Sample records for risk management implementation

  1. Engineering Management Capstone Project EM 697: Compare and Contrast Risk Management Implementation at NASA and the US Army

    NASA Technical Reports Server (NTRS)

    Brothers, Mary Ann; Safie, Fayssal M. (Technical Monitor)

    2002-01-01

    NASA at Marshall Space Flight Center (MSFC) and the U.S. Army at Redstone Arsenal were analyzed to determine whether they were successful in implementing their risk management program. Risk management implementation surveys were distributed to aid in this analysis. The scope is limited to NASA S&MA (Safety and Mission Assurance) at MSFC, including applicable support contractors, and the US Army Engineering Directorate, including applicable contractors, located at Redstone Arsenal. NASA has moderately higher risk management implementation survey scores than the Army. Accordingly, the implementation of the risk management program at NASA is considered good while only two of five of the survey categories indicated that the risk management implementation is good at the Army.

  2. Risk Management Implementation Tool

    NASA Technical Reports Server (NTRS)

    Wright, Shayla L.

    2004-01-01

    Continuous Risk Management (CM) is a software engineering practice with processes, methods, and tools for managing risk in a project. It provides a controlled environment for practical decision making, in order to assess continually what could go wrong, determine which risk are important to deal with, implement strategies to deal with those risk and assure the measure effectiveness of the implemented strategies. Continuous Risk Management provides many training workshops and courses to teach the staff how to implement risk management to their various experiments and projects. The steps of the CRM process are identification, analysis, planning, tracking, and control. These steps and the various methods and tools that go along with them, identification, and dealing with risk is clear-cut. The office that I worked in was the Risk Management Office (RMO). The RMO at NASA works hard to uphold NASA s mission of exploration and advancement of scientific knowledge and technology by defining and reducing program risk. The RMO is one of the divisions that fall under the Safety and Assurance Directorate (SAAD). I worked under Cynthia Calhoun, Flight Software Systems Engineer. My task was to develop a help screen for the Continuous Risk Management Implementation Tool (RMIT). The Risk Management Implementation Tool will be used by many NASA managers to identify, analyze, track, control, and communicate risks in their programs and projects. The RMIT will provide a means for NASA to continuously assess risks. The goals and purposes for this tool is to provide a simple means to manage risks, be used by program and project managers throughout NASA for managing risk, and to take an aggressive approach to advertise and advocate the use of RMIT at each NASA center.

  3. NASA's Risk Management System

    NASA Technical Reports Server (NTRS)

    Perera, Jeevan S.

    2013-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  4. Development and Implementation of a Comprehensive Risk Management Program at the USAF Academy Hospital.

    DTIC Science & Technology

    1980-04-01

    much less con - cerned about malpractice problems. As a result of the program, they began to view the risk management program as their own and to recog...that con - tributes to better patient care. 131 Implementing Risk Management According to Donovan and Bader, an action plan for the systems approach might...Al87 344 DEVELOPMENT AND IMPLEMENTATION OF A COMPREHENSIVE RISK 1 MANAGEMENT PROGRAM AT THE USAF ACADEMY HOSPITAL(U) ARMY HEALTH CARE STUDIES AND

  5. Urban Tree Risk Management:A Community Guide to Program Design and Implementation

    Treesearch

    Jill Pokorny; Joseph O' Brien; Richard Hauer; Gary Johnson; Jana Albers; Peter Bedker; Manfred Mielke

    2003-01-01

    Urban Tree Risk Management: A Community Guide to Program Design and Implementation is a fully illustrated, easy to read training manual written for community leaders, administrators, city foresters, parks and public works staff, and private tree care practitioners. The manual is designed to assist communities design, adopt and implement tree risk management programs,...

  6. NASA's Risk Management System

    NASA Technical Reports Server (NTRS)

    Perera, Jeevan S.

    2011-01-01

    Leadership is key to success. Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks -- risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  7. Risk Management Issues - An Aerospace Perspective

    NASA Technical Reports Server (NTRS)

    Perera, Jeevan S.

    2011-01-01

    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks--risk office personnel. Each group is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk reporting and communication is an essential element of risk management and will combine both qualitative and quantitative elements.. Risk informed decision making should be introduced to all levels of management. Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner, Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  8. Modeling Open Architecture and Evolutionary Acquisition: Implementation Lessons from the ARCI Program for the Rapid Capability Insertion Process

    DTIC Science & Technology

    2009-04-22

    Implementation Issues Another RCIP implementation risk is program management burnout . The ACRI program manager specifically identified the potential...of burnout in his program management team due to the repeated, intense Integration phases. To investigate the possibility and severity of this risk to...the ACRI simulation. This suggests that the burnout risk will be larger for RCIP than it was for ACRI. Successfully implementing a sustainable RCIP

  9. Designing new institutions for implementing integrated disaster risk management: key elements and future directions.

    PubMed

    Gopalakrishnan, Chennat; Okada, Norio

    2007-12-01

    The goal of integrated disaster risk management is to promote an overall improvement in the quality of safety and security in a region, city or community at disaster risk. This paper presents the case for a thorough overhaul of the institutional component of integrated disaster risk management. A review of disaster management institutions in the United States indicates significant weaknesses in their ability to contribute effectively to the implementation of integrated disaster risk management. Our analysis and findings identify eight key elements for the design of dynamic new disaster management institutions. Six specific approaches are suggested for incorporating the identified key elements in building new institutions that would have significant potential for enhancing the effective implementation of integrated disaster risk management. We have developed a possible blueprint for effective design and construction of efficient, sustainable and functional disaster management institutions.

  10. Towards a Framework for Managing Risk Associated with Technology-Induced Error.

    PubMed

    Borycki, Elizabeth M; Kushniruk, Andre W

    2017-01-01

    Health information technologies (HIT) promised to streamline and modernize healthcare processes. However, a growing body of research has indicated that if such technologies are not designed, implemented or maintained properly this may lead to an increased incidence of new types of errors which the authors have referred to as "technology-induced errors". In this paper, framework is presented that can be used to manage HIT risk. The framework considers the reduction of technology-induced errors at different stages by managing risks associated with the implementation of HIT. Frameworks that allow health information technology managers to employ proactive and preventative approaches that can be used to manage the risks associated with technology-induced errors are critical to improving HIT safety and managing risk associated with implementing new technologies.

  11. Risk assessment for enterprise resource planning (ERP) system implementations: a fault tree analysis approach

    NASA Astrophysics Data System (ADS)

    Zeng, Yajun; Skibniewski, Miroslaw J.

    2013-08-01

    Enterprise resource planning (ERP) system implementations are often characterised with large capital outlay, long implementation duration, and high risk of failure. In order to avoid ERP implementation failure and realise the benefits of the system, sound risk management is the key. This paper proposes a probabilistic risk assessment approach for ERP system implementation projects based on fault tree analysis, which models the relationship between ERP system components and specific risk factors. Unlike traditional risk management approaches that have been mostly focused on meeting project budget and schedule objectives, the proposed approach intends to address the risks that may cause ERP system usage failure. The approach can be used to identify the root causes of ERP system implementation usage failure and quantify the impact of critical component failures or critical risk events in the implementation process.

  12. Barriers to implementation of risk management for federal wildland fire management agencies in the United States

    Treesearch

    Dave Calkin; Matthew P. Thompson; Alan A. Ager; Mark Finney

    2010-01-01

    In this presentation we review progress towards the implementation of a risk-based management framework for U.S. Federal wildland fire policy and operations. We first describe new developments in wildfire simulation technology that catalyzed the development of risk-based decision support systems for strategic wildfire management. These systems include new analytical...

  13. Development and implementation of a business continuity management risk index.

    PubMed

    Kadar, Michael

    This paper will present the building blocks for developing and implementing the BCM risk index; whether it is used as a comprehensive metric for risk or preparedness. This paper introduces the concept of a business continuity management (BCM) risk index--a comprehensive metric that measures and reports the status of the primary 'intended outcome' of the BCM programme to top management. In addition to measuring the primary programme output,;the BCM risk index can be used to demonstrate the overall value of the BCM programme to executive management. This is accomplished because the BCM risk index allows quantitative measurement of current risk levels and their comparison with established risk tolerances. The BCM Risk Index can provide executive management with reports on the risk level of individual business units, departments, subsidiaries or the enterprise in a way that drives both risk management and BCM initiatives. The name 'risk index' can be misleading, however. The BCM risk index concept can also be used to measure preparedness levels. In fact, implementation at DTE Energy has resulted in calling it the 'preparedness index', which is used to measure and report preparedness levels rather than risk levels.

  14. Risk management for food and beverage industry using Australia/New Zealand 4360 Standard

    NASA Astrophysics Data System (ADS)

    Kristina, S.; Wijaya, B. M.

    2017-12-01

    This research aims to identifying, measuring and establishing risk in food and beverage industry. The risk management is implemented by referring to Australia/New Zealand 4360 Standard which has four phases such as problem formulation, risk analysis, risk characterization, and risk management. The implementation of risk management is done by case study at Back Alley Café. Based on the risk identification result, there are 59 risks were found in Back Alley Café. The risk identification is conducted based on observation and interview with the café manager who understand the condition of Back Alley Café properly. Based on the assessment of impact and probability, the risk mapping produced four risks at extreme level, 16 risks at high level, 24 risks at medium level, and 18 risks at low level. The strategy was designed as the risk mitigation after the risk mapping for the extreme and high level. The strategy which is given as the prevention or treatment of risk in Back Alley Café is divided into three. There are reducing the risk, sharing the risk and accepting the risk. The strategy is then implemented for each relevant activities.

  15. An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

    PubMed Central

    Laws, Rachel A; Kemp, Lynn A; Harris, Mark F; Davies, Gawaine Powell; Williams, Anna M; Eames-Brown, Rosslyn

    2009-01-01

    Background Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed. Methods The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data. Results The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices. Conclusion The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices. PMID:19825189

  16. 77 FR 55371 - System Safety Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-07

    ...-based rule and FRA seeks comments on all aspects of the proposed rule. An SSP would be implemented by a... SSP would be the risk-based hazard management program and risk-based hazard analysis. A properly implemented risk-based hazard management program and risk-based hazard analysis would identify the hazards and...

  17. [Clinical risk management in german hospitals - does size really matter?].

    PubMed

    Bohnet-Joschko, S; Jandeck, L M; Zippel, C; Andersen, M; Krummenauer, F

    2011-06-01

    In the last years, German hospitals have implemented different measures to increase patient safety. Special importance has been attached to near miss reporting systems (critical incident reporting system, CIRS) as instruments for risk identification in health care, instruments that promise high potential for organisational learning. To gain insight into the current status of critical incident reporting systems and other instruments for clinical risk management, a survey among 341 hospitals was carried out in 2009. Questions covered a process of six steps: from risk strategy to methods for risk identification, to risk analysis and risk assessment, to risk controlling and risk monitoring. Structured telephone interviews were conducted with 341 German hospitals, featuring in their statutory quality reports certain predefined key terms that indicated the concluded or planned implementation of clinical risk management. The main objective of those interviews was to check the relation between status/organisation of self-reported risk management and both operator (private, public, NPO) and size of hospital. The implementation of near miss reporting systems (CIRS) in German hospitals has been constantly rising since 2004: in 2009, 54 % of the interviewed hospitals reported an implemented CIRS; of these, 72 % reported the system to be hospital-wide. An association between CIRS and private, public or NPO-operator could not be detected (Fisher p = 1.000); however, the degree of CIRS implementation was significantly increasing with the size of the hospital, i.e., the number of beds (Fisher p = 0.008): only 38 % of the hospitals with less than 100 beds reported CIRS implementation against 52 % of those between 100 to 500 beds, and 67 % of those with more than 500 beds. While 62 % of the hospitals interviewed reported the maintenance of a risk management committee, only 14 % reported the implementation of risk analysing techniques. As to clinical risk management, 92 % of the hospitals see potential for internal improvement; 44 % have already communicated with external consultants. While identification of clinical risks with near miss and other incident reporting systems meets increasing acceptance, the learning potential based on incident reporting is not yet appropriately being used. There is a deficit regarding systematic and comprehensive risk assessment and controlling; this will have to be met by improving the organisational framework for clinical risk management. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Children's Aquatics: Managing the Risk.

    ERIC Educational Resources Information Center

    Langendorfer, Stephen; And Others

    1989-01-01

    This article identifies the major risks faced by young children in aquatic programs, outlines several methods for managing risk factors, and discusses the steps involved in implementing a risk-management system. (IAH)

  19. Failure mode effect analysis and fault tree analysis as a combined methodology in risk management

    NASA Astrophysics Data System (ADS)

    Wessiani, N. A.; Yoshio, F.

    2018-04-01

    There have been many studies reported the implementation of Failure Mode Effect Analysis (FMEA) and Fault Tree Analysis (FTA) as a method in risk management. However, most of the studies usually only choose one of these two methods in their risk management methodology. On the other side, combining these two methods will reduce the drawbacks of each methods when implemented separately. This paper aims to combine the methodology of FMEA and FTA in assessing risk. A case study in the metal company will illustrate how this methodology can be implemented. In the case study, this combined methodology will assess the internal risks that occur in the production process. Further, those internal risks should be mitigated based on their level of risks.

  20. 77 FR 9237 - Agency Information Collection Activities; Proposed Collection; Comment Request; Risk Management...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-16

    ... Activities; Proposed Collection; Comment Request; Risk Management Program Requirements and Petitions To..., non-chemical manufacturers, etc. Title: Risk Management Program Requirements and Petitions to Modify... regulated substance in a process develop and implement a risk management program and submit a risk...

  1. Guidance for Conducting Risk Management Program Inspections Under Clean Air Act Section 112(r)

    EPA Pesticide Factsheets

    This guidance is for implementing agencies that conduct inspections of facilities (i.e., stationary sources) subject to 40 CFR Part 68, which requires development and implementation of a Risk Management Plan.

  2. Continuous Risk Management: An Overview

    NASA Technical Reports Server (NTRS)

    Rosenberg, Linda; Hammer, Theodore F.

    1999-01-01

    Software risk management is important because it helps avoid disasters, rework, and overkill, but more importantly because it stimulates win-win situations. The objectives of software risk management are to identify, address, and eliminate software risk items before they become threats to success or major sources of rework. In general, good project managers are also good managers of risk. It makes good business sense for all software development projects to incorporate risk management as part of project management. The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to implement risk management. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This is an introductory tutorial to continuous risk management based on this course. The rational for continuous risk management and how it is incorporated into project management are discussed. The risk management structure of six functions is discussed in sufficient depth for managers to understand what is involved in risk management and how it is implemented. These functions include: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions.

  3. ERM for Health Care Organizations: An Economic Enterprise Risk Management Innovation Program (E2RMhealth care).

    PubMed

    da Silva Etges, Ana Paula Beck; Grenon, Veronique; de Souza, Joana Siqueira; Kliemann Neto, Francisco José; Felix, Elaine Aparecida

    2018-05-14

    In recent years, health care organizations have looked to enterprise risk management (ERM) for novel systems to obtain more accurate data on which to base risk strategies. This study proposes a conceptual ERM framework specifically designed for health care organizations. We explore how hospitals in the United States and Brazil are structuring and implementing ERM processes within their management structure. This study incorporates interviews with 15 chief risk officers (8 from the United States and 7 from Brazil) with qualitative data analysis using NVivo (QSR International software). The interviews confirm that adopting ERM for health care organizations has gained momentum and become a priority, and that the demand for risk economic assessment orientation is common among health care risk managers. We propose an ERM model for health care (Economic Enterprise Risk Management in Health Care) divided into four maturity levels and complemented by an implementation timeline. The model is accompanied by guidelines to orient the gradual implementation of ERM, including orientation to perform risk economic assessment. Copyright © 2018. Published by Elsevier Inc.

  4. Project Risk Management

    NASA Technical Reports Server (NTRS)

    Jr., R. F. Miles

    1995-01-01

    Project risk management is primarily concerned with performance, reliability, cost, and schedule. Environmental risk management is primarily concerned with human health and ecological hazards and likelihoods. This paper discusses project risk management and compares it to environmental risk management, both with respect to goals and implementation. The approach of the Jet Propulsion Laboratory to risk management is presented as an example of a project risk management approach that is an extension to NASA NHB 7120.5: Management of Major System Programs and Projects.

  5. Continuous Risk Management at NASA

    NASA Technical Reports Server (NTRS)

    Hammer, Theodore F.; Rosenberg, Linda

    1999-01-01

    NPG 7120.5A, "NASA Program and Project Management Processes and Requirements" enacted in April, 1998, requires that "The program or project manager shall apply risk management principles..." The Software Assurance Technology Center (SATC) at NASA GSFC has been tasked with the responsibility for developing and teaching a systems level course for risk management that provides information on how to comply with this edict. The course was developed in conjunction with the Software Engineering Institute at Carnegie Mellon University, then tailored to the NASA systems community. This presentation will briefly discuss the six functions for risk management: (1) Identify the risks in a specific format; (2) Analyze the risk probability, impact/severity, and timeframe; (3) Plan the approach; (4) Track the risk through data compilation and analysis; (5) Control and monitor the risk; (6) Communicate and document the process and decisions. This risk management structure of functions has been taught to projects at all NASA Centers and is being successfully implemented on many projects. This presentation will give project managers the information they need to understand if risk management is to be effectively implemented on their projects at a cost they can afford.

  6. National Aeronautics and Space Administration Marshall Space Flight Center Space Transportation Directorate Risk Management Implementation Program

    NASA Technical Reports Server (NTRS)

    Duarte, Luis Alberto; Kross, Denny (Technical Monitor)

    2001-01-01

    The US civil aerospace program has been a great contributor to the creation and implementation of techniques and methods to identify, analyze, and confront risk. NASA has accomplished mission success in many instances, but also has had many failures. Anomalies have kept the Agency from achieving success on other occasions, as well. While NASA has mastered ways to prevent risks, and to quickly and effectively react and recover from anomalies or failures, it was not until few years ago that a comprehensive Risk Management process started being implemented in some of its programs and projects. A Continuous Risk Management (CRM) cycle process was developed and has been promoted and used successfully in programs and projects across the Agency.

  7. PDA survey of quality risk management practices in the pharmaceutical, devices, & biotechnology industries.

    PubMed

    Ahmed, Ruhi; Baseman, Harold; Ferreira, Jorge; Genova, Thomas; Harclerode, William; Hartman, Jeffery; Kim, Samuel; Londeree, Nanette; Long, Michael; Miele, William; Ramjit, Timothy; Raschiatore, Marlene; Tomonto, Charles

    2008-01-01

    In July 2006 the Parenteral Drug Association's Risk Management Task Force for Aseptic Processes, conducted an electronic survey of PDA members to determine current industry practices regarding implementation of Quality Risk Management in their organizations. This electronic survey was open and publicly available via the PDA website and targeted professionals in our industry who are involved in initiating, implementing, or reviewing risk management programs or decisions in their organizations. One hundred twenty-nine members participated and their demographics are presented in the sidebar "Correspondents Profile". Among the major findings are: *The "Aseptic Processing/Filling" operation is the functional area identified as having the greatest need for risk assessment and quality risk management. *The most widely used methodology in industry to identify risk is Failure Mode and Effects Analysis (FMEA). This tool was most widely applied in assessing change control and for adverse event, complaint, or failure investigations. *Despite the fact that personnel training was identified as the strategy most used for controlling/minimizing risk, the largest contributors to sterility failure in operations are still "Personnel". *Most companies still rely on "Manufacturing Controls" to mitigate risk and deemed the utilization of Process Analytical Technology (PAT) least important in this aspect. *A majority of correspondents verified that they did not periodically assess their risk management programs. *A majority of the correspondents desired to see case studies or examples of risk analysis implementation (as applicable to aseptic processing) in future PDA technical reports on risk management.

  8. 75 FR 4007 - Risk Management Controls for Brokers or Dealers With Market Access

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-26

    ... 3235-AK53 Risk Management Controls for Brokers or Dealers With Market Access AGENCY: Securities and... or other persons, to implement risk management controls and supervisory procedures reasonably... access may not utilize any pre-trade risk management controls (i.e., ``unfiltered'' or ``naked'' access...

  9. 5 CFR 930.301 - Information systems security awareness training program.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... training in system/application life cycle management, risk management, and contingency planning. (4) Chief... security management, system/application life cycle management, risk management, and contingency planning... management; and management and implementation level training in system/application life cycle management...

  10. 77 FR 37903 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... Activities; Submission to OMB for Review and Approval; Comment Request; Risk Management Program Requirements... information about the electronic docket, go to www.regulations.gov . Title: Risk Management Program... process develop and implement a risk management program and submit a risk management plan to EPA. The...

  11. 76 FR 65317 - 60-Day Notice of Proposed Information Collection: DS-4184, Risk Management and Analysis (RAM)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ..., Risk Management and Analysis (RAM) ACTION: Notice of request for public comments. SUMMARY: The... of 1995. Title of Information Collection: Risk Analysis and Management. OMB Control Number: None.... Methodology: The State Department, is implementing a Risk Analysis and Management Program to vet potential...

  12. Proposed Performance Measures and Strategies for Implementation of the Fatigue Risk Management Guidelines for Emergency Medical Services.

    PubMed

    Martin-Gill, Christian; Higgins, J Stephen; Van Dongen, Hans P A; Buysse, Daniel J; Thackery, Ronald W; Kupas, Douglas F; Becker, David S; Dean, Bradley E; Lindbeck, George H; Guyette, Francis X; Penner, Josef H; Violanti, John M; Lang, Eddy S; Patterson, P Daniel

    2018-02-15

    Performance measures are a key component of implementation, dissemination, and evaluation of evidence-based guidelines (EBGs). We developed performance measures for Emergency Medical Services (EMS) stakeholders to enable the implementation of guidelines for fatigue risk management in the EMS setting. Panelists associated with the Fatigue in EMS Project, which was supported by the National Highway Traffic Safety Administration (NHTSA), used an iterative process to develop a draft set of performance measures linked to 5 recommendations for fatigue risk management in EMS. We used a cross-sectional survey design and the Content Validity Index (CVI) to quantify agreement among panelists on the wording and content of draft measures. An anonymous web-based tool was used to solicit the panelists' perceptions of clarity and relevance of draft measures. Panelists rated the clarity and relevance separately for each draft measure on a 4-point scale. CVI scores ≥0.78 for clarity and relevance were specified a priori to signify agreement and completion of measurement development. Panelists judged 5 performance measures for fatigue risk management as clear and relevant. These measures address use of fatigue and/or sleepiness survey instruments, optimal duration of shifts, access to caffeine as a fatigue countermeasure, use of napping during shift work, and the delivery of education and training on fatigue risk management for EMS personnel. Panelists complemented performance measures with suggestions for implementation by EMS agencies. Performance measures for fatigue risk management in the EMS setting will facilitate the implementation and evaluation of the EBG for Fatigue in EMS.

  13. Implementing the Deputy Administrator's Risk Characterization Memorandum, May 26, 1992

    EPA Pesticide Factsheets

    The purpose of this memorandum is to implement in the Superfund program the reccomendations of the Deputy Administrator in his memorandum of February 26, 1992, 'Guidance on risk characterization for risk managers and risk assessors.'

  14. Causes and remedies for the dominant risk factors in Enterprise System implementation projects: the consultants' perspective.

    PubMed

    Lech, Przemysław

    2016-01-01

    The purpose of this research was to investigate the causes of the dominant risk factors, affecting Enterprise System implementation projects and propose remedies for those risk factors from the perspective of implementation consultants. The study used a qualitative research strategy, based on e-mail interviews, semi-structured personal interviews with consultants and participant observation during implementation projects. The main contribution of this paper is that it offers viable indications of how to mitigate the dominant risk factors. These indications were grouped into the following categories: stable project scope, smooth communication supported by the project management, dedicated, competent and decision-making client team, competent and engaged consultant project manager, schedule and budget consistent with the project scope, use of methodology and procedures, enforced and enabled by the project managers, competent and dedicated consultants. A detailed description is provided for each category.

  15. 76 FR 16587 - Risk Management Requirements for Derivatives Clearing Organizations

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-24

    ... COMMODITY FUTURES TRADING COMMISSION 17 CFR Part 39 RIN 3038-AC98 Risk Management Requirements for... other things, would implement DCO Core Principle D (Risk Management) and would establish a related... framework to reduce risk, increase transparency, and promote market integrity within the financial system...

  16. The German clinical risk management survey for hospitals: Implementation levels and areas for improvement in 2015.

    PubMed

    Manser, Tanja; Frings, Janina; Heuser, Gregory; Mc Dermott, Fiona

    2016-01-01

    Despite the growing recognition of the need to implement systematic approaches for managing the risks associated with healthcare, few studies have investigated the level of implementation for clinical risk management (CRM) at a national level. Therefore, this study aimed to assess the current level of CRM implementation in German hospitals and to explore differences across hospital types. From March to June 2015, persons responsible for CRM in 2,617 hospitals and rehabilitation clinics in Germany were invited to participate in a voluntary online survey assessing the level of implementation for various aspects of CRM: CRM strategy, structures and processes; risk assessment (risk identification, risk analysis, risk evaluation) with a focus on incident reporting systems; risk mitigation measures; and risk monitoring and reporting. 572 hospitals participated in the survey (response rate 22 %). Most of these hospitals had a formalised, binding CRM strategy (72 %). 66 % had a centralised and 34 % a decentralised CRM structure. We also found that, despite a broad range of risk assessment methods being applied, there was a lack of integration of risk information from different data sources. Hospitals also reported a high level of implementation of critical incident reporting systems with a strong preference for local (74 %) over transorganisational systems. This study provides relevant data to inform targeted interventions concerning CRM implementation at a national level and to consider the specific context of different types of hospitals more carefully in this process. The approach to CRM assessment illustrated in this article could be the basis of a system for monitoring CRM over time and, thus, for evaluating the impact of strategy decisions at the policy level on CRM development. Copyright © 2016. Published by Elsevier GmbH.

  17. 12 CFR 615.5135 - Management of interest rate risk.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Management of interest rate risk. 615.5135... agricultural credit bank shall develop and implement an interest rate risk management program as set forth in subpart G of this part. The board of directors shall adopt an interest rate risk management section of an...

  18. 12 CFR 615.5135 - Management of interest rate risk.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Management of interest rate risk. 615.5135... agricultural credit bank shall develop and implement an interest rate risk management program as set forth in subpart G of this part. The board of directors shall adopt an interest rate risk management section of an...

  19. As good as it gets? Managing risks of cardiovascular disease in California's top-performing physician organizations.

    PubMed

    Rodriguez, Hector P; Ivey, Susan L; Raffetto, Brian J; Vaughn, Jennifer; Knox, Margae; Hanley, Hattie Rees; Mangione, Carol M; Shortell, Stephen M

    2014-04-01

    The California Right Care Initiative (RCI) accelerates the adoption of evidence-based guidelines and improved care management practices for conditions for which the gap between science and practice is significant, resulting in preventable disability and death. Medical directors and quality improvement leaders from 11 of the 12 physician organizations that met the 2010 national 90th percentile performance benchmarks for control of hyperlipidemia and glycated hemoglobin in 2011 were interviewed in 2012. Interviews, as well as surveys, assessed performance reporting and feedback to individual physicians; medication management protocols; team-based care management; primary care team huddles; coordination of care between primary care clinicians and specialists; implementation of shared medical appointments; and telephone visits for high-risk patients. All but 1 of 11 organizations implemented electronic health records. Electronic information exchange between primary care physicians and specialists, however, was uncommon. Few organizations routinely used interdisciplinary team approaches, shared medical appointments, or telephonic strategies for managing cardiovascular risks among patients. Implementation barriers included physicians' resistance to change, limited resources and reimbursement for team approaches, and limited organizational capacity for change. Implementation facilitators included routine use of reliable data to guide improvement, leadership facilitation of change, physician buy-in, health information technology use, and financial incentives. To accelerate improvements in managing cardiovascular risks, physician organizations may need to implement strategies involving extensive practice reorganization and work flow redesign.

  20. Health-Based Capitation Risk Adjustment in Minnesota Public Health Care Programs

    PubMed Central

    Gifford, Gregory A.; Edwards, Kevan R.; Knutson, David J.

    2004-01-01

    This article documents the history and implementation of health-based capitation risk adjustment in Minnesota public health care programs, and identifies key implementation issues. Capitation payments in these programs are risk adjusted using an historical, health plan risk score, based on concurrent risk assessment. Phased implementation of capitation risk adjustment for these programs began January 1, 2000. Minnesota's experience with capitation risk adjustment suggests that: (1) implementation can accelerate encounter data submission, (2) administrative decisions made during implementation can create issues that impact payment model performance, and (3) changes in diagnosis data management during implementation may require changes to the payment model. PMID:25372356

  1. Risk Management for the International Space Station

    NASA Technical Reports Server (NTRS)

    Sebastian, J.; Brezovic, Philip

    2002-01-01

    The International Space Station (ISS) is an extremely complex system, both technically and programmatically. The Space Station must support a wide range of payloads and missions. It must be launched in numerous launch packages and be safely assembled and operated in the harsh environment of space. It is being designed and manufactured by many organizations, including the prime contractor, Boeing, the NASA institutions, and international partners and their contractors. Finally, the ISS has multiple customers, (e.g., the Administration, Congress, users, public, international partners, etc.) with contrasting needs and constraints. It is the ISS Risk Management Office strategy to proactively and systematically manages risks to help ensure ISS Program success. ISS program follows integrated risk management process (both quantitative and qualitative) and is integrated into ISS project management. The process and tools are simple and seamless and permeate to the lowest levels (at a level where effective management can be realized) and follows the continuous risk management methodology. The risk process assesses continually what could go wrong (risks), determine which risks need to be managed, implement strategies to deal with those risks, and measure effectiveness of the implemented strategies. The process integrates all facets of risk including cost, schedule and technical aspects. Support analysis risk tools like PRA are used to support programatic decisions and assist in analyzing risks.

  2. Risk-Informed Decision Making: Application to Technology Development Alternative Selection

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Maggio, Gaspare; Everett, Christopher

    2010-01-01

    NASA NPR 8000.4A, Agency Risk Management Procedural Requirements, defines risk management in terms of two complementary processes: Risk-informed Decision Making (RIDM) and Continuous Risk Management (CRM). The RIDM process is used to inform decision making by emphasizing proper use of risk analysis to make decisions that impact all mission execution domains (e.g., safety, technical, cost, and schedule) for program/projects and mission support organizations. The RIDM process supports the selection of an alternative prior to program commitment. The CRM process is used to manage risk associated with the implementation of the selected alternative. The two processes work together to foster proactive risk management at NASA. The Office of Safety and Mission Assurance at NASA Headquarters has developed a technical handbook to provide guidance for implementing the RIDM process in the context of NASA risk management and systems engineering. This paper summarizes the key concepts and procedures of the RIDM process as presented in the handbook, and also illustrates how the RIDM process can be applied to the selection of technology investments as NASA's new technology development programs are initiated.

  3. Evaluation of Risk Management Strategies for a Low-Cost, High-Risk Project

    NASA Technical Reports Server (NTRS)

    Shishko, Robert; Jorgensen, Edward J.

    1996-01-01

    This paper summarizes work in progress to define and implement a risk management process tailored to a low-cost, high-risk, NASA mission -the Microrover Flight Experiment (MFEX, commonly called the Mars microrover).

  4. Adoption of Building Information Modelling in project planning risk management

    NASA Astrophysics Data System (ADS)

    Mering, M. M.; Aminudin, E.; Chai, C. S.; Zakaria, R.; Tan, C. S.; Lee, Y. Y.; Redzuan, A. A.

    2017-11-01

    An efficient and effective risk management required a systematic and proper methodology besides knowledge and experience. However, if the risk management is not discussed from the starting of the project, this duty is notably complicated and no longer efficient. This paper presents the adoption of Building Information Modelling (BIM) in project planning risk management. The objectives is to identify the traditional risk management practices and its function, besides, determine the best function of BIM in risk management and investigating the efficiency of adopting BIM-based risk management during the project planning phase. In order to obtain data, a quantitative approach is adopted in this research. Based on data analysis, the lack of compliance with project requirements and failure to recognise risk and develop responses to opportunity are the risks occurred when traditional risk management is implemented. When using BIM in project planning, it works as the tracking of cost control and cash flow give impact on the project cycle to be completed on time. 5D cost estimation or cash flow modeling benefit risk management in planning, controlling and managing budget and cost reasonably. There were two factors that mostly benefit a BIM-based technology which were formwork plan with integrated fall plan and design for safety model check. By adopting risk management, potential risks linked with a project and acknowledging to those risks can be identified to reduce them to an acceptable extent. This means recognizing potential risks and avoiding threat by reducing their negative effects. The BIM-based risk management can enhance the planning process of construction projects. It benefits the construction players in various aspects. It is important to know the application of BIM-based risk management as it can be a lesson learnt to others to implement BIM and increase the quality of the project.

  5. Electronic medical record system at an opioid agonist treatment programme: study design, pre-implementation results and post-implementation trends.

    PubMed

    Kritz, Steven; Brown, Lawrence S; Chu, Melissa; John-Hull, Carlota; Madray, Charles; Zavala, Roberto; Louie, Ben

    2012-08-01

    Electronic medical record (EMR) systems are commonly included in health care reform discussions. However, their embrace by the health care community has been slow. At Addiction Research and Treatment Corporation, an outpatient opioid agonist treatment programme that also provides primary medical care, HIV medical care and case management, substance abuse counselling and vocational services, we studied the implementation of an EMR in the domains of quality, productivity, satisfaction, risk management and financial performance utilizing a prospective pre- and post-implementation study design. This report details the research approach, pre-implementation findings for all five domains, analysis of the pre-implementation findings and some preliminary post-implementation results in the domains of quality and risk management. For quality, there was a highly statistically significant improvement in timely performance of annual medical assessments (P < 0.001) and annual multidiscipline assessments (P < 0.0001). For risk management, the number of events was not sufficient to perform valid statistical analysis. The preliminary findings in the domain of quality are very promising. Should the findings in the other domains prove to be positive, then the impetus to implement EMR in similar health care facilities will be advanced. © 2011 Blackwell Publishing Ltd.

  6. 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.

  7. 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

  8. 78 FR 52808 - Proposed Collection; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-26

    ... access to customers or other persons, to implement risk management controls and supervisory procedures... requires brokers or dealers to establish, document, and maintain certain risk management controls and... of its risk management controls as part of its books and records in a manner consistent with Rule 17a...

  9. 78 FR 65718 - Submission for OMB Review; Comment Request

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-01

    ... maintain certain risk management controls and supervisory procedures as well as regularly review such... supervisory procedures and a written description of its risk management controls as part of its books and... providing sponsored or direct market access to customers or other persons, to implement risk management...

  10. Environmental Assessment for Management of South End of Runway Wetlands, Moody AFB, Georgia

    DTIC Science & Technology

    2010-11-01

    implement a management program for the wetlands at the south end of runway (EOR) at Moody AFB to reduce the bird/wildlife aircraft strike hazard (BASH) risk...because birds and other wildlife pose an increased bird/wildlife aircraft strike hazard (BASH) risk to aircraft utilizing the Moody AFB airfield. ln...support ofthe military mission, Moody AFB has implemented a BASH management program designed to minimize aircraft exposure to potentially hazardous

  11. Implementing system-wide risk stratification approaches: A review of critical success and failure factors.

    PubMed

    Huckel Schneider, Carmen; Gillespie, James A; Wilson, Andrew

    2017-05-01

    Risk stratification has become a widely used tool for linking people identified at risk of health deterioration to the most appropriate evidence-based care. This article systematically reviews recent literature to determine key factors that have been identified as critical enablers and/or barriers to successful implementation of risk stratification tools at a system level. A systematic search found 23 articles and four promising protocols for inclusion in the review, covering the use to 20 different risk stratification tools. These articles reported on only a small fraction of the risk stratification tools used in health systems; suggesting that while the development and statistical validation of risk stratification algorithms is widely reported, there has been little published evaluation of how they are implemented in real-world settings. Controlled studies provided some evidence that the use of risk stratification tools in combination with a care management plan offer patient benefits and that the use of a risk stratification tool to determine components of a care management plan may contribute to reductions in hospital readmissions, patient satisfaction and improved patient outcomes. Studies with the strongest focus on implementation used qualitative and case study methods. Among these, the literature converged on four key areas of implementation that were found to be critical for overcoming barriers to success: the engagement of clinicians and safeguarding equity, both of which address barriers of acceptance; the health system context to address administrative, political and system design barriers; and data management and integration to address logistical barriers.

  12. 12 CFR Appendix A to Part 1720 - Policy Guidance; Minimum Safety and Soundness Requirements

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... maintains an effective risk management framework, including review of such framework to monitor its... credit quality. II. Balance sheet growth and management. III. Market risk. IV. Information technology. V..., measurement, monitoring, and management of market risk. The Enterprise should: i. Establish and implement...

  13. 12 CFR Appendix A to Part 1720 - Policy Guidance; Minimum Safety and Soundness Requirements

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... maintains an effective risk management framework, including review of such framework to monitor its... credit quality. II. Balance sheet growth and management. III. Market risk. IV. Information technology. V..., measurement, monitoring, and management of market risk. The Enterprise should: i. Establish and implement...

  14. 12 CFR Appendix A to Part 1720 - Policy Guidance; Minimum Safety and Soundness Requirements

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... maintains an effective risk management framework, including review of such framework to monitor its... credit quality. II. Balance sheet growth and management. III. Market risk. IV. Information technology. V..., measurement, monitoring, and management of market risk. The Enterprise should: i. Establish and implement...

  15. Bridging the gap between preventive and restorative dentistry: identification of caries risk factors and strategies for minimizing risk.

    PubMed

    Maragliano-Muniz, Pamela

    2013-10-01

    Following the introduction of CAMBRA (Caries Management by Risk Assessment) in 2007, a number of recommendations for office protocols were introduced, and many companies have formulated products and procedures for implementing CAMBRA. As a result, the implementation of a caries management program can be confounding and overwhelming to a dental practitioner. Understanding risk factors as they contribute to the caries process can help mitigate confusion and guide the practitioner when selecting materials for their practice. Ultimately, knowing how the risk factors play a role in the progression of dental caries will lead to appropriate risk management and product recommendations. The purpose of this article is to discuss the contribution of risk factors to the caries process and to introduce strategies that restorative dentists can utilize to minimize caries risk.

  16. Implementation of Risk Management in NASA's CEV Project- Ensuring Mission Success

    NASA Astrophysics Data System (ADS)

    Perera, Jeevan; Holsomback, Jerry D.

    2005-12-01

    Most project managers know that Risk Management (RM) is essential to good project management. At NASA, standards and procedures to manage risk through a tiered approach have been developed - from the global agency-wide requirements down to a program or project's implementation. The basic methodology for NASA's risk management strategy includes processes to identify, analyze, plan, track, control, communicate and document risks. The identification, characterization, mitigation plan, and mitigation responsibilities associated with specific risks are documented to help communicate, manage, and effectuate appropriate closure. This approach helps to ensure more consistent documentation and assessment and provides a means of archiving lessons learned for future identification or mitigation activities.A new risk database and management tool was developed by NASA in 2002 and since has been used successfully to communicate, document and manage a number of diverse risks for the International Space Station, Space Shuttle, and several other NASA projects and programs including at the Johnson Space Center. Organizations use this database application to effectively manage and track each risk and gain insight into impacts from other organization's viewpoint to develop integrated solutions. Schedule, cost, technical and safety issues are tracked in detail through this system.Risks are tagged within the system to ensure proper review, coordination and management at the necessary management level. The database is intended as a day-to- day tool for organizations to manage their risks and elevate those issues that need coordination from above. Each risk is assigned to a managing organization and a specific risk owner who generates mitigation plans as appropriate. In essence, the risk owner is responsible for shepherding the risk through closure. The individual that identifies a new risk does not necessarily get assigned as the risk owner. Whoever is in the best position to effectuate comprehensive closure is assigned as the risk owner. Each mitigation plan includes the specific tasks that will be conducted to either decrease the likelihood of the risk occurring and/or lessen the severity of the consequences if they do occur. As each mitigation task is completed, the responsible managing organization records the completion of the task in the risk database and then re-scores the risk considering the task's results. By keeping scores updated, a managing organization's current top risks and risk posture can be readily identified including the status of any risk in the system.A number of metrics measure risk process trends from data contained in the database. This allows for trend analysis to further identify improvements to the process and assist in the management of all risks. The metrics will also scrutinize both the effectiveness and compliance of risk management requirements.The risk database is an evolving tool and will be continuously improved with capabilities requested by the NASA project community. This paper presents the basic foundations of risk management, the elements necessary for effective risk management, and the capabilities of this new risk database and how it is implemented to support NASA's risk management needs.

  17. Successful implementation of clinical practice guidelines for pressure risk management in a home nursing setting.

    PubMed

    Kapp, Suzanne

    2013-10-01

    This paper reports an initiative which promoted evidence-based practice in pressure risk assessment and management among home nursing clients in Melbourne, Australia. The aim of this study was to evaluate the introduction and uptake of the Australian Wound Management Association Guidelines for the Prediction and Prevention of Pressure Ulcers. In 2007 a pilot study was conducted. Nurse perspectives (n=21) were obtained via survey and a client profile (n=218) was generated. Audit of the uptake and continued use of the pressure risk screening tool, during the pilot study and later once implemented as standard practice organizational wide, was conducted. Nurses at the pilot site successfully implemented the practice guidelines, pressure risk screening was adopted and supporting resources were well received. Most clients were at low risk of pressure ulcer development. The pilot site maintained and extended their pilot study success, ensuring more than 90% of clients were screened for pressure risk over the 18 months which followed. All other sites performed less well initially, however subsequently improved, meeting the pilot sites success after 18 months. Two years later, the organization continues to screen more than 90% of all clients for pressure risk. Implementation of clinical practice guidelines was successful in the pilot project and pressure risk screening became a well-adopted practice. Success continued following organizational wide implementation. Pilot study findings suggest it may be prudent to monitor the pressure ulcer risk status of low risk clients so as to prevent increasing risk and pressure ulcer development among this group. © 2012 John Wiley & Sons Ltd.

  18. Do Italian Companies Manage Work-Related Stress Effectively? A Process Evaluation in Implementing the INAIL Methodology

    PubMed Central

    Di Tecco, Cristina; Ronchetti, Matteo; Ghelli, Monica; Russo, Simone; Persechino, Benedetta

    2015-01-01

    Studies on Intervention Process Evaluation are attracting growing attention in the literature on interventions linked to stress and the wellbeing of workers. There is evidence that some elements relating to the process and content of an intervention may have a decisive role in implementing it by facilitating or hindering the effectiveness of the results. This study aimed to provide a process evaluation on interventions to assess and manage risks related to work-related stress using a methodological path offered by INAIL. The final sample is composed of 124 companies participating to an interview on aspects relating to each phase of the INAIL methodological path put in place to implement the intervention. INAIL methodology has been defined as useful in the process of assessing and managing the risks related to work-related stress. Some factors related to the process (e.g., implementation of a preliminary phase, workers' involvement, and use of external consultants) showed a role in significant differences that emerged in the levels of risk, particularly in relation to findings from the preliminary assessment. Main findings provide information on the key aspects of process and content that are useful in implementing an intervention for assessing and managing risks related to work-related stress. PMID:26504788

  19. Do Italian Companies Manage Work-Related Stress Effectively? A Process Evaluation in Implementing the INAIL Methodology.

    PubMed

    Di Tecco, Cristina; Ronchetti, Matteo; Ghelli, Monica; Russo, Simone; Persechino, Benedetta; Iavicoli, Sergio

    2015-01-01

    Studies on Intervention Process Evaluation are attracting growing attention in the literature on interventions linked to stress and the wellbeing of workers. There is evidence that some elements relating to the process and content of an intervention may have a decisive role in implementing it by facilitating or hindering the effectiveness of the results. This study aimed to provide a process evaluation on interventions to assess and manage risks related to work-related stress using a methodological path offered by INAIL. The final sample is composed of 124 companies participating to an interview on aspects relating to each phase of the INAIL methodological path put in place to implement the intervention. INAIL methodology has been defined as useful in the process of assessing and managing the risks related to work-related stress. Some factors related to the process (e.g., implementation of a preliminary phase, workers' involvement, and use of external consultants) showed a role in significant differences that emerged in the levels of risk, particularly in relation to findings from the preliminary assessment. Main findings provide information on the key aspects of process and content that are useful in implementing an intervention for assessing and managing risks related to work-related stress.

  20. Establishing a proactive safety and health risk management system in the fire service.

    PubMed

    Poplin, Gerald S; Pollack, Keshia M; Griffin, Stephanie; Day-Nash, Virginia; Peate, Wayne F; Nied, Ed; Gulotta, John; Burgess, Jefferey L

    2015-04-19

    Formalized risk management (RM) is an internationally accepted process for reducing hazards in the workplace, with defined steps including hazard scoping, risk assessment, and implementation of controls, all within an iterative process. While required for all industry in the European Union and widely used elsewhere, the United States maintains a compliance-based regulatory structure, rather than one based on systematic, risk-based methodologies. Firefighting is a hazardous profession, with high injury, illness, and fatality rates compared with other occupations, and implementation of RM programs has the potential to greatly improve firefighter safety and health; however, no descriptions of RM implementation are in the peer-reviewed literature for the North American fire service. In this paper we describe the steps used to design and implement the RM process in a moderately-sized fire department, with particular focus on prioritizing and managing injury hazards during patient transport, fireground, and physical exercise procedures. Hazard scoping and formalized risk assessments are described, in addition to the identification of participatory-led injury control strategies. Process evaluation methods were conducted to primarily assess the feasibility of voluntarily instituting the RM approach within the fire service setting. The RM process was well accepted by the fire department and led to development of 45 hazard specific-interventions. Qualitative data documenting the implementation of the RM process revealed that participants emphasized the: value of the RM process, especially the participatory bottom-up approach; usefulness of the RM process for breaking down tasks to identify potential risks; and potential of RM for reducing firefighter injury. As implemented, this risk-based approach used to identify and manage occupational hazards and risks was successful and is deemed feasible for U.S. (and other) fire services. While several barriers and challenges do exist in the implementation of any intervention such as this, recommendations for adopting the process are provided. Additional work will be performed to determine the effectiveness of select controls strategies that were implemented; however participants throughout the organizational structure perceived the RM process to be of high utility while researchers also found the process improved the awareness and engagement in actively enhancing worker safety and health.

  1. Early decision framework for integrating sustainable risk management for complex remediation sites: Drivers, barriers, and performance metrics.

    PubMed

    Harclerode, Melissa A; Macbeth, Tamzen W; Miller, Michael E; Gurr, Christopher J; Myers, Teri S

    2016-12-15

    As the environmental remediation industry matures, remaining sites often have significant underlying technical challenges and financial constraints. More often than not, significant remediation efforts at these "complex" sites have not achieved stringent, promulgated cleanup goals. Decisions then have to be made about whether and how to commit additional resources towards achieving those goals, which are often not achievable nor required to protect receptors. Guidance on cleanup approaches focused on evaluating and managing site-specific conditions and risks, rather than uniformly meeting contaminant cleanup criteria in all media, is available to aid in this decision. Although these risk-based cleanup approaches, such as alternative endpoints and adaptive management strategies, have been developed, they are under-utilized due to environmental, socio-economic, and risk perception barriers. Also, these approaches are usually implemented late in the project life cycle after unsuccessful remedial attempts to achieve stringent cleanup criteria. In this article, we address these barriers by developing an early decision framework to identify if site characteristics support sustainable risk management, and develop performance metrics and tools to evaluate and implement successful risk-based cleanup approaches. In addition, we address uncertainty and risk perception challenges by aligning risk-based cleanup approaches with the concepts of risk management and sustainable remediation. This approach was developed in the context of lessons learned from implementing remediation at complex sites, but as a framework can, and should, be applied to all sites undergoing remediation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Safe drinking water in regional NSW, Australia.

    PubMed

    Byleveld, Paul M; Leask, Sandy D; Jarvis, Leslie A; Wall, Katrina J; Henderson, Wendy N; Tickell, Joshua E

    2016-04-15

    The New South Wales (NSW) Public Health Act 2010 requires water suppliers to implement a drinking water quality assurance program that addresses the 'Framework for management of drinking water quality' in the Australian drinking water guidelines. NSW Health has recognised the importance of a staged implementation of this requirement and the need to support regional water utilities. To date, NSW Health has assisted 74 regional utilities to develop and implement their management systems. The Public Health Act 2010 has increased awareness of drinking water risk management, and offers a systematic process to identify and control risks. This has benefited large utilities, smaller suppliers, and remote and Aboriginal communities. Work is continuing to ensure implementation of the process by private suppliers and water carters.

  3. Assessing and Managing Multiple Risks in a Changing World – the Roskilde Recommendations

    EPA Science Inventory

    Roskilde University hosted a November 2015 workshop on “Environmental Risk – Assessing and Managing Multiple Risks in a Changing World”. Thirty attendees from 9 countries developed consensus recommendations regarding: implementation of a common currency (ecosyst...

  4. Report: EPA Region 8 Needs to Better Manage the Risk Management Program for Airborne Chemical Releases

    EPA Pesticide Factsheets

    Report #09-P-0130, March 30, 2009. The two Region 8 offices jointly responsible for implementing the CAA 112(r) Risk Management Program have not effectively planned or coordinated compliance assurance activities.

  5. Managing IT service management implementation complexity: from the perspective of the Warfield Version of systems science

    NASA Astrophysics Data System (ADS)

    Wan, Jiangping; Jones, James D.

    2013-11-01

    The Warfield version of systems science supports a wide variety of application areas, and is useful to practitioners who use the work program of complexity (WPOC) tool. In this article, WPOC is applied to information technology service management (ITSM) for managing the complexity of projects. In discussing the application of WPOC to ITSM, we discuss several steps of WPOC. The discovery step of WPOC consists of a description process and a diagnosis process. During the description process, 52 risk factors are identified, which are then narrowed to 20 key risk factors. All of this is done by interviews and surveys. Root risk factors (the most basic risk factors) consist of 11 kinds of common 'mindbugs' which are selected from an interpretive structural model. This is achieved by empirical analysis of 25 kinds of mindbugs. (A lesser aim of this research is to affirm that these mindbugs developed from a Western mindset have corresponding relevance in a completely different culture: the Peoples Republic of China.) During the diagnosis process, the relationships among the root risk factors in the implementation of the ITSM project are identified. The resolution step of WPOC consists of a design process and an implementation process. During the design process, issues related to the ITSM application are compared to both e-Government operation and maintenance, and software process improvement. The ITSM knowledge support structure is also designed at this time. During the implementation process, 10 keys to the successful implementation of ITSM projects are identified.

  6. Sunway Medical Laboratory Quality Control Plans Based on Six Sigma, Risk Management and Uncertainty.

    PubMed

    Jairaman, Jamuna; Sakiman, Zarinah; Li, Lee Suan

    2017-03-01

    Sunway Medical Centre (SunMed) implemented Six Sigma, measurement uncertainty, and risk management after the CLSI EP23 Individualized Quality Control Plan approach. Despite the differences in all three approaches, each implementation was beneficial to the laboratory, and none was in conflict with another approach. A synthesis of these approaches, built on a solid foundation of quality control planning, can help build a strong quality management system for the entire laboratory. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Overview of Risk Management for Engineered Nanomaterials

    NASA Astrophysics Data System (ADS)

    Schulte, P. A.; Geraci, C. L.; Hodson, L. L.; Zumwalde, R. D.; Kuempel, E. D.; Murashov, V.; Martinez, K. F.; Heidel, D. S.

    2013-04-01

    Occupational exposure to engineered nanomaterials (ENMs) is considered a new and challenging occurrence. Preliminary information from laboratory studies indicates that workers exposed to some kinds of ENMs could be at risk of adverse health effects. To protect the nanomaterial workforce, a precautionary risk management approach is warranted and given the newness of ENMs and emergence of nanotechnology, a naturalistic view of risk management is useful. Employers have the primary responsibility for providing a safe and healthy workplace. This is achieved by identifying and managing risks which include recognition of hazards, assessing exposures, characterizing actual risk, and implementing measures to control those risks. Following traditional risk management models for nanomaterials is challenging because of uncertainties about the nature of hazards, issues in exposure assessment, questions about appropriate control methods, and lack of occupational exposure limits (OELs) or nano-specific regulations. In the absence of OELs specific for nanomaterials, a precautionary approach has been recommended in many countries. The precautionary approach entails minimizing exposures by using engineering controls and personal protective equipment (PPE). Generally, risk management utilizes the hierarchy of controls. Ideally, risk management for nanomaterials should be part of an enterprise-wide risk management program or system and this should include both risk control and a medical surveillance program that assesses the frequency of adverse effects among groups of workers exposed to nanomaterials. In some cases, the medical surveillance could include medical screening of individual workers to detect early signs of work-related illnesses. All medical surveillance should be used to assess the effectiveness of risk management; however, medical surveillance should be considered as a second line of defense to ensure that implemented risk management practices are effective.

  8. Managing risks and hazardous in industrial operations

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

    Almaula, S.C.

    1996-12-31

    The main objective of this paper is to demonstrate that it makes good business sense to identify risks and hazards of an operation and take appropriate steps to manage them effectively. Developing and implementing an effective risk and hazard management plan also contibutes to other industry requirements and standards. Development of a risk management system, key elements of a risk management plan, and hazards and risk analysis methods are outlined. Comparing potential risk to the cost of prevention is also discussed. It is estimated that the cost of developing and preparing the first risk management plan varies between $50,000 tomore » $200,000. 3 refs., 2 figs., 1 tab.« less

  9. University building safety index measurement using risk and implementation matrix

    NASA Astrophysics Data System (ADS)

    Rahman, A.; Arumsari, F.; Maryani, A.

    2018-04-01

    Many high rise building constructed in several universities in Indonesia. The high-rise building management must provide the safety planning and proper safety equipment in each part of the building. Unfortunately, most of the university in Indonesia have not been applying safety policy yet and less awareness on treating safety facilities. Several fire accidents in university showed that some significant risk should be managed by the building management. This research developed a framework for measuring the high rise building safety index in university The framework is not only assessed the risk magnitude but also designed modular building safety checklist for measuring the safety implementation level. The safety checklist has been developed for 8 types of the university rooms, i.e.: office, classroom, 4 type of laboratories, canteen, and library. University building safety index determined using risk-implementation matrix by measuring the risk magnitude and assessing the safety implementation level. Building Safety Index measurement has been applied in 4 high rise buildings in ITS Campus. The building assessment showed that the rectorate building in secure condition and chemical department building in beware condition. While the library and administration center building was in less secure condition.

  10. [Maturity Levels of Quality and Risk Management at the University Hospital Schleswig-Holstein].

    PubMed

    Jussli-Melchers, Jill; Hilbert, Carsten; Jahnke, Iris; Wehkamp, Kai; Rogge, Annette; Freitag-Wolf, Sandra; Kahla-Witzsch, Heike A; Scholz, Jens; Petzina, Rainer

    2018-05-16

    Quality and risk management in hospitals are not only required by law but also for an optimal patient-centered and process-optimized patient care. To evaluate the maturity levels of quality and risk management at the University Hospital Schleswig-Holstein (UKSH), a structured analytical tool was developed for easy and efficient application. Four criteria concerning quality management - quality assurance (QS), critical incident reporting system (CIRS), complaint management (BM) and process management (PM) - were evaluated with a structured questionnaire. Self-assessment and external assessment were performed to classify the maturity levels at the UKSH (location Kiel and Lübeck). Every quality item was graded into four categories from "A" (fully implemented) to "D" (not implemented at all). First of all, an external assessment was initiated by the head of the department of quality and risk management. Thereafter, a self-assessment was performed by 46 clinical units of the UKSH. Discrepancies were resolved in a collegial dialogue. Based on these data, overall maturity levels were obtained for every clinical unit. The overall maturity level "A" was reached by three out of 46 (6.5%) clinical units. No unit was graded with maturity level "D". 50% out of all units reached level "B" and 43.5% level "C". The distribution of the four different quality criteria revealed a good implementation of complaint management (maturity levels "A" and "B" in 78.3%), whereas the levels for CIRS were "C" and "D" in 73.9%. Quality assurance and process management showed quite similar distributions for the levels of maturity "B" and "C" (87% QS; 91% PM). The structured analytical tool revealed maturity levels of 46 clinical units of the UKSH and defined the maturity levels of four relevant quality criteria (QS, CIRS, BM, PM). As a consequence, extensive procedures were implemented to raise the standard of quality and risk management. In future, maturity levels will be reevaluated every two years. This qualitative maturity level model enables in a simple and efficient way precise statements concerning presence, manifestation and development of quality and risk management. © Georg Thieme Verlag KG Stuttgart · New York.

  11. Report: EPA Can Improve Implementation of the Risk Management Program for Airborne Chemical Releases

    EPA Pesticide Factsheets

    Report #09-P-0092, February 10, 2009. EPA can improve its program management and oversight to better assure that facilities covered by the Clean Air Act’s Risk Management Program submit or re-submit an RMP.

  12. Integrated management system: The integration of ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000

    NASA Astrophysics Data System (ADS)

    Muzaimi, Hafizzudin; Chew, Boon Cheong; Hamid, Syaiful Rizal

    2017-03-01

    The implementation of integrated management system (IMS) for better quality management has become a preference for many organizations. This can be seen as many organizations used the combination of quality ISO 9001, an environment ISO 14001 and occupational health and safety management system OHSAS 18001 as a core for the IMS that largely implemented. Besides, the linked between quality management with risk management system need to be identified as the management system that enhance the effectiveness of IMS. Therefore, the risk management system ISO 31000 also presented as a part of integration. In nowadays competitive environment, the increasing pressure and needs from customer or stakeholders make it compulsory for the organization to propose the new system and standards. This paper presents and discusses about the benefit of integration, the management system components that can be converged and the implementation approach. A series of interview was conducted through in-depth interviews with 8 experts in this field, while data collected were analyzed qualitatively. The results consist of 16 factors of IMS implementation that have been identified and the use of PDCA approach for an effective implementation of IMS. As a conclusion, the paper proposes the integration of four management systems (ISO 9001, ISO 14001, OHSAS 18001 and ISO 31000) and on how the IMS can be used to structure the process of management for quality management towards sustainability practices in the organization.

  13. Managing Risk for Cassini During Mission Operations and Data Analysis (MOandDA)

    NASA Technical Reports Server (NTRS)

    Witkowski, Mona M.

    2002-01-01

    A Risk Management Process has been tailored for Cassini that not only satisfies the requirements of NASA and JPL, but also allows the Program to proactively identify and assess risks that threaten mission objectives. Cassini Risk Management is a team effort that involves both management and engineering staff. The process is managed and facilitated by the Mission Assurance Manager (MAM), but requires regular interactions with Program Staff and team members to instill the risk management philosophy into the day to day mission operations. While Risk Management is well defined for projects in the development phase, it is a relatively new concept for Mission Operations. The Cassini team has embraced this process and has begun using it in an effective, proactive manner, to ensure mission success. It is hoped that the Cassini Risk Management Process will form the basis by which risk management is conducted during MO&DA on future projects. proactive in identifying, assessing and mitigating risks before they become problems. Cost ehtiveness is achieved by: Comprehensively identifying risks Rapidly assessing which risks require the expenditure of pruject cewums Taking early actions to mitigate these risks Iterating the process frequently, to be responsive to the dynamic internal and external environments The Cassini Program has successfully implemented a Risk Management Process for mission operations, The initial SRL has been developed and input into he online tool. The Risk Management webbased system has been rolled out for use by the flight team and risk owners we working proactive in identifying, assessing and mitigating risks before they become problems. Cost ehtiveness is achieved by: Comprehensively identifying risks Rapidly assessing which risks require the expenditure of pruject cewums Taking early actions to mitigate these risks Iterating the process frequently, to be responsive to the dynamic internal and external environments The Cassini Program has successfully implemented a Risk Management Process for mission operations, The initial SRL has been developed and input into he online tool. The Risk Management webbased system has been rolled out for use by the flight team and risk owners we working put into place will become visible and will be illusmted in future papers.

  14. 76 FR 48193 - Self-Regulatory Organizations; The NASDAQ Stock Market LLC; Notice of Filing and Immediate...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... Proposed Rule To Amend Fees Assessed for Use of NASDAQ Pre-Trade Risk Management August 3, 2011. Pursuant... Risk Management (``PRM'') and to make a minor technical correction. NASDAQ will implement the amended... in italics; proposed deletions are in brackets. 7016. Nasdaq Risk Management (a) No change. (b) Users...

  15. The Evidence for a Risk-Based Approach to Australian Higher Education Regulation and Quality Assurance

    ERIC Educational Resources Information Center

    Edwards, Fleur

    2012-01-01

    This paper explores the nascent field of risk management in higher education, which is of particular relevance in Australia currently, as the Commonwealth Government implements its plans for a risk-based approach to higher education regulation and quality assurance. The literature outlines the concept of risk management and risk-based approaches…

  16. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state

    PubMed Central

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-01-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version. PMID:23975626

  17. Implementing health information exchange for public health reporting: a comparison of decision and risk management of three regional health information organizations in New York state.

    PubMed

    Phillips, Andrew B; Wilson, Rosalind V; Kaushal, Rainu; Merrill, Jacqueline A

    2014-02-01

    Health information exchange (HIE) is a significant component of healthcare transformation strategies at both the state and national levels. HIE is expected to improve care coordination, and advance public health, but implementation is massively complex and involves significant risk. In New York, three regional health information organizations (RHIOs) implemented an HIE use case for public health reporting by demonstrating capability to deliver accurate responses to electronic queries via a set of services called the Universal Public Health Node. We investigated process and outcomes of the implementation with a comparative case study. Qualitative analysis was structured around a decision and risk matrix. Although each RHIO had a unique operational model, two common factors influenced risk management and implementation success: leadership capable of agile decision-making and commitment to a strong organizational vision. While all three RHIOs achieved certification for the public health reporting, only one has elected to deploy a production version.

  18. Implementing the dynamic appraisal of situational aggression in mental health units.

    PubMed

    Lantta, Tella; Daffern, Michael; Kontio, Raija; Välimäki, Maritta

    2015-01-01

    The aims of this study are to explain the intervention of implementing a structured violence risk assessment procedure in mental health inpatient units using the Ottawa Model of Research Use (OMRU) as a guiding framework and to consider nurses' perspectives of its clinical utility and implementation process. Patient aggression toward staff is a global concern in mental health units. The limited extant literature exploring the use of structured violence risk assessments in mental health units, although small and inconsistent, reveals some positive impacts on the incidence of aggression and staff's use of restrictive interventions. Although numerous violence risk assessment instruments have been developed and tested, their systematic implementation and use are still limited. A project titled "Safer Working Management" (111298) was conducted in a Finnish hospital district, across 3 mental health units. The 6 steps of OMRU were followed during implementation of the Dynamic Appraisal of Situational Aggression (DASA). Nurses' views toward structured violence risk assessment procedures varied. Although implementation of the DASA was seen as a useful method to increase discussions with patients and nursing staff, some staff preferred their own clinical judgment for assessment of violence risk. It is possible to use a specific model to promote the implementation of risk assessment instruments in mental health units. However, the complex mental health inpatient environment and the difficulties in understanding and managing aggressive patients present challenges for the implementation of structured violence risk assessment methods. The OMRU provides a tool for clinical nurse specialists to guide implementation process in mental health units. Clinical nurse specialists must promote training for staff regarding use of new innovations, such as the DASA. Implementation processes should be reviewed so that clinical nurse specialists can lead and support mental health staff to properly use structured violence risk assessment measures.

  19. 12 CFR Appendix C to Part 1720 - Policy Guidance; Safety and Soundness Standards for Information

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... implementation and reviewing reports from management. 2. Assess Risk. Each Enterprise shall: a. Identify... control risks. 3. Manage and Control Risk. Each Enterprise shall: a. Design its information security... security program. The frequency and nature of such tests should be determined by the Enterprise's risk...

  20. Back to basics--just how much should a risk manager know about risk financing?

    PubMed

    Miller, Vivian B

    2011-01-01

    Whether directly involved in development and implementation of the organization's risk financing program or not, risk management professionals, at the very least, need to be familiar with and understand the various risk financing strategies available to address all areas of exposure. This article addresses the types of coverages and risk financing options that should be considered when developing a comprehensive risk-financing program, and why it is important for risk management professionals to have some knowledge about these products, in order for their true value to be fully appreciated. © 2011 American Society for Healthcare Risk Management of the American Hospital Association.

  1. Risk Management as Strategic Change in National Homeland Security Policy

    DTIC Science & Technology

    2007-09-01

    HSI is operated under contract by Analytic Services Inc., with oversight from DHS Science and Technology (S& T ). 94 Threat and risk analysis are...Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget...risk management to the nation’s critical infrastructure owners and operators . This paper explores the challenges involved in implementing the risk

  2. Optimal environmental management strategy and implementation for groundwater contamination prevention and restoration.

    PubMed

    Wang, Mingyu

    2006-04-01

    An innovative management strategy is proposed for optimized and integrated environmental management for regional or national groundwater contamination prevention and restoration allied with consideration of sustainable development. This management strategy accounts for availability of limited resources, human health and ecological risks from groundwater contamination, costs for groundwater protection measures, beneficial uses and values from groundwater protection, and sustainable development. Six different categories of costs are identified with regard to groundwater prevention and restoration. In addition, different environmental impacts from groundwater contamination including human health and ecological risks are individually taken into account. System optimization principles are implemented to accomplish decision-makings on the optimal resources allocations of the available resources or budgets to different existing contaminated sites and projected contamination sites for a maximal risk reduction. Established management constraints such as budget limitations under different categories of costs are satisfied at the optimal solution. A stepwise optimization process is proposed in which the first step is to select optimally a limited number of sites where remediation or prevention measures will be taken, from all the existing contaminated and projected contamination sites, based on a total regionally or nationally available budget in a certain time frame such as 10 years. Then, several optimization steps determined year-by-year optimal distributions of the available yearly budgets for those selected sites. A hypothetical case study is presented to demonstrate a practical implementation of the management strategy. Several issues pertaining to groundwater contamination exposure and risk assessments and remediation cost evaluations are briefly discussed for adequately understanding implementations of the management strategy.

  3. Risk Management Plan Rule

    EPA Pesticide Factsheets

    RMP implements Section 112(r) of the 1990 Clean Air Act amendments, and requires facilities that use extremely hazardous substances to develop a Risk Management Plan and revise/resubmit every five years. Find guidance, factsheets, training, and assistance.

  4. Issues Management Process Course # 38401

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

    Binion, Ula Marie

    The purpose of this training it to advise Issues Management Coordinators (IMCs) on the revised Contractor Assurance System (CAS) Issues Management (IM) process. Terminal Objectives: Understand the Laboratory’s IM process; Understand your role in the Laboratory’s IM process. Learning Objectives: Describe the IM process within the context of the CAS; Describe the importance of implementing an institutional IM process at LANL; Describe the process flow for the Laboratory’s IM process; Apply the definition of an issue; Use available resources to determine initial screening risk levels for issues; Describe the required major process steps for each risk level; Describe the personnelmore » responsibilities for IM process implementation; Access available resources to support IM process implementation.« less

  5. A Proactive and Top-Down Approach to Managing Risk at NASA

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon

    2010-01-01

    Our ultimate goal is to manage risk in a holistic and coherent fashion across the Agency: a) The RIDM process is intended to risk-inform direction-setting decisions. c) The CRM process is intended to manage risk associated with the implementation of baseline performance requirements. Currently we are working on: a) Enhancements to the CRM process. b) Better integration of the RIDM and CRM processes. c) Better integration of institutional risk considerations into RM framework.

  6. Implementation of cold risk management in occupational safety, occupational health and quality practices. Evaluation of a development process and its effects at the finnish maritime administration.

    PubMed

    Risikko, Tanja; Remes, Jouko; Hassi, Juhani

    2008-01-01

    Cold is a typical environmental risk factor in outdoor work in northern regions. It should be taken into account in a company's occupational safety, health and quality systems. A development process for improving cold risk management at the Finnish Maritime Administration (FMA) was carried out by FMA and external experts. FMA was to implement it. Three years after the development phase, the outcomes and implementation were evaluated. The study shows increased awareness about cold work and few concrete improvements. Concrete improvements in occupational safety and health practices could be seen in the pilot group. However, organization-wide implementation was insufficient, the main reasons being no organization-wide practices, unclear process ownership, no resources and a major reorganization process. The study shows a clear need for expertise supporting implementation. The study also presents a matrix for analyzing the process.

  7. Tools and Methods for Risk Management in Multi-Site Engineering Projects

    NASA Astrophysics Data System (ADS)

    Zhou, Mingwei; Nemes, Laszlo; Reidsema, Carl; Ahmed, Ammar; Kayis, Berman

    In today's highly global business environment, engineering and manufacturing projects often involve two or more geographically dispersed units or departments, research centers or companies. This paper attempts to identify the requirements for risk management in a multi-site engineering project environment, and presents a review of the state-of-the-art tools and methods that can be used to manage risks in multi-site engineering projects. This leads to the development of a risk management roadmap, which will underpin the design and implementation of an intelligent risk mapping system.

  8. Continuing Professional Education of Insurance and Risk Management Practitioners: A Comparative Case Study of Customer Service Representatives, Insurance Agents and Risk Managers

    ERIC Educational Resources Information Center

    Krauss, George E.

    2009-01-01

    The purpose of this study is to understand how selected insurance practitioners learn and developed in their practices setting. The selected insurance practitioners (collectively customer service representatives, insurance agents, and risk managers) are responsible for the counseling and placement of insurance products and the implementation of…

  9. 12 CFR 234.5 - Changes to rules, procedures, or operations.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... risk-management techniques. (4) A designated financial market utility shall not implement a change to...) Participant eligibility or access criteria; (ii) Product eligibility; (iii) Risk management; (iv) Settlement..., procedures, or operations that could materially affect the nature or level of risks presented by the...

  10. 12 CFR 234.5 - Changes to rules, procedures, or operations.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... risk-management techniques. (4) A designated financial market utility shall not implement a change to...) Participant eligibility or access criteria; (ii) Product eligibility; (iii) Risk management; (iv) Settlement..., procedures, or operations that could materially affect the nature or level of risks presented by the...

  11. The role of organizational culture and leadership in water safety plan implementation for improved risk management.

    PubMed

    Summerill, Corinna; Pollard, Simon J T; Smith, Jennifer A

    2010-09-15

    Appropriate implementation of WSPs offers an important opportunity to engage in and promote preventative risk management within water utilities. To ensure success, the whole organization, especially executive management, need to be advocates. Illustrated by two case studies, we discuss the influence of organizational culture on buy-in and commitment to public health protection and WSPs. Despite an internal desire to undertake risk management, some aspects of organizational culture prevented these from reaching full potential. Enabling cultural features included: camaraderie; competition; proactive, involved leaders; community focus; customer service mentality; transparency; accountability; competent workforce; empowerment; appreciation of successes, and a continual improvement culture. Blocking features included: poor communication; inflexibility; complacency; lack of awareness, interest or reward and coercion. We urge water utilities to consider the influence of organizational culture on the success and sustainability of WSP adoption, and better understand how effective leadership can mould culture to support implementation. Copyright 2010 Elsevier B.V. All rights reserved.

  12. Management strategies for trace organic chemicals in water - A review of international approaches.

    PubMed

    Bieber, Stefan; Snyder, Shane A; Dagnino, Sonia; Rauch-Williams, Tanja; Drewes, Jörg E

    2018-03-01

    To ensure an appropriate management of potential health risks and uncertainties from the release of trace organic chemicals (TOrCs) into the aqueous environment, many countries have evaluated and implemented strategies to manage TOrCs. The aim of this study was to evaluate existing management strategies for TOrCs in different countries to derive and compare underlying core principles and paradigms and to develop suggestions for more holistic management strategies to protect the environment and drinking water supplies from the discharge of undesired TOrCs. The strategies in different industrial countries were summarized and subsequently compared with regards to three particular questions: 1) Do the approaches different countries have implemented manage all or only specific portions of the universe of chemicals; 2) What implementation and compliance strategies are used to manage aquatic and human health risk and what are their pros and cons; and 3) How are site-specific watershed differences being addressed? While management strategies of the different countries target similar TOrCs, the programs differ in several important aspects, including underlying principles, the balance between aquatic or human health protection, implementation methods, and financing mechanisms used to fund regulatory programs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. [Global risk management].

    PubMed

    Sghaier, W; Hergon, E; Desroches, A

    2015-08-01

    Risk management is a fundamental component of any successful company, whether it is in economic, societal or environmental aspect. Risk management is an especially important activity for companies that optimal security challenge of products and services is great. This is the case especially for the health sector institutions. Risk management is therefore a decision support tool and a means to ensure the sustainability of an organization. In this context, what methods and approaches implemented to manage the risks? Through this state of the art, we are interested in the concept of risk and risk management processes. Then we focus on the different methods of risk management and the criteria for choosing among these methods. Finally we highlight the need to supplement these methods by a systemic and global approach including through risk assessment by the audits. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Application of Risk Assessment Tools in the Continuous Risk Management (CRM) Process

    NASA Technical Reports Server (NTRS)

    Ray, Paul S.

    2002-01-01

    Marshall Space Flight Center (MSFC) of the National Aeronautics and Space Administration (NASA) is currently implementing the Continuous Risk Management (CRM) Program developed by the Carnegie Mellon University and recommended by NASA as the Risk Management (RM) implementation approach. The four most frequently used risk assessment tools in the center are: (a) Failure Modes and Effects Analysis (FMEA), Hazard Analysis (HA), Fault Tree Analysis (FTA), and Probabilistic Risk Analysis (PRA). There are some guidelines for selecting the type of risk assessment tools during the project formulation phase of a project, but there is not enough guidance as to how to apply these tools in the Continuous Risk Management process (CRM). But the ways the safety and risk assessment tools are used make a significant difference in the effectiveness in the risk management function. Decisions regarding, what events are to be included in the analysis, to what level of details should the analysis be continued, make significant difference in the effectiveness of risk management program. Tools of risk analysis also depends on the phase of a project e.g. at the initial phase of a project, when not much data are available on hardware, standard FMEA cannot be applied; instead a functional FMEA may be appropriate. This study attempted to provide some directives to alleviate the difficulty in applying FTA, PRA, and FMEA in the CRM process. Hazard Analysis was not included in the scope of the study due to the short duration of the summer research project.

  15. Managing the Risks Associated with End-User Computing.

    ERIC Educational Resources Information Center

    Alavi, Maryam; Weiss, Ira R.

    1986-01-01

    Identifies organizational risks of end-user computing (EUC) associated with different stages of the end-user applications life cycle (analysis, design, implementation). Generic controls are identified that address each of the risks enumerated in a manner that allows EUC management to select those most appropriate to their EUC environment. (5…

  16. The impact of risk management practice upon the implementation of recovery-oriented care in community mental health services: a qualitative investigation.

    PubMed

    Holley, Jessica; Chambers, Mary; Gillard, Steven

    2016-08-01

    Recovery-oriented care has become guiding principle for mental health policies and practice in the UK and elsewhere. However, a pre-existing culture of risk management practice may impact upon the provision of recovery-oriented mental health services. To explore how risk management practice impacts upon the implementation of recovery-oriented care within community mental health services. Semi-structured interviews using vignettes were conducted with eight mental health worker and service user dyads. Grounded theory techniques were used to develop explanatory themes. Four themes arose: (1) recovery and positive risk taking; (2) competing frameworks of practice; (3) a hybrid of risk and recovery; (4) real-life recovery in the context of risk. In abstract responses to the vignettes, mental health workers described how they would use a positive-risk taking approach in support of recovery. In practice, this was restricted by a risk-averse culture embedded within services. Mental health workers set conditions with which service users complied to gain some responsibility for recovery. A lack of strategic guidance at policy level and lack of support and guidance at practice level may result in resistance to implementing ROC in the context of RMP. Recommendations are made for policy, training and future research.

  17. When methods meet politics: how risk adjustment became part of Medicare managed care.

    PubMed

    Weissman, Joel S; Wachterman, Melissa; Blumenthal, David

    2005-06-01

    Health-based risk adjustment has long been touted as key to the success of competitive models of health care. Because it decreases the incentive to enroll only healthy patients in insurance plans, risk adjustment was incorporated into Medicare policy via the Balanced Budget Act of 1997. However, full implementation of risk adjustment was delayed due to clashes with the managed care industry over payment policy, concerns over perverse incentives, and problems of data burden. We review the history of risk adjustment leading up to the Balanced Budget Act and examine the controversies surrounding attempts to stop or delay its implementation during the years that followed. The article provides lessons for the future of health-based risk adjustment and possible alternatives.

  18. Improving regulatory capacity to manage risks associated with trade agreements.

    PubMed

    Walls, Helen L; Smith, Richard D; Drahos, Peter

    2015-03-21

    Modern trade negotiations have delivered a plethora of bilateral and regional preferential trade agreements (PTAs), which involve considerable risk to public health, thus placing demands on governments to strengthen administrative regulatory capacities in regard to the negotiation, implementation and on-going management of PTAs. In terms of risk management, the administrative regulatory capacity requisite for appropriate negotiation of PTAs is different to that for the implementation or on-going management of PTAs, but at all stages the capacity needed is expensive, skill-intensive and requires considerable infrastructure, which smaller and poorer states especially struggle to find. It is also a task generally underestimated. If states do not find ways to increase their capacities then PTAs are likely to become much greater drivers of health inequities. Developing countries especially struggle to find this capacity. In this article we set out the importance of administrative regulatory capacity and coordination to manage the risks to public health associated with PTAs, and suggest ways countries can improve their capacity.

  19. [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.

  20. Do risk assessment tools help manage and reduce risk of violence and reoffending? A systematic review.

    PubMed

    Viljoen, Jodi L; Cochrane, Dana M; Jonnson, Melissa R

    2018-06-01

    Although it is widely believed that risk assessment tools can help manage risk of violence and offending, it is unclear what evidence exists to support this view. As such, we conducted a systematic review and narrative synthesis. To identify studies, we searched 13 databases, reviewed reference lists, and contacted experts. Through this review, we identified 73 published and unpublished studies (N = 31,551 psychiatric patients and offenders, N = 10,002 professionals) that examined either professionals' risk management efforts following the use of a tool, or rates of violence or offending following the implementation of a tool. These studies included a variety of populations (e.g., adults, adolescents), tools, and study designs. The primary findings were as follows: (a) despite some promising findings, professionals do not consistently adhere to tools or apply them to guide their risk management efforts; (b) following the use of a tool, match to the risk principle is moderate and match to the needs principle is limited, as many needs remained unaddressed; (c) there is insufficient evidence to conclude that tools directly reduce violence or reoffending, as findings are mixed; and (d) tools appear to have a more beneficial impact on risk management when agencies use careful implementation procedures and provide staff with training and guidelines related to risk management. In sum, although risk assessment tools may be an important starting point, they do not guarantee effective treatment or risk management. However, certain strategies may bolster their utility. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  1. Using Geographical Information Systems (GIS) as an instrument of water resource management: a case study from a GIS-based Water Safety Plan in Germany.

    PubMed

    Wienand, I; Nolting, U; Kistemann, T

    2009-01-01

    Following international developments and the new WHO Drinking Water Guidelines (WHO 2004) a process-orientated concept for risk, monitoring and incident management has been developed and implemented in this study. The concept will be reviewed with special consideration for resource protection (first barrier of the multi-barrier system) and in turn, for the Water Safety Plan (WSP) which adequately considers-beyond the current framework of legal requirements-possible new hygienic-microbiologically relevant risks (especially emerging pathogens) for the drinking water supply. The development of a WSP within the framework of risk, monitoring and incident management includes the application of Geographical Information Systems (GIS). In the present study, GIS was used for visualization and spatial analysis in decisive steps in the WSP. The detailed process of GIS-supported implementation included the identification of local participants and their tasks and interactions as an essential part of risk management. A detailed ecological investigation of drinking water conditions in the catchment area was conducted in addition to hazard identification, risk assessment and the monitoring of control measures. The main task of our study was to find out in which steps of the WSP the implementation of GIS could be integrated as a useful, and perhaps even an essential tool.

  2. Best management practices for creating a community wildfire protection plan

    Treesearch

    Pamela J. Jakes; Christine Esposito; Sam Burns; Antony S. Cheng; Kristen C. Nelson; Victoria E. Sturtevant; Daniel R. Williams

    2012-01-01

    A community wildfire protection plan (CWPP) is a means of bringing local solutions to wildland fire management. In developing and implementing CWPPs, communities assume a leadership role in reducing wildfi re risk on federal and nonfederal land. In this publication, we identify best management practices for CWPP development and implementation based on the experiences...

  3. DOD Financial Management: Ongoing Challenges in Implementing the Financial Improvement and Audit Readiness Plan

    DTIC Science & Technology

    2011-09-15

    programs and operations at high risk of being vulnerable to fraud, waste, and abuse.1 Despite several reform initiatives, DOD’s financial management...remains on GAO’s high- risk list today. Long- standing and pervasive weaknesses in DOD’s financial management and related business processes and systems...GAO has identified as being at high risk of waste, fraud, abuse, and mismanagement. The seven specific DOD high- risk areas are (1) approach to

  4. Implementing the EU Floods Directive (2007/60/EC) in Austria: Flood Risk Management Plans

    NASA Astrophysics Data System (ADS)

    Neuhold, Clemens

    2013-04-01

    he Directive 2007/60/EC of the European Parliament and of the Council of 23 October 2007 on the assessment and management of flood risks (EFD) aims at the reduction of the adverse consequences for human health, the environment, cultural heritage and economic activity associated with floods in the Community. This task is to be achieved based on three process steps (1) preliminary flood risk assessment (finalised by the end of 2011), (2) flood hazard maps and flood risk maps (due 2013) and (3) flood risk management plans (due 2015). Currently, an interdisciplinary national working group is defining the methodological framework for flood risk management plans in Austria supported by a constant exchange with international bodies and experts. Referring to the EFD the components of the flood risk management plan are (excerpt): 1. conclusions of the preliminary flood risk assessment 2. flood hazard maps and flood risk maps and the conclusions that can be drawn from those maps 3. a description of the appropriate objectives of flood risk management 4. a summary of measures and their prioritisation aiming to achieve the appropriate objectives of flood risk management The poster refers to some of the major challenges in this process, such as the legal provisions, coordination of administrative units, definition of public relations, etc. The implementation of the EFD requires the harmonisation of legal instruments of various disciplines (e.g. water management, spatial planning, civil protection) enabling a coordinated - and ideally binding - practice of flood risk management. This process is highly influenced by the administrative organisation in Austria - federal, provincial and municipality level. The Austrian approach meets this organisational framework by structuring the development of the flood risk management plan into 3 time-steps: (a) federal blueprint, (b) provincial editing and (c) federal finishing as well as reporting to the European Commission. Each time-step addresses different administrative levels and spatial scales accompanied by the active involvement of interested parties.

  5. SYN-OP-SYS™: A Computerized Management Information System for Quality Assurance and Risk Management

    PubMed Central

    Thomas, David J.; Weiner, Jayne; Lippincott, Ronald C.

    1985-01-01

    SYN·OP·SYS™ is a computerized management information system for quality assurance and risk management. Computer software for the efficient collection and analysis of “occurrences” and the clinical data associated with these kinds of patient events is described. The system is evaluated according to certain computer design criteria, and the system's implementation is assessed.

  6. 12 CFR Appendix B to Part 364 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Relationships Risk Management Principles,” Nov. 1, 2001; FDIC FIL 68-99, Risk Assessment Tools and Practices for... Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and...

  7. Notification: Evaluation of EPA’s Management Controls to Implement and Enforce Pesticide Worker Protection Standards

    EPA Pesticide Factsheets

    Project #OPE-FY17-0008, Feb 9, 2017.The EPA OIG plans to begin research to evaluate EPA’s management controls implementing the revised Worker Protection Standards (WPS) requirements to reduce pesticide exposure and risks to agricultural workers.

  8. RMP Guidance for Warehouses - Chapter 10: Implementation

    EPA Pesticide Factsheets

    The implementing agency is the federal, state, or local agency taking the lead for implementation and enforcement of part 68. They review risk management plans, select some for audits, and conduct on-site inspections.

  9. Assessing and Managing Multiple Risks in a Changing World ...

    EPA Pesticide Factsheets

    Roskilde University hosted a November 2015 workshop on “Environmental Risk – Assessing and Managing Multiple Risks in a Changing World”. Thirty attendees from 9 countries developed consensus recommendations regarding: implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process involving both universal and site-, region-, or problem-specific protection goals; addressing societal issues; risk management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. We encourage both cross- and inter-disciplinary approaches to address 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and non-chemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk assessment process; 4) fully integrate risk assessors and communities of interest into the risk management process; 5) consider socio-economics and increase transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference con

  10. A crisis management quality improvement initiative in a children's psychiatric hospital: design, implementation, and outcome.

    PubMed

    Paccione-Dyszlewski, Margaret R; Conelea, Christine A; Heisler, Walter C; Vilardi, Jodie C; Sachs, Henry T

    2012-07-01

    Behavioral crisis management, including the use of seclusion and restraint, is the most high risk process in the psychiatric care of children and adolescents. The authors describe hospital-wide programmatic changes implemented at a children's psychiatric hospital that aimed to improve the quality of crisis management services. Pre/post quantitative and qualitative data suggest reduced restraint and seclusion use, reduced patient and staff injury related to crisis management, and increased patient satisfaction during the post-program period. Factors deemed beneficial in program implementation are discussed.

  11. [Organizational and management companies models].

    PubMed

    Tomei, G; Tomei, F; Fiaschetti, M; De Sio, S; Tria, M; Schifano, M P; Monti, C; Tasciotti, Z; Panfili, T; Caciari, A; Sancini, A

    2010-01-01

    With the legislative decree 81/08 and s.m.i. it's explicitly defined a model of management and corporate organization that can contribute to prevent security risks in work environments. The realization of the model is not obligatory, but desirable because the result of its implementation is a decrease of company's risks and costs for safety. Our study group has developed the structure of an organizational and management model for corporate safety and the tools necessary for its realization. The realization of a model is structured in various phases: initial exam, safety policy, planification, implementation, monitoring, system retest and improvement. Such a model, in continuous evolution, is based on the responsibilities of the different corporate figures through an accurate analysis of the measured risks and the measures adopted.

  12. Risk Governance of Multiple Natural Hazards: Centralized versus Decentralized Approach in Europe

    NASA Astrophysics Data System (ADS)

    Komendantova, Nadejda; Scolobig, Anna; Vinchon, Charlotte

    2014-05-01

    The multi-risk approach is a relatively new field and its definition includes the need to consider multiple hazards and vulnerabilities in their interdependency (Selva, 2013) and the current multi-hazards disasters, such as the 2011 Tohoku earthquake, tsunami and nuclear catastrophe, showed the need for a multi-risk approach in hazard mitigation and management. Our knowledge about multi-risk assessment, including studies from different scientific disciplines and developed assessment tools, is constantly growing (White et al., 2001). However, the link between scientific knowledge, its implementation and the results in terms of improved governance and decision-making have gained significantly less attention (IRGC, 2005; Kappes et al., 2012), even though the interest to risk governance, in general, has increased significantly during the last years (Verweiy and Thompson, 2006). Therefore, the key research question is how risk assessment is implemented and what is the potential for the implementation of a multi-risk approach in different governance systems across Europe. More precisely, how do the characteristics of risk governance, such as the degree of centralization versus decentralization, influence the implementation of a multi-risk approach. The methodology of this research includes comparative case study analysis of top-down and bottom-up interactions in governance in the city of Naples, (Italy), where the institutional landscape is marked by significant autonomy of Italian regions in decision-making processes for assessing the majority of natural risks, excluding volcanic, and in Guadeloupe, French West Indies, an overseas department of France, where the decision-making process is marked by greater centralization in decision making associated with a well established state governance within regions, delegated to the prefect and decentralised services of central ministries. The research design included documentary analysis and extensive empirical work involving policy makers, private sector actors and practitioners in risk and emergency management. This work was informed by 36 semi-structured interviews, three workshops with over seventy participants from eleven different countries, feedback from questionnaires and focus group discussions (Scolobig et al., 2013). The results show that both governance systems have their own strengths and weaknesses (Komendantova et al., 2013). Elements of the centralized multi-risk governance system could lead to improvements in interagency communication and the creation of an inter-agency environment, where the different departments at the national level can exchange information, identify the communities that are most exposed to multiple risks and set priorities, while providing consistent information about and responses to multi-risk to the relevant stakeholders at the local level. A decentralised multi-risk governance system by contrast can instead favour the creation of local multi-risk commissions to conduct discussions between experts in meteorological, geological and technological risks and practitioners, to elaborate risk and hazard maps, and to develop local capacities which would include educational and training activities. Both governance systems suffer from common deficiencies, the most important being the frequent lack of capacities at the local level, especially financial, but sometimes also technical and institutional ones, as the responsibilities for disaster risk management are often transferred from the national to local levels without sufficient resources for implementation of programs on risk management (UNISDR, 2013). The difficulty in balancing available resources between short-term and medium-term priorities often complicates the issue. Our recommendations are that the implementation of multi-risk approach can be facilitated through knowledge exchange and dialogue between different disciplinary communities, such as geological and meteorological, and between the natural and social sciences. The implementation of a multi-risk approach can be strengthened through the creation of multi-risk platforms and multi-risk commissions, which can liaise between risk management experts and local communities and to unify numerous actions on natural hazard management. However, the multi-risk approach cannot be a subsidiary to a single risk approach, and both have to be pursued. References: IRGC. (2011). Concept note: Improving the management of emerging risks: Risks from new technologies, system interactions, and unforeseen or changing circumstances. International Risk Governance Council (IRGC), Geneva. Kappes, M. S., Keiler, M., Elverfeldt, von K., & Glade, T, (2012). Challenges of analyzing multi-hazard risk: A review. Natural Hazards, 64(2), 1925-1958. doi: 10.1007/s11069-012-0294-2. Komendantova N, Scolobig A, Vinchon C (2013). Multi-risk approach in centralized and decentralized risk governance systems: Case studies of Naples, Italy and Guadeloupe, France. International Relations and Diplomacy, 1(3):224-239 (December 2013) Scolobig, A., Vichon, C., Komendantova, N., Bengoubou-Valerius, M., & Patt, A. (2013). Social and institutional barriers to effective multi-hazard and multi-risk decision-making governance. D6.3 MATRIX project. Selva, J. (2013). Long-term multi-risk assessment: statistical treatment of interaction among risks. Natural Hazards, 67(2),701-722. UNISDR. (2013). Implementing the HYOGO framework for action in Europe: Regional synthesis report 2011-2013. Verweij, M., & Thompson, M. (Eds.). (2006). Clumsy solutions for a complex world: Governance, politics, and plural perceptions. New York: Palgrave Macmillan. White, G., Kates, R., & Burton, I. (2001). Knowing better and losing even more: the use of knowledge in hazards management. Environmental Hazards, 3, 81-92.

  13. Assessing and managing multiple risks in a changing world ...

    EPA Pesticide Factsheets

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological c

  14. Periodontal Management by Risk Assessment: A Pragmatic Approach.

    PubMed

    Mullins, Joanna M; Even, Joshua B; White, Joel M

    2016-06-01

    An evidence-based periodontal disease risk assessment and diagnosis system has been developed and combined with a clinical decision support and management program to improve treatment and measure patient outcomes. There is little agreement on a universally accepted periodontal risk assessment, periodontal diagnosis, and treatment management tool and their incorporation into dental practice to improve patient care. This article highlights the development and use of a practical periodontal management and risk assessment program that can be implemented in dental settings. The approach taken by Willamette Dental Group to develop a periodontal disease risk assessment, periodontal diagnosis, and treatment management tool is described using evidence-based best practices. With goals of standardized treatment interventions while maintaining personalized care and improved communication, this process is described to facilitate its incorporation into other dental settings. Current electronic health records can be leveraged to enhance patient-centered care through the use of risk assessments and standardized guidelines to more effectively assess, diagnose, and treat patients to improve outcomes. Dental hygienists, and other committed providers, with their emphasis on prevention of periodontal disease can be principal drivers in creation and implementation of periodontal risk assessments and personalized treatment planning. Willamette Dental Group believes that such evidence-based tools can advance dentistry to new diagnostic and treatment standards. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. National Risk Management Research Laboratory Strategic plan and Implementation - Overview

    EPA Science Inventory

    This publication provides an overview of the strategic plan recently developed by the National Risk Management Research Laboratory (NRMRL). It includes a description of NRMRL's mission and goals and their alignment with Agency goals. Additionally, the overview contains a brief se...

  16. Assessing and managing multiple risks in a changing world – the Roskilde recommendations.

    EPA Science Inventory

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk—Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common curre...

  17. Pain management and opioid risk mitigation in the military.

    PubMed

    Sharpe Potter, Jennifer; Bebarta, Vikhyat S; Marino, Elise N; Ramos, Rosemarie G; Turner, Barbara J

    2014-05-01

    Opioid analgesics misuse is a significant military health concern recognized as a priority issue by military leadership. Opioids are among those most commonly prescribed medications in the military for pain management. The military has implemented opioid risk mitigation strategies, including the Sole Provider Program and the Controlled Drug Management Analysis and Reporting Tool, which are used to identify and monitor for risk and misuse. However, there are substantial opportunities to build on these existing systems to better ensure safer opioid prescribing and monitor for misuse. Opioid risk mitigation strategies implemented by the civilian sector include establishing clinical guidelines for opioid prescribing and prescription monitoring programs. These strategies may help to inform opioid risk mitigation in the military health system. Reducing the risk of opioid misuse and improving quality of care for our Warfighters is necessary. This must be done through evidence-based approaches with an investment in research to improve patient care and prevent opioid misuse as well as its sequelae. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  18. RMP Guidance for Chemical Distributors - Chapter 10: Implementation

    EPA Pesticide Factsheets

    The implementing agency is the federal, state, or local agency taking the lead for implementation and enforcement of part 68. They will review Risk Management Plans, select some for audits, and conduct on-site inspections.

  19. Quality assurance and the need to evaluate interventions and audit programme outcomes.

    PubMed

    Zhao, Min; Vaartjes, Ilonca; Klipstein-Grobusch, Kerstin; Kotseva, Kornelia; Jennings, Catriona; Grobbee, Diederick E; Graham, Ian

    2017-06-01

    Evidence-based clinical guidelines provide standards for the provision of healthcare. However, these guidelines have been poorly implemented in daily practice. Clinical audit is a quality improvement tool to promote quality of care in daily practice and to improve outcomes through the systematic review of care delivery and implementation of changes. A major priority in the management of subjects with cardiovascular disease (CVD) management is secondary prevention by controlling cardiovascular risk factors and providing appropriate medical treatment. Clinical audits can be applied to monitor modifiable risk factors and evaluate quality improvements of CVD management in daily practice. Existing clinical audits have provided an overview of the burden of risk factors in subjects with CVD and reflect real-world risk factor recording and management. However, consistent and representative data from clinic audits are still insufficient to fully monitor quality improvement of CVD management. Data are lacking in particular from low- and middle-income countries, limiting the evaluation of CVD management quality by clinical audit projects in many settings. To support the development of clinical standards, monitor daily practice performance, and improve quality of care in CVD management at national and international levels, more widespread clinical audits are warranted.

  20. Strengthening the Security of ESA Ground Data Systems

    NASA Astrophysics Data System (ADS)

    Flentge, Felix; Eggleston, James; Garcia Mateos, Marc

    2013-08-01

    A common approach to address information security has been implemented in ESA's Mission Operations (MOI) Infrastructure during the last years. This paper reports on the specific challenges to the Data Systems domain within the MOI and how security can be properly managed with an Information Security Management System (ISMS) according to ISO 27001. Results of an initial security risk assessment are reported and the different types of security controls that are being implemented in order to reduce the risks are briefly described.

  1. DOD Financial Management: Improvement Needed in DOD Components’ Implementation of Audit Readiness Effort

    DTIC Science & Technology

    2011-09-01

    DOD Financial Management Abbreviations AFB Air Force Base COSO Committee of Sponsoring Organizations of the Treadway... Management and mismanagement.11 All of DOD’s programs on GAO’s High- Risk List relate to its business operations, including systems and processes... Management maintains audit readiness through risk -based periodic testing of internal controls utilizing the OMB Circular No. A-123, Appendix A

  2. Implementation of infants risk detection sensing system using IoT

    NASA Astrophysics Data System (ADS)

    Yang, Youseok; Lee, Taeo; Lee, Yechan; Choi, Jaehyeon; Park, Eunju; Lim, Hankyu

    2017-06-01

    Infants are vulnerable to surrounding environment and they receive large influence from even a small change. As their body composition is not complete yet, infants receive huge impact from small pressure. Small change can cause disease or even death of infants. This paper designed and implemented a risk-detection system for infants. In addition to the fundamental function of safety management system, the risk-detection system implemented in this paper in corporate child-caring function by using a variety of sensors.

  3. 77 FR 71404 - Intent To Prepare an Environmental Impact Statement for the Proposed Flood Risk Management Study...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-30

    ... Policy Act (NEPA) of 1969 as implemented by the Council on Environmental Quality regulations (40 CFR... specifically, this document will discuss measures to improve flood risk management, navigation, water quality.... The overall goal of the study is to reduce flood risk by saving lives and minimizing property damage...

  4. A Pilot Test of a Graduate Course in Suicide Theory, Risk Assessment, and Management

    ERIC Educational Resources Information Center

    Cramer, Robert J.; Bryson, Claire N.; Stroud, Caroline H.; Ridge, Brittany E.

    2016-01-01

    The present discussion outlines the design and initial implementation of a semester-long graduate course in suicide theory, risk assessment, and management. While the structure of the course is adaptable in light of various considerations (e.g., targeted group of students and availability of resources), we review suicide risk assessment core…

  5. The Effect of a Professional Development Classroom Management Model on At-Risk Elementary Students' Misbehaviors

    ERIC Educational Resources Information Center

    Reglin, Gary; Akpo-Sanni, Joretta; Losike-Sedimo, Nonofo

    2012-01-01

    The problem in the study was that at-risk elementary school students had too many classroom disruptive behaviors. The purpose was to investigate the effect a Professional Development Classroom Management Model would have on reducing these students' misbehaviors. The study implemented a classroom management model to improve the classroom management…

  6. Analysis of Risks in a Learning Management System: A Case Study in the Spanish National University of Distance Education (UNED)

    ERIC Educational Resources Information Center

    Vázquez-Cano, Esteban; Sevillano García, Ma. Luisa

    2015-01-01

    This article presents a research that examines the university students' risk perception when using a Learning Management System called "aLF" and implemented by the Spanish National University of Distance Education (UNED) for the development of its university distance studies. The development of comprehensive Learning Management Systems…

  7. Critical factors in case management: practical lessons from a cardiac case management program.

    PubMed

    Stafford, Randall S; Berra, Kathy

    2007-08-01

    Case management (CM) is an important strategy for chronic disease care. By utilizing non-physician providers for conditions requiring ongoing care and follow-up, CM can facilitate guideline-concordant care, patient empowerment, and improvement in quality of life. We identify a series of critical factors required for successful CM implementation. Heart to Heart is a clinical trial evaluating CM for coronary heart disease (CHD) risk reduction in a multiethnic, low-income population. Patients at elevated cardiac risk were randomized to CM plus primary care (212 patients) or to primary care alone (207). Over a mean follow-up of 17 months, patients received face-to-face nurse and dietitian visits. Mean contact time was 14 hours provided at an estimated cost of $1250 per patient for the 341 (81%) patients completing follow-up. Visits emphasized behavior change, risk-factor monitoring, self-management skills, and guideline-based pharmacotherapy. A statistically significant reduction in mean Framingham risk probability occurred in CM plus primary care relative to primary care alone (1.6% decrease in 10-year CHD risk, p = 0.007). Favorable changes were noted across individual risk factors. Our findings suggest that successful CM implementation relies on choosing appropriate case managers and investing in training, integrating CM into existing care systems, delineating the scope and appropriate levels of clinical decision making, using information systems, and monitoring outcomes and costs. While our population, setting, and intervention model are unique, these insights are broadly relevant. If implemented with attention to critical factors, CM has great potential to improve the process and outcomes of chronic disease care.

  8. Storage management in Ada. Three reports. Volume 1: Storage management in Ada as a risk to the development of reliable software. Volume 2: Relevant aspects of language. Volume 3: Requirements of the language versus manifestations of current implementations

    NASA Technical Reports Server (NTRS)

    Auty, David

    1988-01-01

    The risk to the development of program reliability is derived from the use of a new language and from the potential use of new storage management techniques. With Ada and associated support software, there is a lack of established guidelines and procedures, drawn from experience and common usage, which assume reliable behavior. The risk is identified and clarified. In order to provide a framework for future consideration of dynamic storage management on Ada, a description of the relevant aspects of the language is presented in two sections: Program data sources, and declaration and allocation in Ada. Storage-management characteristics of the Ada language and storage-management characteristics of Ada implementations are differentiated. Terms that are used are defined in a narrow and precise sense. The storage-management implications of the Ada language are described. The storage-management options available to the Ada implementor and the implications of the implementor's choice for the Ada programmer are also described.

  9. Implementing sustainable drainage systems for urban surface water management within the regulatory framework in England and Wales.

    PubMed

    Ellis, J Bryan; Lundy, Lian

    2016-12-01

    The UK 2007 floods resulted in damages estimated to exceed over £4 billion. This triggered a national review of strategic flood risk management (Pitt, 2008) with its recommendations informing and implemented by the Flood and Water Management, Act (FWMA, 2010). Estimating that up to two-thirds of properties flooded in the 2007 event as a direct result of overloaded sewer systems, the FWMA set out an ambitious overhaul of flood risk management approaches including identifying bodies responsible for the management of local flood risk (local municipalities) and the development of over-arching Lead Local Flood Authorities (LLFAs) at a regional level. LLFAs duties include developing local flood risk management strategies and, aligned with this, many LLFAs and local municipalities produced sustainable drainage system (SUDS) guidance notes. In parallel, changes to the national planning policy framework (NPPF) in England give priority to the use of SUDS in new major developments, as does the related Town and Country Planning Order (2015). However, whilst all three pieces of legislation refer to the preferential use of SUDs, these requirements remain "economically proportionate" and thus the inclusion of SUDS within development controls remain desirable - but not mandatory - obligations. Within this dynamic policy context, reignited most recently by the December 2015 floods, this paper examines some of the challenges to the implementation of SUDS in England and Wales posed by the new regulatory frameworks. In particular, it examines how emerging organisational procedures and processes are likely to impact on future SUDS implementation, and highlights the need for further cross-sectoral working to ensure opportunities for cross-sectoral benefits- such as that accrued by reducing stormwater flows within combined sewer systems for water companies, property developers and environmental protection - are not lost. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. High-risk population health management--achieving improved patient outcomes and near-term financial results.

    PubMed

    Lynch, J P; Forman, S A; Graff, S; Gunby, M C

    2000-07-01

    A managed care organization sought to achieve efficiencies in care delivery and cost savings by anticipating and better caring for its frail and least stable members. Time sequence case study of program intervention across an entire managed care population in its first year compared with the prior baseline year. Key attributes of the intervention included predictive registries of at-risk members based on existing data, relentless focus on the high-risk group, an integrated clinical and psychosocial approach to assessments and are planning, a reengineered care management process, secured Internet applications enabling rapid implementation and broad connectivity, and population-based outcomes metrics derived from widely used measures of resource utilization and functional status. Concentrating on the highest-risk group, which averaged just 1.1% prevalence in the total membership, yielded bottom line results. When the year before program implementation (July 1997 through June 1998) was compared with the subsequent year, the total population's annualized commercial admission rate was reduced 5.3%, and seniors' was reduced 3.0%. A claims-paid analysis exclusively of the highest-risk group revealed that their efficiencies and savings overwhelmingly contributed to the membershipwide effect. This subgroup's costs dropped 35.7% from preprogram levels of $2590 per member per month (excluding pharmaceuticals). During the same time, patient-derived cross-sectional functional status rose 12.5%. A sharply focused, Internet-deployed case management strategy achieved economic and functional status results on a population basis and produced systemwide savings in its first year of implementation.

  11. Risk Management Interventions to Reduce Injuries and Maximize Economic Benefits in U.S. Mining.

    PubMed

    Griffin, Stephanie C; Bui, David P; Gowrisankaran, Gautam; Lutz, Eric A; He, Charles; Hu, Chengcheng; Burgess, Jefferey L

    2018-03-01

    Risk management (RM) is a cyclical process of identifying and ranking risks, implementing controls, and evaluating their effectiveness. This study aims to identify effective RM interventions in the U.S. mining industry. RM interventions were identified in four companies representing metal, aggregate, and coal mining sectors. Injury rates were determined using Mine Safety and Health Administration (MSHA) data and changes in injury rates identified through change point analysis. Program implementation costs and associated changes in injury costs were evaluated for select interventions. Six of 20 RM interventions were associated with a decline in all injuries and one with a reduction in lost-time injuries, all with a positive return on investment. Reductions in injuries and associated costs were observed following implementation of a limited number of specific RM interventions.

  12. Applying the Heuristic to the Risk Assessment within the Automotive Industry Supply Chain

    NASA Astrophysics Data System (ADS)

    Marasova, Daniela; Andrejiova, Miriam; Grincova, Anna

    2017-03-01

    Risk management facilitates risk identification, evaluation, control, and by means of appropriate set of measures, risk reduction or complete elimination. Therefore, the risk management becomes a strategic factor for a company's success. Properly implemented risk management system does not represent a tool to avoid the risk; it is used to understand the risk and provide the bases for strategic decision-making. Risk management represents a key factor for the supply chain operations. Managing the risks is crucial for achieving the customer satisfaction and thus also a company's success. The subject-matter of the article is the assessment of the supply chain in the automobile industry, in terms of risks. The topicality of this problem is even higher, as after the economic crisis it is necessary to revaluate the readiness of the supply chain for prospective risk conditions. One advantage of this article is the use of the Saaty method as a tool for the risk management within the supply chain.

  13. Risk Management for Enterprise Resource Planning System Implementations in Project-Based Firms

    ERIC Educational Resources Information Center

    Zeng, Yajun

    2010-01-01

    Enterprise Resource Planning (ERP) systems have been regarded as one of the most important information technology developments in the past decades. While ERP systems provide the potential to bring substantial benefits, their implementations are characterized with large capital outlay, long duration, and high risks of failure including…

  14. RMP Guidance for Warehouses - Chapter 5: Management System

    EPA Pesticide Factsheets

    Your management system should oversee the implementation of the risk management program elements, and designate and assign responsibility in order to make process safety a constant priority. Includes sample documentation.

  15. [Risk management project: reactive or proactive approach?].

    PubMed

    Vastola, Pasquale; Saracino, Donato M T

    2006-01-01

    Risk management in healthcare refers to the process of developing strategies aimed at preventing and controlling the risk of occurrence of errors and harmful events. The final objective is primarily that of increasing patient safety and secondarily, that of reducing the financial burden of adverse events. The implementation of a risk management system is therefore of vital strategic importance. Nevertheless, a fundamental question that needs to be answered in the operational phase is: should a proactive or reactive approach to risk management be taken? In our view, proactive risk management has many advantages over a reactive approach and is therefore preferable. The reactive approach should be taken exclusively to obtain information regarding risk and errors, in the preliminary, as well as monitoring and follow-up phases of the project.

  16. Risk management for drinking water safety in low and middle income countries - cultural influences on water safety plan (WSP) implementation in urban water utilities.

    PubMed

    Omar, Yahya Y; Parker, Alison; Smith, Jennifer A; Pollard, Simon J T

    2017-01-15

    We investigated cultural influences on the implementation of water safety plans (WSPs) using case studies from WSP pilots in India, Uganda and Jamaica. A comprehensive thematic analysis of semi-structured interviews (n=150 utility customers, n=32 WSP 'implementers' and n=9 WSP 'promoters'), field observations and related documents revealed 12 cultural themes, offered as 'enabling', 'limiting', or 'neutral', that influence WSP implementation in urban water utilities to varying extents. Aspects such as a 'deliver first, safety later' mind set; supply system knowledge management and storage practices; and non-compliance are deemed influential. Emergent themes of cultural influence (ET1 to ET12) are discussed by reference to the risk management, development studies and institutional culture literatures; by reference to their positive, negative or neutral influence on WSP implementation. The results have implications for the utility endorsement of WSPs, for the impact of organisational cultures on WSP implementation; for the scale-up of pilot studies; and they support repeated calls from practitioner communities for cultural attentiveness during WSP design. Findings on organisational cultures mirror those from utilities in higher income nations implementing WSPs - leadership, advocacy among promoters and customers (not just implementers) and purposeful knowledge management are critical to WSP success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Improving organisational resilience through enterprise security risk management.

    PubMed

    Petruzzi, John; Loyear, Rachelle

    Enterprise Security Risk Management (ESRM) is a new philosophy and method of managing security programmes through the use of traditional risk principles. As a philosophy and life cycle, ESRM is focused on creating a business partnership between security practitioners and business leaders to more effectively provide protection against security risks in line with acceptable risk tolerances as defined by business asset owners and stakeholders. This paper explores the basics of the ESRM philosophy and life cycle and also shows how embracing the ESRM philosophy and implementing a risk-based security management model in the business organisation can lead to higher levels of organisational resilience as desired by organisation leaders, executives and the board of directors.

  18. Space systems engineering and risk management - joined at the hip

    NASA Technical Reports Server (NTRS)

    Rose, James R.

    2004-01-01

    This paper explores the separate skills and capabilities practiced until now, and the powerful coupling to be achieved, practically and effectively, in implementing a space mission, from inception (pre-phase A) to the end of Operations (phase E). The use of risk assessment techniques in balancing cost risk against performance risk, and the application of the systems engineering team in these trades, is the key to achieving this new implementation paradigm.

  19. Robust Decision Making Approach to Managing Water Resource Risks (Invited)

    NASA Astrophysics Data System (ADS)

    Lempert, R.

    2010-12-01

    The IPCC and US National Academies of Science have recommended iterative risk management as the best approach for water management and many other types of climate-related decisions. Such an approach does not rely on a single set of judgments at any one time but rather actively updates and refines strategies as new information emerges. In addition, the approach emphasizes that a portfolio of different types of responses, rather than any single action, often provides the best means to manage uncertainty. Implementing an iterative risk management approach can however prove difficult in actual decision support applications. This talk will suggest that robust decision making (RDM) provides a particularly useful set of quantitative methods for implementing iterative risk management. This RDM approach is currently being used in a wide variety of water management applications. RDM employs three key concepts that differentiate it from most types of probabilistic risk analysis: 1) characterizing uncertainty with multiple views of the future (which can include sets of probability distributions) rather than a single probabilistic best-estimate, 2) employing a robustness rather than an optimality criterion to assess alternative policies, and 3) organizing the analysis with a vulnerability and response option framework, rather than a predict-then-act framework. This talk will summarize the RDM approach, describe its use in several different types of water management applications, and compare the results to those obtained with other methods.

  20. General RMP Guidance - Chapter 10: Implementation

    EPA Pesticide Factsheets

    The implementing agency is the federal, state, or local agency taking the lead for implementation and enforcement of part 68 (risk management program) or the state or local equivalent. They review RMPs, select some for audits, and conduct inspections.

  1. Flood Risk Management Policy in Scotland: Research Questions Past, Present and Future

    NASA Astrophysics Data System (ADS)

    Wilkinson, Mark; Hastings, Emily; MacDonald, Jannette

    2016-04-01

    Scotland's Centre of Expertise for Waters (CREW) delivers accessible research and expert opinion to support the Scottish Government and its delivery partners in the development and implementation of water policy. It was established in 2011 by the Scottish Government (Rural and Environmental Science and Analytical Services) in recognition of a gap in the provision of short term advice and research to policy (development and implementation). Key policy areas include the Water Framework Directive, Floods Directive, Drinking Water Directive, Habitats Directive and Scotland's Hydro Nation Strategy. CREW is unique in its demand-driven and free service for policy makers and practitioners, managing the engagement between scientists, policy makers and practitioners to work effectively across this interface. The users of CREW are the Scottish Government, Scottish Environment Protection Agency, Scottish Natural Heritage and Scottish Water. CREW has funded around 100 projects relating to water policy since its inception in 2011. Of these, a significant number relate to flood risk management policy. Based on a review of work to date, this poster will give an overview of these projects and a forward look at the challenges that remain. From learning from community led flood risk management to surface water flood forecasting for urban communities, links will be made between sustainable and traditional flood risk management while considering the perceptions of stakeholders to flood risk management. How can we deliver fully integrated flood risk management options? How policy makers, scientists and land managers can better work together will also be explored.

  2. A review on disaster risk mitigation in the oil and gas project

    NASA Astrophysics Data System (ADS)

    Rodhi, N. N.; Anwar, N.; Wiguna, I. P. A.

    2018-01-01

    In addition to the very complex risks, hazards potentially lead to disasters in the oil and gas projects. These risks can certainly be anticipated with the application of risk management, but an unsystematic and ineffective implementation of risk management will still bring adverse impacts. According to the eleven risk management principles in ISO 31000:2009, the application of risk management must pay attention to all aspects, both internal and external factors. Thus, this paper aims to identify variables that could affect the disaster mitigation efforts of oil and gas projects. This research began with literature study to determine the problems of risk management in oil and gas projects, so the affecting variables as the study objectives can be specified subsequently based on the literature review as well. The variables that must be considered in the efforts of disaster risk mitigation of oil and gas project are the risk factors and sustainability aspect.

  3. Managing Mentoring Programs.

    ERIC Educational Resources Information Center

    IUME Briefs, 1992

    1992-01-01

    Some programs for helping at-risk youth achieve excellent results, while others do not. One reason for program success can be proper management. Mentoring is a promising strategy for helping at-risk youth. Planners who want to create effective mentoring programs should look at the implementation experiences of other youth programs. Evaluations…

  4. Management of the volcanic crises of Galeras volcano: Social, economic and institutional aspects

    NASA Astrophysics Data System (ADS)

    Cardona, Omar D.

    1997-05-01

    This paper presents a summary of the institutional management of the volcanic hazard and risk in the areas that surround Galeras volcano, Colombia, during its recent activity. The social and economic problems discussed have stemmed from difficulties in forecasting the behavior of the volcano and the inadequate management of the warnings by various government bodies and the media. The Galeras situation had economic, social, and psychological effects that contributed to resistance in implementing mitigation measures. Furthermore, the political authorities were reluctant to accept the volcanic risk. At regional and local levels, certain business organizations and a large part of the population also were inadequately prepared to accept the risk, despite the effort and insistence at the national level to implement a volcano emergency preparedness plan.

  5. Development of risk models for Florida's bridge management system.

    DOT National Transportation Integrated Search

    2013-06-01

    Florida Department of Transportation (FDOT) has been actively implementing the American Association of State Highway Transportation Officials (AASHTO) Pontis Bridge Management System (BMS), recently renamed AASHTOWare Bridge Management (BrM), to supp...

  6. Case Study of Engineering Risk in Automotive Industry

    NASA Astrophysics Data System (ADS)

    Popa, Dan Mihai

    2018-03-01

    The primary objective of this paper is to show where the engineering of risk management is placed and how its implementation has been tried in multinational companies in automotive industry from Romania. A large number of companies don't use a strategy to avoid the engineering risk in their design products. The main reason is not because these companies haven't heard about standards for risk management such as ISO 31000; the problem is that the business units which were summed up, have just set up a risk list at the beginning of the project, without any follow up. The purpose of this article is to create an implementation risk tracking in automotive industry companies in Romania, due to a change request from customers according to supply companies within the quality process, in the research and development phase.

  7. Application of the Flood-IMPAT procedure in the Valle d'Aosta Region, Italy

    NASA Astrophysics Data System (ADS)

    Minucci, Guido; Mendoza, Marina Tamara; Molinari, Daniela; Atun, Funda; Menoni, Scira; Ballio, Francesco

    2016-04-01

    Flood Risk Management Plans (FRMPs) established by European "Floods" Directive (Directive 2007/60/EU) to Member States in order to address all aspects of flood risk management, taking into account costs and benefits of proposed mitigation tools must be reviewed by the same law every six years. This is aimed at continuously increasing the effectiveness of risk management, on the bases of the most advanced knowledge of flood risk and most (economically) feasible solutions, also taking into consideration achievements of the previous management cycle. Within this context, the Flood-IMPAT (i.e. Integrated Meso-scale Procedure to Assess Territorial flood risk) procedure has been developed aiming at overcoming limits of risk maps produced by the Po River Basin Authority and adopted for the first version of the Po River FRMP. The procedure allows the estimation of flood risk at the meso-scale and it is characterized by three main peculiarities. First is its feasibility for the entire Italian territory. Second is the possibility to express risk in monetary terms (i.e. expected damage), at least for those categories of damage for which suitable models are available. Finally, independent modules compose the procedure: each module allows the estimation of a certain type of damage (i.e. direct, indirect, intangibles) on a certain sector (e.g. residential, industrial, agriculture, environment, etc.) separately, guaranteeing flexibility in the implementation. This paper shows the application of the Flood-IMPAT procedure and the recent advancements in the procedure, aiming at increasing its reliability and usability. Through a further implementation of the procedure in the Dora Baltea River Basin (North of Italy), it was possible to test the sensitivity of risk estimates supplied by Flood-IMPAT with respect to different damage models and different approaches for the estimation of assets at risk. Risk estimates were also compared with observed damage data in the investigated areas to identify the most suitable damage model/exposure assessment approach to be implemented in the procedure. In the end, the procedure was adapted to be applied at the micro-scale, in such a way to supply risk estimates, which are coherent with those at the meso-scale. This way the procedure can be first implemented in the whole catchment to identify hotspots; the micro-scale approach can be implemented in a second run to investigate in depth (i) the most risk prone areas and (ii) the possible risk mitigation strategies.

  8. An Exploratory Study of Risk Factors for Implementing Service-Oriented IS Projects

    NASA Astrophysics Data System (ADS)

    Chang, Hsin-Lu; Lue, Chia-Pei

    For IS project managers, how to implement the projects successfully is always a challenge. Further, as more and more enterprises start to develop service-oriented IS projects, it is essential to assess the sources and impacts of relevant risks. This research aimed at identifying risk factors related to service-oriented IS projects and analyzing the impact of these risk factors. Applying the SIMM (service integrated maturity model) proposed by IBM, customer service systems were selected to justify the research framework. Result showed that the risk factors influencing the adoption of service-oriented systems were insufficient technology planning, lack of expertise, ineffective project governance, and organizational misalignment, listed in the order of strength of influence. The findings of this research is expected to assist managers realize the risks and the importance of these risks that have to be noticed and controlled when making decisions on service-oriented systems adoption.

  9. Evolution and Implementation of the NASA Robotic Conjunction Assessment Risk Analysis Concept of Operations

    NASA Technical Reports Server (NTRS)

    Newman, Lauri K.; Frigm, Ryan C.; Duncan, Matthew G.; Hejduk, Matthew D.

    2014-01-01

    Reacting to potential on-orbit collision risk in an operational environment requires timely and accurate communication and exchange of data, information, and analysis to ensure informed decision-making for safety of flight and responsible use of the shared space environment. To accomplish this mission, it is imperative that all stakeholders effectively manage resources: devoting necessary and potentially intensive resource commitment to responding to high-risk conjunction events and preventing unnecessary expenditure of resources on events of low collision risk. After 10 years of operational experience, the NASA Robotic Conjunction Assessment Risk Analysis (CARA) is modifying its Concept of Operations (CONOPS) to ensure this alignment of collision risk and resource management. This evolution manifests itself in the approach to characterizing, reporting, and refining of collision risk. Implementation of this updated CONOPS is expected to have a demonstrated improvement on the efficacy of JSpOC, CARA, and owner/operator resources.

  10. Practice guidelines need to address the 'how' and the 'what' of implementation.

    PubMed

    McKillop, Ann; Crisp, Jackie; Walsh, Kenneth

    2012-01-01

    The aim of this study was to explore the realities of everyday nursing practice associated with the implementation of a guideline for the assessment and management of cardiovascular risk. The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable and, in spite of much investigation, remains resistant to explanation of what works and why. Exploration of the nature of guideline implementation has the potential to illuminate the complexities of guideline implementation by focussing on the nature of practice. Nurses are well placed at the front line of primary health care to contribute to an understanding of how guideline implementation plays out in their everyday practice. Qualitative description was used, involving focus groups and interviews with 32 participants (20 nurses, four doctors, five managers and three funder/planners), to explore the use of a guideline in everyday primary health-care practice. Thematic analysis of data was managed through an inductive process of familiarisation, coding, categorising and generation of themes. Four themes were generated from the data portraying the realities of guideline implementation for primary health-care nurses: self-managing patient, everyday nursing practice, developing new relationships in the health team and impact on health-care delivery. The findings reveal that, even with the best of intentions to implement the guideline, health professionals were frustrated and at a loss as to how to achieve that in practice. Consequently, cardiovascular risk assessment and management was uneven and fragmented. Primary health-care practice environments vary so much that solutions to the difficulties of implementing evidence into practice requires context-specific solution-finding through collaborative teamwork. Furthermore, the attention of guideline developers, health-care policymakers, funders and researchers requires direct focus on the 'how' and the 'what' of evidence implementation.

  11. [The workplace injury trends in the petrochemical industry: from data analysis to risk management].

    PubMed

    Campo, Giuseppe; Martini, Benedetta

    2013-01-01

    The most recent INAIL data show that, in 2009-2011, the accident frequency rate and the severity rate of workplace injuries in the chemical industry are lower than for the total non-agricultural workforce. The chemical industry, primarily because of the complex and hazardous work processes, requires an appropriate system for assessing and monitoring specific risks.The implementation of Responsible Care, a risk management system specific for the chemical industry, in 1984, has represented a historical step in the process of critical awareness of risk management by the chemical companies. Responsible Care is a risk management system specifically designed on the risk profiles of this type of enterprise, which integrates safety, health and environment. A risk management system, suitable for the needs of a chemical company, should extend its coverage area, beyond the responsible management of products throughout the entire production cycle, to the issues of corporate responsibility.

  12. Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.

    PubMed

    O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry

    2013-06-01

    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.

  13. Disaster Risk Management and Measurement Indicators for Cultural Heritage in Taiwan

    NASA Astrophysics Data System (ADS)

    Yen, Y. N.; Cheng, C. F.; Cheng, H. M.

    2015-08-01

    Under the influence of global climate change, the risk preparedness has become a universal issue in different research fields. In the conservation of cultural heritage, disaster risk management is becoming one of the major research topics. Besides researches on the theory and mechanism of disaster risk management, the tools for the performance of site managers to protect cultural heritage is another important issue that needs development. UNESCO and ICOMOS have released some important documents on disaster risk management including its concept, identification, evaluation, mitigation, monitoring and resilience, etc. However, there is a big gap between concept and implementation in Taiwan. Presently there are 2000 monuments in Taiwan that hardly meet the modern code. First, based on international documents released, this research presents 13 disaster indicators on monuments and their environments. Next, 345 monuments in northern Taiwan are taken as examples to evaluate their risk situations with indicators designed in 2011. Some positive recommendations were given at the same time. As a result, a comparative evaluation was completed in 2012 and some key issues are found, such as too many electrical facilities, lack of efficient firefighting equipment, and a shortage of management mechanism, just to name a few. Through the improvement of the management, some major risk can be mitigated. In 2013~14, this research took 23 national monuments from the 345 monuments to evaluate their risk situations and compare the differences between national and local monuments. Results show that almost all management mechanisms in the national monuments have been established and are running well. However, problems like inappropriate electrical facilities and insufficient monitoring equipment remain. In addition, the performance of private monuments is not as good as public ones. Based on the collected information and evaluation, this research develops safety measures of heritage conservation in two aspects. One is for researchers to measure the risk of the heritage; the other is for site managers to manage the risk of their monument with ease. In conclusion, intendants of monuments in Taiwan have to develop more disaster risk management ideas to mitigate and prevent risks. In the meantime, the management and monitoring mechanisms available are helpful tools for risk mitigation. The awareness and training of the site managers are important issues for the implementation of risk prevention.

  14. International comparative analyses of healthcare risk management.

    PubMed

    Sun, Niuyun; Wang, Li; Zhou, Jun; Yuan, Qiang; Zhang, Zongjiu; Li, Youping; Liang, Minghui; Cheng, Lan; Gao, Guangming; Cui, Xiaohui

    2011-02-01

    Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province, hospital, and non-governmental organization. The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an "NGO-led mode" represented by the United States and Canada and a "government-led mode" represented by the United Kingdom, Australia, and Taiwan. © 2011 Blackwell Publishing Asia Pty Ltd and Chinese Cochrane Center, West China Hospital of Sichuan University.

  15. 12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

  16. 12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

  17. 12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

  18. 12 CFR Appendix A to Part 748 - Guidelines for Safeguarding Member Information

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... Implementation of Member Information Security Program A. Involve the Board of Directors B. Assess Risk C. Manage and Control Risk D. Oversee Service Provider Arrangements E. Adjust the Program F. Report to the Board.... Development and Implementation of Member Information Security Program A. Involve the Board of Directors. The...

  19. Enterprise Resource Planning Systems: Assessment of Risk Factors by California Community College Leaders

    ERIC Educational Resources Information Center

    Valente, Mario Manuel

    2011-01-01

    Most California Community Colleges have chosen to purchase and implement a Management Information Systems software solution also known as an Enterprise Resource Planning (ERP) system in order to monitor, control, and automate their administrative tasks. ERP implementations are complex, expensive, high profile, and therefore high risk. To reduce…

  20. Risk management analysis for construction of Kutai Kartanegara bridge-East Kalimantan-Indonesia

    NASA Astrophysics Data System (ADS)

    Azis, Subandiyah

    2017-11-01

    Many sources of risk that may impede the achievement of the project objectives through either cost or quality and time, especially for bridges that have collapsed before, so when the implementation of possible hazard / high hazard so when should the possible hazard/high hazard be implemented The purpose of this research is to identify, to analyze risks by classifying the risks using the method of Risk Breakdown Structure (RBS) and managing the dominant risk of execution of the installation work to determine the handling of the steel frame in order to maximize the positive and minimize the incidence of adverse events. The results of this study indicate there are 15 sources of risks are identified, and there are 6 risk indicates the dominant risks. Mitigation performed on the dominant risks unacceptable i.e. Project factor that shows the delays in the arrival of materials due to locations, schedule of the arrival of materials should be tailored to the needs of the field and the amount of material that comes with the required field should also be evaluated. The result is expected to be a guideline for identifying risks and mitigation measures for further research. Subsequent researchers to pay attention on the security factor that implementation time does not affect the productivity of work in construction projects.

  1. 75 FR 69791 - Risk Management Controls for Brokers or Dealers With Market Access

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-15

    ... relationship with the ultimate customer, can more effectively implement them. In addition, a broker or dealer... specific risk management controls and supervisory procedures to a customer that is a registered broker... such customer, based on its position in the transaction and relationship with the ultimate customer...

  2. Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

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

    Singh, Ravindra; Reilly, James T.; Wang, Jianhui

    Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to commonmore » barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.« less

  3. Using data and quality monitoring to enhance maternity outcomes: a qualitative study of risk managers' perspectives.

    PubMed

    Simms, Rebecca A; Yelland, Andrew; Ping, Helen; Beringer, Antonia J; Draycott, Timothy J; Fox, Robert

    2014-06-01

    Risk management is a core part of healthcare practice, especially within maternity services, where litigation and societal costs are high. There has been little investigation into the experiences and opinions of those staff directly involved in risk management: lead obstetricians and specialist risk midwives, who are ideally placed to identify how current implementation of risk management strategies can be improved. A qualitative study of consultant-led maternity units in an English region. Semistructured interviews were conducted with the obstetric and midwifery risk management leads for each unit. We explored their approach to risk management, particularly their opinions regarding quality monitoring and related barriers/issues. Interviews were recorded, transcribed and thematically analysed. Twenty-seven staff from 12/15 maternity units participated. Key issues identified included: concern for the accuracy and validity of their local data, potential difficulties related to data collation, the negative impact of external interference by national regulatory bodies on local clinical priorities, the influence of the local culture of the maternity unit on levels of engagement in the risk management process, and scepticism about the value of benchmarking of maternity units without adjustment for population characteristics. Local maternity risk managers may provide valuable, clinically relevant insights into current issues in clinical data monitoring. Improvements should focus on the accuracy and ease of data collation with a need for an agreed maternity indicators set, populated from validated databases, and not reliant on data collection systems that distract clinicians from patient activity and quality improvement. It is clear that working relationships between risk managers, their own clinical teams and external national bodies require improvement and alignment. Further discussion regarding benchmarking between maternity units is required prior to implementation. These findings are likely to be relevant to other clinical specialties. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Knowledge, attitudes and practices of dental hygienists regarding caries management by risk assessment.

    PubMed

    Urban, Ruth A; Rowe, Dorothy J

    2015-02-01

    The purpose of this study was to survey dental hygienists to determine their knowledge, attitudes and practices regarding the implementation of caries risk assessment, particularly caries management by risk assessment (CAMBRA), in private dental practices. A 17 item survey was developed to evaluate dental hygienists' knowledge, attitudes and practices related to CAMBRA and perceived barriers to CAMBRA implementation in private dental practice. Surveys were mailed to a randomized sample of 1,000 dental hygienists licensed to practice in California. Responses were tabulated for each respondent, and the response frequency for each survey item was calculated. Respondents' comments to the open-ended question were compiled, according to themes. The response rate was 18%. Only 66% of the respondents were familiar with the term CAMBRA, although 89% agreed with its underlying principles of risk assessment. CAMBRA protocol had been implemented in 40% of the respondents' employment sites. Respondents disagreed that time (45%) and cost of products (68%) were barriers to implementation. Many did not know their employers' knowledge or attitudes about CAMBRA and its implementation, as evidenced by a "don't know" response range of 29 to 48% for the 4 relevant statements. Respondents' comments included both successes and barriers implementing CAMBRA. CAMBRA protocol has not been widely implemented in private practice, although the current data do not indicate insurmountable barriers. Broader dissemination may be feasible if dental hygienists would obtain more comprehensive knowledge of evidence-based risk assessment protocols and would assume a leadership role in implementing CAMBRA protocols and procedures in private dental practices. Copyright © 2015 The American Dental Hygienists’ Association.

  5. Quantitative option analysis for implementation and management of landfills.

    PubMed

    Kerestecioğlu, Merih

    2016-09-01

    The selection of the most feasible strategy for implementation of landfills is a challenging step. Potential implementation options of landfills cover a wide range, from conventional construction contracts to the concessions. Montenegro, seeking to improve the efficiency of the public services while maintaining affordability, was considering privatisation as a way to reduce public spending on service provision. In this study, to determine the most feasible model for construction and operation of a regional landfill, a quantitative risk analysis was implemented with four steps: (i) development of a global risk matrix; (ii) assignment of qualitative probabilities of occurrences and magnitude of impacts; (iii) determination of the risks to be mitigated, monitored, controlled or ignored; (iv) reduction of the main risk elements; and (v) incorporation of quantitative estimates of probability of occurrence and expected impact for each risk element in the reduced risk matrix. The evaluated scenarios were: (i) construction and operation of the regional landfill by the public sector; (ii) construction and operation of the landfill by private sector and transfer of the ownership to the public sector after a pre-defined period; and (iii) operation of the landfill by the private sector, without ownership. The quantitative risk assessment concluded that introduction of a public private partnership is not the most feasible option, unlike the common belief in several public institutions in developing countries. A management contract for the first years of operation was advised to be implemented, after which, a long term operating contract may follow. © The Author(s) 2016.

  6. Meeting CCS communication challenges head-on: Integrating communications, planning, risk assessment, and project management

    USGS Publications Warehouse

    Greenberg, S.; Gauvreau, L.; Hnottavange-Telleen, K.; Finley, R.; Marsteller, S.

    2011-01-01

    The Midwest Geological Sequestration Consortium, Schlumberger Carbon Services, and Archer Daniels Midland has implemented a comprehensive communications plan at the Illinois Basin - Decatur Project (IBDP), a one million metric tonne Carbon Capture and Storage project in Decatur, IL, USA funded by the U.S. Department of Energy's National Energy Technology Laboratory. The IBDP Communication Plan includes consortium information, funding and disclaimer citations, description of target audiences, media communications guidelines, paper and presentations guidelines, site visit information, crisis communication, on-site photography regulations, and other components. The creation, development, and implementation processes for the IBDP Communication Plan (the Plan) are shared in this paper. New communications challenges, such as how to address add-on research requests, data sharing and management, scope increase, and contract agreements have arisen since the Plan was completed in January 2009, resulting in development of new policies and procedures by project management. Integrating communications planning, risk assessment, and project management ensured that consistent, factual information was developed and incorporated into project planning, and constitutes the basis of public communications. Successful integration has allowed the IBDP to benefit from early identification and mitigation of the potential project risks, which allows more time to effectively deal with unknown and unidentified risks that may arise. Project risks and risks associated with public perception can be managed through careful planning and integration of communication strategies into project management and risk mitigation. ?? 2011 Published by Elsevier Ltd.

  7. Business continuity and risk management at a strategic level: Case study of the Flemish government.

    PubMed

    Bouve, Joris; Steens, Herman-Peter; Ruebens, Martin

    2018-01-01

    The Flemish government comprises a number of different departments and agencies with the autonomy to optimise their service level in a proactive and resilient manner. Recently, the Flemish government defined four organisational values: openness, decisiveness, trust and agility. In addition, the Internal Audit Agency developed guidelines concerning internal control and organisational management, in which risk management was emphasised. In combination with goal setting and process management, this paper considers risk management as a starting point for the overall management of Flemish government entities. The paper then develops tools to support the establishment of business continuity and risk management processes. These tools fit into the organisation's strategic framework and are easy to understand, pragmatically designed and flexible in their use. The paper goes on to illustrate how the Department of the Chancellery and Public Governance is implementing BCM and risk management, and how it is integrating BCM, risk management and crisis management. It will then focus on the Flemish government's long-term strategy across the boundaries between the different entities and the question of how risk management can become a useful tool for policy makers.

  8. Implementation of a chest pain management service improves patient care and reduces length of stay.

    PubMed

    Scott, Adam C; O'Dwyer, Kristina M; Cullen, Louise; Brown, Anthony; Denaro, Charles; Parsonage, William

    2014-03-01

    Chest pain is one of the most common complaints in patients presenting to an emergency department. Delays in management due to a lack of readily available objective tests to risk stratify patients with possible acute coronary syndromes can lead to an unnecessarily lengthy admission placing pressure on hospital beds or inappropriate discharge. The need for a co-ordinated system of clinical management based on enhanced communication between departments, timely and appropriate triage, clinical investigation, diagnosis, and treatment was identified. An evidence-based Chest Pain Management Service and clinical pathway were developed and implemented, including the introduction of after-hours exercise stress testing. Between November 2005 and March 2013, 5662 patients were managed according to a Chest Pain Management pathway resulting in a reduction of 5181 admission nights by more timely identification of patients at low risk who could then be discharged. In addition, 1360 days were avoided in high-risk patients who received earlier diagnosis and treatment. The creation of a Chest Pain Management pathway and the extended exercise stress testing service resulted in earlier discharge for low-risk patients; and timely treatment for patients with positive and equivocal exercise stress test results. This service demonstrated a significant saving in overnight admissions.

  9. Systematic implementation of clinical risk management in a large university hospital: the impact of risk managers.

    PubMed

    Sendlhofer, Gerald; Brunner, Gernot; Tax, Christa; Falzberger, Gebhard; Smolle, Josef; Leitgeb, Karina; Kober, Brigitte; Kamolz, Lars Peter

    2015-01-01

    For health care systems in recent years, patient safety has increasingly become a priority issue. National and international strategies have been considered to attempt to overcome the most prominent hazards while patients are receiving health care. Thereby, clinical risk management (CRM) plays a dominant role in enabling the identification, analysis, and management of potential risks. CRM implementation into routine procedures within complex hospital organizations is challenging, as in the past, organizational change strategies using a top-down approach have often failed. Therefore, one of our main objectives was to educate a certain number of risk managers in facilitating CRM using a bottom-up approach. To achieve our primary purpose, five project strands were developed, and consequently followed, introducing CRM: corporate governance, risk management (RM) training, CRM process, information, and involvement. The core part of the CRM process involved the education of risk managers within each organizational unit. To account for the size of the existing organization, we assumed that a minimum of 1 % of the workforce had to be trained in RM to disseminate the continuous improvement of quality and safety. Following a roll-out plan, CRM was introduced in each unit and potential risks were identified. Alongside the changes in the corporate governance, a hospital-wide CRM process was introduced resulting in 158 trained risk managers correlating to 2.0 % of the total workforce. Currently, risk managers are present in every unit and have identified 360 operational risks. Among those, 176 risks were scored as strategic and clustered together into top risks. Effective meeting structures and opportunities to share information and knowledge were introduced. Thus far, 31 units have been externally audited in CRM. The CRM approach is unique with respect to its dimension; members of all health care professions were trained to be able to identify potential risks. A network of risk managers supported the centrally coordinated CRM process. There is a strong commitment among management, academia, clinicians, and administration to foster cooperation. The introduction of CRM led to a visible shift with regard to patient safety culture throughout the entire organization. Still, there is a long way to go to keep people engaged in CRM and work on national and international patient safety initiatives to continuously decrease potential hazards.

  10. The role of paediatric nurses in medication safety prior to the implementation of electronic prescribing: a qualitative case study.

    PubMed

    Farre, Albert; Heath, Gemma; Shaw, Karen; Jordan, Teresa; Cummins, Carole

    2017-04-01

    Objectives To explore paediatric nurses' experiences and perspectives of their role in the medication process and how this role is enacted in everyday practice. Methods A qualitative case study on a general surgical ward of a paediatric hospital in England, one year prior to the planned implementation of ePrescribing. Three focus groups and six individual semi-structured interviews were conducted, involving 24 nurses. Focus groups and interviews were audio-recorded, transcribed, anonymized and subjected to thematic analysis. Results Two overarching analytical themes were identified: the centrality of risk management in nurses' role in the medication process and the distributed nature of nurses' medication risk management practices. Nurses' contribution to medication safety was seen as an intrinsic feature of a role that extended beyond just preparing and administering medications as prescribed and placed nurses at the heart of a dynamic set of interactions, practices and situations through which medication risks were managed. These findings also illustrate the collective nature of patient safety. Conclusions Both the recognized and the unrecognized contributions of nurses to the management of medications needs to be considered in the design and implementation of ePrescribing systems.

  11. The Maricopa Integrated Risk Assessment Project: A New Way of Looking at Risk

    ERIC Educational Resources Information Center

    Unks, Ruth A.; Thor, Linda

    2008-01-01

    This article reviews the Maricopa Integrated Risk Assessment (MIRA) project and discusses its challenges and successes. Strategies and resources are offered for assisting community college administrators, faculty, and staff to successfully implement enterprise risk management at their institutions.

  12. Data warehousing in disease management programs.

    PubMed

    Ramick, D C

    2001-01-01

    Disease management programs offer the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the data warehouse. This article surveys recent warehousing techniques from HMOs to map out critical issues relating to the preparation, design, and implementation of a successful data warehouse. Discussions of scope, data cleansing, and storage management are included in depicting warehouse preparation and design; data implementation options are contrasted. Examples are provided of data warehouse execution in disease management programs that identify members with preexisting illnesses, as well as those exhibiting high-risk conditions. The proper deployment of successful data warehouses in disease management programs benefits both the organization and the member. Organizations benefit from decreased medical costs; members benefit through an improved quality of life through disease-specific care.

  13. DOD Acquisition Information Management

    DTIC Science & Technology

    1994-09-30

    instead of on a real- time management information flow. The process of identifying risks and implementing corrective actions is lengthened by using the current system; performance measurement and reporting are impeded.

  14. 12 CFR Appendix C to Part 1720 - Policy Guidance; Safety and Soundness Standards for Information

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... Information Security Program 1. Involve the Board of Directors. 2. Assess Risk. 3. Manage and Control Risk. 4. Oversee Service Provider Arrangements. 5. Adjust the Program. 6. Report to the Board. 7. Implementation. A...—Development and Implementation of Information Security Program 1. Involve the Board of Directors. The board of...

  15. Obstetric simulation as a risk control strategy: course design and evaluation.

    PubMed

    Gardner, Roxane; Walzer, Toni B; Simon, Robert; Raemer, Daniel B

    2008-01-01

    Patient safety initiatives aimed at reducing medical errors and adverse events are being implemented in Obstetrics. The Controlled Risk Insurance Company (CRICO), Risk Management Foundation (RMF) of the Harvard Medical Institutions pursued simulation as an anesthesia risk control strategy. Encouraged by their success, CRICO/RMF promoted simulation-based team training as a risk control strategy for obstetrical providers. We describe the development, implementation, and evaluation of an obstetric simulation-based team training course grounded in crisis resource management (CRM) principles. We pursued systematic design of course development, implementation, and evaluation in 3 phases, including a 1-year or more posttraining follow-up with self-assessment questionnaires. The course was highly rated overall by participants immediately after the course and 1-year or more after the course. Most survey responders reported having experienced a critical clinical event since the course and that various aspects of their teamwork had significantly or somewhat improved as a result of the course. Most (86%) reported CRM principles as useful for obstetric faculty and most (59%) recommended repeating the simulation course every 2 years. A simulation-based team-training course for obstetric clinicians was developed and is a central component of CRICO/RMF's obstetric risk management incentive program that provides a 10% reduction in annual obstetrical malpractice premiums. The course was highly regarded immediately and 1 year or more after completing the course. Most survey responders reported improved teamwork and communication in managing a critical obstetric event in the interval since taking the course. Simulation-based CRM training can serve as a strategy for mitigating adverse perinatal events.

  16. Pedagogical Design for a Cross-Functional Course in the Accelerated MBA Program

    ERIC Educational Resources Information Center

    Balasubramnian, Bhanu; Steigner, Tanja; Coulson, Kevin R.

    2011-01-01

    The sub-prime financial crisis exposed weaknesses in the financial risk management of several prominent firms. A deficient risk management is mainly attributed to the lack of integration of finance with other business disciplines. In this paper, we describe a tested implementation of a cross-functional project that improves students' understanding…

  17. Research and guidelines for implementing Fatigue Risk Management Systems for the French regional airlines.

    PubMed

    Cabon, Philippe; Deharvengt, Stephane; Grau, Jean Yves; Maille, Nicolas; Berechet, Ion; Mollard, Régis

    2012-03-01

    This paper describes research that aims to provide the overall scientific basis for implementation of a Fatigue Risk Management System (FRMS) for French regional airlines. The current research has evaluated the use of different tools and indicators that would be relevant candidates for integration into the FRMS. For the Fatigue Risk Management component, results show that biomathematical models of fatigue are useful tools to help an airline to prevent fatigue related to roster design and for the management of aircrew planning. The Fatigue Safety assurance includes two monitoring processes that have been evaluated during this research: systematic monitoring and focused monitoring. Systematic monitoring consists of the analysis of existing safety indicators such as Air Safety Reports (ASR) and Flight Data Monitoring (FDM). Results show a significant relationship between the hours of work and the frequency of ASR. Results for the FDM analysis show that some events are significantly related to the fatigue risk associated with the hours of works. Focused monitoring includes a website survey and specific in-flight observations and data collection. Sleep and fatigue measurements have been collected from 115 aircrews over 12-day periods (including rest periods). Before morning duties, results show a significant sleep reduction of up to 40% of the aircrews' usual sleep needs leading to a clear increase of fatigue during flights. From these results, specific guidelines are developed to help the airlines to implement the FRMS and for the airworthiness to oversight the implementation of the FRMS process. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. An Examination of an Information Security Framework Implementation Based on Agile Values to Achieve Health Insurance Portability and Accountability Act Security Rule Compliance in an Academic Medical Center: The Thomas Jefferson University Case Study

    ERIC Educational Resources Information Center

    Reis, David W.

    2012-01-01

    Agile project management is most often examined in relation to software development, while information security frameworks are often examined with respect to certain risk management capabilities rather than in terms of successful implementation approaches. This dissertation extended the study of both Agile project management and information…

  19. Case histories in pharmaceutical risk management.

    PubMed

    McCormick, Cynthia G; Henningfield, Jack E; Haddox, J David; Varughese, Sajan; Lindholm, Anders; Rosen, Susan; Wissel, Janne; Waxman, Deborah; Carter, Lawrence P; Seeger, Vickie; Johnson, Rolley E

    2009-12-01

    The development and implementation of programs in the U.S. to minimize risks and assess unintended consequences of new medications has been increasingly required by the Food and Drug Administration (FDA) since the mid 1990s. This paper provides four case histories of risk management and post-marketing surveillance programs utilized recently to address problems associated with possible abuse, dependence and diversion. The pharmaceutical sponsors of each of these drugs were invited to present their programs and followed a similar template for their summaries that are included in this article. The drugs and presenting companies were OxyContin, an analgesic marketed by Purdue Pharma L.P., Daytrana and Vyvanse, ADHD medications marketed by Shire Pharmaceuticals, Xyrem for narcolepsy marketed by Jazz Pharmaceuticals, and Subutex and Suboxone for opioid dependence marketed by Reckitt Benckiser Pharmaceuticals Inc. These case histories and subsequent discussions provide invaluable real-world examples and illustrate both the promise of risk management programs in providing a path to market and/or for keeping on the market drugs with serious potential risks. They also illustrate the limitations of such programs in actually controlling unintended consequences, as well as the challenge of finding the right balance of reducing risks without posing undue barriers to patient access. These experiences are highly relevant as the FDA increasingly requires pharmaceutical sponsors to develop and implement the more formalized and enforceable versions of the risk management term Risk Evaluation and Mitigation Strategies (REMS).

  20. ICARUSS, the Integrated Care for the Reduction of Secondary Stroke trial: rationale and design of a randomized controlled trial of a multimodal intervention to prevent recurrent stroke in patients with a recent cerebrovascular event, ACTRN = 12611000264987.

    PubMed

    Joubert, J; Davis, S M; Hankey, G J; Levi, C; Olver, J; Gonzales, G; Donnan, G A

    2015-07-01

    The majority of strokes, both ischaemic and haemorrhagic, are attributable to a relatively small number of risk factors which are readily manageable in primary care setting. Implementation of best-practice recommendations for risk factor management is calculated to reduce stroke recurrence by around 80%. However, risk factor management in stroke survivors has generally been poor at primary care level. A model of care that supports long-term effective risk factor management is needed. To determine whether the model of Integrated Care for the Reduction of Recurrent Stroke (ICARUSS) will, through promotion of implementation of best-practice recommendations for risk factor management reduce the combined incidence of stroke, myocardial infarction and vascular death in patients with recent stroke or transient ischaemic attack (TIA) of the brain or eye. A prospective, Australian, multicentre, randomized controlled trial. Academic stroke units in Melbourne, Perth and the John Hunter Hospital, New South Wales. 1000 stroke survivors recruited as from March 2007 with a recent (<3 months) stroke (ischaemic or haemorrhagic) or a TIA (brain or eye). Randomization and data collection are performed by means of a central computer generated telephone system (IVRS). Exposure to the ICARUSS model of integrated care or usual care. The composite of stroke, MI or death from any vascular cause, whichever occurs first. Risk factor management in the community, depression, quality of life, disability and dementia. With 1000 patients followed up for a median of one-year, with a recurrence rate of 7-10% per year in patients exposed to usual care, the study will have at least 80% power to detect a significant reduction in primary end-points The ICARUSS study aims to recruit and follow up patients between 2007 and 2013 and demonstrate the effectiveness of exposure to the ICARUSS model in stroke survivors to reduce recurrent stroke or vascular events and promote the implementation of best practice risk factor management at primary care level. © 2015 World Stroke Organization.

  1. The application of risk management in sport.

    PubMed

    Fuller, Colin; Drawer, Scott

    2004-01-01

    The process of risk management can be implemented as part of a best practice management system within the sport and leisure sector. The process enables risk factors that might lead to injuries to be identified and the levels of risk associated with activities to be estimated and evaluated. This information can be utilised proactively by sports governing bodies and participants to identify preventive and therapeutic interventions in order to reduce the frequency of occurrence and/or severity of injuries within their sports. The acceptability of risk within specific sports, however, is dependent on the perceptions of the participants involved. Copyright 2004 Adis Data Information BV

  2. Legionella (Legionnaires' Disease and Pontiac Fever): Prevention

    MedlinePlus

    ... on Facebook Tweet Share Compartir Español: Prevención Water Management Programs There are no vaccines that can prevent ... owners and managers develop and implement a water management program to reduce their building’s risk for growing ...

  3. General RMP Guidance - Chapter 5: Management System

    EPA Pesticide Factsheets

    If you have at least one Program 2 or Program 3 process, you are required to develop a management system to oversee the implementation of the risk management program elements, and designate responsibility for making process safety a constant priority.

  4. Development of a community-based intervention for the control of Chagas disease based on peridomestic animal management: an eco-bio-social perspective

    PubMed Central

    De Urioste-Stone, Sandra M.; Pennington, Pamela M.; Pellecer, Elizabeth; Aguilar, Teresa M.; Samayoa, Gabriela; Perdomo, Hugo D.; Enríquez, Hugo; Juárez, José G.

    2015-01-01

    Background Integrated vector management strategies depend on local eco-bio-social conditions, community participation, political will and inter-sectorial partnership. Previously identified risk factors for persistent Triatoma dimidiata infestation include the presence of rodents and chickens, tiled roofs, dirt floors, partial wall plastering and dog density. Methods A community-based intervention was developed and implemented based on cyclical stakeholder and situational analyses. Intervention implementation and evaluation combined participatory action research and cluster randomized pre-test post-test experimental designs. The intervention included modified insecticide application, education regarding Chagas disease and risk factors, and participatory rodent control. Results At final evaluation there was no significant difference in post-test triatomine infestation between intervention and control, keeping pre-test rodent and triatomine infestations constant. Knowledge levels regarding Chagas disease and prevention practices including rodent control, chicken management and health service access increased significantly only in intervention communities. The odds of nymph infection and rat infestation were 8.3 and 1.9-fold higher in control compared to intervention communities, respectively. Conclusion Vector control measures without reservoir control are insufficient to reduce transmission risk in areas with persistent triatomine infestation. This integrated vector management program can complement house improvement initiatives by prioritizing households with risk factors such as tiled roofs. Requirement for active participation and multi-sectorial coordination poses implementation challenges. PMID:25604767

  5. Supply chain risk management in newspaper company: House of risk approach

    NASA Astrophysics Data System (ADS)

    Ratnasari, Sintya; Hisjam, Muhammad; Sutopo, Wahyudi

    2018-02-01

    In the supply chain (SC) of newspapers, the printing company is the main entity that has several processes, i.e. procure raw materials, print plate and newspapers, and also distribute newspaper to consumers. The existing risks in the newspaper printing company are quite high. A wide range of disturbances or risks needs to be identified to map out the characteristics of the risk sources that will impact on the performance of the supply chain. Therefore, the printing companies need to manage their supply chain risk of the five major SC processes (such as plan, source, deliver, make, and return). In a case study of a newspaper company in Surakarta, the company have not implemented a risk management process that affects the company. This study is aimed to map the risks in the printing company and formulate risk mitigation alternatives to mitigate the risks. The house of risk (HOR) method was chosen to select a set of proactive actions deemed cost-effective in managing SC Risks in the newspaper company. The model consisting of two stages, the first stage (HOR1) was done by identifying risk, risk causing agents and then measured the severity and occurrences to calculate the Aggregate Risk Priority (ARP) value. The second stage (HOR2) is intended to formulate and prioritize the action of mitigation that the company should pursue to reduce the probability of risk agents to occur. The result shows that the innovative model of HOR in Newspaper Company was presented. There are 24 risk events, 20 causing agents and two priority risks in HOR1. The HOR 2 was proposed 9 ranks of mitigation strategy for priority risk agents, from the easiest to the hardest strategy for the company to implement it.

  6. [The critical incident reporting system as an instrument of risk management for better patient safety].

    PubMed

    Panzica, M; Krettek, C; Cartes, M

    2011-09-01

    The probability that an inpatient will be harmed by a medical procedure is at least 3% of all patients. As a consequence, hospital risk management has become a central management task in the health care sector. The critical incident reporting system (CIRS) as a voluntary instrument for reporting (near) incidents plays a key role in the implementation of a risk management system. The goal of the CIRS is to register system errors without assigning guilt or meting out punishment and at the same time increasing the number of voluntary reports.

  7. Validating and determining the weight of items used for evaluating clinical governance implementation based on analytic hierarchy process model.

    PubMed

    Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Vafaee Najar, Ali; Meraji, Marziye; Ebrahimipour, Hossein

    2015-04-08

    The purpose of implementing a system such as Clinical Governance (CG) is to integrate, establish and globalize distinct policies in order to improve quality through increasing professional knowledge and the accountability of healthcare professional toward providing clinical excellence. Since CG is related to change, and change requires money and time, CG implementation has to be focused on priority areas that are in more dire need of change. The purpose of the present study was to validate and determine the significance of items used for evaluating CG implementation. The present study was descriptive-quantitative in method and design. Items used for evaluating CG implementation were first validated by the Delphi method and then compared with one another and ranked based on the Analytical Hierarchy Process (AHP) model. The items that were validated for evaluating CG implementation in Iran include performance evaluation, training and development, personnel motivation, clinical audit, clinical effectiveness, risk management, resource allocation, policies and strategies, external audit, information system management, research and development, CG structure, implementation prerequisites, the management of patients' non-medical needs, complaints and patients' participation in the treatment process. The most important items based on their degree of significance were training and development, performance evaluation, and risk management. The least important items included the management of patients' non-medical needs, patients' participation in the treatment process and research and development. The fundamental requirements of CG implementation included having an effective policy at national level, avoiding perfectionism, using the expertise and potentials of the entire country and the coordination of this model with other models of quality improvement such as accreditation and patient safety. © 2015 by Kerman University of Medical Sciences.

  8. Risk assessment and economic impact analysis of the implementation of new European legislation on radiopharmaceuticals in Italy: the case of the new monograph chapter Compounding of Radiopharmaceuticals (PHARMEUROPA, Vol. 23, No. 4, October 2011).

    PubMed

    Chitto, Giuseppe; Di Domenico, Elvira; Gandolfo, Patrizia; Ria, Francesco; Tafuri, Chiara; Papa, Sergio

    2013-12-01

    An assessment of the new monograph chapter Compounding of Radiopharmaceuticals has been conducted on the basis of the first period of implementation of Italian legislation on Good Radiopharmaceuticals Practice (NBP) in the preparation of radiopharmaceuticals, in keeping with Decree by the Italian Ministry of Health dated March 30, 2005. This approach is well grounded in the several points of similarity between the two sets of regulations. The impact on patient risk, on staff risk, and on healthcare organization risk, has been assessed. At the same time, the actual costs of coming into compliance with regulations have been estimated. A change risk analysis has been performed through the identification of healthcare-associated risks, the analysis and measurement of the likelihood of occurrence and of the potential impact in terms of patient harm and staff harm, and the determination of the healthcare organization's controlling capability. In order to evaluate the economic impact, the expenses directly related to the implementation of the activities as per ministerial decree have been estimated after calculating the overall costs unrelated to NBP implementation. The resulting costs have then been averaged over the total number of patient services delivered. NBP implementation shows an extremely positive impact on risk management for both patients receiving Nuclear Medicine services and the healthcare organization. With regard to healthcare workers, instead, the implementation of these regulations has a negative effect on the risk for greater exposure and a positive effect on the defense against litigation. The economic impact analysis of NBP implementation shows a 34% increase in the costs for a single patient service. The implementation of the ministerial decree allows for greater detectability of and control over a number of critical elements, paving the way for risk management and minimization. We, therefore, believe that the proposed tool can provide basic criteria for analysis that could be used by other organizations setting about completing the same process.

  9. [Psychosocial Risk Evaluation in the Workplace: Expert-based Development of a Checklist for Occupational Physicians].

    PubMed

    Weigl, M; Müller, A; Angerer, P; Petru, R

    2016-03-01

    The implementation of psychosocial risk assessment at the workplace often fails in practice. One reason is the lack of competence of those who are in charge of the process. We present a checklist for the effective implementation of psychosocial risk assessment at workplace. This tool shall support occupational physicians in the preparation, planning and implementation of a psychosocial risks assessment process. Based on a stepwise development and validation process, specific steps and factors for the successful implementation were identified qualitatively with 15 occupational physicians and experts. This was conducted in a 2-stage Delphi study. In the following, the identified steps and factors were transferred into a checklist. Subsequently, the checklist was evaluated in a focus group of occupational physicians (user evaluation). Thereafter, the contents were subjected to an expert evaluation. Our checklist for the effective implementation of the process of psychosocial risk management in the workplace aims to strengthen the competence of occupational physicians, especially in the implementation of risk assessments in small and medium-sized enterprises (SMEs). © Georg Thieme Verlag KG Stuttgart · New York.

  10. Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options—a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

    PubMed Central

    Kirchhof, Paulus; Lip, Gregory Y.H.; Van Gelder, Isabelle C.; Bax, Jeroen; Hylek, Elaine; Kaab, Stefan; Schotten, Ulrich; Wegscheider, Karl; Boriani, Giuseppe; Brandes, Axel; Ezekowitz, Michael; Diener, Hans; Haegeli, Laurent; Heidbuchel, Hein; Lane, Deirdre; Mont, Luis; Willems, Stephan; Dorian, Paul; Aunes-Jansson, Maria; Blomstrom-Lundqvist, Carina; Borentain, Maria; Breitenstein, Stefanie; Brueckmann, Martina; Cater, Nilo; Clemens, Andreas; Dobrev, Dobromir; Dubner, Sergio; Edvardsson, Nils G.; Friberg, Leif; Goette, Andreas; Gulizia, Michele; Hatala, Robert; Horwood, Jenny; Szumowski, Lukas; Kappenberger, Lukas; Kautzner, Josef; Leute, Angelika; Lobban, Trudie; Meyer, Ralf; Millerhagen, Jay; Morgan, John; Muenzel, Felix; Nabauer, Michael; Baertels, Christoph; Oeff, Michael; Paar, Dieter; Polifka, Juergen; Ravens, Ursula; Rosin, Ludger; Stegink, W.; Steinbeck, Gerhard; Vardas, Panos; Vincent, Alphons; Walter, Maureen; Breithardt, Günter; Camm, A. John

    2012-01-01

    While management of atrial fibrillation (AF) patients is improved by guideline-conform application of anticoagulant therapy, rate control, rhythm control, and therapy of accompanying heart disease, the morbidity and mortality associated with AF remain unacceptably high. This paper describes the proceedings of the 3rd Atrial Fibrillation NETwork (AFNET)/European Heart Rhythm Association (EHRA) consensus conference that convened over 60 scientists and representatives from industry to jointly discuss emerging therapeutic and diagnostic improvements to achieve better management of AF patients. The paper covers four chapters: (i) risk factors and risk markers for AF; (ii) pathophysiological classification of AF; (iii) relevance of monitored AF duration for AF-related outcomes; and (iv) perspectives and needs for implementing better antithrombotic therapy. Relevant published literature for each section is covered, and suggestions for the improvement of management in each area are put forward. Combined, the propositions formulate a perspective to implement comprehensive management in AF. PMID:21791573

  11. Review of clinical practice guidelines for the management of LDL-related risk.

    PubMed

    Morris, Pamela B; Ballantyne, Christie M; Birtcher, Kim K; Dunn, Steven P; Urbina, Elaine M

    2014-07-15

    Managing risk related to low-density lipoprotein (LDL) is vital in therapy for patients at risk for atherosclerotic cardiovascular disease (ASCVD) events given its important etiologic role in atherogenesis. Despite decades of research showing reduction of ASCVD risk with multiple approaches to lowering of LDL cholesterol, there continue to be significant gaps in care with inadequate numbers of patients receiving standard of care lipid-lowering therapy. Confusion regarding implementation of the multiple published clinical practice guidelines has been identified as one contributor to suboptimal management of LDL-related risk. This review summarizes the current guidelines for reduction of LDL-related cardiovascular risk provided by a number of major professional societies, which have broad applicability to diverse populations worldwide. Statements have varied in the process and methodology of development of recommendations, the grading system for level and strength of evidence, the inclusion or exclusion of expert opinion, the suggested ASCVD risk assessment tool, the lipoproteins recommended for risk assessment, and the lipoprotein targets of therapy. The similarities and differences among important guidelines in the United States and internationally are discussed, with recommendations for future strategies to improve consistency in approaches to LDL-related ASCVD risk and to reduce gaps in implementation of evidence-based therapies. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  12. Influence Diagrams as Decision-Making Tools for Pesticide Risk Management

    EPA Science Inventory

    The pesticide policy arena is filled with discussion of probabilistic approaches to assess ecological risk, however, similar discussions about implementing formal probabilistic methods in pesticide risk decision making are less common. An influence diagram approach is proposed f...

  13. Managing Conflict: Policy and Research Implications.

    ERIC Educational Resources Information Center

    Horowitz, Sandra V.; Boardman, Susan K.

    1994-01-01

    Highlights the importance of constructive conflict management in resolving disagreements arising from diversity. The authors discuss policy recommendations for implementing conflict-management programs in schools, training individuals in nonschool settings, and designing cross-cultural programs for high-risk inner-city youth. Procedural…

  14. Progress towards and barriers to implementation of a risk framework for US federal wildland fire policy and decision making

    Treesearch

    David C. Calkin; Mark A. Finney; Alan A. Ager; Matthew P. Thompson; Krista M. Gebert

    2011-01-01

    In this paper we review progress towards the implementation of a riskmanagement framework for US federal wildland fire policy and operations. We first describe new developments in wildfire simulation technology that catalyzed the development of risk-based decision support systems for strategic wildfire management. These systems include new analytical methods to measure...

  15. Current Barriers to Successful Implementation of FIST Principles

    DTIC Science & Technology

    2013-07-01

    risks will surface during development that could not have been predicted. Managing a thin budget with no schedule slack for these unknown-unknowns is...Fleischer » Keywords: Fast, Inexpensive, Simple, Tiny (FIST); Program Management ; Heuristics; Innovation; Oversight Current Barriers to Successful...Implementation of FIST Principles Capt Brandon Keller, USAF, and Lt Col J. Robert Wirthlin, USAF The Fast, Inexpensive, Simple, and Tiny (FIST

  16. Why projects often fail even with high cost contingencies

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

    Kujawski, Edouard

    2002-02-28

    In this note we assume that the individual risks have been adequately quantified and the total project cost contingency adequately computed to ensure an agreed-to probability or confidence level that the total project cost estimate will not be exceeded. But even projects that implement such a process are likely to result in significant cost overruns and/or project failure if the project manager allocates the contingencies to the individual subsystems. The intuitive and mathematically valid solution is to maintain a project-wide contingency and to distribute it to the individual risks on an as-needed basis. Such an approach ensures cost-efficient risk management,more » and projects that implement it are more likely to succeed and to cost less. We illustrate these ideas using a simplified project with two independent risks. The formulation can readily be extended to multiple risks.« less

  17. A novel community-based model to enhance health promotion, risk factor management and chronic disease prevention.

    PubMed

    Carson, Shannon Ryan; Carr, Caroline; Kohler, Graeme; Edwards, Lynn; Gibson, Rick; Sampalli, Tara

    2014-01-01

    Chronic disease is a highly expensive but preventable problem to the healthcare system. Evidence suggests that impacting modifiable behaviours and risk management factors in the areas of physical inactivity, unhealthy diet, stress and obesity can alleviate the burden of chronic disease problem to a large extent. Despite this recognition, the challenge is embedding these recognized priorities into the community and in primary care in a sustainable and meaningful manner. Primary Health Care in Capital Health responded to this challenge by developing and implementing a free, interprofessional and community-based service, namely, the Community Health Teams (CHTs), that offers health and wellness, risk factor management, wellness navigation and behaviour-based programming. In this paper, the development and implementation of the CHTs are discussed. Preliminary outcomes for the model are significant and promising. Formal and large-scale studies are planned to validate these outcomes with additional research rigour. Copyright © 2014 Longwoods Publishing.

  18. Aligning population-based care management with chronic disease complexity.

    PubMed

    Hewner, Sharon; Seo, Jin Young; Gothard, Sandra E; Johnson, Barbara J

    2014-01-01

    Risk-stratified care management requires knowledge of the complexity of chronic disease and comorbidity, information that is often not readily available in the primary care setting. The purpose of this article was to describe a population-based approach to risk-stratified care management that could be applied in primary care. Three populations (Medicaid, Medicare, and privately insured) at a regional health plan were divided into risk-stratified cohorts based on chronic disease and complexity, and utilization was compared before and after the implementation of population-specific care management teams of nurses. Risk-stratified care management was associated with reductions in hospitalization rates in all three populations, but the opportunities to avoid admissions were different. Knowledge of population complexity is critical to the development of risk-stratified care management in primary care, and a complexity matrix can help nurses identify gaps in care and align interventions to cohort and population needs. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Just-in-Time Training for High-Risk Low-Volume Therapies: An Approach to Ensure Patient Safety.

    PubMed

    Helman, Stephanie; Lisanti, Amy Jo; Adams, Ann; Field, Cynthia; Davis, Katherine Finn

    2016-01-01

    High-risk low-volume therapies are those therapies that are practiced infrequently and yet carry an increased risk to patients because of their complexity. Staff nurses are required to competently manage these therapies to treat patients' unique needs and optimize outcomes; however, maintaining competence is challenging. This article describes implementation of Just-in-Time Training, which requires validation of minimum competency of bedside nurses managing high-risk low-volume therapies through direct observation of a return-demonstration competency checklist.

  20. 78 FR 40816 - Self-Regulatory Organizations; New York Stock Exchange LLC; Notice of Filing of Proposed Rule...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-08

    ... committee has an oversight role with respect to internal audit and risk management, it is appropriate for that newly-constituted committee to have a significant role in the design and implementation of the... committee an opportunity to become familiar with the internal controls and risk management of the company...

  1. Managing wildland fire risk in Florida

    Treesearch

    J. Brenner; D. Carlton; S. McLellan; A. Dozier; T. Spencer; D. Buckley; A. Ralowicz

    2010-01-01

    Florida’s Wildland Fire Risk Assessment (FRA), which was completed in 2002, is a statewide effort to develop a comprehensive suite of standardized spatial data layers developed to support implementation of a statewide fuels management strategy. By maintaining focus on fire and fuel dynamics for use with scientifically credible local to statewide applications, the FRA...

  2. Risk Management by a Neoliberal State: Construction of New Knowledge through Lifelong Learning in Japan

    ERIC Educational Resources Information Center

    Ogawa, Akihiro

    2013-01-01

    This article examines the current developments in Japan's lifelong learning policy and practices. I argue that promoting lifelong learning is an action that manages the risks of governance for the neoliberal state. Implementing a new lifelong learning policy involves the employment of a political technique toward integrating the currently divided…

  3. DDP - a tool for life-cycle risk management

    NASA Technical Reports Server (NTRS)

    Cornford, S. L.; Feather, M. S.; Hicks, K. A.

    2001-01-01

    At JPL we have developed, and implemented, a process for achieving life-cycle risk management. This process has been embodied in a software tool and is called Defect Detection and Prevention (DDP). The DDP process can be succinctly stated as: determine where we want to be, what could get in the way and how we will get there.

  4. Positioning the Learning Asset Portfolio as a Key Component in an Organization's Enterprise Risk Management Strategy

    ERIC Educational Resources Information Center

    McAliney, Peter J.

    2009-01-01

    This article presents a process for valuing a portfolio of learning assets used by line executives across industries to value traditional business assets. Embedded within the context of enterprise risk management, this strategic asset allocation process is presented step by step, providing readers the operational considerations to implement this…

  5. Barriers to the implementation of checklists in the office-based procedural setting.

    PubMed

    Shapiro, Fred E; Fernando, Rohesh J; Urman, Richard D

    2014-01-01

    Patient safety is critical for the patients, providers, and risk managers in the office-based procedural setting, and the same standard of care should be maintained regardless of the healthcare environment. Checklists may improve patient safety and potentially decrease risk. This study explored utilization of checklists in the office-based setting and the potential barriers to their implementation. A cross-sectional prospective study was performed by using a 19-question anonymous survey designed with REDCap®. Medical providers including physicians and nurses from 25 different offices that performed procedures participated, and 38 individual responses were included in the study. Only 50% of offices surveyed use safety checklists in their practice. Only 34% had checklists or equivalent protocol for emergencies such as anaphylaxis or failed airway. As many as 23.7% of respondents indicated that they encountered barriers to implementing checklists. The top barriers identified in the study were no incentive to use a checklist (77.8%), no mandate from a local or federal regulatory agency (44.4%), being too time consuming (33.3%), and lack of training (33.3%). Reasons identified that would encourage providers to use checklists included a clear mandate (36.8%) and evidence-based research (26.3%). Checklists are not being universally utilized in the office-based setting. There are barriers preventing their successful implementation. Risk managers may be able to improve patient safety and decrease risk by encouraging practitioners, possibly through incentives, to use customizable safety checklists. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

  6. Parenteral nutrition: risks, complications, and management.

    PubMed

    Worthington, Patricia H; Gilbert, Karen A

    2012-01-01

    Parenteral nutrition is a life-saving modality, but one that also carries risks for potentially life-threatening complications. Comprehensive management of patients receiving parenteral nutrition includes careful selection of candidates, individualizing formulas to meet patients' unique needs, monitoring response to therapy, and implementing strategies designed to avoid complications. Measures to mitigate the risk of central line-associated bloodstream infections are particularly important. As with all complex therapies, a collaborative, multidisciplinary approach promotes optimal outcomes.

  7. Agents, Bayes, and Climatic Risks - a modular modelling approach

    NASA Astrophysics Data System (ADS)

    Haas, A.; Jaeger, C.

    2005-08-01

    When insurance firms, energy companies, governments, NGOs, and other agents strive to manage climatic risks, it is by no way clear what the aggregate outcome should and will be. As a framework for investigating this subject, we present the LAGOM model family. It is based on modules depicting learning social agents. For managing climate risks, our agents use second order probabilities and update them by means of a Bayesian mechanism while differing in priors and risk aversion. The interactions between these modules and the aggregate outcomes of their actions are implemented using further modules. The software system is implemented as a series of parallel processes using the CIAMn approach. It is possible to couple modules irrespective of the language they are written in, the operating system under which they are run, and the physical location of the machine.

  8. The Expert and the Lay Public: Reflections on Influenza A (H1N1) and the Risk Society

    PubMed Central

    Williams-Jones, Bryn

    2012-01-01

    Trust between the lay public and scientific experts is a key element to ensuring the efficient implementation of emergency public health measures. In modern risk societies, the management and elimination of risk have become preeminent drivers of public policy. In this context, the protection of public trust is a complex task. Those actors involved in public health decision-making and implementation (e.g., mass vaccination for influenza A virus) are confronted with growing pressures and responsibility to act. However, they also need to accept the limits of their own expertise and recognize the ability of lay publics to understand and be responsible for public health. Such a shared responsibility for risk management, if grounded in participative public debates, can arguably strengthen public trust in public health authorities and interventions. PMID:22397338

  9. Probability concepts in quality risk management.

    PubMed

    Claycamp, H Gregg

    2012-01-01

    Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although risk is generally a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management tools are relatively silent on the meaning and uses of "probability." The probability concept is typically applied by risk managers as a combination of frequency-based calculation and a "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management. A rich history of probability in risk management applied to other fields suggests that high-quality risk management decisions benefit from the implementation of more thoughtful probability concepts in both risk modeling and risk management. Essentially any concept of risk is built on fundamental concepts of chance, likelihood, or probability. Although "risk" generally describes a probability of loss of something of value, given that a risk-generating event will occur or has occurred, it is ironic that the quality risk management literature and guidelines on quality risk management methodologies and respective tools focus on managing severity but are relatively silent on the in-depth meaning and uses of "probability." Pharmaceutical manufacturers are expanding their use of quality risk management to identify and manage risks to the patient that might occur in phases of the pharmaceutical life cycle from drug development to manufacture, marketing to product discontinuation. A probability concept is typically applied by risk managers as a combination of data-based measures of probability and a subjective "degree of belief" meaning of probability. Probability as a concept that is crucial for understanding and managing risk is discussed through examples from the most general, scenario-defining and ranking tools that use probability implicitly to more specific probabilistic tools in risk management.

  10. Nature-based flood risk management -challenges in implementing catchment-wide management concepts

    NASA Astrophysics Data System (ADS)

    Thaler, Thomas; Fuchs, Sven

    2017-04-01

    Traditionally, flood risk management focused on coping with the flow at a given point by, for example, building dikes or straightening the watercourse. Increasingly the emphasis has shifted to measures within the flood plain to delay the flow through storage. As such the fluent boundaries imposed by the behaviour of the catchment at a certain point are relocated upstream by the human intervention. Therefore, the implementation of flood storages and the use of natural retention areas are promoted as mitigation measures to support sustainable flood risk management. They aimed at reducing the effluent boundaries on the floodplain by increasing the effluent boundaries upstream. However, beyond the simple change of practices it is indeed often a question of land use change which is at stake in water management. As such, it poses the questions on how to govern both water and land to satisfy the different stakeholders. Nature-based strategies often follow with voluntary agreements, which are promoted as an alternative instrument to the traditional top-down command and control regulation. Voluntary agreements aim at bringing more efficiency, participatory and transparency in solving problems between different social groups. In natural hazard risk management voluntary agreements are now receiving high interests to complement the existing policy instruments in order to achieve the objectives the EU WFD and of the Floods Directive. This paper investigates the use of voluntary agreements as an alternative instrument to the traditional top-down command and control regulation in the implementation of flood storages in Austria. The paper provides a framework of analysis to reveal barriers and opportunities associated with such approach. The paper concludes that institution and power are the central elements to tackle for allowing the success of voluntary agreement.

  11. Evaluation of a pilot hypertension management programme for Guatemalan adults

    PubMed Central

    Mendoza Montano, Carlos; Fort, Meredith; deRamirez, Miriam; Cruz, Judith; Ramirez-Zea, Manuel

    2016-01-01

    Corazón Sano y Feliz is a hypertension management intervention developed to address deficiencies in the management of hypertensive patients in Guatemala. From 2007 to 2009, Corazón Sano y Feliz was pilot-tested in the community of Mixco. Corazón Sano y Feliz comprises a clinical risk assessment and treatment component implemented primarily by nurses, and a health education component implemented by community health workers. To accomplish our secondary objective of determining Corazon Sano y Feliz's potential for change at the patient level, we implemented a one-group pretest-posttest study design to examine changes in clinical measures, knowledge and practices between baseline and the end of the 6-month intervention. Two nurses and one physician set up a hypertension clinic to manage patients according to risk level. Twenty-nine community health workers were trained in CVD risk reduction and health promotion and in turn led six educational sessions for patients. Comparing baseline and 6-month measures, the intervention achieved significant improvements in mean knowledge and behaviour (increase from 54.6 to 59.1 out of a possible 70 points) and significant reductions of mean systolic and diastolic blood pressure (27.2 and 7.7 mmHg), body mass index (from 26.5 to 26.2 kg/m2) and waist circumference (89.6–88.9 cm). In this pilot study we obtained preliminary evidence that this community-oriented hypertension management and health promotion intervention model was feasible and achieved significant reduction in risk factors. If scaled up, this intervention has the potential to substantially reduce CVD burden. PMID:25595280

  12. Managing glacier related risks in the Chucchún Catchment, Cordillera Blanca, Peru

    NASA Astrophysics Data System (ADS)

    Muñoz, Randy; Gonzáles, César; Price, Karen; Frey, Holger; Huggel, Christian; Cochachin, Alejo; García, Javier; Mesa, Luis

    2015-04-01

    On April 11 2010, the city of Carhuaz and settlements in the Chucchún Catchment (Ancash region, Peru) suffered the impact of a glacier lake outburst flood. An avalanche of rock and ice from the Mount Hualcán hit the glacier lake 513, triggering a glacial lake outburst flood (GLOF) of 1 million m3 which destroyed farmland and several infrastructures. Although there was no loss of human life, the event caused panic in the population. In consequence, the Municipality of Carhuaz prioritized GLOF-related risk management. The Glacier Project, funded by Swiss Agency for Development and Cooperation, and executed by CARE Peru and the University of Zurich, fosters the coordination among public institutions (Glaciological Unit of the National Water Authority, the Ministry of Environment and Municipality) and the population for risk management. In this contribution we present all components of the risk management strategy as well as the lessons learned during the implementation. Risk management involves managing both glacier hazard as well as the vulnerability of the population. In this framework a glaciological and geomorphological characterization of Mount Hualcán and lake 513 was perfomed in order to model past and potential future outburst floods and to assess the slope stability conditions. Based on three potential GLOF scenarios of different magnitudes, a hazard map was produced for the entire catchment, which served as the basis for the vulnerability and risk assessment as well as for the design and the implementation of an Early Warning System (EWS), including evacuation planning. The EWS consists of 4 components: 1) knowledge of risk, through hazard and vulnerability characterization; 2) monitoring and alert, through the installation of monitoring stations on lake 513 for detecting avalanches with geophones and cameras; 3) broadcasting and communications, through the implementation of communication protocols between the Municipality of Carhuaz and emergency institutions (police, health centers and schools) and also authorities at higher coordination levels (Regional Government and the National Emergency Operations Center) enabling rapid emergency care; and 4) Responsiveness, through strengthening and training of public and private institutions and local leaders that make up the Civil Defense Platforms, the development of Emergency Operations Plan, and continuous organization of simulations for the population. As result, the population is aware of the risks they face and knok how to respond in case of a lake outburst event. In addition, the results generated during studies related to the risk analysis are used for land management of the Municipality of Carhuaz. The successful implementation of this risk management strategy was only possible by combining comprehensively scientific and local knowledge. This EWS represents a pilot experience in Peru and the Andes, and contributes to relatively scarce international experience with GLOF EWS. An important lesson is that these processes require active leadership of local authorities and continuous learning by the population. The mere existence of technology does not ensure the success of the risk reduction measures; this can only be attained by the internalization of processes and by taking responsibility against the existing hazard by each resident, authority and institution.

  13. Patient Blood Management Implementation Strategies and Their Effect on Physicians' Risk Perception, Clinical Knowledge and Perioperative Practice – the Frankfurt Experience

    PubMed Central

    Fischer, Dania P.; Zacharowski, Kai D.; Müller, Markus M.; Geisen, Christof; Seifried, Erhard; Müller, Heiko; Meybohm, Patrick

    2015-01-01

    Introduction A multicomponent, evidence-based and interdisciplinary Patient Blood Management (PBM) program was introduced at the University Hospital Frankfurt in July 2013. The implementation strategy included practical and tactical components aimed to increase knowledge on the risks of preoperative anemia, to standardize hemotherapy, and to facilitate PBM components. Methods This article analyzes barriers to PBM implementation and outlines a strategy to introduce and manifest PBM. The effects in Frankfurt were measured in a before and after questionnaire study distributed among groups of physicians immediately before and 1 year after PBM implementation. Results 142 clinicians completed the questionnaire in July 2013 and 101 clinicians in August 2014. Absolute certainty that the treatment of preoperative anemia favorably influences morbidity and mortality rose from 25 to 37%. Transfusion behavior seems to have been affected: In 2014, 56% of clinicians stated that they clinically reassess the patient and analyze hemoglobin following each single red blood cell unit compared to only 38% stating this in 2013. Conclusion These results show that our implementation strategy was effective in changing physicians' risk perception, attitude, and knowledge on PBM principles. Our experience highlights key success factors for the implementation of a comprehensive PBM program. PMID:26019704

  14. The role of health-risk appraisals in disease management.

    PubMed

    Hudson, Laurel R; Pope, James E

    2006-02-01

    Managed care organizations and disease management vendors often find themselves in the position of responding to employers who want to administer a health-risk appraisal (HRA) without committing to implementation of a comprehensive health promotion program. The assumption appears to be that information on health risks is sufficient to motivate employees to change their health behaviors in order to reduce estimated health risks. A review of the relevant literature does not substantiate the efficacy of a stand-alone HRA for motivating behavior change. The challenge is to engage employers in informed conversations on what works in health promotion and achieve cost-effective benefits.

  15. Implementation of nutrition risk screening using the Malnutrition Universal Screening Tool across a large metropolitan health service.

    PubMed

    Cooper, P L; Raja, R; Golder, J; Stewart, A J; Shaikh, R F; Apostolides, M; Savva, J; Sequeira, J L; Silvers, M A

    2016-12-01

    A standardised nutrition risk screening (NRS) programme with ongoing education is recommended for the successful implementation of NRS. This project aimed to develop and implement a standardised NRS and education process across the adult bed-based services of a large metropolitan health service and to achieve a 75% NRS compliance at 12 months post-implementation. A working party of Monash Health (MH) dietitians and a nutrition technician revised an existing NRS medical record form consisting of the Malnutrition Universal Screening Tool and nutrition management guidelines. Nursing staff across six MH hospital sites were educated in the use of this revised form and there was a formalised implementation process. Support from Executive Management, nurse educators and the Nutrition Risk Committee ensured the incorporation of NRS into nursing practice. Compliance audits were conducted pre- and post-implementation. At 12 months post-implementation, organisation-wide NRS compliance reached 34.3%. For those wards that had pre-implementation NRS performed by nursing staff, compliance increased from 7.1% to 37.9% at 12 months (P < 0.001). The improved NRS form is now incorporated into standard nursing practice and NRS is embedded in the organisation's 'Point of Care Audit', which is reported 6-monthly to the Nutrition Risk Committee and site Quality and Safety Committees. NRS compliance improved at MH with strong governance support and formalised implementation; however, the overall compliance achieved appears to have been affected by the complexity and diversity of multiple healthcare sites. Ongoing education, regular auditing and establishment of NRS routines and ward practices is recommended to further improve compliance. © 2016 The British Dietetic Association Ltd.

  16. Assessing and managing multiple risks in a changing world-The Roskilde recommendations.

    PubMed

    Selck, Henriette; Adamsen, Peter B; Backhaus, Thomas; Banta, Gary T; Bruce, Peter K H; Burton, G Allen; Butts, Michael B; Boegh, Eva; Clague, John J; Dinh, Khuong V; Doorn, Neelke; Gunnarsson, Jonas S; Hauggaard-Nielsen, Henrik; Hazlerigg, Charles; Hunka, Agnieszka D; Jensen, John; Lin, Yan; Loureiro, Susana; Miraglia, Simona; Munns, Wayne R; Nadim, Farrokh; Palmqvist, Annemette; Rämö, Robert A; Seaby, Lauren P; Syberg, Kristian; Tangaa, Stine R; Thit, Amalie; Windfeld, Ronja; Zalewski, Maciej; Chapman, Peter M

    2017-01-01

    Roskilde University (Denmark) hosted a November 2015 workshop, Environmental Risk-Assessing and Managing Multiple Risks in a Changing World. This Focus article presents the consensus recommendations of 30 attendees from 9 countries regarding implementation of a common currency (ecosystem services) for holistic environmental risk assessment and management; improvements to risk assessment and management in a complex, human-modified, and changing world; appropriate development of protection goals in a 2-stage process; dealing with societal issues; risk-management information needs; conducting risk assessment of risk management; and development of adaptive and flexible regulatory systems. The authors encourage both cross-disciplinary and interdisciplinary approaches to address their 10 recommendations: 1) adopt ecosystem services as a common currency for risk assessment and management; 2) consider cumulative stressors (chemical and nonchemical) and determine which dominate to best manage and restore ecosystem services; 3) fully integrate risk managers and communities of interest into the risk-assessment process; 4) fully integrate risk assessors and communities of interest into the risk-management process; 5) consider socioeconomics and increased transparency in both risk assessment and risk management; 6) recognize the ethical rights of humans and ecosystems to an adequate level of protection; 7) determine relevant reference conditions and the proper ecological context for assessments in human-modified systems; 8) assess risks and benefits to humans and the ecosystem and consider unintended consequences of management actions; 9) avoid excessive conservatism or possible underprotection resulting from sole reliance on binary, numerical benchmarks; and 10) develop adaptive risk-management and regulatory goals based on ranges of uncertainty. Environ Toxicol Chem 2017;36:7-16. © 2016 SETAC. © 2016 SETAC.

  17. The HSE management system in practice-implementation

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

    Primrose, M.J.; Bentley, P.D.; Sykes, R.M.

    1996-11-01

    This paper sets out the necessary strategic issues that must be dealt with when setting up a management system for HSE. It touches on the setting of objectives using a form of risk matrix and the establishment of corporate risk tolerability levels. Such issue management is vital but can be seen as yet another corporate HQ initiative. It must therefore be linked, and made relevant to those in middle management tasked with implementing the system and also to those at risk {open_quote}at the sharp end{close_quote} of the business. Setting acceptance criteria is aimed at demonstrating a necessary and sufficient levelmore » of control or coverage for those hazards considered as being within the objective setting of the Safety or HSE Case. Critical risk areas addressed via the Safety Case, within Shell companies at least, must show how this coverage is extended to critical health and environmental issues. Methods of achieving this are various ranging from specific Case deliverables (like the Hazard Register and Accountability Matrices) through to the incorporation of topics from the hazard analysis in toolbox talks and meetings. Risk analysis techniques are increasingly seen as complementary rather than separate with environmental assessments, health risk assessment sand safety risk analyses taking place together and results being considered jointly. The paper ends with some views on the way ahead regarding the linking of risk decisions to target setting at the workplace and views on how Case information may be retrieved and used on a daily basis.« less

  18. [The hospital perspective: disease management and integrated health care].

    PubMed

    Schrappe, Matthias

    2003-06-01

    Disease Management is a transsectoral, population-based form of health care, which addresses groups of patients with particular clinical entities and risk factors. It refers both to an evidence-based knowledge base and corresponding guidelines, evaluates outcome as a continuous quality improvement process and usually includes active participation of patients. In Germany, the implementation of disease management is associated with financial transactions for risk adjustment between health care assurances [para. 137 f, Book V of Social Code (SGB V)] and represents the second kind of transsectoral care, besides a program designed as integrated health care according to para. 140 a ff f of Book V of Social Code. While in the USA and other countries disease management programs are made available by several institutions involved in health care, in Germany these programs are offered by health care insurers. Assessment of disease management from the hospital perspective will have to consider three questions: How large is the risk to compensate inadequate quality in outpatient care? Are there synergies in internal organisational development? Can the risk of inadequate funding of the global "integrated" budget be tolerated? Transsectoral quality assurance by valid performance indicators and implementation of a quality improvement process are essential. Internal organisational changes can be supported, particularly in the case of DRG introduction. The economic risk and financial output depends on the kind of disease being focussed by the disease management program. In assessing the underlying scientific evidence of their cost effectiveness, societal costs will have to be precisely differentiated from hospital-associated costs.

  19. Strategic and Operational Considerations for the Implementation of Performance Based Logistics (PBL) Within the Japan Maritime Self Defense Force

    DTIC Science & Technology

    2010-06-01

    logistics in support of weapon systems (D-2004-110). Washington, DC: Young , S. R. Keating , S., & Huff, K. (2005). Managing risk in the new supply chain...implementing PBL ( Keating & Huff, 2005; Reeve, 2001). Cohen (2007) found that cost-sharing support and maintenance services can generate "up to seven times as...to suppliers (Cohen, 2007; Keating & Huff, 2005); therefore, suppliers demand a risk premium (Cohen, & Nines, 2008). The degree of risk

  20. SCIENCE, RISK, AND RISK ASSESSMENT AND THEIR ROLE(S) SUPPORTING ENVIRONMENTAL RISK MANAGEMENT

    EPA Science Inventory

    Abstract: The U.S. Environmental Protection Agency (EPA) fulfills its mission of protecting public health and the environment by, among other things, developing and enforcing regulations that implement environmental laws enacted by Congress. Ensuring that its regulations have a s...

  1. [How the information system can contribute to the implementation of a risk management program in a hospital?].

    PubMed

    Staccini, P; Quaranta, J F; Staccini-Myx, A; Veyres, P; Jambou, P

    2003-09-01

    Nowadays, information system is recognised as one of the key points of the management strategy. An information system is regarded conceptualised as a mean to link 3 aspects of a firm (structure, organisation rules and staff). Its design and implementation have to meet the objectives of medical and economical evaluation, especially risk management objectives. In order to identify, analyse, reduce and prevent the occurrence of adverse events, and also to measure the efficacy and efficiency of the production of care services, the design of information systems should be based on a process analysis in order to describe and classify all the working practices within the hospital. According to various methodologies (usually top-down analysis), each process can be divided into activities. Each activity (especially each care activity) can be described according to its potential risks and expected results. For care professionals performing a task, the access to official or internal guidelines and the adverse events reporting forms has also to be defined. Putting together all the elements of such a process analysis will contribute to integrate, into daily practice, the management of risks, supported by the information system.

  2. [Role of the independent microbiology laboratory in supporting infection control programs in small to mid-sized hospitals].

    PubMed

    Yanagisawa, Hideji

    2009-05-01

    With the revision of the Medical Service Law in 2006 by the Japanese Ministry of Health, Labour and Welfare (MHLW), all healthcare institutions are now required to implement a healthcare risk management program including infection control program. At a national level, an infection control surveillance program (JANIS) was implemented in July 2007. Regular weekly, monthly, and yearly infection control surveillance reports from independent microbiology laboratories can make significant contributions to infection control programs in small to mid-sized hospitals; furthermore, such programs are consistent with the framework of the MHLW's objective of strengthening risk management in healthcare institutions. Against the backdrop of current efforts to improve risk management, independent laboratories can make a significant contribution. Independent laboratories must play a role beyond merely receiving and processing specimens for microbiological examination. In addition to generating results for patients, hospital epidemiological data that contribute to local infection control programs must be a value-added component of the service. A major obstacle for independent laboratories to make a significant contribution to risk management is the current reimbursement system, which makes it economically impossible for independent laboratories to support infection control programs in healthcare institutions.

  3. Evaluating the implementation of "managing the risk of suicide: a suicide prevention strategy for the ACT 2009-2014".

    PubMed

    Sheehan, Johann; Griffiths, Kathleen; Rickwood, Debra; Carron-Arthur, Bradley

    2015-01-01

    Over the past two decades, governments have invested significantly in policies and strategies to prevent the tragic loss of life to suicide. However, there has been little focus on evaluating the implementation of such policies. This paper reports on the evaluation of the implementation of "Managing the Risk of Suicide: A Suicide Prevention Strategy for the ACT 2009-2014," the Australian Capital Territory's (ACT) suicide prevention strategy. We sought to answer two questions: (1) Could agencies provide data reporting on their progress in implementing the activities for which they were responsible?; and (2) Could a judgment about implementation progress be made and, if so, to what extent was the activity implemented? Individually tailored electronic surveys were sent to 18 ACT agencies annually over 4 years to measure their progress in implementing activities for which they had responsibility. By year four, full data were provided for 64% of activities, maximal partial data for 9%, and minimal partial data for 27%. Forty-two per cent of activities were fully implemented, 20% were partially implemented, and 38% were not implemented or could not be measured. It is possible to measure implementation of suicide prevention strategies, but appropriate processes and dedicated resources must be in place at the outset.

  4. Mapping for the management of diffuse pollution risks related to agricultural plant protection practices: case of the Etang de l'Or catchment area in France.

    PubMed

    Mghirbi, Oussama; Bord, Jean-Paul; Le Grusse, Philippe; Mandart, Elisabeth; Fabre, Jacques

    2018-03-08

    Faced with health, environmental, and socio-economic issues related to the heavy use of pesticides, diffuse phytosanitary pollution becomes a major concern shared by all the field actors. These actors, namely the farmers and territorial managers, have expressed the need to implement decision support tools for the territorial management of diffuse pollution resulting from the plant protection practices and their impacts. To meet these steadily increasing requests, a cartographic analysis approach was implemented based on GIS which allows the spatialization of the diffuse pollution impacts related to plant protection practices on the Etang de l'Or catchment area in the South of France. Risk mapping represents a support-decision tool that enables the different field actors to identify and locate vulnerable areas, so as to determine action plans and agri-environmental measures depending on the context of the natural environment. This work shows that mapping is helpful for managing risks related to the use of pesticides in agriculture by employing indicators of pressure (TFI) and risk on the applicator's health (IRSA) and on the environment (IRTE). These indicators were designed to assess the impact of plant protection practices at various spatial scales (field, farm, etc.). The cartographic analysis of risks related to plant protection practices shows that diffuse pollution is unequally located in the North (known for its abundant garrigues and vineyards) and in the South of the Etang de l'Or catchment area (the Mauguio-Lunel agricultural plain known for its diversified cropping systems). This spatial inequity is essentially related to land use and agricultural production system. Indeed, the agricultural lands cover about 60% of the total catchment area. Consequently, this cartographic analysis helps the territorial actors with the implementation of strategies for managing risks of diffuse pollution related to pesticides use in agriculture, based on environmental and socio-economic issues and the characteristics of the natural environment.

  5. The development of effects-based air quality management regimes

    NASA Astrophysics Data System (ADS)

    Longhurst, J. W. S.; Irwin, J. G.; Chatterton, T. J.; Hayes, E. T.; Leksmono, N. S.; Symons, J. K.

    This paper considers the evolution of attempts to control and manage air pollution, principally but not exclusively focussing upon the challenge of managing air pollution in urban environments. The development and implementation of a range of air pollution control measures are considered. Initially the measures implemented primarily addressed point sources, a small number of fuel types and a limited number of pollutants. The adequacy of such a source-control approach is assessed within the context of a changing and challenging air pollution climate. An assessment of air quality management in the United Kingdom over a 50-year timeframe exemplifies the range of issues and challenges in contemporary air quality management. The need for new approaches is explored and the development and implementation of an effects-based, risk management system for air quality regulation is evaluated.

  6. Management and monitoring of the endangered Shenandoah salamander under climate change: Workshop report 10-12 April 2012

    USGS Publications Warehouse

    Grant, Evan H. Campbell; Wofford, John E.B.; Smith, D.R.; Dennis, J.; Hawkins-Hoffman, C.; Schaberl, J.; Foley, M.; Bogle, M.

    2014-01-01

    Here we report on a structured decision making (SDM) process to identify management strategies to ensure persistence of the federally endangered Shenandoah salamander (Plethodon shenandoah), given that it may be at increased extinction risk under projected climate change. The focus of this report is the second of two SDM workshops; in the first workshop, participants developed a prototype of the decision, including problem frame, management objectives and a suite of potential management strategies, predictive models to inform the decision and link alternatives with the objectives to identify potential solutions, and identified data needs to reduce key uncertainties in the decision. Participants in this second workshop included experts in National Park Service policy at multiple administrative levels, who refined objectives, further evaluated the initial management alternatives, and discussed policy constraints on implementing active management for the species and its high-elevation habitat. The conclusion of the second workshop was similar to that of the first: the current state of information and objectives suggest that there is some value in considering active management to reduce the long-term extinction risk for the species, though there are institutional conservative policies to implementing active management at range-wide scales. The workshop participants also emphasized a conservative NPS management philosophy, including caution in implementing management actions that may ultimately harm the system, a stated assumption that ecosystem changes were “natural” unless demonstrated otherwise (therefore not warranting active management to mitigate), and a need to demonstrate that extinction risk is tied to anthropogenic influence prior to taking active management to mitigate specific anthropogenic influences. Even within a protected area having minimal human disturbance, intertwined environmental variables and interspecific relationships that drive population trends challenge our ability to demonstrate direct links with (anthropogenically influenced) climate change and the decline of a species. Thus while this policy may reduce the potential for injurious management, it may also necessitate extraordinary resources to reduce uncertainty regarding fundamental drivers of species decline prior to taking action.

  7. ECOLOGICAL RISK ASSESSMENT IN THE CONTEXT OF GLOBAL CLIMATE CHANGE

    PubMed Central

    Landis, Wayne G; Durda, Judi L; Brooks, Marjorie L; Chapman, Peter M; Menzie, Charles A; Stahl, Ralph G; Stauber, Jennifer L

    2013-01-01

    Changes to sources, stressors, habitats, and geographic ranges; toxicological effects; end points; and uncertainty estimation require significant changes in the implementation of ecological risk assessment (ERA). Because of the lack of analog systems and circumstances in historically studied sites, there is a likelihood of type III error. As a first step, the authors propose a decision key to aid managers and risk assessors in determining when and to what extent climate change should be incorporated. Next, when global climate change is an important factor, the authors recommend seven critical changes to ERA. First, develop conceptual cause–effect diagrams that consider relevant management decisions as well as appropriate spatial and temporal scales to include both direct and indirect effects of climate change and the stressor of management interest. Second, develop assessment end points that are expressed as ecosystem services. Third, evaluate multiple stressors and nonlinear responses—include the chemicals and the stressors related to climate change. Fourth, estimate how climate change will affect or modify management options as the impacts become manifest. Fifth, consider the direction and rate of change relative to management objectives, recognizing that both positive and negative outcomes can occur. Sixth, determine the major drivers of uncertainty, estimating and bounding stochastic uncertainty spatially, temporally, and progressively. Seventh, plan for adaptive management to account for changing environmental conditions and consequent changes to ecosystem services. Good communication is essential for making risk-related information understandable and useful for managers and stakeholders to implement a successful risk-assessment and decision-making process. Environ. Toxicol. Chem. 2013;32:79–92. © 2012 SETAC PMID:23161373

  8. Ecological risk assessment in the context of global climate change.

    PubMed

    Landis, Wayne G; Durda, Judi L; Brooks, Marjorie L; Chapman, Peter M; Menzie, Charles A; Stahl, Ralph G; Stauber, Jennifer L

    2013-01-01

    Changes to sources, stressors, habitats, and geographic ranges; toxicological effects; end points; and uncertainty estimation require significant changes in the implementation of ecological risk assessment (ERA). Because of the lack of analog systems and circumstances in historically studied sites, there is a likelihood of type III error. As a first step, the authors propose a decision key to aid managers and risk assessors in determining when and to what extent climate change should be incorporated. Next, when global climate change is an important factor, the authors recommend seven critical changes to ERA. First, develop conceptual cause-effect diagrams that consider relevant management decisions as well as appropriate spatial and temporal scales to include both direct and indirect effects of climate change and the stressor of management interest. Second, develop assessment end points that are expressed as ecosystem services. Third, evaluate multiple stressors and nonlinear responses-include the chemicals and the stressors related to climate change. Fourth, estimate how climate change will affect or modify management options as the impacts become manifest. Fifth, consider the direction and rate of change relative to management objectives, recognizing that both positive and negative outcomes can occur. Sixth, determine the major drivers of uncertainty, estimating and bounding stochastic uncertainty spatially, temporally, and progressively. Seventh, plan for adaptive management to account for changing environmental conditions and consequent changes to ecosystem services. Good communication is essential for making risk-related information understandable and useful for managers and stakeholders to implement a successful risk-assessment and decision-making process. Copyright © 2012 SETAC.

  9. Landslide risk impact management and web services for improving resilience: the LIFE+IMAGINE project approach

    NASA Astrophysics Data System (ADS)

    Congi, Maria Pia; Campo, Valentina; Cipolloni, Carlo; Delmonaco, Giuseppe; Guerrieri, Luca; Iadanza, Carla; Spizzichino, Daniele; Trigila, Alessandro

    2014-05-01

    The increasing damage caused by natural disasters in the last decades points out the need for interoperable added-value services to support environmental safety and human protection, by reducing vulnerability of exposed elements as well as improving the resilience of the involved communities. For this reason, to provide access to harmonized and customized data is only one of several steps towards delivering adequate support to risk assessment, reduction and management. Scope of the present work is to illustrate a methodology under development for analysis of potential impacts in areas prone to landslide hazard in the framework of the EC project LIFE+IMAGINE. The project aims to implement an infrastructure based on web services for environmental analysis, that integrates in its own architecture specifications and results from INSPIRE, SEIS and GMES. Existing web services will be customized during the project to provide functionalities for supporting the environmental integrated management. The implemented infrastructure will be applied to landslide risk scenarios, to be developed in selected pilot areas, aiming at: i) application of standard procedures to implement a landslide risk analysis; ii) definition of a procedure for assessment of potential environmental impacts, based on a set of indicators to estimate the different exposed elements with their specific vulnerability in the pilot area. More in detail, the landslide pilot will be aimed at providing a landslide risk scenario through the implementation and analysis of: 1) a landslide inventory from available historical databases and maps; 2) landslide susceptibility and hazard maps; 3) assessment of exposure and vulnerability on selected typologies of elements at risk; 4) implementation of a landslide risk scenario for different sets of exposed elements (e.g. population, road network, residential area, cultural heritage). The pilot will be implemented in Liguria, Italy, in two different catchment areas located in the Cinque Terre National Park, characterized by a high landslide susceptibility and low resilience, being highly vulnerable to landslides induced by heavy rainfall. The landslide risk impact analysis will be calibrated taking into account the socio-economic damage caused by landslides triggered by the October 2011 meteorological event. Most of landslides affected the diffuse system of anthropogenic terraces and caused the direct disruption of the walls as well as transportation of a large amount of loose sediments along the slopes and channels as induced consequence of the event. The final target of the landslide risk assessment scenario will be to improve the knowledge and awareness on hazard, exposure, vulnerability and landslide risk in the Cinque Terre National Park to the benefit of local authorities and population. In addition, the results of the application can have a practical and positive effects for i.e. i) updating the land planning process in order to improve the resilience of local communities, ii) implementing preliminary cost-benefit analysis aimed at the definition of guidelines for sustainable landslide risk mitigation strategies, iii) suggesting a general road map for the implementation of a local adaptation plan.

  10. NASA System Safety Handbook. Volume 2: System Safety Concepts, Guidelines, and Implementation Examples

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Feather, Martin; Rutledge, Peter; Sen, Dev; Youngblood, Robert

    2015-01-01

    This is the second of two volumes that collectively comprise the NASA System Safety Handbook. Volume 1 (NASASP-210-580) was prepared for the purpose of presenting the overall framework for System Safety and for providing the general concepts needed to implement the framework. Volume 2 provides guidance for implementing these concepts as an integral part of systems engineering and risk management. This guidance addresses the following functional areas: 1.The development of objectives that collectively define adequate safety for a system, and the safety requirements derived from these objectives that are levied on the system. 2.The conduct of system safety activities, performed to meet the safety requirements, with specific emphasis on the conduct of integrated safety analysis (ISA) as a fundamental means by which systems engineering and risk management decisions are risk-informed. 3.The development of a risk-informed safety case (RISC) at major milestone reviews to argue that the systems safety objectives are satisfied (and therefore that the system is adequately safe). 4.The evaluation of the RISC (including supporting evidence) using a defined set of evaluation criteria, to assess the veracity of the claims made therein in order to support risk acceptance decisions.

  11. Implementation of health and safety management system to reduce hazardous potential in PT.XYZ Indonesia

    NASA Astrophysics Data System (ADS)

    Widodo, L.; Adianto; Sartika, D. I.

    2017-12-01

    PT. XYZ is a large automotive manufacturing company that manufacture, assemble as well as a car exporter. The other products are spare parts, jig and dies. PT. XYZ has long been implementing the Occupational Safety and Health Management System (OSHMS) to reduce the potential hazards that cause work accidents. However, this does not mean that OSHMS that has been implemented does not need to be upgraded and improved. This is due to the potential danger caused by work is quite high. This research was conducted in Sunter 2 Plant where its production activities have a high level of potential hazard. Based on Hazard Identification risk assessment, Risk Assessment, and Risk Control (HIRARC) found 10 potential hazards in Plant Stamping Production, consisting of 4 very high risk potential hazards (E), 5 high risk potential hazards (H), and 1 moderate risk potential hazard (M). While in Plant Casting Production found 22 potential hazards findings consist of 7 very high risk potential hazards (E), 12 high risk potential hazards (H), and 3 medium risk potential hazards (M). Based on the result of Fault Tree Analysis (FTA), the main priority is the high risk potential hazards (H) and very high risk potential hazards (E). The proposed improvement are to make the visual display of the importance of always using the correct Personal Protective Equipment (PPE), establishing good working procedures, conducting OSH training for workers on a regular basis, and continuing to conduct safety campaigns.

  12. [Risk management from the judicial perspective].

    PubMed

    Ulsenheimer, Klaus

    2003-11-01

    The jurisdification of medicine is an unstoppable force that finds its visible expression in a medical liability boom which--apart from the negative impact of legal and out-of-court proceedings on the bond of the doctor-patient relationship--bears considerable economic disadvantages for the providers of care. It is therefore necessary to fight in particular the legally influenced causes of medical liability for which risk management seems to be a suitable, effective tool. As the examples taken from the jurisdiction in the organisational sector will demonstrate, risk management pinpoints the sources of trouble so that we are able to learn from current errors and provide appropriate remedies for the future. Risk management, though, is not a "unique event", but a dynamic, repetitive process that has to be institutionally secured by appointing a risk manager so that the proposals discussed, recommendations and essential measures can actually be implemented.

  13. A Risk-Analysis Approach to Implementing Web-Based Assessment

    ERIC Educational Resources Information Center

    Ricketts, Chris; Zakrzewski, Stan

    2005-01-01

    Computer-Based Assessment is a risky business. This paper proposes the use of a model for web-based assessment systems that identifies pedagogic, operational, technical (non web-based), web-based and financial risks. The strategies and procedures for risk elimination or reduction arise from risk analysis and management and are the means by which…

  14. 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...

  15. Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry

    PubMed Central

    Basketter, David A.; Kruszewski, Francis H.; Mathieu, Sophie; Kirchner, Donald Bruce; Panepinto, Anthony; Fieldsend, Mark; Siegert, Volker; Barnes, Fiona; Bookstaff, Robert; Simonsen, Merete; Concoby, Beth

    2015-01-01

    Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes. PMID:25692928

  16. Managing the Risk of Occupational Allergy in the Enzyme Detergent Industry.

    PubMed

    Basketter, David A; Kruszewski, Francis H; Mathieu, Sophie; Kirchner, Donald Bruce; Panepinto, Anthony; Fieldsend, Mark; Siegert, Volker; Barnes, Fiona; Bookstaff, Robert; Simonsen, Merete; Concoby, Beth

    2015-01-01

    Enzyme proteins have potential to cause occupational allergy/asthma. Consequently, as users of enzymes in formulated products, detergents manufacturers have implemented a number of control measures to ensure that the hazard does not translate into health effects in the workforce. To that end, trade associations have developed best practice guidelines which emphasize occupational hygiene and medical monitoring as part of an effective risk management strategy. The need for businesses to recognize the utility of this guidance is reinforced by reports where factories which have failed to follow good industrial hygiene practices have given rise to incidences of occupational allergy. In this article, an overview is provided of how the industry guidelines are actually implemented in practice and what experience is to be derived therefrom. Both medical surveillance and air monitoring practices associated with the implementation of industry guidelines at approximately 100 manufacturing facilities are examined. The data show that by using the approaches described for the limitation of exposure, for the provision of good occupational hygiene and for the active monitoring of health, the respiratory allergenic risk associated with enzyme proteins can be successfully managed. This therefore represents an approach that could be recommended to other industries contemplating working with enzymes.

  17. [Medical safety management in the setting of a clinical reference laboratory--risk management efforts in clinical testing].

    PubMed

    Seki, Akira; Miya, Tetsumasa

    2011-03-01

    As a result of recurring medical accidents, risk management in the medical setting has been given much attention. The announcement in August, 2000 by the Ministry of Health committee for formulating a standard manual for risk management, of a "Risk management manual formulation guideline" has since been accompanied by the efforts of numerous medical testing facilities to develop such documents. In 2008, ISO/TS 22367:2008 on "Medical laboratories-Reduction of error through risk management and continual improvement" was published. However, at present, risk management within a medical testing facility stresses the implementation of provisional actions in response to a problem after it has occurred. Risk management is basically a planned process and includes "corrective actions" as well as "preventive actions." A corrective action is defined as identifying the root cause of the problem and removing it, and is conducted to prevent the problem from recurring. A preventive action is defined as identifying of the any potential problem and removing it, and is conducted to prevent a problem before it occurs. Presently, I shall report on the experiences of our laboratory regarding corrective and preventive actions taken in response to accidents and incidents, respectively.

  18. Traceability and Risk Analysis Strategies for Addressing Counterfeit Electronics in Supply Chains for Complex Systems.

    PubMed

    DiMase, Daniel; Collier, Zachary A; Carlson, Jinae; Gray, Robin B; Linkov, Igor

    2016-10-01

    Within the microelectronics industry, there is a growing concern regarding the introduction of counterfeit electronic parts into the supply chain. Even though this problem is widespread, there have been limited attempts to implement risk-based approaches for testing and supply chain management. Supply chain risk management tends to focus on the highly visible disruptions of the supply chain instead of the covert entrance of counterfeits; thus counterfeit risk is difficult to mitigate. This article provides an overview of the complexities of the electronics supply chain, and highlights some gaps in risk assessment practices. In particular, this article calls for enhanced traceability capabilities to track and trace parts at risk through various stages of the supply chain. Placing the focus on risk-informed decision making through the following strategies is needed, including prioritization of high-risk parts, moving beyond certificates of conformance, incentivizing best supply chain management practices, adoption of industry standards, and design and management for supply chain resilience. © 2016 Society for Risk Analysis.

  19. Trial Implementation of a Multihazard Risk Assessment Framework for High-Impact Low-Frequency Power Grid Events

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

    Veeramany, Arun; Coles, Garill A.; Unwin, Stephen D.

    The Pacific Northwest National Laboratory developed a risk framework for modeling high-impact, low-frequency power grid events to support risk-informed decisions. In this paper, we briefly recap the framework and demonstrate its implementation for seismic and geomagnetic hazards using a benchmark reliability test system. We describe integration of a collection of models implemented to perform hazard analysis, fragility evaluation, consequence estimation, and postevent restoration. We demonstrate the value of the framework as a multihazard power grid risk assessment and management tool. As a result, the research will benefit transmission planners and emergency planners by improving their ability to maintain a resilientmore » grid infrastructure against impacts from major events.« less

  20. Trial Implementation of a Multihazard Risk Assessment Framework for High-Impact Low-Frequency Power Grid Events

    DOE PAGES

    Veeramany, Arun; Coles, Garill A.; Unwin, Stephen D.; ...

    2017-08-25

    The Pacific Northwest National Laboratory developed a risk framework for modeling high-impact, low-frequency power grid events to support risk-informed decisions. In this paper, we briefly recap the framework and demonstrate its implementation for seismic and geomagnetic hazards using a benchmark reliability test system. We describe integration of a collection of models implemented to perform hazard analysis, fragility evaluation, consequence estimation, and postevent restoration. We demonstrate the value of the framework as a multihazard power grid risk assessment and management tool. As a result, the research will benefit transmission planners and emergency planners by improving their ability to maintain a resilientmore » grid infrastructure against impacts from major events.« less

  1. Managing Research in a Risk World

    NASA Technical Reports Server (NTRS)

    Anton, W.; Havenhill, M.

    2014-01-01

    The Office of Chief Medical Officer (OCHMO) owns all human health and performance risks managed by the Human System Risk Board (HSRB). While the HSRB manages the risks, the Human Research Program (HRP) manages the research portion of the overall risk mitigation strategy for these risks. The HSRB manages risks according to a process that identifies and analyzes risks, plans risk mitigation and tracks and reviews the implementation of these strategies according to its decisions pertaining to the OCHMO risk posture. HRP manages risk research work using an architecture that describes evidence-based risks, gaps in our knowledge about characterizing or mitigating the risk, and the tasks needed to produce deliverables to fill the gaps and reduce the risk. A planning schedule reflecting expected research milestones is developed, and as deliverables and new evidence are generated, research progress is tracked via the Path to Risk Reduction (PRR) that reflects a risk's research plan for a design reference mission. HRP's risk research process closely interfaces with the HSRB risk management process. As research progresses, new deliverables and evidence are used by the HSRB in conjunction with other operational and non-research evidence to inform decisions pertaining to the likelihood and consequence of the risk and risk posture. Those decisions in turn guide forward work for research as it contributes to overall risk mitigation strategies. As HRP tracks its research work, it aligns its priorities by assessing the effectiveness of its contributions and maintaining specific core competencies that would be invaluable for future work for exploration missions.

  2. Early childhood caries: risk-based disease prevention and management.

    PubMed

    Ng, Man Wai; Chase, Isabelle

    2013-01-01

    Early childhood caries (ECC), common in preschoolers, can lead to pain and infection if left untreated. Yet, ECC is largely preventable, and if it is identified early and the responsible risk factors are addressed, its progression can be halted or slowed. This article reviews the rationale for a first dental visit by age 1 year, caries risk assessment, and risk-based prevention and management of ECC and discusses strategies for providers to implement these contemporary evidence-based concepts into clinical practice. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Need of risk management practice amongst bumiputera contractors in Malaysia construction industries

    NASA Astrophysics Data System (ADS)

    Syuhada Fadzil, Nur; Noor, Nurazuwa Md; Rahman, Ismail Abdul

    2017-11-01

    Malaysia construction industry has been growing continuously with double-digit growth for the past two decades. There are many issues surrounded the industry such as delay in delivery, cost overrun, quality and safety. In bumiputera contractor’s context, the literature review found that 32 issues were encountered in the construction project. These issues can be handled properly with the application of risk management. According to previous researchers, application of risk management in Malaysia construction industry is at the low level where it is implemented in traditional ways that are brainstorming and checklist. These were due to lack of knowledge, the high cost of hiring experts and avoiding extra cost. Besides that, this study also intentions to analyse the risk categories in the construction industry as well as identify risk management process to resolve the construction issues. Hence, this paper presents issues engulfed by Bumiputera contractors which can partly be resolved by applying risk management practice in carrying out the construction activity. This may inspire the contractors to apply the risk management practice in ensuring the success of their construction project.

  4. 78 FR 13924 - Self-Regulatory Organizations; The Depository Trust Company; Notice of Filing Amendment No. 2 and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-01

    ... systemic risk since the reversals may override DTC's risk management controls such as the Collateral...,\\11\\ require that clearing agencies establish, implement, maintain and enforce written policies and...

  5. How to implement security controls for an information security program at CBRN facilities

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

    Lenaeus, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.

    This document was prepared by PNNL within the framework of Project 19 of the European Union Chemical Biological Radiological and Nuclear Risk Mitigation Centres of Excellence Initiative entitled, ''Development of procedures and guidelines to create and improve secure information management systems and data exchange mechanisms for CBRN materials under regulatory control.'' It provides management and workers at CBRN facilities, parent organization managers responsible for those facilities, and regulatory agencies (governmental and nongovernmental) with guidance on the best practices for protecting information security. The security mitigation approaches presented in this document were chosen because they present generally accepted guidance in anmore » easy-to-understand manner, making it easier for facility personnel to grasp key concepts and envision how security controls could be implemented by the facility. This guidance is presented from a risk management perspective.« less

  6. Safety and compliance-related hazards in the medical practice: Part one.

    PubMed

    Calway, R C

    2001-01-01

    Safety and risk management hazards are a fact of life for the medical practice, and the costs of these incidents can place the group at significant risk of liability. Good compliance and risk management programs help minimize these incidents, improve staff morale, increase a practice's visibility in the community, and positively affect the practice's financial and operational bottom line performance. Medical practices that implement effective safety and risk management programs can realize savings in staffing costs, operational efficiency, morale, insurance premiums, and improved third-party relationships while at the same time avoiding embarrassing risks, fines, and liability. This article outlines some of the most common safety and risk management-related deficiencies seen in medical practices today. The author explains how to remedy these deficiencies and provides a self-test tool to enable the reader to assess areas within his or her own practice in need of attention.

  7. Proposed Performance Measures and Strategies for Implementation of the Fatigue Risk Management Guidelines for Emergency Medical Services

    DOT National Transportation Integrated Search

    2018-01-11

    Background: Performance measures are a key component of implementation, dissemination, and evaluation of evidence-based guidelines (EBGs). We developed performance measures for Emergency Medical Services (EMS) stakeholders to enable the implementatio...

  8. DESCRIPTION OF RISK REDUCTION ENGINEERING LABORATORY TEST AND EVALUATION FACILITIES

    EPA Science Inventory

    An onsite team of multidisciplined engineers and scientists conduct research and provide technical services in the areas of testing, design, and field implementation for both solid and hazardous waste management. Engineering services focus on the design and implementation of...

  9. From Process to Product: Your Risk Process at Work

    NASA Technical Reports Server (NTRS)

    Kundrot, Craig E.; Fogarty, Jenifer; Charles, John; Buquo, Lynn; Sibonga, Jean; Alexander, David; Horn, Wayne G.; Edwards, J. Michelle

    2010-01-01

    The Space Life Sciences Directorate (SLSD) and Human Research Program (HRP) at the NASA/Johnson Space Center work together to address and manage the human health and performance risks associated with human space flight. This includes all human system requirements before, during, and after space flight, providing for research, and managing the risk of adverse long-term health outcomes for the crew. We previously described the framework and processes developed for identifying and managing these human system risks. The focus of this panel is to demonstrate how the implementation of the framework and associated processes has provided guidance in the management and communication of human system risks. The risks of early onset osteoporosis, CO2 exposure, and intracranial hypertension in particular have all benefitted from the processes developed for human system risk management. Moreover, we are continuing to develop capabilities, particularly in the area of information architecture, which will also be described. We are working to create a system whereby all risks and associated actions can be tracked and related to one another electronically. Such a system will enhance the management and communication capabilities for the human system risks, thereby increasing the benefit to researchers and flight surgeons.

  10. Risk-based approach in valuation of workplace injury rate for transportation and construction industry

    NASA Astrophysics Data System (ADS)

    Pykhtin, Kirill; Simankina, Tatiana; Sharmanov, Vladimir; Kopytova, Anna

    2017-10-01

    The danger of injuries and accidents in various industries such as transportation and construction urges the government to control the occupational health and safety more strictly. However, in order to do so with the minimal costs modern risk management tools, have to be implemented. Risk-based approach is an essential tool for competent risk- assessment and used in a great variety of other countries, demonstrating great results in providing of safe working environment. The article describes the problems that the implementation of the method faces in Russia and suggests certain ways to resolve them.

  11. 78 FR 40525 - Self-Regulatory Organizations; National Securities Clearing Corporation; Notice of No Objection...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ...\\ The stated purpose of Title VIII is to mitigate systemic risk in the financial system and promote.... 5464(b). promote robust risk management; promote safety and soundness; reduce systemic risks; and... that perform central counterparty (``CCP'') services to establish, implement, maintain, and enforce...

  12. 78 FR 28936 - Self-Regulatory Organizations; National Securities Clearing Corporation; Notice of Filing and No...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... mitigate systemic risk in the financial system and promote financial stability by, among other things...(a)(2). Promote robust risk management; promote safety and soundness; reduce systemic risks; and... require registered clearing agencies to establish, implement, maintain, and enforce written policies and...

  13. Valuing risks to the environment

    Treesearch

    Robin Gregory; Thomas C. Brown; Jack L. Knetsch

    1996-01-01

    Increasing awareness of exposure to environmental risks has focused attention on measures that would give greater assurance that such risks are effectively managed and that the adverse consequences of risky activities are mitigated. Implementing such actions is made more difficult by the uncertainties of environmental changes, their often delayed impacts, the great...

  14. Exploring the effect of at-risk case management compensation on hospital pay-for-performance outcomes: tools for change.

    PubMed

    Granata, Randy L; Hamilton, Karen

    2015-01-01

    Acute care nurse case managers are charged with compliance oversight, managing throughput, and ensuring safe care transitions. Leveraging the roles of nurse case managers and social workers during care transitions translates into improved fiscal performance under the Affordable Care Act. This article aims to equip leaders in the field of case management with tools to facilitate the alignment of case management systems with hospital pay-for-performance measures. A quality improvement project was implemented at a hospital in south Alabama to examine the question: for acute care case managers, what is the effect of key performance indictors using an at-risk compensation model in comparison to past nonincentive models on hospital readmissions, lengths of stay, and patient satisfaction surrounding the discharge process. Inpatient acute care hospital. The implementation of an at-risk compensation model using key performance indicators, Lean Six Sigma methodology, and Creative Health Care Management's Relationship-Based Care framework demonstrated reduced length of stay, hospital readmissions, and improved patient experiences. Regulatory changes and new models of reimbursement in the acute care environment have created the perfect storm for case management leaders. Hospital fiscal performance is dependent on effective case management processes and the ability to optimize scarce resources. The quality improvement project aimed to further align case management systems and structures with hospital pay-for-performance measures. Tools for change were presented to assist leaders with the change acceleration process.

  15. [Design, implementation and evaluation of a management model of patient safety in hospitals in Catalonia, Spain].

    PubMed

    Saura, Rosa Maria; Moreno, Pilar; Vallejo, Paula; Oliva, Glòria; Alava, Fernando; Esquerra, Miquel; Davins, Josep; Vallès, Roser; Bañeres, Joaquim

    2014-07-01

    Since its inception in 2006, the Alliance for Patient Safety in Catalonia has played a major role in promoting and shaping a series of projects related to the strategy of the Ministry of Health, Social Services and Equality, for improving patient safety. One such project was the creation of functional units or committees of safety in hospitals in order to facilitate the management of patient safety. The strategy has been implemented in hospitals in Catalonia which were selected based on criteria of representativeness. The intervention was based on two lines of action, one to develop the model framework and the other for its development. Firstly the strategy for safety management based on EFQM (European Foundation for Quality Management) was defined with the development of standards, targets and indicators to implement security while the second part involved the introduction of tools, methodologies and knowledge to the management support of patient safety and risk prevention. The project was developed in four hospital areas considered higher risk, each assuming six goals for safety management. Some of these targets such as the security control panel or system of adverse event reporting were shared. 23 hospitals joined the project in Catalonia. Despite the different situations in each centre, high compliance was achieved in the development of the objectives. In each of the participating areas the security control panel was developed. Stable structures for safety management were established or strengthened. Training in patient safety played and important role, 1415 professionals participated. Through these kind of projects not only have been introduced programs of proven effectiveness in reducing risks, but they also provide to the facilities a work system that allows autonomy in diagnosis and analysis of the different risk situations or centre specific safety issues. Copyright © 2014. Published by Elsevier Espana.

  16. Evaluation of a pilot hypertension management programme for Guatemalan adults.

    PubMed

    Mendoza Montano, Carlos; Fort, Meredith; deRamirez, Miriam; Cruz, Judith; Ramirez-Zea, Manuel

    2016-06-01

    Corazón Sano y Feliz is a hypertension management intervention developed to address deficiencies in the management of hypertensive patients in Guatemala. From 2007 to 2009, Corazón Sano y Feliz was pilot-tested in the community of Mixco. Corazón Sano y Feliz comprises a clinical risk assessment and treatment component implemented primarily by nurses, and a health education component implemented by community health workers. To accomplish our secondary objective of determining Corazon Sano y Feliz's potential for change at the patient level, we implemented a one-group pretest-posttest study design to examine changes in clinical measures, knowledge and practices between baseline and the end of the 6-month intervention. Two nurses and one physician set up a hypertension clinic to manage patients according to risk level. Twenty-nine community health workers were trained in CVD risk reduction and health promotion and in turn led six educational sessions for patients. Comparing baseline and 6-month measures, the intervention achieved significant improvements in mean knowledge and behaviour (increase from 54.6 to 59.1 out of a possible 70 points) and significant reductions of mean systolic and diastolic blood pressure (27.2 and 7.7 mmHg), body mass index (from 26.5 to 26.2 kg/m(2)) and waist circumference (89.6-88.9 cm). In this pilot study we obtained preliminary evidence that this community-oriented hypertension management and health promotion intervention model was feasible and achieved significant reduction in risk factors. If scaled up, this intervention has the potential to substantially reduce CVD burden. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Flood risk perception and adaptation capacity: a contribution to the socio-hydrology debate

    NASA Astrophysics Data System (ADS)

    Fuchs, Sven; Karagiorgos, Konstantinos; Kitikidou, Kyriaki; Maris, Fotios; Paparrizos, Spyridon; Thaler, Thomas

    2017-04-01

    Dealing with flood hazard and risk requires approaches rooted both in natural and social sciences, which provided the nexus for the ongoing debate on socio-hydrology. Various combinations of non-structural and structural flood risk reduction options are available to communities. Focusing on flood risk and the information associated with it, developing risk management plans is required but often overlooking public perception of a threat. The perception of risk varies in many different ways, especially between the authorities and the affected public. It is because of this disconnection that many risk management plans concerning floods have failed in the past. This paper examines the private adaptation capacity and willingness with respect to flooding in two different catchments in Greece prone to multiple flood events during the last 20 years. Two studies (East Attica and Evros) were carried out, comprised of a survey questionnaire of 155 and 157 individuals, from a peri-urban (East Attica) and a rural (Evros) area, respectively, and they focused on those vulnerable to periodical (rural area) and flash floods (peri-urban area). Based on the comparisons drawn from these responses, and identifying key issues to be addressed when flood risk management plans are implemented, improvements are being recommended for the social dimension surrounding such implementation. As such, the paper contributes to the ongoing discussion on human-environment interaction in socio-hydrology.

  18. Flood risk perception and adaptation capacity: a contribution to the socio-hydrology debate

    NASA Astrophysics Data System (ADS)

    Fuchs, Sven; Karagiorgos, Konstantinos; Kitikidou, Kyriaki; Maris, Fotios; Paparrizos, Spyridon; Thaler, Thomas

    2017-06-01

    Dealing with flood hazard and risk requires approaches rooted in both natural and social sciences, which provided the nexus for the ongoing debate on socio-hydrology. Various combinations of non-structural and structural flood risk reduction options are available to communities. Focusing on flood risk and the information associated with it, developing risk management plans is required but often overlooks public perception of a threat. The perception of risk varies in many different ways, especially between the authorities and the affected public. It is because of this disconnection that many risk management plans concerning floods have failed in the past. This paper examines the private adaptation capacity and willingness with respect to flooding in two different catchments in Greece prone to multiple flood events during the last 20 years. Two studies (East Attica and Evros) were carried out, comprised of a survey questionnaire of 155 and 157 individuals, from a peri-urban (East Attica) and a rural (Evros) area, respectively, and they focused on those vulnerable to periodic (rural area) and flash floods (peri-urban area). Based on the comparisons drawn from these responses, and identifying key issues to be addressed when flood risk management plans are implemented, improvements are being recommended for the social dimension surrounding such implementation. As such, the paper contributes to the ongoing discussion on human-environment interaction in socio-hydrology.

  19. Development of Management Methodology for Engineering Production Quality

    NASA Astrophysics Data System (ADS)

    Gorlenko, O.; Miroshnikov, V.; Borbatc, N.

    2016-04-01

    The authors of the paper propose four directions of the methodology developing the quality management of engineering products that implement the requirements of new international standard ISO 9001:2015: the analysis of arrangement context taking into account stakeholders, the use of risk management, management of in-house knowledge, assessment of the enterprise activity according to the criteria of effectiveness

  20. Implementation of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guideline Including Data From the Improved Reduction of Outcomes: Vytorin Efficacy International Trial

    PubMed Central

    Ziaeian, Boback; Dinkler, John; Watson, Karol

    2015-01-01

    Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of morbidity and mortality in developed countries. The management of blood cholesterol through use of 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) in at-risk patients is a pillar of medical therapy for the primary and secondary prevention of cardiovascular disease. The recent 2013 American College of Cardiology/American Heart Association guideline on managing blood cholesterol provides an important framework for the effective implementation of risk-reduction strategies. The guideline identifies four cohorts of patients with proven benefits from statin therapy and streamlines the dosing and monitoring recommendations based on evidence from published, randomized controlled trials. Primary care physicians and cardiologists play key roles in identifying populations at elevated ASCVD risk. In providing a practical management overview of the current blood cholesterol guideline, we facilitate more informed discussions on treatment options between healthcare providers and their patients. PMID:26198559

  1. [Management of the risks associated with allergens in school canteens in Barcelona (Spain)].

    PubMed

    Caballé-Gavaldà, Laura; García-Cid, Ester; Fontcuberta-Famadas, Mireia; Balfagón-Marzal, Pere; Durán-Neira, Julia

    2014-01-01

    To determine demand for special meals and their types for students with food allergies or intolerances (FAI) in school canteens in Barcelona (Spain) during the 2011-12 school year, and to ascertain the degree of implementation of self-assessment plans and preventive measures for the management of allergens, and the relationships between the application of such measures and other variables. A descriptive study was performed of a representative sample of schools (n=129). The dependent variables collected data on the schools and students, the level of demand for special meals, and the implementation of preventive measures. Independent variables consisted of canteen management, the number of users, and whether self-assessment plans were implemented. For those schools that prepared meals (n=92), an index was calculated from the questions on preventive measures. Student t-tests were used to compare the means of the indices with stratification by the independent variables. A total of 89% of schools served special meals for students with FAI (1,507 special meals per day, 5% of all meals) and 65% had no allergen control plan. The mean of the indices was 11.6 out of 17. Externally managed canteens, with more users and with self-assessment plans, implemented more preventive measures for allergen management (p<0.05). A high proportion of schools report carrying out preventive measures in the process of preparing and serving special meals. Those with self-assessment plans have better preventive practices. To manage this food-related risk, food hygiene inspection services should promote the implementation of allergen control plans in school canteens. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  2. Improvement of Physical Therapist Assessment of Risk of Falls in the Hospital and Discharge Handover Through an Intervention to Modify Clinical Behavior.

    PubMed

    Thomas, Susie; Mackintosh, Shylie

    2016-06-01

    Discharge from the hospital is a high risk transition period for older adults at risk of falls. Guidelines relevant to physical therapists for managing this risk are well documented, but commonly not implemented. This project implemented an intervention to improve physical therapists' adherence to key guideline recommendations for managing risk of falls on discharge from one hospital. A pretest-posttest study design was undertaken and was underpinned by the Theoretical Domains Framework (TDF) to aid in the design of interventions to increase physical therapists' adherence to guideline recommendations and to identify barriers to these interventions. A multifaceted intervention was implemented, including the establishment of a governance committee, education sessions, development of a "pathway" to guide practice, modification of an existing standardized assessment proforma, development of standardized processes and indicators for handover, increasing availability of educational handouts, audit and feedback processes, and allocation of dedicated staffing to oversee falls prevention within the physical therapy department. There were significant improvements in physical therapist behavior leading to key guideline recommendations being met, including: the proportion of patients who were identified to be at risk of falls (6.3% preintervention versus 94.8% postintervention) prior to discharge, an increase in documentation of clinical handover at discharge (68.6% preintervention versus 90.9% postintervention), and improvement in the quality of this documented clinical handover (34.9% of case notes met 5 criteria preintervention versus 92.9% postintervention). The approach was resource intensive and consequently may be difficult to replicate at other sites. A multifaceted intervention underpinned by the TDF, designed to modify physical therapists' behavior to improve adherence to guideline recommendations for managing risk of falls on discharge from one hospital, was successful. © 2016 American Physical Therapy Association.

  3. Examining Behavioral Consultation plus Computer-Based Implementation Planning on Teachers' Intervention Implementation in an Alternative School

    ERIC Educational Resources Information Center

    Long, Anna C. J.; Sanetti, Lisa M. Hagermoser; Lark, Catherine R.; Connolly, Jennifer J. G.

    2018-01-01

    Students who demonstrate the most challenging behaviors are at risk of school failure and are often placed in alternative schools, in which a primary goal is remediating behavioral and academic concerns to facilitate students' return to their community school. Consistently implemented evidence-based classroom management is necessary toward this…

  4. Security breaches: tips for assessing and limiting your risks.

    PubMed

    Coons, Leeanne R

    2011-01-01

    As part of their compliance planning, medical practices should undergo a risk assessment to determine any vulnerability within the practice relative to security breaches. Practices should also implement safeguards to limit their risks. Such safeguards include facility access controls, information and electronic media management, use of business associate agreements, and education and enforcement. Implementation of specific policies and procedures to address security incidents is another critical step that medical practices should take as part of their security incident prevention plan. Medical practices should not only develop policies and procedures to prevent, detect, contain, and correct security violations, but should make sure that such policies and procedures are actually implemented in their everyday operations.

  5. VA Disability Benefits: Additional Planning Would Enhance Efforts to Improve the Timeliness of Appeals Decisions

    DTIC Science & Technology

    2017-03-01

    manage risks and help ensure successful implementation of significant institutional change. VA officials told GAO that pilot testing—which would...Organization: How Do I Implement Complex Change at Scale? Dallas, TX: McKinsey & Company, May 2011, and Project Management Institute , Inc. A Guide to...options compared in its analysis. We conducted this performance audit from February 2016 to March 2017 in accordance with generally accepted government

  6. NASA Risk Management Handbook. Version 1.0

    NASA Technical Reports Server (NTRS)

    Dezfuli, Homayoon; Benjamin, Allan; Everett, Christopher; Maggio, Gaspare; Stamatelatos, Michael; Youngblood, Robert; Guarro, Sergio; Rutledge, Peter; Sherrard, James; Smith, Curtis; hide

    2011-01-01

    The purpose of this handbook is to provide guidance for implementing the Risk Management (RM) requirements of NASA Procedural Requirements (NPR) document NPR 8000.4A, Agency Risk Management Procedural Requirements [1], with a specific focus on programs and projects, and applying to each level of the NASA organizational hierarchy as requirements flow down. This handbook supports RM application within the NASA systems engineering process, and is a complement to the guidance contained in NASA/SP-2007-6105, NASA Systems Engineering Handbook [2]. Specifically, this handbook provides guidance that is applicable to the common technical processes of Technical Risk Management and Decision Analysis established by NPR 7123.1A, NASA Systems Engineering Process and Requirements [3]. These processes are part of the \\Systems Engineering Engine. (Figure 1) that is used to drive the development of the system and associated work products to satisfy stakeholder expectations in all mission execution domains, including safety, technical, cost, and schedule. Like NPR 7123.1A, NPR 8000.4A is a discipline-oriented NPR that intersects with product-oriented NPRs such as NPR 7120.5D, NASA Space Flight Program and Project Management Requirements [4]; NPR 7120.7, NASA Information Technology and Institutional Infrastructure Program and Project Management Requirements [5]; and NPR 7120.8, NASA Research and Technology Program and Project Management Requirements [6]. In much the same way that the NASA Systems Engineering Handbook is intended to provide guidance on the implementation of NPR 7123.1A, this handbook is intended to provide guidance on the implementation of NPR 8000.4A. 1.2 Scope and Depth This handbook provides guidance for conducting RM in the context of NASA program and project life cycles, which produce derived requirements in accordance with existing systems engineering practices that flow down through the NASA organizational hierarchy. The guidance in this handbook is not meant to be prescriptive. Instead, it is meant to be general enough, and contain a sufficient diversity of examples, to enable the reader to adapt the methods as needed to the particular risk management issues that he or she faces. The handbook highlights major issues to consider when managing programs and projects in the presence of potentially significant uncertainty, so that the user is better able to recognize and avoid pitfalls that might otherwise be experienced.

  7. Report: Early-Outs and Buyouts Aided OIG Workforce Reduction, but Weak Management Controls Led to Misused Authority

    EPA Pesticide Factsheets

    Report #17-P-0362, August 14, 2017. The OIG should implement management controls for high-risk operations such as a VERA-VSIP program to prevent future noncompliance and support improved workforce outcomes.

  8. [The implementation of strategy of medicinal support in multi-type hospital].

    PubMed

    Ludupova, E Yu

    2016-01-01

    The article presents brief review of implementation of strategy of medicinal support of population of the Russian Federation and experience of application of at the level of regional hospital. The necessity and importance of implementation into practice of hospitals of methodology of pharmaco-economical management of medicinal care using modern technologies of XYZ-, ABC and VEN-analysis is demonstrated. The stages of development and implementation of process of medicinal support of multifield hospital applying principles of system of quality management (processing and systemic approaches, risk management) on the basis of standards ISO 9001 are described. The significance of monitoring of results ofprocess of medicinal support of the basis of implementation of priority target programs (prevention of venous thrombo-embolic complications, system od control of anti-bacterial therapy) are demonstrated in relation to multi-field hospital using technique of ATC/DDD-analysis for evaluating indices of effectiveness and efficiency.

  9. Meeting report: development of environmental health indicators in Brazil and other countries in the americas.

    PubMed

    Carneiro, Fernando F; Oliveira, Mara Lúcia C; Netto, Guilherme F; Galvão, Luis A C; Cancio, Jacira A; Bonini, Estela M; Corvalan, Carlos F

    2006-09-01

    This report summarizes the Brazilian experience on the design and implementation of environmental health, with contributions from Argentina, Canada, and Cuba, presented at the International Symposium on the Development of Indicators for Environmental Health Integrated Management, held in Recife, Pernambuco, Brazil, on 17-18 June 2004. The methodology for the development of environmental health indicators has been used as a reference in the implementation of environmental health surveillance in Brazil. This methodology has provided tools and processes to facilitate the understanding and to measure the determinants of risks to environmental health, to help decision makers control those risks. Key words: environmental health indicators, environmental health surveillance, integrated management.

  10. IMPLEMENTATION OF QUALITY ASSURANCE OF MULTILABORATORY STUDIES WITHIN THE US EPA

    EPA Science Inventory

    Implementation of Quality Assurance on Multilaboratory Studies Within the U. S. EPA
    Thomas J. Hughes1, Brenda Culpepper1, Nancy Adams2, and John Martinson3, 1National Health and Environmental Effects Research Laboratory (NHEERL), 2National Risk Management Research Laboratory...

  11. JCL Implementation On A Human Spaceflight Program

    NASA Technical Reports Server (NTRS)

    Kulpa, Vyga; Karpowich, Mike; Abel, Diana; Archiable, Wes; Carson, William

    2013-01-01

    Joint Confidence Level (JCL) analysis focuses on the integration of traditionally stove-piped programmatic components (schedule, cost and risk) to establish projected resource and schedule requirements at various confidence levels and to identify programmatic cost and schedule risk drivers. SLS Program consists of multiple Prime Contractors managed by independent SLS Elements which are integrated using SE&I and Program Management. SLS further integrates with GSDO and MPCV through ESD integrated working groups.

  12. Project ARM: alcohol risk management to prevent sales to underage and intoxicated patrons.

    PubMed

    Toomey, T L; Wagenaar, A C; Gehan, J P; Kilian, G; Murray, D M; Perry, C L

    2001-04-01

    Clear policies and expectations are key to increasing responsible service of alcohol in licensed establishments. Few training programs focus exclusively on owners and managers of alcohol establishments to reduce the risk of alcohol service. Project ARM: Alcohol Risk Management is a one-on-one consultation program for owners and managers. Participants received information on risk level, policies to prevent illegal sales, legal issues, and staff communication. This nonrandomized demonstration project was implemented in five diverse bars. Two waves of underage and pseudo-intoxicated purchase attempts were conducted pre- and postintervention in the five intervention bars and nine matched control bars. Underage sales decreased by 11.5%, and sales to pseudo-intoxicated buyers decreased by 46%. Results were in the hypothesized direction but not statistically significant. A one-on-one, outlet-specific training program for owners and managers is a promising way to reduce illegal alcohol sales, particularly to obviously intoxicated individuals.

  13. MAVEN Information Security Governance, Risk Management, and Compliance (GRC): Lessons Learned

    NASA Technical Reports Server (NTRS)

    Takamura, Eduardo; Gomez-Rosa, Carlos A.; Mangum, Kevin; Wasiak, Fran

    2014-01-01

    As the first interplanetary mission managed by the NASA Goddard Space Flight Center, the Mars Atmosphere and Volatile EvolutioN (MAVEN) had three IT security goals for its ground system: COMPLIANCE, (IT) RISK REDUCTION, and COST REDUCTION. In a multiorganizational environment in which government, industry and academia work together in support of the ground system and mission operations, information security governance, risk management, and compliance (GRC) becomes a challenge as each component of the ground system has and follows its own set of IT security requirements. These requirements are not necessarily the same or even similar to each other's, making the auditing of the ground system security a challenging feat. A combination of standards-based information security management based on the National Institute of Standards and Technology (NIST) Risk Management Framework (RMF), due diligence by the Mission's leadership, and effective collaboration among all elements of the ground system enabled MAVEN to successfully meet NASA's requirements for IT security, and therefore meet Federal Information Security Management Act (FISMA) mandate on the Agency. Throughout the implementation of GRC on MAVEN during the early stages of the mission development, the Project faced many challenges some of which have been identified in this paper. The purpose of this paper is to document these challenges, and provide a brief analysis of the lessons MAVEN learned. The historical information documented herein, derived from an internal pre-launch lessons learned analysis, can be used by current and future missions and organizations implementing and auditing GRC.

  14. Effective Risk Management in Innovative Projects: A Case Study of the Construction of Energy-efficient, Sustainable Building of the Laboratory of Intelligent Building in Cracow

    NASA Astrophysics Data System (ADS)

    Krechowicz, Maria

    2017-10-01

    Many construction projects fail to meet deadlines or they exceed the assumed budget. This scenario is particularly common in the case of innovative projects, in which too late identification of a high risk of delays and exceeding the assumed costs makes a potentially profitable project untenable. A high risk level, far exceeding the level of risk in standard non-innovative projects, is a characteristic feature of the realization phase of innovative projects. This is associated not only with greater complexity of the design and construction phases, but also with the problems with application of new technologies and prototype solutions, lack of qualified personnel with suitable expertise in specialized areas, and with the ability to properly identify the gaps between available and required knowledge and skills. This paper discusses the process of effective risk management in innovative projects on the example of the realization phase of an innovative, energy-efficient and sustainable building of the Laboratory of Intelligent Building in Cracow - DLJM Lab, from the point of view of DORBUD S.A., its general contractor. In this paper, a new approach to risk management process for innovative construction projects is proposed. Risk management process was divided into five stages: gathering information, identification of the important unwanted events, first risk assessment, development and choice of risk reaction strategies, assessment of the residual risk after introducing risk reactions. 18 unwanted events in an innovative construction project were identified. The first risk assessment was carried out using two-parametric risk matrix, in which the probability of unwanted event occurrence and its consequences were analysed. Three levels of risks were defined: tolerable, controlled and uncontrolled. Risk reactions to each defined unwanted event were developed. The following risk reaction types were considered: risk retention, risk reduction, risk transfer and risk elimination. Three-parametric risk matrix was developed to make it possible to assess risk after implementing risk reactions. The possibility of implementing risk management was inversely proportional to the probability of unwanted event occurrence and its contribution to the project outcome. Introducing this risk management strategy allowed to significantly reduce the risk of the innovative construction project. It proved to be an effective tool to reduce risk to an acceptable level. It had a significant contribution to carrying out the project within the assumed time, budget and quality standards.

  15. An evaluation of HACCP implementation status in UK small and medium enterprises in food manufacturing.

    PubMed

    Fielding, L M; Ellis, L; Beveridge, C; Peters, A C

    2005-04-01

    To reduce foodborne illnesses, hazard and risk-based quality management systems are essential. Small and medium sized companies (SMEs) tend to have a poor understanding of such systems and limited adoption of the Hazard Analysis Critical Control Point system (HACCP). The requirement for full HACCP implementation by 2006 will place an even greater burden on these businesses. The aim of this project is to assess the current levels of understanding of hazards and risks in SMEs in the manufacturing sector. A questionnaire survey was made of 850 SMEs, including microbusinesses. This determined the industry sector and processes carried out, whether the company operated hazard-based quality management and the knowledge of the technical manager regarding the associated hazards and risks. Follow-up visits to the manufacturing plant observed the processes and the operatives to determine their level of understanding. A benchmarking audit was carried out and each company was rated. The results show that the majority of respondents stated that they operated hazard analysis-based quality management. The ability of the respondents to correctly define a hazard or risk or identify different types of hazard was, however, poor. There was no correlation between business type and audit score. The microbusinesses did, however, perform significantly less well than the larger SMEs.

  16. Risk-trading in flood management: An economic model.

    PubMed

    Chang, Chiung Ting

    2017-09-15

    Although flood management is no longer exclusively a topic of engineering, flood mitigation continues to be associated with hard engineering options. Flood adaptation or the capacity to adapt to flood risk, as well as a demand for internalizing externalities caused by flood risk between regions, complicate flood management activities. Even though integrated river basin management has long been recommended to resolve the above issues, it has proven difficult to apply widely, and sometimes even to bring into existence. This article explores how internalization of externalities as well as the realization of integrated river basin management can be encouraged via the use of a market-based approach, namely a flood risk trading program. In addition to maintaining efficiency of optimal resource allocation, a flood risk trading program may also provide a more equitable distribution of benefits by facilitating decentralization. This article employs a graphical analysis to show how flood risk trading can be implemented to encourage mitigation measures that increase infiltration and storage capacity. A theoretical model is presented to demonstrate the economic conditions necessary for flood risk trading. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. 49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

  18. 49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

  19. 49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

  20. 49 CFR Appendix C to Part 195 - Guidance for Implementation of an Integrity Management Program

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... get this information from topographical maps such as U.S. Geological Survey quadrangle maps. (2... risk.)—Risk Value=3 Close interval survey: (yes/no)—no—Risk Value =5 Internal Inspection tool used..., including a summary of performance improvements, both qualitative and quantitative, to an operator's...

  1. Securing Location Services Infrastructures: Practical Criteria for Application Developers and Solutions Architects

    ERIC Educational Resources Information Center

    Karamanian, Andre

    2013-01-01

    This qualitative, exploratory, normative study examined the security and privacy of location based services in mobile applications. This study explored risk, and controls to implement privacy and security. This study was addressed using components of the FIPS Risk Management Framework. This study found that risk to location information was…

  2. Integrated risk assessment and screening analysis of drinking water safety of a conventional water supply system.

    PubMed

    Sun, F; Chen, J; Tong, Q; Zeng, S

    2007-01-01

    Management of drinking water safety is changing towards an integrated risk assessment and risk management approach that includes all processes in a water supply system from catchment to consumers. However, given the large number of water supply systems in China and the cost of implementing such a risk assessment procedure, there is a necessity to first conduct a strategic screening analysis at a national level. An integrated methodology of risk assessment and screening analysis is thus proposed to evaluate drinking water safety of a conventional water supply system. The violation probability, indicating drinking water safety, is estimated at different locations of a water supply system in terms of permanganate index, ammonia nitrogen, turbidity, residual chlorine and trihalomethanes. Critical parameters with respect to drinking water safety are then identified, based on which an index system is developed to prioritize conventional water supply systems in implementing a detailed risk assessment procedure. The evaluation results are represented as graphic check matrices for the concerned hazards in drinking water, from which the vulnerability of a conventional water supply system is characterized.

  3. Joint Venture Health Plans May Give ACOs a Run for Their Money.

    PubMed

    Reinke, Thomas

    2016-12-01

    Joint venture plans are starting to demonstrate their ability to implement clinical management and financial management reforms. A JV health plan replaces the offloading of financial risk by health plans to ill-equipped providers with an executive-level cost management committee stated jointly by the hospital and payer.

  4. 78 FR 20613 - Ochoco National Forest, Paulina Ranger District; Oregon; Wolf Creek Vegetation and Fuels...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-05

    ...; Wolf Creek Vegetation and Fuels Management Project EIS AGENCY: Forest Service. ACTION: Notice of Intent... under what circumstances vegetation and fuels management will be implemented in the Wolf Creek project... populations of noxious weeds are known to exist within the project area. There is a risk that management...

  5. Impact of a Classroom Behavior Management Intervention on Teacher Risk Ratings for Student Behavior

    ERIC Educational Resources Information Center

    Hansen, William B.; Bishop, Dana C.; Jackson-Newsom, Julia

    2010-01-01

    Classroom behavior management interventions have been used successfully with drug prevention programs to prevent subsequent antisocial behavior and substance use among youth. This article presents results from implementation of the All Stars Challenge, a classroom-based behavior management component to a drug prevention program for fifth graders.…

  6. Simulation of changes on the psychosocial risk in the nursing personnel after implementing the policy of good practices on the risk treatment.

    PubMed

    Bolívar Murcia, María Paula; Cruz González, Joan Paola; Rodríguez Bello, Luz Angélica

    2018-02-01

    Evaluate the change over time of psychosocial risk management for the nursing personnel of an intermediate complexity clinic of Bogota (Colombia). Descriptive and correlational research performed under the approach of risk management (identification, analysis, assessment and treatment). The psychosocial risk of the nursing personnel was studied through 10-year system dynamics models (with and without the implementation of the policy of good practices on the risk treatment) in two scenarios: when the nursing personnel works shifts of 6 hours (morning or afternoon) and when they work over 12 hours (double shift or night shift). When implementing a policy of good practices on the risk treatment, the double shift scenario shows an improvement among 25% to 88% in the variables of: health, labor motivation, burnout, service level and productivity; as well as in the variables of the organization associated to number of patients, nursing personnel and profit. Likewise, the single shift scenario with good practices improves in all the above-mentioned variables and generates stability on the variables of absenteeism and resignations. The best scenario is the single shift scenario with the application of good practices of risk treatment in comparison with the double shift scenario with good practices, which allows concluding that the good practices have a positive effect on the variables of nursing personnel and on those associated to the organization. Copyright© by the Universidad de Antioquia.

  7. Best practices: The Administrative Review Committee at New Hampshire Hospital: a one-year follow-up.

    PubMed

    de Nesnera, Alexander; Folks, David G

    2012-06-01

    New Hampshire Hospital implemented an Administrative Review Committee (ARC), a best practice that provides a risk management process to mitigate potential liability for the hospital and clinicians treating high-profile, high-risk patients. This column reports on the first year of the ARC's operation, during which the committee reviewed 206 patients. The authors describe four patient groups and their distinguishing characteristics. The ARC is accepted by clinicians as an important venue to present high-risk clinical cases and to obtain risk management guidance and consultation. The committee has become an integral part of the hospital culture.

  8. Managing Canine Aggression in the Home.

    PubMed

    Pike, Amy

    2018-05-01

    Canine aggression occurring in the home can be a dangerous diagnosis with costly consequences to all members of the household. Management is a key modality in the treatment of canine aggression in the home. A thorough history will detail each trigger, target, and context and allow for the veterinary team to put together a comprehensive management plan. Management allows for the avoidance of future aggressive episodes and minimizes the risks associated with living with a patient with these diagnoses. Although risk cannot be mitigated 100%, thorough management can create a safe environment for the implementation of the behavior treatment plan. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Managing dependencies in forest offset projects: toward a more complete evaluation of reversal risk

    Treesearch

    David M Cooley; Chrsitopher S Galik; Thomas P Holmes; Carolyn Kousky; Roger M Cooke

    2011-01-01

    Although forest carbon offsets can play an important role in the implementation of comprehensive climate policy, they also face an inherent risk of reversal. If such risks are positively correlated across projects, it can affect the integrity of larger project portfolios and potentially the entire offsets program. Here, we discuss three types of risks that could affect...

  10. 78 FR 35310 - Implementation of the Privacy Act of 1974, as Amended; Privacy Act System of Records, Family Self...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-12

    ... research in support of program operations, management, performance monitoring, evaluation, risk management... the Privacy Act of 1974 (U.S.C. 552a(e)(4)), as amended, and Office of Management and Budget (OMB... submitted to the Office of Management and Budget (OMB), the Senate Committee on Homeland Security and...

  11. A comparative analysis of occupational health and safety risk prevention practices in Sweden and Spain.

    PubMed

    Morillas, Rosa María; Rubio-Romero, Juan Carlos; Fuertes, Alba

    2013-12-01

    Scandinavian countries such as Sweden implemented the occupational health and safety (OHS) measures in the European Directive 89/391/EEC earlier than other European counties, including Spain. In fact, statistics on workplace accident rates reveal that between 2004 and 2009, there were considerably fewer accidents in Sweden than in Spain. The objective of the research described in this paper was to reduce workplace accidents and to improve OHS management in Spain by exploring the OHS practices in Sweden. For this purpose, an exploratory comparative study was conducted, which focused on the effectiveness of the EU directive in both countries. The study included a cross-sectional analysis of workplace accident rates and other contextual indicators in both national contexts. A case study of 14 Swedish and Spanish companies identified 14 differences in the preventive practices implemented. These differences were then assessed with a Delphi study to evaluate their contribution to the reduction of workplace accidents and their potential for improving health and safety management in Spain. The results showed that there was agreement concerning 12 of the 14 practices. Finally, we discuss opportunities of improvement in Spanish companies so that they can make their risk management practices more effective. The findings of this comparative study on the implementation of the European Directive 89/391/EEC in both Sweden and Spain have revealed health and safety managerial practices which, if properly implemented, could contribute to improved work conditions and accident statistics of Spanish companies. In particular, the results suggest that Spanish employers, safety managers, external prevention services, safety deputies and Labour Inspectorates should consider implementing streamlined internal preventive management, promoting the integration of prevention responsibilities to the chain of command, and preventing health and safety management from becoming a mere exchange of documents. The authors also encourage future research studies to use the methodology presented to compare and assess the European Directive 89/391/EEC implementation in other European countries. © 2013.

  12. An Integrated Risk Management Model for Source Water Protection Areas

    PubMed Central

    Chiueh, Pei-Te; Shang, Wei-Ting; Lo, Shang-Lien

    2012-01-01

    Watersheds are recognized as the most effective management unit for the protection of water resources. For surface water supplies that use water from upstream watersheds, evaluating threats to water quality and implementing a watershed management plan are crucial for the maintenance of drinking water safe for humans. The aim of this article is to establish a risk assessment model that provides basic information for identifying critical pollutants and areas at high risk for degraded water quality. In this study, a quantitative risk model that uses hazard quotients for each water quality parameter was combined with a qualitative risk model that uses the relative risk level of potential pollution events in order to characterize the current condition and potential risk of watersheds providing drinking water. In a case study of Taipei Source Water Area in northern Taiwan, total coliforms and total phosphorus were the top two pollutants of concern. Intensive tea-growing and recreational activities around the riparian zone may contribute the greatest pollution to the watershed. Our risk assessment tool may be enhanced by developing, recording, and updating information on pollution sources in the water supply watersheds. Moreover, management authorities could use the resultant information to create watershed risk management plans. PMID:23202770

  13. Progress of environmental management and risk assessment of industrial chemicals in China.

    PubMed

    Wang, Hong; Yan, Zhen-Guang; Li, Hong; Yang, Ni-Yun; Leung, Kenneth M Y; Wang, Yi-Zhe; Yu, Ruo-Zhen; Zhang, Lai; Wang, Wan-Hua; Jiao, Cong-Ying; Liu, Zheng-Tao

    2012-06-01

    With China's rapid economic growth, chemical-related environmental issues have become increasingly prominent, and the environmental management of chemicals has garnered increased attention from the government. This review focuses on the current situation and the application of risk assessment in China's environmental management of industrial chemicals. The related challenges and research needs of the country are also discussed. The Chinese government promulgated regulations for the import and export of toxic chemicals in 1994. Regulations for new chemical substances came into force in 2003, and were revised in 2010 based on the concept of risk management. In order to support the implementation of new regulations, Guidance for Risk Assessment of Chemicals is under development in an attempt to provide the concepts and techniques of risk assessment. With increasing concern and financial support from Chinese government, China is embarking on the fast track of research and development in environmental management of industrial chemicals. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Implementation and evaluation of a nursing home fall management program.

    PubMed

    Rask, Kimberly; Parmelee, Patricia A; Taylor, Jo A; Green, Diane; Brown, Holly; Hawley, Jonathan; Schild, Laura; Strothers, Harry S; Ouslander, Joseph G

    2007-03-01

    To evaluate the feasibility and effectiveness of a falls management program (FMP) for nursing homes (NHs). A quality improvement project with data collection throughout FMP implementation. NHs in Georgia owned and operated by a single nonprofit organization. All residents of participating NHs. A convenience sample of 19 NHs implemented the FMP. The FMP is a multifaceted quality improvement and culture change intervention. Key components included organizational leadership buy-in and support, a designated facility-based falls coordinator and interdisciplinary team, intensive education and training, and ongoing consultation and oversight by advanced practice nurses with expertise in falls management. Process-of-care documentation using a detailed 24-item audit tool and fall and physical restraint use rates derived from quality improvement software currently used in all Georgia NHs (MyInnerView). Care process documentation related to the assessment and management of fall risk improved significantly during implementation of the FMP. Restraint use decreased substantially during the project period, from 7.9% to 4.4% in the intervention NHs (a relative reduction of 44%), and decreased in the nonintervention NHs from 7.0% to 4.9% (a relative reduction of 30%). Fall rates remained stable in the intervention NHs (17.3 falls/100 residents per month at start and 16.4 falls/100 residents per month at end), whereas fall rates increased 26% in the NHs not implementing the FMP (from 15.0 falls/100 residents/per month to 18.9 falls/100 residents per month). Implementation was associated with significantly improved care process documentation and a stable fall rate during a period of substantial reduction in the use of physical restraints. In contrast, fall rates increased in NHs owned by the same organization that did not implement the FMP. The FMP may be a helpful tool for NHs to manage fall risk while attempting to reduce physical restraint use in response to the Centers for Medicare and Medicaid Services quality initiatives.

  15. Determinants of quality management systems implementation in hospitals.

    PubMed

    Wardhani, Viera; Utarini, Adi; van Dijk, Jitse Pieter; Post, Doeke; Groothoff, Johan Willem

    2009-03-01

    To identify the problems and facilitating factors in the implementation of quality management system (QMS) in hospitals through a systematic review. A search strategy was performed on the Medline database for articles written in English published between 1992 and early 2006. Using the thesaurus terms 'Total Quality Management' and 'Quality Assurance Health Care', combined with the term 'hospital' and 'implement*', we identified 533 publications. The screening process was based on empirical articles describing organization-wide QMS implementation. Fourteen empirical articles fulfilled the inclusion criteria and were reviewed in this paper. An organization culture emphasizing standards and values associated with affiliation, teamwork and innovation, assumption of change and risk taking, play as the key success factor in QMS implementation. This culture needs to be supported by sufficient technical competence to apply a scientific problem-solving approach. A clear distribution of QMS function within the organizational structure is more important than establishing a formal quality structure. In addition to management leadership, physician involvement also plays an important role in implementing QMS. Six supporting and limiting factors determining QMS implementation are identified in this review. These are the organization culture, design, leadership for quality, physician involvement, quality structure and technical competence.

  16. [Computer-assisted cardiovascular disease management: better implementation of care but no improvement in clinical outcomes].

    PubMed

    de Wit, Niek J

    2012-01-01

    Computer support is considered by many to be a promising strategy for improving healthcare interventions, especially in the management of chronic diseases. So far, however, evidence of the effectiveness of ICT support in healthcare is limited. Recently, computer-supported cardiovascular disease management was compared with usual care during an RCT comprised of 1100 primary care patients. This trial demonstrated that neither the clinical outcome nor the cardiovascular morbidity rate improved, even though management of the risk factors improved over 1 year of follow-up. The pragmatic design of the RCT in daily general practice may have restricted implementing the computer support, and may also have hampered the evaluation of the cardiovascular effects. The results demonstrate that although computer support may help improve the performance of disease management, its impact on disease outcomes is questionable. ICT innovations in healthcare require rigorous investigative evaluation before their implementation in daily practice can be justified.

  17. Appraising longitudinal trends in the strategic risks cited by risk managers in the international water utility sector, 2005-2015.

    PubMed

    Chalker, Rosemary T C; Pollard, Simon J T; Leinster, Paul; Jude, Simon

    2018-03-15

    We report dynamic changes in the priorities for strategic risks faced by international water utilities over a 10year period, as cited by managers responsible for managing them. A content analysis of interviews with three cohorts of risk managers in the water sector was undertaken. Interviews probed the focus risk managers' were giving to strategic risks within utilities, as well as specific questions on risk analysis tools (2005); risk management cultures (2011) and the integration of risk management with corporate decision-making (2015). The coding frequency of strategic (business, enterprise, corporate) risk terms from 18 structured interviews (2005) and 28 semi-structured interviews (12 in 2011; 16 in 2015) was used to appraise changes in the perceived importance of strategic risks within the sector. The aggregated coding frequency across the study period, and changes in the frequency of strategic risks cited at three interview periods identified infrastructure assets as the most significant risk over the period and suggests an emergence of extrinsic risk over time. Extended interviews with three utility risk managers (2016) from the UK, Canada and the US were then used to contextualise the findings. This research supports the ongoing focus on infrastructure resilience and the increasing prevalence of extrinsic risk within the water sector, as reported by the insurance sector and by water research organisations. The extended interviews provided insight into how strategic risks are now driving the implementation agenda within utilities, and into how utilities can secure tangible business value from proactive risk governance. Strategic external risks affecting the sector are on the rise, involve more players and are less controllable from within a utility's own organisational boundaries. Proportionate risk management processes and structures provide oversight and assurance, whilst allowing a focus on the tangible business value that comes from managing strategic risks well. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  18. Evaluation of volcanic risk management in Merapi and Bromo Volcanoes

    NASA Astrophysics Data System (ADS)

    Bachri, S.; Stöetter, J.; Sartohadi, J.; Setiawan, M. A.

    2012-04-01

    Merapi (Central Java Province) and Bromo (East Java Province) volcanoes have human-environmental systems with unique characteristics, thus causing specific consequences on their risk management. Various efforts have been carried out by many parties (institutional government, scientists, and non-governmental organizations) to reduce the risk in these areas. However, it is likely that most of the actions have been done for temporary and partial purposes, leading to overlapping work and finally to a non-integrated scheme of volcanic risk management. This study, therefore, aims to identify and evaluate actions of risk and disaster reduction in Merapi and Bromo Volcanoes. To achieve this aims, a thorough literature review was carried out to identify earlier studies in both areas. Afterward, the basic concept of risk management cycle, consisting of risk assessment, risk reduction, event management and regeneration, is used to map those earlier studies and already implemented risk management actions in Merapi and Bromo. The results show that risk studies in Merapi have been developed predominantly on physical aspects of volcanic eruptions, i.e. models of lahar flows, hazard maps as well as other geophysical modeling. Furthermore, after the 2006 eruption of Merapi, research such on risk communication, social vulnerability, cultural vulnerability have appeared on the social side of risk management research. Apart from that, disaster risk management activities in the Bromo area were emphasizing on physical process and historical religious aspects. This overview of both study areas provides information on how risk studies have been used for managing the volcano disaster. This result confirms that most of earlier studies emphasize on the risk assessment and only few of them consider the risk reduction phase. Further investigation in this field work in the near future will accomplish the findings and contribute to formulate integrated volcanic risk management cycles for both Merapi and Bromo. Keywords: Risk management, volcanoes hazard, Merapi and Bromo Volcano Indonesia

  19. Assessing hospitals' clinical risk management: Development of a monitoring instrument

    PubMed Central

    2010-01-01

    Background Clinical risk management (CRM) plays a crucial role in enabling hospitals to identify, contain, and manage risks related to patient safety. So far, no instruments are available to measure and monitor the level of implementation of CRM. Therefore, our objective was to develop an instrument for assessing CRM in hospitals. Methods The instrument was developed based on a literature review, which identified key elements of CRM. These elements were then discussed with a panel of patient safety experts. A theoretical model was used to describe the level to which CRM elements have been implemented within the organization. Interviews with CRM practitioners and a pilot evaluation were conducted to revise the instrument. The first nationwide application of the instrument (138 participating Swiss hospitals) was complemented by in-depth interviews with 25 CRM practitioners in selected hospitals, for validation purposes. Results The monitoring instrument consists of 28 main questions organized in three sections: 1) Implementation and organizational integration of CRM, 2) Strategic objectives and operational implementation of CRM at hospital level, and 3) Overview of CRM in different services. The instrument is available in four languages (English, German, French, and Italian). It allows hospitals to gather comprehensive and systematic data on their CRM practice and to identify areas for further improvement. Conclusions We have developed an instrument for assessing development stages of CRM in hospitals that should be feasible for a continuous monitoring of developments in this important area of patient safety. PMID:21144039

  20. How to reduce the vulnerability of properties threatened by flood?

    NASA Astrophysics Data System (ADS)

    Vinet, Freddy; Leone, Frederic; Pelletier, Hugo; Queral, Fanny

    2010-05-01

    Over the last 20 or 30 years, increasing flood damage has compelled stakeholders to reconsider flood prevention. Indeed, the increase in damage emphasizes the failure of the current flood management policies based on river channel management instead of the mitigation of the flood risk. In the aftermath of the recent disasters in France and Europe, national and local authorities fostered an increasing number of initiatives geared towards reducing risks and rectifying the way of managing flood risks. All experts are now convinced that we must reduce risk through the mitigation of vulnerability. In this purpose, the French government and some river basin authorities try to develop programmes and laws intended to reduce the vulnerability of flood-prone buildings, mostly by retrofitting them. Through the results of field studies conducted in France, this presentation focuses on pros and cons of retrofitting. As of now, if many assessment of the vulnerability of buildings have been conducted, only a few huge retrofitting programmes have actually been implemented. Many bottlenecks emerge when implementing concrete measures. These difficulties include technical problems, cost, and the reluctance of many property owners... On the long run, retrofitting may be an efficient way to prevent damage to buildings threatened by floodwater. However current programmes fail to address the specificities of the local context in which such actions are implemented, e.g. accurate appraisal of flooding conditions, awareness of risk, vulnerability of people... The key is to involve all local actors including people threatened by flooding rather than to impose general and inappropriate measures.

  1. A comprehensive Network Security Risk Model for process control networks.

    PubMed

    Henry, Matthew H; Haimes, Yacov Y

    2009-02-01

    The risk of cyber attacks on process control networks (PCN) is receiving significant attention due to the potentially catastrophic extent to which PCN failures can damage the infrastructures and commodity flows that they support. Risk management addresses the coupled problems of (1) reducing the likelihood that cyber attacks would succeed in disrupting PCN operation and (2) reducing the severity of consequences in the event of PCN failure or manipulation. The Network Security Risk Model (NSRM) developed in this article provides a means of evaluating the efficacy of candidate risk management policies by modeling the baseline risk and assessing expectations of risk after the implementation of candidate measures. Where existing risk models fall short of providing adequate insight into the efficacy of candidate risk management policies due to shortcomings in their structure or formulation, the NSRM provides model structure and an associated modeling methodology that captures the relevant dynamics of cyber attacks on PCN for risk analysis. This article develops the NSRM in detail in the context of an illustrative example.

  2. Risk Analysis Related to Quality Management Principles

    NASA Astrophysics Data System (ADS)

    Vykydal, David; Halfarová, Petra; Nenadál, Jaroslav; Plura, Jiří; Hekelová, Edita

    2012-12-01

    Efficient and effective implementation of quality management principles asks for a responsible approach from top managers' perspectives. A study of the current state of affairs in Czech organizations discovers a lot of shortcomings in this field that can be changed to vary managerial risks. The article identifies and analyses some of them and gives short guidance for appropriate treatment. Text of the article reflects the authors' experience as well as knowledge obtained from the systematic analysis of industrial companies' environments.

  3. Focused Review of Perioperative Care of Patients with Pulmonary Hypertension and Proposal of a Perioperative Pathway.

    PubMed

    Steppan, Jochen; Diaz-Rodriguez, Natalia; Barodka, Viachaslau M; Nyhan, Daniel; Pullins, Erica; Housten, Traci; Damico, Rachel L; Mathai, Stephen C; Hassoun, Paul M; Berkowitz, Dan E; Maxwell, Bryan G; Kolb, Todd M

    2018-01-15

    Morbidity and mortality risk increase considerably for patients with pulmonary hypertension (PH) undergoing non-cardiac surgery. Unfortunately, there are no comprehensive, evidence-based guidelines for perioperative evaluation and management of these patients. We present a brief review of the literature on perioperative outcomes for patients with PH and describe the implementation of a collaborative perioperative management program for these high-risk patients at a tertiary academic center.

  4. Project Delivery Methods and Contracting Approaches Available for Implementation by the Texas Department of Transportation

    DOT National Transportation Integrated Search

    2001-10-01

    Public agencies across the country are pursuing innovative project delivery methods such as design-build (D-B) and construction manager-at-risk (CM-at-risk) to improve cycle-time performance on projects, and numerous transportation departments are cu...

  5. Risk assessment and management of brucellosis in the southern greater Yellowstone area (II): Cost-benefit analysis of reducing elk brucellosis prevalence.

    PubMed

    Boroff, Kari; Kauffman, Mandy; Peck, Dannele; Maichak, Eric; Scurlock, Brandon; Schumaker, Brant

    2016-11-01

    Recent cases of bovine brucellosis (Brucella abortus) in cattle (Bos taurus) and domestic bison (Bison bison) of the southern Greater Yellowstone Area (SGYA) have been traced back to free-ranging elk (Cervus elaphus). Several management activities have been implemented to reduce brucellosis seroprevalence in elk, including test-and-slaughter, low-density feeding at elk winter feedgrounds, and elk vaccination. It is unclear which of these activities are most cost-effective at reducing the risk of elk transmitting brucellosis to cattle. In a companion paper, a stochastic risk model was used to translate a reduction in elk seroprevalence to a reduction in the risk of transmission to cattle. Here, we use those results to estimate the expected economic benefits and costs of reducing seroprevalence in elk using three different management activities: vaccination of elk with Brucella strain 19 (S19), low-density feeding of elk, and elk test-and-slaughter. Results indicate that the three elk management activities yield negative expected net benefits, ranging from -$2983 per year for low-density feeding to -$595,471 per year for test-and-slaughter. Society's risk preferences will determine whether strategies that generate small negative net benefit, such as low-density feeding, are worth implementing. However, activities with large negative net benefits, such as test-and-slaughter and S19 vaccination, are unlikely to be economically worthwhile. Given uncertainty about various model parameters, we identify some circumstances in which individual management activities might generate positive expected net benefit. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. An overview of Quality Management System implementation in a research laboratory

    NASA Astrophysics Data System (ADS)

    Molinéro-Demilly, Valérie; Charki, Abdérafi; Jeoffrion, Christine; Lyonnet, Barbara; O'Brien, Steve; Martin, Luc

    2018-02-01

    The aim of this paper is to show the advantages of implementing a Quality Management System (QMS) in a research laboratory in order to improve the management of risks specific to research programmes and to increase the reliability of results. This paper also presents experience gained from feedback following the implementation of the Quality process in a research laboratory at INRA, the French National Institute for Agronomic Research and details the various challenges encountered and solutions proposed to help achieve smoother adoption of a QMS process. The 7Ms (Management, Measurement, Manpower, Methods, Materials, Machinery, Mother-nature) methodology based on the Ishikawa `Fishbone' diagram is used to show the effectiveness of the actions considered by a QMS, which involve both the organization and the activities of the laboratory. Practical examples illustrate the benefits and improvements observed in the laboratory.

  7. Overcoming Barriers to Implementing Outdoor and Environmental Education (Continued): Safety/Legal Liability.

    ERIC Educational Resources Information Center

    Hanna, Glenda

    1994-01-01

    A risk management plan for outdoor education programs should include procedures for regular program implementation, as well as rescue, first aid, and accident follow-up procedures. Stresses understanding legal and ethical responsibilities and the importance of sufficient insurance protection. Includes suggestions for dealing with conflicts in…

  8. Class D Management Implementation Approach of the First Orbital Mission of the Earth Venture Series

    NASA Technical Reports Server (NTRS)

    Wells, James E.; Scherrer, John; Law, Richard; Bonniksen, Chris

    2013-01-01

    A key element of the National Research Council's Earth Science and Applications Decadal Survey called for the creation of the Venture Class line of low-cost research and application missions within NASA (National Aeronautics and Space Administration). One key component of the architecture chosen by NASA within the Earth Venture line is a series of self-contained stand-alone spaceflight science missions called "EV-Mission". The first mission chosen for this competitively selected, cost and schedule capped, Principal Investigator-led opportunity is the CYclone Global Navigation Satellite System (CYGNSS). As specified in the defining Announcement of Opportunity, the Principal Investigator is held responsible for successfully achieving the science objectives of the selected mission and the management approach that he/she chooses to obtain those results has a significant amount of freedom as long as it meets the intent of key NASA guidance like NPR 7120.5 and 7123. CYGNSS is classified under NPR 7120.5E guidance as a Category 3 (low priority, low cost) mission and carries a Class D risk classification (low priority, high risk) per NPR 8705.4. As defined in the NPR guidance, Class D risk classification allows for a relatively broad range of implementation strategies. The management approach that will be utilized on CYGNSS is a streamlined implementation that starts with a higher risk tolerance posture at NASA and that philosophy flows all the way down to the individual part level.

  9. Risk contracting and operational capabilities in large medical groups during national healthcare reform.

    PubMed

    Mechanic, Robert E; Zinner, Darren

    2016-06-01

    Little is known about the scope of alternative payment models outside of Medicare. This study measures the full complement of public and private payment arrangements in large, multi-specialty group practices as a barometer of payment reform among advanced organizations. We collected information from 33 large, multi-specialty group practices about the proportion of their total revenue in 7 payment models, physician compensation strategies, and the implementation of selected performance management initiatives. We grouped respondents into 3 categories based on the proportion of their revenue in risk arrangements: risk-based (45%-100%), mixed (10%-35%), and fee-for-service (FFS) (0%-10%). We analyzed changes in contracting and operating characteristics between 2011 and 2013. In 2013, 68% of groups' total patient revenue was from FFS payments and 32% was from risk arrangements (unweighted average). Risk-based groups had 26% FFS revenue, whereas mixed-payment and FFS groups had 75% and 98%, respectively. Between 2011 and 2013, 9 groups increased risk contract revenue by about 15 percentage points and 22 reported few changes. Risk-based groups reported more advanced implementation of performance management strategies and were more likely to have physician financial incentives for quality and patient experience. The groups in this study are well positioned to manage risk-based contracts successfully, but less than one-third receive a majority of their revenue from risk arrangements. The experience of these relatively advanced groups suggests that expanding risk-based arrangements across the US health system will likely be slower and more challenging than many people assume.

  10. Decentralization of storm runoff via engagement of social and cultural capitals - implications for the management of flood risk at the municipal scale

    EPA Science Inventory

    This research tests a novel method that focuses limited community resources on a decentralized approach to storm water management. A reverse auction was used to relieve legal constraints on management implementation on private land. Residents voluntarily bid on rain gardens and r...

  11. 77 FR 4757 - Ochoco National Forest, Lookout Mountain Ranger District; Oregon; McKay Fuels and Vegetation...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... National Forest, Lookout Mountain Ranger District; Oregon; McKay Fuels and Vegetation Management Project... and vegetation management will be implemented in the McKay Fuels and Vegetation project area. [[Page... populations of noxious weeds are known to exist within the project area. There is a risk that management...

  12. Project Risk Management in Educational Organizations: A Case from the Czech Republic

    ERIC Educational Resources Information Center

    Eger, Ludvík; Egerová, Dana

    2016-01-01

    The past 20 years have been a period of reforms for school systems in Visegrad countries. However, the successful implementation of educational reforms requires effective leaders and managers and, to produce effective leaders, changes in the system of leadership and management programmes need to be adopted. From 2004, the Czech Republic saw a…

  13. Overview and Status of the Bioastronautics Critical Path Roadmap (BCPR)

    NASA Technical Reports Server (NTRS)

    Charles, John

    2004-01-01

    Viewgraphs on the status and overview of the Bioastronautics Critical Path Roadmap (BCPR) are presented. The topics include: 1) BCPR Objectives; 2) BCPR and OBPR Program Management; 3) BCPR Disciplines & Cross-Cutting Areas; 4) Characteristics of BCPR Reference Missions; 5) Bioastronautics Timetable (notional); 6) BCPR Processes Risk Identification, Assessment, and Management; 7) Types of BCPR Risks; 8) Enabling Questions Categories; 9) Risk Mitigation Status; 10) Defining Levels of Accepted Risk; 11) BCPR Integration; 12) BCPR Implementation, Integration, and Validation; 13) BCPR Refinement Schedule; 14) Academy Review; 15) Rating Bioastronautics Risks; 16) Risk Rating Exercises; 17) Human Health Risk Assessment Criteria (examples); 18) A Recent Risk Rating Exercise; 19) Consensus Workshop Background; 20) Consensus Workshop Rating Analysis; 21) Consensus Workshop Selected Preliminary Recommendations; and 22) Access to BCPR Content.

  14. From aviation to medicine: applying concepts of aviation safety to risk management in ambulatory care.

    PubMed

    Wilf-Miron, R; Lewenhoff, I; Benyamini, Z; Aviram, A

    2003-02-01

    The development of a medical risk management programme based on the aviation safety approach and its implementation in a large ambulatory healthcare organisation is described. The following key safety principles were applied: (1). errors inevitably occur and usually derive from faulty system design, not from negligence; (2). accident prevention should be an ongoing process based on open and full reporting; (3). major accidents are only the "tip of the iceberg" of processes that indicate possibilities for organisational learning. Reporting physicians were granted immunity, which encouraged open reporting of errors. A telephone "hotline" served the medical staff for direct reporting and receipt of emotional support and medical guidance. Any adverse event which had learning potential was debriefed, while focusing on the human cause of error within a systemic context. Specific recommendations were formulated to rectify processes conducive to error when failures were identified. During the first 5 years of implementation, the aviation safety concept and tools were successfully adapted to ambulatory care, fostering a culture of greater concern for patient safety through risk management while providing support to the medical staff.

  15. From aviation to medicine: applying concepts of aviation safety to risk management in ambulatory care

    PubMed Central

    Wilf-Miron, R; Lewenhoff, I; Benyamini, Z; Aviram, A

    2003-01-01

    

 The development of a medical risk management programme based on the aviation safety approach and its implementation in a large ambulatory healthcare organisation is described. The following key safety principles were applied: (1) errors inevitably occur and usually derive from faulty system design, not from negligence; (2) accident prevention should be an ongoing process based on open and full reporting; (3) major accidents are only the "tip of the iceberg" of processes that indicate possibilities for organisational learning. Reporting physicians were granted immunity, which encouraged open reporting of errors. A telephone "hotline" served the medical staff for direct reporting and receipt of emotional support and medical guidance. Any adverse event which had learning potential was debriefed, while focusing on the human cause of error within a systemic context. Specific recommendations were formulated to rectify processes conducive to error when failures were identified. During the first 5 years of implementation, the aviation safety concept and tools were successfully adapted to ambulatory care, fostering a culture of greater concern for patient safety through risk management while providing support to the medical staff. PMID:12571343

  16. At-Risk Student Averse: Risk Management and Accountability

    ERIC Educational Resources Information Center

    Vasquez Heilig, Julian; Young, Michelle; Williams, Amy

    2012-01-01

    Purpose: The prevailing theory of action underlying accountability is that holding schools and students accountable will increase educational output. While accountability's theory of action intuitively seemed plausible, at the point of No Child Left Behind's national implementation, little empirical research was available to either support or…

  17. Report: EPA Should Assess Needs and Implement Management Controls to Ensure Effective Incorporation of Chemical Safety Research Products

    EPA Pesticide Factsheets

    Report #17-P-0294, June 23, 2017. With management controls that ensure the collaborative development of research products and prioritize chemical safety research needs, the EPA would be better able to conduct faster chemical risk assessments.

  18. Evaluation of a disease state management guideline for urinary tract infection.

    PubMed

    Zmarlicka, Monika T; Cardwell, Sophia M; Crandon, Jared L; Nicolau, David P; McClure, Mitchell H; Nailor, Michael D

    2016-06-01

    A urinary tract infection (UTI) disease state management guideline, including risk-based antimicrobial recommendations, Foley catheter management and transitions of care, was implemented. This study evaluated the outcomes associated with implementation of the guideline. A retrospective study was conducted between 1 July 2013 and 30 September 2013 (pre-implementation) and between 1 July 2014 and 30 September 2014 (post-implementation). Symptomatic patients treated for UTI within 24 h with an identified pathogen were included. Risk-based patient groups were community-acquired UTI, healthcare-associated UTI, or extended-spectrum β-lactamase (ESBL) history in prior 12 months. Recommended antimicrobials were ceftriaxone, cefepime ± vancomycin, or doripenem ± vancomycin, respectively. Given the low post-implementation guideline adherence, pre- and post-groups were combined to evaluate potential guideline value. Length of stay (LOS) decreased when guidelines were followed [5 (IQR 4-7) days vs. 6 (IQR 4-8) days; P = 0.03] or appropriate therapy (according to in vitro susceptibilities) was given [5 (IQR 4-7) days vs. 6 (IQR 4-9) days; P = 0.03]. Those receiving guideline-recommended antimicrobials were more likely to have appropriate therapy within 24 h (84.4% vs. 64.2%; P <0.001). On multivariate analysis, intensive care unit (ICU) admission and admission from home were associated with longer and shorter LOS, respectively. Despite less than anticipated adherence, these data suggest that the established disease state management guideline can improve outcomes in patients admitted with UTI. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  19. Chemical leasing--a review of implementation in the past decade.

    PubMed

    Moser, Frank; Jakl, Thomas

    2015-04-01

    In the past decade, research on innovative business models to manage the risk of chemical substances has sought to provide solutions to achieve the goals of the World Summit on Sustainable Development of 2002, which called for a renewal of the commitment to the sound management of chemicals and of hazardous wastes throughout their life cycle and set the ambitious goal, by 2020, to use and produce chemicals in ways that do not lead to significant adverse effects on human health and the environment. Chemical Leasing is an innovative business model that shows a great potential to become a global model for sustainable development within chemical management. This paper provides a review of the current standings of literature regarding the implementation of Chemical Leasing in the past decade. In doing so, the paper highlights the potential of this business model to serve as an approach for dematerializing production processes and managing the risks of chemicals at all levels. More in detail, it provides an outline of how Chemical Leasing has supported the alignment and implementation of the objectives of chemicals policy-makers and industry regarding the production and use of chemicals and analyses to what extent Chemical Leasing contributes to the implementation of a number of voluntary global initiatives, such as Cleaner Production, Sustainable Chemistry and Corporate Social Responsibility. This paper provides a systematic analysis of the gaps identified in literature regarding the implementation of Chemical Leasing business models. Based on this analysis, specific aspects in the field of Chemical Leasing are recommended to be further elaborated in order to increase the understanding and applicability of the business model.

  20. Perceptions of risk, risk aversion, and barriers to adoption of decision support systems and integrated pest management: an introduction.

    PubMed

    Gent, David H; De Wolf, Erick; Pethybridge, Sarah J

    2011-06-01

    Rational management of plant diseases, both economically and environmentally, involves assessing risks and the costs associated with both correct and incorrect tactical management decisions to determine when control measures are warranted. Decision support systems can help to inform users of plant disease risk and thus assist in accurately targeting events critical for management. However, in many instances adoption of these systems for use in routine disease management has been perceived as slow. The under-utilization of some decision support systems is likely due to both technical and perception constraints that have not been addressed adequately during development and implementation phases. Growers' perceptions of risk and their aversion to these perceived risks can be reasons for the "slow" uptake of decision support systems and, more broadly, integrated pest management (IPM). Decision theory provides some tools that may assist in quantifying and incorporating subjective and/or measured probabilities of disease occurrence or crop loss into decision support systems. Incorporation of subjective probabilities into IPM recommendations may be one means to reduce grower uncertainty and improve trust of these systems because management recommendations could be explicitly informed by growers' perceptions of risk and economic utility. Ultimately though, we suggest that an appropriate measure of the value and impact of decision support systems is grower education that enables more skillful and informed management decisions independent of consultation of the support tool outputs.

  1. [Impact of interventions in the pressure ulcer rate].

    PubMed

    Araya Farías, I; Febré, N

    To evaluate the impact of a risk management program for prevention of pressure ulcers (PUs) in an adult Intensive Care Unit (ICU). A quantitative, prospective study performed with a «before and after» evaluation, and designed in three stages: 1) PU incidence study; 2) Intervention by implementing a risk management program, and 3) Assessment of the impact. Adherence to the preventive measures showed a significant increase (11.7%) between the first month of the program and the final month (58.5%) of the assessment. Initial PU rate was 20.9, with a decrease in the rate to 14.0 per 1000 bed occupancy days (P<.05) after the risk management program. The data show that the risk management program, using prevention measures, was effective in reducing the rate of PU in the period under study by more than 33%. Copyright © 2017 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Farmers' attitudes to disease risk management in England: a comparative analysis of sheep and pig farmers.

    PubMed

    Garforth, C J; Bailey, A P; Tranter, R B

    2013-07-01

    The UK Department for Environment, Food and Rural Affairs (Defra) identified practices to reduce the risk of animal disease outbreaks. We report on the response of sheep and pig farmers in England to promotion of these practices. A conceptual framework was established from research on factors influencing adoption of animal health practices, linking knowledge, attitudes, social influences and perceived constraints to the implementation of specific practices. Qualitative data were collected from nine sheep and six pig enterprises in 2011. Thematic analysis explored attitudes and responses to the proposed practices, and factors influencing the likelihood of implementation. Most feel they are doing all they can reasonably do to minimise disease risk and that practices not being implemented are either not relevant or ineffective. There is little awareness and concern about risk from unseen threats. Pig farmers place more emphasis than sheep farmers on controlling wildlife, staff and visitor management and staff training. The main factors that influence livestock farmers' decision on whether or not to implement a specific disease risk measure are: attitudes to, and perceptions of, disease risk; attitudes towards the specific measure and its efficacy; characteristics of the enterprise which they perceive as making a measure impractical; previous experience of a disease or of the measure; and the credibility of information and advice. Great importance is placed on access to authoritative information with most seeing vets as the prime source to interpret generic advice from national bodies in the local context. Uptake of disease risk measures could be increased by: improved risk communication through the farming press and vets to encourage farmers to recognise hidden threats; dissemination of credible early warning information to sharpen farmers' assessment of risk; and targeted information through training events, farming press, vets and other advisers, and farmer groups, tailored to the different categories of livestock farmer. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Care zoning in a psychiatric intensive care unit: strengthening ongoing clinical risk assessment.

    PubMed

    Mullen, Antony; Drinkwater, Vincent; Lewin, Terry J

    2014-03-01

    To implement and evaluate the care zoning model in an eight-bed psychiatric intensive care unit and, specifically, to examine the model's ability to improve the documentation and communication of clinical risk assessment and management. Care zoning guides nurses in assessing clinical risk and planning care within a mental health context. Concerns about the varying quality of clinical risk assessment prompted a trial of the care zoning model in a psychiatric intensive care unit within a regional mental health facility. The care zoning model assigns patients to one of 3 'zones' according to their clinical risk, encouraging nurses to document and implement targeted interventions required to manage those risks. An implementation trial framework was used for this research to refine, implement and evaluate the impact of the model on nurses' clinical practice within the psychiatric intensive care unit, predominantly as a quality improvement initiative. The model was trialled for three months using a pre- and postimplementation staff survey, a pretrial file audit and a weekly file audit. Informal staff feedback was also sought via surveys and regular staff meetings. This trial demonstrated improvement in the quality of mental state documentation, and clinical risk information was identified more accurately. There was limited improvement in the quality of care planning and the documentation of clinical interventions. Nurses' initial concerns over the introduction of the model shifted into overall acceptance and recognition of the benefits. The results of this trial demonstrate that the care zoning model was able to improve the consistency and quality of risk assessment information documented. Care planning and evaluation of associated outcomes showed less improvement. Care zoning remains a highly applicable model for the psychiatric intensive care unit environment and is a useful tool in guiding nurses to carry out routine patient risk assessments. © 2013 John Wiley & Sons Ltd.

  4. A review on risk assessment techniques for hydraulic fracturing water and produced water management implemented in onshore unconventional oil and gas production.

    PubMed

    Torres, Luisa; Yadav, Om Prakash; Khan, Eakalak

    2016-01-01

    The objective of this paper is to review different risk assessment techniques applicable to onshore unconventional oil and gas production to determine the risks to water quantity and quality associated with hydraulic fracturing and produced water management. Water resources could be at risk without proper management of water, chemicals, and produced water. Previous risk assessments in the oil and gas industry were performed from an engineering perspective leaving aside important social factors. Different risk assessment methods and techniques are reviewed and summarized to select the most appropriate one to perform a holistic and integrated analysis of risks at every stage of the water life cycle. Constraints to performing risk assessment are identified including gaps in databases, which require more advanced techniques such as modeling. Discussions on each risk associated with water and produced water management, mitigation strategies, and future research direction are presented. Further research on risks in onshore unconventional oil and gas will benefit not only the U.S. but also other countries with shale oil and gas resources. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Safety management practices in small and medium enterprises in India.

    PubMed

    Unnikrishnan, Seema; Iqbal, Rauf; Singh, Anju; Nimkar, Indrayani M

    2015-03-01

    Small and medium enterprises (SMEs) are often the main pillar of an economy. Minor accidents, ergonomics problems, old and outdated machinery, and lack of awareness have created a need for implementation of safety practices in SMEs. Implementation of healthy working conditions creates positive impacts on economic and social development. In this study, a questionnaire was developed and administered to 30 randomly chosen SMEs in and around Mumbai, Maharashtra, and other states in India to evaluate safety practices implemented in their facilities. The study also looked into the barriers and drivers for technology innovation and suggestions were also received from the respondent SMEs for best practices on safety issues. In some SMEs, risks associated with safety issues were increased whereas risks were decreased in others. Safety management practices are inadequate in most SMEs. Market competitiveness, better efficiency, less risk, and stringent laws were found to be most significant drivers; and financial constraints, lack of awareness, resistance to change, and lack of training for employees were found to be main barriers. Competition between SMEs was found to be major reason for implementation of safety practices in the SMEs. The major contribution of the study has been awareness building on safety issues in the SMEs that participated in the project.

  6. Safety Management Practices in Small and Medium Enterprises in India

    PubMed Central

    Unnikrishnan, Seema; Iqbal, Rauf; Singh, Anju; Nimkar, Indrayani M.

    2014-01-01

    Background Small and medium enterprises (SMEs) are often the main pillar of an economy. Minor accidents, ergonomics problems, old and outdated machinery, and lack of awareness have created a need for implementation of safety practices in SMEs. Implementation of healthy working conditions creates positive impacts on economic and social development. Methods In this study, a questionnaire was developed and administered to 30 randomly chosen SMEs in and around Mumbai, Maharashtra, and other states in India to evaluate safety practices implemented in their facilities. The study also looked into the barriers and drivers for technology innovation and suggestions were also received from the respondent SMEs for best practices on safety issues. Results In some SMEs, risks associated with safety issues were increased whereas risks were decreased in others. Safety management practices are inadequate in most SMEs. Market competitiveness, better efficiency, less risk, and stringent laws were found to be most significant drivers; and financial constraints, lack of awareness, resistance to change, and lack of training for employees were found to be main barriers. Conclusion Competition between SMEs was found to be major reason for implementation of safety practices in the SMEs. The major contribution of the study has been awareness building on safety issues in the SMEs that participated in the project. PMID:25830070

  7. Health workers' views of a program to facilitate physical health care in mental health settings: implications for implementation and training.

    PubMed

    Baker, Wendy; Harris, Melanie; Battersby, Malcolm

    2014-12-01

    Physical comorbidities shorten the lifespan of people with severe mental illness therefore mental health clinicians need to support service users in risk factor-related behaviour change. We investigated mental health care workers' views of a physical health self-management support program in order to identify implementation requirements. Qualitative interviews were conducted with workers who had differing levels of experience with a self-management support program. Themes were identified using interpretive descriptive analysis and then matched against domains used in implementation models to draw implications for successful practice change. Three main themes emerged related to: (1) understandings of disease management within job roles; (2) requirements for putting self-management support into practice; and (3) challenges of coordination in disease management. Priority domains from implementation models were inner and outer health service settings. While staff training is required, practice change for care which takes account of both mental and physical health also requires changes in organisational frameworks. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  8. Strategic environmental management planning, team-building and implementation: Principles and experience at Watkins-Johnson Company

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

    Molony, C.

    This paper provides a short discussion of the realities of implementing a strategic environmental management program in a modern corporation. The first half lists typical business challenges which are related to EPA regulations, to property risk management, and to company performance which can have a positive impact on the environment. The strategic environmental manager anticipates these business issues successfully. The list provided is based on my experiences as an environment and safety professional over the past sixteen years, while working at three Silicon Valley electronics firms. The second half discusses examples of relevant, specific accomplishments in the environment-related business activitiesmore » of Watkins-Johnson Company.« less

  9. A guide to understanding and implementing risk evaluation and mitigation strategies in organ transplantation.

    PubMed

    Gabardi, Steven; Tichy, Eric M

    2013-03-01

    To review the components of the Congressional mandate for risk evaluation and mitigation strategies (REMS) managed by the Food and Drug Administration and assess their impact on health care providers practicing within the organ transplant arena. A non-date-limited search of MEDLINE and EMBASE (January 2007-June 2012) was conducted by using the following search terms: risk evaluation and mitigation strategies, REMS, and organ transplant, including a query of the individual organs. Information from the Federal Register and the Food and Drug Administration was also evaluated. REMS are strategies implemented to manage known or potential risks associated with medications and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical product. Elements of REMS programs may consist of 3 levels: a medication guide, communication plan, and elements to assure safe use. A medication guide is used to help prevent serious adverse events, aid in patients' decision making, and enhance medication adherence. Communication plans help educate health care providers and encourage adherence with REMS. The elements to assure safe use is a restrictive process implemented when it is deemed necessary to ensure safe access for patients to products with known serious risks. In transplant medicine, REMS currently exist for belatacept (medication guide and communication plan) and the mycophenolic acid derivatives (medication guide and elements to assure safe use). REMS are another step in the evolution of the development and marketing of pharmaceutical agents. Use of REMS in solid-organ transplant is becoming common. Transplant clinicians must provide required patient education and become involved with other aspects of REMS implementation to reduce the serious risks of pharmaceuticals and to improve patients' outcomes.

  10. Risks posed by climate change to the delivery of Water Framework Directive objectives in the UK.

    PubMed

    Wilby, R L; Orr, H G; Hedger, M; Forrow, D; Blackmore, M

    2006-12-01

    The EU Water Framework Directive (WFD) is novel because it integrates water quality, water resources, physical habitat and, to some extent, flooding for all surface and groundwaters and takes forward river basin management. However, the WFD does not explicitly mention risks posed by climate change to the achievement of its environmental objectives. This is despite the fact that the time scale for the implementation process and achieving particular objectives extends into the 2020s, when climate models project changes in average temperature and precipitation. This paper begins by reviewing the latest UK climate change scenarios and the wider policy and science context of the WFD. We then examine the potential risks of climate change to key phases of the River Basin Management Process that underpin the WFD (such as characterisation of river basins and their water bodies, risk assessments to identify pressures and impacts, programmes of measures (POMs) options appraisal, monitoring and modelling, policy and management activities). Despite these risks the WFD could link new policy and participative mechanisms (being established for the River Basin Management Plans) to the emerging framework of national and regional climate change adaptation policy. The risks are identified with a view to informing policy opportunities, objective setting, adaptation strategies and the research agenda. Key knowledge gaps have already been identified during the implementation of the WFD, such as the links between hydromorphology and ecosystem status, but the overarching importance of linking climate change to these considerations needs to be highlighted. The next generation of (probabilistic) climate change scenarios will present new opportunities and challenges for risk analysis and policy-making.

  11. Integrated and Adaptive Reservoir Management in the Context of Hydroclimatic Variability: a Case Study of the Gunnison Basin, Colorado

    NASA Astrophysics Data System (ADS)

    Ray, A. J.

    2007-12-01

    Water resources managers in the West face the challenge of meeting multiple and expanding demands for water in the context of existing and future hydroclimatic variations. This case study of water resources management in the Gunnison Basin of Colorado describes a context similar to many others in the western U.S.: demands match or exceed supply, and yet more demands are being made on the system. As elsewhere, new demands often relate to restoring or maintaining environmental sustainability, in this case the flow requirements to implement the Recovery Program for Endangered Fish of the Colorado River and a water right for the Black Canyon of the Gunnison National Park. Strategies to meet these demands focus on use of stored water in the Aspinall Unit, a system of reservoirs managed by the U.S. Bureau of Reclamation (USBR) in conjunction with a diverse set of stakeholders. In response to increased demands, USBR has implemented strategies to more intensively and efficiently use water. However, as a result, the buffer to shortage or drought is all but exhausted and the system is now more sensitive to shortage. Thus by neglecting the risks of hydroclimatic variations, the implementation of these policies to achieve environmental sustainability could be hindered. On the other hand, by more fully recognizing the risks and uncertainty surrounding these variations, managers might adjust annual to interannual operating plans to mitigate adverse conditions in dry years and take advantage of wet years. The presentation will describe two factors important in the incorporation of hydroclimatic risk into management: 1) the potential to use hydroclimatic climate information in operations and long-range planning, and 2) the institutional capacity to use this information effectively. In contrast to the rigid operating constraints found in other systems, operations here are often adjusted for a variety of reasons, revealing flexibility and adaptability in operations and a collaborative management structure that seeks creative solutions . However, the uncertainty of the inflow forecast is itself a major constraining factor for operations, resulting in conservative operational choices even well into the runoff period. Advance notice about conditions in climate forecast could give more time to negotiate contracts, implement agreements, or develop new ones. The advance notice could also allow managers to plan to take advantage of wet years and maximize benefits of surplus, for example, for peak flows for ecosystems. The incorporation of hydroclimatic risk into longer-range planning, such as building flexibility into reservoir operating policies being negotiated under the EIS for the could avoid problems in implementing these policies later if changes in climate limit the amount of water available in the basin. In particular, the capacity of water management institutions to cope with climate will be described through the responses to past hydroclimatic variations.

  12. [Level of implementation of the Program for Safety and Health at Work in Antioquia, Colombia].

    PubMed

    Vega-Monsalve, Ninfa Del Carmen

    2017-07-13

    This study describes the level of implementation of the Program for Safety and Health at Work in companies located in the Department of Antioquia, Colombia, and associated factors. A cross-sectional survey included 73 companies with more than 50 workers each and implementation of the program. A total of 65 interviews were held, in addition to 73 checklists and process reviews. The companies showed suboptimal compliance with the management model for workplace safety and health proposed by the International Labor Organization (ILO). The component with the best development was Organization (87%), and the worst was Policy (67%). Company executives contended that the causes of suboptimal implementation were the limited commitment by area directors and scarce budget resources. Risk management mostly aimed to comply with the legal requirements in order to avoid penalties, plus documenting cases. There was little implementation of effective checks and controls to reduce the sources of work accidents. The study concludes that workers' health management lacks effective strategies.

  13. A strategic approach for Water Safety Plans implementation in Portugal.

    PubMed

    Vieira, Jose M P

    2011-03-01

    Effective risk assessment and risk management approaches in public drinking water systems can benefit from a systematic process for hazards identification and effective management control based on the Water Safety Plan (WSP) concept. Good results from WSP development and implementation in a small number of Portuguese water utilities have shown that a more ambitious nationwide strategic approach to disseminate this methodology is needed. However, the establishment of strategic frameworks for systematic and organic scaling-up of WSP implementation at a national level requires major constraints to be overcome: lack of legislation and policies and the need for appropriate monitoring tools. This study presents a framework to inform future policy making by understanding the key constraints and needs related to institutional, organizational and research issues for WSP development and implementation in Portugal. This methodological contribution for WSP implementation can be replicated at a global scale. National health authorities and the Regulator may promote changes in legislation and policies. Independent global monitoring and benchmarking are adequate tools for measuring the progress over time and for comparing the performance of water utilities. Water utilities self-assessment must include performance improvement, operational monitoring and verification. Research and education and resources dissemination ensure knowledge acquisition and transfer.

  14. [Outsourcing in long-term care: a risk management approach].

    PubMed

    Guimarães, Cristina Machado; Carvalho, José Crespo de

    2012-05-01

    This article seeks to investigate outsourcing decisions in supply chain management of healthcare organizations, namely the motives and constraints behind the decision, the selection criteria for activities to be outsourced to third parties, the type of possible agreements, and the impact of this decision on the organization per se. A case study of the start-up phase of a Long-term Care unit with an innovative approach and high levels of customization was conducted to understand the outsourcing process in a start-up context (not in the standard context of organizational change) and a risk evaluation matrix was created for outsourcing activities in order to define and implement a performance monitoring process. This study seeks to understand how to evaluate and assess the risks of an outsourcing strategy and proposes a monitoring model using risk management tools. It was shown that the risk management approach can be a solution for monitoring outsourcing in the organizational start-up phase. Conclusions concerning dissatisfaction with the results of outsourcing strategies adopted are also presented.

  15. A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.

    PubMed

    Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George

    2018-01-01

    The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.

  16. Risk-based Process Development of Biosimilars as Part of the Quality by Design Paradigm.

    PubMed

    Zalai, Dénes; Dietzsch, Christian; Herwig, Christoph

    2013-01-01

    In the last few years, several quality by design (QbD) studies demonstrated the benefit of systematic approaches for biopharmaceutical development. However, only very few studies identified biosimilars as a special case of product development. The targeted quality profile of biosimilars is strictly defined by the originator's product characteristic. Moreover, the major source of prior knowledge is the experience with the originator product itself. Processing this information in biosimilar development has a major effect on risk management and process development strategies. The main objective of this contribution is to demonstrate how risk management can facilitate the implementation of QbD in early-stage product development with special emphasis on fitting the reported approaches to biosimilars. Risk assessments were highlighted as important tools to integrate prior knowledge in biosimilar development. The risk assessment process as suggested by the International Conference on Harmonization (ICH Q9) was reviewed and three elements were identified to play a key role in targeted risk assessment approaches: proper understanding of target linkage, risk assessment tool compliance, and criticality threshold value. Adjusting these steps to biosimilar applications helped to address some unique challenges of these products such as a strictly defined quality profile or a lack of process knowledge. This contribution demonstrates the need for tailored risk management approaches for the risk-based development of biosimilars and provides novel tools for the integration of additional knowledge available for these products. The pharmaceutical industry is facing challenges such as profit loss and price competition. Companies are forced to rationalize business models and to cut costs in development as well as manufacturing. These trends recently hinder the implementation of any concepts that do not offer certain financial benefit or promise a long return of investment. Quality by design (QbD) is a concept that is currently struggling for more acceptance from the side of the pharmaceutical industry. To achieve this, the major goals of QbD have to be revisited and QbD tools have to be subsequently developed. This contribution offers an example as to how implement risk management in early-stage biosimilar development as part of the QbD concept. The main goal was to go beyond the conventional QbD workflow and to adjust risk management to the challenges of biosimilar products. Accordingly, instead of using methods like failure mode and effects analysis, recommendations of the ICH Q9 guideline were reviewed and put into practice by creating tailored risk assessment tools. The novelty of this contribution is to report those tailored tools ready-to-use for early bioprocess development of biosimilars along QbD principles.

  17. Full Implementation of Screening for Nutritional Risk and Dysphagia in an Acute Stroke Unit: A Clinical Audit.

    PubMed

    Kampman, Margitta T; Eltoft, Agnethe; Karaliute, Migle; Børvik, Margrethe T; Nilssen, Hugo; Rasmussen, Ida; Johnsen, Stein H

    2015-10-01

    In patients with acute stroke, undernutrition and aspiration pneumonia are associated with increased mortality and length of hospital stay. Formal screening for nutritional risk and dysphagia helps to ensure optimal nutritional management in all patients with stroke and to reduce the risk of aspiration in patients with dysphagia. We developed a national guideline for nutritional and dysphagia screening in acute stroke, which was introduced in our stroke unit on June 1, 2012. The primary objective was to audit adherence to the guideline and to achieve full implementation. Second, we assessed the prevalence of nutritional risk and dysphagia. We performed a chart review to assess performance of screening for nutritional risk and dysphagia in all patients with stroke hospitalized for ≥48 hours between June 1, 2012, and May 31, 2013. Next we applied a "clinical microsystems approach" with rapid improvement cycles and audits over a 6-month period to achieve full implementation. The chart review showed that nutritional risk screening was performed in 65% and swallow testing in 91% of eligible patients (n = 185). Proactive implementation resulted in >95% patients screened (n = 79). The overall prevalence of nutritional risk was 29%, and 23% of the patients failed the initial swallow test. Proactive implementation is required to obtain high screening rates for nutritional risk and swallowing difficulties using validated screening tools. The proportion of patients at nutritional risk and the prevalence of dysphagia at initial swallow test were in the lower range of previous reports.

  18. Patient safety in external beam radiotherapy, results of the ACCIRAD project: Current status of proactive risk assessment, reactive analysis of events, and reporting and learning systems in Europe.

    PubMed

    Malicki, Julian; Bly, Ritva; Bulot, Mireille; Godet, Jean-Luc; Jahnen, Andreas; Krengli, Marco; Maingon, Philippe; Prieto Martin, Carlos; Przybylska, Kamila; Skrobała, Agnieszka; Valero, Marc; Jarvinen, Hannu

    2017-04-01

    To describe the current status of implementation of European directives for risk management in radiotherapy and to assess variability in risk management in the following areas: 1) in-country regulatory framework; 2) proactive risk assessment; (3) reactive analysis of events; and (4) reporting and learning systems. The original data were collected as part of the ACCIRAD project through two online surveys. Risk assessment criteria are closely associated with quality assurance programs. Only 9/32 responding countries (28%) with national regulations reported clear "requirements" for proactive risk assessment and/or reactive risk analysis, with wide variability in assessment methods. Reporting of adverse error events is mandatory in most (70%) but not all surveyed countries. Most European countries have taken steps to implement European directives designed to reduce the probability and magnitude of accidents in radiotherapy. Variability between countries is substantial in terms of legal frameworks, tools used to conduct proactive risk assessment and reactive analysis of events, and in the reporting and learning systems utilized. These findings underscore the need for greater harmonisation in common terminology, classification and reporting practices across Europe to improve patient safety and to enable more reliable inter-country comparisons. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Modeling potential outcomes of fire and fuel management scenarios on the structure of forested habitats in northeast Oregon, USA.

    Treesearch

    B.C. Wales; L.H. Suring; M.A. Hemstrom

    2007-01-01

    Thinning and prescribed fire are being used extensively across the interior Western United States to reduce the risk of large, severe wildfires. However, the full ecological consequences of implementing these management practices on the landscape have not been completely evaluated. We projected future vegetation trends resulting from four management scenarios and...

  20. 12 CFR Appendix D-2 to Part 208 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Relationships Risk Management Principles,” Nov. 1, 2001; FDIC FIL 68-99, Risk Assessment Tools and Practices for.... Definitions II. Standards for Safeguarding Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of...

  1. 12 CFR Appendix F to Part 225 - Interagency Guidelines Establishing Information Security Standards

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Relationships Risk Management Principles,” Nov. 1, 2001; FDIC FIL 68-99, Risk Assessment Tools and Practices for.... Standards for Safeguarding Customer Information A. Information Security Program B. Objectives III. Development and Implementation of Customer Information Security Program A. Involve the Board of Directors B...

  2. [Process management in the hospital pharmacy for the improvement of the patient safety].

    PubMed

    Govindarajan, R; Perelló-Juncá, A; Parès-Marimòn, R M; Serrais-Benavente, J; Ferrandez-Martí, D; Sala-Robinat, R; Camacho-Calvente, A; Campabanal-Prats, C; Solà-Anderiu, I; Sanchez-Caparrós, S; Gonzalez-Estrada, J; Martinez-Olalla, P; Colomer-Palomo, J; Perez-Mañosas, R; Rodríguez-Gallego, D

    2013-01-01

    To define a process management model for a hospital pharmacy in order to measure, analyse and make continuous improvements in patient safety and healthcare quality. In order to implement process management, Igualada Hospital was divided into different processes, one of which was the Hospital Pharmacy. A multidisciplinary management team was given responsibility for each process. For each sub-process one person was identified to be responsible, and a working group was formed under his/her leadership. With the help of each working group, a risk analysis using failure modes and effects analysis (FMEA) was performed, and the corresponding improvement actions were implemented. Sub-process indicators were also identified, and different process management mechanisms were introduced. The first risk analysis with FMEA produced more than thirty preventive actions to improve patient safety. Later, the weekly analysis of errors, as well as the monthly analysis of key process indicators, permitted us to monitor process results and, as each sub-process manager participated in these meetings, also to assume accountability and responsibility, thus consolidating the culture of excellence. The introduction of different process management mechanisms, with the participation of people responsible for each sub-process, introduces a participative management tool for the continuous improvement of patient safety and healthcare quality. Copyright © 2012 SECA. Published by Elsevier Espana. All rights reserved.

  3. 76 FR 48093 - Hazardous Chemical Reporting: Revisions to the Emergency and Hazardous Chemical Inventory Forms...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-08

    ... provisions to the Office of Information and Regulatory Affairs, Office of Management and Budget (OMB), Attn... information provided, unless the comment includes information claimed to be Confidential Business Information... EPA information about these programs and hazards in a risk management plan (RMP). The implementing...

  4. The Role of Private Sector Management in Public Education.

    ERIC Educational Resources Information Center

    Doyle, Denis P.

    1994-01-01

    The school system's uniformity is clearly a liability in the modern era. Today's schools need entrepreneurship, not change by rule, regulation, and statute. The central issue of entrepreneurship is not risk-taking, but innovative, implementation methods. Eventually, using private contractors to improve the management of instructional services will…

  5. Experiences of using a participatory action research approach to strengthen district local capacity in Eastern Uganda

    PubMed Central

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

    2017-01-01

    ABSTRACT Background: To achieve a sustained improvement in health outcomes, the way health interventions are designed and implemented is critical. A participatory action research approach is applauded for building local capacity such as health management. Thereby increasing the chances of sustaining health interventions. Objective: This study explored stakeholder experiences of using PAR to implement an intervention meant to strengthen the local district capacity. Methods: This was a qualitative study featuring 18 informant interviews and a focus group discussion. Respondents included politicians, administrators, health managers and external researchers in three rural districts of eastern Uganda where PAR was used. Qualitative content analysis was used to explore stakeholders’ experiences. Results: ‘Being awakened’ emerged as an overarching category capturing stakeholder experiences of using PAR. This was described in four interrelated and sequential categories, which included: stakeholder involvement, being invigorated, the risk of wide stakeholder engagement and balancing the risk of wide stakeholder engagement. In terms of involvement, the stakeholders felt engaged, a sense of ownership, felt valued and responsible during the implementation of the project. Being invigorated meant being awakened, inspired and supported. On the other hand, risks such as conflict, stress and uncertainty were reported, and finally these risks were balanced through tolerance, risk-awareness and collaboration. Conclusions: The PAR approach was desirable because it created opportunities for building local capacity and enhancing continuity of interventions. Stakeholders were awakened by the approach, as it made them more responsive to systems challenges and possible local solutions. Nonetheless, the use of PAR should be considered in full knowledge of the undesirable and complex experiences, such as uncertainty, conflict and stress. This will enable adequate preparation and management of stakeholder expectations to maximize the benefits of the approach. PMID:28856974

  6. Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction.

    PubMed

    Reyers, Belinda; Nel, Jeanne L; O'Farrell, Patrick J; Sitas, Nadia; Nel, Deon C

    2015-06-16

    Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social-ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making.

  7. Navigating complexity through knowledge coproduction: Mainstreaming ecosystem services into disaster risk reduction

    PubMed Central

    Reyers, Belinda; Nel, Jeanne L.; O’Farrell, Patrick J.; Sitas, Nadia; Nel, Deon C.

    2015-01-01

    Achieving the policy and practice shifts needed to secure ecosystem services is hampered by the inherent complexities of ecosystem services and their management. Methods for the participatory production and exchange of knowledge offer an avenue to navigate this complexity together with the beneficiaries and managers of ecosystem services. We develop and apply a knowledge coproduction approach based on social–ecological systems research and assess its utility in generating shared knowledge and action for ecosystem services. The approach was piloted in South Africa across four case studies aimed at reducing the risk of disasters associated with floods, wildfires, storm waves, and droughts. Different configurations of stakeholders (knowledge brokers, assessment teams, implementers, and bridging agents) were involved in collaboratively designing each study, generating and exchanging knowledge, and planning for implementation. The approach proved useful in the development of shared knowledge on the sizable contribution of ecosystem services to disaster risk reduction. This knowledge was used by stakeholders to design and implement several actions to enhance ecosystem services, including new investments in ecosystem restoration, institutional changes in the private and public sector, and innovative partnerships of science, practice, and policy. By bringing together multiple disciplines, sectors, and stakeholders to jointly produce the knowledge needed to understand and manage a complex system, knowledge coproduction approaches offer an effective avenue for the improved integration of ecosystem services into decision making. PMID:26082541

  8. Conceptualization and Pilot Testing of a Core Competency-Based Training Workshop in Suicide Risk Assessment and Management: Notes From the Field.

    PubMed

    Cramer, Robert J; Bryson, Claire N; Eichorst, Morgam K; Keyes, Lee N; Ridge, Brittany E

    2017-03-01

    As professional psychology training programs and continuing education have moved toward competency based approaches, it has become equally important to develop uniform, evidence-based approaches for suicide risk assessment and management. The present article presents a workshop curriculum based on established core competencies in suicide risk assessment and management. Drawing on theories suicide risk formation, the workshop features an integration of didactic, process, and experiential components. We present pilot data from 2 small group workshops (n = 17): 1 from a clinical psychology doctoral program and 1 from a university counseling center. Workshop participation yielded increases in (a) the ability to recognize appropriate clinician responses to suicidal client statements, (b) self-perceptions of general capacity to interface with suicidal patients and mastery of the 10 core competencies, (c) factual knowledge concerning suicide risk assessment and management, and (d) the self-rated ability to assess and manage a suicidal patient. We discuss statistical and generalizability limitations as well as implications for future modification, implementation, and provision of this training method. © 2016 Wiley Periodicals, Inc.

  9. SeCom - Serious Community 2.0 prevent flooding

    NASA Astrophysics Data System (ADS)

    Komma, Juergen; Breuer, Roman; Sewilam, Hani; Concia, Francesca; Aliprandi, Bruno; Siegmund, Sabine; Goossens, Jannis

    2013-04-01

    There is a significant need for raising the awareness and building the capacity of water professionals in different water sectors cross Europe. There is also a need for qualified graduates to implement the EU Flood Risk Directive (FRD). The main aim of this work is to prepare and build the capacity of both groups in flood risk management through identifying synergies, sharing knowledge, and strengthen partnerships between universities and different stakeholders(mainly water professionals). The specific objectives are to develop; a) Development of a dynamic and active tool that allows all target-groups/users to assess their knowledge about flood risk management. b) Development of an innovative, active and problem-based learning methodology for flood risk education and training. c)Development of flood related Vocational Education & Training (VET) modules for water professionals (involving the students to gain practical experience). This will include some modules for undergraduate students on flood risk management and protection.

  10. Drought early warning and risk management in a changing environment

    NASA Astrophysics Data System (ADS)

    Pulwarty, R. S.

    2011-12-01

    Drought has long been recognized as falling into the category of incremental but long-term and cumulative environmental changes, also termed slow-onset or creeping events. These event types would include: air and water quality decline, desertification processes, deforestation and forest fragmentation, loss of biodiversity and habitats, and nitrogen overloading, among others. Climate scientists continue to struggle with recognizing the onset of drought and scientists and policy makers continue to debate the basis (i.e., criteria) for declaring an end to a drought. Risk-based management approaches to drought planning at the national and regional levels have been recommended repeatedly over the years but their prototyping, testing and operational implementation have been limited. This presentation will outline two avenues for disaster risk reduction in the context of drought (1) integrated early warning information systems, and (2) linking disaster risk reduction to climate change adaptation strategies. Adaptation involves not only using operational facilities and infrastructure to cope with the immediate problems but also leaving slack or reserve for coping with multiple stress problems that produce extreme impacts and surprise. Increasing the 'anticipatability' of an event, involves both monitoring of key indicators from appropriate baseline data, and observing early warning signs that assumptions in risk management plans are failing and critical transitions are occurring. Illustrative cases will be drawn from the IPCC Special Report on Managing the Risks of Extreme Events and Disasters (2011), the UN Global Assessment of Disaster Risk Reduction (2011) and implementation activities in which the author has been engaged. Most drought early warning systems have tended to focus on the development and use of physical system indicators and forecasts of trends and thresholds. We show that successful early warning systems that meet expectations of risk management also have explicit foci on (1) integrating physical and social vulnerability indicators across timescales, (2) analytical capacity to generate local scenarios of risk using both analogs and projections, (3) the communication of risk-based information, and (4) the support and governance of a collaborative framework for early warning structures across spatial scales.

  11. [Quantitative assessment of fungal risk in the case of construction works in healthcare establishments: Proposed indicators for the determination of the impact of management precautions on the risk of fungal infection].

    PubMed

    Gangneux, J-P; Adjidé, C-C; Bernard, L; Botterel, F; Carel, A; Castel, O; Derouin, F; Hoarau, G; Labussière, H; Lafaurie, M; Millon, L; Pottecher, B; Thiebaut, A; Turco, M; Baron, R

    2012-03-01

    Construction works in healthcare establishments produce airborne fungal spores and considerably increase the risk of exposure of immunosuppressed patients. It is necessary to reinforce protective measures, or even to implement specific precautions, during this critical phase. The aim of these precautions is to protect both those areas, which are susceptible to dust, and patients at risk of a fungal infection particularly invasive aspergillosis. When construction works are planned in healthcare establishments, the first step consists in the characterisation of the environmental fungal risk and the second one in proposing risk management methods. It is then essential to establish impact indicators in order to evaluate the risk management precautions applied. The working group promoted by the French societies of medical mycology and hospital hygiene (SFMM & SF2H) details here both environmental and epidemiological impact indicators that can be used. Copyright © 2012. Published by Elsevier SAS.

  12. Capacity and readiness of civil society organisations to implement community case management of malaria in Kenya.

    PubMed

    Marita, Enock; Oule, Jared; Mungai, Margaret; Thiam, Sylla; Ilako, Festus

    2016-01-01

    Civil Society Organizations (CSOs) contribute to achieving development goals through advocacy, social mobilisation and provision of health services. CSO programming is a key component of Global Fund (GF) grants; however, CSOs face technical and governance capacity challenges in grant utilisation leading to missed opportunities for improving health at community level. Amref Health Africa was appointed Principal Recipient of a GF grant aimed at scaling up community case management of malaria through CSOs as sub-recipients in western Kenya. To identify potential risks and strengthen grant management, Amref Health Africa and the Ministry of Health conducted a capacity needs assessment to determine the capacity of CSOs to effectively utilise grants. 26 selected CSOs participated in this study. Document reviews and on-site assessments and observations were conducted using structured tool. The five main assessment areas were: governance and risk management; strategic and operational planning; monitoring and evaluation; programme management; and financial management. Overall performance was grouped into four categories: 3.0-2.5 (excellent), 2.0-2.4 (good), 1.5-1.9 (fair), and 1.0-1.4 (poor). Data were collected and analysed using Excel software. Twenty five out of 26 CSOs were legally compliant. 14(54%) CSOs were categorized as good; 7(27%) as excellent; 3(12%) as poor and 2(8%) as fair. Most CSOs had good programme management capacity but monitoring and evaluation presented the most capacity gaps. More than 75% of the CSOs were rated as excellent or good. A capacity building plan, programme risk management plan and oversight mechanisms were important for successful grant implementation.

  13. Systems engineering implementation in the preliminary design phase of the Giant Magellan Telescope

    NASA Astrophysics Data System (ADS)

    Maiten, J.; Johns, M.; Trancho, G.; Sawyer, D.; Mady, P.

    2012-09-01

    Like many telescope projects today, the 24.5-meter Giant Magellan Telescope (GMT) is truly a complex system. The primary and secondary mirrors of the GMT are segmented and actuated to support two operating modes: natural seeing and adaptive optics. GMT is a general-purpose telescope supporting multiple science instruments operated in those modes. GMT is a large, diverse collaboration and development includes geographically distributed teams. The need to implement good systems engineering processes for managing the development of systems like GMT becomes imperative. The management of the requirements flow down from the science requirements to the component level requirements is an inherently difficult task in itself. The interfaces must also be negotiated so that the interactions between subsystems and assemblies are well defined and controlled. This paper will provide an overview of the systems engineering processes and tools implemented for the GMT project during the preliminary design phase. This will include requirements management, documentation and configuration control, interface development and technical risk management. Because of the complexity of the GMT system and the distributed team, using web-accessible tools for collaboration is vital. To accomplish this GMTO has selected three tools: Cognition Cockpit, Xerox Docushare, and Solidworks Enterprise Product Data Management (EPDM). Key to this is the use of Cockpit for managing and documenting the product tree, architecture, error budget, requirements, interfaces, and risks. Additionally, drawing management is accomplished using an EPDM vault. Docushare, a documentation and configuration management tool is used to manage workflow of documents and drawings for the GMT project. These tools electronically facilitate collaboration in real time, enabling the GMT team to track, trace and report on key project metrics and design parameters.

  14. A free and open source QGIS plugin for flood risk analysis: FloodRisk

    NASA Astrophysics Data System (ADS)

    Albano, Raffaele; Sole, Aurelia; Mancusi, Leonardo

    2016-04-01

    An analysis of global statistics shows a substantial increase in flood damage over the past few decades. Moreover, it is expected that flood risk will continue to rise due to the combined effect of increasing numbers of people and economic assets in risk-prone areas and the effects of climate change. In order to increase the resilience of European economies and societies, the improvement of risk assessment and management has been pursued in the last years. This results in a wide range of flood analysis models of different complexities with substantial differences in underlying components needed for its implementation, as geographical, hydrological and social differences demand specific approaches in the different countries. At present, it is emerging the need of promote the creation of open, transparent, reliable and extensible tools for a comprehensive, context-specific and applicable flood risk analysis. In this context, the free and open-source Quantum GIS (QGIS) plugin "FloodRisk" is a good starting point to address this objective. The vision of the developers of this free and open source software (FOSS) is to combine the main features of state-of-the-art science, collaboration, transparency and interoperability in an initiative to assess and communicate flood risk worldwide and to assist authorities to facilitate the quality and fairness of flood risk management at multiple scales. Among the scientific community, this type of activity can be labelled as "participatory research", intended as adopting a set of techniques that "are interactive and collaborative" and reproducible, "providing a meaningful research experience that both promotes learning and generates knowledge and research data through a process of guided discovery"' (Albano et al., 2015). Moreover, this FOSS geospatial approach can lowering the financial barriers to understanding risks at national and sub-national levels through a spatio-temporal domain and can provide better and more complete information and to generate knowledge in the stakeholders for improving flood risk management. In particular, Floodrisk comprises a set of calculators capable of computing human or economic losses for a collection of assets, caused by a given scenario event, explicitly covering mitigation and adaptation measures (Mancusi et al., 2015). It is important to mention that despite the fact that some literature models incorporates calculator philosophies identical to the ones implemented in the FloodRisk engine, its implementation might vary significantly, such as the need for a user-friendly and intuitive user interface, or the capability of running the calculations on any platform (Windows, Mac, Linux, etc.), the ability to promotes extensibility, efficient testability, and scientific operability. FloodRisk has been designed as an initiative for implemented a standard and harmonized procedure to determine the flood impacts. Albano, R.; Mancusi, L.; Sole, A.; Adamowski, J. Collaborative Strategies for Sustainable EU Flood Risk Management: FOSS and Geospatial Tools - Challenges and Opportunities for Operative Risk Analysis. ISPRS Int. J. Geo-Inf. 2015, 4, 2704-2727. Mancusi, L., Albano, R., Sole, A.. FloodRisk: a QGIS plugin for flood consequences estimation, In: Geomatics Workbooks n°12 - FOSS4G Europe Como, 2015

  15. From design to implementation--the Joint Asia Diabetes Evaluation (JADE) program: a descriptive report of an electronic web-based diabetes management program.

    PubMed

    Ko, Gary T; So, Wing-Yee; Tong, Peter C; Le Coguiec, Francois; Kerr, Debborah; Lyubomirsky, Greg; Tamesis, Beaver; Wolthers, Troels; Nan, Jennifer; Chan, Juliana

    2010-05-13

    The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes.

  16. Pharmacist-led admission medication reconciliation before and after the implementation of an electronic medication management system.

    PubMed

    Sardaneh, Arwa A; Burke, Rosemary; Ritchie, Angus; McLachlan, Andrew J; Lehnbom, Elin C

    2017-05-01

    To investigate the impact of the introduction of an electronic medication management system on the proportion of patients with a recorded medication reconciliation on admission, the time from admission to when medication reconciliation was performed, and the characteristics of patients receiving this intervention pre-and post-implementation. An electronic medication management system was implemented in an Australian hospital from May to July 2015. A retrospective observational study was conducted in three wards across two phases; pre- (August 2014) and post- (August 2015) implementation. The study sample included every second patient admitted to these wards. A total of 370 patients were included, 179 pre- and 191 post-implementation. The proportion of recorded admission medication reconciliation significantly increased post-implementation in all study wards; coronary care unit (40 vs 68%, p=0.004), gastroenterology ward (39 vs 59%, p=0.015), and the neurology ward (19 vs 45%, p=0.002). The proportion of patients with recorded medication reconciliation within 24h of weekday admissions, or 48-72h of weekend admissions, increased from 47% pre- to 84% post-implementation. Admission medication reconciliation was recorded within a median of 1.0day for weekday admissions pre- and post-implementation (IQR 1.1 vs 0.2, respectively), and 3.5days (IQR 2.0) pre-implementation vs 1.5days (IQR 2.0) post-implementation for weekend admissions. Overall, across both phases pre-and post-implementation, admission medication reconciliation was recorded for patients who were significantly older (median 77 and 71 years, p<0.001), had a higher number of preadmission medications (median 6.5 and 5.0 medicines, p=0.001), and had a longer hospital stay (median 6.5 and 5.1days, p=0.003). A significantly higher proportion of patients with recorded medication reconciliation in the pre-implementation phase experienced polypharmacy (61%, p=0.002), hyperpolypharmacy (15%, p=0.001), and used a high-risk medication (44%, p=0.007). Implementing an electronic medication management system facilitates the medication reconciliation process leading to more high risk patients receiving this service on admission to hospital and in a more timely manner. The impact of electronic medication reconciliation on patient safety and clinical outcomes remains unknown. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. The effectiveness of risk communication regarding drug safety information: a nationwide survey by the Japanese public health insurance claims data.

    PubMed

    Hagiwara, Hiromi; Nakano, Shun; Ogawa, Yoshihiro; Tohkin, Masahiro

    2015-06-01

    We evaluated the effectiveness of warning letters published by the pharmaceutical regulatory agency in Japan on communication of drug safety and risk by quantitative analysis of the national health insurance claims database (NHICD). We then explored what factors may have affected risk communication. We measured the implementation rate of the hepatitis virus-monitoring test among methotrexate (MTX)-treated patients; a warning letter had been issued regarding the use of MTX, as it apparently activates the hepatitis virus. Data from the NHICD, which include 99·3% of Japanese residents, were used. A total of 4,933,481 patients with rheumatoid arthritis (RA) (January-June, 2010) were the focus of this study. The implementation rate of the hepatitis virus-monitoring test increased from 1·4% before to 1·8% after the warning letter announcement. Logistic regression analysis suggested that the installation of a drug information management room is one of the important factors affecting risk communication. Further analysis revealed that the hepatitis virus monitoring rates in hospitals without drug information management rooms increased from 2·3% to 4·1% due to the issue of the warning letter. The warning letter from the regulatory agency plays an important role in risk communication in hospitals without drug information management rooms. © 2015 John Wiley & Sons Ltd.

  18. A multi-criteria decision analysis of management alternatives for anaerobically digested kraft pulp mill sludge

    PubMed Central

    Eikelboom, Martijn; Lopes, Alice do Carmo Precci; Silva, Claudio Mudadu; Rodrigues, Fábio de Ávila; Zanuncio, José Cola

    2018-01-01

    The Multi-Criteria Decision Analysis (MCDA) procedure was used to compare waste management options for kraft pulp mill sludge following its anaerobic digestion. Anaerobic digestion of sludge is advantageous because it produces biogas that may be used to generate electricity, heat and biofuels. However, adequate management of the digested sludge is essential. Landfill disposal is a non-sustainable waste management alternative. Kraft pulp mill digested sludge applied to land may pose risks to the environment and public health if the sludge has not been properly treated. This study is aimed to compare several recycling alternatives for anaerobically digested sludge from kraft pulp mills: land application, landfill disposal, composting, incineration, pyrolysis/gasification, and biofuel production by algae. The MCDA procedure considered nine criteria into three domains to compare digested sludge recycling alternatives in a kraft pulp mill: environmental (CO2 emission, exposure to pathogens, risk of pollution, material and energy recovery), economic (overall costs, value of products) and technical (maintenance and operation, feasibility of implementation). The most suitable management options for digested sludge from kraft pulp mills were found to be composting and incineration (when the latter was coupled with recycling ash to the cement industry). Landfill disposal was the worst option, presenting low performance in feasibility of implementation, risk of pollution, material and energy recovery. PMID:29298296

  19. Implementation of Environmental Flows for Intermittent River Systems: Adaptive Management and Stakeholder Participation Facilitate Implementation

    NASA Astrophysics Data System (ADS)

    Conallin, John; Wilson, Emma; Campbell, Josh

    2018-03-01

    Anthropogenic pressure on freshwater ecosystems is increasing, and often leading to unacceptable social-ecological outcomes. This is even more prevalent in intermittent river systems where many are already heavily modified, or human encroachment is increasing. Although adaptive management approaches have the potential to aid in providing the framework to consider the complexities of intermittent river systems and improve utility within the management of these systems, success has been variable. This paper looks at the application of an adaptive management pilot project within an environmental flows program in an intermittent stream (Tuppal Creek) in the Murray Darling Basin, Australia. The program focused on stakeholder involvement, participatory decision-making, and simple monitoring as the basis of an adaptive management approach. The approach found that by building trust and ownership through concentrating on inclusiveness and transparency, partnerships between government agencies and landholders were developed. This facilitated a willingness to accept greater risks and unintended consequences allowing implementation to occur.

  20. Effects of conservation management of landscapes and vertebrate communities on Lyme borreliosis risk in the United Kingdom

    PubMed Central

    Gilbert, Lucy; Medlock, Jolyon; Hansford, Kayleigh; Thompson, Des BA; Biek, Roman

    2017-01-01

    Landscape change and altered host abundance are major drivers of zoonotic pathogen emergence. Conservation and biodiversity management of landscapes and vertebrate communities can have secondary effects on vector-borne pathogen transmission that are important to assess. Here we review the potential implications of these activities on the risk of Lyme borreliosis in the United Kingdom. Conservation management activities include woodland expansion, management and restoration, deer management, urban greening and the release and culling of non-native species. Available evidence suggests that increasing woodland extent, implementing biodiversity policies that encourage ecotonal habitat and urban greening can increase the risk of Lyme borreliosis by increasing suitable habitat for hosts and the tick vectors. However, this can depend on whether deer population management is carried out as part of these conservation activities. Exclusion fencing or culling deer to low densities can decrease tick abundance and Lyme borreliosis risk. As management actions often constitute large-scale perturbation experiments, these hold great potential to understand underlying drivers of tick and pathogen dynamics. We recommend integrating monitoring of ticks and the risk of tick-borne pathogens with conservation management activities. This would help fill knowledge gaps and the production of best practice guidelines to reduce risks. This article is part of the themed issue ‘Conservation, biodiversity and infectious disease: scientific evidence and policy implications’. PMID:28438912

  1. Effects of conservation management of landscapes and vertebrate communities on Lyme borreliosis risk in the United Kingdom.

    PubMed

    Millins, Caroline; Gilbert, Lucy; Medlock, Jolyon; Hansford, Kayleigh; Thompson, Des Ba; Biek, Roman

    2017-06-05

    Landscape change and altered host abundance are major drivers of zoonotic pathogen emergence. Conservation and biodiversity management of landscapes and vertebrate communities can have secondary effects on vector-borne pathogen transmission that are important to assess. Here we review the potential implications of these activities on the risk of Lyme borreliosis in the United Kingdom. Conservation management activities include woodland expansion, management and restoration, deer management, urban greening and the release and culling of non-native species. Available evidence suggests that increasing woodland extent, implementing biodiversity policies that encourage ecotonal habitat and urban greening can increase the risk of Lyme borreliosis by increasing suitable habitat for hosts and the tick vectors. However, this can depend on whether deer population management is carried out as part of these conservation activities. Exclusion fencing or culling deer to low densities can decrease tick abundance and Lyme borreliosis risk. As management actions often constitute large-scale perturbation experiments, these hold great potential to understand underlying drivers of tick and pathogen dynamics. We recommend integrating monitoring of ticks and the risk of tick-borne pathogens with conservation management activities. This would help fill knowledge gaps and the production of best practice guidelines to reduce risks.This article is part of the themed issue 'Conservation, biodiversity and infectious disease: scientific evidence and policy implications'. © 2017 The Authors.

  2. Blood management issues using blood management strategies.

    PubMed

    Stulberg, Bernard N; Zadzilka, Jayson D

    2007-06-01

    Blood management strategies is a term used to address a coordinated approach to the management of blood loss in the perioperative period for total joint arthroplasty. The premise of any blood management strategy is that each patient, surgeon, and operative intervention experiences different risks of requiring transfusion, that those risks can be identified, and that a plan can be implemented to address them. A surgeon's decision to transfuse should be based on physiologic assessment of the patient's response to anemia and not on an arbitrary number ("transfusion trigger"). Intervention strategies can be applied preoperatively, intraoperatively, and postoperatively. Patient-specific planning allows for the appropriate use of patient, hospital, and system resources, ensuring that the consequences of anemia are minimized and that the patient's recovery process is optimized.

  3. 2017 Guidelines for the management of arterial hypertension in primary health care in Portuguese-speaking countries.

    PubMed

    Oliveira, Gláucia Maria Moraes de; Mendes, Miguel; Malachias, Marcus Vinícius Bolívar; Morais, João; Filho, Osni Moreira; Coelho, Armando Serra; Capingana, Daniel Pires; Azevedo, Vanda; Soares, Irenita; Menete, Alda; Ferreira, Beatriz; Soares, Miryan Bandeira Dos Prazeres Cassandra; Fernandes, Mário

    2017-11-01

    The World Health Organization goal's to reduce mortality due to chronic non-communicable diseases by 2% per year demands a huge effort from member countries. This challenge for health professionals requires global political action on implementation of social measures, with cost-effective population interventions to reduce chronic non-communicable diseases and their risk factors. Systemic arterial hypertension is highly prevalent in Portuguese-speaking countries, and is a major risk factor for complications such as stroke, acute myocardial infarction and chronic kidney disease, rivaling dyslipidemia and obesity in importance for the development of atherosclerotic disease. Joint actions to implement primary prevention measures can reduce outcomes related to hypertensive disease, especially ischemic heart disease and stroke. It is essential to ensure the implementation of guidelines for the management of systemic hypertension via a continuous process involving educational actions, lifestyle changes and guaranteed access to pharmacological treatment. Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. [Quality Management for Surgeons: The Knowledge of Basic Contexts and Innovative Strategies Promotes the Competitiveness of Clinical Department].

    PubMed

    Hellmann, Wolfgang

    2017-12-01

    Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners. This paper provides basic knowledge on quality management, risk management, and quality assurance in the context of relevant medical terms. It demonstrates new ways for implementation on the level of a surgery department, and introduces a new model of quality. Georg Thieme Verlag KG Stuttgart · New York.

  5. Cavity degradation risk insurance assessment. Final report

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

    Hampson, C.; Neill, P.; de Bivort, L.

    1980-01-01

    This study examined the risks and risk management issues involved with the implementation by electric power utilities of compressed air energy storage and underground pumped hydro storage systems. The results are listed in terms of relative risks for the construction and operation of these systems in different geologic deposits, with varying amounts of pressurization, with natural or man-made disasters in the vicinity of the storage equipment, and with different modes of operating the facilities. (LCL)

  6. Public acceptance of disturbance-based forest management: a study of the Blue River Landscape Strategy in the Central Cascades Adaptive Management Area.

    Treesearch

    Bruce Shindler; Angela L. Mallon

    2009-01-01

    This report examines public perspectives on disturbance-based management conducted in the central Cascade Range in Oregon as part of the Blue River Landscape Strategy. A mail survey to local residents was used to describe the public’s understanding of this form of management, identify perceived associated risks and potential barriers to implementation, and the overall...

  7. Managing outbreaks of invasive species - a new method to prioritize preemptive quarantine efforts across large geographic regions

    Treesearch

    J.R. Withrow; E.L. Smith; F.H. Koch; D. Yemshanov

    2015-01-01

    In pest risk assessment it is frequently necessary to make time-critical decisions regarding management of expanding pest populations. When an invasive pest outbreak is expanding rapidly, preemptive quarantine of areas that are under imminent threat of infestation is one of only a few available management tools that can be implemented quickly to help control the...

  8. Implementing AORN recommended practices for minimally invasive surgery: part I.

    PubMed

    Morton, Paula J

    2012-09-01

    This article focuses on the patient safety aspects of the revised AORN "Recommended practices for minimally invasive surgery" (MIS). Key considerations include ensuring proper fluid management practices, assessing patients for risk factors related to MIS, implementing precautions for electrosurgery, planning for risks related to MIS, and assessing patients postoperatively for potential complications related to MIS. Collaboration and collegiality among members of the surgical team are essential for ensuring all pertinent aspects of care are recognized and considered. Copyright © 2012 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  9. Concussion management in US college football: progress and pitfalls

    PubMed Central

    Kroshus, Emily

    2015-01-01

    Reducing the frequency and severity of concussions from sport is an important issue in public health currently addressed by a multifaceted approach. Given the large number of participants and the comparatively high risk of injury, American football is an important sport to consider when examining concussion management practices. Focusing on American football at the collegiate level, this manuscript describes current research regarding concussion epidemiology, policy, implementation of clinical diagnosis, management and return-to-play standards and athlete concussion education. Although American collegiate sports leagues have put forth concussion-related policies in recent years, the implementation of these policies and related effects on athlete concussion education, clinical management of concussion and ultimately athlete health outcomes are not well understood. Additional research is needed. PMID:27064258

  10. A Multicase Study: Exploring Human Resource Information System Implementation and Utilization in Multinational Corporations in Kenya

    ERIC Educational Resources Information Center

    Nzyoka Yongo, Cyd W.

    2016-01-01

    Implementation and utilization of human resource information system (HRIS) though a very desirable prospect for many organizations, still remains a daunting task for many. This has been daunting because of prohibitive costs, security risks, top management resistance, employee attitudes, and so forth. Trends globally show that, organizations that…

  11. Applying the Social Ecological Model to Creating Asthma-Friendly Schools in Louisiana

    ERIC Educational Resources Information Center

    Nuss, Henry J.; Hester, Laura L.; Perry, Mark A.; Stewart-Briley, Collette; Reagon, Valamar M.; Collins, Pamela

    2016-01-01

    Background: In 2010, the Louisiana Asthma Management and Prevention Program (LAMP) implemented the Asthma-Friendly Schools Initiative in high-risk Louisiana populations. The social ecological model (SEM) was used as a framework for an asthma program implemented in 70 state K-12 public schools over 2 years. Methods: Activities included a needs…

  12. The adoption of IT security standards in a healthcare environment.

    PubMed

    Gomes, Rui; Lapão, Luís Velez

    2008-01-01

    Security is a vital part of daily life to Hospitals that need to ensure that the information is adequately secured. In Portugal, more CIOs are seeking that their hospital IS departments are properly protecting information assets from security threats. It is imperative to take necessary measures to ensure risk management and business continuity. Security management certification provides just such a guarantee, increasing patient and partner confidence. This paper introduces one best practice for implementing four security controls in a hospital datacenter infrastructure (ISO27002), and describes the security assessment for implementing such controls.

  13. An agent based architecture for high-risk neonate management at neonatal intensive care unit.

    PubMed

    Malak, Jaleh Shoshtarian; Safdari, Reza; Zeraati, Hojjat; Nayeri, Fatemeh Sadat; Mohammadzadeh, Niloofar; Farajollah, Seide Sedighe Seied

    2018-01-01

    In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision support tools. To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management. This study was a basic research for medical informatics method development that was carried out in 2017. The requirement analysis was done by reviewing articles on NICU Decision Support Systems. PubMed, Science Direct, and IEEE databases were searched. Only English articles published after 1990 were included; also, a needs assessment was done by reviewing the extracted features and current processes at the NICU environment where the research was conducted. We analyzed the requirements and identified the main system roles (agents) and interactions by a comparative study of existing NICU decision support systems. The Universal Multi Agent Platform (UMAP) was applied to implement a prototype of our multi agent based high-risk neonate management architecture. Local environment agents interacted inside a container and each container interacted with external resources, including other NICU systems and consultation centers. In the NICU container, the main identified agents were reception, monitoring, NICU registry, and outcome prediction, which interacted with human agents including nurses and physicians. Managing patients at the NICU units requires online data collection, real-time collaboration, and management of many components. Multi agent systems are applied as a well-known solution for management, coordination, modeling, and control of NICU processes. We are currently working on an outcome prediction module using artificial intelligence techniques for neonatal mortality risk prediction. The full implementation of the proposed architecture and evaluation is considered the future work.

  14. 12 CFR 933.2 - Contents of plan.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 7 2011-01-01 2011-01-01 false Contents of plan. 933.2 Section 933.2 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS BANK... regulatory risk-based capital requirement after the plan is implemented. [66 FR 8310, Jan. 30, 2001, as...

  15. 78 FR 28933 - Self-Regulatory Organizations; The Depository Trusts Company; Notice of Filing and No Objection...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-16

    ... purpose of Title VIII is to mitigate systemic risk in the financial system and promote financial stability... U.S.C. 5464(a)(2). promote robust risk management; promote safety and soundness; reduce systemic... January 2, 2013 and require registered clearing agencies to establish, implement, maintain, and enforce...

  16. 12 CFR 933.2 - Contents of plan.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Contents of plan. 933.2 Section 933.2 Banks and Banking FEDERAL HOUSING FINANCE BOARD FEDERAL HOME LOAN BANK RISK MANAGEMENT AND CAPITAL STANDARDS BANK... regulatory risk-based capital requirement after the plan is implemented. [66 FR 8310, Jan. 30, 2001, as...

  17. Edgeware Security Risk Management: A Three Essay Thesis on Cloud, Virtualization and Wireless Grid Vulnerabilities

    ERIC Educational Resources Information Center

    Brooks, Tyson T.

    2013-01-01

    This thesis identifies three essays which contribute to the foundational understanding of the vulnerabilities and risk towards potentially implementing wireless grid Edgeware technology in a virtualized cloud environment. Since communication networks and devices are subject to becoming the target of exploitation by hackers (e.g. individuals who…

  18. Strategy for Coordinated EPA/Occupational Safety and Health Administration (OSHA) Implementation of the Chemical Accident Prevention Requirements of the Clean Air Act Amendments of 1990

    EPA Pesticide Factsheets

    EPA and the Occupational Safety and Health Administration (OSHA) share responsibility for prevention: OSHA has the Process Safety Management Standard to protect workers, and EPA the Risk Management Program to protect the general public and environment.

  19. Fuels Management-How to Measure Success: Conference Proceedings

    Treesearch

    Patricia L. Andrews; Bret W. Butler

    2006-01-01

    Fuels management programs are designed to reduce risks to communities and to improve and maintain ecosystem health. The International Association of Wildland Fire initiated the 1st Fire Behavior and Fuels Conference to address development, implementation, and evaluation of these programs. The focus was on how to measure success. Over 500 participants from several...

  20. Cholera management and prevention at Hôpital Albert Schweitzer, Haiti.

    PubMed

    Ernst, Silvia; Weinrobe, Carolyn; Bien-Aime, Charbel; Rawson, Ian

    2011-11-01

    In October 2010, Hopital Albert Schweitzer Haiti treated some of the first patients with cholera in Haiti. Over the following 10 months, a strategic plan was developed and implemented to improve the management of cases at the hospital level and to address the underlying risk factors at the community level.

  1. Effects of Culturally Adapted Parent Management Training on Latino Youth Behavioral Health Outcomes

    ERIC Educational Resources Information Center

    Martinez, Charles R.; Eddy, J. Mark

    2005-01-01

    A randomized experimental test of the implementation feasibility and the efficacy of a culturally adapted Parent Management Training intervention was conducted with a sample of 73 Spanish-speaking Latino parents with middle-school-aged youth at risk for problem behaviors. Intervention feasibility was evaluated through weekly parent satisfaction…

  2. Management mechanisms for development of personnel professional competencies at a loading and haulage company

    NASA Astrophysics Data System (ADS)

    Shishkina, S. V.; Pristupa, Yu D.; Pavlova, L. D.; Fryanov, V. N.

    2018-05-01

    The necessity for development a management mechanism for development of personnel professional competencies at a loading and haulage company in order to ensuring the compliance of competencies with labor functions, regulated by the current professional standards, is substantiated. A functional diagram of the organizational and technical system of the loading and haulage company was developed, that includes the interaction mechanism between the personnel and the objects of the main production. The problem of algorithm development to assess the correspondence of communicative competencies and labor functions of loading and haulage companies, ensuring the achievement of the management goal with a minimum risk of an emergency situation or an accident, was set and solved. The idea of management problem solving consists in the operational development and implementation of anticipatory measures at each deviation in personnel actions from normative or target indicators. The dependence of the risk of imbalance of communicative competences and labor functions in a given period of time is established. The effectiveness of the developed and implemented mechanism is confirmed by the positive dynamics of the test results.

  3. The Value of Risk Pooling for Mitigating Water Utility Financial Risks Arising From Water Scarcity

    NASA Astrophysics Data System (ADS)

    Baum, R.; Characklis, G. W.; Hughes, J.; Eskaf, S.

    2015-12-01

    Water utilities across the United States face growing supply risks as demand growth and extreme weather events make water scarcity more common. As it has become more difficult and expensive to build new supply capacity to accommodate these events, many utility managers respond by either imposing conservation measures, which reduces revenues, or acquiring additional water from other sources, which increases costs. These actions lead to changing financial trends that are difficult to predict and that utilities are currently ill-equipped to manage. As a result, adaptation strategies and tools are being developed to reduce utility vulnerabilities, ensuring both financial stability and continued access to low cost financing, a critical consideration for a capital intensive industry. Previous work in this area has involved the development of utility specific financial hedging tools. However, the time and informational requirements associated with developing these individualized strategies may be a limiting factor for widespread implementation. The objective of this research is to develop more generalized hedging instruments that can be applied simultaneously to multiple utilities across the United States, thereby increasing the potential for widespread implementation. This work first analyzes the financial risks of water scarcity for a large set of water utilities across the country and then proposes a financial hedging solution to mitigate these risks through hydrologic index-based financial insurance. Results provide insights into the most effective indices, the potential for risk pooling to reduce insurance costs, and the performance of these contracts in managing utility financial risk arising from drought.

  4. Organizational factors affecting safety implementation in food companies in Thailand.

    PubMed

    Chinda, Thanwadee

    2014-01-01

    Thai food industry employs a massive number of skilled and unskilled workers. This may result in an industry with high incidences and accident rates. To improve safety and reduce the accident figures, this paper investigates factors influencing safety implementation in small, medium, and large food companies in Thailand. Five factors, i.e., management commitment, stakeholders' role, safety information and communication, supportive environment, and risk, are found important in helping to improve safety implementation. The statistical analyses also reveal that small, medium, and large food companies hold similar opinions on the risk factor, but bear different perceptions on the other 4 factors. It is also found that to improve safety implementation, the perceptions of safety goals, communication, feedback, safety resources, and supervision should be aligned in small, medium, and large companies.

  5. Rocky milieu: challenges of effective integration of clinical risk management into hospitals in Iran.

    PubMed

    Farokhzadian, Jamileh; Nayeri, Nahid Dehghan; Borhani, Fariba

    2015-01-01

    Healthcare risks and clinical risks have been recognized as a major challenge in healthcare. Clinical risks can never be eliminated and can have serious adverse effects on patient safety. Thus, a clinical risk management (CRM) system has been introduced in the healthcare system to improve quality services. The aim of this study was to explore nurses' experiences related to the challenges of implementing CRM in the organizational context. This qualitative study was based on the conventional content analysis of the Lundman and Graneheim approach, and it consisted of 22 interview sessions with 20 nurses. The purposive sampling method was used to choose the participants from three hospitals affiliated with the Kerman University of Medical Sciences. We used semi-structured interviews and review of relevant documents to collect data. The analysis of the data led to the emergence of "rocky milieu" as the main theme, and it consisted of three categories that, along with their subcategories, explain the challenges of implementing CRM. The three categories and their subcategories were (1) organizational culture and leadership challenges (decision and performance of leadership and cultural resistance to change), (2) limitation of resources (financial, human, and physical and equipment resources), and (3) variations and complexities in working conditions (the emotional, psychological, and social atmosphere and the heaviness of workload). Attempts have been made to establish CRM through clinical governance and accreditation, but organizational challenges have created a rocky milieu for implementing CRM. However, from an organizational context concerning the suitability of healthcare in Iran, there are obvious needs to move toward quality improvement and safe practices through the effective implementation of CRM.

  6. Rocky milieu: Challenges of effective integration of clinical risk management into hospitals in Iran

    PubMed Central

    Farokhzadian, Jamileh; Nayeri, Nahid Dehghan; Borhani, Fariba

    2015-01-01

    Healthcare risks and clinical risks have been recognized as a major challenge in healthcare. Clinical risks can never be eliminated and can have serious adverse effects on patient safety. Thus, a clinical risk management (CRM) system has been introduced in the healthcare system to improve quality services. The aim of this study was to explore nurses’ experiences related to the challenges of implementing CRM in the organizational context. This qualitative study was based on the conventional content analysis of the Lundman and Graneheim approach, and it consisted of 22 interview sessions with 20 nurses. The purposive sampling method was used to choose the participants from three hospitals affiliated with the Kerman University of Medical Sciences. We used semi-structured interviews and review of relevant documents to collect data. The analysis of the data led to the emergence of “rocky milieu” as the main theme, and it consisted of three categories that, along with their subcategories, explain the challenges of implementing CRM. The three categories and their subcategories were (1) organizational culture and leadership challenges (decision and performance of leadership and cultural resistance to change), (2) limitation of resources (financial, human, and physical and equipment resources), and (3) variations and complexities in working conditions (the emotional, psychological, and social atmosphere and the heaviness of workload). Attempts have been made to establish CRM through clinical governance and accreditation, but organizational challenges have created a rocky milieu for implementing CRM. However, from an organizational context concerning the suitability of healthcare in Iran, there are obvious needs to move toward quality improvement and safe practices through the effective implementation of CRM. PMID:25968444

  7. From Hydroclimatic Prediction to Negotiated and Risk Managed Water Allocation and Reservoir Operation (Invited)

    NASA Astrophysics Data System (ADS)

    Lall, U.

    2013-12-01

    The availability of long lead climate forecasts that can in turn inform streamflow, agricultural, ecological and municipal/industrial and energy demands provides an opportunity for innovations in water resources management that go beyond the current practices and paradigms. In a practical setting, managers seek to meet registered demands as well as they can. Pricing mechanisms to manage demand are rarely invoked. Drought restrictions and operations are implemented as needed, and pressures from special interest groups are sometimes accommodated through a variety of processes. In the academic literature, there is a notion that demand curves for different sectors could be established and used for "optimal management". However, the few attempts to implement such ideas have invariably failed as elicitation of demand elasticity and socio-political factors is imperfect at best. In this talk, I will focus on what is worth predicting and for whom and how operational risks for the water system can be securitized while providing a platform for priced and negotiated allocation of the resources in the presence of imperfect forecasts. The possibility of a national or regional market for water contracts as part of the framework is explored, and its potential benefits and pitfalls identified.

  8. Ventilator-associated pneumonia management in critical illness.

    PubMed

    Albertos, Raquel; Caralt, Berta; Rello, Jordi

    2011-03-01

    Ventilator-associated pneumonia (VAP) is a frequent adverse event in the intensive care unit.We review recent publications about the management and prevention of VAP. The latest care bundles introduced standard interventions to facilitate implementation of evidence-based clinical guidelines and to improve the outcome of patients. Recent studies find that prevention management of ventilated patients decreases the risk of VAP. Enteral feeding, considered a risk factor for VAP, currently has been recommended, with appropriate administration, for all critical ill patients if no contraindications exist. In view of the recently available data, it can be concluded that the implementation of care bundles on the general management of ventilated patients in daily practice has reduced the VAP rates. The main pharmacological measures to prevent VAP are proper hands hygiene, high nurse-to-patient ratio, avoid unnecessary transfer of ventilated patients, use of noninvasive mechanical ventilation, shortening weaning period, avoid the use of nasal intubation, prevent bio-film deposition in endotracheal tube, aspiration of subglottic secretions, maintenance of adequate pressure of endotracheal cuffs, avoid manipulation of ventilator circuits, semi-recumbent position and adequate enteral feeding.In addition, updated guidelines incorporate more comprehensive diagnostic protocols to the evidence-based management of VAP.

  9. A System-Level Approach to Overweight and Obesity in the Veterans Health Administration.

    PubMed

    Raffa, Susan D; Maciejewski, Matthew L; Zimmerman, Lindsey E; Damschroder, Laura J; Estabrooks, Paul A; Ackermann, Ronald T; Tsai, Adam G; Histon, Trina; Goldstein, Michael G

    2017-04-01

    Healthcare systems are challenged by steady increases in the number of patients who are overweight and obese. Large-scale, evidence-based behavioral approaches for addressing overweight and obesity have been successfully implemented in systems such as the Veterans Health Administration (VHA). These population-based interventions target reduction in risk for obesity-associated conditions through lifestyle change and weight loss, and are associated with modest weight loss. Despite the fact that VHA has increased the overall reach of these behavioral interventions, the number of high-risk overweight and obese patients continues to rise. Recommendations for weight loss medications and bariatric surgery are included in clinical practice guidelines for the management of overweight and obesity, but these interventions are underutilized. During a recent state of the art conference on weight management held by VHA, subject matter experts identified challenges and gaps, as well as potential solutions and overarching policy recommendations, for implementing an integrated system-wide approach for improving population-based weight management.

  10. Fatigue Risk Management: A Maritime Framework

    PubMed Central

    Grech, Michelle Rita

    2016-01-01

    It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer’s role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this “poor compliance” trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue. PMID:26840326

  11. Fatigue Risk Management: A Maritime Framework.

    PubMed

    Grech, Michelle Rita

    2016-01-29

    It is evident that despite efforts directed at mitigating the risk of fatigue through the adoption of hours of work and rest regulations and development of codes and guidelines, fatigue still remains a concern in shipping. Lack of fatigue management has been identified as a contributory factor in a number of recent accidents. This is further substantiated through research reports with shortfalls highlighted in current fatigue management approaches. These approaches mainly focus on prescriptive hours of work and rest and include an individualistic approach to managing fatigue. The expectation is that seafarers are responsible to manage and tolerate fatigue as part of their working life at sea. This attitude is an accepted part of a seafarer's role. Poor compliance is one manifest of this problem with shipboard demands making it hard for seafarers to follow hours of work and rest regulations, forcing them into this "poor compliance" trap. This makes current fatigue management approaches ineffective. This paper proposes a risk based approach and way forward for the implementation of a fatigue risk management framework for shipping, aiming to support the hours of work and rest requirements. This forms part of the work currently underway to review and update the International Maritime Organization, Guidelines on Fatigue.

  12. Implementation of a Risk Stratification and Management Pathway for Acute Chest Pain in the Emergency Department.

    PubMed

    Baugh, Christopher W; Greenberg, Jeffrey O; Mahler, Simon A; Kosowsky, Joshua M; Schuur, Jeremiah D; Parmar, Siddharth; Ciociolo, George R; Carr, Christina W; Ghazinouri, Roya; Scirica, Benjamin M

    2016-12-01

    Chest pain is a common complaint in the emergency department, and a small but important minority represents an acute coronary syndrome (ACS). Variation in diagnostic workup, risk stratification, and management may result in underuse, misuse, and/or overuse of resources. From July to October 2014, we conducted a prospective cohort study in an academic medical center by implementing a Standardized Clinical Assessment and Management Plan (SCAMP) for chest pain based on the HEART score. In addition to capturing adherence to the SCAMP algorithm and reasons for any deviations, we measured troponin sample timing; rates of stress test utilization; length of stay (LOS); and 30-day rates of revascularization, ACS, and death. We identified 239 patients during the enrollment period who were eligible to enter the SCAMP, of whom 97 patients were entered into the pathway. Patients were risk stratified into one of 3 risk tiers: high (n = 3), intermediate (n = 40), and low (n = 54). Among low-risk patients, recommendations for troponin testing were not followed in 56%, and 11% received stress tests contrary to the SCAMP recommendation. None of the low-risk patients had elevated troponin measurements, and none had an abnormal stress test. Mean LOS in low-risk patients managed with discordant plans was 22:26 h/min, compared with 9:13 h/min in concordant patients (P < 0.001). Mean LOS in intermediate-risk patients with stress testing was 25:53 h/min, compared with 7:55 h/min for those without (P < 0.001). At 30 days, 10% of intermediate-risk patients and 0% of low-risk patients experienced an ACS event (risk difference 10% [0.7%-19%]); none experienced revascularization or death. The most frequently cited reason for deviation from the SCAMP was lack of confidence in the tool. Compliance with SCAMP recommendations for low- and intermediate-risk patients was poor, largely due to lack of confidence in the tool. However, in our study population, outcomes suggest that deviation from the SCAMP yielded no additional clinical benefit while significantly prolonging emergency department LOS.

  13. Science in the Public Sphere: Greater Sage-grouse Conservation Planning from a Transdisciplinary Perspective

    USGS Publications Warehouse

    Torregrosa, Alicia; Casazza, Michael L.; Caldwell, Margaret R.; Mathiasmeier, Teresa A.; Morgan, Peter M.; Overton, Cory T.

    2010-01-01

    Integration of scientific data and adaptive management techniques is critical to the success of species conservation, however, there are uncertainties about effective methods of knowledge exchange between scientists and decisionmakers. The conservation planning and implementation process for Greater Sage-grouse (Centrocercus urophasianus; ) in the Mono Basin, Calif. region, was used as a case study to observe the exchange of scientific information among stakeholders with differing perspectives; resource manager, scientist, public official, rancher, and others. The collaborative development of a risk-simulation model was explored as a tool to transfer knowledge between stakeholders and inform conservation planning and management decisions. Observations compiled using a transdisciplinary approach were used to compare the exchange of information during the collaborative model development and more traditional interactions such as scientist-led presentations at stakeholder meetings. Lack of congruence around knowledge needs and prioritization led to insufficient commitment to completely implement the risk-simulation model. Ethnographic analysis of the case study suggests that further application of epistemic community theory, which posits a strong boundary condition on knowledge transfer, could help support application of risk simulation models in conservation-planning efforts within similarly complex social and bureaucratic landscapes.

  14. Implementation of safety management systems in Hong Kong construction industry - A safety practitioner's perspective.

    PubMed

    Yiu, Nicole S N; Sze, N N; Chan, Daniel W M

    2018-02-01

    In the 1980s, the safety management system (SMS) was introduced in the construction industry to mitigate against workplaces hazards, reduce the risk of injuries, and minimize property damage. Also, the Factories and Industrial Undertakings (Safety Management) Regulation was introduced on 24 November 1999 in Hong Kong to empower the mandatory implementation of a SMS in certain industries including building construction. Therefore, it is essential to evaluate the effectiveness of the SMS in improving construction safety and identify the factors that influence its implementation in Hong Kong. A review of the current state-of-the-practice helped to establish the critical success factors (CSFs), benefits, and difficulties of implementing the SMS in the construction industry, while structured interviews were used to establish the key factors of the SMS implementation. Results of the state-of-the-practice review and structured interviews indicated that visible senior commitment, in terms of manpower and cost allocation, and competency of safety manager as key drivers for the SMS implementation. More so, reduced accident rates and accident costs, improved organization framework, and increased safety audit ratings were identified as core benefits of implementing the SMS. Meanwhile, factors such as insufficient resources, tight working schedule, and high labor turnover rate were the key challenges to the effective SMS implementation in Hong Kong. The findings of the study were consistent and indicative of the future development of safety management practice and the sustainable safety improvement of Hong Kong construction industry in the long run. Copyright © 2018 National Safety Council and Elsevier Ltd. All rights reserved.

  15. Short Duration Emergency Incidents Managed as Projects

    NASA Astrophysics Data System (ADS)

    Nixon, Thomas J.

    Emergency incidents have historically been managed by experience and some directional principles usually found in SOPs/SOGs or other pre-incident planning documents. The use of experience has the risk of bias influencing the decisions being made in truly life or death situations. Responders of disasters, long duration emergency incidents, are often equipped with a framework adapted to the project management lifecycle to assure the project priorities are adequately addressed. The disaster framework provides for savings from risk, loss, waste. This research is demonstrating the ability and reasoning to develop a framework to address short duration emergency incidents and expand the events that can be managed as a project. The research of the literature found that a framework can be applied to the project management lifecycle and the priorities of a short duration emergency incident can be managed as a project. The limitations of not having the ability to conduct empirical testing and the risks of not developing a formal implementation plan are discussed. Short duration emergency incidents are found to be capable of being managed as projects and will benefit from the effectiveness of project management methodologies.

  16. Interest rate swaps: financial tool of the '90s.

    PubMed

    Woodard, M A

    1993-11-01

    The implementation of prospective payment for capital costs makes it more necessary than ever for healthcare financial managers to be able to creatively balance capital costs with risk. A new financial management tool--the interest rate swap (a contractual agreement in which one party with a fixed interest rate payment liability and another party with a variable interest payment liability agree to trade those obligations)--is proving to be a solution for a growing number of hospital managers. This article describes the uses of interest rate swaps and discusses the variables to be considered when evaluating whether the benefits of an interest rate swap offset the additional risk.

  17. A mixed methods pilot study with a cluster randomized control trial to evaluate the impact of a leadership intervention on guideline implementation in home care nursing.

    PubMed

    Gifford, Wendy A; Davies, Barbara; Graham, Ian D; Lefebre, Nancy; Tourangeau, Ann; Woodend, Kirsten

    2008-12-10

    Foot ulcers are a significant problem for people with diabetes. Comprehensive assessments of risk factors associated with diabetic foot ulcer are recommended in clinical guidelines to decrease complications such as prolonged healing, gangrene and amputations, and to promote effective management. However, the translation of clinical guidelines into nursing practice remains fragmented and inconsistent, and a recent homecare chart audit showed less than half the recommended risk factors for diabetic foot ulcers were assessed, and peripheral neuropathy (the most significant predictor of complications) was not assessed at all. Strong leadership is consistently described as significant to successfully transfer guidelines into practice. Limited research exists however regarding which leadership behaviours facilitate and support implementation in nursing. The purpose of this pilot study is to evaluate the impact of a leadership intervention in community nursing on implementing recommendations from a clinical guideline on the nursing assessment and management of diabetic foot ulcers. Two phase mixed methods design is proposed (ISRCTN 12345678). Phase I: Descriptive qualitative to understand barriers to implementing the guideline recommendations, and to inform the intervention. Phase II: Matched pair cluster randomized controlled trial (n = 4 centers) will evaluate differences in outcomes between two implementation strategies. Nursing assessments of client risk factors, a composite score of 8 items based on Diabetes/Foot Ulcer guideline recommendations. In addition to the organization's 'usual' implementation strategy, a 12 week leadership strategy will be offered to managerial and clinical leaders consisting of: a) printed materials, b) one day interactive workshop to develop a leadership action plan tailored to barriers to support implementation; c) three post-workshop teleconferences. This study will provide vital information on which leadership strategies are well received to facilitate and support guideline implementation. The anticipated outcomes will provide information to assist with effective management of foot ulcers for people with diabetes. By tracking clinical outcomes associated with guideline implementation, health care administrators will be better informed to influence organizational and policy decision-making to support evidence-based quality care. Findings will be useful to inform the design of future multi-centered trials on various clinical topics to enhance knowledge translation for positive outcomes.

  18. Implementation of National Fire Plan treatments near the wildland-urban interface in the western United States.

    PubMed

    Schoennagel, Tania; Nelson, Cara R; Theobald, David M; Carnwath, Gunnar C; Chapman, Teresa B

    2009-06-30

    Because of increasing concern about the effects of catastrophic wildland fires throughout the western United States, federal land managers have been engaged in efforts to restore historical fire behavior and mitigate wildfire risk. During the last 5 years (2004-2008), 44,000 fuels treatments were implemented across the western United States under the National Fire Plan (NFP). We assessed the extent to which these treatments were conducted in and near the wildland-urban interface (WUI), where they would have the greatest potential to reduce fire risk in neighboring homes and communities. Although federal policies stipulate that significant resources should be invested in the WUI, we found that only 3% of the area treated was within the WUI, and another 8% was in an additional 2.5-km buffer around the WUI, totaling 11%. Only 17% of this buffered WUI is under federal ownership, which significantly limits the ability of federal agencies to implement fire-risk reduction treatments near communities. Although treatments far from the WUI may have some fire mitigation benefits, our findings suggest that greater priority must be given to locating treatments in and near the WUI, rather than in more remote settings, to satisfy NFP goals of reducing fire risk to communities. However, this may require shifting management and policy emphasis from public to private lands.

  19. Promoting condom-only brothels through solidarity and support for brothel managers.

    PubMed

    Sakondhavat, C; Werawatanakul, Y; Bennett, A; Kuchaisit, C; Suntharapa, S

    1997-01-01

    Brothel workers in Thailand are at high risk of HIV infection but they alone do not have adequate bargaining power to insist on condom use with all clients. Brothel managers, on the other hand, are a source of influence over both clients and their workers and can promote universal condom use in their establishments. To test whether brothel managers in Khon Kaen City would adopt and successfully implement a condom-only policy in their establishments, all 24 brothel managers in Khon Kaen City attended a meeting on the dangers of HIV and benefits of an all-condom policy. Ideas on how to implement the policy were discussed. Follow-up visits were made once a month to brothels to resupply condoms, provide reinforcement and to collect data. All brothel managers approved of the condom-only in principle and are now implementing the policy. Results of the evaluation of condom use and degree of solidarity in these 24 brothels are available for the AIDS prevention programme. However, a condom-only policy in brothels can only succeed if managers and brothel workers show solidarity in rejecting all non-condom using clients. Laws to promote condom use may not be needed if brothels are given the opportunity to implement a condom-only policy using their own resourcefulness and determination.

  20. Implementation of pregnancy weight management and obesity guidelines: a meta-synthesis of healthcare professionals' barriers and facilitators using the Theoretical Domains Framework.

    PubMed

    Heslehurst, N; Newham, J; Maniatopoulos, G; Fleetwood, C; Robalino, S; Rankin, J

    2014-06-01

    Obesity in pregnancy is rising and is associated with severe health consequences for both the mother and the child. There is an increasing international focus on guidelines to manage the clinical risks of maternal obesity, and for pregnancy weight management. However, passive dissemination of guidelines is not effective and more active strategies are required for effective guideline implementation into practice. Implementation of guidelines is a form of healthcare professional behaviour change, and therefore implementation strategies should be based on appropriate behaviour change theory. This systematic review aimed to identify the determinants of healthcare professionals' behaviours in relation to maternal obesity and weight management. Twenty-five studies were included. Data synthesis of the existing international qualitative and quantitative evidence base used the Theoretical Domains Framework to identify the barriers and facilitators to healthcare professionals' maternal obesity and weight management practice. The domains most frequently identified included 'knowledge', 'beliefs about consequences' and 'environmental context and resources'. Healthcare professionals' weight management practice had the most barriers compared with any other area of maternal obesity practice. The results of this review will be used to inform the development of an intervention to support healthcare professional behaviour change. © 2014 The Authors. obesity reviews © 2014 International Association for the Study of Obesity.

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

    Munganahalli, D.

    Sedco Forex is a drilling contractor that operates approximately 80 rigs on land and offshore worldwide. The HSE management system developed by Sedco Forex is an effort to prevent accidents and minimize losses. An integral part of the HSE management system is establishing risk profiles and thereby minimizing risk and reducing loss exposures. Risk profiles are established based on accident reports, potential accident reports and other risk identification reports (RIR) like the Du Pont STOP system. A rig could fill in as many as 30 accident reports, 30 potential accident reports and 500 STOP cards each year. Statistics are importantmore » for an HSE management system, since they are indicators of success or failure of HSE systems. It is however difficult to establish risk profiles based on statistical information, unless tools are available at the rig site to aid with the analysis. Risk profiles are then used to identify important areas in the operation that may require specific attention to minimize the loss exposure. Programs to address the loss exposure can then be identified and implemented with either a local or corporate approach. In January 1995, Sedco Forex implemented a uniform HSE Database on all the rigs worldwide. In one year companywide, the HSE database would contain information on approximately 500 accident and potential accident reports, and 10,000 STOP cards. This paper demonstrates the salient features of the database and describes how it has helped in establishing key risk profiles. It also shows a recent example of how risk profiles have been established at the corporate level and used to identify the key contributing factors to hands and finger injuries. Based on this information, a campaign was launched to minimize the frequency of occurrence and associated loss attributed to hands and fingers accidents.« less

  2. A strategy for prioritizing threats and recovery actions for at-risk species.

    PubMed

    Darst, Catherine R; Murphy, Philip J; Strout, Nathan W; Campbell, Steven P; Field, Kimberleigh J; Allison, Linda; Averill-Murray, Roy C

    2013-03-01

    Ensuring the persistence of at-risk species depends on implementing conservation actions that ameliorate threats. We developed and implemented a method to quantify the relative importance of threats and to prioritize recovery actions based on their potential to affect risk to Mojave desert tortoises (Gopherus agassizii). We used assessments of threat importance and elasticities of demographic rates from population matrix models to estimate the relative contributions of threats to overall increase in risk to the population. We found that urbanization, human access, military operations, disease, and illegal use of off highway vehicles are the most serious threats to the desert tortoise range-wide. These results suggest that, overall, recovery actions that decrease habitat loss, predation, and crushing will be most effective for recovery; specifically, we found that habitat restoration, topic-specific environmental education, and land acquisition are most likely to result in the greatest decrease in risk to the desert tortoise across its range. In addition, we have developed an application that manages the conceptual model and all supporting information and calculates threat severity and potential effectiveness of recovery actions. Our analytical approach provides an objective process for quantifying threats, prioritizing recovery actions, and developing monitoring metrics for those actions for adaptive management of any at-risk species.

  3. Capacity and readiness of civil society organisations to implement community case management of malaria in Kenya

    PubMed Central

    Marita, Enock; Oule, Jared; Mungai, Margaret; Thiam, Sylla; Ilako, Festus

    2016-01-01

    Introduction Civil Society Organizations (CSOs) contribute to achieving development goals through advocacy, social mobilisation and provision of health services. CSO programming is a key component of Global Fund (GF) grants; however, CSOs face technical and governance capacity challenges in grant utilisation leading to missed opportunities for improving health at community level. Amref Health Africa was appointed Principal Recipient of a GF grant aimed at scaling up community case management of malaria through CSOs as sub-recipients in western Kenya. To identify potential risks and strengthen grant management, Amref Health Africa and the Ministry of Health conducted a capacity needs assessment to determine the capacity of CSOs to effectively utilise grants. Methods 26 selected CSOs participated in this study. Document reviews and on-site assessments and observations were conducted using structured tool. The five main assessment areas were: governance and risk management; strategic and operational planning; monitoring and evaluation; programme management; and financial management. Overall performance was grouped into four categories: 3.0-2.5 (excellent), 2.0-2.4 (good), 1.5-1.9 (fair), and 1.0-1.4 (poor). Data were collected and analysed using Excel software. Results Twenty five out of 26 CSOs were legally compliant. 14(54%) CSOs were categorized as good; 7(27%) as excellent; 3(12%) as poor and 2(8%) as fair. Most CSOs had good programme management capacity but monitoring and evaluation presented the most capacity gaps. Conclusion More than 75% of the CSOs were rated as excellent or good. A capacity building plan, programme risk management plan and oversight mechanisms were important for successful grant implementation. PMID:28523081

  4. A National Model for Diabetes Prevention and Treatment Program in Civilian and Military Healthcare Beneficiary Populations

    DTIC Science & Technology

    2010-03-01

    Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC...evidence-based pediatric and adult primary prevention and management programs would reduce risk for diabetes and its complications in civilian and... management system for childhood obesity; (3) implemented primary prevention by disseminating the modified Diabetes Prevention Program strategies

  5. Views of practice managers and general practitioners on implementing NHS Health Checks.

    PubMed

    Krska, Janet; du Plessis, Ruth; Chellaswamy, Hannah

    2016-03-01

    As part of an evaluation of a contract with general practices to deliver the national NHS Health Checks programme in Sefton, North West England, we surveyed general practitioners (GPs) and practice managers (PMs) in all 55 practices. The contract required practices to identify individuals from their practice registers with potentially high cardiovascular disease risk, and provide annual reviews. Responses were obtained from 43/178 GPs and 40/55 PMs representing 56 and 73% of practices, respectively. There was variation in many aspects of implementation. Time and software were viewed as barriers to implementation, the increased nurse workload impacted on other services and payments were insufficient to cover costs. The main enabler for successful implementation was IT support. Fewer than half the respondents viewed the programme as beneficial to their practice. Findings have been used to address many issues raised. Practices need more support from commissioners to help implement NHS Health Checks.

  6. General RMP Guidance - Chapter 6: Prevention Program (Program 2)

    EPA Pesticide Factsheets

    Sound prevention practices are founded on safety information, hazard review, operating procedures, training, maintenance, compliance audits, and accident investigation. These must be integrated into a risk management system that you implement consistently.

  7. Improving diabetic foot care in a nurse-managed safety-net clinic.

    PubMed

    Peterson, Joann M; Virden, Mary D

    2013-05-01

    This article is a description of the development and implementation of a Comprehensive Diabetic Foot Care Program and assessment tool in an academically affiliated nurse-managed, multidisciplinary, safety-net clinic. The assessment tool parallels parameters identified in the Task Force Foot Care Interest Group of the American Diabetes Association's report published in 2008, "Comprehensive Foot Examination and Risk Assessment." Review of literature, Silver City Health Center's (SCHC) 2009 Annual Report, retrospective chart review. Since the full implementation of SCHC's Comprehensive Diabetic Foot Care Program, there have been no hospitalizations of clinic patients for foot-related complications. The development of the Comprehensive Diabetic Foot Assessment tool and the implementation of the Comprehensive Diabetic Foot Care Program have resulted in positive outcomes for the patients in a nurse-managed safety-net clinic. This article demonstrates that quality healthcare services can successfully be developed and implemented in a safety-net clinic setting. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  8. Premise to Implement a Grading System to Evaluate the Sanitary Level in Food Service Establishments in Milan, Italy

    PubMed Central

    Razzini, Katia

    2015-01-01

    The regulatory framework of the official controls on food safety, the criteria and methods from the planning of interventions in the field of official control to the management of information flows, and the standards described in the operation manual of the local competent authorities drafted by the Lombardy Region (2011) were evaluated. A questionnaire consisting of n. 10 questions with multiple answers draft in partnership with EPAM (the Association of Provincial Public Retail and catering businesses in Milan) to n. 107 Food service establishments of Milan shows that 92% of managers approve the introduction of a grading system. The regulatory framework is planned to support the implementation of risk assignment, unfortunately the attribution of risk category of retail and catering businesses is still different among regions. PMID:27800403

  9. Integrating TeamSTEPPS® into ambulatory reproductive health care: Early successes and lessons learned.

    PubMed

    Paul, Maureen E; Dodge, Laura E; Intondi, Evelyn; Ozcelik, Guzey; Plitt, Ken; Hacker, Michele R

    2017-04-01

    Most medical teamwork improvement interventions have occurred in hospitals, and more efforts are needed to integrate them into ambulatory care settings. In 2014, Affiliates Risk Management Services, Inc. (ARMS), the risk management services organization for a large network of reproductive health care organizations in the United States, launched a voluntary 5-year initiative to implement a medical teamwork system in this network using the TeamSTEPPS model. This article describes the ARMS initiative and progress made during the first 2 years, including lessons learned. The ARMS TeamSTEPPS program consists of the following components: preparation of participating organizations, TeamSTEPPS master training, implementation of teamwork improvement programs, and evaluation. We used self-administered questionnaires to assess satisfaction with the ARMS program and with the master training course. In the first 2 years, 20 organizations enrolled. Participants found the preparation phase valuable and were highly satisfied with the master training course. Although most attendees felt that the course imparted the knowledge and tools critical for TeamSTEPPS implementation, they identified time restraints and competing initiatives as potential barriers. The project team has learned valuable lessons about obtaining buy-in, consolidating the change teams, making the curriculum relevant, and evaluation. Ambulatory care settings require innovative approaches to integration of teamwork improvement systems. Evaluating and sharing lessons learned will help to hone best practices as we navigate this new frontier in the field of patient safety. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  10. Multiparameter models in the management of the development of territories, taking into account the influence of hydrometeorological factors

    NASA Astrophysics Data System (ADS)

    Istomin, E. P.; Popov, N. N.; Sokolov, A. G.; Fokicheva, A. A.

    2018-01-01

    The article considers the geoinformation management of the territory as a way to manage the organizational and technical systems and territories distributed in space. The article describes the main factors for the development and implementation of management decisions, requirements for the territorial management system and the structure of knowledge and data. Mathematical one-parameter and multiparameter models of risk assessment of management decisions applied to the natural and climatic potential of the development of the territory were considered.

  11. Quantitative risk management in gas injection project: a case study from Oman oil and gas industry

    NASA Astrophysics Data System (ADS)

    Khadem, Mohammad Miftaur Rahman Khan; Piya, Sujan; Shamsuzzoha, Ahm

    2017-09-01

    The purpose of this research was to study the recognition, application and quantification of the risks associated in managing projects. In this research, the management of risks in an oil and gas project is studied and implemented within a case company in Oman. In this study, at first, the qualitative data related to risks in the project were identified through field visits and extensive interviews. These data were then translated into numerical values based on the expert's opinion. Further, the numerical data were used as an input to Monte Carlo simulation. RiskyProject Professional™ software was used to simulate the system based on the identified risks. The simulation result predicted a delay of about 2 years as a worse case with no chance of meeting the project's on stream date. Also, it has predicted 8% chance of exceeding the total estimated budget. The result of numerical analysis from the proposed model is validated by comparing it with the result of qualitative analysis, which was obtained through discussion with various project managers of company.

  12. Health risk assessment along the wastewater and faecal sludge management and reuse chain of Kampala, Uganda: a visualization.

    PubMed

    Fuhrimann, Samuel; Winkler, Mirko S; Schneeberger, Pierre H H; Niwagaba, Charles B; Buwule, Joseph; Babu, Mohammed; Medlicott, Kate; Utzinger, Jürg; Cissé, Guéladio

    2014-11-01

    Reuse of wastewater in agriculture is a common feature in the developing world. While this strategy might contribute to the livelihood of farming communities, there are health risks associated with the management and reuse of wastewater and faecal sludge. We visualise here an assessment of health risks along the major wastewater channel in Kampala, Uganda. The visualization brings to bear the context of wastewater reuse activities in the Nakivubo wetlands and emphasises interconnections to disease transmission pathways. The contextual features are complemented with findings from environmental sampling and a cross-sectional epidemiological survey in selected exposure groups. Our documentation can serve as a case study for a step-by-step implementation of risk assessment and management as described in the World Health Organization's 2006 guidelines for the safe use of wastewater, greywater and excreta in light of the forthcoming sanitation safety planning approach.

  13. An evaluation of a risk-based environmental regulation in Brazil: Limitations to risk management of hazardous installations

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

    Naime, Andre, E-mail: andre.naime.ibama@gmail.com

    The environmental regulation of hazardous projects with risk-based decision-making processes can lead to a deficient management of human exposure to technological hazards. Such an approach for regulation is criticized for simplifying the complexity of decisions involving the economic, social, and environmental aspects of the installation and operation of hazardous facilities in urban areas. Results of a Brazilian case study indicate that oil and gas transmission pipelines may represent a threat to diverse communities if the relationship between such linear projects and human populations is overlooked by regulatory bodies. Results also corroborate known challenges to the implementation of EIA processes andmore » outline limitations to an effective environmental and risk management. Two preliminary topics are discussed to strengthen similar regulatory practices. Firstly, an effective integration between social impact assessment and risk assessment in EIA processes to have a more comprehensive understanding of the social fabric. Secondly, the advancement of traditional management practices for hazardous installations to pursue a strong transition from assessment and evaluation to management and control and to promote an effective interaction between land-use planning and environmental regulation.« less

  14. Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia

    PubMed Central

    Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B.

    2016-01-01

    Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled “Weight Management in Pharmacy” was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students’ ORK scores and students’ perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were “service-ready” and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services. PMID:27293236

  15. Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia.

    PubMed

    Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

    2016-05-25

    Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled "Weight Management in Pharmacy" was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students' ORK scores and students' perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were "service-ready" and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services.

  16. DE-CERTS: A Decision Support System for a Comparative Evaluation Method for Risk Management Methodologies and Tools

    DTIC Science & Technology

    1991-09-01

    iv III. THE ANALYTIC HIERARCHY PROCESS ..... ........ 15 A. INTRODUCTION ...... ................. 15 B. THE AHP PROCESS ...... ................ 16 C...INTRODUCTION ...... ................. 26 B. IMPLEMENTATION OF CERTS USING AHP ........ .. 27 1. Consistency ...... ................ 29 2. User Interface...the proposed technique into a Decision Support System. Expert Choice implements the Analytic Hierarchy Process ( AHP ), an approach to multi- criteria

  17. Entrepreneurship Education in Vocational Schools: Characteristics of Teachers, Schools and Risk Implementation of the Curriculum 2013 in Indonesia

    ERIC Educational Resources Information Center

    Winarno, Agung

    2016-01-01

    This study examines the problems of entrepreneurship education at Vocational High School based on the perspective of teachers and school management characteristics related to the implementation of the curriculum in 2013 and trials of character-based education model. The research and development survey was conducted on a Vocational High Schools in…

  18. Crossing the implementation chasm: a proposal for bold action.

    PubMed

    Lorenzi, Nancy M; Novak, Laurie L; Weiss, Jacob B; Gadd, Cynthia S; Unertl, Kim M

    2008-01-01

    As health care organizations dramatically increase investment in information technology (IT) and the scope of their IT projects, implementation failures become critical events. Implementation failures cause stress on clinical units, increase risk to patients, and result in massive costs that are often not recoverable. At an estimated 28% success rate, the current level of investment defies management logic. This paper asserts that there are "chasms" in IT implementations that represent risky stages in the process. Contributors to the chasms are classified into four categories: design, management, organization, and assessment. The American College of Medical Informatics symposium participants recommend bold action to better understand problems and challenges in implementation and to improve the ability of organizations to bridge these implementation chasms. The bold action includes the creation of a Team Science for Implementation strategy that allows for participation from multiple institutions to address the long standing and costly implementation issues. The outcomes of this endeavor will include a new focus on interdisciplinary research and an inter-organizational knowledge base of strategies and methods to optimize implementations and subsequent achievement of organizational objectives.

  19. From design to implementation - The Joint Asia Diabetes Evaluation (JADE) program: A descriptive report of an electronic web-based diabetes management program

    PubMed Central

    2010-01-01

    Background The Joint Asia Diabetes Evaluation (JADE) Program is a web-based program incorporating a comprehensive risk engine, care protocols, and clinical decision support to improve ambulatory diabetes care. Methods The JADE Program uses information technology to facilitate healthcare professionals to create a diabetes registry and to deliver an evidence-based care and education protocol tailored to patients' risk profiles. With written informed consent from participating patients and care providers, all data are anonymized and stored in a databank to establish an Asian Diabetes Database for research and publication purpose. Results The JADE electronic portal (e-portal: http://www.jade-adf.org) is implemented as a Java application using the Apache web server, the mySQL database and the Cocoon framework. The JADE e-portal comprises a risk engine which predicts 5-year probability of major clinical events based on parameters collected during an annual comprehensive assessment. Based on this risk stratification, the JADE e-portal recommends a care protocol tailored to these risk levels with decision support triggered by various risk factors. Apart from establishing a registry for quality assurance and data tracking, the JADE e-portal also displays trends of risk factor control at each visit to promote doctor-patient dialogues and to empower both parties to make informed decisions. Conclusions The JADE Program is a prototype using information technology to facilitate implementation of a comprehensive care model, as recommended by the International Diabetes Federation. It also enables health care teams to record, manage, track and analyze the clinical course and outcomes of people with diabetes. PMID:20465815

  20. Biophysical risks to carbon sequestration and storage in Australian drylands.

    PubMed

    Nolan, Rachael H; Sinclair, Jennifer; Eldridge, David J; Ramp, Daniel

    2018-02-15

    Carbon abatement schemes that reduce land clearing and promote revegetation are now an important component of climate change policy globally. There is considerable potential for these schemes to operate in drylands which are spatially extensive. However, projects in these environments risk failure through unplanned release of stored carbon to the atmosphere. In this review, we identify factors that may adversely affect the success of vegetation-based carbon abatement projects in dryland ecosystems, evaluate their likelihood of occurrence, and estimate the potential consequences for carbon storage and sequestration. We also evaluate management strategies to reduce risks posed to these carbon abatement projects. Identified risks were primarily disturbances, including unplanned fire, drought, and grazing. Revegetation projects also risk recruitment failure, thereby failing to reach projected rates of sequestration. Many of these risks are dependent on rainfall, which is highly variable in drylands and susceptible to further variation under climate change. Resprouting vegetation is likely to be less vulnerable to disturbance and have faster recovery rates upon release from disturbance. We conclude that there is a strong impetus for identifying management strategies and risk reduction mechanisms for carbon abatement projects. Risk mitigation would be enhanced by effective co-ordination of mitigation strategies at scales larger than individual abatement project boundaries, and by implementing risk assessment throughout project planning and implementation stages. Reduction of risk is vital for maximising carbon sequestration of individual projects and for reducing barriers to the establishment of new projects entering the market. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Community-Based Disaster Management: A Lesson Learned From Community Emergency Response Management in Banyumas, Indonesia

    NASA Astrophysics Data System (ADS)

    Pratama, A. Y.; Sariffuddin, S.

    2018-02-01

    This article aimed to review community-based disaster management in terms of its independent coordination and disaster management. Community resilience was tested during disaster emergency. While panic, the community is required to be viable and able to evacuate, manage logistic, collect data on damage and the victim, and coordinate with outsiders independently. The community in Gununglurah Village, Banyumas Regency which was hit by a landslide in 2015 provides a lesson learned about community based disaster management. This research used qualitative descriptive methodology with in-depth interview with 23 informants from the community, donor institution, village officers, and government officers. Through traditional and informal methods, the community implemented disaster management that was categorized into 3 mechanisms that were social, functional, and sequential mechanism. These mechanisms controlled different portion in which social mechanism holds the most important role in disaster management, then functional mechanism and sequential mechanism. Various community activities in the village equipped the community with organizational experience to manage logistic, human resource and other coordination. In 2007, in fact, there was vulnerability risk assessment done by the local government, which recommended efforts to be done by the community to reduce the disaster risk, yet it was not implemented. It was interesting to note that in spite of the independent disaster management there was a scientific assessment neglected. Based on this research, a new discussion on how to synchronize the endogenous knowledge with scientific modern knowledge was opened.

  2. Integrating Corporate Governance Concepts in the Classroom with the Risk Assessment Project

    ERIC Educational Resources Information Center

    Elson, Raymond J.; O'Callaghan, Susanne; Walker, John P.

    2015-01-01

    The recession of 2008 and the demise of established financial firms served as a reminder that effective corporate governance is important to ensure that businesses remain as going concern. One key area is the implementation of effective enterprise-wide risk management practices. The resulting regulatory oversight enacted through the Dodd Frank Act…

  3. Biosafety practices associated with potential agents of biocrime and biowarfare.

    PubMed

    Burnett, LouAnn C

    2006-12-01

    Conducting research in a manner that guards against theft and intentional misuse of biological materials requires a process of hazard identification and risk assessment to most effectively identify and implement a risk management plan. Procedures describing physical security, personnel reliability, and material control and accountability define a security plan for this type of research.

  4. The Child Well-Being Scales as a Clinical Tool and a Management Information System.

    ERIC Educational Resources Information Center

    Lyons, Peter; Doueck, Howard J.; Koster, Andrew J.; Witzky, Melissa K.; Kelly, Patricia L.

    1999-01-01

    Describes implementation of a computerized version of the Child Welfare League of America's Child Well-Being Scales by a family services agency in southern Ontario. Reviews results obtained from 172 families to illustrate the potential for using computerized risk assessment as an aid in clinical, supervisory, and management decision-making…

  5. The Efficacy of a Multifaceted Weight Management Program for Children and Young Adolescents

    ERIC Educational Resources Information Center

    Kihm, Holly Spencer

    2014-01-01

    The incidence of overweight and obesity among children and young adolescents remains unacceptably high and places our youth at risk for several negative outcomes. Recognizing the need for a youth-focused weight management program in our community, the researcher developed, implemented, and evaluated a small pilot study, FitKids. The aims of…

  6. Auditing Organizational Security

    DTIC Science & Technology

    2017-01-01

    Managing organizational security is no different from managing any other of the command’s missions. Establish your policies, goals and risk...parameters; implement, train, measure and benchmark them. And then audit, audit, audit. Today, more than ever, Organizational Security is an essential...not be regarded as independent or standing alone. Cybersecurity is an indispensable element of organizational security, which is the subject of

  7. Risk assessment in the upstream crude oil supply chain: Leveraging analytic hierarchy process

    NASA Astrophysics Data System (ADS)

    Briggs, Charles Awoala

    For an organization to be successful, an effective strategy is required, and if implemented appropriately the strategy will result in a sustainable competitive advantage. The importance of decision making in the oil industry is reflected in the magnitude and nature of the industry. Specific features of the oil industry supply chain, such as its longer chain, the complexity of its transportation system, its complex production and storage processes, etc., pose challenges to its effective management. Hence, understanding the risks, the risk sources, and their potential impacts on the oil industry's operations will be helpful in proposing a risk management model for the upstream oil supply chain. The risk-based model in this research uses a three-level analytic hierarchy process (AHP), a multiple-attribute decision-making technique, to underline the importance of risk analysis and risk management in the upstream crude oil supply chain. Level 1 represents the overall goal of risk management; Level 2 is comprised of the various risk factors; and Level 3 represents the alternative criteria of the decision maker as indicated on the hierarchical structure of the crude oil supply chain. Several risk management experts from different oil companies around the world were surveyed, and six major types of supply chain risks were identified: (1) exploration and production, (2) environmental and regulatory compliance, (3) transportation, (4) availability of oil, (5) geopolitical, and (6) reputational. Also identified are the preferred methods of managing risks which include; (1) accept and control the risks, (2) avoid the risk by stopping the activity, or (3) transfer or share the risks to other companies or insurers. The results from the survey indicate that the most important risk to manage is transportation risk with a priority of .263, followed by exploration/production with priority of .198, with an overall inconsistency of .03. With respect to major objectives the most preferred risk management policy option based on the result of the composite score is accept and control risk with a priority of .446, followed by transfer or share risk with a priority of .303. The least likely option is to terminate or forgo activity with a priority of .251.

  8. [Hospital risk management from the viewpoint of insurers].

    PubMed

    Gausmann, Peter; Petry, Franz Michael

    2004-10-01

    The present article deals with the significance of risk management in hospitals from the viewpoint of liability insurers. From the perspective of insurance companies, the liability risk of a hospital and its personnel has considerably increased during the past 25 years. The present risk situation is characterized by a growing number of reported liability cases, as well as by an enormous increase of average compensation claims. This development has led some insurance companies to financial deficits in the segment of hospital liability. While some insurers have withdrawn their activities from this market segment, others have reacted by raising their premiums. Since in Germany the premiums usually depend on the number of beds held by a hospital, the problem of rising premiums is exacerbated by the general increase of the number of clinical cases in the face of a parallel reduction of the number of beds. In the process of finding new criteria or methods for adequate premium calculation, a key role will be played by the individual future risk development of a hospital and by the evaluation of this risk by its insurance company. An extensive system of clinical quality management supported by elements of risk management will have persistent positive effects on the development of individual insurance premiums and on the insurability of clinical liability. Risk management is defined as the totality of measures taken by a company to identify risks that could lead to reduced success. Clinical risk management must be regarded in the context of a general trend that is not limited to the field of health service. In this process, the handling of errors and their causes plays a central role. Further variants of hospital risk management are the technical and economic risk management, both of which are increasingly important and are in part implemented in the German legislation. Clinical risk management has originated from the U.S., where as early as in the nineteen-seventies instruments and methods have been developed to avoid errors. Important application fields are anesthetics, surgery, orthopedics, and obstetrics. Risk management is primarily a task of the internal personnel of a hospital. The support by external consultants promises additional benefits for the hospital. Measures of classical risk management usually are essential elements of any quality management system; as such, they are therefore certifiable. Certification alone, however, does not prove the sustained efficiency of a risk-prevention system.

  9. Use of life cycle assessments to evaluate the environmental footprint of contaminated sediment remediation.

    PubMed

    Sparrevik, Magnus; Saloranta, Tuomo; Cornelissen, Gerard; Eek, Espen; Fet, Annik Magerholm; Breedveld, Gijs D; Linkov, Igor

    2011-05-15

    Ecological and human risks often drive the selection of remedial alternatives for contaminated sediments. Traditional human and ecological risk assessment (HERA) includes assessing risk for benthic organisms and aquatic fauna associated with exposure to contaminated sediments before and after remediation as well as risk for human exposure but does not consider the environmental footprint associated with implementing remedial alternatives. Assessment of environmental effects over the whole life cycle (i.e., Life Cycle Assessment, LCA) could complement HERA and help in selecting the most appropriate sediment management alternative. Even though LCA has been developed and applied in multiple environmental management cases, applications to contaminated sediments and marine ecosystems are in general less frequent. This paper implements LCA methodology for the case of the polychlorinated dibenzo-p-dioxins and -furans (PCDD/F)-contaminated Grenland fjord in Norway. LCA was applied to investigate the environmental footprint of different active and passive thin-layer capping alternatives as compared to natural recovery. The results showed that capping was preferable to natural recovery when analysis is limited to effects related to the site contamination. Incorporation of impacts related to the use of resources and energy during the implementation of a thin layer cap increase the environmental footprint by over 1 order of magnitude, making capping inferior to the natural recovery alternative. Use of biomass-derived activated carbon, where carbon dioxide is sequestered during the production process, reduces the overall environmental impact to that of natural recovery. The results from this study show that LCA may be a valuable tool for assessing the environmental footprint of sediment remediation projects and for sustainable sediment management.

  10. Framework for managing mycotoxin risks in the food industry.

    PubMed

    Baker, Robert C; Ford, Randall M; Helander, Mary E; Marecki, Janusz; Natarajan, Ramesh; Ray, Bonnie

    2014-12-01

    We propose a methodological framework for managing mycotoxin risks in the food processing industry. Mycotoxin contamination is a well-known threat to public health that has economic significance for the food processing industry; it is imperative to address mycotoxin risks holistically, at all points in the procurement, processing, and distribution pipeline, by tracking the relevant data, adopting best practices, and providing suitable adaptive controls. The proposed framework includes (i) an information and data repository, (ii) a collaborative infrastructure with analysis and simulation tools, (iii) standardized testing and acceptance sampling procedures, and (iv) processes that link the risk assessments and testing results to the sourcing, production, and product release steps. The implementation of suitable acceptance sampling protocols for mycotoxin testing is considered in some detail.

  11. [Security of the medicinal therapy: Cartography of risks a priori within service of orthopaedic surgery].

    PubMed

    Razurel, A; Bertrand, É; Deranlot, J; Benhamou, F; Tritz, T; Le Mercier, F; Hardy, P

    2015-11-01

    Security and quality of the Medicinal Therapy are one of the most important objectives of the April 6th, 2011 order. The objective is to realize this study of the risks incurred by patients related to management and security of medicinal therapy in order to establish a plan to reduce the risks of drug's dispensation. The method of the Preliminary Risk Analysis (PRA) has been implemented by a multidisciplinary group in a hospital service of orthopaedic surgery. The study focused on the dispensation phase of medicinal circuit. This analysis revealed 148 scenarii, 35 were criticality unacceptable. Fifty-four initial risk control actions were proposed and their stress levels to put them in place were evaluated. The main measures of risk management are: training, information, communication, computerization, automation, dual control, updating the documentation system, drug reconciliation and respect for Best Practices Hospitallers (BPH). Risk management requires a significant human and financial investment as well as, material resources and multidisciplinary expertise in order to offer the best solutions. Copyright © 2015 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  12. Risk management and post-marketing surveillance for the abuse of medications acting on the central nervous system: expert panel report.

    PubMed

    Johanson, Chris-Ellyn; Balster, Robert L; Henningfield, Jack E; Schuster, Charles R; Anthony, James C; Barthwell, Andrea G; Coleman, John J; Dart, Richard C; Gorodetzky, Charles W; O'Keeffe, Charles; Sellers, Edward M; Vocci, Frank; Walsh, Sharon L

    2009-12-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and 11 recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized.

  13. Risk Management Post-Marketing Surveillance for the Abuse of Medications Acting on the Central Nervous System: Expert Panel Report

    PubMed Central

    Johanson, Chris-Ellyn; Balster, Robert L.; Henningfield, Jack E.; Schuster, Charles R.; Anthony, James C.; Barthwell, Andrea G.; Coleman, John J.; Dart, Richard C.; Gorodetzky, Charles W.; O’Keeffe, Charles; Sellers, Edward M.; Vocci, Frank; Walsh, Sharon L.

    2010-01-01

    The abuse and diversion of medications is a significant public health problem. This paper is part of a supplemental issue of Drug and Alcohol Dependence focused on the development of risk management plans and post-marketing surveillance related to minimizing this problem. The issue is based on a conference that was held in October, 2008. An Expert Panel was formed to provide a summary of the conclusions and recommendations that emerged from the meeting involving drug abuse experts, regulators and other government agencies, pharmaceutical companies and professional and other non-governmental organizations. This paper provides a written report of this Expert Panel. Eleven conclusions and eleven recommendations emerged concerning the state of the art of this field of research, the regulatory and public health implications and recommendations for future directions. It is concluded that special surveillance tools are needed to detect the emergence of medication abuse in a timely manner and that risk management tools can be implemented to increase the benefit to risk ratio. The scientific basis for both the surveillance and risk management tools is in its infancy, yet progress needs to be made. It is also important that the unintended consequences of increased regulation and the imposition of risk management plans be minimized. PMID:19783383

  14. The role of risk perception in making flood risk management more effective

    NASA Astrophysics Data System (ADS)

    Buchecker, M.; Salvini, G.; Di Baldassarre, G.; Semenzin, E.; Maidl, E.; Marcomini, A.

    2013-11-01

    Over the last few decades, Europe has suffered from a number of severe flood events and, as a result, there has been a growing interest in probing alternative approaches to managing flood risk via prevention measures. A literature review reveals that, although in the last decades risk evaluation has been recognized as key element of risk management, and risk assessment methodologies (including risk analysis and evaluation) have been improved by including social, economic, cultural, historical and political conditions, the theoretical schemes are not yet applied in practice. One main reason for this shortcoming is that risk perception literature is mainly of universal and theoretical nature and cannot provide the necessary details to implement a comprehensive risk evaluation. This paper therefore aims to explore a procedure that allows the inclusion of stakeholders' perceptions of prevention measures in risk assessment. It proposes to adopt methods of risk communication (both one-way and two-way communication) in risk assessment with the final aim of making flood risk management more effective. The proposed procedure not only focuses on the effect of discursive risk communication on risk perception, and on achieving a shared assessment of the prevention alternatives, but also considers the effects of the communication process on perceived uncertainties, accepted risk levels, and trust in the managing institutions. The effectiveness of this combined procedure has been studied and illustrated using the example of the participatory flood prevention assessment process on the Sihl River in Zurich, Switzerland. The main findings of the case study suggest that the proposed procedure performed well, but that it needs some adaptations for it to be applicable in different contexts and to allow a (semi-) quantitative estimation of risk perception to be used as an indicator of adaptive capacity.

  15. Disease management for the diabetic foot: effectiveness of a diabetic foot prevention program to reduce amputations and hospitalizations.

    PubMed

    Lavery, Lawrence A; Wunderlich, Robert P; Tredwell, Jeffrey L

    2005-10-01

    To demonstrate the effectiveness of a diabetic foot disease management program in a managed care organization. We implemented a lower extremity disease management program consisting of screening and treatment protocols for diabetic members in a managed care organization. Screening consisted of evaluation of neuropathy, peripheral vascular disease, deformities, foot pressures, and history of lower extremity pathology. We stratified patients into low and high-risk groups, and implemented preventive or acute care protocols. Utilization was tracked for 28 months and compared to 12 months of historic data prior to implementation of the disease management program. After we implemented the disease management program, the incidence of amputations decreased 47.4% from 12.89 per 1000 diabetics per year to 6.18 (p<0.05). The number of foot-related hospital admissions decreased 37.8% from 22.86 per 1000 members per year to 14.23 (37.8%). The average inpatient length-of-stay (LOS) was reduced 21.7% from 4.75 to 3.72 days (p<0.05). In addition, there was a 69.8% reduction in the number of skilled nursing facility (SNF) admissions per 1000 members per year (Table 1) and a 38.2% reduction in the average SNF LOS from 8.72 to 6.52 days (p<0.05). A population-based screening and treatment program for the diabetic foot can dramatically reduce hospitalizations and clinical outcomes.

  16. Disease management and health care reforms in Germany - does more competition lead to less solidarity?

    PubMed

    Stock, Stephanie Anja Katharina; Redaelli, Marcus; Lauterbach, Karl Wilhelm

    2007-01-01

    Up to the 1990s German health care legislation was dominated by measures regulating the supply side. Measures, such as budgets, aimed at volume control and sought to confine the increase of health care spending to the growth of the national income. To curb costs more effectively, competitive elements were introduced in the 1990s with free choice of sickness funds (open enrollment). To balance competition and solidarity, a risk compensation scheme (RCS) was implemented two years prior to open enrollment. Since then, balancing competition and solidarity has been a key feature of all consecutive health care reforms. The implementation of disease management programs in the statutory health insurance (SHI) served the dual purpose to promote quality of care and to foster competition. Preliminary experiences suggest, that the aligning of disease management programs with a RCS can greatly aid its implementation and benefit solidarity and competition.

  17. Low back pain among nurses in Slovenian hospitals: cross-sectional study.

    PubMed

    Skela-Savič, B; Pesjak, K; Hvalič-Touzery, S

    2017-12-01

    The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings. © 2017 International Council of Nurses.

  18. Clinical Assessment of Risk Management: an INtegrated Approach (CARMINA).

    PubMed

    Tricarico, Pierfrancesco; Tardivo, Stefano; Sotgiu, Giovanni; Moretti, Francesca; Poletti, Piera; Fiore, Alberto; Monturano, Massimo; Mura, Ida; Privitera, Gaetano; Brusaferro, Silvio

    2016-08-08

    Purpose - The European Union recommendations for patient safety calls for shared clinical risk management (CRM) safety standards able to guide organizations in CRM implementation. The purpose of this paper is to develop a self-evaluation tool to measure healthcare organization performance on CRM and guide improvements over time. Design/methodology/approach - A multi-step approach was implemented including: a systematic literature review; consensus meetings with an expert panel from eight Italian leader organizations to get to an agreement on the first version; field testing to test instrument feasibility and flexibility; Delphi strategy with a second expert panel for content validation and balanced scoring system development. Findings - The self-assessment tool - Clinical Assessment of Risk Management: an INtegrated Approach includes seven areas (governance, communication, knowledge and skills, safe environment, care processes, adverse event management, learning from experience) and 52 standards. Each standard is evaluated according to four performance levels: minimum; monitoring; outcomes; and improvement actions, which resulted in a feasible, flexible and valid instrument to be used throughout different organizations. Practical implications - This tool allows practitioners to assess their CRM activities compared to minimum levels, monitor performance, benchmarking with other institutions and spreading results to different stakeholders. Originality/value - The multi-step approach allowed us to identify core minimum CRM levels in a field where no consensus has been reached. Most standards may be easily adopted in other countries.

  19. Influence of the economy crisis on project cost management

    NASA Astrophysics Data System (ADS)

    Simankina, Tatyana; Ćetković, Jasmina; Verstina, Natalia; Evseev, Evgeny

    2017-10-01

    Economy crisis significantly affects primarily the project cost management. The article considers the problems of project management in the field of housing under conditions of economy crisis. Project budgets are reduced, their mutual interference grows and framework of risks changes. Apparently, specific approaches are required to be developed to optimize the expenses and guarantee the project implementation within the approved budget. There is considered domestic and foreign experience in terms of project cost management with involvement of BIM technologies.

  20. Lessons learnt from past Flash Floods and Debris Flow events to propose future strategies on risk management

    NASA Astrophysics Data System (ADS)

    Cabello, Angels; Velasco, Marc; Escaler, Isabel

    2010-05-01

    Floods, including flash floods and debris flow events, are one of the most important hazards in Europe regarding both economic and life loss. Moreover, changes in precipitation patterns and intensity are very likely to increase due to the observed and predicted global warming, rising the risk in areas that are already vulnerable to floods. Therefore, it is very important to carry out new strategies to improve flood protection, but it is also crucial to take into account historical data to identify high risk areas. The main objective of this paper is to show a comparative analysis of the flood risk management information compiled in four test-bed basins (Llobregat, Guadalhorce, Gardon d'Anduze and Linth basins) from three different European countries (Spain, France and Switzerland) and to identify which are the lessons learnt from their past experiences in order to propose future strategies on risk management. This work is part of the EU 7th FP project IMPRINTS which aims at reducing loss of life and economic damage through the improvement of the preparedness and the operational risk management of flash flood and debris flow (FF & DF) events. The methodology followed includes the following steps: o Specific survey on the effectivity of the implemented emergency plans and risk management procedures sent to the test-bed basin authorities that participate in the project o Analysis of the answers from the questionnaire and further research on their methodologies for risk evaluation o Compilation of available follow-up studies carried out after major flood events in the four test-bed basins analyzed o Collection of the lessons learnt through a comparative analysis of the previous information o Recommendations for future strategies on risk management based on lessons learnt and management gaps detected through the process As the Floods Directive (FD) already states, the flood risks associated to FF & DF events should be assessed through the elaboration of Flood Risk Management Plans (FRMP) with tailored solutions for each basin, evaluating their flood mitigation potential, promoting environmental objectives and increasing the efficiency of the already adopted measures. The FRMP should focus on prevention (and protection), preparedness and response, and these have been the three main risk management phases of a flood crisis that have been assessed when extracting the lessons learnt from past events. Lessons learnt concerning dissemination through the three previously mentioned phases and also related to education initiatives have also been included. A common response to most of the events described in this paper was to upgrade the meteorological and hydrological forecasting systems, making the forecasting lead-time as large as possible. Another common recommendation from the test-beds was the need to implement and accomplish the land use regulations. All the basins also detected that structural measures are necessary to increase the population's protection level, but replacing the traditional safety mentality by a risk culture based on a comprehensive analysis of the flood risk. The four basins studied have also highlighted the importance of collecting information when FF & DF events occur and creating historic databases that will provide extremely useful information in the future.

  1. Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana.

    PubMed

    Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S-N; Kirby, Ryan

    2016-02-01

    Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders.

  2. Influences on Adaptive Planning to Reduce Flood Risks among Parishes in South Louisiana

    PubMed Central

    Paille, Mary; Reams, Margaret; Argote, Jennifer; Lam, Nina S.-N.; Kirby, Ryan

    2016-01-01

    Residents of south Louisiana face a range of increasing, climate-related flood exposure risks that could be reduced through local floodplain management and hazard mitigation planning. A major incentive for community planning to reduce exposure to flood risks is offered by the Community Rating System (CRS) of the National Flood Insurance Program (NFIP). The NFIP encourages local collective action by offering reduced flood insurance premiums for individual policy holders of communities where suggested risk-reducing measures have been implemented. This preliminary analysis examines the extent to which parishes (counties) in southern Louisiana have implemented the suggested policy actions and identifies key factors that account for variation in the implementation of the measures. More measures implemented results in higher CRS scores. Potential influences on scores include socioeconomic attributes of residents, government capacity, average elevation and past flood events. The results of multiple regression analysis indicate that higher CRS scores are associated most closely with higher median housing values. Furthermore, higher scores are found in parishes with more local municipalities that participate in the CRS program. The number of floods in the last five years and the revenue base of the parish does not appear to influence CRS scores. The results shed light on the conditions under which local adaptive planning to mitigate increasing flood risks is more likely to be implemented and offer insights for program administrators, researchers and community stakeholders. PMID:27330828

  3. Cardiovascular risk management in rheumatoid arthritis patients still suboptimal: the Implementation of Cardiovascular Risk Management in Rheumatoid Arthritis project.

    PubMed

    van den Oever, Inge A M; Heslinga, Maaike; Griep, Ed N; Griep-Wentink, Hanneke R M; Schotsman, Rob; Cambach, Walter; Dijkmans, Ben A C; Smulders, Yvo M; Lems, Willem F; Boers, Maarten; Voskuyl, Alexandre E; Peters, Mike J L; van Schaardenburg, Dirkjan; Nurmohamed, Micheal T

    2017-09-01

    To assess the 10-year cardiovascular (CV) risk score and to identify treatment and undertreatment of CV risk factors in patients with established RA. Demographics, CV risk factors and prevalence of cardiovascular disease (CVD) were assessed by questionnaire. To calculate the 10-year CV risk score according to the Dutch CV risk management guideline, systolic blood pressure was measured and cholesterol levels were determined from fasting blood samples. Patients were categorized into four groups: indication for treatment but not treated; inadequately treated, so not meeting goals (systolic blood pressure ⩽140 mmHg and/or low-density lipoprotein ⩽2.5 mmol/l); adequately treated; or no treatment necessary. A total of 720 consecutive RA patients were included, 375 from Reade and 345 from the Antonius Hospital. The mean age of patients was 59 years (s.d. 12) and 73% were female. Seventeen per cent of the patients had a low 10-year CV risk (<10%), 21% had an intermediate risk (10-19%), 53% a high risk (⩾20%) and 9% had CVD. In total, 69% had an indication for preventive treatment (cholesterol-lowering or antihypertensive drugs). Of those, 42% received inadequate treatment and 40% received no treatment at all. Optimal CV risk management remains a major challenge and better awareness and management are urgently needed to reduce the high risk of CVD in the RA population. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  4. Fall Prevention for Older Adults Receiving Home Healthcare.

    PubMed

    Bamgbade, Sarah; Dearmon, Valorie

    2016-02-01

    Falls pose a significant risk for community-dwelling older adults. Fall-related injuries increase healthcare costs related to hospitalization, diagnostic procedures, and/or surgeries. This article describes a quality improvement project to reduce falls in older adults receiving home healthcare services. The fall prevention program incorporated best practices for fall reduction, including fall risk assessment, medication review/management, home hazard and safety assessment, staff and patient fall prevention education, and an individualized home-based exercise program. The program was implemented and evaluated during a 6-month time frame. Fewer falls occurred post implementation of the falls prevention program with no major injuries.

  5. Strengthening health disaster risk management in Africa: multi-sectoral and people-centred approaches are required in the post-Hyogo Framework of Action era.

    PubMed

    Olu, Olushayo; Usman, Abdulmumini; Manga, Lucien; Anyangwe, Stella; Kalambay, Kalula; Nsenga, Ngoy; Woldetsadik, Solomon; Hampton, Craig; Nguessan, Francois; Benson, Angela

    2016-08-02

    In November 2012, the 62nd session of the Regional Committee for Africa adopted a comprehensive 10-year regional strategy for health disaster risk management (DRM). This was intended to operationalize the World Health Organization's core commitments to health DRM and the Hyogo Framework for Action 2005-2015 in the health sectors of the 47 African member states. This study reported the formative evaluation of the strategy, including evaluation of the progress in achieving nine targets (expected to be achieved incrementally by 2014, 2017, and 2022). We proposed recommendations for accelerating the strategy's implementation within the Sendai Framework for Disaster Risk Reduction. This study used a mixed methods design. A cross-sectional quantitative survey was conducted along with a review of available reports and information on the implementation of the strategy. A review meeting to discuss and finalize the study findings was also conducted. In total, 58 % of the countries assessed had established DRM coordination units within their Ministry of Health (MOH). Most had dedicated MOH DRM staff (88 %) and national-level DRM committees (71 %). Only 14 (58 %) of the countries had health DRM subcommittees using a multi-sectoral disaster risk reduction platform. Less than 40 % had conducted surveys such as disaster risk analysis, hospital safety index, and mapping of health resources availability. Key challenges in implementing the strategy were inadequate political will and commitment resulting in poor funding for health DRM, weak health systems, and a dearth of scientific evidence on mainstreaming DRM and disaster risk reduction in longer-term health system development programs. Implementation of the strategy was behind anticipated targets despite some positive outcomes, such as an increase in the number of countries with health DRM incorporated in their national health legislation, MOH DRM units, and functional health sub-committees within national DRM committees. Health system-based, multi-sectoral, and people-centred approaches are proposed to accelerate implementation of the strategy in the post-Hyogo Framework of Action era.

  6. Developing predictive systems models to address complexity and relevance for ecological risk assessment.

    PubMed

    Forbes, Valery E; Calow, Peter

    2013-07-01

    Ecological risk assessments (ERAs) are not used as well as they could be in risk management. Part of the problem is that they often lack ecological relevance; that is, they fail to grasp necessary ecological complexities. Adding realism and complexity can be difficult and costly. We argue that predictive systems models (PSMs) can provide a way of capturing complexity and ecological relevance cost-effectively. However, addressing complexity and ecological relevance is only part of the problem. Ecological risk assessments often fail to meet the needs of risk managers by not providing assessments that relate to protection goals and by expressing risk in ratios that cannot be weighed against the costs of interventions. Once more, PSMs can be designed to provide outputs in terms of value-relevant effects that are modulated against exposure and that can provide a better basis for decision making than arbitrary ratios or threshold values. Recent developments in the modeling and its potential for implementation by risk assessors and risk managers are beginning to demonstrate how PSMs can be practically applied in risk assessment and the advantages that doing so could have. Copyright © 2013 SETAC.

  7. [New approach for managing microbial risks in food].

    PubMed

    Augustin, Jean-Christophe

    2015-01-01

    The aim of the food legislation is to ensure the protection of human health. Traditionally, the food legislation requires food business operators to apply good hygiene practices and specific procedures to control foodborne pathogens. These regulations allowed reaching a high level of health protection. The improvement of the system will require risk-based approaches. Firstly, risk assessment should allow the identification of high-risk situations where resources should be allocated for a better targeting of risk management. Then, management measures should be adapted to the health objective. In this approach, the appropriate level of protection is converted intofood safety and performance objectives on the food chain, i.e., maximum microbial contamination to fulfil the acceptable risk level. When objectives are defined, the food business operators and competent authorities can identify control options to comply with the objectives and establish microbiological criteria to verify compliance with these objectives. This approach, described for approximately 10 years, operative thanks to the development of quantitative risk assessment techniques, is still difficult to use in practical terms since it requires a commitment of competent authorities to define the acceptable risk and needs also the implementation of sometimes complex risk models.

  8. Uncertainty and risk in wildland fire management: a review.

    PubMed

    Thompson, Matthew P; Calkin, Dave E

    2011-08-01

    Wildland fire management is subject to manifold sources of uncertainty. Beyond the unpredictability of wildfire behavior, uncertainty stems from inaccurate/missing data, limited resource value measures to guide prioritization across fires and resources at risk, and an incomplete scientific understanding of ecological response to fire, of fire behavior response to treatments, and of spatiotemporal dynamics involving disturbance regimes and climate change. This work attempts to systematically align sources of uncertainty with the most appropriate decision support methodologies, in order to facilitate cost-effective, risk-based wildfire planning efforts. We review the state of wildfire risk assessment and management, with a specific focus on uncertainties challenging implementation of integrated risk assessments that consider a suite of human and ecological values. Recent advances in wildfire simulation and geospatial mapping of highly valued resources have enabled robust risk-based analyses to inform planning across a variety of scales, although improvements are needed in fire behavior and ignition occurrence models. A key remaining challenge is a better characterization of non-market resources at risk, both in terms of their response to fire and how society values those resources. Our findings echo earlier literature identifying wildfire effects analysis and value uncertainty as the primary challenges to integrated wildfire risk assessment and wildfire management. We stress the importance of identifying and characterizing uncertainties in order to better quantify and manage them. Leveraging the most appropriate decision support tools can facilitate wildfire risk assessment and ideally improve decision-making. Published by Elsevier Ltd.

  9. An evaluation of the Well at Dell health management program: health risk change and financial return on investment.

    PubMed

    Musich, Shirley; McCalister, Tre'; Wang, Sara; Hawkins, Kevin

    2015-01-01

    To investigate the effectiveness of the Well at Dell comprehensive health management program in delivering health care and productivity cost savings relative to program investment (i.e., return on investment). A quasi-experimental design was used to quantify the financial impact of the program and nonexperimental pre-post design to evaluate change in health risks. Ongoing worksite health management program implemented across multiple U.S. locations. Subjects were 24,651 employees with continuous medical enrollment in 2010-2011 who were eligible for 2011 health management programming. Incentive-driven, outcomes-based multicomponent corporate health management program including health risk appraisal (HRA)/wellness, lifestyle management, and disease management coaching programs. Medical, pharmacy, and short-term disability pre/post expenditure trends adjusted for demographics, health status, and baseline costs. Self-reported health risks from repeat HRA completers. Analysis: Propensity score-weighted and multivariate regression-adjusted comparison of baseline to post trends in health care expenditures and productivity costs for program participants and nonparticipants (i.e., difference in difference) relative to programmatic investment. The Well at Dell program achieved an overall return on investment of 2.48 in 2011. Most of the savings were realized from the HRA/wellness component of the program. Cost savings were supported with high participation and significant health risk improvement. An incentive-driven, well-managed comprehensive corporate health management program can continue to achieve significant health improvement while promoting health care and productivity cost savings in an employee population.

  10. Comparisons of Food and Drug Administration and European Medicines Agency risk management implementation for recent pharmaceutical approvals: report of the International Society for Pharmacoeconomics and outcomes research risk benefit management working group.

    PubMed

    Lis, Yvonne; Roberts, Melissa H; Kamble, Shital; J Guo, Jeff; Raisch, Dennis W

    2012-12-01

    1) To compare the Food and Drug Administration's (FDA's) Risk Evaluation and Mitigation Strategies (REMS) and European Medicines Agency's (EMA's) Risk Management Plan (RMP) guidances and 2) to compare REMS and RMPs for specific chemical entities and biological products. FDA, EMA, and pharmaceutical company Web sites were consulted for details pertaining to REMS and RMPs. REMS requirements include medication guides, communication plans, elements to ensure safe use, implementation systems, and specified assessment intervals. RMP requirements are increased pharmacovigilance and risk minimization activities. We compared these requirements for drugs requiring both REMS and RMPs. We identified 95 drugs on FDA's REMS list as of March 2010. Of these, there were 29 drugs (11 biologics and 18 new chemical entities) with EMA RMPs. REMS and RMPs are similar in objectives, with comparable toolkits. Both allow flexibility in product-specific actions, recognizing adverse effects of potential concern. Of the 29 drugs reviewed, REMS requirements not included in RMPs were patient medication guides (100% of the drugs), provider communication plans (38%), and routine monitoring of REMS (66%). RMP requirements not included in REMS were specific adverse event reporting (45% of the drugs), prospective registry studies (34%), prospective epidemiology studies (24%), additional trial data (28%), and Summary of Product Characteristics contraindications (76%). Both REMS and RMPs provide positive guidance for identification, monitoring, and minimization of risk to patient safety. Currently, neither agency provides specific guidance on how risk should be related to benefit either qualitatively or quantitatively. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Risk Analysis for Unintentional Slide Deployment During Airline Operations.

    PubMed

    Ayra, Eduardo S; Insua, David Ríos; Castellanos, María Eugenia; Larbi, Lydia

    2015-09-01

    We present a risk analysis undertaken to mitigate problems in relation to the unintended deployment of slides under normal operations within a commercial airline. This type of incident entails relevant costs for the airline industry. After assessing the likelihood and severity of its consequences, we conclude that such risks need to be managed. We then evaluate the effectiveness of various countermeasures, describing and justifying the chosen ones. We also discuss several issues faced when implementing and communicating the proposed measures, thus fully illustrating the risk analysis process. © 2015 Society for Risk Analysis.

  12. A practical discussion of risk management for manufacturing of pharmaceutical products.

    PubMed

    Mollah, A Hamid; Baseman, Harold S; Long, Mike; Rathore, Anurag S

    2014-01-01

    Quality risk management (QRM) is now a regulatory expectation, and it makes good business sense. The goal of the risk assessment is to increase process understanding and deliver safe and effective product to the patients. Risk analysis and management is an acceptable and effective way to minimize patient risk and determine the appropriate level of controls in manufacturing. While understanding the elements of QRM is important, knowing how to apply them in the manufacturing environment is essential for effective process performance and control. This article will preview application of QRM in pharmaceutical and biopharmaceutical manufacturing to illustrate how QRM can help the reader achieve that objective. There are several areas of risk that a drug company may encounter in pharmaceutical manufacturing, specifically addressing oral solid and liquid formulations. QRM tools can be used effectively to identify the risks and develop strategy to minimize or control them. Risks are associated throughout the biopharmaceutical manufacturing process-from raw material supply through manufacturing and filling operations to final distribution via a controlled cold chain process. Assessing relevant attributes and risks for biotechnology-derived products is more complicated and challenging for complex pharmaceuticals. This paper discusses key risk factors in biopharmaceutical manufacturing. Successful development and commercialization of pharmaceutical products is all about managing risks. If a company was to take zero risk, most likely the path to commercialization would not be commercially viable. On the other hand, if the risk taken was too much, the product is likely to have a suboptimal safety and efficacy profile and thus is unlikely to be a successful product. This article addresses the topic of quality risk management with the key objective of minimizing patient risk while creating an optimal process and product. Various tools are presented to aid implementation of these concepts. © PDA, Inc. 2014.

  13. Exploration Systems Development (ESD) Approach to Enterprise Risk Management

    NASA Technical Reports Server (NTRS)

    Bauder, Stephen P.

    2014-01-01

    The National Aeronautics and Space Administration (NASA) Exploration Systems Development (ESD) Division has implemented an innovative approach to Enterprise Risk Management under a unique governance structure and streamlined integration model. ESD's mission is to design and build the capability to extend human existence to deep space. The Enterprise consists of three Programs: Space Launch System (SLS), Orion, and Ground Systems Development and Operations (GSDO). The SLS is a rocket and launch system that will be capable of powering humans, habitats, and support systems to deep space. Orion will be the first spacecraft in history capable of taking humans to multiple destinations within deep space. GSDO is modernizing Kennedy's spaceport to launch spacecraft built and designed by both NASA and private industry. ESD's approach to Enterprise Risk Management is commensurate with affordability and a streamlined management philosophy. ESD Enterprise Risk Management leverages off of the primary mechanisms for integration within the Enterprise. The Enterprise integration approach emphasizes delegation of authority to manage and execute the majority of cross-program activities and products to the individual Programs, while maintaining the overall responsibility for all cross-program activities at the Division. The intent of the ESD Enterprise Risk Management approach is to improve risk communication, to avoid replication and/or contradictory strategies, and to minimize overhead process burden. This is accomplished by the facilitation and integration of risk information within ESD. The ESD Division risks, Orion risks, SLS risks, and GSDO risks are owned and managed by the applicable Program. When the Programs have shared risks with multiple consequences, they are jointly owned and managed. When a risk is associated with the integrated system that involves more than one Program in condition, consequence, or mitigation plan, it is considered an Exploration Systems Integration (ESI) Risk. An ESI risk may require visibility and risk handling by multiple organizations. The Integrated Risk Working Group (IRWG) is a small team of Risk experts that are responsible for collaborating and communicating best practices. In addition, the forum facilitates proper integration of risks across the Enterprise. The IRWG uses a Continuous Risk Management approach for facilitating the identification, analysis, planning, tracking, and controlling of ESI Risks. The ESD Division, Programs, and Integrated Task Teams identify ESI Risks. The IRWG maintains a set of metrics for understanding Enterprise Risk process and the overall Risk Posture. The team is also actively involved in the modeling of risk for Enterprise Performance Management. With the Enterprise being constrained in Schedule and Budget, and with significant technical complexity, the appropriate use of Risk Management techniques is crucial to the success of the Enterprise. The IRWG achieves this through the modified approach, providing a forum for collaboration on risks that cross boundaries between the separate entities.

  14. Stewardship as a Means to Create Organizational Reform: A View into Minnesota 4-H Youth Development

    ERIC Educational Resources Information Center

    Skuza, Jennifer A.; Freeman, Dorothy M.; Bremseth, Tamara J.; Doering, Shirley A.; Quinlan, Robert B.; Morreim, Patricia A.; Deidrick, James C.

    2010-01-01

    Minnesota 4-H Youth Development (MN 4-H) used stewardship as a means to create organizational reform to address the public use of the 4-H name and emblem in terms of risk management, real estate and equipment, and finances. A task force implemented a participatory process with colleagues and stakeholders to build and implement the reform effort.…

  15. Implementation of quality by design toward processing of food products.

    PubMed

    Rathore, Anurag S; Kapoor, Gautam

    2017-05-28

    Quality by design (QbD) is a systematic approach that begins with predefined objectives and emphasizes product and process understanding and process control. It is an approach based on principles of sound science and quality risk management. As the food processing industry continues to embrace the idea of in-line, online, and/or at-line sensors and real-time characterization for process monitoring and control, the existing gaps with regard to our ability to monitor multiple parameters/variables associated with the manufacturing process will be alleviated over time. Investments made for development of tools and approaches that facilitate high-throughput analytical and process development, process analytical technology, design of experiments, risk analysis, knowledge management, and enhancement of process/product understanding would pave way for operational and economic benefits later in the commercialization process and across other product pipelines. This article aims to achieve two major objectives. First, to review the progress that has been made in the recent years on the topic of QbD implementation in processing of food products and second, present a case study that illustrates benefits of such QbD implementation.

  16. [Study on the overall implementation status of the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

    PubMed

    Li, J J; Li, J L; Zhang, J; Jin, R R; Ma, S; Deng, G J; Su, X W; Bian, F; Qu, Y M; Hu, L L; Jiang, Y

    2018-04-10

    Objective: To understand the current overall status of implementation on the National Demonstration Areas of Comprehensive Prevention and Control of Non-communicable Diseases. Methods: According to the scheme design of the questionnaires, all the National Demonstration Areas were involved in this study. For each National Demonstration Areas, eight departments were selected to complete a total of 12 questionnaires. Results: Scores related to the implementation of the National Demonstration Areas accounted for 71.8% of the total 170 points. Based on the scores gathered from this study, the 23-items-index-system that represented the status of project implementation was classified into seven categories. Categories with higher percentile scores would include: monitoring (88.0%), safeguard measures (75.0%), health education and health promotion (75.0%). Categories with lower percentile scores would include: the national health lifestyle actions (67.7%), community diagnosis (66.7%), discovery and intervention of high-risk groups (64.7%), and patient management (60.9%). There were significant differences noticed among the eastern, central and western areas on items as safeguard measures, health education/promotion, discovery and intervention of high-risk groups. In all, the implementation programs in the eastern Demonstration Areas seemed better than in the central or western regions. As for the 23 items, five of the highest scores appeared on policy support, mortality surveillance, tumor registration, reporting system on cardiovascular/cerebrovascular events, and on tobacco control, respectively. However, the lowest five scores fell on healthy diet, patient self-management program, oral hygiene, setting up the demonstration units and promotion on basic public health services, respectively. The overall scores in the eastern region was higher than that in the central or the western regions. The scores in the central and western regions showed basically the same. Conclusions: The overall status of implementation on the National Demonstration Areas was satisfactory. Future attention should be focusing on patient management as well as discovery and intervention of high-risk groups, which also presented the lowest scores, in this survey.

  17. Motivation-based intervention to promote colonoscopy screening: An integration of a fear management model and motivational interviewing

    PubMed Central

    Pengchit, Watcharaporn; Walters, Scott T.; Simmons, Rebecca G.; Kohlmann, Wendy; Burt, Randall W.; Schwartz, Marc D.; Kinney, Anita Y.

    2011-01-01

    Colorectal cancer (CRC) screening rates have been low despite effectiveness of screening in reducing CRC mortality. This article outlines the theoretical background and development of an innovative, telephone-based risk communication designed to promote screening among individuals at increased risk for familial CRC. This ongoing intervention integrates the Extended Parallel Process Model of fear management and the motivational interviewing counselling style. Tailoring and implementation intentions are incorporated. The primary outcome is self-reported colonoscopy within nine months following intervention. If proven effective, the remote intervention could be broadly disseminated to individuals at increased familial CRC risk, especially those in geographically underserved areas. PMID:21464114

  18. Risk management in mental health: applying lessons from commercial aviation.

    PubMed

    Hatcher, Simon

    2010-02-01

    Risk management in mental health focuses on risks in patients and fails to predict rare but catastrophic events such as suicide. Commercial aviation has a similar task in preventing rare but catastrophic accidents. This article describes the systems in place in commercial aviation that allows that industry to prevent disasters and contrasts this with the situation in mental health. In mental health we should learn from commercial aviation by having: national policies to promote patient safety; a national body responsible for implementing this policy which maintains a database of safety occurrences, sets targets and investigates adverse outcomes; legislation in place which encourages clinicians to report safety occurrences; and a common method and language for investigating safety occurrences.

  19. Measurement of Software Project Management Effectiveness

    DTIC Science & Technology

    2008-12-01

    with technical, financial, policy, and non -technical concerns of stakeholders, to develop and select suitable risk control actions, and implementation...not intervene in their projects and therefore affect their views. In most research experiments, researchers apply a controlled event, method or...enable a consistency check among the responses and for other research purposes. Therefore, for the risk control area model, only the responses from

  20. Employee Perceptions of Their Organization's Level of Emergency Preparedness Following a Brief Workplace Emergency Planning Educational Presentation.

    PubMed

    Renschler, Lauren A; Terrigino, Elizabeth A; Azim, Sabiya; Snider, Elsa; Rhodes, Darson L; Cox, Carol C

    2016-06-01

    A brief emergency planning educational presentation was taught during work hours to a convenience sample of employees of various workplaces in Northern Missouri, USA. Participants were familiarized with details about how an emergency plan is prepared by management and implemented by management-employee crisis management teams - focusing on both employee and management roles. They then applied the presentation information to assess their own organization's emergency preparedness level. Participants possessed significantly (p < 0.05) higher perceptions of their organization's level of emergency preparedness than non-participants. It is recommended that an assessment of organizational preparedness level supplement emergency planning educational presentations in order to immediately apply the material covered and encourage employees to become more involved in their organization's emergency planning and response. Educational strategies that involve management-employee collaboration in activities tailored to each workplace's operations and risk level for emergencies should be implemented.

  1. Report to the administrator by the NASA Aerospace Safety Advisory Panel on the Skylab program. Volume 2: Program implementation and maturity. [systems management evaluation and design analysis

    NASA Technical Reports Server (NTRS)

    1973-01-01

    Results of the design and manufacturing reviews on the maturity of the Skylab modules are presented along with results of investigations on the scope of the cluster risk assessment efforts. The technical management system and its capability to assess and resolve problems are studied.

  2. The Effects of Anger Management on Children's Social and Emotional Outcomes: A Meta-Analysis

    ERIC Educational Resources Information Center

    Candelaria, Ashley M.; Fedewa, Alicia L.; Ahn, Soyeon

    2012-01-01

    The occurrence of violent behaviors and bullying in schools continues to be a recognized problem among students and school personnel. The concern caused by these behaviors have led many schools to implement anger management and other impulse control based programs for at-risk students in an effort to prevent many of these incidences. This study…

  3. 20th Annual Systems Engineering Conference. Volume 1, Monday-Tuesday

    DTIC Science & Technology

    2017-10-26

    Environment will follow Mr. Thompson’s presentation with a presentation focusing on how ESOH Risk Management is an integral part of the RIO Management...office successes and failures in implementing the DoDI 5000.02 acquisition ESOH policy. HUMAN SYSTEMS INTEGRATION (HSI) Track Chair: Matthew...practices, process improvements, applications and approaches to program integration . INTEROPERABILITY/NET - CENTRIC OPERATIONS Track Chairs

  4. Optimising fuel treatments over time and space

    Treesearch

    Woodam Chung; Greg Jones; Kurt Krueger; Jody Bramel; Marco Contreras

    2013-01-01

    Fuel treatments have been widely used as a tool to reduce catastrophic wildland fire risks in many forests around the world. However, it is a challenging task for forest managers to prioritise where, when and how to implement fuel treatments across a large forest landscape. In this study, an optimisation model was developed for long-term fuel management decisions at a...

  5. Letter from EPA to All State Emergency Response Commissions

    EPA Pesticide Factsheets

    Provides information related to the implementation of the Emergency Planning and Community Right to Know Act, and the Risk Management Program under Section 112r of the Clean Air Act, and suggestions for future actions.

  6. RMP Guidance for Warehouses - Introduction

    EPA Pesticide Factsheets

    If you handle, manufacture, use, or store any of the toxic and flammable substances listed in 40 CFR Part 68 above the specified threshold quantities in a process, you are required to develop and implement a risk management program rule.

  7. Risk management in waste water treatment.

    PubMed

    Wagner, M; Strube, I

    2005-01-01

    With the continuous restructuring of the water market due to liberalisation, privatisation and internationalisation processes, the requirements on waste water disposal companies have grown. Increasing competition requires a target-oriented and clearly structured procedure. At the same time it is necessary to meet the environment-relevant legal requirements and to design the processes to be environment-oriented. The implementation of risk management and the integration of such a management instrument in an existing system in addition to the use of modern technologies and procedures can help to make the operation of the waste water treatment safer and consequently strengthen market position. The risk management process consists of three phases, risk identification, risk analysis/risk assessment and risk handling, which are based on each other, as well as of the risk managing. To achieve an identification of the risks as complete as possible, a subdivision of the kind of risks (e.g. legal, financial, market, operational) is suggested. One possibility to assess risks is the portfolio method which offers clear representation. It allows a division of the risks into classes showing which areas need handling. The determination of the appropriate measures to handle a risk (e.g. avoidance, reduction, shift) is included in the concluding third phase. Different strategies can be applied here. On the one hand, the cause-oriented strategy, aiming at preventive measures which aim to reduce the probability of occurrence of a risk (e.g. creation of redundancy, systems with low susceptibility to malfunction). On the other hand, the effect-oriented strategy, aiming to minimise the level of damage in case of an undesired occurrence (e.g. use of alarm systems, insurance cover).

  8. Juggling Act: Re-Planning and Building on Observatory...Simultaneously!

    NASA Technical Reports Server (NTRS)

    Zavala, Eddie; Daws, Patricia

    2011-01-01

    SOFIA (Stratospheric Observatory for Infrared Astronomy) is a major SMD program that has been required to meet several requirements and implement major planning and business initiatives overthe past 1 1/2 years, in the midst of system development and flight test phases. The program was required to implementing JCL and EVM simultaneously, as well as undergo a major replan and Standing Review Board - and all without impacting technical schedule progress. The team developed innovative processes that met all the requirements, and improved Program Management process toolsets. The SOFIA team, being subject to all the typical budget constraints, found ways to leverage existing roles in new ways to meet the requirements without creating unmanageable overhead. The team developed strategies and value added processes - such as improved risk identification, structured reserves management, cost/risk integration - so that the effort expended resulted in a positive return to the program.

  9. Safe teleradiology: information assurance as project planning methodology.

    PubMed

    Collmann, Jeff; Alaoui, Adil; Nguyen, Dan; Lindisch, David

    2005-01-01

    The Georgetown University Medical Center Department of Radiology used a tailored version of OCTAVE, a self-directed information security risk assessment method, to design a teleradiology system that complied with the regulation implementing the security provisions of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The system addressed threats to and vulnerabilities in the privacy and security of protected health information. By using OCTAVE, Georgetown identified the teleradiology program's critical assets, described threats to the assurance of those assets, developed and ran vulnerability scans of a system pilot, evaluated the consequences of security breaches, and developed a risk management plan to mitigate threats to program assets, thereby implementing good information assurance practices. This case study illustrates the basic point that prospective, comprehensive planning to protect the privacy and security of an information system strategically benefits program management as well as system security.

  10. Applying the Land Use Portfolio Model to Estimate Natural-Hazard Loss and Risk - A Hypothetical Demonstration for Ventura County, California

    USGS Publications Warehouse

    Dinitz, Laura B.

    2008-01-01

    With costs of natural disasters skyrocketing and populations increasingly settling in areas vulnerable to natural hazards, society is challenged to better allocate its limited risk-reduction resources. In 2000, Congress passed the Disaster Mitigation Act, amending the Robert T. Stafford Disaster Relief and Emergency Assistance Act (Robert T. Stafford Disaster Relief and Emergency Assistance Act, Pub. L. 93-288, 1988; Federal Emergency Management Agency, 2002, 2008b; Disaster Mitigation Act, 2000), mandating that State, local, and tribal communities prepare natural-hazard mitigation plans to qualify for pre-disaster mitigation grants and post-disaster aid. The Federal Emergency Management Agency (FEMA) was assigned to coordinate and implement hazard-mitigation programs, and it published information about specific mitigation-plan requirements and the mechanisms (through the Hazard Mitigation Grant Program-HMGP) for distributing funds (Federal Emergency Management Agency, 2002). FEMA requires that each community develop a mitigation strategy outlining long-term goals to reduce natural-hazard vulnerability, mitigation objectives and specific actions to reduce the impacts of natural hazards, and an implementation plan for those actions. The implementation plan should explain methods for prioritizing, implementing, and administering the actions, along with a 'cost-benefit review' justifying the prioritization. FEMA, along with the National Institute of Building Sciences (NIBS), supported the development of HAZUS ('Hazards U.S.'), a geospatial natural-hazards loss-estimation tool, to help communities quantify potential losses and to aid in the selection and prioritization of mitigation actions. HAZUS was expanded to a multiple-hazard version, HAZUS-MH, that combines population, building, and natural-hazard science and economic data and models to estimate physical damages, replacement costs, and business interruption for specific natural-hazard scenarios. HAZUS-MH currently performs analyses for earthquakes, floods, and hurricane wind. HAZUS-MH loss estimates, however, do not account for some uncertainties associated with the specific natural-hazard scenarios, such as the likelihood of occurrence within a particular time horizon or the effectiveness of alternative risk-reduction options. Because of the uncertainties involved, it is challenging to make informative decisions about how to cost-effectively reduce risk from natural-hazard events. Risk analysis is one approach that decision-makers can use to evaluate alternative risk-reduction choices when outcomes are unknown. The Land Use Portfolio Model (LUPM), developed by the U.S. Geological Survey (USGS), is a geospatial scenario-based tool that incorporates hazard-event uncertainties to support risk analysis. The LUPM offers an approach to estimate and compare risks and returns from investments in risk-reduction measures. This paper describes and demonstrates a hypothetical application of the LUPM for Ventura County, California, and examines the challenges involved in developing decision tools that provide quantitative methods to estimate losses and analyze risk from natural hazards.

  11. Effective information campaign for management of exposure to hand-arm vibration in the metal and construction industries.

    PubMed

    Sauni, Riitta; Toivio, Pauliina; Esko, Toppila; Pääkkönen, Rauno; Uitti, Jukka

    2015-01-01

    European Directive 2002/44/EC defines employers' responsibilities in the risk management of hand-arm vibration (HAV). However, the directive is still not completely implemented in all risk industries. The aim of our study was to determine whether it is possible to improve the recognition and management of the risks of HAV at workplaces with a one-year information campaign. A questionnaire on opinions and measures for controlling HAV exposure at workplaces was sent to all occupational safety representatives and occupational safety managers in the construction and metal industry in Finland (n=1887) and once again to those who responded to the first questionnaire (n=961) one year after the campaign. The campaign increased recognition of HAV in risk assessment from 57.0% to 68.3% (p=.001), increased measures to decrease exposure to HAV from 54.6% to 64.2% (p=.006) and increased the number of programmes to control the risks due to HAV (p<.001). The information campaign, which focuses on the construction and metal industries, proved to be effective in increasing the awareness of the risks of HAV and the measures needed to control exposure to HAV. A similar campaign can be recommended in the case of risks specific to certain occupations.

  12. Venous Thromboembolism Prophylaxis in Outpatient Lower Limb Fractures and Injuries.

    PubMed

    Ajwani, Sanil H; Shaw, Alex; Naiz, Osamah; Bhaskar, Deepu; Charalambous, Charalambos P

    2016-05-05

    The risk of venous thromboembolism (VTE) is a preventable complication of trauma in ambulatory patients requiring temporary lower limb immobilisation. We introduced a VTE risk assessment and management tool in fracture clinics, to help improve appropriate VTE management of trauma patients that do not require hospitalisation. This was based on guidelines published by the College of Emergency Medicine (UK). Clinicians were asked to follow the screening tool and manage patients as per the pathway. We aimed to determine the rate of VTE risk assessment and management of outpatient fracture patients following the introduction of the new assessment tool. We prospectively evaluated a cohort of lower limb fracture patients presenting to a fracture clinic following the introduction of the new VTE risk assessment group and compared it to a retrospective cohort treated prior to the new tool. Prior to introduction of the new assessment tool only 5 of 30 (16.7%) patients were assessed for VTE risk. After introduction of the VTE screening tool, 27 of 28 patients (96.4%) were assessed for VTE risk (P<0.001). We are able to show that implementing a VTE screening tool in an orthopaedic outpatient fracture clinic to patients with lower limb trauma requiring temporary limb immobilisation can improve VTE risk assessment in accordance with current guidelines.

  13. Current Management of NAFLD

    PubMed Central

    MUNTEANU, MIHAI ALEXANDRU; NAGY, GEORGIANA ANCA; MIRCEA, PETRU ADRIAN

    2016-01-01

    Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries. It affects about 1 billion individuals worldwide. While people with simple steatosis have no higher risk of death than the general population, people with non-alcoholic steatohepatitis are at increased risk of death compared to general population. Current management for NAFLD includes diet and lifestyle changes, management of underlying metabolic risk factors and pharmacological therapies. The objective of therapy is to prevent the complications. The problem with dietary and lifestyle interventions is that they are hard to implement. Compliance is the key. Until now, there is still no approved drug for the treatment of NAFLD. Insulin resistance is the main target of pharmacological therapy, but the question that we ask ourselves as physicians is who should receive medical treatment among NAFLD patients and for how long. PMID:27004021

  14. Innovations and Challenges of Implementing a Glucose Gel Toolkit for Neonatal Hypoglycemia.

    PubMed

    Hammer, Denise; Pohl, Carla; Jacobs, Peggy J; Kaufman, Susan; Drury, Brenda

    2018-05-24

    Transient neonatal hypoglycemia occurs most commonly in newborns who are small for gestational age, large for gestational age, infants of diabetic mothers, and late preterm infants. An exact blood glucose value has not been determined for neonatal hypoglycemia, and it is important to note that poor neurologic outcomes can occur if hypoglycemia is left untreated. Interventions that separate mothers and newborns, as well as use of formula to treat hypoglycemia, have the potential to disrupt exclusive breastfeeding. To determine whether implementation of a toolkit designed to support staff in the adaptation of the practice change for management of newborns at risk for hypoglycemia, that includes 40% glucose gel in an obstetric unit with a level 2 nursery will decrease admissions to the Intermediate Care Nursery, and increase exclusive breastfeeding. This descriptive study used a retrospective chart review for pre/postimplementation of the Management of Newborns at Risk for Hypoglycemia Toolkit (Toolkit) using a convenience sample of at-risk newborns in the first 2 days of life to evaluate the proposed outcomes. Following implementation of the Toolkit, at-risk newborns had a clinically but not statistically significant 6.5% increase in exclusive breastfeeding and a clinically but not statistically significant 5% decrease in admissions to the Intermediate Care Nursery. The Toolkit was designed for ease of staff use and to improve outcomes for the at-risk newborn. Future research includes replication at other level 2 and level 1 obstetric centers and investigation into the number of 40% glucose gel doses that can safely be administered.

  15. Physical activity and metabolic disease among people with affective disorders: Prevention, management and implementation.

    PubMed

    Vancampfort, Davy; Stubbs, Brendon

    2017-12-15

    One in ten and one in three of people with affective disorders experience diabetes and metabolic syndrome respectively. Physical activity (PA) and sedentary behaviour (SB) are key risk factors that can ameliorate the risk of metabolic disease among this population. However, PA is often seen as luxury and/or a secondary component within the management of people with affective disorders. The current article provides a non-systematic best-evidence synthesis of the available literature, detailing a number of suggestions for the implementation of PA into clinical practice. Whilst the evidence is unequivocal for the efficacy of PA to prevent and manage metabolic disease in the general population, it is in its infancy in this patient group. Nonetheless, action must be taken now to ensure that PA and reducing SB are given a priority to prevent and manage metabolic diseases and improve wider health outcomes. PA should be treated as a vital sign and all people with affective disorders asked about their activity levels and if appropriate advised to increase this. There is a need for investment in qualified exercise specialists in clinical practice such as physiotherapists to undertake and oversee PA in practice. Behavioural strategies such as the self-determined theory should be employed to encourage adherence. Funding is required to develop the evidence base and elucidate the optimal intervention characteristics. PA interventions should form an integral part of the multidisciplinary management of people with affective disorders and our article outlines the evidence and strategies to implement this in practice. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Risk assessment of underpass infrastructure project based on IS0 31000 and ISO 21500 using fishbone diagram and RFMEA (project risk failure mode and effects analysis) method

    NASA Astrophysics Data System (ADS)

    Purwanggono, Bambang; Margarette, Anastasia

    2017-12-01

    Completion time of highway construction is very meaningful for smooth transportation, moreover expected number of ownership motor vehicle will increase each year. Therefore, this study was conducted with to analyze the constraints that contained in an infrastructure development project. This research was conducted on Jatingaleh Underpass Project, Semarang. This research was carried out while the project is running, on the implementation, this project is experiencing delays. This research is done to find out what are the constraints that occur in execution of a road infrastructure project, in particular that causes delays. The method that used to find the root cause is fishbone diagram to obtain a possible means of mitigation. Coupled with the RFMEA method used to determine the critical risks that must be addressed immediately on road infrastructure project. The result of data tabulation in this study indicates that the most possible mitigation tool to make a Standard Operating Procedure (SOP) recommendations to disrupt utilities that interfere project implementation. Process of risk assessment has been carried out systematically based on ISO 31000:2009 on risk management and for determination of delayed variables, the requirements of process groups according to ISO 21500:2013 on project management were used.

  17. Flood risk management in Italy: challenges and opportunities for the implementation of the EU Floods Directive (2007/60/EC)

    NASA Astrophysics Data System (ADS)

    Mysiak, J.; Testella, F.; Bonaiuto, M.; Carrus, G.; De Dominicis, S.; Ganucci Cancellieri, U.; Firus, K.; Grifoni, P.

    2013-11-01

    Italy's recent history is punctuated with devastating flood disasters claiming high death toll and causing vast but underestimated economic, social and environmental damage. The responses to major flood and landslide disasters such as the Polesine (1951), Vajont (1963), Firenze (1966), Valtelina (1987), Piedmont (1994), Crotone (1996), Sarno (1998), Soverato (2000), and Piedmont (2000) events have contributed to shaping the country's flood risk governance. Insufficient resources and capacity, slow implementation of the (at that time) novel risk prevention and protection framework, embodied in the law 183/89 of 18 May 1989, increased the reliance on the response and recovery operations of the civil protection. As a result, the importance of the Civil Protection Mechanism and the relative body of norms and regulation developed rapidly in the 1990s. In the aftermath of the Sarno (1998) and Soverato (2000) disasters, the Department for Civil Protection (DCP) installed a network of advanced early warning and alerting centres, the cornerstones of Italy's preparedness for natural hazards and a best practice worth following. However, deep convective clouds, not uncommon in Italy, producing intense rainfall and rapidly developing localised floods still lead to considerable damage and loss of life that can only be reduced by stepping up the risk prevention efforts. The implementation of the EU Floods Directive (2007/60/EC) provides an opportunity to revise the model of flood risk governance and confront the shortcomings encountered during more than 20 yr of organised flood risk management. This brief communication offers joint recommendations towards this end from three projects funded by the 2nd CRUE ERA-NET (http://www.crue-eranet.net/) Funding Initiative: FREEMAN, IMRA and URFlood.

  18. Case Managers for High-Risk, High-Cost Patients as Agents and Street-Level Bureaucrats.

    PubMed

    Swanson, Jeffrey; Weissert, William G

    2017-08-01

    Case management programs often designate a nurse or social worker to take responsibility for guiding care when patients are expected to be expensive or risk a major decline. We hypothesized that though an intuitively appealing idea, careful program design and faithful implementation are essential if case management programs are to succeed. We employed two theory perspectives, principal-agent framework and street-level bureaucratic theory to describe the relationship between program designers (principals) and case managers (agents/street-level bureaucrats) to review 65 case management studies. Most programs were successful in limited program-specific process and outcome goals. But there was much less success in cost-saving or cost-effectiveness-the original and overarching goal of case management. Cost results might be improved if additional ideas of agency and street-level theory were adopted, specifically, incentives, as well as "green tape," clear rules, guidelines, and algorithms relating to resource allocation among patients.

  19. Managing security risks for inter-organisational information systems: a multiagent collaborative model

    NASA Astrophysics Data System (ADS)

    Feng, Nan; Wu, Harris; Li, Minqiang; Wu, Desheng; Chen, Fuzan; Tian, Jin

    2016-09-01

    Information sharing across organisations is critical to effectively managing the security risks of inter-organisational information systems. Nevertheless, few previous studies on information systems security have focused on inter-organisational information sharing, and none have studied the sharing of inferred beliefs versus factual observations. In this article, a multiagent collaborative model (MACM) is proposed as a practical solution to assess the risk level of each allied organisation's information system and support proactive security treatment by sharing beliefs on event probabilities as well as factual observations. In MACM, for each allied organisation's information system, we design four types of agents: inspection agent, analysis agent, control agent, and communication agent. By sharing soft findings (beliefs) in addition to hard findings (factual observations) among the organisations, each organisation's analysis agent is capable of dynamically predicting its security risk level using a Bayesian network. A real-world implementation illustrates how our model can be used to manage security risks in distributed information systems and that sharing soft findings leads to lower expected loss from security risks.

  20. Predicting bycatch hotspots for endangered leatherback turtles on longlines in the Pacific Ocean.

    PubMed

    Roe, John H; Morreale, Stephen J; Paladino, Frank V; Shillinger, George L; Benson, Scott R; Eckert, Scott A; Bailey, Helen; Tomillo, Pilar Santidrián; Bograd, Steven J; Eguchi, Tomoharu; Dutton, Peter H; Seminoff, Jeffrey A; Block, Barbara A; Spotila, James R

    2014-02-22

    Fisheries bycatch is a critical source of mortality for rapidly declining populations of leatherback turtles, Dermochelys coriacea. We integrated use-intensity distributions for 135 satellite-tracked adult turtles with longline fishing effort to estimate predicted bycatch risk over space and time in the Pacific Ocean. Areas of predicted bycatch risk did not overlap for eastern and western Pacific nesting populations, warranting their consideration as distinct management units with respect to fisheries bycatch. For western Pacific nesting populations, we identified several areas of high risk in the north and central Pacific, but greatest risk was adjacent to primary nesting beaches in tropical seas of Indo-Pacific islands, largely confined to several exclusive economic zones under the jurisdiction of national authorities. For eastern Pacific nesting populations, we identified moderate risk associated with migrations to nesting beaches, but the greatest risk was in the South Pacific Gyre, a broad pelagic zone outside national waters where management is currently lacking and may prove difficult to implement. Efforts should focus on these predicted hotspots to develop more targeted management approaches to alleviate leatherback bycatch.

  1. Predicting bycatch hotspots for endangered leatherback turtles on longlines in the Pacific Ocean

    PubMed Central

    Roe, John H.; Morreale, Stephen J.; Paladino, Frank V.; Shillinger, George L.; Benson, Scott R.; Eckert, Scott A.; Bailey, Helen; Tomillo, Pilar Santidrián; Bograd, Steven J.; Eguchi, Tomoharu; Dutton, Peter H.; Seminoff, Jeffrey A.; Block, Barbara A.; Spotila, James R.

    2014-01-01

    Fisheries bycatch is a critical source of mortality for rapidly declining populations of leatherback turtles, Dermochelys coriacea. We integrated use-intensity distributions for 135 satellite-tracked adult turtles with longline fishing effort to estimate predicted bycatch risk over space and time in the Pacific Ocean. Areas of predicted bycatch risk did not overlap for eastern and western Pacific nesting populations, warranting their consideration as distinct management units with respect to fisheries bycatch. For western Pacific nesting populations, we identified several areas of high risk in the north and central Pacific, but greatest risk was adjacent to primary nesting beaches in tropical seas of Indo-Pacific islands, largely confined to several exclusive economic zones under the jurisdiction of national authorities. For eastern Pacific nesting populations, we identified moderate risk associated with migrations to nesting beaches, but the greatest risk was in the South Pacific Gyre, a broad pelagic zone outside national waters where management is currently lacking and may prove difficult to implement. Efforts should focus on these predicted hotspots to develop more targeted management approaches to alleviate leatherback bycatch. PMID:24403331

  2. Comprehensive Health Risk Management after the Fukushima Nuclear Power Plant Accident.

    PubMed

    Yamashita, S

    2016-04-01

    Five years have passed since the Great East Japan Earthquake and the subsequent Fukushima Daiichi Nuclear Power Plant accident on 11 March 2011. Countermeasures aimed at human protection during the emergency period, including evacuation, sheltering and control of the food chain were implemented in a timely manner by the Japanese Government. However, there is an apparent need for improvement, especially in the areas of nuclear safety and protection, and also in the management of radiation health risk during and even after the accident. Continuous monitoring and characterisation of the levels of radioactivity in the environment and foods in Fukushima are now essential for obtaining informed consent to the decisions on living in the radio-contaminated areas and also on returning back to the evacuated areas once re-entry is allowed; it is also important to carry out a realistic assessment of the radiation doses on the basis of measurements. Until now, various types of radiation health risk management projects and research have been implemented in Fukushima, among which the Fukushima Health Management Survey is the largest health monitoring project. It includes the Basic Survey for the estimation of external radiation doses received during the first 4 months after the accident and four detailed surveys: thyroid ultrasound examination, comprehensive health check-up, mental health and lifestyle survey, and survey on pregnant women and nursing mothers, with the aim to prospectively take care of the health of all the residents of Fukushima Prefecture for a long time. In particular, among evacuees of the Fukushima Nuclear Power Plant accident, concern about radiation risk is associated with psychological stresses. Here, ongoing health risk management will be reviewed, focusing on the difficult challenge of post-disaster recovery and resilience in Fukushima. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  3. Metal bioavailability in ecological risk assessment of freshwater ecosystems: From science to environmental management.

    PubMed

    Väänänen, Kristiina; Leppänen, Matti T; Chen, XuePing; Akkanen, Jarkko

    2018-01-01

    Metal contamination in freshwater ecosystems is a global issue and metal discharges to aquatic environments are monitored in order to protect aquatic life and human health. Bioavailability is an important factor determining metal toxicity. In aquatic systems, metal bioavailability depends on local water and sediment characteristics, and therefore, the risks are site-specific. Environmental quality standards (EQS) are used to manage the risks of metals in aquatic environments. In the simplest form of EQSs, total concentrations of metals in water or sediment are compared against pre-set acceptable threshold levels. Now, however, the environmental administration bodies have stated the need to incorporate metal bioavailability assessment tools into environmental regulation. Scientific advances have been made in metal bioavailability assessment, including passive samplers and computational models, such as biotic ligand models (BLM). However, the cutting-edge methods tend to be too elaborate or laborious for standard environmental monitoring. We review the commonly used metal bioavailability assessment methods and introduce the latest scientific advances that might be applied to environmental management in the future. We present the current practices in environmental management in North America, Europe and China, highlighting the good practices and the needs for improvement. Environmental management has met these new challenges with varying degrees of success: the USA has implemented site-specific environmental risk assessment for water and sediment phases, and they have already implemented metal mixture toxicity evaluation. The European Union is promoting the use of bioavailability and BLMs in ecological risk assessment (ERA), but metal mixture toxicity and sediment phase are still mostly neglected. China has regulation only for total concentrations of metals in surface water. We conclude that there is a need for (1) Advanced and up-to-date guidelines and legislation, (2) New and simple scientific methods for assessing metal bioavailability and (3) Improvement of knowledge and skills of administrators. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Implementing an Information Security Program

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

    Glantz, Clifford S.; Lenaeus, Joseph D.; Landine, Guy P.

    The threats to information security have dramatically increased with the proliferation of information systems and the internet. Chemical, biological, radiological, nuclear, and explosives (CBRNe) facilities need to address these threats in order to protect themselves from the loss of intellectual property, theft of valuable or hazardous materials, and sabotage. Project 19 of the European Union CBRN Risk Mitigation Centres of Excellence Initiative is designed to help CBRN security managers, information technology/cybersecurity managers, and other decision-makers deal with these threats through the application of cost-effective information security programs. Project 19 has developed three guidance documents that are publically available to covermore » information security best practices, planning for an information security management system, and implementing security controls for information security.« less

  5. The political economy of a public health case management program's transition into medical homes.

    PubMed

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

  6. Risk management and post-marketing surveillance of CNS drugs.

    PubMed

    Henningfield, Jack E; Schuster, Charles R

    2009-12-01

    Drugs affecting the central nervous system span a broad range of chemical entities, dosage forms, indications, and risks. Unintended consequences include potential abuse and overdose in non-patient drug abusers, deliberate tampering of drug dosage forms, and criminal behavior associated with diversion. Regulators must consider diverse factors to find the appropriate conditions of approval to minimize unintended consequences while enabling a level of access desired by health care providers and patients. This commentary appears as part of a special issue of Drug and Alcohol Dependence that focuses on risk management and post-marketing surveillance and addresses key issues that pose real-world challenges to pharmaceutical sponsors and regulators in particular. For example, in the U.S., Controlled Substances Act drug scheduling can be considered a risk management strategy but its legal authorities and administrative processes are independent from those of risk management (including Risk Evaluation and Mitigation Strategies or REMS); better harmonization of these approaches is vital from drug development and regulatory perspectives. Risk management would ideally be implemented on a strong science foundation demonstrating that the tools employed to mitigate risks and ensure safe use are effective. In reality, research and evaluation of tools in this area is in its infancy and will necessarily be an evolutionary process; furthermore, there is little precedent for linking interventions and program evolution to unintended consequences such as regional outbreaks of abuse and diversion. How such issues are resolved has the potential to stimulate or stifle innovations in drug development and advance or imperil health care.

  7. Evaluating nonindigenous species management in a Bayesian networks derived relative risk framework for Padilla Bay, WA, USA.

    PubMed

    Herring, Carlie E; Stinson, Jonah; Landis, Wayne G

    2015-10-01

    Many coastal regions are encountering issues with the spread of nonindigenous species (NIS). In this study, we conducted a regional risk assessment using a Bayesian network relative risk model (BN-RRM) to analyze multiple vectors of NIS introductions to Padilla Bay, Washington, a National Estuarine Research Reserve. We had 3 objectives in this study. The 1st objective was to determine whether the BN-RRM could be used to calculate risk from NIS introductions for Padilla Bay. Our 2nd objective was to determine which regions and endpoints were at greatest risk from NIS introductions. Our 3rd objective was to incorporate a management option into the model and predict endpoint risk if it were to be implemented. Eradication can occur at different stages of NIS invasions, such as the elimination of these species before being introduced to the habitat or removal of the species after settlement. We incorporated the ballast water treatment management scenario into the model, observed the risk to the endpoints, and compared this risk with the initial risk estimates. The model results indicated that the southern portion of the bay was at greatest risk because of NIS. Changes in community composition, Dungeness crab, and eelgrass were the endpoints most at risk from NIS introductions. The currents node, which controls the exposure of NIS to the bay from the surrounding marine environment, was the parameter that had the greatest influence on risk. The ballast water management scenario displayed an approximate 1% reduction in risk in this Padilla Bay case study. The models we developed provide an adaptable template for decision makers interested in managing NIS in other coastal regions and large bodies of water. © 2015 SETAC.

  8. Knowledge management in the QbD paradigm: manufacturing of biotech therapeutics.

    PubMed

    Herwig, Christoph; Garcia-Aponte, Oscar F; Golabgir, Aydin; Rathore, Anurag S

    2015-07-01

    In the quality by design (QbD) paradigm, global regulatory agencies have introduced the concepts of quality risk management and knowledge management (KM) as enablers for an enhanced pharmaceutical quality system. Although the concept of quality risk management has been well elucidated in the literature, the topic of KM has received relatively scant attention. In this paper we present an opinion on KM in the QbD paradigm as it relates to the manufacturing of biotech therapeutic products. Both academic and industrial viewpoints have been considered and key gaps have been elucidated. The authors conclude that there is an urgent need for the biotech industry to create efficient KM approaches if they wish to be successful in QbD implementation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Telephone Care Management of Fall Risk:: A Feasibility Study.

    PubMed

    Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

    2017-03-01

    Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  10. PRACTICAL BARRIERS TO IMPLEMENTATION OF THYROID CANCER GUIDELINES IN THE ASIA-PACIFIC REGION.

    PubMed

    Yang, Samantha Peiling; Ying, Lee Suat; Saw, Stephanie; Tuttle, R Michael; Venkataraman, Kavita; Su-Ynn, Chia

    2015-11-01

    Numerous published guidelines have described the optimal management of thyroid cancer. However, these rely on the clinical availability of diagnostic and therapeutic modalities. We hypothesized that the availability of medical resources and economic circumstances vary in Asia-Pacific countries, making it difficult to implement guideline recommendations into clinical practice. We surveyed participants at the 2009 and 2013 Congresses of the Association of Southeast Asian Nations Federation of Endocrine Societies by distributing questionnaires to attendees at registration. Responses were obtained from 268 respondents in 2009 and 163 respondents in 2013. Similar to the high prevalence of low-risk thyroid cancer observed in the Surveillance, Epidemiology, and End Results database, across the Asia-Pacific countries surveyed in 2009 and 2013, 50 to 100% of the respondents from the Philippines, Malaysia, Singapore, China, Taiwan, Thailand, Hong Kong, Korea, and Sri Lanka reported that more than 50% of the patients had low-risk thyroid cancer on follow-up. Importantly, there was much variation with regards to the perceived availability of investigation and treatment modalities. We found a wide variation in clinicians' perception of availability of diagnostic and therapeutic modalities in the face of a rise in thyroid cancer incidence and thyroid cancer management guidelines that emphasized their importance. The lack of availability of management tools and treatments will prove to be a major barrier to the implementation of thyroid cancer management guidelines in Southeast Asia, and likely in other parts of the world as well.

  11. Risk perception as a driver for risk management policies

    NASA Astrophysics Data System (ADS)

    Carmona, María; Mañez, María

    2016-04-01

    Risk is generally defined as the "combination of the probability of the occurrence of an event and its negative consequences" ( UNISDR, 2009). However, the perception of a risk differs among cultures regarding different features such as the context,causes, benefits or damage. Risk perception is the subjective valuation of the probability of an event happening and how concerned individuals or groups are with the consequences (Sjöberg, 2004). Our study is based on an existing framework for risk perception (Rehn and Rohrmann, 2000). We analyse the characteristics of the risk perception regarding extreme events (e.g.droughts) and how the perception of the group drives the action to manage the risk. We do this to achieve an overview of the conditions that let stakeholders join each other to improve risk management especially when governments are not reacting properly. For our research, attention is paid on risk perception of Multi-Sector Partnerships not taking into account the individual level of risk perception. We focus on those factors that make risk management effective and increase resilience. Multi-Sector Partnerships, considered as significant governance structures for risk management, might contribute to reduce vulnerability in prone areas to natural hazards and disasters. The Multi-Sector Partnerships used for our research are existing partnerships identified in the cases studies of the European project ENHANCE. We implement a survey to analyse the perception of risk in the case studies. That survey is based on the Cultural Theory (Douglas and Wildavsky, 1982)and the Protection Motivation Theory (Rogers, 1975). We analyse the results using the Qualitative-Comparative Analysis proposed by Ragin in 1987. The results show the main characteristics of a risk culture that are beneficial to manage a risk. Those characteristics are shaped by the perception of risk of the people involved in the partnership, which in turn shapes their risk management. Nevertheless, we have to recognise that there is no "one-size-fit-all" solution and that Multi-Sector Partnerships are shape by the hazard they face and also by the social, political and historical background of the area where they are.

  12. Surveying perceptions of landslide risk management in Norway

    NASA Astrophysics Data System (ADS)

    Chiu, Jessica Ka Yi; Eidsvig, Unni

    2016-04-01

    Enhanced precipitation due to climate change leads to increase in both frequency and intensity of landslides in Norway. A proactive approach to risk management is therefore required to significantly reduce the losses associated with landslides. Opinions and perceptions from practitioners on the performance of landslide risk management can provide insights on areas for improvement in the landslide risk management strategies in Norway. The Risk Management Index (RMI), proposed by Cardona et al. (2004), is a well-established method to measure perceptions of disaster management of selected actors holistically. The RMI is measured based on opinion questionnaires to technical staff, decision-makers, and stakeholders involved in all stages of risk reduction strategies. It is a composite index that considers a wide variety of strategies to manage risks, including structural and non-structural measures, acceptance strategies, disaster management, and risk transfer. The RMI method was modified to be implemented in landslide hazards and to fit with Norwegian conditions. An opinion survey was conducted in autumn 2015 to measure perceptions of landslide risk management in Norway. Perceptions were surveyed for two time periods: 2015 and 2050, and are based on national, county, and municipality levels. Based on the survey results, performance of landslide risk management at any administrative levels in Norway is perceived to improve from `significant' in 2015 to `significant' to `outstanding' in 2050. Knowledge and technology, climate, risk perceptions, and anthropogenic activities are mostly considered by respondents for their 2050 perceptions. Several aspects of landslide risk management in Norway can be improved. For example, landslide hazard evaluation and mapping should be prioritised in Norway. Upgrading, retrofitting, and reconstruction of assets may also be included in the landslide risk reduction strategies. In addition, there should be more focus on inter-institutional organisation as well as allocation and use of financial resources for dealing with landslides at local levels. Although the survey was considered too difficult by some of the respondents, it can be regarded as a starting point to develop a common terminology/language in landslide risk management in Norway that allows mutual understandings among people with different backgrounds. The approach of surveying perceptions of landslide risk management can also be expanded to the public to enable comparisons of perceptions between experts and the public. Furthermore, the methodology can be applied to other types of natural hazards in Norway, such as floods. This project is supported by Klima2050 (http://www.klima2050.no/).

  13. Biosecurity Risk Assessment Methodology (BioRAM) v. 2.0

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

    CASKEY, SUSAN; GAUDIOSO, JENNIFER; SALERNO, REYNOLDS

    Sandia National Laboratories International Biological Threat Reduction Dept (SNL/IBTR) has an ongoing mission to enhance biosecurity assessment methodologies, tools, and guise. These will aid labs seeking to implement biosecurity as advocated in the recently released WHO's Biorisk Management: Lab Biosecurity Guidance. BioRAM 2.0 is the software tool developed initially using the SNL LDRD process and designed to complement the "Laboratory Biosecurity Risk Handbook" written by Ren Salerno and Jennifer Gaudioso defining biosecurity risk assessment methodologies.

  14. A framework for understanding risk perception, explored from the perspective of the water practitioner.

    PubMed

    Dobbie, Meredith Frances; Brown, Rebekah Ruth

    2014-02-01

    Sustainable urban water systems are likely to be hybrids of centralized and decentralized infrastructure, managed as an integrated system in water-sensitive cities. The technology for many of these systems is available. However, social and institutional barriers, which can be understood as deeply embedded risk perceptions, have impeded their implementation. Risk perceptions within the water sector are often unrecognized or unacknowledged, despite their role in risk management generally in informing value judgments and specifically in ranking risks to achieve management objectives. There has been very little examination of the role of these risk perceptions in advancing more sustainable water supply management through the adoption of alternative sources. To address this gap, this article presents a framework that can be used as a tool for understanding risk perceptions. The framework is built on the relational theory of risk and presents the range of human phenomena that might influence the perception of an "object at risk" in relation to a "risk object." It has been synthesized from a critical review of theoretical, conceptual, and empirical studies of perception broadly and risk perception specifically, and interpreted in relation to water practitioners. For a water practitioner, the risk object might be an alternative water system, a component, a process, or a technology, and the object at risk could be public or environmental health, profitability, or professional reputation. This framework has two important functions: to allow practitioners to understand their own and others' risk perceptions, which might differ, and to inform further empirical research. © 2013 Society for Risk Analysis.

  15. Holistic approach to prevention and management of type 2 diabetes mellitus in a family setting.

    PubMed

    Ofori, Sandra N; Unachukwu, Chioma N

    2014-01-01

    Diabetes mellitus (DM) is a chronic, progressive metabolic disorder with several complications that affect virtually all the systems in the human body. Type 2 DM (T2DM) is a major risk factor for cardiovascular disease (CVD). The management of T2DM is multifactorial, taking into account other major modifiable risk factors, like obesity, physical inactivity, smoking, blood pressure, and dyslipidemia. A multidisciplinary team is essential to maximize the care of individuals with DM. DM self-management education and patient-centered care are the cornerstones of management in addition to effective lifestyle strategies and pharmacotherapy with individualization of glycemic goals. Robust evidence supports the effectiveness of this approach when implemented. Individuals with DM and their family members usually share a common lifestyle that, not only predisposes the non-DM members to developing DM but also, increases their collective risk for CVD. In treating DM, involvement of the entire family, not only improves the care of the DM individual but also, helps to prevent the risk of developing DM in the family members.

  16. Psychosocial Modeling of Insider Threat Risk Based on Behavioral and Word Use Analysis

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

    Greitzer, Frank L.; Kangas, Lars J.; Noonan, Christine F.

    In many insider crimes, managers and other coworkers observed that the offenders had exhibited signs of stress, disgruntlement, or other issues, but no alarms were raised. Barriers to using such psychosocial indicators include the inability to recognize the signs and the failure to record the behaviors so that they can be assessed. A psychosocial model was developed to assess an employee’s behavior associated with an increased risk of insider abuse. The model is based on case studies and research literature on factors/correlates associated with precursor behavioral manifestations of individuals committing insider crimes. A complementary Personality Factor modeling approach was developedmore » based on analysis to derive relevant personality characteristics from word use. Several implementations of the psychosocial model were evaluated by comparing their agreement with judgments of human resources and management professionals; the personality factor modeling approach was examined using email samples. If implemented in an operational setting, these models should be part of a set of management tools for employee assessment to identify employees who pose a greater insider threat.« less

  17. Effective and efficient implementation of alternative project delivery : research summary.

    DOT National Transportation Integrated Search

    2017-05-01

    Alternative project delivery (APD) methods such as Design Build (DB) and Construction Manager at Risk (CMAR), are used by state departments of transportation to improve the efficiency and effectiveness of project delivery. The Maryland Department of ...

  18. ETV - ENVIRONMENTAL TECHNOLOGY VERIFICATION (ETV) - RISK MANAGEMENT

    EPA Science Inventory

    In October 1995, the Environmental Technology Verification (ETV) Program was established by EPA. The goal of ETV is to provide credible performance data for commercial-ready environmental technologies to speed their implementation for the benefit of vendors, purchasers, permitter...

  19. RMP Guidance for Chemical Distributors - Introduction

    EPA Pesticide Factsheets

    If you handle, manufacture, use, or store any of the toxic and flammable substances (e.g., chlorine, ammonia) listed in Appendix A above the specified threshold quantities in a process, you are required to develop and implement a risk management plan.

  20. Performance based design of laterally loaded drilled shafts.

    DOT National Transportation Integrated Search

    2013-12-01

    Reliability-based design of deep foundations such as drilled shafts has been increasingly important due to the : heightened awareness of the importance of risk management. The load and resistance factor design has been : implemented by FHWA since 200...

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