Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.

This is a print on demand edition of a hard to find publication. A fundamental objective of congressional oversight (CO) is to hold exec. officials accountable for the implementation of delegated authority. This objective is especially important given the huge expansion of executive influence in the modern era. Clearly, given the role and scope of the fed. establishment, the importance of Congress¿s review function looms large in checking and monitoring the delegated authority that it grants to fed. departments and agencies. This report: (1) highlights several reasons for the expansion of the fed. gov¿t.; (2) discusses a few definitions of CO; (3) spotlights 3 purposes of oversight; (4) comments upon CO laws and rules; (5) reviews CO techniques; and (6) identifies incentives and disincentives to CO. Illus.

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.

In a world that is increasingly unstable, intelligence services like the American CIA and the United Kingdom's MI6 exist to deliver security. Whether the challenge involves terrorism, cyber-security, or the renewed specter of great power conflict, intelligence agencies mitigate threats and provide decisional advantage to national leaders. But empowered intelligence services require adequate supervision and oversight, which must be about more than the narrow (if still precarious) task of ensuring the legality of covert operations and surveillance activities. Global Intelligence Oversight is a comparative investigation of how democratic countries can govern their intelligence services so that they are effective, but operate within frameworks that are acceptable to their people in an interconnected world. The book demonstrates how the institutions that oversee intelligence agencies participate in the protection of national security while safeguarding civil liberties, balancing among competing national interests, and building public trust in inherently secret activities. It does so by analyzing the role of courts and independent oversight bodies as they operate in countries with robust constitutional frameworks and powerful intelligence services. The book also illuminates a new transnational oversight dynamic that is shaping and constraining security services in new ways. It describes how global technology companies and litigation in transnational forums constitute a new form of oversight whose contours are still undefined. As rapid changes in technology bring the world closer together, these forces will complement their more traditional counterparts in ensuring that intelligence activities remain effective, legitimate, and sustainable.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Safeguarding Our Privacy and Our Values in an Age of Mass Surveillance America’s mass surveillance programs, once secret, can no longer be ignored. While Edward Snowden began the process in 2013 with his leaks of top secret documents, the Obama administration’s own reforms have also helped bring the National Security Agency and its programs of signals intelligence collection out of the shadows. The real question is: What should we do about mass surveillance? Timothy Edgar, a long-time civil liberties activist who worked inside the intelligence community for six years during the Bush and Obama administrations, believes that the NSA’s programs are profound threat to the privacy of everyone in the world. At the same time, he argues that mass surveillance programs can be made consistent with democratic values, if we make the hard choices needed to bring transparency, accountability, privacy, and human rights protections into complex programs of intelligence collection. Although the NSA and other agencies already comply with rules intended to prevent them from spying on Americans, Edgar argues that the rules—most of which date from the 1970s—are inadequate for this century. Reforms adopted during the Obama administration are a good first step but, in his view, do not go nearly far enough. Edgar argues that our communications today—and the national security threats we face—are both global and digital. In the twenty first century, the only way to protect our privacy as Americans is to do a better job of protecting everyone’s privacy. Beyond Surveillance: Privacy, Mass Surveillance, and the Struggle to Reform the NSA explains both why and how we can do this, without sacrificing the vital intelligence capabilities we need to keep ourselves and our allies safe. If we do, we set a positive example for other nations that must confront challenges like terrorism while preserving human rights. The United States already leads the world in mass surveillance. It can lead the world in mass surveillance reform.

In the past 30 years, the population of prisoners in the United States has expanded almost 5-fold, correctional facilities are increasingly overcrowded, and more of the country's disadvantaged populations—racial minorities, women, people with mental illness, and people with communicable diseases such as HIV/AIDS, hepatitis C, and tuberculosis—are under correctional supervision. Because prisoners face restrictions on liberty and autonomy, have limited privacy, and often receive inadequate health care, they require specific protections when involved in research, particularly in today's correctional settings. Given these issues, the Department of Health and Human Services' Office for Human Research Protections commissioned the Institute of Medicine to review the ethical considerations regarding research involving prisoners. The resulting analysis contained in this book, Ethical Considerations for Research Involving Prisoners, emphasizes five broad actions to provide prisoners involved in research with critically important protections: • expand the definition of "prisoner"; • ensure universally and consistently applied standards of protection; • shift from a category-based to a risk-benefit approach to research review; • update the ethical framework to include collaborative responsibility; and • enhance systematic oversight of research involving prisoners.