https://doi.org/10.1016/j.cya.2017.03.003
Research Paper
Proposal
of a coefficient to evaluate the management of the internal control
Propuesta de un índice para evaluar la gestión
del control interno
Leudis Orlando Vega de la Cruz1
Yosvani Orlando Lao León1
Any Flor Nieves Julbe1
1Departamento de
Ingeniería Industrial, Facultad de Ciencias Empresariales, Universidad de
Holguín, Holguín, Cuba
Corresponding autor: L.O. Vega de
la Cruz, email: leovega@uho.edu.cu
Abstract:
The objective of this
article is to propose a management index for the Internal Control of care
entities. This was conceived following the multicriteria
modeling guidelines in conjunction with the detection of weaknesses through the
Petri networks. For this purpose, the order of importance and compliance of the
internal control components were determined, and the lack of reliability of the
critical processes in the entity subject to the practical implementation was
identified. Derived from its humanitarian mission – lending quality health care
to the population – it is necessary to decrease the emergence of events that
could infringe upon the physical and psychological integrity of the patients in
hospitals. One of the strategies to consider to overcome this challenge is the
adequate implementation of the Internal Control System, which guarantees the
sustainability of the insurers through the increase in the efficiency of the
care of the people, feasible only within a care model that quantifies the
control over the population already identified and cared for.
Keywords: Internal control,Multi-criteria
modeling,Petri's nets, Reliability, Hospital.
Códigos JEL: C18, C44, I18.
Resumen:
El objetivo de este artículo fue proponer un índice de
gestión del control interno para una entidad hospitalaria. Este fue concebido
siguiendo las pautas de la modelación multicriterio
en conjunto con la detección de debilidades a través de las redes de Petri.
Para esto se determinó el orden de importancia y cumplimiento de los
componentes del control interno y al unísono se identificó la no fiabilidad de
los procesos críticos en la entidad objeto de aplicación práctica. Derivado de
su misión humanitaria, de prestar una asistencia sanitaria de calidad a la
población, en los hospitales y establecimientos sanitarios, se necesita
disminuir la aparición de hechos que puedan atentar contra la integridad física
y psicológica de los pacientes que atienden. Una de las estrategias a
considerar para superar este reto es la implementación adecuada del sistema de
control interno, que garantice la sostenibilidad de los aseguradores, mediante
el aumento de la eficiencia en la atención de las personas, factible únicamente
dentro de un modelo de atención que cuantifique la gestión sobre la población
ya identificada y atendida.
Palabras clave: Control interno, Modelación multicriterio,
Redes de Petri, Fiabilidad, Hospital.
Códigos JEL: C18, C44, I18.
Received: 10/12/
2015
Accepted: 30/ 06/
2016
Introduction
The uncertainty of the
current scenarios in which the entrepreneurial activity develops, together with
the need to adequately address the continuous changes and changing demands of
the clients, entails a significant modification regarding entrepreneurial
management. Thus, the role of Internal Control is essential as the element of
the management process that contributes the most to the development of the
system.
In recent studies ( Bolaño Rodríguez, 2014;
Comas Rodríguez, 2013 ), a group of shortcomings related to the management
of Internal Control in Cuban organizations are demonstrated, and these are
fundamentally focused on:
1. A limited
process-based approach that moves toward continuous improvement.
2. The isolated
implementation of control tools for entrepreneurial management.
3. Inopportuneness
and little flexibility in the decision-making process.
4. Lack of tools
for a permanent diagnosis.
5. Poor
reliability of the information provided.
6. Little
reliability of the decision-making process developed by the management.
The intention of
entities belonging to the health sector in particular, after declaring the
Hippocratic Oath, is to benefit the patients and hold said oath as a policy and
obligation. However, as the result of the complex relation between the
developed processes, the influence of technologies, and human relations, this
care implies the high probability of occurrence of adverse events that could
harm the patient ( Pérez Rave, Trujillo,
Castro, & Gómez, 2014 ). These generate an increase in claims and/or legal
actions, together with the over expenditure in the medical care global cost.
In
order to solve this problematic situation, a procedure that integrates
Management Control tools such as Internal Control assessment, Risk management,
and Process Approach was developed. This was done through the determination of
the General Administration Evaluation Value ( Valor
de Evaluación General de Administración
– VEGA) in Internal control, contextualized to the Cuban regulatory
framework by means of its five components stated in Resolution 60 of 2011 of
the Comptroller General of the Republic of Cuba. Given the diversity of
variables that influence in its determination, the introduction of the multicriteria modeling was necessary. This has been used in
similar contexts ( Badri, Ghazanfari,
& Shahanaghi, 2014; Mejía
Argueta, Gaytán Iniestra,
& Arroyo López, 2014 ) to determine the level
of importance of the variables within a certain object of study.
Parting
from the fact that the Internal Control intends to simultaneously inspect the
activities under determined restrictions in their functioning, such as the use
of the available resources, the Petri networks were used as an analysis tool
that allowed identifying, modeling, and prioritizing these restrictions ( Araújo, Araújo,
Medeiros, & Barroso, 2015; Castro Rivera & Cuervo
Oliveros, 2015; Hernández Cely,
Leal, & López, 2013; Morales Varela, Rojas Ramírez, Hernández Gómez, Morales González, & Jiménez
Reyes, 2015; Zapata, Hoyos, & Quintero, 2014 ). In order to validate
the proposal, its implementation in a Cuban care entity is presented.
Methodology
The design of the
procedure resulted from the analysis of the theoretical-practical experience of
the authors and the results analyzed in the Cuban entrepreneurial system. The
procedure is comprised by four phases, as shown in Figure 1, and is explained below:
Phase I. Setting
Objectives: to determine
the vital elements for the start of the control management; define the
objectives of the investigation, the state of the Internal Control in
accordance with the controls of the last periods according to the self-control
guide, and the critical processes of the organization to achieve relevance in
the study.
Define the research objectives
The objectives specific
to the assessments to be carried out will be defined in order to verify in what
measure the desired state is achieved once this phase culminates, which will
help prevent moving on to the next phase with an erroneous model.
Internal contexts
These will be defined in
conjunction with the auditing group and the prevention committee, the report of
the results of the implementation of the self-control guide, issued in
Resolution 60 of 2011 by the Comptroller General of the Republic of Cuba, as
well as other strategic elements related to the control.
Selection
of the experts
For this, the field of knowledge that
encompasses their expertise will be defined as “Management” with command of the
following topics: quality specialist, auditing and process control, high proven
experience and institution diversity.
Identification of the most significant processes in the entity
The weights of each process will be
obtained through the valuations of the experts, who will be able to express their
preferences in two forms: through a quantitative value or through the
comparison between the criteria. If two criteria issued by the experts have an
equal valuation, this will indicate that both criteria are equally significant;
nevertheless, if a criterion has a greater value than another, it will mean
that the former is more significant. The weight values must comply with the
following condition:
where m is the maximum amount
of processes and j represents the displacement pointer in the selection
of a process within the summation function. Afterwards, the Pareto principle
will be implemented to select those critical processes.
Phase II. Diagnostic
Objective: to determine the control
management indices through two variants: the process approach and the Internal
Control components, by means of the reliability and significance of the
processes and their components.
Determining the significance of each
internal control component
For this, each expert will be asked for
their opinion regarding the significance of each Internal Control component
with regard to the rest of the components, this according to different criteria
such as societal impact and the need for improvement. It will be verified that
the sum of these relative values is equal to 100 ( Mar Cornelio, Jiménez Hernández, & Bron Fonseca, 2014 ).
Determining the
assessments issued by the components
Each indicator will be assigned to its
percentage, equivalent to the average of the selected component, to match the
values identified in the guide.
Determining the
control index by components
The implementation of the Weighted Sum
method is proposed, using expression (1)
presented below:
(1)
where ICcompSCI :
internal control management index by components; P i : absolute weight of
component i (previously obtained); C i : represents the
numerical values corresponding to the compliance of the standards (previously
obtained).
With the IC result, the scale defined in Table 1 will be used,
corresponding the control values to the state of the organization.
Figure 2:
Elements of a Petri network.
Source: Own elaboration.
Construction of the Petri
network
From the process or processes selected as
critical, we will start with the translation of the actions to places and
transitions 1
Referred to as tasks in the investigation for the construction of the Petri network,
as shown in Table 2.
Determining control points
The objective is to avoid errors as those
exemplified in Figure 3
( Gómez Alvarado, Alverca Torres, & Valarezo Collahuazo, 2012; Distéfano &
Pérez, 2011; Murillo Soto, 2010; Sánchez, Herrera, & Rovetto,
2014 ):
1. Transitions without entry and/or exit
conditions: prevents
the process from ending satisfactorily. Transitions two and four do not have
places of entry or exit, respectively.
2. Dead transitions: transitions that can never be ended.
Transition six does not have the place or marking of condition P 4 , therefore, it will never be executed
and would be dead.
3. Blocking: standstill of a transition before it
reaches the final process. Transition three sends a single marking to place
three, therefore, one of the transitions, six or five, will not occur, which
would cause a blockage in the process and it will not continue its course.
Figure 3:
Non-compliances of the structural
properties.
Source: Own elaboration.
4. Infinite cycles: a trap in which a transition can
repeatedly fall into over and over in an endless loop, as is the case of
transition five.
5. Activity in execution after
finalizing the process: the
final objective of the process is reached, followed by transitions that
continue to be executed. Transition nine will be executed when the final marker
is reached from transition seven.
6. Places in sites different from
the final site after finalizing the process: the existence of markers after
finalizing the process. Place nine will be marked when it is reached in the process.
Determining the significance of each
process
Similar to the aforementioned, this time
for the processes, the following criteria are recommended: societal impact of
the process, generated income, maturity of the information system, and process
performance.
Determining the
reliability of the processes
Determine
the reliability of each individual task through the following steps.
Step 1.
Determining the minimum cuts
A path between two places is any
succession of tasks and arches, where no tasks are repeated. A cut ( K i ) is a set of arches, whose failure causes
the failure of the system ( Andújar
Rodríguez, García Pérez, & Cruz Rembaud, 2000 ).
Step 2. Determining the
critical cuts
Once the paths and minimum cuts have been
determined, the non-reliability will be determined as the probability that at
least a minimum cut has occurred. From the minimum paths, it will be possible
to find the minimum cuts, which will be determined by assuming independence in
the failures, such as the probability that both procedures fail as a result of
the non-reliability of the tasks that comprise them.
Determining the reliability of each
activity
In order to determine the reliability of
the system, the reliability of the activities will be individually determined,
following a similar method to that proposed in the PERT (Program Evaluation and
Review Technique) method, with the reliability being given by expression (2):
(2)
where a : optimistic reliability,
minimum execution reliability of an activity when all the variables that
intervene are exceptionally developed; b : pessimistic
reliability, execution reliability when unfavorable circumstances coincide; m : most probable
reliability, when the execution reliability does not experience positive or
negative circumstances.
In order to determine the most probably
reliability, the complement of the number of times that failures occurred
within a determined (expression (3))
period (N f ) will be looked for in a given time
horizon, taking into consideration that in a single determined interval of time
( N T ) there can be different failures.
(3)
Determining the non-reliability of
the cuts
After calculating the individual reliability
of the activities, the minimum cuts were determined by assuming the
independence of the failures. The probability that both procedures fail is due
to the non-reliability of the tasks that comprise them. The critical cuts are
determined by selecting those activities whose probability of non-reliability
is greater than 5% (though this threshold is recommended, the audit team could
very well change it).
Step 3. Determining the reliability
index
The calculation of the reliability of the
process control ( F i ) is done using expression (4):
(4)
where N k : number of critical cuts
in process i; N T : total number of
minimum cuts in process i.
Determining the process
control index
The determination of the process control
management index is done using expression (5) , and its evaluation is to be done
according to what is shown in Table
1.
(5)
where ICprocess :
internal control management index by process; P i : absolute weight of
process i (previously obtained); F i : represents the
reliability of process i (previously obtained).
Phase III.
Evaluation
Once the control indices are determined by
the Internal Control component and by the critical process of the organization,
the VEGA is calculated using expression (6):
(6)
For the evaluation of
the indicator, the reference levels shown in Table 1 will be used.
Determining the VEGA of the Internal
Control
The report will be prepared according to the
weaknesses detected, in which the auditor must include, as part of their
systematic study, all that concerns the suggestions made to increase the
reliability of the critical processes and in the evaluation of the standards of
the Internal Control System. The reports of the results must include the
description of the procedures utilized, the verification of the results, as
well as the analysis of the historical behavior of the values obtained and
their trend analysis.
Phase IV. Improvement
Objective: to evaluate the supervisory and
monitoring activities of Internal Control, under the guidelines of continuous
improvement.
Comparison of the results
The trends (increase, decrease,
seasonality, or stability) of the indicator will be compared to previous
periods. When changes are made to the reference values of the indicator, the
causes for these changes must be detailed.
Development of the
action plan
To define the implementation program of
the improvement projects for which the action plans or specific programs would
be established, as well as the technical and organizational means necessary for
their effective execution.
Results
The objective of this study was to
determine the VEGA in the health care entity selected as the practical subject
of study. For this, we began with the characterization of the entity, which has
strategic elements relevant for this study, such as a mission, vision and work
objectives, in addition to the results of the self-control guide applied on
July 2015 as a result of an external audit.
Figure 4:
Pareto representation with the significant
weights of the processes.
Source: Own elaboration.
Table
3:
Compliance weight of the indicators.
Source: Own elaboration.
In the selection of the experts who would
work on the implementation of the procedure, it was necessary to consider the
criteria established here, with a final selection of the following: General
Manager, Teaching Deputy Director, Nursing Deputy Director, Administration
Deputy Director, Internal Control Specialist, Leader of the Oncological Center
Department, and Leader of the Emergency Care Department. The critical and most
significant processes were selected according to criteria such as the societal
impact of the process, generated costs, maturity of the information system, and
process performance in the entity through a weighted vote. Subsequently a
Pareto analysis was carried out ( Fig.
4 ) with its weights remaining as relevant processes: Sterilization,
Emergency Services, Outpatient Consultation, Hospitalization, Egress, and Care
to the Population, where the key processes predominated due to their societal
impact.
Table 4:
Weights of the components according to the
experts.
Source:
Own elaboration.
Table 5:
Determination of the control index by
component.
Source:
Own elaboration.
For this step, the result of the applied Guide
was reviewed. Table 3
shows the indicators that were satisfactorily defined by the organization and
standardized, expressing their corresponding percentage.
The value relative to the significance
that was attributed to the evaluation of an internal control component with
regard to the rest was determined. Table
4 visualizes the result of the survey applied to the experts, which
allows determining the weight of each component. The consistency of the experts
was verified, for which the Friedman contrast test was carried out with the
help of the SPSS software version 20.0. The results are shown in Table 4.
According to the result of the calculation
in the previous table: p-value = 0.979 > 0.05, therefore, there was consistency
between the experts. Subsequently, the Control Management Index was calculated
by component as shown in Table 5.
For this, each expert was surveyed a second
time, requesting for them to provide their opinion on the importance of each
selected process with regard to the rest of the processes, this according to
different criteria such as: monthly and yearly evaluation, indiscipline
increase, maturity of the information system, and process performance. The
results are shown in Table 6
. The consistency of the experts was verified.
According to the result of the calculation
in the previous table: p-value = 0.998 > 0.05, there was consistency between the
experts. Subsequently, the process structure and sequences were represented. Figure 5 shows the RdP that represents one of the selected processes
(Emergency Service); the key of the RdP is defined in
Table 7.
Source:
Own elaboration.
Figure 5:
Petri network of the emergency service
process.
Source: Own elaboration.
Table 7:
Description of the Petri network elements.
Source:
Own elaboration.
In the network, the activity executed
after finalizing the process is evidenced. In the case of task two, it will be
executed and will reach the final state while tasks three and four are
activated, respectively. Tokens in sites different from the final site will be
activated as well, after finalizing the processes by the same event; therefore,
the control in task two must be imminent.
Table 8:
Description of the failures due to
activities of the process.
Source:
Own elaboration.
The aforementioned allows concluding that,
although the control is established in most of the analyzed activities, the need
to increase it in the previously mentioned task can be inferred, since this
would incur in high budgetary costs by concept of time, workforce, and possible
loss of human lives due to the nature of the decisions.
In order to calculate the more probable
reliability, that is, the number of times that no failures occurred in a given
temporal horizon, 2
The third quarter of 2015 was used for this
study it was taken into consideration that in a single determined
interval of time different failures could occur. The data are presented in Table 8.
Therefore, the most probable reliability
of task one was of 83.33%. The rest of the reliabilities (optimist and
pessimist) were determined through a survey for the experts in each process.
Subsequently, we proceeded according to the established to calculate the
reliability of the task, obtaining that the reliability of task one is of 83.05%
as shown below.
Afterwards, the critical cuts were
determined ( Table 9
). Given that independence is assumed in the failures, the probability that
both procedures fail is the result of the non-reliability of the tasks that
comprise them. For the cuts, those activities with a non-reliability
probability greater than 5% were selected (this threshold was established by
the audit team). The summary of the diagnostic of the cuts is shown in Table 9.
Table 9:
Diagnostic of the minimum cuts of the
network.
Source:
Own elaboration.
Minimum cuts |
Probability of non-reliability |
Critical cuts |
K 1 = (T 1); K 2 = (T 2); K 3 = (T 3); K 4 = (T 4;T
2); K 5 = (T 5;T 2) |
Pr(K 1) = 0.1695;Pr(K 2) = 0.0667; Pr(K
3) =
0.1433; Pr(K 4) = 0.0030;
Pr(K 5) = 0.0022;
|
K
1;
K 2;
K 3
|
The reliability calculation of the
emergency service process control ( C i ) ended up as follows:
The reliability was of 40% in the
particular case of this process. Afterwards, the reliability ( C i ) of the rest of the processes was
identified and the control index (IC) was calculated from the integral solution
per processes, as shown in Table
10.
The VEGA of the Internal Control was
determined through its two components as follows:
The Internal Control management in the
entity was of 67%, classified as High; however, it is not considered efficient
given that it is a health care entity, as such this VEGA is not considered
acceptable. For the elaboration of the report, the weaknesses detected in the
individual tasks of each processes were taken into consideration, then it was
discussed with the managers of the entity to subsequently elaborate an action
plan in function of its weaknesses, with the corresponding people responsible
and executors.
Discussion
In recent decades, the evaluation of internal
control is carried out through the Self-control Guide (Cuba) and other control
reports (other countries), which, although relevant tools, are limited
exclusively to the identification of conformities with the elements associated
to its components, such as the determination of a value of compliance with the
standards or maturity index of the internal control as is the case of the
Internal Control Standard Model in Latin American countries such as Columbia
with the Town Hall of Gachancipa in 2014. On the
other hand, the management by process through the ISO 9000:2015 is revealed,
where the shortcomings in its integration with the internal control system are
identified. Recent studies ( Mar
Cornelio et al., 2014 ) highlight the need of the multicriteria modeling for an increase in effectiveness in
their evaluation, in addition to the proposal of Andújar Rodríguez et al. (2000) of a mathematical
algorithm to detect failures in the internal control system, where the
weaknesses by components are not evidenced.
The opinion of the authors is that the
proposed tool solves the aforementioned shortcomings by allowing to identify,
in the critical processes, the activities that comprise them and the components
of Internal Control, which are critical points for this, with the use of the multicriteria modeling and the Petri networks as efficient
tools in the representation of processes and the detection of failures. The
usage of these contributes to the determination of the VEGA and the elaboration
of objective and concrete action plans, through the detected weaknesses, to
which the integral solutions would be focused, impacting simultaneously on
various elements of Internal Control.
Conclusions
The relevance of the multicriteria
modeling and the Petri networks was proven for the conception and development
of the model proposed, validating its reliability in practice. As a result of
determining the VEGA from the analysis of its components and according to the
processes of the entity, we can conclude that although the health care
entity—object of a practical study—presents an Internal Control that is
evaluated as High, as it allows detecting the main weaknesses in its
management, there are reserves that must be exploited in the interest of
increasing the efficiency of its services.
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1.-
Referred to as tasks in the investigation.
2.-
The third quarter of 2015 was used for
this study.
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CONTADURÍA Y ADMINISTRACIÓN, año 70, 2025, es una publicación trimestral editada por la Universidad Nacional Autónoma de México, Colonia Ciudad Universitaria, Delegación Coyoacán, C.P. 04510, México, Ciudad de México, a través de la División de Investigación de la Facultad de Contaduría y Administración - UNAM, Circuito Exterior, s/n, Colonia Ciudad Universitaria, Delegación Coyoacán, C.P. 04510, México, Ciudad de México., Tels. (55) 56 22 84 57, (55) 56 22 84 58 Ext. 144 y (55) 56 22 84 94, http://www.cya.unam.mx, correo electrónico: revista_cya@fca.unam.mx, Editor responsable: José Alberto García Narváez, Reserva de Derechos al Uso Exclusivo No. 04-2016-071316434900-203, otorgada por el Instituto Nacional del Derecho de Autor, ISSN 2448-8410, Responsable de la última actualización de este Número, División de Investigación de la Facultad de Contaduría y Administración-UNAM, José Alberto García Narváez, Circuito Exterior, s/n, Colonia Ciudad Universitaria, Delegación Coyoacán, C.P. 04510, México, Cd., Mx., fecha de última modificación, 29 de enero de 2025.
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Contaduría y Administración by División de Investigación de la Facultad de Contaduría y Administración is licensed under a Creative Commons Reconocimiento- 4.0 Internacional.
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ISSN: 0186-1042 (Print) 2448-8410 (Online)