The final thesis topic focuses on the issue of internal audits and their contribution to enhancing quality of the provided care. The aim of the final thesis was to find out how the nurses working shifts and head nurses assess internal audits. Next, the aim was to research nurses? opinions on further enhancing quality of the provided care. Another goal of the thesis was to explore internal auditors? professional qualifications and find out their opinion on the issue of internal audits. In the empirical part of the diploma thesis, I have chosen a quantitative and a qualitative research method. The quantitative research was carried out in the form of an anonymous questionnaire for non-medical workers. In the qualitative research I have applied in-depth interviews, carried out with three quality managers and three internal auditors. Furthermore, three internal audits of nursing units and three internal audits of medical documentation have been carried out. The results of the thesis may be practically used as a source of information about quality, continual enhancement of the quality of the provided care and ensuring quality by the means of internal audits.

Fin 2001, début 2002, les États-Unis ont été frappés par un nombre élevé de scandales financiers. Plusieurs affaires ont été révélées par les médias, singulièrement le cas Enron. La reformulation de la profession d'audit en matière d'indépendance des auditeurs et des comités d'audit après le scandale Enron a cherché à garantir la crédibilité des états financiers. L'objectif de ce travail est de tester l'effet de la nouvelle formulation de la profession d'audit, notamment en matière d'indépendance des auditeurs et des comités d'audit, précisément sur la question de la crédibilité des états financiers. Trois objectifs opérationnels ont été traités dans le cadre de cette étude. Premièrement, nous avons analysé les effets de l’affaire Enron sur la réaction des marchés financiers, le choix des commissaires aux comptes et l’affermissement du conservatisme des auditeurs, dans le contexte français. Deuxièmement, nous avons étudié l’impact de l’institution du Haut Conseil du Commissariat aux Comptes sur l’indépendance des auditeurs. Finalement, nous avons étudié l’influence du Comité d’audit sur la crédibilité des états financiers après le rapport Bouton de 2002. Les résultats empiriques s’attachent à montrer que la présence d’un co-commissaire aux comptes Non-Big a minimisé l’effet négatif de la réaction du marché financier français lors de l’annonce du scandale Enron. Par contre, le scandale Enron n’a pas influencé significativement la perception des investisseurs institutionnels étrangers envers les services des grands cabinets d’audit. Ces derniers n’ont pas justifié la production d’une bonne qualité d’audit par rapport aux Non-Big. Pour rétablir la confiance sur les marchés financiers, le législateur français est intervenu via la création d’un organisme de supervision publique de la profession comptable intitulé le H3C. Les résultats empiriques montrent que la création du H3C a renforcé l’indépendance des auditeurs. Par contre, l’annonce du lancement des activités disciplinaires de ce nouvel organisme après 2005 n’a pas d’effet significatif sur l’indépendance des auditeurs. Par contre l’apparition du rapport Bouton en 2002, et la nouvelle dimension accordée au contrôle interne, montre que ce dernier dépendant des caractéristiques des comités d’audit notamment l’expertise et l’indépendance de leurs membres. / At the end of 2001, the scandal series was announced in the US context. Several scandals, especially the Eron failure, were revealed in the first stage by the media. The main purpose of this research is to study the impact of the new reform, in audit after Enron scandal, on auditor independence, audit comity and financial statement credibility. Three operational objectives have been treated in this study. First, we have analyzed the effects of Enron scandal on financial market reaction, auditor choice and auditor conservatism in the French context. Second, we have investigated the impact of the new reform on the auditor independence. Finally, we have examined the effect of audit committee on financial statement credibility after the adoption of the Bouton Report in 2002.The empirical results have shown that the presence of the Non-Big4 members in the legal audit process have minimized the negative effect of the reaction of the SBF 250. However, the perception of the foreign institutional investors has not changed significantly for the Big4 audit services. This auditor group (Big4) does not justify the production of the audit quality compared to other auditors in France. To restore confidence in the financial market, the French legislative authority has created the H3C. The empirical results have revealed that the establishment of the H3C has ameliorated the auditor independence. Hence, the announcement of the launch of H3C disciplinary activity after 2005 has not had a significant effect on auditor independence. In contrast, the appearance of the Bouton Report in 2002 and the reform related to the internal control depend on the audit committee characteristics (expertise and independence audit committee members).

O propósito deste estudo é investigar os potenciais determinantes da qualidade das auditorias no Brasil. Seus determinantes foram definidos a partir da abordagem teórica oferecida pelo modelo de Arruñada (1997), expandido na dimensão de competência profissional dos auditores. Adicionalmente, no sentido de se testar, empiricamente, os determinantes da qualidade das auditorias realizadas nas empresas listadas na Bovespa no período de 1998 a 2008, um construto inédito (o Índice de Qualidade das Auditorias IQUA) foi desenvolvido. Os resultados alcançados sugeriram que a qualidade das auditorias é inferior quanto maior o conflito de agência entre controladores e não controladores e quanto maior o tempo de relacionamento contínuo entre o auditor e a entidade auditada. Adicionalmente, as evidências empíricas coletadas indicaram que as firmas de auditoria chamadas de Big-N, bem como os auditores especialistas nos segmentos de indústria de seus clientes, oferecem serviços de maior qualidade. / The aim of this research is to investigate the potential determinants of audit quality in Brazil. Such determinants were defined by using the theoretical perspective of Arruñadas (1997) model, expanded in the dimension of auditors professional competence. Furthermore, in order to empirically test the determinants of audit quality for Brazilian listed companies between 1998 and 2008, an original construct (Audit Quality Index IQUA) has been developed. Results from such tests suggest that audit quality is lower when agency conflicts between controlling and non-controlling shareholders are higher and when auditors tenure is higher. Moreover, evidence obtained from empirical testing indicated that the so-called Big-N audit firms, as well as specialized auditors, offer higher quality audit services to their clients.

Sammanfattning Bakgrund: Härlett ur finansiella skandaler har revisorns oberoende i allmänhet ifrågasatts och som åtgärd har EU-kommissionen via ett revisionspaket påfört regler om tvingande byrårotation för företag av allmänt intresse. Den relationella uppdragstiden mellan revisionsbyråer och klienten har således tidsbegränsats. Härav följer diskussioner såväl inom revisionsbranschen som inom litteraturen kring huruvida en sådan tidsbegränsning kommer påverka revisionskvaliteten. I samma diskussioner förekommer inte bara uttalanden om revisorns faktiska och synbara oberoende då även revisorns kompetens diskuteras som beroende faktorer till revisionskvaliteten. Uppsatsen kommer därmed beakta såväl faktiska som synbara aspekter kring begränsade uppdragstiders påverkan på revisionskvaliteten. Syfte: Uppsatsen syftar till att komplettera redan befintliga diskussioner inom det vetenskapliga forskningsområdet som berör uppdragstiders påverkan på revisionskvaliteten. Syftet uppfylls genom att på byrånivå studera hur begränsade uppdragstider påverkar revisionskvaliteten ur såväl faktiska som synbara aspekter. Metod: Multipel logistisk regression kommer analysera insamlad data från årsredovisningar och revisionsberättelser mot faktisk revisionskvalitet. Samtidigt har en enkät utformats, vilken avser att studera tredje parts uppfattning kring synbar revisionskvalitet. Teorikapitlet kommer ligga till grund för såväl definitioner som analyser. Slutsatser: Via analysen av uppsatsens resultat för såväl den faktiska revisionskvaliteten som för den synbara revisionskvaliteten tillåts en samlad slutsats kring total revisionskvalitet. Vad avser faktisk revisionskvalitet ses inte uppdragstidens längd på byrånivå ha någon signifikant påverkan på revisionskvaliteten. Därav förmodas inte revisorns oberoende eller kompetens beröras nämnvärt av lagändringen. Dock diskuteras en indirekt påverkan på revisorns faktiska oberoende varför faktisk revisionskvalitet ändock torde anses positivt påverkad. Tredje part medger att lagändringen upplevs få en positiv effekt på synbar revisionskvalitet trots att revisorn upplevs göra avkall på sin kompetens till förmån för ett stärkt oberoende. Således förväntas den totala revisionskvaliteten bli stärkt av begränsade uppdragstider i relationen mellan revisionsbyråer och klienter. / Abstract Background: Derived from financial scandals the independence of the auditor has publicly been questioned and as a result the EU Commission regulated mandatory audit-firm rotation for public companies. Thus, the audit firm and client relationship has been limited. Hence, discussions within the accountancy profession as well as within the literature surrounding the possible effects the change in regulation might have on audit quality. Not only statements surrounding the auditors’ independence of mind and independence in appearance occur in these discussions but also the competence of the auditor as a dependent factor to audit quality. The paper will hereby consider quality aspects in fact as well as in appearance related to mandatory audit-firm rotation and its impact on audit quality. Purpose: The purpose of the paper is to complement existing discussions within the scientific area concerning the effects mandatory audit-firm rotation have on audit quality. The purpose is met while a study on firm-level is conducted combining aspects in fact with aspects in appearance related to a limitation in the length of the firm-client relationship. Method: A multiple logistic regression will be used to analyze data from annual reports and audit opinions against audit quality in fact. A survey has been designed, which intends to study external third parties’ perception of audit quality in appearance. The literature chapter will form the basis for definitions as well as analyzes. Conclusions: Through an analysis of the papers result for both audit quality in fact and audit quality in appearance, a comprehensive conclusion of total audit quality can be made. In regard to audit quality in fact, our result show no significant effect between the length of the firm-client relationship and audit quality. Hence, neither the auditor’s independence nor competence are assumed to be substantially affected by the change in regulation. However, an indirect impact on the auditor’s independence in fact is discussed, which is why audit quality in fact might still be considered to be positively affected. Third parties perceive that the change in regulation positively affects audit quality in appearance despite the fact that the auditor is seemed to sacrifice competence in favour of improved independence in appearance. Thus, the total audit quality is expected to be improved by the mandatory audit-firm rotation.

Abstract The only observable outcome of the audit process is normally the issued audit report, which, at least in its standard form, does not contain much information about audit quality (Balsam et al. 2003). Auditor quality is multidimensional and inherently unobservable, and there is no single auditor characteristic that can be used as a proxy for it. In the absence of direct measures for quality, audit consumers must assess the quality by using quality surrogates, or the overall reputation of an auditor (e.g. Shapiro 1983, Riley 2001). The purpose of this dissertation is to enhance our understanding of the determinants and implications of quality-differentiated audits through four inter-related essays. The findings of the essays shed light on the various ways in which client firms strive to signal high audit and consequent earnings quality. From the supply-side perspective, the essays of this dissertation provide evidence how some (individual) auditors have been able to establish a reputation higher than the generic reputation. Importantly, this dissertation adds to the ongoing debate about the regulator changes and initiatives in the European Union and the U.S.A. requiring disclosure of engagement partner identity. The rationale behind such a requirement is that it could bring within investors’ reach greater transparency and accountability in the auditing process thereby helping to restore investor confidence in the capital markets. Consistent with this rationale, the results of this dissertation support the view that audit markets (and/or firm insiders) infer audit quality, at least to some extent, from the characteristics of the individual audit partner in charge.

Poor audit quality has historically led to huge consequences for the society. A low audit quality is often related to a low auditor independence, which can be caused by the auditor's incentive to maximize personal gain. In attempts to strengthen the auditor independence and thereby the audit quality, several audit regulations have been issued, where the mandatory audit rotation has been the subject to intensive debate. Although the previous research on audit rotation and audit quality is extensive, few studies investigate the contingency aspects of the relationship more specifically firm visibility. The purpose of the study is to explain how audit firm rotation and audit partner rotation relate to audit quality and how this relationship is contingent on firm visibility. The study is conducted quantitatively using a positivistic deductive approach. Hypotheses are developed from existing theories and literature in the area. These are later tested by translating concepts into measurable variables. Audit quality has been measured through the proxy variable discretionary accruals which was estimated by two variants of the modified Jones model. The sample consisted out of 58 large-cap firms listed on the Stockholm OMX stock exchange, constituting a total of 580 firm years. The results of this study suggest that neither audit partner rotation nor audit firm rotation has an influence on audit quality. Furthermore, these relationships are not found to be contingent on firm visibility. The study’s findings contribute to existing debate on mandatory audit rotation. However, the results need to be interpreted with certain caution as we cannot be certain that discretionary accruals measured audit quality as it was intended to do.

Abstract Purpose: The primary goal of this thesis is to provide a deeper understanding of how big data affect professional judgment, audit efficiency, and perceived audit quality. It also aims to explore the effect of Big Data Analytics (BDA) on the skills and competence required by auditors to perform an audit in a big data environment. Theoretical perspectives: Theoretical concepts base on previous research and publications by practitioners and regulators on BDA, professional judgment, audit efficiency, and audit quality. Literature was used to derive the research gap and research questions. Methodology: A qualitative method base exploratory approach. A literature review was conducted to uncover areas of interest that require more research. The effect of data analytics on the audit was identified as a potential area for research; a focus on audit quality was chosen, including key factors that contribute to overall audit quality. The research is based on semi-structured interviews with auditors from big four audit firms in Sweden. Empirical foundation: Empirical evidence was generated through an interview with seven auditors at different levels of the professional hierarchy. Empirical data was analyzed using a thematic data analysis approach. Conclusions: The findings of this research show that using BDA in the audit methodology affect the required skills and competence by auditors to carry out audit engagement activities. More IT related skills and knowledge gaining prominent in the audit field. Implementing data analytics will not be efficient in the early stage but will save time as auditors become more familiar with the tools. Data analytics improve audit quality. Auditors use analytics to gain more insight into the client’s business and communicate such insights to clients. It was found that data analytics generate fact-based audit evidence. The visualization ability enables auditors to visualize and analyze audit evidence to guide their professional judgment and decision making. Key words: Big data, Data analytics, Auditors skills and competence, Audit process, Audit efficiency, Audit quality and Professional judgment.

This dissertation examines whether managers influence corporate boards of directors in their auditor selection, change, and compensation decisions. This topic is important because it addresses concerns that the Sarbanes-Oxley Act of 2002 (SOX) is not effective in eliminating managerial influence over auditor engagement decisions and that it may provide a false sense of security to investors. These concerns are based on the implicit assumption that managers prefer weaker governance oversight and lower audit quality. However, empirical research testing associations between managerial influence and audit-related decisions post-SOX is scarce and generally guided by agency theory. Incorporating agency, stewardship, and resource dependence perspectives, I find that managerial preferences for auditor selection are not aligned. Specifically, CEOs positively influence the selection of higher quality auditors, whereas CFOs have the opposite effect. Further, CEOs who hold powerful roles as chairs of their companies' boards of directors appear to mitigate the negative influence of CFOs and inside directors on audit quality. CEOs serving in dual roles also oppose auditor turnover when lower earnings quality prompt higher demand for audit effort. Finally, my study provides some evidence that management exercises downward pressures on audit fees, suggesting that managers utilize their authority beyond the regulations established by SOX to negotiate auditor compensation.

Revisionsyrket är en profession kännetecknad av hög arbetsbelastning och tidspress, något som i högre grad karaktäriserar marknadsledande revisionsbyråer. Flertalet studier kring tidspress och hög arbetsbelastning har gjorts, vilka visar att det i många fall påverkar revisorns prestation negativt. Däremot finns även studier som antyder en högre prestation i denna kontext. De motstridiga resultaten kan tyda på att det finns bakomliggande orsaker vilka inte tidigare undersökts och som har betydelse för hanteringen av tidspress och hög arbetsbelastning. Studiens syfte är därför att skapa en mer djupgående förståelse för tidspress bland revisorer. Den teoretiska referensramen indikerar främst att revisorer påverkas negativt av tidspress, samt att kvaliteten på granskningar de utför påverkas negativt. Den visar också att det finns olika personlighetstyper som hanterar olika situationer bättre respektive sämre. Dessutom kan personlighet tillsammans med faktorer som omgivning, erfarenhet och kunskap påverka revisorns professionella skepticism och därmed dennes prestation. Det resultat som insamlats via intervjustudier stämmer till viss del överens med den teoretiska referensramen och slutsatser som kan dras är att vissa personlighetstyper, särskilt samvetsgrannhet, passar bättre in på en revisor. Även omgivning, livssituation och erfarenhet förefaller spela roll i hur revisorer hanterar tidspress. Det är dock svårt att avgöra hur tidspressen påverkar revisionskvaliteten, eftersom definitionen av revisionskvalitet är svår att precisera. Dessutom verkar det föreligga ett förväntningsgap i vad revisorns uppgift egentligen är, vilket försvårar en slutsats angående kvaliteten. / The audit profession is characterized by heavy workloads and time pressure, especially at the market-leading audit firms. Multiple studies regarding time pressure and heavy workloads show that these factors often have a negative impact on the auditor’s performance. However, there are also studies which state that time pressure can lead to better performance. These contradictory results indicate underlying causes not previously investigated which may affect how auditors handle time pressure and heavy workloads. Therefore, the purpose of this study is to create a profound understanding of time pressure among auditors. The theoretical frame of reference indicates that auditors are mainly negatively affected by time pressure and that the quality of the audits they perform are adversely affected. It also shows that people with different personality types handle situations in different ways. Further, it shows that personality as well as other factors such as the work environment, experience and knowledge can influence the auditor’s professional scepticism and thus their performance. The results collected through interviews correspond to some extent with the theoretical frame of reference. The conclusions that can be drawn are that some personality traits, especially conscientiousness, are more suitable for an auditor, but also that the work environment, life situation and experience play a role in how auditors handle time pressure. However, it is difficult to determine how time pressure affects audit quality as the definition of audit quality is hard to specify and grasp. There also appears to be an expectation gap in what the auditor’s tasks really are which makes it difficult to draw a conclusion about the quality.

Dysfunctional auditor behavior has transformed into one of the biggest challenges for audit quality. The purpose of this study is to analyze the culture to the ethical decision process in the Swedish context. The study uses a self- administered questioner with 75 junior and senior auditors employed in Mid-East Sweden including Stockholm. The study finds that ethical firm culture has an important relationship to the decision-making process. Furthermore, the study shows that the components of the decision-making model; recognition, judgment, intention and RAQA reacts differently to ethical firm culture. Finally, the study finds a relationship when the data is grouped separately as big 4 and non-big 4 auditing firms. Big 4 firms show a negative relationship between ethical firm culture and RAQA, while non-big 4 firms show a positive relationship between ethical firm culture, intention and, recognition.