30 CFR 285.814 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-07-01

... Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY ALTERNATE USES OF EXISTING FACILITIES ON THE OUTER CONTINENTAL SHELF Environmental and Safety Management, Inspections, and Facility Assessments for Activities Conducted Under SAPs, COPs and GAPs Maintenance and...

76 FR 45650 - Motorcoach Safety Summit and Regional Roundtables

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-29

... is limited for all events. Individuals with diverse experience, expertise, and perspectives are... motorcoach safety and how do we develop opportunities to address each? 3. What are the challenges and gaps... Docket Management System (FDMS) address: http://www.regulations.gov . Fax: 202-493-2251. Mail: Docket...

Labor unions and safety climate: perceived union safety values and retail employee safety outcomes.

PubMed

Sinclair, Robert R; Martin, James E; Sears, Lindsay E

2010-09-01

Although trade unions have long been recognized as a critical advocate for employee safety and health, safety climate research has not paid much attention to the role unions play in workplace safety. We proposed a multiple constituency model of workplace safety which focused on three central safety stakeholders: top management, ones' immediate supervisor, and the labor union. Safety climate research focuses on management and supervisors as key stakeholders, but has not considered whether employee perceptions about the priority their union places on safety contributes contribute to safety outcomes. We addressed this gap in the literature by investigating unionized retail employee (N=535) perceptions about the extent to which their top management, immediate supervisors, and union valued safety. Confirmatory factor analyses demonstrated that perceived union safety values could be distinguished from measures of safety training, workplace hazards, top management safety values, and supervisor values. Structural equation analyses indicated that union safety values influenced safety outcomes through its association with higher safety motivation, showing a similar effect as that of supervisor safety values. These findings highlight the need for further attention to union-focused measures related to workplace safety as well as further study of retail employees in general. We discuss the practical implications of our findings and identify several directions for future safety research. 2009 Elsevier Ltd. All rights reserved.

Modeling pedestrian gap crossing index under mixed traffic condition.

PubMed

Naser, Mohamed M; Zulkiple, Adnan; Al Bargi, Walid A; Khalifa, Nasradeen A; Daniel, Basil David

2017-12-01

There are a variety of challenges faced by pedestrians when they walk along and attempt to cross a road, as the most recorded accidents occur during this time. Pedestrians of all types, including both sexes with numerous aging groups, are always subjected to risk and are characterized as the most exposed road users. The increased demand for better traffic management strategies to reduce the risks at intersections, improve quality traffic management, traffic volume, and longer cycle time has further increased concerns over the past decade. This paper aims to develop a sustainable pedestrian gap crossing index model based on traffic flow density. It focusses on the gaps accepted by pedestrians and their decision for street crossing, where (Log-Gap) logarithm of accepted gaps was used to optimize the result of a model for gap crossing behavior. Through a review of extant literature, 15 influential variables were extracted for further empirical analysis. Subsequently, data from the observation at an uncontrolled mid-block in Jalan Ampang in Kuala Lumpur, Malaysia was gathered and Multiple Linear Regression (MLR) and Binary Logit Model (BLM) techniques were employed to analyze the results. From the results, different pedestrian behavioral characteristics were considered for a minimum gap size model, out of which only a few (four) variables could explain the pedestrian road crossing behavior while the remaining variables have an insignificant effect. Among the different variables, age, rolling gap, vehicle type, and crossing were the most influential variables. The study concludes that pedestrians' decision to cross the street depends on the pedestrian age, rolling gap, vehicle type, and size of traffic gap before crossing. The inferences from these models will be useful to increase pedestrian safety and performance evaluation of uncontrolled midblock road crossings in developing countries. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

30 CFR 285.815 - What must I do if I have facility damage or an equipment failure?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Environmental and Safety Management, Inspections, and Facility Assessments for Activities Conducted Under SAPs..., MMS may require you to revise your SAP, COP, or GAP to describe how you will address the facility damage or failure as required by § 285.634 (COP), § 285.617 (SAP), § 285.655 (GAP). You must submit a...

Defining and Measuring Safety Climate: A Review of the Construction Industry Literature.

PubMed

Schwatka, Natalie V; Hecker, Steven; Goldenhar, Linda M

2016-06-01

Safety climate measurements can be used to proactively assess an organization's effectiveness in identifying and remediating work-related hazards, thereby reducing or preventing work-related ill health and injury. This review article focuses on construction-specific articles that developed and/or measured safety climate, assessed safety climate's relationship with other safety and health performance indicators, and/or used safety climate measures to evaluate interventions targeting one or more indicators of safety climate. Fifty-six articles met our inclusion criteria, 80% of which were published after 2008. Our findings demonstrate that researchers commonly defined safety climate as perception based, but the object of those perceptions varies widely. Within the wide range of indicators used to measure safety climate, safety policies, procedures, and practices were the most common, followed by general management commitment to safety. The most frequently used indicators should and do reflect that the prevention of work-related ill health and injury depends on both organizational and employee actions. Safety climate scores were commonly compared between groups (e.g. management and workers, different trades), and often correlated with subjective measures of safety behavior rather than measures of ill health or objective safety and health outcomes. Despite the observed limitations of current research, safety climate has been promised as a useful feature of research and practice activities to prevent work-related ill health and injury. Safety climate survey data can reveal gaps between management and employee perceptions, or between espoused and enacted policies, and trigger communication and action to narrow those gaps. The validation of safety climate with safety and health performance data offers the potential for using safety climate measures as a leading indicator of performance. We discuss these findings in relation to the related concept of safety culture and offer suggestions for future research and practice including (i) deriving a common definition of safety climate, (ii) developing and testing construction-specific indicators of safety climate, and (iii) focusing on construction-specific issues such as the transient workforce, subcontracting, work organization, and induction/acculturation processes. © The Author 2016. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.

Managing Uncertainty in Water Infrastructure Design Using Info-gap Robustness

NASA Astrophysics Data System (ADS)

Irias, X.; Cicala, D.

2013-12-01

Info-gap theory, a tool for managing deep uncertainty, can be of tremendous value for design of water systems in areas of high seismic risk. Maintaining reliable water service in those areas is subject to significant uncertainties including uncertainty of seismic loading, unknown seismic performance of infrastructure, uncertain costs of innovative seismic-resistant construction, unknown costs to repair seismic damage, unknown societal impacts from downtime, and more. Practically every major earthquake that strikes a population center reveals additional knowledge gaps. In situations of such deep uncertainty, info-gap can offer advantages over traditional approaches, whether deterministic approaches that use empirical safety factors to address the uncertainties involved, or probabilistic methods that attempt to characterize various stochastic properties and target a compromise between cost and reliability. The reason is that in situations of deep uncertainty, it may not be clear what safety factor would be reasonable, or even if any safety factor is sufficient to address the uncertainties, and we may lack data to characterize the situation probabilistically. Info-gap is a tool that recognizes up front that our best projection of the future may be wrong. Thus, rather than seeking a solution that is optimal for that projection, info-gap seeks a solution that works reasonably well for all plausible conditions. In other words, info-gap seeks solutions that are robust in the face of uncertainty. Info-gap has been used successfully across a wide range of disciplines including climate change science, project management, and structural design. EBMUD is currently using info-gap to help it gain insight into possible solutions for providing reliable water service to an island community within its service area. The island, containing about 75,000 customers, is particularly vulnerable to water supply disruption from earthquakes, since it has negligible water storage and is entirely dependent on four potentially fragile water transmission mains for its day-to-day water supply. Using info-gap analysis, EBMUD is evaluating competing strategies for providing water supply to the island, for example submarine pipelines versus tunnels. The analysis considers not only the likely or 'average' results for each strategy, but also the worst-case performance of each strategy under varying levels of uncertainty. This analysis is improving the quality of the planning process, since it can identify strategies that ensure minimal disruption of water supply following a major earthquake, even if the earthquake and resulting damage fail to conform to our expectations. Results to date are presented, including a discussion of how info-gap analysis complements existing tools for comparing alternative strategies, and how info-gap improves our ability to quantify our tolerance for uncertainty.

Ecology and management of morels harvested from the forests of western North America.

Treesearch

David Pilz; Rebecca McLain; Susan Alexander; Luis Villarreal-Ruiz; Shannon Berch; Tricia L. Wurtz; Catherine G. Parks; Erika McFarlane; Blaze Baker; Randy Molina; Jane E. Smith

2007-01-01

Morels are prized edible mushrooms that fruit, sometimes prolifically, in many forest types throughout western North America. They are collected for personal consumption and commercially harvested as valuable special (nontimber) forest products. Large gaps remain, however, in our knowledge about their taxonomy, biology, ecology, cultivation, safety, and how to manage...

30 CFR 285.813 - When do I have to report removing equipment from service?

Code of Federal Regulations, 2010 CFR

2010-07-01

... from service? 285.813 Section 285.813 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE... Environmental and Safety Management, Inspections, and Facility Assessments for Activities Conducted Under SAPs, COPs and GAPs Maintenance and Shutdowns § 285.813 When do I have to report removing equipment from...

STS-114: Discovery Flight Day 7 Post MMT Meeting

NASA Technical Reports Server (NTRS)

2005-01-01

Wayne Hale Space Shuttle Deputy Program Manager, and Chuck Campbell Subsystem Engineer in Aerothermodynamics are seen in this post mission management teem briefing on this seventh day of space flight. Wayne Hale begins with talking about how the International Space Station has been resupplied with its necessities, and that the Control Moment Gyroscope (CSG) has been replaced. Hale expresses his concern about the health of the Space Shuttle Discovery with the two protruding gap fillers present, and the aerothermodynamics surrounding the gap fillers. These concerns led to the conclusion to have spacewalker Stephen Robinson remove the gap fillers during EVA-3. Campbell shows a video of the protruding gap filler aft of Nose Landing Gear Door (NLGD). Campbell and Hale answer questions from the news media about the risks of performing this spacewalk, boundary layer transitions, flight safety, inspections, and temperature concerns.

A hierarchical factor analysis of a safety culture survey.

PubMed

Frazier, Christopher B; Ludwig, Timothy D; Whitaker, Brian; Roberts, D Steve

2013-06-01

Recent reviews of safety culture measures have revealed a host of potential factors that could make up a safety culture (Flin, Mearns, O'Connor, & Bryden, 2000; Guldenmund, 2000). However, there is still little consensus regarding what the core factors of safety culture are. The purpose of the current research was to determine the core factors, as well as the structure of those factors that make up a safety culture, and establish which factors add meaningful value by factor analyzing a widely used safety culture survey. A 92-item survey was constructed by subject matter experts and was administered to 25,574 workers across five multi-national organizations in five different industries. Exploratory and hierarchical confirmatory factor analyses were conducted revealing four second-order factors of a Safety Culture consisting of Management Concern, Personal Responsibility for Safety, Peer Support for Safety, and Safety Management Systems. Additionally, a total of 12 first-order factors were found: three on Management Concern, three on Personal Responsibility, two on Peer Support, and four on Safety Management Systems. The resulting safety culture model addresses gaps in the literature by indentifying the core constructs which make up a safety culture. This clarification of the major factors emerging in the measurement of safety cultures should impact the industry through a more accurate description, measurement, and tracking of safety cultures to reduce loss due to injury. Copyright © 2013 National Safety Council and Elsevier Ltd. All rights reserved.

Baseline knowledge survey of restaurant food handlers in suburban Chicago: do restaurant food handlers know what they need to know to keep consumers safe?

PubMed

Manes, Mindi R; Liu, Li C; Dworkin, Mark S

2013-01-01

In the U.S., foodborne disease causes millions of illnesses annually, resulting in thousands of deaths. To reduce food poisoning, restaurant food handlers need accurate knowledge of food safety principles as a starting point for the outcome of optimal food safety behavior. The study described in this article determined food safety knowledge gaps among suburban Chicago restaurant food handlers. A cross-sectional survey of 729 food handlers at 211 suburban Chicago restaurants was conducted from June 2009 through February 2010. A 50-question survey was administered by a trained interviewer in either English or Spanish. Mixed-effects regression analysis identified risk factors associated with an overall food safety knowledge score. The mean overall knowledge score was only 72% and substantial knowledge gaps related to cross contamination, cooking, and holding and storage of food were identified. Spanish-speaking food handlers scored significantly lower than English-speaking food handlers (p < .05). Although certified food managers scored significantly higher than noncertified food handlers, their score was only 79%. These data provide targets for educational interventions to remedy knowledge gaps in food handlers in order to prevent food poisoning from restaurants.

Managing Asbestos-Containing Materials in the Built Environment: Report of a Health and Safety Executive and Government Office for Science Workshop.

PubMed

Bowen, Jo; Davies, Laurie; Burdett, Garry John; Barber, Christopher Michael

2017-01-01

The duty to manage asbestos in non-domestic premises is described in the Control of Asbestos Regulations 2012. Health and Safety Executive (HSE) policy and guidance on asbestos in the built environment in Great Britain is that asbestos-containing materials (ACMs) that are in good condition and unlikely to be disturbed can be managed in place. Where ACMs are in poor condition or likely to be disturbed they should be repaired, encapsulated or, if necessary, removed. HSE and Government Office for Science hosted a stakeholder workshop to consider evidence on the management of ACMs in public buildings. Invitees attended from a range of backgrounds (including regulatory, government, academic, medical, public interest groups, and professional service providers). Participants considered the evidence, suggested nine evidence gap areas and ranked these according to preference in an anonymous vote. The top three suggested evidence gaps were: (i) the comparative risks of managing ACMs in place versus removal; (ii) improved measurement techniques at lower fibre concentrations; and (iii) building the evidence base on the effectiveness of asbestos management and safe removal. HSE will use the workshop outputs to inform its research planning. It is anticipated that a number of initiatives for shared research will be explored. © Crown copyright 2017.

Management capacity to promote nurse workplace health and safety.

PubMed

Fang, Yaxuan; McDonald, Tracey

2018-04-01

To investigate regarding workplace health and safety factors, and to identify strategies to preserve and promote a healthy nursing workplace. Data collected using the Delphi technique with input from 41 key informants across four participant categories drawn from a Chinese university and four hospitals were thematically analysed. Most respondents agreed on the importance of nurses' health and safety, and that nurse managers should act to protect nurses, but not enough on workplace safety. Hospital policies, staff disempowerment, workload and workplace conflicts are major obstacles. The reality of Chinese nurses' workplaces is that health and safety risks abound and relate to socio-cultural expectations of women. Self-management of risks is neccessary, gaps exist in understanding of workplace risks among different nursing groups and their perceptions of the professional status, and the value of nurses' contribution to ongoing risks in the hospital workplace. The Chinese hospital system must make these changes to produce a safer working environment for nurses. This research, based in China, presents an instructive tale for all countries that need support on the types and amounts of management for nurses working at the clinical interface, and on the consequences of management neglect of relevant policies and procedures. © 2017 John Wiley & Sons Ltd.

Work-related road safety in Australia, the United Kingdom and the United States of America: an overview of regulatory approaches and recommendations to enhance strategy and practice

PubMed Central

Stuckey, R; Pratt, SG; Murray, W

2015-01-01

Work-related travel and transport by road is fundamental for industry, government and organisations. Traditionally, road safety interventions at societal level have focussed on improving road and vehicle engineering and changing road-user behaviour through transport laws and safety campaigns. Crash data indicate that significant numbers of road-user fatalities occur while driving to or for work. Therefore, workplace initiatives can improve both road and worker safety. This paper reviews regulatory approaches to work-related road safety (WRRS) in Australia, the United Kingdom and United States, identifying significant and consistent gaps in policy, management and research. In all three countries, responsibility for managing and regulating WRRS is spread across government agencies, without a single coordinating body. This paper makes the case that integrating management of WRRS into regulatory and non-regulatory occupational health and safety (OHS) initiatives would foster and support collaboration between research and practice communities, ensuring a comprehensive evidence base for future programs. PMID:26279686

Individual employee's perceptions of " Group-level Safety Climate" (supervisor referenced) versus " Organization-level Safety Climate" (top management referenced): Associations with safety outcomes for lone workers.

PubMed

Huang, Yueng-Hsiang; Lee, Jin; McFadden, Anna C; Rineer, Jennifer; Robertson, Michelle M

2017-01-01

Research has shown that safety climate is among the strongest predictors of safety behavior and safety outcomes in a variety of settings. Previous studies have established that safety climate is a multi-faceted construct referencing multiple levels of management within a company, most generally: the organization level (employee perceptions of top management's commitment to and prioritization of safety) and group level (employee perceptions of direct supervisor's commitment to and prioritization of safety). Yet, no research to date has examined the potential interaction between employees' organization-level safety climate (OSC) and group-level safety climate (GSC) perceptions. Furthermore, prior research has mainly focused on traditional work environments in which supervisors and workers interact in the same location throughout the day. Little research has been done to examine safety climate with regard to lone workers. The present study aims to address these gaps by examining the relationships between truck drivers' (as an example of lone workers) perceptions of OSC and GSC, both potential linear and non-linear relationships, and how these predict important safety outcomes. Participants were 8095 truck drivers from eight trucking companies in the United States with an average response rate of 44.8%. Results showed that employees' OSC and GSC perceptions are highly correlated (r= 0.78), but notable gaps between the two were observed for some truck drivers. Uniquely, both OSC and GSC scores were found to have curvilinear relationships with safe driving behavior, and both scores were equally predictive of safe driving behavior. Results also showed the two levels of climate significantly interacted with one another to predict safety behavior such that if either the OSC or GSC scores were low, the other's contribution to safety behavior became stronger. These findings suggest that OSC and GSC may function in a compensatory manner and promote safe driving behavior even when either OSC or GSC scores are low. The results of this study provide critical insight into the supplementary interaction between perceptions of OSC and GSC. Recommendations for future research, as well as practical recommendations for organizational intervention, are discussed. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies.

PubMed

Yazdani, Amin; Wells, Richard

2012-01-01

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.

Medicaid managed care for mental health services: the survival of safety net institutions in rural settings.

PubMed

Willging, Cathleen E; Waitzkin, Howard; Nicdao, Ethel

2008-09-01

Few accounts document the rural context of mental health safety net institutions (SNIs), especially as they respond to changing public policies. Embedded in wider processes of welfare state restructuring, privatization has transformed state Medicaid systems nationwide. We carried out an ethnographic study in two rural, culturally distinct regions of New Mexico to assess the effects of Medicaid managed care (MMC) and the implications for future reform. After 160 interviews and participant observation at SNIs, we analyzed data through iterative coding procedures. SNIs responded to MMC by nonparticipation, partnering, downsizing, and tapping into alternative funding sources. Numerous barriers impaired access under MMC: service fragmentation, transportation, lack of cultural and linguistic competency, Medicaid enrollment, stigma, and immigration status. By privatizing Medicaid and contracting with for-profit managed care organizations, the state placed additional responsibilities on "disciplined" providers and clients. Managed care models might compromise the rural mental health safety net unless the serious gaps and limitations are addressed in existing services and funding.

`G.A.T.E': Gap analysis for TTX evaluation

NASA Astrophysics Data System (ADS)

Cacciotti, Ilaria; Di Giovanni, Daniele; Pergolini, Alessandro; Malizia, Andrea; Carestia, Mariachiara; Palombi, Leonardo; Bellecci, Carlo; Gaudio, Pasquale

2016-06-01

A Table Top Exercise (TTX) gap analysis tool was developed with the aim to provide a complete, systematic and objective evaluation of TTXs organized in safety and security fields. A TTX consists in a discussion-based emergency management exercise, organized in a simulated emergency scenario, involving groups of players who are subjected to a set of solicitations (`injects'), in order to evaluate their emergency response abilities. This kind of exercise is devoted to identify strengths and shortfalls and to propose potential and promising changes in the approach to a particular situation. In order to manage the TTX derived data collection and analysis, a gap analysis tool would be very useful and functional at identifying the 'gap' between them and specific areas and actions for improvement, consisting the gap analysis in a comparison between actual performances and optimal/expected ones. In this context, a TTX gap analysis tool was designed, with the objective to provide an evaluation of Team players' competences and performances and TTX organization and structure. The influence of both the players' expertise and the reaction time (difference between expected time and time necessary to actually complete the injects) on the final evaluation of the inject responses was also taken into account.

Improving the Pharmacologic Management of Pain in Older Adults: Identifying the Research Gaps and Methods to Address Them

PubMed Central

Reid, M. C.; Bennett, David A.; Chen, Wen G.; Eldadah, Basil A.; Farrar, John T.; Ferrell, Bruce; Gallagher, Rollin M.; Hanlon, Joseph T.; Herr, Keela; Horn, Susan D.; Inturrisi, Charles E.; Lemtouni, Salma; Lin, Yu Woody; Michaud, Kaleb; Morrison, R. Sean; Neogi, Tuhina; Porter, Linda L.; Solomon, Daniel H.; Von Korff, Michael; Weiss, Karen; Witter, James; Zacharoff, Kevin L.

2011-01-01

Objective There has been a growing recognition of the need for better pharmacologic management of chronic pain among older adults. To address this need, the National Institutes of Health Pain Consortium sponsored an “Expert Panel Discussion on the Pharmacological Management of Chronic Pain in Older Adults” conference in September, 2010, to identify research gaps and strategies to address them. Specific emphasis was placed on ascertaining gaps regarding use of opioid and non-steroidal anti-inflammatory medications because of continued uncertainties regarding their risks and benefits. Design Eighteen panel members provided oral presentations; each was followed by a multidisciplinary panel discussion. Meeting transcripts and panelists’ slide presentations were reviewed to identify the gaps, and the types of studies and research methods panelists suggested could best address them. Results Fifteen gaps were identified in the areas of treatment(e.g., uncertainty regarding the long-term safety and efficacy of commonly prescribed analgesics), epidemiology (e.g., lack of knowledge regarding the course of common pain syndromes), and implementation(e.g., limited understanding of optimal strategies to translate evidence-based pain treatments into practice). Analyses of data from electronic health care databases, observational cohort studies, and ongoing cohort studies (augmented with pain and other relevant outcomes measures) were felt to be practical methods for building an age-appropriate evidence base to improve the pharmacologic management of pain in later life. Conclusions Addressing the gaps presented in the current report was judged by the panel to have substantial potential to improve the health and well being of older adults with chronic pain. PMID:21834914

IFKIS - a basis for managing avalanche risk in settlements and on roads in Switzerland

NASA Astrophysics Data System (ADS)

Bründl, M.; Etter, H.-J.; Steiniger, M.; Klingler, Ch.; Rhyner, J.; Ammann, W. J.

2004-04-01

After the avalanche winter of 1999 in Switzerland, which caused 17 deaths and damage of over CHF 600 mill. in buildings and on roads, the project IFKIS, aimed at improving the basics of organizational measures (closure of roads, evacuation etc.) in avalanche risk management, was initiated. The three main parts of the project were the development of a compulsory checklist for avalanche safety services, a modular education and training course program and an information system for safety services. The information system was developed in order to improve both the information flux between the national centre for avalanche forecasting, the Swiss Federal Institute for Snow and Avalanche Research SLF, and the local safety services on the one hand and the communication between avalanche safety services in the communities on the other hand. The results of this project make a valuable contribution to strengthening organizational measures in avalanche risk management and to closing the gaps, which became apparent during the avalanche winter of 1999. They are not restricted to snow avalanches but can also be adapted for dealing with other natural hazard processes and catastrophes.

Plugging the Patient Evidence Gap: What Patients with Swallowing Disorders Post-Stroke Say about Thickened Liquids

ERIC Educational Resources Information Center

McCurtin, Arlene; Healy, Chiara; Kelly, Linda; Murphy, Fiona; Ryan, Jean; Walsh, Joanne

2018-01-01

Background: Oropharyngeal dysphagia post-stroke is well known, with its presence increasing the risk of poor outcomes in particular aspiration and aspiration pneumonia. Management to minimize the risk of aspiration and improve swallow safety post-stroke includes the treatment of thickened liquids (TL), an established bolus modification…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sofu, Tanju; LaChance, Jeffrey L.; Bari, R.

This report proposes potential research priorities for the Department of Energy (DOE) with the intent of improving the licensability of the Sodium Fast Reactor (SFR). In support of this project, five panels were tasked with identifying potential safety-related gaps in available information, data, and models needed to support the licensing of a SFR. The areas examined were sodium technology, accident sequences and initiators, source term characterization, codes and methods, and fuels and materials. It is the intent of this report to utilize a structured and transparent process that incorporates feedback from all interested stakeholders to suggest future funding priorities formore » the SFR research and development. While numerous gaps were identified, two cross-cutting gaps related to knowledge preservation were agreed upon by all panels and should be addressed in the near future. The first gap is a need to re-evaluate the current procedures for removing the Applied Technology designation from old documents. The second cross-cutting gap is the need for a robust Knowledge Management and Preservation system in all SFR research areas. Closure of these and the other identified gaps will require both a reprioritization of funding within DOE as well as a re-evaluation of existing bureaucratic procedures within the DOE associated with Applied Technology and Knowledge Management.« less

[Approaching the "evidence-practice gap" in pharmaceutical risk management: analysis of healthcare claim data].

PubMed

Nakayama, Takeo

2012-01-01

The concept of evidence-based medicine (EBM) has promulgated among healthcare professionals in recent years, on the other hand, the problem of underuse of useful clinical evidence is coming to be important. This is called as evidence-practice gap. The major concern about evidence-practice gap is insufficient implementation of evidence-based effective treatment, however, the perspective can be extended to measures to improve drug safety and prevention of drug related adverse events. First, this article reviews the characteristics of the database of receipt (healthcare claims) and the usefulness for research purpose of pharmacoepidemiology. Second, as the real example of the study on evidence-practice gap by using the receipt database, the case of ergot-derived anti-Parkinson drugs, of which risk of valvulopathy has been identified, is introduced. The receipt analysis showed that more than 70% of Parkinson's disease patients prescribed with cabergoline or pergolide did not undergo echocardiography despite the revision of the product label recommendation. Afterwards, the issues of pharmaceutical risk management and risk communication will be discussed.

Drinking Water Management and Governance in Canada: An Innovative Plan-Do-Check-Act (PDCA) Framework for a Safe Drinking Water Supply

NASA Astrophysics Data System (ADS)

Bereskie, Ty; Rodriguez, Manuel J.; Sadiq, Rehan

2017-08-01

Drinking water management in Canada is complex, with a decentralized, three-tiered governance structure responsible for safe drinking water throughout the country. The current approach has been described as fragmented, leading to governance gaps, duplication of efforts, and an absence of accountability and enforcement. Although there have been no major waterborne disease outbreaks in Canada since 2001, a lack of performance improvement, especially in small drinking water systems, is evident. The World Health Organization water safety plan approach for drinking water management represents an alternative preventative management framework to the current conventional, reactive drinking water management strategies. This approach has seen successful implementation throughout the world and has the potential to address many of the issues with drinking water management in Canada. This paper presents a review and strengths-weaknesses-opportunities-threats analysis of drinking water management and governance in Canada at the federal, provincial/territorial, and municipal levels. Based on this analysis, a modified water safety plan (defined as the plan-do-check-act (PDCA)-WSP framework) is proposed, established from water safety plan recommendations and the principles of PDCA for continuous performance improvement. This proposed framework is designed to strengthen current drinking water management in Canada and is designed to fit within and incorporate the existing governance structure.

Drinking Water Management and Governance in Canada: An Innovative Plan-Do-Check-Act (PDCA) Framework for a Safe Drinking Water Supply.

PubMed

Bereskie, Ty; Rodriguez, Manuel J; Sadiq, Rehan

2017-08-01

Drinking water management in Canada is complex, with a decentralized, three-tiered governance structure responsible for safe drinking water throughout the country. The current approach has been described as fragmented, leading to governance gaps, duplication of efforts, and an absence of accountability and enforcement. Although there have been no major waterborne disease outbreaks in Canada since 2001, a lack of performance improvement, especially in small drinking water systems, is evident. The World Health Organization water safety plan approach for drinking water management represents an alternative preventative management framework to the current conventional, reactive drinking water management strategies. This approach has seen successful implementation throughout the world and has the potential to address many of the issues with drinking water management in Canada. This paper presents a review and strengths-weaknesses-opportunities-threats analysis of drinking water management and governance in Canada at the federal, provincial/territorial, and municipal levels. Based on this analysis, a modified water safety plan (defined as the plan-do-check-act (PDCA)-WSP framework) is proposed, established from water safety plan recommendations and the principles of PDCA for continuous performance improvement. This proposed framework is designed to strengthen current drinking water management in Canada and is designed to fit within and incorporate the existing governance structure.

Occupational safety training and practices in selected vocational training institutions and workplaces in Kampala, Uganda.

PubMed

Kintu, Denis; Kyakula, Michael; Kikomeko, Joseph

2015-01-01

Several industrial accidents, some of them fatal, have been reported in Uganda. Causes could include training gaps in vocational training institutions (VTIs) and workplaces. This study investigated how occupational safety training in VTIs and workplaces is implemented. The study was carried out in five selected VTIs and workplaces in Kampala. Data were collected from instructors, workshop technicians, students, workshop managers, production supervisors, machine operators and new technicians in the workplaces. A total of 35 respondents participated in the study. The results revealed that all curricula in VTIs include a component of safety but little is practiced in VTI workshops; in workplaces no specific training content was followed and there were no regular consultations between VTIs and industry on safety skills requirements, resulting in a mismatch in safety skills training. The major constraints to safety training include inadequate funds to purchase safety equipment and inadequate literature on safety.

Towards a Competency-based Vision for Construction Safety Education

NASA Astrophysics Data System (ADS)

Pedro, Akeem; Hai Chien, Pham; Park, Chan Sik

2018-04-01

Accidents still prevail in the construction industry, resulting in injuries and fatalities all over the world. Educational programs in construction should deliver safety knowledge and skills to students who will become responsible for ensuring safe construction work environments in the future. However, there is a gap between the competencies current pedagogical approaches target, and those required for safety in practice. This study contributes to addressing this issue in three steps. Firstly, a vision for competency-based construction safety education is conceived. Building upon this, a research scheme to achieve the vision is developed, and the first step of the scheme is initiated in this study. The critical competencies required for safety education are investigated through analyses of literature, and confirmed through surveys with construction and safety management professionals. Results from the study would be useful in establishing and orienting education programs towards current industry safety needs and requirements

[A systemic risk analysis of hospital management processes by medical employees--an effective basis for improving patient safety].

PubMed

Sobottka, Stephan B; Eberlein-Gonska, Maria; Schackert, Gabriele; Töpfer, Armin

2009-01-01

Due to the knowledge gap that exists between patients and health care staff the quality of medical treatment usually cannot be assessed securely by patients. For an optimization of safety in treatment-related processes of medical care, the medical staff needs to be actively involved in preventive and proactive quality management. Using voluntary, confidential and non-punitive systematic employee surveys, vulnerable topics and areas in patient care revealing preventable risks can be identified at an early stage. Preventive measures to continuously optimize treatment quality can be defined by creating a risk portfolio and a priority list of vulnerable topics. Whereas critical incident reporting systems are suitable for continuous risk assessment by detecting safety-relevant single events, employee surveys permit to conduct a systematic risk analysis of all treatment-related processes of patient care at any given point in time.

76 FR 30241 - Pipeline Safety: Notice of Public Meetings on Managing Challenges With Pipeline Seam Welds and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-24

... involving seam weld anomalies and gaps in data and recordkeeping are driving a stronger focus on better... measures. These public meetings are designed to provide an open forum for exchanging information on the... determining the nature and extent of the seam weld issue from industry and government data. 2. Presenting...

State Regulatory Authority (SRA) Coordination of Safety, Security, and Safeguards of Nuclear Facilities: A Framework for Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mladineo, Stephen V.; Frazar, Sarah L.; Kurzrok, Andrew J.

This paper will explore the development of a framework for conducting an assessment of safety-security-safeguards integration within a State. The goal is to examine State regulatory structures to identify conflicts and gaps that hinder management of the three disciplines at nuclear facilities. Such an analysis could be performed by a State Regulatory Authority (SRA) to provide a self-assessment or as part of technical cooperation with either a newcomer State, or to a State with a fully developed SRA.

A review of the effect of traffic and weather characteristics on road safety.

PubMed

Theofilatos, Athanasios; Yannis, George

2014-11-01

Taking into consideration the increasing availability of real-time traffic data and stimulated by the importance of proactive safety management, this paper attempts to provide a review of the effect of traffic and weather characteristics on road safety, identify the gaps and discuss the needs for further research. Despite the existence of generally mixed evidence on the effect of traffic parameters, a few patterns can be observed. For instance, traffic flow seems to have a non-linear relationship with accident rates, even though some studies suggest linear relationship with accidents. On the other hand, increased speed limits have found to have a straightforward positive relationship with accident occurrence. Regarding weather effects, the effect of precipitation is quite consistent and leads generally to increased accident frequency but does not seem to have a consistent effect on severity. The impact of other weather parameters on safety, such as visibility, wind speed and temperature is not found straightforward so far. The increasing use of real-time data not only makes easier to identify the safety impact of traffic and weather characteristics, but most importantly makes possible the identification of their combined effect. The more systematic use of these real-time data may address several of the research gaps identified in this research. Copyright © 2014 Elsevier Ltd. All rights reserved.

Evaluating North Carolina Food Pantry Food Safety-Related Operating Procedures.

PubMed

Chaifetz, Ashley; Chapman, Benjamin

2015-11-01

Almost one in seven American households were food insecure in 2012, experiencing difficulty in providing enough food for all family members due to a lack of resources. Food pantries assist a food-insecure population through emergency food provision, but there is a paucity of information on the food safety-related operating procedures used in the pantries. Food pantries operate in a variable regulatory landscape; in some jurisdictions, they are treated equivalent to restaurants, while in others, they operate outside of inspection regimes. By using a mixed methods approach to catalog the standard operating procedures related to food in 105 food pantries from 12 North Carolina counties, we evaluated their potential impact on food safety. Data collected through interviews with pantry managers were supplemented with observed food safety practices scored against a modified version of the North Carolina Food Establishment Inspection Report. Pantries partnered with organized food bank networks were compared with those that operated independently. In this exploratory research, additional comparisons were examined for pantries in metropolitan areas versus nonmetropolitan areas and pantries with managers who had received food safety training versus managers who had not. The results provide a snapshot of how North Carolina food pantries operate and document risk mitigation strategies for foodborne illness for the vulnerable populations they serve. Data analysis reveals gaps in food safety knowledge and practice, indicating that pantries would benefit from more effective food safety training, especially focusing on formalizing risk management strategies. In addition, new tools, procedures, or policy interventions might improve information actualization by food pantry personnel.

The relationships between OHS prevention costs, safety performance, employee satisfaction and accident costs.

PubMed

Bayram, Metin; Ünğan, Mustafa C; Ardıç, Kadir

2017-06-01

Little is known about the costs of safety. A literature review conducted for this study indicates there is a lack of survey-based research dealing with the effects of occupational health and safety (OHS) prevention costs. To close this gap in the literature, this study investigates the interwoven relationships between OHS prevention costs, employee satisfaction, OHS performance and accident costs. Data were collected from 159 OHS management system 18001-certified firms operating in Turkey and analyzed through structural equation modeling. The findings indicate that OHS prevention costs have a significant positive effect on safety performance, employee satisfaction and accident costs savings; employee satisfaction has a significant positive effect on accident costs savings; and occupational safety performance has a significant positive effect on employee satisfaction and accident costs savings. Also, the results indicate that safety performance and employee satisfaction leverage the relationship between prevention costs and accident costs.

Children’s Safety Initiative: A National Assessment of Pediatric Educational Needs amongEmergency Medical Services Providers

PubMed Central

Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

2014-01-01

Objective Emergency Medical Services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps most likely to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. Methods The Children’s Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care including physicians, nurses and pre-hospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them “highly likely” (likert-type score 7–10 out of 10) to contribute to safety events. Results There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents; EMT-Basics/first responders were 22% and physicians 11.4%. The top educational priorities identified in the final round of the survey include: pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform and advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseos access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. Conclusions This is the first large-scale Delphi survey related to pediatric pre-hospital education. Our results provide foundational information related to the educational needs of pre-hospital providers. Medical directors and educators can use the results to shape future curricular development. PMID:25296191

Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

PubMed

Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

2015-01-01

Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi survey related to pediatric prehospital education. Our results provide foundational information related to the educational needs of prehospital providers. Medical directors and educators can use the results to shape future curricular development.

The Toxic Truth About Carbon Nanotubes in Water Purification: a Perspective View.

PubMed

Das, Rasel; Leo, Bey Fen; Murphy, Finbarr

2018-06-18

Without nanosafety guidelines, the long-term sustainability of carbon nanotubes (CNTs) for water purifications is questionable. Current risk measurements of CNTs are overshadowed by uncertainties. New risks associated with CNTs are evolving through different waste water purification routes, and there are knowledge gaps in the risk assessment of CNTs based on their physical properties. Although scientific efforts to design risk estimates are evolving, there remains a paucity of knowledge on the unknown health risks of CNTs. The absence of universal CNT safety guidelines is a specific hindrance. In this paper, we close these gaps and suggested several new risk analysis roots and framework extrapolations from CNT-based water purification technologies. We propose a CNT safety clock that will help assess risk appraisal and management. We suggest that this could form the basis of an acceptable CNT safety guideline. We pay particular emphasis on measuring risks based on CNT physico-chemical properties such as diameter, length, aspect ratio, type, charge, hydrophobicity, functionalities and so on which determine CNT behaviour in waste water treatment plants and subsequent release into the environment.

Setting the most robust effluent level under severe uncertainty: application of information-gap decision theory to chemical management.

PubMed

Yokomizo, Hiroyuki; Naito, Wataru; Tanaka, Yoshinari; Kamo, Masashi

2013-11-01

Decisions in ecological risk management for chemical substances must be made based on incomplete information due to uncertainties. To protect the ecosystems from the adverse effect of chemicals, a precautionary approach is often taken. The precautionary approach, which is based on conservative assumptions about the risks of chemical substances, can be applied selecting management models and data. This approach can lead to an adequate margin of safety for ecosystems by reducing exposure to harmful substances, either by reducing the use of target chemicals or putting in place strict water quality criteria. However, the reduction of chemical use or effluent concentrations typically entails a financial burden. The cost effectiveness of the precautionary approach may be small. Hence, we need to develop a formulaic methodology in chemical risk management that can sufficiently protect ecosystems in a cost-effective way, even when we do not have sufficient information for chemical management. Information-gap decision theory can provide the formulaic methodology. Information-gap decision theory determines which action is the most robust to uncertainty by guaranteeing an acceptable outcome under the largest degree of uncertainty without requiring information about the extent of parameter uncertainty at the outset. In this paper, we illustrate the application of information-gap decision theory to derive a framework for setting effluent limits of pollutants for point sources under uncertainty. Our application incorporates a cost for reduction in pollutant emission and a cost to wildlife species affected by the pollutant. Our framework enables us to settle upon actions to deal with severe uncertainty in ecological risk management of chemicals. Copyright © 2013 Elsevier Ltd. All rights reserved.

Variability of patient safety culture in Belgian acute hospitals.

PubMed

Vlayen, Annemie; Schrooten, Ward; Wami, Welcome; Aerts, Marc; Barrado, Leandro Garcia; Claes, Neree; Hellings, Johan

2015-06-01

The aim of this study was to measure differences in safety culture perceptions within Belgian acute hospitals and to examine variability based on language, work area, staff position, and work experience. The Hospital Survey on Patient Safety Culture was distributed to hospitals participating in the national quality and safety program (2007-2009). Hospitals were invited to participate in a comparative study. Data of 47,136 respondents from 89 acute hospitals were used for quantitative analysis. Percentages of positive response were calculated on 12 dimensions. Generalized estimating equations models were fitted to explore differences in safety culture. Handoffs and transitions, staffing, and management support for patient safety were considered as major problem areas. Dutch-speaking hospitals had higher odds of positive perceptions for most dimensions in comparison with French-speaking hospitals. Safety culture scores were more positive for respondents working in pediatrics, psychiatry, and rehabilitation compared with the emergency department, operating theater, and multiple hospital units. We found an important gap in safety culture perceptions between leaders and assistants within disciplines. Administration and middle management had lower perceptions toward patient safety. Respondents working less than 1 year in the current hospital had more positive safety culture perceptions in comparison with all other respondents. Large comparative databases provide the opportunity to identify distinct high and low scoring groups. In our study, language, work area, and profession were identified as important safety culture predictors. Years of experience in the hospital had only a small effect on safety culture perceptions.

Diagnosis and management of acute kidney injury: deficiencies in the knowledge base of non-specialist, trainee medical staff.

PubMed

Muniraju, T M; Lillicrap, M H; Horrocks, J L; Fisher, J M; Clark, R M W; Kanagasundaram, N S

2012-06-01

Enhanced education has been recommended to improve non-specialist management of acute kidney injury (AKI). However, the extent of any gaps in knowledge has yet to be defined fully. The aim of this study was to assess understanding of trainee doctors in the prevention, diagnosis and initial management of AKI. An anonymised questionnaire was completed by hospital-based trainees across Newcastle Renal Unit's catchment area. Responses were evaluated against a panel of pre-defined ideal answers. The median score was 9.5 out of 20 (n = 146; range 0-17) and was lower in more junior trainees. Fifty percent of trainees could not define AKI, 30% could not name more than two risk factors for AKI and 37% could not name even one indication for renal referral. These serious gaps in knowledge highlight the need for enhanced education aimed at all training grades. Organisational changes may also be required to optimise patient safety.

Pesticide management approach towards protecting the safety and health of farmers in Southeast Asia.

PubMed

Mohammad, Norsyazwani; Abidin, Emilia Zainal; How, Vivien; Praveena, Sarva Mangala; Hashim, Zailina

2018-06-27

It is estimated that pesticide production and use have increased continuously in the countries of Southeast Asia in recent years. Within the context of protecting the safety and health of workers in the agricultural sector, there is an existing gap in the implementation of the pesticide management framework because safety and health effects arising from occupational exposures continue to be reported. This study aims to provide narrative similarities, differences and weaknesses of the existing pesticide management system in Southeast Asian countries (Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam) within the context of occupational safety and health. This is preliminary traditional review study. Pesticide regulation and management at the country level were identified using web-based search engines such as Scopus, ScienceDirect, PubMed and Google. Book, reports, legislation document and other documents retrieved were also gathered from international organizations and specific websites of governmental agency in Southeast Asian countries. The scope of this review is only limited to literature written in English. In total, 44 review articles, reports and documents were gathered for this study. The approach of pesticide management in protecting safety and health in the agricultural setting were benchmarked according to the elements introduced by the United States Environmental Protection Agency, namely, (1) the protection of workers and (2) the practice of safety. All countries have assigned a local authority and government organization to manage and control pesticide use in the agricultural sector. The countries with the highest usage of pesticide are Thailand, Philippines and Malaysia. Most Southeast Asian countries have emphasized safety practice in the management of pesticide usage, but there were less emphasis on the element of protection of workers within the framework in Indonesia, Myanmar, Thailand and Vietnam. The governing bodies in the countries of Southeast Asia have placed significant effort to develop framework related to pesticide management at the country level. The implementation of pesticide management based on the existing framework is evident in most of the countries but needs to be improved. It is suggested that emphasis be given to the implementation of diagnosis, health surveillance and reporting system as well as following or adopting standard guidelines for the protection of workers in terms of safety and health in the agricultural sector.

Safety compliance and safety climate: A repeated cross-sectional study in the oil and gas industry.

PubMed

Kvalheim, Sverre A; Dahl, Øyvind

2016-12-01

Violations of safety rules and procedures are commonly identified as a causal factor in accidents in the oil and gas industry. Extensive knowledge on effective management practices related to improved compliance with safety procedures is therefore needed. Previous studies of the causal relationship between safety climate and safety compliance demonstrate that the propensity to act in accordance with prevailing rules and procedures is influenced to a large degree by workers' safety climate. Commonly, the climate measures employed differ from one study to another and identical measures of safety climate are seldom tested repeatedly over extended periods of time. This research gap is addressed in the present study. The study is based on a survey conducted four times among sharp-end workers of the Norwegian oil and gas industry (N=31,350). This is done by performing multiple tests (regression analysis) over a period of 7years of the causal relationship between safety climate and safety compliance. The safety climate measure employed is identical across the 7-year period. Taking all periods together, the employed safety climate model explained roughly 27% of the variance in safety compliance. The causal relationship was found to be stable across the period, thereby increasing the reliability and the predictive validity of the factor structure. The safety climate factor that had the most powerful effect on safety compliance was work pressure. The factor structure employed shows high predictive validity and should therefore be relevant to organizations seeking to improve safety in the petroleum sector. The findings should also be relevant to other high-hazard industries where safety rules and procedures constitute a central part of the approach to managing safety. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

The roles and functions of safety professionals in Taiwan: Comparing the perceptions of safety professionals and safety educators.

PubMed

Wu, Tsung-Chih

2011-10-01

The perspectives of both internal and external members have to be considered when developing safety curricula. This study discusses perceptional differences between safety educators (SEs) and safety professionals (SPs) regarding the function of SPs. The findings will serve as a reference framework for the establishment of core safety competencies and the development of safety curricula for SPs. 248 respondents, including both SEs and SPs, completed self-administered questionnaires, which included the 45-item safety function scale (SFS). Nine factors were extracted from the scale using exploratory factor analysis (EFA), namely inspection and research, regulatory tasks, emergency procedures and settlement of damage, management and financial affairs, culture change, problem identification and analysis, developing and implementing solutions, knowledge management, and training and communications. Descriptive statistical results indicated that SPs and SEs hold differing views on the rank of the frequency of safety functions. MANOVA results indicated that SPs' perceptions of developing and implementing solutions, training and communications, inspection and research, and management and financial affairs were significantly higher than that of SEs. On the other hand, SE's perceptions regarding participation in regulatory tasks were significantly higher than those of SPs. Based on these results, the author suggests that a clear communication channel should be established between universities and industry to reduce the gap between the perceptions of SEs and SPs. The results of the study are statistically and practically significant. In addition to serving as a reference for the development of safety curricula, the results are also conducive to the establishment of SP roles and functions. Ultimately the development of more suitable safety curricula would open up employment competition for students who graduate from safety-related programs. SPs, on the other hand, can correctly recognize their roles and functions so as to realize the safety expectations invested in them by organizations. Copyright © 2011 Elsevier Ltd. All rights reserved.

Stakeholder Perceptions of Risk in Construction.

PubMed

Zhao, Dong; McCoy, Andrew P; Kleiner, Brian M; Mills, Thomas H; Lingard, Helen

2016-02-01

Safety management in construction is an integral effort and its success requires inputs from all stakeholders across design and construction phases. Effective risk mitigation relies on the concordance of all stakeholders' risk perceptions. Many researchers have noticed the discordance of risk perceptions among critical stakeholders in safe construction work, however few have provided quantifiable evidence describing them. In an effort to fill this perception gap, this research performs an experiment that investigates stakeholder perceptions of risk in construction. Data analysis confirms the existence of such discordance, and indicates a trend in risk likelihood estimation. With risk perceptions from low to high, the stakeholders are architects, contractors/safety professionals, and engineers. Including prior studies, results also suggest that designers have improved their knowledge in building construction safety, but compared to builders they present more difficultly in reaching a consensus of perception. Findings of this research are intended to be used by risk management and decision makers to reassess stakeholders' varying judgments when considering injury prevention and hazard assessment.

Stakeholder Perceptions of Risk in Construction

PubMed Central

Zhao, Dong; McCoy, Andrew P.; Kleiner, Brian M.; Mills, Thomas H.; Lingard, Helen

2015-01-01

Safety management in construction is an integral effort and its success requires inputs from all stakeholders across design and construction phases. Effective risk mitigation relies on the concordance of all stakeholders’ risk perceptions. Many researchers have noticed the discordance of risk perceptions among critical stakeholders in safe construction work, however few have provided quantifiable evidence describing them. In an effort to fill this perception gap, this research performs an experiment that investigates stakeholder perceptions of risk in construction. Data analysis confirms the existence of such discordance, and indicates a trend in risk likelihood estimation. With risk perceptions from low to high, the stakeholders are architects, contractors/safety professionals, and engineers. Including prior studies, results also suggest that designers have improved their knowledge in building construction safety, but compared to builders they present more difficultly in reaching a consensus of perception. Findings of this research are intended to be used by risk management and decision makers to reassess stakeholders’ varying judgments when considering injury prevention and hazard assessment. PMID:26441481

[Preliminary studies on critical control point of traceability system in wolfberry].

PubMed

Liu, Sai; Xu, Chang-Qing; Li, Jian-Ling; Lin, Chen; Xu, Rong; Qiao, Hai-Li; Guo, Kun; Chen, Jun

2016-07-01

As a traditional Chinese medicine, wolfberry (Lycium barbarum) has a long cultivation history and a good industrial development foundation. With the development of wolfberry production, the expansion of cultivation area and the increased attention of governments and consumers on food safety, the quality and safety requirement of wolfberry is higher demanded. The quality tracing and traceability system of production entire processes is the important technology tools to protect the wolfberry safety, and to maintain sustained and healthy development of the wolfberry industry. Thus, this article analyzed the wolfberry quality management from the actual situation, the safety hazard sources were discussed according to the HACCP (hazard analysis and critical control point) and GAP (good agricultural practice for Chinese crude drugs), and to provide a reference for the traceability system of wolfberry. Copyright© by the Chinese Pharmaceutical Association.

A new leadership role for pharmacists: a prescription for change.

PubMed

Burgess, L Hayley; Cohen, Michael R; Denham, Charles R

2010-03-01

Pharmacists can play an important role as leaders to reduce patient safety risks, optimize the safe function of medication management systems, and align pharmacy services with national initiatives that measure and reward quality performance. The objective of this article is to determine the actions that pharmacists can take to create a visible and sustainable safe medication management structure and system in the health care environment. An evidence-based literature search was performed to determine what actions successful pharmacist leaders have taken to improve patient safety. There is a growing number of quality and patient safety standards, as well as measures that focus specifically on medication use and education. Health care organizations must be made aware of the valuable resources that pharmacists provide and of the complexity of medication management. There are steps that pharmacist leaders can take to achieve these goals. The 10 steps that pharmacist leaders can take to create a visible and sustainable safe medication management structure and system are the following: 1. Identify and mitigate medication management risks and hazards to reduce preventable patient harm. 2. Establish pharmacy leadership structures and systems to ensure organizational awareness of medication safety gaps. 3. Support an organizational culture of safe medication use. 4. Ensure evidence-based medication regimens for all patients. 5. Have daily check-in calls/meetings, with the primary focus on significant safety or quality issues. 6. Establish a medication safety committee. 7. Perform medication safety walk-rounds to evaluate medication processes, and request front-line staff ’s input about medication safe practices. 8. Ensure that pharmacy staff engage in teamwork, skill building, and communication training. 9. Engage in readiness planning for implementation of health information technology (HIT). 10. Include medication history-taking and reviews upon entry into the organization; medication counseling and training during the discharge process; and follow-up after the transition to home.

30 CFR 56.6603 - Air gap.

Code of Federal Regulations, 2014 CFR

2014-07-01

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30 CFR 57.6603 - Air gap.

Code of Federal Regulations, 2014 CFR

2014-07-01

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30 CFR 57.6603 - Air gap.

Code of Federal Regulations, 2013 CFR

2013-07-01

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30 CFR 57.6603 - Air gap.

Code of Federal Regulations, 2012 CFR

2012-07-01

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30 CFR 57.6603 - Air gap.

Code of Federal Regulations, 2011 CFR

2011-07-01

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30 CFR 56.6603 - Air gap.

Code of Federal Regulations, 2013 CFR

2013-07-01

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30 CFR 56.6603 - Air gap.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Air gap. 56.6603 Section 56.6603 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Explosives Extraneous Electricity...

30 CFR 56.6603 - Air gap.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Air gap. 56.6603 Section 56.6603 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Explosives Extraneous Electricity...

30 CFR 57.6603 - Air gap.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Air gap. 57.6603 Section 57.6603 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Explosives Extraneous Electricity...

30 CFR 56.6603 - Air gap.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Air gap. 56.6603 Section 56.6603 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND NONMETAL MINE SAFETY AND HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Explosives Extraneous Electricity...

Workplace Violence Training Programs for Health Care Workers: An Analysis of Program Elements.

PubMed

Arbury, Sheila; Hodgson, Michael; Zankowski, Donna; Lipscomb, Jane

2017-06-01

Commercial workplace violence (WPV) prevention training programs differ in their approach to violence prevention and the content they present. This study reviews 12 such programs using criteria developed from training topics in the Occupational Safety and Health Administration's (OSHA) Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers and a review of the WPV literature. None of the training programs addressed all the review criteria. The most significant gap in content was the lack of attention to facility-specific risk assessment and policies. To fill this gap, health care facilities should supplement purchased training programs with specific training in organizational policies and procedures, emergency action plans, communication, facility risk assessment, and employee post-incident debriefing and monitoring. Critical to success is a dedicated program manager who understands risk assessment, facility clinical operations, and program management and evaluation.

Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

PubMed Central

2012-01-01

Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes. PMID:23122411

Hydroxyurea for the Treatment of Sickle Cell Disease: Efficacy, Barriers, Toxicity, and Management in Children

PubMed Central

Strouse, John J.; Heeney, Matthew M.

2012-01-01

Hydroxyurea is the only approved medication in the United States for the treatment of sickle cell anemia (HbSS) and is widely used in children despite an indication limited to adults. We review the evidence of efficacy and safety in children with reference to pivotal adult studies. This evidence and expert opinion form the basis for recommended guidelines for the use of hydroxyurea in children including indications, dosing, therapeutic and safety monitoring, and interventions to improve adherence. However, there are substantial gaps in our knowledge to be addressed by on-going and planned studies in children. PMID:22517797

Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: A qualitative exploration of consumer and health care professional perspectives.

PubMed

Kuruvilla, Lisha; Weeks, Greg; Eastman, Peter; George, Johnson

2018-05-01

Pharmacists have a key role to play in optimisation of medication regimens and promotion of medication safety. The role of specialist pharmacists as part of the multidisciplinary palliative care team, especially in the primary care setting, is not widely recognised. To explore the perspectives of stakeholders about the gaps in the current model of community palliative care services in relation to medication management and to assess their opinions pertaining to the role of a specialist palliative care pharmacist in addressing some of those gaps. Qualitative study utilising three focus groups involving 20 stakeholders. Thematic analysis was carried out using a framework approach and interpreted in the context of the Chronic Care Model for improving primary care for patients with chronic illness. Setting was a large regional Australian palliative care service. Participants included palliative care consumers and clinicians specifically patients, caregivers, physicians, nurses and pharmacists. Five major themes emerged from the focus groups: access to resources, medicines and information; shared care; challenges of polypharmacy; informal caregiver needs and potential roles of a palliative care pharmacist. Gaps in access to medicines/resources, training for generalist practitioners, communication between treating teams and lack of support for patients and carers were cited as factors adversely impacting medication management in community-based palliative care. While community-based palliative care is an essential aspect of meeting the health care demands of an ageing society, the current model has several gaps and limitations. An appropriately qualified and skilled pharmacist within the palliative care team may help to address some of the gaps in relation to medication access and appropriateness.

Patient Safety Competence of Nursing Students in Saudi Arabia: A Self-Reported Survey

PubMed Central

Colet, Paolo C.; Cruz, Jonas P.; Cruz, Charlie P.; Al-otaibi, Jazi; Qubeilat, Hikmet; Alquwez, Nahed

2015-01-01

Objective With the growing recognition of the significance of patient safety (PS) in educational institutions and health organizations, it is essential to understand the perspective of nursing students on their own PS competence. This study analyzed the self-reported PS competence of nursing students at a government university in Saudi Arabia. Methodology A cross-sectional self-reported survey of 191 respondents, using the Health Professional Education in Patient Safety Survey (H-PEPSS) was conducted. The survey tool reflected 6 key socio-cultural dimensions assessing competence in classroom and clinical setting. Results Female nursing students reported higher PS competence in both the classroom and clinical settings along the dimensions ‘working in teams’ and ‘communicating effectively’ while males reported higher competence in both settings as to the ‘managing safety risks’ and ‘understanding human and environmental factors’ dimensions. The respondents’ academic level and self–reported PS competence have weak negative correlation in the classroom while a strong negative correlation between the 2 variables existed in the clinical setting. Self-reported PS competence for the dimensions ‘working in teams’, ‘recognize and respond to remove immediate risks of harm’, and ‘culture of safety’ is significantly higher in classroom than in the clinical setting. Conclusion Generally, the Saudi nursing students reported varying levels of competence in the six dimensions of patient safety. Significant gap between the perceived PS competence was observed between learning settings. Educational and training interventions are suggested for implementation to bridge this gap. PMID:26715921

Differing perceptions of safety culture across job roles in the ambulatory setting: analysis of the AHRQ Medical Office Survey on Patient Safety Culture.

PubMed

Hickner, John; Smith, Scott A; Yount, Naomi; Sorra, Joann

2016-08-01

Experts in patient safety stress the importance of a shared culture of safety. Lack of consensus may be detrimental to patient safety. This study examines differences in patient safety culture perceptions among providers, management and staff in a large national survey of safety culture in ambulatory practices in the USA. The US Agency for Healthcare Research and Quality Medical Office Survey on Patient Safety Culture (SOPS) assesses perceptions about patient safety issues and event reporting in medical offices (ie, ambulatory practices). Using the 2014 data, we analysed responses from medical offices with at least five respondents. We calculated differences in perceptions of patient safety culture across six job positions (physicians, management, nurse practitioners (NPs)/physician assistants (PAs), nurses, clinical support staff and administrative/clerical staff) for 10 survey composites, the average of the 10 composites and an overall patient safety rating using multivariate hierarchical linear regressions. We analysed data from 828 medical offices with responses from 15 523 providers and staff, with an average 20 completed surveys per medical office (range: 5-367) and an average medical office response rate of 65% (range: 3%-100%). Management had significantly more positive patient safety culture perceptions on nine of 10 composite scores compared with all other job positions, including physicians. The composite that showed the largest difference was Communication Openness; Management (85% positive) was 22% points more positive than other clinical and support staff and administrative/clerical staff. Physicians were significantly more positive than PAs/NPs, nursing staff, other clinical and support staff and administrative/clerical staff on four composites: Communication About Error, Communication Openness, Staff Training and Teamwork, ranging from 3% to 20% points more positive. These findings suggest that managers need to pay attention to the training needs of office staff, since this was an area with one of the greatest gaps in perceptions. In addition, both office managers and physicians need to encourage more open communication. As medical offices innovate to improve value, efficiency and patient-centred care, it is important that they continue to foster shared perceptions about what organisational members need, understanding that those perceptions may differ systematically by job position. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Office-based surgery: embracing patient safety strategies.

PubMed

Shapiro, Fred E; Punwani, Nathan; Urman, Richard D

2013-01-01

Office-based surgery continues to grow as more procedures are being performed in the outpatient setting. With this exponential growth, there is an increasing emphasis on safe and effective patient care. Current research shows both gaps in safety and opportunities for improvement. Practice managers, clinicians, and other personnel should be cognizant that office procedures are coming under intense regulatory scrutiny. Effective strategies to maintain quality and patient safety include the use of checklists, obtaining office accreditation, encouraging board-certification and proper credentialing of proceduralists, and appropriate patient and procedure selection. There is increasing regulation of ambulatory surgery on state and national levels that will likely affect the financial and care quality aspects of office-based practice. Socioeconomic and political forces will continue to shape the future of office-based surgery.

A comparative study of vocational education and occupational safety and health training in China and the UK.

PubMed

Nie, Baisheng; Huang, Xin; Xue, Fei; Chen, Jiang; Liu, Xiaobing; Meng, Yangyang; Huang, Jinxin

2018-06-01

In order to enhance Chinese workers' occupational safety awareness, it is essential to learn from developed countries' experiences. This article investigates thoroughly occupational safety and health (OSH) in China and the UK; moreover, the article performs a comparison of Chinese and British OSH training-related laws, regulations and education system. The following conclusions are drawn: China's work safety continues to improve, but there is still a large gap compared with the UK. In China a relatively complete vocational education and training (VET) system has been established. However, there exist some defects in OSH. In the UK, the employer will not only pay attention to employees' physiological health, but also to their mental health. The UK's VET is characterized by classification and grading management, which helps integrate OSH into the whole education system. China can learn from the UK in the development of policies, VET and OSH training.

Seniors managing multiple medications: using mixed methods to view the home care safety lens.

PubMed

Lang, Ariella; Macdonald, Marilyn; Marck, Patricia; Toon, Lynn; Griffin, Melissa; Easty, Tony; Fraser, Kimberly; MacKinnon, Neil; Mitchell, Jonathan; Lang, Eddy; Goodwin, Sharon

2015-12-12

Patient safety is a national and international priority with medication safety earmarked as both a prevalent and high-risk area of concern. To date, medication safety research has focused overwhelmingly on institutional based care provided by paid healthcare professionals, which often has little applicability to the home care setting. This critical gap in our current understanding of medication safety in the home care sector is particularly evident with the elderly who often manage more than one chronic illness and a complex palette of medications, along with other care needs. This study addresses the medication management issues faced by seniors with chronic illnesses, their family, caregivers, and paid providers within Canadian publicly funded home care programs in Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS). Informed by a socio-ecological perspective, this study utilized Interpretive Description (ID) methodology and participatory photographic methods to capture and analyze a range of visual and textual data. Three successive phases of data collection and analysis were conducted in a concurrent, iterative fashion in eight urban and/or rural households in each province. A total of 94 participants (i.e., seniors receiving home care services, their family/caregivers, and paid providers) were interviewed individually. In addition, 69 providers took part in focus groups. Analysis was iterative and concurrent with data collection in that each interview was compared with subsequent interviews for converging as well as diverging patterns. Six patterns were identified that provide a rich portrayal of the complexity of medication management safety in home care: vulnerabilities that impact the safe management and storage of medication, sustaining adequate supports, degrees of shared accountability for care, systems of variable effectiveness, poly-literacy required to navigate the system, and systemic challenges to maintaining medication safety in the home. There is a need for policy makers, health system leaders, care providers, researchers, and educators to work with home care clients and caregivers on three key messages for improvement: adapt care delivery models to the home care landscape; develop a palette of user-centered tools to support medication safety in the home; and strengthen health systems integration.

Evaluating the Safety Profile of Non-Active Implantable Medical Devices Compared with Medicines.

PubMed

Pane, Josep; Coloma, Preciosa M; Verhamme, Katia M C; Sturkenboom, Miriam C J M; Rebollo, Irene

2017-01-01

Recent safety issues involving non-active implantable medical devices (NAIMDs) have highlighted the need for better pre-market and post-market evaluation. Some stakeholders have argued that certain features of medicine safety evaluation should also be applied to medical devices. Our objectives were to compare the current processes and methodologies for the assessment of NAIMD safety profiles with those for medicines, identify potential gaps, and make recommendations for the adoption of new methodologies for the ongoing benefit-risk monitoring of these devices throughout their entire life cycle. A literature review served to examine the current tools for the safety evaluation of NAIMDs and those for medicines. We searched MEDLINE using these two categories. We supplemented this search with Google searches using the same key terms used in the MEDLINE search. Using a comparative approach, we summarized the new product design, development cycle (preclinical and clinical phases), and post-market phases for NAIMDs and drugs. We also evaluated and compared the respective processes to integrate and assess safety data during the life cycle of the products, including signal detection, signal management, and subsequent potential regulatory actions. The search identified a gap in NAIMD safety signal generation: no global program exists that collects and analyzes adverse events and product quality issues. Data sources in real-world settings, such as electronic health records, need to be effectively identified and explored as additional sources of safety information, particularly in some areas such as the EU and USA where there are plans to implement the unique device identifier (UDI). The UDI and other initiatives will enable more robust follow-up and assessment of long-term patient outcomes. The safety evaluation system for NAIMDs differs in many ways from those for drugs, but both systems face analogous challenges with respect to monitoring real-world usage. Certain features of the drug safety evaluation process could, if adopted and adapted for NAIMDs, lead to better and more systematic evaluations of the latter.

Too much information? A document analysis of sport safety resources from key organisations.

PubMed

Bekker, Sheree; Finch, Caroline F

2016-05-06

The field of sport injury prevention has seen a marked increase in published research in recent years, with concomitant proliferation of lay sport safety resources, such as policies, fact sheets and posters. The aim of this study was to catalogue and categorise the number, type and topic focus of sport safety resources from a representative set of key organisations. Cataloguing and qualitative document analysis of resources available from the websites of six stakeholder organisations in Australia. This study was part of a larger investigation, the National Guidance for Australian Football Partnerships and Safety (NoGAPS) project. The NoGAPS study provided the context for a purposive sampling of six organisations involved in the promotion of safety in Australian football. These partners are recognised as being highly representative of organisations at national and state level that reflect similarly in their goals around sport safety promotion in Australia. The catalogue comprised 284 resources. More of the practical and less prescriptive types of resources, such as fact sheets, than formal policies were found. Resources for the prevention of physical injuries were the predominant sport safety issue addressed, with risk management, environmental issues and social behaviours comprising other categories. Duplication of resources for specific safety issues, within and across organisations, was found. People working within sport settings have access to a proliferation of resources, which creates a potential rivalry for sourcing of injury prevention information. Important issues that are likely to influence the uptake of safety advice by the general sporting public include the sheer number of resources available, and the overlap and duplication of resources addressing the same issues. The existence of a large number of resources from reputable organisations does not mean that they are necessarily evidence based, fully up to date or even effective in supporting sport safety behaviour change. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Too much information? A document analysis of sport safety resources from key organisations

PubMed Central

Finch, Caroline F

2016-01-01

Objectives The field of sport injury prevention has seen a marked increase in published research in recent years, with concomitant proliferation of lay sport safety resources, such as policies, fact sheets and posters. The aim of this study was to catalogue and categorise the number, type and topic focus of sport safety resources from a representative set of key organisations. Design Cataloguing and qualitative document analysis of resources available from the websites of six stakeholder organisations in Australia. Setting This study was part of a larger investigation, the National Guidance for Australian Football Partnerships and Safety (NoGAPS) project. Participants The NoGAPS study provided the context for a purposive sampling of six organisations involved in the promotion of safety in Australian football. These partners are recognised as being highly representative of organisations at national and state level that reflect similarly in their goals around sport safety promotion in Australia. Results The catalogue comprised 284 resources. More of the practical and less prescriptive types of resources, such as fact sheets, than formal policies were found. Resources for the prevention of physical injuries were the predominant sport safety issue addressed, with risk management, environmental issues and social behaviours comprising other categories. Duplication of resources for specific safety issues, within and across organisations, was found. Conclusions People working within sport settings have access to a proliferation of resources, which creates a potential rivalry for sourcing of injury prevention information. Important issues that are likely to influence the uptake of safety advice by the general sporting public include the sheer number of resources available, and the overlap and duplication of resources addressing the same issues. The existence of a large number of resources from reputable organisations does not mean that they are necessarily evidence based, fully up to date or even effective in supporting sport safety behaviour change. PMID:27154480

Unequally Safe: The Race Gap in School Safety. Working Paper #01-13

ERIC Educational Resources Information Center

Lacoe, Johanna

2013-01-01

Inequality in educational outcomes is a frequent topic of policy debate. This paper investigates one potential source of educational inequality--school safety. With panel survey data of middle school students, this paper estimates racial gaps in student feelings of safety in the classroom, in the hallways, and outside the school building, and how…

Efforts to improve patient safety in large, capitated medical groups: description and conceptual model.

PubMed

Miller, Robert H; Bovbjerg, Randall R

2002-06-01

Medical care should be safer. Inpatient problems and solutions have received the most attention; this outpatient qualitative case study addresses a gap in knowledge. We describe safety improvements among large physician groups, model the key influences on their behavior, and identify beneficial public and private policies. All groups were trying to reduce medical injury, which was part of the sample design. The most commonly targeted problems are those that are similar across groups: shortcomings in diagnosis, abnormal tests follow-up, scope of practice and referral patterns, and continuity of care. Medical group innovators vary greatly, however, in implementation of improvements, that is, in the extent to which they implement process changes that identify events/problems, analyze and track incidents, decide how to change clinical and administrative practices, and monitor impacts of the changes. Our conceptual model identifies key determinants: (1) demand for safety comes from external factors: legal, market, and professional; (2) organizational responses depend on internal factors: group size, scope, and integration; leadership and governance; professional culture; information-system assets; and financial and intellectual capital. Further, safety is an aspect of quality (the same tools, decision making, interventions, and monitoring apply), and safety management benefits from prior efficiency management (similar skills and culture of innovation). Observed variation in even simple safeguards shows that existing safety incentives are too weak. Our model suggests that the biggest improvement would come from boosting the demand for quality and safety from both private and public larger group purchasers. Current policy relies too much on litigation and discipline, which have sometimes helped, but not solved, problems because they are inefficient, tend to drive needed information underground, and complicate needed cultural change. Patients' safety demand is also weak for want of information and market power. Big purchasers' demands, however, quickly influence the internal environment of medical groups, helping managers advance quality safety toward the top of groups' congested decision-making "queues."

Workplace violence prevention policies in home health and hospice care agencies.

PubMed

Gross, Nathan; Peek-Asa, Corinne; Nocera, Maryalice; Casteel, Carri

2013-01-31

Workplace violence in the home health industry is a growing concern, but little is known about the content of existing workplace violence prevention programs. The authors present the methods for this study that examined workplace violence prevention programs in a sample of 40 California home health and hospice agencies. Data was collected through surveys that were completed by the branch managers of participating facilities. Programs were scored in six different areas, including general workplace violence prevention components; management commitment and employee involvement; worksite analysis; hazard prevention and control; safety and health training; and recordkeeping and program evaluation. The results and discussion sections consider these six areas and the important gaps that were found in existing programs. For example, although most agencies offered workplace violence training, not every worker performing patient care was required to receive the training. Similarly, not all programs were written or reviewed and updated regularly. Few program differences were observed between agency characteristics, but nonetheless several striking gaps were found.

A Gap Analysis Needs Assessment Tool to Drive a Care Delivery and Research Agenda for Integration of Care and Sharing of Best Practices Across a Health System.

PubMed

Golden, Sherita Hill; Hager, Daniel; Gould, Lois J; Mathioudakis, Nestoras; Pronovost, Peter J

2017-01-01

In a complex health system, it is important to establish a systematic and data-driven approach to identifying needs. The Diabetes Clinical Community (DCC) of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality developed a gap analysis tool and process to establish the system's current state of inpatient diabetes care. The collectively developed tool assessed the following areas: program infrastructure; protocols, policies, and order sets; patient and health care professional education; and automated data access. For the purposes of this analysis, gaps were defined as those instances in which local resources, infrastructure, or processes demonstrated a variance against the current national evidence base or institutionally defined best practices. Following the gap analysis, members of the DCC, in collaboration with health system leadership, met to identify priority areas in order to integrate and synergize diabetes care resources and efforts to enhance quality and reduce disparities in care across the system. Key gaps in care identified included lack of standardized glucose management policies, lack of standardized training of health care professionals in inpatient diabetes management, and lack of access to automated data collection and analysis. These results were used to gain resources to support collaborative diabetes health system initiatives and to successfully obtain federal research funding to develop and pilot a pragmatic diabetes educational intervention. At a health system level, the summary format of this gap analysis tool is an effective method to clearly identify disparities in care to focus efforts and resources to improve care delivery. Copyright © 2016 The Joint Commission. Published by Elsevier Inc. All rights reserved.

An examination of the potential added value of water safety plans to the United States national drinking water legislation.

PubMed

Baum, Rachel; Amjad, Urooj; Luh, Jeanne; Bartram, Jamie

2015-11-01

National and sub-national governments develop and enforce regulations to ensure the delivery of safe drinking water in the United States (US) and countries worldwide. However, periodic contamination events, waterborne endemic illness and outbreaks of waterborne disease still occur, illustrating that delivery of safe drinking water is not guaranteed. In this study, we examined the potential added value of a preventive risk management approach, specifically, water safety plans (WSPs), in the US in order to improve drinking water quality. We undertook a comparative analysis between US drinking water regulations and WSP steps to analyze the similarities and differences between them, and identify how WSPs might complement drinking water regulations in the US. Findings show that US drinking water regulations and WSP steps were aligned in the areas of describing the water supply system and defining monitoring and controls. However, gaps exist between US drinking water regulations and WSPs in the areas of team procedures and training, internal risk assessment and prioritization, and management procedures and plans. The study contributes to understanding both required and voluntary drinking water management practices in the US and how implementing water safety plans could benefit water systems to improve drinking water quality and human health. Copyright © 2015 Elsevier GmbH. All rights reserved.

A gap analysis of the United States death care sector to determine training and education needs pertaining to highly infectious disease mitigation and management.

PubMed

Le, Aurora B; Witter, Lesley; Herstein, Jocelyn J; Jelden, Katelyn C; Beam, Elizabeth L; Gibbs, Shawn G; Lowe, John J

2017-09-01

A United States industry-specific gap analysis survey of the death care sector-which comprises organizations and businesses affiliated with the funeral industry and the handling of human remains- was developed, the results analyzed, and training and education needs in relation to highly infectious disease mitigation and management were explored in an effort to identify where occupational health and safety can be enhanced in this worker population. Collaborating national death care organizations distributed the 47-question electronic survey. N = 424 surveys were initiated and results recorded. The survey collected death care sector-specific information pertaining to the comfortability and willingness to handle highly infectious remains; perceptions of readiness, current policies and procedures in place to address highly infectious diseases; current highly infectious disease training levels, available resources, and personal protective equipment. One-third of respondents have been trained on how to manage highly infectious remains. There was a discrepancy between Supervisor/Management and Employee/Worker perceptions on employees' willingness and comfortability to manage potentially highly infectious remains. More than 40% of respondents did not know the correct routes of transmission for viral hemorrhagic fevers. Results suggest death care workers could benefit from increasing up-to-date industry-specific training and education on highly infectious disease risk mitigation and management. Professional death care sector organizations are positioned to disseminate information, training, and best practices.

Reactor Safety Gap Evaluation of Accident Tolerant Components and Severe Accident Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Farmer, Mitchell T.; Bunt, R.; Corradini, M.

The overall objective of this study was to conduct a technology gap evaluation on accident tolerant components and severe accident analysis methodologies with the goal of identifying any data and/or knowledge gaps that may exist, given the current state of light water reactor (LWR) severe accident research, and additionally augmented by insights obtained from the Fukushima accident. The ultimate benefit of this activity is that the results can be used to refine the Department of Energy’s (DOE) Reactor Safety Technology (RST) research and development (R&D) program plan to address key knowledge gaps in severe accident phenomena and analyses that affectmore » reactor safety and that are not currently being addressed by the industry or the Nuclear Regulatory Commission (NRC).« less

Hand safety for specialty crop production workers: a pilot study investigating frequencies of minor open-wound hand injuries and presence of pathogenic bacteria.

PubMed

Pate, M L; Nummer, B

2013-10-01

The purpose of this study was to quantify the presence of minor open-wound hand injuries in addition to Salmonella, Staphylococcus aureus, coliforms, and Escherichia coli on the hands of farm workers who hand-harvest fruit crops in Utah. Data collection was conducted on four farms without USDA Good Agricultural Practices (GAP) certification and on two farms with GAP certification. This study identified essential safety issues that need to be addressed for improving the effectiveness of safety training for migrant farm workers. Farms that have a food safety audit program in place are less likely to have farm workers exposed to pathogenic bacteria and open-wound injuries to their hands. High frequency of S. aureus may indicate a potentially higher risk for wound infection within this worker population. This could lead to infections that are resistant to the antibiotics commonly used to treat ordinary staph infections, resulting in greater work loss time and medical expenses for these workers. Higher frequencies of bacterial presence on workers' hands on non-certified farms indicate a need to identify essential practices to improve worker hygiene habits and on-farm management practices to promote healthy hygiene. Open-wound injuries to migrant farm workers during hand-harvesting could create additional health problems with the possibility of infection and the spread of diseases. Continued research is needed to understand workers' acceptance of these injuries and barriers to personal protection.

Blending technology and teamwork for successful management of product recalls.

PubMed

Frush, Karen; Pleasants, Jane; Shulby, Gail; Hendrix, Barbara; Berson, Brooke; Gordon, Cynthia; Cuffe, Michael S

2009-12-01

Patient safety programs have been developed in many hospitals to reduce the risk of harm to patients. Proactive, real-time, and retrospective risk-reduction strategies should be implemented in hospitals, but patient safety leaders should also be cognizant of the risks associated with thousands of products that enter the hospital through the supply chain. A growing number of recalls and alerts related to these products are received by health care facilities each year, through a recall process that is fraught with challenges. Despite the best efforts of health care providers, weaknesses and gaps in the process lead to delays, fragmentation, and disruptions, thus extending the number of days patients may be at risk from potentially faulty or misused products. To address these concerns, Duke Medicine, which comprises an academic medical center, two community hospitals, outlying clinics, physicians' offices, and home health and hospice, implemented a Web-based recall management system. Within three months, the time required to receive, deliver, and close alerts decreased from 43 days to 2.74 days. To maximize the effectiveness of the recall management process, a team of senior Duke Medicine leaders was established to evaluate the impact of product recalls and alerts on patient safety, to evaluate response action plans, and to provide oversight of patient and provider communication strategies. Alerts are now communicated more effectively and responded to in a more consistent and global manner. This comprehensive approach to product recalls is a critical component of a broader Duke Medicine strategy to improve patient safety.

Patient safety, quality of care, and knowledge translation in the intensive care unit.

PubMed

Needham, Dale M

2010-07-01

A large gap exists between the completion of clinical research demonstrating the benefit of new treatment interventions and improved patient outcomes resulting from implementation of these interventions as part of routine clinical practice. This gap clearly affects patient safety and quality of care. Knowledge translation is important for addressing this gap, but evaluation of the most appropriate and effective knowledge translation methods is still ongoing. Through describing one model for knowledge translation and an example of its implementation, insights can be gained into systematic methods for advancing the implementation of evidence-based interventions to improve safety, quality, and patient outcomes.

Schools and Disasters: Safety and Mental Health Assessment and Interventions for Children.

PubMed

Lai, Betty S; Esnard, Ann-Margaret; Lowe, Sarah R; Peek, Lori

2016-12-01

This article draws on experiences and lessons from global disasters and utilizes the United Nations Comprehensive School Safety Framework to highlight the necessary role of safe schools in protecting children, as well as adult staff, from the immediate threats and long-term implications of disasters. Specifically, we focus on three well-established pillars of school safety: Pillar I: Safe Learning Facilities; Pillar II: Disaster Management; and Pillar III: Risk Reduction and Resilience Education. In addition, we propose a potential fourth pillar, which underscores the function of schools in postdisaster mental health assessment and intervention for children. We argue that schools offer a central location and trusted institutional space for mental health assessment and intervention after disasters. We also examine the important linkages between schools, child mental health, and household and family recovery. We conclude with recommendations for filling gaps in research and practice related to ensuring the safety of schools and the associated health and well-being of children in the face of future disasters.

Transformational leadership in nursing and medication safety education: a discussion paper.

PubMed

Vaismoradi, Mojtaba; Griffiths, Pauline; Turunen, Hannele; Jordan, Sue

2016-10-01

This paper discusses the application of transformational leadership to the teaching and learning of safe medication management. The prevalence of adverse drug events (ADEs) and medication-related hospitalisations (one hundred thousand each year in the USA) are of concern. This discussion is based on a narrative literature review and scrutiny of international nursing research to synthesise pedagogical strategies for the application of transformational leadership to teaching medication safety. The four elements relating transformational leadership to medication safety education are: 'Idealised influence' or role modelling, both actual and exemplary, 'Inspirational motivation' providing students with commitment to medication safety, 'Intellectual stimulation' encouraging students to value improvement and change, and 'Individualised consideration' of individual students' educational goals, practice development and patient outcomes. The model lends itself to experiential learning and a case-study approach to teaching, offering an opportunity to reduce nursing's theory-practice gap. Transformational leadership for medication safety education is characterised by a focus on the role of nurse educators and mentors in the development of students' abilities, creation of a supportive culture, and enhancement of students' creativity, motivation and ethical behaviour. This will prepare nursing graduates with the competencies necessary to be diligent about medication safety and the prevention of errors. Teaching medication safety through transformational leadership requires the close collaboration of educators, managers and policy makers. Investigation of strategies to reduced medication errors and consequent patient harm should include exploration of the application of transformational leadership to education and its impact on the number and severity of medication errors. © 2016 John Wiley & Sons Ltd.

[Establishment of traceability system of Chinese medicinal materials' quality].

PubMed

Qi, Yao-dong; Gao, Shi-man; Liu, Hai-tao; Li, Xi-wen; Wei, Jian-he; Zhang, Ben-gang; Sun, Xiao-bo; Xiao, Pei-gen

2015-12-01

The quality of Chinese medicinal materials relates greatly to the clinical curative effect and security. In order to ensure the quality and safety of Chinese medicinal materials, a systematic and operable traceability system needs to be established. It can realize the whole process of quality and safety management of Chinese medicinal materials "from production to consumption" through recording and inquiring information and recalling defective products, which is an important direction for the future development of traditional Chinese medicine. But it is still at the exploration and trial stage. In this paper, a framework of Chinese medicinal materials' quality and safety traceability system was established on the basis of the domestic and international experience about the construction of food and agricultural products traceability systems. The relationship between traceability system of Chinese medicinal materials' quality and GAP, GMP, GSP was analyzed, and the possible problems and the corresponding solutions were discussed.

Knowledge Insufficient: The Management of Haemoglobin SC Disease

PubMed Central

Pecker, Lydia H.; Schaefer, Beverly A.; Luchtman-Jones, Lori

2016-01-01

Although haemoglobin SC (HbSC) accounts for 30% of sickle cell disease (SCD) in the United States and United Kingdom, evidence-based guidelines for genotype specific management are lacking. The unique pathology of HbSC disease is complex, characterized by erythrocyte dehydration, intracellular sickling and increased blood viscosity. The evaluation and treatment of patients with HbSC is largely inferred from studies of SCD consisting mostly of haemoglobin SS (HbSS) patients. These studies are underpowered to allow definitive conclusions about HbSC. We review the pathophysiology of HbSC disease, including known and potential differences between HbSS and HbSC, and highlight knowledge gaps in HbSC disease management. Clinical and translational research is needed to develop targeted treatments and to validate management recommendations for efficacy, safety and impact on quality of life for people with HbSC. PMID:27982424

From Board to Bedside: How the Application of Financial Structures to Safety and Quality Can Drive Accountability in a Large Health Care System.

PubMed

Austin, J Matthew; Demski, Renee; Callender, Tiffany; Lee, K H Ken; Hoffman, Ann; Allen, Lisa; Radke, Deborah A; Kim, Yungjin; Werthman, Ronald J; Peterson, Ronald R; Pronovost, Peter J

2017-04-01

As the health care system in the United States places greater emphasis on the public reporting of quality and safety data and its use to determine payment, provider organizations must implement structures that ensure discipline and rigor regarding these data. An academic health system, as part of a performance management system, applied four key components of a financial reporting structure to support the goal of top-to-bottom accountability for improving quality and safety. The four components implemented by Johns Hopkins Medicine were governance, accountability, reporting of consolidated quality performance statements, and auditing. Governance is provided by the health system's Patient Safety and Quality Board Committee, which reviews goals and strategy for patient safety and quality, reviews quarterly performance for each entity, and holds organizational leaders accountable for performance. An accountability plan includes escalating levels of review corresponding to the number of months an entity misses the defined performance target for a measure. A consolidated quality statement helps inform the Patient Safety and Quality Board Committee and leadership on key quality and safety issues. An audit evaluates the efficiency and effectiveness of processes for data collection, validation, and storage, as to ensure the accuracy and completeness of quality measure reporting. If hospitals and health systems truly want to prioritize improvements in safety and quality, they will need to create a performance management system that ensures data validity and supports performance accountability. Without valid data, it is difficult to know whether a performance gap is due to data quality or clinical quality. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

STS-114: Mission Status/Post MMT Briefing

NASA Technical Reports Server (NTRS)

2005-01-01

Paul Hill, STS-114 Lead Shuttle Flight Director, and Wayne Hill, Deputy Manager for the Space Shuttle Program and Chair of the Mission Management Team, discusses with the News media the complete operational success of the STS-114 Flight. Paul Hill mentioned the undocking and flight around did occur right on time that day, and checking out Discovery's entry system in preparation for de-orbit on Monday morning. He summarized the long list of flight operations and activities demonstrated like various forms of inspections on RCC and tile, gap fillers and blanket, imagery and photography, three space walks and re-supply. Wayne Hill talked about flight control check out, pre-entry plans, opportunity landing in Cape Carneval, Florida and back-up landing operations in Edwards Air Force Base, California. He emphasized the concern for crew and public safety during landing. News media focused their questions on public expectations and feelings about the return of the Shuttle to Earth, analysis of mechanical and technical failures, safety of dark or daylight landings.

Emergency Manuals: How Quality Improvement and Implementation Science Can Enable Better Perioperative Management During Crises.

PubMed

Goldhaber-Fiebert, Sara N; Macrae, Carl

2018-03-01

How can teams manage critical events more effectively? There are commonly gaps in performance during perioperative crises, and emergency manuals are recently available tools that can improve team performance under stress, via multiple mechanisms. This article examines how the principles of implementation science and quality improvement were applied by multiple teams in the development, testing, and systematic implementations of emergency manuals in perioperative care. The core principles of implementation have relevance for future patient safety innovations perioperatively and beyond, and the concepts of emergency manuals and interprofessional teamwork are applicable for diverse fields throughout health care. Copyright © 2017 Sara N. Goldhaber-Fiebert, Carl Macrae. Published by Elsevier Inc. All rights reserved.

Risky Business

NASA Technical Reports Server (NTRS)

Yarbrough, Katherine

2015-01-01

During my internship I worked on two major projects, recommending improvements for the Center's Risk Management Workshop and helping with the strategic planning efforts for Safety and Mission Assurance (S&MA). The risk management improvements is the key project I worked on this semester through my internship, while the strategic planning is the secondary assignment. S&MA Business Office covers both aspects in its delegation, getting both spans some of the work done in the office. A risk is a future event with a negative consequence that has some probability of occurring. Safety and Mission Assurance identifies, analyzes, plans, and tracks risk. The directorate offers the Center a Risk Management Workshop, and part of the ongoing efforts of S&MA is to make continuous improvements to the RM Workshop. By using the Project Management Institute's (PMI) Standard for Risk Management, I performed a gap analysis to make improvements for our materials. I benchmarked the PMI's Risk Management Standard, compared our Risk Management Workshop materials to PMI's standard, and identified any gaps in our material. My major findings were presented to the Business Office of S&MA for a decision on whether or not to incorporate the improvements. These suggestions were made by attending JSC working group meetings, Health, Safety and Environment (HSE) panel reviews and various risk review meetings. The improvements provide better understanding of risk management processes and enhanced risk tracking knowledge and skills. Risk management is an integral part of any engineering discipline, getting exposed to this section of engineering will greatly help shape my career in the future. Johnson Space Center is a world leader in risk management processes; learning risk management here gives me a huge advantage over my peers, as well as understanding decision making in the context of risk management will help me to be a well-rounded engineer. Strategic planning is an area I had not previously studied. Helping with the strategic planning efforts in S&MA has taught me how organizations think and function as a whole. S&MA is adopting a balanced scorecard approach to strategic planning. As part of this planning method strategic themes, objectives, and initiatives are formed. I attended strategic theme team workshops that formed the strategy map for the directorate and gave shape to the plan. Also during these workshops the objectives were discussed and built. Learning the process for strategic planning has helped me better understand how organizations and businesses function, which also helps me to be a more effective employee. Other assignments I had during my internship included completing the Safety and Mission Assurance Technical Excellent Program (STEP) Level 1, as well as doing a two week rotation through the Space Exploration division in S&MA, specifically working with a thermal protection systems (TPS) engineer. While working there, I learned about the Orion capsule and the SpaceX Dragon cargo capsule. I attended meetings to prepare the engineers for the upcoming Critical Design Reviews for both capsules and reviewed test data. Learning risk management, strategic planning, and working in the Space Exploration division has taught me about many aspects of S&MA. My internship at NASA has given me new experiences and taught me numerous subjects that I would have otherwise not learned. This opportunity has expanded my educational horizons and is helping me to become a more useful engineer and employee.

Seismic risk management solution for nuclear power plants

DOE PAGES

Coleman, Justin; Sabharwall, Piyush

2014-12-01

Nuclear power plants should safely operate during normal operations and maintain core-cooling capabilities during off-normal events, including external hazards (such as flooding and earthquakes). Management of external hazards to expectable levels of risk is critical to maintaining nuclear facility and nuclear power plant safety. Seismic risk is determined by convolving the seismic hazard with seismic fragilities (capacity of systems, structures, and components). Seismic isolation (SI) is one protective measure showing promise to minimize seismic risk. Current SI designs (used in commercial industry) reduce horizontal earthquake loads and protect critical infrastructure from the potentially destructive effects of large earthquakes. The benefitmore » of SI application in the nuclear industry is being recognized and SI systems have been proposed in American Society of Civil Engineer Standard 4, ASCE-4, to be released in the winter of 2014, for light water reactors facilities using commercially available technology. The intent of ASCE-4 is to provide criteria for seismic analysis of safety related nuclear structures such that the responses to design basis seismic events, computed in accordance with this standard, will have a small likelihood of being exceeded. The U.S. nuclear industry has not implemented SI to date; a seismic isolation gap analysis meeting was convened on August 19, 2014, to determine progress on implementing SI in the U.S. nuclear industry. The meeting focused on the systems and components that could benefit from SI. As a result, this article highlights the gaps identified at this meeting.« less

Practices and challenges of infectious waste management: A qualitative descriptive study from tertiary care hospitals in Pakistan

PubMed Central

Kumar, Ramesh; Shaikh, Babar Tasneem; Somrongthong, Ratana; Chapman, Robert S

2015-01-01

Background and Objective: Infectious waste management practices among health care workers in the tertiary care hospitals have been questionable. The study intended to identify issues that impede a proper infectious waste management. Methods: Besides direct observation, in-depths interviews were conducted with the hospital administrators and senior management involved in healthcare waste management during March 2014. We looked at the processes related to segregation, collection, storage and disposal of hospital waste, and identified variety of issues in all the steps. Results: Serious gaps and deficiencies were observed related to segregation, collection, storage and disposal of the hospital wastes, hence proving to be hazardous to the patients as well as the visitors. Poor safety, insufficient budget, lack of trainings, weak monitoring and supervision, and poor coordination has eventually resulted in improper waste management in the tertiary hospitals of Rawalpindi. Conclusion: Study has concluded that the poor resources and lack of healthcare worker’s training in infectious waste results in poor waste management at hospitals. PMID:26430405

Use of simulation to assess electronic health record safety in the intensive care unit: a pilot study

PubMed Central

March, Christopher A; Steiger, David; Scholl, Gretchen; Mohan, Vishnu; Hersh, William R; Gold, Jeffrey A

2013-01-01

Objective To establish the role of high-fidelity simulation training to test the efficacy and safety of the electronic health record (EHR)–user interface within the intensive care unit (ICU) environment. Design Prospective pilot study. Setting Medical ICU in an academic medical centre. Participants Postgraduate medical trainees. Interventions A 5-day-simulated ICU patient was developed in the EHR including labs, hourly vitals, medication administration, ventilator settings, nursing and notes. Fourteen medical issues requiring recognition and subsequent changes in management were included. Issues were chosen based on their frequency of occurrence within the ICU and their ability to test different aspects of the EHR–user interface. ICU residents, blinded to the presence of medical errors within the case, were provided a sign-out and given 10 min to review the case in the EHR. They then presented the case with their management suggestions to an attending physician. Participants were graded on the number of issues identified. All participants were provided with immediate feedback upon completion of the simulation. Primary and secondary outcomes To determine the frequency of error recognition in an EHR simulation. To determine factors associated with improved performance in the simulation. Results 38 participants including 9 interns, 10 residents and 19 fellows were tested. The average error recognition rate was 41% (range 6–73%), which increased slightly with the level of training (35%, 41% and 50% for interns, residents, and fellows, respectively). Over-sedation was the least-recognised error (16%); poor glycemic control was most often recognised (68%). Only 32% of the participants recognised inappropriate antibiotic dosing. Performance correlated with the total number of screens used (p=0.03). Conclusions Despite development of comprehensive EHRs, there remain significant gaps in identifying dangerous medical management issues. This gap remains despite high levels of medical training, suggesting that EHR-specific training may be beneficial. Simulation provides a novel tool in order to both identify these gaps as well as foster EHR-specific training. PMID:23578685

Occupational Health and Safety for Agricultural Workers in Thailand: Gaps and Recommendations, with a Focus on Pesticide Use

PubMed Central

Kaewboonchoo, Orawan; Kongtip, Pornpimol; Woskie, Susan

2018-01-01

Over 16.7 million workers in Thailand (42 percent of the working population) are engaged in agriculture, disproportionately from the lower socioeconomic strata of Thai society. Most agricultural workers (over 93 percent) work in the informal sector without the protections of regulations or enforcement of labor or health and safety laws or enrollment in a social security system. Although Thailand’s use of herbicides, fungicides, and insecticides is growing, there is little regulation of the sale, use, or application of these potentially toxic chemicals. This paper summarizes the research to date on occupational health and safety for Thai agricultural workers, identifies gaps in pesticide regulations and the current systems for occupational health and safety and social support for Thai agricultural workers, and makes recommendations for future policy and research initiatives to fill the identified gaps. PMID:25815744

Occupational health and safety for agricultural workers in Thailand: gaps and recommendations, with a focus on pesticide use.

PubMed

Kaewboonchoo, Orawan; Kongtip, Pornpimol; Woskie, Susan

2015-05-01

Over 16.7 million workers in Thailand (42 percent of the working population) are engaged in agriculture, disproportionately from the lower socioeconomic strata of Thai society. Most agricultural workers (over 93 percent) work in the informal sector without the protections of regulations or enforcement of labor or health and safety laws or enrollment in a social security system. Although Thailand's use of herbicides, fungicides, and insecticides is growing, there is little regulation of the sale, use, or application of these potentially toxic chemicals. This paper summarizes the research to date on occupational health and safety for Thai agricultural workers, identifies gaps in pesticide regulations and the current systems for occupational health and safety and social support for Thai agricultural workers, and makes recommendations for future policy and research initiatives to fill the identified gaps. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Reach and Validity of an Objective Medication Adherence Measure Among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study.

PubMed

Ratanawongsa, Neda; Karter, Andrew J; Quan, Judy; Parker, Melissa M; Handley, Margaret; Sarkar, Urmimala; Schmittdiel, Julie A; Schillinger, Dean

2015-08-01

With the expansion of Medicaid and low-cost health insurance plans among diverse patient populations, objective measures of medication adherence using pharmacy claims could advance clinical care and translational research for safety net care. However, safety net patients may experience fluctuating prescription drug coverage, affecting the performance of adherence measures. To evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. We conducted this cross-sectional analysis using administrative and clinical data for 680 members eligible for a self-management support trial at a nonprofit, government-sponsored managed care plan. We applied CMG methodology to cardiometabolic medication claims for English- , Cantonese- , or Spanish-speaking members with diabetes. We examined inclusiveness (the proportion with calculable CMG) and selectivity (sociodemographic and medical differences from members without CMG). For validity, we examined unadjusted associations of suboptimal adherence (CMG >  20%) with suboptimal cardiometabolic control. 429 members (63%) had calculable CMG. Compared with members without CMG, members with CMG were younger, more likely employed, and had poorer glycemic control but had better blood pressure and lipid control. Suboptimal adherence occurred more frequently among members with poor cardiometabolic control than among members with optimal control (28% vs. 12%, P = 0.02). CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable with its performance in studies among other insured populations. CMG may provide a useful tool to measure adherence among increasingly diverse Medicaid populations, complemented by other strategies to reach those not captured by CMG.

Knowledge insufficient: the management of haemoglobin SC disease.

PubMed

Pecker, Lydia H; Schaefer, Beverly A; Luchtman-Jones, Lori

2017-02-01

Although haemoglobin SC (HbSC) accounts for 30% of sickle cell disease (SCD) in the United States and United Kingdom, evidence-based guidelines for genotype specific management are lacking. The unique pathology of HbSC disease is complex, characterized by erythrocyte dehydration, intracellular sickling and increased blood viscosity. The evaluation and treatment of patients with HbSC is largely inferred from studies of SCD consisting mostly of haemoglobin SS (HbSS) patients. These studies are underpowered to allow definitive conclusions about HbSC. We review the pathophysiology of HbSC disease, including known and potential differences between HbSS and HbSC, and highlight knowledge gaps in HbSC disease management. Clinical and translational research is needed to develop targeted treatments and to validate management recommendations for efficacy, safety and impact on quality of life for people with HbSC. © 2016 John Wiley & Sons Ltd.

RN Diabetes Virtual Case Management: A New Model for Providing Chronic Care Management.

PubMed

Brown, Nancy N; Carrara, Barbara E; Watts, Sharon A; Lucatorto, Michelle A

2016-01-01

The U.S. chronic disease health care system has substantial gaps in delivery of services. New models of care change traditional delivery of care and explore new settings for care. This article describes a new model of diabetes chronic care delivery: nurse-delivered care that includes protocol-based insulin titration and patient education delivered solely in a virtual environment. In phase 1, the clinical outcome of time to achievement of glycated hemoglobin (A(1C)) goals (P < .001; 95% confidence interval, 1.68-2.24) was significantly improved by registered nurse (RN) standing order intervention (n = 24) as compared with historical controls (n = 28). In phase 2, patients who were referred to an RN-managed insulin titration protocol with individualized A(1C) goals had a significant (P < .001; 95% confidence interval, 1.680-2.242) reduction in results from a mean of 9.6% at baseline to 7.7% at completion. Average patient age was 66 years, with a mean duration of 11 years diagnosed with diabetes. Safety was demonstrated by the absence of hypoglycemia related to RN protocol adjustment. There were no admissions or emergency room (ER) visits for hypoglycemia. This study demonstrates safety and efficacy of RN virtual chronic disease management for an older population of patients with long-standing diabetes.

Leveraging Event Reporting Through Knowledge Support: A Knowledge-Based Approach to Promoting Patient Fall Prevention.

PubMed

Yao, Bin; Kang, Hong; Miao, Qi; Zhou, Sicheng; Liang, Chen; Gong, Yang

2017-01-01

Patient falls are a common safety event type that impairs the healthcare quality. Strategies including solution tools and reporting systems for preventing patient falls have been developed and implemented in the U.S. However, the current strategies do not include timely knowledge support, which is in great need in bridging the gap between reporting and learning. In this study, we constructed a knowledge base of fall events by combining expert-reviewed fall prevention solutions and then integrating them into a reporting system. The knowledge base enables timely and tailored knowledge support and thus will serve as a prevailing fall prevention tool. This effort holds promise in making knowledge acquisition and management a routine process for enhancing the reporting and understanding of patient safety events.

National consultation leads to agrivita research to practice plan for Canada.

PubMed

Asselin, Johanne; MacLeod, Martha L P; Dosman, James A

2009-01-01

A gap exists between research development and its implementation in agricultural health and safety. In order to fill this gap, the goal of this project was to consult agricultural stakeholders across Canada in order to identify the health and safety priorities in research and knowledge translation, and then to propose an approach to bridge the gap. Between April and August 2007, "A National Stakeholder Consultation on Health and Safety Research and its Effective Translation to the Agricultural Sector" was initiated by the Canadian Centre for Heath and Safety in Agriculture. The experiences and opinions of stakeholders across Canada were gathered through focus groups with over 150 participants in seven Canadian provinces and a survey of 289 individuals across Canada. Stakeholders identified a range of health and safety research priorities. Chemical exposure, stress, and farm safety issues were immediate concerns and issues surrounding labor and trained workers, whereas health problems and environmental issues were long-term concerns. Results identified research and knowledge translation priorities, which provided elements for a proposed program aiming at bridging the gap existing between research development and its translation into practice. A request for a knowledge translation/transfer mechanism, where all agricultural stakeholders from researchers to end users are involved in the process, was identified. Findings from the national consultation were used to develop a business plan entitled "Agrivita Research to Practice Program: A Partnership Plan for Health and Safety and its Effective Transfer to the Agricultural Sector in Canada." The plan provides for a coordinated and integrated approach in Canada, conceptually drawing on the American experience established by The National Institute for Occupational Safety and Health.

Medication errors in residential aged care facilities: a distributed cognition analysis of the information exchange process.

PubMed

Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

2013-05-01

Medication safety is a pressing concern for residential aged care facilities (RACFs). Retrospective studies in RACF settings identify inadequate communication between RACFs, doctors, hospitals and community pharmacies as the major cause of medication errors. Existing literature offers limited insight about the gaps in the existing information exchange process that may lead to medication errors. The aim of this research was to explicate the cognitive distribution that underlies RACF medication ordering and delivery to identify gaps in medication-related information exchange which lead to medication errors in RACFs. The study was undertaken in three RACFs in Sydney, Australia. Data were generated through ethnographic field work over a period of five months (May-September 2011). Triangulated analysis of data primarily focused on examining the transformation and exchange of information between different media across the process. The findings of this study highlight the extensive scope and intense nature of information exchange in RACF medication ordering and delivery. Rather than attributing error to individual care providers, the explication of distributed cognition processes enabled the identification of gaps in three information exchange dimensions which potentially contribute to the occurrence of medication errors namely: (1) design of medication charts which complicates order processing and record keeping (2) lack of coordination mechanisms between participants which results in misalignment of local practices (3) reliance on restricted communication bandwidth channels mainly telephone and fax which complicates the information processing requirements. The study demonstrates how the identification of these gaps enhances understanding of medication errors in RACFs. Application of the theoretical lens of distributed cognition can assist in enhancing our understanding of medication errors in RACFs through identification of gaps in information exchange. Understanding the dynamics of the cognitive process can inform the design of interventions to manage errors and improve residents' safety. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Bridging existing governance gaps: five evidence-based actions that boards can take to pursue high quality care.

PubMed

Leggat, Sandra G; Balding, Cathy

2017-11-13

Objective To explore the impact of the organisational quality systems on quality of care in Victorian health services. Methods During 2015 a total of 55 focus groups were conducted with more than 350 managers, clinical staff and board members in eight Victorian health services to explore the effectiveness of health service quality systems. A review of the quality and safety goals and strategies outlined in the strategic and operating plans of the participating health services was also undertaken. Results This paper focuses on the data related to the leadership role of health service boards in ensuring safe, high-quality care. The findings suggest that health service boards are not fully meeting their governance accountability to ensure consistently high-quality care. The data uncovered major clinical governance gaps between stated board and executive aspirations for quality and safety and the implementation of these expectations at point of care. These gaps were further compounded by quality system confusion, over-reliance on compliance, and inadequate staff engagement. Conclusion Based on the existing evidence we propose five specific actions boards can take to close the gaps, thereby supporting improved care for all consumers. What is known about this topic? Effective governance is essential for high-quality healthcare delivery. Boards are required to play an active role in their organisation's pursuit of high quality care. What does this paper add? Recent government reports suggest that Australian health service boards are not fully meeting their governance requirements for high quality, safe care delivery, and our research pinpoints key governance gaps. What are the implications for practitioners? Based on our research findings we outline five evidence-based actions for boards to improve their governance of quality care delivery. These actions focus on an organisational strategy for high-quality care, with the chief executive officer held accountable for successful implementation, which is actively guided and monitored by the board.

Status of pesticide management in the practice of vector control: a global survey in countries at risk of malaria or other major vector-borne diseases.

PubMed

van den Berg, Henk; Hii, Jeffrey; Soares, Agnes; Mnzava, Abraham; Ameneshewa, Birkinesh; Dash, Aditya P; Ejov, Mikhail; Tan, Soo Hian; Matthews, Graham; Yadav, Rajpal S; Zaim, Morteza

2011-05-14

It is critical that vector control pesticides are used for their acceptable purpose without causing adverse effects on health and the environment. This paper provides a global overview of the current status of pesticides management in the practice of vector control. A questionnaire was distributed to WHO member states and completed either by the director of the vector-borne disease control programme or by the national manager for vector control. In all, 113 countries responded to the questionnaire (80% response rate), representing 94% of the total population of the countries targeted. Major gaps were evident in countries in pesticide procurement practices, training on vector control decision making, certification and quality control of pesticide application, monitoring of worker safety, public awareness programmes, and safe disposal of pesticide-related waste. Nevertheless, basic conditions of policy and coordination have been established in many countries through which the management of vector control pesticides could potentially be improved. Most countries responded that they have adopted relevant recommendations by the WHO. Given the deficiencies identified in this first global survey on public health pesticide management and the recent rise in pesticide use for malaria control, the effectiveness and safety of pesticide use are being compromised. This highlights the urgent need for countries to strengthen their capacity on pesticide management and evidence-based decision making within the context of an integrated vector management approach.

Status of pesticide management in the practice of vector control: a global survey in countries at risk of malaria or other major vector-borne diseases

PubMed Central

2011-01-01

Background It is critical that vector control pesticides are used for their acceptable purpose without causing adverse effects on health and the environment. This paper provides a global overview of the current status of pesticides management in the practice of vector control. Methods A questionnaire was distributed to WHO member states and completed either by the director of the vector-borne disease control programme or by the national manager for vector control. In all, 113 countries responded to the questionnaire (80% response rate), representing 94% of the total population of the countries targeted. Results Major gaps were evident in countries in pesticide procurement practices, training on vector control decision making, certification and quality control of pesticide application, monitoring of worker safety, public awareness programmes, and safe disposal of pesticide-related waste. Nevertheless, basic conditions of policy and coordination have been established in many countries through which the management of vector control pesticides could potentially be improved. Most countries responded that they have adopted relevant recommendations by the WHO. Conclusions Given the deficiencies identified in this first global survey on public health pesticide management and the recent rise in pesticide use for malaria control, the effectiveness and safety of pesticide use are being compromised. This highlights the urgent need for countries to strengthen their capacity on pesticide management and evidence-based decision making within the context of an integrated vector management approach. PMID:21569601

Doxylamine succinate-pyridoxine hydrochloride (Diclegis) for the management of nausea and vomiting in pregnancy: an overview.

PubMed

Nuangchamnong, Nina; Niebyl, Jennifer

2014-01-01

Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP. This review addresses the historical context, safety, efficacy, pharmacology, and practical role of doxylamine and pyridoxine for the management of NVP. The reintroduction of this doxylamine-pyridoxine combination pill into the American market fills a therapeutic gap in the management of NVP left by the removal of the same active drugs marketed over 30 years ago in the form of Bendectin. The substantial amount of safety data accumulated over the years makes it one of the few drugs that qualify for FDA Pregnancy Category A status. In the hierarchical approach to pharmacological treatment of NVP, the combination of doxylamine and pyridoxine should thus be first-tier.

Doxylamine succinate–pyridoxine hydrochloride (Diclegis) for the management of nausea and vomiting in pregnancy: an overview

PubMed Central

Nuangchamnong, Nina; Niebyl, Jennifer

2014-01-01

Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP. This review addresses the historical context, safety, efficacy, pharmacology, and practical role of doxylamine and pyridoxine for the management of NVP. The reintroduction of this doxylamine–pyridoxine combination pill into the American market fills a therapeutic gap in the management of NVP left by the removal of the same active drugs marketed over 30 years ago in the form of Bendectin. The substantial amount of safety data accumulated over the years makes it one of the few drugs that qualify for FDA Pregnancy Category A status. In the hierarchical approach to pharmacological treatment of NVP, the combination of doxylamine and pyridoxine should thus be first-tier. PMID:24748822

Problem Reporting Taxonomy and Data Preparation Tool Evaluation

NASA Technical Reports Server (NTRS)

Beil, Robert J.

2010-01-01

A member of the NASA Engineering and Safety Center (NESC) Systems Engineering Office (SEO) Technical Discipline Team (TDT) requested a SEO-managed activity to perform a gap analysis on the proposed NASA Standard 0006, "Common NASA Taxonomy for Problem Reporting, Analysis, and Resolution", and to create an input filter and set of instructions for using the data-mining/data-cleansing tool TechOasis1 with Space Shuttle Program (SSP) problem reporting data. The work that achieved these objectives and deployment of TechOasis are discussed in this report.

Food Safety Practices Linked with Proper Refrigerator Temperatures in Retail Delis.

PubMed

Brown, Laura G; Hoover, Edward Rickamer; Faw, Brenda V; Hedeen, Nicole K; Nicholas, David; Wong, Melissa R; Shepherd, Craig; Gallagher, Daniel L; Kause, Janell R

2018-05-01

Listeria monocytogenes (L. monocytogenes) causes the third highest number of foodborne illness deaths annually. L. monocytogenes contamination of sliced deli meats at the retail level is a significant contributing factor to L. monocytogenes illness. The Centers for Disease Control and Prevention's Environmental Health Specialists Network (EHS-Net) conducted a study to learn more about retail delis' practices concerning L. monocytogenes growth and cross-contamination prevention. This article presents data from this study on the frequency with which retail deli refrigerator temperatures exceed 41°F, the Food and Drug Administration (FDA)-recommended maximum temperature for ready-to-eat food requiring time and temperature control for safety (TCS) (such as retail deli meat). This provision was designed to control bacterial growth in TCS foods. This article also presents data on deli and staff characteristics related to the frequency with which retail delis refrigerator temperatures exceed 41°F. Data from observations of 445 refrigerators in 245 delis showed that in 17.1% of delis, at least one refrigerator was >41°F. We also found that refrigeration temperatures reported in this study were lower than those reported in a related 2007 study. Delis with more than one refrigerator, that lacked refrigerator temperature recording, and had a manager who had never been food safety certified had greater odds of having a refrigerator temperature >41°F. The data from this study suggest that retail temperature control is improving over time. They also identify a food safety gap: some delis have refrigerator temperatures that exceed 41°F. We also found that two food safety interventions were related to better refrigerated storage practices: kitchen manager certification and recording refrigerated storage temperatures. Regulatory food safety programs and the retail industry may wish to consider encouraging or requiring kitchen manager certification and recording refrigerated storage temperatures.

Training gaps for pediatric residents planning a career in primary care: a qualitative and quantitative study.

PubMed

Rosenberg, Adam A; Kamin, Carol; Glicken, Anita Duhl; Jones, M Douglas

2011-09-01

Resident training in pediatrics currently entails similar training for all residents in a fragmented curriculum with relatively little attention to the career plans of individual residents. To explore strengths and gaps in training for residents planning a career in primary care pediatrics and to present strategies for addressing the gaps. Surveys were sent to all graduates of the University of Colorado Denver Pediatric Residency Program (2003-2006) 3 years after completion of training. Respondents were asked to evaluate aspects of their training, using a 5-point Likert scale and evaluating each item ranging from "not at all well prepared" to "extremely well prepared" for their future career. In addition, focus groups were conducted with practitioners in 8 pediatric practices in Colorado. Sessions were transcribed and hand coded by 2 independent coders. Survey data identified training in behavior and development (mean score, 3.72), quality improvement and patient safety strategies (mean, 3.57), and practice management (mean, 2.46) as the weakest aspects of training. Focus groups identified deficiencies in training in mental health, practice management, behavioral medicine, and orthopedics. Deficiencies noted in curriculum structure were lack of residents' long-term continuity of relationships with patients; the need for additional training in knowledge, skills, and attitudes needed for primary care (perhaps even a fourth year of training); and a training structure that facilitates greater resident autonomy to foster development of clinical capability and self-confidence. Important gaps were identified in the primary care training of pediatric residents. These data support the need to develop more career-focused training.

Child Pedestrians' Judgments of Safe Crossing Gaps at Three Different Vehicle Approach Speeds: A Preliminary Study.

ERIC Educational Resources Information Center

Connelly, Marie L.; And Others

1996-01-01

Judgments made by four children between seven and nine years of age regarding the safety of crossing a road in front of an approaching vehicle were studied. All participants consistently allowed smaller safety gaps as vehicle speeds increased, and three children often made potentially dangerous decisions at high vehicle speeds. (Author/PB)

The visualisation of clinical leadership in the content of nursing education--a qualitative study of nursing students' experiences.

PubMed

Démeh, Waddah; Rosengren, Kristina

2015-07-01

The aim of this study was to describe nursing students' experiences of clinical leadership during their last year of education. Work as a nurse is complex with several demands from stakeholders who are colleagues, managers, patients and relatives. Therefore, it is important to provide students with tools for a forthcoming professional life as a nurse. A qualitative descriptive study was carried out in Jordan. Narratives (n=20) written by nursing students in their last year before graduation as a registered nurse were collected. The data were analysed by a manifest content analysis. The results formed one category: (Clinical leadership-safety in being a nurse), and three subcategories (eye-opener, a role model and bridging the gap) described the students' clinical leadership experiences due to the preparation process for being a nurse. Clinical leadership applies theory to practice by using a holistic view in nursing. Clinical leadership is a valuable tool for bridging the gap between theory and practice in nursing education. Skills within nursing management clarify and simplify nursing activities, which facilitates the transition from student to nurse. Focus on learning needs in nursing management is needed for stakeholders within education and health care organisations to facilitate graduation of well skilled nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.

New Space Weather Systems Under Development and Their Contribution to Space Weather Management

NASA Astrophysics Data System (ADS)

Tobiska, W.; Bouwer, D.; Schunk, R.; Garrett, H.; Mertens, C.; Bowman, B.

2008-12-01

There have been notable successes during the past decade in the development of operational space environment systems. Examples include the Magnetospheric Specification Model (MSM) of the Earth's magnetosphere, 2000; SOLAR2000 (S2K) solar spectral irradiances, 2001; High Accuracy Satellite Drag Model (HASDM) neutral atmosphere densities, 2004; Global Assimilation of Ionospheric Measurements (GAIM) ionosphere specification, 2006; Hakamada-Akasofu-Fry (HAF) solar wind parameters, 2007; Communication Alert and Prediction System (CAPS) ionosphere, high frequency radio, and scintillation S4 index prediction, 2008; and GEO Alert and Prediction System (GAPS) geosynchronous environment satellite charging specification and forecast, 2008. Operational systems that are in active operational implementation include the Jacchia-Bowman 2006/2008 (JB2006/2008) neutral atmosphere, 2009, and the Nowcast of Atmospheric Ionizing Radiation for Aviation Safety (NAIRAS) aviation radiation model using the Radiation Alert and Prediction System (RAPS), 2010. U.S. national agency and commercial assets will soon reach a state where specification and prediction will become ubiquitous and where coordinated management of the space environment and space weather will become a necessity. We describe the status of the CAPS, GAPS, RAPS, and JB2008 operational development. We additionally discuss the conditions that are laying the groundwork for space weather management and estimate the unfilled needs as we move beyond specification and prediction efforts.

There is more to risk and safety planning than dramatic risks: Mental health nurses' risk assessment and safety-management practice.

PubMed

Higgins, Agnes; Doyle, Louise; Downes, Carmel; Morrissey, Jean; Costello, Paul; Brennan, Michael; Nash, Michael

2016-04-01

Risk assessment and safety planning are considered a cornerstone of mental health practice, yet limited research exists into how mental health nurses conceptualize 'risk' and how they engage with risk assessment and safety planning. The aim of the present study was to explore mental health nurses' practices and confidence in risk assessment and safety planning. A self-completed survey was administered to 381 mental health nurses in Ireland. The findings indicate that nurses focus on risk to self and risk to others, with the risk of suicide, self-harm, substance abuse, and violence being most frequently assessed. Risk from others and 'iatrogenic' risk were less frequently considered. Overall, there was limited evidence of recovery-oriented practice in relation to risk. The results demonstrate a lack of meaningful engagement with respect to collaborative safety planning, the identification and inclusion of protective factors, and the inclusion of positive risk-taking opportunities. In addition, respondents report a lack of confidence working with positive risk taking and involving family/carers in the risk-assessment and safety-planning process. Gaps in knowledge about risk-assessment and safety-planning practice, which could be addressed through education, are identified, as are the implications of the findings for practice and research. © 2015 Australian College of Mental Health Nurses Inc.

The effect of structural empowerment of nurses on quality outcomes in hospitals: a scoping review.

PubMed

Goedhart, Nicole S; van Oostveen, Catharina J; Vermeulen, Hester

2017-04-01

To assess and synthesise studies reporting direct associations between the structural empowerment of frontline nurses and quality outcomes, and to identify gaps in the current literature. The empowerment of nurses seems essential for delivering high-quality patient care. Understanding the relationship between empowerment and quality outcomes would enable nurse managers to make informed choices on improving the quality of care. A scoping review examining the relationship between the structural empowerment of nurses and the quality, effectiveness, safety, efficiency and patient-centredness of care in hospitals. Searching in MEDLINE, CINAHL, Business Source Premier and Embase identified 672 potentially relevant articles. Independent selection, quality assessment, data extraction and analysis were completed. Twelve cross-sectional studies originating from North America were included. These studies showed a variety of quality outcomes and statistics used. All studies reported positive associations between the structural empowerment of nurses, nurse assessed quality of care and patient safety climate, and work and unit effectiveness. Nurses having access to empowering structures positively affects the quality outcomes, i.e. quality, effectiveness, safety, efficiency and patient-centredness of patient care in hospitals. Nurse managers and leaders should ensure empowering work conditions for nurses in order to increase hospitals' quality of patient care. © 2017 John Wiley & Sons Ltd.

Closing the gap between research and management

Treesearch

Deborah M. Finch; Marcia Patton-Mallory

1993-01-01

In this paper, we evaluate the reasons for gaps in communication between researchers and natural resource managers and identify methods to close these gaps. Gaps originate from differing patterns of language use, disparities in organizational culture and values, generation of knowledge that is too narrowly-focused to solve complex problems, failure by managers to relay...

Leading clinical handover improvement: a change strategy to implement best practices in the acute care setting.

PubMed

Clarke, Christina M; Persaud, Drepaul David

2011-03-01

Many contemporary acute care facilities lack safe and effective clinical handover practices resulting in patient transitions that are vulnerable to discontinuities in care, medical errors, and adverse patient safety events. This article is intended to supplement existing handover improvement literature by providing practical guidance for leaders and managers who are seeking to improve the safety and the effectiveness of clinical handovers in the acute care setting. A 4-stage change model has been applied to guide the application of strategies for handover improvement. Change management and quality improvement principles, as well as concepts drawn from safety science and high-reliability organizations, were applied to inform strategies. A model for handover improvement respecting handover complexity is presented. Strategies targeted to stages of change include the following: 1. Enhancing awareness of handover problems and opportunities with the support of strategic directions, accountability, end user involvement, and problem complexity recognition. 2. Identifying solutions by applying and adapting best practices in local contexts. 3. Implementing locally adapted best practices supported by communication, documentation, and training. 4. Institutionalizing practice changes through integration, monitoring, and active dissemination. Finally, continued evaluation at every stage is essential. Although gaps in handover process and function knowledge remain, efforts to improve handover safety and effectiveness are still possible. Continued evaluation is critical in building this understanding and to ensure that practice changes lead to improvements in patient safety, organizational effectiveness, and patient and provider satisfaction. Through handover knowledge building, fundamental changes in handover policies and practices may be possible.

Reach and Validity of An Objective Medication Adherence Measure among Safety Net Health Plan Members with Diabetes: A Cross-Sectional Study

PubMed Central

Ratanawongsa, Neda; Karter, Andrew J.; Quan, Judy; Parker, Melissa M.; Handley, Margaret; Sarkar, Urmimala; Schmittdiel, Julie A.; Schillinger, Dean

2015-01-01

Background With the expansion of Medicaid and low-cost health insurance plans among diverse patient populations, objective measures of medication adherence using pharmacy claims could advance clinical care and translational research for safety net care. However, safety net patients may experience fluctuating prescription drug coverage, affecting the performance of adherence measures. Objective To evaluate the performance of continuous medication gap (CMG) for diverse, low-income managed care members with diabetes. Methods We conducted this cross-sectional analysis using administrative and clinical data for 680 members eligible for a self-management support trial at a non-profit, government-sponsored managed care plan. We applied CMG methodology to cardiometabolic medication claims for English-, Cantonese-, or Spanish-speaking members with diabetes. We examined inclusiveness (the proportion with calculable CMG) and selectivity (sociodemographic and medical differences from members without CMG). To examine validity, we examined unadjusted associations of suboptimal adherence (CMG>20%) with suboptimal cardiometabolic control. Results 429 members (63%) had calculable CMG. Compared to members without CMG, members with CMG were younger; more likely employed; and had poorer glycemic control, but better blood pressure and lipid control. Suboptimal adherence occurred more frequently among members with poor cardiometabolic control than among members with optimal control (28% vs. 12%, p=0.02). Conclusions CMG demonstrated acceptable inclusiveness and validity in a diverse, low-income safety net population, comparable to its performance in studies among other insured populations. CMG may provide a useful tool to measure adherence among increasingly diverse Medicaid populations, complemented by other strategies to reach those not captured by CMG. Trial Registration NCT00683020 PMID:26233541

Virtual reality simulation for construction safety promotion.

PubMed

Zhao, Dong; Lucas, Jason

2015-01-01

Safety is a critical issue for the construction industry. Literature argues that human error contributes to more than half of occupational incidents and could be directly impacted by effective training programs. This paper reviews the current safety training status in the US construction industry. Results from the review evidence the gap between the status and industry expectation on safety. To narrow this gap, this paper demonstrates the development and utilisation of a training program that is based on virtual reality (VR) simulation. The VR-based safety training program can offer a safe working environment where users can effectively rehearse tasks with electrical hazards and ultimately promote their abilities for electrical hazard cognition and intervention. Its visualisation and simulation can also remove the training barriers caused by electricity's features of invisibility and dangerousness.

The Quadriga Effect Revisited: Designing a “Safety Incision” to Prevent Tendon Repair Rupture and Gap Formation in a Canine Model In Vitro

PubMed Central

Giambini, Hugo; Ikeda, Jun; Amadio, Peter C.; An, Kai-Nan; Zhao, Chunfeng

2012-01-01

Loss of experimental animals due to tendon repair failure results in the need for additional animals to complete the study. We designed a relief proximal to the flexor digitorum profundus (FDP) tendon repair site to serve as a “safety incision” to prevent repair site ruptures and maximize safety incision-to-suture strength. The FDP tendons were dissected in 24 canine forepaws. The 2nd and 5th tendons were lacerated at the proximal interphalangeal joint level and sutured using a modified Kessler technique and peripheral running suture. Tendon width was measured where the FDP tendon separates into each individual digit and a safety incision, equal to the 2nd and 5th tendon widths, was performed 3, 4, or 5 mm (Groups 1, 2, and 3) proximal to the separation. The tendons were pulled at a rate of 1 mm/s until either the “safety incision” ruptured or the repair failed. There was no gap formation at the repair site in Groups 1 and 2. However, all Group 3 tendons failed by repair site rupture with the safety incision intact. An adequate safety incision to protect repair gap and rupture and maintain tendon tension for the FDP animal model should be about 4 mm from where the FDP tendon separates. PMID:20872585

RH-LLW Disposal Facility Project CD-2/3 to Design/Build Proposal Reconciliation Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Annette L. Schafer

2012-06-01

A reconciliation plan was developed and implemented to address potential gaps and responses to gaps between the design/build vendor proposals and the Critical Decision-2/3 approval request package for the Remote-Handled Low Level Waste Disposal Facility Project. The plan and results of the plan implementation included development of a reconciliation team comprised of subject matter experts from Battelle Energy Alliance and the Department of Energy Idaho Operations Office, identification of reconciliation questions, reconciliation by the team, identification of unresolved/remaining issues, and identification of follow-up actions and subsequent approvals of responses. The plan addressed the potential for gaps to exist in themore » following areas: • Department of Energy Order 435.1, “Radioactive Waste Management,” requirements, including the performance assessment, composite analysis, monitoring plan, performance assessment/composite analysis maintenance plan, and closure plan • Environmental assessment supporting the National Environmental Policy Act • Nuclear safety • Safeguards and security • Emplacement operations • Requirements for commissioning • General project implementation. The reconciliation plan and results of the plan implementation are provided in a business-sensitive project file. This report provides the reconciliation plan and non-business sensitive summary responses to identified gaps.« less

Risk assessment principle for engineered nanotechnology in food and drug.

PubMed

Hwang, Myungsil; Lee, Eun Ji; Kweon, Se Young; Park, Mi Sun; Jeong, Ji Yoon; Um, Jun Ho; Kim, Sun Ah; Han, Bum Suk; Lee, Kwang Ho; Yoon, Hae Jung

2012-06-01

While the ability to develop nanomaterials and incorporate them into products is advancing rapidly worldwide, understanding of the potential health safety effects of nanomaterials has proceeded at a much slower pace. Since 2008, Korea Food and Drug Administration (KFDA) started an investigation to prepare "Strategic Action Plan" to evaluate safety and nano risk management associated with foods, drugs, medical devices and cosmetics using nano-scale materials. Although there are some studies related to potential risk of nanomaterials, physical-chemical characterization of nanomaterials is not clear yet and these do not offer enough information due to their limitations. Their uncertainties make it impossible to determine whether nanomaterials are actually hazardous to human. According to the above mention, we have some problems to conduct the human exposure risk assessment currently. On the other hand, uncertainty about safety may lead to polarized public debate and to businesses unwillingness for further nanotechnology investigation. Therefore, the criteria and methods to assess possible adverse effects of nanomaterials have been vigorously taken into consideration by many international organizations: the World Health Organization, the Organization for Economic and Commercial Development and the European Commission. The object of this study was to develop risk assessment principles for safety management of future nanoproducts and also to identify areas of research to strengthen risk assessment for nanomaterials. The research roadmaps which were proposed in this study will be helpful to fill up the current gaps in knowledge relevant nano risk assessment.

Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety

PubMed Central

Vincent, Charles; Burnett, Susan; Carthey, Jane

2014-01-01

Patients, clinicians and managers all want to be reassured that their healthcare organisation is safe. But there is no consensus about what we mean when we ask whether a healthcare organisation is safe or how this is achieved. In the UK, the measurement of harm, so important in the evolution of patient safety, has been neglected in favour of incident reporting. The use of softer intelligence for monitoring and anticipation of problems receives little mention in official policy. The Francis Inquiry report into patient treatment at the Mid Staffordshire NHS Foundation Trust set out 29 recommendations on measurement, more than on any other topic, and set the measurement of safety an absolute priority for healthcare organisations. The Berwick review found that most healthcare organisations at present have very little capacity to analyse, monitor or learn from safety and quality information. This paper summarises the findings of a more extensive report and proposes a framework which can guide clinical teams and healthcare organisations in the measurement and monitoring of safety and in reviewing progress against safety objectives. The framework has been used so far to promote self-reflection at both board and clinical team level, to stimulate an organisational check or analysis in the gaps of information and to promote discussion of ‘what could we do differently’. PMID:24764136

Overview of NRC Proactive Management of Materials Degradation (PMMD) Program

NASA Astrophysics Data System (ADS)

Carpenter, C. E. Gene; Hull, Amy; Oberson, Greg

Materials degradation phenomena, if not appropriately managed, have the potential to adversely impact the design functionality and safety margins of nuclear power plant (NPP) systems, structures and components (SSCs). Therefore, the U.S. Nuclear Regulatory Commission (NRC) has initiated an over-the-horizon multi-year research Proactive Management of Materials Degradation (PMMD) Research Program, which is presently evaluating longer time frames (i.e., 80 or more years) and including passive long-lived SSCs beyond the primary piping and core internals, such as concrete containment and cable insulation. This will allow the NRC to (1) identify significant knowledge gaps and new forms of degradation; (2) capture current knowledge base; and, (3) prioritize materials degradation research needs and directions for future efforts. This effort is being accomplished in collaboration with the U.S. Department of Energy's (DOE) LWR Sustainability (LWRS) program. This presentation will discuss the activities to date, including results, and the path forward.

Developing GAP Training for Growers: Perspectives from Pennsylvania Supermarkets

ERIC Educational Resources Information Center

Tobin, Daniel; Thomson, Joan; LaBorde, Luke; Bagdonis, Jessica

2011-01-01

Major supermarket chains increasingly are requiring their produce suppliers to provide evidence of compliance with on-farm food safety standards, known as Good Agricultural Practices (GAPs). To develop a relevant GAP training curriculum that meets the needs of Pennsylvania growers, supermarkets that operate in the state were surveyed to determine…

Implementation of GIS-based highway safety analyses : bridging the gap

DOT National Transportation Integrated Search

2001-01-01

In recent years, efforts have been made to expand the analytical features of the Highway Safety Information System (HSIS) by integrating Geographic Information System (GIS) capabilities. The original version of the GIS Safety Analysis Tools was relea...

Functional Gap Analysis of the Maritime Operations Centers

DTIC Science & Technology

2009-12-01

Messaging Services TBMCS , DJC2 MI.1.3.5 Manage Suspense Control Capability Gap MI.1.3.6 Provide Component IM Cell Services Capability Gap MI.1.4 Provide...Admin Support MSRT MI.1.3.3 Manage Electronic File Plan Capability Gap MI.1.3.4 Manage Messaging Services TBMCS , DJC2 MI.1.3.5 Manage Suspense...1.5.9 Execute C4 Policies & Procedures for the Joint Operations Area GCCS-J, DCGS-N, TBMCS , CENTRIX-M EHQ.1.11 Sub Component Interagency

Power System Concepts for the Lunar Outpost: A Review of the Power Generation, Energy Storage, Power Management and Distribution (PMAD) System Requirements and Potential Technologies for Development of the Lunar Outpost

NASA Technical Reports Server (NTRS)

Khan, Z.; Vranis, A.; Zavoico, A.; Freid, S.; Manners, B.

2006-01-01

This paper will review potential power system concepts for the development of the lunar outpost including power generation, energy storage, and power management and distribution (PMAD). In particular, the requirements of the initial robotic missions will be discussed and the technologies considered will include cryogenics and regenerative fuel cells (RFC), AC and DC transmission line technology, high voltage and low voltage power transmission, conductor materials of construction and power beaming concepts for transmitting power to difficult to access locations such as at the bottom of craters. Operating conditions, component characteristics, reliability, maintainability, constructability, system safety, technology gaps/risk and adaptability for future lunar missions will be discussed for the technologies considered.

Taipower`s radioactive waste management program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, B.C.C.

1996-09-01

Nuclear safety and radioactive waste management are the two major concerns of nuclear power in Taiwan. Recognizing that it is an issue imbued with political and social-economic concerns, Taipower has established an integrated nuclear backend management system and its associated financial and mechanism. For LLW, the Orchid Island storage facility will play an important role in bridging the gap between on-site storage and final disposal of LLW. Also, on-site interim storage of spent fuel for 40 years or longer will provide Taipower with ample time and flexibility to adopt the suitable alternative of direct disposal or reprocessing. In other words,more » by so exercising interim storage option, Taipower will be in a comfortable position to safely and permanently dispose of radwaste without unduly forgoing the opportunities of adopting better technologies or alternatives. Furthermore, Taipower will spare no efforts to communicate with the general public and make her nuclear backend management activities accountable to them.« less

Emotional exhaustion and workload predict clinician-rated and objective patient safety

PubMed Central

Welp, Annalena; Meier, Laurenz L.; Manser, Tanja

2015-01-01

Aims: To investigate the role of clinician burnout, demographic, and organizational characteristics in predicting subjective and objective indicators of patient safety. Background: Maintaining clinician health and ensuring safe patient care are important goals for hospitals. While these goals are not independent from each other, the interplay between clinician psychological health, demographic and organizational variables, and objective patient safety indicators is poorly understood. The present study addresses this gap. Method: Participants were 1425 physicians and nurses working in intensive care. Regression analysis (multilevel) was used to investigate the effect of burnout as an indicator of psychological health, demographic (e.g., professional role and experience) and organizational (e.g., workload, predictability) characteristics on standardized mortality ratios, length of stay and clinician-rated patient safety. Results: Clinician-rated patient safety was associated with burnout, trainee status, and professional role. Mortality was predicted by emotional exhaustion. Length of stay was predicted by workload. Contrary to our expectations, burnout did not predict length of stay, and workload and predictability did not predict standardized mortality ratios. Conclusion: At least in the short-term, clinicians seem to be able to maintain safety despite high workload and low predictability. Nevertheless, burnout poses a safety risk. Subjectively, burnt-out clinicians rated safety lower, and objectively, units with high emotional exhaustion had higher standardized mortality ratios. In summary, our results indicate that clinician psychological health and patient safety could be managed simultaneously. Further research needs to establish causal relationships between these variables and support to the development of managerial guidelines to ensure clinicians’ psychological health and patients’ safety. PMID:25657627

Mind the Gap. A systematic review to identify usability and safety challenges and practices during electronic health record implementation.

PubMed

Ratwani, Raj; Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-11-16

Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders' perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders' perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical workflow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation.

Semiquantitative analysis of gaps in microbiological performance of fish processing sector implementing current food safety management systems: a case study.

PubMed

Onjong, Hillary Adawo; Wangoh, John; Njage, Patrick Murigu Kamau

2014-08-01

Fish processing plants still face microbial food safety-related product rejections and the associated economic losses, although they implement legislation, with well-established quality assurance guidelines and standards. We assessed the microbial performance of core control and assurance activities of fish exporting processors to offer suggestions for improvement using a case study. A microbiological assessment scheme was used to systematically analyze microbial counts in six selected critical sampling locations (CSLs). Nine small-, medium- and large-sized companies implementing current food safety management systems (FSMS) were studied. Samples were collected three times on each occasion (n = 324). Microbial indicators representing food safety, plant and personnel hygiene, and overall microbiological performance were analyzed. Microbiological distribution and safety profile levels for the CSLs were calculated. Performance of core control and assurance activities of the FSMS was also diagnosed using an FSMS diagnostic instrument. Final fish products from 67% of the companies were within the legally accepted microbiological limits. Salmonella was absent in all CSLs. Hands or gloves of workers from the majority of companies were highly contaminated with Staphylococcus aureus at levels above the recommended limits. Large-sized companies performed better in Enterobacteriaceae, Escherichia coli, and S. aureus than medium- and small-sized ones in a majority of the CSLs, including receipt of raw fish material, heading and gutting, and the condition of the fish processing tables and facilities before cleaning and sanitation. Fish products of 33% (3 of 9) of the companies and handling surfaces of 22% (2 of 9) of the companies showed high variability in Enterobacteriaceae counts. High variability in total viable counts and Enterobacteriaceae was noted on fish products and handling surfaces. Specific recommendations were made in core control and assurance activities associated with sampling locations showing poor performance.

Transcranial magnetic stimulation for the treatment of major depression

PubMed Central

Janicak, Philip G; Dokucu, Mehmet E

2015-01-01

Major depression is often difficult to diagnose accurately. Even when the diagnosis is properly made, standard treatment approaches (eg, psychotherapy, medications, or their combination) are often inadequate to control acute symptoms or maintain initial benefit. Additional obstacles involve safety and tolerability problems, which frequently preclude an adequate course of treatment. This leaves an important gap in our ability to properly manage major depression in a substantial proportion of patients, leaving them vulnerable to ensuing complications (eg, employment-related disability, increased risk of suicide, comorbid medical disorders, and substance abuse). Thus, there is a need for more effective and better tolerated approaches. Transcranial magnetic stimulation is a neuromodulation technique increasingly used to partly fill this therapeutic void. In the context of treating depression, we critically review the development of transcranial magnetic stimulation, focusing on the results of controlled and pragmatic trials for depression, which consider its efficacy, safety, and tolerability. PMID:26170668

Assessment of perceived injury risks and priorities among truck drivers and trucking companies in Washington State.

PubMed

Spielholz, Peregrin; Cullen, Jennifer; Smith, Caroline; Howard, Ninica; Silverstein, Barbara; Bonauto, David

2008-01-01

The trucking industry experiences one of the highest work-related injury rates. Little work has been conducted previously in the United States to assess the hazards, needs, and injury prevention priorities in trucking. Two separate industry-wide surveys of 359 trucking companies and 397 commercial truck drivers were conducted in Washington State. Trucking companies and drivers both ranked musculoskeletal and slip, trip, fall injuries as the top two priorities. Controlling heavy lifting, using appropriate equipment, and addressing slippery surfaces were frequently listed as solutions. There appears to be a gap in safety climate perception between workers and employers. However, driver and company priorities agreed with industry workers' compensation claims. There is room for safety program management improvement in the industry. The study findings detail opportunities for prioritizing and reducing injuries. This information can be used to focus and design interventions for the prevention of work-related injuries while improving industry competitiveness.

Application research of rail transit safety protection based on laser detection

NASA Astrophysics Data System (ADS)

Wang, Zhifei

2016-10-01

Platform screen door can not only prevent the passengers fell or jumped the track danger, to passengers bring comfortable waiting environment, but also has the function of environmental protection and energy saving. But platform screen door and train the full-length gap region is insecure in the system design of a hidden, such as passengers for some reason (grab the train) in the interstitial region retention, is sandwiched between the intercity safety door and the door, and such as the region lacks security detection and alarm system, once the passengers in the gap region retention (caught), bring more serious threat to the safety of passengers and traffic safety. This paper from the point of view of the design presents the physical, infrared, laser three safety protection device setting schemes. Domestic intelligence of between rail transit shield door and train security clearance processing used is screen door system standard configuration, the obstacle detection function for avoid passengers stranded in the clearance has strong prevention function. Laser detection research and development projects can access to prevent shield door and train gap clamp safety measures. Rail safety protection method are studied applying laser detection technique. According to the laser reflection equation of foreign body, the characteristics of laser detection of foreign bodies are given in theory. By using statistical analysis method, the workflow of laser detection system is established. On this basis, protection methods is proposed. Finally the simulation and test results show that the laser detection technology in the rail traffic safety protection reliability and stability, And the future laser detection technology in is discussed the development of rail transit.

Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future.

PubMed

Rossignol, Patrick; Legrand, Matthieu; Kosiborod, Mikhail; Hollenberg, Steven M; Peacock, W Frank; Emmett, Michael; Epstein, Murray; Kovesdy, Csaba P; Yilmaz, Mehmet Birhan; Stough, Wendy Gattis; Gayat, Etienne; Pitt, Bertram; Zannad, Faiez; Mebazaa, Alexandre

2016-11-01

Hyperkalemia is a common electrolyte disorder, especially in chronic kidney disease, diabetes mellitus, or heart failure. Hyperkalemia can lead to potentially fatal cardiac dysrhythmias, and it is associated with increased mortality. Determining whether emergency therapy is warranted is largely based on subjective clinical judgment. The Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT) aimed to evaluate the current knowledge pertaining to the emergency treatment of hyperkalemia. The INI-CRCT developed a treatment algorithm reflecting expert opinion of best practices in the context of current evidence, identified gaps in knowledge, and set priorities for future research. We searched PubMed (to August 4, 2015) for consensus guidelines, reviews, randomized clinical trials, and observational studies, limited to English language but not by publication date. Treatment approaches are based on small studies, anecdotal experience, and traditional practice patterns. The safety and real-world effectiveness of standard therapies remain unproven. Prospective research is needed and should include studies to better characterize the population, define the serum potassium thresholds where life-threatening arrhythmias are imminent, assess the potassium and electrocardiogram response to standard interventions. Randomized, controlled trials are needed to test the safety and efficacy of new potassium binders for the emergency treatment of severe hyperkalemia in hemodynamically stable patients. Existing emergency treatments for severe hyperkalemia are not supported by a compelling body of evidence, and they are used inconsistently across institutions, with potentially significant associated side effects. Further research is needed to fill knowledge gaps, and definitive clinical trials are needed to better define optimal management strategies, and ultimately to improve outcomes in these patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

Dust control products at Hagerman National Wildlife Refuge, Texas: environmental safety and performance

USGS Publications Warehouse

Kunz, Bethany K.; Little, Edward E.

2015-01-01

Controlling fugitive dust while protecting natural resources is a challenge faced by all managers of unpaved roads. Unfortunately, road managers choosing between dust control products often have little objective environmental information to aid their decisions. To address this information gap, the U.S. Geological Survey and the U.S. Fish and Wildlife Service collaborated on a field test of three dust control products with the objectives of (a) evaluating product performance under real-world conditions, (b) verifying the environmental safety of products identified as practically nontoxic in laboratory tests, and (c) testing the feasibility of several environmental monitoring techniques for use in dust control tests. In cooperation with refuge staff and product vendors, three products (one magnesium chloride plus binder, one cellulose, and one synthetic fluid plus binder) were applied in July 2012 to replicated road sections at the Hagerman National Wildlife Refuge in Texas. These sections were monitored periodically for 12 months after application. Product performance was assessed by mobile-mounted particulate-matter meters measuring production of fugitive dust and by observations of road conditions. Environmental safety was evaluated through on-site biological observations and leaching tests with samples of treated aggregate. All products reduced dust and improved surface condition during those 12 months. Planned environmental measurements were not always compatible with day-to-day refuge management actions; this incompatibility highlighted the need for flexible biological monitoring plans. As one of the first field tests of dust suppressants that explicitly incorporated biological endpoints, this effort provides valuable information for improving field tests and for developing laboratory or semifield alternatives.

Unstoppable The Gap Between Public Safety and Traffic Safety in the Age of Driverless Cars

DTIC Science & Technology

2017-03-01

themselves, what will the increase in traffic safety cost society in terms of public safety? • What can public safety and homeland security...industry. Safer products are more marketable products, and companies that work with law enforcement for the benefit of public safety may have an...secondary public safety benefit of crime suppression. Reasonable suspicion to stop a vehicle would be an infrequent occurrence, and the legal authority

Communication and relationship skills for rapid response teams at hamilton health sciences.

PubMed

Cziraki, Karen; Lucas, Janie; Rogers, Toni; Page, Laura; Zimmerman, Rosanne; Hauer, Lois Ann; Daniels, Charlotte; Gregoroff, Susan

2008-01-01

Rapid response teams (RRT) are an important safety strategy in the prevention of deaths in patients who are progressively failing outside of the intensive care unit. The goal is to intervene before a critical event occurs. Effective teamwork and communication skills are frequently cited as critical success factors in the implementation of these teams. However, there is very little literature that clearly provides an education strategy for the development of these skills. Training in simulation labs offers an opportunity to assess and build on current team skills; however, this approach does not address how to meet the gaps in team communication and relationship skill management. At Hamilton Health Sciences (HHS) a two-day program was developed in collaboration with the RRT Team Leads, Organizational Effectiveness and Patient Safety Leaders. Participants reflected on their conflict management styles and considered how their personality traits may contribute to team function. Communication and relationship theories were reviewed and applied in simulated sessions in the relative safety of off-site team sessions. The overwhelming positive response to this training has been demonstrated in the incredible success of these teams from the perspective of the satisfaction surveys of the care units that call the team, and in the multi-phased team evaluation of their application to practice. These sessions offer a useful approach to the development of the soft skills required for successful RRT implementation.

Engineering graduates' skill sets in the MENA region: a gap analysis of industry expectations and satisfaction

NASA Astrophysics Data System (ADS)

Ramadi, Eric; Ramadi, Serge; Nasr, Karim

2016-01-01

This study explored gaps between industry expectations and perceptions of engineering graduates' skill sets in the Middle East and North Africa (MENA) region. This study measured the importance that managers of engineers placed on 36 skills relevant to engineers. Also measured was managers' satisfaction with engineering graduates' skill sets. Importance and satisfaction were used to calculate skill gaps for each skill. A principal components analysis was then performed, consolidating the 36 skills into 8 categories. The means of importance, satisfaction, and skill gaps were ranked to determine the areas in which graduates needed improvement. Results showed significant gaps between managers' expectations of and satisfaction with all 36 skills. The areas in which managers felt that graduates needed most improvement were communication, time management, and continuous learning. Managers reported that recent engineering graduates exhibited low overall preparedness for employment. These findings may help to inform curricular reform in engineering education.

A radiological chronicle of the presentation and management of a long gap oesophageal atresia.

PubMed

Charlesworth, Paul; Mahomed, Anies

2009-01-01

Long gap oesophageal atresia is a clinically and technically challenging condition to manage. Documentation of the gap between the upper and lower pouches is critical to deciding the timing and feasibility of a primary anastamosis. Integral to this process is the role of radiology. We present a case of long gap oesophageal atresia accompanied by chronological radiography demonstrating its' staged management and highlighting some common complications.

Improving Patient Safety in Public Hospitals: Developing Standard Measures to Track Medical Errors and Process Breakdowns.

PubMed

Ackerman, Sara L; Gourley, Gato; Le, Gem; Williams, Pamela; Yazdany, Jinoos; Sarkar, Urmimala

2018-03-14

The aim of the study was to develop standards for tracking patient safety gaps in ambulatory care in safety net health systems. Leaders from five California safety net health systems were invited to participate in a modified Delphi process sponsored by the Safety Promotion Action Research and Knowledge Network (SPARKNet) and the California Safety Net Institute in 2016. During each of the three Delphi rounds, the feasibility and validity of 13 proposed patient safety measures were discussed and prioritized. Surveys and transcripts from the meetings were analyzed to understand the decision-making process. The Delphi process included eight panelists. Consensus was reached to adopt 9 of 13 proposed measures. All 9 measures were unanimously considered valid, but concern was expressed about the feasibility of implementing several of the measures. Although safety net health systems face high barriers to standardized measurement, our study demonstrates that consensus can be reached on acceptable and feasible methods for tracking patient safety gaps in safety net health systems. If accompanied by the active participation key stakeholder groups, including patients, clinicians, staff, data system professionals, and health system leaders, the consensus measures reported here represent one step toward improving ambulatory patient safety in safety net health systems.

From cradle-to-grave at the nanoscale: gaps in U.S. regulatory oversight along the nanomaterial life cycle.

PubMed

Beaudrie, Christian E H; Kandlikar, Milind; Satterfield, Terre

2013-06-04

Engineered nanomaterials (ENMs) promise great benefits for society, yet our knowledge of potential risks and best practices for regulation are still in their infancy. Toward the end of better practices, this paper analyzes U.S. federal environmental, health, and safety (EHS) regulations using a life cycle framework. It evaluates their adequacy as applied to ENMs to identify gaps through which emerging nanomaterials may escape regulation from initial production to end-of-life. High scientific uncertainty, a lack of EHS and product data, inappropriately designed exemptions and thresholds, and limited agency resources are a challenge to both the applicability and adequacy of current regulations. The result is that some forms of engineered nanomaterials may escape federal oversight and rigorous risk review at one or more stages along their life cycle, with the largest gaps occurring at the postmarket stages, and at points of ENM release to the environment. Oversight can be improved through pending regulatory reforms, increased research and development for the monitoring, control, and analysis of environmental and end-of-life releases, introduction of periodic re-evaluation of ENM risks, and fostering a "bottom-up" stewardship approach to the responsible management of risks from engineered nanomaterials.

Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety.

PubMed

Brand, C; Ibrahim, J; Bain, C; Jones, C; King, B

2007-05-01

Several event studies, including the Australian Safety and Quality in Healthcare Study, emphasize gaps in safety for hospitalized patients. It is now recognized that system-based factors contribute significantly to risk of adverse events and this has led to a shift in focus of patient safety from the autonomous responsibility of medical clinicians to a systems-based approach. The aim of this study was to determine medical practitioner awareness of, level of engagement in and barriers to engagement in a systems approach to patient safety and quality. Information from acute and subacute care medical practitioners at a metropolitan public hospital was collected within an anonymous structured electronic survey, a discussion group and key informant interviews. There were 73 survey respondents (response rate 7.6%). Fifty-one (69.9%) were unaware of the Institute of Medicine report 'To Err is human'. Thirty-six (49.3%) were unaware of the Australian Quality in Healthcare Study and 12 (16.4%) had read the article. There was a positive relation identified between awareness and seniority. There was a low level of participation in systems-focused quality and safety activities and limited understanding of the role of systems in medical error causation. There was uncertainty about the changing role of medical practitioners in patient safety and perceived lack of skills to effectively engage with hospital management about safety and quality issues. Several factors are limiting engagement of medical practitioners in a systems approach to patient safety. Increased educational support is needed and may be best focused within clinical effectiveness activities pertinent to practitioner interest and expertise.

Assessment of sidewalk/bicycle-lane gaps with safety and developing statewide pedestrian crash rates.

DOT National Transportation Integrated Search

2016-05-31

Pedestrian and bicycle safety have emerged to be of major concern to federal and selected states in the U.S. With the : increased emphasis on the multimodal transportation, pedestrian and bicycle safety has become more common for : governmental agenc...

BWR Spent Nuclear Fuel Integrity Research and Development Survey for UKABWR Spent Fuel Interim Storage

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bevard, Bruce Balkcom; Mertyurek, Ugur; Belles, Randy

The objective of this report is to identify issues and support documentation and identify and detail existing research on spent fuel dry storage; provide information to support potential R&D for the UKABWR (United Kingdom Advanced Boiling Water Reactor) Spent Fuel Interim Storage (SFIS) Pre-Construction Safety Report; and support development of answers to questions developed by the regulator. Where there are gaps or insufficient data, Oak Ridge National Laboratory (ORNL) has summarized the research planned to provide the necessary data along with the schedule for the research, if known. Spent nuclear fuel (SNF) from nuclear power plants has historically been storedmore » on site (wet) in spent fuel pools pending ultimate disposition. Nuclear power users (countries, utilities, vendors) are developing a suite of options and set of supporting analyses that will enable future informed choices about how best to manage these materials. As part of that effort, they are beginning to lay the groundwork for implementing longer-term interim storage of the SNF and the Greater Than Class C (CTCC) waste (dry). Deploying dry storage will require a number of technical issues to be addressed. For the past 4-5 years, ORNL has been supporting the U.S. Department of Energy (DOE) in identifying these key technical issues, managing the collection of data to be used in issue resolution, and identifying gaps in the needed data. During this effort, ORNL subject matter experts (SMEs) have become expert in understanding what information is publicly available and what gaps in data remain. To ensure the safety of the spent fuel under normal and frequent conditions of wet and subsequent dry storage, intact fuel must be shown to: 1.Maintain fuel cladding integrity; 2.Maintain its geometry for cooling, shielding, and subcriticality; 3.Maintain retrievability, and damaged fuel with pinhole or hairline cracks must be shown not to degrade further. Where PWR (pressurized water reactor) information is utilized or referenced, justification has been provided as to why the data can be utilized for BWR fuel.« less

Actinide Solubility and Speciation in the WIPP [PowerPoint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Reed, Donald T.

2015-11-02

The presentation begins with the role and need for nuclear repositories (overall concept, international updates (Sweden, Finland, France, China), US approach and current status), then moves on to the WIPP TRU repository concept (design, current status--safety incidents of February 5 and 14, 2014, path forward), and finally considers the WIPP safety case: dissolved actinide concentrations (overall approach, oxidation state distribution and redox control, solubility of actinides, colloidal contribution and microbial effects). The following conclusions are set forth: (1) International programs are moving forward, but at a very slow and somewhat sporadic pace. (2) In the United States, the Salt repositorymore » concept, from the perspective of the long-term safety case, remains a viable option for nuclear waste management despite the current operational issues/concerns. (3) Current model/PA prediction (WIPP example) are built on redundant conservatisms. These conservatisms are being addressed in the ongoing and future research to fill existing data gaps--redox control of plutonium by Fe(0, II), thorium (analog) solubility studies in simulated brine, contribution of intrinsic and biocolloids to the mobile concentration, and clarification of microbial ecology and effects.« less

Diversifying the composition and structure of managed late-successional forests with harvest gaps: What is the optimal gap size?

Treesearch

Christel C. Kern; Anthony W. D’Amato; Terry F. Strong

2013-01-01

Managing forests for resilience is crucial in the face of uncertain future environmental conditions. Because harvest gap size alters the species diversity and vertical and horizontal structural heterogeneity, there may be an optimum range of gap sizes for conferring resilience to environmental uncertainty. We examined the impacts of different harvest gap sizes on...

Patient safety is not enough: targeting quality improvements to optimize the health of the population.

PubMed

Woolf, Steven H

2004-01-06

Ensuring patient safety is essential for better health care, but preoccupation with niches of medicine, such as patient safety, can inadvertently compromise outcomes if it distracts from other problems that pose a greater threat to health. The greatest benefit for the population comes from a comprehensive view of population needs and making improvements in proportion with their potential effect on public health; anything less subjects an excess of people to morbidity and death. Patient safety, in context, is a subset of health problems affecting Americans. Safety is a subcategory of medical errors, which also includes mistakes in health promotion and chronic disease management that cost lives but do not affect "safety." These errors are a subset of lapses in quality, which result not only from errors but also from systemic problems, such as lack of access, inequity, and flawed system designs. Lapses in quality are a subset of deficient caring, which encompasses gaps in therapeutics, respect, and compassion that are undetected by normative quality indicators. These larger problems arguably cost hundreds of thousands more lives than do lapses in safety, and the system redesigns to correct them should receive proportionately greater emphasis. Ensuring such rational prioritization requires policy and medical leaders to eschew parochialism and take a global perspective in gauging health problems. The public's well-being requires policymakers to view the system as a whole and consider the potential effect on overall population health when prioritizing care improvements and system redesigns.

The effectiveness of an e-learning program on pediatric medication safety for undergraduate students: a pretest-post-test intervention study.

PubMed

Lee, Tzu-Ying; Lin, Fang-Yi

2013-04-01

Safe medication management is a major competency taught in the nursing curriculum. However, administering pediatric medications is considered a common clinical stressor for Taiwanese students. A supplemental e-learning program that helps students fill the gap between basic nursing skills and pediatric knowledge on medication safety was developed. To evaluate the effectiveness of an e-learning program to increase pediatric medication management among students who take pediatric nursing courses. This intervention study used a historical comparison design. A university in Northern Taiwan. A total of 349 undergraduate nursing students who took pediatric nursing courses participated. Eighty students in the comparison group received regular pediatric courses, including the lectures and clinical practicum; 269 students in the intervention group received an e-learning program, in addition to the standard pediatric courses. Between February 2011 and July 2012 pediatric medication management, including pediatric medication knowledge and calculation ability, was measured at the beginning of the first class, at the completion of the lectures, and at the completion of the clinical practicum. The program was evaluated qualitatively and quantitatively. The intervention group had significantly higher pediatric medication management scores at completion of the lecture course and at the completion of the clinical practicum than the comparison group based on the first day of the lecture course, after adjusting for age, nursing program, and having graduated from a junior college in nursing. Overall, the students appreciated the program that included various teaching modalities content that related to the administration of medication. Using an e-learning program on pediatric medication management is an effective learning method in addition to sitting in a regular lecture course. The different emphases in each module, provided by experienced instructors, enabled the students to be more aware of their role in pediatric medication safety. Copyright © 2013 Elsevier Ltd. All rights reserved.

What do healthcare workers in elderly care know about occupational health and safety? An explorative survey.

PubMed

Schönrock, Stefanie; Schablon, Anja; Nienhaus, Albert; Peters, Claudia

2015-01-01

Demographic changes will lead to a growing demand for healthy, motivated healthcare workers (HCW) in the years ahead. Along with well-targeted prevention, knowledge of occupational health and safety and infection precaution is essential for a healthy working life. In this context back-friendly working methods and protection from infectious diseases are necessary in elderly care. In 2012, a survey was conducted in nine residential and two semi-residential nursing homes, as well as in one home care service in the Schwerin area of northeast Germany. Four hundred and seventy three HCWs were asked to fill in a questionnaire on what they knew about aspects of occupational health and safety such as vaccinations and preventative measures administered by occupational physicians, hygiene, back-friendly working methods and infection prevention. The statistical evaluation was descriptive, with a comparison between job title. Differences were examined with chi square or Fisher's exact test. The response rate was 28 % (n = 132). The largest group of respondents (36 %) were qualified geriatric HCWs. More than 74 % of employees felt well informed about opportunities for precautionary checks and vaccination by occupational physician, and 93 % utilized these opportunities. When it came to assigning modes of transmission to specific infectious diseases, only 23 % of participants were well informed, and one in three (31 %) care assistants was inadequately informed. Fewer than half of participants could correctly name the indications for hand disinfection. Only 66 % of the HCWs said they were aware of training offers for the management of multidrug-resistant organisms in their institution. They did know about possible aids to back-friendly working, although gaps in knowledge were apparent. Only 59 % of respondents knew that care utensils should preferably be stored at working height so as to reduce awkward body postures. Employees in elderly care are well informed about the range of precautionary occupational medical examinations and take advantage of this offering. Questions in the survey regarding hygiene management were answered in a competent manner. On the other hand some gaps in the knowledge about infection prevention and occupational safety became apparent. Differences between qualified and unqualified participating professionals occurred only in the knowledge of infectious diseases and pathogens and the associated path of infection. The extent to which training can help to improve infection prevention and occupational health and safety should be investigated.

Vaccine Safety Datalink

Cancer.gov

The Vaccine Safety Datalink is part of the National Immunization Program within the Centers for Disease Control and Prevention and was started in recognition of gaps in the scientific knowledge of rare vaccine side effects.

European Natural Disaster Coordination and Information System for Aviation (EUNADICS-AV)

NASA Astrophysics Data System (ADS)

Wotawa, Gerhard; Hirtl, Marcus; Arnold, Delia; Katzler-Fuchs, Susanne; Pappalardo, Gelsomina; Mona, Lucia; Sofiev, Mikhail; de Leeuw, Gerrit; Theys, Nicolas; Brenot, Hugues; Plu, Matthieu; Rockitansky, Carl-Herbert; Eschbacher, Kurt; Apituley, Arnoud; Som de Cerff, Wim

2017-04-01

Commercial aviation is one of the key infrastructures of our modern world. Even short interruptions can cause economic damages summing up to the Billion-Euro range. As evident from the past, aviation shows vulnerability with regard to natural hazards. Safe flight operations, air traffic management and air traffic control is a shared responsibility of EUROCONTROL, national authorities, airlines and pilots. All stakeholders have one common goal, namely to warrant and maintain the safety of flight crews and passengers. Currently, however, there is a significant gap in the Europe-wide availability of real time hazard measurement and monitoring information for airborne hazards describing "what, where, how much" in 3 dimensions, combined with a near-real-time European data analysis and assimilation system. This gap creates circumstances where various stakeholders in the system may base their decisions on different data and information. The H-2020 project EUNADICS-AV ("European Natural Disaster Coordination and Information System for Aviation"), started in October 2016, intends to close this gap in data and information availability, enabling all stakeholders in the aviation system to obtain fast, coherent and consistent information. The project intends to combine and harmonize data from satellite earth observation, ground based and airborne platforms, and to integrate them into state-of-the art data assimilation and analysis systems. Besides operational data sources, data from the research community are integrated as well. Hazards considered in the project include volcano eruptions, nuclear accidents and events, and forest fires. The availability of consistent and coherent data analysis fields based on all available measurements will greatly enhances our capability to respond to disasters effectively and efficiently, minimizing system downtimes and thus economic damage while maintaining the safety of millions of passengers.

Drug treatment of obesity: current status and future prospects.

PubMed

Kakkar, Ashish Kumar; Dahiya, Neha

2015-03-01

Obesity is a growing epidemic and a major contributor to the global burden of disease. Obesity strains the healthcare systems and has profound economic and psychosocial consequences. Historically, pharmacotherapy for obesity has witnessed the rise and fall of several promising drug candidates that had to be eventually withdrawn due to unacceptable safety concerns. Currently four drugs are approved for chronic weight management in obese adults: orlistat, lorcaserin, phentermine/topiramate extended release and naltrexone/bupropion extended release. While lorcaserin and phentermine/topiramate were approved by US Food and Drug Administration (FDA) in 2012, after a gap of 13 years following the licensing of orlistat, naltrexone/bupropion has been recently approved in 2014. This review provides a brief overview of these current therapeutic interventions available for management of obesity along with the evidence of their safety and efficacy. Additionally, several novel monotherapies as well as combination products are undergoing evaluation in various stages of clinical development. These therapies if proven successful will strengthen the existing armamentarium of antiobesity drugs and will be critical to combat the global public health crisis of obesity and its associated co-morbidities. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Global Access Programs: A Collaborative Approach for Effective Implementation and Management.

PubMed

Ainge, Debra; Aitken, Suzanne; Corbett, Mark; De-Keyzer, David

Global access programs (GAPs) provide access to medicinal products for patients with serious medical conditions and no commercially available treatment options. Providing early access to medicines can be challenging for a pharmaceutical company. The demand for a GAP often occurs at a time when other activities are the prime focus, such as delivery of pivotal clinical trials or gaining of marketing authorization. Furthermore, the skills, experience, and infrastructure necessary to implement and manage a successful GAP vary significantly from those required for regular clinical trial execution, and the regulatory environment presents its own challenges, with regulations often poorly defined and with considerable inter-country variation. This article considers the triggers for early access requests and examines the need for companies to develop a global strategy for GAPs in order to respond appropriately to requests for early access. It also provides a comprehensive overview of the processes for GAP set-up, implementation, management, and closure, along with the considerations affecting the type and scope of GAP, such as demand, regulatory feasibility, license status of the product, drug pricing structure, company strategy, costs, and product supply. Also discussed is the need for appropriate personnel to implement and manage the GAP, and when to consider collaboration with an external GAP provider. In summary, GAPs require careful and efficient planning and management, from set-up to closure. Well-run GAPs provide an ethical and regulatory-compliant pathway for access of new treatments to patients with serious conditions and an unmet medical need.

Determinants of safety outcomes and performance: A systematic literature review of research in four high-risk industries.

PubMed

Cornelissen, Pieter A; Van Hoof, Joris J; De Jong, Menno D T

2017-09-01

In spite of increasing governmental and organizational efforts, organizations still struggle to improve the safety of their employees as evidenced by the yearly 2.3 million work-related deaths worldwide. Occupational safety research is scattered and inaccessible, especially for practitioners. Through systematically reviewing the safety literature, this study aims to provide a comprehensive overview of behavioral and circumstantial factors that endanger or support employee safety. A broad search on occupational safety literature using four online bibliographical databases yielded 27.527 articles. Through a systematic reviewing process 176 online articles were identified that met the inclusion criteria (e.g., original peer-reviewed research; conducted in selected high-risk industries; published between 1980-2016). Variables and the nature of their interrelationships (i.e., positive, negative, or nonsignificant) were extracted, and then grouped and classified through a process of bottom-up coding. The results indicate that safety outcomes and performance prevail as dependent research areas, dependent on variables related to management & colleagues, work(place) characteristics & circumstances, employee demographics, climate & culture, and external factors. Consensus was found for five variables related to safety outcomes and seven variables related to performance, while there is debate about 31 other relationships. Last, 21 variables related to safety outcomes and performance appear understudied. The majority of safety research has focused on addressing negative safety outcomes and performance through variables related to others within the organization, the work(place) itself, employee demographics, and-to a lesser extent-climate & culture and external factors. This systematic literature review provides both scientists and safety practitioners an overview of the (under)studied behavioral and circumstantial factors related to occupational safety behavior. Scientists could use this overview to study gaps, and validate or falsify relationships. Safety practitioners could use the insights to evaluate organizational safety policies, and to further development of safety interventions. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Pedestrian temporal and spatial gap acceptance at mid-block street crossing in developing world.

PubMed

Pawar, Digvijay S; Patil, Gopal R

2015-02-01

Most of the midblock pedestrian crossings on urban roads in India are uncontrolled; wherein the high degree of discretion in pedestrians' behavior while crossing the traffic stream, has made the situation complex to analyze. Vehicles do not yield to pedestrians, even though the traffic laws give priority to pedestrians over motorized vehicles at unsignalized pedestrian crossings. Therefore, a pedestrian has to decide if an available gap is safe or not for crossing. This paper aims to investigate pedestrian temporal and spatial gap acceptance for midblock street crossings. Field data were collected using video camera at two midblock pedestrian crossings. The data extraction in laboratory resulted in 1107 pedestrian gaps. Available gaps, pedestrians' decision, traffic volume, etc. were extracted from the videos. While crossing a road with multiple lanes, rolling gap acceptance behavior was observed. Using binary logit analysis, six utility models were developed, three each for temporal and spatial gaps. The 50th percentile temporal and spatial gaps ranged from 4.1 to 4.8s and 67 to 79 m respectively, whereas the 85th percentile temporal and spatial gaps ranged from 5 to 5.8s and 82 to 95 m respectively. These gap values were smaller than that reported in the studies in developed countries. The speed of conflicting vehicle was found to be significant in spatial gap but not in temporal gap acceptance. The gap acceptance decision was also found to be affected by the type of conflicting vehicles. The insights from this study can be used for the safety and performance evaluation of uncontrolled midblock street crossings in developing countries. Copyright © 2014 Elsevier Ltd and National Safety Council. All rights reserved.

Safe medication management in specialized home healthcare - an observational study.

PubMed

Lindblad, Marléne; Flink, Maria; Ekstedt, Mirjam

2017-08-24

Medication management is a complex, error-prone process. The aim of this study was to explore what constitutes the complexity of the medication management process (MMP) in specialized home healthcare and how healthcare professionals handle this complexity. The study is theoretically based in resilience engineering. Data were collected during the MMP at three specialized home healthcare units in Sweden using two strategies: observation of workplaces and shadowing RNs in everyday work, including interviews. Transcribed material was analysed using grounded theory. The MMP in home healthcare was dynamic and complex with unclear boundaries of responsibilities, inadequate information systems and fluctuating work conditions. Healthcare professionals adapted their everyday clinical work by sharing responsibility and simultaneously being authoritative and preserving patients' active participation, autonomy and integrity. To promote a safe MMP, healthcare professionals constantly re-prioritized goals, handled gaps in communication and information transmission at a distance by creating new bridging solutions. Trade-offs and workarounds were necessary elements, but also posed a threat to patient safety, as these interim solutions were not systematically evaluated or devised learning strategies. To manage a safe medication process in home healthcare, healthcare professionals need to adapt to fluctuating conditions and create bridging strategies through multiple parallel activities distributed over time, space and actors. The healthcare professionals' strategies could be integrated in continuous learning, while preserving boundaries of safety, instead of being more or less interim solutions. Patients' and family caregivers' as active partners in the MMP may be an underestimated resource for a resilient home healthcare.

Chlorine leak on Mumbai Port Trust's Sewri yard: A case study

PubMed Central

Sharma, Rakesh Kumar; Chawla, Raman; Kumar, Surendra

2010-01-01

Chemical emergencies involving hazardous chemicals are not uncommon in India. More than 25 incidents have been identified in National Disaster Management Guidelines – Chemical (Industrial) Disaster Management, released in May 2007. In a recent occurrence on the morning of 14 July 2010, nearly at 3:00 a.m., chlorine leak was reported from a gas cylinder referred as turner, weighing about 650 kg, corroding with time at the Haji Bunder hazardous cargo warehouse in Mumbai Port Trust, Sewri, affecting over 120 people in the neighborhood, including students, laborers, port workers and fire fighters, of whom 70 were reported critical. It has been observed to be a blatant case of ignorance and negligence as well as contraventions to the safety and environmental safeguard requirements under existing statues as well as non-maintenance of failsafe conditions at the site requisite for chlorine storage. The analysis revealed significant gaps in the availability of neutralization mechanism and the chlorine stored in open increased the possibility of formation of ingress mixture due to busting of chlorine filled tankers. The Government of India has institutionalized emergency preparedness framework at national, state and district level as envisaged in Disaster Management Act, 2005, to prepare the nation to mitigate such incidences, if all the preventive safety provisions fail. Ministry of Environment and Forests (MoEF) is preparing National Action Plan-Chemical (Industrial) Disaster Management based on National Guidelines to implement all the mechanisms of capacity development across the country. PMID:21829311

Measuring and improving patient safety through health information technology: The Health IT Safety Framework

PubMed Central

Singh, Hardeep

2016-01-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings. PMID:26369894

The translation of sports injury prevention and safety promotion knowledge: insights from key intermediary organisations.

PubMed

Bekker, Sheree; Paliadelis, Penny; Finch, Caroline F

2017-03-28

A recognised research-to-practice gap exists in the health research field of sports injury prevention and safety promotion. There is a need for improved insight into increasing the relevancy, accessibility and legitimacy of injury prevention and safety promotion research knowledge for sport settings. The role of key organisations as intermediaries in the process of health knowledge translation for sports settings remains under-explored, and this paper aims to determine, and describe, the processes of knowledge translation undertaken by a set of key organisations in developing and distributing injury prevention and safety promotion resources. The National Guidance for Australian Football Partnerships and Safety (NoGAPS) project provided the context for this study. Representatives from five key NoGAPS organisations participated in individual face-to-face interviews about organisational processes of knowledge translation. A qualitative descriptive methodology was used to analyse participants' descriptions of knowledge translation activities undertaken at their respective organisations. Several themes emerged around health knowledge translation processes and considerations, including (1) identifying a need for knowledge translation, (2) developing and disseminating resources, and (3) barriers and enablers to knowledge translation. This study provides insight into the processes that key organisations employ when developing and disseminating injury prevention and safety promotion resources within sport settings. The relevancy, accessibility and legitimacy of health research knowledge is foregrounded, with a view to increasing the influence of research on the development of health-related resources suitable for community sport settings.

Closing the information gap: informing better medical decisionmaking through the use of post-market safety and comparative effectiveness information.

PubMed

Fox, Bethany

2012-01-01

While FDA gathers vast amounts of data about prescription drugs prior to their marketing approval, important information about the relative effectiveness and long term safety of products is not required for approval, and often is never collected. Increased postmarket research on the safety and comparative effectiveness of products would improve medical decisionmaking and lead to better clinical outcomes. Fortunately, Congress has recognized the value of this information for healthcare professionals. In response to a congressional mandate in the FDA Amendments Act (FDAAA), FDA is developing the Sentinel Initiative, an active surveillance system for monitoring postmarket drug safety issues. FDAAA also authorized FDA to require a drug sponsor to conduct postmarket safety studies or clinical trials to address a specific safety concern. To increase the repository of comparative effectiveness information, Congress established the Patient-Centered Outcomes Research Institute (PCORI) in the Patient Protection and Affordable Care Act (PPACA), directing it to manage comparative effectiveness research (CER). This article discusses the need for better safety and comparative effectiveness information and outlines methods to efficiently conduct the research and communicate it effectively to healthcare professionals. Coordination between FDA and the PCORI in gathering and communicating postmarket information is recommended. Medical source data collected by the Sentinel Initiative should be used for CER in addition to postmarket safety surveillance, and FDA and the PCORI should adopt identical standards for the distribution and communication of CER. Coordination between the two entities is recommended to save costs, reduce duplication of efforts, and to generate and communicate more information on prescription drugs for medical decisionmakers.

A study of leading indicators for occupational health and safety management systems in healthcare.

PubMed

Almost, Joan M; VanDenKerkhof, Elizabeth G; Strahlendorf, Peter; Caicco Tett, Louise; Noonan, Joanna; Hayes, Thomas; Van Hulle, Henrietta; Adam, Ryan; Holden, Jeremy; Kent-Hillis, Tracy; McDonald, Mike; Paré, Geneviève C; Lachhar, Karanjit; Silva E Silva, Vanessa

2018-04-23

In Ontario, Canada, approximately $2.5 billion is spent yearly on occupational injuries in the healthcare sector. The healthcare sector has been ranked second highest for lost-time injury rates among 16 Ontario sectors since 2009 with female healthcare workers ranked the highest among all occupations for lost-time claims. There is a great deal of focus in Ontario's occupational health and safety system on compliance and fines, however despite this increased focus, the injury statistics are not significantly improving. One of the keys to changing this trend is the development of a culture of healthy and safe workplaces including the effective utilization of leading indicators within Occupational Health and Safety Management Systems (OHSMSs). In contrast to lagging indicators, which focus on outcomes retrospectively, a leading indicator is associated with proactive activities and consists of selected OHSMSs program elements. Using leading indicators to measure health and safety has been common practice in high-risk industries; however, this shift has not occurred in healthcare. The aim of this project is to conduct a longitudinal study implementing six elements of the Ontario Safety Association for Community and Healthcare (OSACH) system identified as leading indicators and evaluating the effectiveness of this intervention on improving selected health and safety workplace indicators. A quasi-experimental longitudinal research design will be used within two Ontario acute care hospitals. The first phase of the study will focus on assessing current OHSMSs using the leading indicators, determining potential facilitators and barriers to changing current OHSMSs, and identifying the leading indicators that could be added or changed to the existing OHSMS in place. Phase I will conclude with the development of an intervention designed to support optimizing current OHSMSs in participating hospitals based on identified gaps. Phase II will pilot test and evaluate the tailored intervention. By implementing specific elements to test leading indicators, this project will examine a novel approach to strengthening the occupational health and safety system. Results will guide healthcare organizations in setting priorities for their OHSMSs and thereby improve health and safety outcomes.

Assessment of sidewalk/bicycle-lane gaps with safety and developing statewide pedestrian [summary].

DOT National Transportation Integrated Search

2016-04-01

Interest in multimodal transportation and walkable/bikeable communities has led to : construction of more sidewalks and bicycle paths. However, in many places, sidewalks or : bicycle paths are not continuous, leaving gaps that force pedestrians and b...

Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership

PubMed Central

Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

2018-01-01

Objectives To identify the top 10 unanswered research questions for primary care patient safety research. Design A modified nominal group technique. Setting UK. Participants Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. Main outcomes A top 10, and top 30, future research questions for primary care patient safety. Results 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. Conclusions This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. PMID:29490970

Umbilical cord mesenchyme stem cell local intramuscular injection for treatment of uterine niche: Protocol for a prospective, randomized, double-blinded, placebo-controlled clinical trial.

PubMed

Fan, Dazhi; Wu, Shuzhen; Ye, Shaoxin; Wang, Wen; Guo, Xiaoling; Liu, Zhengping

2017-11-01

Uterine niche is defined as a triangular anechoic structure at the site of the scar or a gap in the myometrium at the site of a previous caesarean section. The main clinical manifestations are postmenstrual spotting and intrauterine infection, which may seriously affect the daily life of nonpregnant women. Trials have shown an excellent safety and efficacy for the potential of mesenchymal stem cells (MSCs) as a therapeutic option for scar reconstruction. Therefore, this study is designed to investigate the safety and efficacy of using MSCs in the treatment for the uterine niche. This phase II clinical trial is a single-center, prospective, randomized, double-blind, placebo-controlled with 2 arms. One hundred twenty primiparous participants will be randomly (1:1 ratio) assigned to receive direct intramuscular injection of MSCs (a dose of 1*10 cells in 1 mL of 0.9% saline) (MSCs group) or an identical-appearing 1 mL of 0.9% saline (placebo-controlled group) near the uterine incision. The primary outcome of this trial is to evaluate the proportion of participants at 6 months who is found uterine niche in the uterus by transvaginal utrasonography. Adverse events will be documented in a case report form. The study will be conducted at the Department of Obstetric of Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan. This trial is the first investigation of the potential for therapeutic use of MSCs for the management of uterine niche after cesarean delivery. This protocol will help to determine the efficacy and safety of MSCs treatment in uterine niche and bridge the gap with regards to the current preclinical and clinical evidence. NCT02968459 (Clinical Trials.gov: http://clinicaltrials.gov/).

Umbilical cord mesenchyme stem cell local intramuscular injection for treatment of uterine niche

PubMed Central

Fan, Dazhi; Wu, Shuzhen; Ye, Shaoxin; Wang, Wen; Guo, Xiaoling; Liu, Zhengping

2017-01-01

Abstract Background: Uterine niche is defined as a triangular anechoic structure at the site of the scar or a gap in the myometrium at the site of a previous caesarean section. The main clinical manifestations are postmenstrual spotting and intrauterine infection, which may seriously affect the daily life of nonpregnant women. Trials have shown an excellent safety and efficacy for the potential of mesenchymal stem cells (MSCs) as a therapeutic option for scar reconstruction. Therefore, this study is designed to investigate the safety and efficacy of using MSCs in the treatment for the uterine niche. Methods/design: This phase II clinical trial is a single-center, prospective, randomized, double-blind, placebo-controlled with 2 arms. One hundred twenty primiparous participants will be randomly (1:1 ratio) assigned to receive direct intramuscular injection of MSCs (a dose of 1∗107 cells in 1 mL of 0.9% saline) (MSCs group) or an identical-appearing 1 mL of 0.9% saline (placebo-controlled group) near the uterine incision. The primary outcome of this trial is to evaluate the proportion of participants at 6 months who is found uterine niche in the uterus by transvaginal utrasonography. Adverse events will be documented in a case report form. The study will be conducted at the Department of Obstetric of Southern Medical University Affiliated Maternal & Child Health Hospital of Foshan. Discussion: This trial is the first investigation of the potential for therapeutic use of MSCs for the management of uterine niche after cesarean delivery. Conclusion: This protocol will help to determine the efficacy and safety of MSCs treatment in uterine niche and bridge the gap with regards to the current preclinical and clinical evidence. Trial registration number: NCT02968459 (Clinical Trials.gov: http://clinicaltrials.gov/). PMID:29095305

Applying revised gap analysis model in measuring hotel service quality.

PubMed

Lee, Yu-Cheng; Wang, Yu-Che; Chien, Chih-Hung; Wu, Chia-Huei; Lu, Shu-Chiung; Tsai, Sang-Bing; Dong, Weiwei

2016-01-01

With the number of tourists coming to Taiwan growing by 10-20 % since 2010, the number has increased due to an increasing number of foreign tourists, particularly after deregulation allowed admitting tourist groups, followed later on by foreign individual tourists, from mainland China. The purpose of this study is to propose a revised gap model to evaluate and improve service quality in Taiwanese hotel industry. Thus, service quality could be clearly measured through gap analysis, which was more effective for offering direction in developing and improving service quality. The HOLSERV instrument was used to identify and analyze service gaps from the perceptions of internal and external customers. The sample for this study included three main categories of respondents: tourists, employees, and managers. The results show that five gaps influenced tourists' evaluations of service quality. In particular, the study revealed that Gap 1 (management perceptions vs. customer expectations) and Gap 9 (service provider perceptions of management perceptions vs. service delivery) were more critical than the others in affecting perceived service quality, making service delivery the main area of improvement. This study contributes toward an evaluation of the service quality of the Taiwanese hotel industry from the perspectives of customers, service providers, and managers, which is considerably valuable for hotel managers. It was the aim of this study to explore all of these together in order to better understand the possible gaps in the hotel industry in Taiwan.

A Step Towards Improving Food Safety in India: Determining Baseline Knowledge and Behaviors Among Restaurant Food Handlers in Chennai.

PubMed

Manes, Mindi R; Kuganantham, Paraswami; Jagadeesan, Murugesan; Laxmidevi, M; Dworkin, Mark S

2016-01-01

With the establishment of the Food Safety and Standards Authority of India (FSSAI) and new food safety regulations, a precedent has been set to prevent foodborne illness in India. The objective of the authors' study was to identify knowledge gaps among food handlers in Chennai, Tamil Nadu, to establish priorities for future intervention. A 44-question survey was administered to 156 food handlers at 36 restaurants in Chennai between April and June of 2011. The overall mean knowledge score was 49% and knowledge gaps related to hand hygiene, proper food cooking and holding temperatures, and cross contamination were identified. Food handlers with a Medical Fitness Certificate scored significantly higher than those without a certificate, after controlling for food safety training and level of education (p < .05). As the FSSAI standards now require a medical certificate for restaurant licensure and registration, consideration should be given to include an educational component to this certification with an explanation of expected food safety behavior.

Improving Health Care Workers for Seasonal Influenza Vaccination at University Health System: A Paradigm for Closing the Quality Chasm

PubMed Central

Patterson, Jan E.; Cadena, Jose; Prigmore, Teresa; Bowling, Jason; Ayala, Beth Ann; Kirkman, Leni; Parekh, Amruta; Scepanski, Theresa

2011-01-01

Significant gaps in quality and patient safety in the US health-care system have been identified and were reported in the past decade by the Institute of Medicine. Despite recognition of these gaps in “knowing versus doing,” change in health care is slow and difficult. The quality improvement and clinical safety movement is increasing among US medical centers. Our health science center implemented the UT System Clinical Safety and Effectiveness course, providing project-based teaching of quality-improvement tools and principles of patient safety. A quality-improvement project that increased healthcare workers' influenza vaccination rate by 17.8% from that in 2008 to a rate of 76.6% in 2009 serves as a paradigm of how physicians can lead quality-improvement project teams to narrow the quality chasm (1). Local efforts to narrow the chasm are discussed in the present paper, including inter-professional education in quality improvement and clinical safety. PMID:21686222

Burn injury models of care: A review of quality and cultural safety for care of Indigenous children.

PubMed

Fraser, Sarah; Grant, Julian; Mackean, Tamara; Hunter, Kate; Holland, Andrew J A; Clapham, Kathleen; Teague, Warwick J; Ivers, Rebecca Q

2018-05-01

Safety and quality in the systematic management of burn care is important to ensure optimal outcomes. It is not clear if or how burn injury models of care uphold these qualities, or if they provide a space for culturally safe healthcare for Indigenous peoples, especially for children. This review is a critique of publically available models of care analysing their ability to facilitate safe, high-quality burn care for Indigenous children. Models of care were identified and mapped against cultural safety principles in healthcare, and against the National Health and Medical Research Council standard for clinical practice guidelines. An initial search and appraisal of tools was conducted to assess suitability of the tools in providing a mechanism to address quality and cultural safety. From the 53 documents found, 6 were eligible for review. Aspects of cultural safety were addressed in the models, but not explicitly, and were recorded very differently across all models. There was also limited or no cultural consultation documented in the models of care reviewed. Quality in the documents against National Health and Medical Research Council guidelines was evident; however, description or application of quality measures was inconsistent and incomplete. Gaps concerning safety and quality in the documented care pathways for Indigenous peoples' who sustain a burn injury and require burn care highlight the need for investigation and reform of current practices. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

30 CFR 285.647 - How will my GAP be processed for Federal consistency under the Coastal Zone Management Act?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false How will my GAP be processed for Federal consistency under the Coastal Zone Management Act? 285.647 Section 285.647 Mineral Resources BUREAU OF OCEAN... under the Coastal Zone Management Act? Your GAP will be processed based on how your limited lease, ROW...

33 CFR 96.220 - What makes up a safety management system?

Code of Federal Regulations, 2011 CFR

2011-07-01

... SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE SAFE OPERATION OF VESSELS AND SAFETY MANAGEMENT SYSTEMS Company and Vessel Safety Management Systems § 96.220 What makes up a safety management system? (a) The safety management system must document the responsible person's— (1) Safety and pollution prevention...

A Review of Interventions To Increase Driving Safety among Teenage Drivers.

ERIC Educational Resources Information Center

Mattox, John R., II

Young drivers across the United States represent a persistent traffic safety problem. Many interventions have been imposed on these drivers but few studies have evaluated the impact of these interventions on risky behaviors or traffic safety measures. To fill this gap, a review was undertaken to examine the most rigorous methodological evaluations…

Analyzing system safety in lithium-ion grid energy storage

NASA Astrophysics Data System (ADS)

Rosewater, David; Williams, Adam

2015-12-01

As grid energy storage systems become more complex, it grows more difficult to design them for safe operation. This paper first reviews the properties of lithium-ion batteries that can produce hazards in grid scale systems. Then the conventional safety engineering technique Probabilistic Risk Assessment (PRA) is reviewed to identify its limitations in complex systems. To address this gap, new research is presented on the application of Systems-Theoretic Process Analysis (STPA) to a lithium-ion battery based grid energy storage system. STPA is anticipated to fill the gaps recognized in PRA for designing complex systems and hence be more effective or less costly to use during safety engineering. It was observed that STPA is able to capture causal scenarios for accidents not identified using PRA. Additionally, STPA enabled a more rational assessment of uncertainty (all that is not known) thereby promoting a healthy skepticism of design assumptions. We conclude that STPA may indeed be more cost effective than PRA for safety engineering in lithium-ion battery systems. However, further research is needed to determine if this approach actually reduces safety engineering costs in development, or improves industry safety standards.

A Threshold Concept in Managing: What Students in Introductory Management Courses Must Know

ERIC Educational Resources Information Center

Donovan, Paul

2017-01-01

In the field of management, a practice--theory gap has developed and consequently, management education has been criticized for being irrelevant to the needs of stakeholders. This article argues that introduction to management courses in higher education perpetuate this gap by not teaching what managers do. These courses fail to communicate well…

Review of Studies on Pedestrian and Bicyclist Safety, 1991-2007

DOT National Transportation Integrated Search

2012-06-01

This report reviews the pedestrian and bicyclist safety research literature in print as of 2007. It summarizes and synthesizes the key studies, evaluates existing knowledge and identifies research gaps and provides recommendations for future directio...

The Event Chain of Survival in the Context of Music Festivals: A Framework for Improving Outcomes at Major Planned Events.

PubMed

Lund, Adam; Turris, Sheila

2017-08-01

Despite the best efforts of event producers and on-site medical teams, there are sometimes serious illnesses, life-threatening injuries, and fatalities related to music festival attendance. Producers, clinicians, and researchers are actively seeking ways to reduce the mortality and morbidity associated with these events. After analyzing the available literature on music festival health and safety, several major themes emerged. Principally, stakeholder groups planning in isolation from one another (ie, in silos) create fragmentation, gaps, and overlap in plans for major planned events (MPEs). The authors hypothesized that one approach to minimizing this fragmentation may be to create a framework to "connect the dots," or join together the many silos of professionals responsible for safety, security, health, and emergency planning at MPEs. Adapted from the well-established literature regarding the management of cardiac arrests, both in and out of hospital, the "chain of survival" concept is applied to the disparate groups providing services that support event safety in the context of music festivals. The authors propose this framework for describing, understanding, coordinating and planning around the integration of safety, security, health, and emergency service for events. The adapted Event Chain of Survival contains six interdependent links, including: (1) event producers; (2) police and security; (3) festival health; (4) on-site medical services; (5) ambulance services; and (6) off-site medical services. The authors argue that adapting and applying this framework in the context of MPEs in general, and music festivals specifically, has the potential to break down the current disconnected approach to event safety, security, health, and emergency planning. It offers a means of shifting the focus from a purely reactive stance to a more proactive, collaborative, and integrated approach. Improving health outcomes for music festival attendees, reducing gaps in planning, promoting consistency, and improving efficiency by reducing duplication of services will ultimately require coordination and collaboration from the beginning of event production to post-event reporting. Lund A , Turris SA . The Event Chain of Survival in the context of music festivals: a framework for improving outcomes at major planned events. Prehosp Disaster Med. 2017;32(4):437-443.

From the traditional concept of safety management to safety integrated with quality.

PubMed

García Herrero, Susana; Mariscal Saldaña, Miguel Angel; Manzanedo del Campo, Miguel Angel; Ritzel, Dale O

2002-01-01

This editorial reviews the evolution of the concepts of safety and quality that have been used in the traditional workplace. The traditional programs of safety are explored showing strengths and weaknesses. The concept of quality management is also viewed. Safety management and quality management principles, stages, and measurement are highlighted. The concepts of quality and safety guarantee are assessed. Total Quality Management concepts are reviewed and applied to safety quality. Total safety management principles are discussed. Finally, an analysis of the relationship between quality and safety from data collected from a company in Spain is presented.

Can Civility Norms Boost Positive Effects of Management Commitment to Safety?

PubMed

McGonagle, Alyssa K; Childress, Niambi M; Walsh, Benjamin M; Bauerle, Timothy J

2016-07-03

We proposed that civility norms would strengthen relationships between management commitment to safety and workers' safety motivation, safety behaviors, and injuries. Survey data were obtained from working adults in hazardous jobs-those for which physical labor is required and/or a realistic possibility of physical injury is present (N = 290). Results showed that management commitment positively related to workers' safety motivation, safety participation, and safety compliance, and negatively related to minor injuries. Furthermore, management commitment to safety displayed a stronger positive relationship with safety motivation and safety participation, and a stronger negative relationship with minor worker injuries when civility norms were high (versus low). The results confirm existing known relationships between management commitment to safety and worker safety motivation and behavior; furthermore, civility norms facilitate the relationships between management commitment to safety and various outcomes important to worker safety. In order to promote an optimally safe working environment, managers should demonstrate a commitment to worker safety and promote positive norms for interpersonal treatment between workers in their units.

Assessing Drinking Water Quality and Water Safety Management in Sub-Saharan Africa Using Regulated Monitoring Data.

PubMed

Kumpel, Emily; Peletz, Rachel; Bonham, Mateyo; Khush, Ranjiv

2016-10-18

Universal access to safe drinking water is prioritized in the post-2015 Sustainable Development Goals. Collecting reliable and actionable water quality information in low-resource settings, however, is challenging, and little is known about the correspondence between water quality data collected by local monitoring agencies and global frameworks for water safety. Using 42 926 microbial water quality test results from 32 surveillance agencies and water suppliers in seven sub-Saharan African countries, we determined the degree to which water sources were monitored, how water quality varied by source type, and institutional responses to results. Sixty-four percent of the water samples were collected from piped supplies, although the majority of Africans rely on nonpiped sources. Piped supplies had the lowest levels of fecal indicator bacteria (FIB) compared to any other source type: only 4% of samples of water piped to plots and 2% of samples from water piped to public taps/standpipes were positive for FIB (n = 14 948 and n = 12 278, respectively). Among other types of improved sources, samples from harvested rainwater and boreholes were less often positive for FIB (22%, n = 167 and 31%, n = 3329, respectively) than protected springs or protected dug wells (39%, n = 472 and 65%, n = 505). When data from different settings were aggregated, the FIB levels in different source types broadly reflected the source-type water safety framework used by the Joint Monitoring Programme. However, the insufficient testing of nonpiped sources relative to their use indicates important gaps in current assessments. Our results emphasize the importance of local data collection for water safety management and measurement of progress toward universal safe drinking water access.

Complete attenuation of genetically engineered Plasmodium falciparum sporozoites in human subjects.

PubMed

Kublin, James G; Mikolajczak, Sebastian A; Sack, Brandon K; Fishbaugher, Matt E; Seilie, Annette; Shelton, Lisa; VonGoedert, Tracie; Firat, Melike; Magee, Sara; Fritzen, Emma; Betz, Will; Kain, Heather S; Dankwa, Dorender A; Steel, Ryan W J; Vaughan, Ashley M; Noah Sather, D; Murphy, Sean C; Kappe, Stefan H I

2017-01-04

Immunization of humans with whole sporozoites confers complete, sterilizing immunity against malaria infection. However, achieving consistent safety while maintaining immunogenicity of whole parasite vaccines remains a formidable challenge. We generated a genetically attenuated Plasmodium falciparum (Pf) malaria parasite by deleting three genes expressed in the pre-erythrocytic stage (Pf p52 - /p36 - /sap1 - ). We then tested the safety and immunogenicity of the genetically engineered (Pf GAP3KO) sporozoites in human volunteers. Pf GAP3KO sporozoites were delivered to 10 volunteers using infected mosquito bites with a single exposure consisting of 150 to 200 bites per subject. All subjects remained blood stage-negative and developed inhibitory antibodies to sporozoites. GAP3KO rodent malaria parasites engendered complete, protracted immunity against infectious sporozoite challenge in mice. The results warrant further clinical testing of Pf GAP3KO and its potential development into a vaccine strain. Copyright © 2017, American Association for the Advancement of Science.

Safety management vs. picking leaves.

PubMed

Wright, D

1991-09-01

A safety program will generally have as its base a comprehensive written document made available for everyone in the organization. The document should indicate a positive commitment to safety by management. It should not be a "how to" guide, but rather a broad outline to establish responsibilities, goals, and methods. The safety manager is appointed in writing and answers to the highest level of management. As opposed to a "doer," the safety manager acts as a director and administrator of the safety program. This is accomplished through the advisory capacity of the safety program for solicited and unsolicited problems. The focus of the safety manager is on the system and how it contributes to safety problems, rather than individual problems. Management has the ultimate responsibility for safety. Their efforts should reflect a proactive attitude to correct problems in the system. In order to identify areas of interest, technically competent input from the safety manager should be required. The support of the safety program by top management determines the success of the program. Without a clear and firm commitment by the organization, safety will receive no more than lip service from the employees. The benefits of a proactive approach will be realized in the organization's ability to manage safety issues, rather than reacting to them.

Multidisciplinary analysis of invasive meningococcal disease as a framework for continuous quality and safety improvement in regional Australia

PubMed Central

Taylor, Kathryn A; Durrheim, David N; Merritt, Tony; Massey, Peter; Ferguson, John; Ryan, Nick; Hullick, Carolyn

2018-01-01

Background System factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues. Context Baseline assessment of IMD cases (2005–2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge. Methods Clinical governance, in partnership with clinical and public health services, established a multidisciplinary Meningococcal Reference Group (MRG) to routinely review management of all IMD cases. The MRG comprised representatives from primary care, acute care, public health, laboratory medicine and clinical governance. Baseline data were compared with two subsequent evaluation points (2011–2012 and 2013–2015). Interventions Phase I involved multidisciplinary process mapping and development of a standardised audit tool from national IMD management guidelines. Phase II involved formalisation of group processes and advocacy for operational change. Phase III focused on dissemination of findings to clinicians and managers. Results Greatest care improvements were observed in the final evaluation. Median antibiotic delay decreased from 72 to 42 min and proportion of cases triaged appropriately improved from 38% to 75% between 2013 and 2015. Increasing fatal outcomes were attributed to the emergence of more virulent meningococcal serotypes. Conclusions The MRG was a key mechanism for identifying system gaps, advocating for change and enhancing communication and coordination across services. Employing IMD case review as a focus for district-level process reflection presents an innovative patient safety approach, combining the strengths of prospective hazard analysis with more traditional RCA methodologies. PMID:29527576

A system of safety management practices and worker engagement for reducing and preventing accidents: an empirical and theoretical investigation.

PubMed

Wachter, Jan K; Yorio, Patrick L

2014-07-01

The overall research objective was to theoretically and empirically develop the ideas around a system of safety management practices (ten practices were elaborated), to test their relationship with objective safety statistics (such as accident rates), and to explore how these practices work to achieve positive safety results (accident prevention) through worker engagement. Data were collected using safety manager, supervisor and employee surveys designed to assess and link safety management system practices, employee perceptions resulting from existing practices, and safety performance outcomes. Results indicate the following: there is a significant negative relationship between the presence of ten individual safety management practices, as well as the composite of these practices, with accident rates; there is a significant negative relationship between the level of safety-focused worker emotional and cognitive engagement with accident rates; safety management systems and worker engagement levels can be used individually to predict accident rates; safety management systems can be used to predict worker engagement levels; and worker engagement levels act as mediators between the safety management system and safety performance outcomes (such as accident rates). Even though the presence of safety management system practices is linked with incident reduction and may represent a necessary first-step in accident prevention, safety performance may also depend on mediation by safety-focused cognitive and emotional engagement by workers. Thus, when organizations invest in a safety management system approach to reducing/preventing accidents and improving safety performance, they should also be concerned about winning over the minds and hearts of their workers through human performance-based safety management systems designed to promote and enhance worker engagement. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Guidelines for Safety in the Gastrointestinal Endoscopy Unit

PubMed Central

Calderwood, Audrey H.; Chapman, Frank J.; Cohen, Jonathan; Cohen, Lawrence B.; Collins, James; Day, Lukejohn W.; Early, Dayna S.

2014-01-01

EXECUTIVE SUMMARY Historically, safety in the gastrointestinal (GI) endoscopy unit has focused on infection control, particularly around the reprocessing of endoscopes. Two highly publicized outbreaks where the transmission of infectious agents were related to GI endoscopy have highlighted the need to address potential gaps along the endoscopy care continuum that could impact patient safety. PMID:24485393

"I'm Scared of the Disappointment": Young Adult Smokers' Relational Identity Gaps and Management Strategies as Sites of Communication Intervention.

PubMed

Stanley, Samantha J; Pitts, Margaret Jane

2018-02-22

While cigarette smoking is decreasing among young adults, rates of nicotine consumption through other devices, most notably electronic cigarettes, are on the rise. Framed by communication theory of identity, this study examines young adult smokers' experiences with relational others in regard to their smoking. Focus group discussions and individual interviews convened with 20 young adult cigarette and electronic cigarette smokers revealed identity gaps implicating the relational layer of identity, including personal-relational, enacted-relational, and personal-enacted-relational identity gaps. Participants used communicative and behavioral strategies to manage relational discrepancies. The documented identity gaps and management strategies present opportunities for targeted smoking cessation interventions that amplify dissonance created through identity gaps as a motivational tactic.

Phlebotomy, a bridge between laboratory and patient.

PubMed

Ialongo, Cristiano; Bernardini, Sergio

2016-01-01

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to "bridge" patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient's compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper.

An Assessment of Civil Tiltrotor Concept of Operations in the Next Generation Air Transportation System

NASA Technical Reports Server (NTRS)

Chung, William W.; Salvano, Dan; Rinehart, David; Young, Ray; Cheng, Victor; Lindsey, James

2012-01-01

Based on a previous Civil Tiltrotor (CTR) National Airspace System (NAS) performance analysis study, CTR operations were evaluated over selected routes and terminal airspace configurations assuming noninterference operations (NIO) and runway-independent operations (RIO). This assessment aims to further identify issues associated with these concepts of operations (ConOps), and their dependency on the airspace configuration and interaction with conventional fixed-wing traffic. Safety analysis following a traditional Safety Management System (SMS) methodology was applied to CTR-unique departure and arrival failures in the selected airspace to identify any operational and certification issues. Additional CTR operational cases were then developed to get a broader understanding of issues and gaps that will need to be addressed in future CTR operational studies. Finally, needed enhancements to National Airspace System performance analysis tools were reviewed, and recommendations were made on improvements in these tools that are likely to be required to support future progress toward CTR fleet operations in the Next Generation Air Transportation System (NextGen).

Phlebotomy, a bridge between laboratory and patient

PubMed Central

Ialongo, Cristiano; Bernardini, Sergio

2016-01-01

The evidence-based paradigm has changed and evolved medical practice. Phlebotomy, which dates back to the age of ancient Greece, has gained experience through the evolution of medicine becoming a fundamental diagnostic tool. Nowadays it connects the patient with the clinical laboratory dimension building up a bridge. However, more often there is a gap between laboratory and phlebotomist that causes misunderstandings and burdens on patient safety. Therefore, the scope of this review is delivering a view of modern phlebotomy to “bridge” patient and laboratory. In this regard the paper describes devices, tools and procedures in the light of the most recent scientific findings, also discussing their impact on both quality of blood testing and patient safety. It also addresses the issues concerning medical aspect of venipuncture, like the practical approach to the superficial veins anatomy, as well as the management of the patient’s compliance with the blood draw. Thereby, the clinical, technical and practical issues are treated with the same relevance throughout the entire paper. PMID:26981016

A Review on Internet of Things for Defense and Public Safety

PubMed Central

Fraga-Lamas, Paula; Fernández-Caramés, Tiago M.; Suárez-Albela, Manuel; Castedo, Luis; González-López, Miguel

2016-01-01

The Internet of Things (IoT) is undeniably transforming the way that organizations communicate and organize everyday businesses and industrial procedures. Its adoption has proven well suited for sectors that manage a large number of assets and coordinate complex and distributed processes. This survey analyzes the great potential for applying IoT technologies (i.e., data-driven applications or embedded automation and intelligent adaptive systems) to revolutionize modern warfare and provide benefits similar to those in industry. It identifies scenarios where Defense and Public Safety (PS) could leverage better commercial IoT capabilities to deliver greater survivability to the warfighter or first responders, while reducing costs and increasing operation efficiency and effectiveness. This article reviews the main tactical requirements and the architecture, examining gaps and shortcomings in existing IoT systems across the military field and mission-critical scenarios. The review characterizes the open challenges for a broad deployment and presents a research roadmap for enabling an affordable IoT for defense and PS. PMID:27782052

A Review on Internet of Things for Defense and Public Safety.

PubMed

Fraga-Lamas, Paula; Fernández-Caramés, Tiago M; Suárez-Albela, Manuel; Castedo, Luis; González-López, Miguel

2016-10-05

The Internet of Things (IoT) is undeniably transforming the way that organizations communicate and organize everyday businesses and industrial procedures. Its adoption has proven well suited for sectors that manage a large number of assets and coordinate complex and distributed processes. This survey analyzes the great potential for applying IoT technologies (i.e., data-driven applications or embedded automation and intelligent adaptive systems) to revolutionize modern warfare and provide benefits similar to those in industry. It identifies scenarios where Defense and Public Safety (PS) could leverage better commercial IoT capabilities to deliver greater survivability to the warfighter or first responders, while reducing costs and increasing operation efficiency and effectiveness. This article reviews the main tactical requirements and the architecture, examining gaps and shortcomings in existing IoT systems across the military field and mission-critical scenarios. The review characterizes the open challenges for a broad deployment and presents a research roadmap for enabling an affordable IoT for defense and PS.

The use of mental models in chemical risk protection: developing a generic workplace methodology.

PubMed

Cox, Patrick; Niewöhmer, Jörg; Pidgeon, Nick; Gerrard, Simon; Fischhoff, Baruch; Riley, Donna

2003-04-01

We adopted a comparative approach to evaluate and extend a generic methodology to analyze the different sets of beliefs held about chemical hazards in the workplace. Our study mapped existing knowledge structures about the risks associated with the use of perchloroethylene and rosin-based solder flux in differing workplaces. "Influence diagrams" were used to represent beliefs held by chemical experts; "user models" were developed from data elicited from open-ended interviews with the workplace users of the chemicals. The juxtaposition of expert and user understandings of chemical risks enabled us to identify knowledge gaps and misunderstandings and to reinforce appropriate sets of safety beliefs and behavior relevant to chemical risk communications. By designing safety information to be more relevant to the workplace context of users, we believe that employers and employees may gain improved knowledge about chemical hazards in the workplace, such that better chemical risk management, self-protection, and informed decision making develop over time.

30 CFR 285.800 - How must I conduct my activities to comply with safety and environmental requirements?

Code of Federal Regulations, 2011 CFR

2011-07-01

..., Inspections, and Facility Assessments for Activities Conducted Under SAPs, COPs and GAPs § 285.800 How must I... approved SAP, COP, or GAP, as required under §§ 285.615(c), 285.633(b), or 285.653(c). ...

Therapeutic drug monitoring of antithyroid drugs in pregnancy: the knowledge gaps.

PubMed

Koren, Gideon; Soldin, Offie

2006-02-01

Despite being a common condition in pregnancy, and despite propylthiouracil (PTU) being perceived as safer than methimazole, there are virtually no epidemiological controlled studies on malformation rate an neurobehavioral outcomes with the former. This knowledge gap must be filled to ensure fetal safety.

From ontology selection and semantic web to an integrated information system for food-borne diseases and food safety.

PubMed

Yan, Xianghe; Peng, Yun; Meng, Jianghong; Ruzante, Juliana; Fratamico, Pina M; Huang, Lihan; Juneja, Vijay; Needleman, David S

2011-01-01

Several factors have hindered effective use of information and resources related to food safety due to inconsistency among semantically heterogeneous data resources, lack of knowledge on profiling of food-borne pathogens, and knowledge gaps among research communities, government risk assessors/managers, and end-users of the information. This paper discusses technical aspects in the establishment of a comprehensive food safety information system consisting of the following steps: (a) computational collection and compiling publicly available information, including published pathogen genomic, proteomic, and metabolomic data; (b) development of ontology libraries on food-borne pathogens and design automatic algorithms with formal inference and fuzzy and probabilistic reasoning to address the consistency and accuracy of distributed information resources (e.g., PulseNet, FoodNet, OutbreakNet, PubMed, NCBI, EMBL, and other online genetic databases and information); (c) integration of collected pathogen profiling data, Foodrisk.org ( http://www.foodrisk.org ), PMP, Combase, and other relevant information into a user-friendly, searchable, "homogeneous" information system available to scientists in academia, the food industry, and government agencies; and (d) development of a computational model in semantic web for greater adaptability and robustness.

Addressing the implementation gap in global road safety: exploring features of an effective response and introducing a 10-country program.

PubMed

Hyder, Adnan A; Allen, Katharine A; Di Pietro, Gayle; Adriazola, Claudia A; Sobel, Rochelle; Larson, Kelly; Peden, Margie

2012-06-01

Yearly, more than 1.2 million people are killed by road traffic injuries (RTIs) around the globe, and another 20 to 50 million are injured. The global burden of RTIs is predicted to rise. We explored the need for concerted action for global road safety and propose characteristics of an effective response to the gap in addressing RTIs. We propose that a successful response includes domains such as strong political will, capacity building, use of evidence-based interventions, rigorous evaluation, increased global funding, multisectoral action, and sustainability. We also present a case study of the global Road Safety in 10 Countries project, which is a new, 5-year, multipartner initiative to address the burden of RTIs in 10 low- and middle-income countries.

33 CFR 96.220 - What makes up a safety management system?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false What makes up a safety management... SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE SAFE OPERATION OF VESSELS AND SAFETY MANAGEMENT SYSTEMS Company and Vessel Safety Management Systems § 96.220 What makes up a safety management system? (a) The...

Mind the Gap

PubMed Central

Fairbanks, Terry; Savage, Erica; Adams, Katie; Wittie, Michael; Boone, Edna; Hayden, Andrew; Barnes, Janey; Hettinger, Zach; Gettinger, Andrew

2016-01-01

Summary Objective Decisions made during electronic health record (EHR) implementations profoundly affect usability and safety. This study aims to identify gaps between the current literature and key stakeholders’ perceptions of usability and safety practices and the challenges encountered during the implementation of EHRs. Materials and Methods Two approaches were used: a literature review and interviews with key stakeholders. We performed a systematic review of the literature to identify usability and safety challenges and best practices during implementation. A total of 55 articles were reviewed through searches of PubMed, Web of Science and Scopus. We used a qualitative approach to identify key stakeholders’ perceptions; semi-structured interviews were conducted with a diverse set of health IT stakeholders to understand their current practices and challenges related to usability during implementation. We used a grounded theory approach: data were coded, sorted, and emerging themes were identified. Conclusions from both sources of data were compared to identify areas of misalignment. Results We identified six emerging themes from the literature and stakeholder interviews: cost and resources, risk assessment, governance and consensus building, customization, clinical work-flow and usability testing, and training. Across these themes, there were misalignments between the literature and stakeholder perspectives, indicating major gaps. Discussion Major gaps identified from each of six emerging themes are discussed as critical areas for future research, opportunities for new stakeholder initiatives, and opportunities to better disseminate resources to improve the implementation of EHRs. Conclusion Our analysis identified practices and challenges across six different emerging themes, illustrated important gaps, and results suggest critical areas for future research and dissemination to improve EHR implementation. PMID:27847961

Recent advances in biomarkers and therapeutic interventions for hepatic drug safety - false dawn or new horizon?

PubMed

Clarke, Joanna I; Dear, James W; Antoine, Daniel J

2016-05-01

Drug-induced liver injury (DILI) represents a serious medical challenge and a potentially fatal adverse event. Currently, DILI is a diagnosis of exclusion, and whilst the electronic evaluation of serious drug-induced hepatotoxicity (eDISH) have revolutionised the early assessment of DILI, this model is dependent upon clinical chemistry parameters that lack sensitivity and specificity. DILI management usually consists of initial withdrawal of the suspected drug and, in the case of acetaminophen, administration of specific therapy. We summarise recent advances and knowledge gaps in the development and qualification of novel DILI biomarkers and therapeutic interventions. Promising biomarkers have been identified that provide increased hepatic specificity (miR-122), mechanistic insight (Keratin-18), and prognostic information (HMGB1, KIM-1, CSF-1). Pharmacogenomics holds potential to preselect susceptible populations and tailor drug therapy. Biomarkers can uncover new mechanisms of drug-induced pathophysiology which, for HMGB1 and CSF-1, have led to promising mechanism-based therapeutic interventions. However, these biomarkers have not been formally qualified and are not in routine clinical use. With the development of inventive clinical trials and by maximising DILI data registries, these novel biomarkers could add substantial value to the current armoury, change the management of DILI in the near future and improve patient safety.

Identity threat at work: how social identity threat and situational cues contribute to racial and ethnic disparities in the workplace.

PubMed

Emerson, Katherine T U; Murphy, Mary C

2014-10-01

Significant disparities remain between racial and ethnic minorities' and Whites' experiences of American workplaces. Traditional prejudice and discrimination approaches explain these gaps in hiring, promotion, satisfaction, and well-being by pointing to the prejudice of people within organizations such as peers, managers, and executives. Grounded in social identity threat theory, this theoretical review instead argues that particular situational cues-often communicated by well-meaning, largely unprejudiced employees and managers-signal to stigmatized groups whether their identity is threatened and devalued or respected and affirmed. First, we provide an overview of how identity threat shapes the psychological processes of racial and ethnic minorities by heightening vigilance to certain situational cues in the workplace. Next, we outline several of these cues and their role in creating and sustaining perceptions of identity threat (or safety). Finally, we provide empirically grounded suggestions that organizations may use to increase identity safety among their employees of color. Taken together, the research demonstrates how situational cues contribute to disparate psychological experiences for racial and ethnic minorities at work, and suggests that by altering threatening cues, organizations may create more equitable, respectful, and inclusive environments where all people may thrive. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Gaps in Management Education: A Case Study of University of Management and Technology

ERIC Educational Resources Information Center

Abdur-Raouf; Kalim, Rukhsana; Siddiqi, Ahmed F.

2010-01-01

This paper aims to identify the gaps in management education highlighted by 3 primary stakeholders: students, faculty and alumni. The study tries to address the issue of relevance and compatibility of management education and investigates areas of improvement perceived by respondents. The paper assumes that business departments of universities…

Restaurant manager and worker food safety certification and knowledge.

PubMed

Brown, Laura G; Le, Brenda; Wong, Melissa R; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A

2014-11-01

Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N=387) and workers (N=365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge.

Restaurant Manager and Worker Food Safety Certification and Knowledge

PubMed Central

Brown, Laura G.; Le, Brenda; Wong, Melissa R.; Reimann, David; Nicholas, David; Faw, Brenda; Davis, Ernestine; Selman, Carol A.

2017-01-01

Over half of foodborne illness outbreaks occur in restaurants. To combat these outbreaks, many public health agencies require food safety certification for restaurant managers, and sometimes workers. Certification entails passing a food safety knowledge examination, which is typically preceded by food safety training. Current certification efforts are based on the assumption that certification leads to greater food safety knowledge. The Centers for Disease Control and Prevention conducted this study to examine the relationship between food safety knowledge and certification. We also examined the relationships between food safety knowledge and restaurant, manager, and worker characteristics. We interviewed managers (N = 387) and workers (N = 365) about their characteristics and assessed their food safety knowledge. Analyses showed that certified managers and workers had greater food safety knowledge than noncertified managers and workers. Additionally, managers and workers whose primary language was English had greater food safety knowledge than those whose primary language was not English. Other factors associated with greater food safety knowledge included working in a chain restaurant, working in a larger restaurant, having more experience, and having more duties. These findings indicate that certification improves food safety knowledge, and that complex relationships exist among restaurant, manager, and worker characteristics and food safety knowledge. PMID:25361386

41 CFR 102-80.10 - What are the basic safety and environmental management policies for real property?

Code of Federal Regulations, 2010 CFR

2010-07-01

... safety and environmental management policies for real property? 102-80.10 Section 102-80.10 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT General Provisions § 102-80.10 What are the basic safety and environmental management policies for real property? The basic safety and...

33 CFR 96.320 - What is involved to complete a safety management audit and when is it required to be completed?

Code of Federal Regulations, 2011 CFR

2011-07-01

... certificate or a Safety Management Certificate; (3) Periodic audits including— (i) An annual verification... safety management audit and when is it required to be completed? 96.320 Section 96.320 Navigation and... SAFE OPERATION OF VESSELS AND SAFETY MANAGEMENT SYSTEMS How Will Safety Management Systems Be...

Analyzing system safety in lithium-ion grid energy storage

DOE PAGES

Rosewater, David; Williams, Adam

2015-10-08

As grid energy storage systems become more complex, it grows more di cult to design them for safe operation. This paper first reviews the properties of lithium-ion batteries that can produce hazards in grid scale systems. Then the conventional safety engineering technique Probabilistic Risk Assessment (PRA) is reviewed to identify its limitations in complex systems. To address this gap, new research is presented on the application of Systems-Theoretic Process Analysis (STPA) to a lithium-ion battery based grid energy storage system. STPA is anticipated to ll the gaps recognized in PRA for designing complex systems and hence be more e ectivemore » or less costly to use during safety engineering. It was observed that STPA is able to capture causal scenarios for accidents not identified using PRA. Additionally, STPA enabled a more rational assessment of uncertainty (all that is not known) thereby promoting a healthy skepticism of design assumptions. Lastly, we conclude that STPA may indeed be more cost effective than PRA for safety engineering in lithium-ion battery systems. However, further research is needed to determine if this approach actually reduces safety engineering costs in development, or improves industry safety standards.« less

2014-2015 Partnership accomplishments report on joint activities: National Gap Analysis Program and LANDFIRE

USGS Publications Warehouse

Davidson, Anne; McKerrow, Alexa; Long, Don; Earnhardt, Todd

2015-01-01

The intended target audience for this document initially is management and project technical specialist and scientists involved in the Gap Analysis Program (GAP) and the Landscape Fire and Resource Management Planning Tools - (LANDFIRE) program to help communicate coordination activities to all involved parties. This document is also intended to give background information in other parts of the USGS and beyond, although some details given are relatively oriented to management of the respective programs. Because the Gap Analysis Program (GAP) and the Landscape Fire and Resource Management Planning Tools - LANDFIRE programs both rely on characterizations of land cover using similar scales and resolutions, the programs have been coordinating their work to improve scientific consistency and efficiency of production. Initial discussions and informal sharing of ideas and work began in 2008. Although this collaboration was fruitful, there was no formal process for reporting results, plans, or outstanding issues, nor was there any formally-defined coordinated management team that spanned the two programs. In 2012, leadership from the two programs agreed to strengthen the coordination of their respective work efforts. In 2013 the GAP and LANDFIRE programs developed an umbrella plan of objectives and components related to three mutual focus areas for the GAP and LANDFIRE collaboration for the years 2013 and 2014 (GAP/LANDFIRE 2013). The evolution of this partnership resulted in the drafting of an inter-program Memorandum of Understanding (MOU) in 2014. This MOU identified three coordination topics relevant to the two programs participating at this point in the MOU history: Vegetation mappingDisturbance classesFormal quality assessment

The Application of Failure Modes and Effects Analysis Methodology to Intrathecal Drug Delivery for Pain Management

PubMed Central

Patel, Teresa; Fisher, Stanley P.

2016-01-01

Objective This study aimed to utilize failure modes and effects analysis (FMEA) to transform clinical insights into a risk mitigation plan for intrathecal (IT) drug delivery in pain management. Methods The FMEA methodology, which has been used for quality improvement, was adapted to assess risks (i.e., failure modes) associated with IT therapy. Ten experienced pain physicians scored 37 failure modes in the following categories: patient selection for therapy initiation (efficacy and safety concerns), patient safety during IT therapy, and product selection for IT therapy. Participants assigned severity, probability, and detection scores for each failure mode, from which a risk priority number (RPN) was calculated. Failure modes with the highest RPNs (i.e., most problematic) were discussed, and strategies were proposed to mitigate risks. Results Strategic discussions focused on 17 failure modes with the most severe outcomes, the highest probabilities of occurrence, and the most challenging detection. The topic of the highest‐ranked failure mode (RPN = 144) was manufactured monotherapy versus compounded combination products. Addressing failure modes associated with appropriate patient and product selection was predicted to be clinically important for the success of IT therapy. Conclusions The methodology of FMEA offers a systematic approach to prioritizing risks in a complex environment such as IT therapy. Unmet needs and information gaps are highlighted through the process. Risk mitigation and strategic planning to prevent and manage critical failure modes can contribute to therapeutic success. PMID:27477689

Challenges in Implementing a Biorisk Management Program at Universitas Indonesia: A Checklist Tool for Biorisk Management.

PubMed

Naroeni, Aroem; Bachtiar, Endang Winiati; Ibrahim, Fera; Bela, Budiman; Kusminanti, Yuni; Pujiriani, Ike; Lestari, Fatma

Rapid development and advancement of bioresearch at a university's laboratories can have both positive and negative implications for public health and the environment. Many research activities in which biological materials have been created, modified, stored, and manipulated require safety procedures to keep the negative effects on humans and the environment as low as possible. The Occupational Health, Safety and Environmental (OHS&E) Department of the University of Indonesia (UI) is trying to increase the awareness and responsibility of its university members and laboratory staffs who work with biohazard materials by creating a biorisk checklist. The checklist was developed based on WHO guidelines and the National University of Singapore (NUS) Laboratory Manual, which contains 311 questions about the management, administration, and handling of various hazards, recombinant experiments, and animal and plant experiments. A gap analysis was run against the checklist in 14 laboratories at the University of Indonesia Salemba campus, which daily works with highly infectious pathogens and high-risk agents. Overall result showed that none of these laboratories had met all of the checklist items, and there were only 2 laboratories that had implemented more than half of the items. This checklist was proven to be a simple tool for assessing laboratories that handle and store biohazard materials, and it could be used as a monitoring tool for biorisk programs as well. It also could be further developed as a laboratory software application to increase its effectiveness and its accuracy.

The Coast Guard Proceedings of the Marine Safety and Security Council: Spring 2016

DTIC Science & Technology

2016-04-01

PROCEEDINGS Spring 2016 Vol. 73, Number 1 Safety Management System Objectives 6 Safety Management Facilitates Safe Vessel Operation Vessel systems...crew, and operations. by LCDR Aaron W. Demo 9 Safety Management Systems to Prevent Pollution from Ships Standard procedures protect the environment...by LCDR Michael Lendvay 11 Dead Reckoning by Safety Management ? Check your course. by LCDR Corydon F. Heard IV Safety Management Systems and the Outer

Practice gaps in patient safety among dermatology residents and their teachers: a survey study of dermatology residents.

PubMed

Swary, Jillian Havey; Stratman, Erik J

2014-07-01

Curriculum and role modeling adjustments are necessary to address patient safety gaps occurring during dermatology residency. To identify the source of clinical practices among dermatology residents that affect patient safety and determine the best approach for overcoming gaps in knowledge and practice patterns that contribute to these practices. A survey-based study, performed at a national medical dermatology meeting in Itasca, Illinois, in 2012, included 142 dermatology residents from 44 residency programs in the United States and Canada. Self-reported rates of dermatology residents committing errors, identifying local systems errors, and identifying poor patient safety role modeling. Of surveyed dermatology residents, 45.2% have failed to report needle-stick injuries incurred during procedures, 82.8% reported cutting and pasting a previous author's patient history information into a medical record without confirming its validity, 96.7% reported right-left body part mislabeling during examination or biopsy, and 29.4% reported not incorporating clinical photographs of lesions sampled for biopsy in the medical record at their institution. Residents variably perform a purposeful pause ("time-out") when indicated to confirm patient, procedure, and site before biopsy, with 20.0% always doing so. In addition, 59.7% of residents work with at least 1 attending physician who intimidates the residents, reducing the likelihood of reporting safety issues they witness. Finally, 78.3% have witnessed attending physicians purposefully disregarding required safety steps. Our data reinforce the need for modified curricula, systems, and teacher development to reduce injuries, improve communication with patients and between physicians, residents, and other members of the health care team, and create an environment free of intimidation.

Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership.

PubMed

Morris, Rebecca Lauren; Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

2018-02-28

To identify the top 10 unanswered research questions for primary care patient safety research. A modified nominal group technique. UK. Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. A top 10, and top 30, future research questions for primary care patient safety. 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Case management information systems: how to put the pieces together now and beyond year 2000.

PubMed

Matthews, P

1999-01-01

Healthcare organizations must establish the goals and objectives of their case management processes before functional and system requirements can be defined. A gap analysis will identify existing systems that can be used to support case management as well as areas in need of systems support. The gap analysis will also identify short-term tactical projects and long-term strategic initiatives supporting the automation of case management. The projects resulting from the gap analysis must be incorporated into the organization's business and information systems plan and budget to ensure appropriate funding and prioritization.

Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

PubMed

Singh, Hardeep; Sittig, Dean F

2016-04-01

Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety benefits of health IT in real-world clinical settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Assessment of Adoption Gaps in Management of Aflatoxin Contamination of Groundnut ("Arachis Hypogaea" L.)

ERIC Educational Resources Information Center

Kumar, G. D. S.; Popat, M. N.

2010-01-01

One of the major impediments for diversification of groundnut ("Arachis Hypogaea" L.) as food crop is aflatoxin contamination. The study was conducted with an objective to assess the adoption gaps in aflatoxin management practices of groundnut (AMPG) and the farmer's characteristics influencing these gaps. The study used an expost-facto…

Anti-inflammatory drugs and analgesics for managing symptoms in people with cystic fibrosis-related arthritis.

PubMed

Thornton, Judith; Rangaraj, Satyapal

2016-01-21

Arthritis remains a relatively infrequent complication of cystic fibrosis, but is a cause of significant morbidity when it does occur. Two distinct types of arthritis are described in cystic fibrosis: cystic fibrosis-related arthropathy (CFA) and hypertrophic pulmonary osteoarthropathy (HPO). Management of arthritis in people with cystic fibrosis is uncertain and complex because of the underlying disease and its intense treatment. This is an update of a previously published review. To review the effectiveness and safety of pharmacological agents for the symptomatic management of cystic fibrosis-related arthritis in adults and children with cystic fibrosis. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register which comprises references identified from comprehensive electronic database searches, handsearches of relevant journals and abstract books of conference proceedings.Date of most recent search: 19 January 2016. Randomised controlled studies which compared the efficacy and safety of anti-inflammatory and analgesic agents (e.g. non-steroidal anti-inflammatory agents, systemic corticosteroids, intra-articular corticosteroids) with each other, with no treatment or with placebo for CFA and HPO. No relevant studies were identified. No studies were included in this review. Although it is generally recognised that CFA may be episodic and resolve spontaneously, treatment with analgesics and anti-inflammatory agents may be needed. While this approach may be sufficient to manage symptoms, it is disappointing that no randomised controlled trials to rigorously evaluate these agents were found, nor could the authors identify any quasi-randomised. This systematic review has identified the need for a well-designed adequately-powered randomised controlled trial to assess the efficacy and safety of pharmacological agents for the symptomatic management of cystic fibrosis-related arthritis (CFA and HPO) in adults and children with cystic fibrosis. Studies should also better define the two conditions. A study has recently been conducted in CFA and may help fill this gap when analysed and published.There are no trials included in the review up to January 2016. We will continue to run searches to identify any potentially relevant studies; however, we do not plan to update other sections of the review until new studies are published.

Women's Entry into Management: Trends in Earnings, Authority, and Valued among Salaried Managers.

ERIC Educational Resources Information Center

Jacobs, Jerry A.

1992-01-01

Earnings and authority differentials between male and female managers are analyzed with data from three sources for the period between 1970 and 1988. Results indicate that the sex gap in earnings among managers narrowed during this period, whereas the gap in authority remained constant. The implication of these results for theories of internal…

Study on development and application of platform with students' safety based on SOA

NASA Astrophysics Data System (ADS)

Jiang, Derong

2011-10-01

Students' safety management is a very important work, which is responsible for the entire school student security problems, student safety primarily prevent, only advance predict various of the imminent problems, to better protect their safety. The system mainly used on the development request the student safety management, safety evaluation, safety education, and etc, which are for daily management work completed for students in the security digital management. Development of the system can reduce the safety management for department working pressure, meanwhile, can reduce the labor force to use, accelerate query speed, strengthens the management, as well as the national various departments about the information step, making each management standardized. Therefore, developing a set of suitability and the populace, compatibly good system is very necessary.

Using the "customer service framework" to successfully implement patient- and family-centered care.

PubMed

Rangachari, Pavani; Bhat, Anita; Seol, Yoon-Ho

2011-01-01

Despite the growing momentum toward patient- and family-centered care at the federal policy level, the organizational literature remains divided on its effectiveness, especially in regard to its key dimension of involving patients and families in treatment decisions and safety practices. Although some have argued for the universal adoption of patient involvement, others have questioned both the effectiveness and feasibility of patient involvement. In this article, we apply a well-established theoretical perspective, that is, the Service Quality Model (SQM) (also known as the "customer service framework") to the health care context, to reconcile the debate related to patient involvement. The application helps support the case for universal adoption of patient involvement and also question the arguments against it. A key contribution of the SQM lies in highlighting a set of fundamental service quality determinants emanating from basic consumer service needs. It also provides a simple framework for understanding how gaps between consumer expectations and management perceptions of those expectations can affect the gap between "expected" and "perceived" service quality from a consumer's perspective. Simultaneously, the SQM also outlines "management requirements" for the successful implementation of a customer service strategy. Applying the SQM to the health care context therefore, in addition to reconciling the debate on patient involvement, helps identify specific steps health care managers could take to successfully implement patient- and family-centered care. Correspondingly, the application also provides insights into strategies for the successful implementation of policy recommendations related to patient- and family-centered care in health care organizations.

Suicide Prevention for School Communities: An Educational Initiative for Student Safety.

PubMed

Roberts, Diane Cody; Taylor, Mary Ellen; Pyle, Audrey D'Ann

2018-05-01

A knowledge gap exists in school communities regarding suicide prevention and means reduction education. The article highlights two core interrelated topics: school nurse engagement in dialogue with students' families and the implementation of an innovative, community-based suicide prevention educational program at a suburban public school district. The authors provide an overview of the public health problem of suicide for students, current student challenges, role of the school nurse in suicide prevention, and a key gap in current school nursing practice. At the request of the school counselors and principal, an innovative suicide prevention educational program was initiated as a community-based project at a large suburban public school district in Texas. The two overarching goals for this community-based collaboration are the following: school nurses will engage in frank, productive conversations with students' parents and families about suicidality concerns and increase the school community's knowledge about suicide prevention. This school community knowledge includes effective risk mitigation and means reduction strategies to better manage suicidality in students. Ultimately, this ongoing family and school community collaboration aims to prevent student deaths by suicide.

Safety management by walking around (SMBWA): a safety intervention program based on both peer and manager participation.

PubMed

Luria, Gil; Morag, Ido

2012-03-01

"Management by walking around" (MBWA) is a practice that has aroused much interest in management science and practice. The purpose of this study is to demonstrate adaptation of this practice to safety management. We describe a three-year long case study that collected empirical data in which a modified MBWA was practiced in order to improve safety in a semiconductor fabrication facility. The main modification involved integrating an information system with the MBWA in order to create a practice that would generate safety leadership development and an organizational safety learning mechanism, while promoting employee safety participation. The results of the case study demonstrate that the SMBWA practice facilitated thousands of tours in which safety leadership behaviors were practiced by managers and by employees (employees performed five times as many tours as managers). The information system collected information about safety behaviors and safety conditions that could not otherwise be obtained. Thus, this study presents a new organizational safety practice SMBWA, and demonstrates the ways in which SMBWA may improve safety in organizations. Copyright © 2011 Elsevier Ltd. All rights reserved.

Using quality and safety education for nurses to guide clinical teaching on a new dedicated education unit.

PubMed

McKown, Terri; McKeon, Leslie; McKown, Leslie; Webb, Sherry

2011-12-01

Gaps exist in health professional education versus the demands of current practice. Leveraging front-line nurses to teach students exemplary practice in a Dedicated Education Unit (DEU) may narrow this gap. The DEU is an innovative model for experiential learning, capitalizing on the expertise of staff nurses as clinical teachers. This study evaluated the effectiveness of a new academic-practice DEU in facilitating quality and safety competency achievement among students. Six clinical teachers received education in clinical teaching and use of Quality and Safety Education for Nurses (QSEN) competencies to guide acquisition of essential knowledge, skills, and attitudes for continuous health care improvement. Twelve students assigned to the six teachers completed daily logs for the 10-week practicum. Findings suggest that DEU students achieved QSEN competencies through clinical teacher mentoring in interdisciplinary collaboration, using electronic information for best practice and patient teaching, patient/family decision making, quality improvement, and resolution of safety issues.

Spent Nuclear Fuel (SNF) project Integrated Safety Management System phase I and II Verification Review Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

CARTER, R.P.

1999-11-19

The U.S. Department of Energy (DOE) commits to accomplishing its mission safely. To ensure this objective is met, DOE issued DOE P 450.4, Safety Management System Policy, and incorporated safety management into the DOE Acquisition Regulations ([DEAR] 48 CFR 970.5204-2 and 90.5204-78). Integrated Safety Management (ISM) requires contractors to integrate safety into management and work practices at all levels so that missions are achieved while protecting the public, the worker, and the environment. The contractor is required to describe the Integrated Safety Management System (ISMS) to be used to implement the safety performance objective.

The Research on Safety Management Information System of Railway Passenger Based on Risk Management Theory

NASA Astrophysics Data System (ADS)

Zhu, Wenmin; Jia, Yuanhua

2018-01-01

Based on the risk management theory and the PDCA cycle model, requirements of the railway passenger transport safety production is analyzed, and the establishment of the security risk assessment team is proposed to manage risk by FTA with Delphi from both qualitative and quantitative aspects. The safety production committee is also established to accomplish performance appraisal, which is for further ensuring the correctness of risk management results, optimizing the safety management business processes and improving risk management capabilities. The basic framework and risk information database of risk management information system of railway passenger transport safety are designed by Ajax, Web Services and SQL technologies. The system realizes functions about risk management, performance appraisal and data management, and provides an efficient and convenient information management platform for railway passenger safety manager.

The sensitivity of tokamak magnetohydrodynamics stability on the edge equilibrium

NASA Astrophysics Data System (ADS)

Zheng, L. J.; Kotschenreuther, M. T.; Valanju, P.

2017-10-01

Due to the X-point singularity, the safety factor tends to infinity as approaching to the last closed flux surface. The numerical treatments of the near X-point behavior become challenging both for equilibrium and stability. The usual solution is to cut off a small fraction of edge region for system stability evaluation or simply use an up-down symmetric equilibrium without X-point as an approximation. In this work, we assess the sensitivity of this type of equilibrium treatments on the stability calculation. It is found that the system stability can depend strongly on the safety factor value (qa) at the edge after the cutting-off. When the edge safety factor value falls in the vicinity of a rational mode number (referred to as the resonant gap), the system becomes quite unstable due to the excitation of the peeling type modes. Instead, when the edge safety factor is outside the resonant gaps, the system is much more stable and the predominant modes become the usual external kink (or ballooning and infernal) type. It is also found that the resonant gaps become smaller and smaller as qa increases. The ideal magnetohydrodynamic peeling ballooning stability diagram is widely used to explain the experimental observations, and the current results indicate that the conventional peeling ballooning stability diagram based on the simplified equilibrium needs to be reexamined.

Current status of pharmacokinetic and safety studies of multidrug-resistant tuberculosis treatment in children.

PubMed

Garcia-Prats, A J; Svensson, E M; Weld, E D; Schaaf, H S; Hesseling, A C

2018-05-01

After decades of neglect, data are finally becoming available on the appropriate, safe dosing of key second-line anti-tuberculosis drugs used for treating multidrug-resistant tuberculosis (MDR-TB) in children, including levofloxacin (LVX), moxifloxacin (MFX), linezolid (LZD) and delamanid (DLM). Much needed data on some novel and repurposed drugs are still lacking, including for bedaquiline (BDQ), pretomanid (PTM) and clofazimine (CFZ). We review the status of pharmacokinetic (PK) and safety studies of key anti-tuberculosis medications in children with MDR-TB, identify priority knowledge gaps and note ongoing work to address those gaps, in the context of planning for an efficacy trial in children with MDR-TB. There is international consensus that an efficacy trial of a novel, all-oral, shortened MDR-TB treatment trial in children is both needed and feasible. Key novel and repurposed second-line anti-tuberculosis drugs include BDQ, DLM, PTM, MFX, LVX, CFZ and LZD. The rapidly emerging PK and safety data on these medications in children with MDR-TB from studies that are underway, completed or planned, will be critical in supporting such an efficacy trial. Commitment to addressing the remaining knowledge gaps, developing child-friendly formulations of key medications, improving the design of paediatric PK and safety studies, and development of international trial capacity in children with MDR-TB are important priorities.

The Impact of eHealth on the Quality and Safety of Healthcare

NASA Astrophysics Data System (ADS)

Majeed, Azeem; Black, Ashly; Car, Josip; Anandan, Chantelle; Cresswell, Kathrin; McKinstry, Brian; Pagliari, Claudia; Procter, Rob; Sheikh, Aziz

There is considerable interest in using information technology (IT) to enhance the quality and safety of healthcare. We undertook a systematic literature review to assess the impact of eHealth applications on the quality and safety of healthcare. We retrieved 46,349 potentially relevant publications, from which we selected 67 relevant systematic reviews for inclusion. The literature was found to be poorly collated and of variable quality in its methodology, reporting and utility. We categorised eHealth applications into three main areas: i). storing, managing and transmission of data; ii). supporting clinical decision-making; and iii). facilitating care from a distance. We found that relative to the potential benefits noted within the literature, little empirical evidence exists in support of these applications. Of the few studies revealing the clearest evidence of benefits, many are from academic clinical centres where developers of new applications have also been directly associated with their evaluation. It is therefore unclear how effective these applications would be if deployed outside the environment in which they were developed. Our review of the impact of eHealth applications on quality and safety of healthcare demonstrated a vast gap between the postulated and empirically demonstrated benefits. In addition, there is a lack of robust research on risks and costs. Consequently, the cost-effectiveness of these interventions has yet to be demonstrated.

Addressing the Implementation Gap in Global Road Safety: Exploring Features of an Effective Response and Introducing a 10-Country Program

PubMed Central

Allen, Katharine A.; Di Pietro, Gayle; Adriazola, Claudia A.; Sobel, Rochelle; Larson, Kelly; Peden, Margie

2012-01-01

Yearly, more than 1.2 million people are killed by road traffic injuries (RTIs) around the globe, and another 20 to 50 million are injured. The global burden of RTIs is predicted to rise. We explored the need for concerted action for global road safety and propose characteristics of an effective response to the gap in addressing RTIs. We propose that a successful response includes domains such as strong political will, capacity building, use of evidence-based interventions, rigorous evaluation, increased global funding, multisectoral action, and sustainability. We also present a case study of the global Road Safety in 10 Countries project, which is a new, 5-year, multipartner initiative to address the burden of RTIs in 10 low- and middle-income countries. PMID:22515864

Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection.

PubMed

Peterson, Kristina; Rogers, Bonnie M E; Brosseau, Lisa M; Payne, Julianne; Cooney, Jennifer; Joe, Lauren; Novak, Debra

2016-07-01

This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices. © 2016 The Author(s).

75 FR 68224 - Safety Management Systems for Part 121 Certificate Holders

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... the general framework for an organization-wide safety management approach to air carrier operations... System? An SMS is an organization-wide approach to managing safety risk and assuring the effectiveness of... under 14 CFR part 121 to develop and implement a safety management system (SMS) to improve the safety of...

Graduates' Vocational Skills for the Management Accountancy Profession: Exploring the Accounting Education Expectation-Performance Gap

ERIC Educational Resources Information Center

Howcroft, Douglas

2017-01-01

This paper focuses on understanding the vocational skills required by graduates and assessing the competence of graduates for the management accountancy profession. It explores "expectation gaps" by examining whether the Chartered Institute of Management Accountants, practitioner employers and university educators have different…

Diversity Management Interventions and Organizational Performance: A Synthesis of Current Literature

ERIC Educational Resources Information Center

Curtis, Ellen Foster; Dreachslin, Janice L.

2008-01-01

Despite the growing body of literature focused on diversity management and its implications for career experiences and perceptions, team dynamics, customer service, and other dimensions of organizational performance, a significant gap remains. To address the gap, this article reviews the managing diversity literature published between January 2000…

30 CFR 285.647 - How will my GAP be processed for Federal consistency under the Coastal Zone Management Act?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false How will my GAP be processed for Federal consistency under the Coastal Zone Management Act? 285.647 Section 285.647 Mineral Resources MINERALS... Activities Plan § 285.647 How will my GAP be processed for Federal consistency under the Coastal Zone...

An Economic Evaluation of Food Safety Education Interventions: Estimates and Critical Data Gaps.

PubMed

Zan, Hua; Lambea, Maria; McDowell, Joyce; Scharff, Robert L

2017-08-01

The economic evaluation of food safety interventions is an important tool that practitioners and policy makers use to assess the efficacy of their efforts. These evaluations are built on models that are dependent on accurate estimation of numerous input variables. In many cases, however, there is no data available to determine input values and expert opinion is used to generate estimates. This study uses a benefit-cost analysis of the food safety component of the adult Expanded Food and Nutrition Education Program (EFNEP) in Ohio as a vehicle for demonstrating how results based on variable values that are not objectively determined may be sensitive to alternative assumptions. In particular, the focus here is on how reported behavioral change is translated into economic benefits. Current gaps in the literature make it impossible to know with certainty how many people are protected by the education (what are the spillover effects?), the length of time education remains effective, and the level of risk reduction from change in behavior. Based on EFNEP survey data, food safety education led 37.4% of participants to improve their food safety behaviors. Under reasonable default assumptions, benefits from this improvement significantly outweigh costs, yielding a benefit-cost ratio of between 6.2 and 10.0. Incorporation of a sensitivity analysis using alternative estimates yields a greater range of estimates (0.2 to 56.3), which highlights the importance of future research aimed at filling these research gaps. Nevertheless, most reasonable assumptions lead to estimates of benefits that justify their costs.

30 CFR 585.647 - How will my GAP be processed for Federal consistency under the Coastal Zone Management Act?

Code of Federal Regulations, 2012 CFR

2012-07-01

... consistency under the Coastal Zone Management Act? 585.647 Section 585.647 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY AND ALTERNATE USES OF EXISTING... Management Act? Your GAP will be processed based on how your limited lease, ROW grant, or RUE grant was...

30 CFR 585.647 - How will my GAP be processed for Federal consistency under the Coastal Zone Management Act?

Code of Federal Regulations, 2013 CFR

2013-07-01

... consistency under the Coastal Zone Management Act? 585.647 Section 585.647 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY AND ALTERNATE USES OF EXISTING... Management Act? Your GAP will be processed based on how your limited lease, ROW grant, or RUE grant was...

Contraception and mental health: a commentary on the evidence and principles for practice.

PubMed

Hall, Kelli Stidham; Steinberg, Julia R; Cwiak, Carrie A; Allen, Rebecca H; Marcus, Sheila M

2015-06-01

Among the most prevalent and disabling chronic diseases affecting reproductive-aged women worldwide, depression and anxiety can contribute to adverse reproductive health outcomes, including an increased risk of unintended pregnancy and its health and social consequences. For women with these common mental health conditions who want to avoid an unintended pregnancy, effective contraception can be an important strategy to maintain and even improve health and well-being. Reproductive health clinicians play a critical role in providing and managing contraception to help women with mental health considerations achieve their desired fertility. In this commentary, we review the literature on relationships between mental health and contraception and describe considerations for the clinical management of contraception among women with depression and anxiety. We discuss issues related to contraceptive method effectiveness and adherence concerns, mental health-specific contraceptive method safety and drug interaction considerations, and clinical counseling and management strategies. Given important gaps in current scientific knowledge of mental health and contraception, we highlight areas for future research. Copyright © 2015 Elsevier Inc. All rights reserved.

Review of the Federal Motor Carrier Safety Regulations for Automated Commercial Vehicles: Preliminary Assessment of Interpretation and Enforcement Challenges, Questions, and Gaps

DOT National Transportation Integrated Search

2018-03-01

The Volpe National Transportation Systems Center (Volpe) reviewed the Federal Motor Carrier Safety Regulations (FMCSRs) to identify compliance and enforcement challenges related to the operation of automated commercial vehicles (CMVs) in interstate c...

Berkeley Lab - Materials Sciences Division

Science.gov Websites

? Click Here! Resources for MSD Safety MSD Safety MSD's Integrated Safety Management Plan [PDF] Safety culture and policies at MSD MSD0010: Integrated Safety Management: Principles and Case Studies Calendar for MSD classes on Integrated Safety Management MSD0015 Handout - Waste Briefing Document [PDF] Waste

Effects of organizational safety on employees' proactivity safety behaviors and occupational health and safety management systems in Chinese high-risk small-scale enterprises.

PubMed

Mei, Qiang; Wang, Qiwei; Liu, Suxia; Zhou, Qiaomei; Zhang, Jingjing

2018-06-07

Based on the characteristics of small-scale enterprises, the improvement of occupational health and safety management systems (OHS MS) needs an effective intervention. This study proposed a structural equation model and examined the relationships of perceived organization support for safety (POSS), person-organization safety fit (POSF) and proactivity safety behaviors with safety management, safety procedures and safety hazards identification. Data were collected from 503 employees of 105 Chinese high-risk small-scale enterprises over 6 months. The results showed that both POSS and POSF were positively related to improvement in safety management, safety procedures and safety hazards identification through proactivity safety behaviors. Our findings provide a new perspective on organizational safety for improving OHS MS for small-scale enterprises and extend the application of proactivity safety behaviors.

Identifying behaviour patterns of construction safety using system archetypes.

PubMed

Guo, Brian H W; Yiu, Tak Wing; González, Vicente A

2015-07-01

Construction safety management involves complex issues (e.g., different trades, multi-organizational project structure, constantly changing work environment, and transient workforce). Systems thinking is widely considered as an effective approach to understanding and managing the complexity. This paper aims to better understand dynamic complexity of construction safety management by exploring archetypes of construction safety. To achieve this, this paper adopted the ground theory method (GTM) and 22 interviews were conducted with participants in various positions (government safety inspector, client, health and safety manager, safety consultant, safety auditor, and safety researcher). Eight archetypes were emerged from the collected data: (1) safety regulations, (2) incentive programs, (3) procurement and safety, (4) safety management in small businesses (5) production and safety, (6) workers' conflicting goals, (7) blame on workers, and (8) reactive and proactive learning. These archetypes capture the interactions between a wide range of factors within various hierarchical levels and subsystems. As a free-standing tool, they advance the understanding of dynamic complexity of construction safety management and provide systemic insights into dealing with the complexity. They also can facilitate system dynamics modelling of construction safety process. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Art World's Concept of Negative Space Applied to System Safety Management

NASA Technical Reports Server (NTRS)

Goodin, James Ronald (Ronnie)

2005-01-01

Tools from several different disciplines can improve system safety management. This paper relates the Art World with our system safety world, showing useful art schools of thought applied to system safety management, developing an art theory-system safety bridge. This bridge is then used to demonstrate relations with risk management, the legal system, personnel management and basic management (establishing priorities). One goal of this presentation/paper is simply to be a fun diversion from the many technical topics presented during the conference.

Expanding research to provide an evidence base for nutritional interventions for the management of inborn errors of metabolism.

PubMed

Camp, Kathryn M; Lloyd-Puryear, Michele A; Yao, Lynne; Groft, Stephen C; Parisi, Melissa A; Mulberg, Andrew; Gopal-Srivastava, Rashmi; Cederbaum, Stephen; Enns, Gregory M; Ershow, Abby G; Frazier, Dianne M; Gohagan, John; Harding, Cary; Howell, R Rodney; Regan, Karen; Stacpoole, Peter W; Venditti, Charles; Vockley, Jerry; Watson, Michael; Coates, Paul M

2013-08-01

A trans-National Institutes of Health initiative, Nutrition and Dietary Supplement Interventions for Inborn Errors of Metabolism (NDSI-IEM), was launched in 2010 to identify gaps in knowledge regarding the safety and utility of nutritional interventions for the management of inborn errors of metabolism (IEM) that need to be filled with evidence-based research. IEM include inherited biochemical disorders in which specific enzyme defects interfere with the normal metabolism of exogenous (dietary) or endogenous protein, carbohydrate, or fat. For some of these IEM, effective management depends primarily on nutritional interventions. Further research is needed to demonstrate the impact of nutritional interventions on individual health outcomes and on the psychosocial issues identified by patients and their families. A series of meetings and discussions were convened to explore the current United States' funding and regulatory infrastructure and the challenges to the conduct of research for nutritional interventions for the management of IEM. Although the research and regulatory infrastructure are well-established, a collaborative pathway that includes the professional and advocacy rare disease community and federal regulatory and research agencies will be needed to overcome current barriers. Copyright © 2013. Published by Elsevier Inc. All rights reserved.

The culture of patient safety from the perspective of the pediatric emergency nursing team.

PubMed

Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri

2016-01-01

To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento entre a cultura de segurança e as emergências pediátricas, porém vislumbrou possibilidades de transformação, que contribuirão para segurança do paciente pediátrico. Os profissionais de enfermagem precisam se tornar protagonistas no processo de substituição do atual paradigma para uma cultura focada na segurança. Sugere-se replicação deste estudo em outras instituições a fim de aprimorar o atual cenário de assistência à saúde.

Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness.

PubMed

Koch, Sven H; Weir, Charlene; Haar, Maral; Staggers, Nancy; Agutter, Jim; Görges, Matthias; Westenskow, Dwayne

2012-01-01

Fatal errors can occur in intensive care units (ICUs). Researchers claim that information integration at the bedside may improve nurses' situation awareness (SA) of patients and decrease errors. However, it is unclear which information should be integrated and in what form. Our research uses the theory of SA to analyze the type of tasks, and their associated information gaps. We aimed to provide recommendations for integrated, consolidated information displays to improve nurses' SA. Systematic observations methods were used to follow 19 ICU nurses for 38 hours in 3 clinical practice settings. Storyboard methods and concept mapping helped to categorize the observed tasks, the associated information needs, and the information gaps of the most frequent tasks by SA level. Consensus and discussion of the research team was used to propose recommendations to improve information displays at the bedside based on information deficits. Nurses performed 46 different tasks at a rate of 23.4 tasks per hour. The information needed to perform the most common tasks was often inaccessible, difficult to see at a distance or located on multiple monitoring devices. Current devices at the ICU bedside do not adequately support a nurse's information-gathering activities. Medication management was the most frequent category of tasks. Information gaps were present at all levels of SA and across most of the tasks. Using a theoretical model to understand information gaps can aid in designing functional requirements. Integrated information that enhances nurses' Situation Awareness may decrease errors and improve patient safety in the future.

Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness

PubMed Central

Weir, Charlene; Haar, Maral; Staggers, Nancy; Agutter, Jim; Görges, Matthias; Westenskow, Dwayne

2012-01-01

Objective Fatal errors can occur in intensive care units (ICUs). Researchers claim that information integration at the bedside may improve nurses' situation awareness (SA) of patients and decrease errors. However, it is unclear which information should be integrated and in what form. Our research uses the theory of SA to analyze the type of tasks, and their associated information gaps. We aimed to provide recommendations for integrated, consolidated information displays to improve nurses' SA. Materials and Methods Systematic observations methods were used to follow 19 ICU nurses for 38 hours in 3 clinical practice settings. Storyboard methods and concept mapping helped to categorize the observed tasks, the associated information needs, and the information gaps of the most frequent tasks by SA level. Consensus and discussion of the research team was used to propose recommendations to improve information displays at the bedside based on information deficits. Results Nurses performed 46 different tasks at a rate of 23.4 tasks per hour. The information needed to perform the most common tasks was often inaccessible, difficult to see at a distance or located on multiple monitoring devices. Current devices at the ICU bedside do not adequately support a nurse's information-gathering activities. Medication management was the most frequent category of tasks. Discussion Information gaps were present at all levels of SA and across most of the tasks. Using a theoretical model to understand information gaps can aid in designing functional requirements. Conclusion Integrated information that enhances nurses' Situation Awareness may decrease errors and improve patient safety in the future. PMID:22437074

Defining the performance gap: Conducting a self-assessment

NASA Technical Reports Server (NTRS)

Braymer, Susan A.; Stoner, David L.; Powell, William C.

1992-01-01

This paper presents two different approaches to performing self-assessments of continuous improvement activities. Case Study 1 describes the activities performed by JSC to assess the implementation of continuous improvement efforts at the NASA Center. The JSC approach included surveys administered to randomly selected NASA personnel and personal interviews with NASA and contractor management personnel. Case Study 2 describes the continuous improvement survey performed by the JSC Safety, Reliability, and Quality Assurance (SR&QA) organization. This survey consisted of a short questionnaire (50 questions) administered to all NASA and contractor SR&QA personnel. The questionnaire is based on the eight categories of the President's Award for Quality and Productivity Improvement. It is designed to objectively determine placement on the TQ benchmark and identify a roadmap for improvement.

Globalization of healthcare: case management in a 21st-century world.

PubMed

Craig, Kathy; Beichl, Lisa

2009-01-01

This article explains the current state of the global healthcare market with respect to international medical travel (medical tourism) and worldwide provider sourcing. Emphasis is placed on the traditional twin pillars of oversight: program accreditation and branding affiliation. These are discussed for their main strength, which is their ability to operate at a system-strata level. This strength also represents a primary weakness from the international patient's perspective, which is the functional gap between systemic oversight and bedside surveillance. International case management (ICM) is identified as the right conduit of patient-level service delivery that fills the gap between system and bedside. The ICM professional is introduced and defined as the provider of patient-centered quality and safety improvements, who coordinates and collaborates using international network connections and culture-sensitive in-country communication skills. The article's information is useful for healthcare practitioners who want to learn about the global medical marketplace. Practitioners who are preparing to or who already have business enterprises associated with the global healthcare market will also find the information helpful. Explanations and content are useful to case management generalists, specialists, and business developers. The content is intended for uptake by interested parties within and outside the healthcare practice arena. All research and syntheses were executed by the authors. Sources included business correspondences, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. Clinical competencies stem from the international practice experiences of one author (K. Craig). International health insurance, economics, and financing expertise stems from other author (L. Beichl). This article launches the platform for development of checklists, tools, and guidelines for international case management practice. The article focuses on (1) the examination of traditional quality safeguards of accreditation and branding and (2) the introduction of patient-centered ICM practices. The article aims to identify sources of risk for individual medical consumers who travel across national borders to seek medical care and methods of risk mitigation, especially international case management.

Regeneration in bottomland forest canopy gaps six years after variable retention harvests to enhance wildlife habitat

USGS Publications Warehouse

Twedt, Daniel J.; Somershoe, Scott G.; Guldin, James M.

2013-01-01

To promote desired forest conditions that enhance wildlife habitat in bottomland forests, managers prescribed and implemented variable-retention harvest, a.k.a. wildlife forestry, in four stands on Tensas River National Wildlife Refuge, LA. These treatments created canopy openings (gaps) within which managers sought to regenerate shade-intolerant trees. Six years after prescribed harvests, we assessed regeneration in 41 canopy gaps and 4 large (>0.5-ha) patch cut openings that resulted from treatments and in 21 natural canopy gaps on 2 unharvested control stands. Mean gap area of anthropogenic gaps (582 m²) was greater than that of natural gaps (262 m²). Sweetgum (Liquidambar styraciflua) and red oaks (Quercus nigra, Q. nuttallii, and Q. phellos) were common in anthropogenic gaps, whereas elms (Ulmus spp.) and sugarberry (Celtis laevigata) were numerous in natural gaps. We recommend harvest prescriptions include gaps with diameter >25 m, because the proportion of shade-intolerant regeneration increased with gap area up to 500 m². The proportion of shade-intolerant definitive gap fillers (individuals likely to occupy the canopy) increased with gap area: 35 percent in natural gaps, 54 percent in anthropogenic gaps, and 84 percent in patch cuts. Sweetgum, green ash (Fraxinus pennsylvanica), and red oaks were common definitive gap fillers.

Achievements and Perspectives of the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Louvat, D.; Lacoste, A.C.

The Joint Convention on the Safety of Spent Fuel management and on the Safety of Radioactive Waste Management is the first legal instrument to directly address the safety of spent fuel and radioactive waste management on a global scale. The Joint Convention entered into force in 2001. This paper describes its process and its main achievements to date. The perspectives to establish of a Global Waste Safety Regime based on the Joint Convention are also discussed. (authors)

A study for safety and health management problem of semiconductor industry in Taiwan.

PubMed

Chao, Chin-Jung; Wang, Hui-Ming; Feng, Wen-Yang; Tseng, Feng-Yi

2008-12-01

The main purpose of this study is to discuss and explore the safety and health management in semiconductor industry. The researcher practically investigates and interviews the input, process and output of the safety and health management of semiconductor industry by using the questionnaires and the interview method which is developed according to the framework of the OHSAS 18001. The result shows that there are six important factors for the safety and health management in Taiwan semiconductor industry. 1. The company should make employee clearly understand the safety and health laws and standards. 2. The company should make the safety and health management policy known to the public. 3. The company should put emphasis on the pursuance of the safety and health management laws. 4. The company should prevent the accidents. 5. The safety and health message should be communicated sufficiently. 6. The company should consider safety and health norm completely.

Environment, Health, and Safety | NREL

Science.gov Websites

property, and the environment. View the Environmental Stewardship, Health, Safety, and Quality Management (OHSAS) 18001 certification demonstrates NREL's commitment to a health and safety management system that into all activities. NREL's staff and management are committed to managing health and safety risk

National Safety Council

MedlinePlus

... Safety Management Systems Workplace Safety Consulting Employee Perception Surveys Research Journey to Safety Excellence Join the Journey What ... Safety Management Systems Workplace Safety Consulting Employee Perception Surveys Research Journey to Safety Excellence Join the Journey What ...

Integrating info-gap decision theory with robust population management: a case study using the Mountain Plover.

PubMed

van der Burg, Max Post; Tyre, Andrew J

2011-01-01

Wildlife managers often make decisions under considerable uncertainty. In the most extreme case, a complete lack of data leads to uncertainty that is unquantifiable. Information-gap decision theory deals with assessing management decisions under extreme uncertainty, but it is not widely used in wildlife management. So too, robust population management methods were developed to deal with uncertainties in multiple-model parameters. However, the two methods have not, as yet, been used in tandem to assess population management decisions. We provide a novel combination of the robust population management approach for matrix models with the information-gap decision theory framework for making conservation decisions under extreme uncertainty. We applied our model to the problem of nest survival management in an endangered bird species, the Mountain Plover (Charadrius montanus). Our results showed that matrix sensitivities suggest that nest management is unlikely to have a strong effect on population growth rate, confirming previous analyses. However, given the amount of uncertainty about adult and juvenile survival, our analysis suggested that maximizing nest marking effort was a more robust decision to maintain a stable population. Focusing on the twin concepts of opportunity and robustness in an information-gap model provides a useful method of assessing conservation decisions under extreme uncertainty.

Findings From the National Machine Guarding Program

PubMed Central

Parker, David L.; Yamin, Samuel; Xi, Min; Gordon, Robert; Most, Ivan; Stanley, Rod

2017-01-01

Objectives: This manuscript assesses safety climate data from the National Machine Guarding Program (NMGP)—a nationwide intervention to improve machine safety. Methods: Baseline safety climate surveys were completed by 2161 employees and 341 owners or managers at 115 businesses. A separate onsite audit of safety management practices and machine guarding equipment was conducted at each business. Results: Safety climate measures were not correlated with machine guarding or safety management practices. The presence of a safety committee was correlated with higher scores on the safety management audit when contrasted with those without one. Conclusions: The presence of a safety committee is easily assessed and provides a basis on which to make recommendations with regard to how it functions. Measures of safety climate fail to provide actionable information. Future research on small manufacturing firms should emphasize the presence of an employee-management safety committee. PMID:28930801

Why Can't We Talk? : Working Together to Bridge the Communications Gap to Save Lives : A Guide For Public Officials

DOT National Transportation Integrated Search

2003-01-01

The inability of our public safety officials to readily communicate with each other threatens the publics safety and often results in unnecessary loss of lives and property. Recognizing that solutions to this national issue can only be achieved throu...

Vehicle-to-infrastructure (V2I) safety applications : performance requirements, vol. 7, stop sign gap assist (SSGA).

DOT National Transportation Integrated Search

2015-08-01

This document is the seventh of a seven volume report that describe the Performance Requirements for the connected vehicle vehicle-to-infrastructure (V2I) safety applications developed for the U.S. Department of Transportation (U.S. DOT). This volume...

Knowledge Management Assessment Trends

DTIC Science & Technology

2011-01-01

Recommendations for strategies and approaches to close the gaps An action plan with practical and operational solutions, along with a pilot and evaluation...access to a continuity book or a formal program to orient them to the organization. The BCKS assessment team has helped organizations close these gaps ...managers, and employees in the organization. The Knowledge Assessment identifies: • Knowledge and performance gaps • The causes or factors

The role of the ward manager in promoting patient safety.

PubMed

Pinnock, David

In this article the role of the ward manager in promoting patient safety is explored. The background to the development of the patient safety agenda is briefly discussed and the relationship between quality and safety is illustrated. The pivotal importance of the role of the ward manager in delivering services to patients is underlined and literature on patient safety is examined to identify what a ward manager can do to make care safer. Possible actions of the ward manager to improve safety discussed in the literature are structured around the Leadership Framework. This framework identifies seven domains for the leadership of service delivery. Ward managers use their personal qualities, and network and work within teams, while managing performance and facilitating innovation, change and measurement for improvement. The challenge of promoting patient safety for ward managers is briefly explored and recommendations for further research are made.

Safety intelligence: an exploration of senior managers' characteristics.

PubMed

Fruhen, L S; Mearns, K J; Flin, R; Kirwan, B

2014-07-01

Senior managers can have a strong influence on organisational safety. But little is known about which of their personal attributes support their impact on safety. In this paper, we introduce the concept of 'safety intelligence' as related to senior managers' ability to develop and enact safety policies and explore possible characteristics related to it in two studies. Study 1 (N = 76) involved direct reports to chief executive officers (CEOs) of European air traffic management (ATM) organisations, who completed a short questionnaire asking about characteristics and behaviours that are ideal for a CEO's influence on safety. Study 2 involved senior ATM managers (N = 9) in various positions in interviews concerning their day-to-day work on safety. Both studies indicated six attributes of senior managers as relevant for their safety intelligence, particularly, social competence and safety knowledge, followed by motivation, problem-solving, personality and interpersonal leadership skills. These results have recently been applied in guidance for safety management practices in a White Paper published by EUROCONTROL. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

The pie-crusting technique using a blade knife for medial collateral ligament release is unreliable in varus total knee arthroplasty.

PubMed

Kwak, Dai-Soon; In, Yong; Kim, Tae Kyun; Cho, Han Suk; Koh, In Jun

2016-01-01

Despite the documented clinical efficacy of the pie-crusting technique for medial collateral ligament (MCL) release in varus total knee arthroplasty, its quantitative effects on medial gaps and safety remain unclear. This study was undertaken to determine the efficacy (quantitative effect and consistency of the number of punctures) and the safety (frequency of early over-release) of the pie-crusting technique for MCL release. From ten pairs of cadaveric knees, one knee from each pair was randomly assigned to undergo pie crusting in extension (group E) or in flexion (group F). Pie crusting was performed in the superficial MCL using a blade until over-release occurred. After every puncture, the incremental medial gap increase was recorded, and the number of punctures required for 2- or 4-mm gap increases was assessed. In group E, the extension gap increased from 0.8 to 5.0 mm and the flexion gap increased from 0.8 to 3.0 mm. In group F, the extension gap increased from 1.0 to 3.0 mm and the flexion gap increased from 2.6 to 6.0 mm. However, the gap increments were inconsistent with those that followed the preceding blade punctures, and the number of punctures required to increase the gaps by 2 or 4 mm was variable. The number of punctures leading to over-release in group E and group F was 6 ± 1 and 3 ± 1 punctures, respectively. Overall, 70% of over-release occurred earlier than the average number of punctures leading to over-release. Pie crusting led to unpredictable gap increments and to frequent early over-release. Surgeons should decide carefully before using the pie-crusting technique for MCL release and should be cautious of performing throughout the procedure, especially when performing in a flexed knee. Therapeutic study, Level I.

Functional Land Management: Bridging the Think-Do-Gap using a multi-stakeholder science policy interface.

PubMed

O'Sullivan, Lilian; Wall, David; Creamer, Rachel; Bampa, Francesca; Schulte, Rogier P O

2018-03-01

Functional Land Management (FLM) is proposed as an integrator for sustainability policies and assesses the functional capacity of the soil and land to deliver primary productivity, water purification and regulation, carbon cycling and storage, habitat for biodiversity and recycling of nutrients. This paper presents the catchment challenge as a method to bridge the gap between science, stakeholders and policy for the effective management of soils to deliver these functions. Two challenges were completed by a wide range of stakeholders focused around a physical catchment model-(1) to design an optimised catchment based on soil function targets, (2) identify gaps to implementation of the proposed design. In challenge 1, a high level of consensus between different stakeholders emerged on soil and management measures to be implemented to achieve soil function targets. Key gaps including knowledge, a mix of market and voluntary incentives and mandatory measures were identified in challenge 2.

National Machine Guarding Program: Part 2. Safety management in small metal fabrication enterprises.

PubMed

Parker, David L; Yamin, Samuel C; Brosseau, Lisa M; Xi, Min; Gordon, Robert; Most, Ivan G; Stanley, Rodney

2015-11-01

Small manufacturing businesses often lack important safety programs. Many reasons have been set forth on why this has remained a persistent problem. The National Machine Guarding Program (NMGP) was a nationwide intervention conducted in partnership with two workers' compensation insurers. Insurance safety consultants collected baseline data in 221 business using a 33-question safety management audit. Audits were completed during an interview with the business owner or manager. Most measures of safety management improved with an increasing number of employees. This trend was particularly strong for lockout/tagout. However, size was only significant for businesses without a safety committee. Establishments with a safety committee scored higher (55% vs. 36%) on the safety management audit compared with those lacking a committee (P < 0.0001). Critical safety management programs were frequently absent. A safety committee appears to be a more important factor than business size in accounting for differences in outcome measures. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Application of Gap Analysis to Education: A Case Study of the Food Safety and Quality Assurance Program at the University of Guelph

ERIC Educational Resources Information Center

Fuchs, C.; Wilcock, A.; Aung, M.

2004-01-01

This study was designed to identify the skills and knowledge deemed important for food safety professionals and the degree to which the Food Safety and Quality Assurance (FSQA) program at the Univ. of Guelph helps students to develop these skills. The research included 2 phases: interviews were conducted to identify these skill and knowledge…

Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions.

PubMed

Jarrar, Mu'taman; Abdul Rahman, Hamzah; Don, Mohammad Sobri

2015-10-20

Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme "1 Care for 1 Malaysia" in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.

Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions

PubMed Central

Jarrar, Mu’taman; Rahman, Hamzah Abdul; Don, Mohammad Sobri

2016-01-01

Background and Objective: Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Design: Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. Results: The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme “1 Care for 1 Malaysia” in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. Conclusions: There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia. PMID:26755459

[Document management systems to support quality management systems at university hospitals - an interview-based study].

PubMed

Holderried, Martin; Bökel, Ann-Catrin; Ochsmann, Elke

2018-05-01

In order to save and control the processes and quality of medical services, a suitable steering system of all relevant documents is essential from the point of view of clinical quality management. Systems supporting an automated steering system of documents are called document management systems (DMS), and they also enter the healthcare sector. The use of DMS in the German healthcare sector has hardly been investigated so far. To close this knowledge gap, interviews were carried out with German university hospitals over a six-month period and subjected to a qualitative content analysis according to Mayring. In total, 25 university hospitals agreed to participate in this study, 19 of which have been working with a digital DMS for about six years on average. There was a great variety among the IT systems used. Document management and usability of the DMS as well as its integration into existing IT structures were key decision-making criteria for the selection of a digital DMS. In general, the long-term usability of the DMS is supported by regular evaluation of one's own requirements for the system, administration and training programs. In addition, DMS have a positive effect on patient safety and the quality of medical care. Copyright © 2018. Published by Elsevier GmbH.

Advanced Outage and Control Center: Strategies for Nuclear Plant Outage Work Status Capabilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gregory Weatherby

The research effort is a part of the Light Water Reactor Sustainability (LWRS) Program. LWRS is a research and development program sponsored by the Department of Energy, performed in close collaboration with industry to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants. The LWRS Program serves to help the US nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. The Outage Control Center (OCC) Pilot Project was directed at carrying out the applied researchmore » for development and pilot of technology designed to enhance safe outage and maintenance operations, improve human performance and reliability, increase overall operational efficiency, and improve plant status control. Plant outage management is a high priority concern for the nuclear industry from cost and safety perspectives. Unfortunately, many of the underlying technologies supporting outage control are the same as those used in the 1980’s. They depend heavily upon large teams of staff, multiple work and coordination locations, and manual administrative actions that require large amounts of paper. Previous work in human reliability analysis suggests that many repetitive tasks, including paper work tasks, may have a failure rate of 1.0E-3 or higher (Gertman, 1996). With between 10,000 and 45,000 subtasks being performed during an outage (Gomes, 1996), the opportunity for human error of some consequence is a realistic concern. Although a number of factors exist that can make these errors recoverable, reducing and effectively coordinating the sheer number of tasks to be performed, particularly those that are error prone, has the potential to enhance outage efficiency and safety. Additionally, outage management requires precise coordination of work groups that do not always share similar objectives. Outage managers are concerned with schedule and cost, union workers are concerned with performing work that is commensurate with their trade, and support functions (safety, quality assurance, and radiological controls, etc.) are concerned with performing the work within the plants controls and procedures. Approaches to outage management should be designed to increase the active participation of work groups and managers in making decisions that closed the gap between competing objectives and the potential for error and process inefficiency.« less

Building Collaboration: A Scoping Review of Cultural Competency and Safety Education and Training for Healthcare Students and Professionals in Canada.

PubMed

Guerra, Olivia; Kurtz, Donna

2017-01-01

Phenomenon: This scoping literature review summarizes current Canadian health science education and training aimed to lessen health gaps between Aboriginal and non-Aboriginal peoples. Keyword searches of peer-reviewed and gray literature databases, websites, and resources recommended by local Aboriginal community members identified 1,754 resources. Using specific inclusion and exclusion criteria, 26 resources relevant to education and training of healthcare professionals and students in Canada were selected. Information included self-assessment for cultural competency/safety skills, advocacy within Canadian healthcare, and descriptions of current programs and training approaches. In spite of increasing awareness and use of cultural competency and safety concepts, few programs have been successfully implemented. Insights: A concerted effort among health science education and training bodies to develop integrated and effective programs could result in comprehensive processes that hasten the Canadian culturally safe healthcare provision, thus reducing the gaps among populations.

33 CFR 96.250 - What documents and reports must a safety management system have?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Safety management system document and data maintenance (1) Procedures which establish and maintain control of all documents and data relevant to the safety management system. (2) Documents are available at... safety management system have? 96.250 Section 96.250 Navigation and Navigable Waters COAST GUARD...

33 CFR 96.240 - What functional requirements must a safety management system meet?

Code of Federal Regulations, 2010 CFR

2010-07-01

... a safety management system meet? 96.240 Section 96.240 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE SAFE OPERATION OF VESSELS AND SAFETY MANAGEMENT SYSTEMS Company and Vessel Safety Management Systems § 96.240 What functional...

33 CFR 96.230 - What objectives must a safety management system meet?

Code of Federal Regulations, 2010 CFR

2010-07-01

... management system meet? 96.230 Section 96.230 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE SAFE OPERATION OF VESSELS AND SAFETY MANAGEMENT SYSTEMS Company and Vessel Safety Management Systems § 96.230 What objectives must a safety...

76 FR 14592 - Safety Management System; Withdrawal

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

...-06A] RIN 2120-AJ15 Safety Management System; Withdrawal AGENCY: Federal Aviation Administration (FAA... (``product/ service providers'') to develop a Safety Management System (SMS). The FAA is withdrawing the... management with a set of robust decision-making tools to use to improve safety. The FAA received 89 comments...

77 FR 75176 - Drug Safety and Risk Management Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

...] Drug Safety and Risk Management Advisory Committee; Notice of Meeting AGENCY: Food and Drug... being rescheduled due to the postponement of the October 29-30, 2012, Drug Safety and Risk Management... Committee: Drug Safety and Risk Management Advisory Committee. General Function of the Committee: To provide...

77 FR 65000 - Drug Safety and Risk Management Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-24

...] Drug Safety and Risk Management Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Drug Safety and Risk Management Advisory Committee. General Function of the Committee: To provide... Use (ETASU) before CDER's Drug Safety and Risk Management Advisory Committee (DSaRM). The Agency plans...

78 FR 30929 - Drug Safety and Risk Management Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

...] Drug Safety and Risk Management Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Drug Safety and Risk Management Advisory Committee. General Function of the Committee: To provide... (REMS) with elements to assure safe use (ETASU) before its Drug Safety and Risk Management Advisory...

The determinants of employee participation in occupational health and safety management.

PubMed

Masso, Märt

2015-01-01

This article focuses on employee direct participation in occupational health and safety (OHS) management. The article explains what determines employee opportunities to participate in OHS management. The explanatory framework focuses on safety culture and safety management at workplaces. The framework is empirically tested using Estonian cross-sectional, multilevel data of organizations and their employees. The analysis indicates that differences in employee participation in OHS management in the Estonian case could be explained by differences in OHS management practices rather than differences in safety culture. This indicates that throughout the institutional change and shift to the European model of employment relations system, change in management practices has preceded changes in safety culture which according to theoretical argument is supposed to follow culture change.

The influence of environmental conditions on safety management in hospitals: a qualitative study.

PubMed

Alingh, Carien W; van Wijngaarden, Jeroen D H; Huijsman, Robbert; Paauwe, Jaap

2018-05-02

Hospitals are confronted with increasing safety demands from a diverse set of stakeholders, including governmental organisations, professional associations, health insurance companies, patient associations and the media. However, little is known about the effects of these institutional and competitive pressures on hospital safety management. Previous research has shown that organisations generally shape their safety management approach along the lines of control- or commitment-based management. Using a heuristic framework, based on the contextually-based human resource theory, we analysed how environmental pressures affect the safety management approach used by hospitals. A qualitative study was conducted into hospital care in the Netherlands. Five hospitals were selected for participation, based on organisational characteristics as well as variation in their reputation for patient safety. We interviewed hospital managers and staff with a central role in safety management. A total of 43 semi-structured interviews were conducted with 48 respondents. The heuristic framework was used as an initial model for analysing the data, though new codes emerged from the data as well. In order to ensure safe care delivery, institutional and competitive stakeholders often impose detailed safety requirements, strong forces for compliance and growing demands for accountability. As a consequence, hospitals experience a decrease in the room to manoeuvre. Hence, organisations increasingly choose a control-based management approach to make sure that safety demands are met. In contrast, in case of more abstract safety demands and an organisational culture which favours patient safety, hospitals generally experience more leeway. This often results in a stronger focus on commitment-based management. Institutional and competitive conditions as well as strategic choices that hospitals make have resulted in various combinations of control- and commitment-based safety management. A balanced approach is required. A strong focus on control-based management generates extrinsic motivation in employees but may, at the same time, undermine or even diminish intrinsic motivation to work on patient safety. Emphasising commitment-based management may, in contrast, strengthen intrinsic motivation but increases the risk of priorities being set elsewhere. Currently, external pressures frequently lead to the adoption of control-based management. A balanced approach requires a shift towards more trust-based safety demands.

Associations between safety climate and safety management practices in the construction industry.

PubMed

Marín, Luz S; Lipscomb, Hester; Cifuentes, Manuel; Punnett, Laura

2017-06-01

Safety climate, a group-level measure of workers' perceptions regarding management's safety priorities, has been suggested as a key predictor of safety outcomes. However, its relationship with actual injury rates is inconsistent. We posit that safety climate may instead be a parallel outcome of workplace safety practices, rather than a determinant of workers' safety behaviors or outcomes. Using a sample of 25 commercial construction companies in Colombia, selected by injury rate stratum (high, medium, low), we examined the relationship between workers' safety climate perceptions and safety management practices (SMPs) reported by safety officers. Workers' perceptions of safety climate were independent of their own company's implementation of SMPs, as measured here, and its injury rates. However, injury rates were negatively related to the implementation of SMPs. Safety management practices may be more important than workers' perceptions of safety climate as direct predictors of injury rates. © 2017 Wiley Periodicals, Inc.

Bridging the knowledge gap: an innovative surveillance system to monitor the health of British Columbia's healthcare workforce.

PubMed

Gilligan, Tony; Alamgir, Hasanat

2008-01-01

Healthcare workers are exposed to a variety of work-related hazards including biological, chemical, physical, ergonomic, psychological hazards; and workplace violence. The Occupational Health and Safety Agency for Healthcare in British Columbia (OHSAH), in conjunction with British Columbia (BC) health regions, developed and implemented a comprehensive surveillance system that tracks occupational exposures and stressors as well as injuries and illnesses among a defined population of healthcare workers. Workplace Health Indicator Tracking and Evaluation (WHITE) is a secure operational database, used for data entry and transaction reporting. It has five modules: Incident Investigation, Case Management, Employee Health, Health and Safety, and Early Intervention/Return to Work. Since the WHITE database was first introduced into BC in 2004, it has tracked the health of 84,318 healthcare workers (120,244 jobs), representing 35,927 recorded incidents, resulting in 18,322 workers' compensation claims. Currently, four of BC's six healthcare regions are tracking and analyzing incidents and the health of healthcare workers using WHITE, providing OHSAH and healthcare stakeholders with comparative performance indicators on workplace health and safety. A number of scientific manuscripts have also been published in peer-reviewed journals. The WHITE database has been very useful for descriptive epidemiological studies, monitoring health risk factors, benchmarking, and evaluating interventions.

Research on the management and endorsement of nuclear safety standards in the United States and its revelation for China

NASA Astrophysics Data System (ADS)

Liu, Ting; Tian, Yu; Yang, Lili; Gao, Siyi; Song, Dahu

2018-01-01

This paper introduces the American standard system, the Nuclear Regulatory Commission (NRC)’s responsibility, NRC nuclear safety regulations and standards system, studies on NRC’s standards management and endorsement mode, analyzes the characteristics of NRC standards endorsement management, and points out its disadvantages. This paper draws revelation from the standard management and endorsement model of NRC and points suggestion to China’s nuclear and radiation safety standards management.The issue of the “Nuclear Safety Law”plays an important role in China’s nuclear and radiation safety supervision. Nuclear and radiation safety regulations and standards are strong grips on the implementation of “Nuclear Safety Law”. This paper refers on the experience of international advanced countriy, will effectively promote the improvement of the endorsed management of China’s nuclear and radiation safety standards.

Forging community partnerships to improve health care: the experience of four Medicaid managed care organizations.

PubMed

Silow-Carroll, Sharon; Rodin, Diana

2013-04-01

Some managed care organizations (MCOs) serving Medicaid beneficiaries are actively engaging in community partnerships to meet the needs of vulnerable members and nonmembers. We found that the history, leadership, and other internal factors of four such MCOs primarily drive that focus. However, external factors such as state Medicaid policies and competition or collaboration among MCOs also play a role. The specific strat­egies of these MCOs vary but share common goals: (1) improve care coordination, access, and delivery; (2) strengthen the community and safety-net infrastructure; and (3) prevent illness and reduce disparities. The MCOs use data to identify gaps in care, seek community input in designing interventions, and commit resources to engage community organiza­tions. State Medicaid programs can promote such work by establishing goals, priorities, and guidelines; providing data analysis and technical assistance to evaluate local needs and community engagement efforts; and convening stakeholders to collaborate and share best practices.

Lean methodology in health care.

PubMed

Kimsey, Diane B

2010-07-01

Lean production is a process management philosophy that examines organizational processes from a customer perspective with the goal of limiting the use of resources to those processes that create value for the end customer. Lean manufacturing emphasizes increasing efficiency, decreasing waste, and using methods to decide what matters rather than accepting preexisting practices. A rapid improvement team at Lehigh Valley Health Network, Allentown, Pennsylvania, implemented a plan, do, check, act cycle to determine problems in the central sterile processing department, test solutions, and document improved processes. By using A3 thinking, a consensus building process that graphically depicts the current state, the target state, and the gaps between the two, the team worked to improve efficiency and safety, and to decrease costs. Use of this methodology has increased teamwork, created user-friendly work areas and processes, changed management styles and expectations, increased staff empowerment and involvement, and streamlined the supply chain within the perioperative area. Copyright (c) 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Post-disaster Risk Assessment for Hilly Terrain exposed to Seismic Loading

NASA Astrophysics Data System (ADS)

Yates, Katherine; Villeneuve, Marlene; Wilson, Thomas

2013-04-01

The 2010-present Canterbury earthquake sequence in the central South Island of New Zealand has identified and highlighted the value of practical, standardised and coordinated geotechnical risk assessment guidelines for inhabited structures in the aftermath of a geotechnical disaster. The lack of such guidelines and provisions to enforce risk assessments was a major gap which hindered coordinated, timely and transparent management of geotechnical risk. The earthquake sequence initiated a series of rockfall, cliff collapse and landslide events around the Port Hills southeast of Christchurch. This was particularly the case with the 22 February 2011 earthquakes, which put thousands of people inhabiting the area at risk. Lives were lost and thousands of houses and critical infrastructure were damaged. Given the highly seismic environment in New Zealand and a significant number of active faults near population centres, it is prudent to develop such guidelines to ensure response mechanisms and geotechnical risk assessment is effective following an earthquake rupture in a largely populated urban environment. For response and associated risk assessments to be effective, the mechanisms of the geotechnical failure should be taken into consideration as part of the life safety assessment. This is to ensure that the hazard's potential risk is fully assessed and encompassed in decisions regarding life safety. This paper examines the event sequence, slope failure mechanisms and the geotechnical risk management approach that developed immediately post-earthquake. It highlights experiences from key municipal, management and operational stakeholders who were involved in geotechnical risk assessment during the Canterbury earthquake sequence, and sheds light on the evolution of information needed through time during the emergency response and identify the hard won lessons. It then discusses what is needed for life safety assessment post-earthquake and create awareness of potential geotechnical hazards. This is not only important to New Zealand but has international implications as there are many other regions of the world also subject to high seismic risk.

Repeat prescribing of medications: A system‐centred risk management model for primary care organisations

PubMed Central

Price, Julie; Man, Shu Ling; Bartlett, Stephen; Taylor, Kate; Dinwoodie, Mark

2017-01-01

Abstract Rationale, aims and objectives Reducing preventable harm from repeat medication prescriptions is a patient safety priority worldwide. In the United Kingdom, repeat prescriptions items issued has doubled in the last 20 years from 5.8 to 13.3 items per patient per annum. This has significant resource implications and consequences for avoidable patient harms. Consequently, we aimed to test a risk management model to identify, measure, and reduce repeat prescribing system risks in primary care. Methods All 48 general medical practices in National Health Service (NHS) Lambeth Clinical Commissioning Group (an inner city area of south London in England) were recruited. Multiple interventions were implemented, including educational workshops, a web‐based risk monitoring system, and external reviews of repeat prescribing system risks by clinicians. Data were collected via documentation reviews and interviews and subject to basic thematic and descriptive statistical analyses. Results Across the 48 participating general practices, 62 unique repeat prescribing risks were identified on 505 occasions (eg, practices frequently experiencing difficulty interpreting medication changes on hospital discharge summaries), equating to a mean of 8.1 risks per practice (range: 1‐33; SD = 7.13). Seven hundred sixty‐seven system improvement actions were recommended across 96 categories (eg, alerting hospitals to illegible writing and delays with discharge summaries) with a mean of 15.6 actions per practice (range: 0‐34; SD = 8.0). Conclusions The risk management model tested uncovered important safety concerns and facilitated the development and communication of related improvement recommendations. System‐wide information on hazardous repeat prescribing and how this could be mitigated is very limited. The approach reported may have potential to close this gap and improve the reliability of general practice systems and patient safety, which should be of high interest to primary care organisations internationally. PMID:28370904

GAP Analysis Bulletin Number 15

USGS Publications Warehouse

Maxwell, Jill; Gergely, Kevin; Aycrigg, Jocelyn; Canonico, Gabrielle; Davidson, Anne; Coffey, Nicole

2008-01-01

The Mission of the Gap Analysis Program (GAP) is to promote conservation by providing broad geographic information on biological diversity to resource managers, planners, and policy makers who can use the information to make informed decisions. As part of the National Biological Information Infrastructure (NBII) ?a collaborative program to provide increased access to data and information on the nation?s biological resources--GAP data and analytical tools have been used in hundreds of applications: from basic research to comprehensive state wildlife plans; from educational projects in schools to ecoregional assessments of biodiversity. The challenge: keeping common species common means protecting them BEFORE they become threatened. To do this on a state or regional basis requires key information such as land cover descriptions, predicted distribution maps for native animals, and an assessment of the level of protection currently given to those plants and animals. GAP works cooperatively with Federal, state, and local natural resource professionals and academics to provide this kind of information. GAP activities focus on the creation of state and regional databases and maps that depict patterns of land management, land cover, and biodiversity. These data can be used to identify ?gaps? in conservation--instances where an animal or plant community is not adequately represented on the existing network of conservation lands. GAP is administered through the U.S. Geological Survey. Through building partnerships among disparate groups, GAP hopes to foster the kind of collaboration that is needed to address conservation issues on a broad scale. For more information, contact: John Mosesso National GAP Director 703-648-4079 Kevin Gergely National GAP Operations Manager 208-885-3565

76 FR 12300 - Safety Management System for Certificated Airports; Extension of Comment Period

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-07

...-0997; Notice No. 10-14] RIN 2120-AJ38 Safety Management System for Certificated Airports; Extension of...: Background On October 7, 2010, the FAA published Notice No. 10-14, entitled ``Safety Management System for... conclusions from the safety management systems proof of concept. The FAA anticipates making this report...

33 CFR 96.320 - What is involved to complete a safety management audit and when is it required to be completed?

Code of Federal Regulations, 2010 CFR

2010-07-01

... up the safety management system. (c) Actions required during safety management audits for a company... management system, as defined in subpart B of this part. (2) Make sure the audit complies with this subpart... safety management system is found during an audit, it must be reported in writing by the auditor: (1) For...

The price of safety: costs for mitigating and coping with Alpine hazards

NASA Astrophysics Data System (ADS)

Pfurtscheller, C.; Thieken, A. H.

2013-10-01

Due to limited public budgets and the need to economize, the analysis of costs of hazard mitigation and emergency management of natural hazards becomes increasingly important for public natural hazard and risk management. In recent years there has been a growing body of literature on the estimation of losses which supported to help to determine benefits of measures in terms of prevented losses. On the contrary, the costs of mitigation are hardly addressed. This paper thus aims to shed some light on expenses for mitigation and emergency services. For this, we analysed the annual costs of mitigation efforts in four regions/countries of the Alpine Arc: Bavaria (Germany), Tyrol (Austria), South Tyrol (Italy) and Switzerland. On the basis of PPP values (purchasing power parities), annual expenses on public safety ranged from EUR 44 per capita in the Free State of Bavaria to EUR 216 in the Autonomous Province of South Tyrol. To analyse the (variable) costs for emergency services in case of an event, we used detailed data from the 2005 floods in the Federal State of Tyrol (Austria) as well as aggregated data from the 2002 floods in Germany. The analysis revealed that multi-hazards, the occurrence and intermixture of different natural hazard processes, contribute to increasing emergency costs. Based on these findings, research gaps and recommendations for costing Alpine natural hazards are discussed.

Predicting safety culture: the roles of employer, operations manager and safety professional.

PubMed

Wu, Tsung-Chih; Lin, Chia-Hung; Shiau, Sen-Yu

2010-10-01

This study explores predictive factors in safety culture. In 2008, a sample 939 employees was drawn from 22 departments of a telecoms firm in five regions in central Taiwan. The sample completed a questionnaire containing four scales: the employer safety leadership scale, the operations manager safety leadership scale, the safety professional safety leadership scale, and the safety culture scale. The sample was then randomly split into two subsamples. One subsample was used for measures development, one for the empirical study. A stepwise regression analysis found four factors with a significant impact on safety culture (R²=0.337): safety informing by operations managers; safety caring by employers; and safety coordination and safety regulation by safety professionals. Safety informing by operations managers (ß=0.213) was by far the most significant predictive factor. The findings of this study provide a framework for promoting a positive safety culture at the group level. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

The STEP (Safety and Toxicity of Excipients for Paediatrics) database: part 2 - the pilot version.

PubMed

Salunke, Smita; Brandys, Barbara; Giacoia, George; Tuleu, Catherine

2013-11-30

The screening and careful selection of excipients is a critical step in paediatric formulation development as certain excipients acceptable in adult formulations, may not be appropriate for paediatric use. While there is extensive toxicity data that could help in better understanding and highlighting the gaps in toxicity studies, the data are often scattered around the information sources and saddled with incompatible data types and formats. This paper is the second in a series that presents the update on the Safety and Toxicity of Excipients for Paediatrics ("STEP") database being developed by Eu-US PFIs, and describes the architecture data fields and functions of the database. The STEP database is a user designed resource that compiles the safety and toxicity data of excipients that is scattered over various sources and presents it in one freely accessible source. Currently, in the pilot database data from over 2000 references/10 excipients presenting preclinical, clinical, regulatory information and toxicological reviews, with references and source links. The STEP database allows searching "FOR" excipients and "BY" excipients. This dual nature of the STEP database, in which toxicity and safety information can be searched in both directions, makes it unique from existing sources. If the pilot is successful, the aim is to increase the number of excipients in the existing database so that a database large enough to be of practical research use will be available. It is anticipated that this source will prove to be a useful platform for data management and data exchange of excipient safety information. Copyright © 2013 Elsevier B.V. All rights reserved.

Complexity analysis of the Next Gen Air Traffic Management System: trajectory based operations.

PubMed

Lyons, Rhonda

2012-01-01

According to Federal Aviation Administration traffic predictions currently our Air Traffic Management (ATM) system is operating at 150 percent capacity; forecasting that within the next two decades, the traffic with increase to a staggering 250 percent [17]. This will require a major redesign of our system. Today's ATM system is complex. It is designed to safely, economically, and efficiently provide air traffic services through the cost-effective provision of facilities and seamless services in collaboration with multiple agents however, contrary the vision, the system is loosely integrated and is suffering tremendously from antiquated equipment and saturated airways. The new Next Generation (Next Gen) ATM system is designed to transform the current system into an agile, robust and responsive set of operations that are designed to safely manage the growing needs of the projected increasingly complex, diverse set of air transportation system users and massive projected worldwide traffic rates. This new revolutionary technology-centric system is dynamically complex and is much more sophisticated than it's soon to be predecessor. ATM system failures could yield large scale catastrophic consequences as it is a safety critical system. This work will attempt to describe complexity and the complex nature of the NextGen ATM system and Trajectory Based Operational. Complex human factors interactions within Next Gen will be analyzed using a proposed dual experimental approach designed to identify hazards, gaps and elicit emergent hazards that would not be visible if conducted in isolation. Suggestions will be made along with a proposal for future human factors research in the TBO safety critical Next Gen environment.

Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines.

PubMed

Zhou, Lu-Jie; Cao, Qing-Gui; Yu, Kai; Wang, Lin-Lin; Wang, Hai-Bin

2018-04-26

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines.

Research on Occupational Safety, Health Management and Risk Control Technology in Coal Mines

PubMed Central

Zhou, Lu-jie; Cao, Qing-gui; Yu, Kai; Wang, Lin-lin; Wang, Hai-bin

2018-01-01

This paper studies the occupational safety and health management methods as well as risk control technology associated with the coal mining industry, including daily management of occupational safety and health, identification and assessment of risks, early warning and dynamic monitoring of risks, etc.; also, a B/S mode software (Geting Coal Mine, Jining, Shandong, China), i.e., Coal Mine Occupational Safety and Health Management and Risk Control System, is developed to attain the aforementioned objectives, namely promoting the coal mine occupational safety and health management based on early warning and dynamic monitoring of risks. Furthermore, the practical effectiveness and the associated pattern for applying this software package to coal mining is analyzed. The study indicates that the presently developed coal mine occupational safety and health management and risk control technology and the associated software can support the occupational safety and health management efforts in coal mines in a standardized and effective manner. It can also control the accident risks scientifically and effectively; its effective implementation can further improve the coal mine occupational safety and health management mechanism, and further enhance the risk management approaches. Besides, its implementation indicates that the occupational safety and health management and risk control technology has been established based on a benign cycle involving dynamic feedback and scientific development, which can provide a reliable assurance to the safe operation of coal mines. PMID:29701715

Why Can't We Talk? : Working Together to Bridge the Communications Gap to Save Lives : A Guide For Public Officials. Supplemental Resources

DOT National Transportation Integrated Search

2003-01-01

The inability of our public safety officials to readily communicate with each other threatens the publics safety and often results in unnecessary loss of lives and property. Recognizing that solutions to this national issue can only be achieved throu...

Evaluation of On-Farm Food Safety Programming in Pennsylvania: Implications for Extension

ERIC Educational Resources Information Center

Nayak, Roshan; Tobin, Daniel; Thomson, Joan; Radhakrishna, Rama; LaBorde, Luke

2015-01-01

Penn State Extension conducted on-farm food safety workshops statewide to train fruit and vegetable growers on Good Agricultural Practices (GAPs). These workshops were evaluated using pre- and post-tests to assess the impact of the training on participating growers. Results indicate overall increases in produce growers' knowledge, attitudes,…

How Can We Improve School Safety Research?

ERIC Educational Resources Information Center

Astor, Ron Avi; Guerra, Nancy; Van Acker, Richard

2010-01-01

The authors of this article consider how education researchers can improve school violence and school safety research by (a) examining gaps in theoretical, conceptual, and basic research on the phenomena of school violence; (b) reviewing key issues in the design and evaluation of evidence-based practices to prevent school violence; and (c)…

Challenges and strategies to facilitate formulation development of pediatric drug products: Safety qualification of excipients.

PubMed

Buckley, Lorrene A; Salunke, Smita; Thompson, Karen; Baer, Gerri; Fegley, Darren; Turner, Mark A

2018-02-05

A public workshop entitled "Challenges and strategies to facilitate formulation development of pediatric drug products" focused on current status and gaps as well as recommendations for risk-based strategies to support the development of pediatric age-appropriate drug products. Representatives from industry, academia, and regulatory agencies discussed the issues within plenary, panel, and case-study breakout sessions. By enabling practical and meaningful discussion between scientists representing the diversity of involved disciplines (formulators, nonclinical scientists, clinicians, and regulators) and geographies (eg, US, EU), the Excipients Safety workshop session was successful in providing specific and key recommendations for defining paths forward. Leveraging orthogonal sources of data (eg. food industry, agro science), collaborative data sharing, and increased awareness of the existing sources such as the Safety and Toxicity of Excipients for Paediatrics (STEP) database will be important to address the gap in excipients knowledge needed for risk assessment. The importance of defining risk-based approaches to safety assessments for excipients vital to pediatric formulations was emphasized, as was the need for meaningful stakeholder (eg, patient, caregiver) engagement. Copyright © 2017 Elsevier B.V. All rights reserved.

Examining the Relationship between Safety Management System Implementation and Safety Culture in Collegiate Flight Schools

ERIC Educational Resources Information Center

Robertson, Mike Fuller

2017-01-01

Safety Management Systems (SMS) are becoming the industry standard for safety management throughout the aviation industry. As the Federal Aviation Administration (FAA) continues to mandate SMS for different segments, the assessment of an organization's safety culture becomes more important. An SMS can facilitate the development of a strong…

46 CFR 71.75-13 - Safety Management Certificate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 3 2010-10-01 2010-10-01 false Safety Management Certificate. 71.75-13 Section 71.75-13... CERTIFICATION Certificates Under the International Convention for Safety of Life at Sea, 1960 § 71.75-13 Safety... valid Safety Management Certificate and a copy of their company's valid Document of Compliance...

National machine guarding program: Part 2. Safety management in small metal fabrication enterprises

PubMed Central

Yamin, Samuel C.; Brosseau, Lisa M.; Xi, Min; Gordon, Robert; Most, Ivan G.; Stanley, Rodney

2015-01-01

Background Small manufacturing businesses often lack important safety programs. Many reasons have been set forth on why this has remained a persistent problem. Methods The National Machine Guarding Program (NMGP) was a nationwide intervention conducted in partnership with two workers' compensation insurers. Insurance safety consultants collected baseline data in 221 business using a 33‐question safety management audit. Audits were completed during an interview with the business owner or manager. Results Most measures of safety management improved with an increasing number of employees. This trend was particularly strong for lockout/tagout. However, size was only significant for businesses without a safety committee. Establishments with a safety committee scored higher (55% vs. 36%) on the safety management audit compared with those lacking a committee (P < 0.0001). Conclusions Critical safety management programs were frequently absent. A safety committee appears to be a more important factor than business size in accounting for differences in outcome measures. Am. J. Ind. Med. 58:1184–1193, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26345591

Using info-Gap Decision Theory for Water Resources Planning Under Severe Uncertainty

NASA Astrophysics Data System (ADS)

Korteling, B.; Brazier, R.; Kapelan, Z.; Dessai, S.

2012-12-01

Water resource managers are required to develop comprehensive water resource plans based on severely uncertain information of the effects of climate change on local hydrology and future socio-economic changes on localised demand. In England and Wales, current water resource planning methodologies include a headroom estimation process that quantifies uncertainty based on only one point of an assumed range of deviations from the expected climate and projected demand 25 years into the future. There are many situations where there is not enough knowledge to be able to estimate a representative probability of occurrence, or to be confident that the tails of an assumed probability distribution will not exhibit unexpected skewness, or that the kurtosis of a distribution differs from the norm. These situations can be considered severely uncertain. Information-Gap decision theory offers a method to sample a wider range of uncertainty than with traditional methods, and as a result, compare the robustness of various water resource management options under conditions of severe uncertainty. A more robust management option is one that delivers the same level of performance as other options at higher levels of uncertainty. A case study is based on a Water Supply Area that encompasses the county of Cornwall in southwest England containing 17 reservoirs and 19 demand nodes. The performance success of management options are evaluated primarily by measures of water availability including a reservoir risk measure that tests the probability and magnitude that strategic reservoir storage levels fall below the drought management curve under adverse conditions and also a safety margin deficit that tests how quickly reservoir levels can return to optimum operating levels in favourable conditions. Multi-Criteria Decision Analysis (MCDA) is used to test the effectiveness of different management options with different weightings for metrics other than water availability including; capital and operating costs, costs to customers, carbon emissions, environmental impact and social acceptability. Findings show that beyond the uncertainty range explored with the traditional headroom method, preference reversals can occur, i.e. some management options that underperform at lower uncertainties, outperform at higher levels of uncertainty. This study also shows that when 50% or more of the population adopts demand side management, efficiency related measures and innovative options such as rainwater collection can perform equally well or better than some supply side options. The additional use of MCDA shifts the focus away from reservoir expansion options that perform best with respect to water availability, to combined strategies that include innovative demand side management actions of rainwater collection and greywater reuse as well as efficiency measures and additional regional transfers. This research illustrates how an Info-Gap based approach can offer a comprehensive picture of potential supply/demand futures and a rich variety of information to support adaptive management of water systems under severe uncertainty.

Dune management challenges on developed coasts

USGS Publications Warehouse

Elko, Nicole A.; Brodie, Kate; Stockdon, Hilary F.; Nordstrom, Karl F.; Houser, Chris; McKenna, Kim; Moore, Laura; Rosati, Julie D.; Ruggiero, Peter; Thuman, Roberta; Walker, Ian J.

2015-01-01

From October 26-28, 2015, nearly 100 members of the coastal management and research communities met in Kitty Hawk, NC, USA to bridge the apparent gap between the coastal dune research of scientists and engineers and the needs of coastal management practitioners. The workshop aimed to identify the challenges involved in building and managing dunes on developed coasts, assess the extent to which scientific knowledge can be applied to the management community, and identify approaches to provide means to bridge the gap between needs and potential solutions.

Effective Safety Management in Construction Project

NASA Astrophysics Data System (ADS)

Othman, I.; Shafiq, Nasir; Nuruddin, M. F.

2017-12-01

Effective safety management is one of the serious problems in the construction industry worldwide, especially in large-scale construction projects. There have been significant reductions in the number and the rate of injury over the last 20 years. Nevertheless, construction remains as one of the high risk industry. The purpose of this study is to examine safety management in the Malaysian construction industry, as well as to highlight the importance of construction safety management. The industry has contributed significantly to the economic growth of the country. However, when construction safety management is not implemented systematically, accidents will happen and this can affect the economic growth of the country. This study put the safety management in construction project as one of the important elements to project performance and success. The study emphasize on awareness and the factors that lead to the safety cases in construction project.

Safety management in multiemployer worksites in the manufacturing industry: opinions on co-operation and problems encountered.

PubMed

Nenonen, Sanna; Vasara, Juha

2013-01-01

Co-operation between different parties and effective safety management play an important role in ensuring safety in multiemployer worksites. This article reviews safety co-operation and factors complicating safety management in Finnish multiemployer manufacturing worksites. The paper focuses on the service providers' opinions; however, a comparison of the customers' views is also presented. The results show that safety-related co-operation between providers and customers is generally considered as successful but strongly dependent on the partner. Safety co-operation is provided through, e.g., training, orientation and risk analysis. Problems encountered include ensuring adequate communication, identifying hazards, co-ordinating work tasks and determining responsibilities. The providers and the customers encounter similar safety management problems. The results presented in this article can help companies to focus their efforts on the most problematic points of safety management and to avoid common pitfalls.

Evaluation of the Quality of Occupational Health and Safety Management Systems Based on Key Performance Indicators in Certified Organizations.

PubMed

Mohammadfam, Iraj; Kamalinia, Mojtaba; Momeni, Mansour; Golmohammadi, Rostam; Hamidi, Yadollah; Soltanian, Alireza

2017-06-01

Occupational Health and Safety Management Systems are becoming more widespread in organizations. Consequently, their effectiveness has become a core topic for researchers. This paper evaluates the performance of the Occupational Health and Safety Assessment Series 18001 specification in certified companies in Iran. The evaluation is based on a comparison of specific criteria and indictors related to occupational health and safety management practices in three certified and three noncertified companies. Findings indicate that the performance of certified companies with respect to occupational health and safety management practices is significantly better than that of noncertified companies. Occupational Health and Safety Assessment Series 18001-certified companies have a better level of occupational health and safety; this supports the argument that Occupational Health and Safety Management Systems play an important strategic role in health and safety in the workplace.

Sources of uncertanity as a basis to fill the information gap in a response to flood

NASA Astrophysics Data System (ADS)

Kekez, Toni; Knezic, Snjezana

2016-04-01

Taking into account uncertainties in flood risk management remains a challenge due to difficulties in choosing adequate structural and/or non-structural risk management options. Despite stated measures wrong decisions are often being made when flood occurs. Parameter and structural uncertainties which include model and observation errors as well as lack of knowledge about system characteristics are the main considerations. Real time flood risk assessment methods are predominantly based on measured water level values and vulnerability as well as other relevant characteristics of flood affected area. The goal of this research is to identify sources of uncertainties and to minimize information gap between the point where the water level is measured and the affected area, taking into consideration main uncertainties that can affect risk value at the observed point or section of the river. Sources of uncertainties are identified and determined using system analysis approach and relevant uncertainties are included in the risk assessment model. With such methodological approach it is possible to increase response time with more effective risk assessment which includes uncertainty propagation model. Response phase could be better planned with adequate early warning systems resulting in more time and less costs to help affected areas and save human lives. Reliable and precise information is necessary to raise emergency operability level in order to enhance safety of citizens and reducing possible damage. The results of the EPISECC (EU funded FP7) project are used to validate potential benefits of this research in order to improve flood risk management and response methods. EPISECC aims at developing a concept of a common European Information Space for disaster response which, among other disasters, considers the floods.

Gaps in Data for American Indians and Alaska Natives in the National Healthcare Disparities Report

ERIC Educational Resources Information Center

Moy, Ernest; Smith, Colleen Ryan; Johansson, Patrik; Andrews, Roxanne

2006-01-01

The aim of this study was to identify and quantify gaps in health care data for American Indians and Alaska Natives. Findings indicate that only 42% of measures of health care quality and access tracked in the National Healthcare Disparities Report could be used to assess disparities among American Indians and Alaska Natives. Patient safety data…

Implementation of Good Agricultural Practices Food Safety Standards on Mid-Atlantic States and New York Produce Farms

ERIC Educational Resources Information Center

Nayak, Roshan

2016-01-01

In the wake of multistate outbreaks and subsequent economic cost and health causalities, food industry stakeholders formulated policies for their produce suppliers. The U.S. Food and Drug Administration's guidance on Good Agricultural Practices (GAPs) have been the basis for most of the industry initiated GAP certifications or audit processes. In…

75 FR 17417 - Joint Meeting of the Arthritis Advisory Committee and the Drug Safety and Risk Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-06

...] Joint Meeting of the Arthritis Advisory Committee and the Drug Safety and Risk Management Advisory... Arthritis Advisory Committee and the Drug Safety and Risk Management Advisory Committee. This meeting was... Drug Safety and Risk Management Advisory Committee would be held on May 12, 2010. On page 10490, in the...

SafetyAnalyst : software tools for safety management of specific highway sites

DOT National Transportation Integrated Search

2010-07-01

SafetyAnalyst provides a set of software tools for use by state and local highway agencies for highway safety management. SafetyAnalyst can be used by highway agencies to improve their programming of site-specific highway safety improvements. SafetyA...

Leadership for safety: industrial experience.

PubMed

Flin, R; Yule, S

2004-12-01

The importance of leadership for effective safety management has been the focus of research attention in industry for a number of years, especially in energy and manufacturing sectors. In contrast, very little research into leadership and safety has been carried out in medical settings. A selective review of the industrial safety literature for leadership research with possible application in health care was undertaken. Emerging findings show the importance of participative, transformational styles for safety performance at all levels of management. Transactional styles with attention to monitoring and reinforcement of workers' safety behaviours have been shown to be effective at the supervisory level. Middle managers need to be involved in safety and foster open communication, while ensuring compliance with safety systems. They should allow supervisors a degree of autonomy for safety initiatives. Senior managers have a prime influence on the organisation's safety culture. They need to continuously demonstrate a visible commitment to safety, best indicated by the time they devote to safety matters.

30 CFR 285.652 - How long do I have to conduct activities under an approved GAP?

Code of Federal Regulations, 2010 CFR

2010-07-01

... an approved GAP? 285.652 Section 285.652 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF... SHELF Plans and Information Requirements Activities Under An Approved Gap § 285.652 How long do I have to conduct activities under an approved GAP? After MMS approves your GAP, you have: (a) For a limited...

30 CFR 285.652 - How long do I have to conduct activities under an approved GAP?

Code of Federal Regulations, 2011 CFR

2011-07-01

... an approved GAP? 285.652 Section 285.652 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT... FACILITIES ON THE OUTER CONTINENTAL SHELF Plans and Information Requirements Activities Under An Approved Gap § 285.652 How long do I have to conduct activities under an approved GAP? After MMS approves your GAP...

Brazed Joints Design and Allowables: Discuss Margins of Safety in Critical Brazed Structures

NASA Technical Reports Server (NTRS)

FLom, Yury

2009-01-01

This slide presentation tutorial discusses margins of safety in critical brazed structures. It reviews: (1) the present situation (2) definition of strength (3) margins of safety (4) design allowables (5) mechanical testing (6) failure criteria (7) design flowchart (8) braze gap (9) residual stresses and (10) delayed failures. This presentation addresses the strength of the brazed joints, the methods of mechanical testing, and our ability to evaluate the margins of safety of the brazed joints as it applies to the design of critical and expensive brazed assemblies.

Error reduction, patient safety and institutional ethics committees.

PubMed

Meaney, Mark E

2004-01-01

Institutional ethics committees remain largely absent from the literature on error reduction and patient safety. In this paper, the author endeavors to fill the gap. As noted in the Hastings Center's recent report, "Promoting Patient Safety," the occurrence of medical error involves complex web of multiple factors. Human misstep is certainly one such factor, but not the only one. This paper builds on the Hastings Center's report in arguing that institutional ethics committees ought to play an integral role in the transformation of a "culture of blame" to a "culture of safety" in healthcare delivery.

Building Comprehensive Strategies for Obstetric Safety: Simulation Drills and Communication.

PubMed

Austin, Naola; Goldhaber-Fiebert, Sara; Daniels, Kay; Arafeh, Julie; Grenon, Veronique; Welle, Dana; Lipman, Steven

2016-11-01

As pioneers in the field of patient safety, anesthesiologists are uniquely suited to help develop and implement safety strategies to minimize preventable harm on the labor and delivery unit. Most existing obstetric safety strategies are not comprehensive, lack input from anesthesiologists, are designed with a relatively narrow focus, or lack implementation details to allow customization for different units. This article attempts to address these gaps and build more comprehensive strategies by discussing the available evidence and multidisciplinary authors' local experience with obstetric simulation drills and optimization of team communication.

Safety climate and safety behaviors in the construction industry: The importance of co-workers commitment to safety.

PubMed

Schwatka, Natalie V; Rosecrance, John C

2016-06-16

There is growing empirical evidence that as safety climate improves work site safety practice improve. Safety climate is often measured by asking workers about their perceptions of management commitment to safety. However, it is less common to include perceptions of their co-workers commitment to safety. While the involvement of management in safety is essential, working with co-workers who value and prioritize safety may be just as important. To evaluate a concept of safety climate that focuses on top management, supervisors and co-workers commitment to safety, which is relatively new and untested in the United States construction industry. Survey data was collected from a cohort of 300 unionized construction workers in the United States. The significance of direct and indirect (mediation) effects among safety climate and safety behavior factors were evaluated via structural equation modeling. Results indicated that safety climate was associated with safety behaviors on the job. More specifically, perceptions of co-workers commitment to safety was a mediator between both management commitment to safety climate factors and safety behaviors. These results support workplace health and safety interventions that build and sustain safety climate and a commitment to safety amongst work teams.

Harvest-created canopy gaps increase species and functional trait diversity of the forest ground-layer community

Treesearch

Christel C. Kern; Rebecca A. Montgomery; Peter B. Reich; Terry F. Strong

2014-01-01

Biodiversity conservation within managed forests depends, in part, on management practices that restore or maintain plant community diversity and function. Because many plant communities are adapted to natural disturbances, gap-based management has potential to meet this need by using the historical range of variation in canopy disturbances to guide elements of harvest...

Adaptive environmental management of tourism in the province of Siena, Italy using the ecological footprint.

Treesearch

Trista M. Patterson; Valentina Niccolucci; Nadia Marchettini

2007-01-01

Adaptive management as applied to tourism policy treats management policies as experiments that probe the responses of the system as human behavior changes. We present a conceptual systems model that incorporates the gap between observed and desired levels of the ecological footprint with respect to biocapacity. Addressing this gap (or "overshoot") can inform...

Elements for harnessing participatory action research to strengthen health managers' capacity: a critical interpretative synthesis.

PubMed

Tetui, Moses; Zulu, Joseph Mumba; Hurtig, Anna-Karin; Ekirapa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

2018-04-19

Health managers play a key role in ensuring that health services are responsive to the needs of the population. Participatory action research (PAR) is one of the approaches that have been used to strengthen managers' capacity. However, collated knowledge on elements for harnessing PAR to strengthen managers' capacity is missing. This paper bridges this gap by reviewing existing literature on the subject matter. A critical interpretive synthesis method was used to interrogate eight selected articles. These articles reported the use of PAR to strengthen health managers' capacity. The critical interpretive synthesis method's approach to analysis guided the synthesis. Here, the authors interpretively made connections and linkages between different elements identified in the literature. Finally, the Atun et al. (Heal Pol Plann, 25:104-111, 2010) framework on integration was used to model the elements synthesised in the literature into five main domains. Five elements with intricate bi-directional interactions were identified in the literature reviewed. These included a shared purpose, skilled facilitation and psychological safety, activity integration into organisational procedures, organisational support, and external supportive monitoring. A shared purpose of the managers' capacity strengthening initiative created commitment and motivation to learn. This purpose was built upon a set of facilitation skills that included promoting participation, self-efficacy and reflection, thereby creating a safe psychological space within which the managers interacted and learnt from each other and their actions. Additionally, an integrated intervention strengthened local capacity and harnessed organisational support for learning. Finally, supportive monitoring from external partners, such as researchers, ensured quality, building of local capacity and professional safety networks essential for continued learning. The five elements identified in this synthesis provide a basis upon which the use of PAR can be harnessed, not only to strengthen health managers' capacity, but also to foster other health systems strengthening initiatives involving implementation research. In addition, the findings demonstrated the intricate and complex relations between the elements, which further affirms the need for a systems thinking approach to tackling health systems challenges.

Modeling when and where a secondary accident occurs.

PubMed

Wang, Junhua; Liu, Boya; Fu, Ting; Liu, Shuo; Stipancic, Joshua

2018-01-31

The occurrence of secondary accidents leads to traffic congestion and road safety issues. Secondary accident prevention has become a major consideration in traffic incident management. This paper investigates the location and time of a potential secondary accident after the occurrence of an initial traffic accident. With accident data and traffic loop data collected over three years from California interstate freeways, a shock wave-based method was introduced to identify secondary accidents. A linear regression model and two machine learning algorithms, including a back-propagation neural network (BPNN) and a least squares support vector machine (LSSVM), were implemented to explore the distance and time gap between the initial and secondary accidents using inputs of crash severity, violation category, weather condition, tow away, road surface condition, lighting, parties involved, traffic volume, duration, and shock wave speed generated by the primary accident. From the results, the linear regression model was inadequate in describing the effect of most variables and its goodness-of-fit and accuracy in prediction was relatively poor. In the training programs, the BPNN and LSSVM demonstrated adequate goodness-of-fit, though the BPNN was superior with a higher CORR and lower MSE. The BPNN model also outperformed the LSSVM in time prediction, while both failed to provide adequate distance prediction. Therefore, the BPNN model could be used to forecast the time gap between initial and secondary accidents, which could be used by decision makers and incident management agencies to prevent or reduce secondary collisions. Copyright © 2018 Elsevier Ltd. All rights reserved.

A pilot survey of the U.S. medical waste industry to determine training needs for safely handling highly infectious waste.

PubMed

Le, Aurora B; Hoboy, Selin; Germain, Anne; Miller, Hal; Thompson, Richard; Herstein, Jocelyn J; Jelden, Katelyn C; Beam, Elizabeth L; Gibbs, Shawn G; Lowe, John J

2018-02-01

The recent Ebola outbreak led to the development of Ebola virus disease (EVD) best practices in clinical settings. However, after the care of EVD patients, proper medical waste management and disposal was identified as a crucial component to containing the virus. Category A waste-contaminated with EVD and other highly infectious pathogens-is strictly regulated by governmental agencies, and led to only several facilities willing to accept the waste. A pilot survey was administered to determine if U.S. medical waste facilities are prepared to handle or transport category A waste, and to determine waste workers' current extent of training to handle highly infectious waste. Sixty-eight percent of survey respondents indicated they had not determined if their facility would accept category A waste. Of those that had acquired a special permit, 67% had yet to modify their permit since the EVD outbreak. This pilot survey underscores gaps in the medical waste industry to handle and respond to category A waste. Furthermore, this study affirms reports a limited number of processing facilities are capable or willing to accept category A waste. Developing the proper management of infectious disease materials is essential to close the gaps identified so that states and governmental entities can act accordingly based on the regulations and guidance developed, and to ensure public safety. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The Safety Attitudes of Senior Managers in the Chinese Coal Industry.

PubMed

Zhang, Jiangshi; Chen, Na; Fu, Gui; Yan, Mingwei; Kim, Young-Chan

2016-11-17

Introduction: Senior managers' attitudes towards safety are very important regarding the safety practices in an organization. The study is to describe the current situation of senior managers' attitudes towards safety in the Chinese coal industry. Method : We evaluated the changing trends as well as the reasons for these changes in the Chinese coal industry in 2009 and in 2014 with 168 senior manager samples from large Chinese state-owned coal enterprises. Evaluations of 15 safety concepts were performed by means of a questionnaire. Results and Conclusions : Results indicate that, in 2014, three concepts were at a very high level (mean > 4.5), and six were at a relatively high level (4.5 > mean > 4.0). Analyses of changing trends revealed that nine concepts improved significantly, while four greatly declined in 2014 compared to those in 2009. The data reported here suggest that the reasons for the significant improvement with respect to the nine concepts include the improvement in social and legal environments, the improvement of the culture of social safety, workers' safety demands being met, and scientific and technical advances in the coal industry. The decline of the four concepts seemed to be caused by a poor awareness of managers in the coal industry that safety creates economic benefits, insufficient information on safety, inadequate attention to the development of a safety culture and safety management methods, and safety organizations and workers' unions not playing their role effectively. Practical Applications : We therefore recommend strengthening the evidence that safety creates economic benefits, providing incentives for employees to encourage their participation in safety management, and paying more attention to the prevention of accidents in coal mines via safety organizations and unions. These results can provide guidelines for workers, industrialists, and government regarding occupational safety in the whole coal industry.

[Quality management and safety culture in medicine: context and concepts].

PubMed

Wischet, Werner; Eitzinger, Claudia

2009-01-01

The publication of the IOM report "To err is human: building a safer health system" in 1999 put spotlight on the primacy of the principle of primum non nocere and made patient safety a central topic of quality management. A key conclusion of the report was the need for a well-developed safety culture. While concepts of quality management have evolved along the lines of ISO and Total Quality Management over the last decades patient safety still has not got the same amount of attention (PubMed). Evidence from other safety-critical areas but also from the field of medicine itself suggests that an efficient culture of safety is a conditio sine qua non for the sustainable improvement of patient safety. Considering these arguments the present paper aims at emphasizing the importance of an efficient culture of safety for patient safety and quality management in healthcare. In addition, key instruments of safety culture as well as their limitations will be presented.

Feasibility, safety, acceptability, and preliminary efficacy of measurement-based care depression treatment for HIV patients in Bamenda, Cameroon.

PubMed

Pence, Brian W; Gaynes, Bradley N; Atashili, Julius; O'Donnell, Julie K; Kats, Dmitry; Whetten, Kathryn; Njamnshi, Alfred K; Mbu, Tabenyang; Kefie, Charles; Asanji, Shantal; Ndumbe, Peter

2014-06-01

Depression affects 18-30 % of HIV-infected patients in Africa and is associated with greater stigma, lower antiretroviral adherence, and faster disease progression. However, the region's health system capacity to effectively identify and treat depression is limited. Task-shifting models may help address this large mental health treatment gap. Measurement-Based Care (MBC) is a task-shifting model in which a Depression Care Manager guides a non-psychiatric (e.g., HIV) provider in prescribing and managing antidepressant treatment. We adapted MBC for depressed HIV-infected patients in Cameroon and completed a pilot study to assess feasibility, safety, acceptability, and preliminary efficacy. We enrolled 55 participants; all started amitriptyline 25-50 mg daily at baseline. By 12 weeks, most remained at 50 mg daily (range 25-125 mg). Median (interquartile range) PHQ-9 depressive severity scores declined from 13 (12-16) (baseline) to 2 (0-3) (week 12); 87 % achieved depression remission (PHQ-9 <5) by 12 weeks. Intervention fidelity was high: HIV providers followed MBC recommendations at 96 % of encounters. Most divergences reflected a failure to increase dose when indicated. No serious and few bothersome side effects were reported. Most suicidality (prevalence 62 % at baseline; 8 % at 12 weeks) was either passive or low-risk. Participant satisfaction was high (100 %), and most participants (89 %) indicated willingness to pay for medications if MBC were implemented in routine care. The adapted MBC intervention demonstrated high feasibility, safety, acceptability, and preliminary efficacy in this uncontrolled pilot study. Further research should assess whether MBC could improve adherence and HIV outcomes in this setting.

Lost in hospital: a qualitative interview study that explores the perceptions of NHS inpatients who spent time on clinically inappropriate hospital wards.

PubMed

Goulding, Lucy; Adamson, Joy; Watt, Ian; Wright, John

2015-10-01

Prior research suggests that the placement of patients on clinically inappropriate hospital wards may increase the risk of experiencing patient safety issues. To explore patients' perspectives of the quality and safety of the care received during their inpatient stay on a clinically inappropriate hospital ward. Qualitative study using semi-structured interviews. Nineteen patients who had spent time on at least one clinically inappropriate ward during their hospital stay at a large NHS teaching hospital in England. Patients would prefer to be treated on the correct specialty ward, but it is generally accepted that this may not be possible. When patients are placed on inappropriate wards, they may lack a sense of belonging. Participants commented on potential failings in communication, medical staff availability, nurses' knowledge and the resources available, each of which may contribute to unsafe care. Patients generally acknowledge the need for placement on inappropriate wards due to demand for inpatient beds, but may report dissatisfaction in terms of preference and belonging. Importantly, patients recount issues resulting from this placement that may compromise their safety. Hospital managers should be encouraged to appreciate this insight and potential threat to safe practice and where possible avoid inappropriate ward transfers and admissions. Where such admissions are unavoidable, staff should take action to address the gaps in safety of care that have been identified. © 2013 John Wiley & Sons Ltd.

The Human Dimension of Closing the Training Gap for Fifth-Generation Fighters

NASA Technical Reports Server (NTRS)

Hoke, Jaclyn; Postnikov, Alex; Schnell, Thomas

2012-01-01

Based on a review of the recent technical literature there is little question that a serious training gap exists for fifth-generation fighters, primarily arising from the need to provide their own red-air. There are several methods for reducing this gap, including injecting virtual and constructive threats into the live cockpit. This live-virtual-constructive (LVC) training approach provides a cost effective means for addressing training needs but faces several challenges. Technical challenges include data links and information assurance. A more serious challenge may be the human factors dimension of representing virtual and constructive entities in the cockpit while ensuring safety-of-flight. This also needs to happen without increasing pilot workload. This paper discusses the methods Rockwell Collins and the University of Iowa's Operator Performance Lab use to assess pilot workload and training fidelity measures in an LVC training environment and the research we are conducting in safety-of-flight requirements of integrated LVC symbology.

41 CFR 102-80.110 - What must an equivalent level of safety analysis indicate?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What must an equivalent... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety...

Achieving Safety through Security Management

NASA Astrophysics Data System (ADS)

Ridgway, John

Whilst the achievement of safety objectives may not be possible purely through the administration of an effective Information Security Management System (ISMS), your job as safety manager will be significantly eased if such a system is in place. This paper seeks to illustrate the point by drawing a comparison between two of the prominent standards within the two disciplines of security and safety management.

41 CFR 128-1.8004 - Seismic Safety Coordinators.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false Seismic Safety... Management Regulations System (Continued) DEPARTMENT OF JUSTICE 1-INTRODUCTION 1.80-Seismic Safety Program § 128-1.8004 Seismic Safety Coordinators. (a) The Justice Management Division shall designate an...

41 CFR 128-1.8004 - Seismic Safety Coordinators.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false Seismic Safety... Management Regulations System (Continued) DEPARTMENT OF JUSTICE 1-INTRODUCTION 1.80-Seismic Safety Program § 128-1.8004 Seismic Safety Coordinators. (a) The Justice Management Division shall designate an...

41 CFR 128-1.8004 - Seismic Safety Coordinators.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false Seismic Safety... Management Regulations System (Continued) DEPARTMENT OF JUSTICE 1-INTRODUCTION 1.80-Seismic Safety Program § 128-1.8004 Seismic Safety Coordinators. (a) The Justice Management Division shall designate an...

41 CFR 128-1.8004 - Seismic Safety Coordinators.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false Seismic Safety... Management Regulations System (Continued) DEPARTMENT OF JUSTICE 1-INTRODUCTION 1.80-Seismic Safety Program § 128-1.8004 Seismic Safety Coordinators. (a) The Justice Management Division shall designate an...

Scale development of safety management system evaluation for the airline industry.

PubMed

Chen, Ching-Fu; Chen, Shu-Chuan

2012-07-01

The airline industry relies on the implementation of Safety Management System (SMS) to integrate safety policies and augment safety performance at both organizational and individual levels. Although there are various degrees of SMS implementation in practice, a comprehensive scale measuring the essential dimensions of SMS is still lacking. This paper thus aims to develop an SMS measurement scale from the perspective of aviation experts and airline managers to evaluate the performance of company's safety management system, by adopting Schwab's (1980) three-stage scale development procedure. The results reveal a five-factor structure consisting of 23 items. The five factors include documentation and commands, safety promotion and training, executive management commitment, emergency preparedness and response plan and safety management policy. The implications of this SMS evaluation scale for practitioners and future research are discussed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Initial development of a practical safety audit tool to assess fleet safety management practices.

PubMed

Mitchell, Rebecca; Friswell, Rena; Mooren, Lori

2012-07-01

Work-related vehicle crashes are a common cause of occupational injury. Yet, there are few studies that investigate management practices used for light vehicle fleets (i.e. vehicles less than 4.5 tonnes). One of the impediments to obtaining and sharing information on effective fleet safety management is the lack of an evidence-based, standardised measurement tool. This article describes the initial development of an audit tool to assess fleet safety management practices in light vehicle fleets. The audit tool was developed by triangulating information from a review of the literature on fleet safety management practices and from semi-structured interviews with 15 fleet managers and 21 fleet drivers. A preliminary useability assessment was conducted with 5 organisations. The audit tool assesses the management of fleet safety against five core categories: (1) management, systems and processes; (2) monitoring and assessment; (3) employee recruitment, training and education; (4) vehicle technology, selection and maintenance; and (5) vehicle journeys. Each of these core categories has between 1 and 3 sub-categories. Organisations are rated at one of 4 levels on each sub-category. The fleet safety management audit tool is designed to identify the extent to which fleet safety is managed in an organisation against best practice. It is intended that the audit tool be used to conduct audits within an organisation to provide an indicator of progress in managing fleet safety and to consistently benchmark performance against other organisations. Application of the tool by fleet safety researchers is now needed to inform its further development and refinement and to permit psychometric evaluation. Copyright © 2012 Elsevier Ltd. All rights reserved.

77 FR 39721 - Proposed Flood Hazard Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-05

..., identified by Docket No. FEMA-B-1256, to Luis Rodriguez, Chief, Engineering Management Branch, Federal..., Engineering Management Branch, Federal Insurance and Mitigation Administration, FEMA, 500 C Street SW..., 2040 Hay Terrace, Easton, PA 18042. Borough of Wind Gap Borough Offices, 29 Mechanic Street, Wind Gap...

[Effectiveness of a self-management program using goal setting based on a G-AP for patients after a stroke].

PubMed

Park, Min Gyeong; Ha, Yeongmi

2014-10-01

This study was conducted to develop a self-management program using goal setting for patients after a stroke. The program was based on a theory-based Goal setting and Action Planning framework (G-AP), and the effectiveness of the program was examined. A non-equivalent control group pretest-posttest design was used. The experimental group (n=30) received the self-management program using goal setting based on the G-AP over 7 weeks. The education was delivered individually with a specifically designed stroke workbook. The control group (n=30) received only patient information leaflets about stroke. There were significant differences between the two groups. Stroke knowledge, self-efficacy, and health behavior compliance were significantly higher (all p<.001), and hospital anxiety (p<.001) and depression (p<.001) were significantly lower in the experimental group compared to the control group. This self-management program using goal setting based on a G-AP was found to be useful and beneficial for patients in stroke rehabilitation settings.

Towards Excellence in Asthma Management: final report of an eight-year program aimed at reducing care gaps in asthma management in Quebec.

PubMed

Boulet, Louis-Philippe; Dorval, E; Labrecque, M; Turgeon, M; Montague, T; Thivierge, R L

2008-09-01

Asthma care in Canada and around the world persistently falls short of optimal treatment. To optimize care, a systematic approach to identifying such shortfalls or 'care gaps', in which all stakeholders of the health care system (including patients) are involved, was proposed. Several projects of a multipartner, multidisciplinary disease management program, developed to optimize asthma care in Quebec, was conducted in a period of eight years. First, two population maps were produced to identify regional variations in asthma-related morbidity and to prioritize interventions for improving treatment. Second, current care was evaluated in a physician-patient cohort, confirming the many care gaps in asthma management. Third, two series of peer-reviewed outcome studies, targeting high-risk populations and specific asthma care gaps, were conducted. Finally, a process to integrate the best interventions into the health care system and an agenda for further research on optimal asthma management were proposed. Key observations from these studies included the identification of specific patterns of noncompliance in using inhaled corticosteroids, the failure of increased access to spirometry in asthma education centres to increase the number of education referrals, the transient improvement in educational abilities of nurses involved with an asthma hotline telephone service, and the beneficial effects of practice tools aimed at facilitating the assessment of asthma control and treatment needs by general practitioners. Disease management programs such as Towards Excellence in Asthma Management can provide valuable information on optimal strategies for improving treatment of asthma and other chronic diseases by identifying care gaps, improving guidelines implementation and optimizing care.

Safety, Health, and Fire Prevention Guide for Hospital Safety Managers

DTIC Science & Technology

1993-03-01

Safety committee S 2-5 Oxygen quality assurance program 0 2-6 Safety and fire prevention library 0 2-7 Safety services to Dental Activities • 2-8...Chapter 2 Safety Management 2-1. Safety policy statement Health Services Command (HSC) Supplement (Suppl) 1 to Army Regulation (AR) 385-10 and the...Management. (b) The medical staff. (c) The nursing service . (d) Logistics. (e) Nutritional care. (f) Preventive medicine. * 2-3 USAEHA TG No. 152 March 1993 (g

Evaluation and review of the safety management system implementation in the Royal Thai Air Force

NASA Astrophysics Data System (ADS)

Chaiwan, Sakkarin

This study was designed to determine situation and effectiveness of the safety management system currently implemented in the Royal Thai Air Force. Reviewing the ICAO's SMS and the RTAF's SMS was conducted to identify similarities and differences between the two safety management systems. Later, the researcher acquired safety statistics from the RTAF Safety Center to investigate effectiveness of its safety system. The researcher also collected data to identify other factors affecting effectiveness of the safety system during conducting in-depth interviews. Findings and Conclusions: The study shows that the Royal Thai Air Force has never applied the International Civil Aviation Organization's Safety management System to its safety system. However, the RTAF's SMS and the ICAO's SMS have been developed based on the same concepts. These concepts are from Richard H. Woods's book, Aviation safety programs: A management handbook. However, the effectiveness of the Royal Thai Air Force's safety system is in good stance. An accident rate has been decreasing regularly but there are no known factors to describe the increasing rate, according to the participants' opinion. The participants have informed that there are many issues to be resolved to improve the RTAF's safety system. Those issues are cooperation among safety center's staffs, attitude toward safety of the RTAF senior commanders, and safety standards.

Health and safety management systems: liability or asset?

PubMed

Bennett, David

2002-01-01

Health and safety management systems have a background in theory and in various interests among employers and workplace health and safety professionals. These have resulted in a number of national systems emanating from national standard-writing centres and from employers' organizations. In some cases these systems have been recognized as national standards. The contenders for an international standard have been the International Organization of Standardization (ISO) and the International Labour Organization (ILO). The quality and environmental management systems of ISO indicate what an ISO health and safety management standard would look like. The ILO Guidelines on Safety and Health Management Systems, by contrast, are stringent, specific and potentially effective in improving health and safety performance in the workplace.

Which skills are associated with residents' sense of preparedness to manage chronic pain?

PubMed

Fox, Aaron D; Kunins, Hillary V; Starrels, Joanna L

2012-01-01

To identify gaps in residents' confidence and knowledge in managing chronic nonmalignant pain (CNMP) and to explore whether specific skills or pain knowledge was associated with global preparedness to manage CNMP. Cross-sectional web-based survey. Internal medicine residents in Bronx, NY. The authors assessed the following: 1) confidence in skills within the following four content areas: physical examination, diagnosis, treatment, and safer opioid prescribing; 2) pain-related knowledge on a 16-item scale; and 3) global preparedness to manage CNMP (agreement with, "I feel prepared to manage CNMP"). Gaps in confidence were skills in which fewer than 50 percent reported confidence. Gaps in knowledge were items in which fewer than 50 percent answered correctly. Using logistic regression, the authors examined whether skills or knowledge was associated with global preparedness. Of 145 residents, 92 (63 percent) responded. Gaps in confidence included diagnosing fibromyalgia, performing corticosteroid injections, and using pain medication agreements. Gaps in knowledge included pharmacotherapy for neuropathic pain and interpreting urine drug test results. Twenty-four residents (26 percent) felt globally prepared to manage CNMP. Confidence using pain medication agreements (adjusted odds ratio [AOR], 5.99; 95% confidence interval [CI], 2.02-17.75), prescribing long-acting opioids (AOR, 5.85; 95% CI, 2.00-17.18), and performing corticosteroid injection of the knee (AOR, 5.76; 95% CI, 1.16-28.60]) were strongly associated with global preparedness. Few internal medicine residents felt prepared to manage CNMP. Our findings suggest that educational interventions to improve residents' preparedness to manage CNMP should target complex pain syndromes (eg, fibromyalgia and neuropathic pain), safer opioid prescribing practices, and alternatives to opioid analgesics.

Which Skills are Associated with Residents’ Sense of Preparedness to Manage Chronic Pain?

PubMed Central

Fox, Aaron D.; Kunins, Hillary V.; Starrels, Joanna L.

2013-01-01

Objective To identify gaps in residents’ confidence and knowledge in managing chronic non-malignant pain (CNMP) and to explore whether specific skills or pain knowledge were associated with global preparedness to manage CNMP. Design Cross-sectional web-based survey Setting & Participants Internal medicine residents in Bronx, NY Main Outcome Measures We assessed: (1) confidence in skills within four content areas: physical examination, diagnosis, treatment, and safer opioid prescribing; (2) pain-related knowledge on a 16-item scale; and (3) global preparedness to manage CNMP (agreement with, “I feel prepared to manage CNMP”). Gaps in confidence were skills in which fewer than 50% reported confidence. Gaps in knowledge were items in which fewer than 50% answered correctly. Using logistic regression, we examined whether skills or knowledge were associated with global preparedness. Results Of 145 residents, 92 (63%) responded. Gaps in confidence included diagnosing fibromyalgia, performing corticosteroid injections, and using pain medication agreements. Gaps in knowledge included pharmacotherapy for neuropathic pain and interpreting urine drug test results. Twenty-four residents (26%) felt globally prepared to manage CNMP. Confidence using pain medication agreements (AOR 5.99, 95% CI: 2.02, 17.75), prescribing long-acting opioids (AOR 5.85, 95%CI: 2.00, 17.18), and performing corticosteroid injection of the knee (AOR 5.76, 95% CI: 1.16, 28.60]) were strongly associated with global preparedness. Conclusions Few internal medicine residents felt prepared to manage CNMP. Our findings suggest that educational interventions to improve residents’ preparedness to manage CNMP should target complex pain syndromes (e.g., fibromyalgia and neuropathic pain), safer opioid prescribing practices, and alternatives to opioid analgesics. PMID:23247909

Wildfire and invasive species in the west: challenges that hinder current and future management and protection of the sagebrush-steppe ecosystem: a Gap Report

USGS Publications Warehouse

Mayer, Kenneth F.; Anderson, Pete; Chambers, Jeanne; Boyd, Chad; Christiansen, Tom; Davis, Dawn; Espinosa, Shawn; Havlina, Doug; Ielmini, Michael; Kemner, Don; Kurth, Laurie; Maestas, Jeremy; Mealor, Brian; Milesneck, Ted; Niell, Lara; Pellant, Mike; Pyke, David A.; Tague, Joe; Vernon, Jason

2013-01-01

The WG will continue to meet on a regular basis to further develop and expand this list of gaps. Additionally, the WG will offer specific options to address the identified gaps. However, the WG recommends that the FWS, possibly through the State/Federal (Western Governors Association) Sage Grouse Task Force or the National Sage-grouse Executive Oversight Committee, establish a Subcommittee to specifically review this Gap Report and develop a multi-agency approach on how to address each gap. The WG will continue to endeavor to establish a priority list and identify the “low hanging fruit” that can be addressed in the short-term to affect the listing decision. Additionally, the WG will propose a longer-term strategy. However, to successfully establish such a strategy it will take buy-in and commitment at the highest levels in federal and state governments. In an effort to provide managers an opportunity to address the most important issues this coming fiscal year, we offer the following top 5 gaps. Beyond these top 5, the WG has identified 17 additional gaps that should be evaluated by both federal and state agencies as a means to help better manage the wildfire/invasive threat in the west.

Hazard Analysis and Safety Requirements for Small Drone Operations: To What Extent Do Popular Drones Embed Safety?

PubMed

Plioutsias, Anastasios; Karanikas, Nektarios; Chatzimihailidou, Maria Mikela

2018-03-01

Currently, published risk analyses for drones refer mainly to commercial systems, use data from civil aviation, and are based on probabilistic approaches without suggesting an inclusive list of hazards and respective requirements. Within this context, this article presents: (1) a set of safety requirements generated from the application of the systems theoretic process analysis (STPA) technique on a generic small drone system; (2) a gap analysis between the set of safety requirements and the ones met by 19 popular drone models; (3) the extent of the differences between those models, their manufacturers, and the countries of origin; and (4) the association of drone prices with the extent they meet the requirements derived by STPA. The application of STPA resulted in 70 safety requirements distributed across the authority, manufacturer, end user, or drone automation levels. A gap analysis showed high dissimilarities regarding the extent to which the 19 drones meet the same safety requirements. Statistical results suggested a positive correlation between drone prices and the extent that the 19 drones studied herein met the safety requirements generated by STPA, and significant differences were identified among the manufacturers. This work complements the existing risk assessment frameworks for small drones, and contributes to the establishment of a commonly endorsed international risk analysis framework. Such a framework will support the development of a holistic and methodologically justified standardization scheme for small drone flights. © 2017 Society for Risk Analysis.

The management of building fire safety towards the sustainability of Malaysian public universities

NASA Astrophysics Data System (ADS)

Ebenehi, I. Y.; Mohamed, S.; Sarpin, N.; Masrom, M. A. N.; Zainal, R.; Azmi, M. A. Mohd

2017-11-01

Recently, there had been reduction in annual budgetary allocations to public universities in Malaysia due to some economic tensions. This situation had left many institutions in question with the options of scaling down their expenses as well as sourcing for other means of meeting up with the shortfalls in allocated funds. Hence, it affects the sustainability of the building itself. This paper is an attempt to look at the possibility of reducing incidents that could lead to expending unbudgeted fund to rehabilitating property unfortunately destroyed by fire on campus, in addition to limiting risk to life and interruption of academic and business activities. Several research had been conducted on FSM, nevertheless very few consider Higher Education Institutions (HEI)s holistically. Hence this research intends to fill that gap.

44 CFR 150.5 - Joint Public Safety Awards Board.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Joint Public Safety Awards Board. 150.5 Section 150.5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY FIRE PREVENTION AND CONTROL PUBLIC SAFETY AWARDS TO PUBLIC SAFETY OFFICERS...

Early Warning Systems of natural disasters in the frame of EUNADICS-AV

NASA Astrophysics Data System (ADS)

Brenot, Hugues; Theys, Nicolas; Clarisse, Lieven; Kopp, Anna; Graf, Kaspar; Mona, Lucia; Coltelli, Mauro; Peltonen, Tuomas; Hirtl, Marcus; Virtanen, Timo; Nína Petersen, Guðrún

2017-04-01

Aviation is one of the most critical infrastructures of the 21st century. In Europe, safe flight operations, air traffic management and air traffic control are shared responsibilities of EUROCONTROL, national authorities, airlines and pilots. All stakeholders have one common goal, namely to warrant and maintain the safety of flight crews and passengers. Currently, however, there is a significant gap in the availability of real-time hazard measurement and monitoring information for airborne hazards. The main objective of the new Horizon 2020 project EUNADICS-AV (European Natural Airborne Disaster Information and Coordination System for Aviation; http://www.eunadics.eu) is to close this gap in data and information availability, enabling all stakeholders in the aviation system to obtain fast, coherent, and consistent information. Here we report on WP5 of EUNADICS-AV, the objective of which is to develop a prototype multi-hazard monitoring and early warning system. This task includes the development of a service for improved near real-time analyses (delay of a few hours maximum) of observations from satellite and ground-based platforms in order to detect ash and SO2 plumes (at the global scale), as well as desert sand dusts, fire plumes, and radioactive plumes.

Safety valve

DOEpatents

Bergman, Ulf C.

1984-01-01

The safety valve contains a resilient gland to be held between a valve seat and a valve member and is secured to the valve member by a sleeve surrounding the end of the valve member adjacent to the valve seat. The sleeve is movable relative to the valve member through a limited axial distance and a gap exists between said valve member and said sleeve.

Implementing Good Practices Programs to Encourage Production of High-Quality, Safer Produce in Mississippi

ERIC Educational Resources Information Center

Mahmoud, Barakat S. M.; Stafne, Eric T.; Coker, Christine H.; Bachman, Gary R.; Bell, Nicole

2016-01-01

Fifty-four growers/producers attended four 1-day good agricultural practices (GAP) and good handling practices (GHP) workshops at four locations in Mississippi. Pre- and post workshop survey data indicated that the participants' food safety knowledge increased by 15%. Furthermore, the workshops helped producers develop their own food safety plans.…

Social but safe? Quality and safety of diabetes-related online social networks.

PubMed

Weitzman, Elissa R; Cole, Emily; Kaci, Liljana; Mandl, Kenneth D

2011-05-01

To foster informed decision-making about health social networking (SN) by patients and clinicians, the authors evaluated the quality/safety of SN sites' policies and practices. Multisite structured observation of diabetes-focused SN sites. Measurements 28 indicators of quality and safety covering: (1) alignment of content with diabetes science and clinical practice recommendations; (2) safety practices for auditing content, supporting transparency and moderation; (3) accessibility of privacy policies and the communication and control of privacy risks; and (4) centralized sharing of member data and member control over sharing. Quality was variable across n=10 sites: 50% were aligned with diabetes science/clinical practice recommendations with gaps in medical disclaimer use (30% have) and specification of relevant glycosylated hemoglobin levels (0% have). Safety was mixed with gaps in external review approaches (20% used audits and association links) and internal review approaches (70% use moderation). Internal safety review offers limited protection: misinformation about a diabetes 'cure' was found on four moderated sites. Of nine sites with advertising, transparency was missing on five; ads for unfounded 'cures' were present on three. Technological safety was poor with almost no use of procedures for secure data storage and transmission; only three sites support member controls over personal information. Privacy policies' poor readability impedes risk communication. Only three sites (30%) demonstrated better practice. Limitations English-language diabetes sites only. The quality/safety of diabetes SN is variable. Observed better practice suggests improvement is feasible. Mechanisms for improvement are recommended that engage key stakeholders to balance autonomy, community ownership, conditions for innovation, and consumer protection.

Safety and Waste Management for SAM Pathogen Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the pathogens included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Safety and Waste Management for SAM Biotoxin Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the biotoxins included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Requirements Analysis for the Army Safety Management Information System (ASMIS)

DTIC Science & Technology

1989-03-01

8217_>’ Telephone Number « .. PNL-6819 Limited Distribution Requirements Analysis for the Army Safety Management Information System (ASMIS) Final...PNL-6819 REQUIREMENTS ANALYSIS FOR THE ARMY SAFETY MANAGEMENT INFORMATION SYSTEM (ASMIS) FINAL REPORT J. S. Littlefield A. L. Corrigan March...accidents. This accident data is available under the Army Safety Management Information System (ASMIS) which is an umbrella for many databases

USDOT Integrated Corridor Management (ICM) Initiative Transit Data Gaps for Rail Transit Systems Initial Planning Workshop Notes

DOT National Transportation Integrated Search

2008-06-23

This document presents the notes taken at the USDOT Integrated Corridor Management (ICM) Transit Data Gaps for Rail Transit Systems Initial Planning Workshop. Different scenarios for handling increased demand on rail and bus transit systems are discu...

Protocol for a mixed-methods study on leader-based interventions in construction contractors' safety commitments.

PubMed

Pedersen, Betina Holbaek; Dyreborg, Johnny; Kines, Pete; Mikkelsen, Kim Lyngby; Hannerz, Harald; Andersen, Dorte Raaby; Spangenberg, Søren

2010-06-01

Owing to high injury rates, safety interventions are needed in the construction industry. Evidence-based interventions tailored to this industry are, however, scarce. Leader-based safety interventions have proven more effective than worker-based interventions in other industries. To test a leader-based safety intervention for construction sites. The intervention consists of encouraging safety coordinators to provide feedback on work safety to the client and line management. The intention is to increase communication and interactions regarding safety within the line management and between the client and the senior management. It is hypothesised that this, in turn, will lead to increased communication and interaction about safety between management and coworkers as well as an increased on-site safety level. A group-randomised double-blinded case study of six Danish construction sites (three intervention sites and three control sites). The recruitment of the construction sites is performed continuously from January 2010 to June 2010. The investigation of each site lasts 20 continuous weeks. Confirmatory statistical analysis is used to test if the safety level increased, and if the probability of safety communications between management and coworkers increases as a consequence of the intervention. The data collection will be blinded. Qualitative methods are used to evaluate if communication and interactions about safety at all managerial levels, including the client, increase. (1) The proportion of safety-related communications out of all studied communications between management and coworkers. (2) The safety level index of the construction sites.

Tranexamic Acid and Trauma: Current Status and Knowledge Gaps with Recommended Research Priorities

DTIC Science & Technology

2013-01-01

Review Article TRANEXAMIC ACID AND TRAUMA: CURRENT STATUS AND KNOWLEDGE GAPS WITH RECOMMENDED RESEARCH PRIORITIES Anthony E. Pusateri,* Richard B...on the use of tranexamic acid (TXA) for trauma reported important survival benefits. Subsequently, successful use of TXA for combat casualties in...refinement of practice guidelines over time. KEYWORDS— Tranexamic acid , trauma, efficacy, safety, research requirements INTRODUCTION Tranexamic acid (TXA

46 CFR 107.415 - Safety Management Certificate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Safety Management Certificate. 107.415 Section 107.415 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) A-MOBILE OFFSHORE DRILLING UNITS INSPECTION AND CERTIFICATION Certificates Under International Convention for Safety of Life at Sea, 1974 § 107.415 Safety Management Certificate. (a)...

System safety education focused on flight safety

NASA Technical Reports Server (NTRS)

Holt, E.

1971-01-01

The measures necessary for achieving higher levels of system safety are analyzed with an eye toward maintaining the combat capability of the Air Force. Several education courses were provided for personnel involved in safety management. Data include: (1) Flight Safety Officer Course, (2) Advanced Safety Program Management, (3) Fundamentals of System Safety, and (4) Quantitative Methods of Safety Analysis.

Safety and Waste Management for SAM Chemistry Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the chemical analytes included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Safety and Waste Management for SAM Radiochemical Methods

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for the radiochemical analytes included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

Leadership for safety: industrial experience

PubMed Central

Flin, R; Yule, S

2004-01-01

The importance of leadership for effective safety management has been the focus of research attention in industry for a number of years, especially in energy and manufacturing sectors. In contrast, very little research into leadership and safety has been carried out in medical settings. A selective review of the industrial safety literature for leadership research with possible application in health care was undertaken. Emerging findings show the importance of participative, transformational styles for safety performance at all levels of management. Transactional styles with attention to monitoring and reinforcement of workers' safety behaviours have been shown to be effective at the supervisory level. Middle managers need to be involved in safety and foster open communication, while ensuring compliance with safety systems. They should allow supervisors a degree of autonomy for safety initiatives. Senior managers have a prime influence on the organisation's safety culture. They need to continuously demonstrate a visible commitment to safety, best indicated by the time they devote to safety matters. PMID:15576692

Interpositional Gap Arthroplasty by Versatile Pedicled Temporalis Myofascial Flap in the Management of Temporomandibular Joint Ankylosis- A Case Series Study.

PubMed

Aneja, Vikas; Raval, Rushik; Bansal, Anupam; Kumawat, Vinod; Kaur, Jasleen; Shaikh, Ahemer Arif

2016-10-01

Temporomandibular Joint (TMJ) ankylosis is a situation in which the mandibular condyle is fused to the glenoid fossa by bone or fibrous tissue. The management of TMJ ankylosis has a complicated chore and it is challenging for the maxillofacial surgeon because of technical hitches and high rate of re-ankylosis. Interpositional gap arthroplasty is one of the modalities for its management. A range of inter-positional materials have been used to avert recurrence after gap arthroplasty in TMJ ankylosis. The aim of this series was to evaluate the effectiveness of the temporomyofacial flap in the treatment of TMJ ankylosis as an interpositional gap arthroplasty. A total of 10 cases with unilateral TMJ ankylosis were treated by interpositional gap arthroplasty by pedicled temporalis myofacial flap and evaluated with a follow-up of 6 months to 5 years (Mean 3.3 years) for the functional stability of TMJ. All the patients were successfully treated. There were no signs of recurrence in any patients up to last follow up visit. The result showed that temporalis myofascial flap is a preferable choice for inter-positional gap arthroplasty which proves its versatility as an inter-positional material.

Interpositional Gap Arthroplasty by Versatile Pedicled Temporalis Myofascial Flap in the Management of Temporomandibular Joint Ankylosis- A Case Series Study

PubMed Central

Aneja, Vikas; Bansal, Anupam; Kumawat, Vinod; Kaur, Jasleen; Shaikh, Ahemer Arif

2016-01-01

Temporomandibular Joint (TMJ) ankylosis is a situation in which the mandibular condyle is fused to the glenoid fossa by bone or fibrous tissue. The management of TMJ ankylosis has a complicated chore and it is challenging for the maxillofacial surgeon because of technical hitches and high rate of re-ankylosis. Interpositional gap arthroplasty is one of the modalities for its management. A range of inter-positional materials have been used to avert recurrence after gap arthroplasty in TMJ ankylosis. The aim of this series was to evaluate the effectiveness of the temporomyofacial flap in the treatment of TMJ ankylosis as an interpositional gap arthroplasty. A total of 10 cases with unilateral TMJ ankylosis were treated by interpositional gap arthroplasty by pedicled temporalis myofacial flap and evaluated with a follow-up of 6 months to 5 years (Mean 3.3 years) for the functional stability of TMJ. All the patients were successfully treated. There were no signs of recurrence in any patients up to last follow up visit. The result showed that temporalis myofascial flap is a preferable choice for inter-positional gap arthroplasty which proves its versatility as an inter-positional material. PMID:27891496

77 FR 54615 - Strategic Management Program; Fiscal Year 2013-2016 Strategic Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-05

... Manager, Strategic Management Program; National Transportation Safety Board, 490 L'Enfant Plaza SW., MD-1... NATIONAL TRANSPORTATION SAFETY BOARD Strategic Management Program; Fiscal Year 2013-2016 Strategic Plan AGENCY: National Transportation Safety Board. ACTION: Notice: Request for comments. SUMMARY: This...

Laboratory medicine handoff gaps experienced by primary care practices: A report from the shared networks of collaborative ambulatory practices and partners (SNOCAP).

PubMed

West, David R; James, Katherine A; Fernald, Douglas H; Zelie, Claire; Smith, Maxwell L; Raab, Stephen S

2014-01-01

The majority of errors in laboratory medicine testing are thought to occur in the pre- and postanalytic testing phases, and a large proportion of these errors are secondary to failed handoffs. Because most laboratory tests originate in ambulatory primary care, understanding the gaps in handoff processes within and between laboratories and practices is imperative for patient safety. Therefore, the purpose of this study was to understand, based on information from primary care practice personnel, the perceived gaps in laboratory processes as a precursor to initiating process improvement activities. A survey was used to assess perceptions of clinicians, staff, and management personnel of gaps in handoffs between primary care practices and laboratories working in 21 Colorado primary care practices. Data were analyzed to determine statistically significant associations between categorical variables. In addition, qualitative analysis of responses to open-ended survey questions was conducted. Primary care practices consistently reported challenges and a desire/need to improve their efforts to systematically track laboratory test status, confirm receipt of laboratory results, and report results to patients. Automated tracking systems existed in roughly 61% of practices, and all but one of those had electronic health record-based tracking systems in place. One fourth of these electronic health record-enabled practices expressed sufficient mistrust in these systems to warrant the concurrent operation of an article-based tracking system as backup. Practices also reported 12 different procedures used to notify patients of test results, varying by test result type. The results highlight the lack of standardization and definition of roles in handoffs in primary care laboratory practices for test ordering, monitoring, and receiving and reporting test results. Results also identify high-priority gaps in processes and the perceptions by practice personnel that practice improvement in these areas is needed. Commonalities in these areas warrant the development and support of tools for use in primary care settings. © Copyright 2014 by the American Board of Family Medicine.

The Role of Veterinary Education in Safety Policies for Animal-Assisted Therapy and Activities in Hospitals and Nursing Homes.

PubMed

Linder, Deborah E; Mueller, Megan K; Gibbs, Debra M; Siebens, Hannah C; Freeman, Lisa M

Animal-assisted activities (AAA) and animal-assisted therapy (AAT) programs are increasing in popularity, but current programs vary in their safety and health policies. Veterinarians can have an important role in ensuring the safety of both the animals and humans involved, but it is unclear how best to educate veterinary students to serve effectively in this role. Therefore, the goal of this study was to assess the knowledge gaps and perceptions of first-year veterinary students on health and safety aspects of AAA/AAT programs by administering a survey. This information could then guide future educational training in veterinary schools to address the knowledge gaps in this area. Formal education during the veterinary curriculum had not yet been provided to these students on AAA/AAT before the survey. Of 98 first-year veterinary students, 91 completed the survey. When asked about policies on visiting animals, 58% of students responded that nursing homes are required to have a policy and 67% responded that hospitals are required to have one. Three quarters of students reported that veterinarians, animal handlers, and facilities should share the responsibility for ensuring safe human-animal interaction in AAA/AAT programs. Most (82%) of the students responded that all or most national and local therapy animal groups prohibit animals that consume raw meat diets from participating in AAA/AAT programs. The results of this survey will help veterinary schools better identify knowledge gaps that can be addressed in veterinary curricula so future veterinarians will be equipped to provide appropriate public health information regarding AAA/AAT programs.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chi Xinwen, E-mail: x.chi@pgrad.unimelb.edu.au; Streicher-Porte, Martin; Wang, Mark Y.L.

Informal recycling is a new and expanding low cost recycling practice in managing Waste Electrical and Electronic Equipment (WEEE or e-waste). It occurs in many developing countries, including China, where current gaps in environmental management, high demand for second-hand electronic appliances and the norm of selling e-waste to individual collectors encourage the growth of a strong informal recycling sector. This paper gathers information on informal e-waste management, takes a look at its particular manifestations in China and identifies some of the main difficulties of the current Chinese approach. Informal e-waste recycling is not only associated with serious environmental and healthmore » impacts, but also the supply deficiency of formal recyclers and the safety problems of remanufactured electronic products. Experiences already show that simply prohibiting or competing with the informal collectors and informal recyclers is not an effective solution. New formal e-waste recycling systems should take existing informal sectors into account, and more policies need to be made to improve recycling rates, working conditions and the efficiency of involved informal players. A key issue for China's e-waste management is how to set up incentives for informal recyclers so as to reduce improper recycling activities and to divert more e-waste flow into the formal recycling sector.« less

Supervisor vs. employee safety perceptions and association with future injury in US limited-service restaurant workers.

PubMed

Huang, Yueng-Hsiang; Verma, Santosh K; Chang, Wen-Ruey; Courtney, Theodore K; Lombardi, David A; Brennan, Melanye J; Perry, Melissa J

2012-07-01

Many studies have found management commitment to safety to be an important construct of safety climate. This study examined the association between supervisor and employee (shared and individual) perceptions of management commitment to safety and the rate of future injuries in limited-service restaurant workers. A total of 453 participants (34 supervisors/managers and 419 employees) from 34 limited-service restaurants participated in a prospective cohort study. Employees' and managers' perceptions of management commitment to safety and demographic variables were collected at the baseline. The survey questions were made available in three languages: English, Spanish, and Portuguese. For the following 12 weeks, participants reported their injury experience and weekly work hours. A multivariate negative binomial generalized estimating equation model with compound symmetry covariance structure was used to assess the association between the rate of self-reported injuries and measures of safety perceptions. There were no significant relationships between supervisor and either individual or shared employee perceptions of management commitment to safety. Only individual employee perceptions were significantly associated with future employee injury experience but not supervisor safety perceptions or shared employee perceptions. Individual employee perception of management commitment to safety is a significant predictor for future injuries in restaurant environments. A study focusing on employee perceptions would be more predictive of injury outcomes than supervisor/manager perceptions. Copyright © 2012 Elsevier Ltd. All rights reserved.

General Safety and Waste Management Related to SAM

EPA Pesticide Factsheets

The General Safety and Waste Management page offers section-specific safety and waste management details for chemicals, radiochemicals, pathogens, and biotoxins included in EPA's Selected Analytical Methods for Environmental Remediation and Recovery (SAM).

The role of health and safety experts in the management of hazardous and toxic wastes in Indonesia

NASA Astrophysics Data System (ADS)

Supriyadi; Hadiyanto

2018-02-01

Occupational Safety and Health Experts in Indonesia have an important role in integrating environmental health and safety factors, including in this regard as human resources assigned to undertake hazardous waste management. Comprehensive knowledge and competence skills need to be carried out responsibly, as an inherent professional occupational safety and health profession. Management leaders should continue to provide training in external agencies responsible for science in the management of toxic waste to enable occupational safety and health experts to improve their performance in the hierarchy of control over the presence of hazardous materials. This paper provides an overview of what strategies and competencies the Occupational Safety and Health expert needs to have in embracing hazardous waste management practices.

Measurement of worker perceptions of trust and safety climate in managers and supervisors at commercial grain elevators.

PubMed

Mosher, G A; Keren, N; Freeman, S A; Hurburgh, C R

2013-04-01

The safety climate of an agricultural workplace may be affected by several things, including the level of trust that workers have in their work group supervisor and organizational management. Safety climate has been used by previous safety researchers as a measure of worker perceptions of the relative importance of safety as compared with other operational goals. Trust has been linked to several positive safety outcomes, particularly in hazardous work environments, but has not been examined relative to safety climate in the perennially hazardous work environment of a commercial grain elevator. In this study, 177 workers at three Midwest grain elevator companies completed online surveys measuring their perceptions of trust and safety at two administrative levels: organizational management and work group supervisors. Positive and significant relationships were noted between trust and safety climate perceptions for organizational managers and for work group supervisors. Results from this research suggest that worker trust in organizational management and work group supervisors has a positive influence on the employees' perceptions of safety climate at the organizational and work group levels in an agricultural workplace.

Measuring patient safety culture in maternal and child health institutions in China: a qualitative study.

PubMed

Wang, Yuanyuan; Liu, Weiwei; Shi, Huifeng; Liu, Chaojie; Wang, Yan

2017-07-12

Patient safety culture (PSC) plays a critical role in ensuring safe and quality care. Extensive PSC studies have been undertaken in hospitals. However, little is known about PSC in maternal and child health (MCH) institutions in China, which provide both population-based preventive services as well as individual care for patients. This study aimed to develop a theoretical framework for conceptualising PSC in MCH institutions in China. The study was undertaken in six MCH institutions (three in Hebei and three in Beijing). Participants (n=118) were recruited through stratified purposive sampling: 20 managers/administrators, 59 care providers and 39 patients. In-depth interviews were conducted with the participants. The interview data were coded using both inductive (based on the existing PSC theory developed by the Agency for Healthcare Research and Quality) and deductive (open coding arising from data) approaches. A PSC framework was formulated through axial coding that connected initial codes and selective coding that extracted a small number of themes. The interviewees considered patient safety in relation to six aspects: safety and security in public spaces, safety of medical services, privacy and information security, financial security, psychological safety and gap in services. A 12-dimensional PSC framework was developed, containing 69 items. While the existing PSC theory was confirmed by this study, some new themes emerged from the data. Patients expressed particular concerns about psychological safety and financial security. Defensive medical practices emerged as a PSC dimension that is associated with not only medical safety but also financial security and psychological safety. Patient engagement was also valued by the interviewees, especially the patients, as part of PSC. Although there are some common features in PSC across different healthcare delivery systems, PSC can also be context specific. In MCH settings in China, the meaning of 'patient safety' goes beyond the traditional definition of patients. General well-being, health and disease prevention are important anchor points for defining PSC in such settings. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Gas gap heat switch for a cryogen-free magnet system

NASA Astrophysics Data System (ADS)

Barreto, J.; Borges de Sousa, P.; Martins, D.; Kar, S.; Bonfait, G.; Catarino, I.

2015-12-01

Cryogen-free superconducting magnet systems (CFMS) have become popular over the last two decades for the simple reason that the use of liquid helium is rather cumbersome and that helium is a scarce resource. Some available CFMS use a mechanical cryocooler as the magnet's cold source. However, the variable temperature insert (VTI) for some existing CFMS are not strictly cryogen-free as they are still based on helium gas circulation through the sample space. We designed a prototype of a gas gap heat switch (GGHS) that allows a thermal management of a completely cryogen-free magnet system, with no helium losses. The idea relies on a parallel cooling path to a variable temperature insert (VTI) of a magnetic properties measurement system under development at Inter-University Accelerator Centre. A Gifford-McMahon cryocooler (1.5 W @ 4.2 K) would serve primarily as the cold source of the superconducting magnet, dedicating 1 W to this cooling, under quite conservative safety factors. The remaining cooling power (0.5 W) is to be diverted towards a VTI through a controlled GGHS that was designed and built with a 80 μm gap width. The built GGHS thermal performance was measured at 4 K, using helium as the exchange gas, and its conductance is compared both with a previously developed analytical model and a finite element method. Lessons learned lead to a new and more functional prototype yet to be reported.

Ulcerative colitis outpatient management: development and evaluation of tools to support primary care practitioners.

PubMed

Bennett, A L; Buckton, S; Lawrance, I; Leong, R W; Moore, G; Andrews, J M

2015-12-01

Current models of care for ulcerative colitis (UC) across healthcare systems are inconsistent with a paucity of existing guidelines or supportive tools for outpatient management. This study aimed to produce and evaluate evidence-based outpatient management tools for UC to guide primary care practitioners and patients in clinical decision-making. Three tools were developed after identifying current gaps in the provision of healthcare services for patients with UC at a Clinical Insights Meeting in 2013. Draft designs were further refined through consultation and consolidation of feedback by the steering committee. Final drafts were developed following feasibility testing in three key stakeholder groups (gastroenterologists, general practitioners and patients) by questionnaire. The tools were officially launched into mainstream use in Australia in 2014. Three quarters of all respondents liked the layout and content of each tool. Minimal safety concerns were aired and those, along with pieces of information that were felt to be omitted, that were reviewed by the steering committee and incorporated into the final documents. The majority (over 80%) of respondents felt that the tools would be useful and would improve outpatient management of UC. Evidence-based outpatient clinical management tools for UC can be developed. The concept and end-product have been well received by all stakeholder groups. These tools should support non-specialist clinicians to optimise UC management and empower patients by facilitating them to safely self-manage and identify when medical support is needed. © 2015 Royal Australasian College of Physicians.

41 CFR 102-80.110 - What must an equivalent level of safety analysis indicate?

Code of Federal Regulations, 2014 CFR

2014-01-01

..., and reliability of all building systems impacting fire growth, occupant knowledge of the fire, and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety...

41 CFR 102-80.110 - What must an equivalent level of safety analysis indicate?

Code of Federal Regulations, 2013 CFR

2013-07-01

..., and reliability of all building systems impacting fire growth, occupant knowledge of the fire, and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety...

41 CFR 102-80.110 - What must an equivalent level of safety analysis indicate?

Code of Federal Regulations, 2011 CFR

2011-01-01

..., and reliability of all building systems impacting fire growth, occupant knowledge of the fire, and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety...

41 CFR 102-80.110 - What must an equivalent level of safety analysis indicate?

Code of Federal Regulations, 2012 CFR

2012-01-01

..., and reliability of all building systems impacting fire growth, occupant knowledge of the fire, and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety...

Mind the gap in clinical trials: A participatory action analysis with citizen collaborators.

PubMed

Price, Amy; Liew, Su May; Kirkpatrick, Jo; Price, Jazmin; Lopreto, Taylor; Nelken, Yasmin

2017-02-01

What are the strengths, gaps, expectations, and barriers to research engagement in clinical trials as communicated through social media? Clinical trials test treatments to provide reliable information for safety and effectiveness. Trials are building blocks in which what is learned in earlier research can be used to improve treatments, compare alternatives, and improve quality of life. For 20 years, the percentages of clinical trials volunteers have decreased whereas the costs of running clinical trials have multiplied. Participants enroll in trials to access latest treatments, to help others, and to advance science, but there is growing unrest. The priorities of those running the trials differ from those of the participants, and the roles for public research involvement lack clarity. Changes to bridge these gaps in the research culture are proposed through the use of participatory action research (PAR) in which stakeholders collaborate to improve research methodology, galvanize citizen participation, multiply health knowledge, problem-solve barriers to access, and explore the value of research volunteers as collaborators. PAR enabled the inclusion of citizens as full collaborators. Social media data were gathered for 120 days until saturation was reached. De-identified data were organized into a Strengths Weaknesses, Opportunities and Threats framework and coded into themes for analysis. After the analysis, the authors prioritized potential solutions for improving research engagement. Strengths and opportunities remained constant through trial phases, disease burdens, and interventions. Threats included alienation, litigation, disparity, and shaming. Poor management and barriers to inclusion were identified as weaknesses. Opportunities included improving resource management and information quality. Barriers were minimized when relationships between staff and participants were inclusive, respectful, tolerant, and open to change. Participants' communications ranged from fulfillment through trial involvement to disparities and rights violations. PAR provides a safe space without power imbalances in which researchers and citizen worked as equals rather than as researchers and objects of research. © 2016 John Wiley & Sons, Ltd.

Effects of major-road vehicle speed and driver age and gender on left-turn gap acceptance.

PubMed

Yan, Xuedong; Radwan, Essam; Guo, Dahai

2007-07-01

Because the driver's gap-acceptance maneuver is a complex and risky driving behavior, it is a highly concerned topic for traffic safety and operation. Previous studies have mainly focused on the driver's gap acceptance decision itself but did not pay attention to the maneuver process and driving behaviors. Using a driving simulator experiment for left-turn gap acceptance at a stop-controlled intersection, this study evaluated the effects of major traffic speed and driver age and gender on gap acceptance behaviors. The experiment results illustrate relationships among drivers' left-turn gap decision, driver's acceleration rate, steering action, and the influence of the gap-acceptance maneuver on the vehicles in the major traffic stream. The experiment results identified an association between high crash risk and high traffic speed at stop-controlled intersections. The older drivers, especially older female drivers, displayed a conservative driving attitude as a compensation for reduced driving ability, but also showed to be the most vulnerable group for the relatively complex driving maneuvers.

30 CFR 585.642 - How do I submit my GAP?

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 2 2013-07-01 2013-07-01 false How do I submit my GAP? 585.642 Section 585.642 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY... any project easement as part of your original GAP submission or as a revision to your GAP. ...

30 CFR 585.642 - How do I submit my GAP?

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 2 2012-07-01 2012-07-01 false How do I submit my GAP? 585.642 Section 585.642 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY... any project easement as part of your original GAP submission or as a revision to your GAP. ...

30 CFR 585.642 - How do I submit my GAP?

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 2 2014-07-01 2014-07-01 false How do I submit my GAP? 585.642 Section 585.642 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE RENEWABLE ENERGY... any project easement as part of your original GAP submission or as a revision to your GAP. ...

Evaluation of service quality of hospital outpatient department services.

PubMed

Chakravarty, Abhijit

2011-07-01

It has become essential for hospital managers to understand and measure consumer perspectives and service quality gaps, so that any perceived gap in delivery of service is identified and suitably addressed. A study was conducted at a peripheral service hospital to ascertain any service gap between consumer expectations and perceptions in respect of the hospital outpatient department (OPD) services. A cross-sectional study was conducted using SERVQUAL as the survey instrument, the instrument being validated for use in the hospital environment. Consumer ratings across 22 items of the survey instrument were collected in paired expectation and perception scores and then service quality gaps were identified and statistically analysed. Service quality gaps were identified to exist across all the five dimensions of the survey instrument, with statistically significant gaps across the dimensions of 'tangibles' and 'responsiveness.' The quality gaps were further validated by a total unweighted SERVQUAL score of (-) 1.63. The study concludes that significant service quality gaps existed in the delivery of the hospital OPD services, which need to be addressed by focused improvement efforts by the hospital management.

49 CFR 385.321 - What failures of safety management practices disclosed by the safety audit will result in a...

Code of Federal Regulations, 2010 CFR

2010-10-01

... disclosed by the safety audit will result in a notice to a new entrant that its USDOT new entrant... MOTOR CARRIER SAFETY REGULATIONS SAFETY FITNESS PROCEDURES New Entrant Safety Assurance Program § 385.321 What failures of safety management practices disclosed by the safety audit will result in a notice...

41 CFR 102-80.130 - Who must perform the equivalent level of safety analysis?

Code of Federal Regulations, 2010 CFR

2010-07-01

...-SAFETY AND ENVIRONMENTAL MANAGEMENT Accident and Fire Prevention Equivalent Level of Safety Analysis... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Who must perform the equivalent level of safety analysis? 102-80.130 Section 102-80.130 Public Contracts and Property Management...

46 CFR 91.60-30 - Safety Management Certificate.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Safety Management Certificate. 91.60-30 Section 91.60-30 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CARGO AND MISCELLANEOUS VESSELS INSPECTION AND CERTIFICATION Certificates Under International Convention for Safety of Life at Sea, 1974 § 91.60-30 Safety Management Certificate. All...

Hydrogen Safety Sensor Performance and Use Gap Analysis: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buttner, William J; Burgess, Robert M; Schmidt, Kara

Hydrogen sensors are recognized as an important technology for facilitating the safe implementation of hydrogen as an alternative fuel, and there are numerous reports of a sensor alarm successfully preventing a potentially serious event. However, gaps in sensor metrological specifications, as well as in their performance for some applications, exist.The U.S. Department of Energy (DOE) Fuel Cell Technology Office published a short list of critical gaps in the 2007 and 2012 multiyear project plans; more detailed gap analyses were independently performed by the JRC and NREL. There have been, however, some significant advances in sensor technologies since these assessments, includingmore » the commercial availability of hydrogen sensors with fast response times (t90 less than 1 s, which had been an elusive DOE target since 2007), improved robustness to chemical poisons, improved selectivity, and improved lifetime and stability. These improvements, however, have not been universal and typically pertain to select platforms or models. Moreover, as hydrogen markets grow and new applications are being explored, more demands will be imposed on sensor performance. The hydrogen sensor laboratories at NREL and JRC are currently updating the hydrogen safety sensor gap analysis through direct interaction with international stakeholders in the hydrogen community, especially end-users. NREL and the JRC are currently organizing a series of workshops (in Europe and the U.S.) with sensor developers, end-users, and other stakeholders in 2017 to identify technology gaps and to develop a path forward to address them. One workshop is scheduled for May 10 in Brussels, Belgium at the Headquarters of the Fuel Cell and Hydrogen Joint Undertaking. A second workshop is planned at the National Renewable Energy Laboratory in Golden, CO, USA. This presentation will review improvements in sensor technologies in the past 5 to 10 years, identify gaps in sensor performance and use requirements, and identify potential research strategies to address the gaps. The presentation will also summarize the outcomes of the Hydrogen Sensors Workshops.« less

The Nanotoxicology Research Program in NIOSH

NASA Astrophysics Data System (ADS)

Castranova, Vincent

2009-01-01

The National Institute for Occupational Safety and Health through its Nanotechnology Research Center has developed a Strategic Plan for Nanotechnology Safety and Health Research. This Strategic Plan identified knowledge gaps and critical issues, which must be addressed to protect the health and safety of workers producing nanoparticles as well as those incorporating nanoparticles into commercial products or using nanomaterials in novel applications. This manuscript lists the projects that comprise the Nanotoxicology Program in NIOSH and provides a brief description of the goals and accomplishments of these projects.

76 FR 35130 - Pipeline Safety: Control Room Management/Human Factors

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-16

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Parts...: Control Room Management/Human Factors AGENCY: Pipeline and Hazardous Materials Safety Administration... safety standards, risk assessments, and safety policies for natural gas pipelines and for hazardous...

49 CFR 237.31 - Adoption of bridge management programs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program to...

41 CFR 102-80.35 - What are Federal agencies' responsibilities concerning the monitoring of hazardous materials and...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 102-80.35 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT Safety and... Safety and Health Administration (OSHA), Department of Transportation, EPA, and applicable State and...

49 CFR 237.31 - Adoption of bridge management programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Adoption of bridge management programs. 237.31... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION BRIDGE SAFETY STANDARDS Railroad Bridge Safety Assurance § 237.31 Adoption of bridge management programs. Each track owner shall adopt a bridge safety management program to...

77 FR 34051 - Drug Safety and Risk Management Advisory Committee; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

...] Drug Safety and Risk Management Advisory Committee; Notice of Meeting AGENCY: Food and Drug...: Drug Safety and Risk Management Advisory Committee. General Function of the Committee: To provide... comments to http://www.regulations.gov . Submit written comments to the Division of Dockets Management (HFA...

The perceived compatibility of safety and production expectations in hazardous occupations.

PubMed

McLain, David L; Jarrell, Kimberly A

2007-01-01

Safety hazards are unavoidable in many work environments. Employees must be both productive and safe, however, conflicting safety and production demands can negatively affect safety, production, or both. The employee's perception of the compatibility of management's safety and production expectations is a possible predictor of such consequences. This paper defines "safety-production compatibility" and describes how measures of safety-production compatibility, as well as safety pressure and production pressure, were developed. We used LISREL structural equation modeling to test the influences of safety-production compatibility, safety pressure, and production pressure on safe work behavior and interference with performing other work tasks. The 239 study participants were workers employed in diverse but hazardous occupations. Pressure to work safely was positively associated with safe work behavior. The perceived compatibility of safety and production demands positively influenced safe work behavior and reduced the interference of safety hazards performing other tasks. Safety-production compatibility was also found to mediate the relationship between trust in management and safe work behavior. The results of this field study suggest increased compatibility, and thus less conflict, between safety and production demands influences safe work behavior and the interference of safety hazards with performing other work tasks. More broadly, the worker's reaction to multiple work demands is a safety and performance influence. Safety management efforts that focus only on the hazards fail to eliminate many accidents because accidents arise from many factors including technology, safety climate, social influences, production, and safety demands. This study suggests that workers differ in their perception of the compatibility of safety and production demands. These differences will show up in safe work behavior, influencing the effectiveness of safety management efforts and the trust workers have in management's concern for safety.

Canadian residents' perceived manager training needs.

PubMed

Stergiopoulos, Vicky; Lieff, Susan; Razack, Saleem; Lee, A Curtis; Maniate, Jerry M; Hyde, Stacey; Taber, Sarah; Frank, Jason R

2010-01-01

Despite widespread endorsement for administrative training during residency, teaching and learning in this area remains intermittent and limited in most programmes. To inform the development of a Manager Train-the-Trainer program for faculty, the Royal College of Physicians and Surgeons of Canada undertook a survey of perceived Manager training needs among postgraduate trainees. A representative sample of Canadian specialty residents received a web-based questionnaire in 2009 assessing their perceived deficiencies in 13 Manager knowledge and 11 Manager skill domains, as determined by gap scores (GSs). GSs were defined as the difference between residents' perceived current and desired level of knowledge or skill in selected Manager domains. Residents' educational preferences for furthering their Manager knowledge and skills were also elicited. Among the 549 residents who were emailed the survey, 199 (36.2%) responded. Residents reported significant gaps in most knowledge and skills domains examined. Residents' preferred educational methods for learning Manager knowledge and skills included workshops, web-based formats and interactive small groups. The results of this national survey, highlighting significant perceived gaps in multiple Manager knowledge and skills domains, may inform the development of Manager curricula and faculty development activities to address deficiencies in training in this important area.

Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study

PubMed Central

Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

2011-01-01

Objective To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Design Ethnographic case study. Setting Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. Participants 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Main outcome measures Potential threats to patient safety and characteristics of good practice. Methods Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as “exceptions” by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy documents or previous research. Yet it was sometimes critical to getting the job done and contributed in subtle ways to safeguarding patients. Conclusion Receptionists and administrative staff make important “hidden” contributions to quality and safety in repeat prescribing in general practice, regarding themselves accountable to patients for these contributions. Studying technology-supported work routines that seem mundane, standardised, and automated, but which in reality require a high degree of local tailoring and judgment from frontline staff, opens up a new agenda for the study of patient safety. PMID:22053317

Receptionist input to quality and safety in repeat prescribing in UK general practice: ethnographic case study.

PubMed

Swinglehurst, Deborah; Greenhalgh, Trisha; Russell, Jill; Myall, Michelle

2011-11-03

To describe, explore, and compare organisational routines for repeat prescribing in general practice to identify contributors and barriers to safety and quality. Ethnographic case study. Four urban UK general practices with diverse organisational characteristics using electronic patient records that supported semi-automation of repeat prescribing. 395 hours of ethnographic observation of staff (25 doctors, 16 nurses, 4 healthcare assistants, 6 managers, and 56 reception or administrative staff), and 28 documents and other artefacts relating to repeat prescribing locally and nationally. Potential threats to patient safety and characteristics of good practice. Observation of how doctors, receptionists, and other administrative staff contributed to, and collaborated on, the repeat prescribing routine. Analysis included mapping prescribing routines, building a rich description of organisational practices, and drawing these together through narrative synthesis. This was informed by a sociological model of how organisational routines shape and are shaped by information and communications technologies. Results Repeat prescribing was a complex, technology-supported social practice requiring collaboration between clinical and administrative staff, with important implications for patient safety. More than half of requests for repeat prescriptions were classed as "exceptions" by receptionists (most commonly because the drug, dose, or timing differed from what was on the electronic repeat list). They managed these exceptions by making situated judgments that enabled them (sometimes but not always) to bridge the gap between the idealised assumptions about tasks, roles, and interactions that were built into the electronic patient record and formal protocols, and the actual repeat prescribing routine as it played out in practice. This work was creative and demanded both explicit and tacit knowledge. Clinicians were often unaware of this input and it did not feature in policy documents or previous research. Yet it was sometimes critical to getting the job done and contributed in subtle ways to safeguarding patients. Conclusion Receptionists and administrative staff make important "hidden" contributions to quality and safety in repeat prescribing in general practice, regarding themselves accountable to patients for these contributions. Studying technology-supported work routines that seem mundane, standardised, and automated, but which in reality require a high degree of local tailoring and judgment from frontline staff, opens up a new agenda for the study of patient safety.

Impact of access management practices to pedestrian safety.

DOT National Transportation Integrated Search

2017-03-31

This study focused on the impact of access management practices to the safety of pedestrians. Some : of the access management practices considered to impact pedestrian safety included limiting direct : access to and from major streets, locating signa...

33 CFR 96.300 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY VESSEL OPERATING REGULATIONS RULES FOR THE SAFE OPERATION OF VESSELS AND SAFETY MANAGEMENT SYSTEMS How Will Safety Management Systems... international certification for the company's and vessel's safety management system. ...

Design Modification and Calibration of the Picatinny Activator for Setback Safety Testing of SADARM

DTIC Science & Technology

1992-05-01

Modified activator 25 13 Hammer velocity versus gap closing velocity 27 14 Peak air pressures 28 15 Peak air temperatures, 29 16 Pulse durations at half...Variations in P, and P 2 with gap size for 20 KG’s and 30 KG’s acceleration, and for the 20 KG’s case with the heat transfer arbitrarily reduced to 10... closing velocity at first jump-up and its value is plotted in figure 7. It only depends on gap size and acceleration and appears to be the most

Agricultural Management Practices Explain Variation in Global Yield Gaps of Major Crops

NASA Astrophysics Data System (ADS)

Mueller, N. D.; Gerber, J. S.; Ray, D. K.; Ramankutty, N.; Foley, J. A.

2010-12-01

The continued expansion and intensification of agriculture are key drivers of global environmental change. Meeting a doubling of food demand in the next half-century will further induce environmental change, requiring either large cropland expansion into carbon- and biodiversity-rich tropical forests or increasing yields on existing croplands. Closing the “yield gaps” between the most and least productive farmers on current agricultural lands is a necessary and major step towards preserving natural ecosystems and meeting future food demand. Here we use global climate, soils, and cropland datasets to quantify yield gaps for major crops using equal-area climate analogs. Consistent with previous studies, we find large yield gaps for many crops in Eastern Europe, tropical Africa, and parts of Mexico. To analyze the drivers of yield gaps, we collected sub-national agricultural management data and built a global dataset of fertilizer application rates for over 160 crops. We constructed empirical crop yield models for each climate analog using the global management information for 17 major crops. We find that our climate-specific models explain a substantial amount of the global variation in yields. These models could be widely applied to identify management changes needed to close yield gaps, analyze the environmental impacts of agricultural intensification, and identify climate change adaptation techniques.

CSHM: Web-based safety and health monitoring system for construction management.

PubMed

Cheung, Sai On; Cheung, Kevin K W; Suen, Henry C H

2004-01-01

This paper describes a web-based system for monitoring and assessing construction safety and health performance, entitled the Construction Safety and Health Monitoring (CSHM) system. The design and development of CSHM is an integration of internet and database systems, with the intent to create a total automated safety and health management tool. A list of safety and health performance parameters was devised for the management of safety and health in construction. A conceptual framework of the four key components of CSHM is presented: (a) Web-based Interface (templates); (b) Knowledge Base; (c) Output Data; and (d) Benchmark Group. The combined effect of these components results in a system that enables speedy performance assessment of safety and health activities on construction sites. With the CSHM's built-in functions, important management decisions can theoretically be made and corrective actions can be taken before potential hazards turn into fatal or injurious occupational accidents. As such, the CSHM system will accelerate the monitoring and assessing of performance safety and health management tasks.

Message Received How to Bridge the Communication Gap and Save Lives

DTIC Science & Technology

2004-03-01

safety during an emergency depend on the ability of first responders to talk via radio, directly, without dispatch and in real time. Many technologies are...Words interoperability Coast Guard first responders procedures interagency communications policies 18...communication interoperability for public safety first responders entails far more than finding and emplacing a technology and training the operators. The

Getting the Right Wheelchair for Travel: A WC19-Compliant Wheelchair

ERIC Educational Resources Information Center

Manary, Miriam A.; Hobson, Douglas A.; Schneider, Lawrence W.

2007-01-01

Children and adults who must remain seated in their wheelchairs while traveling are often at a disadvantage in terms of crash safety. The new voluntary wheelchair industry standard WC19 (short for Section 19 of the ANSI/RESNA wheelchair standards) works to close the safety gap by providing design and performance criteria and test methods to assess…

Toward cellulose nanomaterial commercialization: knowledge gap analysis for safety data sheets according to the globally harmonized system

Treesearch

Jo Anne Shatkin; Kimberly J. Ong; James D. Ede; Theodore H. Wegner; Michael Goergen

2016-01-01

Commercialization of cellulose nanomaterials (CNs) is rapidly advancing, to the benefit of many end-use product sectors, and providing information about the safe manufacturing and handling for CNs is a priority. Safety Data Sheets (SDS) are required for industrially produced materials to communicate information on their potential health, fire, reactivity, and...

Road Infrastructure Safety Management in Poland

NASA Astrophysics Data System (ADS)

Budzynski, Marcin; Jamroz, Kazimierz; Kustra, Wojciech; Michalski, Lech; Gaca, Stanislaw

2017-10-01

The objective of road safety infrastructure management is to ensure that when roads are planned, designed, built and used road risks can be identified, assessed and mitigated. Road transport safety is significantly less developed than that of rail, water and air transport. The average individual risk of being a fatality in relation to the distance covered is thirty times higher in road transport that in the other modes. This is mainly because the different modes have a different approach to safety management and to the use of risk management methods and tools. In recent years Poland has had one of the European Union’s highest road death numbers. In 2016 there were 3026 fatalities on Polish roads with 40,766 injuries. Protecting road users from the risk of injury and death should be given top priority. While Poland’s national and regional road safety programmes address this problem and are instrumental in systematically reducing the number of casualties, the effects are far from the expectations. Modern approaches to safety focus on three integrated elements: infrastructure measures, safety management and safety culture. Due to its complexity, the process of road safety management requires modern tools to help with identifying road user risks, assess and evaluate the safety of road infrastructure and select effective measures to improve road safety. One possible tool for tackling this problem is the risk-based method for road infrastructure safety management. European Union Directive 2008/96/EC regulates and proposes a list of tools for managing road infrastructure safety. Road safety tools look at two criteria: the life cycle of a road structure and the process of risk management. Risk can be minimized through the application of the proposed interventions during design process as reasonable. The proposed methods of risk management bring together two stages: risk assessment and risk response occurring within the analyzed road structure (road network, road stretch, road section, junction, etc.). The objective of the methods is to help road authorities to take rational decisions in the area of road safety and road infrastructure safety and understand the consequences occurring in the particular phases of road life cycle. To help with assessing the impact of a road project on the safety of related roads, a method was developed for long-term forecasts of accidents and accident cost estimation as well as a risk classification to identify risks that are not acceptable risks. With regard to road safety audits and road safety inspection, a set of principles was developed to identify risks and the basic classification of mistakes and omissions. This work has added to the Polish experience of preparing and implementing such tools within the competent road authorities.

WISE recommendations to ensure the safety of injections in diabetes.

PubMed

Strauss, K

2012-01-01

Injections and fingersticks administered to patients with diabetes in health care settings present a risk of blood exposure to the injector as well as other workers in potential contact with sharps. Such exposures could lead to transmission of bloodborne pathogens such as hepatitis and HIV. A recent EU Directive requires that where such risks have been identified, processes and devices must be put in place to reduce or eliminate the risk. The aim of this paper is to provide formal guidelines on the application of this Directive to diabetes care settings. These evidence-based recommendations were written and vetted by a large group of international safety experts. A systematic literature search was conducted for all peer-reviewed studies and publications which bear on sharps safety in diabetes. Initially a group of experts reviewed this literature and drafted the recommendations. These were then presented for review, debate and revision to 57 experts from 14 countries at the WISE workshop in October, 2011. After the WISE meeting, the revised Recommendations were circulated electronically to attendees on three occasions, each time in a new iteration with revisions. Each recommendation was graded by the weight it should have in daily practice and by its degree of support in the medical literature. The topics covered include Risks of Sharps Injury and Muco-cutaneous Exposure, The EU Directive, Device Implications, Injection Technique Implications, Education and Training (Creating a "Safety Culture"), Value, Awareness and Responsibility. These safety recommendations provide practical guidance and fill an important gap in diabetes management. If followed, they should help ensure safe, effective and largely injury-free injections and fingersticks. They will serve as the roadmap for applying the new EU Directive to diabetes care. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Swiss and Dutch "consumer-driven health care": ideal model or reality?

PubMed

Okma, Kieke G H; Crivelli, Luca

2013-02-01

This article addresses three topics. First, it reports on the international interest in the health care reforms of Switzerland and The Netherlands in the 1990s and early 2000s that operate under the label "managed competition" or "consumer-driven health care." Second, the article reviews the behavior assumptions that make plausible the case for the model of "managed competition." Third, it analyze the actual reform experience of Switzerland and Holland to assess to what extent they confirm the validity of those assumptions. The article concludes that there is a triple gap in understanding of those topics: a gap between the theoretical model of managed competition and the reforms as implemented in both Switzerland and The Netherlands; second, a gap between the expectations of policy-makers and the results of the reforms, and third, a gap between reform outcomes and the observations of external commentators that have embraced the reforms as the ultimate success of "consumer-driven health care." The article concludes with a discussion of the implications of this "triple gap". Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Prioritization of patient-centered comparative effectiveness research for osteoarthritis.

PubMed

Gierisch, Jennifer M; Myers, Evan R; Schmit, Kristine M; McCrory, Douglas C; Coeytaux, Remy R; Crowley, Matthew J; Chatterjee, Ranee; Kendrick, Amy S; Sanders, Gillian D

2014-06-17

Osteoarthritis is a leading cause of disability in the United States. This article describes a prioritized research agenda about osteoarthritis management developed for the Patient-Centered Outcomes Research Institute. Evidence gaps were identified by reviewing existing literature and engaging diverse stakeholders to expand and refine gaps. Stakeholders ranked evidence gaps by importance from their perspectives.Prioritized evidence gaps included the need to determine or evaluate key patient-centered outcomes; optimal duration, intensity, and frequency of nonsurgical interventions; whether the comparative effectiveness of nonsurgical interventions varies by socioeconomic factors; when and how to transition from nonsurgical to surgical interventions; effective ways to engage patients in self-management and promote long-term behavior change; standardized screening tools that improve early diagnosis; biomechanical strategies that improve symptoms; mechanisms for promoting and delivering coordinated, longitudinal care; and comparative effectiveness of nonsurgical therapies. Searches of PubMed and ClinicalTrials.gov showed many recent and ongoing studies addressing comparative effectiveness of nonsurgical interventions; relatively few of these evaluated treatments across categories (for example, drug therapy vs. weight management) or combined categories of treatment. Few studies addressed other high-priority evidence gaps.

Safety awareness, pilot education, and incident reporting programs

NASA Technical Reports Server (NTRS)

Enders, J.

1984-01-01

Education in safety awareness, pilot training, and accident reporting is discussed. Safety awareness and risk management are examined. Both quantitative and qualitive risk management are explored. Information dissemination on safety is considered.

76 FR 62035 - Privacy Act of 1974: Notice of Proposed Privacy Act System of Records Revision

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... the purpose of the Radiation Safety Management System (RSMS). The RSMS was developed by the Radiation Safety Division, a component of USDA's DM, as a tool for the management of the USDA's radiation safety... USDA employees and the Radiation Safety Division (RSD) of USDA to manage information required by the...

Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment

PubMed Central

Kumie, Abera; Amera, Tadesse; Berhane, Kiros; Samet, Jonathan; Hundal, Nuvjote; G/Michael, Fitsum; Gilliland, Frank

2017-01-01

Background The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers’ health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia. Objectives The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services. Methods Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review. Results Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international permissible limits. There is a high level of workplace injuries that often leads to an extended loss of productive working days. Occupational safety and health services were found to be inadequately organized. There is limited practice in exposure assessment and monitoring. This happens to be true despite the existing favorable environment in areas of policies and regulations. Conclusion and Recommendation There is a severe scarcity of peer-reviewed literature related to workplace exposures and their impact on workplace health and safety. Limited adequately skilled manpower is available. The internal infrastructural capacity is weak and cannot help to identify and assess hazards in the workplace. Monitoring system and laboratory investigation is limited despite the presence of favorable policy and regulatory frameworks. Addressing these gaps is of immediate concern. PMID:28867918

Occupational Health and Safety in Ethiopia: A review of Situational Analysis and Needs Assessment.

PubMed

Kumie, Abera; Amera, Tadesse; Berhane, Kiros; Samet, Jonathan; Hundal, Nuvjote; G/Michael, Fitsum; Gilliland, Frank

2016-01-01

The current rapid economic development has brought changes in workplaces in developing countries, including Ethiopia. The organization of occupational health and safety services is not yet resilient enough to handle the growing demands for workers' health in the context of industrialization. There is limited information on the gaps and needs of occupational health services in workplaces in Ethiopia. The present review article describes the existing profile of occupational safety and health services in Ethiopia and identifies the current gaps and needs in the services. Secondary data sources were reviewed using a structured checklist to explore the status of occupational safety, health services and related morbidity. Local literature was consulted in order to describe the type and prevalence of work related hazards, patterns of industries and of workforce. Published articles were searched in Google, Google scholar, PUBMED, and HINARI databases. Relevant heads of stakeholder organizations and experts were interviewed to verify the gaps that were synthesized using desk review. Ethiopia is an agrarian country that is industrializing rapidly with a focus on construction, manufacturing, mining, and road infrastructure. An estimated work force of about two million is currently engaged in the public and private sectors. Males constitute the majority of this workforce. Most of the workforce has basic primary education. Commonly observed hazards in the workplace include occupational noise and dust of various types in manufacturing sectors and chemical exposures in the flower industry. Injury in both the agriculture and the manufacturing sectors is another workplace hazard commonly observed in the country. A lack of information made assessing workplace exposures in detail difficult. The prevalence of noise exposure was found to be high with the potential to seriously impact hearing capacity. Exposure to dust in textile and cement factories greatly exceeded international permissible limits. There is a high level of workplace injuries that often leads to an extended loss of productive working days. Occupational safety and health services were found to be inadequately organized. There is limited practice in exposure assessment and monitoring. This happens to be true despite the existing favorable environment in areas of policies and regulations. There is a severe scarcity of peer-reviewed literature related to workplace exposures and their impact on workplace health and safety. Limited adequately skilled manpower is available. The internal infrastructural capacity is weak and cannot help to identify and assess hazards in the workplace. Monitoring system and laboratory investigation is limited despite the presence of favorable policy and regulatory frameworks. Addressing these gaps is of immediate concern.

A system safety model for developmental aircraft programs

NASA Technical Reports Server (NTRS)

Amberboy, E. J.; Stokeld, R. L.

1982-01-01

Basic tenets of safety as applied to developmental aircraft programs are presented. The integration of safety into the project management aspects of planning, organizing, directing and controlling is illustrated by examples. The basis for project management use of safety and the relationship of these management functions to 'real-world' situations is presented. The rationale which led to the safety-related project decision and the lessons learned as they may apply to future projects are presented.

USDOT guidance summary for connected vehicle deployments : safety management.

DOT National Transportation Integrated Search

2016-07-01

This document provides guidance material in regards to safety management plan for the CV Pilots DeploymentConcept Development Phase. This guidance provides key concepts and references in developing the SafetyManagement Plan in Task 4, lists relevant ...

Skills Gaps in Australian Firms

ERIC Educational Resources Information Center

Lindorff, Margaret

2011-01-01

This paper reports the results of a survey of more than 2000 managers examining perceptions of skills gaps in a range of Australian firms. It finds that three quarters report a skills gap, and almost one third report skills gaps across the whole organisation. Firm size and industry differences exist in perceptions of the effect of the skills gap…

Taking stock of the occupational safety and health challenges of nanotechnology: 2000-2015

NASA Astrophysics Data System (ADS)

Schulte, P. A.; Roth, G.; Hodson, L. L.; Murashov, V.; Hoover, M. D.; Zumwalde, R.; Kuempel, E. D.; Geraci, C. L.; Stefaniak, A. B.; Castranova, V.; Howard, J.

2016-06-01

Engineered nanomaterials significantly entered commerce at the beginning of the 21st century. Concerns about serious potential health effects of nanomaterials were widespread. Now, approximately 15 years later, it is worthwhile to take stock of research and efforts to protect nanomaterial workers from potential risks of adverse health effects. This article provides and examines timelines for major functional areas (toxicology, metrology, exposure assessment, engineering controls and personal protective equipment, risk assessment, risk management, medical surveillance, and epidemiology) to identify significant contributions to worker safety and health. The occupational safety and health field has responded effectively to identify gaps in knowledge and practice, but further research is warranted and is described. There is now a greater, if imperfect, understanding of the mechanisms underlying nanoparticle toxicology, hazards to workers, and appropriate controls for nanomaterials, but unified analytical standards and exposure characterization methods are still lacking. The development of control-banding and similar strategies has compensated for incomplete data on exposure and risk, but it is unknown how widely such approaches are being adopted. Although the importance of epidemiologic studies and medical surveillance is recognized, implementation has been slowed by logistical issues. Responsible development of nanotechnology requires protection of workers at all stages of the technological life cycle. In each of the functional areas assessed, progress has been made, but more is required.

Taking stock of the occupational safety and health challenges of nanotechnology: 2000-2015.

PubMed

Schulte, P A; Roth, G; Hodson, L L; Murashov, V; Hoover, M D; Zumwalde, R; Kuempel, E D; Geraci, C L; Stefaniak, A B; Castranova, V; Howard, J

2016-06-01

Engineered nanomaterials significantly entered commerce at the beginning of the 21st century. Concerns about serious potential health effects of nanomaterials were widespread. Now, approximately 15 years later, it is worthwhile to take stock of research and efforts to protect nanomaterial workers from potential risks of adverse health effects. This article provides and examines timelines for major functional areas (toxicology, metrology, exposure assessment, engineering controls and personal protective equipment, risk assessment, risk management, medical surveillance, and epidemiology) to identify significant contributions to worker safety and health. The occupational safety and health field has responded effectively to identify gaps in knowledge and practice, but further research is warranted and is described. There is now a greater, if imperfect, understanding of the mechanisms underlying nanoparticle toxicology, hazards to workers, and appropriate controls for nanomaterials, but unified analytical standards and exposure characterization methods are still lacking. The development of control-banding and similar strategies has compensated for incomplete data on exposure and risk, but it is unknown how widely such approaches are being adopted. Although the importance of epidemiologic studies and medical surveillance is recognized, implementation has been slowed by logistical issues. Responsible development of nanotechnology requires protection of workers at all stages of the technological life cycle. In each of the functional areas assessed, progress has been made, but more is required.

Taking stock of the occupational safety and health challenges of nanotechnology: 2000–2015

PubMed Central

Roth, G.; Hodson, L. L.; Murashov, V.; Hoover, M. D.; Zumwalde, R.; Kuempel, E. D.; Geraci, C. L.; Stefaniak, A. B.; Castranova, V.; Howard, J.

2016-01-01

Engineered nanomaterials significantly entered commerce at the beginning of the 21st century. Concerns about serious potential health effects of nanomaterials were widespread. Now, approximately 15 years later, it is worthwhile to take stock of research and efforts to protect nanomaterial workers from potential risks of adverse health effects. This article provides and examines timelines for major functional areas (toxicology, metrology, exposure assessment, engineering controls and personal protective equipment, risk assessment, risk management, medical surveillance, and epidemiology) to identify significant contributions to worker safety and health. The occupational safety and health field has responded effectively to identify gaps in knowledge and practice, but further research is warranted and is described. There is now a greater, if imperfect, understanding of the mechanisms underlying nanoparticle toxicology, hazards to workers, and appropriate controls for nanomaterials, but unified analytical standards and exposure characterization methods are still lacking. The development of control-banding and similar strategies has compensated for incomplete data on exposure and risk, but it is unknown how widely such approaches are being adopted. Although the importance of epidemiologic studies and medical surveillance is recognized, implementation has been slowed by logistical issues. Responsible development of nanotechnology requires protection of workers at all stages of the technological life cycle. In each of the functional areas assessed, progress has been made, but more is required. PMID:27594804

Interoperability Gap Challenges for Learning Object Repositories & Learning Management Systems

ERIC Educational Resources Information Center

Mason, Robert T.

2011-01-01

An interoperability gap exists between Learning Management Systems (LMSs) and Learning Object Repositories (LORs). Learning Objects (LOs) and the associated Learning Object Metadata (LOM) that is stored within LORs adhere to a variety of LOM standards. A common LOM standard found in LORs is the Sharable Content Object Reference Model (SCORM)…

Knowledge Management Practices and Enablers in Public Universities: A Gap Analysis

ERIC Educational Resources Information Center

Ramachandran, Sharimllah Devi; Chong, Siong-Choy; Wong, Kuan-Yew

2013-01-01

Purpose: The purpose of this paper is to examine the gap between knowledge management (KM) practices and key strategic enablers in public universities. For this purpose, a 57-item survey on two dimensions--"use" and "importance"--was used as the instrument for this study. Design/methodology/approach: The questionnaire was…

23 CFR 630.1106 - Policy and procedures for work zone safety management.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Policy and procedures for work zone safety management... Policy and procedures for work zone safety management. (a) Each agency's policy and processes, procedures... established in accordance with 23 CFR 630.1006, shall include the consideration and management of road user...

Pyroglutamic acidemia: a cause of high anion gap metabolic acidosis.

PubMed

Dempsey, G A; Lyall, H J; Corke, C F; Scheinkestel, C D

2000-06-01

To report four cases of pyroglutamic acidemia in adults causing clinically significant acidosis. Patients admitted to the intensive care units of the Alfred Hospital (a quaternary referral center) and Geelong Hospital (a major regional center) with an unexplained high anion gap acidosis. Pyroglutamic acidemia (5-oxoprolinemia) is a rare cause of high anion gap metabolic acidosis that should be suspected in patients presenting with sepsis, hepatic, and/or renal dysfunction who are receiving drugs such as acetaminophen, flucloxacillin, and vigabatrin after the more common causes of a high anion gap acidosis have been excluded. Should pyroglutamic aciduria be present, known precipitants should be ceased, infection should be managed aggressively, and supportive management should be instituted.

Non-invasive versus invasive management in patients with prior coronary artery bypass surgery with a non-ST segment elevation acute coronary syndrome: study design of the pilot randomised controlled trial and registry (CABG-ACS)

PubMed Central

Lee, Matthew M Y; Petrie, Mark C; Rocchiccioli, Paul; Simpson, Joanne; Jackson, Colette; Brown, Ammani; Corcoran, David; Mangion, Kenneth; McEntegart, Margaret; Shaukat, Aadil; Rae, Alan; Hood, Stuart; Peat, Eileen; Findlay, Iain; Murphy, Clare; Cormack, Alistair; Bukov, Nikolay; Balachandran, Kanarath; Papworth, Richard; Ford, Ian; Briggs, Andrew; Berry, Colin

2016-01-01

Introduction There is an evidence gap about how to best treat patients with prior coronary artery bypass grafts (CABGs) presenting with non-ST segment elevation acute coronary syndromes (NSTE-ACS) because historically, these patients were excluded from pivotal randomised trials. We aim to undertake a pilot trial of routine non-invasive management versus routine invasive management in patients with NSTE-ACS with prior CABG and optimal medical therapy during routine clinical care. Our trial is a proof-of-concept study for feasibility, safety, potential efficacy and health economic modelling. We hypothesise that a routine invasive approach in patients with NSTE-ACS with prior CABG is not superior to a non-invasive approach with optimal medical therapy. Methods and analysis 60 patients will be enrolled in a randomised clinical trial in 4 hospitals. A screening log will be prospectively completed. Patients not randomised due to lack of eligibility criteria and/or patient or physician preference and who give consent will be included in a registry. We will gather information about screening, enrolment, eligibility, randomisation, patient characteristics and adverse events (including post-discharge). The primary efficacy outcome is the composite of all-cause mortality, rehospitalisation for refractory ischaemia/angina, myocardial infarction and hospitalisation for heart failure. The primary safety outcome is the composite of bleeding, stroke, procedure-related myocardial infarction and worsening renal function. Health status will be assessed using EuroQol 5 Dimensions (EQ-5D) assessed at baseline and 6 monthly intervals, for at least 18 months. Trial registration number NCT01895751 (ClinicalTrials.gov). PMID:27110377

Simulation studies for the evaluation of health information technologies: experiences and results.

PubMed

Ammenwerth, Elske; Hackl, Werner O; Binzer, Kristine; Christoffersen, Tue E H; Jensen, Sanne; Lawton, Kitta; Skjoet, Peter; Nohr, Christian

It is essential for new health information technologies (IT) to undergo rigorous evaluations to ensure they are effective and safe for use in real-world situations. However, evaluation of new health IT is challenging, as field studies are often not feasible when the technology being evaluated is not sufficiently mature. Laboratory-based evaluations have also been shown to have insufficient external validity. Simulation studies seem to be a way to bridge this gap. The aim of this study was to evaluate, using a simulation methodology, the impact of a new prototype of an electronic medication management system on the appropriateness of prescriptions and drug-related activities, including laboratory test ordering or medication changes. This article presents the results of a controlled simulation study with 50 simulation runs, including ten doctors and five simulation patients, and discusses experiences and lessons learnt while conducting the study. Although the new electronic medication management system showed tendencies to improve medication safety when compared with the standard system, this tendency was not significant. Altogether, five distinct situations were identified where the new medication management system did help to improve medication safety. This simulation study provided a good compromise between internal validity and external validity. However, several challenges need to be addressed when undertaking simulation evaluations including: preparation of adequate test cases; training of participants before using unfamiliar applications; consideration of time, effort and costs of conducting the simulation; technical maturity of the evaluated system; and allowing adequate preparation of simulation scenarios and simulation setting. Simulation studies are an interesting but time-consuming approach, which can be used to evaluate newly developed health IT systems, particularly those systems that are not yet sufficiently mature to undergo field evaluation studies.

Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities.

PubMed

Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet

2016-10-01

To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. Exploratory, qualitative pilot study. Two community based SNFs. Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators. Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self-reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety. Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Informing the development of an Internet-based chronic pain self-management program.

PubMed

Gogovor, Amédé; Visca, Regina; Auger, Claudine; Bouvrette-Leblanc, Lucie; Symeonidis, Iphigenia; Poissant, Lise; Ware, Mark A; Shir, Yoram; Viens, Natacha; Ahmed, Sara

2017-01-01

Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program. Two methods were used. First was a structured literature review: electronic databases were searched up to 2015 with combinations of MeSH terms and text-words such as chronic pain, self-management, self-efficacy, technology, Internet-based, patient portal, and e-health. A narrative synthesis of the characteristics and content of Internet-based pain management programs emerging from the literature review and how they relate to gaps in chronic pain management were completed. Second, four audiotaped focus group sessions were conducted with individuals with chronic pain and caregivers (n=9) and health professionals (n=7) recruited from three multidisciplinary tertiary and rehabilitation centres. A thematic analysis of the focus group transcripts was conducted. Thirty-nine primary articles related to 20 patient-oriented Internet-based programs were selected. Gaps in CP management included lack of knowledge, limited access to health care, suboptimal care, and lack of self-management support. Overall, 14 themes related to information needs and gaps in care were identified by both health professionals and patients, three were exclusive to patients and five to health professionals. Common themes from the focus groups included patient education on chronic pain care, attitude-belief-culture, financial and legal issues, end-of-program crash, and motivational content. Internet-based programs contain automated, communication and decision support features that can address information and care gaps reported by patients and clinicians. However, focus groups identified functionalities not reported in the literature, non-medical and condition- and context-specific information, integration of personal health records, and the role of the different health professionals in chronic pain management were not identified. These gaps need to be considered in the future development of Internet-based programs. While the association between the mechanisms of Internet-based programs' features and outcomes is not clearly established, the results of this study indicate that interactivity, personalization and tailored messages, combined with therapist contact will maximize the effectiveness of an Internet-based chronic pain program in enhancing self-management. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

77 FR 34123 - Pipeline Safety: Public Meeting on Integrity Management of Gas Distribution Pipelines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-08

... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No. PHMSA-2012-0100] Pipeline Safety: Public Meeting on Integrity Management of Gas Distribution Pipelines AGENCY: Office of Pipeline Safety, Pipeline and Hazardous Materials Safety Administration, DOT. ACTION...

Safety cost management in construction companies: A proposal classification.

PubMed

López-Alonso, M; Ibarrondo-Dávila, M P; Rubio, M C

2016-06-16

Estimating health and safety costs in the construction industry presents various difficulties, including the complexity of cost allocation, the inadequacy of data available to managers and the absence of an accounting model designed specifically for safety cost management. Very often, the costs arising from accidents in the workplace are not fully identifiable due to the hidden costs involved. This paper reviews some studies of occupational health and safety cost management and proposes a means of classifying these costs. We conducted an empirical study in which the health and safety costs of 40 construction worksites are estimated. A new classification of the health and safety cost and its categories is proposed: Safety and non-safety costs. The costs of the company's health and safety policy should be included in the information provided by the accounting system, as a starting point for analysis and control. From this perspective, a classification of health and safety costs and its categories is put forward.

The Perception, Level of Safety Satisfaction and Safety Feedback on Occupational Safety and Health Management among Hospital Staff Nurses in Sabah State Health Department.

PubMed

Cheah, Whye Lian; Giloi, Nelbon; Chang, Ching Thon; Lim, Jac Fang

2012-07-01

This study aimed to determine the perception and level of safety satisfaction of staff nurses with regards to Occupational Safety and Health (OSH) management practice in the Sabah Health Department, and to associate the OSH management dimensions, to Safety Satisfaction and Safety Feedback. A cross-sectional study using a validated self-administered questionnaire was conducted among randomly respondents. 135 nurses responded the survey. Mean (SD) score for each dimension ranged from 1.70 ± 0.68-4.04 ± 0.65, with Training and Competence dimension (mean [SD], 4.04 ± 0.65) had the highest while Safety Incidence was the least score (mean [SD], 1.70 ± 0.68). Both mean (SD) scores for Safety Satisfaction and Safety Feedback was high, 3.28 ± 0.51 and 3.57 ± 0.73, respectively. Pearson's correlation analysis indicated that all OSH dimensions had significant correlation with Safety Satisfaction and Safety Feedback (r coefficient ranged from 0.176-0.512) except for Safety Incidence. The overall perception of OSH management was rather low. Significant correlation between Safety Satisfaction and Safety Feedback and several dimensions, suggest that each organization to put in place the leaders who have appropriate leadership and supervisory skills and committed in providing staff training to improve staff's competency in OSH practice. In addition, clear goals, rules, and reporting system will help the organization to implement proper OSH management practice.

Efficacy of a food safety comic book on knowledge and self-reported behavior for persons living with AIDS.

PubMed

Dworkin, Mark S; Peterson, Caryn E; Gao, Weihua; Mayor, Angel; Hunter, Robert; Negron, Edna; Fleury, Alison; Besch, C Lynn

2013-01-01

Persons living with AIDS are highly vulnerable to foodborne enteric infections with the potential for substantial morbidity and mortality. Educational materials about foodborne enteric infections intended for this immunocompromised population have not been assessed for their efficacy in improving knowledge or encouraging behavior change. AIDS patients in four healthcare facilities in Chicago, New Orleans, and Puerto Rico were recruited using fliers and word of mouth to healthcare providers. Those who contacted research staff were interviewed to determine food safety knowledge gaps and risky behaviors. A food safety educational comic book that targeted knowledge gaps was created, piloted, and provided to these patients who were instructed to read it and return at least 2 weeks later for a follow-up interview. The overall food safety score was determined by the number of the 26 knowledge/belief/behavior questions from the survey answered correctly. Among 150 patients who participated in both the baseline and follow-up questionnaire, the intervention resulted in a substantial increase in the food safety score (baseline 59%, post-intervention 81%, p<0.001). The intervention produced a significant increase in all the food safety knowledge, belief, and behavior items that comprised the food safety score. Many of these increases were from baseline knowledge below 80 percent to well above 90%. Most (85%) of the patients stated they made a change to their behavior since receiving the educational booklet. This comic book format intervention to educate persons living with AIDS was highly effective. Future studies should examine to what extent long-term behavioral changes result.

A Review on the Rising Prevalence of International Standards: Threats or Opportunities for the Agri-Food Produce Sector in Developing Countries, with a Focus on Examples from the MENA Region.

PubMed

Faour-Klingbeil, Dima; Todd, Ewen C D

2018-03-03

Food safety standards are a necessity to protect consumers' health in today's growing global food trade. A number of studies have suggested safety standards can interrupt trade, bringing financial and technical burdens on small as well as large agri-food producers in developing countries. Other examples have shown that economical extension, key intermediaries, and funded initiatives have substantially enhanced the capacities of growers in some countries of the Middle East and North Africa (MENA) region to meet the food safety and quality requirements, and improve their access to international markets. These endeavors often compensate for the weak regulatory framework, but do not offer a sustainable solution. There is a big gap in the food safety level and control systems between countries in the MENA region and those in the developed nations. This certainly has implications for the safety of fresh produce and agricultural practices, which hinders any progress in their international food trade. To overcome the barriers of legal and private standards, food safety should be a national priority for sustainable agricultural development in the MENA countries. Local governments have a primary role in adopting the vision for developing and facilitating the implementation of their national Good Agricultural Practices (GAP) standards that are consistent with the international requirements and adapted to local policies and environment. Together, the public and private sector's support are instrumental to deliver the skills and infrastructure needed for leveraging the safety and quality level of the agri-food chain.

A Review on the Rising Prevalence of International Standards: Threats or Opportunities for the Agri-Food Produce Sector in Developing Countries, with a Focus on Examples from the MENA Region

PubMed Central

Faour-Klingbeil, Dima

2018-01-01

Food safety standards are a necessity to protect consumers’ health in today’s growing global food trade. A number of studies have suggested safety standards can interrupt trade, bringing financial and technical burdens on small as well as large agri-food producers in developing countries. Other examples have shown that economical extension, key intermediaries, and funded initiatives have substantially enhanced the capacities of growers in some countries of the Middle East and North Africa (MENA) region to meet the food safety and quality requirements, and improve their access to international markets. These endeavors often compensate for the weak regulatory framework, but do not offer a sustainable solution. There is a big gap in the food safety level and control systems between countries in the MENA region and those in the developed nations. This certainly has implications for the safety of fresh produce and agricultural practices, which hinders any progress in their international food trade. To overcome the barriers of legal and private standards, food safety should be a national priority for sustainable agricultural development in the MENA countries. Local governments have a primary role in adopting the vision for developing and facilitating the implementation of their national Good Agricultural Practices (GAP) standards that are consistent with the international requirements and adapted to local policies and environment. Together, the public and private sector’s support are instrumental to deliver the skills and infrastructure needed for leveraging the safety and quality level of the agri-food chain. PMID:29510498

NYC CV Pilot Deployment : Safety Management Plan : New York City.

DOT National Transportation Integrated Search

2016-04-22

This safety management plan identifies preliminary safety hazards associated with the New York City Connected Vehicle Pilot Deployment project. Each of the hazards is rated, and a plan for managing the risks through detailed design and deployment is ...

Ohio Aquatic Gap Analysis-An Assessment of the Biodiversity and Conservation Status of Native Aquatic Animal Species

USGS Publications Warehouse

Covert, S. Alex; Kula, Stephanie P.; Simonson, Laura A.

2007-01-01

The goal of the GAP Analysis Program is to keep common species common by identifying those species and habitats that are not yet adequately represented in the existing matrix of conservation lands. The Gap Analysis Program (GAP) is sponsored by the Biological Resources Discipline of the U.S. Geological Survey (USGS). The Ohio Aquatic GAP (OH-GAP) is a pilot project that is applying the GAP concept to aquatic-specifically, riverine-data. The mission of GAP is to provide regional assessments of the conservation status of native animal species and to facilitate the application of this information to land-management activities. OH-GAP accomplished this through * mapping aquatic habitat types, * mapping the predicted distributions of fish, crayfish, and bivalves, * documenting the presence of aquatic species in areas managed for conservation, * providing GAP results to the public, planners, managers, policy makers, and researchers, and * building cooperation with multiple organizations to apply GAP results to state and regional management activities. Gap analysis is a coarse-scale assessment of aquatic biodiversity and conservation; the goal is to identify gaps in the conservation of native aquatic species. It is not a substitute for biological field studies and monitoring programs. Gap analysis was conducted for the continuously flowing streams in Ohio. Lakes, reservoirs, wetlands, and the Lake Erie islands were not included in this analysis. The streams in Ohio are in the Lake Erie and Ohio River watersheds and pass through six of the level III ecoregions defined by Omernik: the Eastern Corn Belt Plains, Southern Michigan/Northern Indiana Drift Plains, Huron/Erie Lake Plain, Erie Drift Plains, Interior Plateau, and the Western Allegheny Plateau. To characterize the aquatic habitats available to Ohio fish, crayfish, and bivalves, a classification system needed to be developed and mapped. The process of classification includes delineation of areas of relative homogeneity and labeling these areas using categories defined by the classification system. The variables were linked to the 1:100,000-scale streams of the National Hydrography Dataset of the USGS. Through discussions with Ohio aquatic experts, OH-GAP identified eight separate enduring physical features which, when combined, form the physical habitat type: * Shreve link (a measure of stream size) * Downstream Shreve link (a measure of stream connectivity and size) * Sinuosity * Gradient * Bedrock * Stream temperature * Character of glacial drift * Glacial-drift thickness Potential distribution models were developed for 130 fish, 70 bivalve, and 17 native crayfish species. These models are based on 5,686 fish, 4,469 crayfish, and 2,899 freshwater bivalve (mussels and clams) sampling locations, the variables describing the physical habitat types, and variables indicating the major drainage basins and Omernik's Level III ecoregion. All potential species distributions are displayed and analyzed at the 14-digit hydrologic unit (14-HUs), or subwatershed, level. Mainland Ohio contains 1,749 14-HUs. All statistics and conclusions, as well as spatial data, are discussed and presented in terms of these units. The Ohio Aquatic Gap Analysis Project compiled a map of public and private conservation lands and OH-GAP classified the lands into four status categories (status 1 through status 4) by the degree of protection offered based on management practices. A status of 1 denotes the highest, most permanent level of maintenance, and status 4 represents the lowest level of biodiversity management, or unknown status. The results of this mapping show that only about 3.7 percent of the state's land (4.3 percent if lakes and reservoirs are also included) is protected for conservation, either publicly or privately. Of this total, state agencies control about 52 percent, and Federal agencies control about 29 percent. Conservation areas that presently protect

The influece of forest gaps on some properties of humus in a managed beech forest, northern Iran

NASA Astrophysics Data System (ADS)

Vajari, K. A.

2015-10-01

The present research focuses on the effect of eight-year-old artificially created gaps on some properties of humus in managed beech-dominated stand in Hyrcanian forest of northern Iran. In this study, six-teen gaps were sampled in site and were classified into four classes (small, medium, large, and very large) with four replications for each. Humus sampling was carried out at the centre and at the cardinal points within each gap as well as in the adjacent closed stand, separately, as composite samples. The variables of organic carbon, P, K, pH, and total N were measured for each sample. It was found that the gap size had significant effect only on total N (%) and organic carbon (%) in beech stand. The amount of potassium clearly differed among three positions in beech forest. The adjacent stand had higher significantly potassium than center and edge of gaps. Different amount of potassium was detected in gap center and gap edge. Comparison of humus properties between gaps and its adjacent stand pointed to the higher amount of potassium in adjacent stand than that in gaps but there was no difference between them regarding other humus properties. According to the results, it can be concluded that there is relatively similar condition among gaps and closed adjacent stands in terms of humus properties eight years after logging in the beech stand.

Construction managers' perceptions of construction safety practices in small and large firms: a qualitative investigation.

PubMed

Gillen, Marion; Kools, Susan; McCall, Cade; Sum, Juliann; Moulden, Kelli

2004-01-01

Despite the institution of explicit safety practices in construction, there continue to be exceedingly high rates of morbidity and mortality from work-related injury. This study's purpose was to identify, compare and contrast views of construction managers from large and small firms regarding construction safety practices. A complementary analysis was conducted with construction workers. A semi-structured interview guide was used to elicit information from construction managers (n = 22) in a series of focus groups. Questions were designed to obtain information on direct safety practices and indirect practices such as communication style, attitude, expectations, and unspoken messages. Data were analyzed using thematic content analysis. Managers identified a broad commitment to safety, worker training, a changing workplace culture, and uniform enforcement as key constructs in maintaining safe worksites. Findings indicate that successful managers need to be involved, principled, flexible, and innovative. Best practices, as well as unsuccessful injury prevention programs, were discussed in detail. Obstacles to consistent safety practice include poor training, production schedules and financial constraints. Construction managers play a pivotal role in the definition and implementation of safety practices in the workplace. In order to succeed in this role, they require a wide variety of management skills, upper management support, and tools that will help them instill and maintain a positive safety culture. Developing and expanding management skills of construction managers may assist them in dealing with the complexity of the construction work environment, as well as providing them with the tools necessary to decrease work-related injuries.

Perceived safety management practices in the logistics sector.

PubMed

Auyong, Hui-Nee; Zailani, Suhaiza; Surienty, Lilis

2016-03-09

Malaysia's progress on logistics has been slowed to keep pace with its growth in trade. The Government has been pressing companies to improve the safety of their activities in order to reduce society's loss due to occupational accidents and illnesses. Occupational safety and health is a crucial part of a workplace because every worker has to take care of his/her own safety and health. The main occupational safety and health (OSH) national policy in Malaysia is the enactment of the Occupational Safety and Health Act (OSHA) 1994. Only those companies which have excellent health and safety care have good quality and productive employees. This study investigated safety management practices in the logistics sector. The present study is concerned with the human factors to safety in the logistics industry. The authors examined the perceived safety management practices of workers in the logistics sector. The purpose was to identify the perception of safety management practices of Malaysian logistics personnel. Survey questionnaires were distributed to assess logistics personnel about management commitment. The quantitative method using the availability sampling method was applied. The data gathered from the survey were analysed using SPSS software. The responses to the survey were rated according to the Likert scale type, with '1' indicating strongly disagree and '5' indicating strongly agree. One hundred and three employees of logistics functions completed the survey. The highest mean scores were found for fire apparatus, prioritisation of safety, and safety policy. The results from this study also emphasise the importance of the management's commitment in enhancing workplace safety. Specifically, companies should maintain good relations between the employer and the employee to help reduce workplace injuries.

Safety management as a foundation for evidence-based aeromedical standards and reporting of medical events.

PubMed

Evans, Anthony D; Watson, Dougal B; Evans, Sally A; Hastings, John; Singh, Jarnail; Thibeault, Claude

2009-06-01

The different interpretations by States (countries) of the aeromedical standards established by the International Civil Aviation Organization has resulted in a variety of approaches to the development of national aeromedical policy, and consequently a relative lack of harmonization. However, in many areas of aviation, safety management systems have been recently introduced and may represent a way forward. A safety management system can be defined as "A systematic approach to managing safety, including the necessary organizational structures, accountabilities, policies, and procedures" (1). There are four main areas where, by applying safety management principles, it may be possible to better use aeromedical data to enhance flight safety. These are: 1) adjustment of the periodicity and content of routine medical examinations to more accurately reflect aeromedical risk; 2) improvement in reporting and analysis of routine medical examination data; 3) improvement in reporting and analysis of in-flight medical events; and 4) support for improved reporting of relevant aeromedical events through the promotion of an appropriate culture by companies and regulatory authorities. This paper explores how the principles of safety management may be applied to aeromedical systems to improve their contribution to safety.

76 FR 2123 - Agency Forms Undergoing Paperwork Reduction Act Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-12

... control; improving nutrition, physical activity, and food safety; reducing healthcare-associated... planning, response and recovery activities of subsequent emergencies, and fill gaps in knowledge that will...

Approved CAR T cell therapies: ice bucket challenges on glaring safety risks and long-term impacts.

PubMed

Zheng, Ping-Pin; Kros, Johan M; Li, Jin

2018-03-01

Two autologous chimeric antigen receptor (CAR) T cell therapies (Kymriah™ and Yescarta™) were recently approved by the FDA. Kymriah™ is for the treatment of pediatric patients and young adults with refractory or relapse (R/R) B cell precursor acute lymphoblastic leukemia and Yescarta™ is for the treatment of adult patients with R/R large B cell lymphoma. In common, both are CD19-specific CAR T cell therapies lysing CD19-positive targets. Their dramatic efficacy in the short term has been highlighted by many media reports. By contrast, their glaring safety gaps behind the miracles remain much less addressed. Here, we focus on addressing the crucial challenges in relation to the gaps. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Experiences and lessons learned from 29 HPV vaccination programs implemented in 19 low and middle-income countries, 2009-2014.

PubMed

Ladner, Joël; Besson, Marie-Hélène; Audureau, Etienne; Rodrigues, Mariana; Saba, Joseph

2016-10-13

Cervical cancer is the greatest cause of age-weighted years of life lost in the developing world. Human papillomavirus (HPV) infection is associated with a high proportion of cervical cancers, and HPV vaccination may help to reduce the incidence of cancer. The aim of the study was to identify barriers, obstacles, and strategies and to analyze key concerns and lessons learned with respect to the implementation of HPV vaccination program in low- and middle-income countries. The Gardasil Access Program (GAP) is a donation program established to enable organizations and institutions in eligible low-resource countries to gain operational experience designing and implementing HPV vaccination programs. This study used an online survey to capture the experiences and insights of program managers participating in the GAP. Different factors related to HPV vaccination program management were collected. A mixed-method approach enabled the presentation of both quantitative measurements and qualitative insights. Twenty-nine programs implemented by 23 institutions in 19 low- and middle-income countries were included. Twenty programs managers (97.7 %) reported that their institution implemented sensitization strategies about vaccination prior to the launch of vaccination campaign. The most frequently reported obstacles to HPV vaccination by the program managers were erroneous perceptions of population related to the vaccine's safety and efficacy. Reaching and maintaining follow-up with target populations were identified as challenges. Insufficient infrastructure and human resources financing and the vaccine delivery method were identified as significant health system barriers. Coupling HPV vaccination with other health interventions for mothers of targeted girls helped to increase vaccination and cervical cancer screening. The majority of program managers reported that their programs had a positive impact on national HPV vaccination policy. The majority of institutions had national and international partners that provided support for human resources, technical assistance, and training and financial support for health professionals. Local organizations and institutions can implement successful HPV vaccination campaigns. Adequate and adapted planning and resources that support information sharing, sensitization, and mobilization are essential for such success. These results can inform the development of programs and policies related to HPV vaccination in low- and middle-income countries.

Managing Safety and Operations: The Effect of Joint Management System Practices on Safety and Operational Outcomes.

PubMed

Tompa, Emile; Robson, Lynda; Sarnocinska-Hart, Anna; Klassen, Robert; Shevchenko, Anton; Sharma, Sharvani; Hogg-Johnson, Sheilah; Amick, Benjamin C; Johnston, David A; Veltri, Anthony; Pagell, Mark

2016-03-01

The aim of this study was to determine whether management system practices directed at both occupational health and safety (OHS) and operations (joint management system [JMS] practices) result in better outcomes in both areas than in alternative practices. Separate regressions were estimated for OHS and operational outcomes using data from a survey along with administrative records on injuries and illnesses. Organizations with JMS practices had better operational and safety outcomes than organizations without these practices. They had similar OHS outcomes as those with operations-weak practices, and in some cases, better outcomes than organizations with safety-weak practices. They had similar operational outcomes as those with safety-weak practices, and better outcomes than those with operations-weak practices. Safety and operations appear complementary in organizations with JMS practices in that there is no penalty for either safety or operational outcomes.

A Recipe for Streamlining Mission Management

NASA Technical Reports Server (NTRS)

Mitchell, Andrew E.; Semancik, Susan K.

2004-01-01

This paper describes a project's design and implementation for streamlining mission management with knowledge capture processes across multiple organizations of a NASA directorate. Thc project's focus is on standardizing processes and reports; enabling secure information access and case of maintenance; automating and tracking appropriate workflow rules through process mapping; and infusing new technologies. This paper will describe a small team's experiences using XML technologies through an enhanced vendor suite of applications integrated on Windows-based platforms called the Wallops Integrated Scheduling and Document Management System (WISDMS). This paper describes our results using this system in a variety of endeavors, including providing range project scheduling and resource management for a Range and Mission Management Office; implementing an automated Customer Feedback system for a directorate; streamlining mission status reporting across a directorate; and initiating a document management, configuration management and portal access system for a Range Safety Office's programs. The end result is a reduction of the knowledge gap through better integration and distribution of information, improved process performance, automated metric gathering, and quicker identification of problem areas and issues. However, the real proof of the pudding comes through overcoming the user's reluctance to replace familiar, seasoned processes with new technology ingredients blended with automated procedures in an untested recipe. This paper shares some of the team's observations that led to better implementation techniques, as well as an IS0 9001 Best Practices citation. This project has provided a unique opportunity to advance NASA's competency in new technologies, as well as to strategically implement them within an organizational structure, while wetting the appetite for continued improvements in mission management.

The evolving role and care management approaches of safety-net Medicaid managed care plans.

PubMed

Gusmano, Michael K; Sparer, Michael S; Brown, Lawrence D; Rowe, Catherine; Gray, Bradford

2002-12-01

This article provides new empirical data about the viability and the care management activities of Medicaid managed-care plans sponsored by provider organizations that serve Medicaid and other low-income populations. Using survey and case study methods, we studied these "safety-net" health plans in 1998 and 2000. Although the number of safety-net plans declined over this period, the surviving plans were larger and enjoying greater financial success than the plans we surveyed in 1998. We also found that, based on a partnership with providers, safety-net plans are moving toward more sophisticated efforts to manage the care of their enrollees. Our study suggests that, with supportive state policies, safety-net plans are capable of remaining viable. Contracting with safety-net plans may not be an efficient mechanism for enabling Medicaid recipients to "enter the mainstream of American health care," but it may provide states with an effective way to manage and coordinate the care of Medicaid recipients, while helping to maintain the health care safety-net for the uninsured.

Underlying influence of perception of management leadership on patient safety climate in healthcare organizations - A mediation analysis approach.

PubMed

Weng, Shao-Jen; Kim, Seung-Hwan; Wu, Chieh-Liang

2017-02-01

We aim to draw insights on how medical staff's perception of management leadership affects safety climate with key safety related dimensions-teamwork climate, job satisfaction and working conditions. A cross-sectional survey using Safety Attitude Questionnaire (SAQ) was performed in a medical center in Taichung City, Taiwan. The relationships among the dimensions in SAQ were then analyzed by structural equation modeling with a mediation analysis. 2205 physicians and nurses of the medical center participated in the survey. Because not all questions in the survey are suitable for entire hospital staff, only the valid responses (n = 1596, response rate of 72%) were extracted for analysis. Key measures are the direct and indirect effects of teamwork climate, job satisfaction, perception of management leadership, and working conditions on safety climate. Outcomes show that effect of perception of management leadership on safety climate is significant (standardized indirect effect of 0.892 with P-value 0.002) and fully mediated by other dimensions, where 66.9% is mediated through teamwork climate, 24.1% through working conditions and 9.0% through job satisfaction. Our findings point to the importance of management leadership and the mechanism of its influence on safety climate. To improve safety climate, the implication is that commitment by management on leading safety improvement needs to be demonstrated when it implements daily supportive actions for other safety dimensions. For future improvement, development of a management system that can facilitate two-way trust between management and staff over the long term is recommended. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

76 FR 64110 - Safety and Health Management Programs for Mines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... DEPARTMENT OF LABOR Mine Safety and Health Administration RIN 1219-AB71 Safety and Health Management Programs for Mines AGENCY: Mine Safety and Health Administration, Labor. ACTION: Notice of public meetings. SUMMARY: The Mine Safety and Health Administration (MSHA) is holding a public meeting, and plans...

78 FR 48046 - Safety Zone; Kuoni Destination Management Fireworks; San Diego, CA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-07

...-AA00 Safety Zone; Kuoni Destination Management Fireworks; San Diego, CA AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a safety zone on the navigable..., 2013. This temporary safety zone is necessary to provide for the safety of the participants, crew...

Integrating interdisciplinary pain management into primary care: development and implementation of a novel clinical program.

PubMed

Dorflinger, Lindsey M; Ruser, Christopher; Sellinger, John; Edens, Ellen L; Kerns, Robert D; Becker, William C

2014-12-01

The aims of this study were to develop and implement an interdisciplinary pain program integrated in primary care to address stakeholder-identified gaps. Program development and evaluation project utilizing a Plan-Do-Study-Act (PDSA) approach to address the identified problem of insufficient pain management resources within primary care. A large Healthcare System within the Veterans Health Administration, consisting of two academically affiliated medical centers and six community-based outpatients clinics. An interprofessional group of stakeholders participated in a Rapid Process Improvement Workshop (RPIW), a consensus-building process to identify systems-level gaps and feasible solutions and obtain buy-in. Changes were implemented in 2012, and in a 1-year follow-up, we examined indicators of engagement in specialty and multimodal pain care services as well as patient and provider satisfaction. In response to identified barriers, RPIW participants proposed and outlined two readily implementable, interdisciplinary clinics embedded within primary care: 1) the Integrated Pain Clinic, providing in-depth assessment and triage to targeted resources; and 2) the Opioid Reassessment Clinic, providing assessment and structured monitoring of patients with evidence of safety, efficacy, or misuse problems with opioids. Implementation of these programs led to higher rates of engagement in specialty and multimodal pain care services; patients and providers reported satisfaction with these services. Our PDSA cycle engaged an interprofessional group of stakeholders that recommended introduction of new systems-based interventions to better integrate pain resources into primary care to address reported barriers. Early data suggest improved outcomes; examination of additional outcomes is planned. Wiley Periodicals, Inc.

Comparing Occupational Health and Safety Management System Programming with Injury Rates in Poultry Production.

PubMed

Autenrieth, Daniel A; Brazile, William J; Douphrate, David I; Román-Muñiz, Ivette N; Reynolds, Stephen J

2016-01-01

Effective methods to reduce work-related injuries and illnesses in animal production agriculture are sorely needed. One approach that may be helpful for agriculture producers is the adoption of occupational health and safety management systems. In this replication study, the authors compared the injury rates on 32 poultry growing operations with the level of occupational health and safety management system programming at each farm. Overall correlations between injury rates and programming level were determined, as were correlations between individual management system subcomponents to ascertain which parts might be the most useful for poultry producers. It was found that, in general, higher levels of occupational health and safety management system programming were associated with lower rates of workplace injuries and illnesses, and that Management Leadership was the system subcomponent with the strongest correlation. The strength and significance of the observed associations were greater on poultry farms with more complete management system assessments. These findings are similar to those from a previous study of the dairy production industry, suggesting that occupational health and safety management systems may hold promise as a comprehensive way for producers to improve occupational health and safety performance. Further research is needed to determine the effectiveness of such systems to reduce farm work injuries and illnesses. These results are timely given the increasing focus on occupational safety and health management systems.

Implementing the national priorities for injury surveillance.

PubMed

Mitchell, Rebecca J; McClure, Rod J; Williamson, Ann M; McKenzie, Kirsten

2008-04-07

Injury is a leading cause of disability and death in Australia and is recognised as a national health priority area. The foundation of successful injury prevention is injury surveillance, and national policies and strategies developed over the past 20 years to reduce the burden of injury in Australia have included 22 recommendations on surveillance--only three of which have been completely implemented. Priorities for improving injury surveillance include: improving current injury mortality and morbidity data collection systems; filling the gaps in injury surveillance; maintaining vigilance over data quality; increasing the integration and accessibility of injury data; developing technical expertise in surveillance. Barriers to implementation of the current National Injury Prevention and Safety Promotion Plan include the lack of an implementation plan, performance management structure, appropriate national governance structure and resources--all of which could be overcome with government commitment.

75 FR 65353 - Proposed Data Collections Submitted for Public Comment and Recommendations

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

...; improving nutrition, physical activity, and food safety; reducing healthcare-associated infections... and recovery activities of subsequent emergencies, and fill gaps in knowledge that will strengthen...

Operation and Development Status of the Spacecraft Fire Experiments (Saffire)

NASA Technical Reports Server (NTRS)

Ruff, Gary A.; Urban, David L.

2016-01-01

Since 2012, a series of Spacecraft Fire Experiments (Saffire) have been under development by the Spacecraft Fire Safety Demonstration (SFS Demo) project, funded by NASA's Advanced Exploration Systems Division. The overall objective of this project is to reduce the uncertainty and risk associated with the design of spacecraft fire safety systems for NASA's exploration missions. The approach to achieving this goal has been to define, develop, and conduct experiments that address gaps in spacecraft fire safety knowledge and capabilities identified by NASA's Fire Safety System Maturation Team. The Spacecraft Fire Experiments (Saffire-I, -II, and -III) are material flammability tests at length scales that are realistic for a spacecraft fire in low-gravity. The specific objectives of these three experiments are to (1) determine how rapidly a large scale fire grows in low-gravity and (2) investigate the low-g flammability limits compared to those obtained in NASA's normal gravity material flammability screening test. The experiments will be conducted in Orbital ATK's Cygnus vehicle after it has unberthed from the International Space Station. The tests will be fully automated with the data downlinked at the conclusion of the test before the Cygnus vehicle reenters the atmosphere. This paper discusses the status of the Saffire-I, II, and III experiments followed by a review of the fire safety technology gaps that are driving the development of objectives for the next series of experiments, Saffire-IV, V, and VI.

Connecticut Department of Transportation safety techniques enhancement plan.

DOT National Transportation Integrated Search

2015-03-15

The Highway Safety Manual (HSM) defines a six-step cycle of safety management processes. This report evaluates the : Conncituct Department on how well conform to the six safety management steps. The methods recommended in the HSM : require additional...

Safety culture: analysis of the causal relationships between its key dimensions.

PubMed

Fernández-Muñiz, Beatriz; Montes-Peón, José Manuel; Vázquez-Ordás, Camilo José

2007-01-01

Several fields are showing increasing interest in safety culture as a means of reducing accidents in the workplace. The literature shows that safety culture is a multidimensional concept. However, considerable confusion surrounds this concept, about which little consensus has been reached. This study proposes a model for a positive safety culture and tests this on a sample of 455 Spanish companies, using the structural equation modeling statistical technique. Results show the important role of managers in the promotion of employees' safe behavior, both directly, through their attitudes and behaviors, and indirectly, by developing a safety management system. This paper identifies the key dimensions of safety culture. In addition, a measurement scale for the safety management system is validated. This will assist organizations in defining areas where they need to progress if they wish to improve their safety. Also, we stress that managers need to be wholly committed to and personally involved in safety activities, thereby conveying the importance the firm attaches to these issues.

Regional Mass Fatality Management in Pandemic Surge

DTIC Science & Technology

2008-12-01

Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction...demands multiagency participation and full public-business-government leverage. This thesis explores pathways to reach operational regional MFM...identifying state guidance gaps; 2) identifying local/regional operational gaps; 3) assessing regional resource capabilities; 4) categorizing proposed

Educational Leadership and Management: Blending Greek Philosophy, Myth and Current Thinking

ERIC Educational Resources Information Center

Pashiardis, Petros

2009-01-01

In this conceptual paper, an exploration of the leadership gap between theory and praxis, which manifests itself in three different kinds of fissure in current thinking and research in the field of educational leadership, management and administration, will be undertaken. It is argued that there is a public image/communication gap, which current…

Bat activity in selection harvests and intact forest canopy gaps at Indiana state forests

Treesearch

Scott Haulton; Kathryn L. DeCosta

2014-01-01

Forest managers often prescribe silvicultural methods based on how effectively they mimic the natural disturbance agents that have historically shaped the forests they manage. On Indiana state forests, selection systems are used on most harvested acreage and appear to structurally mimic the effects of naturally occurring, gap-forming disturbances affecting individual...

Chapter 6: The scientific basis for conserving forest carnivores: considerations for management

Treesearch

L. Jack Lyon; Keith B. Aubry; William J. Zielinski; Steven W. Buskirk; Leonard F. Ruggiero

1994-01-01

The reviews presented in previous chapters reveal substantial gaps in our knowledge about marten, fisher, lynx, and wolverine. These gaps severely constrain our ability to design reliable conservation strategies. This problem will be explored in depth in Chapter 7. In this chapter, our objective is to discuss management considerations resulting from what we currently...

Engineering Graduates' Skill Sets in the MENA Region: A Gap Analysis of Industry Expectations and Satisfaction

ERIC Educational Resources Information Center

Ramadi, Eric; Ramadi, Serge; Nasr, Karim

2016-01-01

This study explored gaps between industry expectations and perceptions of engineering graduates' skill sets in the Middle East and North Africa (MENA) region. This study measured the importance that managers of engineers placed on 36 skills relevant to engineers. Also measured was managers' satisfaction with engineering graduates' skill sets.…

Exploring the Theory-Practice Gap: Applications to Health Information Management/Technology Education and Training

ERIC Educational Resources Information Center

Green, Zakevia Denise

2013-01-01

Although research on the theory-practice gap is available across multiple disciplines, similar studies focusing on the profession of health information management/technology (HIM/T) are not yet available. The projected number of qualified HIM/T needed with advanced skills and training suggests that skillful use of electronic health records (EHR)…

Health Policy and Management: in praise of political science. Comment on "On Health Policy and Management (HPAM): mind the theory-policy-practice gap".

PubMed

Hunter, David J

2015-03-12

Health systems have entered a third era embracing whole systems thinking and posing complex policy and management challenges. Understanding how such systems work and agreeing what needs to be put in place to enable them to undergo effective and sustainable change are more pressing issues than ever for policy-makers. The theory-policy-practice-gap and its four dimensions, as articulated by Chinitz and Rodwin, is acknowledged. It is suggested that insights derived from political science can both enrich our understanding of the gap and suggest what changes are needed to tackle the complex challenges facing health systems. © 2015 by Kerman University of Medical Sciences.

Ethical issues in patient safety: Implications for nursing management.

PubMed

Kangasniemi, Mari; Vaismoradi, Mojtaba; Jasper, Melanie; Turunen, Hannele

2013-12-01

The purpose of this article is to discuss the ethical issues impacting the phenomenon of patient safety and to present implications for nursing management. Previous knowledge of this perspective is fragmented. In this discussion, the main drivers are identified and formulated in 'the ethical imperative' of patient safety. Underlying values and principles are considered, with the aim of increasing their visibility for nurse managers' decision-making. The contradictory nature of individual and utilitarian safety is identified as a challenge in nurse management practice, together with the context of shared responsibility and identification of future challenges. As a conclusion, nurse managers play a strategic role in patient safety. Their role is to incorporate ethical values of patient safety into decision-making at all levels in an organization, and also to encourage clinical nurses to consider values in the provision of care to patients. Patient safety that is sensitive to ethics provides sustainable practice where the humanity and dignity of all stakeholders are respected.

Safety management of a complex R and D ground operating system

NASA Technical Reports Server (NTRS)

Connors, J. F.; Maurer, R. A.

1975-01-01

A perspective on safety program management was developed for a complex R&D operating system, such as the NASA-Lewis Research Center. Using a systems approach, hazardous operations are subjected to third-party reviews by designated-area safety committees and are maintained under safety permit controls. To insure personnel alertness, emergency containment forces and employees are trained in dry-run emergency simulation exercises. The keys to real safety effectiveness are top management support and visibility of residual risks.

Safety management of a complex R&D ground operating system

NASA Technical Reports Server (NTRS)

Connors, J. F.; Maurer, R. A.

1975-01-01

A perspective on safety program management has been developed for a complex R&D operating system, such as the NASA-Lewis Research Center. Using a systems approach, hazardous operations are subjected to third-party reviews by designated area safety committees and are maintained under safety permit controls. To insure personnel alertness, emergency containment forces and employees are trained in dry-run emergency simulation exercises. The keys to real safety effectiveness are top management support and visibility of residual risks.

76 FR 15953 - Agency Information Collection Activities; Announcement of Office of Management and Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

... CONSUMER PRODUCT SAFETY COMMISSION Agency Information Collection Activities; Announcement of Office of Management and Budget Approval; Publicly Available Consumer Product Safety Information Database... Product Safety Information Database has been approved by the Office of Management and Budget (OMB) under...

75 FR 5244 - Pipeline Safety: Integrity Management Program for Gas Distribution Pipelines; Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... Management Program for Gas Distribution Pipelines; Correction AGENCY: Pipeline and Hazardous Materials Safety... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration 49 CFR Part... Regulations to require operators of gas distribution pipelines to develop and implement integrity management...

Management of children exposed to Mycobacterium tuberculosis: a public health evaluation in West Java, Indonesia.

PubMed

Rutherford, Merrin E; Ruslami, Rovina; Anselmo, Melissa; Alisjahbana, Bachti; Yulianti, Neti; Sampurno, Hedy; van Crevel, Reinout; Hill, Philip C

2013-12-01

To investigate qualitatively and quantitatively the performance of a programme for managing the child contacts of adult tuberculosis patients in Indonesia. A public health evaluation framework was used to assess gaps in a child contact management programme at a lung clinic. Targets for programme performance indicators were derived from established programme indicator targets, the scientific literature and expert opinion. Compliance with tuberculosis screening, the initiation of isoniazid preventive therapy in children younger than 5 years, the accuracy of tuberculosis diagnosis and adherence to preventive therapy were assessed in 755 child contacts in two cohorts. In addition, 22 primary caregivers and 34 clinic staff were interviewed to evaluate knowledge and acceptance of child contact management. The cost to caregivers was recorded. Gaps between observed and target indicator values were quantified. THE GAPS BETWEEN OBSERVED AND TARGET PERFORMANCE INDICATORS WERE: 82% for screening compliance; 64 to 100% for diagnostic accuracy, 50% for the initiation of preventive therapy, 54% for adherence to therapy and 50% for costs. Many staff did not have adequate knowledge of, or an appropriate attitude towards, child contact management, especially regarding isoniazid preventive therapy. Caregivers had good knowledge of screening but not of preventive therapy and had difficulty travelling to the clinic and paying costs. The study identified widespread gaps in the performance of a child contact management system in Indonesia, all of which appear amenable to intervention. The public health evaluation framework used could be applied in other settings where child contact management is failing.

Towards integrated hygiene and food safety management systems: the Hygieneomic approach.

PubMed

Armstrong, G D

1999-09-15

Integrated hygiene and food safety management systems in food production can give rise to exceptional improvements in food safety performance, but require high level commitment and full functional involvement. A new approach, named hygieneomics, has been developed to assist management in their introduction of hygiene and food safety systems. For an effective introduction, the management systems must be designed to fit with the current generational state of an organisation. There are, broadly speaking, four generational states of an organisation in their approach to food safety. They comprise: (i) rules setting; (ii) ensuring compliance; (iii) individual commitment; (iv) interdependent action. In order to set up an effective integrated hygiene and food safety management system a number of key managerial requirements are necessary. The most important ones are: (a) management systems must integrate the activities of key functions from research and development through to supply chain and all functions need to be involved; (b) there is a critical role for the senior executive, in communicating policy and standards; (c) responsibilities must be clearly defined, and it should be clear that food safety is a line management responsibility not to be delegated to technical or quality personnel; (d) a thorough and effective multi-level audit approach is necessary; (e) key activities in the system are HACCP and risk management, but it is stressed that these are ongoing management activities, not once-off paper generating exercises; and (f) executive management board level review is necessary of audit results, measurements, status and business benefits.

The state of quality improvement and patient safety teaching in health professional education in New Zealand.

PubMed

Robb, Gillian; Stolarek, Iwona; Wells, Susan; Bohm, Gillian

2017-10-27

To investigate how quality and patient safety domains are being taught in the pre-registration curricula of health profession education programmes in New Zealand. All tertiary institutions providing training for medicine, nursing, midwifery, dentistry, pharmacy, physiotherapy, dietetics and 11 other allied health professions in New Zealand were contacted and a person with relevant curriculum knowledge was invited to participate. Interviews were conducted using a semi-structured interview guide to explore nine quality and safety domains; improvement science, patient safety, quality and safety culture, evidence-based practice, patient-centred care, teamwork and communication, leadership for change, systems thinking and use of information technology (IT). Transcribed data were extracted and categorised by discipline and domain. Two researchers independently identified and categorised themes within each domain, using a general inductive approach. Forty-nine institutions were contacted and 43 (88%) people were interviewed. The inclusion and extent of quality and safety teaching was variable. Evidence-based practice, patient-centred care and teamwork and communication were the strongest domains and well embedded in programmes, while leadership, systems thinking and the role of IT were less explicitly included. Except for two institutions, improvement science was absent from pre-registration curricula. Patient safety teaching was focused mainly around incident reporting, and to a lesser extent learning from adverse events. Although a 'no blame' culture was articulated as important, the theme of individual accountability was still apparent. While participants agreed that all domains were important, the main barriers to incorporating improvement science and patient safety concepts into existing programmes included an 'already stretched curriculum' and having faculty with limited expertise in these areas. Although the building blocks for improving the quality and safety of healthcare are present, this national study of multiple health professional pre-registration education programmes has identified teaching gaps in patient safety and improvement science methods and tools. Failure to address these gaps will compromise the ability of new graduates to successfully implement and sustain improvements.

The Perception, Level of Safety Satisfaction and Safety Feedback on Occupational Safety and Health Management among Hospital Staff Nurses in Sabah State Health Department

PubMed Central

Cheah, Whye Lian; Giloi, Nelbon; Chang, Ching Thon; Lim, Jac Fang

2012-01-01

Background: This study aimed to determine the perception and level of safety satisfaction of staff nurses with regards to Occupational Safety and Health (OSH) management practice in the Sabah Health Department, and to associate the OSH management dimensions, to Safety Satisfaction and Safety Feedback. Methods: A cross-sectional study using a validated self-administered questionnaire was conducted among randomly respondents. Results: 135 nurses responded the survey. Mean (SD) score for each dimension ranged from 1.70 ± 0.68–4.04 ± 0.65, with Training and Competence dimension (mean [SD], 4.04 ± 0.65) had the highest while Safety Incidence was the least score (mean [SD], 1.70 ± 0.68). Both mean (SD) scores for Safety Satisfaction and Safety Feedback was high, 3.28 ± 0.51 and 3.57 ± 0.73, respectively. Pearson’s correlation analysis indicated that all OSH dimensions had significant correlation with Safety Satisfaction and Safety Feedback (r coefficient ranged from 0.176–0.512) except for Safety Incidence. Conclusion: The overall perception of OSH management was rather low. Significant correlation between Safety Satisfaction and Safety Feedback and several dimensions, suggest that each organization to put in place the leaders who have appropriate leadership and supervisory skills and committed in providing staff training to improve staff’s competency in OSH practice. In addition, clear goals, rules, and reporting system will help the organization to implement proper OSH management practice. PMID:23610550

Food consumption data needs for food and agricultural policy.

PubMed

Myers, L H

1994-09-01

Food and agricultural policy strives to provide stable, safe, nutritional, and affordable food supplies with policies on farm income, low-income food security, food safety (including nutritional risk), and nutrition education. For each policy area, comparisons are made between food consumption data needs and information currently collected with four human nutrition monitoring system components administered by the U.S. Department of Agriculture. Identified data gaps become the basis for recommendations for future data needs. Food consumption data are essential to management of programs. However, many food safety and nutritional well-being issues require specific food product consumption data for high risk groups. Sampling procedures are often too aggregate to meet these needs. Food consumed away-from-home is not well measured, yet this market segment now accounts for about half of all consumer food expenditures. Surveys should be designed to provide complementary and additive data. A premium should be placed on standardizing household description variables to enable "splicing" together data from different surveys. Survey continuity across time is essential. Data collection should be planned with funding limitations and respondent burden in mind so that a balance is achieved between survey objectives and the practical constraints of obtaining accurate data.

Smart fabrics and interactive textile enabling wearable personal applications: R&D state of the art and future challenges.

PubMed

Lymberis, A; Paradiso, R

2008-01-01

Smart fabrics and interactive textiles (SFIT) are fibrous structures that are capable of sensing, actuating, generating/storing power and/or communicating. Research and development towards wearable textile-based personal systems allowing e.g. health monitoring, protection & safety, and healthy lifestyle gained strong interest during the last 10 years. Under the Information and Communication Programme of the European Commission, a cluster of R&D projects dealing with smart fabrics and interactive textile wearable systems regroup activities along two different and complementary approaches i.e. 'application pull' and 'technology push'. This includes projects aiming at personal health management through integration, validation, and use of smart clothing and other networked mobile devices as well as projects targeting the full integration of sensors/actuators, energy sources, processing and communication within the clothes to enable personal applications such as protection/safety, emergency and healthcare. The integration part of the technologies into a real SFIT product is at present stage on the threshold of prototyping and testing. Several issues, technical as well user-centred, societal and business, remain to be solved. The paper presents on going major R&D activities, identifies gaps and discuss key challenges for the future.

Concise Review: Workshop Review: Understanding and Assessing the Risks of Stem Cell-Based Therapies

PubMed Central

Heslop, James A.; Hammond, Thomas G.; Santeramo, Ilaria; Tort Piella, Agnès; Hopp, Isabel; Zhou, Jing; Baty, Roua; Graziano, Enrique I.; Proto Marco, Bernabé; Caron, Alexis; Sköld, Patrik; Andrews, Peter W.; Baxter, Melissa A.; Hay, David C.; Hamdam, Junnat; Sharpe, Michaela E.; Patel, Sara; Jones, David R.; Reinhardt, Jens; Danen, Erik H.J.; Ben-David, Uri; Stacey, Glyn; Björquist, Petter; Piner, Jacqueline; Mills, John; Rowe, Cliff; Pellegrini, Giovanni; Sethu, Swaminathan; Antoine, Daniel J.; Cross, Michael J.; Murray, Patricia; Williams, Dominic P.; Kitteringham, Neil R.; Park, B. Kevin

2015-01-01

The field of stem cell therapeutics is moving ever closer to widespread application in the clinic. However, despite the undoubted potential held by these therapies, the balance between risk and benefit remains difficult to predict. As in any new field, a lack of previous application in man and gaps in the underlying science mean that regulators and investigators continue to look for a balance between minimizing potential risk and ensuring therapies are not needlessly kept from patients. Here, we attempt to identify the important safety issues, assessing the current advances in scientific knowledge and how they may translate to clinical therapeutic strategies in the identification and management of these risks. We also investigate the tools and techniques currently available to researchers during preclinical and clinical development of stem cell products, their utility and limitations, and how these tools may be strategically used in the development of these therapies. We conclude that ensuring safety through cutting-edge science and robust assays, coupled with regular and open discussions between regulators and academic/industrial investigators, is likely to prove the most fruitful route to ensuring the safest possible development of new products. PMID:25722427

Integrating environmental management into food safety and food packaging in Malaysia: review of the food regulation 1985

NASA Astrophysics Data System (ADS)

Nordin, N. H.; Hara, H.; Kaida, N.

2017-05-01

Food safety is an important issue that is related to public safety to prevent the toxicity threats of the food. Management through legal approach has been used in Malaysia as one of the predominant approaches to manage the environment. In this regard, the Food Regulation 1985 has been one of the mechanisms of environmental management through legal approach in controlling the safety of packaged food in food packaging industry in Malaysia. The present study aims to analyse and to explain the implementation of the Food Regulation 1985 in controlling the safety of packaged food in Malaysia and to integrate the concept of environmental management into the food safety issue. Qualitative analysis on the regulation document revealed that there are two main themes, general and specific, while their seven sub themes are included harmful packages, safety packages, reuse packages, polyvinyl chloride (PVC), alcoholic bottle, toys, money and others and iron powder. The implementation of the Food Regulation 1985 in controlling the safety of packaged food should not be regarded solely for regulation purposes but should be further developed for a broader sense of food safety from overcoming the food poisoning.

[Road map for health and safety management systems in healthcare facilities, according to the OHSAS 18001:2007 standard].

PubMed

Pugliese, F; Albini, E; Serio, O; Apostoli, P

2011-01-01

The 81/2008 Act has defined a model of a health and safety management system that can contribute to prevent the occupational health and safety risks. We have developed the structure of a health and safety management system model and the necessary tools for its implementation in health care facilities. The realization of a model is structured in various phases: initial review, safety policy, planning, implementation, monitoring, management review and continuous improvement. Such a model, in continuous evolution, is based on the responsibilities of the different corporate characters and on an accurate analysis of risks and involved norms.

[Patient safety and a culture of responsibility in ambulatory care: strategies for improving practice].

PubMed

Lichte, Thomas; Klement, Andreas; Herrmann, Markus

2009-01-01

The development of a medical safety culture is spreading beyond the hospital into the ambulatory setting. Patient safety defined as "absence of unwanted events" (primum non nocere) can serve as a starting point for the advancement of our ambulatory medical care system. Error analyses conducted in GP and specialist practices will identify gaps and traps in the system and provide ideas for the development and implementation of new safety strategies in ambulatory patient care. In the light of the structures and processes of GP medical care aspects of patient safety will be correlated to the outcome quality and examples will be discussed. Possible strategies for the improvement of patient safety in GP practice will be presented from the perspective of both patient- and practice individuality.

49 CFR 192.911 - What are the elements of an integrity management program?

Code of Federal Regulations, 2010 CFR

2010-10-01

...) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas Transmission Pipeline Integrity Management § 192.911 What are the elements of an integrity management program...

75 FR 57898 - NIST Blue Ribbon Commission on Management and Safety-II

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-23

... DEPARTMENT OF COMMERCE National Institute of Standards and Technology NIST Blue Ribbon Commission... Commerce. ACTION: Notice of establishment of the NIST Blue Ribbon Commission on Management and Safety--II... NIST Blue Ribbon Commission on Management and Safety--II ``Commission''. The Commission will assess...

49 CFR 192.909 - How can an operator change its integrity management program?

Code of Federal Regulations, 2010 CFR

2010-10-01

... (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) PIPELINE SAFETY TRANSPORTATION OF NATURAL AND OTHER GAS BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Gas Transmission Pipeline Integrity Management § 192.909 How can an operator change its integrity management...