a preprinted order (PPO) set for EOL care influenced EOL discussions and outcomes. METHODS: A single-centre retrospective chart review of all RRT calls (January 2009 to December 2010) was performed. The effect of RRT EOL discussions and the effect of a hospital-wide PPO set on EOL care was examined. Charts were from the Ontario Ministry of Health and Long-Term Care Critical Care Information Systemic database, and were interrogated by two reviewers. RESULTS: In patients whose EOL status changed following RRT EOL discussion, there were fewer intensive care unit (ICU) transfers (8.4% versus 17%; PEOL status following the introduction of an EOL PPO, from 20% (before) to 31% (after) (PEOL status following RRT-led EOL discussion was associated with reduced ICU transfers and enhanced access to palliative care services. Further study is required to identify and deconstruct barriers impairing timely and appropriate EOL discussions. PMID:25299222

Supracricoid hemilaryngopharyngectomy for selected pyriform sinus carcinoma patients – a retrospective chart review

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Yiotakis Ioannis E

2009-08-01

Full Text Available Abstract Background The aim of this study is to assess the functional and oncologic results of supracricoid hemilaryngopharyngectomy and report our experience in the technique, local control and overall survival rates. Materials and methods 18 selected patients with pyriform sinus cancer treated by supracricoid hemilaryngopharyngectomy in a University Hospital setting. Retrospective chart review was used to assess functional and oncologic results of the procedure. Results The actuarial 5 year survival rate in our study was 55.56% and the actuarial neck recurrence rate was 16.67%. All patients were successfully decannulated. Aspiration pneumonia was the most common postoperative complication (22.23% and was treated mostly conservatively. One patient required a temporary gastrostomy but no patient needed total laryngectomy in the postoperative period. Conclusion Supracricoid hemilaryngopharyngectomy in experienced hands is a reliable technique for selected patients with pyriform sinus cancer.

Limited Documentation and Treatment Quality of Glycemic Inpatient Care in Relation to Structural Deficits of Heterogeneous Insulin Charts at a Large University Hospital.

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Kopanz, Julia; Lichtenegger, Katharina M; Sendlhofer, Gerald; Semlitsch, Barbara; Cuder, Gerald; Pak, Andreas; Pieber, Thomas R; Tax, Christa; Brunner, Gernot; Plank, Johannes

2018-02-09

Insulin charts represent a key component in the inpatient glycemic management process. The aim was to evaluate the quality of structure, documentation, and treatment of diabetic inpatient care to design a new standardized insulin chart for a large university hospital setting. Historically grown blank insulin charts in use at 39 general wards were collected and evaluated for quality structure features. Documentation and treatment quality were evaluated in a consecutive snapshot audit of filled-in charts. The primary end point was the percentage of charts with any medication error. Overall, 20 different blank insulin charts with variable designs and significant structural deficits were identified. A medication error occurred in 55% of the 102 audited filled-in insulin charts, consisting of prescription and management errors in 48% and 16%, respectively. Charts of insulin-treated patients had more medication errors relative to patients treated with oral medication (P international standards, a new insulin chart was developed to overcome these quality hurdles.

A retrospective chart review of pirfenidone-treated patients in Sweden: the REPRIS study

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Carl Magnus Sköld

2016-07-01

Full Text Available Background: Idiopathic pulmonary fibrosis (IPF is a chronic, progressive lung disease that usually results in respiratory failure and death. Pirfenidone was approved as the first licensed therapy for IPF in Europe based on phase III trials where patients with a forced vital capacity (FVC >50% of predicted were included. The aim of this study was to characterise patients treated with pirfenidone in Swedish clinical practice and to describe the adherence to the reimbursement restriction since reimbursement was only applied for patients with FVC below 80% of predicted. Methods: This was a retrospective, observational chart review of IPF patients treated with pirfenidone from three Swedish university clinics. Patients initiated on treatment during the period 28 June 2012 to 20 November 2014 were included. Data on patient characteristics, basis of diagnosis, treatment duration, quality of life, and adverse drug reactions (ADRs were collected from medical charts. Results: Forty-four patients were screened and 33 were included in the study. The mean treatment duration from start of pirfenidone until discontinuation or end of study was 38 weeks. At the initiation of pirfenidone treatment, FVC was 62.7% (12.1 [mean (SD], diffusion capacity (DLco was 45.1% (13.8 of predicted, and the ratio of forced expiratory volume on 1 sec (FEV1 to FVC was 0.78 (0.1. The percentage of patients with an FVC between 50 and 80% was 87%. Ten of the patients had ADRs including gastrointestinal and skin-related events, cough and signs of impaired hepatic function, but this led to treatment discontinuation in only two patients. Conclusion: Data from this chart review showed that adherence to the Swedish reimbursement restriction was followed in the majority of patients during the study period. At the start of pirfenidone treatment, lung function, measured as FVC, was lower in the present cohort of Swedish IPF patients compared with other registry and real-life data. About a

Process monitoring in intensive care with the use of cumulative expected minus observed mortality and risk-adjusted P charts.

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Cockings, Jerome G L; Cook, David A; Iqbal, Rehana K

2006-02-01

A health care system is a complex adaptive system. The effect of a single intervention, incorporated into a complex clinical environment, may be different from that expected. A national database such as the Intensive Care National Audit & Research Centre (ICNARC) Case Mix Programme in the UK represents a centralised monitoring, surveillance and reporting system for retrospective quality and comparative audit. This can be supplemented with real-time process monitoring at a local level for continuous process improvement, allowing early detection of the impact of both unplanned and deliberately imposed changes in the clinical environment. Demographic and UK Acute Physiology and Chronic Health Evaluation II (APACHE II) data were prospectively collected on all patients admitted to a UK regional hospital between 1 January 2003 and 30 June 2004 in accordance with the ICNARC Case Mix Programme. We present a cumulative expected minus observed (E-O) plot and the risk-adjusted p chart as methods of continuous process monitoring. We describe the construction and interpretation of these charts and show how they can be used to detect planned or unplanned organisational process changes affecting mortality outcomes. Five hundred and eighty-nine adult patients were included. The overall death rate was 0.78 of predicted. Calibration showed excess survival in ranges above 30% risk of death. The E-O plot confirmed a survival above that predicted. Small transient variations were seen in the slope that could represent random effects, or real but transient changes in the quality of care. The risk-adjusted p chart showed several observations below the 2 SD control limits of the expected mortality rate. These plots provide rapid analysis of risk-adjusted performance suitable for local application and interpretation. The E-O chart provided rapid easily visible feedback of changes in risk-adjusted mortality, while the risk-adjusted p chart allowed statistical evaluation. Local analysis of

Fine motor and self-care milestones for individuals with Down syndrome using a Retrospective Chart Review.

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Frank, K; Esbensen, A J

2015-08-01

Developmental milestone markers for fine motor and self-care skills among children with Down syndrome (DS) are either minimal, anecdotal or out-of date. Our goal was to produce normative expectations for the development of fine motor and self-care milestones specific to children with DS. A cross-sectional retrospective chart review was completed on 274 children with DS seen at a specialty clinic that ranged in age from 4 months to 18 years. Specific skills were assessed at occupational therapy assessments as either present or absent, including fine motor, handwriting, scissor usage, self-feeding and clothing management. Fine motor milestones describing when 10-30% ('early achievers') and 75-95% ('representative achievement') of children with DS had mastered each skill were developed based upon descriptive review. As the fine motor and self-care skills advanced in complexity, the range of ages for documented skill acquisition was observed to increase. Age ranges for the mastery of fine motor developmental milestones for early and representative achievement were developed based upon descriptive analysis of cross-sectional retrospective clinical chart reviews. That the age range for mastering fine motor and self-care skills broadens as children with DS get older is in agreement with what is identified in the DS behavioural phenotype with regard to variable motor skills overall. These fine motor and self-care developmental milestone markers contribute to the field by informing parents, caregivers and healthcare providers of potential fine motor and self-care outcomes and describing normative development for children with DS. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Clinical management issues vary by specialty in the Victorian Audit of Surgical Mortality: a retrospective observational study

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Vinluan, Jessele; Retegan, Claudia; Chen, Andrew; Beiles, Charles Barry

2014-01-01

Objective Clinical management issues are contributory factors to mortality. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM), an educational peer-review process for surgeons, to discover differences in the incidence of these issues between surgical specialties in order to focus attention to areas of care that might be improved. Design This study used retrospectively analysed observational data from VASM. Clinical management issues between eight speci...

Adherence to the Australian National Inpatient Medication Chart: the efficacy of a uniform national drug chart on improving prescription error.

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Atik, Alp

2013-10-01

In 2006, the National Inpatient Medication Chart (NIMC) was introduced as a uniform medication chart in Australian public hospitals with the aim of reducing prescription error. The rate of regular medication prescription error in the NIMC was assessed. Data was collected using the NIMC Audit Tool and analyzed with respect to causes of error per medication prescription and per medication chart. The following prescription requirements were assessed: date, generic drug name, route of administration, dose, frequency, administration time, indication, signature, name and contact details. A total of 1877 medication prescriptions were reviewed. 1653 prescriptions (88.07%) had no contact number, 1630 (86.84%) did not have an indication, 1230 and 675 (35.96%) used a drug's trade name. Within 261 medication charts, all had at least one entry, which did not include an indication, 258 (98.85%) had at least one entry, which did not have a contact number and 200 (76.63%) had at least one entry, which used a trade name. The introduction of a uniform national medication chart is a positive step, but more needs to be done to address the root causes of prescription error. © 2012 John Wiley & Sons Ltd.

THE EFFECTS OF AMOXICILLIN WITH OR WITHOUT CLAVULANIC ACID ON THE POSTOPERATIVE COMPLAINTS AFTER THIRD MOLAR SURGERY: A RETROSPECTIVE CHART ANALYSIS

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Alparslan ESEN

2017-04-01

Full Text Available Purpose: The aim of this chart-based retrospective study was to evaluate the effects of orally administered amoxicillin alone or amoxicillin combined with clavulanic acid on the frequency of post-operative complications and patients’ comfort after mandibular third molar surgery. Materials and Methods: The records of patients who had undergone lower third molar surgery between October 2014 and December 2015 were examined. A total of 62 patients who had fully impacted teeth in mesioangular position and who had been prescribed same type and dose of anti-inflammatory drug were included in this study. Among them, 32 subjects were found to have been prescribed 500 mg amoxicillin trihydrate orally every 8 h for 5 days (Group A and 30 patients 500 mg amoxicillin trihydrate plus 125 mg potassium clavulanate orally every 8 h for 5 days postoperatively (Group AC. Post-operative pain levels, swelling, presence of trismus, frequency of alveolar osteitis and quality of life (QoL scores were gathered from patients’ charts and were statistically compared. Results: Analysis of the variables showed that there were no significant differences between the Groups A and AC regarding pain levels, swelling, trismus and QoL scores. The frequency of alveolar osteitis was found to be 1.6% in the Group A, however, no significant difference was observed among study groups. Conclusion: Within the limitations of this retrospective chart review, it can be stated that amoxicillin and amoxicillin with clavulanic acid might provide similar outcome in terms of patient comfort following third molar surgery.

Factors Influencing Clinical Performance of Baccalaureate Nursing Majors: A Retrospective Audit.

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Johnston, Sandra; Fox, Amanda; Coyer, Fiona Maree

2018-06-01

Transition of nursing student to new graduate depends on successful completion of clinical work placement during an undergraduate course. Supporting students during the clinical placement is imperative. This study examined associations between grade point average, domestic or international status, course entry qualification, and single or dual nursing degree to successful completion of clinical placement. A retrospective audit of 665 students in a baccalaureate nursing program was conducted to examine factors influencing clinical performance of baccalaureate nursing students. A significant association between entry qualification, lower grade point average, international status, and receipt of a constructive note was found: χ 2 = 8.678, df = 3, p = .034, t(3.862), df = 663, p ⩽ .001, and Fisher's exact test = 8.581, df = 1, p = .003, respectively. Understanding factors that affect clinical performance may help early identification of students at risk and allow for supportive intervention during placement and subsequent program completion. [J Nurs Educ. 2018;57(6):333-338.]. Copyright 2018, SLACK Incorporated.

A retrospective audit on usage of Diatrizoate Meglumine (Gastrografin®) for intestinal obstruction or constipation in patients with advanced neoplasms.

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Heng, Sharon; Hardy, Janet; Good, Phillip

2018-01-01

Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these conditions without good quality evidence of its effectiveness and safety. This audit aimed to assess the usage, effectiveness and adverse effects of Diatrizoate Meglumine for intestinal obstruction and constipation in patients with advanced neoplasms. A retrospective chart review was undertaken. Descriptive statistics were utilised. All patients with known advanced neoplasms admitted to Mater Health Services and St Vincent's Private Hospital Brisbane between January 2013 and October 2015; who were administered Diatrizoate Meglumine were included. Seventy-one patients received Diatrizoate Meglumine. The most common diagnoses were ovarian or primary peritoneal neoplasms (33.8%). Diatrizoate Meglumine was most commonly used for intestinal obstruction (59.2%). The median dose used per patient episode was 50 mL (range: 15-500 mL). Thirty-two patients (45%) had imaging 4-24 h post-dose with Diatrizoate Meglumine being present in the large intestine in 75% of these images. Intestinal obstruction or constipation resolved in 90% of patients post-dose. Most clinicians used 50 mL of Diatrizoate Meglumine as a single dose and repeated imaging after 4-24 h. Diatrizoate Meglumine was well tolerated and may be effective in resolving intestinal obstruction and constipation in patients with advanced neoplasms. Quality controlled studies are needed to further guide the use of Diatrizoate Meglumine in intestinal obstruction and constipation in patients with advanced neoplasms.

Specialist pediatric palliative care prescribing practices: A large 5-year retrospective audit

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Anuja Damani

2016-01-01

Full Text Available Introduction: There is a gradual increasing trend in childhood cancers in India and pediatric palliative care in India is an emerging specialty. Prescribing pain and symptom control drugs in children with cancer requires knowledge of palliative care formulary, dosing schedules, and prescription guidelines. This study is a retrospective audit of prescribing practices of a specialist palliative care service situated in a tertiary cancer center. Methods: A total of 1135 medication records of children receiving specialist pediatric palliative care services were audited for 5 years (2010-2014 to evaluate prescribing practices in children with advanced cancer. Results: A total of 51 types of drugs were prescribed with an average of 4.2 drugs per prescription. 66.9% of the prescriptions had paracetamol, and 33.9% of the prescriptions had morphine. Most common nonsteroidal anti-inflammatory drugs prescribed was ibuprofen (23.9%, and more than 50% of the prescriptions had aperients. The most commonly prescribed aperient was a combination of liquid paraffin and sodium-picosulfate. Dexamethasone was prescribed in 51.9% of patients and in most cases this was part of oral chemotherapy regimen. Generic names in prescription were used only in 33% of cases, and adverse effects of the drugs were documented in only 9% of cases. In 25% of cases, noncompliance to the WHO prescription guidelines was seen, and patient compliance to prescription was seen in 40% of cases. Conclusions: Audit of the prescribing practices in specialist pediatric palliative care service shows that knowledge of pediatric palliative care formulary, rational drug use, dosing, and prescribing guidelines is essential for symptom control in children with advanced life-limiting illness. Noncompliance to WHO prescribing guidelines in one fourth of cases and using nongeneric names in two-thirds of prescription indicates poor prescribing practices and warrants prescriber education. Prescription

Data audit as a management tool.

Science.gov (United States)

Baldwin, J K; Hoover, B K

1989-09-01

Management faces the three basic challenges of achieving cost efficiency, successfully applying new technology, and minimizing risk. This paper examines the ways in which data audits can help managers come to terms with each of these challenges. It emphasizes the role of data audits in providing reliable information on which to base decisions and stresses the importance of auditing data in process rather than retrospectively. The paper examines frequently encountered sources of error and discusses the ways audits benefit management by assuring the integrity of experimental design, by preventing misassignment of observations, and by preventing the loss of data.

Timing of Physical Therapy Referral in Adolescent Athletes With Acute Spondylolysis: A Retrospective Chart Review.

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Selhorst, Mitchell; Fischer, Anastasia; Graft, Kristine; Ravindran, Reno; Peters, Eric; Rodenberg, Richard; Welder, Eric; MacDonald, James

2017-05-01

The purposes of this study were (1) to determine whether the duration of rest before referral to physical therapy (PT) affects the time to make a full return to activity for patients with an acute spondylolysis, (2) to assess the safety of an early referral to PT in patients with an acute spondylolysis. Retrospective chart review. Hospital-based sports medicine clinic. The medical charts of 196 adolescent athletes (mean age = 14.3 ± 1.8 years) with an acute spondylolytic injury met the inclusion criteria and were reviewed. Patients were subgrouped based on physician referral to PT. An aggressive referral group (10 weeks). Duration of rest before clearance to a full return to activity and the frequency of adverse reactions during the course of treatment. Safety was assessed by calculating the risk of experiencing an adverse reaction in each group. Median days to a full return to activity for aggressive referral group (115.5 days, interquartile range 98-150 days) and conservative referral group (140.0 days, interquartile range 114.5-168 days) were significantly different (P = 0.002). Eleven patients had adverse reactions during the course of treatment. The risk of adverse reaction was not statistically significant between groups (P = 0.509). Patients with acute spondylolysis in the aggressive referral group were able to make a full return activity almost 25 days sooner. No differences in the risk of adverse reactions were noted between aggressive and conservative referral groups.

Separation from supported employment: a retrospective chart review study.

Science.gov (United States)

West, Michael; Targett, Pamela; Wehman, Paul; Cifu, Gabriella; Davis, Jacob

2015-01-01

The objective of this study was to examine job separations from supported employment (SE). The aim was to identify the types and nature of separations and precipitating events leading to the separation. A retrospective chart review methodology was utilized. The study was conducted in a metropolitan area in the Southeast United States by a university-based SE program. Participants were 47 SE clients who had been placed into and separated from 67 jobs. Using a coding form, information regarding the type of separation and issues that preceded the separation were recorded. Data were aggregated using descriptive statistics. The largest number of separations was due to termination, followed by resignation and mutual consent of the employer and employee. The mean number of issues leading to the separation was 2.2, ranging from one to five. Only eight positive issues were found (compared to 116 negative and 20 neutral), the most prevalent being entry into an educational or training program. Common negative issues included poor work performance, attendance and punctuality problems, conflicts with the supervisor, and social and behavioral issues. The findings of this study illustrate the need to address job retention issues during the job development process, finding the most appropriate person-job fit and workplace culture for each client. The findings also support the need for vigilant and regular communication between the SE program and employers to intervene quickly when problems arise. Separation from Supported Employment (SE) SE is an evidence-based employment practice that has been shown effective across multiple disability groups. Studying job separations can provide valuable information for improving service. Locating the best person-job fit, as well as frequent contract with employers, can help prevent unnecessary job loss.

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

Radiologically defining horizontal gaze using EOS imaging-a prospective study of healthy subjects and a retrospective audit.

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Hey, Hwee Weng Dennis; Tan, Kimberly-Anne; Ho, Vivienne Chien-Lin; Azhar, Syifa Bte; Lim, Joel-Louis; Liu, Gabriel Ka-Po; Wong, Hee-Kit

2018-06-01

As sagittal alignment of the cervical spine is important for maintaining horizontal gaze, it is important to determine the former for surgical correction. However, horizontal gaze remains poorly-defined from a radiological point of view. The objective of this study was to establish radiological criteria to define horizontal gaze. This study was conducted at a tertiary health-care institution over a 1-month period. A prospective cohort of healthy patients was used to determine the best radiological criteria for defining horizontal gaze. A retrospective cohort of patients without rigid spinal deformities was used to audit the incidence of horizontal gaze. Two categories of radiological parameters for determining horizontal gaze were tested: (1) the vertical offset distances of key identifiable structures from the horizontal gaze axis and (2) imaginary lines convergent with the horizontal gaze axis. Sixty-seven healthy subjects underwent whole-body EOS radiographs taken in a directed standing posture. Horizontal gaze was radiologically defined using each parameter, as represented by their means, 95% confidence intervals (CIs), and associated 2 standard deviations (SDs). Subsequently, applying the radiological criteria, we conducted a retrospective audit of such radiographs (before the implementation of a strict radioimaging standardization). The mean age of our prospective cohort was 46.8 years, whereas that of our retrospective cohort was 37.2 years. Gender was evenly distributed across both cohorts. The four parameters with the lowest 95% CI and 2 SD were the distance offsets of the midpoint of the hard palate (A) and the base of the sella turcica (B), the horizontal convergents formed by the tangential line to the hard palate (C), and the line joining the center of the orbital orifice with the internal occipital protuberance (D). In the prospective cohort, good sensitivity (>98%) was attained when two or more parameters were used. Audit using Criterion B

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.

Depreciation Accounting in the Uniform Chart of Accounts.

Science.gov (United States)

1982-12-01

footage of building occupied. Reason( s ) for Compute full cost of Rate setting, cash accounting for patient care flow generation and fund- depreciation ing... Horngren , Charles T., Cost Accounting ; A Managerial Emphasis, Prentice-Hall Inc., 1972. 32. Sawyer, Lawrence B., The Practice of Modern Internal Auditing...Awd ubtlft) S . TYPE or RE PORT a PE*IoO CovIERWO Master’s Thesis; Depreciation Accounting in the Uniform Dembr18 Chart of Accounts .PSOiwON.EORlumm

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.

Guideline implementation in clinical practice: Use of statistical process control charts as visual feedback devices

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Fahad A Al-Hussein

2009-01-01

Conclusions: A process of audits in the context of statistical process control is necessary for any improvement in the implementation of guidelines in primary care. Statistical process control charts are an effective means of visual feedback to the care providers.

Sertraline May Improve Language Developmental Trajectory in Young Children with Fragile X Syndrome: A Retrospective Chart Review

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Tri Indah Winarni

2012-01-01

Full Text Available Young children with fragile X syndrome (FXS often experience anxiety, irritability, and hyperactivity related to sensory hyperarousal. However, there are no medication recommendations with documented efficacy for children under 5 years old of age with FXS. We examined data through a chart review for 45 children with FXS, 12–50 months old, using the Mullen Scales of Early Learning (MSEL for baseline and longitudinal assessments. All children had clinical level of anxiety, language delays based on MSEL scores, and similar early learning composite (ELC scores at their first visit to our clinic. Incidence of autism spectrum disorder (ASD was similar in both groups. There were 11 children who were treated with sertraline, and these patients were retrospectively compared to 34 children who were not treated with sertraline by chart review. The baseline assessments were done at ages ranging from 18 to 44 months (mean 26.9, SD 7.99 and from 12 to 50 months (mean 29.94, SD 8.64 for treated and not treated groups, respectively. Mean rate of improvement in both expressive and receptive language development was significantly higher in the group who was treated with sertraline (<0.0001 and =0.0071, resp.. This data supports the need for a controlled trial of sertraline treatment in young children with FXS.

Rural anaesthetic audit 2006 to 2010.

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Mills, P D; Newbury, J

2012-03-01

In order to review anaesthetic morbidity in our remote rural hospital, a retrospective audit of all anaesthetic records was undertaken for a five-year period between 2006 and 2010. Eight hundred and eighty-nine anaesthetic records were reviewed. The patients were all American Society of Anaesthesiologists physical status I to III. Ninety-eight percent of the anaesthetics were performed by general practitioner (non-specialist) anaesthetists. There were no anaesthetic deaths or serious adverse outcomes reported over this period. Sixteen intraoperative and seven postoperative problems were documented, but all were resolved uneventfully. The most common problems documented were difficult intubation (n=9) and respiratory depression (n=3). Within the limitations of this retrospective audit, these findings indicate that general practitioner anaesthetists provided safe anaesthesia in a remote rural hospital. It is our opinion that the case selection, prior experience of anaesthetic and theatre staff, stable nursing workforce and the use of protocols were important factors in determining the low rate of adverse events. However, we caution against over-interpretation of the data, given its retrospective nature, relatively small sample size, reliance on case records and the absence of agreed definitions for adverse events. We would also like to encourage all anaesthetic services, however remote, to audit their results as part of ongoing quality assurance.

Goal planning: a retrospective audit of rehabilitation process and outcome.

Science.gov (United States)

Duff, Jane; Evans, Matthew J; Kennedy, Paul

2004-05-01

To consider the effectiveness of a goal planning programme for people with spinal cord injury (SCI) and address some of the current evidence gaps in goal setting. Retrospective audit. Consecutive series of 65 newly injured SCI patients. The Needs Assessment Checklist (NAC) has been specifically developed for the SCI population, and is used to assess patient attainment in core rehabilitation areas. A 'Goal Planning Progress' form was also used to specifically detail the goal planning process. Across the 65 patients, 396 goal planning meetings were held with 6176 goals set in total. Seventy-two per cent of the goals set at the first goal planning meeting were achieved by the second meeting. The rate of achievement at subsequent meetings was 68%. Significant differences in the number of planned rehabilitation days, number of goal planning meetings, and goals set were identified between injury categories. Significant positive correlations were found between the number of goals set and achievement, as measured by the NAC, in certain rehabilitation domains. The findings of this study demonstrate that the Needs Assessment and Goal Planning framework is effective in planning SCI rehabilitation. The capacity of this goal planning system to reflect individual need has also been established. Further systematic analyses of this process could potentially lead to more efficient rehabilitation and the identification of care pathways within clinical areas.

A tale of two audits: statistical process control for improving diabetes care in primary care settings.

Science.gov (United States)

Al-Hussein, Fahad Abdullah

2008-01-01

Diabetes constitutes a major burden of disease globally. Both primary and secondary prevention need to improve in order to face this challenge. Improving management of diabetes in primary care is therefore of fundamental importance. The objective of these series of audits was to find means of improving diabetes management in chronic disease mini-clinics in primary health care. In the process, we were able to study the effect and practical usefulness of different audit designs - those measuring clinical outcomes, process of care, or both. King Saud City Family and Community Medicine Centre, Saudi National Guard Health Affairs in Riyadh city, Saudi Arabia. Simple random samples of 30 files were selected every two weeks from a sampling frame of file numbers for all diabetes clients seen over the period. Information was transferred to a form, entered on the computer and an automated response was generated regarding the appropriateness of management, a criterion mutually agreed upon by care providers. The results were plotted on statistical process control charts, p charts, displayed for all employees. Data extraction, archiving, entry, analysis, plotting and design and preparation of p charts were managed by nursing staff specially trained for the purpose by physicians with relevant previous experience. Audit series with mixed outcome and process measures failed to detect any changes in the proportion of non-conforming cases over a period of one year. The process measures series, on the other hand, showed improvement in care corresponding to a reduction in the proportion non-conforming by 10% within a period of 3 months. Non-conformities dropped from a mean of 5.0 to 1.4 over the year (P process audits and feedbacks. Frequent process audits in the context of statistical process control should be supplemented with concurrent outcome audits, once or twice a year.

An Audit of Surgical Antibiotic Prophylaxis at the Veterinary ...

African Journals Online (AJOL)

An audit of surgical antibiotic prophylaxis at the Veterinary Teaching Hospital, Ibadan between 2008 and 2011 was conducted to evaluate the level of compliance with standard practices. The study involved retrospective case note audit of surgical procedures performed during the period. A total number of 108 operations ...

Comparing Melanoma Invasiveness in Dermatologist- versus Patient-Detected Lesions: A Retrospective Chart Review

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Cindy L. Lamerson

2012-01-01

Full Text Available This study examined whether patient-identified melanomas were more advanced than dermatologist-identified tumors at routine clinic visits, and whether a personal or family history of skin cancer was associated with patterns of detection. A retrospective chart review was performed on melanoma patients (N=201 in a private dermatology clinic. Variables included age, gender, pattern of detection (i.e., patient or a board certified dermatologist, personal or family history of skin cancer, skin type, and previous sun exposure, as well as tumor location and severity. Dermatologist-diagnosed melanomas were less invasive (P<0.0005, and more likely present on the chest, back, and legs (P<0.01. Conversely, patient-identified lesions were more likely to occur on the face, neck and scalp, be associated with younger patients, and a family history of melanoma, but not other types of skin cancer (P<0.01. In a post-hoc analysis examining these factors as predictors of tumor invasiveness, only diagnostic source was significant. Specifically, dermatologist-identified tumors were significantly less invasive than patient-identified tumors. Although age, family history, and tumor location played roles in the early detection of melanomas, the most important factor was diagnostic source. Thus, board-certified dermatologists play a key role in the early detection of malignant melanoma.

Children's vomiting following posterior fossa surgery: A retrospective study

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Dundon Belinda

2009-07-01

Full Text Available Abstract Background Nausea and vomiting is a problem for children after neurosurgery and those requiring posterior fossa procedures appear to have a high incidence. This clinical observation has not been quantified nor have risk factors unique to this group of children been elucidated. Methods A six year retrospective chart audit at two Canadian children's hospitals was conducted. The incidence of nausea and vomiting was extracted. Hierarchical multivariable logistic regression was used to quantify risk and protective factors at 120 hours after surgery and early vs. late vomiting. Results The incidence of vomiting over a ten day postoperative period was 76.7%. Documented vomiting ranged from single events to greater than 20 over the same period. In the final multivariable model: adolescents (age 12 to Conclusion The incidence of vomiting in children after posterior fossa surgery is sufficient to consider all children requiring these procedures to be at high risk for POV. Nausea requires better assessment and documentation.

Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

Science.gov (United States)

Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

2013-04-01

Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

An audit of risk assessments for suicide and attempted suicide in ED: a retrospective review of quality.

Science.gov (United States)

de Beer, Wayne; DeWitt, Bernard; Schofield, Jules; Clark, Helen; Gibbons, Veronique

2018-02-23

The primary aim of this audit was to determine the quality of psychiatric risk assessments conducted by Mental Health & Addiction Services clinicians for patients presenting to the emergency department, Waikato Hospital, Hamilton, New Zealand following an attempted suicide. A retrospective, randomised audit of 376 files of patients who had presented to the ED over a 12-month period from 1 July 2015 to 30 June 2016 was conducted, following the standards outlined in the present New Zealand Ministry of Health Clinical Practice Guideline for Deliberate Self Harm (DSH). It was found that clinicians routinely focused on the historical features of the suicide attempt presentation while failing to record judgements about future suicidal behaviours. Interactions with family members were recorded in less than half of the cases. The guideline most poorly adhered to was checking whether Māori patients wanted culturally appropriate services during the assessment and treatment planning, with this recorded in less than 10% of the clinical records. To improve the quality of the suicide risk assessments, and to better align with Clinical Practice Guidelines, the authors propose redevelopment of clinician training, including focus on cultural competence, and training in confidentiality and privacy relating to an attempted suicide episode.

Healthcare professionals' perceptions on the emotional impact of having an inadequate response to antidepressant medications: survey and prospective patient audit.

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Mago, Rajnish; Fagiolini, Andrea; Weiller, Emmanuelle; Weiss, Catherine

2018-01-01

Despite the availability of effective antidepressants, about half of patients with major depressive disorder (MDD) display an inadequate response to their initial treatment. A large patient survey recently reported that 29.8% of MDD patients experiencing an inadequate treatment response felt frustrated about their medication and 19.2% were frustrated with their healthcare provider. This survey and chart audit evaluated healthcare professionals' (HCP) views on the emotional impact of having an inadequate response to antidepressant medication. HCPs who frequently treat patients with MDD completed a survey and chart audit of their MDD patients currently experiencing an inadequate response to antidepressant treatment. 287 HCPs completed 1336 chart audits. HCPs reported that 38% of their patients were trusting/accepting of their MDD medications and 41% of their patients trusted/felt confident with their healthcare provision. Conversely, HCPs reported that 11% of their patients were frustrated with their medication and 5% with their healthcare benefits. HCPs cited impact on daily life (53%) and treatment issues (lack of efficacy and side effects; 50%) as the main drivers for their patients' feelings of frustration. When HCPs recognized patients' feelings of frustration, the top concerns of the HCPs were worsening of symptoms (43%) and non-compliance (41%). This survey and chart audit highlights the emotional burden associated with inadequate responses to MDD treatment in addition to persistent symptoms. Differences between the views of the HCPs and patients are highlighted and suggest that HCPs may underestimate the full impact that having to try numerous medications has on their patients.

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

Science.gov (United States)

Schrem, Harald; Schneider, Valentin; Kurok, Marlene; Goldis, Alon; Dreier, Maren; Kaltenborn, Alexander; Gwinner, Wilfried; Barthold, Marc; Liebeneiner, Jan; Winny, Markus; Klempnauer, Jürgen; Kleine, Moritz

2016-01-01

The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers. 1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs) of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences. Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21). Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46), post-transplant lymphoproliferative disorder (SIR = 8.36), prostate cancer (SIR = 2.22), bladder cancer (SIR = 3.24), thyroid cancer (SIR = 10.13) and melanoma (SIR = 3.08). Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29), polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD) (p = 0.001, HR: 0.68), high body mass index in kg/m2 (pKaizen events and audits for root-cause analysis of relevant detection rate changes. Further, comparative G-chart analysis would enable benchmarking of cancer surveillance processes between centers.

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

A pediatric death audit in a large referral hospital in Malawi.

Science.gov (United States)

Fitzgerald, Elizabeth; Mlotha-Mitole, Rachel; Ciccone, Emily J; Tilly, Alyssa E; Montijo, Jennie M; Lang, Hans-Joerg; Eckerle, Michelle

2018-02-21

Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%. This is the first known audit of pediatric death files conducted at this hospital. A retrospective chart review on all pediatric deaths that occurred at Kamuzu Central Hospital (excluding deaths in the neonatal nursery) during a 13-month period was done using a standardized death audit form. A descriptive analysis was completed, including patient demographics, HIV and nutritional status, and cause of death. Modifiable factors were identified that may have contributed to mortality, including a lack of vital sign collection, poor documentation, and delays in the procurement or results of tests, studies, and specialist review. Seven hundred forty three total pediatric deaths were recorded and 700 deceased patient files were reviewed. The mortality rate by month ranged from a low of 2.2% to a high of 4.4%. Forty-four percent of deaths occurred within the first 24 h of admission, and 59% occurred within the first 48 h. The most common causes of death were malaria, malnutrition, HIV-related illnesses, and sepsis. The mortality rate for this pediatric referral center has dramatically decreased in the 6 years since the last published mortality data, but remains high. Areas identified for continued development include improved record keeping, improved patient assessment and monitoring, and more timely and reliable provision of testing and treatment. This study demonstrates that in low-resource settings, where reliable record keeping is often difficult

Transversus abdominis plane block in renal allotransplant recipients: A retrospective chart review.

Science.gov (United States)

Gopwani, S R; Rosenblatt, M A

2016-01-01

The efficacy of the transversus abdominis plane (TAP) block appears to vary considerably, depending on the surgical procedure and block technique. This study aims to add to the existing literature and provide a more clear understanding of the TAP blocks role as a postoperative analgesic technique, specifically in renal allotransplant recipients. A retrospective chart review was conducted by querying the intraoperative electronic medical record system of a 1200-bed tertiary academic hospital over a 5 months period, and reviewing anesthetic techniques, as well as postoperative morphine equivalent consumption. Fifty renal allotransplant recipients were identified, 13 of whom received TAP blocks while 37 received no regional analgesic technique. All blocks were performed under ultrasound guidance, with 20 mL of 0.25% bupivacaine injected in the transversus abdominis fascial plane under direct visualization. The primary outcome was postoperative morphine equivalent consumption. Morphine consumption was compared with the two-tailed Mann-Whitney U -test. Continuous variables of patient baseline characteristics were analyzed with unpaired t -test and categorical variables with Fischer Exact Test. A P consumption was found in the group that received the TAP block at 6 h (2.46 mg vs. 7.27 mg, P = 0.0010), 12 h (3.88 mg vs. 10.20 mg, P = 0.0005), 24 h (6.96 mg vs. 14.75 mg, P = 0.0013), and 48 h (11 mg vs. 20.13 mg, P = 0.0092). The TAP block is a beneficial postoperative analgesic, opiate-sparing technique in renal allotransplant recipients.

A Development of Automatic Audit System for Written Informed Consent using Machine Learning.

Science.gov (United States)

Yamada, Hitomi; Takemura, Tadamasa; Asai, Takahiro; Okamoto, Kazuya; Kuroda, Tomohiro; Kuwata, Shigeki

2015-01-01

In Japan, most of all the university and advanced hospitals have implemented both electronic order entry systems and electronic charting. In addition, all medical records are subjected to inspector audit for quality assurance. The record of informed consent (IC) is very important as this provides evidence of consent from the patient or patient's family and health care provider. Therefore, we developed an automatic audit system for a hospital information system (HIS) that is able to evaluate IC automatically using machine learning.

Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

Directory of Open Access Journals (Sweden)

Harald Schrem

Full Text Available The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers.1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences.Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21. Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46, post-transplant lymphoproliferative disorder (SIR = 8.36, prostate cancer (SIR = 2.22, bladder cancer (SIR = 3.24, thyroid cancer (SIR = 10.13 and melanoma (SIR = 3.08. Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29, polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD (p = 0.001, HR: 0.68, high body mass index in kg/m2 (p<0.001, HR: 1.04, ADPKD (p = 0.008, HR: 1.26 and diabetic nephropathy (p = 0.004, HR = 1.51. G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05.Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes

Audit and account billing process in a private general hospital: a case study

Directory of Open Access Journals (Sweden)

Raquel Silva Bicalho Zunta

2017-12-01

Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

"Waiting for DAAs": A retrospective chart review of patients with untreated hepatitis C in Rwanda.

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Neil Gupta

Full Text Available Access to treatment for hepatitis C virus (HCV in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs, highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs.We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65, and 149 (58.9% were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09-1.17, but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus.Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub-Saharan Africa.

A 6-month audit of epidural analgesia in a teaching hospital

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Shahla Siddiqui

2016-01-01

Full Text Available Introduction: Major laparotomies generally herald high pain scores postoperatively and have high intraoperative hemodynamic shifts. Traditional analgesic regimens with intravenous opioids were supplanted with the superior epidural analgesia (EA in the mid-1980s. This was based on the perception that EA provided highly effective postoperative analgesia for patients undergoing major abdominal surgery. However, recent literature points to a high failure rate. We aimed to retrospectively audit our EA performance in terms of success and complications and take an in-depth look at factors associated with failure. Methods: We retrospectively reviewed charts and our EA forms over 6 months. Results: Our results show a low rate of mortality and neurological morbidity. However we have a high rate of failure of 37% as judged by high pain scores, use of adjuvant analgesics and also an unacceptably high rate of hypotension from epidural infusions, requiring fluid boluses, inotropes and Intensive Care Unit admission. Registrar level and senior insertion did not show any difference in failure rate. Conclusion: Level of training per se does not equate to experiential skip and prior level of experience with administration of this type of anesthesia. We can conclude that EA in our setting is safe but not effective and requires further and frequent scrutiny in terms of procedures, technical skill, education and perhaps looking at its cost-effectiveness and need for standardization.

Retrospective chart review of a referenced EEG database in assisting medication selection for treatment of depression in patients with eating disorders

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Greenblatt JM

2011-09-01

Full Text Available James M Greenblatt1, Craig Sussman1, Mariko Jameson1, Lee Yuan1, Daniel A Hoffman2, Dan V Iosifescu31Comprehensive Psychiatric Resources, Waltham, MA, USA; 2Neuro-Therapy Clinic Inc, Denver, CO, USA; 3Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USABackground: A retrospective chart review was undertaken in a private clinic to examine the clinical outcomes for patients with an eating disorder comorbid with depression or bipolar illness who underwent a referenced electroencephalographic (EEG database analysis to help guide medication selection.Method: We examined 33 charts for patients with the primary psychiatric diagnosis of an eating disorder and comorbid major depressive disorder or bipolar disorder who underwent a quantitative EEG database assessment to provide additional information for choices of medication. The current analysis includes data from 22 subjects who accepted treatments based on information from the referenced-EEG medication database. Hamilton Depression Rating Scale, Clinical Global Impression-Severity, Clinical Global Impression-Improvement, and hospitalization data were examined for these patients.Results: Patients whose EEG data was used for clinical treatment reported significant decreases in associated depressive symptoms (HDRS scores, overall severity of illness (Clinical Global Impression-Severity, and overall clinical global improvement (Clinical Global Impression-Improvement. This cohort also reported fewer inpatient, residential, and partial hospitalization program days following referenced-EEG compared with the two-year period prior to treatment.Conclusion: These findings are consistent with previously reported data for patients with eating disorders and suggest the need for future studies using EEG data correlated with those from other patients with similar quantitative EEG features.Keywords: eating disorders, anorexia, bulimia, depression, referenced-EEG, chart review

Influence of Continuing Medical Education on Rheumatologists' Performance on National Quality Measures for Rheumatoid Arthritis.

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Sapir, Tamar; Rusie, Erica; Greene, Laurence; Yazdany, Jinoos; Robbins, Mark L; Ruderman, Eric M; Carter, Jeffrey D; Patel, Barry; Moreo, Kathleen

2015-12-01

In recent years researchers have reported deficits in the quality of care provided to patients with rheumatoid arthritis (RA), including low rates of performance on quality measures. We sought to determine the influence of a quality improvement (QI) continuing education program on rheumatologists' performance on national quality measures for RA, along with other measures aligned with National Quality Strategy priorities. Performance was assessed through baseline and post-education chart audits. Twenty community-based rheumatologists across the United States were recruited to participate in the QI education program and chart audits. Charts were retrospectively audited before (n = 160 charts) and after (n = 160 charts) the rheumatologists participated in a series of accredited QI-focused educational activities that included private audit feedback, small-group webinars, and online- and mobile-accessible print and video activities. The charts were audited for patient demographics and the rheumatologists' documented performance on the 6 quality measures for RA included in the Physician Quality Reporting System (PQRS). In addition, charts were abstracted for documentation of patient counseling about medication benefits/risks and adherence, lifestyle modifications, and quality of life; assessment of RA medication side effects; and assessment of RA medication adherence. Mean rates of documented performance on 4 of the 6 PQRS measures for RA were significantly higher in the post-education versus baseline charts (absolute increases ranged from 9 to 24% of patient charts). In addition, after the intervention, significantly higher mean rates were observed for patient counseling about medications and quality of life, and for assessments of medication side effects and adherence (absolute increases ranged from 9 to 40% of patient charts). This pragmatic study provides preliminary evidence for the positive influence of QI-focused education in helping rheumatologists improve

Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

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Mosam Phirke

2015-01-01

Full Text Available Background: Electroconvulsive therapy (ECT is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014, and it was observed that 23 elderly patients (aged ≥60 years had received ECT. Results: The patients received modified bitemporal ECT using a brief pulse ECT machine and had no major complications. A total of 184 ECT treatments were administered at an average of 8 treatments per case. The major diagnoses of patients were schizophrenia and major depression. The main indications of ECT were intolerance to medication, suicidal behavior and aggression. Out of the 23 elderly patients, 18 (78.26% showed a good response to ECT. The only complication noted was memory loss and confusion in 3 cases. Patients with medical illnesses like hypertension, diabetes and both together received ECT without any complications. Conclusions: This study adds to the scarce database on the use of ECT in elderly patients in India and adds evidence to the fact that ECT is a safe and effective treatment in the elderly.

CQUIN audit for prescription of antibiotics for urinary tract infections in an acute medical assessment unit.

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Oppenheimer, Maylin; Rezwan, Nivin

2015-01-01

Urinary tract infections (UTI) are a common presentation in a medical assessment unit, and we wanted to check compliance with hospital guidelines for antibiotic prescribing in patients presenting to hospital with urinary tract infection. The guidelines are based on local organisms and sensitivities. A retrospective audit of 40 patient records with positive urine cultures from July to August 2013 showed that 20% of patients with culture confirmed UTI were not given antibiotics at all. Of those prescribed antibiotics, 25% were non-compliant with local policy, and nearly one in two patients received more than one antibiotic. Furthermore, stop dates were not stated on 77% of the drug charts and duration of treatment ranged from one to 11 days. Interventions were then introduced in the form of group teaching sessions, proactive checks by Trust pharmacists and widely distributed posters, and the same data sets collected for April to March 2014 to assess for efficacy of the interventions. On re-auditing, 35% patients were not prescribed any antibiotics. However, compliance with local policy was 100%, including 100% drug charts having a stop/review date stated. The overall duration of treatment now ranged from one to seven days, and fewer than one in four patients had more than one antibiotic. Our results showed that improvement was needed in antibiotic stewardship, in particular with regards to compliance with the local guidelines and documentation of prescription. We have demonstrated that it is possible to improve compliance through teaching, by displaying information prominently, and vigilance by the clinical team. The outcome of this is a decreased number and duration of antibiotics prescribed, which has benefits for the patients, the hospital, and the community as a whole. Further work would include interventions to improve the number of patients who are missing antibiotic prescriptions altogether.

Recovery Audit Contractor audits and appeals at three academic medical centers.

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Sheehy, Ann M; Locke, Charles; Engel, Jeannine Z; Weissburg, Daniel J; Mackowiak, Stephanie; Caponi, Bartho; Gangireddy, Sreedevi; Deutschendorf, Amy

2015-04-01

Outpatient (observation) and inpatient status determinations for hospitalized Medicare beneficiaries have generated increasing concern for hospitals and patients. Recovery Audit Contractor (RAC) activity alleging improper status, however, has received little attention, and there are conflicting federal and hospital reports of RAC activity and hospital appeals success. To detail complex Medicare Part A RAC activity. Retrospective descriptive study of complex Medicare Part A audits at 3 academic hospitals from 2010 to 2013. Complex Part A audits, outcome of audits, and hospital workforce required to manage this process. Of 101,862 inpatient Medicare encounters, RACs audited 8110 (8.0%) encounters, alleged overpayment in 31.3% (2536/8110), and hospitals disputed 91.0% (2309/2536). There was a nearly 3-fold increase in RAC overpayment determinations in 2 years, although the hospitals contested and won a larger percent of cases each year. One-third (645/1935, 33.3%) of settled claims were decided in the discussion period, which are favorable decisions for the hospitals not reported in federal appeals data. Almost half (951/1935, 49.1%) of settled contested cases were withdrawn by the hospitals and rebilled under Medicare Part B to avoid the lengthy (mean 555 [SD 255] days) appeals process. These original inpatient claims are considered improper payments recovered by the RAC. The hospitals also lost appeals (0.9%) by missing a filing deadline, yet there was no reciprocal case concession when the appeals process missed a deadline. No overpayment determinations contested the need for care delivered, rather that care should have been delivered under outpatient, not inpatient, status. The institutions employed an average 5.1 full-time staff in the audits process. These findings suggest a need for RAC reform, including improved transparency in data reporting. © 2015 Society of Hospital Medicine.

Preventable deaths following emergency medical dispatch - an audit study

DEFF Research Database (Denmark)

Andersen, Mikkel S; Johnsen, Søren; Hansen, Andreas

2014-01-01

an ambulance with lights and sirens by the Emergency Medical Communication Centre (EMCC).MethodsAn audit was performed by an external panel of experienced prehospital consultant anaesthesiologists. The panel focused exclusively on the role of the EMCC, assessing whether same-day deaths among 112 callers could...... have been prevented if the EMCC had assessed the situations as highly urgent. The panels¿ assessments were based on review of patient charts and voice-log recordings of 112 calls. All patient related material was reviewed by the audit panel and all cases where then scored as preventable, potentially......¿100 years) and 45.4% were female. The audit panel found no definitively preventable deaths; however, 18 (11.8%) of the analysed same-day deaths (0.02% of all non-high-acuity callers) were found to be potentially preventable. In 13 of these 18 cases, the dispatch protocol was either not used or not used...

Measuring severe adverse events and medication selection using a “PEER Report” for nonpsychotic patients: a retrospective chart review

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Hoffman DA

2012-06-01

Full Text Available Daniel A Hoffman,1 Charles DeBattista,2 Rob J Valuck,3 Dan V Iosifescu41Neuro-Therapy Clinic, Inc, Denver, CO, USA; 2Stanford University School of Medicine, Palo Alto, CA, USA; 3University of Colorado, SKAGES School of Pharmacy and Pharmaceutical Sciences, Aurora, CO, USA; 4Mood and Anxiety Disorders Program, Mount Sinai School of Medicine, New York, NY, USAAbstract: We previously reported on an objective new tool that uses quantitative electroencephalography (QEEG normative- and referenced-electroencephalography sampling databases (currently called Psychiatric EEG Evaluation Registry [PEER], which may assist physicians in determining medication selection for optimal efficacy to overcome trial-and-error prescribing. The PEER test compares drug-free QEEG features for individual patients to a database of patients with similar EEG patterns and known outcomes after pharmacological interventions. Based on specific EEG data elements and historical outcomes, the PEER Report may also serve as a marker of future severe adverse events (eg, agitation, hostility, aggressiveness, suicidality, homicidality, mania, hypomania with specific medications. We used a retrospective chart review to investigate the clinical utility of such a registry in a naturalistic environment.Results: This chart review demonstrated significant improvement on the global assessment scales Clinical Global Impression – Improvement and Quality of Life Enjoyment and Satisfaction – Short Form as well as time to maximum medical improvement and decreased suicidality occurrences. The review also showed that 54.5% of previous medications causing a severe adverse event would have been raised as a caution had the PEER Report been available at the time the drug was prescribed. Finally, due to the significant amount of off-label prescribing of psychotropic medications, additional, objective, evidence-based data aided the prescriber toward better choices.Conclusion: The PEER Report may be

Quality of care in palliative sedation: audit and compliance monitoring of a clinical protocol.

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Benitez-Rosario, Miguel Angel; Castillo-Padrós, Manuel; Garrido-Bernet, Belén; Ascanio-León, Belen

2012-10-01

The European Association for Palliative Care and the U.S. National Hospice and Palliative Care Organization have published statements that recommend an audit of palliative sedation practices. The aim was to assess the feasibility of a quality care project in palliative sedation. We carried out an audit of adherence to a guideline regarding palliative sedation, undertaken as a yearly assessment during two years, of a sample of patient charts. With an audit tool, the charts were evaluated as to the presence of the ethical sedation checklist, information that justified palliative sedation, patient and/or family agreement, and the appropriateness of treatment in concordance with the clinical protocol. An educational program and result feedback meetings were used as the implementation strategy. Roughly 25% of the medical charts of patients who died in the palliative care unit were evaluated, 94 in 2007 and 110 in 2008. In 2007 and 2008, 63% and 57% of the patients, respectively, whose median age was 65 years, were sedated, with a median length of two days. The main reason for sedation was agitation concomitant with respiratory failure in roughly 60% and 75% of the cases in 2007 and 2008, respectively. Agreement of the patient/family about sedation was collected from 100% of the cases. The concordance of procedures with the sedation guideline was 100% in both years. Our quality-of-care strategy was shown to obtain a higher level of compliance with the palliative sedation guideline for at least two years. Copyright © 2012 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

Winning a prudence audit

International Nuclear Information System (INIS)

Shepherd, S.H.; Quan, T.F.; Carroll, D.W.T.

1989-01-01

The greatest hazard that a utility faces from owning a nuclear power plant is not radiation--it is regulation. Retrospective prudence audits have been used by public utility commissions (PUCs) as a basis to disallow recovery of billions of dollars of nuclear plant construction costs. These disallowances have caused severe financial damage to many utilities. Although a final decision on rates has not been made, the Arizona Corporation Commission's (ACC's) auditor recently completed its examination of the construction costs of the Palo Verde Nuclear Generating Station (PVNGS). The auditor reported that PVNGS was prudently designed and constructed. It concluded that ∼1% of the project (approximately $60.2 million out of the plant's overall $5.9 billion cost) was unreasonably expended. The auditor also found that the project management team had actually saved ratepayers over $300 million through exceptional management actions. This is a resounding endorsement of the work of the staff and management of Arizona Public Service (APS), Bechtel, Combustion Engineering, the AFL-CIO, and the hundreds of suppliers and contractors that participated in the construction of PVNGS. It is also a much different result from that of other recent prudence audits. The history, strategy, planning, and conduct of the audit overcame the biases that had produced proposals for large disallowances on other good plants. This paper describes the efforts taken that promoted fair and balanced audit findings (although APS does not endorse all of the audit findings)

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement.

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Dupont, Corinne; Occelli, Pauline; Deneux-Tharaux, Catherine; Touzet, Sandrine; Duclos, Antoine; Bouvier-Colle, Marie-Hélène; Rudigoz, René-Charles; Huissoud, Cyril

2014-07-01

Severe postpartum haemorrhage after vaginal delivery: a statistical process control chart to report seven years of continuous quality improvement To use statistical process control charts to describe trends in the prevalence of severe postpartum haemorrhage after vaginal delivery. This assessment was performed 7 years after we initiated a continuous quality improvement programme that began with regular criteria-based audits Observational descriptive study, in a French maternity unit in the Rhône-Alpes region. Quarterly clinical audit meetings to analyse all cases of severe postpartum haemorrhage after vaginal delivery and provide feedback on quality of care with statistical process control tools. The primary outcomes were the prevalence of severe PPH after vaginal delivery and its quarterly monitoring with a control chart. The secondary outcomes included the global quality of care for women with severe postpartum haemorrhage, including the performance rate of each recommended procedure. Differences in these variables between 2005 and 2012 were tested. From 2005 to 2012, the prevalence of severe postpartum haemorrhage declined significantly, from 1.2% to 0.6% of vaginal deliveries (pcontrol limits, that is, been out of statistical control. The proportion of cases that were managed consistently with the guidelines increased for all of their main components. Implementation of continuous quality improvement efforts began seven years ago and used, among other tools, statistical process control charts. During this period, the prevalence of severe postpartum haemorrhage after vaginal delivery has been reduced by 50%. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A PCT-wide collaborative clinical audit selecting recall intervals for patients according to risk.

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Cannell, P J

2011-03-26

This audit was carried out to assess the level to which recall intervals were individually and appropriately selected for patients attending dental practices across a primary care trust (PCT) area in Essex. A retrospective audit was carried out by reference to patient records to assess various criteria, including whether patients were categorised according to risk of oral disease, whether an appropriate recall had been selected and whether a discussion regarding a recall interval had been undertaken. An educational event highlighting the issue of recall intervals was held. Subsequent to this a prospective audit was undertaken to assess relevant criteria. Prospective audit data showed a marked increase in the use of patient risk assessments for caries, periodontal disease, oral cancer and non-carious tooth surface loss (NCTSL). Recall intervals were also more often selected based on a patient's risk status and discussed with the patient compared to that observed in the retrospective audit data. This audit was successful as a tool to bring about change in the behaviour of dentists regarding their determination of appropriate recall intervals for patients. Whether that change in behaviour is long-term or transient requires further investigation.

Resident participation in neighbourhood audit tools - a scoping review.

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Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

2018-02-01

Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. In total, 13 participatory instruments were identified. The role of residents in most instruments was as 'data collectors'; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Hypnosis for treatment of insomnia in school-age children: a retrospective chart review

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Slothower Molly P

2006-08-01

Full Text Available Abstract Background The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. Methods A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17. When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. Results Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. Conclusion Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children.

Resident participation in neighbourhood audit tools — a scoping review

Science.gov (United States)

Hofland, Aafke C L; Devilee, Jeroen; van Kempen, Elise; den Broeder, Lea

2018-01-01

Abstract Background Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. Methods A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. Results In total, 13 participatory instruments were identified. The role of residents in most instruments was as ‘data collectors’; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. Conclusions The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing. PMID:29346663

MODEL REVISI KEYAKINAN DAN KEPUTUSAN AUDIT: SUATU PENGUJIAN EKSPERIMENTAL

Directory of Open Access Journals (Sweden)

Tri Ika Ayuananda

2015-12-01

Full Text Available The purpose of the research is to assess the recency effect about sequence, manner of presentation and form of information on audit decisions when the information is presented sequentially or simultaneously. Recency effect is a biased decision of the auditor when information is given in sequence and auditors tend to weigh the last information greater than the earlier information. The research used a 2x2x2 experimental design with 80 participants between the subject of undergraduate students majoring in accounting. The results of the research showed that: (i belief revision occurs when information is presented in the sequential method; and (ii in the audit decision-making, reviews effects occur in the form of a chart.

“Waiting for DAAs”: A retrospective chart review of patients with untreated hepatitis C in Rwanda

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Gupta, Neil; Kabahizi, Jules; Mukabatsinda, Constance; Walker, Timothy David; Musabeyezu, Emmanuel; Kiromera, Athanase; Steiner, Kevin; Mukherjee, Joia; Nsanzimana, Sabin; Mbituyumuremyi, Aimable

2017-01-01

Background Access to treatment for hepatitis C virus (HCV) in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs), highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs. Methods and findings We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda. Patient charts at these centers were reviewed, and routinely collected data were recorded and analyzed. Overall, 253 patients were identified; median age was 56 years (IQR: 43, 65), and 149 (58.9%) were female. Median viral load was 688,736 IU/ml and 96.7% were HCV genotype 4. As classified by FIB-4 score, 64.8% of the patients had moderate to severe fibrosis. Fibrosis stage was associated with age (OR 1.12, CI 1.09–1.17), but not with time since diagnosis, gender, treatment center, or type of insurance. There was a low frequency of documented co-morbid conditions, including hypertension, diabetes, HIV, and hepatitis B virus. Conclusions Compared to an estimated 55,000 patients eligible for HCV treatment in Rwanda, this study identified only 253 patients currently diagnosed and engaged in care, highlighting an immense treatment gap in HCV, likely due to the lack of accessible and affordable screening, diagnostic, and treatment modalities. The patients that were enrolled in care had a disproportionately advanced fibrosis stage, possibly indicating late presentation to care or lack of treatment options. In the context of newly available and effective treatment options, this study supports the overall need to accelerate access to HCV screening, diagnostics, and care and treatment services in resource-limited settings in sub

High-dose estrogen as salvage hormonal therapy for highly refractory metastatic breast cancer: a retrospective chart review.

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Mahtani, Reshma L; Stein, Alisha; Vogel, Charles L

2009-01-01

High-dose estrogens (HDEs) are an efficacious but widely overlooked treatment option for patients with metastatic breast cancer (MBC). This is due in part to the introduction of tamoxifen in the 1970s, which was proven to be equivalent in efficacy and associated with fewer adverse events (AEs). The aim of this study was to report our experience with the use of HDE in postmenopausal women with advanced breast cancer. Local institutional review board approval was obtained to conduct a retrospective chart review of patients with MBC treated with HDEs at the Boca Raton Comprehensive Cancer Center, Boca Raton, Florida, from 2001 through March 2009. Demographic information, response rates, and tolerability profiles were collected. Of the 426 patients with MBC identified, we found 26 patients with MBC who were prescribed HDEs as a treatment in any line of therapy for advanced breast cancer. The median age at the start of HDE therapy was 59 years (range, 42-92 years). Three of the 26 patients (11.5%) were human epidermal growth factor receptor 2-positive determined via fluorescent in situ hybridization analysis. With the exception of 1 patient who had received no prior systemic treatment for metastatic disease, all patients received multiple lines of treatment (both chemotherapy and hormonal treatments) in the advanced setting (median, 7 lines; range, 0-12) prior to the initiation of HDE. Five of 20 patients (25%) with measurable metastatic disease (visceral and/or soft tissue metastases) had objective antitumor responses defined as either a partial response (PR) or a complete response (CR). Four additional patients (20%) had prolonged stable disease (SD) for > or =6 months. Three of 6 patients (50%) with nonmeasurable metastatic disease (bone-only) had prolonged SD for > or =6 months. Clinical benefit rate (defined as CR + PR + SD > or =6 months) for all patients was 46% (12/26), with a median duration of 10 months. Overall median progression-free survival for the 26

Randomized controlled trial of the effect of medical audit on AIDS prevention in general practice

DEFF Research Database (Denmark)

Sandbæk, Annelli

1999-01-01

OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including a p...... of such consultations initiated by the GPs. CONCLUSIONS: Medical audit had no observed effect on AIDS prevention in general practice. Udgivelsesdato: 1999-Oct......OBJECTIVE: We aimed to evaluate the effect of a medical audit on AIDS prevention in general practice. METHODS: We conducted a prospective randomized controlled study performed as 'lagged intervention'. At the time of comparison, the intervention group had completed 6 months of audit including....... One hundred and thirty-three GPs completed the project. The main outcome measures were the number of consultations involving AIDS prevention and the number of talks about AIDS initiated by the GP, and some elements of the content were registered on a chart. RESULTS: No statistically significant...

Impact of clinical audits on cesarean section rate.

Science.gov (United States)

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

2016-08-01

Many countries have noted a substantial increase in the cesarean section rate (CSR). Several methods for lowering the CSR have been described. Understanding the impact of clinical audits on the CSR may aid in lowering CSR. Thus, our aim is to elucidate the effect of clinical audits on the CSR. We retrospectively analyzed 3781 pregnant women who gave birth in a medical center between January 2008 and January 2011. Pregnant women who delivered between January 2008 and July 2009 were enrolled as the pre-audit group (n = 1592). After August 2009, all cesarean section cases that were audited were enrolled in the audit group (n = 2189). The CSR was compared between groups. The overall CSR (34.5% vs. 31.1%, adjusted odds ratio [OR] = 0.83, p = 0.008) and the cesarean section rate due to dystocia (9.6% vs. 6.2%, p strategy for reducing the CSR. Therefore, we recommend strict monitoring of the indications in dystocia for cesarean section to reduce the CSR. Copyright © 2016. Published by Elsevier B.V.

Participation restriction in childhood phenotype of myotonic dystrophy type 1: a systematic retrospective chart review.

Science.gov (United States)

Gagnon, Cynthia; Kierkegaard, Marie; Blackburn, Catherine; Chrestian, Nicolas; Lavoie, Mélissa; Bouchard, Marie-Frédéric; Mathieu, Jean

2017-03-01

Myotonic dystrophy type 1 (DM1), a neuromuscular disorder, is divided into four clinical phenotypes: congenital; childhood; adult-onset, and late-onset. Publications about the childhood phenotype, especially the long-term outcome, are scarce. The aims of this study were to assess and describe participation outcomes in adults with the childhood phenotype. A retrospective chart methodology. Data were extracted from health records for 63 adults with childhood DM1 (32 males, 31 females; mean age 34y, standard deviation [SD] 11y 6mo; range 18-54y) who had attended the Saguenay Neuromuscular Clinic, Canada. Thirty-four adults (54%) lived with their parents or in foster homes, and most patients needed services or help to live independently. A significant proportion (22%) were isolated in regard to friendship. Very few adults had children, although 33% lived with a spouse. The majority of patients (86%) relied on social security and only one person was currently working. Financial responsibilities were often an issue and 13 (21%) were under legal guardianship. This study showed that patients with the childhood phenotype present a guarded prognosis regarding long-term social participation. These participation restrictions could be related to behavioural, cognitive, and social stigma problems in childhood. This study illustrates the absolute necessity to pursue an interdisciplinary follow-up of these patients when they are reaching adulthood. © 2016 Mac Keith Press.

A Retrospective Chart Review of 10 Hz Versus 20 Hz Repetitive Transcranial Magnetic Stimulation for Depression

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Kristie L. DeBlasio

2012-12-01

Full Text Available We performed a retrospective chart review to examine the progress of patients with depression who received different frequencies of repetitive transcranial magnetic stimulation (rTMS delivered to the left dorsolateral prefrontal cortex (DLPFC. rTMS is a safe and effective alternative treatment for patients with various psychological and medical conditions. During treatment, a coil delivering a time-varying magnetic pulse placed over the scalp penetrates the skull, resulting in clinical improvement. There were 47 patients and three distinct treatment groups found: 10 Hz, 20 Hz, and a separate group who received both frequencies (10/20 Hz. The primary outcome indicator was the difference in Beck Depression Inventory–II (BDI-II scores. Secondary outcomes included categorical indicators of remission, response, and partial response rates as assessed with the BDI-II. In all 3 groups, the majority of patients had depression that remitted, with the highest rate occurring in the 20 Hz group. There were similar response rates in the 10 Hz and 20 Hz groups. There were no patients in the 10/20 Hz group whose depression responded and the highest partial response and nonresponse rates occurred in this group. Although within-group differences were significant from baseline to end of treatment, there were no between-group differences.

ENERGY AUDIT ANALYSIS BY BUSINESS INTELLIGENCE APPLICATION

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Alfa Firdaus

2015-12-01

Full Text Available Energy audit is one of the first tasks to be performed in the accomplishment of an effective energy cost control program. To obtain the best information for a successful energy audit, the auditor must make some measurements during the audit visit. One of the tools that primarily used in audit visit is the portable Power Quality Analyzers (PQA for measuring single to three-phase lines with a high degree of precision and accuracy. It is utilized for monitoring and recording power supply anomalies. For most survey applications, changing currents makes it mandatory for data to be compiled over a period of time with enormous amount of electricity data. Hence, this paper proposed a Business Intelligence approach that can facilitate the auditor to quickly analyze the PQA data. There are five Key Performance Indicators (KPI to be displayed for analyze in form of dashboard. The method that uses to construct the dashboard is classification and association rules with the help of orange dataminer tools. Classification method is utilized to display the data distributions by frequency on a bar chart. Once we got the frequent sets, they allow us to extract association rules among the item sets, where we make some statement about how likely are two sets of items to co-occur or to conditionally occur. The result of this paper is a dashboard of five scorecards, namely unbalanced voltage, unbalanced currents, voltage harmonic, currents harmonic, and power factor. 

(W)righting women: constructions of gender, sexuality and race in the psychiatric chart.

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Daley, Andrea; Costa, Lucy; Ross, Lori

2012-01-01

This paper examines the interpretative nature of psychiatry in relation to gender, sexuality and race within the particular time and place of one urban, Canadian, clinical psychiatric setting. We bring women's psychiatric inpatient charts and a critical feminist perspective into dialogue in an effort to focus on gender, sexuality and race in psychiatric narratives on women's madness. The research used a qualitative, retrospective research design to examine the psychiatric narrative as a technique of power as it operates on women. This paper focuses on the overarching theme of 'medicalisation', identified from the analysis of women's psychiatric inpatient charts, including two subthemes: (1) language and composition and (2) decontextualisation. Our analysis suggests that psychiatric chart documentation practices that reproduce gendered, sexualised, and racialised biases and assumptions and decontextualise the social and structural context of women's experiences of madness serve to create the paradox of women's visibility/erasure in psychiatric charts. The paper concludes with an exploration of the significance of women's authorship legitimacy in psychiatric chart documentation.

A Retrospective Audit of In-Hospital 30-day Mortality from Acute Myocardial Infarction in Connolly Hospital Blanchardstown

LENUS (Irish Health Repository)

Hensey, M

2017-09-01

In 2015, The Department of Health published the first annual report of the “National Healthcare Quality Reporting System.” Connolly Hospital was reported to a mortality rate within 30 days post-Acute Myocardial Infarction (AMI) of 9.87 per 100 cases which was statistically significantly higher than the national rate. We carried out a retrospective audit of patients who were HIPE-coded as having died within 30 days of AMI from 2011-2013 and identified 42 patients. On review, only 23 patients (54.8%) were confirmed as having had an AMI. We identified 12 patients who had AMI included on death certificate without any evidence for same. If the 22 patients incorrectly coded were excluded, the mortality rate within 30 days post-AMI in CHB would fall to 4.14 deaths per 100 cases, well below the national average. Inaccuracies of data collection can lead to erroneous conclusions when examining healthcare data.

National audit of provision of MRI services 2006/07

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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.

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

A novel income security intervention to address poverty in a primary care setting: a retrospective chart review.

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Jones, Marcella K; Bloch, Gary; Pinto, Andrew D

2017-08-17

To examine the development and implementation of a novel income security intervention in primary care. A retrospective, descriptive chart review of all patients referred to the Income Security Heath Promotion service during the first year of the service (December 2013-December 2014). A multisite interdisciplinary primary care organisation in inner city Toronto, Canada, serving over 40 000 patients. The study population included 181 patients (53% female, mean age 48 years) who were referred to the Income Security Health Promotion service and engaged in care. The Income Security Health Promotion service consists of a trained health promoter who provides a mixture of expert advice and case management to patients to improve income security. An advisory group, made up of physicians, social workers, a community engagement specialist and a clinical manager, supports the service. Sociodemographic information, health status, referral information and encounter details were collected from patient charts. Encounters focused on helping patients with increasing their income (77.4%), reducing their expenses (58.6%) and improving their financial literacy (26.5%). The health promoter provided an array of services to patients, including assistance with taxes, connecting to community services, budgeting and accessing free services. The service could be improved with more specific goal setting, better links to other members of the healthcare team and implementing routine follow-up with each patient after discharge. Income Security Health Promotion is a novel service within primary care to assist vulnerable patients with a key social determinant of health. This study is a preliminary look at understanding the functioning of the service. Future research will examine the impact of the Income Security Health Promotion service on income security, financial literacy, engagement with health services and health outcomes. © Article author(s) (or their employer(s) unless otherwise stated in

A retrospective audit of bacterial culture results of donated human milk in Perth, Western Australia.

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Almutawif, Yahya; Hartmann, Benjamin; Lloyd, Megan; Erber, Wendy; Geddes, Donna

2017-02-01

The bacterial content of donated human milk is either endogenous or introduced via contamination. Defining milk bank bacterial content will allow researchers to devise appropriate tests for significant and commonly encountered organisms. A retrospective audit was conducted on data recorded from the Perron Rotary Express Milk Bank, King Edward Memorial Hospital, Subiaco, Western Australia. This aimed to describe the incidence of bacterial species detected in donated human milk and to identify potentially pathogenic bacteria. The data comprised of 2890 batches donated by 448 women between 2007 and 2011. Coagulase negative Staphylococcus (CoNS) represented the highest prevalence of bacteria in donated milk, isolated from 85.5% of batches (range: 20 to 650,000CFU/mL) followed by Acinetobacter species in 8.1% of batches (range: 100 to 180,000CFU/mL). Staphylococcus aureus was the most prevalent potentially pathogenic bacteria in 5% of batches (range: 40 to 100,000CFU/mL). Further investigation is warranted to better define the risks posed by the presence of toxin-producing S. aureus in raw and pasteurized human milk which may allow minimization of risk to the preterm infants. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

A Retrospective Chart Review of Contraceptive Use among Adolescents with Opioid Use Disorder.

Science.gov (United States)

Handy, Caitlin J; Lange, Hannah L H; Manos, Brittny E; Berlan, Elise D; Bonny, Andrea E

2018-04-01

To describe contraceptive use among female adolescents initiating outpatient treatment for opioid use disorder. Retrospective chart review. Outpatient clinic providing medication-assisted treatment for substance use disorders to adolescents and young adults. Nonpregnant female adolescents who presented for treatment from January 1, 2013 to January 31, 2016 (N = 123). None. Prescription contraceptive use at baseline and initiation of a new method within 90 days. Of 123 female adolescents who presented for treatment of opioid use disorder, 113 (91.9%) reported sexual activity and 80 (65.0%) were not using prescription contraception at intake. Previous pregnancy was reported by 43 (35.0%) and 20 (16.3%) were positive for a sexually transmitted infection. Contraceptive counseling was not documented for 73 (59.3%) patients. Among patients with no prescription contraception at baseline, 56 of 80 (70.0%) initiated a method within the study window. Significant predictors (odds ratio [OR]; 95% confidence interval) of contraceptive initiation included previous pregnancy (8.6; 1.39-52.99), education of less than a high school diploma/general equivalency diploma (7.4; 1.63-33.41), and return for follow-up visit (9.8; 2.18-43.69). Young women who presented for opioid use disorder treatment were at high risk of adverse reproductive health outcomes. Most were sexually active and not using prescription contraception. Findings underscore the need for contraceptive counseling in this patient population. Optimally, these services would be provided in conjunction with substance use treatment. Improved contraceptive counseling documentation will allow evaluation of effective contraceptive counseling strategies for adolescents with opioid use disorders and might serve to inform future interventions. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Safe excipient exposure in neonates and small children - protocol for the SEEN project

DEFF Research Database (Denmark)

Valeur, Kristine Svinning; Hertel, Steen Axel; Lundstrøm, Kaare Engell

2017-01-01

are treated with potentially harmful excipients. METHODS: This is a retrospective cohort study based on chart-audit on multi-medicated patients ≤ 5 years of age treated at the Rigshospitalet, Denmark. Preparations with ethanol, propylene glycol, benzyl alcohol, parabens, acesulfame p, aspartame, glycerol...

Rapid infusion of esketamine for unipolar and bipolar depression: a retrospective chart review

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Correia-Melo FS

2017-06-01

Full Text Available Fernanda S Correia-Melo,1 Felipe C Argolo,1 Lucas Araújo-de-Freitas,1,2 Gustavo Carneiro Leal,1 Flávio Kapczinski,3 Acioly Luiz Lacerda,4 Lucas C Quarantini1,2 1Psychiatry Service, University Hospital, Federal University of Bahia, Salvador, Brazil; 2Postgraduate Program in Medicine and Health, Federal University of Bahia, Salvador, Brazil; 3Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil; 4Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil Background: This study evaluated efficacy and safety of intravenous subanesthetic doses of esketamine using an administration time of 10 minutes in patients with treatment-resistant depression and bipolar depression.Methods: A retrospective chart review was conducted to identify patients who met the inclusion criteria for treatment-resistant depression and bipolar depression according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and these patients received rapid infusion of esketamine between June 2012 and December 2015. The Montgomery–Åsberg Depression Rating Scale (MADRS was administered to measure and score depressive symptom severity before infusion and at 24 hours, 72 hours, and 7 days after infusion. In addition, Clinical Global Impression scale was administered before and 7 days after esketamine infusion.Results: Esketamine was administered to 30 patients. A total of 27 patients met the inclusion criteria and had MADRS evaluation data, which showed that 23 had unipolar and 4 had bipolar depression. Thirteen patients (48.1% showed therapeutic response (MADRS reduction ≥50% within 1 week (7 days of intervention. Remission (MADRS <7 was observed in 10 patients (37.0% in the same period. Therapeutic response and remission frequencies were seen in 16 (59.3% and 11 (40.7% patients, respectively, within 24 hours following drug infusion. The most relevant side effect observed during

Retrospective audit of the investigation of patients with suspected acute subarachnoid haemorrhage

International Nuclear Information System (INIS)

Muhammed, O.; Teubnet, D.; Jones, D.N.; Slavotinek, J.P.

2010-01-01

Recommended investigational care (RIC) of emergency department (ED) patients with suspected subarachnoid haemorrhage comprises lumbar puncture (LP) to detect xanthochromia if the preceding CT scan is negative. Retrospective audit of the investigational care of 100 consecutive ED patients presenting with possible subarachnoid haemorrhage. Of the 100 patients, 91 had negative CT, and 36 (39.6%) of these patients had an LP performed to detect xanthochromia (i.e. RIC). Fifty-five of 91 (60.4%) patients did not receive RIC. Of the 55 patients who did not receive RIC, 25 (45.5%) had a documented senior clinical decision not to perform an LP; 15 (27.3%) had no documented reason; five (9.1%) refused consent; two (3.6%) had an LP but no xanthochromia requested, one patient did not have an LP because of technical issues, six patients underwent CT angiography (CTA), and one patient underwent magnetic resonance angiography (MRA), in the absence of a LP, following a negative CT. Two patients underwent CTA following a negative xanthochromia result. Patients admitted to the emergency extended care unit had 6.85 times the odds of receiving RIC (95% CI 2.20-21.4). Fifty-five (55) of 91 (60%) ED patients did not receive RIC. Fifteen of the 55 did not have any documented justification for not performing an LP with xanthochromia testing. Admission to an emergency extended care unit was a predictor of receiving RIC. Inappropriate use of CTA and MRA was identified. These findings have important implications for patient safety. Multifaceted strategies are required to close this evidence-practice gap.

STATUTORY AUDIT AND PERFORMANCE AUDIT

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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.

Asking the difficult questions: Building the capacity of community paediatricians to routinely enquire and respond to family violence.

Science.gov (United States)

Gibbons, Claire L; Holmes, Hilary; Bragg, Judith; Neeman, Teresa

2018-03-01

To enhance the confidence and capacity of community paediatricians and paediatric trainees to identify and respond to family violence, through a series of education sessions and evidence-based recommendations. The action research methodology included a literature search to review the data on family violence education programmes and evidence-based family violence screening tools. Six education sessions were then developed and held for physicians at the Community Paediatric and Child Health Service (CPCHS). An audit was performed on the charts of all new referrals to the CPCHS for a period of 18 months prior to the education sessions and 5 months following the education sessions. A questionnaire was distributed at the first and final education sessions to gauge physician comfort with enquiry into family violence. The documented rate of enquiry into family violence at CPCHS was 24% in the retrospective chart audit. Following the series of education sessions, the documented rate of enquiry increased to 60% (P family violence also increased from 13% of all new patients in the retrospective chart audit to 24% in the prospective arm of the study (P family violence and were comfortable enquiring about family violence. This study demonstrates that clinician education about family violence supports routine enquiry about family violence in community paediatric consultations. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Concordance of chart and billing data with direct observation in dental practice.

Science.gov (United States)

Demko, Catherine A; Victoroff, Kristin Zakariasen; Wotman, Stephen

2008-10-01

The commonly used methods of chart review, billing data summaries and practitioner self-reporting have not been examined for their ability to validly and reliably represent time use and service delivery in routine dental practice. A more thorough investigation of these data sources would provide insight into the appropriateness of each approach for measuring various clinical behaviors. The aim of this study was to assess the validity of commonly used methods such as dental chart review, billing data, or practitioner self-report compared with a 'gold standard' of information derived from direct observation of routine dental visits. A team of trained dental hygienists directly observed 3751 patient visits in 120 dental practices and recorded the behaviors and procedures performed by dentists and hygienists during patient contact time. Following each visit, charts and billing records were reviewed for the performed and billed procedures. Dental providers characterized their frequency of preventive service delivery through self-administered surveys. We standardized the observation and abstraction methods to obtain optimal measures from each of the multiple data sources. Multi-rater kappa coefficients were computed to monitor standardization, while sensitivity, specificity, and kappa coefficients were calculated to compare the various data sources with direct observation. Chart audits were more sensitive than billing data for all observed procedures and demonstrated higher agreement with directly observed data. Chart and billing records were not sensitive for several prevention-related tasks (oral cancer screening and oral hygiene instruction). Provider self-reports of preventive behaviors were always over-estimated compared with direct observation. Inter-method reliability kappa coefficients for 13 procedures ranged from 0.197 to 0.952. These concordance findings suggest that strengths and weaknesses of data collection sources should be considered when investigating

FEATURES OF ACCOUNTING AND AUDIT OF INSURANCE ORGANIZATIONS IN UKRAINE

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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.

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.

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.

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

Audit of Medical Records of Shahid Madani Hospital

Directory of Open Access Journals (Sweden)

Mohammad farough-khosravi

2016-12-01

Full Text Available Background and Objectives: Evaluation of the quality of services and provided cares through comparing them with existing standards in order to identify and prioritize problems and trying to fix them are important steps in the audit of clinical functions. This study aimed to improve the quality of performance of medical records registrations about patients admitted to hospital Shahid Madani and deals with the audit of records listed them. Material and Methods: To perform this study, data were collected using researcher checklist. Target data of 30 medical records were gathered. We used software package of Mini Tab and SPSS to develop process statistical control charts and for statistical analysis of data, respectively. Results: By plotting control charts, we determined three specific reasons in the ADMISSION AND DISCHARGE SUMMARY SHEET, four specific reasons in the SUMMARY SHEET, and three specific reasons in CONSULTATION REQUEST SHEET. The lack of the standard form (on-delivered copies of a summary form “with 90%”, lack of the main form in patient's clinical record “with 83.3%”, lack of the patient's procedure “with 73.3%”are ranked as the most defects in SUMMARY SHEET. In the CONSULTATION REQUEST SHEET, failure to comply with doctor's stamp and signature standard with “20%” has highest percentage of defects. In the ADMISSION AND DISCHARGE SUMMARY SHEET nonconformity of standard records, patient's duration of stay “100%”, coding of diseases based on ICD"100%", recording of patient number based on signs and symptoms "93.3%", usingthe abbreviations to record the recognitions "93.3%" have highest percentage of defects respectively. Conclusion: Based on the results of this study and noting that studied standards of process statistical control charts are in the range of control, the quality of standards and the documentations of �

Pengaruh Gender dan Pengalaman Audit terhadap Audit Judgment

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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.

The Value of Electronically Extracted Data for Auditing Outpatient Antimicrobial Prescribing.

Science.gov (United States)

Livorsi, Daniel J; Linn, Carrie M; Alexander, Bruce; Heintz, Brett H; Tubbs, Traviss A; Perencevich, Eli N

2018-01-01

OBJECTIVE The optimal approach to auditing outpatient antimicrobial prescribing has not been established. We assessed how different types of electronic data-including prescriptions, patient-visits, and International Classification of Disease, Tenth Revision (ICD-10) codes-could inform automated antimicrobial audits. DESIGN Outpatient visits during 2016 were retrospectively reviewed, including chart abstraction, if an antimicrobial was prescribed (cohort 1) or if the visit was associated with an infection-related ICD-10 code (cohort 2). Findings from cohorts 1 and 2 were compared. SETTING Primary care clinics and the emergency department (ED) at the Iowa City Veterans Affairs Medical Center. RESULTS In cohort 1, we reviewed 2,353 antimicrobial prescriptions across 52 providers. ICD-10 codes had limited sensitivity and positive predictive value (PPV) for validated cases of cystitis and pneumonia (sensitivity, 65.8%, 56.3%, respectively; PPV, 74.4%, 52.5%, respectively). The volume-adjusted antimicrobial prescribing rate was 13.6 per 100 ED visits and 7.5 per 100 primary care visits. In cohort 2, antimicrobials were not indicated in 474 of 851 visits (55.7%). The antimicrobial overtreatment rate was 48.8% for the ED and 59.7% for primary care. At the level of the individual prescriber, there was a positive correlation between a provider's volume-adjusted antimicrobial prescribing rate and the individualized rates of overtreatment in both the ED (r=0.72; P<.01) and the primary care setting (r=0.82; P=0.03). CONCLUSIONS In this single-center study, ICD-10 codes had limited sensitivity and PPV for 2 infections that typically require antimicrobials. Electronically extracted data on a provider's rate of volume-adjusted antimicrobial prescribing correlated with the frequency at which unnecessary antimicrobials were prescribed, but this may have been driven by outlier prescribers. Infect Control Hosp Epidemiol 2018;39:64-70.

Improving the quality of endodontic record keeping through clinical audit.

Science.gov (United States)

King, E; Shekaran, L; Muthukrishnan, A

2017-03-10

Introduction Record keeping is an essential part of day-to-day practice and plays an important role in treatment, audit and dento-legal procedures. Creating effective endodontic records is challenging due to the scope of information required for comprehensive notes. Two audits were performed to assess the standards of endodontic record keeping by dentists in a restorative dentistry department and students on an endodontic MSc course.Methods Fifty sets of departmental records and 10 sets of student records were retrospectively evaluated against the European Society of Endodontology 2006 guidelines. Results of the first cycle of both audits were presented to departmental staff and MSc students, alongside an educational session. Additionally, departmental guidelines, consent leaflets and endodontic record keeping forms were developed. Both audits were repeated using the same number of records, thus completing both audit cycles.Results The most commonly absent records included consent, anaesthetic details, rubber dam method, working length reference point, irrigation details and obturation technique. Almost all areas of record keeping improved following the second audit cycle, with some areas reaching 100% compliance when record keeping forms were used. Statistically significant improvements were seen in 24 of the 29 areas in the departmental audit and 14 of the 29 areas in the MSc audit (P = 0.05).Conclusions Significant improvements in endodontic record keeping can be achieved through the provision of education, departmental guidelines, consent leaflets and endodontic record keeping forms.

Retrospective audit of the acute management of stroke in two district general hospitals in the uk.

Science.gov (United States)

Faluyi, O O; Omodara, J A; Tay, K H; Muhiddin, K

2008-06-01

There is some evidence to suggest that the standard of acute medical care provided to patients with cerebrovascular disease is a major determinant of the eventual outcome. Consequently, the Royal College of Physicians (RCP) of London issues periodic guidelines to assist healthcare providers in the management of patients presenting with stroke. An audit of the acute management of stroke in two hospitals belonging to the same health care trust in the UK. Retrospective review of 98 randomly selected case-notes of patients managed for cerebrovascular disease in two acute hospitals in the UK between April and June 2004. The pertinent guidelines of RCP (London) are highlighted while audit targets were set at 70%. 84% of patients presenting with cerebrovascular disease had a stroke rather than a TIA, anterior circulation strokes were commonest. All patients with stroke were admitted while those with TIAs were discharged on the same day but most patients with TIA were not followed up by Stroke specialists. Most CT-imaging of the head was done after 24 hours delaying the commencement of anti-platelets for patients with ischaemic stroke or neurosurgical referral for haemorrhagic stroke. Furthermore, there was a low rate of referral for carotid ultrasound in patients with anterior circulation strokes. Anti-platelets and statins were commenced for most patients with ischaemic stroke while diabetes was well controlled in most of them. However, ACE-inhibitors and diuretics such as indapamide were under-utilized for secondary prevention in such patients. Warfarin anti-coagulation was underutilized in patients with ischaemic stroke who had underlying chronic atrial fibrillation. While there was significant multi-disciplinary team input, dysphagia and physiotherapy assessments were delayed. Similarly, occupational therapy input and psychological assesment were omitted from the care of most patients. Hospital service provision for the management of cerebrovascular disease needs to

Retrospective chart review for obesity and associated interventions among rural Mexican-American adolescents accessing healthcare services.

Science.gov (United States)

Champion, Jane Dimmitt; Collins, Jennifer L

2013-11-01

To report a retrospective analysis of data routinely collected in the course of healthcare services at a rural health clinic and to assess obesity incidence and associated interventions among rural Mexican-American adolescents. Two hundred and twelve charts reviewed; 98 (46.2%) males and 114 (53.8%) females. Data extracted included Medicaid exams conducted at the clinic within 5 years. Equal overweight or obese (n = 105, 49.5%), versus normal BMI categorizations (n = 107, 50.5%) documented overall and by gender. Female obesity higher (25.4%) than national norms (17.4%); male rates (25.5%) were within national norm. Interventions provided by nurse practitioners (94%) for 34.8%-80% of overweight/obese had limited follow-up (4%). Obesity incidence markedly increased between 13 and 18 years of age without associated interventions; 51.4%-75.6% without interventions. Obesity is a healthcare problem among rural Mexican-American adolescents accessing care at the rural health clinic. Obesity intervention and follow-up was suboptimal within this setting. Rural and ethnic minority adolescents experience health disparities concerning obesity prevalence and remote healthcare access. Obesity prevention and treatment during adolescence is a national health priority given physiologic and psychological tolls on health and potential for obesity into adulthood. Obesity assessment and translation of evidence-based interventions for rural Mexican-American adolescents at rural health clinics is implicated. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

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.

The UK radiotherapy dosimetry audit network

International Nuclear Information System (INIS)

Thwaites, D.I.

2002-01-01

: S Powley, Lincoln), of one representative from each group and one from NPL. It reviews experience and results and oversees standards. It makes recommendations on minimum frequencies and content (current aim:at least every two years). This ensures uniformity for intergroup comparison of audit performance. In addition, the group uses collaboration with the NPL to co-ordinate first level dosimetry audits in at least one centre per group at 2-yearly intervals. This is to audit the dissemination of chamber calibration factors from NPL to the centres and links the network groups at the level of basic dosimetry. The normal minimum group audits cover megavoltage photons and include ion chamber and beam calibration, beam quality, beam modifiers and other single field parameters, geometric parameters and simple multi-field planned irradiations. Various groups have extended the scope of the audits to kV x-rays, electrons and brachytherapy. A number are using more sophisticated phantoms to audit more complex, more realistic treatment situations. Some of these use phantoms developed for clinical trial audit (eg head-and-neck, lung (CHART), breast (START), prostate (RTO1), eg. ref. Others have developed specific phantoms for the audit group programme. Some audits follow the process through from simulator or CT scanner to volume delineation to planning to delivery. Some groups are currently developing audits for conformal and other sophisticated treatments. In addition to practical measurement audit, there is always also procedural audit, considering dosimetry, quality control, etc. in the visited centre in terms of procedures, documentation and records. As an example the Scottish+ group (including centres in Scotland, northern England, Northern Ireland) is using a semi-anatomic epoxy-resin-based phantom which has enabled audits of irradiations representative of 'treatments' for breast, lung/thorax and three head-and-neck situations. The group has audited kV x-rays and electrons

Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

Science.gov (United States)

Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

2016-06-01

Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care

Obstacles faced when conducting a clinical audit in Botswana ...

African Journals Online (AJOL)

This led to abandonment of a retrospective pilot of the audit. When the medical records were available, the documentation was poor and unsatisfactory for the purposes of the study. Lack of local criteria and guidelines for ICU admission resulted in inappropriate referrals. Proposed guidelines had still not been adopted after ...

Audit with feedback (AWF) as a CME tool for radiation oncologists (ROs): evaluation of efficacy, perception, and cost-effectiveness

International Nuclear Information System (INIS)

Shakespeare, T.P.; Mukherjee, R.K.; Lu, J.J.; Wynne, C.J.; Back, M.F.

2003-01-01

Meta-analyses demonstrate Audit with Feedback (AWF) is effective CME, however educational efficacy for ROs is unknown. We evaluated an AWF CME intervention for ROs, determining efficacy, cost-effectiveness and participant satisfaction. CME program: CME incorporated fortnightly random patient chart audit, scoring management adequacy via checklist. Scores were presented at a same-day institutional meeting, and case management discussed. Senior peers provided educational feedback. RO behavior/performance was evaluated via chart review of new patients seen 2 months before commencement of CME (T0), and after 12 months of CME (T1). A validated instrument scored 19 items as '0' (inadequate/inappropriate) or '1' (adequate/appropriate). Comparisons of mean point-score for 10 behaviour items targeted by the CME AWF checklist, 3 non-targeted behaviour items, and 6 performance items were made; also percent charts achieving a '1' for each item at T0 and T1. A 14-item participant questionnaire measured satisfaction before and after efficacy results were known. Responses scored from 0 (very dissatisfied) to 5 (very satisfied), then averaged. Annual cost and cost-per-point gained incorporated salaries of organizers/ participants, and consumables. 113 and 118 charts were evaluated at T0 and T1. Mean score of targeted behavior improved between T0 and T1 (8.7 to 9.2 out of 10,p=0.0001), with no significant improvement for non-targeted behavior/performance items. Improvement occurred for 'Decision for treatment' (non-targeted; percent charts scoring '1' increased from 84% to 92%,p=0.08), and targeted items 'Letter to referrer' (53% to 66%,p=0.04), 'Treatment intent' (54 to 77%,p=0.0002), 'Laterality doublet' (91 to 98%, p=0.04), and 'Isodose-plan signed' (94 to 100%,p=0.006). Improvements varied between ROs. Participant satisfaction was positive, increasing from 3.2 to 3.7 after efficacy result distribution (p=0.0001). Annual costs and cost-per-point gained were $AUD13,820 and $27

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.

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

Science.gov (United States)

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

2017-12-20

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

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

Science.gov (United States)

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

2017-04-01

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

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...

FusionCharts Beginner's Guide The Official Guide for FusionCharts Suite

CERN Document Server

Nadhani, Sanket; Bhattacharya, Shamasis

2012-01-01

The book is written as a practical, step-by-step guide to using FusionCharts Suite. The book not only teaches you the fundamentals and implementation of FusionCharts Suite, but also makes you the data visualization guru among your friends and colleagues by teaching how to select the right chart type and usability tips. Filled with examples, code samples and practical tips in a no-nonsense way, the book is a breeze to read.This book is both for beginners and advanced web developers who need to create interactive charts for their web applications. No previous knowledge of FusionCharts Suite is a

Diabetes Self-Management Education and Medical Nutrition Therapy Improve Patient Outcomes: A Pilot Study Documenting the Efficacy of Registered Dietitian Nutritionist Interventions through Retrospective Chart Review.

Science.gov (United States)

Marincic, Patricia Z; Hardin, Amie; Salazar, Maria V; Scott, Susan; Fan, Shirley X; Gaillard, Philippe R

2017-08-01

Diabetes self-management education (DSME) and medical nutrition therapy (MNT) improve patient outcomes; poor reimbursement limits access to care. Our aim was to develop methodology for tracking patient outcomes subsequent to registered dietitian nutritionist interventions, document outcomes for patients with type 2 diabetes attending an American Diabetes Association-recognized program, and obtain outcome data to support reimbursement and public policy initiatives to improve patient access to DSME and MNT. Retrospective chart review. A random sample of 100 charts was chosen from the electronic medical records of patients with type 2 diabetes completing DSME and individualized MNT, June 2013 to 2014. Data were extracted on body mass index (calculated as kg/m 2 ), weight, hemoglobin A1c, blood glucose, and lipids. Mixed-model analysis of variance was used to determine differences between means for continuous variables; McNemar's tests and γ-statistic trend analysis were used to assess frequency of patients reaching glycemic targets. Significant weight loss was observed from baseline (94.3±21.1 kg) to end of program (91.7±21.2 kg [-1.6±3.9 kg]; P0.05). Significant hemoglobin A1c reduction was observed from baseline (8.74%±2.30%) to end of program (6.82%±1.37% [-1.92%±2.25%]; Phemoglobin A1c targets (≤7.0%) vs 27% at baseline (P=0.008). When stratified by diet alone and diet plus drug therapy, patients exhibited a 1.08%±1.20% (Phemoglobin A1c, respectively. Triglycerides decreased from baseline 181.6±75.5 mg/dL (2.0±0.9 mmol/L) to 115.8±48.1 mg/dL (1.3±0.5mmol/L) (P=0.023). High-density lipoprotein increased from 41.4±12.4 mg/dL (1.1±0.3 mmol/L) to 47.3±12.4 mg/dL (1.2±0.3 mmol/L) (P=0.007). Retrospective chart review provides an operational model for abstracting existing patient outcome data subsequent to registered dietitian nutritionist interventions. In support of universal reimbursement and patient access to DSME with supplemental individualized

Point-of-care outcome assessment in the cancer clinic: Audit of data quality

International Nuclear Information System (INIS)

Wong, Karen; Huang, Shao Hui; O'Sullivan, Brian; Lockwood, Gina; Dale, Darlene; Michaelson, Terry; Waldron, John; Bayley, Andrew; Cummings, Bernard; Dawson, Laura A.; Kim, John; Liu, Geoffrey; Ringash, Jolie

2010-01-01

Background and purpose: To assess the completeness and accuracy of stage and outcome data in the Anthology of Outcomes (AOs), a prospective point-of-care physician-collected electronic data system for patients at Princess Margaret Hospital. Material and methods: A random sample of 10% of the AO cases registered between July 2003 and December 2005 was drawn. An audit was conducted of the AO data compared with chart review and cancer registry. Results: The AO system was applied first to a head and neck (HN) cancer patient cohort. From 1152 HN cases, 120 were audited. TNM stage was recorded in all cases. Discrepancy was found between the AO and primary data sources in 3-13% of cases. Physician review showed a 3% error rate in overall stage recorded in the AO. Sixty-two outcomes in 43 patients were found on chart review. No outcomes were incorrectly recorded in the AO. Nineteen (31%) outcomes in 17 patients were missed in the AO. Conclusions: Our experience has demonstrated the feasibility of real-time outcome recording at point-of-care. New processes needed to improve the completeness of capture of patient outcomes in the AO have more recently been introduced. This successful system has been expanded to other disease sites.

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...

Assessing adherence to accepted national guidelines for immigrant and refugee screening and vaccines in an urban primary care practice: a retrospective chart review.

Science.gov (United States)

Waldorf, Barbara; Gill, Christopher; Crosby, Sondra S

2014-10-01

In the United States, 38.5 million people are foreign-born, one in three arriving since 2000. Health issues include high rates of hepatitis B, humanimmunodeficiency virus infection, parasitic infections, and M. tuberculosis. We sought to determine rates of provider adherence to accepted national guidelines for immigrant and refugee health screening and vaccines done at the primary care clinics at Boston Medical Center. Randomized, retrospective chart review of foreign born patients in the primary care clinics. We found low screening and immunization rates that do not conform to CDC/ACIP guidelines. Only 43 % of immigrant patients had tuberculosis screening, 36 % were screened for HIV and hepatitis B, and 33 % received tetanus vaccinations. Organizational changes incorporating multi-disciplinary approaches such as creative use of nursing staff, protocols, standing orders, EMR reminders, and web based educational tools can contribute to better outcomes by identifying patients and improving utilization of guidelines.

Laboratory-based clinical audit as a tool for continual improvement: an example from CSF chemistry turnaround time audit in a South-African teaching hospital.

Science.gov (United States)

Imoh, Lucius C; Mutale, Mubanga; Parker, Christopher T; Erasmus, Rajiv T; Zemlin, Annalise E

2016-01-01

Timeliness of laboratory results is crucial to patient care and outcome. Monitoring turnaround times (TAT), especially for emergency tests, is important to measure the effectiveness and efficiency of laboratory services. Laboratory-based clinical audits reveal opportunities for improving quality. Our aim was to identify the most critical steps causing a high TAT for cerebrospinal fluid (CSF) chemistry analysis in our laboratory. A 6-month retrospective audit was performed. The duration of each operational phase across the laboratory work flow was examined. A process-mapping audit trail of 60 randomly selected requests with a high TAT was conducted and reasons for high TAT were tested for significance. A total of 1505 CSF chemistry requests were analysed. Transport of samples to the laboratory was primarily responsible for the high average TAT (median TAT = 170 minutes). Labelling accounted for most delays within the laboratory (median TAT = 71 minutes) with most delays occurring after regular work hours (P audit identified sample transportation, work shift periods and use of inappropriate CSF sample tubes as drivers of high TAT for CSF chemistry in our laboratory. The results of this audit will be used to change pre-analytical practices in our laboratory with the aim of improving TAT and customer satisfaction.

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

The clinical utility and cost effectiveness of routine thyroid screening ...

African Journals Online (AJOL)

on medication or comment on the extent of stressors. Another possible ... transient nature of abnormal thyroid test results may be a reflection of a multitude of factors, which include the timing of testing, the ... This study was a retrospective chart audit and it was therefore not .... Case finding and screening strategies for thyroid.

Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review.

Science.gov (United States)

Artico, Marco; Dante, Angelo; D'Angelo, Daniela; Lamarca, Luciano; Mastroianni, Chiara; Petitti, Tommasangelo; Piredda, Michela; De Marinis, Maria Grazia

2018-01-01

Terminally ill patients are at high risk of pressure ulcers, which have a negative impact on quality of life. Data about pressure ulcers' prevalence, incidence and associated factors are largely insufficient. To document the point prevalence at admission and the cumulative incidence of pressure ulcers in terminally ill patients admitted to an Italian home palliative care unit, and to analyse the patients' and caregivers' characteristics associated with their occurrence. Retrospective chart review. Patients ( n = 574) with a life expectancy ⩽6 months admitted to a palliative home care service were included in this study. The prevalence and incidence rates were 13.1% and 13.0%, respectively. The logistic regression models showed body mass index ( p 70 and >1 caregiver at home as the dichotomous variables predictors of presenting with a pressure ulcer at time of admission and during home palliative care. The notable pressure ulcers' incidence and prevalence rates suggest the need to include this issue among the main outcomes to pursue during home palliative care. The accuracy of body mass index, Braden Scale and Karnofsky Performance Scale in predicting the pressure ulcers risk is confirmed. Therefore, they appear as essential tools, in combination with nurses' clinical judgment, for a structured approach to pressure ulcers prevention. Further research is needed to explore the home caregivers' characteristics and attitudes associated with the occurrence of pressure ulcers and the relations between their strategies for pressure ulcer prevention and gender-related patient's needs.

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...

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

Science.gov (United States)

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

2017-06-01

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

Predictive factors for pharyngocutaneous fistulization after total laryngectomy: a Dutch Head and Neck Society audit.

Science.gov (United States)

Lansaat, Liset; van der Noort, Vincent; Bernard, Simone E; Eerenstein, Simone E J; Plaat, Boudewijn E C; Langeveld, Ton A P M; Lacko, Martin; Hilgers, Frans J M; de Bree, Remco; Takes, Robert P; van den Brekel, Michiel W M

2018-03-01

Incidences of pharyngocutaneous fistulization (PCF) after total laryngectomy (TL) reported in the literature vary widely, ranging from 2.6 to 65.5%. Comparison between different centers might identify risk factors, but also might enable improvements in quality of care. To enable this on a national level, an audit in the 8 principle Dutch Head and Neck Centers (DHNC) was initiated. A retrospective chart review of all 324 patients undergoing laryngectomy in a 2-year (2012 and 2013) period was performed. Overall PCF%, PCF% per center and factors predictive for PCF were identified. Furthermore, a prognostic model predicting the PCF% per center was developed. To provide additional data, a survey among the head and neck surgeons of the participating centers was carried out. Overall PCF% was 25.9. The multivariable prediction model revealed that previous treatment with (chemo)radiotherapy in combination with a long interval between primary treatment and TL, previous tracheotomy, near total pharyngectomy, neck dissection, and BMI model. PCF performance rate (difference between the PCF% and the predicted PCF%) per DHNC, though, shows that not all differences are explained by factors established in the prediction model. However, these factors explain enough of the differences that, compensating for these factors, hospital is no longer independently predictive for PCF. This nationwide audit has provided valid comparative PCF data confirming the known risk factors from the literature which are important for counseling on PCF risks. Data show that variations in PCF% in the DHNCs (in part) are explainable by the variations in these predictive factors. Since elective neck dissection is a major risk factor for PCF, it only should be performed on well funded indication.

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...

Optimizing adherence to advice from antimicrobial stewardship audit and feedback rounds.

Science.gov (United States)

Rawlins, Matthew D M; Sanfilippo, Frank M; Ingram, Paul R; McLellan, Duncan G J; Crawford, Colin; D'Orsogna, Luca; Dyer, John

2018-02-01

We examined adherence to antimicrobial stewardship prospective audit and feedback rounds in a rehabilitation service compared with the remainder of the acute hospital, and explored the reasons for this. Between October 2014 and December 2015, we retrospectively assessed the rate of non-adherence to advice from antimicrobial stewardship prospective audit and feedback rounds between the rehabilitation service and the acute hospital, along with the source of the patient referral. Compared with the rehabilitation service, acute hospital medical staff were almost twice as likely to not adhere to advice provided on antimicrobial stewardship prospective audit and feedback rounds (13.8% vs. 7.6%, p risk 1.8 [95% confidence interval 1.3, 2.5]). In the rehabilitation service, referrals were more likely to come from medical staff (61.9% vs. 16.3%, p model potentially applicable to other settings.

A retrospective chart study: The pathway to a diagnosis for adults referred for ASD assessment

NARCIS (Netherlands)

Geurts, H.M.; Jansen, M.D.

2012-01-01

Charts of 125 adults (18 to 82 years), referred to an autism expert team for Autism Spectrum Disorder (ASD) assessment, were reviewed to explore the pathway to an adulthood ASD diagnosis. The participants first contacted the mental health care clinic at a median age of 19 years (range 2 to 78

CHARTED'AUDIT INTERNE

International Development Research Centre (IDRC) Digital Library (Canada)

KPMG

excellence l'anime dans toutes ses sphères d'activité, à savoir la programmation, la dotation, la gestion et la gouvernance. Par ailleurs, le CRDI est résolu à respecter les normes les plus rigoureuses en matière de reddition de comptes ...

Development of Markup Language for Medical Record Charting: A Charting Language.

Science.gov (United States)

Jung, Won-Mo; Chae, Younbyoung; Jang, Bo-Hyoung

2015-01-01

Nowadays a lot of trials for collecting electronic medical records (EMRs) exist. However, structuring data format for EMR is an especially labour-intensive task for practitioners. Here we propose a new mark-up language for medical record charting (called Charting Language), which borrows useful properties from programming languages. Thus, with Charting Language, the text data described in dynamic situation can be easily used to extract information.

 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.

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 ...

Growth Charts (For Parents)

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Growth Charts KidsHealth / For Parents / Growth Charts What's in ... Problem? Print en español Tablas de crecimiento About Growth Charts Look at any class picture, and you' ...

Inclusion of extremes of prematurity in ventricular index centile charts.

Science.gov (United States)

Boyle, M; Shim, R; Gnanasekaran, R; Tarrant, A; Ryan, S; Foran, A; McCallion, N

2015-06-01

To assess the relationship between ventricular index (VI) measurements and postmenstrual age in preterm infants and to generate centile charts and normal ranges for frontal horn ratio (FHR) for a large contemporary cohort of preterm infants. A retrospective cohort study of 253 infants with birth gestation less than 32 weeks admitted between January 2009 and December 2011 to a tertiary NICU in Ireland. A total of 816 cranial ultrasounds were reviewed. Data collected were grouped according to postmenstrual age at the time of scan from 23 weeks to 45 weeks. Median values for VI show a general trend to increase with gestation. FHR did not significantly change with postmenstrual age at scan with a median value of 0.31. There is a slight increase in VI as gestation at the time of scans increases. These results provide the basis for updated centile charts which we propose for current practice.

Surface Prognostic Charts

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Surface Prognostic Charts are historical surface prognostic (forecast) charts created by the United States Weather Bureau. They include fronts, isobars, cloud, and...

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.

Perampanel: An audit of clinical experience using the epilepsy electronic patient record.

LENUS (Irish Health Repository)

Ryan, E

2016-07-01

Perampanel is a non-competitive antagonist of AMPA glutamate receptors on post synaptic neurons. The aim of this study was to conduct an audit of the experience of perampanel treatment in Ireland based on the interrogation of the national epilepsy electronic patient record (EPR). A retrospective audit was compiled which reviewed the progress of patients who had been treated across two regional epilepsy centres. The EPR was used to identify patients and collect information relevant to their perampanel therapy. Collected data was entered into a statistical package for social sciences for analysis using descriptive statistics.\\r\

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...

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.

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.

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...

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 ...

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

Science.gov (United States)

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

2018-06-01

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

Clinical audit of patients with cerebrovascular accident and transient ischemic attack in our lady of lourdes hospital drogheda, ireland

International Nuclear Information System (INIS)

Nagi, D.; Aamar, A.; Rahim, I.; Sadaf, M.I.

2012-01-01

Stroke is a major health problem and is one of leading causes of morbidity and mortality. Methods: A clinical audit comprising retrospective chart review of 101 patients randomly selected from admission register in Our Lady of Lourdes Hospital Drogheda, Ireland, was done during the first quarter of 2009. Keeping in view the recommendations, in this audit the following areas were evaluated: type of event, time of event and arrival to hospital, thrombolytic therapy, past medical history, investigations, smoking history, utilization of multidisciplinary services (physiotherapy and occupational therapy, speech and language therapy), medications, referral to GP, carotid pathology, and outcome. Results: Of the 101 patients, 43 (42.5%) were males and 58 (57.4%) were females. 47.5% (48/101) had TIA while 52.5% (53/101) had CVA. Of the total patients, 62.8% males and 56.8% females were hypertensive and 48.8% of males and 36.2% of females had hypercholesterolemia. Of the total number of patients, 23% of males and 15.5% of females were smokers. Utilization of different multidisciplinary services for males and females was following: physical therapy (46.5% and 45.8%); occupational therapy (11.6% and 15.3%); speech and language therapy (13.9% and 22%). Of all the patients 5% died in the hospital, 77.2% were discharged home and 17.8% were sent to Nursing home for long term care. Conclusion: The commonest risk factor for CVA / TIA is hypertension followed by hypercholesterolemia. Smoke cessation advice should be given to all at risk. (author)

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...

Pressure Injury Progression and Factors Associated With Different End-Points in a Home Palliative Care Setting: A Retrospective Chart Review Study.

Science.gov (United States)

Artico, Marco; D'Angelo, Daniela; Piredda, Michela; Petitti, Tommasangelo; Lamarca, Luciano; De Marinis, Maria Grazia; Dante, Angelo; Lusignani, Maura; Matarese, Maria

2018-07-01

Patients with advanced illnesses show the highest prevalence for pressure injuries. In the palliative care setting, the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. To describe the course of healing for pressure injuries in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement. Four-year retrospective chart review of 669 patients cared for in a home palliative care service, of those 124 patients (18.5%) had at least one pressure injury with a survival rate less than or equal to six months. The proportion of healed pressure injuries was 24.4%. Of the injuries not healed, 34.0% were in a maintenance phase, whereas 63.6% were in a process of deterioration. Body mass index (P = 0.0014), artificial nutrition (P = 0.002), and age pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Sticker charts: a method for improving adherence to treatment of chronic diseases in children.

Science.gov (United States)

Luersen, Kara; Davis, Scott A; Kaplan, Sebastian G; Abel, Troy D; Winchester, Woodrow W; Feldman, Steven R

2012-01-01

Poor adherence is a common problem and may be an underlying cause of poor clinical outcomes. In pediatric populations, positive reinforcement techniques such as sticker charts may increase motivation to adhere to treatment regimens. To review the use of sticker charts to improve adherence in children with chronic disease, Medline and PsycINFO searches were conducted using the key words "positive reinforcement OR behavior therapy" and "adherence OR patient compliance" and "child." Randomized controlled retrospective cohort or single-subject-design studies were selected. Studies reporting adherence to the medical treatment of chronic disease in children using positive reinforcement techniques were included in the analysis. The systematic search was supplemented by identifying additional studies identified through the reference lists and authors of the initial articles found. Positive reinforcement techniques such as sticker charts increase adherence to medical treatment regimens. In several studies, this effect was maintained for months after the initial intervention. Better adherence correlated with better clinical outcomes in some, but not all, studies. Few studies examining the use of sticker charts were identified. Although single-subject-design studies are useful in establishing the effect of a behavioral intervention, larger randomized controlled trials would help determine the precise efficacy of sticker chart interventions. Adherence to medical treatments in children can be increased using sticker charts or other positive reinforcement techniques. This may be an effective means to encourage children with atopic dermatitis to apply their medications and improve clinical outcomes. © 2012 Wiley Periodicals, Inc.

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.

APPLICATION OF U-CHART AND C-CHART IN TECHNOLOGICAL PROCESS OF PRIMARY WOOD PROCESSING

Directory of Open Access Journals (Sweden)

Damjan Stanojević

2014-01-01

Full Text Available Control charts are statistical methods of quality control. Basically it is a graph where the abscissa represents the order of control, and the ordinate is marked with parameter values, which are controled by samples over a certain size. Using charts determine varying quality and also related the stability and capacity of the production process in relation to the established control limits. Dr. Schuchardt, which can be regarded as the creator of control charts, says that their mission: to maintain the production process in a state of control, to lead the production process into a state of control, to show that the state of control has been achieved. According to Dr. Schuchardt „for a phenomenon is said to be controlled if based on current data we can predict, at least within certain limits, how the phenomenon will change in the future. Here, under certain prediction within limits means that we can determine, at least approximately, the probability that the phenomenon is found within the given limits“. Control charts for attribute quality characteristics are: p- control chart, m- control chart, u- control chart, c- control chart.

Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

Directory of Open Access Journals (Sweden)

Gorwill R Hugh

2004-11-01

Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

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

Science.gov (United States)

Miettunen, Kirsi; Metsälä, Eija

2017-06-01

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

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...

Audit of cases with uterine rupture: A process indicator of quality of ...

African Journals Online (AJOL)

Audit of uterine rupture (UR) used as a process indicator, can identify factors considered avoidable to improve future quality of obstetric care. Records of UR cases at a referral maternity in Luanda were studied retrospectively (n=43) and prospectively (n=67) including basic obstetric information, maternal and foetal outcome, ...

ICAO Aeronautical chart production: aerodrome obstruction charts from small–format aerial digital imagery

Directory of Open Access Journals (Sweden)

Jorge Padro Molina

2012-11-01

Full Text Available Aeronautical charts and aerodrome obstruction charts, provide information about obstacles around the airport, so pilots and air traffic controllers can comply with the procedures and limitations of its utilization. Safety in aviation demands updated and precise aeronautical charts production, adopting the standards of the International Civil Aviation Organization (ICAO. In this paper the methodology employed to generate obstruction charts for five airports in Mexico, using aerial digital imagery obtained with small–format cameras, is described. Through two aerial surveys on each airport, from 10 000 and 5 000 feet above ground level, two orthomosaics were generated covering the airport influence area, the runway, and the obstacle limitation surfaces: approach/Take–off climb, transitional, inner horizontal, and conical. Using stereopair photointerpretation most of the obstacles were identified, and by means of the orthomosaics; aerodrome charts, and aerodrome obstruction charts types A, B and C, were generated. Using satellite geodetic receivers, 18 points were surveyed on each runway in order to obtain its dimensions, and to establish ground control points for mosaics generation. Throughout detailed field work, height and location of the obstacles were verified, and finally, after several reviewing processes by aeronautical authorities, generation of ICAO charts was concluded when all airport maps were integrated in a Geographical Information System.

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.

[Ophthalmologic reading charts : Part 2: Current logarithmically scaled reading charts].

Science.gov (United States)

Radner, W

2016-12-01

To analyze currently available reading charts regarding print size, logarithmic print size progression, and the background of test-item standardization. For the present study, the following logarithmically scaled reading charts were investigated using a measuring microscope (iNexis VMA 2520; Nikon, Tokyo): Eschenbach, Zeiss, OCULUS, MNREAD (Minnesota Near Reading Test), Colenbrander, and RADNER. Calculations were made according to EN-ISO 8596 and the International Research Council recommendations. Modern reading charts and cards exhibit a logarithmic progression of print sizes. The RADNER reading charts comprise four different cards with standardized test items (sentence optotypes), a well-defined stop criterion, accurate letter sizes, and a high print quality. Numbers and Landolt rings are also given in the booklet. The OCULUS cards have currently been reissued according to recent standards and also exhibit a high print quality. In addition to letters, numbers, Landolt rings, and examples taken from a timetable and the telephone book, sheet music is also offered. The Colenbrander cards use short sentences of 44 characters, including spaces, and exhibit inaccuracy at smaller letter sizes, as do the MNREAD cards. The MNREAD cards use sentences of 60 characters, including spaces, and have a high print quality. Modern reading charts show that international standards can be achieved with test items similar to optotypes, by using recent technology and developing new concepts of test-item standardization. Accurate print sizes, high print quality, and a logarithmic progression should become the minimum requirements for reading charts and reading cards in ophthalmology.

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

Short- and long-term effects of clinical audits on compliance with procedures in CT scanning

International Nuclear Information System (INIS)

Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

2016-01-01

To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning. This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific ''paediatric brain CT'' procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test. Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from <0.001 to 0.031) in both hospitals and remained unchanged during the third audit (P ranging from 0.114 to 0.999). Quality improvement through repeated compliance audits with CT procedures durably improves this compliance. (orig.)

Short- and long-term effects of clinical audits on compliance with procedures in CT scanning.

Science.gov (United States)

Oliveri, Antonio; Howarth, Nigel; Gevenois, Pierre Alain; Tack, Denis

2016-08-01

To test the hypothesis that quality clinical audits improve compliance with the procedures in computed tomography (CT) scanning. This retrospective study was conducted in two hospitals, based on 6950 examinations and four procedures, focusing on the acquisition length in lumbar spine CT, the default tube current applied in abdominal un-enhanced CT, the tube potential selection for portal phase abdominal CT and the use of a specific "paediatric brain CT" procedure. The first clinical audit reported compliance with these procedures. After presenting the results to the stakeholders, a second audit was conducted to measure the impact of this information on compliance and was repeated the next year. Comparisons of proportions were performed using the Chi-square Pearson test. Depending on the procedure, the compliance rate ranged from 27 to 88 % during the first audit. After presentation of the audit results to the stakeholders, the compliance rate ranged from 68 to 93 % and was significantly improved for all procedures (P ranging from audit (P ranging from 0.114 to 0.999). Quality improvement through repeated compliance audits with CT procedures durably improves this compliance. • Compliance with CT procedures is operator-dependent and not perfect. • Compliance differs between procedures and hospitals, even within a unified department. • Compliance is improved through audits followed by communication to the stakeholders. • This improvement is sustainable over a one-year period.

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.

 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...

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% ...

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.

Spectral Imaging of Portolan Charts

Science.gov (United States)

France, Fenella G.; Wilson, Meghan A.; Ghez, Anita

2018-05-01

Spectral imaging of Portolan Charts, early nautical charts, provided extensive new information about their construction and creation. The origins of the portolan chart style have been a continual source of perplexity to numerous generations of cartographic historians. The spectral imaging system utilized incorporates a 50 megapixel mono-chrome camera with light emitting diode (LED) illumination panels that cover the range from 365 nm to 1050 nm to capture visible and non-visible information. There is little known about how portolan charts evolved, and what influenced their creation. These early nautical charts began as working navigational tools of medieval mariners, initially made in the 1300s in Italy, Portugal and Spain; however the origin and development of the portolan chart remained shrouded in mystery. Questions about these early navigational charts included whether colorants were commensurate with the time period and geographical location, and if different, did that give insight into trade routes, or possible later additions to the charts? For example; spectral data showed the red pigment on both the 1320 portolan chart and the 1565 Galapagos Islands matched vermillion, an opaque red pigment used since antiquity. The construction of these charts was also of great interest. Spectral imaging with a range of illumination modes revealed the presence of a "hidden circle" often referred to in relation to their construction. This paper will present in-depth analysis of how spectral imaging of the Portolans revealed similarities and differences, new hidden information and shed new light on construction and composition.

Impact of Quality Improvement Educational Interventions on Documented Adherence to Quality Measures for Adults with Crohn's Disease.

Science.gov (United States)

Greene, Laurence; Sapir, Tamar; Moreo, Kathleen; Carter, Jeffrey D; Patel, Barry; Higgins, Peter D R

2015-09-01

In recent years, leading organizations in inflammatory bowel disease (IBD) have developed quality measures for the care of adults with Crohn's disease or ulcerative colitis. We used chart audits to assess the impact of quality improvement educational activities on documented adherence to Physician Quality Reporting System measures for IBD. Twenty community-based gastroenterologists were recruited to participate in baseline chart audits (n = 200), a series of 4 accredited educational activities with feedback, and follow-up chart audits (n = 200). Trained abstractors reviewed randomly selected charts of adults with moderate or severe Crohn's disease. The charts were retrospectively abstracted for physicians' documented performance of the 2013 Physician Quality Reporting System IBD quality measures. We compared the physicians' baseline and posteducation rates of documented adherence with 10 of these measures. In a secondary analysis, we compared preeducation with posteducation difference scores of low-performing physicians, those whose baseline documentation rates were in the lowest quartile, and the rest of the cohort. At baseline, documentation of mean provider-level adherence to the 10 quality measures ranged from 3% to 98% (grand mean = 35.8%). In the overall analysis, baseline and posteducation rates of documented adherence did not differ significantly for any of the measures. However, for 4 measures, preeducation to posteducation difference scores were significantly greater among low performers than physicians in the highest 3 quartiles. The results of this preliminary pragmatic study indicate that quality improvement education affords the potential to improve adherence to Physician Quality Reporting System quality measures for IBD among low-performing gastroenterologists.

Adherence to Canadian C-Spine Rule in a regional hospital: a retrospective study of 406 cases.

Science.gov (United States)

Paxton, Mark; Heal, Clare F; Drobetz, Herwig

2012-10-01

Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule. This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography. Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography. Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure. © 2012 The Authors. Journal of Medical Imaging and Radiation Oncology © 2012 The Royal Australian and New Zealand College of Radiologists.

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

'Screening audit' as a quality assurance tool in good clinical practice compliant research environments.

Science.gov (United States)

Park, Sinyoung; Nam, Chung Mo; Park, Sejung; Noh, Yang Hee; Ahn, Cho Rong; Yu, Wan Sun; Kim, Bo Kyung; Kim, Seung Min; Kim, Jin Seok; Rha, Sun Young

2018-04-25

With the growing amount of clinical research, regulations and research ethics are becoming more stringent. This trend introduces a need for quality assurance measures for ensuring adherence to research ethics and human research protection beyond Institutional Review Board approval. Audits, one of the most effective tools for assessing quality assurance, are measures used to evaluate Good Clinical Practice (GCP) and protocol compliance in clinical research. However, they are laborious, time consuming, and require expertise. Therefore, we developed a simple auditing process (a screening audit) and evaluated its feasibility and effectiveness. The screening audit was developed using a routine audit checklist based on the Severance Hospital's Human Research Protection Program policies and procedures. The measure includes 20 questions, and results are summarized in five categories of audit findings. We analyzed 462 studies that were reviewed by the Severance Hospital Human Research Protection Center between 2013 and 2017. We retrospectively analyzed research characteristics, reply rate, audit findings, associated factors and post-screening audit compliance, etc. RESULTS: Investigator reply rates gradually increased, except for the first year (73% → 26% → 53% → 49% → 55%). The studies were graded as "critical," "major," "minor," and "not a finding" (11.9, 39.0, 42.9, and 6.3%, respectively), based on findings and number of deficiencies. The auditors' decisions showed fair agreement with weighted kappa values of 0.316, 0.339, and 0.373. Low-risk level studies, single center studies, and non-phase clinical research showed more prevalent frequencies of being "major" or "critical" (p = 0.002, audit grade (p audit results of post-screening audit compliance checks in "non-responding" and "critical" studies upon applying the screening audit. Our screening audit is a simple and effective way to assess overall GCP compliance by institutions and to

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...

[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.

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...

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

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.

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)

Fractional smith chart theory

KAUST Repository

Shamim, Atif

2011-03-01

For the first time, a generalized Smith chart is introduced here to represent fractional order circuit elements. It is shown that the standard Smith chart is a special case of the generalized fractional order Smith chart. With illustrations drawn for both the conventional integer based lumped elements and the fractional elements, a graphical technique supported by the analytical method is presented to plot impedances on the fractional Smith chart. The concept is then applied towards impedance matching networks, where the fractional approach proves to be much more versatile and results in a single element matching network for a complex load as compared to the two elements in the conventional approach. © 2010 IEEE.

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

Audit of referrals for concern regarding labial appearance at the Royal Children's Hospital: 2000-2012.

Science.gov (United States)

McQuillan, Sarah K; Jayasinghe, Yasmin; Grover, Sonia R

2018-04-01

To audit the clinical features and outcomes for all patients referred to our centre with concerns regarding labial appearance. Young females referred to a paediatric/adolescent gynaecology tertiary centre between 2000 and 2012 with concerns regarding their labial appearance were retrospectively identified. Adolescents presenting with anomalies were excluded. Retrospective chart review was undertaken to identify reasons for referral, patient characteristics, outcome of referral and concurrent health problems. In total, 46 females presenting with concerns about labial appearance were identified. Five were excluded. Median age of the study population was 14.5 years (range 5-21 years). Only four (9.8%) underwent surgery after a minimum of five consultations each, with mental health review in three of four cases prior to surgery. None of the 41 patients had documented abnormal labia; however, 6 patients had asymmetry, and 3 had a labial width of >5 cm. Of mothers, 24% (n = 10) raised the initial concern regarding labial appearance to a physician, of whom, 50% of patients had a comorbid condition. In total, 70.7% initially reported interference with daily activities, and 87.8% were reassured following discussion. With appropriate education and counselling, the majority of girls with concerns regarding labial appearance can be managed without surgery. Overall, our data support current international policy that female cosmetic genital surgery not be performed in mature minors unless there are specific indications. More research about characteristics of patients referred with labial concerns, definition of labial size and long-term satisfaction of conservative versus surgical methods is necessary to determine the best approach. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Impact of audit and feedback and pay-for-performance interventions on pediatric hospitalist discharge communication with primary care providers.

Science.gov (United States)

Tejedor-Sojo, Javier; Creek, Tracy; Leong, Traci

2015-01-01

The study team sought to improve hospitalist communication with primary care providers (PCPs) at discharge through interventions consisting of (a) audit and feedback and (b) inclusion of a discharge communication measure in the incentive compensation for pediatric hospitalists. The setting was a 16-physician pediatric hospitalist group within a tertiary pediatric hospital. Discharge summaries were selected randomly for documentation of communication with PCPs. At baseline, 57% of charts had documented communication with PCPs, increasing to 84% during the audit and feedback period. Following the addition of a financial incentive, documentation of communication with PCPs increased to 93% and was sustained during the combined intervention period. The number of physicians meeting the study's performance goal increased from 1 to 14 by the end of the study period. A financial incentive coupled with an audit and feedback tool was effective at modifying physician behavior, achieving focused, measurable quality improvement gains. © 2014 by the American College of Medical Quality.

INIS: Terminology charts

Energy Technology Data Exchange (ETDEWEB)

NONE

1970-08-01

This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

INIS: Terminology charts

International Nuclear Information System (INIS)

1970-08-01

This document is one in a series of publications known as the INIS Reference Series. It is to be used in conjunction with the INIS indexing manual and the INIS thesaurus for the preparation of input to the INIS database. The thesaurus and terminology charts in their first edition (Rev.0) were produced as the result of an agreement between the International Atomic Energy Agency (IAEA) and the European Atomic Energy Community (Euratom). Except for minor changes the terminology and the interrelationships between terms are those of the December 1969 edition of the Euratom Thesaurus. The purpose of the terminology harts is to display the descriptors of the thesaurus in the context of their hierarchical and other semantic relationships. Hierarchically related terms are grouped in clusters, each representing one of the principal concepts of a subject field. The descriptors are grouped around or under the broadest term of the clusters which is printed in upper case. The hierarchical relationships within the clusters are shown by the arrangement of the terms in smaller boxes within the larger boxes circumscribing the clusters. The clusters are connected by lines of various thickness, representing the other (mostly non-hierarchical) relationships. These connections are the equivalent to 'see also' and 'related term' cross-references. The thickness of the lines represents the strength of the semantic relations, or, in the practice of a retrieval system the probability that one term replacing a connected term in a query, will still yield pertinent references. The figures accompanying the descriptors represent their frequency of assignment to the first 987,000 documents stored in the Euratom system (May 1970). They are presented in order to show the relative importance of the descriptors within the subject field. The asterisks (*) accompanying descriptors in the charts refer to descriptors, for which a scope note can be found in the INIS: Thesaurus at the time the charts went

A retrospective chart review to assess the safety of nonablative fractional laser resurfacing in Fitzpatrick skin types IV to VI.

Science.gov (United States)

Clark, Charlotte M; Silverberg, Jonathan I; Alexis, Andrew F

2013-04-01

Laser resurfacing in patients with Fitzpatrick skin phototypes (SPT) IV to VI is associated with a higher risk of pigmentary alteration. There is a paucity of studies evaluating optimum treatment parameters for fractional lasers in darkly pigmented skin types. This is a retrospective review of medical records for patients with SPT IV to VI who were treated with a 1,550 nm erbium-doped fractional nonablative laser (Fraxel Re:Store SR 1550; Solta Medical, Hayword, CA). Data were collected from patient charts and the clinic laser logbook from January 2008 to January 2012. The frequency of treatment-associated postinflammatory hyperpigmentation (PIH) and treatment settings used were evaluated. A total of 115 total laser sessions (45 patients) were included in our analysis. Five of the sessions (4%) were accompanied by PIH, 2 of which occurred in a single patient. Only 1 episode of PIH lasted longer than 1 month (2 months). Two of the 5 cases had only transient PIH (≤7 days), one of which was reported by the patient and not clinically evident on examination. The 1,550 nm erbium-doped fractional laser is well tolerated in SPT IV to VI. Fractional laser resurfacing, with the settings used and pretreatment and posttreatment hydroquinone 4% cream, was associated with a low risk of PIH in darker skin types.

A Retrospective Chart Review of Two Different Insulin Administration Systems on Glycemic Control in Older Adults in Long-Term Care.

Science.gov (United States)

Boonin, Alan; Balinski, Brenda; Sauter, Jerry; Martinez, Joe; Abbott, Scott

2017-01-01

The current retrospective chart review compared glycemic control and cost impact of two insulin administration systems, V-Go ® versus usual care with standard of care (SOC) insulin injections, in eight patients residing in a nursing home (NH). A total of 1,937 blood glucose (BG) values were collected over 61 days. Significant improvements were observed for the V-Go versus SOC group in time in range 100 mg/dL to 200 mg/dL (V-Go 59.09% vs. SOC 34.02%; p < 0.001), reduced BG fluctuations as measured by standard deviation (V-Go 61.2 vs. SOC 92.1; p < 0.001), and improved mean daily BG (V-Go 159.38 mg/dL vs. SOC 223.86 mg/dL; p < 0.001). The estimated A1c change, calculated from BG values, decreased from 8.9% to 7.2% in the V-Go group and increased from 9.0% to 9.4% in the SOC group. Compared to SOC, use of V-Go decreased the mean time for insulin administration by nursing staff by 26.3 minutes per patient per day and associated labor costs by $328.75 per patient per month. Insulin administration with V-Go may improve glycemic control and reduce administration costs compared to existing care in the NH setting. [Journal of Gerontological Nursing, 43(1), 10-16.]. Copyright 2017, SLACK Incorporated.

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.

Antiepileptic drug use and the occurrence of pressure ulcers among bedridden institutionalized elderly patients: a retrospective chart review.

Science.gov (United States)

Arinzon, Zeev; Zeilig, Gabriel; Berner, Yitshal N; Adunsky, Abraham

2005-09-01

Phenytoin (PH) is indicated primarily for the control of grand mal and psychomotor seizures. However, topical PH has been used for the treatment of various types of ulcers, including pressure ulcers. The aim of this study was to investigate the possibility of a relationship between the use of oral PH and the prevalence of pressure ulcers among bedridden institutionalized elderly patients. This retrospective chart review was conducted in a state-run urban geriatric medical center in Israel and involved long-term bedridden institutionalized patients who were receiving chronic antiepileptic medication during the 7-year period between January 1996 and December 2003. The prevalence of pressure ulcers in patients who received treatment with PH alone or in combination with other antiepileptic drugs was compared with that in patients who received antiepileptic agents other than PH. The study analyzed data from the medical charts of 153 patients, 72 of whom received PH alone or in combination with other antiepileptic drugs, and 81 of whom received antiepileptic agents other than PH. Patients' mean (SD) age was 78.5 (7.2) years; 106 (69.3%) were women. All patients were totally dependent with respect to activities of daily living (mean Katz score, 2.0 [2.0]) and had severe cognitive decline (mean Mini-Mental State Examination score, 3.5 [3.3]). Pressure ulcers occurred in 9.7% of PH recipients and 27.2% of non-PH recipients (P = 0.006; chi2 = 7.55). In PH recipients, 85.7% of pressure ulcers were of mild to moderate severity (stage I or II), compared with 59.1% of ulcers in non-PH recipients; the difference between groups was not statistically significant. Four (18.2%) non-PH recipients and no PH recipients had stage IV pressure ulcers. In the PH group, 71.4% of patients had a pressure ulcer in only 1 anatomic location, compared with 22.7% of the non-PH group (P = 0.023; chi2 = 5.13); 28.6% of PH recipients and 63.6% of non-PH recipients had pressure ulcers in 2 or 3

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.

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.

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 ...

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.

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.

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.

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,

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.

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

WWW chart of the nuclides

International Nuclear Information System (INIS)

Huang Xiaolong; Zhou Chunmei; Zhuang Youxiang; Zhao Zhixiang; Golashvili, T.V.; Chechev, V.P.

2000-01-01

WWW chart of the nuclides was established on the basis of the latest evaluations of nuclear structure and decay data. By viewing WWW chart of the nuclides, one can retrieve the fundamental data of nuclide such as atomic mass, abundance, spin and parity; the decay mode, branching ratio, half-life and Q-value of radioactive nuclide, energy and intensity of strong γ-ray, etc. The URL (Uniform Resource Locator) of WWW chart of the nuclides is: http://myhome.py.gd.cn/chart/index,asp

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.

Victorian Audit of Surgical Mortality is associated with improved clinical outcomes.

Science.gov (United States)

Beiles, C Barry; Retegan, Claudia; Maddern, Guy J

2015-11-01

Improved outcomes are desirable results of clinical audit. The aim of this study was to use data from the Victorian Audit of Surgical Mortality (VASM) and the Victorian Admitted Episodes Dataset (VAED) to highlight specific areas of clinical improvement and reduction in mortality over the duration of the audit process. This study used retrospective, observational data from VASM and VAED. VASM data were reported by participating public and private health services, the Coroner and self-reporting surgeons across Victoria. Aggregated VAED data were supplied by the Victorian Department of Health. Assessment of outcomes was performed using chi-squared trend analysis over successive annual audit periods. Because initial collection of data was incomplete in the recruitment phase, statistical analysis was confined to the last 3-year period, 2010-2013. A 20% reduction in surgical mortality over the past 5 years has been identified from the VAED data. Progressive increase in both surgeon and hospital participation, significant reduction in both errors in management as perceived by assessors and increased direct consultant involvement in cases returned to theatre have been documented. The benefits of VASM are reflected in the association with a reduction of mortality and adverse clinical outcomes, which have clinical and financial benefits. It is a purely educational exercise and continued participation in this audit will ensure the highest standards of surgical care in Australia. This also highlights the valuable collaboration between the Victorian Department of Health and the RACS. © 2014 Royal Australasian College of Surgeons.

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...

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.

A comparison of RANZCR and Singapore-designed radiation oncology practice audit instruments: how does reproducibility affect future approaches to revalidation

International Nuclear Information System (INIS)

Lu, Jiade J.; Wynne, Christopher J.; Kumar, Mahesh B.; Shakespeare, Thomas P.; Mukherjee, Rahul; Back, Michael F.

2004-01-01

Physician competency assessment requires the use of validated methods and instruments. The Royal Australian and New Zealand College of Radiologists (RANZCR) developed a draft audit form to be evaluated as a competency assessment instrument for radiation oncologists (ROs) in Australasia. We evaluated the reliability of the RANZCR instrument as well as a separate The Cancer Institute (TCI) Singapore-designed instrument by having two ROs perform an independent chart review of 80 randomly selected patients seen at The Cancer Institute (TCI), Singapore. Both RANZCR and TCI Singapore instruments were used to score each chart. Inter- and intra-observer reliability for both audit instruments were compared using misclassification rates as the primary end-point. Overall, for inter-observer reproducibility, 2.3% of TCI Singapore items were misclassified compared to 22.3% of RANZCR items (P < 0.0001, 100.00% confidence that TCI instrument has less inter-observer misclassification). For intra-observer reproducibility, 2.4% of TCI Singapore items were misclassified compared to 13.6% of RANZCR items (P < 0.0001, 100.00% confidence that TCI instrument has less intra-observer misclassification). The proposed RANZCR RO revalidation audit instrument requires further refinement to improve validity. Several items require modification or removal because of lack of reliability, whereas inclusion of other important and reproducible items can be incorporated as demonstrated by the TCI Singapore instrument. The TCI Singapore instrument also has the advantage of incorporating a simple scoring system and criticality index to allow discrimination between ROs and comparisons against future College standards Copyright (2004) Blackwell Publishing Asia Pty Ltd

Emetogenicity-risk procedures in same day surgery center of an academic university hospital in United States: a retrospective cost-audit of postoperative nausea vomiting management.

Science.gov (United States)

Gupta, Deepak; Haber, Halim

2014-06-01

Despite the variable results of published studies, it is imperative for ambulatory surgery centers to self-audit local cost-implications for post-operative nausea and vomiting (PONV) management. Our retrospective cost-audit assessed if there were comparative peri-anesthesia care cost-trends among patients who had undergone Low-Emetogenicity-Risk Procedures (LERP), Moderate-Emetogenicity-Risk Procedures (MERP) and Severe-Emetogenicity-Risk Procedures (SERP). This study was a review of Same Day Surgery Center practices in an academic university hospital setting during a three-year period (2010-2012). The patient lists were accessed from CIS and CITRIX App Bar for time audit and OR (operating room) schedule reports. Subsequently, OR pharmacy department ran a search for peri-operative anti-emetics and opioids that were billed for the patients at Same Day Surgery Center for the review period. The primary outcomes were the comparative costs/charges of these medications and comparative durations/ charges for these patients' stay in the post-anesthesia care unit (PACU). Secondary outcomes analyzed in the study included peri-anesthesia durations. A total of 8,657 patient records were analyzed. Almost all analyzed variables revealed statistically significant inter-variable positive correlations. The patients' age was significantly (P < 0.001) different among LERP/MERP/SERP patients (LERP: 48.8 +/- 14.7 years; MERP: 61.8 +/- 14.6 years; SERP: 51.3 +/- 14.5 years). In regards to primary and secondary outcomes, the statistical significant differences among LERP/MERP/SERP patients (after correcting for both patients' age as well as patients' sex) were only achieved for preoperative times (P = 0.002; Power = 0.9), operating room recovery times (P = 0.003; Power = 0.9), PACU stay times (P < 0.001; Power = 1.0), and PACU charges (P < 0.001; Power = 1.0). PACU stay times and PACU charges were significantly higher in patients who had undergone SERP as compared to patients who had

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.

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

Multivariate Statistical Process Control Charts: An Overview

OpenAIRE

Bersimis, Sotiris; Psarakis, Stelios; Panaretos, John

2006-01-01

In this paper we discuss the basic procedures for the implementation of multivariate statistical process control via control charting. Furthermore, we review multivariate extensions for all kinds of univariate control charts, such as multivariate Shewhart-type control charts, multivariate CUSUM control charts and multivariate EWMA control charts. In addition, we review unique procedures for the construction of multivariate control charts, based on multivariate statistical techniques such as p...

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...

The Implications of Diagnosis of Small for Gestational Age Fetuses Using European and South Asian Growth Charts: An Outcome-Based Comparative Study

Directory of Open Access Journals (Sweden)

Gianpaolo Maso

2014-01-01

Full Text Available The antenatal condition of small for gestational age (SGA is significantly associated with perinatal morbidity and mortality and it is known that there are significant differences in birth weight and fetal size among different populations. The aim of our study was to assess the impact on outcomes of the diagnosis of SGA according to Bangladeshi and European antenatal growth charts in Sri Lankan population. The estimated fetal weight before delivery was retrospectively reviewed according to Bangladeshi and European growth references. Three groups were identified: Group 1-SGA according to Bangladeshi growth chart; Group 2-SGA according to European growth chart but not having SGA according to Bangladeshi growth chart; Group 3-No SGA according to both charts. There was a difference in prevalence of SGA between Bangladeshi and European growth charts: 12.7% and 51.7%, respectively. There were statistically significant higher rates in emergency cesarean section, fetal distress in labour, and intrauterine death (P<0.001 in Group 1 compared with Group, 2 and 3. No differences of outcomes occurred between Groups 2 and 3. Our study demonstrated that only cases diagnosed as SGA according to population-based growth charts are at risk of adverse outcome. The use of inappropriate prenatal growth charts might lead to misdiagnosis and potential unnecessary interventions.

The Hill Chart Calculation for Pelton Runner Models using the HydroHillChart - Pelton Module Software

Directory of Open Access Journals (Sweden)

Adelina Bostan

2015-07-01

Full Text Available The Pelton turbines industrial design is based on the hill chart characteristics obtained by measuring the models. Primary data measurements used to obtain the hill chart can be processed graphically, by hand or by using graphic programs respectively CAD programs; the HydroHillChart - Pelton module software is a specialized tool in achieving the hill chart, using interpolation cubic spline functions. Thereby, based on measurements of several models of Pelton turbines, a computerized library, used to design industrial Pelton turbines can be created. The paper presents the universal characteristics calculated by using the HydroHillChart - Pelton module software for a series of Pelton runners.

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 ...

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

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.

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.

Audit of Orthopaedic Surgical Documentation

Directory of Open Access Journals (Sweden)

Fionn Coughlan

2015-01-01

Full Text Available Introduction. The Royal College of Surgeons in England published guidelines in 2008 outlining the information that should be documented at each surgery. St. James’s Hospital uses a standard operation sheet for all surgical procedures and these were examined to assess documentation standards. Objectives. To retrospectively audit the hand written orthopaedic operative notes according to established guidelines. Methods. A total of 63 operation notes over seven months were audited in terms of date and time of surgery, surgeon, procedure, elective or emergency indication, operative diagnosis, incision details, signature, closure details, tourniquet time, postop instructions, complications, prosthesis, and serial numbers. Results. A consultant performed 71.4% of procedures; however, 85.7% of the operative notes were written by the registrar. The date and time of surgery, name of surgeon, procedure name, and signature were documented in all cases. The operative diagnosis and postoperative instructions were frequently not documented in the designated location. Incision details were included in 81.7% and prosthesis details in only 30% while the tourniquet time was not documented in any. Conclusion. Completion and documentation of operative procedures were excellent in some areas; improvement is needed in documenting tourniquet time, prosthesis and incision details, and the location of operative diagnosis and postoperative instructions.

PILLARS OF THE AUDIT ACTIVITY: MATERIALITY AND AUDIT RISK

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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.

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...

A retrospective clinical audit of general practices in Australia to determine the motivation for switch to dolutegravir/abacavir/lamivudine and clinical outcomes.

Science.gov (United States)

Ferrer, Pedro E; Bloch, Mark; Roth, Norman; Finlayson, Robert; Baker, David; Koh, Ken; Orth, David; Urbaityte, Rimgaile; Brown, Dannae; Drummond, Fraser

2018-03-01

The most common reasons for switching HIV-1 therapy in patients with virologic suppression are treatment regimen simplification and resolving tolerability issues. Single-pill regimens that include an integrase inhibitor are recommended options. A retrospective clinical audit was performed to determine the motivations for switching to dolutegravir (DTG)/abacavir (ABC)/lamivudine (3TC) at high HIV-caseload general practice clinics in Australia. The most common reasons for switching from a prior suppressive therapy to DTG/ABC/3TC were simplification of regimen, resolving toxicity/intolerance and patient preference (73%, 13% and 12%, respectively). Kaplan-Meier analysis showed that the probability of patients remaining on DTG/ABC/3TC therapy at 12 months was 95.1%. Switching to DTG/ABC/3TC from a range of other regimens was associated with a discontinuation rate of 3.2%, with 2.5% of patients discontinuing due to adverse events and no patients discontinuing due to virologic failure. Switching to DTG/ABC/3TC was a viable treatment strategy in this cohort of Australian patients.

SMART AERONAUTICAL CHART MANAGEMENT SYSTEM DESIGN

Directory of Open Access Journals (Sweden)

M. E. Pakdil

2015-10-01

Full Text Available Civil aviation is developing rapidly, and the number of domestic and international operations is increasing exponentially every year than the previous one. Airline companies with increased air traffic and the number of passengers increase the demand of new aircrafts. An aircraft needs not only fuel but also pilot and aeronautical information (charts, digital navigation information, flight plan, and etc. to perform flight operation. One of the most important components in aeronautical information is the terminal chart. Authorized institution in every state is responsible to publish their terminal charts for certain periods. Although these charts are produced in accordance with ICAO’s Annex 4 and Annex 15, cartographic representation and page layout differs in each state’s publication. This situation makes difficult to read them by pilots. In this paper, standard instrument departure (SID charts are analysed to produce by use of cutting-edge and competitive technologies instead of classical computer-aided drawing and vector based graphic applications that are currently used by main chart producers. The goal is to design efficient and commercial chart management system that is able to produce aeronautical charts with same cartographic representation for all states.

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.

Improving patient safety through a clinical audit spiral: prevention of wrong tooth extraction in orthodontics.

Science.gov (United States)

Anwar, H; Waring, D

2017-07-07

Introduction With an increasing demand to improve patient safety within the NHS, it is important to ensure that measures are undertaken to continually improve patient care. Wrong site surgery has been defined as a 'never event'. This article highlights the importance of preventing wrong tooth extraction within orthodontics through an audit spiral over five years investigating the accuracy and clarity of orthodontic extraction letters at the University Dental Hospital of Manchester.Aims To examine compliance with the standards for accuracy and clarity of extraction letters and the incidence of wrong tooth extractions, and to increase awareness of the errors that can occur with extraction letters and of the current guidelines.Method A retrospective audit was conducted examining extraction letters sent to clinicians outside the department.Results It can be seen there has been no occurrence of a wrong site tooth extraction. The initial audit highlighted issues in conformity, with it falling below expected standards. Cycle two generally demonstrated a further reduction in compliance. Cycle three appeared to result in an increase in levels of compliance. Cycles 4 and 5 have demonstrated gradual improvements. However, it is noteworthy that in all cycles the audit standards were still not achieved, with the exception of no incidences of the incorrect tooth being extracted.Conclusion This audit spiral demonstrates the importance of long term re-audit to aim to achieve excellence in clinical care. There has been a gradual increase in standards through each audit.

Do clinicians assess patients' religiousness? An audit of an aged psychiatry community team.

Science.gov (United States)

Payman, Vahid; Lim, Zheng Jie

2018-03-01

To determine the frequency and quality of religious history taking of patients by clinicians working in an old age psychiatry service. A retrospective audit of 80 randomised patient files from the Koropiko Mental Health Services for Older People (MHSOP) in Middlemore Hospital, Auckland, New Zealand. A total of 66 clinical records were available for analysis. A religious history was taken in 33/66 (50%) patients. However, when such histories were evaluated using the FICA assessment tool, only 10/33 (30.3%) histories contained detailed information regarding the patient's religiousness. The infrequency and low quality of religious histories discovered in this audit suggest that clinicians need more training in taking a religious history from patients.

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...

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...

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

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...

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.

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 ...

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 .                                  

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.

[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.

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.

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...

Minimal adverse effects profile following implantation of periauricular percutaneous electrical nerve field stimulators: a retrospective cohort study

Directory of Open Access Journals (Sweden)

Roberts A

2016-11-01

Full Text Available Arthur Roberts,1–3 Alec Sithole,4 Marcos Sedghi,5 Charles A Walker,6,7 Theresa M Quinn,8 1Indiana Craniofacial Center, 2Department of Oral Pathology, Medicine and Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA; 3Department of Anesthesia, Critical Care, and Pain Management, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK; 4Department of Computer Science, Mathematics and Physics, Missouri Western State University, St Joseph, MO, 5Conservative Care Specialists Medical Group, Los Angeles, CA, 6Walker Pain Management Center, Jackson, TN, 7Bethel University, Paris, TN, 8Wisconsin Pain Solutions, Menomonee Falls, WI, USA Abstract: The periauricular percutaneous implantation of the Neuro-Stim System™ family of devices EAD, MFS, and BRIDGE is a procedure involving the use of a non-opiate, neuromodulation analgesic for relieving acute and chronic pain. It has been approved as a minimal-risk procedure by multiple governmental and institutional facilities. This retrospective report of findings will help quantify the incidence of clinically observed bleeding, localized dermatitis, and infections at the implantation sites of the electrode/needle arrays, dermatitis at the site of the generator, and patient syncope. A total of 1,207 devices, each producing up to 16 percutaneous punctures, for a total of 19,312 punctures were monitored for adverse effects, based on retrospective chart audits conducted at six clinical facilities over a 1-year period. Keywords: clinical risks and discomfort, percutaneous auricular neuro-stimulation, Neuro-Stim System™ devices, EAD, MFS, Bridge, neuromodulation, adverse effects

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

Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit

Energy Technology Data Exchange (ETDEWEB)

McCarty, M.; Waugh, R.; McCallum, H.; Montgomery, R.J.; Aszkenasy, O.M. [South Cleveland Hospital, Middlesbrough (United Kingdom)

2001-09-01

In 1996, there were local reports of poor gonad protection for paediatric pelvic radiographs. To investigate the nature of the problem and make necessary improvements. Materials and methods: A retrospective audit of 218 paediatric pelvic radiographs was undertaken in 1997. Each radiograph was assessed for the presence of a gonad shield, appropriateness of the device and its position. A multidisciplinary team was formed with representation from radiology, radiography, orthopaedics and medical physics to investigate ways of improving technique and reducing patient dose. These included radiographer training and the introduction of digital fluoroscopy as an alternative imaging technique in follow-up patients. There were further rounds of data collection in 1998 and 1999. In round 1, a gonad shield was present in 77.9 % of boys' films and 76 % of girls' films where one should have been, increasing to 85.2 % and 85.4 % respectively by round 3 of the audit (P < 0.05). Only 31.6 % of boys' devices and 21.9 % of girls' devices were correctly positioned in round 1, increasing to 78.3 % and 94.3 %, respectively, by round 3 of the audit (P < 0.05). After round 1, no inappropriate devices were used. Audit was an effective tool in gaining the resources needed to improve technique and reduce radiation exposure in children. The multidisciplinary approach was vital in the success of this project. (orig.)

Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit.

Science.gov (United States)

McCarty, M; Waugh, R; McCallum, H; Montgomery, R J; Aszkenasy, O M

2001-09-01

In 1996, there were local reports of poor gonad protection for paediatric pelvic radiographs. To investigate the nature of the problem and make necessary improvements. A retrospective audit of 218 paediatric pelvic radiographs was undertaken in 1997. Each radiograph was assessed for the presence of a gonad shield, appropriateness of the device and its position. A multidisciplinary team was formed with representation from radiology, radiography, orthopaedics and medical physics to investigate ways of improving technique and reducing patient dose. These included radiographer training and the introduction of digital fluoroscopy as an alternative imaging technique in follow-up patients. There were further rounds of data collection in 1998 and 1999. In round 1, a gonad shield was present in 77.9 % of boys' films and 76 % of girls' films where one should have been, increasing to 85.2 % and 85.4 % respectively by round 3 of the audit (P < 0.05). Only 31.6 % of boys' devices and 21.9 % of girls' devices were correctly positioned in round 1, increasing to 78.3 % and 94.3 %, respectively, by round 3 of the audit (P < 0.05). After round 1, no inappropriate devices were used. Audit was an effective tool in gaining the resources needed to improve technique and reduce radiation exposure in children. The multidisciplinary approach was vital in the success of this project.

Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit

International Nuclear Information System (INIS)

McCarty, M.; Waugh, R.; McCallum, H.; Montgomery, R.J.; Aszkenasy, O.M.

2001-01-01

In 1996, there were local reports of poor gonad protection for paediatric pelvic radiographs. To investigate the nature of the problem and make necessary improvements. Materials and methods: A retrospective audit of 218 paediatric pelvic radiographs was undertaken in 1997. Each radiograph was assessed for the presence of a gonad shield, appropriateness of the device and its position. A multidisciplinary team was formed with representation from radiology, radiography, orthopaedics and medical physics to investigate ways of improving technique and reducing patient dose. These included radiographer training and the introduction of digital fluoroscopy as an alternative imaging technique in follow-up patients. There were further rounds of data collection in 1998 and 1999. In round 1, a gonad shield was present in 77.9 % of boys' films and 76 % of girls' films where one should have been, increasing to 85.2 % and 85.4 % respectively by round 3 of the audit (P < 0.05). Only 31.6 % of boys' devices and 21.9 % of girls' devices were correctly positioned in round 1, increasing to 78.3 % and 94.3 %, respectively, by round 3 of the audit (P < 0.05). After round 1, no inappropriate devices were used. Audit was an effective tool in gaining the resources needed to improve technique and reduce radiation exposure in children. The multidisciplinary approach was vital in the success of this project. (orig.)

Control of control charts

NARCIS (Netherlands)

Sri Nurdiati, S.N.

2005-01-01

Although the Shewhart chart is widely used in practice because of its simplicity, applying this control chart to monitor the mean of a process may lead to two types of problems. The first concerns the typically unknown parameters involved in the distribution, while the second concerns the validity

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...

International chart of the nuclides. 2001

International Nuclear Information System (INIS)

Golashvili, T.V.; Kupriyanov, V.M.; Lbov, A.A.

2002-01-01

The International Chart of Nuclides - 2001 has been developed taking into account the data obtained in 1998-2001. Unlike widespread nuclide charts the present Chart of Nuclides contains EVALUATED values of the main characteristics. These values are supplied with the standard deviations. (author)

Shewhart control charts in new perspective

NARCIS (Netherlands)

Albers, Willem/Wim; Kallenberg, W.C.M.

2007-01-01

The effects of estimating parameters and the violation of the assumption of normality when dealing with control charts are discussed. Corrections for estimating errors and extensions of the normal control chart to parametric and nonparametric charts are investigated. The underlying theory is

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.

Influence of an independent quarterly audit on publicly reported vancomycin-resistant enterocococi bacteremia data in Ontario, Canada.

Science.gov (United States)

Prematunge, Chatura; Policarpio, Michelle E; Johnstone, Jennie; Adomako, Kwaku; Nadolny, Emily; Lam, Freda; Li, Ye; Brown, Kevin A; Garber, Gary

2018-04-13

All Ontario hospitals are mandated to self-report vancomycin-resistant enterocococi (VRE) bacteremias to Ontario's Ministry of Health and Long-term Care for public reporting purposes. Independent quarterly audits of publicly reported VRE bacteremias between September 2013 and June 2015 were carried out by Public Health Ontario. VRE bacteremia case-reporting errors between January 2009 and August 2013 were identified by a single retrospective audit. Employing a quasiexperimental pre-post study design, the relative risk of VRE bacteremia reporting errors before and after quarterly audits were modeled using Poisson regression adjusting for hospital type, case counts reported to the Ministry of Health and Long-term Care, and autocorrelation via generalized estimating equation. Overall, 24.5% (126 out of 514) of VRE bacteremias were reported in error; 114 out of 367 (31%) VRE bacteremias reported before quarterly audits and 12 out of 147 (8.1%) reported after audits were found to be incorrect. In adjusted analysis, quarterly audits of VRE bacteremias were associated with significant reductions in reporting errors when compared with before quarterly auditing (relative risk, 0.17; 95% confidence interval, 0.05-0.63). Risk of reporting errors among community hospitals were greater than acute teaching hospitals of the region (relative risk, 4.39; 95% CI, 3.07-5.70). This study found independent quarterly audits of publicly reported VRE bacteremias to be associated with significant reductions in reporting errors. Public reporting systems should consider adopting routine data audits and hospital-targeted training to improve data accuracy. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

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...

NNDC Chart of Nuclides

International Nuclear Information System (INIS)

Sonzogni, A.

2008-01-01

The National Nuclear Data Center has recently developed an interactive chart of nuclides, http://www.nndc.bnl.gov/chart/, that provides nuclear structure and decay data. Since its implementation, it has proven to be one of the most popular web products. The information presented is derived from the ENSDF and Nuclear Wallet Card databases. Experimentally known nuclides are represented by a cell in chart with the number of neutrons on the horizontal axis and the number of protons on the vertical axis. The color of the cell is used to indicate the ground state half-life or the ground state predominant decay mode. (author)

Flowcharting with D-charts

Science.gov (United States)

Meyer, D.

1985-01-01

A D-Chart is a style of flowchart using control symbols highly appropriate to modern structured programming languages. The intent of a D-Chart is to provide a clear and concise one-for-one mapping of control symbols to high-level language constructs for purposes of design and documentation. The notation lends itself to both high-level and code-level algorithmic description. The various issues that may arise when representing, in D-Chart style, algorithms expressed in the more popular high-level languages are addressed. In particular, the peculiarities of mapping control constructs for Ada, PASCAL, FORTRAN 77, C, PL/I, Jovial J73, HAL/S, and Algol are discussed.

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.

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...

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.

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.

National audit of the quality of pain relief provided in emergency departments in Aotearoa, New Zealand: The PRiZED 1 Study.

Science.gov (United States)

2017-04-01

Pain is a common feature of ED presentations and the timely provision of adequate analgesia is important for patient care. However, there is currently no New Zealand data with respect to this indicator of care quality. The present study aimed to provide a baseline for the quality of care with respect to the provision of timely and adequate analgesia in New Zealand EDs. The present study is a secondary analysis of data initially collected for the Shorter Stays in Emergency Department Study, using a retrospective chart review of 1685 randomly selected ED presentations (2006-2012) from 26 New Zealand public hospital EDs. Of the 1685 charts randomly selected, 1547 (91%) were reviewed from 21 EDs. There were 866 ED presentations with painful conditions, of whom 132 (15%) did not have pain recorded, 205 (24%) did not receive pain relief and 19 (2%) did not have time of analgesia documented leaving 510 (59%) for the analysis of time to analgesia. Four hundred and fifty-seven (53%) did not have pain well documented sufficiently to assess adequacy, leaving 277 (32%) for the analysis of adequacy of analgesia. The median (interquartile range) time to analgesia was 62 (30-134) min and the provision of adequate analgesia was 141/277 (51%, 95% CI: 45-57%); however, there was some variation between hospitals for both outcomes. Although these outcomes are on a par with other countries, this baseline audit has shown both poor documentation and variation in the provision of timely and adequate pain relief in New Zealand EDs, with room for improvement with respect to this quality indicator. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

How to work up a patient with polyneuropathy?

LENUS (Irish Health Repository)

Renganathan, R

2009-01-01

Undiagnosed and untreated neuropathy may lead to disability and poor quality of life. Ordering every possible test to find the cause of polyneuropathy can waste time and resources. In this study, we investigated what could be used as a routine neuropathy screen. A retrospective audit of all charts of patients diagnosed to have polyneuropathy by nerve conduction studies from November 2001 to November 2002 were carried out. Demographics, background history, type of neuropathy and investigations done were documented. The charts of 61 patients were audited. 12 patients had a background history of diabetes mellitus. 2 patients had history of alcohol abuse. 23 patients presented with paraesthesia and 33 with weakness of limbs. We found a cause of polyneuropathy in 79% of cases. In most patients with polyneuropathy where a cause can be identified, this can be achieved by the medical history, neurological examination, nerve conduction studies and the baseline blood tests. We suggest a 3-step approach to the diagnostic workup of polyneuropathy.

Post resuscitation management of cardiac arrest patients in the critical care environment: A retrospective audit of compliance with evidence based guidelines.

Science.gov (United States)

Milonas, Annabel; Hutchinson, Ana; Charlesworth, David; Doric, Andrea; Green, John; Considine, Julie

2017-11-01

There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation. A retrospective audit of medical records of patients who met the criteria for survivors of cardiac arrest was conducted at two health services in Melbourne, Australia. Criteria audited were: primary cardiac arrest characteristics, oxygenation and ventilation management, cardiovascular care, neurological care and patient outcomes. The four major findings were: (i) use of fraction of inspired oxygen (FiO 2 ) of 1.0 and hyperoxia was common during the first 24h of post resuscitation management, (ii) there was variability in cardiac care, with timely 12 lead Electrocardiograph and majority of patients achieving systolic blood pressure (SBP) greater than 100mmHg, but delays in transfer to cardiac catheterisation laboratory, (iii) neurological care was suboptimal with a high incidence of hyperglycaemia and failure to provide therapeutic hypothermia in almost 50% of patients and (iv) there was an association between in-hospital mortality and specific elements of post resuscitation care during the first 24h of hospital admission. Evidence-based context-specific guidelines for post resuscitation care that span the whole patient journey are needed. Reliance on national guidelines does not necessarily translate to evidence based care at a local level, so

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.

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...

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.

Audit of prenatal and postnatal diagnosis of isolated open spina bifida in three university hospitals in The Netherlands

NARCIS (Netherlands)

Olde Scholtenhuis, M. A. G.; Cohen-Overbeek, T. E.; Offringa, M.; Barth, P. G.; Stoutenbeek, Ph; Gooskens, R. H.; Wladimiroff, J. W.; Bilardo, C. M.

2003-01-01

Objective To audit the current Dutch policy of prenatal detection of isolated open spina bifida based on offering detailed ultrasound examination only on indication. Methods A retrospective analysis of prenatally diagnosed isolated spina bifida cases and of newborns diagnosed with this condition was

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.

How education changes clinical documentation in early pregnancy.

Science.gov (United States)

Ali, Fida; Higgins, Mary F

2016-05-01

The aim of this audit was to record medical history taking in the records of women attending with early pregnancy issues in order to assess the effect of training in this area. The medical education intervention comprised of a 30-min interactive tutorial. Retrospective chart review at three time points: pre education (July 2013, n = 45), immediately post-education (August 2013, n = 45) and longer term post-intervention (October 2013, n = 20). Pre-education, medical history was missing in 77.8% of charts compared to 13.4% immediately post-intervention and 10% long-term post-intervention (p Education in requirements for medical history taking can improve documentation.

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...

de Sitter relativity in static charts

Energy Technology Data Exchange (ETDEWEB)

Cotaescu, Ion I. [West University of Timisoara, Timisoara (Romania)

2018-02-15

The relative geodesic motion in static (and spherically symmetric) local charts on the (1 + 3)-dimensional de Sitter spacetimes is studied in terms of conserved quantities. The Lorentzian isometries are derived, relating the coordinates of the local chart of a fixed observer with the coordinates of a mobile chart considered as the rest frame of a massive particle freely moving on a timelike geodesic. The time dilation and Lorentz contraction are discussed pointing out some notable features of the de Sitter relativity in static charts. (orig.)

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.

On the Risk Management and Auditing of SOA Based Business Processes

Science.gov (United States)

Orriens, Bart; Heuvel, Willem-Jan V./D.; Papazoglou, Mike

SOA-enabled business processes stretch across many cooperating and coordinated systems, possibly crossing organizational boundaries, and technologies like XML and Web services are used for making system-to-system interactions commonplace. Business processes form the foundation for all organizations, and as such, are impacted by industry regulations. This requires organizations to review their business processes and ensure that they meet the compliance standards set forth in legislation. In this paper we sketch a SOA-based service risk management and auditing methodology including a compliance enforcement and verification system that assures verifiable business process compliance. This is done on the basis of a knowledge-based system that allows integration of internal control systems into business processes conform pre-defined compliance rules, monitor both the normal process behavior and those of the control systems during process execution, and log these behaviors to facilitate retrospective auditing.

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...

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...

Oswestry Disability Index scoring made easy.

Science.gov (United States)

Mehra, A; Baker, D; Disney, S; Pynsent, P B

2008-09-01

Low back pain effects up to 80% of the population at some time during their active life. Questionnaires are available to help measure pain and disability. The Oswestry Disability Index (ODI) is the most commonly used outcome measure for low back pain. The aim of this study was to see if training in completing the ODI forms improved the scoring accuracy. The last 100 ODI forms completed in a hospital's spinal clinic were reviewed retrospectively and errors in the scoring were identified. Staff members involved in scoring the questionnaire were made aware of the errors and the correct method of scoring explained. A chart was created with all possible scores to aid the staff with scoring. A prospective audit on 50 questionnaires was subsequently performed. The retrospective study showed that 33 of the 100 forms had been incorrectly scored. All questionnaires where one or more sections were not completed by the patient were incorrectly scored. A scoring chart was developed and staff training was implemented. This reduced the error rate to 14% in the prospective audit. Clinicians applying outcome measures should read the appropriate literature to ensure they understand the scoring system. Staff must then be given adequate training in the application of the questionnaires.

Software tool for physics chart checks.

Science.gov (United States)

Li, H Harold; Wu, Yu; Yang, Deshan; Mutic, Sasa

2014-01-01

Physics chart check has long been a central quality assurance (QC) measure in radiation oncology. The purpose of this work is to describe a software tool that aims to accomplish simplification, standardization, automation, and forced functions in the process. Nationally recognized guidelines, including American College of Radiology and American Society for Radiation Oncology guidelines and technical standards, and the American Association of Physicists in Medicine Task Group reports were identified, studied, and summarized. Meanwhile, the reported events related to physics chart check service were analyzed using an event reporting and learning system. A number of shortfalls in the chart check process were identified. To address these problems, a software tool was designed and developed under Microsoft. Net in C# to hardwire as many components as possible at each stage of the process. The software consists of the following 4 independent modules: (1) chart check management; (2) pretreatment and during treatment chart check assistant; (3) posttreatment chart check assistant; and (4) quarterly peer-review management. The users were a large group of physicists in the author's radiation oncology clinic. During over 1 year of use the tool has proven very helpful in chart checking management, communication, documentation, and maintaining consistency. The software tool presented in this work aims to assist physicists at each stage of the physics chart check process. The software tool is potentially useful for any radiation oncology clinics that are either in the process of pursuing or maintaining the American College of Radiology accreditation.

Cytopathology practice in Kumasi: A 2-year retrospective audit

Directory of Open Access Journals (Sweden)

Babatunde M Duduyemi

2017-01-01

Full Text Available Aim: Surgical pathology service is generally unavailable in most developing countries and comes with challenges. Cytopathology is a reliable, inexpensive adjunct to surgical histopathology. We present a retrospective review of the various cytopathology cases received at the department. Materials and Methods: A retrospective review of 836 cytopathology cases from January 2010 to December 2011 at the Department of Pathology of our hospital was conducted. All cytopathology reports and records from the department were retrieved and analyzed using the Statistical Package for the Social Sciences version 16 for windows. Results: A total of 836 (mean age 38.18 ± 22.18 cases were reviewed, at an average of approximately 418 cases performed a year (5.7% of the total workload. More than half (58.0% of the cases received had no clinical diagnosis indicated on request forms. Seventy-seven percent (77% of the cases were diagnosed as either definite or nondefinite. The breast was the most aspirated specimen site (20.2%. Benign cases formed 45.0% of all the cases and 29.0% were malignant. There were more benign than malignant cases with respect to all sites aspirated except the breast (18.3%, lymph nodes (35.0%, and soft tissues (11.7% where the reverse occurred. Conclusion: Patronage of cytopathology in Kumasi is increasing and serves as a quick, cheap, and effective alternate means for diagnosis. Improving and expanding on the current practice will ensure that pathologists in practice sustain and improve diagnostic cytopathology and provide material for training young pathologists.

Weighing Rain Gauge Recording Charts

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Weighing rain gauge charts record the amount of precipitation that falls at a given location. The vast majority of the Weighing Rain Gauge Recording Charts...

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.

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...

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...

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...

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.

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...

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...

Full Implementation of Screening for Nutritional Risk and Dysphagia in an Acute Stroke Unit: A Clinical Audit.

Science.gov (United States)

Kampman, Margitta T; Eltoft, Agnethe; Karaliute, Migle; Børvik, Margrethe T; Nilssen, Hugo; Rasmussen, Ida; Johnsen, Stein H

2015-10-01

In patients with acute stroke, undernutrition and aspiration pneumonia are associated with increased mortality and length of hospital stay. Formal screening for nutritional risk and dysphagia helps to ensure optimal nutritional management in all patients with stroke and to reduce the risk of aspiration in patients with dysphagia. We developed a national guideline for nutritional and dysphagia screening in acute stroke, which was introduced in our stroke unit on June 1, 2012. The primary objective was to audit adherence to the guideline and to achieve full implementation. Second, we assessed the prevalence of nutritional risk and dysphagia. We performed a chart review to assess performance of screening for nutritional risk and dysphagia in all patients with stroke hospitalized for ≥48 hours between June 1, 2012, and May 31, 2013. Next we applied a "clinical microsystems approach" with rapid improvement cycles and audits over a 6-month period to achieve full implementation. The chart review showed that nutritional risk screening was performed in 65% and swallow testing in 91% of eligible patients (n = 185). Proactive implementation resulted in >95% patients screened (n = 79). The overall prevalence of nutritional risk was 29%, and 23% of the patients failed the initial swallow test. Proactive implementation is required to obtain high screening rates for nutritional risk and swallowing difficulties using validated screening tools. The proportion of patients at nutritional risk and the prevalence of dysphagia at initial swallow test were in the lower range of previous reports.

NOAA Raster Navigational Charts (RNC)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — NOAA, National Ocean Service, Office of Coast Survey, Marine Chart Division is responsible to build and maintain a suite of more than 1000 nautical charts that are...

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.

Risk Oriented Audit Methodology’s Improvement, based on the Fraud Theory

Directory of Open Access Journals (Sweden)

Sergei V. Arzhenovskii

2016-12-01

Full Text Available Modern economic development is accompanied by the increasing complexity of the relationship structure, intercompany transactions, the requirements for information disclosure on the entity’s activities. It leads to the opportunities growth of fraudulent representation public companies reporting. The external audit is considered as an institution that resists to negative processes. The issues of improving the tools that assessing the risk of material misstatement of the financial statements due to fraud from the standpoint the fraud theory have been examined here. Determining potential areas in which methodology for risk assessment of material misstatement of the financial statements due to fraud in an audit are based on the modern fraud theory interpretations will be develop. Functional and structural, comparative, logical and historical, deductive and inductive analyst methods have been used. Retrospective analysis on research areas in the fraud theory field has been performed. Perspective directions for improving methodology and methods for risk assessment of material misstatement of the financial statements in an audit have been identified. Methodology development for fraud risk assessment procedures in an audit of financial statements is based on “fraud diamond” theory. Creating new interpretations the fraud theory during last fifteen years is a consequence the expansion opportunities for corporate fraud, one of the most common species which is the financial statements falsification. Changing the list of factors that could initiate the fraud in the company's public reporting requires that the methods of its identification during the audit should be improved. Methodology and methods risk assessment of intentional material misstatement of the financial statements need to be improved in the direction both the modern modification of fraud theory.

Construction and validation of a Tamil logMAR chart.

Science.gov (United States)

Varadharajan, Srinivasa; Srinivasan, Krithica; Kumaresan, Brindha

2009-09-01

To design, construct and validate a new Tamil logMAR visual acuity chart based on current recommendations. Ten Tamil letters of equal legibility were identified experimentally and were used in the chart. Two charts, one internally illuminated and one externally illuminated, were constructed for testing at 4 m distance. The repeatability of the two charts was tested. For validation, the two charts were compared with a standard English logMAR chart (ETDRS). When compared to the ETDRS chart, a difference of 0.06 +/- 0.07 and 0.07 +/- 0.07 logMAR was found for the internally and externally illuminated charts respectively. Limits of agreement between the internally illuminated Tamil logMAR chart and ETDRS chart were found to be (-0.08, 0.19), and (-0.07, 0.20) for the externally illuminated chart. The test - retest results showed a difference of 0.02 +/- 0.04 and 0.02 +/- 0.06 logMAR for the internally and externally illuminated charts respectively. Limits of agreement for repeated measurements for the internally illuminated Tamil logMAR chart were found to be (-0.06, 0.10), and (-0.10, 0.14) for the externally illuminated chart. The newly constructed Tamil logMAR charts have good repeatability. The difference in visual acuity scores between the newly constructed Tamil logMAR chart and the standard English logMAR chart was within acceptable limits. This new chart can be used for measuring visual acuity in the literate Tamil population.

Chart Series

Data.gov (United States)

U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) offers several different Chart Series with data on beneficiary health status, spending, operations, and quality...

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.

Can missed breast cancer be recognized by regular peer auditing on screening mammography?

Science.gov (United States)

Pan, Huay-Ben; Yang, Tsung-Lung; Hsu, Giu-Cheng; Chiang, Chia-Ling; Huang, Jer-Shyung; Chou, Chen-Pin; Wang, Yen-Chi; Liang, Huei-Lung; Lee, San-Kan; Chou, Yi-Hong; Wong, Kam-Fai

2012-09-01

This study was conducted to investigate whether detectable missed breast cancers could be distinguished from truly false negative images in a mammographic screening by a regular peer auditing. Between 2004 and 2007, a total of 311,193 free nationwide biennial mammographic screenings were performed for 50- to 69-year-old women in Taiwan. Retrospectively comparing the records in Taiwan's Cancer registry, 1283 cancers were detected (4.1 per 1000). Of the total, 176 (0.6 per 1000) initial mammographic negative assessments were reported to have cancers (128 traditional films and 48 laser-printed digital images). We selected 186 true negative films (138 traditional films and 48 laser-printed ones) as control group. These were seeded into 4815 films of 2008 images to be audited in 2009. Thirty-four auditors interpreted all the films in a single-blind, randomized, pair-control study. The performance of 34 auditors was analyzed by chi-square test. A p value of auditing should reduce the probability of missed cancers. 2012 Published by Elsevier B.V

A retrospective chart review to identify perinatal factors associated with food allergies.

Science.gov (United States)

Dowhower Karpa, Kelly; Paul, Ian M; Leckie, J Alexander; Shung, Sharon; Carkaci-Salli, Nurgul; Vrana, Kent E; Mauger, David; Fausnight, Tracy; Poger, Jennifer

2012-10-19

Gut flora are important immunomodulators that may be disrupted in individuals with atopic conditions. Probiotic bacteria have been suggested as therapeutic modalities to mitigate or prevent food allergic manifestations. We wished to investigate whether perinatal factors known to disrupt gut flora increase the risk of IgE-mediated food allergies. Birth records obtained from 192 healthy children and 99 children diagnosed with food allergies were reviewed retrospectively. Data pertaining to delivery method, perinatal antibiotic exposure, neonatal nursery environment, and maternal variables were recorded. Logistic regression analysis was used to assess the association between variables of interest and subsequent food allergy diagnosis. Retrospective investigation did not find perinatal antibiotics, NICU admission, or cesarean section to be associated with increased risk of food allergy diagnosis. However, associations between food allergy diagnosis and male gender (66 vs. 33; p=0.02) were apparent in this cohort. Additionally, increasing maternal age at delivery was significantly associated with food allergy diagnosis during childhood (OR, 1.05; 95% CI, 1.017 to 1.105; p=0.005). Gut flora are potent immunomodulators, but their overall contribution to immune maturation remains to be elucidated. Additional understanding of the interplay between immunologic, genetic, and environmental factors underlying food allergy development need to be clarified before probiotic therapeutic interventions can routinely be recommended for prevention or mitigation of food allergies. Such interventions may be well-suited in male infants and in infants born to older mothers.

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.

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.

Oversight Review: Quality Control Review of Naval Audit Service's Special Access Program Audits

National Research Council Canada - National Science Library

2005-01-01

.... The Government Auditing Standards (GAS) require that an audit organization performing audits and/or attestation engagements in accordance with GAS should have an appropriate internal quality control system in place and undergo an external...

Pengaruh Atribut Perusahaan dan Faktor Audit Terhadap Keterlambatan Audit pada Perusahaan yang Terdaftar di Bursa Efek Malaysia

Directory of Open Access Journals (Sweden)

Apriayanti Apriayanti

2014-01-01

Full Text Available Audit delay is interval of days between balance sheet date and audit report date. The purpose of this research is to analyze the effect of company attributes and audit factors to audit delay. This research uses 611 companies listed in Malaysian Stock Exchange from the period of 2006 until 2011 as sample. The independent variables used are size of the company, debt to equity ratio, profitability, subsidiaries of multinational companies, audit firm size, audit fees, industry type,  age of company, company financial year end, and audit opinion. The method of analysis in this research is multiple linear regressions. The results of this study shows that size of the company, debt to equity ratio, profitability, subsidiaries of multinational companies, audit firm size, audit fees, industry type, age of company, and audit opinion have significant influence on audit delay while financial year end does not have significant influence on audit delay.

Comparative effectiveness of everolimus-based therapy versus endocrine monotherapy among postmenopausal women with HR+/HER2- metastatic breast cancer: a retrospective chart review in community oncology practices in the US.

Science.gov (United States)

Xie, Jipan; Hao, Yanni; Li, Nanxin; Lin, Peggy L; Ohashi, Erika; Koo, Valerie; Signorovitch, James E; Wu, Eric Q; Yardley, Denise A

2015-06-01

Everolimus-based therapy and endocrine monotherapy are used among postmenopausal women with hormone receptor-positive human epidermal growth factor receptor-2 negative (HR+/HER2-) metastatic breast cancer (mBC) whose disease progressed or recurred on a non-steroidal aromatase inhibitor (NSAI). However, limited evidence exists regarding the real-world comparative effectiveness of these agents. This retrospective chart review examined postmenopausal HR+/HER2- mBC patients in community-based oncology practices who received everolimus-based therapy or endocrine monotherapy (index therapy) as any line of therapy for mBC between 1 July 2012 and 15 April 2013 after NSAI failure. Time on treatment (TOT), progression-free survival (PFS), and time to chemotherapy (TTC) from index therapy initiation were compared using Kaplan-Meier analyses and Cox proportional hazards models adjusting for baseline characteristics. A total of 243 and 270 patients received everolimus-based therapy or endocrine monotherapy in a quota-based sample. Patients treated with everolimus-based therapy had a higher proportion of visceral metastases, high tumor burden, and use of prior chemotherapies for mBC. After adjusting for baseline characteristics, everolimus-based therapy was associated with significantly longer TOT (HR = 0.67, 95% CI: 0.51-0.87) and PFS (HR = 0.75, 95% CI: 0.57-0.98) than endocrine monotherapy. No significant difference was found between everolimus-based therapy and endocrine monotherapy in TTC (HR = 0.81, 95% CI: 0.52-1.27). Results stratified by line of therapy were generally consistent with the overall results. Limitations include recall and information bias with potentially absent or erroneous chart data, unobserved factors due to non-randomization, inability to measure outcome assessments paired with measuring outcomes prior to exposures, and potential patient selection bias associated with chart review. Among a nationwide sample of postmenopausal HR+/HER2- m

7 CFR 1773.7 - Audit standards.

Science.gov (United States)

2010-01-01

... (CONTINUED) POLICY ON AUDITS OF RUS BORROWERS RUS Audit Requirements § 1773.7 Audit standards. (a) The audit must be performed in accordance with GAGAS and this part. The audit must be performed in accordance with GAGAS in effect at the audit date unless the borrower is directed otherwise, in writing, by RUS...

Management of spontaneous pneumothorax compared to British Thoracic Society (BTS) 2003 guidelines: a district general hospital audit.

Science.gov (United States)

Medford, Andrew Rl; Pepperell, Justin Ct

2007-10-01

In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. To determine adherence to the 2003 BTS SP guidelines in a district general hospital. An initial retrospective audit of 52 episodes of acute SP was performed. Subsequent intervention involved a junior doctor educational update on both the 2003 BTS guidelines and the initial audit results, and the setting up of an online guideline hyperlink. After the educational intervention a further prospective re-audit of 28 SP episodes was performed. Management of SP deviated considerably from the 2003 BTS guidelines in the initial audit - deviation rate 26.9%. After the intervention, a number of clinical management deviations persisted (32.1% deviation rate); these included failure to insert a chest drain despite unsuccessful aspiration, and attempting aspiration of symptomatic secondary SPs. Specific tools to improve standards might include a pneumothorax proforma to improve record keeping and a pneumothorax care pathway to reduce management deviations compared to BTS guidelines. Successful change also requires identification of the total target audience for any educational intervention.

Audit Internal Universitas X: Suatu Refleksi

Directory of Open Access Journals (Sweden)

David Adechandra Ashedica Pesudo

2017-04-01

  Penelitian ini bertujuan untuk menyediakan bukti empiris tentang dinamika beroperasinya fungsi audit internal dalam sebuah universitas swasta dengan mendeskripsikan berbagai faktor yang mempengaruhi keefektifan fungsi audit internal di sebuah universitas. Secara khusus, studi ini mendeskripsikan kondisi berbagai faktor yang mempengaruhi keefektifan fungsi audit internal dalam organisasi nirlaba yang diidentifikasi oleh Ahmad et al.., (2009 dalam suatu konteks organisasi sebuah universitas swasta. Studi ini menggunakan strategi penelitian studi kasus dengan menggunakan pendekatan kualitatif untuk menganalisis data. Wawancara mendalam dengan berbagai pihak yang memiliki pengetahuan tentang kegiatan audit internal di universitas yang menjadi studi kasus menjadi sumber utama data untuk studi ini.  Penelitian ini menunjukkan bahwa dinamika beroperasinya fungsi audit internal universitas swasta yang menjadi studi kasus dipengaruhi oleh berbagai faktor. Beroperasinya fungsi audit internal di organisasi dipengaruhi oleh sejumlah faktor yang bersifat mendukung  yaitu jumlah staf audit internal, kerjasama dari auditee, kompetensi/pengetahuan tentang teknik audit, tindakan pada temuan audit dan rekomendasi oleh auditee/manajemen, dan pengalaman audit. Sementara itu, sejumlah faktor bersifat tidak mendukung  bagi beroperasinya fungsi audit internal, yaitu komitmen dari manajemen puncak, pelatihan, independensi, perubahan dalam organisasi divisi audit internal, persepsi dari auditee terhadap fungsi audit internal, dan sumber daya.

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)

10 CFR 603.1295 - Periodic audit.

Science.gov (United States)

2010-01-01

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

Alternative Auditing Approaches

Energy Technology Data Exchange (ETDEWEB)

Kandt, Alicen J [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-09-15

This presentation for the 2017 Energy Exchange in Tampa, Florida, offers information about advanced auditing technologies and techniques including alternative auditing approaches and considerations and caveats.

KOMISARIS INDEPENDEN, KOMITE AUDIT, INTERNAL AUDIT DAN RISK MANAGEMENT COMMITTEE TERHADAP MANAJEMEN LABA

Directory of Open Access Journals (Sweden)

Nurika Restuningdiah

2017-03-01

Full Text Available The purpose of this research was to examine the impact of independency of board commisioner, audit committee,internal audit and risk management comittee to earning management. Regression Analysis of 35 publiccompanies listing in Indonesia Stock Exchange on year 2009 through a random sampling technique indicatedthat there was no significant impact of independency of board commisioner, audit committee, internal auditand risk management comittee to earning management. The implication of this study was relevant to thedecision maker of public companies to consider the skill and expertise of board commisioner, audit committe,internal audit and risk management comittee to support the internal corporate governance mechanism.

Radar Chart

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Radar Chart collection is an archived product of summarized radar data. The geographic coverage is the 48 contiguous states of the United States. These hourly...

The Impact Of Cloud Computing Technology On The Audit Process And The Audit Profession

Directory of Open Access Journals (Sweden)

Yati Nurhajati

2015-08-01

Full Text Available In the future cloud computing audits will become increasingly The use of that technology has influenced of the audit process and be a new challenge for both external and the Internal Auditors to understand IT and learn how to use cloud computing and cloud services that hire in cloud service provider CSP and considering the risks of cloud computing and how to audit cloud computing by risk based audit approach. The wide range of unique risks and depend on the type and model of the cloud solution the uniqueness of the client environmentand the specifics of data or an application make this an complicated subject. The internal audit function is well positioned through its role as a guarantor function of the organization to assist management and the board of the Committee to identify and consider the risks in using cloud computing technology for internal audit can help determine whether the risk has been managed appropriately in a cloud computing environment. Assesses the current impact of cloud computing technology on the audit process and discusses the implications of cloud computing future technological trends for the auditing profession . More specifically Provides a summary of how that information technology has impacted the audit framework.

Audit Report on the Sacramento Army Depot Internal Review and Audit Compliance Office's "Audits of Warranties, Quality Deficiency Reports, and Reports of Discrepancies"

National Research Council Canada - National Science Library

1992-01-01

The Sacramento Army Depot (SAAD) Internal Review and Audit Compliance Office (Internal Review) issued an audit report, "Audit of Warranties, Quality Deficiency Reports, and Reports of Discrepancies," on July 20, 1990...

Italian cardiovascular mortality charts of the CUORE project: are they comparable with the SCORE charts?

LENUS (Irish Health Repository)

Donfrancesco, Chiara

2010-08-01

The aim of this study was to build risk charts for the assessment of cardiovascular mortality of the CUORE project, an Italian longitudinal study, and to compare them with the systematic coronary risk evaluation (SCORE) project charts for low risk European countries.

The internal audit dilemma : The impact of executive directors versus audit committees on internal auditing work

NARCIS (Netherlands)

Eulerich, Marc; Henseler, Jörg; Koehler, Annette

2017-01-01

Purpose The purpose of this study is to analyze how internal audit function (IAF) activities differ, depending on the impact of executive boards (EBs) and audit committees (ACs). Design/methodology/approach This study is based on data collected from the Common Body of Knowledge (CBOK) study

Audits of radiopharmaceutical formulations

International Nuclear Information System (INIS)

Castronovo, F.P. Jr.

1992-01-01

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

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

Science.gov (United States)

Brooks, Keith; And Others

1979-01-01

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

Quantifying Dental Office-Originating Adverse Events: The Dental Practice Study Methods.

Science.gov (United States)

Tokede, Oluwabunmi; Walji, Muhammad; Ramoni, Rachel; Rindal, Donald B; Worley, Donald; Hebballi, Nutan; Kumar, Krishna; van Strien, Claire; Chen, Mengxia; Navat-Pelli, Shaked; Liu, Hongchun; Etolue, Jini; Yansane, Alfa; Obadan-Udoh, Enihomo; Easterday, Casey; Enstad, Chris; Kane, Sheryl; Rush, William; Kalenderian, Elsbeth

2017-12-05

Preventable medical errors in hospital settings are the third leading cause of deaths in the United States. However, less is known about harm that occurs in patients in outpatient settings, where the majority of care is delivered. We do not know the likelihood that a patient sitting in a dentist chair will experience harm. Additionally, we do not know if patients of certain race, age, sex, or socioeconomic status disproportionately experience iatrogenic harm. We initiated the Dental Practice Study (DPS) with the aim of determining the frequency and types of adverse events (AEs) that occur in dentistry on the basis of retrospective chart audit. This article discusses the 6-month pilot phase of the DPS during which we explored the feasibility and efficiency of our multistaged review process to detect AEs. At sites 1, 2, and 3, respectively, 2 reviewers abstracted 21, 11, and 23 probable AEs, respectively, from the 100 patient charts audited per site. At site 2, a third reviewer audited the same 100 charts and found only 1 additional probable AE. Of the total 56 probable AEs (from 300 charts), the expert panel confirmed 9 AE cases. This equals 3 AEs per 100 patients per year. Patients who experienced an AE tended to be male and older and to have undergone more procedures within the study year. This article presents an overview of the DPS. It describes the methods used and summarizes the results of its pilot phase. To minimize threats to dental patient safety, a starting point is to understand their basic epidemiology, both in terms of their frequency and the extent to which they affect different populations.

Audit of co-management and critical care outreach for high risk postoperative patients (The POST audit).

Science.gov (United States)

Story, D A; Shelton, A; Jones, D; Heland, M; Belomo, R

2013-11-01

Co-management and critical care outreach for high risk surgical patients have been proposed to decrease postoperative complications and mortality. We proposed that a clinical project with postoperative comanagement and critical care outreach, the Post Operative Surveillance Team: (POST), would be associated with decreased hospital length of stay. We conducted a retrospective before (control group) and after (POST group) audit of this hospital program. POST was staffed for four months in 2010 by two intensive care nurses and two senior registrars who conducted daily ward rounds for the first five postoperative days on high risk patients undergoing inpatient general or urological surgery. The primary endpoint was length of hospital stay and secondary endpoints were Medical Emergency Team (MET) calls, cardiac arrests and in-hospital mortality. There were 194 patients in the POST group and 1,185 in the control group. The length of stay in the POST group, median nine days (Inter-quartile range [IQR]: 5 to 17 days), was longer than the control group, median seven days (IQR: 4 to 13 days): difference two days longer (95.0% confidence interval [95.0% CI]: 1 to 3 days longer, P audit found that the POST service was not associated with reduced length of stay. Models of co-management, different to POST, or with different performance metrics, could be tested.

Growth charts of human development

NARCIS (Netherlands)

Van Buuren, Stef

2014-01-01

This article reviews and compares two types of growth charts for tracking human development over age. Both charts assume the existence of a continuous latent variable, but relate to the observed data in different ways. The D-score diagram summarizes developmental indicators into a single aggregate

The Conjugate Acid-Base Chart.

Science.gov (United States)

Treptow, Richard S.

1986-01-01

Discusses the difficulties that beginning chemistry students have in understanding acid-base chemistry. Describes the use of conjugate acid-base charts in helping students visualize the conjugate relationship. Addresses chart construction, metal ions, buffers and pH titrations, and the organic functional groups and nonaqueous solvents. (TW)

Using the AUDIT-PC to predict alcohol withdrawal in hospitalized patients.

Science.gov (United States)

Pecoraro, Anna; Ewen, Edward; Horton, Terry; Mooney, Ruth; Kolm, Paul; McGraw, Patty; Woody, George

2014-01-01

Alcohol withdrawal syndrome (AWS) occurs when alcohol-dependent individuals abruptly reduce or stop drinking. Hospitalized alcohol-dependent patients are at risk. Hospitals need a validated screening tool to assess withdrawal risk, but no validated tools are currently available. To examine the admission Alcohol Use Disorders Identification Test-(Piccinelli) Consumption (AUDIT-PC) ability to predict the subsequent development of AWS among hospitalized medical-surgical patients admitted to a non-intensive care setting. Retrospective case–control study of patients discharged from the hospital with a diagnosis of AWS. All patients with AWS were classified as presenting with AWS or developing AWS later during admission. Patients admitted to an intensive care setting and those missing AUDIT-PC scores were excluded from analysis. A hierarchical (by hospital unit) logistic regression was performed and receiver-operating characteristics were examined on those developing AWS after admission and randomly selected controls. Because those diagnosing AWS were not blinded to the AUDIT-PC scores, a sensitivity analysis was performed. The study cohort included all patients age ≥18 years admitted to any medical or surgical units in a single health care system from 6 October 2009 to 7 October 2010. After exclusions, 414 patients were identified with AWS. The 223 (53.9 %) who developed AWS after admission were compared to 466 randomly selected controls without AWS. An AUDIT-PC score ≥4 at admission provides 91.0 % sensitivity and 89.7 % specificity (AUC=0.95; 95 % CI, 0.94–0.97) for AWS, and maximizes the correct classification while resulting in 17 false positives for every true positive identified. Performance remained excellent on sensitivity analysis (AUC=0.92; 95 % CI, 0.90–0.93). Increasing AUDIT-PC scores were associated with an increased risk of AWS (OR=1.68, 95 % CI 1.55–1.82, pAUDIT-PC score is an excellent discriminator of AWS and could be an important component

20 CFR 655.180 - Audit.

Science.gov (United States)

2010-04-01

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

Caesarean section audit to improve quality of care in a rural referral hospital in Tanzania.

Science.gov (United States)

Dekker, Luuk; Houtzager, Tessa; Kilume, Omary; Horogo, John; van Roosmalen, Jos; Nyamtema, Angelo Sadock

2018-05-15

Caesarean section (CS) is often a life-saving procedure, but can also lead to serious complications, even more so in low-resource settings. Therefore unnecessary CS should be avoided and optimal circumstances for vaginal delivery should be created. In this study, we aim to audit indications for Caesarean sections and improve decision-making and obstetric management. Audit of all cases of CS performed from January to August 2013 was performed in a rural referral hospital in Tanzania. The study period was divided in three audit blocks; retrospective (before auditing), prospective 1 and prospective 2. A local audit panel (LP) and an external auditor (EA) judged if obstetric management was adequate and indications were appropriate or if CS could have been prevented and yet retain good pregnancy outcome. Furthermore, changes in modes of deliveries, overall pregnancy outcome and decision-to-delivery interval were monitored. During the study period there were 1868 deliveries. Of these, 403 (21.6%) were Caesarean sections. The proportions of unjustified CS prior to introduction of audit were as high as 34 and 75%, according to the respective judgments of LP and EA. Following introduction of audit, the proportions of unjustified CS decreased to 23% (p = 0.29) and 52% (p = 0.01) according to LP and EA respectively. However, CS rate did not change (20.2 to 21.7%), assisted vacuum delivery rate did not increase (3.9 to 1.8%) and median decision-to-delivery interval was 83 min (range 10 - 390 min). Although this is a single center study, these findings suggest that unnecessary Caesarean sections exist at an alarming rate even in referral hospitals and suggest that a vast number can be averted by introducing a focused CS audit system. Our findings indicate that CS audit is a useful tool and, if well implemented, can enhance rational use of resources, improve decision-making and harmonise practice among care providers.

Auditing fetal nasal bone images in the first trimester of pregnancy: results from a peer review program.

Science.gov (United States)

Palermo, Fernanda Gasparin; Albuquerque, Débora de Paula Soares de Medeiros; Martins, Wellington P; Araujo Júnior, Edward; Bruns, Rafael Frederico

2016-09-01

To establish a structured review process to facilitate the identification of the fetal nasal bone (NB) in the first trimester ultrasound scan to improve the quality images. We conducted a retrospective observational study in fetal NB images obtained during ultrasound exams of singleton pregnancies that underwent first trimester screening (crown-rump length 45-84 mm). When the images were obtained the examiner was not aware of the study. Audit was conducted by an examiner according criteria established by the Fetal Medicine Foundation. Fetal NB images were assessed regarding adequate magnification, mid-sagittal view and transducer held parallel to the direction of the nose. The transvaginal and transabdominal as well as anterior and posterior fetal back groups were compared using χ(2) test. We considered 874 fetal NB images for auditing. Fetal NB was considered present in 865 images (99%). During the audit process, we identified 72 (8.2%) cases of disagreement between examiner and auditor assessments. Disagreement was higher when image quality was poor (62 cases = 7%). Transvaginal approach performed better in the following criteria: adequate magnification (p audit program for fetal NB is feasible in a clinical scenario. Image quality appears to play an important role in compliance to image standards audited and in agreement between examiner and auditor.

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

28 CFR 33.51 - Audit.

Science.gov (United States)

2010-07-01

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

Complex logistics audit system

Directory of Open Access Journals (Sweden)

Zuzana Marková

2010-02-01

Full Text Available Complex logistics audit system is a tool for realization of logistical audit in the company. The current methods for logistics auditare based on “ad hok” analysis of logisticsl system. This paper describes system for complex logistics audit. It is a global diagnosticsof logistics processes and functions of enterprise. The goal of logistics audit is to provide comparative documentation for managementabout state of logistics in company and to show the potential of logistics changes in order to achieve more effective companyperformance.

CONVERGENCE OF INTERNATIONAL AUDIT STANDARDS AND AMERICAN AUDIT STANDARDS REGARDING SAMPLING

OpenAIRE

Chis Anca Oana; Danescu Tatiana

2013-01-01

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 ...

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.

Audit Management System

CERN Document Server

Alconada, Federico

2015-01-01

In the need of renewing their system, the Internal Audit department has given a proposal for building a new one. Taking into consideration the problems of their system they elaborated a requirement's list with the functionalities and features they were expecting from the new management system. This new system would be primarily for the use of the Internal Audit staff but it would also support the follow-up of internal audit recommendations by potentially all CERN staff members.

A Review on Audit Quality Factors

OpenAIRE

Hosseinniakani, Seyed; Inácio, Coelho Helena; Mota, Rui

2014-01-01

“Audit Quality” is not easy to define because of many diverse factors affecting quality. According to the consultation paper of the International Auditing and Assurance Standards Board (IAASB), audit quality is the significant issue that requires more considerable attention. Understanding how audit quality is important requires investigating audit quality factors more precisely. So, the present article aims to review and summarize the different audit quality factors, comparing the results ach...

Oversight Review: Quality Control Review of Air Force Audit Agency's Special Access Program Audits

National Research Council Canada - National Science Library

2005-01-01

.... The Government Auditing Standards (GAS) require that an audit organization performing audits and/or attestation engagements in accordance with GAS should have an appropriate internal quality control system in place and undergo an external...

24 CFR 236.901 - Audit.

Science.gov (United States)

2010-04-01

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

Management of eight labor and delivery patients dependent on buprenorphine (Subutex™: A retrospective chart review [version 2; referees: 2 approved

Directory of Open Access Journals (Sweden)

Solina Tith

2018-02-01

Full Text Available Background: Opioid use during pregnancy is a growing concern in the United States. Buprenorphine has been recommended by “The American College of Obstetrics and Gynecology” as an alternative to methadone to decrease risks associated with the use of illicit opioids during pregnancy. The partial μ-opioid agonists’ unique pharmacology, including its long half time and high affinity to the μ-opioid receptor, complicates patient management in a highly kinetic, and often urgent field like obstetric anesthesia. We reviewed our management and outcomes in this medically complex population. Methods: An Institutional Review Board (IRB approved retrospective chart review was conducted of women admitted to the University of Washington Medical Center Labor and Delivery unit from July 2012 to November 2013 using buprenorphine. All deliveries, including intrauterine fetal demise, were included. Results: Eight women were admitted during this period to our L&D floor on buprenorphine. All required peri-partum anesthetic management either for labor and/or cesarean delivery management. Analgesic management included dilaudid or fentanyl PCA and/or continued epidural infusion, and in one instance ketamine infusion, while the pre-admission buprenorphine regimen was continued. Five babies were viable, two women experienced intrauterine fetal death at 22 and 36 weeks gestational age (GSA, respectively, and one neonate died shortly after delivery due to a congenital diaphragmatic hernia. Conclusions: This case series illuminates the medical complexity of parturients using buprenorphine. Different treatment modalities in the absence of evidence-based guidelines included additional opioid administration and continued epidural analgesia. The management of post-cesarean pain in patients on partial μ-opioid agonists remains complex and variable, and evidence-based guidelines could be useful for clinicians to direct care.

Fuzzy audit risk modeling algorithm

Directory of Open Access Journals (Sweden)

Zohreh Hajihaa

2011-07-01

Full Text Available Fuzzy logic has created suitable mathematics for making decisions in uncertain environments including professional judgments. One of the situations is to assess auditee risks. During recent years, risk based audit (RBA has been regarded as one of the main tools to fight against fraud. The main issue in RBA is to determine the overall audit risk an auditor accepts, which impact the efficiency of an audit. The primary objective of this research is to redesign the audit risk model (ARM proposed by auditing standards. The proposed model of this paper uses fuzzy inference systems (FIS based on the judgments of audit experts. The implementation of proposed fuzzy technique uses triangular fuzzy numbers to express the inputs and Mamdani method along with center of gravity are incorporated for defuzzification. The proposed model uses three FISs for audit, inherent and control risks, and there are five levels of linguistic variables for outputs. FISs include 25, 25 and 81 rules of if-then respectively and officials of Iranian audit experts confirm all the rules.

Pengaruh Audit Quality, Audit Tenure, Audit Report Lag, dan Profitabilitas terhadap Opini Audit Going Concern pada Perusahaan Manufaktur yang Terdaftar di Bursa Efek Indonesia Periode 2010-2013

OpenAIRE

Grace N. Rgg, Hermin

2015-01-01

The purpose of this research is to analyze the effect of audit quality using proxy auditor industry specialization, audit tenure, audit report lag, and profitability using proxy net profit margin ratio on going concern opinion. Population used in this research is manufacturing companies listed in Indonesian Directory Exchange from 2010-2013. This research uses 20 sample companies achieved using purposive sampling. Data used in this research is secondary data are financial statement and indepe...

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.

Audit committee: Some evidence from Malaysia.

Directory of Open Access Journals (Sweden)

Zulkarnain Muhamad Sori

2006-11-01

Full Text Available This study aimed to investigate the perceptions of senior managers of Malaysian publicly listed companies on issues relating to audit committee authority and effectiveness. Questionnaire survey technique was employed to seek the respondents perceptions on five issues, namely audit committee appoints the auditor, audit committee determines and reviews audit fees, audit committee determines and reviews the auditor’s scope and duties, and audit committee’s reports and meetings. The majority of respondents agreed that auditor would be more effective and independent if audit committee assumed the responsibility to appoint the auditor, determine and review the audit fees, and determine and review the external auditor’s scope and duties. It is also found that disclosure of audit committee report and quarterly meeting would enhance the perceptions of users of financial statement concerning the effectiveness of the committee.

Audit Fee Determinants and Audit Quality in Ethiopian Commercial ...

African Journals Online (AJOL)

user

auditor derives a high proportion of revenue from a particular client creates economic ... identified in prior bank audit fee studies holds for Ethiopian commercial .... firms as smaller firms have fewer clients and so each client represents a larger ...... higher level of liquid assets relative to their total assets pay lower audit fees.

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

Science.gov (United States)

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

2016-02-01

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

Georgia : Accounting and Auditing

OpenAIRE

World Bank

2007-01-01

This report provides an assessment of accounting, financial reporting and auditing requirements and practices within the enterprise and financial sectors in Georgia. The report uses International Financial Reporting Standards (IFRS), International Standards on Auditing (ISA) and draws on international experience and good practices in the field of accounting and audit regulation, including in ...

An audit of Colposcopy referrals from a GU/STD clinic.

LENUS (Irish Health Repository)

O'Connor, Catherine

2008-01-01

BACKGROUND: Cervical cancer is increasing at 1.5% per year in Ireland with 50% mortality giving 2.2% of all cancer deaths. In the Mid-West region a pilot screening programme has begun to screen all women 25-60 years. 66% of Genitourinary\\/Sexually transmitted disease (GU\\/STD) clinics\\' abnormal smears are <25 years. Requests to abandon "opportunistic" screening prompted this GU\\/STD clinic audit. METHODS: 221(8.4%) patients referred to colposcopy over 4 years were audited. Retrospective analysis was carried out on GU\\/STD clinic files, hospital files and computer records for biopsy reports. Ethical approval was prospectively granted. RESULTS: 2637 smears were carried out from November 1999 - September 2003.221 patients referred to colposcopy were audited.1%, 3%, 5% had severe, moderate and, mild dyskaryosis, respectively, on cervical screening while 0.8%, 1.2%, 1.5% had CIN3, CIN2, CIN1 abnormalities, respectively, on biopsy with 3.5% having no abnormality (Cervical Intraepithelial Neoplasia = CIN).53% referred to colposcopy were <25 years. CONCLUSION: 2% had high grade lesions. 37% of high grade lesions are <25 years.Of the high grade lesions 13% had Chlamydia trachomatis (27% of CIN3) and 44% had HPV despite Relative Risks (RR) being 0.75 and 1.09 respectively. Older women had higher grade changes. No statistical difference was found for progression, regression and persistence in those over and under 25.

The Effect of Auditor Ethics, Auditor Experience, Audit Fees and Auditor Motivation on Audit Quality

Directory of Open Access Journals (Sweden)

Yeni Kuntari

2017-09-01

Full Text Available This study aimed to determine the effect of auditor ethics, auditor experience, audit fees, and auditor motivation on audit quality of public accounting firm in Semarang. The populations in this study were auditors who work on public accounting firm in Semarang. The total population of public accounting firm in Semarang according to Indonesian Institute of Certified Public Accountants in 2016 was 98 respondents from 14 public accounting firms. Questionnaires were distributed to auditors in all those public accounting firm. This study used purposive sampling judgement with criteria of sample were they have worked and experienced in public accounting firm for one year. A total sample of this study is 30 respondents. Using multiple linier regression analysis the results show that auditor ethics had a significant positive effect on audit quality; auditor experience had a significant positive effect on audit quality; audit fees had a significant positive effect on audit quality; and auditor motivation had a significant positive effect on audit quality. Ethics, experience, fees and motivation of auditor had a significant positive effect on audit quality.

Air Emissions Sources, Charts and Maps

Data.gov (United States)

U.S. Environmental Protection Agency — Air Emissions provides (1) interactive charts supporting national, state, or county charts, (2) county maps of criteria air pollutant emissions for a state, and (3)...

Quality of acute asthma care in two tertiary hospitals in a state in South Western Nigeria: A report of clinical audit.

Science.gov (United States)

Desalu, Olufemi Olumuyiwa; Adeoti, Adekunle Olatayo; Ogunmola, Olarinde Jeffrey; Fadare, Joseph Olusesan; Kolawole, Tolutope Fasanmi

2016-01-01

To audit the quality of acute asthma care in two tertiary hospitals in a state in the southwestern region of Nigeria and to compare the clinical practice against the recommendations of the Global Initiative for Asthma (GINA) guideline. We carried out a retrospective analysis of 101 patients who presented with acute exacerbation of asthma to the hospital between November 2010 and October 2015. Majority of the cases were females (66.3%), audit has implicated the need to address the non-performing areas and organizational issues to improve the quality of care.

Audit Committee Accounting Expert and Earnings Management with “Status” Audit Committee as Moderating Variable

Directory of Open Access Journals (Sweden)

Edy Suprianto

2017-12-01

Full Text Available This research aims to analyze the effect of accounting expert of audit committee on earnings management. This research also assesses the role of audit committee on earnings management with audit committee status as moderating variable. The population is all of firm’s which listed in Indonesia Stock Exchange. Purposive sampling is used to collect data. Data used financial statements and annual report companies from Indonesia Stock Exchange website. Moderated regression analysis (MRA is used to analyze the hypothesis. The result shows that accounting expert of audit committee has negative effect on earnings management. Yet, variable of audit committee status cannot moderate the relationship between accounting expert of audit committee and earnings management in Indonesia.

Relationship between gender in the board of directors and the audit committee with the audit delay

Directory of Open Access Journals (Sweden)

Luis Antonio Lay

2017-12-01

Full Text Available The study verified the relationship between the gender in the composition of the board of directors and the audit committee with the audit delay. The survey sample consisted of 75 companies belonging to the IBrX 100 index. The variables surveyed were the presence of women on the board of directors and on the audit committee, size of the audit committee, independence of the board of directors, expertise, company size, debt, size of the audit firm and audit fees. Data collection took place in the Reference Form and the Economática® database. Data analysis was performed using descriptive statistics and multiple linear regression using SPSS® software. It was found that the presence of women is greater on the board than on the audit committee, with a small number of experienced members. The results showed that the presence of women on the audit committee has a negative and significant association with the audit delay, that is, the presence of women in this organism of corporate governance contributes to the reduction of the period of disclosure of the auditor's report. In addition, the size of the company and the independence of the board of directors were also important in the final model in relation to the audit delay. The presence of women on the board of directors was not significant with the delay in the audit.

29 CFR 96.12 - Audit requirements.

Science.gov (United States)

2010-07-01

.... (b) The audit requirements contained in 29 CFR part 99 shall be followed for audits of all fiscal... 29 Labor 1 2010-07-01 2010-07-01 true Audit requirements. 96.12 Section 96.12 Labor Office of the Secretary of Labor AUDIT REQUIREMENTS FOR GRANTS, CONTRACTS, AND OTHER AGREEMENTS Audits of States, Local...

Internal audit consider the implications.

Science.gov (United States)

Baumgartner, Grant D; Hamilton, Angela

2004-06-01

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

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.

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.

Maintenance Electroconvulsive Therapy in Severe Bipolar Disorder: A Retrospective Chart Review.

Science.gov (United States)

Santos Pina, Laura; Bouckaert, Filip; Obbels, Jasmien; Wampers, Martien; Simons, Wim; Wyckaert, Sabien; Sienaert, Pascal

2016-03-01

The aim of this study was to evaluate the effectiveness of continuation and maintenance electroconvulsive therapy (C/M-ECT) in patients with bipolar or schizoaffective disorder. We reviewed the charts of all patients diagnosed with a bipolar or schizoaffective disorder treated with C/M-ECT from August 2009 until December 2013. We gathered demographic data and treatment variables (electrode placement, stimulus dose, and concomitant use of medication; number of C/M-ECT sessions; and number of new ECT courses). Primary outcome measure was the number of hospitalization days during C/M-ECT as compared with an equal period before starting the index course. Twenty women (64.5%) and 11 men (35.5%) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition bipolar disorder (n = 22, 71%) or schizoaffective disorder (n = 9, 29%) received C/M-ECT. The mean (SD) age was 51.23 (14.86; range, 28-74) years. Before the start of the index ECT, patients had a mean of 290 hospitalization days (248.4 days, full hospitalization; 41.6 days, partial hospitalization), whereas during C/M-ECT, they had a mean of 214.7 hospitalization days (85.4 days, full hospitalization; 129.3 days, partial hospitalization). The number of readmissions before ECT was 2.13, whereas during C/M-ECT, it decreased to 1.48. Only the decrease in number of full hospitalization days was significant. Most patients (n = 23, 74.19%) needed an acute course of ECT during M-ECT. Maintenance ECT seems to significantly reduce the number of full hospitalization days in patients with severe bipolar or schizoaffective disorder.

Making SPC easier with zone control charts

International Nuclear Information System (INIS)

Lanning, B.

1995-01-01

The zone control chart is a simple, easy to learn statistical process control (SPC) tool that can be applied to any process where the data are normally distributed. Several Shewhart runs rules are incorporated into a simple scoring system, with a single rule to determine when a process is out of control. Zone charts have average run lengths (ARLs) for detecting shifts in the process mean which, for most cases, are uniformly better than the standard control charts. This paper presents the simplified methodology behind the zone control chart

29 CFR 99.230 - Audit costs.

Science.gov (United States)

2010-07-01

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

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...

Industrial Energy Audit Guidebook: Guidelines for Conducting an Energy Audit in Industrial Facilities

Energy Technology Data Exchange (ETDEWEB)

Hasanbeigi, Ali; Price, Lynn

2010-10-07

Various studies in different countries have shown that significant energy-efficiency improvement opportunities exist in the industrial sector, many of which are cost-effective. These energy-efficiency options include both cross-cutting as well as sector-specific measures. However, industrial plants are not always aware of energy-efficiency improvement potentials. Conducting an energy audit is one of the first steps in identifying these potentials. Even so, many plants do not have the capacity to conduct an effective energy audit. In some countries, government policies and programs aim to assist industry to improve competitiveness through increased energy efficiency. However, usually only limited technical and financial resources for improving energy efficiency are available, especially for small and medium-sized enterprises. Information on energy auditing and practices should, therefore, be prepared and disseminated to industrial plants. This guidebook provides guidelines for energy auditors regarding the key elements for preparing for an energy audit, conducting an inventory and measuring energy use, analyzing energy bills, benchmarking, analyzing energy use patterns, identifying energy-efficiency opportunities, conducting cost-benefit analysis, preparing energy audit reports, and undertaking post-audit activities. The purpose of this guidebook is to assist energy auditors and engineers in the plant to conduct a well-structured and effective energy audit.

From joint to single audits – Audit quality differences and auditor pairing background

DEFF Research Database (Denmark)

Holm, Claus; Thinggaard, Frank

A recent EU regulation incentivises the use of joint audits. Concerns motivating this regulation imply that a B4 audit firm is paired with a NB4. However, in the first theoretical study of joint audits Deng et al. (2014) predict that adding a firm with lower technological efficiency to form a joi...

Google Charts Testing | CRDI - Centre de recherches pour le ...

International Development Research Centre (IDRC) Digital Library (Canada)

Google Charts Testing. The following item is a demo of Google GeoChart. Please note that geo chart can only recognize country name or city name rather than location or address (that is google my map's expertise). Additionally, Geo chart does support title and legend. To render geo chart properly, please get a ...

NOAA Seamless Raster Navigational Charts (RNC)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Seamless Raster Chart Server provides a seamless collarless mosaic of the NOAA Raster Navigational Charts (RNC). The RNC are a collection of approximately...

A survey of community child health audit.

Science.gov (United States)

Spencer, N J; Penlington, E

1993-03-01

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

Approach to chronic low back pain in a Rural Mission Hospital: An audit report

Directory of Open Access Journals (Sweden)

Tapan Kumar Paraseth

2018-01-01

Full Text Available Background: Challenging psychological and ergonomic burden demands a streamlined approach to Chronic low back pain (LBP in rural population. Methodology: All patients with chronic LBP managed in the outpatient physiotherapy and occupational therapy clinic at the rural mission hospital from July 2015 to June 2016 were included in a retrospective chart audit. Patients' demographic data and diagnosis were statistically analyzed with t-test. Results: One hundred and fifty five patients were included in the study. 65 patients (42% had mechanical LBP, 46 patients (30% had chronic LBP with lumbar radiculopathy, 22 patients (14% had discogenic chronic LBP, 15 patients (10% had chronic LBP due to osteoporosis, 5 patients (3% had chronic infective spondylitis and 2 patients (1% had post-traumatic chronic LBP. 25 patients (16% were less than 30 years old, 106 patients (68% were between 30 and 60 years and 24 patients (16% were older than 60 years. Higher incidence of mechanical chronic LBP was noted in younger group (t [129] = 1.36, P = 0.17 and higher incidence of chronic LBP with lumbar radiculopathy (t [129] =1.181, P = 0.239 was noted in middle aged patients, respectively. Gender prevalence of osteoporosis was statistically significant (t [153] =2.188, P = 0.03. Conclusion: Chronic LBP constituted 23% of all patients managed at the PT/OT outpatient clinic and mechanical chronic LBP was the most common diagnosis. Highest incidence of chronic LBP was noted in the middle aged 'working class' group of patients. Higher proportion of osteoporosis was detected among the female patients.

Communication of Audit Risk to Students.

Science.gov (United States)

Alderman, C. Wayne; Thompson, James H.

1986-01-01

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

THE ROLE OF SELF-REGULATORY AUDITING ASSOCIATIONS IN ARRANGEMENT OF AUDIT ACTIVITIES QUALITY CONTROL

Directory of Open Access Journals (Sweden)

Zinaida P. Arharova

2013-01-01

Full Text Available The role of self-regulatory organizations in audit activities quality control is revealed in this article. Creation of a united audit association is the basis of certain regulating and auditing functions transfer from the government to the public sector.

Refeeding syndrome as an iatrogenic cause of delirium: a retrospective pilot study.

Science.gov (United States)

Caplan, Jason P; Chang, Grace

2010-01-01

Refeeding syndrome describes a pattern of electrolyte disturbances occurring after the reintroduction of nutrition to the malnourished patient; it is often associated with delirium. The authors investigated whether hospitalized elderly patients who develop delirium are more likely to have laboratory findings consistent with refeeding syndrome. The authors conducted a retrospective chart review of 100 patients over age 60. Charts were examined for indications of delirium and refeeding syndrome. Significantly lower serum levels of magnesium and phosphate were found in patients with delirium. Delirium was not associated with any significant difference in levels of potassium. This study supports an association between delirium in elderly patients and electrolyte changes consistent with those seen in refeeding syndrome.

Auditing wildlife

Directory of Open Access Journals (Sweden)

B.K. Reilly

2003-12-01

Full Text Available Reilly B.K. and Y. Reilly. 2003. Auditing wildlife. Koedoe 46(2: 97–102. Pretoria. ISSN 0075-6458. Accountants and auditors are increasingly confronted with the problem of auditing wildlife populations on game ranches as their clients' asset base expands into this industry. This paper aims to provide guidelines on these actions based on case study data and research in the field of wildlife monitoring. Parties entering into dispute on numbers of animals on a property often resort to their auditors for advice. This paper tracks a method of deciding on whether or not to audit the population based on wildlife value and an initial sample count. This will act as a guideline for the accounting profession when confronted by this problem.

Internal Audit Charter, Mar2018

International Development Research Centre (IDRC) Digital Library (Canada)

Jessica Perkins

2018-03-02

Mar 2, 2018 ... authorizes the Finance and Audit Committee to oversee IDRC's Internal ... reassignment, or dismissal of the Chief Audit Executive. ... Audit Executive's duties as the Senior Officer for disclosure pursuant to the Public Servants.

E-Commerce Audit Judgment Expertise: Does Expertise in System Change Management and Information Technology Auditing Mediate E-Commerce Audit Judgment Expertise?

Directory of Open Access Journals (Sweden)

Jagdish PATHAK

2010-01-01

Full Text Available A global survey of 203 E-commerce auditors was conducted to investigate the perceptions about the potential determinants of expertise in E-commerce audits. We hypothesize and find evidence indicating that information technology and communication expertise are positively related to expertise in E-commerce audit judgment. We also find that system change management expertise and information technology audit expertise mediate this relationship.

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

Science.gov (United States)

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

2013-01-01

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

Dental implant suprastructures using cobalt-chromium alloy compared with gold alloy framework veneered with ceramic or acrylic resin: a retrospective cohort study up to 18 years.

Science.gov (United States)

Teigen, Kyrre; Jokstad, Asbjørn

2012-07-01

An association between the long-term success and survival of implant-supported prostheses as a function of biomaterial combinations has not been established. The use of cast cobalt-chromium for the suprastructure framework may be an alternative to the conventional approach of using type 3 gold alloys. A retrospective chart audit of all patients who had received implant-supported fixed dental prostheses (FDP) before 1996 was identified in a private practice clinic. Data were recorded for FDPs made from four combinations of alloy frameworks and veneering material, i.e. type 3 gold and cobalt-chromium with ceramic or prefabricated acrylic teeth. The extracted data from the charts were subjected to explorative statistical tests including Kaplan-Meier survival analyses. Patients (n=198) with 270 short and extensive FDPs supported entirely by 1117 implants were identified. The average follow-up observation periods varied between 4 and 220 months, with an average of 120 months. The success and survival, as well as event rates and types of biological and technical complications, were similar for implant-supported FDPs using cobalt-chromium and type 3 gold alloy frameworks veneered with ceramics or prefabricated acrylic teeth. An influence of the suprastructure biomaterial combination on the clinical performance of the individual supporting implants could not be established. Implant-supported FDPs made from type 3 gold or cobalt-chromium frameworks and veneered with ceramic or prefabricated acrylic teeth demonstrate comparable clinical performance. The biomaterial combinations do not appear to influence the success or survival of the individual implants. © 2011 John Wiley & Sons A/S.

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

Science.gov (United States)

2010-04-01

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

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.

Audits as a Vaccine or Just Aspirin?

Directory of Open Access Journals (Sweden)

Jagrič Timotej

2017-12-01

Full Text Available This paper examines the impact of audits on voluntary tax compliance in the area of value added tax in Slovenia. The analyses argues that audited taxpayers with additional tax assessments as the result of an audit display a higher level of tax compliance within the year of the audit as within the year before audit, while audited taxpayers with no irregularities on the basis of an audit do not change their behavior significantly within the same period. However, regarding the longterm effect, the results reveal the possibility of worsening tax compliance with respect to audits where an additional tax assessment was imposed and where no irregularities were discovered during an audit.

Performance audit procedures for opacity monitors

International Nuclear Information System (INIS)

Plaisance, S.J.; Peeler, J.W.

1987-04-01

This manual contains monitor-specific performance audit procedures and data forms for use in conducting audits of installed opacity continuous emission monitoring systems (CEMS). General auditing procedures and acceptance limits for various audit criteria are discussed. Practical considerations and common problems encountered in conducting audits are delineated, and recommendations are included to optimize the successful completion of performance audits. Performance audit procedures and field-data forms were developed for six common opacity CEMS: (1) Lear Siegler, Inc. Model RM-41; (2) Lear Siegler, Inc. Model RM-4; (3) Dynatron Model 1100; (4) Thermo Electron, Inc. Model 400; (5) Thermo Electron, Inc. Model 1000A; and (6) Enviroplan Model D-R280 AV. Generic audit procedures are included for use in evaluating opacity CEMS with multiple transmissometers and combiner devices. In addition, several approaches for evaluating the zero-alignment or clear-path zero response are described. The zero-alignment procedures are included since the factor is fundamental to the accuracy of opacity monitoring data, even though the zero-alignment checks cannot usually be conducted during a performance audit

Continuous Audit: Implementasi dan Pengendalian Berbasis Teknologi Informasi dalam Menjalankan Fungsi Audit yang lebih Efektif dan Efisien

Directory of Open Access Journals (Sweden)

Siti Elda Hiererra

2014-12-01

Full Text Available Information Technology (IT continues to transform how organizations function, communicate and do business with customers, partners and agents. Directors, audit committee, management and stakeholders sincerely hope their auditors more adept at using technology both in the field of audit (Audit Leveraging Technology to develop a thorough understanding of how they control the company's processes and internal controls. The research methodology to be used is quantitative observation methodology, by collecting data from various data sources such as journals and literature on Continuous Auditing, both best practice (Practical Approach as well as theoretical and raw concept of Continuous Auditing (Teorical Approach. Impact on the internal audit process and methodology by using Continuous Audit will be very revolutionary and a major impact on the development of the company's business and also the audit function which is run by the company.

prepare_taxa_charts.py: A Python program to automate generation of publication ready taxonomic pie chart images from QIIME.

Science.gov (United States)

Lakhujani, Vijay; Badapanda, Chandan

2017-06-01

QIIME (Quantitative Insights Into Microbial Ecology) is one of the most popular open-source bioinformatics suite for performing metagenome, 16S rRNA amplicon and Internal Transcribed Spacer (ITS) data analysis. Although, it is very comprehensive and powerful tool, it lacks a method to provide publication ready taxonomic pie charts. The script plot_taxa_summary . py bundled with QIIME generate a html file and a folder containing taxonomic pie chart and legend as separate images. The images have randomly generated alphanumeric names. Therefore, it is difficult to associate the pie chart with the legend and the corresponding sample identifier. Even if the option to have the legend within the html file is selected while executing plot_taxa_summary . py , it is very tedious to crop a complete image (having both the pie chart and the legend) due to unequal image sizes. It requires a lot of time to manually prepare the pie charts for multiple samples for publication purpose. Moreover, there are chances of error while identifying the pie chart and legend pair due to random alphanumeric names of the images. To bypass all these bottlenecks and make this process efficient, we have developed a python based program, prepare_taxa_charts . py , to automate the renaming, cropping and merging of taxonomic pie chart and corresponding legend image into a single, good quality publication ready image. This program not only augments the functionality of plot_taxa_summary . py but is also very fast in terms of CPU time and user friendly.

Archaeology audit program final report

Energy Technology Data Exchange (ETDEWEB)

NONE

2009-04-15

In order to review oil and gas companies' archaeological management systems, the British Columbia Oil and Gas Commission (OGC) introduced its archaeology audit program (AAP) in April 2008. As part of this audit, twenty six oil and gas companies were selected for an office documentation review and a corresponding field audit. This document presented and described these audit results. The purpose of the final audit report was to provide information to assist oil and gas companies to improve their management systems by increasing the emphasis of the preservation of cultural resources. This report presented an overview of the AAP scope and methodology and provided examples from the audit of both good management practices encountered and practices in which opportunities for improvement to archaeological management systems could be implemented. Recommendations to address improvement opportunities were also discussed. It was concluded that the oil and gas companies subject to the audit were found to have met or exceeded OGC expectations for maintaining archaeological management systems. 2 tabs., 7 figs.

Nurses' participation in audit: a regional study.

Science.gov (United States)

Cheater, F M; Keane, M

1998-03-01

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

Audit in small and medium business

OpenAIRE

Marešová, Edita

2009-01-01

The subject of this thesis is a theoretical introduction to audit of the financial statements. The main part is the audit process, particularly the implementation of procedures to assess the adoption of a new contract, the design's overall performance audit, risk assessment, conducting a further audit procedures, analyzing the information obtained, and finally preparing the auditor's report. The last chapter is devoted to the audit program for fixed assets.

Environmental audits: A lawyer's perspective

International Nuclear Information System (INIS)

Walls, S.K.

1992-01-01

This paper reviews the advantages and disadvantages of using environmental compliance audits to help detect potential environmental violations and/or potential problems. The paper focuses on the legal issues inherent in this type of audit. The primary purpose of conducting such an audit is to determine the suitability of a facility or a site prior to a transaction or to determine a company's own compliance before a regulatory agency identifies it. The paper discusses how to set up a compliance audit and then reviews how various government agencies view voluntary environmental audits. These voluntary actions are perceived by most agencies as commendable and result in significant decreases in penalties and assessments

The use of safety audits

International Nuclear Information System (INIS)

Waldram, I.M.

1991-01-01

It is now widely recognized that implementation of an effective safety policy must include arrangements for auditing and feedback to the policy maker. In the E and P industry safety audits should cover the whole range of activities, from exploration to production, and including the specialist contractors widely employed. Audit schemes can be developed internally, or purchased as a package. In this paper, the development of a comprehensive audit policy is described, and a range of audit techniques are reviewed. The use of these techniques is described with special reference to drilling, diving and offshore construction in the UK sector of the North Sea

POSITIONINGS AND DELIMITATIONS CONCERNING THE PERFORMANCE AUDIT

OpenAIRE

Victoria FIRESCU

2014-01-01

The objectives of the present research are related to the approaches concerning the “performance audit” concept in the specialized literature and practice as well as the clear delimitation of this concept of financial audit and internal audit. For a clear emphasis of the objectives and principles of the performance audit, I highlighted the similarities and differences among the three types of audit by means of several criteria such as: audit standards, audited subjects, nature of the audit ev...

Risk stratification and stroke prevention therapy care gaps in Canadian atrial fibrillation patients (from the Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation chart audit).

Science.gov (United States)

Patel, Ashish D; Tan, Mary K; Angaran, Paul; Bell, Alan D; Berall, Murray; Bucci, Claudia; Demchuk, Andrew M; Essebag, Vidal; Goldin, Lianne; Green, Martin S; Gregoire, Jean C; Gross, Peter L; Heilbron, Brett; Lin, Peter J; Ramanathan, Krishnan; Skanes, Allan; Wheeler, Bruce H; Goodman, Shaun G

2015-03-01

The objectives of this national chart audit (January to June 2013) of 6,346 patients with atrial fibrillation (AF; ≥18 years without a significant heart valve disorder) from 647 primary care physicians were to (1) describe the frequency of stroke and bleed risk assessments in patients with nonvalvular AF by primary care physicians, including the accuracy of these assessments relative to established predictive indexes; (2) outline contemporary methods of anticoagulation used; and (3) report the time in the therapeutic range among patients prescribed warfarin. An annual stroke risk assessment was not undertaken in 15% and estimated without a formal risk tool in 33%; agreement with CHADS2 score estimation was seen in 87% of patients. Major bleeding risk assessment was not undertaken in 25% and estimated without a formal risk tool in 47%; agreement with HAS-BLED score estimation was observed in 64% with physician overestimation in 26% of patients. Antithrombotic therapy included warfarin (58%), dabigatran (22%), rivaroxaban (14%), and apixaban (risk for stroke. There is apparent overestimation of bleeding risk in many patients. Warfarin was the dominant stroke prevention treatment; however, the suggested TTR target was achieved in only 55% of these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Auditor human capital and audit firm survival - The Dutch audit industry in 1930-1992

NARCIS (Netherlands)

Brocheler, [No Value; Maijoor, S; van Witteloostuijn, A; Bröcheler, V.

2004-01-01

This paper studies the relationship between auditor human capital and audit firm survival. Specifically, the effects are investigated of the human capital of auditors on the survival chances of newly established audit firms. Human capital is analyzed both at the time of entry of a new audit firm and

The Impact Of Cloud Computing Technology On The Audit Process And The Audit Profession

OpenAIRE

Yati Nurhajati

2015-01-01

In the future cloud computing audits will become increasingly The use of that technology has influenced of the audit process and be a new challenge for both external and the Internal Auditors to understand IT and learn how to use cloud computing and cloud services that hire in cloud service provider CSP and considering the risks of cloud computing and how to audit cloud computing by risk based audit approach. The wide range of unique risks and depend on the type and model of the cloud soluti...

Validation of a New Method to Automatically Select Cases With Intraoperative Red Blood Cell Transfusion for Audit.

Science.gov (United States)

Dexter, Franklin; Epstein, Richard H; Ledolter, Johannes; Dasovich, Susan M; Herman, Jay H; Maga, Joni M; Schwenk, Eric S

2018-05-01

Hospitals review allogeneic red blood cell (RBC) transfusions for appropriateness. Audit criteria have been published that apply to 5 common procedures. We expanded on this work to study the management decision of selecting which cases involving transfusion of at least 1 RBC unit to audit (review) among all surgical procedures, including those previously studied. This retrospective, observational study included 400,000 cases among 1891 different procedures over an 11-year period. There were 12,616 cases with RBC transfusion. We studied the proportions of cases that would be audited based on criteria of nadir hemoglobin (Hb) greater than the hospital's selected transfusion threshold, or absent Hb or missing estimated blood loss (EBL) among procedures with median EBL 50%) that would be audited and most cases (>50%) with transfusion were among procedures with median EBL 9 g/dL, the procedure's median EBL was 9 g/dL and median EBL for the procedure ≥500 mL. An automated process to select cases for audit of intraoperative transfusion of RBC needs to consider the median EBL of the procedure, whether the nadir Hb is below the hospital's Hb transfusion threshold for surgical cases, and the absence of either a Hb or entry of the EBL for the case. This conclusion applies to all surgical cases and procedures.

POSITIONINGS AND DELIMITATIONS CONCERNING THE PERFORMANCE AUDIT

Directory of Open Access Journals (Sweden)

Victoria FIRESCU

2014-12-01

Full Text Available The objectives of the present research are related to the approaches concerning the “performance audit” concept in the specialized literature and practice as well as the clear delimitation of this concept of financial audit and internal audit. For a clear emphasis of the objectives and principles of the performance audit, I highlighted the similarities and differences among the three types of audit by means of several criteria such as: audit standards, audited subjects, nature of the audit evidence, manners of assessment. Within this basically predominant research, I used several research methods and techniques such as: the critical analysis of the bibliographic sources concerning the performance audit, the documentation related to the international audit standards, comparative studies.

Audit Oversight: Followup Review of the Military Department Audit Agencies Peer Review

National Research Council Canada - National Science Library

2004-01-01

Government Auditing Standards (GAS) issued in June 2003 by the Comptroller General of the United States require that organizations conducting Government audits and attestation engagements have an appropriate internal quality control...

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.

Surgical care for the aged: a retrospective cross-sectional study of a national surgical mortality audit

Science.gov (United States)

Allen, Jennifer; North, John B; Ware, Robert S

2015-01-01

Objectives It is assumed that increased age signifies increased surgical care. Few surgical studies describe the differences in care provided to older patients compared with younger patients. We aimed to examine the relationships between increasing age, preoperative factors and markers of postoperative care in adults who died in-hospital after surgery in Australia. Design This retrospective cross-sectional study extracted data from a national surgical mortality audit—an independent, peer-reviewed process. Setting From January 2009 to December 2012, 111 public and 61 private Australian hospitals notified the audit of in-hospital deaths after general anaesthetic surgery or if the patient was admitted under a surgeon. Participants Notified deaths totalled 19 723. We excluded deaths if patients were brain dead, younger than 17 years or never had an operation (n=11 376). From this baseline population, we divided 11 201 deaths into three patient age groups: youngest (17–64 years), medium (65–79 years) and oldest (≥80 years). Outcome measures Univariable and multivariable logistic regression analyses determined the relationships between increasing age and the measured preoperative factors and postoperative variables. Results The baseline population's median age was 78 years (IQR 66–85), 43.7% (4892/11 201) were 80 years or older and 83.4% (9319/11 173) had emergency admissions. The oldest group had increased trauma and emergency admissions than the medium and youngest age groups. Seven of the eight measured markers of postoperative care demonstrate strong and significant relationships with increasing age. The oldest group compared with the medium group had decreased rates of: unplanned returns to theatre (11.2% (526/4709) vs 20.2% (726/3586)), unplanned intensive care admissions (16.3% (545/3350) vs 24.0% (601/2504)) and treatment in intensive care units (59.7% (2689/4507) vs 76.7% (2754/3590)). Conclusions The oldest patients received

Audit culture revisited

DEFF Research Database (Denmark)

Shore, Cris; Wright, Susan

2015-01-01

the financial and the moral meet’ we ask, what new kinds of ‘ethics of accountability’ does audit produce? We build on the work of Mitchell (1999), Trouillot (2001) and Merry (2011) to identify five ways in which the techniques and logics of financial accountancy have notable ‘audit effects...... these new financialized techniques of governance, not least through the work of the ‘Big 4’ accountancy firms, and trace their impact across a number of different fields, from administration and the military to business corporations and universities. Following Strathern’s observation that audit is ‘where...

24 CFR 511.74 - Audit.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Audit. 511.74 Section 511.74... CLEARANCE AND URBAN RENEWAL RENTAL REHABILITATON GRANT PROGRAM Grant Administration § 511.74 Audit. The... audits in accordance with 24 CFR part 44. ...

Software Engineering Reviews and Audits

CERN Document Server

Summers, Boyd L

2011-01-01

Accurate software engineering reviews and audits have become essential to the success of software companies and military and aerospace programs. These reviews and audits define the framework and specific requirements for verifying software development efforts. Authored by an industry professional with three decades of experience, Software Engineering Reviews and Audits offers authoritative guidance for conducting and performing software first article inspections, and functional and physical configuration software audits. It prepares readers to answer common questions for conducting and perform

The making of Andersen’s liquefaction chart

OpenAIRE

Sabaliauskas, Tomas; Ibsen, Lars Bo

2017-01-01

Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation stabilizing soil response.The process of obtaining the original chart has been improved. Algorithm based approximation is introduced. Pore pressure dependent ultimate bearing capacity normalization factor is introduced to normalize the chart.

Recipient characteristics and outcome of pediatric kidney transplantation at the King Fahad Specialist Hospital-Dammam.

Science.gov (United States)

Khan, Iftikhar A R; Al-Maghrabi, Mohammad; Kassim, Mohammad Salah; Tawfeeq, Mansour; Al-Saif, Faisal; Al-Oraifi, Ibrahim; Al-Qahtani, Mohammed; Alsaghier, Mohammad

2014-07-01

The success of a pediatric kidney transplantation program can only be judged by reviewing its results. We aim to audit our short-term outcome of pediatric kidney transplantation at the King Fahad Specialist Hospital-Dammam. A retrospective chart review was performed to collect data about recipient demographics, etiology of end-stage kidney disease, type of dialysis, type of donor and outcome. Between September 2008 and April 2012, 35 pediatric kidney trans-plantations (need to encourage preemptive transplantation and living donation in this population.

7 CFR 3052.230 - Audit costs.

Science.gov (United States)

2010-01-01

... 7 Agriculture 15 2010-01-01 2010-01-01 false Audit costs. 3052.230 Section 3052.230 Agriculture Regulations of the Department of Agriculture (Continued) OFFICE OF THE CHIEF FINANCIAL OFFICER, DEPARTMENT OF AGRICULTURE AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Audits § 3052.230 Audit costs...

38 CFR 41.230 - Audit costs.

Science.gov (United States)

2010-07-01

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

Comparison of reading speed with 3 different log-scaled reading charts.

Science.gov (United States)

Buari, Noor Halilah; Chen, Ai-Hong; Musa, Nuraini

2014-01-01

A reading chart that resembles real reading conditions is important to evaluate the quality of life in terms of reading performance. The purpose of this study was to compare the reading speed of UiTM Malay related words (UiTM-Mrw) reading chart with MNread Acuity Chart and Colenbrander Reading Chart. Fifty subjects with normal sight were randomly recruited through randomized sampling in this study (mean age=22.98±1.65 years). Subjects were asked to read three different near charts aloud and as quickly as possible at random sequence. The charts were the UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart, respectively. The time taken to read each chart was recorded and any errors while reading were noted. Reading performance was quantified in terms of reading speed as words per minute (wpm). The mean reading speed for UiTM-Mrw Reading Chart, MNread Acuity Chart and Colenbrander Reading Chart was 200±30wpm, 196±28wpm and 194±31wpm, respectively. Comparison of reading speed between UiTM-Mrw Reading Chart and MNread Acuity Chart showed no significant difference (t=-0.73, p=0.72). The same happened with the reading speed between UiTM-Mrw Reading Chart and Colenbrander Reading Chart (t=-0.97, p=0.55). Bland and Altman plot showed good agreement between reading speed of UiTM-Mrw Reading Chart with MNread Acuity Chart with the Colenbrander Reading Chart. UiTM-Mrw Reading Chart in Malay language is highly comparable with standardized charts and can be used for evaluating reading speed. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

AUDIT plan documenting method

International Nuclear Information System (INIS)

Cornecsu, M.

1995-01-01

The work describes a method of documenting the AUDIT plan upon the basis of two quantitative elements resulting from quality assurance program appraisal system function implementation degree as established from the latest AUDIT performed an system function weight in QAP, respectively, appraised by taking into account their significance for the activities that are to be performed in the period for which the AUDITs are planned. (Author) 3 Figs., 2 Refs

The New Architecture for Auditing Standards

OpenAIRE

Sorin-Sandu Vînătoru; Sorinel Domnişoru; Daniela Giurescu

2009-01-01

The purpose of this paper is to challenge the conceptual basis upon which the current auditing standards are based. The paper critically appraises the Auditors’ Code published by the Auditing Practices Board and containing the nine fundamental and enduring principles upon which current auditing standards are based. It is argued that the nine enduring principles should be replaced by seven enduring tensions – the fault lines of auditing - so as to rethink the conceptual basis of auditing stand...

An Audit of Visual Acuity using a Snellen chart for Residents in a Care home, aged 65years or over

OpenAIRE

Ward, Hannah

2012-01-01

Background: Visual impairment (VI) is highly prevalent, but currently remains untreated and preventable in Britain‟s older population (Evans, Fletcher, Wormald et al. 2002). Eighty percent of all VI can be avoided or treated (WHO, 2011). People in residential or nursing homes are at a higher risk of having their eye problems overlooked (Pols, Bates, McGraw et al. 2000). Aim: To conduct an audit of visual acuity (VA), a measure of VI against a national standard, the British Geriatric Societ...

Harmonisation of Audit Practice

DEFF Research Database (Denmark)

Sormunen, Nina; Klarskov Jeppesen, Kim; Sundgren, Stefan

2013-01-01

The study uses a sample of 2,941 bankrupt firms from Denmark, Finland, Norway and Sweden in the period 2007 to 2011, and investigates the harmonisation of audit behaviour in terms of going-concern reporting. Even though the Nordic countries have similar legal systems and, for all practical purposes......, identical audit requirements regarding going-concern reporting, the study findings show significant differences in going-concern reporting before bankruptcy between the Nordic countries. One key result is that Danish and Norwegian companies get a going-concern opinion prior to bankruptcy more frequently...... and Norway compared to Sweden and Finland. Finally, the study findings also indicate that differences in audit reporting behaviour are moderated by international audit firm networks....

HydroHillChart – Francis module. Software used to Calculate the Hill Chart of the Francis Hydraulic Turbines

Directory of Open Access Journals (Sweden)

Dorian Nedelcu

2015-07-01

Full Text Available The paper presents the Hydro Hill Chart - Francis module application, used to calculate the hill chart of the Pelton, Francis and Kaplan hydraulic turbine models, by processing the data measured on the stand. After describing the interface and menu, the input data is graphically presented and the universal characteristic for measuring scenarios ao=const. and n11=const is calculated. Finally, the two calculated hill charts are compared through a graphical superimposition of the isolines.

10 CFR 950.41 - Monitoring/Auditing.

Science.gov (United States)

2010-01-01

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

7 CFR 1948.96 - Audit requirements.

Science.gov (United States)

2010-01-01

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

9 CFR 149.4 - Spot audit.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Spot audit. 149.4 Section 149.4... LIVESTOCK IMPROVEMENT VOLUNTARY TRICHINAE CERTIFICATION PROGRAM § 149.4 Spot audit. (a) In addition to regularly scheduled site audits, certified production sites will be subject to spot audits. (1) Random spot...

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)

Pengaruh Kinerja Keuangan Perusahaan Dan Opini Audit Tahun Sebelumnya Terhadap Opini Audit Mengenai Going Concern

OpenAIRE

Setiyanti, Sri Wiranti

2010-01-01

Companies that receive a going-concern opinion in the previous year wen more likely to receive the same opinion on the current year. Ramadhani (2004) proved that the going-concern audit opinion received the previous year positive impact on acceptance going-concern audit opinion for the year. If previous years the auditor has issued a going-concern audit opinion, the auditors will be more likely to issue going concern audit opinions again next year.Kata kunc...

Internal Audit and Risk Management

OpenAIRE

Constantin Nicolae Vasile; Alexandru Georgiana

2011-01-01

Internal audit and risk management have the same goal: the control of risk. There are various roles for the internal audit in respect of risk management. The main limitations of internal audit in respect of risk management regards assuming risk management tasks. One of the main issues regarding risk management is to make sure that the key risks are taken into consideration and that the management and the board of the organization take action as needed. Internal audit could give advice to mana...

Transmission Line Adapted Analytical Power Charts Solution

Science.gov (United States)

Sakala, Japhet D.; Daka, James S. J.; Setlhaolo, Ditiro; Malichi, Alec Pulu

2017-08-01

The performance of a transmission line has been assessed over the years using power charts. These are graphical representations, drawn to scale, of the equations that describe the performance of transmission lines. Various quantities that describe the performance, such as sending end voltage, sending end power and compensation to give zero voltage regulation, may be deduced from the power charts. Usually required values are read off and then converted using the appropriate scales and known relationships. In this paper, the authors revisit this area of circle diagrams for transmission line performance. The work presented here formulates the mathematical model that analyses the transmission line performance from the power charts relationships and then uses them to calculate the transmission line performance. In this proposed approach, it is not necessary to draw the power charts for the solution. However the power charts may be drawn for the visual presentation. The method is based on applying derived equations and is simple to use since it does not require rigorous derivations.

The New Statutory Audit Framework in Europe: Implications for the Provision of Non-audit Services

DEFF Research Database (Denmark)

Holm, Claus

2016-01-01

Purpose: The individual EU Member States have options on how they implement the new statutory audit framework in Europe. They may introduce stricter rules or apply certain exemptions where deemed appropriate. Denmark exemplifies Member States with a traditionally high level of non-audit services...... provided by its auditors. The aim of this study is to contrast the minimum implementation rationale observed in the Danish implementation process with an ex ante examination of fee dependency. Design/methodology/approach: The audit reform introduces a cap on non-audit fees which implies a regulator......-determined condition of non-independence. The cap is applied as a treatment effect on the ex ante relationship between audit fees and non-audit fees. In a sample with 3,238 observations, Denmark is compared with Finland, Germany, Sweden and the UK in order to determine whether the new measure will have different...

Chart of the nuclides - Strasbourg 1990

International Nuclear Information System (INIS)

Antony, M.S.

1991-01-01

Data were compiled for a nuclide chart over the last two years. The compilation is complete to the end of September 1990. The chart includes about 30000 data. Decay modes are represented by colours. Announcement capabilities and prices are given. (G.P.) 3 refs

Obtaining the Andersen's chart, triangulation algorithm

DEFF Research Database (Denmark)

Sabaliauskas, Tomas; Ibsen, Lars Bo

Andersen’s chart (Andersen & Berre, 1999) is a graphical method of observing cyclic soil response. It allows observing soil response to various stress amplitudes that can lead to liquefaction, excess plastic deformation or stabilizing soil response. The process of obtaining the original chart has...

49 CFR 236.718 - Chart, dog.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Chart, dog. 236.718 Section 236.718 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION, DEPARTMENT OF... OF SIGNAL AND TRAIN CONTROL SYSTEMS, DEVICES, AND APPLIANCES Definitions § 236.718 Chart, dog. A...

The Neighborhood Auditing Tool: a hybrid interface for auditing the UMLS.

Science.gov (United States)

Morrey, C Paul; Geller, James; Halper, Michael; Perl, Yehoshua

2009-06-01

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 any given time, an auditor concentrates on a single-focus concept and one of a variety of neighborhoods of its closely related concepts. Typical diagrammatic displays of concept networks have a number of shortcomings, so the NAT utilizes a hybrid diagram/text interface that features stylized neighborhood views which retain some of the best features of both the diagrammatic layouts and text windows while avoiding the shortcomings. The NAT allows an auditor to display knowledge from both the Metathesaurus (concept) level and the Semantic Network (semantic type) level. Various additional features of the NAT that support the auditing process are described. The usefulness of the NAT is demonstrated through a group of case studies. Its impact is tested with a study involving a select group of auditors.

24 CFR 92.506 - Audit.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Audit. 92.506 Section 92.506 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development HOME INVESTMENT PARTNERSHIPS PROGRAM Program Administration § 92.506 Audit. Audits of the participating...

Conducting One's Own Communication Audit.

Science.gov (United States)

Rogers, Donald P.; Goldhaber, Gerald M.

1978-01-01

Guidelines are offered to a college or university for conducting a communication audit. These include steps in planning the audit, use of the variety of tools available for administering the audit, the development and feedback to the institution, and development of recommendations to improve institutional communication. (JMF)

29 CFR 99.200 - Audit requirements.

Science.gov (United States)

2010-07-01

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

21 CFR 820.22 - Quality audit.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality audit. 820.22 Section 820.22 Food and... QUALITY SYSTEM REGULATION Quality System Requirements § 820.22 Quality audit. Each manufacturer shall establish procedures for quality audits and conduct such audits to assure that the quality system is in...

Komisaris Independen, Komite Audit, Internal Audit Dan Risk Management Committee Terhadap Manajemen Laba

OpenAIRE

Restuningdiah, Nurika

2011-01-01

The purpose of this research was to examine the impact of independency of board commisioner, audit committee,internal audit and risk management comittee to earning management. Regression Analysis of 35 publiccompanies listing in Indonesia Stock Exchange on year 2009 through a random sampling technique indicatedthat there was no significant impact of independency of board commisioner, audit committee, internal auditand risk management comittee to earning management. The implication of this stu...

AUDIT – ASSESSMENT, INSPECTION OR CONTROL?

Directory of Open Access Journals (Sweden)

CONSTANŢA IACOB

2016-10-01

Full Text Available The emergence audit concept has created a lot of confusion, on the one hand between its manifestations, on the other hand between it and the indigenous concepts that are more suggestive and at the same time more explicit. Both theory and practice show that the abolition of auditors within companies that have been subject to financial audit was the result of confusion created between the audit and statutory audit. On the other hand, long it was considered that if was set up internal audit do not need control, something which has to be seen from another perspective given that fact in reality internal control includes internal audit. These are the considerations which, in this article we try to sit concepts in their natural order and to emphasize the implications of corporate governance codes on the audit function.

GENERAL METHOD OF STOCKS AUDIT

Directory of Open Access Journals (Sweden)

Iryna Galushchak

2017-03-01

Full Text Available The article deals with the organization and methodology of accounting and auditing inventory enterprises. Suggestions for improvement of accounting permit to raise processing and presenting economic information to a higher level for making the economic and management decisions. Theory and practice problems of stocks audit were investigated. The basic directions of improvement of  stock audit were defined. The auditor can form an opinion about the state of business transactions of accounting of goods, define shortcomings in its organization and possible directions of elimination of violations and abuses. Program of audit of operations accounting with stocks should include the investigation of the preservation of property, valuation and posting costs, correct evaluation of purchased tangible assets, using of stocks in production. It is worth  to use techniques and methods of verification such as inventory, comparative control,  comparison of documentary evidence, counter check, check arithmetic for  audit of goods. Keywords: audit, stocks, activities of the company.

Computer Assisted Audit Techniques

OpenAIRE

Eugenia Iancu; Mihaela Tulvinschi; Veronica Grosu

2007-01-01

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 pha...

28 CFR 70.26 - Non-Federal audits.

Science.gov (United States)

2010-07-01

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

45 CFR 2543.26 - Non-Federal audits.

Science.gov (United States)

2010-10-01

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

29 CFR 99.510 - Audit findings.

Science.gov (United States)

2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings. 99.510 Section 99.510 Labor Office of the Secretary of Labor AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS Auditors § 99.510 Audit... schedule of prior audit findings prepared by the auditee in accordance with § 99.315(b) materially...

Audit Information Management System

Data.gov (United States)

US Agency for International Development — USAID/OIG has initiated its new Audit Information Management System (AIMS) to track OIG's audit recommendations and USAID's management decisions. OIG's in-house...

The development of interdepartmental audit methods

International Nuclear Information System (INIS)

Thwaites, D.I.; Allahverdi, M.

1995-01-01

The UK Radiotherapy Physics Audit Network is now well-established, with seven network groups and co-ordinated by the IPSM. It is based on visits, using ion chambers as the measurement method, and auditing at least machine calibration, single field parameters and simple multi-field planned irradiations. In addition procedural audit of dosimetry and quality control procedures, and records is incorporated. The general approach has been to use interdepartmental audit involving mutual co-operation with peer professionals from other centres. The different groups have evolved at different paces and in rather different directions. However the IPSM coordinating role ensures a basic common minimum to the system. The Scottish+ group has developed a semi-anatomical phantom to use in audit stages following on from the basic single field and geometric phantom dosimetry audit levels. This has been evaluated experimentally in one department before wider use. The Scottish+ audit system is briefly described. Results from levels 1 and 2 are summarised and the design and testing of the semi-anatomical phantom are discussed. The current and future development of the audit system is presented

20 CFR 638.809 - Audit.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Audit. 638.809 Section 638.809 Employees... THE JOB TRAINING PARTNERSHIP ACT Administrative Provisions § 638.809 Audit. (a) The Secretary of Labor... purpose of making surveys, audits, examinations, excerpts, and transcripts. (b) The Secretary shall, with...

24 CFR 590.27 - Audit.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Audit. 590.27 Section 590.27... COMMUNITY FACILITIES URBAN HOMESTEADING § 590.27 Audit. (a) Access to records. The Secretary, the... funds or property transferred under this part, for the purpose of making surveys, audits, examinations...

An audit of generic prescribing in a general surgical department.

LENUS (Irish Health Repository)

Gleeson, M

2013-01-17

BACKGROUND: The Health Service Executive introduced a generic prescription policy to reduce costs. Despite this, generic prescription rates remain low. AIM: To audit in-patient prescription practice in a single surgical department and identify potential savings which could be realised by adherence to the generic prescribing policy. METHODS: Surgical in-patient charts were obtained at the point of discharge and their drug prescription information was recorded. RESULTS: 51 % of prescriptions involved a trade-name prescription where an appropriate generic equivalent existed. The cost implications for hospital and community patients were found to be greatly affected by substitution policies that exist at hospital pharmacy level. CONCLUSION: There is a need to promote greater adherence to generic prescribing amongst hospital doctors in line with international best practice. It can have a positive impact in terms of safe prescribing and can have cost implications at both hospital and community level.

Treatment Changes in Patients With Moderate to Severe Psoriasis: A Retrospective Chart Review.

Science.gov (United States)

Smith, Jaclyn A; Wehausen, Brooke; Richardson, Irma; Zhao, Yang; Li, Yunfeng; Herrera, Vivian; Feldman, Steven R

Psoriasis treatment involves topical medications, oral medications, phototherapy, and/or biologics. The treatments used depend on a myriad of factors that change over time. To characterise the frequency of and reasons for treatment changes in patients with moderate to severe psoriasis. A chart review examined treatment changes at 902 visits by 116 patients seen between January 1, 2010, and June 30, 2015, for moderate to severe psoriasis and the physicians' justifications for those changes. 'Treatment change' was defined as switching between, adding, or removing medication classes or switching within the oral or biologic class. There were 221 visits with treatment changes identified, and a change occurred every 4.1 visits. On average, there were 1.2 treatment changes per year. Patients treated for at least 1 year averaged 1 treatment change every 16 months. The most common type of change was from one biologic to another biologic (24.9%), followed by adding a nonbiologic to a biologic (18.6%). The most common reason for switching was poor control or flare of psoriasis. Affordability was a more common problem for biologics than for nonbiologic treatments. Biologic treatment options provide a major improvement over older systemic treatments, but patients still undergo frequent treatment changes to help control their disease.

29 CFR 99.220 - Frequency of audits.

Science.gov (United States)

2010-07-01

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

24 CFR 84.26 - Non-Federal audits.

Science.gov (United States)

2010-04-01

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

Cognitive Assessment of Elderly Inpatients: A Clinical Audit

Directory of Open Access Journals (Sweden)

Elizabeth Shermon

2015-01-01

Full Text Available Background: Comprehensive geriatric assessment including cognitive assessment results in better outcomes and quality of life through facilitating access to support and further care. The National Audit of Dementia Care revealed too few patients were being assessed for cognition and therefore failing to receive adequate care. Methods: This was a retrospective clinical audit in a district general hospital with systematic sampling of the clinical records of 50 inpatients on an elderly care ward. A descriptive analysis of the results was performed. Results: Despite guidance that cognitive assessment should be performed on admission, this was only documented in 22% of the medical notes. However, this rate improved to 56% by discharge. The most commonly used tool was the Abbreviated Mental Test (AMT 10. Assessment completion was independent of gender or social support, but only patients aged over 75 years were assessed. Of those, 75% had some level of cognitive impairment and 36.8% received a new or suspected diagnosis of dementia. Discussion: Cognitive assessment rates continue to be low. Our findings support the need for increased education regarding the importance and benefits of assessment as well as how to complete and document the assessment correctly. Conclusion: Cognitive assessment rates need to be further improved to promote better outcomes for patients with dementia.

U.S. Pacific Command > Organization > Organization Chart

Science.gov (United States)

Responsibility USPACOM Previous Commanders Organization Organization Chart Media News Flickr Photos Video Directory Media Inquiries Home : Organization : Organization Chart About DoD DoD Careers Join the Military

Evaluation of the Defense Contract Audit Agency Audit Coverage of Tricare Contracts

National Research Council Canada - National Science Library

Brannin, Patricia

2000-01-01

Our objective was to evaluate the adequacy of the Defense Contract Audit Agency (DCAA) audit coverage of contracts for health care provided under TRICARE and the former Civilian Health Care and Medical Program of the Uniformed Services...

Smart Book Charts

Science.gov (United States)

Chinnapongse, Ronald L.

2015-01-01

Smart book charts for TPSM: Heatshield for Extreme Entry Environment Technology (HEEET), Conformal Ablative TPS (CA-TPS), 3D Woven Multifunctional Ablative TPS (3D MAT), and Adaptable, Deployable, Entry and Placement Technology (ADEPT).

Chart of the nuclides

International Nuclear Information System (INIS)

Yoshizawa, Y.; Horiguchi, T.; Yamada, M.

1980-01-01

In this chart, four colors are use to classify nuclides according to their half-lives. The different symbols are also to show the decay modes and their percentage in each nuclide. Four tables are provided on the back of the chart. Table 1 is the ordinary periodic Table. Table 2 provides fundamental constants used for nuclear physics. Tables 3 lists the physical constants (mean density, ionization potential, melting point, and boiling point) of all elements. Table 4 provides the gamma-ray intensity standards. Half-lives, energy, relative intensity, and intensity per decay are list for 33 nuclides. (J.P.N.)

28 CFR 31.201 - Audit.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Audit. 31.201 Section 31.201 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Formula Grants General Requirements § 31.201 Audit. The State must assure that it adheres to the audit requirements enumerated in the “Financial and...

24 CFR 954.503 - Audit.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Audit. 954.503 Section 954.503 Housing and Urban Development Regulations Relating to Housing and Urban Development (Continued) OFFICE OF... PROGRAM Program Administration § 954.503 Audit. Audits of the grantee and subgrantees must be conducted in...

Neoliberalism, Audit Culture, and Teachers: Empowering Goal Setting within Audit Culture

Science.gov (United States)

Rinehart, Robert E.

2016-01-01

In this paper, I discuss the concepts of neoliberalism and audit culture, and how they affect teaching culture. Moreover, I propose a form of goal setting that, if used properly, will hopefully work to combat some of the more onerous aspects of neoliberalism and audit clture in education.

47 CFR 73.333 - Engineering charts.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Engineering charts. 73.333 Section 73.333 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES RADIO BROADCAST SERVICES FM Broadcast Stations § 73.333 Engineering charts. This section consists of the following Figures 1, 1a, 2, and...

Surgery for vertigo: 10-year audit from a contemporary vertigo clinic.

Science.gov (United States)

Patnaik, U; Srivastava, A; Sikka, K; Thakar, A

2015-12-01