Function Positioning and Implementation Path of Internal Control in Public Hospitals from the Perspective of Finan-cial and Accounting Supervision / 中国卫生经济

With the reform of the medical and health system entering a critical period,public hospitals have also exposed new risks and challenges in economic operation.As an important means of hospital standardized management,internal control can better prevent and resolve the risk of hospital economic operation and ensure the sustainable operation of the hospital.By interpreting the requirements of current national policies on hospital internal control,it analyzes the functional positioning of financial and accounting supervision in hospital internal control,shares the internal control implementation path of sample hospitals from the perspective of financial and accounting supervision,and puts forward suggestions on strengthening internal control construction of public hospitals in the new era,in order to lay a good foundation for the high-quality development of hospitals.

The Main Problems and Strategies in the Procurement of Scientific Research Materials and Services in Public Hospitals under the Background of"Streamlining Management and Serving" / 中国卫生经济

The volume of research funding in public hospitals is increasing year by year,with the majority of research funding being used to purchase research materials and services.Traditional offline procurement methods have problems such as inadequate management systems,difficulty in ensuring product quality,blind spots in procurement processes,and high risks in invoice receipt and storage.Public hospitals urgently need to adopt digital methods,introduce research procurement platforms,and implant key control points into the platform based on reshaping the procurement business process,achieve full process supervision and traceability control of research procurement business,and strengthen internal control and risk management of research

Sistema automatizado para el control de medios de informática, ofimática y comunicaciones CIMIOC

Introducción: en las instituciones pertenecientes al Ministerio de Salud Pública de Cuba, la forma habitual de registrar el control de las Tecnologías de la Información y la Comunicación ha sido mediante hojas de Excel, procesadores de texto y fichas técnicas impresas. El control informatizado ofrece ventajas, pero las aplicaciones informáticas existentes a nivel mundial son costosas o no adaptables a los requerimientos. Objetivo: desarrollar una herramienta informática para el control institucional de medios informáticos, ofimáticos y de comunicaciones. Materiales y Métodos: investigación de desarrollo e innovación tecnológica, realizada durante 2018 y 2019, en dos etapas: 1) trabajo de mesa, definición de objetivos y establecimiento de pre-requisitos; 2) desarrollo de la aplicación, siguiendo la política de utilización de software libre. Las pruebas de funcionamiento y la evaluación se realizaron en la empresa MEDICuba S.A. Resultados: se desarrolló y registró una aplicación para el Control Informatizado de Medios de Informática, Ofimática y Comunicaciones (CIMIOC), con interfaz web, base de datos centralizada y un diseño adaptable a varios tipos de dispositivos. Permite registrar cualquier recurso de este tipo, su historial de movimiento, el estado técnico, los programas de mantenimiento y salvas de información, y ofrece diferentes reportes estadísticos. Conclusiones: la herramienta informática CIMIOC ofrece una solución robusta y económica para la gestión de las Tecnologías de la Información y las Comunicaciones, aplicable a cualquier institución. Facilita de manera objetiva el establecimiento de políticas que tributen a elevar los niveles de calidad en los servicios asociados a la utilización intensiva de estas tecnologías. Se recomienda generalizar la implantación en el Sistema Nacional de Salud.

Introduction: in the institutions belonging to the Ministry of Public Health of Cuba, the usual way of recording the control of Information and Communication Technologies has been through Excel sheets, word processors and printed technical sheets. Computerized control offers advantages, but existing computer applications worldwide are expensive or not adaptable to the requirements. Objective: to develop a computer tool for the institutional control of computer, office and communications media. Materials and Methods: technological development and innovation research, carried out during 2018 and 2019, in 2 stages: 1) table work, definition of objectives and establishment of pre-requisites. 2) development of the application, following the policy of use of free software. The performance tests and the evaluation were carried out in the company MEDICuba S.A. Results: an application for the Computerized Control of Informatics, Office Automation and Communications Media (CIMIOC) was developed and registered, with a web interface, centralized database and a design adaptable to various types of devices. It allows recording any resource of this type, its movement history, technical status, maintenance programs and information saves, and offers different statistical reports. Conclusions: the CIMIOC computer tool offers a robust and economical solution for ICT management, applicable to any institution. It objectively facilitates the establishment of policies that contribute to raising quality levels in services associated with the intensive use of ICT. Authors recommend to generalize the implementation in the National Health System.

Factors influencing hemolysis rate of leukocyte-reduced red blood cells at the end of preservation period in blood donors / 中国输血杂志

【Objective】 To compare the current standards and explore the influencing factors for hemolysis rate of leukocyte-reduced red blood cells at the end of the preservation period, in order to formulate reasonable internal control indicators. 【Methods】 A retrospective analysis was performed on hemolysis rate of 427 samples of leukocyte-reduced red blood cells at the end of the preservation period in Nanning Blood Center from 2015 to 2022. Compared with the current standard for hemolysis rate at the end of the preservation period (GB 18469-2012 Quality Requirements for Whole Blood and Component Blood), the differences were analyzed, and the factors influncing the hemolysis rate were analyzed in terms of different blood donor groups. 【Results】 1) Among the 427 samples, the hemolysis rate of 418 (97.89%) did not exceed 0.4%, all lower than 0.8%; 2)the hemolysis rate of the male group was higher than that of the female group; 3) the hemolysis rate of the 18-29 years old group was lower than that of the 30-39 year old group and the 40-60 year old group, with statistically significant difference; 4) in terms of occupation, the hemolysis rate of students was the lowest, and the differences between groups were statistically significant; 5) no statistical significance was found in ethnicity and blood type. 【Conclusion】 Statistics indicated that gender, age, blood donation volume and occupation of blood donors were the influencing factors of hemolysis rate. The current standard is obviously higher in the qualified range of blood quality control in Nanning. It is advisable to formulate a reasonable quality control strategy with internal control index of hemolysis rate set <0.4%, which is conducive to making accurate evaluation of internal quality control and ensuring blood safety.

Determination of suspended erythrocyte volume range and establishment of its internal control standard / 中国输血杂志

【Objective】 To determine the volume range of suspended erythrocyte and establish its internal control standard. 【Methods】 The theoretical value of suspended erythrocyte volume was calculated according to the screening criteria of healthy blood donors and Quality Requirements for Whole Blood and Blood Components. A total of 2 410 bags of 1 U and 2 U suspended erythrocyte were randomly selected and weighed, and the volume range were formulated by ±2S and ±10% respectively and then compared to determine the volume range in line with the actual situation of our center. 【Results】 The theoretical volume range of 1 U and 2 U suspended erythrocyte were 117-160 mL vs 234-320 mL, and the actual volume range were 142-180 mL vs 276-393 mL. The volume range of 1 U and 2 U suspended erythrocyte formulated by ±2S were 145-181 mL vs 298-358 mL, and by ±10% were 147-179 mL vs 295-361 mL. The hematocrit and hemoglobin content of suspended erythrocyte within the actual volume range met the quality requirements. There were fluctuations in the volume of suspended erythrocyte from different regions. 【Conclusion】 Based on the actual situation of our center and the sampling results of suspended erythrocytes in recent two years, 163 mL±10% and 328 mL±10% were determined as the internal control standards of 1 U and 2 U suspended erythrocyte, respectively. Blood centers should establish accurate and feasible standard of suspended erythrocyte according to the actual situation.

Study on the factors affecting the citation frequency to articles of internal control in public hospitals / 现代医院

Objective This paper discusses the influence factors of the citation frequency of internal control papers in public hospitals,and understands the overall development and hot trends in this field.Methods Descriptive statistics and re-gression analysis was used to analyze the articles searched from CNKI database from 2012 to October 2022.Results 1 682 valid literature was achieved and it was found that the papers with a frequency of citations greater than or equal to seven are highly cited papers,accounting for 16.77%;There are a number of stable high-level researchers and high-quality research institutions in this fields,which are important forces to promote the development of disciplines;Regression analysis found that articles funded and published in core journals were cited frequently;The frequency of citations in research topics such as System construction,Finan-cial control,Contract control and Asset control is significantly higher than other topics.Conclusion High-level researchers,high-level research institutions,high-quality papers and high-quality journals are mutually successful;Fully understanding the"Management Measures for Internal Control in Public Hospitals"is the foundation of internal control construction in the medical and health industry;Strengthening information technology construction is the focus of future internal control work in public hospitals;In-ternal control should work together with other policies in the healthcare industry to promote the reform of the healthcare system.

Preparation of the second generation internal control reference for anti-SARS-CoV-2 IgG antibody and evaluation of its applicability in ELISA detection method / 中国生物制品学杂志

@#Objective To prepare the second generation internal control reference(B2)for Ig G antibody against severe acute respiratory symptom coronavirus 2(SARS-CoV-2)and evaluate its applicability in ELISA detection method. Methods Among the volunteers vaccinated with SARS-CoV-2 inactivated vaccine(BBIBP-Cor V)produced by Beijing Institute of Biological Products Co.,Ltd.,19 Ig G antibody positive plasma samples with ELISA-Ig G dilution ratio of 20 ～ 60 were screened,and the Ig G antibody,IgM antibody and neutralizing antibody were detected by ELISA,B2 was prepared from nonlipid plasma with ELISA-Ig G dilution ratio of 32 ～ 45,IgM negative and similar neutralizing antibody inhibition rate. The neutralizing antibody potency of the first generation internal control reference(B1)and B2 detected by ELISA was calibrated with the first generation WHO international standard of anti-SARS-CoV-2 immunoglobulin(NIBSC 20/136),and the accelerated stability(storage at 2 ～ 8 ℃ for 5,8,14,20,and 30 d respectively),the service stability(storage at 18 ～25 ℃ for 1,2,and 3 h respectively),the freeze-thaw stability(1,2 and 3 times)and the long-term stability(storage at-25 ℃ for10 months)of B2 were tested. B2 was used as standard to detect plasma after single vaccine immunization and mixed plasma was prepared according to different ELISA-Ig G dilution ratio. The correlation and linear regression analysis between ELISA-Ig G dilution ratio and neutralizing antibody potency of pseudovirus in mixed plasma were carried out. Results Among 19 plasma samples,5 samples were non-lipid plasma with ELISA-Ig G dilution ratio of 32 ～ 45,IgM negative and similar neutralizing antibody inhibition rate. B2 was prepared by mixing every plasma in equal volume fraction,and the dilution ratio of ELISA-Ig G was assigned to 32. The neutralizing antibody potency of B1 calibrated with NIBSC 20/136 was 133. 38 EIU/m L and that of B2 was 122. 14 EIU/m L. The recovery rates of accelerated stability,service stability,freeze-thaw stability and long-term stability of B2 were all in the range of(100 ± 15)%. The ELISA-Ig G dilution ratio of the mixed plasma from the same source was significantly correlated with the neutralizing antibody potency of pseudovirus.(each R~2> 0. 99,each P < 0. 000 1).Conclusion B2 prepared from plasma immunized with SARS-CoV-2 inactivated vaccine can replace B1 prepared from plasma of COVID-19 convalescent patients.

Practice on fine management of contract countersignature process at public hospitals / 中华医院管理杂志

Contract countersignature can effectively avoid potential risks caused by sub-standard contract signing, yet its time consuming process will inevitably delay the contract signing and related business development. Therefore, it is necessary to ensure the timely signing of hospital contracts on the premise of meeting internal control requirements. In order to improve the efficiency of contract countersigning, a tertiary hospital has explored various approaches to optimize the contract countersigning process since 2019. These approaches included establishing a three-level centralized contract management model, clarifying the review responsibilities of each countersigning department, customizing the countersigning process, managing the contract by risk classification, and establishing a meeting opportunity system of contract countersigning modification opinions. These measures had cut back the time spent in the contract countersigning process from 12.1 working days in 2018 to 4.2 working days in 2021.

Propuesta para la valoración de la gestión de riesgos de la COVID-19 con enfoque difuso / Proposal for valuation of the risk management of the COVID-19 with a diffuse / Proposta de avaliação da gestão de risco do COVID-19 com abordagem difusa

RESUMEN Introducción: el enfrentamiento a la COVID-19 impone importantes retos a los profesionales de la salud relacionados con los cuidados de la salud de la población y con la prevención y control de infecciones en la comunidad y en las instituciones de salud. Uno de los mayores retos a los que se enfrentan los hospitales es gestionar los riesgos sin que ello suponga un deterioro de la calidad percibida por el paciente y personal sanitario. Objetivo: diseñar un modelo para la gestión de riesgos epidemiológicos relacionado con la COVID-19 en consejos y unidades de salud. Métodos: se utilizó la Lógica Difusa Compensatoria como método pertinente de la modelación matemática en procesos complejos. Resultados: se tiene un modelo de decisión para la valoración de la gestión de riesgos relacionado con la COVID-19, integrado al sistema de control interno hospitalario. Conclusiones: se demostró la pertinencia de la gestión de riesgos como alternativa para exterminar la pandemia causada por el nuevo Coronavirus SARS CoV-2. Se confirma la pertinencia de la lógica difusa compensatoria para la toma de decisiones en proceso complejos. Se integró la gestión de riesgos de la COVID-19 al sistema de control interno hospitalario, permitiendo tomar estrategias para la mejora de las entidades de la salud.

ABSTRACT Introduction: the confrontation with COVID-19 imposes important challenges on health professionals related to the health care of the population and to the prevention and control of infections in the community and in health institutions. One of the biggest challenges that hospitals face is managing their risk more efficiently without this deteriorating the quality perceived by the patient and healthcare personnel. Objective: assessing the management of epidemiological risk related to COVID-19 in healt councils and units. Methods: compensatory fuzzy logic was used as a pertinent method of mathematical modeling in complex processes Results: there is a decision model for the assessment of risk management related to COVID-19, integrated into the hospital internal control system Conclusions: the relevance of risk management as an alternative to exterminate the pandemic caused by the new coronavirus SARS CoV-2was demonstrated. The pertinence of diffuse compensatory logic for decision making in complex processes is confirmed. The risk management of de covid was integrated into the hospital internal control system, allowing the desing of strategies for the improvement of health entities.

RESUMO Introdução: o enfrentamento da COVID-19 impõe desafios importantes para os profissionais de saúde relacionados à atenção à saúde da população e à prevenção e controle de infecções na comunidade e nas instituições de saúde. Um dos maiores desafios que os hospitais enfrentam é gerenciar os riscos sem causar uma deterioração na qualidade percebida pelo paciente e profissionais de saúde. Objetivo: traçarum modelo de gestão dos riscos epidemiológicos relacionados ao COVID-19 em conselhos e unidades de saúde. Métodos: A Lógica Fuzzy Compensatória foi utilizada como um método pertinente de modelagem matemática em processos complexos. Resultados: existe um modelo de decisão para avaliação do gerenciamento de riscos relacionado ao COVID-19, integrado ao sistema de controle interno do hospital. Conclusões: ficou demonstrada a relevância do gerenciamento de risco como alternativa para exterminar a pandemia causada pelo novo Coronavírus SARS CoV-2. A relevância da lógica fuzzy compensatória para a tomada de decisão em processos complexos é confirmada. A gestão de riscos do COVID-19 foi integrada ao sistema de controle interno do hospital, permitindo a adoção de estratégias de melhoria das entidades de saúde.

Sistema informático para un cuadro de mando integral del control interno como apoyo a la gestión de la información hospitalaria / Information system for an integrated internal control panel in support of hospital information management

En Cuba se ha identificado la necesidad de dominar y de introducir en la práctica las tecnologías de la información y las comunicaciones y de lograr una cultura digital como una de las características imprescindibles para los hospitales, lo cual sigue constituyendo un reto con múltiples aristas, enfoques y puntos de vistas. En este sentido se destaca el control interno como un motor de gestión de la información. Este trabajo tuvo como objetivo desarrollar un sistema informático para la automatización del cuadro de mando integral como herramienta de control interno en entidades hospitalarias, que contribuya a la gestión de la información en ciencias de la salud. Se programó un software mediante el entorno de desarrollo integrado Embarcadero Delphi, el cual utilizó Object Pascal como lenguaje de programación. Para el proceso de elaboración del sistema informático se empleó la metodología SCRUM, con una la lista de productos que consiste en el conjunto de requerimientos funcionales y no funcionales que debe satisfacer la aplicación. Se logró el desarrollo del software MULTI-CONTROL-INTERNO, con una ventana principal que incluye un menú contextual para acceder a todas las ventanas de la aplicación e introducir los valores de las variables necesarias para calcular los indicadores y gráficos dinámicos de cada una de las perspectivas del cuadro de mando integral, y se obtuvo el diseño de las estrategias para la mejora del sistema sanitario según la gestión de la información en el hospital a través de los índices de cumplimiento de los objetivos, la eficacia, la eficiencia y los componentes del control interno. El sistema informativo en entidades hospitalarias cubanas es hoy un acápite pendiente por la dinámica del entorno sanitario(AU)

The purpose of the study was to develop an information system for the automation of the integrated control panel as an internal control tool in hospitals, thus contributing to health information management. A software application was programmed in the Embarcadero Delphi integrated development environment, using Object Pascal as programming language. Development of the information system was based on SCRUM methodology, with a list of products consisting in the set of functional and non-functional requirements to be met by the application. The software Multi-internal-control was thus developed, with a main window which includes a context menu to access all the windows in the application and enter the values of variables required to estimate the dynamic charts and indicators of each of the perspectives on the integrated control panel, obtaining the design of strategies for the improvement of the healthcare system according to the information management procedure in place at the hospital, through goal achievement indices, efficacy, efficiency and internal control components. The information system at Cuban hospital institutions is still a pending item due to the dynamics of the healthcare environment(AU)

Stability of two internal control blood nucleic acid detection systems in plateau area / 中国输血杂志

【Objective】 To analyze the difference of the internal control (IC) Ct value of two sets of blood nucleic acid detection(NAT) systems for individual donation and explore the feasibility of the IC Ct value used as stability evaluation index of NAT system. 【Methods】 A total of 4342 blood samples were randomly selected from our center from June to November 2020, and the IC Ct values of NAT system were classified into three categories: 1) classified by detection items: HBV, HCV and HIV; 2) classified by sample type: negative control (NC), positive control (PC), internal quality control (QC), blood donor sample (S); 3) classified by different instruments: system A and system B, and the differences of IC Ct value were analyzed and compared. 【Results】 A total of 14 196 IC Ct values of NAT were collected, showing a non-normal distribution. 1) classified by detection items: there were differences in the median of overall IC Ct values of HBV, HCV and HIV (H=859.6, P0.05), except for HBV QC (Z=1 635)and S (Z=1 848 560), HCV S (Z=1 957 844), HIV S (Z= 2 217 855) (P<0.01). No difference in IC values (P<0.01) was noted for any detection items (NC, PC, QC and S) in the same set of detection system. 【Conclusion】 Although IC values trended to be different due to types of sample, the NC, PC, and QC samples that come with the original reagents were identical in the two detection systems. The change of IC Ct value may be used as an evaluation index for the stability of the detection system.

Research on the internal control evaluation of government procurement at public hospitals / 中华医院管理杂志

Objective:To evaluate the effectiveness of internal control of government procurement at public hospitals.Methods:Literature review and Delphi method were used to construct the internal control evaluation index system of government procurement at public hospitals, and the weight of the index system was determined by analytic hierarchy process. The index system was used to evaluate the internal control of government procurement in Hospital Z.Results:The evaluation index system of government procurement internal control of public hospitals covers all aspects of the whole process of government procurement, including 2 level-1 indexes of government procurement internal control unit level and government procurement internal control business level, 11 level-2 indexes and 27 level-3 indexes. The internal control of government procurement of Hospital Z was evaluated with an evaluation score of 81.37 points, an evaluation result relatively effective.Conclusions:The evaluation index system of government procurement internal control of public hospitals constructed in this study could quantitatively evaluate the effectiveness of each sector of government procurement internal control of public hospitals. It could meet the basic evaluation requirements of internal control of government procurement at public hospitals.

Proceso de desafío a la COVID-19 apoyado en el Ambiente de Control / The process to cope with COVID-19 supported by the control environment

RESUMEN Introducción: la falta de referencias sobre crisis semejantes a la Covid-19 hace difícil la predicción de un futuro inmediato. Como es lógico, los efectos presentes son fácilmente documentables, pero aquellos que dejarán huella en los distintos actores a medio y a largo plazo resultan más sujetos a debate. Objetivos: evidenciar el desempeño que tiene el ambiente de control como base de control interno, en el enfrentamiento a la Covid-19. Métodos: se diseñó el sistema de enfrentamiento a la COVID-19, al evidenciar el papel de los elementos del ambiente de control y su relación con el proceso de capital humano sanitario. Resultados: se tiene el mapa de proceso del sistema de enfrentamiento a la COVID-19 donde el control interno se materializa de manera transversal y se demuestra la importancia de los elementos del ambiente de control como la planificación, los valores éticos, idoneidad demostrada, estructura organizativa, las políticas y prácticas de recursos humanos y su relación con el desempeño de la gestión del capital humano sanitario. Conclusiones: la importancia reflejada en el desafío de la pandemia de los elementos del ambiente de control, como base del proceso transversal "control interno" del sistema de desafío a la COVID-19 y la importancia de la relación con los procesos de gestión de los elementos del capital humano sanitario; permitieron establecer una estrategia de mejora basadas en un plan de acción.

ABSTRACT Introduction: the lack of references to crises similar to COVID-19 in the past makes it difficult to predict what may happen in the immediate future. Logically, the present effects of this pandemic are without doubt documented, but those that will leave their mark on the different protagonists at medium and long-term are more subject to debate. Objectives: to demonstrate the role of the control environment as a basis for the internal control in coping with COVID-19. Methods: the strategy to cope with COVID-19 is designed; the role of the elements that are involved in the control environment and the relationship with the process of human-health capital is evidenced. Results: the process map to develop the strategy to cope with COVID-19 where the internal control is materialized in a cross-sectional approach, as the significance of the elements involved in the control environment such as: planning, ethical values, proven competences, organizational structure in addition to the human resources policies, and the practices, as well as the relationships with the actions established to direct the human-health capital. Conclusions: the impact reflected to cope with this pandemic along with the elements of the control environment, as the basis for the cross-sectional process (internal control) designed for the strategy to cope with COVID-19, as well as the importance of the processes and the relationships to direct the elements involved in human-health capital, allow establishing a strategy of improvement based on an action plan.

Research on the Risk Prevention and Quality Control of Public Hospital Procurement / 中国医疗器械杂志

Through the functional combination of relevant departments involved in hospital procurement, to simplify and unify the work process, we establish a standardized procurement system, to realize the pre-procurement budget and approval, power balance, strengthen the fairness and openness of procurement process. By introducing the closed-loop process of in-process supervision to ensure the impartiality of review and post-evaluation control, it comprehensively strengthens the internal control of procurement management, and finally realizes the purpose of strengthening procurement risk prevention and procurement quality management.

A falta de trabalho institucional e mudanças organizacionais incompletas em municípios brasileiros / La falta de trabajo institucional y cambios organizacionales incompletos en municipios brasileños / Lack of institutional work and organizational change failure in Brazilian local governments

Resumo Este artigo propõe um modelo para explicar falhas na adoção compulsória de novas práticas no ciclo de gestão financeira em municípios. Empiricamente, aplica-se o modelo à adoção de sistemas de controle interno (SCI) em municípios brasileiros. As evidências da análise qualitativa comparada (qualitative comparative analysis - QCA) em sete prefeituras mostram que, apesar de recursos humanos e de sistemas serem condição necessária, eles não são suficientes para a implementação das práticas de controle interno. O chamado capital institucional é uma condição sine qua non para a adoção de novas práticas de administração e controle financeiro em governos locais no Brasil. A adoção dessas reformas depende da atuação de uma rede de "atores com poder" que realizam trabalho institucional em prol das mudanças.

Resumen Este artículo propone un modelo para explicar fallas en la adopción obligatoria de nuevas prácticas en el ciclo de gestión financiera en municipios. Empíricamente, se aplica el modelo a la adopción de los sistemas de control interno en municipios brasileños. Las evidencias del análisis comparativo cualitativo (qualitative comparative analysis - QCA) en siete municipalidades demuestran que la existencia de recursos humanos y de sistemas son una condición necesaria, pero no suficiente para la implementación de las prácticas del control interno. El capital institucional es una condición sine qua non para la adopción de nuevas prácticas de gestión y control financiero en gobiernos locales en Brasil. La adopción de esas reformas depende del apoyo de varios "actores con poder" que realizan trabajo institucional en pro de las reformas.

Abstract This article proposes a theoretical framework to explain the failure of the compulsory adoption of new practices in the financial management cycle in local governments. The empirical analysis applies the framework to the control systems implementation in Brazilian municipalities. The findings of a qualitative comparative analysis applied to seven local governments show that despite human capabilities and information systems being a necessary condition, they are insufficient to deeply implement such internal control practices. Institutional capital is a condition sine qua non for the adoption of new practices on financial management and control in Brazilian local governments. The adoption of such reforms depends on an active network of powerful actors involved in institutional work supporting the changes.

Internal control development at public hospitals in Ya'an city: problems and countermeasures / 中华医院管理杂志

Internal control of public hospital can prevent and control risk exposure of public hospitals in their economic activities,in order to reasonably guarantee their legal compliance,safety and effective use of assets,as well as their authenticity and integrity of financial information.It can also effectively fend off fraud,corruption,and improve the quality of public health services and service efficiency.The authors analyzed the present situation and existing problems of internal control efforts at public hospitals in Ya'an city,and put forward countermeasures and suggestions as well.

Comparison of the Effectiveness in the Application of Competitive and Noncompetitive Internal Control for the Laboratory Developed Polymerase Chain Reaction / 대한수혈학회지

BACKGROUND: A nucleic acid amplification test was adopted to detect transfusion-transmitted infectious agents. In the case of HTLV, however, there was no internal control (IC) because the laboratory developed polymerase chain reaction (laboratory-developed PCR) was used. In this study, noncompetitive IC was constructed for the laboratory-developed PCR of HTLV and the effectiveness was compared with the competitive test that was constructed in a previous study. METHODS: As a competitive IC, plasmid DNA, including the primer recognition sequence for the amplification of the HTLV pX region, was constructed. As a noncompetitive IC, an additional primer was constructed for the amplification of the housekeeping gene, the glyceraldehyde 3-phosphate dehydrogenase (GAPDH) gene. The performance of the competitive and noncompetitive IC was verified and compared using 10 HTLV positive samples and 10 negative samples. In addition, the detection limits in the assay adopting competitive IC and noncompetitive IC were compared. RESULTS: In the case of competitive IC applications, all 10 positive samples were positive and all 10 negative samples were negative. In the case of noncompetitive IC applications, however, one positive sample was not detected. The detection limit of the assay using competitive IC was 100 pg and that of the assay using noncompetitive IC was 1 ng. CONCLUSION: Although the manufacturing processes is not required using noncompetitive IC, the adoption of competitive IC is more effective to ensure the assay results because the ability of detection of the assay adopting competitive IC was better than that using noncompetitive IC.

Integración de los enfoques de gestión documental y gestión de riesgos para el tratamiento de la información como evidencia de actos y transacciones organizacionales / Integration of the approaches of documentary management and risk management for the treatment of the information as evidence of acts and organizational transactions

En el presente artículo se exploran los nexos entre gestión documental y gestión de riesgos. Para esto se analiza cómo la gestión documental ha evolucionado en las últimas décadas hasta enfocarse en los procesos de captura y mantenimiento de evidencias de actos y transacciones de negocios. Se muestra cómo la literatura especializada exploró dicha relación e identificó que los documentos son tanto fuentes de información para la identificación de riesgos, como objetos de riesgos en sí mismos. Se concluye que los sistemas de gestión documental ayudan a las organizaciones a gestionar la incertidumbre en relación con el fracaso en la creación y control de documentos de calidad, por el impacto negativo que esto tiene en la capacidad de la organización para lograr sus objetivos. En este sentido se considera que un sistema de gestión documental es un sistema de gestión de riesgos, en el que es esencial la determinación de requisitos de gestión documental para la identificación y la mitigación de riesgos organizacionales derivados de la información, como evidencia de actos y transacciones de negocios(AU)

In this article the links between records management and risk management are explored. It is exposed how records management has evolved in recent decades to focus on the processes of capture and maintenance of acts evidence and business transactions. It shows how the specialized literature explored this relationship and identified that documents are both information sources for risks identification, and objects of risks in themselves. It is concluded that Records Management Systems help organizations to manage the effect of uncertainty in relation to the failure in the creation and control of quality documents, due to the negative impact that this has on the organization's capacity to achieve its objectives. In that sense a Records Management System is considered to be a Risk Management system, where it is essential the determination of records management requirements for the identification and mitigation of organizational risks derived from information as acts and business transactions evidences(AU)

Contribución a la implantación del control interno a través de sus variables activas en una entidad hospitalaria / Contribution to the implantation of internal control through its active variables in a hospital entity

Introducción: en el nuevo milenio las entidades de la salud pública necesitan poseer herramientas que le permitan desempeñar correctamente sus funciones dentro de la sociedad. En Cuba los hospitales son unidades presupuestadas por lo que resulta imprescindible un eficiente control de sus medios y recursos por el costo que estos representan para el país, de ahí que un eficiente sistema de control interno es vital para el logro de sus metas. Objetivo: gestionar el control interno a través de sus variables activas para diagnosticar sus debilidades. Materiales y Métodos: se manipularon métodos de investigación pertinentes como el análisis prospectivo y la modelación matemática a través de indicadores. Resultados: se obtuvo un índice de gestión del control interno que calificó al hospital con un medio control, así como acciones para su implantación. Quedaron establecidos los principales valores éticos de los trabajadores en una entidad hospitalaria. Conclusiones: se demostró la pertinencia del análisis prospectivo en la contribución de la implantación del control interno. Se determinó como variables activas las referentes al ambiente de control. En su diagnóstico la entidad presentó un control medio (AU).

Introduction: in the new millennium, public health institutions need tools allowing them to correctly perform their functions in the society. Hospitals in Cuba are budgeted entities, resulting unavoidable the efficient control of their means and resources due to the high cost they represent for the country. Therefore, an efficient system of internal control is vital to achieve their goals. Objective: to manage internal control through its active variables to diagnose its weaknesses. Materials and Methods: appropriate research methods such as prospective analysis and mathematical modeling through indicators were handled. Results: an internal control management index was obtained, as well as actions for its implementation. The internal control was qualified as average. The contribution of the research included the establishment of the main ethical values of workers in a hospital institution. Conclusions: the relevance of the prospective analysis as a contribution to the implementation of internal control was acknowledged. Active variables were considered those related with the control environment variable. In the diagnosis the entity showed an average control (AU).

Development of Molecular Diagnosis Using Multiplex Real-Time PCR and T4 Phage Internal Control to Simultaneously Detect Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis from Human Stool Samples

This study aimed to develop a new multiplex real-time PCR detection method for 3 species of waterborne protozoan parasites (Cryptosporidium parvum, Giardia lamblia, and Cyclospora cayetanensis) identified as major causes of traveler's diarrhea. Three target genes were specifically and simultaneously detected by the TaqMan probe method for multiple parasitic infection cases, including Cryptosporidium oocyst wall protein for C. parvum, glutamate dehydrogenase for G. lamblia, and internal transcribed spacer 1 for C. cayetanensis. Gene product 21 for bacteriophage T4 was used as an internal control DNA target for monitoring human stool DNA amplification. TaqMan probes were prepared using 4 fluorescent dyes, FAM™, HEX™, Cy5™, and CAL Fluor Red® 610 on C. parvum, G. lamblia, C. cayetanensis, and bacteriophage T4, respectively. We developed a novel primer-probe set for each parasite, a primer-probe cocktail (a mixture of primers and probes for the parasites and the internal control) for multiplex real-time PCR analysis, and a protocol for this detection method. Multiplex real-time PCR with the primer-probe cocktail successfully and specifically detected the target genes of C. parvum, G. lamblia, and C. cayetanensis in the mixed spiked human stool sample. The limit of detection for our assay was 2×10 copies for C. parvum and for C. cayetanensis, while it was 2×10³ copies for G. lamblia. We propose that the multiplex real-time PCR detection method developed here is a useful method for simultaneously diagnosing the most common causative protozoa in traveler's diarrhea.