This study examines how sustainability accounting practices are integrated into a Romanian medium-sized enterprise in the context of the Corporate Sustainability Reporting Directive (CSRD), addressing the lack of applied evidence from Central and Eastern Europe. The research uses a qualitative single-case study design based on internal documents, ESG and financial reports, carbon accounting data, and six semi-structured interviews with key organizational actors. The methodological framework includes mapping ESG data flows within accounting systems, applying an extended Return on Investment (eROI) model, and using an internal carbon price to assess the environmental benefits of energy-efficiency investments. The results show a structural transformation of the accounting function, including expanded sustainability-related roles, integration of ESG indicators into budgeting and reporting cycles, and improved transparency in evaluating investment projects. The use of analytical tools strengthened decision-making, increasing the assessed return of the investment portfolio when environmental and operational co-benefits were incorporated. The analysis also identifies key barriers—fragmented data systems, limited ESG expertise, and partial digitalization—and enabling factors such as CFO leadership and cross-functional collaboration. The study concludes that accountants play a strategic role in operationalizing CSRD requirements and demonstrates how SMEs can integrate financial, environmental, and operational metrics to support sustainability-oriented decisions. The findings provide theoretical contributions and practical guidance for organizations seeking to improve sustainability accounting in line with EU regulations.

Public hospitals need supply chains that keep working under disruption, yet little is known about how digital governance relates to that outcome. This study examines a serial mediation model linking digital governance, digital capability, supply chain visibility, supply chain resilience, and sustainable performance (respondents’ perception). We surveyed 200 managers, pharmacists, procurement officers, logistics staff, financial controllers, IT specialists, and quality or risk officers from 50 Romanian public hospitals (four per hospital) in 2026. Paths were estimated by ordinary least squares on standardized composite scores, first as separate regressions and then as a recursive system, with hospital-clustered standard errors and cluster bootstrap intervals. In the recursive model, governance was related to capability (β = 0.76), capability to visibility (β = 0.64), visibility to resilience (β = 0.42), and resilience to sustainable performance (β = 0.58), all p < 0.001. The complete serial indirect association was 0.12 (95% CI [0.06, 0.18]), about 57% of the product of separate regressions, and it was smaller within hospitals (0.04), where governance varies little (ICC = 0.73). Convergent validity of visibility, resilience, and sustainable performance was weak. Under a cross-rater specification, the serial association was null, and the direct association of governance with sustainable performance changed sign, so the indirect result is not robust to the source of the ratings. The design is cross-sectional and relies on self-reports, so all results are statistical associations and do not establish causal mediation.

Background/Objectives: Standardised institutional patient satisfaction surveys are the primary quality-monitoring tool in Romanian public hospitals, but their ability to capture the full range of patient experiences remains uncertain. This study quantifies the discrepancy between institutional patient satisfaction scores and an independent, unmediated national feedback instrument, the Patient Feedback Mechanism (MFP), at Targoviste County Emergency Hospital (SJUT) over a six-year period (2019–2024), and examines item-level MFP results across eight dimensions of the patient experience, including dimensions not captured by the institutional indicators routinely reported by SMCSP. Methods: A sequential design combined six years of institutional satisfaction data (2019–2024) from SJUT (N = 32,176 questionnaires) with item-level MFP results for the same period, covering eight questions on medical services, cleanliness, out-of-pocket medication costs, staff involvement, communication, recommendation intent, self-reported health outcome, and willingness to report requests for money from staff. Hypotheses were tested using two-proportion z-tests with Wilson confidence intervals, Mann–Kendall trend analysis, and Cohen’s h for effect sizes. Results: Institutional satisfaction remained consistently high (96.88–97.45%), while MFP satisfaction with medical services ranged from 70.7% to 88.9% across the same years, yielding gaps of 7.9 to 26.7 percentage points, significant in every year (p < 0.001; Cohen’s h ranging from 0.32 to 0.82). The gap did not follow a monotonic trend (Mann–Kendall p = 0.469); instead, it widened to a peak in 2021 and narrowed progressively through 2024. A parallel comparison between the Quality and Patient Safety Management Service (SMCSP) overall impression item (exceeding 99%) and the MFP recommendation item (69.9–76.3%) showed even larger gaps, of 23.3 to 29.6 percentage points. The MFP item on willingness to report requests for money from staff, which is not part of SMCSP’s reported institutional indicators, remained in a narrow 4.0–5.5% range between 2019 and 2023 with no significant trend (Mann–Kendall p = 0.82); a higher 2024 value (6.9%) coincides with a national redesign of this item and is not directly comparable to earlier years. Conclusions: Institutional surveys and an independent national feedback instrument offer structurally distinct perspectives on hospital performance, reflecting differences in administration rather than equivalent estimates of patient satisfaction. The discrepancy between sources is significant and persistent, though not monotonic, widening sharply during 2021 before narrowing. One item with no institutional equivalent documents a measurable, non-trivial proportion of patients willing to report informal payment requests every year, although the available data do not establish whether this proportion is rising over time. Systematic use of existing MFP data, already collected nationally, can complement institutional surveys at minimal additional cost, provided the two instruments are interpreted as structurally different rather than as alternative estimates of the same quantity.

This paper examines the effect of compliance with the Corporate Governance Code (CGC) on the profitability and leverage of Romanian financial institutions listed in the Premium category. The study uses panel data from 2018–2023, applying descriptive and regression analyses processed in Microsoft Excel to evaluate the impact of governance compliance, foreign ownership, and managerial ownership on ROA, ROE, and LEV. The findings show that CGC compliance significantly improves profitability but does not affect leverage. Managerial ownership enhances both ROE and leverage, while foreign ownership increases leverage without improving performance. The results contribute to corporate governance research in emerging markets and offer practical insights for regulators and investors regarding the importance of effective governance mechanisms.

The IESBA Code of Ethics (2023) does not mention artificial intelligence, automation bias, or large language models. The EU AI Act (Regulation EU 2024/1689) does so, imposing binding obligations on accounting organisations deploying AI in high-risk contexts, with full implementation required by August 2026. This study maps the normative gap between these two instruments and assesses its practical consequences for Romanian accounting practitioners. The analysis combines normative comparison of the IESBA Code against the AI Act, scenario-based risk assessment calibrated to the Romanian professional market, and deductive synthesis into a governance framework, drawing on secondary empirical evidence from the Special Eurobarometer 554 (European Commission, 2024) and the AICPA & CIMA Future-Ready Finance Survey (2025). Two critical gaps have been confirmed: the objectivity principle contains no provision for automation bias, and the confidentiality principle does not address the processing of client data by third-party AI systems. Both gaps are structurally worsened in Romania, where sole practitioners are the majority, enterprise AI with contractual data protection is financially out of reach for most practices, and the fiscal legislative framework changes frequently, making LLM outputs unreliable for tax interpretation. The only point of genuine normative convergence-the human oversight requirement shared by the IESBA competence principle and AI Act Article 14-remains aspirational rather than practical, given the absence of any AI guidance from CECCAR or CAFR since August 2024. The governance framework developed in response shows that these risks can be addressed through a coordinated reading of obligations already present across the IESBA Code, the AI Act, the GDPR, and the ISA standards, without requiring new legislation.