Innate and discretionary accruals quality and corporate governance

This paper extends previous research on the association between corporate governance mechanisms and accruals quality. We derive measures of the discretionary and innate components of accruals quality and regress them against corporate governance characteristics. For discretionary accruals, we find use of a Big 4 audit firm and a larger audit committee as the primary governance mechanisms associated with higher accruals quality. For innate accruals quality, we find that higher quality is associated with an independent board of directors, a larger, more independent and more active audit committee, and use of a Big 4 audit firm. Our findings suggest a stronger relation between sound governance mechanisms and innate accruals quality than discretionary accruals quality.Full Tex

Innovating Reentry Reform: Incarcerated People and Inclusive Innovation

The purpose of this case study was to explore the opportunities and barriers for Innovation Engineering (IE) practices within the State of Maine’s only men’s reentry center. The center trains its residents in restorative justice (RJ) processes as part of its evidence based practices (EBP) curriculum. The uncommon use of RJ in reentry offers the rationale for considering the center as innovative or “meaningfully unique” within community corrections. Reasoning followed that an innovative program might be open to directly engaging its most successful residents in inclusive idea creation and implementation for the benefit of the center. Innovation theorists hold that the most successful innovations come from including all levels of stakeholders in developing and solving problems, rather than implementing top-down solutions. The study sought to understand the influence of inclusive restorative practices as they affected residents’ optimism for collaborating. When viewing Innovation Engineering as a vehicle for social innovation, the basic restorative value of empathy crosses over into the interaction. Initially, the case study requested voluntary resident participation in an IE Create Session. The session might determine if there was resident interest and motivation to engage in innovation, given the opportunity. Perhaps people who have used creative skills for antisocial purposes might also be willing and capable in using the same creativity for prosocial innovations. Opportunities included interest by residents in using problem solving skills for prosocial ends, staff willingness to engage in some exploration of resident ideas and their invitation to the researcher to try process coaching with residents. IE exercises were implemented when possible. Barriers included the bureaucracy and hierarchy of corrections and the reentry center’s relative position within the Maine Department of Corrections. Policies and procedures discouraged innovation; and efforts required extreme flexibility and creative interpretation of IE practices, to accommodate the center’s constraints of time and availability of staff. Another hurdle was the center’s need for restraint in making hurried decisions that may affect community relations. Barriers involving residents included difficulty in contacting them from the outside, their scheduled classes and work release, and Maine’s three week scheduling approval process for residents who need or desire non-mandatory interactions with community. This study finds that inclusive innovation within restorative reentry environments may be possible with agreement on investing in equal participation from every level of stakeholders and overcoming hierarchical constraints

Data quality analysis at the National Transonic Facility

The data quality analysis program that was developed at Langley Research Center's National Transonic Facility is described. The program provides a computer driven systematic analysis of data taken during calibrations of the high speed digital data acquisition system. Five distinct checks that are performed on the calibration data are outlined. The five checks are for non-linearity, noise, short term drift, long term drift, and the proper functioning of the calibrator. The program has established a standard set of evaluation guidelines

Are Nurses Joining the Ride? Equine-Assisted Activities and Therapies Review

Background: Equine-assisted activities and therapies (EAAT) is a rapidly growing practice that is described as therapeutic and entertaining. Complementary therapies such as EAAT are gaining acceptance as the health care needs of the population are changing. Method: This systematic review draws from four databases. The final review included 52 articles. Purpose: To explain what is known about EAAT and identify literature gaps. Nursing and rural perspectives are included in the analysis and recommendations. Findings: There are more than eight types of EAAT and different organizations around the world are providing certification for EAAT. Rural communities and organizations may benefit from the availability of EAAT programs. Although hippotherapy research tends to have stronger study designs, most of the reviewed studies were descriptive, not randomized- control trials. Lack of evidence regarding the effect of EAAT prevents some health care providers from refer-ring their clients to EAAT and allows insurance companies to avoid reimbursing for this alternative therapy. Recommendations: More research is needed. Although sociologists, psychotherapists, and physiotherapists are using this complementary therapy and publishing in this field, nurses have made minimal contributions to date. As an avenue for improving health, nurses should consider conducting EAAT research

Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation.

Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation produced perceptions of patient safety improvement. TDF use enabled behaviour change analysis due to implementation, for example, staff adoption of behaviours to ensure general practitioners receive good quality discharge information

Hospital electronic prescribing system implementation impact on discharge information communication and prescribing errors: a before and after study.

The study aimed to test the hypothesis that hospital electronic prescribing and medicine administration (HEPMA) system implementation impacted patient discharge letter quality, and the nature and frequency of prescribing errors. A quasi experimental before and after retrospective case note review was conducted in one United Kingdom district general hospital. The total sample size was 318 (random samples of 159 before and after implementation), calculated to achieve a 10% error reduction with a power of 80% and p < 0.05. Adult patients discharged after ≥24 hour inpatient stay were assessed for discharge information documentation quality using a modified validated discharge document template. Prescribing errors were classified as medicine omissions, commissions, incorrect dose/frequency/ duration, drug interactions, therapeutic duplications or missing/inaccurate allergy information. Post-implementation assessments were undertaken four months after HEPMA implementation. Error severity was determined by a multidisciplinary panel consensus using the Medications at Transitions and Clinical Handoffs (MATCH) study validated scoring system. There were no statistically significant differences in patient demographics between the pre and post-implementation groups. Discharge information documentation quality improved; allergy documentation increased from 11 to 159/159 (p < 0.0001). The number of patients with prescribing errors reduced significantly from 158 to 37/159 (p < 0.001).Prescribing error category incidence identified in preimplementation patients was reduced (e.g. omission incidence from 66 to 18/159 (p < 0.001)), although a new error type (sociotechnical [errors caused by the system]) was identified post-implementation (n=8 patients). Post-implementation prescribing errors severity rating identified 8/37 as likely to cause potential patient harm. In conclusion, HEPMA implementation was associated with improved discharge documentation quality, statistically significant prescribing error reduction and prescribing error type alteration. There remains a need to be alert for potential prescribing errors

Hospital discharge information communication and prescribing errors: a narrative literature overview.

Objectives - To provide a narrative overview of the literature on discharge information communication and medicines discharge prescribing error rate in the UK and other similar healthcare systems. Methods - A narrative review of the peer reviewed literature (2000-2014) on communication of discharge information from hospitals to general practitioners. Databases included were MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, and International Pharmacy Abstracts database. Results - The search yielded 673 results with 15 papers satisfying all inclusion criteria. Direct comparison of studies was not feasible due to differences in study populations and outcome measures. No studies reported post Hospital Electronic Prescribing and Medicine Administration (HEPMA) implementation. Studies (n=6) investigating handwritten discharge communication systems demonstrated medicine information inaccuracy ranging from 0.81 errors per patient to 17.5% medicines with errors and 67% letters missing medicines change information; with 77% assessed as legible. Studies (n=4) comparing interim electronic solutions with traditional showed variable results: improved, unchanged or decreased medicine information accuracy. Studies researching solely interim electronic solutions (n=5) with one including prescribing error rate assessment at 8.4% of prescribed items and identification of a new electronic system-related error type. Conclusion - Implementation of interim electronic discharge solutions resulted in complete legibility but did not eradicate information and prescribing errors. A paucity of information is available about HEPMA implementation impact on discharge information communication and prescribing error rates. There is urgent need for formal evaluation in this area