THE INTERNAL AUDIT IN MANAGEMENT CONTROL.
Explore the source record for details and available documents.
Disease Management↗
SEARCH · Search PubMed
Results for “Management Audit”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Assessment of hypertension levels control and management (hypertension "AUDIT" project). Study in a population of workers.
The hypertension AUDIT project (WHO) was used for the study of large populations of workers in two Romanian industrial centers, Slatina and Sibiu, constituted into two main groups. The objects of the study were: the detection of new cases of arterial hypertension (AH) and of their proportion as compared with older cases, the assessment of the quality of diagnosis control and treatment methodology as well as the estimation of the patient's attitude regarding the conditions of treatment and of the physician's knowledge and attitude regarding AH. Group I (Slatina) included 22,839 workers and the program was applied in 15,740 randomly chosen subjects. Group II (Sibiu) included 14,874 workers of whom 2,838 were randomly chosen for study. From a total of 606 (6.20%) subjects aged 35 to 64 years with AH in both groups, 494 (81.51%) were older cases and 112 (18.48%) were newly detected. The prevalence of AH was found to increase with age and to be higher in women aged 55 to 64 years. The treatment in older cases from both groups was considered effective in 232 cases (46.96%) (of which 26 (11.2%) with overtreatment) and insufficient in 262 (53%). The reasons alleged by the patients for the late detection of AH were the absence of symptoms and a casual interest for their state of health. The risk factors were systematically checked. Smoking was found in 30.36% of the subjects in group I and in 31% of those in group II. The use of diagnostic laboratory procedures was corresponding to the present recommendations. The nonpharmaceutic therapy was frequently recommended, especially reduction of salt consumption. Besides that, pharmaceutic treatment was indicated in most of the patients (63% in group I and 90% in group II). Diuretics (41.26% in group I and 75% in group II), and beta blocking drugs (35.3% in group I and 70% in group II) were the most frequently administered and in a lesser proportion vasodilators with central or peripheral action, calcium blockers, Rauwolfia and angiotensin conversion enzyme inhibitors. The consumer inquiry showed satisfactory compliance of patients, most of them took their tablets regularly, were satisfied with the medical assistance and preferred to consult the same physician. The data of the physician inquiry regarding diagnosis treatment of AH and professional training also proved satisfactory. The use of the AUDIT project has allowed a complex estimation of AH in the groups studied and will prove useful for a more efficient control of AH in the whole population.
Adolescent↗
A six-year audit of the management of ectopic pregnancy.
OBJECTIVE: To audit the management of ectopic pregnancy at National Women's Hospital over a six-year period to monitor changes in practice and assess adherence to hospital protocols. STUDY DESIGN: A retrospective audit of the management of women with a discharge diagnosis of ectopic pregnancy from 1996-2001 at National Women's Hospital, Auckland, New Zealand. Information was collected regarding the demographics, risk factors for ectopic pregnancy, delay in diagnosis, management undertaken and failure and complications of initial treatment. RESULTS: Over a six-year period a total of 673 women had a discharge diagnosis of ectopic pregnancy. Surgery was the most frequent method of management but there was increasing utilisation of systemic methotrexate. The proportion of women who met the criteria for methotrexate varied from 27-54% over the six year period although the highest proportion who received methotrexate in any given year was only 24% (2001). The proportion of women who met the criteria for receiving methotrexate and had the option of methotrexate discussed with them increased from 12% in 1996 to 91% in 2001. Over the six year period 74 women received methotrexate and 14 (18.9%) failed and required surgical management. Surgical management was performed in 537 women and 30 (5.6%) required either further surgery or methotrexate or a combination of both. A laparoscopic procedure was performed in 86.5% (465/533) and 10.9% (51/465) converted to laparotomy CONCLUSIONS: Although there is evidence that methotrexate is an effective and safe option for a proportion of women with ectopic pregnancy, the majority of women still undergo surgical management.
Abortifacient Agents, Nonsteroidal↗
Managing information resources: a study of ten healthcare organizations.
This article presents the results of information technology management audits conducted by senior executives at ten healthcare organizations. The audits evaluated how well the following seven information technology management responsibilities were carried out: (1) strategic information systems planning; (2) employment of a user focus in system development; (3) recruiting of competent personnel; (4) information systems integration; (5) protection of information security and confidentiality; (6) employment of effective project management in system development; and (7) post-implementation evaluation of information systems. The audit results suggest that most of these responsibilities are being met to a considerable extent by a majority of the organizations studied. However, substantial variation across organizations was noted. Executives participating in the study were able to define areas in which the management of information resources in their organizations was in need of attention. The audit process encourages senior management to provide the leadership required to ensure that information technology is used to maximum advantage.
Computer Security↗
The British Association of Dermatologists audit of atopic eczema management in secondary care. Phase 1: audit of service structure.
This first comprehensive study of atopic eczema management describes an audit of service structure (phase 1), process (phase 2) and outcome (phase 3) in the U.K. This paper describes the phase 1 results. Service structure was audited by a single-page questionnaire containing 10 questions on outpatient facilities. This was sent to the lead dermatologist at 187 dermatology centres throughout the U.K., and a final response rate of 98% was achieved. Although the percentage of centres reporting the presence of recommended facilities did not reach the 100% working standard for any one specific criterion, about half of the recommended items, such as provision of height and weight measuring facilities, access to a dietician, patch testing and photochemotherapy, was reported in over 90% of centres. Areas of service structure which were infrequently reported to be in place were issuing of new appointment letters asking patients to bring their treatment details to clinic (52% of centres) and access to nurses with dermatology experience on paediatric wards (57% of centres). Some audit measures, e.g. access to counselling services, showed wide regional variation (range 33-94% of centres), and these variations could not be explained simply in terms of provision of specialists. Some of the elements of service structure, such as access to nurses with dermatology experience on paediatric wards, may be difficult to change in the short term because of funding and staffing constraints, but others, such as provision of growth charts, are easy to change at little cost. This preliminary audit serves as a framework for future audits of atopic eczema management.
Dermatitis, Atopic↗
Audit of the management of patients admitted with community acquired pneumonia.
Community acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. There is evidence that guidelines do guide and standardise management, but with less measurable effect on outcome. We prospectively audited the management of CAP in patients admitted to a Dublin hospital during the winter of 2003/04. The main objective was to evaluate the quality of care for CAP using the BTS guidelines as a standard of management. 164 patients were admitted with CAP during the defined period. Guidelines for assessment of disease severity at presentation were followed in only 56 (34.1%) cases. Appropriate antibiotic therapy was instituted within 8 hours of presentation in 123 (75.0%) cases. The rate of use of a severity assessment score to stratify patients with CAP based on recognized guidelines is low in our hospital. Despite this, the overall mortality rate of 8.5% is comparable with previous results.
Aged↗
Audit in the management of gliomas.
A retrospective study of 139 glioma patients was conducted in an effort to audit management. Factors affecting survival were studied using a Cox Proportional Hazard Model. These factors included age, sex, location, grade, type of surgery, use of radiotherapy, presenting symptoms, Karnofsky score on admission and Karnofsky score 3 months following surgery. Lower grade, high Karnofsky score on admission, radiotherapy and frontal location were associated with better survival. There was statistically insignificant evidence that the other factors had an influence on survival. Patients presenting with a poor neurological score were treated with burrhole biopsy alone. Only 10% of these patients survived more than 6 months. On the other hand, 26% of patients who had craniotomy on the basis of reasonable clinical status lived less than 6 months. Sixty-six per cent of patients in this craniotomy group were aged 60 years or over, and 66% of those aged over 60 had a Karnofsky score of less than 70. We conclude that careful judgement is required before subjecting patients aged over 60, especially those with a low Karnofsky score, to radical therapy.
Adolescent↗
Reverse quality management: developing evidence-based best practices in health emergency management.
The British Columbia Ministry of Health's Framework for Core Functions in Public Health was the catalyst that inspired this review of best practices in health emergency management. The fieldwork was conducted in the fall of 2005 between hurricane Katrina and the South Asia earthquake. These tragedies, shown on 24/7 television news channels, provided an eyewitness account of disaster management, or lack of it, in our global village world. It is not enough to just have best practices in place. There has to be a governance structure that can be held accountable. This review of best practices lists actions in support of an emergency preparedness culture at the management, executive, and corporate/governance levels of the organization. The methodology adopted a future quality management approach of the emergency management process to identify the corresponding performance indictors that correlated with practices or sets of practices. Identifying best practice performance indictors needed to conduct a future quality management audit is described as reverse quality management. Best practices cannot be assessed as stand-alone criteria; they are influenced by organizational culture. The defining of best practices was influenced by doubt about defining a practice it is hoped will never be performed, medical staff involvement, leadership, and an appreciation of the resources required and how they need to be managed. Best practice benchmarks are seen as being related more to "measures" of performance defined locally and agreed on by 2 or more parties rather than to achieving industrial standards. Relating practices to performance indicators and then to benchmarks resulted in the development of a Health Emergency Management Best Practices Matrix that lists specific practice in the different phases of emergency management.
Benchmarking↗
A multidistrict audit of the management of chlamydial PID in genitourinary medicine clinics in Yorkshire.
In response to recent reviews of practice of pelvic inflammatory disease (PID) management, a multidistrict audit involving eight genitourinary clinics within the Yorkshire region was carried out. This audit reports the referral patterns of patients, physical signs and microscopy findings at the first genitourinary medicine (GUM) clinic attendance, antibiotic treatment and follow-up data as well as health adviser involvement and partner participation for 68 patients diagnosed with chlamydial PID. Twenty-eight (41.2%) patients presented with symptoms of less than or equal to four weeks duration, partner notification was recorded as being carried out for all patients and at least one partner was documented as having been treated in 57 (83.8%) patients. There is, however, a wide variation in the antibiotic regimens used for treatment and their duration.
Anti-Bacterial Agents↗
Audit of the management of spontaneous pneumothorax.
This audit suggests that clinical practice in the management of spontaneous pneumothorax differs from guidelines issued by the British Thoracic Society. In particular simple aspiration was attempted in only seven out of 65 patients and clamping of an intercostal chest drain occurred in 12 out of 50 cases. Junior medical staff require more training in intercostal drainage.
Drainage↗
Auditing health and safety management systems--an insurer's view.
Explore the source record for details and available documents.
Cost-Benefit Analysis↗
[Medical audit: a modern undervalued management tool].
Medical audit is defined as the critical and periodical assessment of the quality of medical care, through the revision on medical records and hospital statistics. This review defines the work of the medical auditor and shows the fields of action of medical audit, emphasizing its importance and usefulness as a management tool. The authors propose that every hospital should create an audit system, should provide the necessary tools to carry out medical audits and should form an audit committee.
Humans↗
Organization of health & safety in hospitals.
I intend to concentrate on how we have tackled the practicalities of Health & Safety at St Mary's Hospital in Portsmouth. We have tried to comply effectively, not just give lip service and to take a positive management initiative rather than a purely defensive attitude. This is not merely a response to the loss of crown immunity but a course of action we had already started. Key elements are the appointment of Safety and Audit Managers (SAMs) and Statements of Organisation and Arrangements (SOA) for each department and the conduct of the Health and Safety Committee.
Accident Prevention↗
Following the electronic trail.
How can you protect patient information while maintaining immediate access for qualified employees? HIM professionals across the country are taking leadership roles in developing and managing audit trails for computerized health information. Here are a few of their success stories.
Computer Security↗
An audit of pain management in acute sickle cell crisis.
People undergoing sickle cell crisis can experience extreme pain that is not always managed effectively. This article describes an audit of pain management in sickle cell disease that was used to generate practice guidelines. A subsequent audit of pain management for this client group demonstrated improvements in the quality of care delivered.
Acute Disease↗
Audit helps health & safety management systems development.
Explore the source record for details and available documents.
England↗
Organizational change techniques: their present, their future.
To help carry out their responsibility of managing rapid and often unexpected change, managers have an available set of techniques: organizational behavior modification, management by objectives, management development, organization development, management auditing, and a control cycle of planning, implementation, and control. Each of these has a format that species the procedures to be followed to bring about organizational change. Michael emphasizes that such formats are preferable to a haphazard, trial-and-error approach that may produce unanticipated results. In part because some techniques are newer than others, data from a research project of planning and control that Michael conducted show different rates of usage by a sample of Fortune 500 companies. The control cycle is the most widely used; organizational behavior modification the least widely used. The use of these techniques of organizational change is likely to vary in some ways and experience may bring about changes in the techniques. Michael concludes that the newer breed of managers who are versed in the social sciences, mathematics, and the computer are likely to spread new techniques in the organizational world.
Behavior Therapy↗
Audit commission defines NHS management costs.
Explore the source record for details and available documents.
Hospitals, Public↗