Showing papers on "Audit published in 1976"

Auditing: An Integrated Approach

Abstract: The auditing profession: the auditing profession audit report professional ethics legal liability. The auditing process: audit responsibilities and objectives audit evidence audit planning and documentation materiality and risk the study of internal control and assessment of control risk overall audit plan and audit program audit of the sales and collection cycle audit sampling for tests of transactions completing the tests in the sales and collection cycle - accounts receivable audit sampling for tests of details of balances the effect of complex EDP systems on auditing. Application of the auditing process to other cycles: audit of the payroll and personal cycle audit of the acquisition and payment cycle: tests of controls substantive tests of transactions and accounts payable completing the tests in the acquisitions and payments cycle: verification of selected accounts audit of the inventory and warehousing cycle audit of the capital acquisition and repayment cycle audit of cash balances. Completing the audit and offering other services: completing the audit other audit attestation services and compilation engagements internal and governmental financial auditing and operational auditing.

Expert Judgment in Audit Program Planning

Abstract: Independent auditors collect, weight, and combine information in formulating an opinion about the fairness of their clients' financial statements. Auditors exercise professional judgment in determining the type and extent of information to collect and in assessing the implications of this information. The exact constitution of professional judgment is unknown but is certainly influenced by lengthy formal education and prior job experience. Because precise guidelines for information collection and evaluation in auditing do not exist, individual professional judgment plays an extremely important and pervasive role in auditing (Mautz [1959]). Since individual professional judgment is generally conceded to be very important in auditing, it should be the subject of a commensurate amount of systematic research. The several empirical studies that have been conducted (some of which are reviewed below) have generally reported substantial differences among the judgments made by individual auditors who served as subjects in the research. If auditors are, in fact, idiosyncratic in collecting, weighting, and/or combining information, then the validity of their judgments may be questioned, and research into the nature and costs of such differences may be in order.

The social audit: A political view

Abstract: The experiences of Social Audit are reviewed and appraised. On this basis some key problems of social auditing are discussed and possibilities for the future outlined.

Continuing Medical Education: The Philosophy and Use of Audit

Abstract: In 55 audits of 37 topics totaling 5,499 patient records, 94% of deficiencies were in the area of performance, while only 6% occurred in the area of lack of knowledge. In addition to defining problems, audit serves as an educational experience and a stimulus to improve practice. ( JAMA 236:1485-1488, 1976)

Office records in the evaluation of quality of care.

Abstract: Trained reviewers audited 10,500 charts in the offices of 166 pediatricians and family physicians. Criteria for child health supervision and three diseases had been previously validated for relevance to health outcome and suitability for peer review.Overall documentation of criteria was approximatel

Medical audit, continuing medical education and quality assurance.

Abstract: Medical audit and continuing medical education (CME) are now the mainstays of quality assurance in hospitals. Audits should address problems that have serious consequences for patients if proper treatment is not given. The single most important step is the selection of essential or scientific criteria that relate process to outcomes. CME does less than commonly believed to improve care. Today, quality assurance increasingly means a near-guarantee to every patient of appropriate treatment and fewest possible complications. Maintenance of the public trust rests on a firm commitment of the medical staff and board to this principle, implemented through an organized program of quality assurance. Under these conditions, medical audit and CME can effectively improve care by improving physician performance.

Patient participation in the problem-oriented system: a health care plan.

Abstract: The problem-oriented system can be used to encourage the involvement of the patient in his health care. A Health Care Plan is described, the purposes of which include facilitation of provider-patient communication, and emphasis on the shared responsibility of provider and patient in problem solving and health maintenance. The Health Care Plan is not designed to supplant other parts of the system such as the problem list or audit.

An evaluation of emergency room services during the New York City house officer strike.

Abstract: A chart audit of emergency services provided by attending staff during the New York City House Officers' strike is compared to an audit of work previously performed by house staff. The usual quality of services provided in this institution was maintained during the strike. However, deficiencies in quality noted in house staff charts, continued to be noted in the charts of attending staff. Failure to improve quality of medical records when trained staff substitute for trainees suggests that the central strike issue of poor working conditions contributes to low quality of care.

Biofeedback At the Organizational Level: the Communication Audit:

Abstract: The authors present a rationale for the adoption of a periodic communica tion audit at the organizational level. It is proposed that a periodic communication audit is a tool for more effective management of organiza tional communication policies, networks, and activities. The communica tion audit can provide the organization with a sensoring system for developing a level of internal sensitivity and adaptiveness that biofeedback techniques have made possible on the individual level.

A futurological justification for historical cost and multi-dimensional accounting

Abstract: Futurology, interpreted as a forecast or, even better, as projections intended to influence the future, is applied to justify retention of historical costs in the context of proposed multidimensional accounting extensions for business, government and national goals accounting. Budgetary disclosures supported by opportunity costs and tradeoffs are also examined via multiple-objective models of goal programming varieties. Independent audit and attest is suggested not only for the mathematical model but also for managerial explanations of subsequent discrepancies from plans in each pertinent dimension.

A performance-based method of student evaluation.

Abstract: Summary A method of medical education has been developed which emphasizes audit of student performance in terms of behavioural traits (thoroughness, reliability, analytic sense, and efficiency) rather than in terms of memorized knowledge. This method is dependent upon the Problem-Oriented Medical Record. The tools developed for the audit and some preliminary results are presented.

Surgical audit: one year's experience in a teaching hospital.

Abstract: For 12 months the surgical staff at Hope Hospital have operated a form of audit. The monitored information included work load, methods of treatment, complications, misdiagnoses, and deaths. The method described is suitable for any district general or teaching hospital provided adequate secretarial help is available. In addition to helping to maintain standards, an audit of this type has a positive educational role.

Educational Auditing and Accountability.

Abstract: The federal government is prohibited by the constitution from intruding into educational matters; state governments also have been reluctant to do so. The government has. had to depend on volùntary accrediting organizations as evaluators of educationl quality. These organizations assess educational quality and encourage its improvement. Educational auditing and accountability is one approach toward improving accrediting organizations criteria and procedures and their responsiveness to the needs of users of accreditation. The concept is modeled on the auditing system developed by the Securities and Exchange Commission for"accrediting" business. The auditing plan follows the same basic steps as current accrediting procedures with limited expansion 9f the "research staffs of the regional accrediting commissions and the Council on Postsecondary Accreditation. The basic steps in the accréditing•process pould include (1) the institution carrying on a self-study and preparing two formal reports, in.rluding the 4ducational.stateients of the institution and a report'for publication'; '(2) the regional commission appointing a visiting committee whbse members each have specific responsibilities; (3) the team of educational, auditors, specialized committee members, and the chairperson conducting an on-site investigation to verify the assertions in the educational And financial statements; (4) a report and evaluation submitted by ,the committee to the regional commission; (5) recommendations to the institution; and (6) regular annual self-study analysis reported' back to the commission. (JHF) EDUCATIONAL AUDITING

The cost of auditing outpatient records.

Abstract: When patient records are to be auditied in a program designed to assess the quality of medical care rendered, careful consideration must be given to the cost of the system implemented. Structured data collection and a defined treatment plan are advantageous in facilitating the use of nonphysicians for the majority of the audit. A system using checklists to ensure adequate recording of subjective and objective data and a defined treatment plan for a common symptom complex were implemented by physicians and physician's assistants with a patient load averaging more than 1,000 patient contacts per week in a general medical clinic at Duke University Medical Center. Audit was subsequently accomplished at a cost of 96 cents per record. To reduce this cost, more efficient methods of selecting records for audit should be developed.

Assessing the quality of care by house staff in a municipal hospital emergency department

Abstract: The hypothesis that the results of process measures of the quality of care would be improved in a busy municipal hospital emergency department by using a medical record audit and reviewing findings with house staff and those responsible for their training was tested over a one year period and, tentatively, rejected. Out of 21 audit items, 14 showed no significant change. Of the remaining seven, only three items showed significant improvement. Other mediating factors are related to quality of care in this setting such as patient/staff ratios, supervision, the focus of training programs, the physical plant, staff attitudes, behavior and questions of control.

Director Liability Committee and the Audit

Abstract: To reduce their growing exposure to liability suits, many directors are attempting to take a more active role in the evaluation of their firms and to simultaneously have formally recorded the performance of their responsibility. To meet both of these objectives, directors must have access to complete and reliable corporate information and be able to conduct independent inquiry into the quality of information they receive. The board of directors9 audit committee has the potential to fulfill these needs. The researchers queried CEOs and outside directors of nearly two hundred forms and applied these data to evaluation of the audit committee concept, analysis of the perceived and actual role of audit committees, and identification of actions that can improve audit committee performance and thus reduce the directors9 potential liability exposure.

Auditing the quality of care in emergency departments

Abstract: A methodology for evaluating the quality of emergency department care in the form of a retrospective process audit for emergent and urgent cases was developed and tested in the Philadelphia General Hospital Emergency Department. A physician panel developed criteria against which the management of six "chief complaints," as indicated on the medical record, was measured. Then nonphysician auditors examined records retrospectively for a three-week period, covering every day and shift for a total sample of 389 cases. The physician panel made an implicit review of those records that varied from the criteria. The results of the review in four diagnostic areas showed that for chest pain 51% (36) did not meet the provisional standards; for abdominal pain 35% (35) did not; for wounds 51% (51) did not, and for sore throats 43% (22) did not. These results were presented to the ED staff and charts were re-audited after one month. The results of this second audit are being tabulated though preliminary findings indicate an improvement in the percentage of cases meeting the criteria.

Management Criteria, Documentation, and Peer Review of Initial Urinary Tract Infection

Abstract: During part of a national study to formulate criteria for chart audit of quality assurance of child health care, criteria were developed for diagnosis and management of urinary tract infections. These criteria were validated by pediatricians and family physicians in academic medicine and in practice. They were judged relevant to the medical care process and patient outcome by both. The selected criteria were also recommended by the majority of two large physician groups for use in peer review. An important aspect of the study assessed the frequency of performing and recording indicated procedures or tests. In the first three phases of the study these criteria were said to be performed and recorded by a large majority of physicians. However, in the fourth (community) phase, when charts of 166 primary care physicians were actually audited, documentation was so poor that peer review by chart audit would be impractical at present. Assuming proper documentation of the medical care process, similar criteria could be used for chart audit, clinical research, and educational purposes. Since the diagnostic and management process of initial urinary tract infection is established, development of structured health care forms and education in proper record-keeping are two important challenges for those interested in the evaluation of ambulatory care.

A monitoring and evaluation plan for alcoholism programs.

Abstract: Summary In 1972 a study was undertaken to evaluate the quality of services being delivered to a population of alcohol abusers. This study focused primarily on the system of health care rather than the outcome of treatment modalities. The results of this study indicated a great deficit in the health care delivery system and therefore a system was devised to help correct this identified deficit. This system is described in detail and is currently being implemented in the state of Alaska. The goals are multiple and include assurance of a minimum standard of care, collection of data which will allow audit of the sytsem and of the health care providers and finally information which will increase our understanding of the types of treatment most effective in the care of a given patient.

Discussion of Expert Judgment in Audit Program Planning

Abstract: Joyce has selected an important area of accounting research to investigate. The specific issue addressed here is: given the importance of professional judgment in auditing, and given previous evidence indicating substantial individual differences in judgments concerning the amount of audit work to perform, what specific properties of judgment models can be inferred in a quasi-experimental setting? Given the loss functions being imposed upon public accounting firms for judgmental errors by the courts and the general public, the topic is obviously contemporary and interesting. Aside from the costs of information gathering and usage, analysis of judgment models is mainly of interest if different audit opinions are implied by different evidence-gathering procedures and alternative individual and group judgment models. If decisions concerning, for example, what audit opinion to generate or what particular allocation of resources is appropriate for a specific phase of an audit, are made in a group setting, then the area of group judgment and decision processes is the relevant context. Characteristics of both individuals and groups imply alternative group decisions (Davis [1969]; Davis et al. [1976]). A portion of future work in the auditing area should be concentrated on group processes.