The preliminary survey for an audit of the psychiatric unit of a hospital produced the following information:

The hospital administrator had mentioned at the opening conference that she was especially concerned that some critically ill psychiatric patients had been able to leave the unit unattended, without permission. On more than one occasion, these unattended patients had caused problems in other areas of the hospital. She said the problem seemed to be with the security measures for the entrance door to the unit, but so far the problem was something of a mystery, and nobody knew exactly what was causing the breakdown in controls. Another problem mentioned at the opening conference was the use of an excessive number of overtime hours in the unit. With less than two-thirds of the year over, the unit already exceeded the annual budgeted overtime pay. On the on-site tour of the unit, the auditors observed two doors to the unit — one outer door separating the psychiatric unit from the rest of the floor, and an inner door to a high-security section of the unit.

The auditors asked if any of the patients who had left the unit without authorization were from the high-security area. They were told that all of those who had left were from the high-security area. The auditors were informed that all of the patients had gotten out during meal time, either just prior to the time or just after the food carts came into the area. The nurses felt that the problem lay with the food distribution procedures.

Required:

a. What problems do you see from the administrator’s comments that need investigation on the audit?

b. Write three specific audit steps that you would include in the review of internal controls. These steps need not necessarily relate directly to the problems mentioned in your response to

(a) above.

Transcribed Image Text:

PSYCHIATRIC UNIT Nurses' Nurses' Patient Room Patient Patient Patient Patient Game Station Room Room Room Room Room Station Office Inner High Security Area Security Door Patient Patient Patient Patient Lounge Area Office Room Room Room Room Dining Area Outer Door