In-person Audits Research Articles

The utility of street view imagery in environmental audits for runnability

Understanding the conduciveness of an environment for running is critical for promoting community wellbeing through physical activity. In-person assessment of these factors is time consuming and costly on a large scale, causing researchers to audit environments virtually using Street View Imagery (SVI). However, no studies have assessed the efficacy of SVI for auditing environments for runnability, which measures the conduciveness of an area for running. This research seeks to determine whether virtual audits of street view imagery are a reliable proxy for in-person environmental scans. A secondary goal of this work was to design a preliminary runnability index based solely on runner studies. In this study, virtual and in-person audits were conducted in 30 locations around Metropolitan Vancouver, Canada, assessing runnability to compare SVI with field observations. Results reported high agreement between both methods for most runnability variables, especially for natural environment characteristics. Virtual scans were less reliable than in-person scans for measuring path continuity and street lighting. We recommend researchers continue to validate virtual audits with in-person scans until SVI technology improves.

Improving documentation of blood product administration using a standardized electronic health record-based system: a single-institution experience.

To improve documentation of blood product administration by assessing the completion status of blood transfusions. In this way, we can ensure compliance with the Association for the Advancement of Blood & Biotherapies standards and facilitate investigation of potential blood transfusion reactions. This before-and-after study includes the implementation of an electronic health record (EHR)-based, standardized protocol for documenting the completion of blood product administration. Twenty-four months of retrospective data (January-December 2021) and prospective data (January-December 2022) were collected. Meetings were held before the intervention. Ongoing daily, weekly, and monthly reports were prepared, and targeted education to deficient areas as well as spot in-person audits by the blood bank residents were conducted. During 2022, 8,342 blood products were transfused, of which 6,358 blood product administrations were documented. The overall percentage of completed transfusion order documentation improved from 35.54% (units/units) in 2021 to 76.22% (units/units) in 2022. Interdisciplinary collaborative efforts helped produce quality audits to improve the documentation of blood product transfusion through a standardized and customized EHR-based blood product administration module.

Associations of home and neighborhood environments with children’s physical activity in the U.S.-based Neighborhood Impact on Kids (NIK) longitudinal cohort study

IntroductionPhysical activity is important for children’s health and well-being. Supportiveness for physical activity of home and neighborhood environments may affect children’s PA, but most studies are cross-sectional. We examined environmental predictors of change in children’s physical activity over two years.MethodsData were from the longitudinal, observational cohort study, ‘Neighborhood Impact on Kids’. Participants were children (initially aged 6–12 years) and their parent/caregiver (n = 727 dyads) living in neighborhoods throughout San Diego County, California and King County (Seattle area), Washington, USA. Children’s moderate-to-vigorous physical activity (MVPA) was measured using accelerometers at T1 (Time 1 or baseline, 2007–2009) and T2, the two-year follow-up. At T1, parents survey-reported on physical activity (PA) equipment at home and demographics. Neighborhood environment was measured using spatial data in Geographic Information Systems (intersection density; park availability) and in-person audits (informal play space near home; park-based PA facilities; land use; support for walking/cycling). Generalized additive mixed models estimated total effects, then direct effects, of environmental attributes on MVPA at T1. Two-way moderating effects of child’s sex and age were examined at T1. To examine associations of environmental exposures with changes in MVPA, we estimated interaction effects of environmental attributes on the association between time and MVPA.ResultsOn average, children accumulated 146 min/day (standard deviation or SD = 53) of MVPA at T1, and 113 (SD = 58) min/day at T2. There were no significant total or direct effects of environmental attributes on MVPA at T1, and no significant two-way interaction effects of child’s age and sex for T1 MVPA. Having informal play spaces proximal to home with more amenities was associated with less MVPA decline from T1 to T2. Higher residential density, higher land use mix, and higher number of PA facilities in nearby parks were unexpectedly associated with greater MVPA decline.ConclusionHigher quality informal play spaces close to home may help offset declines in MVPA during middle childhood, as they may promote unstructured active play with opportunities for parental or neighbor surveillance. Unexpectedly, environmental factors consistent with higher walkability were associated with greater declines in children’s MVPA. As physical activity differs across the lifespan, so may environmental factors that facilitate it.

ПРАКТИКА УСПЕШНОГО ПРОВЕДЕНИЯ АУДИТА ПОСТАВЩИКОВ С УЧЕТОМ РИСК-ОРИЕНТИРОВАННОГО ПОДХОДА

Building long-term relations with the supplier is one of the key elements in ensuring the high quality of products and the key to the further success of the enterprise. The time of manufacture and the quality of products depend on the work of suppliers. GOST R ISO 9001 - 2015 in No. 8.4 «Management of externally supplied processes, products and services» indicates that any organization regardless of the type of activity or size should define and apply criteria for evaluating, selecting, monitoring and reassessing external suppliers based on their ability to perform processes or deliver products and services as required» [1]. In order to comply fully with paragraph 8.4, the heads of organizations need to pay considerable attention to:  development and implementation of a documented vendor evaluation procedure;  developing, implementing and conducting ongoing supplier audits;  optimization of the time and material input control procedure. These activities allow:  to ensure stability of supply of raw materials, materials and components;  ensure the quality of the products purchased;  optimize input control (by improving the quality of delivered products by the supplier, increasing trust, transparency and openness in working with the supplier, ensuring timely delivery) and, as a consequence, minimize costs at this stage of the process;  to organize a system of traceability of products, raw materials and materials supplied by the supplier;  exchange information and work experience to develop new design solutions;  identify and minimize potentially hazardous risks by working together to address them;  maintain up-to-date information on the supplier, its business activities, management for management decision-making. In this study data obtained during the in-person audits from suppliers of raw materials and components for the enterprise - manufacturer of control and measuring devices and automatics CJSC «Electronic and mechanical measuring systems» were used. (Chelyabinsk Region). The study achieved the following objectives:  assessment of the established external environment as extremely complex and unfavourable from the point of view of geopolitical and economic factors, characterized by multiple increase of various risks (technical, production, financial, innovative, etc.);  the advantages and disadvantages of the remote audit of the supplier have been identified;  the necessity of conducting a full-time audit of suppliers in modern conditions has been substantiated;  the use of the Deming-Shuhart cycle has been proposed, taking into account the risk-oriented approach when planning the audit of suppliers. The key result of the work is the developed author’s method of conducting in-person audits of suppliers in complex conditions of polycrisis, which has proven its effectiveness for three years.

Assessing Park Quality with a Wearable Video Device and an Unmanned Aerial System.

Parks are ideal places for promoting physical activity, which is vital for achieving and sustaining good health. Thus, it is important to develop and provide the best methods for assessing aspects of parks that could influence physical activity. This study examined the use of high-tech video capture for describing park quality. Videos were obtained with a wearable video device (WVD) and an unmanned aerial system (UAS) at 28 and 17 parks, respectively. In-person audits of park attributes were performed using the Physical Activity Readiness Assessment (PARA) instrument while video was simultaneously captured. The PARA provides quality ratings of park attributes that range from poor to good. Kappa statistics were calculated to compare in-person PARA outcomes with PARA outcomes obtained by reviewing the WVD and UAS videos. Substantial and almost-perfect agreements were found between WVD and in-person PARAs on the quality of features and amenities and the severity of incivilities. Agreements between UAS and in-person PARAs on feature and amenity quality and incivility severity were unacceptable (mostly fair and moderate). In conclusion, being able to reliably assess park quality using video provides advantages over in-person assessments (e.g., retrospective analysis). In addition, it sets up the possibility of utilizing computer vision to automate the video analysis process.

Using a Patient Identification Checklist: How to Make This a Never Safety Event in Perioperative Services

<h3>Background Information</h3> Patient identification is one of the Joint Commission National Patient Safety Goals. Positive patient identification involves accuracy, verification and two-way communication. Occasionally, patient armbands did not match patient labels or paperwork, leading to incorrect patient identification. Safety Events were placed and reviewed at the executive level as high-risk safety events that achieved institutional support. Preoperatively, errors in patient identification can lead to potentially serious errors. The check-in area was able to identify workflow inconsistencies, interview techniques and equipment locations as opportunities for improvement. The focus was on patient wristbands during check in, leading to the development of a checklist and subsequent audits to measure compliance. <h3>Objectives of Project</h3> To maintain a trend of overall reported patient ID events, to sustain no high harm and reduce patient ID reported procedures events, as they relate to safety culture and accountability by 25% six months after training in Just Culture and accountability. <h3>Process of Implementation</h3> A review of current workflow and observation audits were completed prior to beginning the pilot. A Patient Identification Checklist supporting hospital policy was developed. Education to staff and 50 in-person audits were completed to observe the wristband check-in process, using an electronic audit. The checklist was laminated and posted at eye level of the Patient Service Coordinator (PSC). The wristband and label printer were relocated closer to the workstation for ease of use. The patient charts filing order was changed from OR room number to alphabetical order (by last name) to reduce chart adjustments. The level of lighting was also adjusted to improve visualization by patients and staff. <h3>Statement of Successful Practice</h3> The baseline data included five patient ID safety events for PACU/Preop and the implementation of the new workflow resulted in zero patient ID events after the pilot. The patient ID wristband checklist helped reduce the number of patient ID events related to wristbands but is dependent on the employee adhering to the checklist. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> Not verifying patient information is a top causal factor for patient ID overall. Reminding staff about the importance of adhering to the checklist and following best practice standards for patient identification can help ensure this becomes a Never Event in Perioperative Services.

Evidence on Internal Audit Quality from Transitioning to Remote Audits because of COVID-19

ABSTRACT As in-person audits were banned by governments and by company policies due to the COVID-19 pandemic, internal auditors had to transition to remote audits to perform their work. Based on survey responses of internal auditors who have conducted both remote and in-person audits, we find that internal auditors perceive no difference in the efficiency and effectiveness of and stakeholders' reliance on results from remote and in-person audits when considering all responses. However, we also find that perceived efficiency and effectiveness increase the more experience internal auditors have with remote audits. Supplemental analyses show that support from the auditee, but not management or the audit committee, is a central determinant of perceived remote audit success. It is important for internal auditors to consider this later finding in the design of remote audits as it indicates the importance of building support with the auditee to have a successful remote auditing experience. Data Availability: Please contact the authors. JEL Classifications: M40; M42; G3; G34.

Lessons from leveraging technology in auditing during COVID-19: an emerging economy perspective

PurposeThis study aims to examine the challenges posed by COVID-19 restrictions for audit processes in India and explore the perceptions of the profession on how technology was leveraged to conduct audits during this period. The opinions of auditors on future changes in post-COVID-19 audit practices and processes are also explored.Design/methodology/approachSemi-structured interviews were conducted with senior auditors working in various audit firms in major business centers in India and subjected to content and thematic analysis using the institutional theory perspective.FindingsThe auditing profession used technology to respond to COVID-19-imposed disruptions of established audit process and practices while maintaining the legitimacy of audit reports. The findings indicate that auditors now seem to strongly support the integration of emerging technologies into their auditing practices post-COVID to ensure data accuracy and transparency. The interviewees displayed keen interest in continuing remote and in-person audits to maintain audit quality in the future. The experience of COVID-19 appears to have forced the auditing profession to overcome their reluctance to adopt technologies that were previously used by only Big 4 and large audit companies.Practical implicationsThe results will be of particular interest to various stakeholders concerned with aspects of the acceptance of technology-assisted audit reports such as legitimacy, required infrastructure, cost involvement and resistance to change. The findings will also assist professional bodies and policymakers in both developed and developing economies in devising useful strategies to promote technology-aided auditing during and after COVID-19. Limitations posed by inadequate infrastructure and resistance to changes must be overcomed before implementation of technology-aided audits.Originality/valueAs COVID-19 pandemic is a recent phenomenon, to the best of the authors’ knowledge, this study is one of the first few studies that have examined the use of technology to facilitate audits during the COVID-19 period, more specifically from a developing economy perspective.

Development and validation of automated microscale walkability audit method

Measuring microscale factors of walkability has been labor-intensive and expensive. To reduce the cost, various efforts have been made including virtual audits (i.e., manual audits using street view images) and the introduction of computer vision techniques. Although studies have shown that virtual audits (i.e., manual audits using street view images) can reliably replicate in-person audits, they are still prohibitively expensive to be applied to a large geographic area. Past studies used computer vision techniques to help automate the audit process, but off-the-shelf models cannot detect some of the important microscale walkability characteristics, falling short of fully capturing the multi-facetted concept of walkability. This study is one of the earliest attempts to use the combination of custom-trained computer vision models, geographic information systems, and street view images to automatically audit a complete set of items of a validated microscale walkability audit tool. This study validates the reliability of the automated audit with virtual audit results. The automated audit results show high reliability, indicating automated audit can be a highly scalable and reliable replacement of virtual audit.

A Method for Investigating Access to Diaper Changing Stations in Restaurants.

Parents and caretakers of young children need diaper changing stations (DCSs) to fully utilize public and commercial spaces, but few studies measure their availability. We developed a method for assessing the availability of DCSs in restaurant restrooms through phone interviews and validated the results using in-person visits. This study tested a phone interview methodology for investigating availability within restaurants, and the extent to which DCSs were accessible to both male and female caregivers. In May of 2019, phone interviews were conducted to survey the employees of 60 Philadelphia restaurants with a public restroom available to patrons to determine whether they had unisex or gendered restrooms, a DCS, and accessibility to a DCS for both male and female caregivers. Each interview was followed by an in-person audit. During phone interviews, 10 (16.7%) restaurants reported having and 50 (83.3%) reported not having DCSs. In-person audits confirmed 59 of 60 (98.3%) phone interview responses about the presence of DCSs (Cohen’s kappa: 0.94) and 55 of 60 (91.7%) reports of restroom types (Cohen’s kappa: 0.83). In this study, the phone interview methodology accurately identified the presence of DCSs in restaurants. This methodology can be used to identify disparities and to advocate for policy changes to improve access to DCSs for all who need them.

Analysis of Methodology for Scaling up Building Retrofits: Is There a Role for Virtual Energy Audits?—A First Step in Hawai’i, USA

Energy audits are a time-consuming and expensive initial step in the building retrofit process. Virtual energy audits purport to be an alternative that remotely identifies energy efficiency measures (EEMs) that may reduce electricity consumption and offset operational costs to businesses operating during and after the COVID-19 pandemic. This case study reviews virtual energy audits as a means to benchmark energy use and estimate cost savings from future EEMs. A novel feature was the estimation of energy costs associated with increasing ventilation to improve indoor air quality. The authors analyzed ten virtual energy audits performed in Honolulu, Hawai’i, over a two-week period that used existing building information and electricity use data to estimate a potential 9% to 41% annual electricity use reduction per building and a 24 MWh to 1195 MWh reduction, respectively. This paper makes a significant contribution through its assessment of virtual energy audits as a step beyond benchmarking, which has merit as an educational tool to motivate business owners to reduce energy use and improve indoor air quality. Further evaluation and improvements are suggested to study how often the virtual energy audits instigate action, how they compare with in-person audits, and their potential for use at a large scale.

Methods to Prevent Future Severe Animal Welfare Problems Caused by COVID-19 in the Pork Industry.

Simple SummaryIn the U.S., thousands of pigs had to be destroyed on the farms when illness caused by COVID-19 greatly reduced pork slaughter plant capacity. Some of the methods used to destroy pigs on the farms severely compromised animal welfare. Reliance on a few large slaughter plants created a fragile supply chain. Animal welfare auditing conducted by large meat buyers was also hindered by COVID-19. Many live in-person audits were stopped and replaced by a combination of stationary video cameras and live streamed videos from mobile phones. To insure high standards of animal welfare, video methods should never completely replace in-person visits.In the U.S., the most severe animal welfare problems caused by COViD-19 were in the pork industry. Thousands of pigs had to be destroyed on the farm due to reduced slaughter capacity caused by ill workers. In the future, both short-term and long-term remedies will be needed. In the short-term, a portable electrocution unit that uses scientifically validated electrical parameters for inducing instantaneous unconsciousness, would be preferable to some of the poor killing methods. A second alternative would be converting the slaughter houses to carcass production. This would require fewer people to process the same number of pigs. The pandemic revealed the fragility of large centralized supply chains. A more distributed supply chain with smaller abattoirs would be more robust and less prone to disruption, but the cost of pork would be greater. Small abattoirs can coexist with large slaughter facilities if they process pigs for specialized premium markets such as high welfare pork. The pandemic also had a detrimental effect on animal welfare inspection and third party auditing programs run by large meat buyers. Most in-person audits in the slaughter plants were cancelled and audits were done by video. Video audits should never completely replace in-person audits.

Price discrimination in informal labor markets in Bogot\xe1: an audit experiment during the 2018 FIFA World Cup

We conducted an audit experiment to examine whether street vendors in Bogotá (Colombia) exert price discrimination based on buyers’ attributes, such as gender and nationality, and based on product characteristics, such as the increasing marginal valuation of items needed to complete a collection. We exploited the seasonal demand for album stickers related to the FIFA World Cup Russia 2018. In our within-subjects design, experimenters carried out in-person audits and quoted a pre-determined list of missing stickers. They interacted with 59 sticker vendors located in five geographic clusters and collected 287 vendor–buyer interactions. We find that prices quoted to foreign buyers are higher than prices quoted to Colombian buyers. By contrast, we do neither find evidence supporting direct gender-based discrimination, nor that vendors charge a higher price per sticker when the list of missing stickers is shorter. We complement the study with a qualitative analysis based on interviews that reveal vendors’ pricing strategies, their awareness of price discrimination, and the trade of counterfeits. The qualitative results suggest that price discrimination appears to be unconscious.

No long-term store marketing changes following sugar-sweetened beverage tax implementation: Oakland, California.

Globally, more than 45 countries have implemented sugar-sweetened beverage (SSB) taxes; however, little is known about effects on marketing practices. For the 2017 Oakland, California, 1 cent per ounce SSB tax, this study evaluated long-term changes in beverage price promotions, depth of sale, and interior and exterior advertising at stores, collected via in-person audits at two time points (pre-tax and 24-months post-tax). Overall, based on difference-in-differences estimation, relative to the comparison site, no significant pre-post tax changes were found in the odds of price promotions, exterior or interior advertising, or sale depth for SSBs or untaxed beverages. As additional SSB taxes are considered these findings suggest that SSB taxes may not have long-term effects on store marketing practices.

Evidence on Internal Audit Effectiveness from Transitioning to Remote Audits Because of COVID-19

As in-person audits were banned by governments and company policies due to COVID-19, internal auditors had to transition to remote audits to perform their work. Based on survey responses of 271 German internal auditors who have conducted both remote and traditional audits, we find that internal auditors perceive no difference in the efficiency and effectiveness of and stakeholders’ reliance on results from remote and traditional audits when considering all responses. However, we also find that perceptions of efficiency and effectiveness increase the more experience internal auditors have with remote audits. Additional analyses show that support from the auditee, but not management or the audit committee, is an important determinant of perceived remote audit success. This later finding is important for internal auditors to consider when designing remote audits as it indicates the importance of building support with the auditee to have a successful remote auditing experience.

Interrater Reliability of Historical Virtual Audits Using Archived Google Street View Imagery.

Impaired mobility occurs in up to half of community-dwelling older adults and is associated with poor health outcomes and high health care costs. Although the built environment impacts mobility, most studies of older adults lack information about environmental-level factors. In-person observational audits can be utilized but cannot assess the historical environment. We applied a 78-item checklist to archived Google Street View imagery to assess historical residence access and neighborhood characteristics. Interrater reliability between two raters was tested on 50 addresses using prevalence-adjusted and bias-adjusted kappa (PABAK). The mean PABAK for all items was .75, with 81% of the items having substantial (PABAK ≥ .61) or almost perfect (PABAK ≥ .81) agreement. Environmental assessment using archived virtual imagery has excellent reliability for factors related to residence access and many neighborhood characteristics. Archived imagery can assess past neighborhood characteristics, facilitating the use of historical environment data within existing cohorts.

Characterizing the Rural Opioid Use Environment in Kentucky Using Google Earth: Virtual Audit.

BackgroundThe opioid epidemic has ravaged rural communities in the United States. Despite extensive literature relating the physical environment to substance use in urban areas, little is known about the role of physical environment on the opioid epidemic in rural areas.ObjectiveThis study aimed to examine the reliability of Google Earth to collect data on the physical environment related to substance use in rural areas.MethodsSystematic virtual audits were performed in 5 rural Kentucky counties using Google Earth between 2017 and 2018 to capture land use, health care facilities, entertainment venues, and businesses. In-person audits were performed for a subset of the census blocks.ResultsWe captured 533 features, most of which were images taken before 2015 (71.8%, 383/533). Reliability between the virtual audits and the gold standard was high for health care facilities (>83%), entertainment venues (>95%), and businesses (>61%) but was poor for land use features (>18%). Reliability between the virtual audit and in-person audit was high for health care facilities (83%) and entertainment venues (62%) but was poor for land use (0%) and businesses (12.5%).ConclusionsPoor reliability for land use features may reflect difficulty characterizing features that require judgment or natural changes in the environment that are not reflective of the Google Earth imagery because it was captured several years before the audit was performed. Virtual Google Earth audits were an efficient way to collect rich neighborhood data that are generally not available from other sources. However, these audits should use caution when the images in the observation area are dated.

Moderating effect of the neighbourhood physical activity environment on the relation between psychosocial factors and physical activity in children: a longitudinal study

BackgroundFew studies have examined the moderating role of neighbourhood environments on the relation between psychosocial factors and physical activity, and results of these studies are mixed. This study examined this...

Perceiving the Livable City

Problem, research strategy, and findings: Livability is a popular goal, yet a consistent definition and approach for measuring livability remain elusive. Many urban designers embrace etic indicators such as block size, multimodality, and accessibility rather than emic perceptions of users. Kevin Lynch showed great concern for emic livability and studied how culture and technology might affect it. We examine relationships between emic and etic interpretations of livability, drawing on a pilot study involving both in-person and Google Street View audits performed by U.S. and Norwegian student volunteers in San Francisco (CA) and Oslo (Norway) neighborhoods. Audits recorded both etic and emic measurements of walkability, compactness, connectivity, enclosure, and imageability, commonly associated with livable urban environments. Results show substantial differences between emic and etic measures. Regression models show that of all etic variables, only a few are useful predictors of emic measures. Country of origin also has no significant effect in these models, which suggests that emic interpretations of livability are reasonably consistent among auditors from both nations despite their lack of previous familiarity with non-home cities.Takeaway for practice: Emic impressions of livability may be more internationally transferable than etic qualities traditionally associated with livable places. Google Street View led to greater livability impressions than in-person audits, which suggests caution in relying on virtual experiences as proxies for fieldwork.

Online versus in-person comparison of Microscale Audit of Pedestrian Streetscapes (MAPS) assessments: reliability of alternate methods

BackgroundAn online version of the Microscale Audit of Pedestrian Streetscapes (Abbreviated) tool was adapted to virtually audit built environment features supportive of physical activity. The current study assessed inter-rater reliability of MAPS Online between in-person raters and online raters unfamiliar with the regions.MethodsIn-person and online audits were conducted for a total of 120 quarter-mile routes (60 per site) in Phoenix, AZ and San Diego, CA. Routes in each city included 40 residential origins stratified by walkability and SES, and 20 commercial centers. In-person audits were conducted by raters residing in their region. Online audits were conducted by raters in the alternate location using Google Maps (Aerial and Street View) images. The MAPS Abbreviated Online tool consisted of four sections: overall route, street segments, crossings and cul-de-sacs. Items within each section were grouped into subscales, and inter-rater reliability (ICCs) was assessed for subscales at multiple levels of aggregation.ResultsOnline and in-person audits showed excellent agreement for overall positive microscale (ICC = 0.86, 95% CI [0.80, 0.90]) and grand scores (ICC = 0.93, 95% CI [0.89, 0.95]). Substantial to near-perfect agreement was found for 21 of 30 (70%) subscales, valence, and subsection scores, with ICCs ranging from 0.62, 95% CI [0.50, 0.72] to 0.95, 95% CI [0.93, 0.97]. Lowest agreement was found for the aesthetics and social characteristics scores, with ICCs ranging from 0.07, 95% CI [−0.12, 0.24] to 0.27, 95% CI [0.10, 0.43].ConclusionsResults support use of the MAPS Abbreviated Online tool to reliably assess microscale neighborhood features that support physical activity and may be used by raters residing in different geographic regions and unfamiliar with the audit areas.