Towards improved corporate social and environmental reporting in South Africa.

Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.This thesis contributes towards improving corporate social and environmental reporting (CSR) in South Africa, by determining what about CSR would need to be and could be improved. The sources of information for this were twofold. A comprehensive literature review, besides providing the background to the study, determined what specific criticisms have been levied against existing CSR disclosure and CSR systems. This thesis argued that many of these limitations arise out of the many primarily rule-based systems in existence and use, and that CSR should rather be based on sound fundamental principles and a conceptual framework, and be an enforceable standard i.e. with legal backing to ensure compliance. The second source of information on possible areas of improvement was from the users and or the stakeholders. In Part I of the thesis, these users or stakeholders were surveyed to determine which areas of reporting were important, and which needed to be better reported. What was important was that significant expectation gaps were found in CSR specifically regarding reporting the impacts on employees, the public and consumers and the physical and biotic environment. This provided evidence for the need for improvements in actual reporting in these traditional CSR areas, and hence il, . justification for the work ofthis thesis. Having identified areas of weakness and potential improvement in current CSR, an analysis was required to be performed to determine how these areas could be better reported. An assessment would need to be made if in fact these areas could be measured (and hence reported), which was undertaken in Part 2 of the thesis. The thesis revealed the need for improved CSR, and a greater degree of accountability and transparency by business that improved CSR could provide. It was argued that reporting, other than financial, which includes CSR should be prepared using a conceptual framework of principles, similar to that used in financial reporting, and thus a principle-based approach to CSR should be used as opposed to a rule based one. It was noted that such a principle-based approach would address many of the qualitative criticisms levelled against CSR practices, and current rule based systems. Using a systems based approach, a framework of interactions and impacts caused by businesses on social and physical systems was developed, which was used as the basis for a suggested CSR model. The model was validated using a peer and expert review process, and by comparison to the Global Reporting Initiative (GRI), which was used to represent international and South African best practice. However, it was noted that potential measurement difficulties would be encountered if the proposed model were used. It would also need to be determined what practical barriers would exist to implementingthese CSR models in business, which was the objective of Part 3 of this thesis. When the practical implementation of a comprehensive CSR system was evaluated in industry, both the proposed model and the GRI were considered. An important part ofthe measuring process was noted to be company risk assessment, often undertaken by the company's insurers. Where environmental impacts, health and safety, or other potential impacts (e.g. accidents or spills in the transport industry having significant impacts on other road users), were noted to be a significant risk, measurement systems and control procedures had been put in place by most companies. Perhaps the most significant part of risk, besides the potential loss in earning capacity, is potential litigation. Common law litigation would encourage companies to monitor and protect the health of their workers and consumers. Legislation e.g. National Environmental Management Act and Air Quality Act, would encourage companies to monitor their environmental impacts. Thus a combination of risk and legislation encourages monitoring and measurement. The findings of the third part of the thesis suggest that increased pressure should be placed on companies to become IS014001 certified as this would facilitate increased CSR reporting, however, this in itself is unlikely to occur unless increased pressure is placed on companies by (legal of customer). The author suggests that IS014001 certification would be more effective in ensuring environmental protection, than simple CSR disclosure. Significant challenges exist to the possible implementation of many of the key areas identified in the proposed CSR model (specifically where measurement problems exist), and no companies were found to be in a position to report on these aspects comprehensively. The findings of this thesis include that existing legislation and financial imperatives influenced measurement and recording of certain impacts and influences. At the same time, many managers suggested that lack of financial (and other resources), as well as the absence of legal requirements were some of the reasons why other impacts and influences were not measured. Thus it could be concluded that legislation enforcing CSR, together with financial incentives (or penalties for failure to meet such standards), could play a significant role in improving CSR in South Africa

Environmental reporting disclosure in South Africa, a comparative study of the expectations of key stakeholder groups.

Thesis (M.Env.Dev.)-University of Natal, Pietermaritzburg, 2003.Part A of this dissertation, represents the literature review and project outline for this study, and includes the definition of the research problem, aims, objectives and the proposed methodology. The literature review considers the emergence of environmental accounting and reporting in the context of the escalating environmental crisis. It reviews the role of accounting prior to the development of the concept of sustainable development, and subsequently focuses specifically on the rise to prominence of environmental reporting and accounting thereafter. It reviews major academic works in this field as well as major international guidelines, standards, protocols and charters on environmental reporting. In addition, the study also reviews the limitations and problems associated with traditional and environmental accounting, and environmental reporting. It proposes a framework that considers the forces influencing environmental reporting, and briefly examines the previous evidence of the contrasting attitudes and perceptions of both preparers and users of such environmental reports. Arising out of this literature review, a study was developed that would measure and compare the expectations of three key stakeholder groups with regard to environmental accounting and reporting, namely: • The companies responsible for preparation • Environmental professionals, who assist in the preparation of these reports or attest as to their validity, and • Environmental activists, pressure groups and non-governmental organisations (NGOs) that rely on such reporting to assess the impact of a company's activities. The study would look at the perceived importance of environmental reports, the areas that are reported on, and the levels of disclosure. It would then contrast the expectations of the above three groups and compare these to the minimum reporting levels required by the only officially endorsed international reporting guideline in South Africa, the Global Reporting Initiative (GRI). The second part of this dissertation (Part B), is presented in the form of a research paper, and is presented in the specific format required by the academic journal Corporate Social Responsibility and Environmental Management, a Wiley InterScience publication, to which it will be submitted for publication, (after final editing to reduce its overall length). This second part includes a brief review of key literature, the aims, objectives and hypothesis of the study. It then details the methodology and the findings, which are discussed in depth. These findings include significant differences that were found between the expectations of the three groups, and differences between these expectations and the reporting specifications of the GRI. The environmental activists and pressure groups were found to expect greater levels of disclosure than professional environmental consultants, who in turn expected higher levels of disclosure than companies and their representatives. There were also significant differences between the responses of the three groups with regards to the importance of specific areas of environmental disclosure. The responses were more skewed towards considering most specific areas of disclosure as very important or extremely important, by the environmental activists and pressure groups. This was more so than for the environmental professionals or company respondents who also considered most of these areas as important or very important

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London