Commission Requirements Research Articles

Compensation Risk Assessments

In response to Securities and Exchange Commission requirements, most companies have eliminated the more obvious types of corporate exposure to imprudent risk taking linked to pay, such as megagrants of stock options, performance incentives based entirely on top-line growth or significant “guaranteed” severance packages. Risk assessments can dive deeper, though, to uncover risks or opportunities from pay plans that are not obvious on the surface. The risks include financial burdens placed on the company from the incentive plan, operational processes that fail to surface and mitigate errors in judgment or calculation of payments, plans that damage the company’s reputation and plans that have the potential to cause a loss of critical talent. In uncovering risks, opportunities to improve plan design and effectiveness are often revealed, as well.

The role of effective audit committee in strengthening the financial reporting: Evidence from Jordanian listed companies

This study aims to understand the features of an effective audit committee and its role in strengthening financial reporting. A questionnaire based survey was circulated to public listed companies on the Amman Stock Exchange (Banking, insurance, and financial institutions). The study was aimed at internal audit managers and finance managers. Out of 156 questionnaires, we received 110 back which represents a 71% response rate. The study results show that the research respondents have a good level of education and experience. In addition, there is a relationship between internal controls, international standards on auditing, institute of internal audit; Jordan securities commission requirements, external audit, understanding of audit committee functions, and financial reporting. Furthermore, the internal control, international standard on auditing and institute of internal audit, Jordan securities commission requirements, External audit, understanding of audit committee functions can explain a significant amount of the variability in financial reporting. Finally, the research results also show that age and gender make a difference for our respondents when they evaluate financial reporting. The study like other cross sectional studies is not free of limitations. Managerial implications and new avenues of future research are supplied. Future research also can borrow the research model and apply a longitudinal study to solve the cross sectional study problems.

The Roundup

The Roundup

Should Cable Be Included in the Wholesale Broadband Access Market Definition? A Critique of the European Commission Test

In the analysis of the Wholesale Broadband Access (WBA) market, an issue that has constantly been discussed between the European Commission (EC) and the National Regulatory Authorities (NRAs) within the mechanism of the Article 7 Framework Directive Consultation Procedures is whether cable-based access services should be included in the market definition. This article provides an overview of the Commission decisional practice in this market in the period 2008-2010 (up to September), summarizes the Commission's requirements for such inclusion, and ends with some critical remarks on the applicable test and the effects on the NRA's work due to the deployment of Next Generation Networks (NGNs).

Validating Patient Safety in the Endoscopy Unit Using The Joint Commission Standards

Patient safety has gained increasing interest and importance in the endoscopy suite. To maintain standards in patient identification, confidentiality, medication safety, and specimen handling while still meeting The Joint Commission or other agency requirements, all employees must be part of this process. This article demonstrates ways to accomplish this goal, using audits of safety standards that increase staff involvement. A sample audit tool is provided, along with methods to help all employees feel empowered to meet standards and report any patient safety issues.

The Power of the Purse: Supranational Entrepreneurship, Financial Incentives, and European Higher Education Policy

This article shows how the European Commission cultivates policy shifts toward a particular idea of a common European Higher Education Area by using its considerable financial leverage. By making European Union (EU) funding dependent on grant recipients meeting certain strategically selected conditions, the Commission creates new incentive structures for domestic actors, in this case higher education institutions (HEIs), with two important consequences. First, the Commission turns universities into agents for its policies: Universities lobby governments to pass legislation, which would allow them to conform to Commission requirements. Second, HEIs try to comply with the Commission's requirements even in the absence of compatible national frameworks, thereby leapfrogging policy decisions on the national level. Describing this as a “soft” mechanism for achieving convergence, as Open Method of Coordination accounts posit, overlooks the fundamentally non-negotiable nature of the process from the participants' perspective and considerably underestimates the Commission's real influence. We examine this argument through a case study of an EU-funded higher education program, Erasmus Mundus.

Sustainability and Public Museum Buildings - The UK Legislative Perspective

This paper looks first at the overarching UK government sustainability priorities and then follows that policy thread through to the Audit Commission's work on ranking the performance of local authorities. As publicly funded local authorities are the largest providers of museum services in the UK, the Audit Commission's requirements have a considerable effect on how those services are run. The paper examines the Comprehensive Performance Assessment mechanism and moves on to the forthcoming Comprehensive Area Assessment. It focuses in particular on the use of resources and the key lines of enquiry that underpin those judgements, and continues by examining the corporate response of local authorities to such sustainability and asset management targets, and its effects on museums. Three practical strategies of wider application than the UK alone are proposed for making savings and contributing to sustainability: a unified 'one museum' approach to conservation; better internal advocacy for collections management directed towards those who design, maintain and operate museum systems; and more effective training for responsible managers in the science of sustainability. For this last point, a 'demonstration museum' to serve as an exemplar on an international scale is proposed.

Evidence for Increasing Diversity in Graduate Medical Education: The Competence of Underrepresented Minority Residents Measured by an Intern Objective Structured Clinical Examination

Some have commented that the limited number of underrepresented minorities (URMs) in United States' residency programs is due to a lack of qualified candidates. At the University of Michigan, an objective structured clinical examination is administered to incoming residents at the beginning of training to determine baseline competence. In this study we wanted to determine if competence differed for underrepresented minorities when compared to non-URM residents. The postgraduate orientation assessment, a 10-station examination, was developed that focused specifically on the knowledge and skills needed in the first 6 to 18weeks of training. Stations assessed competence in informed consent, aseptic technique, evidence-based medicine, diagnostic images, critical laboratory values, cross-cultural communication, and Joint Commission requirements such as surgical fire safety, pain assessment, and management. We used various assessment measures including standardized patients, computer-based testing, and multiple-choice questions. Our study found no significant differences in overall mean scores between URM residents and all other residents for the 5years during which we administered the examination, except for 2002. This stands in contrast to the consistently worse performances of URM students on USMLE Step 1 and Step 2 Clinical Knowledge. Also, URM residents did not perform better or worse than their non-URM colleagues on standardized patient stations during the course of 5years during which the examination was administered. The postgraduate orientation assessment provides residency program directors with a standard format to measure initial clinical skills. When compared to incoming non-URM residents from a variety of medical schools, URM residents perform as well as other trainees. Our results may aid in the recruitment efforts of URM medical students into academic residency programs such as those at the University of Michigan.

The Joint Commission Practice Performance Evaluation: A Primer for Radiologists

As health care quality continues to move into the limelight, so do physicians. The new Joint Commission requirements (Ongoing Professional Practice Evaluation and Focused Professional Practice Evaluation) mandate continuous data-based evaluation and monitoring of physician practice performance. This task could be seen as cumbersome, but it may provide opportunities to develop quality improvement programs that demonstrate the value provided by hospital-based radiologists.

Healthy Communication in Practice Environments

The contemporary emphasis on the importance of teamwork, communication, and collaboration around patient safety concerns has brought to the forefront an age-old issue, that of verbal abuse and incivility in the workplace. While typically thought of as a nurse-physician issue, it actually exists within and across all health provider groups (Porter & Lauve, 2006). The abusive communication has often been tolerated because of issues related to authority and power, but it is now clear that it will no longer be tolerated. Toward that end, The Joint Commission now requires that accredited health care organizations create a code of conduct that defines acceptable and unacceptable behaviors along with a formal process for managing unacceptable behavior when it does occur ( The Joint Commission, 2008 ). We are all familiar with what is gently referred to as disruptive behavior. Examples include condescending attitudes, rude language, demeaning behavior, verbal outbursts, or other forms of uncivil communication or behavior. It is easy to understand how they would defy teamwork and collaboration in both intra- and interdisciplinary work groups. With the Joint Commission's requirement, a zero tolerance environment for abusive forms of communication and behavior now exists. While these forms of unacceptable behavior are not expected to disappear overnight, it is evident that everyone has a responsibility to ensure that they are addressed and dealt with when they occur in the practice environment. There is a history of tolerance and indifference to disruptive and intimidating behaviors in health care settings. The causal factors can be both individual and environmental. If these types of behaviors are not addressed, they come to be viewed as acceptable. Practice environments are characterized as high stakes, high stress, demanding places to work. Cost containment and fear of litigation are examples of ever-present forces. In addition, these environments are embedded with hierarchies. Factors such as these can strain the development of trust and effective communication among work groups. It is human nature to be reluctant to confront intimidating behavior. This, coupled with fear of retaliation, often contributes to underreporting or not dealing with root causes of the behavior. The Institute of Medicine studies have identified the need for health care organizations to create work environments in which communication flows freely and respectfully. This is essential for working cultures in which everyone has the responsibility to communicate concerns about potentially unsafe situations that can result in adverse events ( Kohn, Corrigan, & Donaldson, 2000 ). In effective safety cultures, patterns of communication are not hierarchical or influenced by dynamics of real or perceived power. Communication patterns with steep authority gradients can result in unquestioning compliance with directives and disincentives to question or challenge a situation that has potential for harm or errors to occur ( Page, 2004 ). The effects of disruptive behavior among health care providers have been well documented. They have been shown to contribute to medical errors, preventable adverse outcomes, and staff and patient dissatisfaction ( Rosenstein & O'Daniel, 2005 ). Evidence exists that employees who are verbally abused are more likely to have low job satisfaction and morale. …

Louisiana's Approach to Criminal Background Checks of Nursing Students

In recent years, growing concern for patient safety has led to additional requirements for health-care personnel. Prominent among these requirements is a criminal background check on all persons who provide patient care, including students. In many cases, contractual agreements between nursing education programs and health-care institutions compel faculty and students who need hands-on clinical experience to meet these requirements. But who is responsible for conducting background checks—nursing education programs, health-care institutions, or the state board of nursing? With the current focus on student privacy rights, increased Joint Commission requirements, and complex jurisdiction over nursing student regulation, this is an appropriate time to examine regulation of students on their enrollment in nursing programs and throughout the progression of their clinical course sequence. Louisiana is the only U.S. state or territory with the authority to regulate nursing students. This article discusses the issues surrounding criminal background checks of nursing students, using Louisiana as a model.

Medical Student Participation in a Disaster Seminar and Drill: Brief Description of Activity and Report of Student Experiences

Background: Although it is a Joint Commission requirement for hospitals to maintain an up-to-date disaster plan and to implement drills, disaster training is not routinely incorporated into undergraduate medical education. Purposes: The objectives are to provide medical students with an introduction to disaster medicine, involving didactics and an experiential component where students participated in a disaster drill, and to evaluate the seminar's effectiveness through scored evaluations and a focus group discussion. Methods: A descriptive and qualitative analysis of a medical student disaster training course is presented. Results: The mean score for the four statements pertaining to the didactics was 4.3/5. Two themes from the focus group discussions emerged: (a) changes in self-perceived attitude toward disaster medicine and (b) changes in student's ability to apply this knowledge in a simulated setting. Conclusions: After the seminar, students appreciated the complexity of the field and the importance of incorporating disaster training into the general medical school curriculum.

A systematic review of the effectiveness of nurse coordinated transitioning of care on readmission rates for patients with heart failure

A systematic review of the effectiveness of nurse coordinated transitioning of care on readmission rates for patients with heart failure

A systematic review of the effectiveness of nurse coordinated transitioning of care on readmission rates for patients with heart failure.

Review question/objective: The objective is to identify the best available evidence on effectiveness of nurse coordinated transitioning of care between hospital and home on all hospital readmission rates in hospitalized adult patients with heart failure. Inclusion criteria: Types of participants: This review will consider studies that include adult patients, 18 years of age or older, hospitalised with heart failure being discharged to home. Types of intervention(s)/phenomena of interest: This review will consider studies that evaluate all models of nurse coordinated transitioning of care from hospital to home, limited to inpatient care coupled with post-discharge home-based and/or telephone education and support by a nurse. Types of outcomes: This review will consider studies that include the following outcome measures: all hospital readmission rates with a focus on 30 day readmissions.

Medical Equipment Management Manual

Author: Robert H. Stiefel, MS, CCE, Publisher: AAMI, ISBN: 1-57020-350-4, Publication date: 2009, Pages: 111, Price: List: $135/AAMI member, discount: $85Audience: The seventh edition of AAMI's Medical Equipment Management Manual by Robert H. Stiefel was released this spring. This manual is useful for those who are responsible for the design and/or implementation of a medical equipment management program in preparation for The Joint Commission's accreditation survey. It is written as a reference that allows the new medical equipment manager to read it from cover to cover and emerge with a thorough understanding of the standards, while also serving as a reference for the more seasoned medical equipment manager. Medical equipment managers will appreciate the discussion of the evolution of the accreditation process and in the accreditation standards included in the manual.Features: The manual includes the standards pertinent to medical equipment management, contained in The Joint Commission's Comprehensive Accreditation Manual for Hospitals. In addition, standards related to human resources, infection prevention and control, information management, and leadership are given the same level of attention.As it is written from a historical perspective, the manual explains how standards have evolved. It contains a helpful “Crosswalk” comparing 2009 standards to those from 2008. A discussion of the history of The Joint Commission's formation and work culminates in a detailed explanation of the most recent Standards Improvement Initiative, launched in August 2006, and the resulting changes.The intent of each standard is discussed, as well as its pertinence to the overall medical equipment management cycle of Plan/Assess, Evaluate/Select, Acquire, Install/Implement, Use, Maintain, and Replace. Suggestions on writing a medical equipment management plan are made and examples of policies that will support the plan are provided, as are multiple sample documents.The survey process and scoring methodology are explained in detail. The scoring section is perhaps the most difficult portion to understand as it represents a process that has developed incrementally and changed with the standards. Recommendations are made regarding documentation to be prepared in advance and presented during the survey process. An overview of the survey process as it relates to the overall organization is also explained. For example, the exit interview and the rendering of an accreditation decision are described as well as the required process for responding to identified deficiencies.Several appendices supplement the text. The glossary is a helpful tool as The Joint Commission survey process is full of acronyms that are used throughout the manual. A listing of other accrediting agencies is included with a short description of each.Assessment: The manual is a very comprehensive treatment of the subject matter and the reader emerges with broad knowledge of The Joint Commission requirements as they pertain to medical equipment management and related standards. The reader will take away the knowledge that there is some latitude in designing a program to meet the standards. However, the example documentation and methodologies described are quite conservative and even dated in their approach, most likely because this is written as a tutorial document. For example, the author favors an all-inclusive medical equipment inventory but recognizes that a risk-based inventory is sufficient. An exhibit of suggested fields for inclusion in that equipment inventory is offered but doesn't illustrate the more contemporary needs of such things as software version, applicable anti-virus software, and operating system. Discussion of the historical development of standards is intertwined with discussion of current standards, making it difficult at times for the reader to focus on the current requirements. This is most evident in the discussion of survey scoring methodologies. While this approach is very interesting for the seasoned medical equipment manager, people new to that role may need more time to study the text for comprehension. Having invested that additional time, however, understanding the historical perspective may better prepare the new medical equipment manager to understand the evolution of his or her own program.

251: Pharmacist Implementation in the Emergency Department

Due to a recent increase in emergency department (ED) patients and The Joint Commission's National Patient Safety Goals requirement to “accurately and completely reconcile medications across the continuum of care,” an opportunity for an ED pharmacist was offered. Additionally, Centers for Medicare and Medicaid Services (CMS) identify core measures as a means to measure effective evidence-based medicine. Thus, the ED pharmacist's primary goal was to facilitate home medication reconciliation (HMR) and to identify core measures patients to assist in medication selection.

Photonic Ultra-Wideband 781.25-Mb/s Signal Generation and Transmission Incorporating Digital Signal Processing Detection

The generation of photonic ultra-wideband (UWB) impulse signals using an uncooled distributed-feedback laser is proposed. For the first time, we experimentally demonstrate bit-for-bit digital signal processing (DSP) bit-error-rate measurements for transmission of a 781.25-Mb/s photonic UWB signal over fiber links. The DSP algorithm is described, the generated UWB signal is shown to comply with the U.S. Federal Communications Commission requirements, and transmission of 1.71times10 <sup xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">5</sup> UWB bits over fiber is demonstrated without error.

Recommendations for the Implementation of Joint Commission Guidelines for Labeling Medications

Recommendations for the Implementation of Joint Commission Guidelines for Labeling Medications

Visual function survey of commercial intercity vehicle drivers in Ilorin, Nigeria

Objective: To determine the prevalence of visual impairment among commercial intercity vehicle drivers (CIVDs) in Ilorin, Nigeria. Design: A cross-sectional descriptive study. Participants: Among the estimated 450 drivers operating in 5 motor parks for CIVDs in Ilorin, 399 drivers participated in the study. Methods: A structured questionnaire was administered at the motor parks to consecutive and consenting drivers, and basic ocular examinations were done. Results: Using the Federal Road Safety Commission's requirement for commercial drivers in Nigeria, the prevalence of drivers with inadequate visual acuity (VA) was determined to be 11.5%, and 3.3% had monocular blindness. The prevalence of abnormal colour vision and visual field loss was 4.3% and 5.5%, respectively. There was no statistically significant relationship between visual impairment (VA and visual fields) and involvement in road traffic accidents (p > 0.05). Uncorrected refractive error, cataract, and glaucoma were the commonest causes of visual defects. Three hundred thirty-seven drivers (84.5%) did not have their eyes tested at first licensing and 370 drivers (92.7%) did not have testing at least once during renewals. Conclusions: A significant number of CIVDs in Ilorin are operating with VA that is far below the expected for their class of licence, and another unacceptably high percentage did not undergo any form of ocular examination prior to obtaining their driving licence. There is a need for renewed efforts to enforce a compulsory basic ocular examination for all prospective commercial drivers, and to ensure that the visual requirement for driving is met.

Use of macroinvertebrate-based multimetric indices for water quality evaluation in Spanish Mediterranean rivers: an intercalibration approach with the IBMWP index

For the European Parliament and Commission to implement the Water Framework Directive (WFD), the water-quality indices that are currently used in Europe need to be compared and calibrated. This will facilitate the comparative assessment of ecological status throughout the European Union. According to the WFD, biologic indices should respond consistently to human impacts, using multimetric approaches and water-quality classification boundaries adjusted to a common set of normative definitions. The European Commission has started an intercalibration exercise to review biologic indices and harmonize class boundaries. We used data from rivers in Spain to compare the IBMWP (Iberian Biological Monitoring Working Party) index, which is commonly used by water authorities in Spain and by several research centers, with the Intercalibration Common Multimetric Index (ICM-Star), which was used as a standard in the intercalibration exercise. We also used data from Spanish rivers to compare the multimetric indices ICM-7 (based on quantitative data) and ICM-9 (based on qualitative data) with the IBMWP. ICM-7 and ICM-9 were proposed by the Mediterranean Geographical Intercalibration Group (Med-GIG). Additionally, we evaluated two new multimetric indices, developed specifically for macroinvertebrate communities inhabiting Mediterranean river systems. One of these is based on quantitative data (ICM-10), while the other is based on qualitative data (ICM-11a). The results show that the IBMWP index responds well to the stressor gradient present in our data, and correlates well with ICM-Star. Moreover, the IBMWP quality class boundaries were consistent with the intercalibration requirements of the WFD. However, multimetric indices showed a more linear relation with the stressor gradient in our data, and less variation in reference values. In addition, they may provide more statistical power for detecting potential environmental impacts. Multimetric indices produced similar results for quantitative and qualitative data. Thus, ICM-10 (also named IMMi-T) and ICM-11a (also named IMMi-L) indices could be used to meet European Commission requirements for assessing the water quality in Spanish Mediterranean rivers.