Audit Policy Research Articles

P-1764. Point Prevalence Study of Antibiotic Appropriateness and Economical Cost in a Tertiary Care Trauma Hospital of Northern India to Tailor Antibiotic Stewardship Interventions

Abstract Background Conducting Point prevalence surveys (PPSs) is challenging, especially in developing countries, in the absence of electronic records, lack of dedicated resources and high patient load. This survey was conducted to provide background data for strengthening antimicrobial stewardship(AMS) practices and estimate the economic cost of antimicrobial resistance per antibiotic consumed in a tertiary care trauma hospital in India. Summary of Quality indicators of antibiotic prescribing (in %) Methods The survey included all inpatients admitted in wards and intensive care units of the hospital (300 beds) during World Antibiotic Awareness Week 2023. Standardised modules were adopted from the Global PPS for collecting data on patient demographics, prescribed antimicrobial agents with dosage, indication(s) and duration of treatment, and microbiolgical results. Further, the cost minimization analysis was carried out to assess the treatment cost and variations in costs arising due to generic or branded prescribing. Results Among the 254 patients admitted, the patients treated with at least one antimicrobial was 88.6% (N=225). The median (IQR) day of hospitalization was 7 (3.75) days. The highest prevalence of antimicrobial use was in the ICU (100%), followed by Emergency medicine (97.5%). The majority of patients received empiric than targeted antimicrobial therapy. Antimicrobial prescription was mostly for surgical prophylaxis (49.04%). Among patients for >7 days on treatment, microbiological culture were sent in 16.7% (5/30) patients. Antibiotic quality indicators such as reason in notes and documentation of review date were comparatively lower (Figure-1). Treatment costs varied significantly with prescriptions of maximum and minimum-priced brands, ranging from 69.81%-1490%. Branded therapy were three times costlier than generic therapy in 36 (52.9%) regimens. Conclusion Poor transition from empiricism to rationalism, continuation of surgical prophylaxis for more than one day and underutilization of microbiological tests were noted. There was large variations in treatment cost of infections depending on regimen chosen. Adherence to local antibiotic policy, optimal dosing and regular audit with positive feedback of antibiotic use to treating physician can be useful approaches to implement the AMS Program in the study centre. Disclosures All Authors: No reported disclosures

Occupational health and safety policy and compliance audit for the welder profession in a metal confectionery company

The company analyzed in the paper presented attaches great importance to the activity of protecting all employees and its assets against the risks of injury or damage, considering life to be the most valuable asset. Therefore, occupational safety and health must be integrated through the collective effort to achieve the desired quality of the services provided. In this paper I wanted to highlight the fact that obtaining positive results in the field of OSH involves much more than the implementation of a formalized structure, the management of a company must develop a culture of continuous improvement and involvement / participation of all employees in order to generate positive effects on OSH performance, as it refers to their health and physical integrity. The implementation of these measures and conclusions can significantly contribute to reducing the risks of occupational accidents and illnesses for any employee, not just for the welding profession, thus promoting a safer and healthier working environment.

Occupational health and safety policy and compliance audit for forklift operator profession in a company with specific production, packaging and distribution of mineral waters

The policy in the field of environment, occupational health and safety is embodied in objectives established and communicated at all levels of the organization and for all operations included in the scope of the management system, which are monitored, analyzed and reviewed periodically, so as to ensure: the planning, implementation, maintenance and continuous improvement of the effectiveness of an environmental management system, occupational health and safety oriented towards the satisfaction of all compliance obligations applicable in this field; training, awareness, stimulation and consultation of employees in order to understand the impact of the organization's activities, products and services on the environment, occupational health and safety of their responsibilities in order to actively support management programs and perform work tasks in conditions of environmental protection and occupational safety; to ensure that decisions on occupational health and safety are taken taking into account the need to promote actions to prevent occupational injuries and diseases.

Occupational health and safety policy and compliance audit for the sanitation worker in a waste management company

As part of our ongoing concern for the safety and well-being of our employees, CleanCity Services has decided to conduct an exhaustive occupational health and safety compliance audit. The purpose of this audit is to assess and ensure compliance with the highest OH&S standards and regulations, and to identify opportunities to improve our existing practices and procedures. In this audit, we will focus on assessing our compliance with applicable laws and regulations, the validity and updating of OSH documentation, the identification and proper management of occupational risks, the effectiveness of our OSH policies and procedures, as well as identifying opportunities to improve our system of occupational health and safety management.

Policy Evaluation and Pathway Optimization for High-Quality Development of National Auditing: A Study Based on Grounded Theory and the PMC Model

National auditing serves as a critical safeguard for the health of China’s economic operations and is an essential mechanism for promoting good governance. Audit policies play a pivotal role in guiding and advancing auditing activities. This study, based on grounded theory and social network analysis, utilizes NVivo 12 Plus and ROSTCM6 software to mine and analyze policy documents from recent years aimed at fostering high-quality national auditing. On this basis, an evaluation index system is constructed using the PMC (Policy Modeling Consistency) index model. The PMC indices for 14 policy samples from 2014 to 2023 are calculated, and a PMC surface plot is generated. The results of the policy evaluation (11 rated as good, 3 as acceptable) indicate that there is still room for optimization in policies concerning the high-quality development of national auditing. Further analysis reveals that while these policies perform well in areas such as policy evaluation and support measures, there are shortcomings in aspects like policy focus, policy domains, and perspectives. Finally, the study proposes recommendations for policy optimization, offering both theoretical and practical insights to support the high-quality development of national auditing and contribute to new roles for national auditing in the process of Chinese-style modernization.

How does auditing outgoing officials' natural resource asset management policies affect carbon emission efficiency? Evidence from a debiased machine learning model

Reducing carbon emissions to improve environmental quality has been the Chinese government's unwavering dedication in recent years. Several policies have been implemented with the objective of driving carbon reduction. The implementation of the outgoing leadership natural resources audit policy has played a pivotal role in encouraging local government officials to prioritize both economic and environmental development in their pursuit of performance metrics. However, whether the implementation of this policy contributes to an enhancement in carbon emission efficiency requires further empirical validation. This study, utilizing panel data from 282 cities across China, explores the potential impact of the audit policy (specifically referring to the outgoing leadership natural resources asset audit policy, without ambiguity) on carbon emission efficiency through the application of a debiased machine learning model. The results of the study show that the audit policy has been crucial in greatly raising the regional level of carbon emission efficiency. Furthermore, mechanistic analysis results suggest that the audit policy can enhance regional carbon emission efficiency by influencing green innovation and raising government environmental awareness and green financial levels. Based on the heterogeneity analysis, the regions east of the Hu Line, cities with low levels of corruption, less stringent economic growth objectives, and areas with high levels of public environmental concern are the areas where auditing rules have the greatest influence on carbon emission efficiency. In conclusion, based on the comprehensive results of this study, a series of policy recommendations are presented to further advance China's efforts in carbon reduction, ultimately achieving a more sustainable balance between economic and environmental development objectives.

High-speed railways, audit partner changes across audit offices and audit quality: Evidence from China

The development of high-speed railways (HSRs) has significant regional economic and social implications. We study a micro externality of such development, namely the impact of HSRs on audit firms' human resource allocation and audit quality. Specifically, we investigate the relationship between the availability of HSRs and audit partner changes across audit offices in China which involves a simultaneous change in audit partner and audit office to reallocate human resources. We find that the advent of HSRs between clients and audit offices increases the likelihood of audit partner changes across audit offices especially for predecessor audit offices with severe human resource constraints due partly to the mandatory auditor rotation requirement. Such audit partner changes across audit offices most likely are reciprocal over time, occur within the optimal HSR transportation interval and can significantly improve audit quality in terms of reducing excessive financing reporting discretions, misstatements and regulatory sanctions, but exert no effect on audit fees. Our study has implications for audit firms’ human resource management in light of infrastructure improvements and for audit policy makers to evaluate the standards for audit partner rotations.

Income tax evasion and third‐party reported consumption and wealth: implications for the optimal tax structure

AbstractTax authorities increasingly make use of third‐party reported consumption expenditures when appraising individual income reports. They may initiate an audit if consumption reports cannot be justified by self‐reported income. This in turn incentivizes tax evaders to avoid third‐party reported consumption goods. I determine the implications of this for the optimal tax structure. A tax on non‐reported goods discourages tax evasion because these goods are disproportionately consumed by tax evaders. A tax on reported goods also discourages tax evasion because it further distorts the evader's consumption bundle. I show that it is desirable to tax third‐party reported goods at a higher (lower) rate than non‐reported goods if the elasticity of substitution between both goods is smaller (larger) than one. I then apply the same logic to third‐party reported wealth – i.e., future consumption goods – which tax authorities also use in their audit policies. Existing evidence on the intertemporal elasticity of substitution suggests that it may be optimal to tax third‐party reported wealth at a positive rate.

S04-5: Lessons learned from the results of policy audits of multiple local governments

S04-5: Lessons learned from the results of policy audits of multiple local governments

S04-4: The HEPA PAT: An in-depth tool to audit HEPA policies at national level

Abstract Purpose The Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT) a standardized protocol for the detailed compilation and communication of country-level policy responses on physical inactivity. This presentation aims to briefly present the structure of the tool as well as its use in PA policy research. Methods The 29 open-ended and closed questions of the HEPA PAT are structured around a set of 17 key criteria, which were identified based on experiences from several previous guidelines and comparisons of physical activity policy. It supports standardized data collection and is to be completed collaboratively by a team of national stakeholders from all relevant political sectors. However, the process of its application differed across countries. Results The HEPA PAT has been applied in 13 European countries (Belgium, Croatia, Finland, France, Germany, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Slovenia, Switzerland). These studies provided a detailed overview of physical activity policies for the different sections of the tool such as, for instance, leadership and partnerships, policy documents, evaluation, and funding. A recent study has shown that the tool can be applied to understand aspects influencing the policy process (agenda-setting, policy formulation, decision-making, policy implementation, evaluation). Conclusions The studies based on the HEPA PAT showed in which areas governments are already active to promote physical activity and what improvements can be made. Cross-country comparisons also showed that procedures and timelines of using the HEPA PAT have to be adapted to national contexts. Overall, the instrument can make an important contribution to understanding and informing physical activity policy, especially when used as an add-on to regular monitoring tools like the EU HEPA Monitoring Framework. The PAT completion also fostered new connections with policy makers and officials in government departments and among HEPA stakeholders within and outside of government, which in itself was seen to be extremely valuable. Funding Source No funding

Internal audit and control in an enterprise: how it works and why it is needed

The author examines the importance and principles of functioning of internal audit and control at enterprises, which is a key tool for ensuring the efficiency of the company, preventing possible problems and compliance of activities with legal and regulatory requirements. The article describes in detail the main stages of conducting an internal audit, including planning, conducting, preparing a report and implementing recommendations. Various types of audits are also discussed, such as: • Audit of the accounting system. • Audit of the risk management system. • Audit of the quality management system. • Audit of personnel policy. • Information security audit. • Audit of logistics processes. • Environmental safety audit. • Occupational safety audit. Particular attention is paid to the role of auditors and the importance of independence and impartiality in the conduct of audits. The article will be useful to business managers, financial directors, auditors and anyone interested in management and control issues in business.

Auditor-Firm Conflict: Theoretical Concepts Application and Analysis of the Power Dynamics Involved

This study undertakes a theoretical analysis of the auditor-firm conflict. It relied on the review of literature methodology contextualized on auditor’s appointment , firm economic pressure , management bargaining power, auditor’s fear of losing a firm, firm’s management economic power over the auditor, auditor’s personal attributes and moral reasoning, auditor’s tenure, audit fees, audit market competitiveness, non-audit services, audit firm size and the firm’s financial condition. The study relied on Goldman and Barlev model, exchange and dependency theories to explain the likely power positions in the auditor-firm relationship. Deductively the study based on the contexts indicated the presence of an asymmetry power structure where the auditor and firm have low and high power positions. The study however, proffered resolution measures such as reputational and litigation costs; strengthening of audit committees; control over auditor’s appointment and remuneration; effective discipline of firms and auditors and strong enforcement of standards. The measures can curtail the auditor’s and firm actions in reducing violation of auditing standards; improving auditor’s independence, reduce the firm’s pressure on the auditor and bring about balance of power positions. The paper has implications for understanding the auditor-firm conflict situation and provides opportunities for strengthening audit policy and audit standards development.

Harnessing policy to promote inclusive medical product evidence: development of a reference standard and structured audit of clinical trial diversity policies

ObjectiveTo develop a reference standard based on US Food and Drug Administration and stakeholder guidance for pharmaceutical companies' policies on diversity in clinical trials and to assess these policies.DesignDevelopment of...

TAX COMPLIANCE CONTROL AND AUDIT OF TRANSFER PRICING TRANSACTIONS

The article presents the authors' vision of the features and mechanism of tax compliance control and audit in the management of transfer pricing operations. Effective interaction between business entities and tax authorities in the process of controlling and auditing transfer pricing transactions should be based on the principles of compliance with the help of two tools – assessment of the quality of transfer pricing policy and internal control system (as a result of interaction of internal and external control systems) and assessment of the quality and effectiveness of internal audit of transfer pricing (as a result of interaction of internal control and audit systems). In accordance with the above, tax compliance control and audit becomes a new element of the established system of monitoring of controlled transactions of a business entity, which proposed to understand as the use of tools to confirm the quality and effectiveness of internal control and audit systems of transfer pricing transactions of a business entity by a tax authority, which certifies the taxpayer's commitment and responsibility to comply with tax legislation in terms of compliance with the arm's length principle. Confirmation by the tax authorities of the quality of the transfer pricing policy and internal control and audit system of the entity should be based on the developed, tested and approved system of assessment parameters. Confirmation of the assessment of the quality of the transfer pricing policy and internal control system will demonstrate the responsible position of the taxpayer based on tax compliance with the transfer pricing legislation in accordance with the arm's length principle and will increase the level of trust in it on the part of the tax authorities. In turn, the introduction of such a tool as an internal transfer pricing audit quality assessment into the process of monitoring-controlled transactions will allow the company to submit and use the results of its internal audit in assessing transfer pricing risks to form its tax rating and assess the need to include it in the audit plan. This tool assumes that the internal audit system is sufficient to timely detect violations of tax legislation in the field of transfer pricing in accordance with the arm's length principle.

Transfer Pricing Audit Policy Design Toward A Fair Tax System In Indonesia

Transfer Pricing Audit Policy Design Toward A Fair Tax System In Indonesia

A critical turn in numeracy education and practice

Research into the nature of numeracy and numeracy practice has typically been focused on the capabilities required to participate effectively within personal, civic, and work life. In this article, we document the development of numeracy theory and practice from a functional perspective through to a view that includes evaluative and decision-making capabilities now required for informed and responsible citizenship—a critical turn. We map this development through an audit of policy and curriculum documents in addition to published research, making connections to the ever-changing mathematical demands of society. These include new demands that require critical approaches to the deployment of numeracy capabilities. We argue that this turn to the critical is central to how citizens support their societies' responses to recent and intensifying disruptive phenomena such as COVID-19 and for ensuring equity, inclusiveness, and social justice remain a high priority in a rapidly changing world.

Политика риск-ориентированного внутреннего аудита предприятий реального сектора экономики

In continuation of the topic of the author’s article «Relevance and practice of risk management in domestic enterprises» (Auditor, No. 4 (2022)) in this material, the author proposes the form of an internal document (standard) «Risk-oriented internal audit Policy», which can be used by enterprises of the real sector of the economy in their practical activities.

Adoption of policies to improve respectful maternity care in Timor-Leste.

There are now well-established global standards for supporting improvement in women's experience of maternity services, including frameworks for the prevention of mistreatment during childbirth. To support initiatives to improve the quality of care in maternal health services in Timor-Leste, we examine the adoption of global respectful maternity care standards in the national intrapartum care policy and in three urban birth facilities in Dili. From May to July 2022, we conducted a desk review of the Timor-Leste National Intrapartum Care Standards and Clinical Protocols for Referral Facilities and Community Health Centres. This was followed by a health-facility audit of policies, guidelines and procedures in three main maternity facilities in the capital, Dili to examine the extent to which the WHO (2016) standards for women's experiences of care have been adopted. Despite the availability of global guidelines, key standards to improve women's experience of care have not been included in the National Intrapartum Care guidelines in Timor-Leste. There was no mention of avoiding mistreatment of women, needing informed consent for procedures, or strengthening women's own capability and confidence. In the policy wording, women tended to be distanced from the care 'procedures' and the protocols could be improved by taking a more woman-centred approach. The results of the health facility assessment showed extremely low use of standards that improve women's experiences of care. Health Facility 1 and 2 met two of the 21 quality measures, while Health Facility 3 met none of them. The discourse communicated through policy fundamentally affects how health care issues are framed and how policies are enacted. Given the findings of this study, combined with previously documented issues around quality of care and low satisfaction with maternal health services, there is a need for a fundamental shift in the culture of care for women. This will require an immediate focus on leadership, training and policy-frameworks to increase respectful care for women in health facilities. It will also require longer-term effort to address the power imbalances that drive mistreatment of women within and across social systems, and to support models of care that inherently foster understanding and compassion.

Regulating vulnerability: policy approaches for preventing violence and abuse of people with disability in Australian service provision settings

This article analyses policy frameworks designed to protect people with disability from harm in service provision settings and respond to their experiences of violence, abuse, neglect, and exploitation, with a focus on the Australian National Disability Insurance Scheme (NDIS). The creation of a new disability services market has facilitated greater choice and empowerment for NDIS participants, but has also exposed them to new risks and vulnerabilities. Drawing on feminist vulnerability theory, a policy audit, and qualitative research with seventeen key stakeholders, the article reflects on the need to incorporate more nuanced understandings of vulnerability in safeguarding policy and respond to the situational and pathogenic vulnerability created by the way systems and structures operate. It identifies opportunities to enhance the personal autonomy of people with disability through accessible pathways for complaints and justice, and greater focus on natural and mainstream safeguarding systems in complementing disability-specific systems.

A systematic evaluation of physical activity and diet policies in Scotland: results from the 2021 Active Healthy Kids Report Card.

Policymaking regarding physical activity (PA) and diet plays an important role in childhood health promotion. This study provides a detailed examination of Scottish government and policy for child and adolescent PA and diet and discusses strengths and areas for improvement. Scottish policy documents (n=18 [PA]; n=10 [diet])-published in 2011-20-were reviewed for grading using an adapted version of the Health-Enhancing Physical Activity Policy Audit Tool Version 2. There is clear evidence of leadership and commitment to improving PA and diet and tackling obesity in children and adolescents. The allocation of funds and resources for policy implementation has increased substantially over the past decade. Progress through early key stages of public policymaking-policy agenda and formation-has improved. However, there is limited information on later key stages, including policy monitoring and evaluation. Childhood PA and diet are a clear priority in Scotland, and PA and diet policies clearly support the desire to achieve other goals, including reducing inequalities and increasing active travel in Scotland. Nonetheless, future policies should be further strengthened through clear(er) plans of implementation, and monitoring and evaluation to support their societal impact.