OPINIONS OF HEALTHCARE EMPLOYEES ON INTERNAL AND EXTERNAL AUDITS: A QUALITATIVE STUDY
OPINIONS OF HEALTHCARE EMPLOYEES ON INTERNAL AND EXTERNAL AUDITS
DOI:
https://doi.org/10.5281/zenodo.17997700Keywords:
Audit, Audit Processes, Healthcare Worker PerceptionAbstract
The study was conducted to comprehensively examine the opinions of healthcare employees regarding internal and external audit processes, which are critical for ensuring quality and accountability in healthcare services. The study had a descriptive qualitative design. The sample consisted of 20 healthcare employees (physicians, nurses, anesthesia technicians) working in various hospitals in Ardahan and Ankara. The data of the study were collected using a semi-structured interview form prepared by the researcher after the voluntary consent of the participants. Participants were coded as P1, P2, ..., P20. During data analysis, similar data were grouped and coded within the framework of certain concepts and themes. The mean age of the participants was found to be 37.95 ± 7.40 (min: 26, max: 53), 35% (n=7) were female, 65% (n=13) were male, and 50% (n=10) were single. In terms of educational background, 20% (n=4) had a bachelor’s degree, and 50% (n=10) had a master’s degree or higher. The occupational distribution was 35% (n=7) nurses, 40% (n=8) anesthesia technicians, and 25% (n=5) physicians. Also, 60% (n=12) of the employees worked in the public sector, and 40% (n=8) worked in the private sector. Although healthcare employees believe that audits are necessary, there are disagreements regarding the functioning of audit processes, the qualifications of auditors, and the impacts of audits on employees. Most participants noted differences in objectivity and frequency between internal and external audits and said that audits increase workload, cause stress, and negatively impact employees, particularly because of increased documentation and the pressure on audit days. These results highlight the need to make processes more efficient and employee-friendly, in addition to the benefits of audits.
References
Akbulut, Y., & Albayrak, E. (2019). Uluslararası akreditasyon standartlarının sağlık kurumlarına etkisi. Sağlık Yönetimi Dergisi, 8(2), 32–41.
Akyıldız, F., & Eren, M. (2021). Sağlıkta iç ve dış denetim uygulamalarının karşılaştırılması. Sağlık Yönetimi Dergisi, 6(2), 134–145.
Berwick, D. M. (2016). Era 3 for medicine and health care. JAMA, 315(13), 1329–1330. https://doi.org/10.1001/jama.2016.1509
Braithwaite, J., Clay-Williams, R., Vecellio, E., Marks, D., Hooper, T., Westbrook, J., ... & Ludlow, K. (2016). The basis of clinical governance and quality improvement in health care: A review of the literature. BMJ Open 2016;6:e012467. doi:10.1136/bmjopen-201
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications.
Demirtaş, H., & Karagöz, E. (2019). Denetim süreçlerinde çalışan tutumları: Teorik bir inceleme. Yönetim Bilimleri Dergisi, 17(1), 91–105.
Dixon-Woods, M., Baker, R., Charles, K., Dawson, J., Jerzembek, G., Martin, G., ... & West, M. (2014). Culture and behavior in the English National Health Service: overview of lessons from a large multimethod study. BMJ Quality & Safety, 23, 106–115. https://qualitysafety.bmj.com/content/qhc/23/2/106.full.pdf
Doğan, M., & Aytekin, A. (2021). Kamu hastanelerinde iç denetimin rolü ve etkinliği. Kamu Politikaları ve Yerel Yönetimler Dergisi, 2(3), 56–68.
Erdem, R., & Çetinkaya, A. (2017). Sağlık kurumlarında dış denetim uygulamaları: Akreditasyon ve kalite değerlendirme süreçleri. Sağlık Akademisyenleri Dergisi, 4(3), 151–160.
Erdoğan, E., & Özdemir, S. (2018). Denetim sonrası ödüllendirme ve geri bildirim süreçlerinin çalışan motivasyonuna etkisi. İş ve İnsan Dergisi, 5(1), 45–59.
Hughes, R. G. (Ed.). (2008). Patient safety and quality: An evidence-based handbook for nurses. Agency for Healthcare Research and Quality (US). https://pubmed.ncbi.nlm.nih.gov/21328752/
Joint Commission International (JCI). (2021). Standards for hospitals: Accreditation standards. Oakbrook Terrace, IL: JCI.
Karakaya, S., & Dursun, M. (2020). Sağlık çalışanlarında denetim kaynaklı stres düzeyi: Dokümantasyon yükünün etkisi. Çalışma Hayatı Araştırmaları Dergisi, 4(2), 89–98.
Karapınar, A., & Uysal, M. (2021). Denetim: Kuram ve uygulama. Nobel Akademik Yayıncılık.
Kaya, H., & Şahin, B. (2021). Sağlık kurumlarında iç denetim sisteminin değerlendirilmesi. Sağlık Yönetimi Dergisi, 10(1), 45–58.
Moustakas, C. (1994). Phenomenological research methods. SAGE Publications.
Özsoy, A., & Özdemir, A. (2020). Sağlık hizmetlerinde kalite ve akreditasyon. Sağlık Akademisyenleri Dergisi, 7(2), 145–152.
Top, M., & Gider, Ö. (2017). Sağlık çalışanlarının akreditasyon sürecine ilişkin bilgi ve tutumları. Sağlıkta Kalite ve Akreditasyon Dergisi, 1(1), 15–27.
Tuan, L. T., & Nguyen, P. V. (2020). Internal audit effectiveness: The role of internal audit function characteristics and organizational culture. Managerial Auditing Journal, 35(2), 259–287. https://doi.org/10.1108/MAJ-07-2018-1944
T.C. Sağlık Bakanlığı. (2015). Sağlıkta kalite değerlendirme ve denetim rehberi. Ankara: Sağlık Hizmetleri Genel Müdürlüğü Yayınları.
T.C. Sağlık Bakanlığı. (2023). Sağlıkta Kalite Standartları (Hastane) – Sürüm 6. Sağlık Hizmetleri Genel Müdürlüğü, Kalite ve Akreditasyon Daire Başkanlığı. https://kalite.saglik.gov.tr/
Türkiye Sayıştay Başkanlığı. (2016). Kamu idarelerinde iç denetim uygulamaları rehberi. Ankara: Sayıştay Yayınları.
World Health Organization (WHO). (2016). Improving health care quality: The path forward. Geneva: WHO Press.
World Health Organization (WHO). (2016). Quality of care: A process for making strategic choices in health systems. Geneva: WHO Press
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