Procedimientos para auditorías internas de procesos implementados en el MINSAL / Procedures for internal audits of processes implemented in the MINSAL

El presente documento tiene como objetivo evaluar la conformidad, la efectividad y el desempeño de un determinado proceso y sus procedimientos para identificar las brechas existentes y orientar las oportunidades de mejora. Las auditorias están dirigidas a todas las dependencias del MINSAL que están ejecutando procesos y procedimientos según manual de proceso y procedimientos acorde con mapa nivel 0

The objective of this document is to evaluate the conformity, effectiveness and performance of a certain process and its procedures to identify existing gaps and guide improvement opportunities. The audits are aimed at all MINSAL units that are executing processes and procedures according to the process and procedures manual according to the level 0 map

Audit of surgical specialty patients and beds at Pietersburg Hospital, Limpopo Province, South Africa in 2021.

BACKGROUND: While the absolute number of hospital beds is usually discussed, adequate utilisation of beds is a far better instrument to measure departmental efficiency. OBJECTIVE: To measure the number of beds for each surgical specialty in Pietersburg Hospital as well as the average length of stay (LoS) to compare bed utilisation. METHOD: We conducted a 1-day descriptive cross-sectional audit of patients admitted to surgical wards on 21 April 2021 at Pietersburg Hospital. RESULTS: There were huge discrepancies in the number of beds per surgical specialty as well as the LoS. Over one-third of surgical beds were occupied by patients waiting for either a computed tomography scan, surgical procedure, or transfer. CONCLUSION: There is a need to address the functioning of the surgical specialties with regards to the number of beds allocated as well as the ideal average length of stay.

Audit of surgical procedures in regional and central hospitals in Limpopo Province, South Africa.

BACKGROUND: There is a paucity of data on the functioning and surgical procedures performed in rural hospitals in South Africa. OBJECTIVE: To determine the category of procedures performed at regional and tertiary hospitals in Limpopo Province, South Africa. METHOD: We conducted a retrospective analysis of surgical procedures performed in the regional and tertiary hospitals in Limpopo Province during a 1-year period from 1 March 2019 to 29 February 2020. RESULTS: A total of 24 263 surgical procedures were performed during the study period. More than half of all cases (50.4%; n=12 252) were operated on at the tertiary hospitals while regional hospitals performed the remaining 12 011 operations. CONCLUSION: There is a great necessity to alleviate the central hospitals from the bulk of surgical procedures.

An audit of the editorial process at the Indian Journal of Cancer: Lessons learned, and how to improve chances of acceptance of your paper.

BACKGROUND: The editors of the Indian Journal of Cancer (IJC) have not, so far, objectively analyzed the editorial processes involving author, referee, and editor data of the journal. Hence, we aimed at doing so in this audit. METHODS: We retrospectively analyzed manuscripts submitted to the IJC from April 1, 2020, to May 31, 2020, for data related to the peer-review process. Microsoft Excel was used to enter the retrieved information and to carry out the statistical analysis. RESULTS: Three hundred and nineteen manuscripts were submitted during the study period. Of these, three were excluded from the study. Of the 316, 79 (25%) were articles on laboratory medicine; 182 (57.6%) were original articles. About half of the submitted manuscripts (166, 52.5%) were desk-rejected. Of the remaining 149 manuscripts, 105 did not follow the instructions to contributors (ITC) and required a median number of two revisions (range = 1-5) to satisfy the ITC. To review 107 manuscripts, 536 external referees were invited; of them 306 did not respond, 79 declined the invitation, and 151 accepted the invitation. Of these 151, 132 reverted with comments. Of the 200 Indians who were invited as referees, 118 (59%) accepted the invitation, whereas of the 336 non-Indian referees, only 33 (9.8%) did. Of the 107 Indian and 25 non-Indian referees who sent their comments, 86 (80.4%) and 19 (88%), respectively, offered useful comments. The median number of days to decision: for desk-rejection was 1 day (range = 0 - 42) days, for rejection after peer-review was 67 (range = 4 - 309) days, and for acceptance was 133.5 (range = 42 - 305) days. Decision has not yet been taken for 14 manuscripts. CONCLUSION: The study provides evidence that it is difficult to get referees. Also, a significant number of authors do not read or follow the ITC. We suggest that the time taken for a decision can be appreciably improved if these issues are addressed.

An institutional audit of the use of novel drugs in pediatric oncology.

BACKGROUND: Significant challenges persist in treating children with rare, relapsed, or refractory malignancies. Novel molecularly targeted drugs promise improved outcomes for these children with reduced toxicity. However, there is often limited evidence to substantiate their clinical efficacy and guide their use. This raises issues for clinical decision-making, ethical concerns surrounding equity of access to these often-expensive agents, and the management of families' expectations for cure. This audit evaluated the off-label use of novel drugs and associated clinical outcomes in order to guide the development of future clinical and ethical guidelines. AIM: To evaluate the patterns in the off-label use of novel drugs for treating childhood cancer and the associated clinical outcomes to guide prospective studies and inform ethical and clinical governance protocols for the use of these agents. METHODS: A retrospective audit was performed for all patients who received novel drugs off-label as treatment for their malignancy at an Australian pediatric oncology center between 2010 and 2019. RESULTS: One hundred patients with 32 unique diagnoses received 133 novel drugs across 124 regimens. Eighty-four patients received these drugs at the second line of treatment or greater. Novel drug median cost was $15 521 AUD (Range: $6.53 AUD to $258 339 AUD) and was primarily funded by the hospital (N = 60/133, 45.1%) or compassionate access from pharmaceutical companies (N = 52/133, 39.1%). Decision-making related to novel drugs was inconsistently documented. Ninety-one of 124 treatment regimens commenced between 2010 and 2019 resulted in objective responses (73.4%), but only 35 were still ongoing upon review in June 2020 (38.5%). Median response duration was 12.6 months (Range: 0-93.2 months). CONCLUSIONS: While novel drugs were largely unable to definitively cure patients, most achieved objective responses. Prospective trials and more rigorous documentation are needed to fully inform the future use of these agents given the heterogeneity of their applications.

A atuação da auditoria do Sistema Único de Saúde em um estado brasileiro / The performance of the audit of the Unified Health System in a Brazilian state / La acción de la auditoría del Sistema Único de Salud de un estado brasileño

Objetivo: Descrever a atuação da auditoria do Sistema Único de Saúde em um estado brasileiro. Métodos: Estudo descritivo, realizado nos anos de 2017 e 2018, no estado do Rio Grande do Norte, dividido em quatro etapas: mapeamento dos sistemas de auditoria nos municípios; elaboração de questionários para coleta de dados; envio dos questionários para os auditores; e análise dos dados presentes nos questionários. A população do estudo correspondeu aos 66 auditores, entretanto a amostra final pós-coleta resultou em 18 participantes, dada a recusa de participação. Na análise dos dados utilizou-se uma descrição quantitativa simples de números e porcentagens para caracterização da coleta referente aos sistemas de auditorias existentes e, nas respostas obtidas pelos questionários, realizou-se o tratamento dos dados por meio de análise lexicográfica de similitude. Resultados: Dos 167 (100%) municípios do estado, 95 (57%) municípios afirmaram não usufruir desses serviços e em 63 (38%) municípios não foi possível obter informação, de modo que apenas nove (5%) responderam possuir os serviços de auditoria. A compreensão dos auditores acerca do seu processo de trabalho trouxe a importância, o impacto e a necessidade de formação na área. Conclusão: A descrição da atuação dos componentes de auditoria do estado do RN mostrou um cenário de preocupação. A percepção dos profissionais auditores sobre o seu processo de trabalho denotou a grande importância da contribuição desses serviços para a saúde.

Objective: To describe the performance of the Unified Health System audit in a Brazilian state. Methods: Descriptive study, carried out in 2017 and 2018, in the State of Rio Grande do Norte, divided into four stages: mapping of audit systems in the municipalities; elaboration of questionnaires for data collection; sending the questionnaires to the auditors; and analysis of the data present in the questionnaires. The study population corresponded to 66 auditors, yet, the final post-collection sample resulted in 18 participants due to the participant's refusal. In the data analysis, a simple quantitative description of numbers and percentages was used to characterize the collection regarding the existing auditing systems, and in the responses obtained by the questionnaires, the data was processed through a lexicographical similarity analysis. Results: Of the 167 municipalities (100%) in the state, 95 (57%) said they did not use these services, and in 63 (38%) municipalities, it was not possible to obtain information so that only nine (5%) answered that they had the audit services. The auditors' understanding about their work process brought the importance, impact, and need for training in the area. Conclusion: The description of the performance of the audit components in the state of RN showed a scenario of concern. The perception of professional auditors about their work process denoted the great importance of the contribution of these services to health.

Objetivo: Describir la acción de la auditoría del Sistema Único de Salud de un estado brasileño. Métodos: Estudio descriptivo realizado entre los años 2017 y 2018 en el estado de Río Grande del Norte (RN) que ha sido dividido en cuatro etapas: el mapeo de los sistemas de auditoría de los municipios; la elaboración de cuestionarios para la recogida de datos; el envío de los cuestionarios para los auditores; y el análisis de los datos de los cuestionarios. La población del estudio ha sido de 66 auditores, sin embargo, la muestra final post-recogida de datos ha resultado en 18 participantes debido a recusa de participación. Para el análisis de los datos se utilizó una descripción cuantitativa simple de números y porcentajes para la caracterización de los datos de los sistemas de auditorías existentes y, para las respuestas de los cuestionarios se ha realizado un análisis lexicográfico de similitud. Resultados: De los 167 (100%) municipios del estado, 95 (57%) municipios afirmaron no usar de esos servicios y em 63 (38%) de ellos no ha sido posible tener información de manera que solamente nueve (5%) han contestado tener los servicios de auditoría. El entendimiento de los auditores sobre su proceso de trabajo trajo la importancia, el impacto y la necesidad de formación en el área. Conclusión: La descripción de la acción de los componentes de la auditoría del estado de RN mostró um escenario de preocupación. La percepción de los profesionales auditores sobre su proceso de trabajo presentó la gran importancia de la contribución de esos servicios para la salud.

Manual de organización y funciones de la Unidad de Auditoría Interna / Organization and functions manual of the Internal Audit Unit

El Manual de Organización y Funciones contiene la estructura organizativa, objetivos, funciones y relaciones que orientan el funcionamiento y la delimitación del campo de acción de los diferentes elementos que intervienen en la Unidad de Auditoría Interna

The Organization and Functions Manual contains the organizational structure, objectives, functions and relationships that guide the operation and the delimitation of the field of action of the different elements that intervene in the Internal Audit Unit

Incident Reporting System in an Italian University Hospital: A New Tool for Improving Patient Safety.

Clinical risk management constitutes a central element in the healthcare systems in relation to the reverberation that it establishes, and as regards the optimization of clinical outcomes for the patient. The starting point for a right clinical risk management is represented by the identification of non-conforming results. The aim of the study is to carry out a systematic analysis of all data received in the first three years of adoption of a reporting system, revealing the strengths and weaknesses. The results emerged showed an increasing trend in the number of total records. Notably, 86.0% of the records came from the medical category. Moreover, 41.0% of the records reported the possible preventive measures that could have averted the event and in 30% of the reports are hints to be put in place to avoid the repetition of the events. The second experimental phase is categorizing the events reported. Implementing the reporting system, it would guarantee a virtuous cycle of learning, training and reallocation of resources. By sensitizing health workers to a correct use of the incident reporting system, it could become a virtuous error learning system. All this would lead to a reduction in litigation and an implementation of the therapeutic doctor-patient alliance.

Environmental sustainability in neurointerventional procedures: a waste audit.

BACKGROUND: Operating rooms contribute between 20% to 70% of hospital waste. This study aimed to evaluate the waste burden of neurointerventional procedures performed in a radiology department, identify areas for waste reduction, and motivate new greening initiatives. METHODS: We performed a waste audit of 17 neurointerventional procedures at a tertiary-referral center over a 3-month period. Waste was categorized into five streams: general waste, clinical waste, recyclable plastic, recyclable paper, and sharps. Our radiology department started recycling soft plastics from 13 December 2019. Hence, an additional recyclable soft plastic waste stream was added from this time point. The weight of each waste stream was measured using a digital weighing scale. RESULTS: We measured the waste from seven cerebral digital subtraction angiograms (DSA), six mechanical thrombectomies (MT), two aneurysm-coiling procedures, one coiling with tumour embolization, and one dural arteriovenous fistula embolization procedure. In total, the 17 procedures generated 135.3 kg of waste: 85.5 kg (63.2%) clinical waste, 28.0 kg (20.7%) general waste, 14.7 kg (10.9%) recyclable paper, 3.5 kg (2.6%) recyclable plastic, 2.2 kg (1.6%) recyclable soft plastic, and 1.4 kg (1.0%) of sharps. An average of 8 kg of waste was generated per case. Coiling cases produced the greatest waste burden (13.1 kg), followed by embolization (10.3 kg), MT (8.8 kg), and DSA procedures (5.1 kg). CONCLUSION: Neurointerventional procedures generate a substantial amount of waste, an average of 8 kg per case. Targeted initiatives such as engaging with suppliers to revise procedure packs and reduce packaging, digitizing paper instructions, opening devices only when necessary, implementing additional recycling programs, and appropriate waste segregation have the potential to reduce the environmental impact of our specialty.

[A&F to monitor and promote quality in healthcare during the COVID-19 emergency: the EASY-NET work]. / A&F per il monitoraggio e la promozione della qualità delle cure in emergenza COVID-19: il lavoro di EASY-NET.

We are presenting here the findings of the reaction to the COVID-19 epidemic during the period March to June 2020 of those centres participating in the research EASY-NET which is on-going in Italy, funded by the Ministry of Health and co-founded by the Regional Health Authorities. The objective of EASY-NET is to evaluate the effectiveness of the audit and feedback (A&F) strategies in different clinical and organizational settings in seven regions. As a negative consequence of the COVID-19 epidemic, the activities of the project have suddenly slowed down; nevertheless, the COVID-19 epidemic represented an opportunity to apply the A&F methodology and support the healthcare within the regional authorities in order to manage and monitor the impact of this new disease. The reaction to the crisis on behalf of EASY-NET was inconsistent across the participating regions for various reasons. Factors which influenced the reaction levels in relation to the rapidity and efficiency of the implementation of the A&F strategies were as follows: the varying epidemiological impact of the COVID-19 epidemic in the various territories, the different clinical and organizational context and availability of expert research teams together with A&F procedures which had already been tested before the start of the epidemic.

Using routine, independent, scientific-data audits as an early-warning for potentially fraudulent toxic-site cleanup: PCE, TCE, and other VOCs at the former Naval-Ordnance Test Station, Pasadena, California.

Two of the most prevalent Superfund-site contaminants are carcinogenic solvents PCE (perchloroethylene) and TCE (trichloroethylene). Because their cleanup is difficult and costly, remediators have repeatedly falsified site-cleanup data, as Tetra Tech apparently did recently in San Francisco. Especially for difficult-to-remediate toxins, this paper hypothesizes that scientific misrepresentations occur in toxic-site assessments, before remediation even begins. To begin to test this hypothesis, the paper (1) defines scientific-data audits (assessing whether published conclusions contradict source data), (2) performs a preliminary scientific-data audit of toxic-site assessments by consultants Ninyo and Moore for developer Trammell Crow. Trammel Crow wants to build 550 apartments on an unremediated Pasadena, California site - once a premier US Navy weapons-testing/development facility. The paper (3) examines four key Ninyo-and-Moore conclusions, that removing only localized metals-hotspots will (3.1) remediate TCE/PCE; (3.2) leave low levels of them; (3.3) clean the northern half of soil, making it usable for grading, and (3.4) ensure site residents have lifetime cancer risks no greater than 1 in 3,000. The paper (4) shows that source data contradict all four conclusions. After summarizing the benefits of routine, independent, scientific-data audits (RISDA), the paper (5) argues that, if these results are generalizable, RISDA might help prevent questionable toxic-site assessments, especially those of expensive-to-remediate toxins like PCE/TCE.

Contribuições da auditoria na gestão hospitalar: revisão integrativa / Contributions of auditing in hospital management: An integrative review

A auditoria em saúde é considerada um instrumento que permite auxiliar na gestão de serviços de saúde. Por meio de sua aplicação, é possível obter um diagnóstico situacional para intervir com a finalidade de obter mudanças e melhorias; entretanto, há controvérsias quanto ao seu enfoque contábil-financeiro e/ou de qualidade assistencial, variando esse foco em diferentes contextos e situações, tanto no Sistema Único de Saúde quanto na saúde suplementar. O objetivo deste estudo é analisar o conhecimento científico produzido sobre a auditoria e sua contribuição para a gestão na atenção hospitalar. Trata-se de revisão integrativa, norteada pela questão "Quais as evidências científicas acerca da auditoria como contribuição para a gestão na atenção hospitalar?", que percorreu cinco etapas para a sua elaboração. Os estudos primários foram selecionados nas bases de dados LILACS, MEDLINE via PubMed, Scopus, Embase e Web of Science. A amostra da revisão integrativa foi composta por 18 estudos, que foram inseridos e armazenados no software EndNote Basic. Para sistematizar os artigos selecionados, optou-se pelo uso do software Rayyan e, para a análise de similaridade das palavras, utilizou-se o Iramuteq. A seleção dos artigos foi realizada em dupla conferência por dois pesquisadores, de modo independente. Após a síntese, os estudos foram agrupados em duas categorias. "A auditoria na qualificação de processos assistenciais e gerenciais" agrupa 16 artigos, que trazem diferentes estratégias, como o processo educativo e a implantação de protocolos/diretrizes assistenciais, que possibilitam o planejamento e a tomada de decisão por parte do gestor para qualificar a assistência. Já a categoria "Auditoria e gestão de custos" agrupa cinco artigos, que trazem uma contribuição importante em relação à adequação de gastos e custos para redistribuir e otimizar os recursos envolvidos na assistência ao paciente. As evidências científicas incluem conhecimentos acerca de auditoria, que favorecem a gestão hospitalar, principalmente em intervenções para a revisão e melhorias de processos assistenciais, a implantação de protocolos clínicos, a promoção de ações que envolvam o processo educativo e a reflexão da prática por parte dos profissionais, propiciando uma assistência de qualidade e possibilitando, também, a gestão de custos.

The health audit is considered a tool to assist in the management of health services. Through its application, it is possible to obtain a situational diagnosis to intervene in order to obtain changes and improvements; however, there are controversies regarding its accounting-financial and/or assistance quality approach, varying this focus in different contexts and situations, both in the Unified Health System and in supplementary health. The objective of this study is to analyze the scientific knowledge produced about auditing and its contribution to management in hospital care. It is an integrative review, guided by the question "What are the scientific evidences about auditing as a contribution to management in hospital care?", which went through five stages for its elaboration. The primary studies were selected in the LILACS, MEDLINE databases via PubMed, Scopus, Embase and Web of Science. The sample of the integrative review was composed of 18 studies, which were inserted and stored in the EndNote Basic software. To systematize the selected articles, the Rayyan software was used, and for the analysis of similarity of words, Iramuteq was used. The selection of the articles was done in a double conference by two researchers, independently. After the synthesis, the studies were grouped into two categories. "The audit on the qualification of assistance and management processes" groups 16 articles, which bring different strategies, such as the educational process and the implementation of assistance protocols/guidelines, which enable the planning and decision making by the manager to qualify the assistance. The category "Audit and cost management" groups five articles, which bring an important contribution in relation to the adequacy of expenses and costs to redistribute and optimize the resources involved in patient care. The scientific evidence includes knowledge about auditing, which favors hospital management, mainly in interventions for the review and improvement of assistance processes, the implementation of clinical protocols, and the promotion of actions that involve the educational process and the reflection of practice by professionals, providing quality assistance and also enabling cost management.

Audit of surgical services in a teaching hospital in Addis Ababa, Ethiopia.

OBJECTIVE: The aim of the study is descriptively analyze services in terms of surgical care, performance and outcome in department of surgery of ZMH which is a university affiliated general hospital in Addis Ababa, Ethiopia. Data on mode of admission, procedures done and outcome were collected from a monthly audit report, patients file. Information on the number of operating days missed and patients cancelled after being scheduled for surgery were collected from OR logo book. RESULT: Emergency operations constitute 57.4% of all operations. Appendectomy is the commonest emergency operation accounting for 41.5%. Thyroid and gallbladder surgeries were the most common elective operations accounting for 23.5% and 22% respectively. There were 26 and 2 deaths from the emergency and elective operations making the postoperative mortality rate of 2.8% and 0.02% respectively. The average hospital stay of a patient is 3.74 days. 23 of 211 (14.7%) operation dates were missed for various reasons. 81 of 693 (11.7%) elective operations were not done the first time they were scheduled. In conclusion this study showed emergency surgery out number elective surgeries, unacceptably high number of operation days are missed and scheduled surgeries are cancelled.

Auditoría del conocimiento orientada a los procesos y al desarrollo profesional en la Editorial Ciencias Médicas / Knowledge audit of processes and professional development at the Medical Sciences Publishing House

Esta auditoría pretendió identificar el conocimiento presente en los procesos principales de la Editorial Ciencias Médicas y el comportamiento de un conjunto de indicadores acerca del desarrollo profesional, que permiten valorar la proyección actual y futura del conocimiento, así como conocer algunos aspectos en que se deben potenciar para contribuir a asegurar la actuación futura de la institución. Se empleó una metodología desarrollada por Ponjuán para valorar el conocimiento presente en los procesos actuales e identificar el comportamiento de sus trabajadores en relación con el desarrollo profesional. Se identificó el conocimiento que se aplica en todos los procesos principales de la organización, así como el comportamiento de la composición profesional del personal, su experiencia laboral y en la institución, el tiempo que dedican a su actualización, su visibilidad en eventos y redes sociales, entre otros. Los puntos fuertes y débiles de la institución, así como la identificación del conocimiento que se necesita en cada proceso, permitieron sugerir a la institución determinados aspectos relativos al conocimiento, su retención, los procesos organizacionales y los componentes humanos y tecnológicos necesarios. Estos resultados permiten conocer mejor a la organización y facilitan la introducción de un programa de gestión del conocimiento al conocer, con mayor profundidad y desde diferentes miradas, las debilidades y las fortalezas existentes relacionadas con el conocimiento necesario y su aplicación en los procesos internos, así como algunas características del desarrollo profesional(AU)

The audit intended to identify the knowledge underlying the main processes performed at the Medical Sciences Publishing House and the behavior of a number of indicators related to professional development which make it possible to assess the current status and future projection of knowledge, as well as become acquainted with areas to be strengthened to contribute to ensure the future performance of the institution. The study was based on a methodology developed by Ponjuán, to assess the knowledge base supporting current processes and identify the behavior of workers in relation to professional development. Identification was made of the knowledge applied in all the main processes of the organization, as well as the behavior of the professional composition of the personnel, their work experience in general and at the institution, the time they devote to their updating, and their visibility in conferences and the social networks, among other factors. The strengths and weaknesses of the institution, as well as identification of the knowledge needed in each process, allowed to suggest a number of aspects related to knowledge, its retention, the organizational processes, and the human and technological components required. These results make it possible to know the organization better and facilitate the introduction of a Knowledge Management program based on a more profound understanding from various perspectives of the current weaknesses and strengths in terms of the knowledge required and its application in internal processes, as well as some characteristics of professional development(AU)

Estado del arte de la Auditoría de Información / State of the Art of Information Audit

RESUMEN La Auditoría Informacional consiste en evaluar y examinar, periódicamente, los recursos informativos que poseen las entidades para identificar la información, sus flujos y elementos como parte de los procesos organizacionales, para comprender la entidad y sus capacidades. Además, permite determinar cuáles son las fuentes informativas que poseen, cuáles son las que realmente se necesitan, cuáles las que no se tienen y las que generan costos inútiles, es decir, valora la efectividad y la eficacia del sistema informacional. Por lo anterior, la presente investigación tiene como objetivo: realizar una revisión de lo publicado sobre Auditoría de Información en EBSCO, SciELO, RedAlyc, Google, Google Académico y el Google Trends. A partir del análisis de la literatura se obtuvo la tendencia sobre el tema a partir de los países y años más productivos e idiomas más frecuentes. Se observó que aún se desarrollan varios estudios de casos sobre la temática y que las metodologías de los autores Bryson (1997), Artiles (2015) y González, Pintoy Ponjuán (2017), son las más citadas.

ABSTRACT The Informational Audit consists of periodically evaluating and examining the information resources that the entities possess to identify the information, its flows and elements that are part of the organizational processes, and thus the entity and its capacities are better understood. In addition, it allows to determine which are the informative sources that are possessed, which are the ones that are really needed, which are the ones that are not available and those that generate useless costs, that is, value the effectiveness and efficiency of the informational system. The present investigation has like objective: to realize a revision of the published thing on Information Audit in EBSCO, SciELO, RedAlyc, Google, Google Scholar and the Google Trends. From the analysis of the literature, the trend was obtained on the subject from the most productive countries and years and most frequent languages. It was observed that several case studies are still being developed on the subject and that the methodologies of the authors Bryson (1997), Artiles (2015) and González, et al (2017), are the most cited.

Práticas de auditoria no sistema único de saúde: uma revisão integrativa / Prácticas de auditoría en el sistema único de salud: una revisión integrativa / Auditing practices in the Brazilian unified health system: an integrative literature review

Objective: The study's purpose has been to analyze the auditing practices in the Sistema Único de Saúde (SUS) [Brazilian Unified Health System]. Methods: It is an integrative literature review that was carried out in the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) [Latin American and Caribbean Literature in Health Sciences], Virtual Health Library (VHL), and Web of Science databases. By using the inclusion and exclusion criteria, 12 scientific articles were selected for in-depth analysis. Results: The findings demonstrate the political and institutional advances regarding to the auditing practices in the SUS. There have been also identified many challenges that must be overcome in order to support such practices, such as the need to qualify the tools of the National Audit Department from the SUS and to improve the communication between State, Municipal, and Federal auditing. Conclusion: Auditing practices in the SUS are still under development, then requiring more studies and dissemination, aiming to bring contributions to both practice and the academic milieu

Objetivo: Analisar as práticas de auditoria no Sistema Único de Saúde (SUS). Métodos: Trata-se de uma revisão integrativa de literatura realizada na Biblioteca Virtual em Saúde (BVS), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), e Web of Science. Ao total, utilizando-se os critérios de inclusão e exclusão selecionou-se 12 artigos científicos para análise. Resultados: Os resultados apontam avanços políticos e nas instituições com relação as práticas de auditoria no SUS. Identificam-se também muitos desafios para fortalecer tais práticas, como a necessidade de qualificar as ferramentas do Departamento Nacional de Auditoria do SUS e melhorar a comunicação entre o componente, estadual, municipal e federal de auditoria. Conclusão: As práticas de auditoria no SUS estão em construção, necessitando de mais estudos e divulgação, afim de que traga contribuições para a prática e o meio acadêmico

Objetivo: Analizar las prácticas de auditoría en el Sistema Único de Salud (SUS). Método: Se trata de una revisión integrativa de literatura realizada en la Biblioteca Virtual en Salud (BVS), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (Lilacs), y Web of Science. Al total, utilizando los criterios de inclusión y exclusión se seleccionaron 12 artículos científicos para análisis. Resultados: Los resultados apuntan avances políticos y en las instituciones con relación a las prácticas de auditoría en el SUS. Se identifican también, muchos desafíos para fortalecer tales prácticas, como la necesidad de calificar las herramientas del Departamento Nacional de Auditoría del SUS y mejorar la comunicación entre el componente, estatal, municipal y municipal, federal de auditoría. Conclusión: Las prácticas de auditoría en el SUS están en construcción, necesitando más estudios y divulgación, a fin de que traiga contribuciones para la práctica y el medio académico

Development and Validation of the Policies, Opportunities, Initiatives and Notable Topics (POINTS) Audit for Campuses and Worksites.

Background: Workplace or campus wellness/obesity-prevention policies and initiatives can improve health. Research tools to assess worksite or campus policies/initiatives are scarce. Thus, the aim of this research is to develop and validate the policies, opportunities, initiatives, and notable topics (POINTS) audit. Methods: POINTS was developed and refined via expert review, pilot-testing, and field testing. Trained researchers completed a web-based review from a student-focus or employee-focus regarding 34 health-promoting topics for colleges. Each topic was evaluated on a 0⁻2 scale: 0 = no policy/initiative, 1 = initiatives, 2 = written policy. When a written policy was detected, additional policy support questions (administered, monitored, reviewed) were completed. Results: Cronbach's Alpha for the student-focused POINTS audit was α = 0.787 (34 items, possible points = 65), and for the employee-focused POINTS audit was α = 0.807 (26 items, possible points = 50). A total of 115 student-focused and 33 employee-focused audits were completed. Although there was little evidence of policy presence beyond stimulant standards (smoking and alcohol), there were extensive examples of health initiatives. The student-focused POINTS audit was validated using the Healthier Campus Initiative's survey. Conclusions: POINTS is a web-based audit tool that is valid and useful for pre-assessment, advocacy, benchmarking, and tracking policies for health and well-being for students (campus) and employees (worksite).

Auditoria operacional: uma nova classificação para os resultados de seus monitoramentos / Auditoría de desempeño: una nueva clasificación para para los resultados de sus seguimientos / A new classification for the results of the performance audit follow up

Resumo Há décadas, as auditorias operacionais (AOPs) constituem importante ferramenta para o aprimoramento da gestão pública no Brasil e no mundo. Contudo, poucos estudos tratam do processo de monitoramento dessas auditorias e de sua adaptação à cultura brasileira. O objetivo desta pesquisa foi propor uma nova classificação para o acompanhamento das determinações e das recomendações resultantes das AOPs realizadas pelo Tribunal de Contas do Estado de Santa Catarina (TCE/SC). A partir da classificação prevista no manual de AOP do Tribunal de Contas da União (TCU), o TCE/SC adotou alterações na classificação descrita nos relatórios de monitoramento das 14 AOPs encerradas até 2015. A atual classificação foi submetida aos auditores e, posteriormente, aos chefes e aos coordenadores de auditoria, para sugestões. Por essa razão, sugere-se uma nova classificação para os resultados das AOPs.

Resumen Durante décadas, las auditorías de desempeño (AOP) han sido una herramienta importante para la mejora de la gestión pública en Brasil y en el mundo. No obstante, pocos estudios abordan el proceso de seguimiento de esas auditorías y su adaptación a la cultura brasileña. El objetivo de esta investigación es proponer una nueva clasificación para el seguimiento de las determinaciones y recomendaciones resultantes de las AOP, llevadas a cabo por el Tribunal de Cuentas del Estado de Santa Catarina (TCE/SC). A partir de la clasificación establecida en el Manual de AOP del Tribunal de Cuentas de la Unión, el TCE/SC adoptó cambios en la clasificación descrita en los informes de seguimiento de las 14 AOP concluidas hasta 2015. La clasificación actual se sometió a los auditores y posteriormente a los jefes y coordinadores de auditoría para posibles sugerencias. Por esta razón, se sugiere una nueva calificación para los resultados de las AOP.

Abstract For several decades, performance audits (AOPs) have significantly helped the improvement of public management in Brazil and the world. However, few studies have investigated this audits follow-up process and how they have adapted to Brazilian culture. This research proposes a new classification for the results of the performance audits follow-up observing whether the determinations and recommendations resulting from AOPs carried out by the Court of Accounts of the State of Santa Catarina (TCE/SC) are implemented. The classification provided in the AOP Manual prepared by the Federal Court of Accounts, was adapted by the TCE/SC, with changes that were described in the follow-up reports of 14 AOPs with information from the fiscal years 2004 to 2015. A first draft of a new classification was submitted to the auditors for analysis and suggestions. After that, it was sent to the analysis and contributions of the chief auditors and audit coordinators. The study, therefore, registered the changes that had occurred in the AOPs and proposed a new classification for the results of the AOPs follow-up that considers the degree of implementation of determinations and recommendations in the performance audit.