Internal Audit Checklist For Hospitals

Conducting an internal audit at a hospital requires precision and care; any mistaken handling could lead to resource losses or increased risks.

An auditor should review books, documents and registers relating to purchases and expenses as well as physical verify investments such as debentures, shares, securities and bonds.

Review of Compliance Program
An internal audit focuses on all areas of hospital operations, from patient treatment and billing, to campus controls that prevent financial arrangements that interfere with treatment decisions, to making sure claims to payers are accurate and supported by medical record documentation.

This section examines a hospital’s overall management system as well as policies and procedures related to patient privacy and communication, as well as methods of identifying hazards and controlling risks.

It is vital that any review be performed by a team of objective and capable individuals, including in-house and outside counsel. The review must follow a formal procedure so as to preserve attorney-client privilege and avoid potential conflicts of interest. Once complete, this team should compile reports for distribution to their compliance committee that include tabulations of cumulative report findings, common deficiencies identified, refunds issued as well as any refunds generated in order to make decisions more effectively.

Review of Design and Development Processes
As medical technology evolves, hospitals are adopting more efficient processes. One such improvement is using checklists to reduce infection rates; as noted by professional surgeon and public health researcher Atul Gawande in his famed New Yorker article, simple tools such as these checklists used by doctors can save both millions of dollars and lives.

Conducting internal audits requires extensive planning, preparation and team cooperation among team members. If an audit isn’t properly organized it may miss key areas and expose a hospital to unnecessary risk should an external regulator inspect or investigate them.

To avoid this scenario, an internal audit team should select a design project and review it thoroughly. For instance, if a product contains software, an audit should ensure that its specifications have been met and any discrepancies resolved satisfactorily; additionally it should ensure the design and development process can produce quality products.

Review of Human Resources
Hospital human resources management encompasses much more than hiring, payroll, benefits and termination. It must also address evolving government regulations and certification requirements as well as employee safety concerns, patient communication practices and privacy considerations, telehealth initiatives and other regulated operations.

HR teams can play an invaluable role in identifying compliance failures, key risks and other areas where improvements could be made. When HR identifies such areas for improvement they should document, communicate and address them before state or federal inspectors come knocking with an audit or investigation.

An internal audit checklist includes questions to ask when reviewing each process and department. Questions should follow a standard set of guidelines such as ISO 9001 internal audit procedure to define information flows in and out, identify control attributes, and map mitigating controls to risks. Before meeting with business stakeholders to confirm they understand objectives and roadmap of audit; this meeting provides an opportunity to gain their trust and support for further assessment efforts.

Review of Information Technology
When conducting an internal audit at a hospital, it is critical that all relevant information from all sources be identified and reviewed. Missing even one source could compromise its effectiveness or put your facility at risk should state or federal authorities find out about an oversight during an external inspection.

Internal audits provide hospitals with an important way of remaining aware of any new compliance obligations that might emerge, allowing them to implement compliance initiatives before the government or Medicare Fraud Control Unit discover any failures during an external audit or investigation. Although such efforts require significant structure, accountability, teamwork and discipline – they could save their hospital from costly mistakes that would put it at risk of fines and sanctions.