The current standard in accounting practice is the double-entry approach. Basis of the double-entry approach is that every financial event brings two equal and offsetting entries. Since these financial events are not automatically confirmed by both parties, the accounting quality can be improved. The blockchain mechanism possibly offers a different take on accounting. Based on an experimentation approach, data was collected to compare the double-entry method with the blockchain-based triple-entry method. The results show that the main difference concerns determining the completeness of the financial statement items. In the situation of double-entry accounting, segregation of duties is applied to do so. In the blockchain situation, the underlying mechanism of the blockchain already ensures this.
Background: Healthy urban environments require careful planning and a testing of environmental quality that goes beyond statutory requirements. Moreover, it requires the inclusion of resident views, perceptions and experiences that help deepen the understanding of local (public health) problems. To facilitate this, neighbourhoods should be mapped in a way that is relevant to them. One way to do this is participative neighbourhood auditing. This paper provides an insight into availability and characteristics of participatory neighbourhood audit instruments. Methods: A scoping review in scientific and grey literature, consisting of the following steps: literature search, identification and selection of relevant audit instruments, data extraction and data charting (including a work meeting to discuss outputs), reporting. Results: In total, 13 participatory instruments were identified. The role of residents in most instruments was as ‘data collectors’; only few instruments included residents in other audit activities like problem definition or analysis of data. The instruments identified focus mainly on physical, not social, neighbourhood characteristics. Paper forms containing closed-ended questions or scales were the most often applied registration method. Conclusions: The results show that neighbourhood auditing could be improved by including social aspects in the audit tools. They also show that the role of residents in neighbourhood auditing is limited; however, little is known about how their engagement takes place in practice. Developers of new instruments need to balance not only social and physical aspects, but also resident engagement and scientific robustness. Technologies like mobile applications pose new opportunities for participative approaches in neighbourhood auditing.
Objectives There is a broad call for change towards € new era' quality systems in healthcare, in which the focus lies on learning and improving. A promising way to establish this in general practice care is to combine audit and feedback with peer group discussion. However, it is not known what different stakeholders think of this type of quality improvement. The aim of this research was to explore the opinions of different stakeholders in general practice on peer discussion of audit and feedback and on its opportunities and risks. Second, their thoughts on transparency versus accountability, regarding this system, were studied. Design An exploratory qualitative study within a constructivist paradigm. Semistructured interviews and focus group discussions were held and coded using thematic analysis. Included stakeholders were general practitioners (GP), patients, professional organisations and insurance companies. Setting General practice in the Netherlands. Participants 22 participants were purposively sampled for eight interviews and two focus group discussions. Results Three main opportunities of peer discussion of audit and feedback were identified: deeper levels of reflection on data, adding context to numbers and more ownership; and three main risks: handling of unwilling colleagues, lacking a safe group and the necessity of patient involvement. An additional theme concerned disagreement on the amount of transparency to be offered: insurance companies and patients advocated for complete transparency on data and improvement of outcomes, while GPs and professional organisations urged to restrict transparency to giving insight into the process. Conclusions Peer discussion of audit and feedback could be part of a change movement, towards a quality system based on learning and trust, that is initiated by the profession. Creating a safe learning environment and involving patients is key herein. Caution is needed when complete transparency is asked, since it could jeopardise practitioners' reflection and learning in safety.
