安达信咨询方法与工具资料库repo076

Mr. Ronald K. Bremer Page 34 July 15, 1994 July 15, 1994 Mr. Ronald K. Bremer Corporate Director of Finance Saint Luke's Hospital 4400 Wornall Road Kansas City, Missouri 64111 Dear Mr. Bremer: We were engaged to perform a review of the purchasing and receiving internal control procedures at Saint Luke's Hospital (Saint Luke's), which includes the areas of purchasing, receiving and accounts payable. Our focus was on current policy and procedures as performed, with identification of areas for improvement in internal controls. Our detailed observations and related recommendations on internal controls are included in the next section of this report. During the course of our review of internal controls, we also identified various opportunities for improvement in the purchasing procedures. We have provided you with our observations and recommendations in this report. We have identified them primarily because we believe that improvement in internal control is closely linked with, if not dependent on, improvement in the effectiveness and efficiency of the purchasing operations. Project Approach In order to gather the necessary information for our review, we performed the following work steps: · Reviewed a work plan with Chuck Robb and Gene Meyer before field work began which outlined the project approach, timetable and expectations. · Developed a listing of key personnel to interview and scheduling timeframe. · Held discussions with department heads and other personnel from Purchasing, Receiving, Accounting, Accounts Payable and Materials Management. · Held discussions with department personnel in Orthopedics, Surgical Services, Continuing Medical Education, Marketing and Security. · Performed job observations in Purchasing, Receiving, Materials Management and user departments. Produced process maps of the general purchasing procedures and compared to "Global Best Practices" knowledge base. Inquired of materials management personnel regarding all receiving points of purchased supplies at Saint Luke's. Inquired of personnel familiar with the materials management system regarding access to data in the system. · Reviewed Policy 955 - Purchasing · Reviewed Policy 950 - Conflict of Interest Reviewed conflict of interest policies and procedures for adequate coverage, and met with the Conflict of Interest Committee. Overall Assessment We believe there is room for improvement in internal controls as well as to the overall process. Overall, the system appears to operate in an effective fashion, but there are various opportunities throughout the process where a breakdown could occur. It appears that the “80/20 rule” applies (the majority of dollars spent relate to a relatively small number of larger vendors), especially with the VHA purchasing group. It also appears that most of the opportunities for process breakdowns lie with the smaller vendors, not the vendors where the majority of dollars are spent. Recommendations Our detailed recommendations are included in the following sections. We have split our observations and recommendations in the following manner: Internal Controls: - Decentralized Procurement - Unauthorized Purchases - Non-Standard Procedures - Receiving - Access to Materials - Inventory Management - Systems Issues - Vendor Management - Conflict of Interest Statements Operations: - Communication/Education - Administrative Tasks - Exceptions - Automation - Process Streamlining - Cost Savings - Purchasing Strategies - Vendor Maintenance - Performance Measurement Some of our general recommendations are as follows: · Educate departments on the necessity of purchasing controls. This will open communication, and cooperation will be enhanced. · Formalize the process for annual review and documentation of the conflict of interest policy. · Establish a single purchasing contact person in each department who will be responsible for compliance with purchasing policies and procedures. · Receiving reports should not include the quantity ordered. Exclusion will mitigate the risk of orders not being counted or excess items being stolen. · Invoices should be sent directly to accounts payable. Departments should not request that invoices side-step payables. · Receiving reports should be sent only to the receiving area. These should never be routed through purchasing. · Receiving reports should only be accepted with adequate proof of delivery. · Review access points (doors, gates, locks, etc.) for access and security. · Provide feedback to appropriate levels of management that identify departments that are circumventing stated purchasing policies and procedures. · Develop updated procedures manuals which are distributed and clearly communicated to user departments. · Reemphasize the revised purchasing policies, especially policy 955-11; 955-12 a