Commonwealth of Virginia, Highway Safety Division comprehensive highway safety plan for the period July 1, 1973-June 30, 1977.

DOT National Transportation Integrated Search

1973-01-01

In fiscal year 1973 the NHTSA required the states to prepare and submit a new "State Comprehensive Plan" to replace the base year study and implementation plan submitted in November 1967. The comprehensive plan is a four-year estimate and projection ...

Space Station crew safety alternatives study. Volume 5: Space Station safety plan

NASA Technical Reports Server (NTRS)

Mead, G. H.; Peercy, R. L., Jr.; Raasch, R. F.

1985-01-01

The Space Station Safety Plan has been prepared as an adjunct to the subject contract final report, suggesting the tasks and implementation procedures to ensure that threats are addressed and resolution strategy options identified and incorporated into the space station program. The safety program's approach is to realize minimum risk exposure without levying undue design and operational constraints. Safety objectives and risk acceptances are discussed.

Water safety plans: bridges and barriers to implementation in North Carolina.

PubMed

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

2016-10-01

First developed by the World Health Organization, and now used in several countries, water safety plans (WSPs) are a multi-step, preventive process for managing drinking water hazards. While the beneficial impacts of WSPs have been documented in diverse countries, how to successfully implement WSPs in the United States remains a challenge. We examine the willingness and ability of water utility leaders to implement WSPs in the US state of North Carolina. Our findings show that water utilities have more of a reactive than preventive organizational culture, that implementation requires prioritization of time and resources, perceived comparative advantage to other hazard management plans, leadership in implementation, and identification of how WSPs can be embedded in existing work practices. Future research could focus on whether WSP implementation provides benefits such as decreases in operational costs, and improved organization of records and communication.

Annual report to Congress: Department of Energy activities relating to the Defense Nuclear Facilities Safety Board, calendar year 1998

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

NONE

1999-02-01

This is the ninth Annual Report to the Congress describing Department of Energy (Department) activities in response to formal recommendations and other interactions with the Defense Nuclear Facilities Safety Board (Board). The Board, an independent executive-branch agency established in 1988, provides advice and recommendations to the Secretary of energy regarding public health and safety issues at the Department`s defense nuclear facilities. The Board also reviews and evaluates the content and implementation of health and safety standards, as well as other requirements, relating to the design, construction, operation, and decommissioning of the Department`s defense nuclear facilities. The locations of the majormore » Department facilities are provided. During 1998, Departmental activities resulted in the proposed closure of one Board recommendation. In addition, the Department has completed all implementation plan milestones associated with four other Board recommendations. Two new Board recommendations were received and accepted by the Department in 1998, and two new implementation plans are being developed to address these recommendations. The Department has also made significant progress with a number of broad-based initiatives to improve safety. These include expanded implementation of integrated safety management at field sites, a renewed effort to increase the technical capabilities of the federal workforce, and a revised plan for stabilizing excess nuclear materials to achieve significant risk reduction.« less

Development and implementation of participant safety plans for international research with stigmatised populations.

PubMed

Sugarman, Jeremy; Barnes, Mark; Rose, Scott; Dumchev, Kostyantyn; Sarasvita, Riza; Viet, Ha Tran; Zeziulin, Oleksandr; Susami, Hepa; Go, Vivian; Hoffman, Irving; Miller, William C

2018-06-22

People who inject drugs with high-risk sharing practices have high rates of HIV transmission and face barriers to HIV care. Interventions to overcome these barriers are needed; however, stigmatisation of drug use and HIV infection leads to safety concerns during the planning and conduct of research on such interventions. In preparing to address concerns about safety and wellbeing of participants in an international research study, HIV Prevention Trials Network 074, we developed participant safety plans (PSPs) at each site to supplement local research ethics committee oversight, community engagement, and usual clinical trial procedures. The PSPs were informed by systematic local legal and policy assessments, and interviews with key stakeholders. After PSP refinement and implementation, we assessed social impacts at each study visit to ensure continued safety. Throughout the study, five participants reported a negative social impact, with three resulting from study participation. Future research with stigmatised populations should consider using and assessing this approach to enhance safety and welfare. Copyright © 2018 Elsevier Ltd. All rights reserved.

Safer Systems: A NextGen Aviation Safety Strategic Goal

NASA Technical Reports Server (NTRS)

Darr, Stephen T.; Ricks, Wendell R.; Lemos, Katherine A.

2008-01-01

The Joint Planning and Development Office (JPDO), is charged by Congress with developing the concepts and plans for the Next Generation Air Transportation System (NextGen). The National Aviation Safety Strategic Plan (NASSP), developed by the Safety Working Group of the JPDO, focuses on establishing the goals, objectives, and strategies needed to realize the safety objectives of the NextGen Integrated Plan. The three goal areas of the NASSP are Safer Practices, Safer Systems, and Safer Worldwide. Safer Practices emphasizes an integrated, systematic approach to safety risk management through implementation of formalized Safety Management Systems (SMS) that incorporate safety data analysis processes, and the enhancement of methods for ensuring safety is an inherent characteristic of NextGen. Safer Systems emphasizes implementation of safety-enhancing technologies, which will improve safety for human-centered interfaces and enhance the safety of airborne and ground-based systems. Safer Worldwide encourages coordinating the adoption of the safer practices and safer systems technologies, policies and procedures worldwide, such that the maximum level of safety is achieved across air transportation system boundaries. This paper introduces the NASSP and its development, and focuses on the Safer Systems elements of the NASSP, which incorporates three objectives for NextGen systems: 1) provide risk reducing system interfaces, 2) provide safety enhancements for airborne systems, and 3) provide safety enhancements for ground-based systems. The goal of this paper is to expose avionics and air traffic management system developers to NASSP objectives and Safer Systems strategies.

[Strategic patient safety action plan for the anesthesiology and intensive care service of Ukraine: basic modules and their components].

PubMed

Федосюк, Роман Н

In recent years, the problem of patient safety has become top-priority in further improvement of national healthcare systems in all developed countries. To develop a modular structure and a component composition of the strategic patient safety action plan for the anesthesiology and intensive care service of Ukraine as a part of the National Action Plan. Major domestic priorities, substantiated and made public by the author in previous works, are taken as the basis for the modular structuring of the action plan. Existing foreign prototypes, evaluated for the patient safety effectiveness and the potential for the adaptation to domestic conditions, as well as author's own innovations are offered for a component filling-up of each module. Eight modules - infectious safety, surgical safety, pharmaceutical safety, infrastructural safety, incident monitoring and reporting, education and training, research and awards - have been proposed. Individual components for each of the modules are selected from a variety of foreign prototypes and author's own developments. Inter-modular stratification of the components into short-term perspective tools and long-term perspective tools, depending on the amount of resources needed for their implementation, is carried out. The strategic patient safety action plan for the anesthesiology and intensive care service of Ukraine is the embodiment, within a particular specialty, of the wider National Action Plan developed by the First National Congress on Patient Safety (Kiev, 2012) on the initiative of the Council of Europe and aimed at the fulfillment of international obligations of Ukraine in the healthcare sector. Its implementation will contribute to enhancing the safety of anesthesia and intensive care services in Ukraine and further development of the specialty.

Implementation of Water Safety Plans (WSPs): A Case Study in the Coastal Area in Semarang City, Indonesia

NASA Astrophysics Data System (ADS)

Budiyono; Ginandjar, P.; Saraswati, L. D.; Pangestuti, D. R.; Martini; Jati, S. P.

2018-02-01

An area of 508.28 hectares in North Semarang is flooded by tidal inundation, including Bandarharjo village, which could affect water quality in the area. People in Bandarharjo use safe water from deep groundwater, without disinfection process. More than 90% of water samples in the Bandaharjo village had poor bacteriological quality. The aimed of the research was to describe the implementation of Water Safety Plans (WSPs) program in Bandarharjo village. This was a descriptive study with steps for implementations adopted the guidelines and tools of the World Health Organization. The steps consist of introducing WSPs program, team building, training the team, examination of water safety before risk assessment, risk assessment, minor repair I, examination of water safety risk, minor repair II (after monitoring). Data were analyzed using descriptive methods. WSPs program has been introduced and formed WSPs team, and the training of the team has been conducted. The team was able to conduct risks assessment, planned the activities, examined water quality, conduct minor repair and monitoring at the source, distribution, and households connection. The WSPs program could be implemented in the coastal area in Semarang, however regularly supervision and some adjustment are needed.

23 CFR 1200.25 - Improvement plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Implementation and Management of the Highway Safety Program § 1200.25 Improvement plan. If a review of the Annual... improvement plan. This plan will detail strategies, program activities, and funding targets to meet the...

Automated Pedestrian Detection, Count and Analysis System

DOT National Transportation Integrated Search

2015-04-15

Pedestrian and bicycle count data is necessary for transportation planning, implementing safety countermeasures, and traffic management. This data is critical when evaluating the pedestrian level of service of safety (LOSS) and pedestrian safety perf...

30 CFR 46.4 - Training plan implementation.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING..., SURFACE CLAY, COLLOIDAL PHOSPHATE, OR SURFACE LIMESTONE MINES. § 46.4 Training plan implementation. (a....9 of this part. (d) Training methods may consist of classroom instruction, instruction at the mine...

30 CFR 46.4 - Training plan implementation.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING..., SURFACE CLAY, COLLOIDAL PHOSPHATE, OR SURFACE LIMESTONE MINES. § 46.4 Training plan implementation. (a....9 of this part. (d) Training methods may consist of classroom instruction, instruction at the mine...

30 CFR 46.4 - Training plan implementation.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING..., SURFACE CLAY, COLLOIDAL PHOSPHATE, OR SURFACE LIMESTONE MINES. § 46.4 Training plan implementation. (a....9 of this part. (d) Training methods may consist of classroom instruction, instruction at the mine...

30 CFR 46.4 - Training plan implementation.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING..., SURFACE CLAY, COLLOIDAL PHOSPHATE, OR SURFACE LIMESTONE MINES. § 46.4 Training plan implementation. (a....9 of this part. (d) Training methods may consist of classroom instruction, instruction at the mine...

30 CFR 46.4 - Training plan implementation.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING..., SURFACE CLAY, COLLOIDAL PHOSPHATE, OR SURFACE LIMESTONE MINES. § 46.4 Training plan implementation. (a....9 of this part. (d) Training methods may consist of classroom instruction, instruction at the mine...

75 FR 13336 - Notice of Passenger Facility Charge (PFC) Approvals and Disapprovals

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... Approved for Collection at Key West International Airport (EYW) and Use at EYW: Runway safety area design. Runway safety area construction. Approach clearing--design. Runway obstruction clearing--design. Runway obstruction clearing, phase II--construction. Noise implementation plan, phase 6--design. Noise implementation...

Ecological policy in oil-gas complexes, HSE MS implementation in oil and gas company

NASA Astrophysics Data System (ADS)

Kochetkova, O. P.; Glyzina, T. S.; Vazim, A. A.; Tugutova, S. S.

2016-09-01

The paper considers the following issues: HSE MS international standard implementation in oil and gas industry, taking into account international practices; implementation of standards in oil and gas companies; policy in the field of environmental protection and occupational health and safety; achievement of planned indicators and targets in environmental protection and occupational health and safety.

Quarterly report on Defense Nuclear Facilities Safety Board Recommendation 90-7 for the period ending December 31, 1992

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

Cash, R.J.; Dukelow, G.T.; Forbes, C.J.

1993-03-01

This is the seventh quarterly report on the progress of activities addressing safety issues associated with Hanford Site high-level radioactive waste tanks that contain ferrocyanide compounds. In the presence of oxidizing materials, such as nitrates or nitrites, ferrocyanide can be made to explode in the laboratory by heating it to high temperatures [above 285{degrees}C (545{degrees}F)]. In the mid 1950s approximately 140 metric tons of ferrocyanide were added to 24 underground high-level radioactive waste tanks. An implementation plan (Cash 1991) responding to the Defense Nuclear Facilities Safety Board Recommendation 90-7 (FR 1990) was issued in March 1991 describing the activities thatmore » were planned and underway to address each of the six parts of Recommendation 90-7. A revision to the original plan was transmitted to US Department of Energy by Westinghouse Hanford Company in December 1992. Milestones completed this quarter are described in this report. Contents of this report include: Introduction; Defense Nuclear Facilities Safety Board Implementation Plan Task Activities (Defense Nuclear Facilities Safety Board Recommendation for enhanced temperature measurement, Recommendation for continuous temperature monitoring, Recommendation for cover gas monitoring, Recommendation for ferrocyanide waste characterization, Recommendation for chemical reaction studies, and Recommendation for emergency response planning); Schedules; and References. All actions recommended by the Defense Nuclear Facilities Safety Board for emergency planning by Hanford Site emergency preparedness organizations have been completed.« less

Safety of High Speed Magnetic Levitation Transportation Systems: Preliminary Safety Review of the Transrapid Maglev System

DOT National Transportation Integrated Search

1990-11-01

The safety of various magnetically levitated trains under development for possible : implementation in the United States is of direct concern to the Federal Railroad : Administration. This report, one in a series of planned reports on maglev safety, ...

Annual report to Congress: Department of Energy activities relating to the Defense Nuclear Facilities Safety Board, Calendar Year 1999

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

None

2000-02-01

This is the tenth Annual Report to the Congress describing Department of Energy activities in response to formal recommendations and other interactions with the Defense Nuclear Facilities Safety Board (Board). The Board, an independent executive-branch agency established in 1988, provides advice and recommendations to the Secretary of Energy regarding public health and safety issues at the Department's defense nuclear facilities. The Board also reviews and evaluates the content and implementation of health and safety standards, as well as other requirements, relating to the design, construction, operation, and decommissioning of the Department's defense nuclear facilities. During 1999, Departmental activities resulted inmore » the closure of nine Board recommendations. In addition, the Department has completed all implementation plan milestones associated with three Board recommendations. One new Board recommendation was received and accepted by the Department in 1999, and a new implementation plan is being developed to address this recommendation. The Department has also made significant progress with a number of broad-based initiatives to improve safety. These include expanded implementation of integrated safety management at field sites, opening of a repository for long-term storage of transuranic wastes, and continued progress on stabilizing excess nuclear materials to achieve significant risk reduction.« less

NASA ELV Payload Safety Program Information Exchange

NASA Technical Reports Server (NTRS)

Staubus, Cal; Palo, Tom; Dook, Mike; Donovan, Shawn

2007-01-01

This presentation details the Expendable Launch Vehicle (ELV) Payload Safety Program in its development and plan for implementation. It is an overview of the program's policies, process and requirements.

Strategic implementation plan

NASA Technical Reports Server (NTRS)

1989-01-01

The Life Science Division of the NASA Office of Space Science and Applications (OSSA) describes its plans for assuring the health, safety, and productivity of astronauts in space, and its plans for acquiring further fundamental scientific knowledge concerning space life sciences. This strategic implementation plan details OSSA's goals, objectives, and planned initiatives. The following areas of interest are identified: operational medicine; biomedical research; space biology; exobiology; biospheric research; controlled ecological life support; flight programs and advance technology development; the life sciences educational program; and earth benefits from space life sciences.

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.

Enhancing Planning Strategies for Sunscreen Use at Different Stages of Change

ERIC Educational Resources Information Center

Craciun, Catrinel; Schuz, Natalie; Lippke, Sonia; Schwarzer, Ralf

2012-01-01

To promote sun safety by implementing different plans for sunscreen use, different psychological interventions are compared. Self-regulatory strategies such as action planning and coping planning are seen as proximal predictors of actual behavior. The study compares a pure planning intervention with a broader resource communication and examines…

Phase II -- Photovoltaics for Utility Scale Applications (PVUSA): Safety and health action plan

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

Berg, K.

1994-09-01

To establish guidelines for the implementation and administration of an injury and illness prevention program for PVUSA and to assign specific responsibilities for the execution of the program. To provide a basic Safety and Health Action Plan (hereinafter referred to as Plan) that assists management, supervision, and project personnel in the recognition, evaluation, and control of hazardous activities and/or conditions within their respective areas of responsibility.

Fire in the OR--developing a fire safety plan.

PubMed

McCarthy, Patricia M; Gaucher, Kenneth A

2004-03-01

Approximately 100 operating room fire occur each year in the United States. Although rare, fire in a perioperative setting can be disastrous for both patients and staff members. It is crucial that all perioperative departments have a well thought out and previously rehearsed fire plan in place. Multidisciplinary planning and implementation of regularly scheduled and scripted fire drills are essential to prevent adverse outcomes. Fire drills ensure that all staff members are familiar with the use and location of fire pull stations, fire extinguishers, and fire blankets. Fire drills also prepare staff members to evacuate the OR area if necessary. This article provides the information and framework necessary to develop and implement comprehensive OR fire safety plans that could make the difference between life and death in a fire emergency.

Recommended child safety seat enforcement guidelines

DOT National Transportation Integrated Search

1989-10-01

The document presents suggestions and examples for planning, developing, implementing and evaluating a local enforcement and public information and education program to increase the use and correct use of child safety seats. The guidelines represent ...

Safety Evaluation Report on Tennessee Valley Authority: Browns Ferry Nuclear Performance Plan: Browns Ferry Unit 2 restart

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

Not Available

1989-04-01

This safety evaluation report (SER) on the information submitted by the Tennessee Valley Authority (TVA) in its Nuclear Performance Plan, through Revision 2, for the Browns Ferry Nuclear Power Station and in supporting documents has been prepared by the US Nuclear Regulatory Commission staff. The plan addresses the plant-specific concerns requiring resolution before startup of Unit 2. The staff will inspect implementation of those programs. Where systems are common to Units 1 and 2 or to Units 2 and 3, the staff safety evaluations of those systems are included herein. 3 refs.

10 CFR Appendix A to Subpart B of... - General Statement of Safety Basis Policy

Code of Federal Regulations, 2012 CFR

2012-01-01

... with DOE Policy 450.2A, “Identifying, Implementing and Complying with Environment, Safety and Health..., safety, and health into work planning and execution (48 CFR 970.5223-1, Integration of Environment...) Using the method in DOE-STD-1120-98, Integration of Environment, Safety, and Health into Facility...

10 CFR Appendix A to Subpart B of... - General Statement of Safety Basis Policy

Code of Federal Regulations, 2014 CFR

2014-01-01

... with DOE Policy 450.2A, “Identifying, Implementing and Complying with Environment, Safety and Health..., safety, and health into work planning and execution (48 CFR 970.5223-1, Integration of Environment...) Using the method in DOE-STD-1120-98, Integration of Environment, Safety, and Health into Facility...

10 CFR Appendix A to Subpart B of... - General Statement of Safety Basis Policy

Code of Federal Regulations, 2013 CFR

2013-01-01

... with DOE Policy 450.2A, “Identifying, Implementing and Complying with Environment, Safety and Health..., safety, and health into work planning and execution (48 CFR 970.5223-1, Integration of Environment...) Using the method in DOE-STD-1120-98, Integration of Environment, Safety, and Health into Facility...

Chemical Hygiene and Safety Plan

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

Berkner, K.

The objective of this Chemical Hygiene and Safety Plan (CHSP) is to provide specific guidance to all LBL employees and contractors who use hazardous chemicals. This Plan, when implemented, fulfills the requirements of both the Federal OSHA Laboratory Standard (29 CFR 1910.1450) for laboratory workers, and the Federal OSHA Hazard Communication Standard (29 CFR 1910.1200) for non-laboratory operations (e.g., shops). It sets forth safety procedures and describes how LBL employees are informed about the potential chemical hazards in their work areas so they can avoid harmful exposures and safeguard their health. Generally, communication of this Plan will occur through trainingmore » and the Plan will serve as a the framework and reference guide for that training.« less

The Development and Implementation of Ground Safety Requirements for Project Orion Abort Flight Testing - A Case Study

NASA Technical Reports Server (NTRS)

Kirkpatrick, Paul D.; Williams, Jeffrey G.; Condzella, Bill R.

2008-01-01

A rigorous set of detailed ground safety requirements is required to make sure that ground support equipment (GSE) and associated planned ground operations are conducted safely. Detailed ground safety requirements supplement the GSE requirements already called out in NASA-STD-5005. This paper will describe the initial genesis of these ground safety requirements, the establishment and approval process and finally the implementation process for Project Orion. The future of the requirements will also be described. Problems and issues encountered and overcame will be discussed.

ITS logical architecture : volume 3, data dictionary.

DOT National Transportation Integrated Search

1981-01-01

The objective of the research effort was to develop an empirically and experiencially based model pedestrian safety program which cities can use as guidelines for pedestrian safety program planning, implementation, and evaluation. The basis of these ...

Asbestos Model Accreditation Plan (MAP) Enforcement Response Policy

EPA Pesticide Factsheets

The Asbestos Model Accreditation Plan (MAP) (40 CFR 763 Subpart E Appendix C) mandates safety training for those who do asbestos removal work, and implements the additional training requirements mandated by Congress

What stage are low-income and middle-income countries (LMICs) at with patient safety curriculum implementation and what are the barriers to implementation? A two-stage cross-sectional study

PubMed Central

Ginsburg, Liane R; Dhingra-Kumar, Neelam; Donaldson, Liam J

2017-01-01

Objectives The improvement of safety in healthcare worldwide depends in part on the knowledge, skills and attitudes of staff providing care. Greater patient safety content in health professional education and training programmes has been advocated internationally. While WHO Patient Safety Curriculum Guides (for Medical Schools and Multi-Professional Curricula) have been widely disseminated in low-income and middle-income countries (LMICs) over the last several years, little is known about patient safety curriculum implementation beyond high-income countries. The present study examines patient safety curriculum implementation in LMICs. Methods Two cross-sectional surveys were carried out. First, 88 technical officers in Ministries of Health and WHO country offices were surveyed to identify the pattern of patient safety curricula at country level. A second survey followed that gathered information from 71 people in a position to provide institution-level perspectives on patient safety curriculum implementation. Results The majority, 69% (30/44), of the countries were either considering whether to implement a patient safety curriculum or actively planning, rather than actually implementing, or embedding one. Most organisations recognised the need for patient safety education and training and felt a safety curriculum was compatible with the values of their organisation; however, important faculty-level barriers to patient safety curriculum implementation were identified. Key structural markers, such as dedicated financial resources and relevant assessment tools to evaluate trainees’ patient safety knowledge and skills, were in place in fewer than half of organisations studied. Conclusions Greater attention to patient safety curriculum implementation is needed. The barriers to patient safety curriculum implementation we identified in LMICs are not unique to these regions. We propose a framework to act as a global standard for patient safety curriculum implementation. Educating leaders through the system in order to embed patient safety culture in education and clinical settings is a critical first step. PMID:28619782

New Jersey Industrial Arts Education Safety Guide.

ERIC Educational Resources Information Center

Kobylarz, Joseph D.; Olender, Francis B.

This guide was developed to assist the teacher in planning, implementing, revising, or improving safety instruction in industrial arts classes in New Jersey, and has as its theme, "Safety Is Everyone's Responsibility." The guide is organized in seven major sections. The first section explains the purpose of the guide, outlines the…

[Comprehensive drug safety plan in a health department].

PubMed

Bujaldón-Querejeta, N; Aznar-Saliente, T; Esplá-González, S; Ruíz-Darbonnéns, S; Pons-Martínez, L; Talens-Bolos, A; Martínez-Ramírez, M; Camacho-Romera, D; Aranaz-Andrés, J M

2014-01-01

To develop and implement a comprehensive drug safety plan in a hospital for the years 2009-2011. Applying the Strengths Weaknesses/Limitations Opportunities Threats (SWOT) methodology, the baseline situation was analyzed and a broad strategy or plan was subsequently developed, defining the scope, responsibilities, objectives and strategic actions and indicators in order to measure the achievement of the results. A comprehensive drug safety plan with the main objective of identifying and reducing the medication-related problems in patients treated in the Hospital de San Juan in Alicante has been developed. The plan contains five strategic objectives, twenty strategic actions and the indicators to assess its outcomes. It also contains a timetable for its establishment and evaluation. Developing a comprehensive strategic plan allows the current situation relating to drug safety to be determined. The results obtained after its introduction will define its applicability. Due to the lack of publications of similar plans and results, the evaluation of this plan will be useful whether it is favorable or not. As a side benefit of the development, the multidisciplinary team continues to work on improving patient safety in the care process, and the safety culture continues to grow among the professionals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

Implementation plan and cost analysis for Oregon's online crash reporting system.

DOT National Transportation Integrated Search

2011-07-01

Federal, state and local transportation agencies, law enforcement, the legislature, consulting firms, safety advocates and the : public use crash data to quantify emerging traffic safety issues and problems, determine priorities, support decision-mak...

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.

[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.

Work-team implementation.

PubMed

Reiste, K K; Hubrich, A

1996-02-01

The authors describe the implementation of the Work-Team Concept at the Frigidaire plans in Jefferson, Iowa. By forming teams, plant staff have made significant improvements in worker safety, product quality, customer service, cost-effectiveness, and overall employee well-being.

Development and Calibration of Highway Safety Manual Equations for Florida Conditions

DOT National Transportation Integrated Search

2011-08-31

The Highway Safety Manual (HSM) provides statistically-valid analytical tools and techniques for quantifying the potential effects on crashes as a result of decisions made in planning, design, operations, and maintenance. Implementation of the new te...

Development and calibration of highway safety manual equations for Florida conditions.

DOT National Transportation Integrated Search

2011-08-31

The Highway Safety Manual (HSM) provides statistically-valid analytical tools and techniques for : quantifying the potential effects on crashes as a result of decisions made in planning, design, : operations, and maintenance. Implementation of the ne...

Traveler safety policy paper : TranPlan 21, amended in 2007

DOT National Transportation Integrated Search

2007-01-01

This policy paper describes the current initiatives and potential policy goals and actions that the Montana Department of Transportation (MDT) could implement to improve public safety on the State's public roadways. these goals and actions were adopt...

[Design of a plan for patient safety in pediatric surgery service].

PubMed

Paredes Esteban, R M; Castillo Fernández, A L; Miñarro del Moral, R; Garrido Pérez, J I; Granero Cendón, R; Gómez Beltrán, O; Berenguer Garcia, M J; Tejedor Fernández, M

2014-10-01

Patient safety is a key priority in quality management for healthcare services providers. Every patient is entitled to receive safe and effective healthcare. The aim of this study was to design a patient safety plan for a Paediatric Surgery Department. We carried out a literature review and we established a work group that included healthcare professionals from the Paediatric Surgery Department and the Quality and Medical Records Department. The group identified potential adverse events, failures and causes and established a rating using Failure Mode Effects Analysis. Potential risks were mapped out and a plan was designed establishing actions to reduce risks. We designated leaders to ensure the effective implementation of the plan. A total of 58 adverse events were identified in the Paediatric Surgery Department. We detected 128 failures that were produced by 211 different causes. The group developed a proposal with 424 specific measures to carry out preventive and/or remedial actions that were then narrowed down to 322. The group designed a plan to apply the programme, which is currently being implemented. The methodology used enabled obtaining key information for improvement of patient safety and developing preventive and/or remedial actions. These measures are applicable in practice, as they were designed using proposals and agreements with professionals that take active part in the care of children with surgical conditions.

Comprehensive evaluation of transportation projects : a toolkit for sketch planning.

DOT National Transportation Integrated Search

2010-10-01

A quick-response project-planning tool can be extremely valuable in anticipating the congestion, safety, : emissions, and other impacts of large-scale network improvements and policy implementations. This report : identifies the advantages and limita...

Tennessee long-range transportation plan : goals, objectives, and policies

DOT National Transportation Integrated Search

2005-12-01

The mission of the Tennessee Department of Transportation (TDOT) is to plan, implement, maintain, and manage an integrated transportation system for the movement of people and products, with emphasis on quality, safety, efficiency, and the environmen...

29 CFR 1952.240 - Description of the plan as initially approved.

Code of Federal Regulations, 2010 CFR

2010-07-01

... occupational safety and health issues as defined by the Secretary of Labor in § 1902.2(c)(1) of this chapter... standards and issue rules and regulations necessary for the implementation of the safety and health law. (d... Section 1952.240 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH...

29 CFR 1952.240 - Description of the plan as initially approved.

Code of Federal Regulations, 2011 CFR

2011-07-01

... occupational safety and health issues as defined by the Secretary of Labor in § 1902.2(c)(1) of this chapter... standards and issue rules and regulations necessary for the implementation of the safety and health law. (d... Section 1952.240 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH...

75 FR 74099 - In the Matter of Nuclear Fuel Services, Inc., Erwin, TN; Confirmatory Order Modifying License...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... cause review, a Safety Culture Implications Review, organizational and process changes in response to... of the assessment. d. NFS agrees to develop and implement an appropriate safety culture improvement plan to address the findings identified in the second Safety Culture Assessment report that was...

30 CFR 46.3 - Training plans.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Training plans. 46.3 Section 46.3 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR EDUCATION AND TRAINING TRAINING AND..., COLLOIDAL PHOSPHATE, OR SURFACE LIMESTONE MINES. § 46.3 Training plans. (a) You must develop and implement a...

77 FR 77117 - Proposed Revision 0 on Access Authorization-Operational Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

...--Operational Program AGENCY: Nuclear Regulatory Commission. ACTION: Standard review plan-draft section revision... public comment on NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for... seeks comments on the new Section 13.6.4 of the Standard Review Plan (SRP) concerning implementation of...

Workshop to review problem-behavior research programs : pedestrian, bicycle, and pupil transportation safety

DOT National Transportation Integrated Search

1981-09-01

This report presents the proceedings of a workshop on pedestrian, bicycle, and pupil transportation safety. The purpose of this workshop was to develop specific recommendations for the planning and implementation of NHTSA research, development, and d...

Workshop to review problem-behavior research programs : alcohol, drugs, and highway safety

DOT National Transportation Integrated Search

1981-05-01

The report presents the proceedings of a workshop on alcohol, drugs, and highway safety. The purpose of this workshop was to develop specific recommendations for the planning and implementation of NHTSA research, development, and demonstration projec...

An interagency space nuclear propulsion safety policy for SEI - Issues and discussion

NASA Technical Reports Server (NTRS)

Marshall, A. C.; Sawyer, J. C., Jr.

1991-01-01

An interagency Nuclear Safety Policy Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative nuclear propulsion program to facilitate the implementation of mission planning and conceptual design studies. The NSPWG developed a top level policy to provide the guiding principles for the development and implementation of the nuclear propulsion safety program and the development of Safety Functional Requirements. In addition, the NSPWG reviewed safety issues for nuclear propulsion and recommended top level safety requirements and guidelines to address these issues. Safety topics include reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations. In this paper the emphasis is placed on the safety policy and the issues and considerations that are addressed by the NSPWG recommendations.

NSPWG-recommended safety requirements and guidelines for SEI nuclear propulsion

NASA Technical Reports Server (NTRS)

Marshall, Albert C.; Sawyer, J. C., Jr.; Bari, Robert A.; Brown, Neil W.; Cullingford, Hatice S.; Hardy, Alva C.; Lee, James H.; Mcculloch, William H.; Niederauer, George F.; Remp, Kerry

1992-01-01

An interagency Nuclear Safety Policy Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program to facilitate the implementation of mission planning and conceptual design studies. The NSPWG developed a top-level policy to provide the guiding principles for the development and implementation of the nuclear propulsion safety program and the development of safety functional requirements. In addition, the NSPWG reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. Safety requirements were developed for reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, and safeguards. Guidelines were recommended for risk/reliability, operational safety, flight trajectory and mission abort, space debris and meteoroids, and ground test safety. In this paper the specific requirements and guidelines will be discussed.

Road Risk Modeling and Cloud-Aided Safety-Based Route Planning.

PubMed

Li, Zhaojian; Kolmanovsky, Ilya; Atkins, Ella; Lu, Jianbo; Filev, Dimitar P; Michelini, John

2016-11-01

This paper presents a safety-based route planner that exploits vehicle-to-cloud-to-vehicle (V2C2V) connectivity. Time and road risk index (RRI) are considered as metrics to be balanced based on user preference. To evaluate road segment risk, a road and accident database from the highway safety information system is mined with a hybrid neural network model to predict RRI. Real-time factors such as time of day, day of the week, and weather are included as correction factors to the static RRI prediction. With real-time RRI and expected travel time, route planning is formulated as a multiobjective network flow problem and further reduced to a mixed-integer programming problem. A V2C2V implementation of our safety-based route planning approach is proposed to facilitate access to real-time information and computing resources. A real-world case study, route planning through the city of Columbus, Ohio, is presented. Several scenarios illustrate how the "best" route can be adjusted to favor time versus safety metrics.

What stage are low-income and middle-income countries (LMICs) at with patient safety curriculum implementation and what are the barriers to implementation? A two-stage cross-sectional study.

PubMed

Ginsburg, Liane R; Dhingra-Kumar, Neelam; Donaldson, Liam J

2017-06-15

The improvement of safety in healthcare worldwide depends in part on the knowledge, skills and attitudes of staff providing care. Greater patient safety content in health professional education and training programmes has been advocated internationally. While WHO Patient Safety Curriculum Guides (for Medical Schools and Multi-Professional Curricula) have been widely disseminated in low-income and middle-income countries (LMICs) over the last several years, little is known about patient safety curriculum implementation beyond high-income countries. The present study examines patient safety curriculum implementation in LMICs. Two cross-sectional surveys were carried out. First, 88 technical officers in Ministries of Health and WHO country offices were surveyed to identify the pattern of patient safety curricula at country level. A second survey followed that gathered information from 71 people in a position to provide institution-level perspectives on patient safety curriculum implementation. The majority, 69% (30/44), of the countries were either considering whether to implement a patient safety curriculum or actively planning, rather than actually implementing, or embedding one. Most organisations recognised the need for patient safety education and training and felt a safety curriculum was compatible with the values of their organisation; however, important faculty-level barriers to patient safety curriculum implementation were identified. Key structural markers, such as dedicated financial resources and relevant assessment tools to evaluate trainees' patient safety knowledge and skills, were in place in fewer than half of organisations studied. Greater attention to patient safety curriculum implementation is needed. The barriers to patient safety curriculum implementation we identified in LMICs are not unique to these regions. We propose a framework to act as a global standard for patient safety curriculum implementation. Educating leaders through the system in order to embed patient safety culture in education and clinical settings is a critical first step. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The development of local calibration factors for implementing the highway safety manual in Maryland : research summary.

DOT National Transportation Integrated Search

2014-03-01

One of the best strategies to improve traffic safety and reduce motor vehicle traffic : crashes is to provide well-planned engineering, education, and enforcement : countermeasures that are tailored to given crash, traffic, and roadway : characterist...

Complying with the Occupational Safety and Health Administration's Bloodborne Pathogens Standard: implementing needleless systems and intravenous safety devices.

PubMed

Marini, Michelle A; Giangregorio, Maeve; Kraskinski, Joanna C

2004-03-01

Preventing the transmission of bloodborne pathogens to healthcare workers has been a mission and a challenge of the healthcare industry for over 20 years. The development of the Occupational Safety and Health Administration Bloodborne Pathogens Standard in 1991 and the passing of the Needlestick Safety Act in 2000 mandated hospitals to develop an Exposure Control Plan to protect workers from these pathogens. Children's Hospital Boston began implementation of a needleless system in 1993. Employees readily accepted these systems into practice, because they were convenient and easy to use. A marked decrease in exposures to bloodborne pathogens naturally followed, which is consistent with the national data. The transition to intravenous (i.v.) safety devices at Children's Hospital began in 2000 and proved to be more of a challenge. First, the clinicians must choose a safety product, which requires developing and implementing a trial plan with potential catheters. This selection process is especially difficult in pediatrics where successful placement of the smallest-gauge catheter, no. 24, is imperative. After choosing an i.v. safety product, successful transition is dependent upon the thoroughness of i.v. safety device training and a commitment by the clinicians to the use of these products. Although the number of needlestick injuries and subsequent transmission of bloodborne pathogens have been further reduced with the use of i.v. safety devices, needlestick injuries still occur. This results from a lack of familiarity with the engineering of the device and therefore poor technique or a failure to activate the safety mechanism. Staff resistance due to loss of expertise with the new device and patient care concerns are additional barriers to the use of these new products. Addressing these obstacles and providing adequate training for all clinicians were required for successful implementation of these i.v. safety devices.

Fire Safety Trianing in Health Care Institutions.

ERIC Educational Resources Information Center

American Hospital Association, Chicago, IL.

The manual details the procedures to be followed in developing and implementing a fire safety plan. The three main steps are first, to organize; second, to set up a procedure and put it in writing; and third, to train and drill employees and staff. Step 1 involves organizing a safety committee, appointing a fire marshall, and seeking help from…

Handbook for Safety Education. A Teacher's Handbook for Safety Education Grades K-12.

ERIC Educational Resources Information Center

Walker, Scott V.; And Others

This handbook is designed to assist classroom teachers and administrators in organizing, planning, and implementing a comprehensive safety program K-12 at the local school or district level. The handbook is organized in three sections. The first section contains 28 units for the elementary level that cover the following topics: first aid training;…

Nuclear safety policy working group recommendations on nuclear propulsion safety for the space exploration initiative

NASA Technical Reports Server (NTRS)

Marshall, Albert C.; Lee, James H.; Mcculloch, William H.; Sawyer, J. Charles, Jr.; Bari, Robert A.; Cullingford, Hatice S.; Hardy, Alva C.; Niederauer, George F.; Remp, Kerry; Rice, John W.

1993-01-01

An interagency Nuclear Safety Working Group (NSPWG) was chartered to recommend nuclear safety policy, requirements, and guidelines for the Space Exploration Initiative (SEI) nuclear propulsion program. These recommendations, which are contained in this report, should facilitate the implementation of mission planning and conceptual design studies. The NSPWG has recommended a top-level policy to provide the guiding principles for the development and implementation of the SEI nuclear propulsion safety program. In addition, the NSPWG has reviewed safety issues for nuclear propulsion and recommended top-level safety requirements and guidelines to address these issues. These recommendations should be useful for the development of the program's top-level requirements for safety functions (referred to as Safety Functional Requirements). The safety requirements and guidelines address the following topics: reactor start-up, inadvertent criticality, radiological release and exposure, disposal, entry, safeguards, risk/reliability, operational safety, ground testing, and other considerations.

[Occupational health protection in business economics--business plan for health intervention].

PubMed

Rydlewska-Liszkowska, Izabela

2011-01-01

One of the company's actions for strengthening human capital is the protection of health and safety of its employees. Its implementation needs financial resources, therefore, employers expect tangible effectiveness in terms of health and economics. Business plan as an element of company planning can be a helpful tool for new health interventions management. The aim of this work was to elaborate a business plan framework for occupational health interventions at the company level, combining occupational health practices with company management and economics. The business plan of occupational health interventions was based on the literature review, the author's own research projects and meta-analysis of research reports on economic relations between occupational health status and company productivity. The study resulted in the development of the business plan for occupational health interventions at the company level. It consists of summary and several sections that address such issues as the key elements of the intervention discussed against a background of the company economics and management, occupational health and safety status of the staff, employees' health care organization, organizational plan of providing the employees with health protection, marketing plan, including specificity of health interventions in the company marketing plan and financial plan, reflecting the economic effects of health care interventions on the overall financial management of the company. Business plan defines occupational health and safety interventions as a part of the company activities as a whole. Planning health care interventions without relating them to the statutory goals of the company may have the adverse impact on the financial balance and profitability of the company. Therefore, business plan by providing the opportunity of comparing different options of occupational health interventions to be implemented by employers is a key element of the management of employees' health.

Information system equality for food security--implementation of the food safety control system in Taiwan.

PubMed

Chen, Shaun C; Hsu, Guoo-Shyng Wang; Chiu, Chihwei P

2009-01-01

Food security plays a central role in governing agricultural policies in Taiwan. In addition to overuse or the illegal use of pesticide, meat leanness promoters, animal drugs and melamine in the food supply; as well as foodborne illness draws the greatest public concern due to incidents that occur every year in Taiwan. The present report demonstrates the implementation of a food safety control system in Taiwan. In order to control foodborne outbreaks effectively, the central government of the Department of Health of Taiwan launched the food safety control system which includes both the good hygienic practice (GHP) and the HACCP plan, in the last decade. From 1998 to the present, 302 food affiliations that implemented the system have been validated and accredited by a well-established audit system. The implementation of a food safety control system in compliance with international standards is of crucial importance to ensure complete safety and the high quality of foods, not only for domestic markets, but also for international trade.

29 CFR 1952.311 - Developmental schedule.

Code of Federal Regulations, 2014 CFR

2014-07-01

... standards promulgation March 1974. (c) Implementation of the Management Information System by December 1975. (d) Complete implementation of the occupational health program by July 1975. (e) Complete State plan... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

29 CFR 1952.311 - Developmental schedule.

Code of Federal Regulations, 2011 CFR

2011-07-01

... standards promulgation March 1974. (c) Implementation of the Management Information System by December 1975. (d) Complete implementation of the occupational health program by July 1975. (e) Complete State plan... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR...

Implementing AORN recommended practices for medication safety.

PubMed

Hicks, Rodney W; Wanzer, Linda J; Denholm, Bonnie

2012-12-01

Medication errors in the perioperative setting can result in patient morbidity and mortality. The AORN "Recommended practices for medication safety" provide guidance to perioperative nurses in developing, implementing, and evaluating safe medication use practices. These practices include recognizing risk points in the medication use process, collaborating with pharmacy staff members, conducting preoperative assessments and postoperative evaluations (eg, medication reconciliation), and handling hazardous medications and pharmaceutical waste. Strategies for successful implementation of the recommended practices include promoting a basic understanding of the nurse's role in the medication use process and developing a medication management plan as well as policies and procedures that support medication safety and activities to measure compliance with safe practices. Published by Elsevier Inc.

Implementation of the WHO Surgical Safety Checklist in an Ethiopian Referral Hospital

PubMed Central

2014-01-01

Background The WHO Surgical Safety Checklist has a growing evidence base to support its role in improving perioperative safety, although its impact is likely to be directly related to the effectiveness of its implementation. There remains a paucity of documented experience from low-resource settings on Checklist implementation approaches. We report an implementation strategy in a public referral hospital in Addis Ababa, Ethiopia, based on consultation, local leadership, formal introduction, and supported supervision with subsequent audit and feedback. Methods Planning, implementation and assessment took place from December 2011 to December 2012. The planning phase, from December 2011 until April 2012, involved a multidisciplinary consultative approach using local leaders, volunteer clinicians, and staff from non-governmental organisations, to draw up a locally agreed and appropriate Checklist. Implementation in April 2012 involved formal teaching and discussion, simulation sessions and role play, with supportive supervision following implementation. Assessment was performed using completed Checklist analysis and staff satisfaction questionnaires at one month and further Checklist analysis combined with semi-structured interviews in December 2012. Results and discussion Checklist compliance rates were 83% for general anaesthetics at one month after implementation, with an overall compliance rate of 65% at eight months. There was a decrease in Checklist compliance over the period of the study to less than 20% by the end of the study period. The ‘Sign out’ section was reported as being the most difficult section of the Checklist to complete, and was missed completely in 21% of cases. The most commonly missed single item was the team introduction at the start of each case. However, we report high staff satisfaction with the Checklist and enthusiasm for its continued use. Conclusion We report a detailed implementation strategy for introducing the WHO Surgical Safety Checklist to a low-resource setting. We show that this approach can lead to high completion rates and high staff satisfaction, albeit with a drop in completion rates over time. We argue that maximal benefit of the Surgical Safety Checklist is likely to be when it engenders a conversation around patient safety within a department, and when there is local ownership of this process. PMID:24678854

14 CFR 417.111 - Launch plans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... controls identified by a launch operator's ground safety analysis and implementation of the ground safety.... (ii) For each toxic propellant, any hazard controls and process constraints determined under the... classification and compatibility group as defined by part 420 of this chapter. (3) A graphic depiction of the...

Nevada Peer Exchange : Strategic Highway Safety Plan (SHSP) Implementation - An RSPCB Peer Exchange

DOT National Transportation Integrated Search

2015-03-01

The Nevada Department of Transportation (NDOT) hosted a peer exchange March 4 and 5, 2015, in Carson City, NV, with support from the Federal Highway Administration (FHWA) Office of Safety. In addition to FHWA and NDOT staff, representatives from the ...

48 CFR 623.302-70 - Policy.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Post Occupational Safety and Health Officer during both planning and implementation phases. [59 FR... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Policy. 623.302-70 Section... WORKPLACE Hazardous Material Identification and Material Safety Data 623.302-70 Policy. Any work which...

48 CFR 623.302-70 - Policy.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Post Occupational Safety and Health Officer during both planning and implementation phases. [59 FR... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Policy. 623.302-70 Section... WORKPLACE Hazardous Material Identification and Material Safety Data 623.302-70 Policy. Any work which...

Administering Safety: Challenge Courses and Climbing Walls.

ERIC Educational Resources Information Center

Evans, Will

1996-01-01

A camp that is establishing a challenge course or climbing wall must ensure program safety. Discusses financial planning, selecting a contractor, adhering to standards for construction, inspections, staff training, screening of participants, and the administrative challenge of implementing and documenting proper actions. Sidebar discusses a study…

[The Results of Self-Assessment by Medical Organizations Their Correspondence to Proposals (Practical Recommendations) of the Roszdravnadzor Concerning Organization of Internal Control of Quality and Safety of Medical Activity].

PubMed

Ivanov, I V; Shvabsky, O R; Minulin, I B

2017-11-01

The article presents the analysis of the results of internal audits (self-rating) in medical organizations implemented on the basis of Proposals (practical guidelines) of the Roszdravnadzor concerning organization of inner control of quality and safety of medical activities in medical organization (hospital). The self-rating was implemented by the medical organizations themselves according the common criteria of the Proposals as provided the following plan: planning of self-rating, collection and processing of data, application of self-rating, analysis of obtained results, preparation of report. The article uses the results of self-rating of medical organizations corresponding to following criteria: profile of activity-multi-field hospital-number of beds more than 350-state property. The self-rating was implemented according to 11 basic parts of the Proposals. The criteria were developed for every part. The evaluation lists developed on the basis of the given Proposals permitted to medical organizations to independently establish problems in their activities. Within the framework of implemented self-rating medical organizations mentioned the directions of activity related to personnel management, identification of personality of patient, support of epidemiological and surgical safety as having significant discrepancies with the Proposals and requiring implementation of improvement measures.

Protecting Our Own. Community Child Passenger Safety Programs.

ERIC Educational Resources Information Center

National Highway Traffic Safety Administration (DOT), Washington, DC.

This manual provides information on implementing a local child passenger safety program. It covers understanding the problems and solutions; deciding what can be done; planning and carrying out a project; providing adequate, accurate, and current technical information; and reaching additional sources of information. Chapter 1 provides community…

Development and Pilot Testing of a Food Safety Curriculum for Managers and Staff of Residential Childcare Institutions (RCCIs)

ERIC Educational Resources Information Center

Pivarnik, Lori F.; Patnoad, Martha S.; Nyachuba, David; McLandsborough, Lynne; Couto, Stephen; Hagan, Elsina E.; Breau, Marti

2013-01-01

Food safety training materials, targeted for residential childcare institution (RCCI) staff of facilities of 20 residents or less, were developed, piloted, and evaluated. The goal was to assist in the implementation of a Hazard Analysis Critical Control Points (HACCP)-based food safety plan as required by Food and Nutrition Service/United States…

Fire safety of ground-based space facilities on the spaceport ;Vostochny;

NASA Astrophysics Data System (ADS)

Artamonov, Vladimir S.; Gordienko, Denis M.; Melikhov, Anatoly S.

2017-06-01

The facilities of the spaceport ;Vostochny; and the innovative technologies for fire safety to be implemented are considered. The planned approaches and prospects for fire safety ensuring at the facilities of the spaceport ;Vostochny; are presented herein, based on the study of emergency situations having resulted in fire accidents and explosion cases at the facilities supporting space vehicles operation.

A framework for the development of patient safety education and training guidelines.

PubMed

Zikos, Dimitrios; Diomidous, Marianna; Mantas, John

2010-01-01

Patient Safety (PS) is a major concern that involves a wide range of roles in healthcare, including those who are directly and indirectly involved, and patients as well. In order to succeed into developing a safety culture among healthcare providers, carers and patients, there should be given great attention into building appropriate education and training tools, especially addressing those who plan patient safety activities. The framework described in this policy paper is based on the results of the European Network for Patient Safety (EUNetPaS) project and analyses the principles and elements of the guidance that should be provided to those who design and implement Patient Safety Education and training activities. The main principles that it should be based on and the core teaching objectives-expected outcomes are addressed. Once the main context and considerations are properly set, the guidance should define the general schema of the content that should be included in the Education and Training activities, as well as how these activities would be delivered. It is also important that the different roles of the recipients are clearly distinguished and linked to their role-specific methods, proper delivery platforms and success stories. Setting these principles into practice when planning and implementing interventions, primarily aims to enlighten and support those who are enrolled to design and implement Patient Safety education and training teaching activities. This is achieved by providing them with a framework to build upon, succeeding to build a collaborative, safety conscious and competent environment, in terms of PS. A guidelines web platform has been developed to support this process.

Safety evaluation report on Tennessee Valley Authority: Browns Ferry nuclear performance plan

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

Not Available

1989-10-01

This safety evaluation report (SER) on the information submitted by the Tennessee Valley Authority (TVA) in its Nuclear Performance Plan, through Revision 2, for the Browns Ferry Nuclear Plant and in supporting documents has been prepared by the US Nuclear Regulatory commission staff. The Browns Ferry Nuclear Plant consists of three boiling-water reactors at a site in Limestone County, Alabama. The plan addresses the plant-specific concerns requiring resolution before the startup of Unit 2. The staff will inspect implementation of those TVA programs that address these concerns. Where systems are common to Units 1 and 2 or to Units 2more » and 3, the staff safety evaluations of those systems are included herein. 85 refs.« less

A terrorism response plan for hospital security and safety officers.

PubMed

White, Donald E

2002-01-01

Security and Safety managers in today's healthcare facilities need to factor terrorism response into their emergency management plans, separate from the customary disaster plans and the comparatively recent security plans. Terrorism incidents will likely be security occurrences that use a weapon of mass destruction to magnify the incidents into disasters. Facility Y2K Plans can provide an excellent framework for the detailed contingency planning needed for terrorism response by healthcare facilities. Tabbed binder notebooks, with bulleted procedures and contact points for each functional section, can provide security and safety officers with at-a-glance instructions for quick 24/7 implementation. Each functional section should focus upon what activities or severity levels trigger activation of the backup processes. Network with your countywide, regional, and/or state organizations to learn what your peers are doing. Comprehensively inventory your state, local, and commercial resources so that you have alternate providers readily available 24/7 to assist your facility upon disasters.

The World Health Organization's water safety plan is much more than just an integrated drinking water quality management plan.

PubMed

Viljoen, F C

2010-01-01

South Africa is a country of contrasts with far ranging variations in climate, precipitation rates, cultures, demographics, housing levels, education, wealth and skills levels. These differences have an impact on water services delivery as do expectations, affordability and available resources. Although South Africa has made much progress in supplying drinking water, the same cannot be said regarding water quality throughout the country. A concerted effort is currently underway to correct this situation and as part of this drive, water safety plans (WSP) are promoted. Rand Water, the largest water services provider in South Africa, used the World Health Organization (WHO) WSP framework as a guide for the development of its own WSP which was implemented in 2003. Through the process of implementation, Rand Water found the WHO WSP to be much more than just another integrated quality system.

Hallways to Highways. Driver Education 1982.

ERIC Educational Resources Information Center

Oklahoma State Dept. of Education, Oklahoma City.

The purpose of this guide is to provide direction and assistance to driver education instructors and school administrators as they plan and implement quality programs of traffic safety instruction. Materials are divided into seven chapters conveying: (1) the organization and administration of driver and traffic safety education, (2) the driving…

School Fire Safety Manual.

ERIC Educational Resources Information Center

Arkansas State Dept. of Education, Little Rock. General Education Div.

This manual provides the background information necessary for the planning of school fire safety programs by local school officials, particularly in Arkansas. The manual first discusses the need for such programs and cites the Arkansas state law regarding them. Policies established by the Arkansas State Board of Education to implement the legal…

75 FR 76465 - Public Safety and Homeland Security Bureau; Federal Advisory Committee Act; Communications...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-08

... significant number of Council members have made business and travel plans in accordance with this schedule... implementation of solutions and best practices for public safety communications and cybersecurity. Recognizing... Public Notice announcing the meeting is available at http://www.fcc.gov/Daily_Releases/Daily_Business...

Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

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

Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.

1994-08-01

This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65.more » The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water.« less

Safety, reliability, maintainability and quality provisions for the Space Shuttle program

NASA Technical Reports Server (NTRS)

1990-01-01

This publication establishes common safety, reliability, maintainability and quality provisions for the Space Shuttle Program. NASA Centers shall use this publication both as the basis for negotiating safety, reliability, maintainability and quality requirements with Shuttle Program contractors and as the guideline for conduct of program safety, reliability, maintainability and quality activities at the Centers. Centers shall assure that applicable provisions of the publication are imposed in lower tier contracts. Centers shall give due regard to other Space Shuttle Program planning in order to provide an integrated total Space Shuttle Program activity. In the implementation of safety, reliability, maintainability and quality activities, consideration shall be given to hardware complexity, supplier experience, state of hardware development, unit cost, and hardware use. The approach and methods for contractor implementation shall be described in the contractors safety, reliability, maintainability and quality plans. This publication incorporates provisions of NASA documents: NHB 1700.1 'NASA Safety Manual, Vol. 1'; NHB 5300.4(IA), 'Reliability Program Provisions for Aeronautical and Space System Contractors'; and NHB 5300.4(1B), 'Quality Program Provisions for Aeronautical and Space System Contractors'. It has been tailored from the above documents based on experience in other programs. It is intended that this publication be reviewed and revised, as appropriate, to reflect new experience and to assure continuing viability.

Planning the diffusion of a neck-injury prevention programme among community rugby union coaches.

PubMed

Donaldson, Alex; Poulos, Roslyn G

2014-01-01

This paper describes the development of a theory-informed and evidence-informed, context-specific diffusion plan for the Mayday Safety Procedure (MSP) among community rugby coaches in regional New South Wales, Australia. Step 5 of Intervention Mapping was used to plan strategies to enhance MSP adoption and implementation. Coaches were identified as the primary MSP adopters and implementers within a system including administrators, players and referees. A local advisory group was established to ensure context relevance. Performance objectives (eg, attend MSP training for coaches) and determinants of adoption and implementation behaviour (eg, knowledge, beliefs, skills and environment) were identified, informed by Social Cognitive Theory. Adoption and implementation matrices were developed and change-objectives for coaches were identified (eg, skills to deliver MSP training to players). Finally, intervention methods and specific strategies (eg, coach education, social marketing and policy and by-law development) were identified based on advisory group member experience, evidence of effective coach safety behaviour-change interventions and Diffusion of Innovations theory. This is the first published example of a systematic approach to plan injury prevention programme diffusion in community sports. The key strengths of this approach were an effective researcher-practitioner partnership; actively engaging local sports administrators; targeting specific behaviour determinants, informed by theory and evidence; and taking context-related practical strengths and constraints into consideration. The major challenges were the time involved in using a systematic diffusion planning approach for the first time; and finding a planning language that was acceptable and meaningful to researchers and practitioners.

Fire Education Planning.

ERIC Educational Resources Information Center

National Fire Prevention and Control Administration (DOC), Washington, DC.

This curriculum guide for public fire educators was developed to assist them in planning and implementing fire educational programs for older Americans (over 65), adults, youthful firesetters, and children. This booklet's content is in four parts: (1) Over 65 and Fire Safety discusses five broad questions which provide the framework for planning…

Identification, assessment, and control of hazards in water supply: experiences from Water Safety Plan implementations in Germany.

PubMed

Mälzer, H-J; Staben, N; Hein, A; Merkel, W

2010-01-01

According to the recommendations of the World Health Organization (WHO) for Water Safety Plans (WSP), a Technical Risk Management was developed, which considers standard demands in drinking water treatment in Germany. It was already implemented at several drinking water treatment plants of different size and treatment processes in Germany. Hazards affecting water quality, continuity, and the reliability of supply from catchment to treatment and distribution could be identified by a systematic approach, and suitable control measures were defined. Experiences are presented by detailed examples covering methods, practical consequences, and further outcomes. The method and the benefits for the water suppliers are discussed and an outlook on the future role of WSPs in German water supply is given.

Review of Issues Associated with Safe Operation and Management of the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Johnstone, Paul M.; Blomberg, Richard D.; Gleghorn, George J.; Krone, Norris J.; Voltz, Richard A.; Dunn, Robert F.; Donlan, Charles J.; Kauderer, Bernard M.; Brill, Yvonne C.; Englar, Kenneth G.;

Site Safety and Health Plan (Phase 3) for the treatability study for in situ vitrification at Seepage Pit 1 in Waste Area Grouping 7, Oak Ridge National Laboratory, Oak Ridge, TN

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

Spalding, B.P.; Naney, M.T.

1995-06-01

This plan is to be implemented for Phase III ISV operations and post operations sampling. Two previous project phases involving site characterization have been completed and required their own site specific health and safety plans. Project activities will take place at Seepage Pit 1 in Waste Area Grouping 7 at ORNL, Oak Ridge, Tennessee. Purpose of this document is to establish standard health and safety procedures for ORNL project personnel and contractor employees in performance of this work. Site activities shall be performed in accordance with Energy Systems safety and health policies and procedures, DOE orders, Occupational Safety and Healthmore » Administration Standards 29 CFR Part 1910 and 1926; applicable United States Environmental Protection Agency requirements; and consensus standards. Where the word ``shall`` is used, the provisions of this plan are mandatory. Specific requirements of regulations and orders have been incorporated into this plan in accordance with applicability. Included from 29 CFR are 1910.120 Hazardous Waste Operations and Emergency Response; 1910.146, Permit Required - Confined Space; 1910.1200, Hazard Communication; DOE Orders requirements of 5480.4, Environmental Protection, Safety and Health Protection Standards; 5480.11, Radiation Protection; and N5480.6, Radiological Control Manual. In addition, guidance and policy will be followed as described in the Environmental Restoration Program Health and Safety Plan. The levels of personal protection and the procedures specified in this plan are based on the best information available from reference documents and site characterization data. Therefore, these recommendations represent the minimum health and safety requirements to be observed by all personnel engaged in this project.« less

Using Theory to Guide Practice in Children's Pedestrian Safety Education

ERIC Educational Resources Information Center

Cross, Donna; Hall, Margaret; Howat, Peter

2003-01-01

Few pedestrian injury prevention programs appear to articulate the theory upon which their design and evaluation are based. This article describes how theory was used to plan, develop, implement, and evaluate the educational component of a comprehensive child pedestrian intervention. Organizational and planning theories were used to guide the…

Factors influencing workers to follow food safety management systems in meat plants in Ontario, Canada.

PubMed

Ball, Brita; Wilcock, Anne; Aung, May

2009-06-01

Small and medium sized food businesses have been slow to adopt food safety management systems (FSMSs) such as good manufacturing practices and Hazard Analysis Critical Control Point (HACCP). This study identifies factors influencing workers in their implementation of food safety practices in small and medium meat processing establishments in Ontario, Canada. A qualitative approach was used to explore in-plant factors that influence the implementation of FSMSs. Thirteen in-depth interviews in five meat plants and two focus group interviews were conducted. These generated 219 pages of verbatim transcripts which were analysed using NVivo 7 software. Main themes identified in the data related to production systems, organisational characteristics and employee characteristics. A socio-psychological model based on the theory of planned behaviour is proposed to describe how these themes and underlying sub-themes relate to FSMS implementation. Addressing the various factors that influence production workers is expected to enhance FSMS implementation and increase food safety.

Database management systems for process safety.

PubMed

Early, William F

2006-03-17

Several elements of the process safety management regulation (PSM) require tracking and documentation of actions; process hazard analyses, management of change, process safety information, operating procedures, training, contractor safety programs, pre-startup safety reviews, incident investigations, emergency planning, and compliance audits. These elements can result in hundreds of actions annually that require actions. This tracking and documentation commonly is a failing identified in compliance audits, and is difficult to manage through action lists, spreadsheets, or other tools that are comfortably manipulated by plant personnel. This paper discusses the recent implementation of a database management system at a chemical plant and chronicles the improvements accomplished through the introduction of a customized system. The system as implemented modeled the normal plant workflows, and provided simple, recognizable user interfaces for ease of use.

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

PubMed

Chen, Ching-Fu; Chen, Shu-Chuan

2012-07-01

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

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis

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

Zheng, Yuanshui, E-mail: yuanshui.zheng@okc.procure.com; Johnson, Randall; Larson, Gary

Purpose: Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. Methods: The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authorsmore » estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. Results: In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. Conclusions: The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.« less

Minimizing treatment planning errors in proton therapy using failure mode and effects analysis.

PubMed

Zheng, Yuanshui; Johnson, Randall; Larson, Gary

2016-06-01

Failure mode and effects analysis (FMEA) is a widely used tool to evaluate safety or reliability in conventional photon radiation therapy. However, reports about FMEA application in proton therapy are scarce. The purpose of this study is to apply FMEA in safety improvement of proton treatment planning at their center. The authors performed an FMEA analysis of their proton therapy treatment planning process using uniform scanning proton beams. The authors identified possible failure modes in various planning processes, including image fusion, contouring, beam arrangement, dose calculation, plan export, documents, billing, and so on. For each error, the authors estimated the frequency of occurrence, the likelihood of being undetected, and the severity of the error if it went undetected and calculated the risk priority number (RPN). The FMEA results were used to design their quality management program. In addition, the authors created a database to track the identified dosimetric errors. Periodically, the authors reevaluated the risk of errors by reviewing the internal error database and improved their quality assurance program as needed. In total, the authors identified over 36 possible treatment planning related failure modes and estimated the associated occurrence, detectability, and severity to calculate the overall risk priority number. Based on the FMEA, the authors implemented various safety improvement procedures into their practice, such as education, peer review, and automatic check tools. The ongoing error tracking database provided realistic data on the frequency of occurrence with which to reevaluate the RPNs for various failure modes. The FMEA technique provides a systematic method for identifying and evaluating potential errors in proton treatment planning before they result in an error in patient dose delivery. The application of FMEA framework and the implementation of an ongoing error tracking system at their clinic have proven to be useful in error reduction in proton treatment planning, thus improving the effectiveness and safety of proton therapy.

The End-To-End Safety Verification Process Implemented to Ensure Safe Operations of the Columbus Research Module

NASA Astrophysics Data System (ADS)

Arndt, J.; Kreimer, J.

2010-09-01

The European Space Laboratory COLUMBUS was launched in February 2008 with NASA Space Shuttle Atlantis. Since successful docking and activation this manned laboratory forms part of the International Space Station(ISS). Depending on the objectives of the Mission Increments the on-orbit configuration of the COLUMBUS Module varies with each increment. This paper describes the end-to-end verification which has been implemented to ensure safe operations under the condition of a changing on-orbit configuration. That verification process has to cover not only the configuration changes as foreseen by the Mission Increment planning but also those configuration changes on short notice which become necessary due to near real-time requests initiated by crew or Flight Control, and changes - most challenging since unpredictable - due to on-orbit anomalies. Subject of the safety verification is on one hand the on orbit configuration itself including the hardware and software products, on the other hand the related Ground facilities needed for commanding of and communication to the on-orbit System. But also the operational products, e.g. the procedures prepared for crew and ground control in accordance to increment planning, are subject of the overall safety verification. In order to analyse the on-orbit configuration for potential hazards and to verify the implementation of the related Safety required hazard controls, a hierarchical approach is applied. The key element of the analytical safety integration of the whole COLUMBUS Payload Complement including hardware owned by International Partners is the Integrated Experiment Hazard Assessment(IEHA). The IEHA especially identifies those hazardous scenarios which could potentially arise through physical and operational interaction of experiments. A major challenge is the implementation of a Safety process which owns quite some rigidity in order to provide reliable verification of on-board Safety and which likewise provides enough flexibility which is desired by manned space operations with scientific objectives. In the period of COLUMBUS operations since launch already a number of lessons learnt could be implemented especially in the IEHA that allow to improve the flexibility of on-board operations without degradation of Safety.

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…

Continental United States Military Housing Inspection National Capital Region

DTIC Science & Technology

2015-08-13

that was flaking, peeling, or chalking. JBAB did not have an asbestos management program, plan, or an appointed asbestos program manager...housing partner to ensure inspection and maintenance plan is achieved; and • Implement an asbestos management plan and appoint an asbestos program...select environmental health and safety requirements, such as those for drinking water, radon, asbestos , and lead based paint. We conducted this

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

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

Annette L. Schafer

2012-06-01

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

78 FR 49762 - Desecheo National Wildlife Refuge, PR; Final Comprehensive Conservation Plan and Finding of No...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-15

... complete the removal of all invasive animal species. We will also develop and implement a plan for..., if necessary, efforts to remove invasive species. The number of vegetation plots and frequency of... safety of the refuge regarding the removal of unexploded ordnance. CCP Alternatives, Including Our...

29 CFR 1952.230 - Description of the plan as initially approved.

Code of Federal Regulations, 2014 CFR

2014-07-01

...” the Federal standard, except those found in parts 1915, 1916, 1917 and 1918 of this chapter (ship repairing, ship building, ship breaking and longshoring). All Federal standards adopted by the State became... statutory authority to implement an occupational safety and health plan modeled after the Federal Act. There...

Paratransit Roadeo Curriculum Guide

DOT National Transportation Integrated Search

1981-10-01

As a result of a contract with the Virginia Department of Highways and : Transportation the Transportation Safety Training Center at Virginia : Commonwealth University, in cooperation with two special transportation : providers planned and implemente...

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

Not Available

This study compared conditions, practices, and attitudes at underground bituminous coal mines having low injury incidence rates with those found at mines having high injury incidence rates. Several characteristics common to many of the low incidence rate mines that differentiate them from those having high incidence rates were identified. (1) Training programs: adequate and relevant training materials; qualified instructors; restricted classroom size to encourage student participation; and tailored to meet individual miner needs. (2) Management/labor relations tend to have a positive impact upon a mine's accident and injury experience when: both management and labor have a positive attitude toward safetymore » and health; open lines of communication permit management and labor to jointly reconcile problems affecting safety and health; representatives of labor become actively involved in issues concerning safety, health and production; and management and labor identify and accept their joint responsibility for correcting unsafe conditions and practices. (3) Safety and health conditions are improved when: standard operating procedures are established, understood, and implemented; management equitably enforces established policies concerning absenteeism, job assignments, and standard operating procedures; formal safety and health programs are communicated to all employees and subsequently implemented by management and labor; safety department has top management support in terms of funds, manpower, and the authority necessary to implement the safety and health program; mine plans are thoroughly reviewed by management, labor, and MSHA to insure that such plans incorporate measures to adequately control the physical environment of a coal mine; and MSHA inspection activity is most effective when the inspectors encourage increased cooperative interaction between themselves, mine management, and labor.« less

[Strategy for implementing and assessing a health care risk management unit in a primary care area].

PubMed

Mena Mateo, José María; de la Fuente, Angel Sanz-Vírseda; Cañada Dorado, Asunción; Villamor Borrego, Manuela

2009-06-01

To describe the setting up of a clinical risk management unit (CRMU) within primary care management, as well as the aims of the project, its implementation phases and the assessment of the results after one year of experience. A safety plan was prepared, based on the European Excellence Model (EFQM), to establish a strategic working framework. The plan included 38 proposed actions, associated with criteria elements and 26 indicators to evaluate the selected criteria. A total of 82% of the anticipated actions were implemented in 2007, which included, actions related to teaching and training (15 activities with 237 trainees), spreading of information associated with patient safety, incident analysis (14) and the introduction of specific safe practices (12). Four of those were considered as "generalisable" safe practices and were spread to the rest of the CRMUs in the Autonomous Region of Madrid. The CRMUs have introduced and monitored three processes related to patient safety, participated in a formal programme on the polymedicated elderly, with good results in cover and quality of the indicators. A primary care team (PCT) from the area took part in the first study carried out in Spain on adverse effects in primary care (APEAS Study). The CRMU can give impetus to strategic lines of safety. The preparation of a strategy defining specific aims has helped in the introduction of patient safety activities and along with the proposed indicators enables the impact of the intervention to be assessed.

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

ERIC Educational Resources Information Center

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

2016-01-01

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

NASA's post-Challenger safety program - Themes and thrusts

NASA Technical Reports Server (NTRS)

Rodney, G. A.

1988-01-01

The range of managerial, technical, and procedural initiatives implemented by NASA's post-Challenger safety program is reviewed. The recommendations made by the Rogers Commission, the NASA post-Challenger review of Shuttle design, the Congressional investigation of the accident, the National Research Council, the Aerospace Safety Advisory Panel, and NASA internal advisory panels and studies are summarized. NASA safety initiatives regarding improved organizational accountability for safety, upgraded analytical techniques and methodologies for risk assessment and management, procedural initiatives in problem reporting and corrective-action tracking, ground processing, maintenance documentation, and improved technologies are discussed. Safety issues relevant to the planned Space Station are examined.

77 FR 24392 - Approval and Promulgation of Implementation Plans; Tennessee; Regional Haze State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

... located across a broad geographic area and emit fine particles (e.g., sulfates, nitrates, organic carbon, elemental carbon, and soil dust), and their precursors (e.g., sulfur dioxide (SO 2 ), nitrogen oxides (NO X... 13045, Protection of Children From Environmental Health Risks and Safety Risks Protection of Children...

Systematic review of qualitative literature on occupational health and safety legislation and regulatory enforcement planning and implementation.

PubMed

MacEachen, Ellen; Kosny, Agnieszka; Ståhl, Christian; O'Hagan, Fergal; Redgrift, Lisa; Sanford, Sarah; Carrasco, Christine; Tompa, Emile; Mahood, Quenby

2016-01-01

The ability of occupational health and safety (OHS) legislation and regulatory enforcement to prevent workplace injuries and illnesses is contingent on political, economic, and organizational conditions. This systematic review of qualitative research articles considers how OHS legislation and regulatory enforcement are planned and implemented. A comprehensive search of peer-reviewed, English-language articles published between 1990 and 2013 yielded 11 947 articles. We identified 34 qualitative articles as relevant, 18 of which passed our quality assessment and proceeded to meta-ethnographic synthesis. The synthesis yielded four main themes: OHS regulation formation, regulation challenges, inspector organization, and worker representation in OHS. It illuminates how OHS legislation can be based on normative suppositions about worker and employer behavior and shaped by economic and political resources of parties. It also shows how implementation of OHS legislation is affected by "general duty" law, agency coordination, resourcing of inspectorates, and ability of workers to participate in the system. The review identifies methodological gaps and identifies promising areas for further research in "grey" zones of legislation implementation.

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.

SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

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

Yang, R; Wang, J

2014-06-15

Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, includingmore » 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy.« less

Project health and safety plan for the Gunite and Associated Tanks at Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

Abston, J.P.

1997-04-01

The Lockheed Martin Energy Systems, Inc. (Energy Systems) policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at the Gunite and Associated Tanks (GAAT) in the North and South Tank Farms (NTF and STF) at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to health and safety (H and S) issues. The policy and procedures in this plan apply to all GAAT operations in the NTF and STF. The provisions of this plan are to bemore » carried out whenever activities identifies s part of the GAAT are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices in order to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to the air. This plan explains additional task-specific health and safety requirements such as the Site Safety and health Addendum and Activity Hazard Analysis, which should be used in concert with this plan and existing established procedures.« less

National plan to enhance aviation safety through human factors improvements

NASA Technical Reports Server (NTRS)

Foushee, Clay

1990-01-01

The purpose of this section of the plan is to establish a development and implementation strategy plan for improving safety and efficiency in the Air Traffic Control (ATC) system. These improvements will be achieved through the proper applications of human factors considerations to the present and future systems. The program will have four basic goals: (1) prepare for the future system through proper hiring and training; (2) develop a controller work station team concept (managing human errors); (3) understand and address the human factors implications of negative system results; and (4) define the proper division of responsibilities and interactions between the human and the machine in ATC systems. This plan addresses six program elements which together address the overall purpose. The six program elements are: (1) determine principles of human-centered automation that will enhance aviation safety and the efficiency of the air traffic controller; (2) provide new and/or enhanced methods and techniques to measure, assess, and improve human performance in the ATC environment; (3) determine system needs and methods for information transfer between and within controller teams and between controller teams and the cockpit; (4) determine how new controller work station technology can optimally be applied and integrated to enhance safety and efficiency; (5) assess training needs and develop improved techniques and strategies for selection, training, and evaluation of controllers; and (6) develop standards, methods, and procedures for the certification and validation of human engineering in the design, testing, and implementation of any hardware or software system element which affects information flow to or from the human.

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

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

CARTER, R.P.

1999-11-19

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

A culture of safety: a business strategy for medical practices.

PubMed

Saxton, James W; Finkelstein, Maggie M; Marles, Adam F

2012-01-01

Physician practices can enhance their economics by taking patient safety to a new level within their practices. Patient safety has a lot to do with systems and processes that occur not only at the hospital but also within a physician's practice. Historically, patient safety measures have been hospital-focused and -driven, largely due to available resources; however, physician practices can impact patient safety, efficiently and effectively, with a methodical plan involving assessment, prioritization, and compliance. With the ever-increasing focus of reimbursement on quality and patient safety, physician practices that implement a true culture of safety now could see future economic benefits using this business strategy.

International perspectives on food safety and regulations - a need for harmonized regulations: perspectives in China.

PubMed

Liu, Xiumei

2014-08-01

Food safety is a major livelihood issue and a priority concern in China. Since the Food Safety Law of the People's Republic of China was issued in 2009, the food safety control system has been strengthened through, inter alia, the Food Safety Risk Surveillance System, the Food Safety Risk Assessment System and the Food Safety Standards System. In accordance with the Food Safety Law and regulations for implementation, the Ministry of Health released the 'Twelfth Five-year Plan' of Food Safety Standards. The existing 5000 food-related standards will be integrated. Notwithstanding, the supervision system in China needs to be further improved and strengthened. © 2014 Society of Chemical Industry.

LANL Safety Conscious Work Environment (SCWE) Self-Assessment

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

Hargis, Barbara C.

2014-01-29

On December 21, 2012 Secretary of Energy Chu transmitted to the Defense Nuclear Facilities Safety Board (DNFSB) revised commitments on the implementation plan for Safety Culture at the Waste Treatment and Immobilization Plant. Action 2-5 was revised to require contractors and federal organizations to complete Safety Conscious Work Environment (SCWE) selfassessments and provide reports to the appropriate U.S. Department of Energy (DOE) - Headquarters Program Office by September 2013. Los Alamos National Laboratory (LANL) planned and conducted a Safety Conscious Work Environment (SCWE) Self-Assessment over the time period July through August, 2013 in accordance with the SCWE Self-Assessment Guidance providedmore » by DOE. Significant field work was conducted over the 2-week period August 5-16, 2013. The purpose of the self-assessment was to evaluate whether programs and processes associated with a SCWE are in place and whether they are effective in supporting and promoting a SCWE.« less

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003. (Arabic)

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Arabic-language guide for parents outlines the goals and…

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003. (Gujarati).

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Gujarati-language guide for parents outlines the goals and…

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003. (Chinese)

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Chinese-language guide for parents outlines the goals and…

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003. (Urdu)

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Urdu-language guide for parents outlines the goals and…

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003. (Korean).

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Korean-language guide for parents outlines the goals and…

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003.

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This guide for parents outlines the goals and characteristics of the…

A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003. (Russian).

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Russian-language guide for parents outlines the goals and…

Katrina Kids! Helping Kids Exposed to Population-Wide Trauma

ERIC Educational Resources Information Center

Bender, William N.; Sims, Rebecca

2007-01-01

Although schools have implemented school safety plans as a result of the violence witnessed on rare occasions in schools today, schools are less likely to be prepared for emergencies such as Katrina or 9/11; this is true even for schools in locations prone to hurricanes, tornadoes, or earthquakes. Whereas disaster plans typically involve school…

Massachusetts Public Fire and Safety Education Curriculum Planning Guidebook. Second Version.

ERIC Educational Resources Information Center

Massachusetts Department of Fire Services, Stow.

This updated curriculum planning guidebook is a resource for fire educators throughout the state of Massachusetts. It is designed to be a tool in efforts to: identify fire problems in the community; select appropriate behaviors and lessons to correct the fire problems; design fire education programs; and implement and evaluate the programs. The…

Investigating and Learning Lessons from Early Experiences of Implementing ePrescribing Systems into NHS Hospitals: A Questionnaire Study

PubMed Central

Cresswell, Kathrin; Coleman, Jamie; Slee, Ann; Williams, Robin; Sheikh, Aziz

2013-01-01

Background ePrescribing systems have significant potential to improve the safety and efficiency of healthcare, but they need to be carefully selected and implemented to maximise benefits. Implementations in English hospitals are in the early stages and there is a lack of standards guiding the procurement, functional specifications, and expected benefits. We sought to provide an updated overview of the current picture in relation to implementation of ePrescribing systems, explore existing strategies, and identify early lessons learned. Methods A descriptive questionnaire-based study, which included closed and free text questions and involved both quantitative and qualitative analysis of the data generated. Results We obtained responses from 85 of 108 NHS staff (78.7% response rate). At least 6% (n = 10) of the 168 English NHS Trusts have already implemented ePrescribing systems, 2% (n = 4) have no plans of implementing, and 34% (n = 55) are planning to implement with intended rapid implementation timelines driven by high expectations surrounding improved safety and efficiency of care. The majority are unclear as to which system to choose, but integration with existing systems and sophisticated decision support functionality are important decisive factors. Participants highlighted the need for increased guidance in relation to implementation strategy, system choice and standards, as well as the need for top-level management support to adequately resource the project. Although some early benefits were reported by hospitals that had already implemented, the hoped for benefits relating to improved efficiency and cost-savings remain elusive due to a lack of system maturity. Conclusions Whilst few have begun implementation, there is considerable interest in ePrescribing systems with ambitious timelines amongst those hospitals that are planning implementations. In order to ensure maximum chances of realising benefits, there is a need for increased guidance in relation to implementation strategy, system choice and standards, as well as increased financial resources to fund local activities. PMID:23335961

Patient safety in the care of mentally ill people in Switzerland: Action plan 2016

PubMed

Richard, Aline; Mascherek, Anna C; Schwappach, David L B

2017-01-01

Background: Patient safety in mental healthcare has not attracted great attention yet, although the burden and the prevalence of mental diseases are high. The risk of errors with potential for harm of patients, such as aggression against self and others or non-drug treatment errors is particularly high in this vulnerable group. Aim: To develop priority topics and strategies for action to foster patient safety in mental healthcare. Method: The Swiss patient safety foundation together with experts conducted round table discussions and a Delphi questionnaire to define topics along the treatment pathway, and to prioritise these topics. Finally, fields of action were developed. Results: An action plan was developed including the definition and prioritization of 9 topics where errors may occur. A global rating task revealed errors concerning diagnostics and structural errors as most important. This led to the development of 4 fields of action (awareness raising, research, implementation, and education and training) including practice-oriented potential starting points to enhance patient safety. Conclusions: The action plan highlights issues of high concern for patient safety in mental healthcare. It serves as a starting point for the development of strategies for action as well as of concrete activities.

Cultivating quality: implementing standardized reporting and safety checklists.

PubMed

Stevens, James D; Bader, Mary Kay; Luna, Michele A; Johnson, Linda M

2011-05-01

Developing processes to create a culture of safety. It's estimated that as many as 98,000 hospitalized patients lose their lives each year in the United States because of medical errors that could have been prevented. While standardized reporting and safety checklists have been shown to improve communication and patient safety, implementation of these tools in hospitals remains challenging. To implement standardized nurse-to-nurse reporting along with safety checklists at Mission Hospital, a 522-bed facility in Mission Viejo, California, using Lewin's change theory and Knowles's adult learning theory. Nurses were tested to assess their knowledge of the standardized nurse-to-physician reporting method called SBAR (Situation, Background, Assessment, Recommendation), their understanding of the concept of the nurse-to-nurse reporting method called SBAP (Situation, Background, Assessment, Plan), and the use of safety checklists. Then, after viewing a 22-minute educational video, they were retested. A total of 482 nurses completed the pretest and posttest. On the pretest, the nurses' mean score was 15.935 points (SD, 3.529) out of 20. On the posttest, the mean score was 18.94 (SD, 1.53) out of 20. A Wilcoxon matched-pairs signed-rank test was performed; the two-tailed P value was < 0.001. The application of Lewin's change theory and Knowles's adult learning theory was successful in the process of implementing standardized nurse-to-nurse reporting and safety checklists at Mission Hospital.

Sounding rocket and balloon flight safety philosophy and methodologies

NASA Technical Reports Server (NTRS)

Beyma, R. J.

1986-01-01

NASA's sounding rocket and balloon goal is to successfully and safely perform scientific research. This is reflected in the design, planning, and conduct of sounding rocket and balloon operations. The purpose of this paper is to acquaint the sounding rocket and balloon scientific community with flight safety philosophy and methodologies, and how range safety affects their programs. This paper presents the flight safety philosophy for protecting the public against the risk created by the conduct of sounding rocket and balloon operations. The flight safety criteria used to implement this philosophy are defined and the methodologies used to calculate mission risk are described.

Prototype Input and Output Data Elements for the Occupational Health and Safety Information System

NASA Technical Reports Server (NTRS)

Whyte, A. A.

1980-01-01

The National Aeronautics and Space Administration plans to implement a NASA-wide computerized information system for occupational health and safety. The system is necessary to administer the occupational health and safety programs and to meet the legal and regulatory reporting, recordkeeping, and surveillance requirements. Some of the potential data elements that NASA will require as input and output for the new occupational health and safety information system are illustrated. The data elements are shown on sample forms that have been compiled from various sources, including NASA Centers and industry.

Wildland Fire Management Plan

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

Schwager, K.

The Wildland Fire Management Plan (FMP) for Brookhaven National Lab (BNL) is written to comply with Department of Energy (DOE) Integrated Safety Management Policy; Federal Wildland Fire Management Policy and Program Review; and Wildland and Prescribed Fire Management Policy and Implementation Procedures Reference Guide. This current plan incorporates changes resulting from new policies on the national level as well as significant changes to available resources and other emerging issues, and replaces BNL's Wildland FMP dated 2014.

Older road user research plan

DOT National Transportation Integrated Search

2001-08-01

In 1999, the Transportation Research Board convened a meeting to discuss older road user issues. Many research and implementation ideas were generated at that conference, though not all of them fell within the National Highway Traffic Safety Administ...

Developing Louisiana crash reduction factors.

DOT National Transportation Integrated Search

2013-10-01

The Louisiana Strategic Highway Safety Plan is to reach the goal of Destination Zero Death on Louisiana : roadways. This tall order calls for implementing all feasible crash countermeasures. A great number of crash : countermeasures have been identif...

Evolution of a holistic systems approach to planning and managing road safety: the Victorian case study, 1970-2015.

PubMed

Muir, Carlyn; Johnston, Ian R; Howard, Eric

2018-06-01

The Victorian Safe System approach to road safety slowly evolved from a combination of the Swedish Vision Zero philosophy and the Sustainable Safety model developed by the Dutch. The Safe System approach reframes the way in which road safety is viewed and managed. This paper presents a case study of the institutional change required to underpin the transformation to a holistic approach to planning and managing road safety in Victoria, Australia. The adoption and implementation of a Safe System approach require strong institutional leadership and close cooperation among all the key agencies involved, and Victoria was fortunate in that it had a long history of strong interagency mechanisms in place. However, the challenges in the implementation of the Safe System strategy in Victoria are generally neither technical nor scientific; they are predominantly social and political. While many governments purport to develop strategies based on Safe System thinking, on-the-ground action still very much depends on what politicians perceive to be publicly acceptable, and Victoria is no exception. This is a case study of the complexity of institutional change and is presented in the hope that the lessons may prove useful for others seeking to adopt more holistic planning and management of road safety. There is still much work to be done in Victoria, but the institutional cultural shift has taken root. Ongoing efforts must be continued to achieve alert and compliant road users; however, major underpinning benefits will be achieved through focusing on road network safety improvements (achieving forgiving infrastructure, such as wire rope barriers) in conjunction with reviews of posted speed limits (to be set in response to the level of protection offered by the road infrastructure) and by the progressive introduction into the fleet of modern vehicle safety features. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Vaccine safety monitoring systems in developing countries: an example of the Vietnam model.

PubMed

Ali, Mohammad; Rath, Barbara; Thiem, Vu Dinh

2015-01-01

Only few health intervention programs have been as successful as vaccination programs with respect to preventing morbidity and mortality in developing countries. However, the success of a vaccination program is threatened by rumors and misunderstanding about the risks of vaccines. It is short-sighted to plan the introduction of vaccines into developing countries unless effective vaccine safety monitoring systems are in place. Such systems that track adverse events following immunization (AEFI) is currently lacking in most developing countries. Therefore, any rumor may affect the entire vaccination program. Public health authorities should implement the safety monitoring system of vaccines, and disseminate safety issues in a proactive mode. Effective safety surveillance systems should allow for the conduct of both traditional and alternative epidemiologic studies through the use of prospective data sets. The vaccine safety data link implemented in Vietnam in mid-2002 indicates that it is feasible to establish a vaccine safety monitoring system for the communication of vaccine safety in developing countries. The data link provided the investigators an opportunity to evaluate AEFI related to measles vaccine. Implementing such vaccine safety monitoring system is useful in all developing countries. The system should be able to make objective and clear communication regarding safety issues of vaccines, and the data should be reported to the public on a regular basis for maintaining their confidence in vaccination programs.

Safety analysis and review system (SARS) assessment report

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

Browne, E.T.

1981-03-01

Under DOE Order 5481.1, Safety Analysis and Review System for DOE Operations, safety analyses are required for DOE projects in order to ensure that: (1) potential hazards are systematically identified; (2) potential impacts are analyzed; (3) reasonable measures have been taken to eliminate, control, or mitigate the hazards; and (4) there is documented management authorization of the DOE operation based on an objective assessment of the adequacy of the safety analysis. This report is intended to provide the DOE Office of Plans and Technology Assessment (OPTA) with an independent evaluation of the adequacy of the ongoing safety analysis effort. Asmore » part of this effort, a number of site visits and interviews were conducted, and FE SARS documents were reviewed. The latter included SARS Implementation Plans for a number of FE field offices, as well as safety analysis reports completed for certain FE operations. This report summarizes SARS related efforts at the DOE field offices visited and evaluates the extent to which they fulfill the requirements of DOE 5481.1.« less

Mission and Safety Critical (MASC) plans for the MASC Kernel simulation

NASA Technical Reports Server (NTRS)

1991-01-01

This report discusses a prototype for Mission and Safety Critical (MASC) kernel simulation which explains the intended approach and how the simulation will be used. Smalltalk is chosen for the simulation because of usefulness in quickly building working models of the systems and its object-oriented approach to software. A scenario is also introduced to give details about how the simulation works. The eventual system will be a fully object-oriented one implemented in Ada via Dragoon. To implement the simulation, a scenario using elements typical of those in the Space Station, was created.

Planning for and implementing an emerald ash borer-induced forest restoration program in municipal woodlands in Oakville, Ontario

Treesearch

Peter A. Williams; Candace. Karandiuk

2017-01-01

Oakville is an urban municipality with 846 ha of woodland. Management priorities are to maintain forest health, environmental health, and safety; wood production is a minor objective. The town developed a comprehensive strategy to plan for emerald ash borer (EAB; Agrilus planipennis) induced ash mortality and forest restoration. Oakville has begun...

Costs of Food Safety Investments in the Meat and Poultry Slaughter Industries.

PubMed

Viator, Catherine L; Muth, Mary K; Brophy, Jenna E; Noyes, Gary

2017-02-01

To develop regulations efficiently, federal agencies need to know the costs of implementing various regulatory alternatives. As the regulatory agency responsible for the safety of meat and poultry products, the U.S. Dept. of Agriculture's Food Safety and Inspection Service is interested in the costs borne by meat and poultry establishments. This study estimated the costs of developing, validating, and reassessing hazard analysis and critical control points (HACCP), sanitary standard operating procedures (SSOP), and sampling plans; food safety training for new employees; antimicrobial equipment and solutions; sanitizing equipment; third-party audits; and microbial tests. Using results from an in-person expert consultation, web searches, and contacts with vendors, we estimated capital equipment, labor, materials, and other costs associated with these investments. Results are presented by establishment size (small and large) and species (beef, pork, chicken, and turkey), when applicable. For example, the cost of developing food safety plans, such as HACCP, SSOP, and sampling plans, can range from approximately $6000 to $87000, depending on the type of plan and establishment size. Food safety training costs from approximately $120 to $2500 per employee, depending on the course and type of employee. The costs of third-party audits range from approximately $13000 to $24000 per audit, and establishments are often subject to multiple audits per year. Knowing the cost of these investments will allow researchers and regulators to better assess the effects of food safety regulations and evaluate cost-effective alternatives. © 2017 Institute of Food Technologists®.

Items Supporting the Hanford Internal Dosimetry Program Implementation of the IMBA Computer Code

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

Carbaugh, Eugene H.; Bihl, Donald E.

2008-01-07

The Hanford Internal Dosimetry Program has adopted the computer code IMBA (Integrated Modules for Bioassay Analysis) as its primary code for bioassay data evaluation and dose assessment using methodologies of ICRP Publications 60, 66, 67, 68, and 78. The adoption of this code was part of the implementation plan for the June 8, 2007 amendments to 10 CFR 835. This information release includes action items unique to IMBA that were required by PNNL quality assurance standards for implementation of safety software. Copie of the IMBA software verification test plan and the outline of the briefing given to new users aremore » also included.« less

Application of demographic analysis to pedestrian safety : [project summary].

DOT National Transportation Integrated Search

2017-05-01

FDOT has been working diligently to improve its facilities for pedestrians and cyclists, including : initiatives like the Complete Streets Policy and Implementation Plan. However, one of the : challenges facing FDOT is targeting those areas of greate...

Data needs for tree removal crash modification factors on Arizona state highways.

DOT National Transportation Integrated Search

2016-07-01

The Arizona Department of Transportation (ADOT) Roadway Departure Safety Implementation Plan (RDSIP) has : identified tree removal as a feasible countermeasure to reduce roadway departure crash frequency or severity. : Previous ADOT work has identifi...

Safety assessment in plant layout design using indexing approach: implementing inherent safety perspective. Part 1 - guideword applicability and method description.

PubMed

Tugnoli, Alessandro; Khan, Faisal; Amyotte, Paul; Cozzani, Valerio

2008-12-15

Layout planning plays a key role in the inherent safety performance of process plants since this design feature controls the possibility of accidental chain-events and the magnitude of possible consequences. A lack of suitable methods to promote the effective implementation of inherent safety in layout design calls for the development of new techniques and methods. In the present paper, a safety assessment approach suitable for layout design in the critical early phase is proposed. The concept of inherent safety is implemented within this safety assessment; the approach is based on an integrated assessment of inherent safety guideword applicability within the constraints typically present in layout design. Application of these guidewords is evaluated along with unit hazards and control devices to quantitatively map the safety performance of different layout options. Moreover, the economic aspects related to safety and inherent safety are evaluated by the method. Specific sub-indices are developed within the integrated safety assessment system to analyze and quantify the hazard related to domino effects. The proposed approach is quick in application, auditable and shares a common framework applicable in other phases of the design lifecycle (e.g. process design). The present work is divided in two parts: Part 1 (current paper) presents the application of inherent safety guidelines in layout design and the index method for safety assessment; Part 2 (accompanying paper) describes the domino hazard sub-index and demonstrates the proposed approach with a case study, thus evidencing the introduction of inherent safety features in layout design.

Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Technology

PubMed Central

Yang, Ruijie; Wang, Junjie; Zhang, Xile; Sun, Haitao; Gao, Yang; Liu, Lu; Lin, Lei

2014-01-01

Objective. To explore the implementation of incident learning for quality management of radiotherapy in a new established radiotherapy program. Materials and Methods. With reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically established for reporting, investigating, and learning of individual incidents. The incidents that occurred in external beam radiotherapy from February, 2012, to February, 2014, were reported. Results. A total of 28 near misses and 5 incidents were reported. Among them, 5 originated in imaging for planning, 25 in planning, and 1 in plan transfer, commissioning, and delivery, respectively. One near miss/incident was classified as wrong patient, 7 wrong sites, 6 wrong laterality, and 5 wrong dose. Five reported incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, and inadequate training contributed to 19, 15, and 12 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4. Conclusion. Effective implementation of incident learning can reduce the occurrence of near misses/incidents and enhance the culture of safety. PMID:25140309

The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study.

PubMed

O'Hara, Jane K; Lawton, Rebecca J; Armitage, Gerry; Sheard, Laura; Marsh, Claire; Cocks, Kim; McEachan, Rosie R C; Reynolds, Caroline; Watt, Ian; Wright, John

2016-11-28

There is growing interest in the role of patients in improving patient safety. One such role is providing feedback on the safety of their care. Here we describe the development and feasibility testing of an intervention that collects patient feedback on patient safety, brings together staff to consider this feedback and to plan improvement strategies. We address two research questions: i) to explore the feasibility of the process of systematically collecting feedback from patients about the safety of care as part of the PRASE intervention; and, ii) to explore the feasibility and acceptability of the PRASE intervention for staff, and to understand more about how staff use the patient feedback for service improvement. We conducted a feasibility study using a wait-list controlled design across six wards within an acute teaching hospital. Intervention wards were asked to participate in two cycles of the PRASE (Patient Reporting & Action for a Safe Environment) intervention across a six-month period. Participants were patients on participating wards. To explore the acceptability of the intervention for staff, observations of action planning meetings, interviews with a lead person for the intervention on each ward and recorded researcher reflections were analysed thematically and synthesised. Recruitment of patients using computer tablets at their bedside was straightforward, with the majority of patients willing and able to provide feedback. Randomisation of the intervention was acceptable to staff, with no evidence of differential response rates between intervention and control groups. In general, ward staff were positive about the use of patient feedback for service improvement and were able to use the feedback as a basis for action planning, although engagement with the process was variable. Gathering a multidisciplinary team together for action planning was found to be challenging, and implementing action plans was sometimes hindered by the need to co-ordinate action across multiple services. The PRASE intervention was found to be acceptable to staff and patients. However, before proceeding to a full cluster randomised controlled trial, the intervention requires adaptation to account for the difficulties in implementing action plans within three months, the need for a facilitator to support the action planning meetings, and the provision of training and senior management support for participating ward teams. The PRASE intervention represents a promising method for the systematic collection of patient feedback about the safety of hospital care.

Effects of using the developing nurses' thinking model on nursing students' diagnostic accuracy.

PubMed

Tesoro, Mary Gay

2012-08-01

This quasi-experimental study tested the effectiveness of an educational model, Developing Nurses' Thinking (DNT), on nursing students' clinical reasoning to achieve patient safety. Teaching nursing students to develop effective thinking habits that promote positive patient outcomes and patient safety is a challenging endeavor. Positive patient outcomes and safety are achieved when nurses accurately interpret data and subsequently implement appropriate plans of care. This study's pretest-posttest design determined whether use of the DNT model during 2 weeks of clinical postconferences improved nursing students' (N = 83) diagnostic accuracy. The DNT model helps students to integrate four constructs-patient safety, domain knowledge, critical thinking processes, and repeated practice-to guide their thinking when interpreting patient data and developing effective plans of care. The posttest scores of students from the intervention group showed statistically significant improvement in accuracy. Copyright 2012, SLACK Incorporated.

Advancing perinatal patient safety through application of safety science principles using health IT.

PubMed

Webb, Jennifer; Sorensen, Asta; Sommerness, Samantha; Lasater, Beth; Mistry, Kamila; Kahwati, Leila

2017-12-19

The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety. Semi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality's (AHRQ's) Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation. Analysis of interview transcripts was used to characterize the process and experience of using health IT for applying safety science principles to L&D unit processes. Forty-six L&D units from 10 states completed participation in SPPC program implementation; thirty-two (70%) reported the use of health IT as an enabling strategy for their local implementation. Health IT was used to improve standardization of processes, use of independent checks, and to facilitate learning from defects. L&D units standardized care processes through use of electronic health record (EHR)-based order sets and use of smart pumps and other technology to improve medication safety. Units also standardized EHR documentation, particularly related to electronic fetal monitoring (EFM) and shoulder dystocia. Cognitive aids and tools were integrated into EHR and care workflows to create independent checks such as checklists, risk assessments, and communication handoff tools. Units also used data from EHRs to monitor processes of care to learn from defects. Units experienced several challenges incorporating health IT, including obtaining organization approval, working with their busy IT departments, and retrieving standardized data from health IT systems. Use of health IT played an integral part in the planning and implementation of SPPC for participating L&D units. Use of health IT is an encouraging approach for incorporating safety science principles into care to improve perinatal safety and should be incorporated into materials to facilitate the implementation of perinatal safety initiatives.

[Expertise level of occupational health physician, implementation of occupational safety and health management system (OSHMS) and occupational safety and health activity level in Japan in the companies listed on Tokyo Stock Exchange first section].

PubMed

Ikeda, Yukiko; Kameda, Takashi; Shirakawa, Chie; Nagata, Tomohisa; Zama, Satoko; Kayashima, Koutarou; Kobayashi, Yuuichi; Mori, Koji

2007-12-01

By enforcement of the revised Japanese Industrial Safety and Health Law on April, 2006, the implementation of OSHMS seems to be expanding and encouraged. In OSHMS of Japan, however, the occupational health aspects have not been put into operated, while only occupational safety aspects have been prioritized. To clarify the issues to deploy OSHMS with occupational health aspects, we conducted a mail survey of 1,581 companies listed on the Tokyo Stock Market First Section in December, 2004. The effective responses were 267 (16.9%). The number of companies which had installed OSHMS, those that planned to install OSHMS and those had no plan for OSHMS were 62 (23.2%), 82 (30.7%) and 123 (46.1%), respectively. Only 12 companies include the complete OH activities in the installed OSHMS. A significant relationship was observed among expertise of OH physicians, actual role and responsibility of OH physicians, installation of OSHMS and OH services quality level. To deploy OSHMS well-balanced for health and safety aspects in present Japan, it was suggested that the education regarding OH operation in OSHMS was necessary to the person in charge of OSHMS in each company, and the participation by OH physicians to operate OSHMS, especially OH physicians with expertise, was essential.

77 FR 66638 - The Standard on Process Safety Management of Highly Hazardous Chemicals; Extension of the Office...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

... analyses and the development of other elements of the standard; developing a written action plan for..., revalidating and retaining the process hazard analysis; developing and implementing written operating [[Page 66639

Patient Safety Culture in Mutual Insurance Companies in Spain.

PubMed

Manzanera, Rafael; Mira, José Joaquín; Plana, Manel; Moya, Daniel; Guilabert, Mercedes; Ortner, Jordi

2017-02-22

The aim of the study was to assess the safety culture in a mutual insurance sector, searching for improvement opportunities. This sector offers health insurance for work-related injuries and occupational illnesses and represents an annual volume of patients corresponding to approximately 10% of the working population in Europe. A cross-sectional study was conducted to assess the safety culture in the mutual insurance sector in Spain. All physicians, nurses, and physiotherapists (N = 816) working in the organization in hospitals, outpatient clinics, and managerial settings were invited to reply to an online survey. A total of 499 professionals completed the questionnaire (response rate, 61%). Two dimensions were assessed: attitudinal (5 items) and instrumental (5 items). There were no differences between professional profiles or centers in the attitudinal (7.8; standard deviation, 1.3; 95% confidence interval, 7.6-7.9) or instrumental (8.5; standard deviation, 1.0; 95% confidence interval, 8.5-8.6) factors. The lowest level of implementation (<9 points) was related to the following: open disclosure after an adverse event (73%), having a quality and safety plan (75%), prioritizing the improvement of patient care (75%), and involving patients when making decisions on potential treatments (63%). Managers showed lower scores than the rest of professionals' groups (P < 0.05). This intent is to introduce a patient safety culture assessment in the mutual insurance companies. These results may encourage the implementation of quality and safety plans in this sector by paying more attention to attitudinal aspects.

Hazards in the hospital.

PubMed

Seibert, P J

1994-02-01

In an earlier article (JAVMA, Jan 15, 1994), the author outlined some of the first steps necessary in establishing a hospital safety program that will comply with current Occupational Safety and Health Administration (OSHA) guidelines. One of the main concerns of the OSHA guidelines is that there be written plans for managing hazardous materials, performing dangerous jobs, and dealing with other potential safety problems. In this article, the author discusses potentially hazardous situations commonly found in veterinary practices and provides details on how to minimize the risks associated with those situations and how to implement safety procedures that will comply with the OSHA guidelines.

Joint FAM/Line Management Assessment Report on LLNL Machine Guarding Safety Program

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

Armstrong, J. J.

2016-07-19

The LLNL Safety Program for Machine Guarding is implemented to comply with requirements in the ES&H Manual Document 11.2, "Hazards-General and Miscellaneous," Section 13 Machine Guarding (Rev 18, issued Dec. 15, 2015). The primary goal of this LLNL Safety Program is to ensure that LLNL operations involving machine guarding are managed so that workers, equipment and government property are adequately protected. This means that all such operations are planned and approved using the Integrated Safety Management System to provide the most cost effective and safest means available to support the LLNL mission.

The Johns Hopkins Hospital: identifying and addressing risks and safety issues.

PubMed

Paine, Lori A; Baker, David R; Rosenstein, Beryl; Pronovost, Peter J

2004-10-01

At The Johns Hopkins Hospital (JHH), a culture of safety refers to the presence of characteristics such as the belief that harm is untenable and the use of a systems approach to analyzing safety issues. The leadership of JHH provides strategic planning guidance for safety and improvement initiatives, involves the patient safety committee in capital investment allocation decisions and in designing and planning new hospital facilities, and ensures that safety and quality head the agenda of board-of-trustees meetings. Although JHH takes a systems approach, structures such as monitoring staff behavior trends are used to hold people accountable for job performance. JHH encountered three major hurdles in implementing and sustaining a culture of safety. First, JHH's decentralized organizational structure contributes to a silo effect that limits the spread of ideas, practices, and culture. JHH intends to create an internal collaborative of departmental safety initiatives to foster opportunities for units to share ideas and results. Second, in response to the challenge of encouraging teams to think and act in an interdisciplinary fashion, communication and teamwork training are being used to enhance the effectiveness of interdisciplinary teams. Further development of valid and meaningful safety-related measurement and data collection methodologies is JHH's largest remaining challenge.

A performance improvement plan to increase nurse adherence to use of medication safety software.

PubMed

Gavriloff, Carrie

2012-08-01

Nurses can protect patients receiving intravenous (IV) medication by using medication safety software to program "smart" pumps to administer IV medications. After a patient safety event identified inconsistent use of medication safety software by nurses, a performance improvement team implemented the Deming Cycle performance improvement methodology. The combined use of improved direct care nurse communication, programming strategies, staff education, medication safety champions, adherence monitoring, and technology acquisition resulted in a statistically significant (p < .001) increase in nurse adherence to using medication safety software from 28% to above 85%, exceeding national benchmark adherence rates (Cohen, Cooke, Husch & Woodley, 2007; Carefusion, 2011). Copyright © 2012 Elsevier Inc. All rights reserved.

Predicting the effectiveness of road safety campaigns through alternative research designs.

PubMed

Adamos, Giannis; Nathanail, Eftihia

2016-12-01

A large number of road safety communication campaigns have been designed and implemented in the recent years; however their explicit impact on driving behavior and road accident rates has been estimated in a rather low proportion. Based on the findings of the evaluation of three road safety communication campaigns addressing the issues of drinking and driving, seat belt usage, and driving fatigue, this paper applies different types of research designs (i.e., experimental, quasi-experimental, and non-experimental designs), when estimating the effectiveness of road safety campaigns, implements a cross-design assessment, and conducts a cross-campaign evaluation. An integrated evaluation plan was developed, taking into account the structure of evaluation questions, the definition of measurable variables, the separation of the target audience into intervention (exposed to the campaign) and control (not exposed to the campaign) groups, the selection of alternative research designs, and the appropriate data collection methods and techniques. Evaluating the implementation of different research designs in estimating the effectiveness of road safety campaigns, results showed that the separate pre-post samples design demonstrated better predictability than other designs, especially in data obtained from the intervention group after the realization of the campaign. The more constructs that were added to the independent variables, the higher the values of the predictability were. The construct that most affects behavior is intention, whereas the rest of the constructs have a lower impact on behavior. This is particularly significant in the Health Belief Model (HBM). On the other hand, behavioral beliefs, normative beliefs, and descriptive norms, are significant parameters for predicting intention according to the Theory of Planned Behavior (TPB). The theoretical and applied implications of alternative research designs and their applicability in the evaluation of road safety campaigns are provided by this study. Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.

An international review of the challenges associated with securing 'buy-in' for water safety plans within providers of drinking water supplies.

PubMed

Summerill, Corinna; Smith, Jen; Webster, James; Pollard, Simon

2010-06-01

Since publication of the 3rd Edition of the World Health Organisation (WHO) Drinking Water Quality guidelines, global adoption of water safety plans (WSPs) has been gathering momentum. Most guidance lists managerial commitment and 'buy-in' as critical to the success of WSP implementation; yet the detail on how to generate it is lacking. This commentary discusses aspects of managerial commitment to WSPs. We argue that the public health motivator should be clearer and a paramount objective and not lost among other, albeit legitimate, drivers such as political or regulatory pressures and financial efficiency.

Consensus document regarding cardiovascular safety at sports arenas: position stand from the European Association of Cardiovascular Prevention and Rehabilitation (EACPR), section of Sports Cardiology.

PubMed

Borjesson, Mats; Serratosa, Luis; Carre, Francois; Corrado, Domenico; Drezner, Jonathan; Dugmore, Dorian L; Heidbuchel, Hein H; Mellwig, Klaus-Peter; Panhuyzen-Goedkoop, Nicole M; Papadakis, Michael; Rasmusen, Hanne; Sharma, Sanjay; Solberg, Erik E; van Buuren, Frank; Pelliccia, Antonio

2011-09-01

Mass gathering events in sports arenas create challenges regarding the cardiovascular safety of both athletes and spectators. A comprehensive medical action plan, to ensure properly applied cardiopulmonary resuscitation, and wide availability and use of automated external defibrillators (AEDs), is essential to improving survival from sudden cardiac arrest at sporting events. This paper outlines minimum standards for cardiovascular care to assist in the planning of mass gathering sports events across Europe with the intention of local adaptation at individual sports arenas, to ensure the full implementation of the chain of survival.

3S (Safeguards, Security, Safety) based pyroprocessing facility safety evaluation plan

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

Ku, J.H.; Choung, W.M.; You, G.S.

The big advantage of pyroprocessing for the management of spent fuels against the conventional reprocessing technologies lies in its proliferation resistance since the pure plutonium cannot be separated from the spent fuel. The extracted materials can be directly used as metal fuel in a fast reactor, and pyroprocessing reduces drastically the volume and heat load of the spent fuel. KAERI has implemented the SBD (Safeguards-By-Design) concept in nuclear fuel cycle facilities. The goal of SBD is to integrate international safeguards into the entire facility design process since the very beginning of the design phase. This paper presents a safety evaluationmore » plan using a conceptual design of a reference pyroprocessing facility, in which 3S (Safeguards, Security, Safety)-By-Design (3SBD) concept is integrated from early conceptual design phase. The purpose of this paper is to establish an advanced pyroprocessing hot cell facility design concept based on 3SBD for the successful realization of pyroprocessing technology with enhanced safety and proliferation resistance.« less

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

Poncio, S.; Adkison, P.

Coating costs are escalating due to increased awareness of the environment and safety and health issues. Owners can reduce the overall cost of maintenance painting projects through the implementation of a total quality program. This program should encompass project pre-planning, evaluation of safety and quality assurance programs, and analysis of employee absenteeism and turnover. The information presented is a case history of one utility's experience managing a maintenance painting program during a five-year period.

Una guia para los padres sobre lo mas importante: el logro academico plan de educacion de Maryland desde preescolar hasta el 12 grado, 2002-2003. (A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003).

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Spanish-language guide for parents outlines the goals and…

Young Children: Priority One. A Project Kit for Kiwanis Clubs--Addressing the Needs of Children, Prenatal through Age Five.

ERIC Educational Resources Information Center

Rice, C.; And Others

This Kiwanis Club project kit contains ideas and instructions for implementing programs that meet local needs in the areas of maternal and infant health, child care and development, parenting, and safety and pediatric trauma. The kit begins with an overview that explains how to assess need and how to plan, implement, and evaluate a project. Tip…

Block 2 Solid Rocket Motor (SRM) conceptual design study. Volume 1: Appendices

NASA Technical Reports Server (NTRS)

1986-01-01

The design studies task implements the primary objective of developing a Block II Solid Rocket Motor (SRM) design offering improved flight safety and reliability. The SRM literature was reviewed. The Preliminary Development and Validation Plan is presented.

49 CFR 239.1 - Purpose and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF TRANSPORTATION PASSENGER TRAIN EMERGENCY PREPAREDNESS General § 239.1 Purpose and scope. (a... manage passenger train emergencies. (b) This part prescribes minimum Federal safety standards for the preparation, adoption, and implementation of emergency preparedness plans by railroads connected with the...

Planning for active traffic management in Virginia : international best practices and implementation strategies.

DOT National Transportation Integrated Search

2012-10-01

Active Traffic Management (ATM) applications, such as variable speed limits, queue warning systems, and dynamic : ramp metering, have been shown to offer mobility and safety benefits. Yet because they differ from conventional capacity : investments i...

Westinghouse corporate development of a decision software program for Radiological Evaluation Decision Input (REDI)

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

Bush, T.S.

1995-03-01

In December 1992, the Department of Energy (DOE) implemented the DOE Radiological Control Manual (RCM). Westinghouse Idaho Nuclear Company, Inc. (WINCO) submitted an implementation plan showing how compliance with the manual would be achieved. This implementation plan was approved by DOE in November 1992. Although WINCO had already been working under a similar Westinghouse RCM, the DOE RCM brought some new and challenging requirements. One such requirement was that of having procedure writers and job planners create the radiological input in work control procedures. Until this time, that information was being provided by radiological engineering or a radiation safety representative.more » As a result of this requirement, Westinghouse developed the Radiological Evaluation Decision Input (REDI) program.« less

Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention

PubMed Central

Lawton, Rebecca; Sheard, Laura; Armitage, Gerry; Cocks, Kim; Buckley, Hannah; Corbacho, Belen; Reynolds, Caroline; Marsh, Claire; Moore, Sally; Watt, Ian; Wright, John

2017-01-01

Objective To evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention. Design A multicentre cluster randomised controlled trial. Setting Clusters were 33 hospital wards within five hospitals in the UK. Participants All patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition. Intervention The ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings. Measurements Primary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS). Results Intervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention. Limitations Adherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure. Conclusions Patients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components. Trial registration number ISRCTN07689702; pre-results. PMID:28159854

Workplace safety and health for the veterinary health care team.

PubMed

Gibbins, John D; MacMahon, Kathleen

2015-03-01

Veterinary clinic employers have a legal and ethical responsibility to provide a safe and healthy workplace. Clinic members are responsible for consistently using safe practices and procedures set up by their employer. Development and implementation of a customized comprehensive workplace safety and health program is emphasized, including an infection control plan. Occupational safety and health regulations are reviewed. The hazards of sharps, animal bites and scratches, and drugs are discussed. Strategies to prevent or minimize adverse health effects and resources for training and education are provided. Published by Elsevier Inc.

A baseline assessment of emergency planning and preparedness in Italian universities.

PubMed

Marincioni, Fausto; Fraboni, Rita

2012-04-01

Besides offering teaching and research services, schools and universities also must provide for the safety and security of their employees, students, and visitors. This paper describes emergency preparedness in a sample of Italian universities. In particular it examines risk perception within a specific professional category (university safety and security officers) in a specific cultural context (Italy). In addition, it discusses the transposition and implementation in a European Union (EU) member state of EU Council Directive 89/391/EEC of 12 June 1989, on the introduction of measures to encourage improvements in the safety and health of workers. The findings highlight heterogeneous and fragmented emergency management models within the Italian university system, underlining the need for a stricter framework of standardised safety protocols and emergency management guidelines. The study also points out that enhancing emergency planning and preparedness in Italian universities entails increasing safety leadership, employee engagement and individual responsibility for safety and security; essentially, it necessitates improving the culture of risk prevention. © 2012 The Author(s). Disasters © Overseas Development Institute, 2012.

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

PubMed

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

2009-01-01

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

Implementing the national priorities for injury surveillance.

PubMed

Mitchell, Rebecca J; McClure, Rod J; Williamson, Ann M; McKenzie, Kirsten

2008-04-07

Injury is a leading cause of disability and death in Australia and is recognised as a national health priority area. The foundation of successful injury prevention is injury surveillance, and national policies and strategies developed over the past 20 years to reduce the burden of injury in Australia have included 22 recommendations on surveillance--only three of which have been completely implemented. Priorities for improving injury surveillance include: improving current injury mortality and morbidity data collection systems; filling the gaps in injury surveillance; maintaining vigilance over data quality; increasing the integration and accessibility of injury data; developing technical expertise in surveillance. Barriers to implementation of the current National Injury Prevention and Safety Promotion Plan include the lack of an implementation plan, performance management structure, appropriate national governance structure and resources--all of which could be overcome with government commitment.

Application of failure mode and effects analysis to treatment planning in scanned proton beam radiotherapy

PubMed Central

2013-01-01

Background A multidisciplinary and multi-institutional working group applied the Failure Mode and Effects Analysis (FMEA) approach to the actively scanned proton beam radiotherapy process implemented at CNAO (Centro Nazionale di Adroterapia Oncologica), aiming at preventing accidental exposures to the patient. Methods FMEA was applied to the treatment planning stage and consisted of three steps: i) identification of the involved sub-processes; ii) identification and ranking of the potential failure modes, together with their causes and effects, using the risk probability number (RPN) scoring system, iii) identification of additional safety measures to be proposed for process quality and safety improvement. RPN upper threshold for little concern of risk was set at 125. Results Thirty-four sub-processes were identified, twenty-two of them were judged to be potentially prone to one or more failure modes. A total of forty-four failure modes were recognized, 52% of them characterized by an RPN score equal to 80 or higher. The threshold of 125 for RPN was exceeded in five cases only. The most critical sub-process appeared related to the delineation and correction of artefacts in planning CT data. Failures associated to that sub-process were inaccurate delineation of the artefacts and incorrect proton stopping power assignment to body regions. Other significant failure modes consisted of an outdated representation of the patient anatomy, an improper selection of beam direction and of the physical beam model or dose calculation grid. The main effects of these failures were represented by wrong dose distribution (i.e. deviating from the planned one) delivered to the patient. Additional strategies for risk mitigation, easily and immediately applicable, consisted of a systematic information collection about any known implanted prosthesis directly from each patient and enforcing a short interval time between CT scan and treatment start. Moreover, (i) the investigation of dedicated CT image reconstruction algorithms, (ii) further evaluation of treatment plan robustness and (iii) implementation of independent methods for dose calculation (such as Monte Carlo simulations) may represent novel solutions to increase patient safety. Conclusions FMEA is a useful tool for prospective evaluation of patient safety in proton beam radiotherapy. The application of this method to the treatment planning stage lead to identify strategies for risk mitigation in addition to the safety measures already adopted in clinical practice. PMID:23705626

10 CFR 850 Implementation of Requirements

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

Lee, S

2012-01-05

10 CFR 850 defines a contractor as any entity, including affiliated entities, such as a parent corporation, under contract with DOE, including a subcontractor at any tier, with responsibility for performing work at a DOE site in furtherance of a DOE mission. The Chronic Beryllium Disease Prevention Program (CBDPP) applies to beryllium-related activities that are performed at the Lawrence Livermore National Laboratory (LLNL). The CBDPP or Beryllium Safety Program is integrated into the LLNL Worker Safety and Health Program and, thus, implementation documents and responsibilities are integrated in various documents and organizational structures. Program development and management of the CBDPPmore » is delegated to the Environment, Safety and Health (ES&H) Directorate, Worker Safety and Health Functional Area. As per 10 CFR 850, Lawrence Livermore National Security, LLC (LLNS) periodically submits a CBDPP to the National Nuclear Security Administration/Livermore Site Office (NNSA/LSO). The requirements of this plan are communicated to LLNS workers through ES&H Manual Document 14.4, 'Working Safely with Beryllium.' 10 CFR 850 is implemented by the LLNL CBDPP, which integrates the safety and health standards required by the regulation, components of the LLNL Integrated Safety Management System (ISMS), and incorporates other components of the LLNL ES&H Program. As described in the regulation, and to fully comply with the regulation, specific portions of existing programs and additional requirements are identified in the CBDPP. The CBDPP is implemented by documents that interface with the workers, principally through ES&H Manual Document 14.4. This document contains information on how the management practices prescribed by the LLNL ISMS are implemented, how beryllium hazards that are associated with LLNL work activities are controlled, and who is responsible for implementing the controls. Adherence to the requirements and processes described in the ES&H Manual ensures that ES&H practices across LLNL are developed in a consistent manner. Other implementing documents, such as the ES&H Manual, are integral in effectively implementing 10 CFR 850.« less

Comprehensive implementation plan for the DOE defense buried TRU- contaminated waste program

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

Everette, S.E.; Detamore, J.A.; Raudenbush, M.H.

1988-02-01

In 1970, the US Atomic Energy Commission established a transuranic'' (TRU) waste classification. Waste disposed of prior to the decision to retrievably store the waste and which may contain TRU contamination is referred to as buried transuranic-contaminated waste'' (BTW). The DOE reference plan for BTW, stated in the Defense Waste Management Plan, is to monitor it, to take such remedial actions as may be necessary, and to re-evaluate its safety as necessary or in about 10-year periods. Responsibility for management of radioactive waste and byproducts generated by DOE belongs to the Secretary of Energy. Regulatory control for these sites containingmore » mixed waste is exercised by both DOE (radionuclides) and EPA (hazardous constituents). Each DOE Operations Office is responsible for developing and implementing plans for long-term management of its radioactive and hazardous waste sites. This comprehensive plan includes site-by-site long-range plans, site characteristics, site costs, and schedules at each site. 13 figs., 15 tabs.« less

An Analysis of Adverse Events in the Rehabilitation Department: Using the Veterans Affairs Root Cause Analysis System.

PubMed

Hagley, Gregory W; Mills, Peter D; Shiner, Brian; Hemphill, Robin R

2018-04-01

Root cause analyses (RCA) are often completed in health care settings to determine causes of adverse events (AEs). RCAs result in action plans designed to mitigate future patient harm. National reviews of RCA reports have assessed the safety of numerous health care settings and suggested opportunities for improvement. However, few studies have assessed the safety of receiving care from physical therapists, occupational therapists, or speech and language pathology pathologists. The objective of this study was to determine the types of AEs, root causes, and action plans for risk mitigation that exist within the disciplines of rehabilitation medicine. This study is a retrospective, cross-sectional review. A national search of the Veterans Health Administration RCA database was conducted to identify reports describing AEs associated with physical therapy, occupational therapy, or speech and language pathology services between 2009 and May 2016. Twenty-five reports met the inclusion requirements. The reports were classified by the event type, root cause, action plans, and strength of action plans. Delays in care (32.0%) and falls (28.0%) were the most common type of AE. Three AEs resulted in death. RCA teams identified deficits regarding policy and procedures as the most common root cause. Eighty-eight percent of RCA reports included strong or intermediate action plans to mitigate risk. Strong action plans included standardizing emergency terminology and implementing a dedicated line to call for an emergency response. These data are self-reported and only AEs that are scored as a safety assessment code 3 in the system receive a full RCA, so there are likely AEs that were not captured in this study. In addition, the RCA reports are deidentified and so do not include all patient characteristics. As the Veterans Health Administration system services mostly men, the data might not generalize to non-Veterans Health Administration systems with a different patient mix. Care provided by rehabilitation professionals is generally safe, but AEs do occur. Based on this RCA review, the safety of rehabilitation services can be improved by implementing strong practices to mitigate risk to patients. Checklists should be considered to aid timely decision making when initiating an emergency response.

Statement of Intent between EPA and the European Chemicals Agency (ECHA)

EPA Pesticide Factsheets

This page contains a Statement of Intent between EPA and the European Chemicals Agency (ECHA) to exchange information, training and experience on chemical safety and the 2015-2016 Rolling Work Plan of activities to implement the Statement of Intent.

Integrated corridor management initiative : demonstration phase evaluation, San Diego technical capability analysis test plan.

DOT National Transportation Integrated Search

1998-11-01

The purpose of this working paper is to present estimates of potential safety benefits resulting from full implementation of Intelligent Transportation Systems (ITS) in the United States. These estimates were derived by integrating results from a num...

Minnesota Peer Exchange : Strategic Highway Safety Plan (SHSP) Implementation - An RSPCB Peer Exchange

DOT National Transportation Integrated Search

2015-02-01

The Minnesota Department of Transportation (MN DOT) hosted a peer exchange February 3-4, 2015, in St. Paul, Minnesota. The event included peer representatives from the Nevada Department of Transportation (NV DOT), the Ohio Department of Transportatio...

Microbiological sampling plan based on risk classification to verify supplier selection and production of served meals in food service operation.

PubMed

Lahou, Evy; Jacxsens, Liesbeth; Van Landeghem, Filip; Uyttendaele, Mieke

2014-08-01

Food service operations are confronted with a diverse range of raw materials and served meals. The implementation of a microbial sampling plan in the framework of verification of suppliers and their own production process (functionality of their prerequisite and HACCP program), demands selection of food products and sampling frequencies. However, these are often selected without a well described scientifically underpinned sampling plan. Therefore, an approach on how to set-up a focused sampling plan, enabled by a microbial risk categorization of food products, for both incoming raw materials and meals served to the consumers is presented. The sampling plan was implemented as a case study during a one-year period in an institutional food service operation to test the feasibility of the chosen approach. This resulted in 123 samples of raw materials and 87 samples of meal servings (focused on high risk categorized food products) which were analyzed for spoilage bacteria, hygiene indicators and food borne pathogens. Although sampling plans are intrinsically limited in assessing the quality and safety of sampled foods, it was shown to be useful to reveal major non-compliances and opportunities to improve the food safety management system in place. Points of attention deduced in the case study were control of Listeria monocytogenes in raw meat spread and raw fish as well as overall microbial quality of served sandwiches and salads. Copyright © 2014 Elsevier Ltd. All rights reserved.

Water quality, compliance, and health outcomes among utilities implementing Water Safety Plans in France and Spain.

PubMed

Setty, Karen E; Kayser, Georgia L; Bowling, Michael; Enault, Jerome; Loret, Jean-Francois; Serra, Claudia Puigdomenech; Alonso, Jordi Martin; Mateu, Arnau Pla; Bartram, Jamie

2017-05-01

Water Safety Plans (WSPs), recommended by the World Health Organization since 2004, seek to proactively identify potential risks to drinking water supplies and implement preventive barriers that improve safety. To evaluate the outcomes of WSP application in large drinking water systems in France and Spain, we undertook analysis of water quality and compliance indicators between 2003 and 2015, in conjunction with an observational retrospective cohort study of acute gastroenteritis incidence, before and after WSPs were implemented at five locations. Measured water quality indicators included bacteria (E. coli, fecal streptococci, total coliform, heterotrophic plate count), disinfectants (residual free and total chlorine), disinfection by-products (trihalomethanes, bromate), aluminum, pH, turbidity, and total organic carbon, comprising about 240K manual samples and 1.2M automated sensor readings. We used multiple, Poisson, or Tobit regression models to evaluate water quality before and after the WSP intervention. The compliance assessment analyzed exceedances of regulated, recommended, or operational water quality thresholds using chi-squared or Fisher's exact tests. Poisson regression was used to examine acute gastroenteritis incidence rates in WSP-affected drinking water service areas relative to a comparison area. Implementation of a WSP generally resulted in unchanged or improved water quality, while compliance improved at most locations. Evidence for reduced acute gastroenteritis incidence following WSP implementation was found at only one of the three locations examined. Outcomes of WSPs should be expected to vary across large water utilities in developed nations, as the intervention itself is adapted to the needs of each location. The approach may translate to diverse water quality, compliance, and health outcomes. Copyright © 2017 Elsevier GmbH. All rights reserved.

TU-C-201-03: The Use of Checklists and Audit Tools for Safety and QA

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

Prisciandaro, J.

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

Risk Management Programs under Clean Air Act Section 112(r): Guidance for Implementing Agencies

EPA Pesticide Factsheets

Accidental release prevention programs under section 112(r) of the Clean Air Act (CAA) are related to and build on activities under the Emergency Planning and Community Right-to-Know Act, and Occupational Safety and Health Administration standards.

National Aeronautics Research and Development Plan

DTIC Science & Technology

2010-02-01

aeronautics research to improve aviation safety, air transportation, and reduce the environmental impacts of aviation; • Promotes the advancement of fuel...Reduce the Adverse Impacts of Weather on Air Traffic Management Decisions...Operational Procedures to Decrease the Significant Environmental Impacts of the Aviation System. . . 42 Future Implementation

SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

PubMed

Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

2014-09-01

Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

V&V Plan for FPGA-based ESF-CCS Using System Engineering Approach.

NASA Astrophysics Data System (ADS)

Maerani, Restu; Mayaka, Joyce; El Akrat, Mohamed; Cheon, Jung Jae

2018-02-01

Instrumentation and Control (I&C) systems play an important role in maintaining the safety of Nuclear Power Plant (NPP) operation. However, most current I&C safety systems are based on Programmable Logic Controller (PLC) hardware, which is difficult to verify and validate, and is susceptible to software common cause failure. Therefore, a plan for the replacement of the PLC-based safety systems, such as the Engineered Safety Feature - Component Control System (ESF-CCS), with Field Programmable Gate Arrays (FPGA) is needed. By using a systems engineering approach, which ensures traceability in every phase of the life cycle, from system requirements, design implementation to verification and validation, the system development is guaranteed to be in line with the regulatory requirements. The Verification process will ensure that the customer and stakeholder’s needs are satisfied in a high quality, trustworthy, cost efficient and schedule compliant manner throughout a system’s entire life cycle. The benefit of the V&V plan is to ensure that the FPGA based ESF-CCS is correctly built, and to ensure that the measurement of performance indicators has positive feedback that “do we do the right thing” during the re-engineering process of the FPGA based ESF-CCS.

Night club patrons who feel safe will return: Evidence to encourage management to address club violence.

PubMed

Johnson, Mark B; Voas, Robert; Miller, Brenda A; Byrnes, Hilary; Bourdeau, Beth

2016-02-01

There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization's business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patrons' perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club's bottom line. Data for this study were collected from entry and exit surveys with 1714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010-2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies. Copyright © 2015 Elsevier Ltd and National Safety Council. All rights reserved.

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

NASA Astrophysics Data System (ADS)

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

2017-08-01

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

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

PubMed

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

2017-08-01

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

Medical operations: Crew surgeon's report. [in Skylab simulation test

NASA Technical Reports Server (NTRS)

Ross, C. E.

1973-01-01

To assure the safety and well being of the Skylab environment simulation crewmembers it was necessary to develop a medical safety plan with emergency procedures. All medical and nonmedical test and operations personnel, except those specifically exempted, were required to meet the medical standards and proficiency levels as established. Implemented programs included health care of the test crew and their families, occupational medical services for chamber operating personnel, clinical laboratory support and hypobaric and other emergency support.

A task force model for statewide change in nursing education: building quality and safety.

PubMed

Mundt, Mary H; Clark, Margherita Procaccini; Klemczak, Jeanette Wrona

2013-01-01

The purpose of this article was to describe a statewide planning process to transform nursing education in Michigan to improve quality and safety of patient care. A task force model was used to engage diverse partners in issue identification, consensus building, and recommendations. An example of a statewide intervention in nursing education and practice that was executed was the Michigan Quality and Safety in Nursing Education Institute, which was held using an integrated approach to academic-practice partners from all state regions. This paper describes the unique advantage of leadership by the Michigan Chief Nurse Executive, the existence of a nursing strategic plan, and a funding model. An overview of the Task Force on Nursing Education is presented with a focus on the model's 10 process steps and resulting seven recommendations. The Michigan Nurse Education Council was established to implement the recommendations that included quality and safety. Copyright © 2013 Elsevier Inc. All rights reserved.

The art of appropriate evaluation : a guide for highway safety program managers

DOT National Transportation Integrated Search

1999-05-01

This Guide provides an overview of the steps that are involved in program evaluations and gets you thinking about how these steps fit into your implementation plans. It also provides some handy suggestions on how to find and work with an evaluation c...

Solar Power Satellites

NASA Technical Reports Server (NTRS)

Kraft, C. C., Jr.

1977-01-01

A satellite based energy concept is described, including the advantages of the basic concept, system characteristics, cost, and environmental considerations. An outline of a plan for the further evaluation and implementation of the system is given. It is concluded that the satellite concept is competitive with other advanced power generation systems when a variety of factors are considered, including technical feasibility, cost, safety, natural resources, environment, baseload capability, location flexibility, land use, and existing industrial base for implementation.

Research on Building Education & Workforce Capacity in Systems Engineering

DTIC Science & Technology

2011-10-31

product or prototype that addresses a real DoD need. Implemented as pilot courses in eight civilian and six military universities affiliated with...Engineering 1 1.1 Computer Engineering 1 1.1 Operations Research 1 1.1 Product Architecture 1 1.1 Total 93 100.0 Table 7: Breakdown of Student... product specifications, inattention to budget limits and safety issues, inattention to product life cycle, poor implementation of risk management plans

SU-E-T-785: Using Systems Engineering to Design HDR Skin Treatment Operation for Small Lesions to Enhance Patient Safety

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

Saw, C; Baikadi, M; Peters, C

2015-06-15

Purpose: Using systems engineering to design HDR skin treatment operation for small lesions using shielded applicators to enhance patient safety. Methods: Systems engineering is an interdisciplinary field that offers formal methodologies to study, design, implement, and manage complex engineering systems as a whole over their life-cycles. The methodologies deal with human work-processes, coordination of different team, optimization, and risk management. The V-model of systems engineering emphasize two streams, the specification and the testing streams. The specification stream consists of user requirements, functional requirements, and design specifications while the testing on installation, operational, and performance specifications. In implementing system engineering tomore » this project, the user and functional requirements are (a) HDR unit parameters be downloaded from the treatment planning system, (b) dwell times and positions be generated by treatment planning system, (c) source decay be computer calculated, (d) a double-check system of treatment parameters to comply with the NRC regulation. These requirements are intended to reduce human intervention to improve patient safety. Results: A formal investigation indicated that the user requirements can be satisfied. The treatment operation consists of using the treatment planning system to generate a pseudo plan that is adjusted for different shielded applicators to compute the dwell times. The dwell positions, channel numbers, and the dwell times are verified by the medical physicist and downloaded into the HDR unit. The decayed source strength is transferred to a spreadsheet that computes the dwell times based on the type of applicators and prescribed dose used. Prior to treatment, the source strength, dwell times, dwell positions, and channel numbers are double-checked by the radiation oncologist. No dosimetric parameters are manually calculated. Conclusion: Systems engineering provides methodologies to effectively design the HDR treatment operation that minimize human intervention and improve patient safety.« less

AN ADVANCED TOOL FOR APPLIED INTEGRATED SAFETY MANAGEMENT

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

Potts, T. Todd; Hylko, James M.; Douglas, Terence A.

2003-02-27

WESKEM, LLC's Environmental, Safety and Health (ES&H) Department had previously assessed that a lack of consistency, poor communication and using antiquated communication tools could result in varying operating practices, as well as a failure to capture and disseminate appropriate Integrated Safety Management (ISM) information. To address these issues, the ES&H Department established an Activity Hazard Review (AHR)/Activity Hazard Analysis (AHA) process for systematically identifying, assessing, and controlling hazards associated with project work activities during work planning and execution. Depending on the scope of a project, information from field walkdowns and table-top meetings are collected on an AHR form. The AHAmore » then documents the potential failure and consequence scenarios for a particular hazard. Also, the AHA recommends whether the type of mitigation appears appropriate or whether additional controls should be implemented. Since the application is web based, the information is captured into a single system and organized according to the >200 work activities already recorded in the database. Using the streamlined AHA method improved cycle time from over four hours to an average of one hour, allowing more time to analyze unique hazards and develop appropriate controls. Also, the enhanced configuration control created a readily available AHA library to research and utilize along with standardizing hazard analysis and control selection across four separate work sites located in Kentucky and Tennessee. The AHR/AHA system provides an applied example of how the ISM concept evolved into a standardized field-deployed tool yielding considerable efficiency gains in project planning and resource utilization. Employee safety is preserved through detailed planning that now requires only a portion of the time previously necessary. The available resources can then be applied to implementing appropriate engineering, administrative and personal protective equipment controls in the field.« less

Applying health education theory to patient safety programs: three case studies.

PubMed

Gilkey, Melissa B; Earp, Jo Anne L; French, Elizabeth A

2008-04-01

Program planning for patient safety is challenging because intervention-oriented surveillance data are not yet widely available to those working in this nascent field. Even so, health educators are uniquely positioned to contribute to patient safety intervention efforts because their theoretical training provides them with a guide for designing and implementing prevention programs. This article demonstrates the utility of applying health education concepts from three prominent patient safety campaigns, including the concepts of risk perception, community participation, and social marketing. The application of these theoretical concepts to patient safety programs suggests that health educators possess a knowledge base and skill set highly relevant to patient safety and that their perspective should be increasingly brought to bear on the design and evaluation of interventions that aim to protect patients from preventable medical error.

Safety evaluation report on Tennessee Valley Authority: Browns Ferry Nuclear Performance Plan

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

Not Available

1991-01-01

This safety evaluation report (SER) was prepared by the US Nuclear Regulatory Commission (NRC) staff and represents the second and last supplement (SSER 2) to the staff's original SER published as Volume 3 of NUREG-1232 in April 1989. Supplement 1 of Volume 3 of NUREG-1232 (SSER 1) was published in October 1989. Like its predecessors, SSER 2 is composed of numerous safety evaluations by the staff regarding specific elements contained in the Browns Ferry Nuclear Performance Plan (BFNPP), Volume 3 (up to and including Revision 2), submitted by the Tennessee Valley Authority (TVA) for the Browns Ferry Nuclear Plant (BFN).more » The Browns Ferry Nuclear Plant consists of three boiling-water reactors (BWRs) at a site in Limestone County, Alabama. The BFNPP describes the corrective action plans and commitments made by TVA to resolve deficiencies with its nuclear programs before the startup of Unit 2. The staff has inspected and will continue to inspect TVA's implementation of these BFNPP corrective action plans that address staff concerns about TVA's nuclear program. SSER 2 documents the NRC staff's safety evaluations and conclusions for those elements of the BFNPP that were not previously addressed by the staff or that remained open as a result of unresolved issues identified by the staff in previous SERs and inspections.« less

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

Farren Hunt

Idaho National Laboratory (INL) performed an Annual Effectiveness Review of the Integrated Safety Management System (ISMS), per 48 Code of Federal Regulations (CFR) 970.5223 1, “Integration of Environment, Safety and Health into Work Planning and Execution.” The annual review assessed Integrated Safety Management (ISM) effectiveness, provided feedback to maintain system integrity, and identified target areas for focused improvements and assessments for fiscal year (FY) 2013. Results of the FY 2012 annual effectiveness review demonstrated that the INL’s ISMS program was significantly strengthened. Actions implemented by the INL demonstrate that the overall Integrated Safety Management System is sound and ensures safemore » and successful performance of work while protecting workers, the public, and environment. This report also provides several opportunities for improvement that will help further strengthen the ISM Program and the pursuit of safety excellence. Demonstrated leadership and commitment, continued surveillance, and dedicated resources have been instrumental in maturing a sound ISMS program. Based upon interviews with personnel, reviews of assurance activities, and analysis of ISMS process implementation, this effectiveness review concludes that ISM is institutionalized and is “Effective”.« less

Incident Learning and Failure-Mode-and-Effects-Analysis Guided Safety Initiatives in Radiation Medicine

PubMed Central

Kapur, Ajay; Goode, Gina; Riehl, Catherine; Zuvic, Petrina; Joseph, Sherin; Adair, Nilda; Interrante, Michael; Bloom, Beatrice; Lee, Lucille; Sharma, Rajiv; Sharma, Anurag; Antone, Jeffrey; Riegel, Adam; Vijeh, Lili; Zhang, Honglai; Cao, Yijian; Morgenstern, Carol; Montchal, Elaine; Cox, Brett; Potters, Louis

2013-01-01

By combining incident learning and process failure-mode-and-effects-analysis (FMEA) in a structure-process-outcome framework we have created a risk profile for our radiation medicine practice and implemented evidence-based risk-mitigation initiatives focused on patient safety. Based on reactive reviews of incidents reported in our departmental incident-reporting system and proactive FMEA, high safety-risk procedures in our paperless radiation medicine process and latent risk factors were identified. Six initiatives aimed at the mitigation of associated severity, likelihood-of-occurrence, and detectability risks were implemented. These were the standardization of care pathways and toxicity grading, pre-treatment-planning peer review, a policy to thwart delay-rushed processes, an electronic whiteboard to enhance coordination, and the use of six sigma metrics to monitor operational efficiencies. The effectiveness of these initiatives over a 3-years period was assessed using process and outcome specific metrics within the framework of the department structure. There has been a 47% increase in incident-reporting, with no increase in adverse events. Care pathways have been used with greater than 97% clinical compliance rate. The implementation of peer review prior to treatment-planning and use of the whiteboard have provided opportunities for proactive detection and correction of errors. There has been a twofold drop in the occurrence of high-risk procedural delays. Patient treatment start delays are routinely enforced on cases that would have historically been rushed. Z-scores for high-risk procedures have steadily improved from 1.78 to 2.35. The initiatives resulted in sustained reductions of failure-mode risks as measured by a set of evidence-based metrics over a 3-years period. These augment or incorporate many of the published recommendations for patient safety in radiation medicine by translating them to clinical practice. PMID:24380074

Factors influencing nurses' perceptions of occupational safety.

PubMed

Samur, Menevse; Intepeler, Seyda Seren

2017-01-02

To determine nurses' perceptions of occupational safety and their work environment and examine the sociodemographic traits and job characteristics that influence their occupational safety, we studied a sample of 278 nurses. According to the nurses, the quality of their work environment is average, and occupational safety is insufficient. In the subdimensions of the work environment scale, it was determined that the nurses think "labor force and other resources" are insufficient. In the occupational safety subdimensions "occupational illnesses and complaints" and "administrative support and approaches," they considered occupational safety to be insufficient. "Doctor-nurse-colleague relationships," "exposure to violence," and "work unit" (eg, internal medicine, surgical, intensive care) are the main factors that affect occupational safety. This study determined that hospital administrations should develop and immediately implement plans to ameliorate communication and clinical precautions and to reduce exposure to violence.

A Sampling Based Approach to Spacecraft Autonomous Maneuvering with Safety Specifications

NASA Technical Reports Server (NTRS)

Starek, Joseph A.; Barbee, Brent W.; Pavone, Marco

2015-01-01

This paper presents a methods for safe spacecraft autonomous maneuvering that leverages robotic motion-planning techniques to spacecraft control. Specifically the scenario we consider is an in-plan rendezvous of a chaser spacecraft in proximity to a target spacecraft at the origin of the Clohessy Wiltshire Hill frame. The trajectory for the chaser spacecraft is generated in a receding horizon fashion by executing a sampling based robotic motion planning algorithm name Fast Marching Trees (FMT) which efficiently grows a tree of trajectories over a set of probabillistically drawn samples in the state space. To enforce safety the tree is only grown over actively safe samples for which there exists a one-burn collision avoidance maneuver that circularizes the spacecraft orbit along a collision-free coasting arc and that can be executed under potential thrusters failures. The overall approach establishes a provably correct framework for the systematic encoding of safety specifications into the spacecraft trajectory generations process and appears amenable to real time implementation on orbit. Simulation results are presented for a two-fault tolerant spacecraft during autonomous approach to a single client in Low Earth Orbit.

Drug Adverse Event Detection in Health Plan Data Using the Gamma Poisson Shrinker and Comparison to the Tree-based Scan Statistic

PubMed Central

Brown, Jeffrey S.; Petronis, Kenneth R.; Bate, Andrew; Zhang, Fang; Dashevsky, Inna; Kulldorff, Martin; Avery, Taliser R.; Davis, Robert L.; Chan, K. Arnold; Andrade, Susan E.; Boudreau, Denise; Gunter, Margaret J.; Herrinton, Lisa; Pawloski, Pamala A.; Raebel, Marsha A.; Roblin, Douglas; Smith, David; Reynolds, Robert

2013-01-01

Background: Drug adverse event (AE) signal detection using the Gamma Poisson Shrinker (GPS) is commonly applied in spontaneous reporting. AE signal detection using large observational health plan databases can expand medication safety surveillance. Methods: Using data from nine health plans, we conducted a pilot study to evaluate the implementation and findings of the GPS approach for two antifungal drugs, terbinafine and itraconazole, and two diabetes drugs, pioglitazone and rosiglitazone. We evaluated 1676 diagnosis codes grouped into 183 different clinical concepts and four levels of granularity. Several signaling thresholds were assessed. GPS results were compared to findings from a companion study using the identical analytic dataset but an alternative statistical method—the tree-based scan statistic (TreeScan). Results: We identified 71 statistical signals across two signaling thresholds and two methods, including closely-related signals of overlapping diagnosis definitions. Initial review found that most signals represented known adverse drug reactions or confounding. About 31% of signals met the highest signaling threshold. Conclusions: The GPS method was successfully applied to observational health plan data in a distributed data environment as a drug safety data mining method. There was substantial concordance between the GPS and TreeScan approaches. Key method implementation decisions relate to defining exposures and outcomes and informed choice of signaling thresholds. PMID:24300404

Experiences of Agency for Healthcare Research and Quality-funded projects that implemented practices for safer patient care.

PubMed

Taylor, Stephanie L; Ridgely, M Susan; Greenberg, Michael D; Sorbero, Melony E S; Teleki, Stephanie S; Damberg, Cheryl L; Farley, Donna O

2009-04-01

To synthesize lessons learned from the experiences of Agency for Healthcare Research and Quality-funded patient safety projects in implementing safe practices. Self-reported data from individual and group interviews with Original, Challenge, and Partnerships in Implementing Patient Safety (PIPS) grantees, from 2003 to 2006. Interviews with three grantee groups (n=60 total) implementing safe practice projects, with comparisons on factors influencing project implementation and sustainability. Semi-structured protocols contained open-ended questions on lessons learned and more structured questions on factors associated with project implementation and sustainability. The grantees shared common experiences, frequently identifying lessons learned regarding structural components needing to be in place before implementation, components of the implementation process, components of interventions' results needed for sustainability, changes in timelines or activities, unanticipated issues, and staff acceptance/adoption. Also, fewer Original grants had many of the factors related project to implementation/sustainability than the PIPS or Challenge grantees had. Although much of what was reported seemed like common sense, surprisingly few projects actually planned for or expected many of the barriers or facilitators they experienced during their project implementation. Others implementing practice improvements likely will share the experiences and issues identified by these implementation projects and can learn from their lessons.

76 FR 32333 - Approval and Promulgation of Air Quality Implementation Plans; Pennsylvania; Revision to the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-06

... duration of the timing of quality assurance audits performed by the Pennsylvania Department of...) Program--Quality Assurance Protocol for the Safety Inspection Program in Non-I/M Counties AGENCY... quality assurance program for its motor vehicle inspection and maintenance program (I/M program...

49 CFR 236.913 - Filing and approval of PSPs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... architectural concepts; the PSP describes a product that uses design or safety assurance concepts considered... the end of the system design review phase of product development and 180 days prior to planned implementation, inviting FRA to participate in the design review process and receive periodic briefings and...

49 CFR 236.913 - Filing and approval of PSPs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... architectural concepts; the PSP describes a product that uses design or safety assurance concepts considered... the end of the system design review phase of product development and 180 days prior to planned implementation, inviting FRA to participate in the design review process and receive periodic briefings and...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

23 CFR 660.105 - Planning and route designation.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) regarding the establishment and implementation of pavement, bridge, and safety management systems for FHs... pavement management systems for FHs on Federal-aid highways are to be provided by the SHAs for... pavement management results for FHs which are not Federal-aid highways. (c) The FHWA, in consultation with...

Edward W. Jennings | NREL

Science.gov Websites

practices promoting a safe and supportive working environment. His research interests include environmental, safety, and health (ESH) and facility issues, he is responsible for implementing safe work plan; working directly with awardees by performing on-site validations to collect and analyze enzyme

Proactive Strategies to Safeguard Young Adolescents in the Cyberage

ERIC Educational Resources Information Center

Miller, Nicole C.; Thompson, Nicole L.; Franz, Dana Pomykal

2009-01-01

Schools should be proactive rather than reactive to issues of technology safety, and this requires careful planning and policy implementation. In this article, the authors provide information and recommendations that will help middle grades educators, students, and parents to safely and successfully manage the many technologies they encounter and…

Test Review: Adolescent and Child Urgent Threat Evaluation

ERIC Educational Resources Information Center

Sullivan, Jeremy R.; Holcomb, Michelle R.

2010-01-01

Recent occurrences of violence on high school and college campuses have led to increased interest among education professionals, parents, students, and community leaders in the identification of potentially violent students. Many school districts have implemented school-wide violence prevention plans to meet the safety needs of their students, and…

Occupational safety and health in Europe: lessons from the past, challenges and opportunities for the future.

PubMed

Gagliardi, Diana; Marinaccio, Alessandro; Valenti, Antonio; Iavicoli, Sergio

2012-01-01

Europe has always played a key role in the field of Occupational Health and Safety (OHS) and can be considered the cradle of Occupational Health. The European policy framework has been set since the establishment of the European Union, but its strength lies in the enactment of the Framework Directive on Occupational Health and Safety (89/391/EC), which has had a strong positive impact on the assessment and management of occupational risk factors and has promoted the quick diffusion of common standards across Europe. Yet, some implementation issues still remain to be addressed, due to changes in the world of work, fragmentation, economic crisis and, more generally, to the impact of globalization. Therefore, actions need to be reviewed with respect to research plans and policy implementation so as to support the OHS social dimension fostering a broader concept of wellbeing at work.

NASA Engineering and Safety Center (NESC) Enhanced Melamine (ML) Foam Acoustic Test (NEMFAT)

NASA Technical Reports Server (NTRS)

McNelis, Anne M.; Hughes, William O.; McNelis, Mark E.

2014-01-01

The NASA Engineering and Safety Center (NESC) funded a proposal to achieve initial basic acoustic characterization of ML (melamine) foam, which could serve as a starting point for a future, more comprehensive acoustic test program for ML foam. A project plan was developed and implemented to obtain acoustic test data for both normal and enhanced ML foam. This project became known as the NESC Enhanced Melamine Foam Acoustic Test (NEMFAT). This document contains the outcome of the NEMFAT project.

The use of geologic and seismologic information to reduce earthquake Hazards in California

USGS Publications Warehouse

Kockelman, W.J.; Campbell, C.C.

1984-01-01

Five examples illustrate how geologic and seismologic information can be used to reduce the effects of earthquakes Included are procedures for anticipating damage to critical facilities, preparing, adopting, or implementing seismic safety studies, plans, and programs, retrofitting highway bridges, regulating development in areas subject to fault-rupture, and strengthening or removing unreinforced masonry buildings. The collective effect of these procedures is to improve the public safety, health, and welfare of individuals and their communities. ?? 1984 Springer-Verlag New York Inc.

Rural hospital information technology implementation for safety and quality improvement: lessons learned.

PubMed

Tietze, Mari F; Williams, Josie; Galimbertti, Marisa

2009-01-01

This grant involved a hospital collaborative for excellence using information technology over 3-year period. The project activities focused on the improvement of patient care safety and quality in Southern rural and small community hospitals through the use of technology and education. The technology component of the design involved the implementation of a Web-based business analytic tool that allows hospitals to view data, create reports, and analyze their safety and quality data. Through a preimplementation and postimplementation comparative design, the focus of the implementation team was twofold: to recruit participant hospitals and to implement the technology at each of the 66 hospital sites. Rural hospitals were defined as acute care hospitals located in a county with a population of less than 100 000 or a state-administered Critical Access Hospital, making the total study population target 188 hospitals. Lessons learned during the information technology implementation of these hospitals are reflective of the unique culture, financial characteristics, organizational structure, and technology architecture of rural hospitals. Specific steps such as recruitment, information technology assessment, conference calls for project planning, data file extraction and transfer, technology training, use of e-mail, use of telephones, personnel management, and engaging information technology vendors were found to vary greatly among hospitals.

A Checklist to Improve Patient Safety in Interventional Radiology

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

Koetser, Inge C. J.; Vries, Eefje N. de; Delden, Otto M. van

2013-04-15

To develop a specific RADiological Patient Safety System (RADPASS) checklist for interventional radiology and to assess the effect of this checklist on health care processes of radiological interventions. On the basis of available literature and expert opinion, a prototype checklist was developed. The checklist was adapted on the basis of observation of daily practice in a tertiary referral centre and evaluation by users. To assess the effect of RADPASS, in a series of radiological interventions, all deviations from optimal care were registered before and after implementation of the checklist. In addition, the checklist and its use were evaluated by interviewingmore » all users. The RADPASS checklist has two parts: A (Planning and Preparation) and B (Procedure). The latter part comprises checks just before starting a procedure (B1) and checks concerning the postprocedural care immediately after completion of the procedure (B2). Two cohorts of, respectively, 94 and 101 radiological interventions were observed; the mean percentage of deviations of the optimal process per intervention decreased from 24 % before implementation to 5 % after implementation (p < 0.001). Postponements and cancellations of interventions decreased from 10 % before implementation to 0 % after implementation. Most users agreed that the checklist was user-friendly and increased patient safety awareness and efficiency. The first validated patient safety checklist for interventional radiology was developed. The use of the RADPASS checklist reduced deviations from the optimal process by three quarters and was associated with less procedure postponements.« less

Verification and Implementation of Operations Safety Controls for Flight Missions

NASA Technical Reports Server (NTRS)

Smalls, James R.; Jones, Cheryl L.; Carrier, Alicia S.

2010-01-01

There are several engineering disciplines, such as reliability, supportability, quality assurance, human factors, risk management, safety, etc. Safety is an extremely important engineering specialty within NASA, and the consequence involving a loss of crew is considered a catastrophic event. Safety is not difficult to achieve when properly integrated at the beginning of each space systems project/start of mission planning. The key is to ensure proper handling of safety verification throughout each flight/mission phase. Today, Safety and Mission Assurance (S&MA) operations engineers continue to conduct these flight product reviews across all open flight products. As such, these reviews help ensure that each mission is accomplished with safety requirements along with controls heavily embedded in applicable flight products. Most importantly, the S&MA operations engineers are required to look for important design and operations controls so that safety is strictly adhered to as well as reflected in the final flight product.

Night club patrons who feel safe will return: Evidence to encourage management to address club violence

PubMed Central

Johnson, Mark B.; Voas, Robert; Miller, Brenda A.; Byrnes, Hilary; Bourdeau, Beth

2017-01-01

Introduction There is substantial evidence that heavy drinking is associated with aggression and violence. Most managers of drinking establishments are required to maintain a security staff to deal with disruptive patrons who threaten an organization’s business or legal status. However, managers may focus little on minor instances of aggression even though these may escalate into more serious events. We hypothesize that proactive security efforts may positively affect patron’s perceptions of nighttime safety and influence their decisions to return to the club, thereby affecting the club’s bottom line. Method Data for this study were collected from entry and exit surveys with 1,714 attendees at 70 electronic music dance events at 10 clubs in the San Francisco Bay Area (2010–2012). Participants were asked to report on observations and experiences with aggressive behavior while in the club, their overall perception of club safety, and their plans to return to the same club in the next 30 days. Mediational multiple regression analysis was used to relate observations of club security to perceptions of personal safety and plans to return to the club. Results Reported observations of an active club security staff were positively related to perceptions of personal safety. Safety perceptions, in turn, were significantly related to plans to return to the club. The indirect path between perceptions of security and plans to return was significant as well. Conclusions The results suggest that an active security presence inside clubs can encourage club attendance by providing an environment where minor altercations are minimized, contributing to the perception of club safety. Practical Applications Evidence that proactive security efforts appear to increase return customers might motivate managers to implement better security policies. PMID:26875162

Provider Experiences With the Identification, Management, and Treatment of Co-Occurring Chronic Non-cancer Pain and Substance Use in the Safety Net

PubMed Central

Chang, Jamie Suki; Kushel, Margot; Miaskowski, Christine; Ceasar, Rachel; Zamora, Kara; Hurstak, Emily; Knight, Kelly R.

2017-01-01

Background In the US and internationally, providers have adopted guidelines on the management of prescription opioids for chronic non-cancer pain (CNCP). For “high-risk” patients with co-occurring CNCP and a history of substance use, guidelines advise providers to monitor patients using urine toxicology screening tests, develop opioid management plans, and refer patients to substance use treatment. Objective We report primary care provider experiences in the safety net interpreting and implementing guideline recommendations for patients with CNCP and substance use. Methods We interviewed primary care providers who work in the safety net (N=23) on their experiences managing CNCP and substance use. We analyzed interviews using a content analysis method. Results Providers found management plans and urine toxicology screening tests useful for informing patients about clinic expectations of opioid therapy and substance use. However, they described that guideline-based clinic policies had unintended consequences, such as raising barriers to open, honest dialogue about substance use and treatment. While substance use treatment was recommended for “high-risk” patients, providers described lack of integration with and availability of substance use treatment programs. Conclusions Our findings indicate that clinicians in the safety net found guideline-based clinic policies helpful. However, effective implementation was challenged by barriers to open dialogue about substance use and limited linkages with treatment programs. Further research is needed to examine how the context of safety net settings shapes the management and treatment of co-occurring CNCP and substance use. PMID:27754719

The national response for preventing healthcare-associated infections: research and adoption of prevention practices.

PubMed

Kahn, Katherine L; Mendel, Peter; Leuschner, Kristin J; Hiatt, Liisa; Gall, Elizabeth M; Siegel, Sari; Weinberg, Daniel A

2014-02-01

Healthcare-associated infections (HAIs) have long been the subject of research and prevention practice. When findings show potential to significantly impact outcomes, clinicians, policymakers, safety experts, and stakeholders seek to bridge the gap between research and practice by identifying mechanisms and assigning responsibility for translating research to practice. This paper describes progress and challenges in HAI research and prevention practices, as explained through an examination of Health and Human Services (HHS) Action Plan's goals, inputs, and implementation in each area. We used the Context-Input-Process-Product evaluation model, together with an HAI prevention system framework, to assess the transformative processes associated with HAI research and adoption of prevention practices. Since the introduction of the Action Plan, HHS has made substantial progress in prioritizing research projects, translating findings from those projects into practice, and designing and implementing research projects in multisite practice settings. Research has emphasized the basic science and epidemiology of HAIs, the identification of gaps in research, and implementation science. The basic, epidemiological, and implementation science communities have joined forces to better define mechanisms and responsibilities for translating HAI research into practice. Challenges include the ongoing need for better evidence about intervention effectiveness, the growing implementation burden on healthcare providers and organizations, and challenges implementing certain practices. Although these HAI research and prevention practice activities are complex spanning multiple system functions and properties, HHS is making progress so that the right methods for addressing complex HAI problems at the interface of patient safety and clinical practice can emerge.

[Implementation of good quality and safety practices. Descriptive study in a occupational mutual health centre].

PubMed

Manzanera, R; Plana, M; Moya, D; Ortner, J; Mira, J J

2016-01-01

To describe the level of implementation of quality and safety good practice elements in a Mutual Society health centre. A Cross-sectional study was conducted to assess the level of implementation of good practices using a questionnaire. Some quality dimensions were also assessed (scale 0 to 10) by a set of 87 quality coordinators of health centres and a random sample of 54 healthcare professionals working in small centres. Seventy quality coordinators and 27 professionals replied (response rates 80% and 50%, respectively. There were no differences in the assessment of quality attributes between both groups. They identified as areas for improvement: use of practice guidelines (7.6/10), scientific and technical skills (7.5/10), and patient satisfaction (7.7/10). Availability and accessibility to clinical reports, informed consent, availability of hydro-alcoholic solution, and to record allergies, were considered of high importance to be implemented, with training and research, improvements in equipment and technology plans, adherence to clinical practice guidelines and the preparation of risk maps, being of less importance. The good practices related to equipment and resources have a higher likelihood to be implemented, meanwhile those related to quality and safety attitudes have more barriers before being implemented. The mutual has a similar behaviour than other healthcare institutions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

The implementation of a Hazard Analysis and Critical Control Point management system in a peanut butter ice cream plant.

PubMed

Hung, Yu-Ting; Liu, Chi-Te; Peng, I-Chen; Hsu, Chin; Yu, Roch-Chui; Cheng, Kuan-Chen

2015-09-01

To ensure the safety of the peanut butter ice cream manufacture, a Hazard Analysis and Critical Control Point (HACCP) plan has been designed and applied to the production process. Potential biological, chemical, and physical hazards in each manufacturing procedure were identified. Critical control points for the peanut butter ice cream were then determined as the pasteurization and freezing process. The establishment of a monitoring system, corrective actions, verification procedures, and documentation and record keeping were followed to complete the HACCP program. The results of this study indicate that implementing the HACCP system in food industries can effectively enhance food safety and quality while improving the production management. Copyright © 2015. Published by Elsevier B.V.

Health Sector Reform in the Kurdistan Region - Iraq: Financing Reform, Primary Care, and Patient Safety.

PubMed

Anthony, C Ross; Moore, Melinda; Hilborne, Lee H; Mulcahy, Andrew W

2014-12-30

In 2010, the Kurdistan Regional Government asked the RAND Corporation to help guide reform of the health care system in the Kurdistan Region of Iraq. The overarching goal of reform was to help establish a health system that would provide high-quality services efficiently to everyone to prevent, treat, and manage physical and mental illnesses and injuries. This article summarizes the second phase of RAND's work, when researchers analyzed three distinct but intertwined health policy issue areas: development of financing policy, implementation of early primary care recommendations, and evaluation of quality and patient safety. For health financing, the researchers reviewed the relevant literature, explored the issue in discussions with key stakeholders, developed and assessed various policy options, and developed plans or approaches to overcome barriers and achieve stated policy objectives. In the area of primary care, they developed and helped to implement a new management information system. In the area of quality and patient safety, they reviewed relevant literature, discussed issues and options with health leaders, and recommended an approach toward incremental implementation.

Facilitators and barriers for the adoption, implementation and monitoring of child safety interventions: a multinational qualitative analysis.

PubMed

Scholtes, Beatrice; Schröder-Bäck, Peter; MacKay, J Morag; Vincenten, Joanne; Förster, Katharina; Brand, Helmut

2017-06-01

The efficiency and effectiveness of child safety interventions are determined by the quality of the implementation process. This multinational European study aimed to identify facilitators and barriers for the three phases of implementation: adoption, implementation and monitoring (AIM process). Twenty-seven participants from across the WHO European Region were invited to provide case studies of child safety interventions from their country. Cases were selected by the authors to ensure broad coverage of injury issues, age groups and governance level of implementation (eg, national, regional or local). Each participant presented their case and provided a written account according to a standardised template. Presentations and question and answer sessions were recorded. The presentation slides, written accounts and the notes taken during the workshops were analysed using thematic content analysis to elicit facilitators and barriers. Twenty-six cases (from 26 different countries) were presented and analysed. Facilitators and barriers were identified within eight general themes, applicable across the AIM process: management and collaboration; resources; leadership; nature of the intervention; political, social and cultural environment; visibility; nature of the injury problem and analysis and interpretation. The importance of the quality of the implementation process for intervention effectiveness, coupled with limited resources for child safety makes it more difficult to achieve successful actions. The findings of this study, divided by phase of the AIM process, provide practitioners with practical suggestions, where proactive planning might help increase the likelihood of effective implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Can we improve patient safety?

PubMed

Corbally, Martin Thomas

2014-01-01

Despite greater awareness of patient safety issues especially in the operating room and the widespread implementation of surgical time out World Health Organization (WHO), errors, especially wrong site surgery, continue. Most such errors are due to lapses in communication where decision makers fail to consult or confirm operative findings but worryingly where parental concerns over the planned procedure are ignored or not followed through. The WHO Surgical Pause/Time Out aims to capture these errors and prevent them, but the combination of human error and complex hospital environments can overwhelm even robust safety structures and simple common sense. Parents are the ultimate repository of information on their child's condition and planned surgery but are traditionally excluded from the process of Surgical Pause and Time Out, perhaps to avoid additional stress. In addition, surgeons, like pilots, are subject to the phenomenon of "plan-continue-fail" with potentially disastrous outcomes. If we wish to improve patient safety during surgery and avoid wrong site errors then we must include parents in the Surgical Pause/Time Out. A recent pilot study has shown that neither staff nor parents found it added to their stress, but, moreover, 100% of parents considered that it should be a mandatory component of the Surgical Pause nor does it add to the stress of surgery. Surgeons should be required to confirm that the planned procedure is in keeping with the operative findings especially in extirpative surgery and this "step back" should be incorporated into the standard Surgical Pause. It is clear that we must improve patient safety further and these simple measures should add to that potential.

Can patient involvement improve patient safety? A cluster randomised control trial of the Patient Reporting and Action for a Safe Environment (PRASE) intervention.

PubMed

Lawton, Rebecca; O'Hara, Jane Kathryn; Sheard, Laura; Armitage, Gerry; Cocks, Kim; Buckley, Hannah; Corbacho, Belen; Reynolds, Caroline; Marsh, Claire; Moore, Sally; Watt, Ian; Wright, John

2017-08-01

To evaluate the efficacy of the Patient Reporting and Action for a Safe Environment intervention. A multicentre cluster randomised controlled trial. Clusters were 33 hospital wards within five hospitals in the UK. All patients able to give informed consent were eligible to take part. Wards were allocated to the intervention or control condition. The ward-level intervention comprised two tools: (1) a questionnaire that asked patients about factors contributing to safety (patient measure of safety (PMOS)) and (2) a proforma for patients to report both safety concerns and positive experiences (patient incident reporting tool). Feedback was considered in multidisciplinary action planning meetings. Primary outcomes were routinely collected ward-level harm-free care (HFC) scores and patient-level feedback on safety (PMOS). Intervention uptake and retention of wards was 100% and patient participation was high (86%). We found no significant effect of the intervention on any outcomes at 6 or 12 months. However, for new harms (ie, those for which the wards were directly accountable) intervention wards did show greater, though non-significant, improvement compared with control wards. Analyses also indicated that improvements were largest for wards that showed the greatest compliance with the intervention. Adherence to the intervention, particularly the implementation of action plans, was poor. Patient safety outcomes may represent too blunt a measure. Patients are willing to provide feedback about the safety of their care. However, we were unable to demonstrate any overall effect of this intervention on either measure of patient safety and therefore cannot recommend this intervention for wider uptake. Findings indicate promise for increasing HFC where wards implement ≥75% of the intervention components. ISRCTN07689702; pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Utilization of cone-beam CT for offline evaluation of target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment.

PubMed

Paluska, Petr; Hanus, Josef; Sefrova, Jana; Rouskova, Lucie; Grepl, Jakub; Jansa, Jan; Kasaova, Linda; Hodek, Miroslav; Zouhar, Milan; Vosmik, Milan; Petera, Jiri

2012-01-01

To assess target volume coverage during prostate image-guided radiotherapy based on bony anatomy alignment and to assess possibility of safety margin reduction. Implementation of IGRT should influence safety margins. Utilization of cone-beam CT provides current 3D anatomic information directly in irradiation position. Such information enables reconstruction of the actual dose distribution. Seventeen prostate patients were treated with daily bony anatomy image-guidance. Cone-beam CT (CBCT) scans were acquired once a week immediately after bony anatomy alignment. After the prostate, seminal vesicles, rectum and bladder were contoured, the delivered dose distribution was reconstructed. Target dose coverage was evaluated by the proportion of the CTV encompassed by the 95% isodose. Original plans employed a 1 cm safety margin. Alternative plans assuming a smaller 7 mm margin between CTV and PTV were evaluated in the same way. Rectal and bladder volumes were compared with the initial ones. Rectal and bladder volumes irradiated with doses higher than 75 Gy, 70 Gy, 60 Gy, 50 Gy and 40 Gy were analyzed. In 12% of reconstructed plans the prostate coverage was not sufficient. The prostate underdosage was observed in 5 patients. Coverage of seminal vesicles was not satisfactory in 3% of plans. Most of the target underdosage corresponded to excessive rectal or bladder filling. Evaluation of alternative plans assuming a smaller 7 mm margin revealed 22% and 11% of plans where prostate and seminal vesicles coverage, respectively, was compromised. These were distributed over 8 and 7 patients, respectively. Sufficient dose coverage of target volumes was not achieved for all patients. Reducing of safety margin is not acceptable. Initial rectal and bladder volumes cannot be considered representative for subsequent treatment.

Improving the food provided and food safety practices in out-of-school-hours services.

PubMed

Cooke, Lara; Sangster, Janice; Eccleston, Philippa

2007-04-01

Food provided and food safety and serving practices in out-of-school-hours (OOSH) services. Health promotion strategies, developed in partnership with an advisory committee, were directed at three main areas: supporting local services; developing statewide training and resources; and advocacy. Significant improvements were seen in the food provided, food safety and serving practices and the number of services with planned menus and nutrition and food safety policies. This project is one of the first implemented and evaluated in the OOSH setting. Statistically significant improvements were achieved in the food provided, food safety and serving practices, and menu and policy development. The project also increased the capacity of the OOSH sector to improve children's health by making suitable nutrition and food safety resources and training available to OOSH services across New South Wales.

System cost performance analysis (study 2.3). Volume 1: Executive summary. [unmanned automated payload programs and program planning

NASA Technical Reports Server (NTRS)

Campbell, B. H.

1974-01-01

A study is described which was initiated to identify and quantify the interrelationships between and within the performance, safety, cost, and schedule parameters for unmanned, automated payload programs. The result of the investigation was a systems cost/performance model which was implemented as a digital computer program and could be used to perform initial program planning, cost/performance tradeoffs, and sensitivity analyses for mission model and advanced payload studies. Program objectives and results are described briefly.

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

PubMed

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

2015-11-01

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

78 FR 11754 - Approval and Promulgation of Implementation Plans; Tennessee: Knox County Supplement Motor...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-20

... December 18, 2012, (77 FR 74820), EPA proposed to approve through parallel processing Tennessee's October... well as changes to future vehicle mix assumptions, that influence the emission estimations. TDEC has... 2014. \\2\\ A safety margin is the difference between the attainment level of emissions from all source...

76 FR 72331 - Shiga Toxin-Producing Escherichia coli in Certain Raw Beef Products

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-23

... Escherichia coli in Certain Raw Beef Products AGENCY: Food Safety and Inspection Service, USDA. ACTION: Public...-O157 Shiga toxin-producing Escherichia coli in raw, intact and non-intact beef products and product... implementation plans and methods for controlling non-O157 Shiga toxin-producing Escherichia coli in raw, intact...

3 CFR 13610 - Executive Order 13610 of May 10, 2012. Identifying and Reducing Regulatory Burdens

Code of Federal Regulations, 2013 CFR

2013-01-01

..., welfare, safety, and our environment, but they can also impose significant burdens and costs. During... in light of changed circumstances, including the rise of new technologies. Executive Order 13563 of.... Significantly larger savings are anticipated as the plans are implemented and as action is taken on additional...

75 FR 16817 - Meeting for Software Developers on the Technical Specifications for Common Formats for Patient...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... Software Developers on the Technical Specifications for Common Formats for Patient Safety Data Collection... software developers can provide input on these technical specifications for the Common Formats Version 1.1... specifications, which provide direction to software developers that plan to implement the Common Formats...

75 FR 49536 - Petitions for Modification of Existing Mandatory Safety Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-13

... alternative method of achieving the result of such standard exists which will at all times guarantee no less... for inspection; (8) the proposed alternative method will not be implemented until miners who have been... training plans will apply. The petitioner asserts that the proposed alternative method will at all times...

78 FR 31614 - Implementation of Regulatory Guide 1.221 on Design-Basis Hurricane and Hurricane Missiles

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-24

... for Nuclear Power Plants,'' in support of NRC reviews of early site permit (ESP), standard design... NUREG-0800, ``Standard Review Plan for the Review of Safety Analysis Reports for Nuclear Power Plants... License Applications for Nuclear Power Plants, (LWR Edition)'' (ML070630003) In addition, this ISG...

78 FR 11984 - Approval and Promulgation of Implementation Plans; State of Hawaii; Update to Materials...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-21

...); Is not an economically significant regulatory action based on health or safety risks subject to... Environmental protection, Air pollution control, Carbon monoxide, Incorporation by reference, Intergovernmental... dust...... 11/29/1982 08/18/1983, 48 FR 37403 11-60-27 Incineration....... 11/29/1982 08/18/1983, 48 FR...

76 FR 17028 - Approval and Promulgation of Gila River Indian Community's Tribal Implementation Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... and judicial review in Tribal court, requirements for area sources of fugitive dust and fugitive... administrative appeals and judicial review in Tribal court, requirements for area sources of fugitive dust and... Risks and Safety Risks'' (62 FR 19885, April 23, 1997), because it is not economically significant. In...

Development of indicators for measuring outcomes of water safety plans

PubMed Central

Lockhart, Gabriella; Oswald, William E.; Hubbard, Brian; Medlin, Elizabeth; Gelting, Richard J.

2015-01-01

Water safety plans (WSPs) are endorsed by the World Health Organization as the most effective method of protecting a water supply. With the increase in WSPs worldwide, several valuable resources have been developed to assist practitioners in the implementation of WSPs, yet there is still a need for a practical and standardized method of evaluating WSP effectiveness. In 2012, the Centers for Disease Control and Prevention (CDC) published a conceptual framework for the evaluation of WSPs, presenting four key outcomes of the WSP process: institutional, operational, financial and policy change. In this paper, we seek to operationalize this conceptual framework by providing a set of simple and practical indicators for assessing WSP outcomes. Using CDC’s WSP framework as a foundation and incorporating various existing performance monitoring indicators for water utilities, we developed a set of approximately 25 indicators of institutional, operational, financial and policy change within the WSP context. These outcome indicators hold great potential for the continued implementation and expansion of WSPs worldwide. Having a defined framework for evaluating a WSP’s effectiveness, along with a set of measurable indicators by which to carry out that evaluation, will help implementers assess key WSP outcomes internally, as well as benchmark their progress against other WSPs in their region and globally. PMID:26361540

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.

Governance and implementation of sports safety practices by municipal offices in Swedish communities.

PubMed

Backe, S; Janson, S; Timpka, T

2012-01-01

The objective of this study was to explore whether all-purpose health or safety promotion programmes and sports safety policies affect sports safety practices in local communities. Case study research methods were used to compare sports safety activities among offices in 73 Swedish municipalities; 28 with ongoing health or safety promotion programmes and 45 controls. The offices in municipalities with the WHO Healthy Cities (HC) or Safe Communities programmes were more likely to perform frequent inspections of sports facilities, and offices in the WHO HC programme were more likely to involve sports clubs in inspections. More than every second, property management office and environmental protection office conducted sports safety inspections compared with less than one in four planning offices and social welfare offices. It is concluded that all-purpose health and safety promotion programmes can reach out to have an effect on sports safety practices in local communities. These safety practices also reflect administrative work routines and managerial traditions.

Impact of reduced ignition propensity cigarette regulation on consumer smoking behavior and quit intentions: evidence from 6 waves (2004–11) of the ITC Four Country Survey

PubMed Central

2013-01-01

Background Although on the decline, smoking-related fires remain a leading cause of fire death in the United States and United Kingdom and account for over 10% of fire-related deaths worldwide. This has prompted lawmakers to enact legislation requiring manufacturers to implement reduced ignition propensity (RIP) safety standards for cigarettes. The current research evaluates how implementation of RIP safety standards in different countries influenced smokers’ perceptions of cigarette self-extinguishment, frequency of extinguishment, and the impact on consumer smoking behaviors, including cigarettes smoked per day and planning to quit. Methods Participants for this research come from Waves 3 through 8 of the International Tobacco Control (ITC) Four Country Survey conducted longitudinally from 2004 through 2011 in the United States, United Kingdom, Australia, and Canada. Results Perceptions of cigarette self-extinguishment and frequency of extinguishment increased concurrently with an increase in the prevalence of RIP safety standards for cigarettes. Presence of RIP safety standards was also associated with a greater intention to quit smoking, but was not associated with the number of cigarettes smoked per day. Intention to quit was higher among those who were more likely to report that their cigarettes self-extinguish sometimes and often, but we found no evidence of an interaction between frequency of extinguishment and RIP safety standards on quit intentions. Conclusions Overall, because these standards largely do not influence consumer smoking behavior, RIP implementation may significantly reduce the number of cigarette-related fires and the associated death and damages. Further research should assess how implementation of RIP safety standards has influenced smoking-related fire incidence, deaths, and other costs associated with smoking-related fires. PMID:24359292

Impact of reduced ignition propensity cigarette regulation on consumer smoking behavior and quit intentions: evidence from 6 waves (2004-11) of the ITC Four Country Survey.

PubMed

Adkison, Sarah E; O'Connor, Richard J; Borland, Ron; Yong, Hua-Hie; Cummings, K Michael; Hammond, David; Fong, Geoffrey T

2013-12-21

Although on the decline, smoking-related fires remain a leading cause of fire death in the United States and United Kingdom and account for over 10% of fire-related deaths worldwide. This has prompted lawmakers to enact legislation requiring manufacturers to implement reduced ignition propensity (RIP) safety standards for cigarettes. The current research evaluates how implementation of RIP safety standards in different countries influenced smokers' perceptions of cigarette self-extinguishment, frequency of extinguishment, and the impact on consumer smoking behaviors, including cigarettes smoked per day and planning to quit. Participants for this research come from Waves 3 through 8 of the International Tobacco Control (ITC) Four Country Survey conducted longitudinally from 2004 through 2011 in the United States, United Kingdom, Australia, and Canada. Perceptions of cigarette self-extinguishment and frequency of extinguishment increased concurrently with an increase in the prevalence of RIP safety standards for cigarettes. Presence of RIP safety standards was also associated with a greater intention to quit smoking, but was not associated with the number of cigarettes smoked per day. Intention to quit was higher among those who were more likely to report that their cigarettes self-extinguish sometimes and often, but we found no evidence of an interaction between frequency of extinguishment and RIP safety standards on quit intentions. Overall, because these standards largely do not influence consumer smoking behavior, RIP implementation may significantly reduce the number of cigarette-related fires and the associated death and damages. Further research should assess how implementation of RIP safety standards has influenced smoking-related fire incidence, deaths, and other costs associated with smoking-related fires.

Safe Surgery for All: Early Lessons from Implementing a National Government-Driven Surgical Plan in Ethiopia.

PubMed

Burssa, Daniel; Teshome, Atlibachew; Iverson, Katherine; Ahearn, Olivia; Ashengo, Tigistu; Barash, David; Barringer, Erin; Citron, Isabelle; Garringer, Kaya; McKitrick, Victoria; Meara, John; Mengistu, Abraham; Mukhopadhyay, Swagoto; Reynolds, Cheri; Shrime, Mark; Varghese, Asha; Esseye, Samson; Bekele, Abebe

2017-12-01

Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity. As Ethiopia progresses with its commitment to prioritize surgery within its Health Sector Transformation Plan, disseminating the process and outcomes of the SaLTS initiative will inform other countries on successful national implementation strategies. The following article describes the process by which the Ethiopian FMOH established surgical system reform and the preliminary results of implementation across these eight pillars.

Evidence That The Citizenship Mandate Curtailed Participation In Oregon’s Medicaid Family Planning Program

PubMed Central

Angus, Lisa; DeVoe, Jennifer

2016-01-01

The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon’s Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net. PMID:20368600

Evidence that the citizenship mandate curtailed participation in Oregon's Medicaid family planning program.

PubMed

Angus, Lisa; Devoe, Jennifer

2010-04-01

The 2005 federal Deficit Reduction Act made proof of citizenship a requirement for Medicaid eligibility. We examined the effects on visits to Oregon's Medicaid family planning services eighteen months after the citizenship requirement was implemented. We analyzed 425,381 records of visits that occurred between May 2005 and April 2008 and found that, compared to the eighteen-month period before the mandate went into effect, visits declined by 33 percent. We conclude that Medicaid citizenship documentation requirements have been burdensome for Oregon Family Planning Expansion Project patients and costly for health care providers, reducing access to family planning and preventive measures and increasing the strain on the safety net.

Diabetes Health Information Technology Innovation to Improve Quality of Life for Health Plan Members in Urban Safety Net

PubMed Central

Ratanawongsa, Neda; Handley, Margaret A.; Sarkar, Urmimala; Quan, Judy; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2014-01-01

Safety net systems need innovative diabetes self-management programs for linguistically diverse patients. A low-income government-sponsored managed care plan implemented a 27-week automated telephone self-management support (ATSM) / health coaching intervention for English, Spanish-, and Cantonese-speaking members from four publicly-funded clinics in a practice-based research network. Compared to waitlist, immediate intervention participants had greater 6-month improvements in overall diabetes self-care behaviors (standardized effect size [ES] 0.29, p<0.01) and SF-12 physical scores (ES 0.25, p=0.03); changes in patient-centered processes of care and cardiometabolic outcomes did not differ. ATSM is a strategy for improving patient-reported self-management and may also improve some outcomes. PMID:24594561

A nationwide hospital survey on patient safety culture in Belgian hospitals: setting priorities at the launch of a 5-year patient safety plan.

PubMed

Vlayen, Annemie; Hellings, Johan; Claes, Neree; Peleman, Hilde; Schrooten, Ward

2012-09-01

To measure patient safety culture in Belgian hospitals and to examine the homogeneous grouping of underlying safety culture dimensions. The Hospital Survey on Patient Safety Culture was distributed organisation-wide in 180 Belgian hospitals participating in the federal program on quality and safety between 2007 and 2009. Participating hospitals were invited to submit their data to a comparative database. Homogeneous groups of underlying safety culture dimensions were sought by hierarchical cluster analysis. 90 acute, 42 psychiatric and 11 long-term care hospitals submitted their data for comparison to other hospitals. The benchmark database included 55 225 completed questionnaires (53.7% response rate). Overall dimensional scores were low, although scores were found to be higher for psychiatric and long-term care hospitals than for acute hospitals. The overall perception of patient safety was lower in French-speaking hospitals. Hierarchical clustering of dimensions resulted in two distinct clusters. Cluster I grouped supervisor/manager expectations and actions promoting safety, organisational learning-continuous improvement, teamwork within units and communication openness, while Cluster II included feedback and communication about error, overall perceptions of patient safety, non-punitive response to error, frequency of events reported, teamwork across units, handoffs and transitions, staffing and management support for patient safety. The nationwide safety culture assessment confirms the need for a long-term national initiative to improve patient safety culture and provides each hospital with a baseline patient safety culture profile to direct an intervention plan. The identification of clusters of safety culture dimensions indicates the need for a different approach and context towards the implementation of interventions aimed at improving the safety culture. Certain clusters require unit level improvements, whereas others demand a hospital-wide policy.

Building 9401-2 Plating Shop Surveillance and Maintenance Plan

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

None

1999-05-01

This document provides a plan for implementing surveillance and maintenance (S and M) activities to ensure that Building 9401-2 Plating Shop is maintained in a cost effective and environmentally secure configuration until subsequent closure during the final disposition phase of decommissioning. U.S. Department of Energy (DOE) G430.1A-2, Surveillance and Maintenance During Facility Disposition (1997), was used as guidance in the development of this plan. The S and M Plan incorporates DOE O 430.1A, Life Cycle Asset Management (LCAM) (1998a) direction to provide for conducting surveillance and maintenance activities required to maintain the facility and remaining hazardous and radioactive materials, wastes,more » and contamination in a stable and known condition pending facility disposition. Recommendations in the S and M plan have been made that may not be requirement-based but would reduce the cost and frequency of surveillance and maintenance activities. During the course of S and M activities, the facility's condition may change so as to present an immediate or developing hazard or unsatisfactory condition. Corrective action should be coordinated with the appropriate support organizations using the requirements and guidance stated in procedure Y10-202, Rev. 1, Integrated Safety Management Program, (Lockheed Martin Energy Systems, Inc. (LMES), 1998a) implemented at the Oak Ridge Y-12 Plant and the methodology of the Nuclear Operations Conduct of Operations Manual (LMES, 1999) for the Depleted Uranium Operations (DUO) organization. The key S and M objectives applicable to the Plating Shop are to: Ensure adequate containment of remaining residual material in exhaust stacks and outside process piping, stored chemicals awaiting offsite shipment, and items located in the Radioactive Material Area (RMA); Provide access control into the facility and physical safety to S and M personnel; Maintain the facility in a manner that will protect the public, the environment, and the S and M personnel; Provide an S and M plan which identifies and complies with applicable environmental, safety, and health safeguards and security requirements; and Provide a cost effective S and M program for the plating shop, Building 9401-2.« less

Beyond the classroom: a case study of immigrant safety liaisons in residential construction.

PubMed

Ochsner, Michele; Marshall, Elizabeth G; Martino, Carmen; Pabelón, Marién Casillas; Kimmel, Louis; Rostran, Damaris

2012-01-01

Latino day laborers often work at dangerous construction sites with little power to change conditions. We describe the development, implementation, and early-stage results of a program to train immigrant day laborers as safety liaisons. These are construction workers prepared to recognize and respond to health and safety hazards. Based in Newark, NJ, the project involves collaboration between New Labor, a membership-based worker center, and university researchers and labor educators. Safety liaisons undergo training and receive ongoing support for their roles. Both qualitative and quantitative data are collected to monitor progress. Although lacking in formal authority, safety liaisons have prompted improvements at specific sites, filed OSHA complaints, and developed a local worker council. Participatory training methods, opportunities for leadership outside the classroom, and participation in project planning have strengthened liaisons' effectiveness, leadership skills, and commitment. The safety liaison approach could be adapted by worker centers and their partner organizations.

Monitoring road safety development at regional level: A case study in the ASEAN region.

PubMed

Chen, Faan; Wang, Jianjun; Wu, Jiaorong; Chen, Xiaohong; Zegras, P Christopher

2017-09-01

Persistent monitoring of progress, evaluating the results of interventions and recalibrating to achieve continuous improvement over time is widely recognized as being crucial towards the successful development of road safety. In the ASEAN (Association of Southeast Asian Nations) region there is a lack of well-resourced teams that contain multidisciplinary safety professionals, and specialists in individual countries, who are able to carry out this work effectively. In this context, not only must the monitoring framework be effective, it must also be easy to use and adapt. This paper provides a case study that can be easily reproduced; based on an updated and refined Road Safety Development Index (RSDI), by means of the RSR (Rank-sum ratio)-based model, for monitoring/reporting road safety development at regional level. The case study was focused on the road safety achievements in eleven Southeast Asian countries; identifying the areas of poor performance, potential problems and delays. These countries are finally grouped into several classes based on an overview of their progress and achievements regarding to road safety. The results allow the policymakers to better understand their own road safety progress toward their desired impact; more importantly, these results enable necessary interventions to be made in a quick and timely manner. Keeping action plans on schedule if things are not progressing as desired. This would avoid 'reinventing the wheel' and trial and error approaches to road safety, making the implementation of action plans more effective. Copyright © 2017 Elsevier Ltd. All rights reserved.

Proceedings of the High Consequence Operations Safety Symposium

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

Not Available

1994-12-01

Many organizations face high consequence safety situations where unwanted stimuli due to accidents, catastrophes, or inadvertent human actions can cause disasters. In order to improve interaction among such organizations and to build on each others` experience, preventive approaches, and assessment techniques, the High Consequence Operations Safety Symposium was held July 12--14, 1994 at Sandia National Laboratories, Albuquerque, New Mexico. The symposium was conceived by Dick Schwoebel, Director of the SNL Surety Assessment Center. Stan Spray, Manager of the SNL System Studies Department, planned strategy and made many of the decisions necessary to bring the concept to fruition on a shortmore » time scale. Angela Campos and about 60 people worked on the nearly limitless implementation and administrative details. The initial symposium (future symposia are planned) was structured around 21 plenary presentations in five methodology-oriented sessions, along with a welcome address, a keynote address, and a banquet address. Poster papers addressing the individual session themes were available before and after the plenary sessions and during breaks.« less

Preventing home health nursing assistant back and shoulder injuries.

PubMed

Leff, E W; Hagenbach, G L; Marn, K K

2000-10-01

Franklin County Home Health Agency (St Albans, Vermont) undertook a performance improvement project in 1996 to reduce employee injuries. A review of recent injuries led to the prevention of licensed nursing assistants' (LNAs') back and shoulder injuries as the first priority. Root causes of injuries were agency communication, employee training, patient home environment, nursing assistant body mechanics, and failure to use safety measures. Given that injury causality is complex and multifactorial, a variety of improvement strategies were implemented over the following two to three years. IMPLEMENTATION OF POTENTIAL SOLUTIONS: Short-term (a few months), mid-term (six months), and long-term (one year) potential solutions to the LNA back and shoulder injury problem were charted. Safety and health training was the major focus of the team's short-term plan. Risk management forms were to be used to identify and follow up on hazardous situations. Project plans that were successfully implemented included revision of LNA plans of care, standardization of the return-to-work process after injury, development of guidelines for identifying unsafe patient lifts and transfers, improved follow-up of employee reports of injury-risk situations in patient homes, improved body mechanics screening of new employees, and a stronger injury-prevention training program for current employees. A less successful initiative was aimed at collecting more data about injuries and causal factors. Employee injuries were gradually reduced from 4-10 per quarter to 0-3 per quarter. Injury prevention requires commitment, persistence, and patience--but not expensive improvements. Multiple interventions increase the chances of success when there are many root causes and lack of evidence regarding the effectiveness of various approaches.

Safety Planning for Military (SAFE MIL): rationale, design, and safety considerations of a randomized controlled trial to reduce suicide risk among psychiatric inpatients.

PubMed

Ghahramanlou-Holloway, Marjan; Brown, Gregory K; Currier, Glenn W; Brenner, Lisa; Knox, Kerry L; Grammer, Geoffrey; Carreno-Ponce, Jaime T; Stanley, Barbara

2014-09-01

Mental health related hospitalizations and suicide are both significant public health problems within the United States Department of Defense (DoD). To date, few evidence-based suicide prevention programs have been developed for delivery to military personnel and family members admitted for psychiatric inpatient care due to suicidal self-directed violence. This paper describes the rationale and detailed methodology for a study called Safety Planning for Military (SAFE MIL) which involves a randomized controlled trial (RCT) at the largest military treatment facility in the United States. The purpose of this study is to test the efficacy of a brief, readily accessible, and personalized treatment called the Safety Planning Intervention (Stanley and Brown, 2012). Primary outcomes, measured by blinded assessors at one and six months following psychiatric discharge, include suicide ideation, suicide-related coping, and attitudes toward help seeking. Additionally, given the study's focus on a highly vulnerable patient population, a description of safety considerations for human subjects' participation is provided. Based on this research team's experience, the implementation of an infrastructure in support of RCT research within DoD settings and the processing of regulatory approvals for a clinical trial with high risk suicidal patients are expected to take up to 18-24 months. Recommendations for expediting the advancement of clinical trials research within the DoD are provided in order to maximize cost efficacy and minimize the research to practice gap. Published by Elsevier Inc.

Planning and Implementing a 3D Printing Service in an Academic Library

ERIC Educational Resources Information Center

Gonzalez, Sara Russell; Bennett, Denise Beaubien

2014-01-01

Initiating a 3D printing service in an academic library goes beyond justification of its value and gaining the necessary library and administrative support. Additional aspects such as policies, environmental safety, training, publicizing, maintenance, and scope of service must be considered. This article provides a guide to developing a 3D print…

Low-Cost In-Fill Installation for High-Energy-Saving, Dynamic Windows

DTIC Science & Technology

2017-07-01

greenhouse gas, HVAC, low emissivity, military construction, photovoltaic, physical vapor deposition, solar heat gain coefficient... Physical vapor deposition ROICC Resident Officer In Charge of Construction SHGC Solar heat gain coefficient S/RM Sustainment, Restoration, and...PERMITS AND REGULATIONS Regulations - The demonstration project planning and implementation followed US Army Corps of Engineers Safety and Health

Inside the Actors' Studio: Exploring Dietetics Education Practices through Dialogical Inquiry

ERIC Educational Resources Information Center

Fox, Ann L.; Gingras, Jacqui

2012-01-01

Two colleagues, Ann and Jacqui, came together, within the safety of an imagined actors' studio, to explore the challenges that Ann faced in planning a new graduate program in public health nutrition. They met before, during, and after program implementation to discuss Ann's experiences, and audio-taped and transcribed the discussions. When all…

78 FR 46504 - Approval and Promulgation of Implementation Plans, State of California, San Joaquin Valley...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

..., in light of information available at the time, to recognize that the District did not have the... time after the effective date of our May 2004 approval of the 2002- amended District NSR rules (i.e... time, District Rule 2020, citing California Health & Safety Code (CH&SC) section 42310(e), included a...

The Multiple-Car Method. Exploring Its Use in Driver and Traffic Safety Education. Second Edition.

ERIC Educational Resources Information Center

American Driver and Traffic Safety Education Association, Washington, DC.

Primarily written for school administrators and driver education teachers, this publication presents information on planning and implementing the multiple car method of driver instruction. An introductory section presents a definition of the multiple car method and its history of development. It is defined as an off-street paved area incorporating…

Principles of Safety in Physical Education and Sport. Revised Edition.

ERIC Educational Resources Information Center

Dougherty, Neil J., IV, Ed.

The purpose of this book is to assist physical education teachers in the development and implementation of a safe and well-balanced program of activities and to provide students with information about safe participation in common sports. Using a checklist format, information is presented to facilitate the development of unit and lesson plans. The…

75 FR 21169 - Approval and Promulgation of Air Quality Implementation Plans; New Mexico; Revisions to New...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... maintenance for carbon monoxide; and Removing the provision that allowed 8-hour ozone areas to use other tests..., 1999); Is not an economically significant regulatory action based on health or safety risks subject to...--Analysis in Serious, Severe, and Extreme Ozone Nonattainment Areas and Serious Carbon Monoxide Areas. 20.2...

77 FR 59335 - Approval and Promulgation of Implementation Plans; North Carolina: Approval of Rocky Mount Motor...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

... account for any future changes to the emission model, projection model and other input data. \\2\\ A safety... changes in the emissions model and vehicle miles traveled (VMT) projection model. EPA is approving this... Regional Office's official hours of business are Monday through Friday, 8:30 to 4:30, excluding federal...

Fluor Daniel Hanford Inc. integrated safety management system phase 1 verification final report

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

PARSONS, J.E.

1999-10-28

The purpose of this review is to verify the adequacy of documentation as submitted to the Approval Authority by Fluor Daniel Hanford, Inc. (FDH). This review is not only a review of the Integrated Safety Management System (ISMS) System Description documentation, but is also a review of the procedures, policies, and manuals of practice used to implement safety management in an environment of organizational restructuring. The FDH ISMS should support the Hanford Strategic Plan (DOE-RL 1996) to safely clean up and manage the site's legacy waste; deploy science and technology while incorporating the ISMS theme to ''Do work safely''; andmore » protect human health and the environment.« less

Huong Dan Cho Phu Huynh Ve Thanh Qua La Viec Quan Trong Nhat: Ke hoach giao duc cua Maryland cho cac lop chuan bi hoc mau giao den lop 12, 2002-2003. (A Parent's Guide to Achievement Matters Most: Maryland's Plan for PreK-12 Education, 2002-2003).

ERIC Educational Resources Information Center

Maryland State Dept. of Education, Baltimore.

To raise the achievement of every student in the state, Maryland implemented "Achievement Matters Most," a new plan for public elementary and secondary schools that sets goals in the areas of achievement, teaching, testing, safety, and family involvement in schools. This Vietnamese-language guide for parents outlines the goals and…

Manufacturing engineering: Principles for optimization

NASA Astrophysics Data System (ADS)

Koenig, Daniel T.

Various subjects in the area of manufacturing engineering are addressed. The topics considered include: manufacturing engineering organization concepts and management techniques, factory capacity and loading techniques, capital equipment programs, machine tool and equipment selection and implementation, producibility engineering, methods, planning and work management, and process control engineering in job shops. Also discussed are: maintenance engineering, numerical control of machine tools, fundamentals of computer-aided design/computer-aided manufacture, computer-aided process planning and data collection, group technology basis for plant layout, environmental control and safety, and the Integrated Productivity Improvement Program.

Hypergol Maintenance Facility Hazardous Waste South Staging Areas, SWMU 070

NASA Technical Reports Server (NTRS)

Wilson, Deborah M.; Miller, Ralinda R.

2015-01-01

The purpose of this CMI Year 9 AGWMR is to present the actions taken and results obtained during the ninth year of implementation of Corrective Measures (CM) at HMF. Groundwater monitoring activities were conducted in accordance with the CMI Work Plan (Tetra Tech, 2005a) and CMI Site-Specific Safety and Health Plan (Tetra Tech, 2005b). Groundwater monitoring activities detailed in this Year 9 report include pre-startup sampling in February 2014(prior to restarting the air sparging system) and quarterly performance monitoring in March, July, and September 2014.

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.

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

NONE

Pollution Prevention (P2) has evolved into one of DOE`s sprime strategies to meet environmental, fiscal, and worker safety obligations. P2 program planning, opportunity identification, and implementation tools were developed under the direction of the Waste Minimization Division (EM-334). Forty experts from EM, DP, ER and DOE subcontractors attended this 2-day workshop to formulate the incentives to drive utilization of these tools. Plenary and small working group sessions were held both days. Working Group 1 identified incentives to overcoming barriers in the area of P2 program planning and resource allocation. Working Group 2 identified mechanisms to drive the completion of P2more » assessments and generation of opportunities. Working Group 3 compiled and documented a broad range of potential P2 incentives that address fundamental barriers to implementation of cost effective opportunities.« less

Risk Management Plans: are they a tool for improving drug safety?

PubMed

Frau, Serena; Font Pous, Maria; Luppino, Maria Rosa; Conforti, Anita

2010-08-01

In 2005, new European legislation authorised Regulatory Agencies to require drug companies to submit a risk management plan (RMP) comprising detailed commitments for post-marketing pharmacovigilance. The aim of the study is to describe the characteristics of RMP for 15 drugs approved by the European Medicines Agency (EMA) and their impact on post-marketing safety issues. Of the 90 new Chemical Entities approved through a centralised procedure by the EMA during 2006 and 2007, 15 of them were selected and their safety aspects and relative RMPs analysed. All post-marketing communications released for safety reasons related to these drugs were also considered. A total of 157 safety specifications were established for the drugs assessed. Risk minimisation activities were foreseen for 5 drugs as training activities. Post-marketing safety issues emerged for 12 of them, leading to 39 type II variations in Summary of Product Characteristics (SPC). Nearly half of such variations, 19 (49%), concerned safety aspects not envisaged by the RMPs. Besides this, 9 Safety Communications were published for 6 out of 15 drugs assessed. The present study reveals several critical points on the way RMPs have been implemented. Several activities proposed by the RMPs do not appear to be adequate in dealing with the potential risks of drugs. Poor communication of risk to practitioners and to the public, and above all limited transparency for the total assessment of risk, seem to transform RMPs into a tool to reassure the public when inadequately evaluated drugs are granted premature marketing authorisation.

Implementing AORN recommended practices for a safe environment of care, part II.

PubMed

Kennedy, Lynne

2014-09-01

Construction in and around a working perioperative suite is a challenge beyond merely managing traffic patterns and maintaining the sterile field. The AORN "Recommended practices for a safe environment of care, part II" provides guidance on building design; movement of patients, personnel, supplies, and equipment; environmental controls; safety and security; and control of noise and distractions. Whether the OR suite evolves through construction, reconstruction, or remodeling, a multidisciplinary team of construction experts and health care professionals should create a functional plan and communicate at every stage of the project to maintain a safe environment and achieve a well-designed outcome. Emergency preparedness, a facility-wide security plan, and minimization of noise and distractions in the OR also help enhance the safety of the perioperative environment. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

WE-G-BRA-01: Patient Safety and Treatment Quality Improvement Through Incident Learning: Experience of a Non-Academic Proton Therapy Center

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

Zheng, Y; Johnson, R; Zhao, L

2015-06-15

Purpose: Incident learning has been proven to improve patient safety and treatment quality in conventional radiation therapy. However, its application in proton therapy has not been reported yet to our knowledge. In this study, we report our experience in developing and implementation of an in-house incident learning system. Methods: An incident learning system was developed based on published principles and tailored for our clinical practice and available resource about 18 months ago. The system includes four layers of error detection and report: 1) dosimetry peer review; 2) physicist plan quality assurance (QA); 3) treatment delivery issue on call and record;more » and 4) other incident report. The first two layers of QA and report were mandatory for each treatment plan through easy-to-use spreadsheets that are only accessible by the dosimetry and physicist departments. The treatment delivery issues were recorded case by case by the on call physicist. All other incidents were reported through an online incident report system, which can be anonymous. The incident report includes near misses on planning and delivery, process deviation, machine issues, work flow and documentation. Periodic incident reviews were performed. Results: In total, about 116 errors were reported through dosimetry review, 137 errors through plan QA, 83 treatment issues through physics on call record, and 30 through the online incident report. Only 8 incidents (2.2%) were considered to have a clinical impact to patients, and the rest of errors were either detected before reaching patients or had negligible dosimetric impact (<5% dose variance). Personnel training & process improvements were implemented upon periodic incident review. Conclusion: An incident learning system can be helpful in personnel training, error reduction, and patient safety and treatment quality improvement. The system needs to be catered for each clinic’s practice and available resources. Incident and knowledge sharing among proton centers are encouraged.« less

Implementing electronic handover: interventions to improve efficiency, safety and sustainability.

PubMed

Alhamid, Sharifah Munirah; Lee, Desmond Xue-Yuan; Wong, Hei Man; Chuah, Matthew Bingfeng; Wong, Yu Jun; Narasimhalu, Kaavya; Tan, Thuan Tong; Low, Su Ying

2016-10-01

Effective handovers are critical for patient care and safety. Electronic handover tools are increasingly used today to provide an effective and standardized platform for information exchange. The implementation of an electronic handover system in tertiary hospitals can be a major challenge. Previous efforts in implementing an electronic handover tool failed due to poor compliance and buy-in from end-users. A new electronic handover tool was developed and incorporated into the existing electronic medical records (EMRs) for medical patients in Singapore General Hospital (SGH). There was poor compliance by on-call doctors in acknowledging electronic handovers, and lack of adherence to safety rules, raising concerns about the safety and efficiency of the electronic handover tool. Urgent measures were needed to ensure its safe and sustained use. A quality improvement group comprising stakeholders, including end-users, developed multi-faceted interventions using rapid PDSA (P-Plan, D-Do, S-Study, A-Act ) cycles to address these issues. Innovative solutions using media and online software provided cost-efficient measures to improve compliance. The percentage of unacknowledged handovers per day was used as the main outcome measure throughout all PDSA cycles. Doctors were also assessed for improvement in their knowledge of safety rules and their perception of the electronic handover tool. An electronic handover tool complementing daily clinical practice can be successfully implemented using solutions devised through close collaboration with end-users supported by the senior leadership. A combined 'bottom-up' and 'top-down' approach with regular process evaluations is crucial for its long-term sustainability. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

NONE

In the Bear Creek Valley Watershed Remedial Investigation, the Boneyard/Burnyard was identified as the source of the largest releases of uranium into groundwater and surface water in Bear Creek Valley. The proposed action for remediation of this site is selective excavation and removal of source material and capping of the remainder of the site. The schedule for this action has been accelerated so that this is the first remedial action planned to be implemented in the Bear Creek Valley Record of Decision. Additional data needs to support design of the remedial action were identified at a data quality objectives meetingmore » held for this project. Sampling at the Boneyard/Burnyard will be conducted through the use of a phased approach. Initial or primary samples will be used to make in-the-field decisions about where to locate follow-up or secondary samples. On the basis of the results of surface water, soil, and groundwater analysis, up to six test pits will be dug. The test pits will be used to provide detailed descriptions of source materials and bulk samples. This document sets forth the requirements and procedures to protect the personnel involved in this project. This document also contains the health and safety plan, quality assurance project plan, waste management plan, data management plan, implementation plan, and best management practices plan for this project as appendices.« less

Lawrence Berkeley Laboratory Institutional Plan, FY 1993--1998

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

Not Available

1992-10-01

The FY 1993--1998 Institutional Plan provides an overview of the Lawrence Berkeley Laboratory mission, strategic plan, scientific initiatives, research programs, environment and safety program plans, educational and technology transfer efforts, human resources, and facilities needs. The Strategic Plan section identifies long-range conditions that can influence the Laboratory, potential research trends, and several management implications. The Initiatives section identifies potential new research programs that represent major long-term opportunities for the Laboratory and the resources required for their implementation. The Scientific and Technical Programs section summarizes current programs and potential changes in research program activity. The Environment, Safety, and Health section describesmore » the management systems and programs underway at the Laboratory to protect the environment, the public, and the employees. The Technology Transfer and Education programs section describes current and planned programs to enhance the nation's scientific literacy and human infrastructure and to improve economic competitiveness. The Human Resources section identifies LBL staff composition and development programs. The section on Site and Facilities discusses resources required to sustain and improve the physical plant and its equipment. The Resource Projections are estimates of required budgetary authority for the Laboratory's ongoing research programs. The plan is an institutional management report for integration with the Department of Energy's strategic planning activities that is developed through an annual planning process. The plan identifies technical and administrative directions in the context of the National Energy Strategy and the Department of Energy's program planning initiatives. Preparation of the plan is coordinated by the Office for Planning and Development from information contributed by the Laboratory's scientific and support divisions.« less

Lessons learned from the implementation of a bedside handoff model.

PubMed

Hagman, Jan; Oman, Kathleen; Kleiner, Catherine; Johnson, Elizabeth; Nordhagen, Jamie

2013-06-01

At the University of Colorado Hospital, nurse-to-nurse shift reports traditionally occurred in a conference room setting and consisted of nurse-to-nurse verbal communication. Evidence supports moving this information exchange to the patient bedside. This model of report improves clinical effectiveness, patient safety, nurse efficiency, and staff satisfaction. Bedside reporting empowers patients and families to ask questions and contribute to their plan of care and increases patient satisfaction. This article describes the process of implementing and evaluating a model of nurse-to-nurse bedside handoff report.

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.

Adapting and implementing an evidence-based sun-safety education program in rural Idaho, 2012.

PubMed

Cariou, Charlene; Gonzales, Melanie; Krebill, Hope

2014-05-08

Melanoma incidence and mortality rates in Idaho are higher than national averages. The importance of increased awareness of skin cancer has been cited by state and local organizations. St. Luke's Mountain States Tumor Institute (MSTI) prioritized educational outreach efforts to focus on the implementation of a skin cancer prevention program in rural Idaho. As a community cancer center, MSTI expanded cancer education services to include dedicated support to rural communities. Through this expansion, an MSTI educator sought to partner with a community organization to provide sun-safety education. MSTI selected, adapted, and implemented an evidence-based program, Pool Cool. The education program was implemented in 5 phases. In Phase I, we identified and recruited a community partner; in Phase 2, after thorough research, we selected a program, Pool Cool; in Phase 3, we planned the details of the program, including identification of desired short- and long-term outcomes and adaptation of existing program materials; in Phase 4, we implemented the program in summer 2012; in Phase 5, we assessed program sustainability and expansion. MSTI developed a sustainable partnership with Payette Municipal Pool, and in summer 2012, we implemented Pool Cool. Sun-safety education was provided to more than 700 young people aged 2 to 17 years, and educational signage and sunscreen benefitted hundreds of additional pool patrons. Community cancer centers are increasingly being asked to assess community needs and implement evidence-based prevention and screening programs. Clinical staff may become facilitators of evidence-based public health programs. Challenges of implementing evidence-based programs in the context of a community cancer centers are staffing, leveraging of resources, and ongoing training and support.

Adapting and Implementing an Evidence-Based Sun-Safety Education Program in Rural Idaho, 2012

PubMed Central

Gonzales, Melanie; Krebill, Hope

2014-01-01

Background Melanoma incidence and mortality rates in Idaho are higher than national averages. The importance of increased awareness of skin cancer has been cited by state and local organizations. St. Luke’s Mountain States Tumor Institute (MSTI) prioritized educational outreach efforts to focus on the implementation of a skin cancer prevention program in rural Idaho. Community Context As a community cancer center, MSTI expanded cancer education services to include dedicated support to rural communities. Through this expansion, an MSTI educator sought to partner with a community organization to provide sun-safety education. MSTI selected, adapted, and implemented an evidence-based program, Pool Cool. Methods The education program was implemented in 5 phases. In Phase I, we identified and recruited a community partner; in Phase 2, after thorough research, we selected a program, Pool Cool; in Phase 3, we planned the details of the program, including identification of desired short- and long-term outcomes and adaptation of existing program materials; in Phase 4, we implemented the program in summer 2012; in Phase 5, we assessed program sustainability and expansion. Outcome MSTI developed a sustainable partnership with Payette Municipal Pool, and in summer 2012, we implemented Pool Cool. Sun-safety education was provided to more than 700 young people aged 2 to 17 years, and educational signage and sunscreen benefitted hundreds of additional pool patrons. Interpretation Community cancer centers are increasingly being asked to assess community needs and implement evidence-based prevention and screening programs. Clinical staff may become facilitators of evidence-based public health programs. Challenges of implementing evidence-based programs in the context of a community cancer centers are staffing, leveraging of resources, and ongoing training and support. PMID:24809363

Leveraging the Partnership for Patients' Initiative to Improve Patient Safety and Quality Within the Military Health System.

PubMed

King, Heidi B; Kesling, Kimberly; Birk, Carmen; Walker, Theodore; Taylor, Heather; Datena, Michael; Burgess, Brittany; Bower, Lyndsay

2017-03-01

Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011. Participation of the Military Health System (MHS) in PfP marked the implementation of the first enterprise-wide patient safety initiative. Three phases of the MHS initiative were developed to meet the aims of the national PfP initiative: (1) Planning and Design, (2) Implementation, and (3) Monitoring and Sustainment. The Planning and Design phase focused on the identification of evidence-based practices (Table III); the development of implementation guides; the implementation of various communication, education, and improvement strategies; and the development of methods by which to track progress and share successes. The implementation phase focused on identifying roles and responsibilities across all levels of care; creating, disseminating, and implementing evidence-based practices at participating military treatment facilities; and establishing a structured learning action network. Finally, during the monitoring and sustainment phase, per the guidance of the Agency for Healthcare Research and Quality, an overall HAC rate was developed for quarterly analysis. The HAC rate per 1,000 dispositions (i.e., discharges) was an aggregate of all PfP HACs. Using the HAC rate, the improvement rate was calculated by comparing the current quarter's HAC rate to the baseline (CY2010). This allowed the MHS to track the overall progress across the enterprise. The MHS achieved a number of accomplishments, including a 15.8% cumulative reduction in HACs by the end of 2013, an 11.1% reduction in readmissions, avoided nearly 500 harm events since PfP implementation, and approximately $13.5 million in cost avoidance (on the basis of national cost estimate data available at the beginning of the PfP initiative). The two most critical lessons learned for the MHS during the PfP initiative are (1) continuous leadership engagement and inspection is vital to ensure field workers are engaged with safety and quality expectations and (2) applying a "one-size-fits-all" approach to improve a large delivery system is not effective. In addition, it is most impactful when local military treatment facility-level teams are involved in determining strategies to implement evidence-based standard processes and protocols that reduce variation when integrating practice change into daily operations. The MHS will continue to integrate PfP efforts into improvement activities by leveraging lessons learned from this initiative and determining how they can be applied to other areas of care and/or patient safety and quality initiatives. The Patient Safety Improvement Collaborative has committed to oversee and support the establishment and implementation of ongoing, focused patient safety and quality initiatives across the MHS using a collaborative vision to engage all levels of leadership and staff, and to ensure sustained improvements. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Evaluating the Implementation of a Twitter-Based Foodborne Illness Reporting Tool in the City of St. Louis Department of Health.

PubMed

Harris, Jenine K; Hinyard, Leslie; Beatty, Kate; Hawkins, Jared B; Nsoesie, Elaine O; Mansour, Raed; Brownstein, John S

2018-04-24

Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City of St. Louis Department of Health adopted the HealthMap Foodborne Dashboard (Dashboard), a tool that monitors Twitter for tweets about food poisoning in a geographic area and allows the health department to respond. We evaluated the implementation by interviewing employees of the City of St. Louis Department of Health involved in food safety. We interviewed epidemiologists, environmental health specialists, health services specialists, food inspectors, and public information officers. Participants viewed engaging innovation participants and executing the innovation as challenges while they felt the Dashboard had relative advantage over existing reporting methods and was not complex once in place. This study is the first to examine practitioner perceptions of the implementation of a new technology in a local health department. Similar implementation projects should focus more on process by developing clear and comprehensive plans to educate and involve stakeholders prior to implementation.

Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation

PubMed Central

Sheard, Laura; Marsh, Claire; O’Hara, Jane; Armitage, Gerry; Wright, John; Lawton, Rebecca

2017-01-01

Objectives A patient safety intervention was tested in a 33-ward randomised controlled trial. No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards. Design Large qualitative process evaluation of the implementation of a patient safety intervention. Setting and participants National Health Service staff based on 17 acute hospital wards located at five hospital sites in the North of England. Data We concentrate on three sources here: (1) analysis of taped discussion between ward staff during action planning meetings; (2) facilitators’ field notes and (3) follow-up telephone interviews with staff focusing on whether action plans had been achieved. The analysis involved the use of pen portraits and adaptive theory. Findings First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff. Conclusions A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components. PMID:28710206

Design, implementation, and first-year outcomes of a value-based drug formulary.

PubMed

Sullivan, Sean D; Yeung, Kai; Vogeler, Carol; Ramsey, Scott D; Wong, Edward; Murphy, Chad O; Danielson, Dan; Veenstra, David L; Garrison, Louis P; Burke, Wylie; Watkins, John B

2015-04-01

Value-based insurance design attempts to align drug copayment tier with value rather than cost. Previous implementations of value-based insurance design have lowered copayments for drugs indicated for select "high value" conditions and have found modest improvements in medication adherence. However, these implementations have generally not resulted in cost savings to the health plan, suggesting a need for increased copayments for "low value" drugs. Further, previous implementations have assigned equal copayment reductions to all drugs within a therapeutic area without assessing the value of individual drugs. Aligning the individual drug's copayment to its specific value may yield greater clinical and economic benefits. In 2010, Premera Blue Cross, a large not-for-profit health plan in the Pacific Northwest, implemented a value-based drug formulary (VBF) that explicitly uses cost-effectiveness analyses after safety and efficacy reviews to estimate the value of each individual drug. Concurrently, Premera increased copayments for existing tiers. To describe and evaluate the design, implementation, and first-year outcomes of the VBF. We compared observed pharmacy cost per member per month in the year following the VBF implementation with 2 comparator groups: (1) observed pharmacy costs in the year prior to implementation, and (2) expected costs if no changes were made to the pharmacy benefits. Expected costs were generated by applying autoregressive integrated moving averages to pharmacy costs over the previous 36 months. We used an interrupted time series analysis to assess drug use and adherence among individuals with diabetes, hypertension, or dyslipidemia compared with a group of members in plans that did not implement a VBF.  Pharmacy costs decreased by 3% compared with the 12 months prior and 11% compared with expected costs. There was no significant decline in medication use or adherence to treatments for patients with diabetes, hypertension, or dyslipidemia. The VBF and copayment changes enabled pharmacy plan cost savings without negatively affecting utilization in key disease states.

Filling the Frame. Adult Education and Vocational Training Institute Guidelines for the Implementation of Integrated Curricula within the Certificates of General Education for Adults Framework.

ERIC Educational Resources Information Center

New South Wales Dept. of Corrective Services, Sydney (Australia).

This document contains learning modules for adult basic education courses in Australia, along with teacher information for integrating curricula, using integrated themes, and planning curricula. The learning modules contain learning activities in the following areas: job search skills; occupational health and safety; life skills; ceramics;…

75 FR 44276 - Bureau of Ocean Energy Management, Regulation, and Enforcement (BOEMRE); Cancellation of Oil and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-28

... Horizon Oil Spill and Offshore Drilling, (the National Commission was established by Executive Order 13543...); Cancellation of Oil and Gas Lease Sale 220 in the Mid- Atlantic Planning Area on the Outer Continental Shelf.... Cancellation of Sale 220 will allow time to develop and implement measures to improve the safety of oil and gas...

Evaluation of DoD Biological Safety and Security Implementation

DTIC Science & Technology

2016-04-27

biosecurity policy and directives, plans, orders, and guidance across DoD Component laboratories that were conducting research using biological select ...taken, • ensure that all BSAT laboratories are inspected regularly according to a standardized set of criteria , • coordinate external technical and...Biological Select Agent and Toxins laboratory inspections. Management Comments and Our Response The Under Secretary of Defense for Acquisition

Resources planning for radiological incidents management

NASA Astrophysics Data System (ADS)

Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

2017-01-01

Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

[Design of a HACCP Plan for the Gouda-type cheesemaking process in a milk processing plant].

PubMed

Dávila, Jacqueline; Reyes, Genara; Corzo, Otoniel

2006-03-01

The Hazard Analysis and Critical Control Point (HACCP) is a preventive and systematic method used to identify, assess and control of the hazards related with raw material, ingredients, processing, marketing and intended consumer in order to assure the safety of the food. The aim of this study was to design a HACCP plan for implementing in a Gouda-type cheese-making process in a dairy processing plant. The used methodology was based in the application of the seven principles of the HACCP, the information from the plant about the compliment of the pre-requisite programs (70-80%), the experience of the HACCP team and the sequence of stages settles down by the COVENIN standard 3802 for implementing the HACCP system. A HACCP plan was proposed with the scope, the selection of HACCP team, the description of the product and the intended use, the flow diagram of the process, the hazard analysis and the control table of the plan with the critical control points (CCP). The following CCP were identified in the process: pasteurization, coagulation and ripening.

Report on SARS backfit evaluation, Exxon Donor Solvent Plant, Baytown, Texas

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

Meyer, A.F. Jr.

1980-07-02

This report provides information on observations, findings, and conclusions arising from a site visit to the Exxon Donor Solvent Plant, Baytown, Texas. That visit was to provide technical assistance and professional services to the DOE/ASFE/OPTA Project Officer regarding verification of his initial determination that this pilot plant is exempt from the SARS backfit requirement (DOE Order 5481.1). A secondary purpose was to obtain further information regarding the occupational safety and health plans and procedures at this new pilot plant facility. It is concluded that a well planned and implemented occupational safety and health program exists at the Exxon Donor Solventmore » Plant. Excellent manuals regarding general safety requirements and protection against carcinogens have been prepared and distributed. A Safe Operations Committee is in effect as is a Risk Management Committee. Adequate safety and industrial hygiene staff has been assigned and an excellent medical surveillance program has been established. Adequate compliance with environmental codes, standards, and regulations is being achieved. Although this plant is not subject to SARS because of the nature of the contract, adequate documentation exists in any case to exempt it from the SARS backfit requirement.« less

Status and future of Quantitative Microbiological Risk Assessment in China

PubMed Central

Dong, Q.L.; Barker, G.C.; Gorris, L.G.M.; Tian, M.S.; Song, X.Y.; Malakar, P.K.

2015-01-01

Since the implementation of the Food Safety Law of the People's Republic of China in 2009 use of Quantitative Microbiological Risk Assessment (QMRA) has increased. QMRA is used to assess the risk posed to consumers by pathogenic bacteria which cause the majority of foodborne outbreaks in China. This review analyses the progress of QMRA research in China from 2000 to 2013 and discusses 3 possible improvements for the future. These improvements include planning and scoping to initiate QMRA, effectiveness of microbial risk assessment utility for risk management decision making, and application of QMRA to establish appropriate Food Safety Objectives. PMID:26089594

2006 NASA Range Safety Annual Report

NASA Technical Reports Server (NTRS)

TenHaken, Ron; Daniels, B.; Becker, M.; Barnes, Zack; Donovan, Shawn; Manley, Brenda

2007-01-01

Throughout 2006, Range Safety was involved in a number of exciting and challenging activities and events, from developing, implementing, and supporting Range Safety policies and procedures-such as the Space Shuttle Launch and Landing Plans, the Range Safety Variance Process, and the Expendable Launch Vehicle Safety Program procedures-to evaluating new technologies. Range Safety training development is almost complete with the last course scheduled to go on line in mid-2007. Range Safety representatives took part in a number of panels and councils, including the newly formed Launch Constellation Range Safety Panel, the Range Commanders Council and its subgroups, the Space Shuttle Range Safety Panel, and the unmanned aircraft systems working group. Space based range safety demonstration and certification (formerly STARS) and the autonomous flight safety system were successfully tested. The enhanced flight termination system will be tested in early 2007 and the joint advanced range safety system mission analysis software tool is nearing operational status. New technologies being evaluated included a processor for real-time compensation in long range imaging, automated range surveillance using radio interferometry, and a space based range command and telemetry processor. Next year holds great promise as we continue ensuring safety while pursuing our quest beyond the Moon to Mars.

Accelerating the Whiteshell Laboratories Decommissioning Through the Implementation of a Projectized and Delivery-Focused Organization - 13074

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

Wilcox, Brian; Mellor, Russ; Michaluk, Craig

2013-07-01

Whiteshell Laboratories (WL) is a nuclear research site in Canada that was commissioned in 1964 by Atomic Energy of Canada Limited. It covers a total area of approximately 4,375 hectares (10,800 acres) and includes the main campus site, the Waste Management Area (WMA) and outer areas of land identified as not used for or impacted by nuclear development or operations. The WL site employed up to 1100 staff. Site activities included the successful operation of a 60 MW organic liquid-cooled research reactor from 1965 to 1985, and various research programs including reactor safety research, small reactor development, fuel development, biophysicsmore » and radiation applications, as well as work under the Canadian Nuclear Fuel Waste Management Program. In 1997, AECL made a business decision to discontinue research programs and operations at WL, and obtained government concurrence in 1998. The Nuclear Legacy Liabilities Program (NLLP) was established in 2006 by the Canadian Government to remediate nuclear legacy liabilities in a safe and cost effective manner, including the WL site. The NLLP is being implemented by AECL under the governance of a Natural Resources Canada (NRCan)/AECL Joint Oversight Committee (JOC). Significant progress has since been made, and the WL site currently holds the only Canadian Nuclear Safety Commission (CNSC) nuclear research site decommissioning license in Canada. The current decommissioning license is in place until the end of 2018. The present schedule planned for main campus decommissioning is 30 years (to 2037), followed by institutional control of the WMA until a National plan is implemented for the long-term management of nuclear waste. There is an impetus to advance work and complete decommissioning sooner. To accomplish this, AECL has added significant resources, reorganized and moved to a projectized environment. This presentation outlines changes made to the organization, the tools implemented to foster projectization, and the benefits and positive impacts on schedule and delivery. A revised organizational structure was implemented in two phases, starting 2011 April 1, to align WL staff with the common goal of decommissioning the site through the direction of the WL Decommissioning Project General Manager. On 2011 September 1, the second phase of the reorganization was implemented and WL Decommissioning staff was organized under five Divisions: Programs and Regulatory Compliance, General Site Services, Decommissioning Strategic Planning, Nuclear Facilities and Project Delivery. A new Mission, Vision and Objectives were developed for the project, and several productivity enhancements are being implemented. These include the use of an integrated and fully re-sourced Site Wide Schedule that is updated and reviewed at Plan-of-the-Week meetings, improved work distribution throughout the year, eliminating scheduling 'push' mentality, project scoreboards, work planning implementation, lean practices and various process improvement initiatives. A revised Strategic Plan is under development that reflects the improved project delivery capabilities. As a result of these initiatives, and a culture change towards a projectized approach, the decommissioning schedule will be advanced by approximately 10 years. (authors)« less

Using IT to improve quality at NewYork-Presybterian Hospital: a requirements-driven strategic planning process.

PubMed

Kuperman, Gilad J; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D; Cooper, Mary

2006-01-01

At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality.

Using IT to Improve Quality at NewYork-Presybterian Hospital: A Requirements-Driven Strategic Planning Process

PubMed Central

Kuperman, Gilad J.; Boyer, Aurelia; Cole, Curt; Forman, Bruce; Stetson, Peter D.; Cooper, Mary

2006-01-01

At NewYork-Presbyterian Hospital, we are committed to the delivery of high quality care. We have implemented a strategic planning process to determine the information technology initiatives that will best help us improve quality. The process began with the creation of a Clinical Quality and IT Committee. The Committee identified 2 high priority goals that would enable demonstrably high quality care: 1) excellence at data warehousing, and 2) optimal use of automated clinical documentation to capture encounter-related quality and safety data. For each high priority goal, a working group was created to develop specific recommendations. The Data Warehousing subgroup has recommended the implementation of an architecture management process and an improved ability for users to get access to aggregate data. The Structured Documentation subgroup is establishing recommendations for a documentation template creation process. The strategic planning process at times is slow, but assures that the organization is focusing on the information technology activities most likely to lead to improved quality. PMID:17238381

Final Work Plan: Targeted Investigation at York, Nebraska

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

LaFreniere, Lorraine M.

The targeted investigation at York will be implemented in phases, so that data collected and interpretations developed at each stage of the program can be evaluated to guide subsequent phases most effectively. Section 2 of this Work Plan presents a brief overview of the York site, its geologic and hydrologic setting, and the previous CCC/USDA investigations. Section 3, outlines the proposed technical program for the targeted investigation, and Section 4 describes the investigative methods to be employed. A community relations plan is in Section 5, and Section 6 includes health and safety information. In addition to this site-specific Work Plan,more » the Master Work Plan (Argonne 2002) developed by Argonne for CCC/USDA investigations in Nebraska should be consulted for complete details of the methods and procedures to be used at York.« less

Lawrence Berkeley Laboratory, Institutional Plan FY 1994--1999

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

Not Available

1993-09-01

The Institutional Plan provides an overview of the Lawrence Berkeley Laboratory mission, strategic plan, scientific initiatives, research programs, environment and safety program plans, educational and technology transfer efforts, human resources, and facilities needs. For FY 1994-1999 the Institutional Plan reflects significant revisions based on the Laboratory`s strategic planning process. The Strategic Plan section identifies long-range conditions that will influence the Laboratory, as well as potential research trends and management implications. The Initiatives section identifies potential new research programs that represent major long-term opportunities for the Laboratory, and the resources required for their implementation. The Scientific and Technical Programs section summarizesmore » current programs and potential changes in research program activity. The Environment, Safety, and Health section describes the management systems and programs underway at the Laboratory to protect the environment, the public, and the employees. The Technology Transfer and Education programs section describes current and planned programs to enhance the nation`s scientific literacy and human infrastructure and to improve economic competitiveness. The Human Resources section identifies LBL staff diversity and development program. The section on Site and Facilities discusses resources required to sustain and improve the physical plant and its equipment. The new section on Information Resources reflects the importance of computing and communication resources to the Laboratory. The Resource Projections are estimates of required budgetary authority for the Laboratory`s ongoing research programs. The Institutional Plan is a management report for integration with the Department of Energy`s strategic planning activities, developed through an annual planning process.« less

Chemical Manufacturing and Refining Industry Legitimacy: Reflective Management, Trust, Precrisis Communication to Achieve Community Efficacy.

PubMed

Heath, Robert L; Lee, Jaesub

2016-06-01

Calls for emergency right-to-know in the 1980s, and, in the 1990s, risk management planning, motivated U.S. chemical manufacturing and refining industries to operationalize a three-pronged approach to risk minimization and communication: reflective management to increase legitimacy, operational safety programs to raise trust, and community engagement designed to facilitate citizens' emergency response efficacy. To assess these management, operational, and communication initiatives, communities (often through Local Emergency Planning Committees) monitored the impact of such programs. In 2012, the fourth phase of a quasi-longitudinal study was conducted to assess the effectiveness of operational change and community outreach in one bellwether community. This study focuses on legitimacy, trust, and response efficacy to suggest that an industry can earn legitimacy credits by raising its safety and environmental impact standards, by building trust via that change, and by communicating emergency response messages to near residents to raise their response efficacy. As part of its campaign to demonstrate its concern for community safety through research, planning, and implementation of safe operations and viable emergency response systems, this industry uses a simple narrative of risk/emergency response-shelter-in-place-communicated by a spokes-character: Wally Wise Guy. © 2015 Society for Risk Analysis.

Health Information Technology in Healthcare Quality and Patient Safety: Literature Review.

PubMed

Feldman, Sue S; Buchalter, Scott; Hayes, Leslie W

2018-06-04

The area of healthcare quality and patient safety is starting to use health information technology to prevent reportable events, identify them before they become issues, and act on events that are thought to be unavoidable. As healthcare organizations begin to explore the use of health information technology in this realm, it is often unclear where fiscal and human efforts should be focused. The purpose of this study was to provide a foundation for understanding where to focus health information technology fiscal and human resources as well as expectations for the use of health information technology in healthcare quality and patient safety. A literature review was conducted to identify peer-reviewed publications reporting on the actual use of health information technology in healthcare quality and patient safety. Inductive thematic analysis with open coding was used to categorize a total of 41 studies. Three pre-set categories were used: prevention, identification, and action. Three additional categories were formed through coding: challenges, outcomes, and location. This study identifies five main categories across seven study settings. A majority of the studies used health IT for identification and prevention of healthcare quality and patient safety issues. In this realm, alerts, clinical decision support, and customized health IT solutions were most often implemented. Implementation, interface design, and culture were most often noted as challenges. This study provides valuable information as organizations determine where they stand to get the most "bang for their buck" relative to health IT for quality and patient safety. Knowing what implementations are being effectivity used by other organizations helps with fiscal and human resource planning as well as managing expectations relative to cost, scope, and outcomes. The findings from this scan of the literature suggest that having organizational champion leaders that can shepherd implementation, impact culture, and bridge knowledge with developers would be a valuable resource allocation to consider. ©Sue S Feldman, Scott Buchalter, Leslie W. Hayes. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 04.06.2018.

49 CFR 244.11 - Contents of a Safety Integration Plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Contents of a Safety Integration Plan. 244.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.11 Contents of a Safety...

49 CFR 244.11 - Contents of a Safety Integration Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Contents of a Safety Integration Plan. 244.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.11 Contents of a Safety...

49 CFR 244.11 - Contents of a Safety Integration Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Contents of a Safety Integration Plan. 244.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.11 Contents of a Safety...

49 CFR 244.11 - Contents of a Safety Integration Plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Contents of a Safety Integration Plan. 244.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.11 Contents of a Safety...

49 CFR 244.11 - Contents of a Safety Integration Plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Contents of a Safety Integration Plan. 244.11... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.11 Contents of a Safety...

29 CFR Appendix A to Subpart P of... - Model Fire Safety Plan (Non-Mandatory)

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 7 2013-07-01 2013-07-01 false Model Fire Safety Plan (Non-Mandatory) A Appendix A to...—Model Fire Safety Plan (Non-Mandatory) Model Fire Safety Plan Note: This appendix is non-mandatory and provides guidance to assist employers in establishing a Fire Safety Plan as required in § 1915.502. Table...

29 CFR Appendix A to Subpart P to... - Model Fire Safety Plan (Non-Mandatory)

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 7 2012-07-01 2012-07-01 false Model Fire Safety Plan (Non-Mandatory) A Appendix A to...—Model Fire Safety Plan (Non-Mandatory) Model Fire Safety Plan Note: This appendix is non-mandatory and provides guidance to assist employers in establishing a Fire Safety Plan as required in § 1915.502. Table...

29 CFR Appendix A to Subpart P of... - Model Fire Safety Plan (Non-Mandatory)

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 7 2014-07-01 2014-07-01 false Model Fire Safety Plan (Non-Mandatory) A Appendix A to...—Model Fire Safety Plan (Non-Mandatory) Model Fire Safety Plan Note: This appendix is non-mandatory and provides guidance to assist employers in establishing a Fire Safety Plan as required in § 1915.502. Table...

49 CFR 659.19 - System safety program plan: contents.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false System safety program plan: contents. 659.19... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAIL FIXED GUIDEWAY SYSTEMS; STATE SAFETY OVERSIGHT Role of the State Oversight Agency § 659.19 System safety program plan: contents. The system safety plan shall...

49 CFR 659.19 - System safety program plan: contents.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false System safety program plan: contents. 659.19... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAIL FIXED GUIDEWAY SYSTEMS; STATE SAFETY OVERSIGHT Role of the State Oversight Agency § 659.19 System safety program plan: contents. The system safety plan shall...

49 CFR 659.19 - System safety program plan: contents.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false System safety program plan: contents. 659.19... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAIL FIXED GUIDEWAY SYSTEMS; STATE SAFETY OVERSIGHT Role of the State Oversight Agency § 659.19 System safety program plan: contents. The system safety plan shall...

49 CFR 659.19 - System safety program plan: contents.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 7 2014-10-01 2014-10-01 false System safety program plan: contents. 659.19... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAIL FIXED GUIDEWAY SYSTEMS; STATE SAFETY OVERSIGHT Role of the State Oversight Agency § 659.19 System safety program plan: contents. The system safety plan shall...

49 CFR 659.19 - System safety program plan: contents.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false System safety program plan: contents. 659.19... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION RAIL FIXED GUIDEWAY SYSTEMS; STATE SAFETY OVERSIGHT Role of the State Oversight Agency § 659.19 System safety program plan: contents. The system safety plan shall...

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

[General Strategies for Implementation of Clinical Practice Guidelines].

PubMed

Valenzuela-Flores, Adriana Abigail; Viniegra-Osorio, Arturo; Torres-Arreola, Laura Laura

2015-01-01

The need to use clinical practice guidelines (CPG) arises from the health conditions and problems that public health institutions in the country face. CPG are informative documents that help improve the quality of care processes and patient safety; having among its objectives, to reduce the variability of medical practice. The Instituto Mexicano del Seguro Social designed a strategic plan for the dissemination, implementation, monitoring and control of CPG to establish an applicable model in the medical units in the three levels of care at the Instituto. This paper summarizes some of the strategies of the plan that were made with the knowledge and experience of clinicians and managers, with which they intend to promote the adoption of the key recommendations of the guidelines, to promote a sense of belonging for health personnel, and to encourage changes in organizational culture.

Development and evaluation of a mass media Theory of Planned Behaviour intervention to reduce speeding.

PubMed

Stead, Martine; Tagg, Stephen; MacKintosh, Anne Marie; Eadie, Douglas

2005-02-01

The Theory of Planned Behaviour (TPB) has been widely applied to the explanation of health and social behaviours. However, despite its potential to inform behaviour change efforts, there have been surprisingly few attempts to use the TPB to design actual interventions. In 1998, the Scottish Road Safety Campaign implemented a 3-year mass media campaign to reduce speeding on Scotland's roads which was explicitly shaped by the TPB's three main predictors: Attitude, Subjective Norms and Perceived Behavioural Control. A 4-year longitudinal cohort study examined the impact of the campaign on communications outcomes and on TPB constructs. Overall, empirical support was found for the decision to use TPB as the theoretical underpinning of the advertising. The advertising was effective in triggering desired communications outcomes, and was associated with significant changes in attitudes and affective beliefs about speeding. In conclusion, future directions for road safety advertising and for TPB research are discussed.

Food safety objectives for Listeria monocytogenes in Spanish food sampled in cafeterias and restaurants.

PubMed

Doménech, E; Amorós, J A; Escriche, I

2011-09-01

To gain more insight into the context of food safety management by public administrations, food safety objectives must be studied. The Valencian administration quantified the prevalence of Listeria monocytogenes in cafeterias and restaurants in this region of Spain between 2002 and 2010. The results obtained from this survey are presented here for 2,262 samples of fish, salad, egg, cold meat, and mayonnaise dishes. Microbiological criteria defined for L. monocytogenes were used to differentiate acceptable and unacceptable samples; more than 99.9% of the samples were acceptable. These findings indicate that established food safety objectives are achievable, consumer health at the time of consumption can be safeguarded, and food safety management systems such as hazard analysis critical control point plans or good manufacturing practices implemented in food establishments are effective. Monitoring of foods and food safety is an important task that must continue to reduce the current L. monocytogenes prevalence of 0.1% in restaurant or cafeteria dishes, which could adversely affect consumer health.

Duties and functions of veterinary public health for the management of food safety: present needs and evaluation of efficiency.

PubMed

Trevisani, M; Rosmini, R

2008-09-01

Functions of veterinarians in the context of food safety assurance have changed very much in the last ten years as a consequence of new legislation. The aim of this review is to evaluate the management tools in veterinary public health that shall be used in response to the actual need and consider some possible key performance indicators. This review involved an examination of the legislation, guidelines and literature, which was then discussed to analyse the actual need, the strategies and the procedures with which the public veterinary service shall comply. The management of information gathered at different stages of the food chain, from both food production operators and veterinary inspectors operating in primary production, food processing and feed production should be exchanged and integrated in a database, not only to produce annual reports and plan national sampling plans, but also to verify and validate the effectiveness of procedures and strategies implemented by food safety operators to control risks. Further, the surveillance data from environmental agencies and human epidemiological units should be used for assessing risks and addressing management options.

Implementation of a New Traceability Process for Breast Milk Feeding.

PubMed

Daus, Mariana Y; Maydana, Thelma G; Rizzato Lede, Daniel A; Luna, Daniel R

2018-01-01

Many newborns at the neonatal intensive care unit are unable to feed themselves, and receive human milk through enteric nutrition devices such as orogastric or nasogastric probes. The mothers extract their milk, and the nursing staff is responsible for the fractionation, storage and administration when prescribed by physicians. It is very important to remind that it is a bodily fluid that carries the risk of disease transmission if misused. Health information technologies can enhance patient safety by avoiding preventable adverse events. Barcoding technology could track every step of the milk manipulation. Many processes must be addressed to implement it. Our goal is to explain our planning and implementation process in an academic tertiary hospital.

Evidence-based and value-based formulary guidelines.

PubMed

Neumann, Peter J

2004-01-01

Health plans and hospitals have long used drug formularies, but the processes by which formulary committees made decisions have typically lacked transparency and scientific rigor. A growing number of organizations have begun implementing formulary guidelines issued by the Academy of Managed Care Pharmacy (AMCP). These guidelines call for health plans to request formally that drug companies present a standardized "dossier" that contains detailed information not only on the drug's effectiveness and safety but also on its economic value relative to alternative therapies. This paper describes the guidelines, reviews progress to date, and analyzes several critical issues for the future.

Staubli TX-90XL robot qualification at the LLIHE.

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

Covert, Timothy Todd

The Light Initiated High Explosive (LIHE) Facility uses a robotic arm to spray explosive material onto test items for impulse tests. In 2007, the decision was made to replace the existing PUMA 760 robot with the Staubli TX-90XL. A qualification plan was developed and implemented to verify the safe operating conditions and failure modes of the new system. The robot satisfied the safety requirements established in the qualification plan. A performance issue described in this report remains unresolved at the time of this publication. The final readiness review concluded the qualification of this robot at the LIHE facility.

2005 8th Annual Systems Engineering Conference. Volume 2, Wednesday Presentations

DTIC Science & Technology

2005-10-27

Acquisition Programs: An OSD Perspective, Col Warren Anderson, OUSD (AT&L) Defense Systems Implementation of Policy Requiring Systems Engineering Plans...Technical Excellence, Col Warren Anderson, OUSD (AT&L) Defense Systems Applying CMMI to System Safety, Mr. Tom Pfitzer, APT Research, Inc. System...to following pages for Tutorials Schedule) Buffett Lunch Tutorial Tracks (Please refer to following pages for Tutorials Schedule) Reception in

Ports and Waterways Safety Assessment Workshop Report, Buzzards Bay, MA

DTIC Science & Technology

2003-09-10

Light tower observations show the highest average sustained winds along this coast. The Bay develops wind chop more than swell. • The National...beaches and shellfish beds pursuant to public health requirements. Well developed notification plans are in place. • Public health agencies are...implementing selected risk mitigation measures. The PAWSA methodology employs a generic model of waterway risk that was conceptually developed by a

Lawrence Berkeley Laboratory Institutional Plan, FY 1993--1998

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

Chew, Joseph T.; Stroh, Suzanne C.; Maio, Linda R.

1992-10-01

The FY 1993--1998 Institutional Plan provides an overview of the Lawrence Berkeley Laboratory mission, strategic plan, scientific initiatives, research programs, environment and safety program plans, educational and technology transfer efforts, human resources, and facilities needs. The Strategic Plan section identifies long-range conditions that can influence the Laboratory, potential research trends, and several management implications. The Initiatives section identifies potential new research programs that represent major long-term opportunities for the Laboratory and the resources required for their implementation. The Scientific and Technical Programs section summarizes current programs and potential changes in research program activity. The Environment, Safety, and Health section describesmore » the management systems and programs underway at the Laboratory to protect the environment, the public, and the employees. The Technology Transfer and Education programs section describes current and planned programs to enhance the nation`s scientific literacy and human infrastructure and to improve economic competitiveness. The Human Resources section identifies LBL staff composition and development programs. The section on Site and Facilities discusses resources required to sustain and improve the physical plant and its equipment. The Resource Projections are estimates of required budgetary authority for the Laboratory`s ongoing research programs. The plan is an institutional management report for integration with the Department of Energy`s strategic planning activities that is developed through an annual planning process. The plan identifies technical and administrative directions in the context of the National Energy Strategy and the Department of Energy`s program planning initiatives. Preparation of the plan is coordinated by the Office for Planning and Development from information contributed by the Laboratory`s scientific and support divisions.« less

48 CFR 1852.223-73 - Safety and Health Plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 6 2014-10-01 2014-10-01 false Safety and Health Plan... 1852.223-73 Safety and Health Plan. As prescribed in 1823.7001(c), insert the following provision: Safety and Health Plan (NOV 2004) (a) The offeror shall submit a detailed safety and occupational health...

48 CFR 1852.223-73 - Safety and Health Plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 6 2011-10-01 2011-10-01 false Safety and Health Plan... 1852.223-73 Safety and Health Plan. As prescribed in 1823.7001(c), insert the following provision: Safety and Health Plan (NOV 2004) (a) The offeror shall submit a detailed safety and occupational health...

48 CFR 1852.223-73 - Safety and Health Plan.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 6 2013-10-01 2013-10-01 false Safety and Health Plan... 1852.223-73 Safety and Health Plan. As prescribed in 1823.7001(c), insert the following provision: Safety and Health Plan (NOV 2004) (a) The offeror shall submit a detailed safety and occupational health...

48 CFR 1852.223-73 - Safety and Health Plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Safety and Health Plan... 1852.223-73 Safety and Health Plan. As prescribed in 1823.7001(c), insert the following provision: Safety and Health Plan (NOV 2004) (a) The offeror shall submit a detailed safety and occupational health...

48 CFR 1852.223-73 - Safety and Health Plan.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 6 2012-10-01 2012-10-01 false Safety and Health Plan... 1852.223-73 Safety and Health Plan. As prescribed in 1823.7001(c), insert the following provision: Safety and Health Plan (NOV 2004) (a) The offeror shall submit a detailed safety and occupational health...

AGRI Grain Power ethanol-for-fuel project feasibility-study report. Volume III. Project environmental/health/safety/ and socioeconomic

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

Not Available

1981-04-01

The AGRI GRAIN POWER (AGP) project, hereafter referred to as the Project, was formed to evaluate the commercial viability and assess the desireability of implementing a large grain based grass-roots anhydrous ethanol fuel project to be sited near Des Moines, Iowa. This report presents the results of a Project feasibility evaluation. The Project concept is based on involving a very strong managerial, financial and technical joint venture that is extremely expert in all facets of planning and implementing a large ethanol project; on locating the ethanol project at a highly desireable site; on utilizing a proven ethanol process; and onmore » developing a Project that is well suited to market requirements, resource availability and competitive factors. This volume contains the results of the environmental, health, safety, and socio-economic studies.« less

Did you have an impact? A theory-based method for planning and evaluating knowledge-transfer and exchange activities in occupational health and safety.

PubMed

Kramer, Desré M; Wells, Richard P; Carlan, Nicolette; Aversa, Theresa; Bigelow, Philip P; Dixon, Shane M; McMillan, Keith

2013-01-01

Few evaluation tools are available to assess knowledge-transfer and exchange interventions. The objective of this paper is to develop and demonstrate a theory-based knowledge-transfer and exchange method of evaluation (KEME) that synthesizes 3 theoretical frameworks: the promoting action on research implementation of health services (PARiHS) model, the transtheoretical model of change, and a model of knowledge use. It proposes a new term, keme, to mean a unit of evidence-based transferable knowledge. The usefulness of the evaluation method is demonstrated with 4 occupational health and safety knowledge transfer and exchange (KTE) implementation case studies that are based upon the analysis of over 50 pre-existing interviews. The usefulness of the evaluation model has enabled us to better understand stakeholder feedback, frame our interpretation, and perform a more comprehensive evaluation of the knowledge use outcomes of our KTE efforts.

Food Fraud Prevention: Policy, Strategy, and Decision-Making - Implementation Steps for a Government Agency or Industry.

PubMed

Spink, John; Fortin, Neal D; Moyer, Douglas C; Miao, Hong; Wu, Yongning

2016-01-01

This paper addresses the role of governments, industry, academics, and non-governmental organizations in Food Fraud prevention. Before providing strategic concepts for governments and authorities, definitions of Food Fraud are reviewed and discussed. Next there is a review of Food Fraud activities by the Global Food Safety Initiative (GFSI), the Elliott Review in the United Kingdom, the European Commission resolution on Food Fraud, and the US Food Safety Modernization Act including the Preventative Controls Rule. Two key concepts for governments or a company are: (1) formally, and specifically, mention food fraud as a food issue and (2) create an enterprise-wide Food Fraud prevention plan. The research includes a case study of the implementation of the concepts by a state or provincial agency. This analysis provides a foundation to review the role of science and technology in detection, deterrence and then contributing to prevention.

Molecular Methods and Platforms for Infectious Diseases Testing

PubMed Central

Emmadi, Rajyasree; Boonyaratanakornkit, Jerry B.; Selvarangan, Rangaraj; Shyamala, Venkatakrishna; Zimmer, Barbara L.; Williams, Laurina; Bryant, Bonita; Schutzbank, Ted; Schoonmaker, Michele M.; Amos Wilson, Jean A.; Hall, Leslie; Pancholi, Preeti; Bernard, Kathryn

2011-01-01

The superior sensitivity and specificity associated with the use of molecular assays has greatly improved the field of infectious disease diagnostics by providing clinicians with results that are both accurate and rapidly obtained. Herein, we review molecularly based infectious disease diagnostic tests that are Food and Drug Administration approved or cleared and commercially available in the United States as of December 31, 2010. We describe specific assays and their performance, as stated in the Food and Drug Administration's Summary of Safety and Effectiveness Data or the Office of In Vitro Diagnostic Device Evaluation and Safety's decision summaries, product inserts, or peer-reviewed literature. We summarize indications for testing, limitations, and challenges related to implementation in a clinical laboratory setting for a wide variety of common pathogens. The information presented in this review will be particularly useful for laboratories that plan to implement or expand their molecular offerings in the near term. PMID:21871973

Dissemination and Implementation Research for Occupational Safety and Health.

PubMed

Dugan, Alicia G; Punnett, Laura

2017-12-01

The translation of evidence-based health innovations into real-world practice is both incomplete and exceedingly slow. This represents a poor return on research investment dollars for the general public. U.S. funders of health sciences research (e.g., NIH, CDC, NIOSH) are increasingly calling for dissemination plans, and to a lesser extent for dissemination and implementation (D&I) research, which are studies that examine the effectiveness of D&I efforts and strategies and the predictors of D&I success. For example, rather than merely broadcasting information about a preventable hazard, D&I research in occupational safety and health (OSH) might examine how employers or practitioners are most likely to receive and act upon that information. We propose here that D&I research should be seen as a dedicated and necessary area of study within OSH, as a way to generate new knowledge that can bridge the research-to-practice gap. We present D&I concepts, frameworks, and examples that can increase the capacity of OSH professionals to conduct D&I research and accelerate the translation of research findings into meaningful everyday practice to improve worker safety and health.

Monitoring process hygiene in Serbian retail establishments

NASA Astrophysics Data System (ADS)

Vesković Moračanin, S.; Baltić, T.; Milojević, L.

2017-09-01

The present study was conducted to estimate the effectiveness of sanitary procedures on food contact surfaces and food handlers’ hands in Serbian retail establishments. For that purpose, a total of 970 samples from food contact surfaces and 525 samples from workers’ hands were microbiologically analyzed. Results of total aerobic plate count and total Enterobacteriaceae count showed that the implemented washing and disinfection procedures, as a part of HACCP plans, were not effective enough in most retail facilities. Constant and intensive education of employees on proper implementation of sanitation procedures are needed in order to ensure food safety in the retail market.

Study of neurontin: titrate to effect, profile of safety (STEPS) trial: a narrative account of a gabapentin seeding trial.

PubMed

Krumholz, Samuel D; Egilman, David S; Ross, Joseph S

2011-06-27

Seeding trials, clinical studies conducted by pharmaceutical companies for marketing purposes, have rarely been described in detail. We examined all documents relating to the clinical trial Study of Neurontin: Titrate to Effect, Profile of Safety (STEPS) produced during the Neurontin marketing, sales practices, and product liability litigation, including company internal and external correspondence, reports, and presentations, as well as depositions elicited in legal proceedings of Harden Manufacturing vs Pfizer and Franklin vs Warner-Lambert, most which were created between 1990 and 2009. Using a systematic search strategy, we identified and reviewed all documents related to the STEPS trial in order to identify key themes related to the trial's conduct and determine the extent of marketing involvement in its planning and implementation. Documents demonstrated that STEPS was a seeding trial posing as a legitimate scientific study. Documents consistently described the trial itself, not trial results, to be a marketing tactic in the company's marketing plans. Documents demonstrated that at least 2 external sources questioned the validity of the study before execution, and that data quality during the study was often compromised. Furthermore, documents described company analyses examining the impact of participating as a STEPS investigator on rates and dosages of gabapentin prescribing, finding a positive association. None of these findings were reported in 2 published articles. The STEPS trial was a seeding trial, used to promote gabapentin and increase prescribing among investigators, and marketing was extensively involved in its planning and implementation.

14 CFR Appendix B to Part 415 - Safety Review Document Outline

Code of Federal Regulations, 2013 CFR

2013-01-01

....0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and... Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety Plan 4.3.1Flight Safety Personnel 4... Safety (§ 415.117) 5.1Ground Safety Analysis Report 5.2Ground Safety Plan 6.0Launch Plans (§ 415.119 and...

14 CFR Appendix B to Part 415 - Safety Review Document Outline

Code of Federal Regulations, 2014 CFR

2014-01-01

....0Flight Safety (§ 415.115) 4.1Initial Flight Safety Analysis 4.1.1Flight Safety Sub-Analyses, Methods, and... Analysis Data 4.2Radionuclide Data (where applicable) 4.3Flight Safety Plan 4.3.1Flight Safety Personnel 4... Safety (§ 415.117) 5.1Ground Safety Analysis Report 5.2Ground Safety Plan 6.0Launch Plans (§ 415.119 and...

49 CFR 244.15 - Subjects to be addressed in a Safety Integration Plan not involving an amalgamation of operations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Subjects to be addressed in a Safety Integration... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.15 Subjects to be addressed in a Safety Integration Plan...

75 FR 80515 - National Boating Safety Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-22

... 15, 2011, from 9 a.m. to 12 p.m., and the Recreational Boating Safety Strategic Planning Subcommittee... Boating Safety Strategic Planning Subcommittee meeting to discuss current status of the strategic planning... Boating Safety Strategic Planning Subcommittee meeting (Cont.). (7) Receipt and discussion of the...

Using a quantitative risk register to promote learning from a patient safety reporting system.

PubMed

Mansfield, James G; Caplan, Robert A; Campos, John S; Dreis, David F; Furman, Cathie

2015-02-01

Patient safety reporting systems are now used in most health care delivery organizations. These systems, such as the one in use at Virginia Mason (Seattle) since 2002, can provide valuable reports of risk and harm from the front lines of patient care. In response to the challenge of how to quantify and prioritize safety opportunities, a risk register system was developed and implemented. Basic risk register concepts were refined to provide a systematic way to understand risks reported by staff. The risk register uses a comprehensive taxonomy of patient risk and algorithmically assigns each patient safety report to 1 of 27 risk categories in three major domains (Evaluation, Treatment, and Critical Interactions). For each category, a composite score was calculated on the basis of event rate, harm, and cost. The composite scores were used to identify the "top five" risk categories, and patient safety reports in these categories were analyzed in greater depth to find recurrent patterns of risk and associated opportunities for improvement. The top five categories of risk were easy to identify and had distinctive "profiles" of rate, harm, and cost. The ability to categorize and rank risks across multiple dimensions yielded insights not previously available. These results were shared with leadership and served as input for planning quality and safety initiatives. This approach provided actionable input for the strategic planning process, while at the same time strengthening the Virginia Mason culture of safety. The quantitative patient safety risk register serves as one solution to the challenge of extracting valuable safety lessons from large numbers of incident reports and could profitably be adopted by other organizations.

MO-F-CAMPUS-T-02: An Electronic Whiteboard Platform to Manage Treatment Planning Process

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

DiCostanzo, D; Woollard, J; Gupta, N

2015-06-15

Purpose: In an effort to improve patient safety and streamline the radiotherapy treatment planning (TP) process, a software based whiteboard had been developed and put in use in our facility Methods: The electronic whiteboard developed using SQL database (DB) and PHP/JavaScript based web interface, is published via department intranet and login credentials. The DB stores data for each TP process such as patient information, plan type, simulation/start dates, physician, dosimetrist, QA and the current status in planning process. Users interact with the DB per plan and perform status updates in real time as the planning process progresses. All user interactionsmore » with the DB are recorded with timestamps so as to calculate statistical information for TP process management such as contouring times, planning and review times, dosimetry, physics and therapist QA times. External beam and brachytherapy plans are categorized according to complexity (ex: IMRT, 3D, HDR, LDR etc) and treatment types and applicators. Each plan category is assigned specific timelines for each planning process. When a plan approaches or passes the predetermined timeline, users are alerted via color coded graphical cues. When certain process items are not completed in time, pre-determined actions are triggered such as a delay in treatment start date. Results: Our institution has been using the electronic whiteboard for two years. Implementation of pre-determined actions based on the statistical information collected by the whiteboard improved our TP process. For example, the average time for normal tissue contouring decreased from 0.73±1.37 to 0.24±0.33 days. The average time for target volume contouring decreased from 3.2±2.84 to 2.37±2.54 days. This increase in efficiency allows more time for quality assurance processes, improving patient safety. Conclusion: The electronic whiteboard has been an invaluable tool for streamlining our TP processes. It facilitates timely and accurate communication between all parties involved in the TP process increasing patient safety.« less

FY17 Strategic Themes.

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

Leland, Robert W.

2017-03-01

I am pleased to present this summary of the FY17 Division 1000 Science and Technology Strategic Plan. As this plan represents a continuation of the work we started last year, the four strategic themes (Mission Engagement, Bold Outcomes, Collaborative Environment, and Safety Imperative) remain the same, along with many of the goals. You will see most of the changes in the actions listed for each goal: We completed some actions, modified others, and added a few new ones. As I’ve stated previously, this is not a strategy to be pursued in tension with the Laboratory strategic plan. The Division 1000more » strategic plan is intended to chart our course as we strive to contribute our very best in service of the greater Laboratory strategy. I welcome your feedback and look forward to our dialogue about these strategic themes. Please join me as we move forward to implement the plan in the coming months.« less

TU-C-201-02: Clinical Implementation of HDR: Afterloader and Applicator Selection

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

Esthappan, J.

2015-06-15

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

TU-C-201-01: Clinical Implementation of HDR: A New User’s Perspective

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

Al-Hallaq, H.

2015-06-15

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

TU-C-201-00: Clinical Implementation of HDR Brachytherapy

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

NONE

2015-06-15

Recent use of HDR has increased while planning has become more complex often necessitating 3D image-based planning. While many guidelines for the use of HDR exist, they have not kept pace with the increased complexity of 3D image-based planning. Furthermore, no comprehensive document exists to describe the wide variety of current HDR clinical indications. This educational session aims to summarize existing national and international guidelines for the safe implementation of an HDR program. A summary of HDR afterloaders available on the market and their existing applicators will be provided, with guidance on how to select the best fit for eachmore » institution’s needs. Finally, the use of checklists will be discussed as a means to implement a safe and efficient HDR program and as a method by which to verify the quality of an existing HDR program. This session will provide the perspective of expert HDR physicists as well as the perspective of a new HDR user. Learning Objectives: Summarize national and international safety and staffing guidelines for HDR implementation Discuss the process of afterloader and applicator selection for gynecologic, prostate, breast, interstitial, surface treatments Learn about the use of an audit checklist tool to measure of quality control of a new or existing HDR program Describe the evolving use of checklists within an HDR program.« less

Identification of serious and reportable events in home care: a Delphi survey to develop consensus.

PubMed

Doran, Diane M; Baker, G Ross; Szabo, Cathy; McShane, Julie; Carryer, Jennifer

2014-04-01

To assess which client events should be considered reportable and preventable in home care (HC) settings in the opinion of HC safety experts. Patient safety in acute care settings has been well documented; however, there are limited data about this issue in HC. While many organizations collect information about 'incidents', there are no standards for reporting and it is challenging to compare incident rates among organizations. A 29-item electronic survey that included potential HC safety issues was used in a two-round Delphi study. Twenty-four pan-Canadian HC safety experts participated in an electronic survey. Perceived reportability and preventability of patient safety events, HC. The events that were perceived as being most reportable and preventable included the following: a serious injury related to inappropriate client service plan (e.g. incomplete/inaccurate assessments, poor care plan design, flawed implementation); an adverse reaction requiring emergency room visit or hospitalization related to a medication-related event; a catheter-site infection (e.g. a new peritoneal dialysis infection or peritonitis); any serious event related to care or services that are contrary to current professional or other practice standards (e.g. incorrect treatment regimen, theft, retention of a foreign object in a wound, individual practicing outside scope or competence). These data represent an important step in the development and validation of standard metrics about client safety in HC. The results address an expanding area of health services where there is a need to improve standardization and reporting.

Effective communications strategies: engaging the media, policymakers, and the public.

PubMed

Blake, Allison; Bonk, Kathy; Heimpel, Daniel; Wright, Cathy S

2013-01-01

Too often, strategic communication is too little, or comes too late, when involved with a child fatality or serious injury. This article explores the challenges arising from negative publicity around child safety issues and the opportunities for communications strategies that employ a proactive public health approach to engaging media, policymakers, and the public. The authors provide a case study and review methods by which child welfare agencies across the nation are building public engagement and support for improved outcomes in child safety while protecting legitimate confidentiality requirements. Finally, the piece articulates the rationale for agency investments in the resources necessary to develop and implement an effective communications plan.

CSPMS supported by information technology

NASA Astrophysics Data System (ADS)

Zhang, Hudan; Wu, Heng

This paper will propose a whole new viewpoint about building a CSPMS(Coal-mine Safety Production Management System) by means of information technology. This system whose core part is a four-grade automatic triggered warning system achieves the goal that information transmission will be smooth, nondestructive and in time. At the same time, the system provides a comprehensive and collective technology platform for various Public Management Organizations and coal-mine production units to deal with safety management, advance warning, unexpected incidents, preplan implementation, and resource deployment at different levels. The database of this system will support national related industry's resource control, plan, statistics, tax and the construction of laws and regulations effectively.

Adoption of safety eyewear among citrus harvesters in rural Florida.

PubMed

Monaghan, Paul F; Bryant, Carol A; McDermott, Robert J; Forst, Linda S; Luque, John S; Contreras, Ricardo B

2012-06-01

The community-based prevention marketing program planning framework was used to adapt an evidence-based intervention to address eye injuries among Florida's migrant citrus harvesters. Participant-observer techniques, other direct observations, and individual and focus group interviews provided data that guided refinement of a safety eyewear intervention. Workers were attracted to the eyewear's ability to minimize irritation, offer protection from trauma, and enable work without declines in productivity or comfort. Access to safety glasses equipped with worker-designed features reduced the perceived barriers of using them; deployment of trained peer-leaders helped promote adoption. Workers' use of safety glasses increased from less than 2% to between 28% and 37% in less than two full harvesting seasons. The combination of formative research and program implementation data provided insights for tailoring an existing evidence-based program for this occupational community and increase potential for future dissemination and worker protection.

Limited English proficiency workers. Health and safety education.

PubMed

Hong, O S

2001-01-01

1. As the population of adults with limited English proficiency plays an increasingly important role in the United States workplaces, there has been a growing recognition that literacy and limited English skills affect health and safety training programs. 2. Several important principles can be used as the underlying framework to guide teaching workers with limited English proficiency: clear and vivid way of teaching; contextual curriculum based on work; using various teaching methods; and staff development. 3. Two feasible strategies were proposed to improve current situation in teaching health and safety to workers with limited English proficiency in one company: integrating safety and health education with ongoing in-house ESL instruction and developing a multilingual video program. 4. Successful development and implementation of proposed programs requires upper management support, workers' awareness and active participation, collaborative teamwork, a well structured action plan, testing of pilot program, and evaluation.

Quality assessment of occupational health and safety management at the level of business units making up the organizational structure of a coal mine: a case study.

PubMed

Korban, Zygmunt

2015-01-01

The audit of the health and safety management system is understood as a form and tool of controlling. The objective of the audit is to define whether the undertaken measures and the obtained results are in conformity with the predicted assumptions or plans, whether the agreed decisions have been implemented and whether they are suitable in view of the accepted health and safety policy. This paper presents the results of an audit examination carried out on the system of health and safety management between 2002 and 2012 on a group of respondents, the employees of two mining departments (G-1 and G-2) of Jan, a coal mine. The audit was carried out using the questionnaire developed by the author based on the MERIT-APBK survey.

FY16 Strategic Themes.

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

Leland, Robert W.

2017-03-01

I am pleased to present this summary of the Division 1000 Science and Technology Strategic Plan. This plan was created with considerable participation from all levels of management in Division 1000, and is intended to chart our course as we strive to contribute our very best in service of the greater Laboratory strategy. The plan is characterized by four strategic themes: Mission Engagement, Bold Outcomes, Collaborative Environment, and the Safety Imperative. Each theme is accompanied by a brief vision statement, several goals, and planned actions to support those goals throughout FY16. I want to be clear that this is notmore » a strategy to be pursued in tension with the Laboratory strategic plan. Rather, it is intended to describe “how” we intend to show up for the “what” described in Sandia’s Strategic Plan. I welcome your feedback and look forward to our dialogue about these strategic themes. Please join me as we move forward to implement the plan in the coming year.« less

Hawai‘i's Opportunity for Active Living Advancement (HO‘ĀLA): Addressing Childhood Obesity through Safe Routes to School

PubMed Central

Dierenfield, Laura; Alexander, Daniel A; Prose, Marcia; Peterson, Ann C

2011-01-01

Increasing active transportation to and from school may reduce childhood obesity rates in Hawai‘i. A community partnership was formed to address this issue in Hawai‘i's Opportunity for Active Living Advancement (HO‘ĀLA), a quasi-experimental study of active transportation in Hawai‘i County. The purpose of this study was to determine baseline rates for active transportation rates to and from school and to track changes related to macro-level (statewide) policy, locally-based Safe Routes to School (SRTS) programs and bicycle and pedestrian planning initiatives expected to improve the safety, comfort and ease of walking and bicycling to and from school. Measures included parent surveys, student travel tallies, traffic counts and safety observations. Assessments of the walking and biking environment around each school were made using the Pedestrian Environment Data Scan. Complete Streets and SRTS policy implementation was tracked through the activities of a state transportation-led Task Force and an advocacy-led coalition, respectively. Planning initiatives were tracked through citizen-based advisory committees. Thirteen volunteer schools participated as the intervention (n=8) or comparison (n=5) schools. The majority of students were Asian, Native Hawaiian, and Pacific Islander in schools located in under-resourced communities. Overall, few children walked or biked to school. The majority of children were driven to and from school by their parents. With the influence of HO‘ĀLA staff members, two intervention schools were obligated SRTS project funding from the state, schools were identified as key areas in the pedestrian master plan, and one intervention school was slated for a bike plan priority project. As the SRTS programs are implemented in the next phase of the project, post-test data will be collected to ascertain if changes in active transportation rates occur. PMID:21886289

49 CFR 1106.4 - The Safety Integration Plan process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 8 2011-10-01 2011-10-01 false The Safety Integration Plan process. 1106.4... CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL § 1106.4 The Safety Integration Plan process. (a) Each applicant in a transaction subject...

49 CFR 1106.4 - The Safety Integration Plan process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 8 2013-10-01 2013-10-01 false The Safety Integration Plan process. 1106.4... CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL § 1106.4 The Safety Integration Plan process. (a) Each applicant in a transaction subject...

49 CFR 1106.4 - The Safety Integration Plan process.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 8 2014-10-01 2014-10-01 false The Safety Integration Plan process. 1106.4... CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL § 1106.4 The Safety Integration Plan process. (a) Each applicant in a transaction subject...

49 CFR 1106.4 - The Safety Integration Plan process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 8 2012-10-01 2012-10-01 false The Safety Integration Plan process. 1106.4... CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL § 1106.4 The Safety Integration Plan process. (a) Each applicant in a transaction subject...

49 CFR 1106.3 - Actions for which Safety Integration Plan is required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false Actions for which Safety Integration Plan is... TRANSPORTATION BOARD CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL § 1106.3 Actions for which Safety Integration Plan is required. A SIP...

49 CFR 1106.4 - The Safety Integration Plan process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 8 2010-10-01 2010-10-01 false The Safety Integration Plan process. 1106.4... CONSIDERATION OF SAFETY INTEGRATION PLANS IN CASES INVOLVING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL § 1106.4 The Safety Integration Plan process. (a) Each applicant in a transaction subject...

Hydrazine Blending and Storage Facility, Interim Response Action Implementation. Final Safety Plan

DTIC Science & Technology

1989-08-30

operators and visitors, will be required to wear a personal hydrazine dosimeter at all times. These will be available from commercial sources and/or the Naval...suspectea or carcinogenic pocen:tal for =an. -- t, :t ha a,,-cn OSL ?:L. Is I pPm or 1.3 mg/m 3 . zo pp=n4p"NIOSI. (1978) hs a oe -nded a ceiling level

Migrant and Seasonal Hired Adolescent Farmworkers: A Plan To Improve Working Conditions. Recommendations from the National Adolescent Farmworker Occupational Health and Safety Advisory Committee.

ERIC Educational Resources Information Center

Vela Acosta, Martha, Ed.; Lee, Barbara, Ed.

Agriculture is the second most common employer of youth and is associated with numerous occupational hazards, but few preventive efforts to protect adolescent farmworkers have been implemented or evaluated. The largest group of adolescent farmworkers is youth who live away from their natural families and migrate, mostly from Mexico, to work in…

Agile Implementation: A Blueprint for Implementing Evidence-Based Healthcare Solutions.

PubMed

Boustani, Malaz; Alder, Catherine A; Solid, Craig A

2018-03-07

To describe the essential components of an Agile Implementation (AI) process, which rapidly and effectively implements evidence-based healthcare solutions, and present a case study demonstrating its utility. Case demonstration study. Integrated, safety net healthcare delivery system in Indianapolis. Interdisciplinary team of clinicians and administrators. Reduction in dementia symptoms and caregiver burden; inpatient and outpatient care expenditures. Implementation scientists were able to implement a collaborative care model for dementia care and sustain it for more than 9 years. The model was implemented and sustained by using the elements of the AI process: proactive surveillance and confirmation of clinical opportunities, selection of the right evidence-based healthcare solution, localization (i.e., tailoring to the local environment) of the selected solution, development of an evaluation plan and performance feedback loop, development of a minimally standardized operation manual, and updating such manual annually. The AI process provides an effective model to implement and sustain evidence-based healthcare solutions. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

A site of communication among enterprises for supporting occupational health and safety management system.

PubMed

Velonakis, E; Mantas, J; Mavrikakis, I

2006-01-01

The occupational health and safety management constitutes a field of increasing interest. Institutions in cooperation with enterprises make synchronized efforts to initiate quality management systems to this field. Computer networks can offer such services via TCP/IP which is a reliable protocol for workflow management between enterprises and institutions. A design of such network is based on several factors in order to achieve defined criteria and connectivity with other networks. The network will be consisted of certain nodes responsible to inform executive persons on Occupational Health and Safety. A web database has been planned for inserting and searching documents, for answering and processing questionnaires. The submission of files to a server and the answers to questionnaires through the web help the experts to make corrections and improvements on their activities. Based on the requirements of enterprises we have constructed a web file server. We submit files in purpose users could retrieve the files which need. The access is limited to authorized users and digital watermarks authenticate and protect digital objects. The Health and Safety Management System follows ISO 18001. The implementation of it, through the web site is an aim. The all application is developed and implemented on a pilot basis for the health services sector. It is all ready installed within a hospital, supporting health and safety management among different departments of the hospital and allowing communication through WEB with other hospitals.

School travel planning: mobilizing school and community resources to encourage active school transportation.

PubMed

Buliung, Ron; Faulkner, Guy; Beesley, Theresa; Kennedy, Jacky

2011-11-01

Active school transport (AST), school travel using an active mode like walking, may be important to children's overall physical activity. A "school travel plan" (STP) documents a school's transport characteristics and provides an action plan to address school and neighborhood barriers to AST. We conducted a pilot STP intervention at 12 schools in 4 Canadian provinces. Facilitators and school personnel created and implemented AST action plans. Parent's self-reports (N = 1489) were the basis for evaluating the intervention. A content analysis identified type, frequency, and perceived success of initiatives. School travel plans emphasized education and promotion, and AST activities and events. Capital improvement projects were more common at schools in older suburban neighborhoods, whereas enforcement was more common at schools in newer suburban neighborhoods. Rates of active transportation increased from 43.8% to 45.9%. At follow-up, 13.3% of households reported less driving. Parents/caregivers cited weather, convenience, and trip chaining as primary reasons for continued driving. The STP process may facilitate changes to patterns of school travel. An STP can expand a school's capacity to address transportation issues through mobilization of diverse community resources. Future STP initiatives may benefit from addressing convenience, safety through enforcement, and by examining how schools can be supported in implementing infrastructure improvements. © 2011, American School Health Association.

Field tests of a participatory ergonomics toolkit for Total Worker Health

PubMed Central

Kernan, Laura; Plaku-Alakbarova, Bora; Robertson, Michelle; Warren, Nicholas; Henning, Robert

2018-01-01

Growing interest in Total Worker Health® (TWH) programs to advance worker safety, health and well-being motivated development of a toolkit to guide their implementation. Iterative design of a program toolkit occurred in which participatory ergonomics (PE) served as the primary basis to plan integrated TWH interventions in four diverse organizations. The toolkit provided start-up guides for committee formation and training, and a structured PE process for generating integrated TWH interventions. Process data from program facilitators and participants throughout program implementation were used for iterative toolkit design. Program success depended on organizational commitment to regular design team meetings with a trained facilitator, the availability of subject matter experts on ergonomics and health to support the design process, and retraining whenever committee turnover occurred. A two committee structure (employee Design Team, management Steering Committee) provided advantages over a single, multilevel committee structure, and enhanced the planning, communication, and team-work skills of participants. PMID:28166897

WE-G-BRC-03: Risk Assessment for Physics Plan Review

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

Parker, S.

2016-06-15

Failure Mode and Effects Analysis (FMEA) originated as an industrial engineering technique used for risk management and safety improvement of complex processes. In the context of radiotherapy, the AAPM Task Group 100 advocates FMEA as the framework of choice for establishing clinical quality management protocols. However, there is concern that widespread adoption of FMEA in radiation oncology will be hampered by the perception that implementation of the tool will have a steep learning curve, be extremely time consuming and labor intensive, and require additional resources. To overcome these preconceptions and facilitate the introduction of the tool into clinical practice, themore » medical physics community must be educated in the use of this tool and the ease in which it can be implemented. Organizations with experience in FMEA should share their knowledge with others in order to increase the implementation, effectiveness and productivity of the tool. This session will include a brief, general introduction to FMEA followed by a focus on practical aspects of implementing FMEA for specific clinical procedures including HDR brachytherapy, physics plan review and radiosurgery. A description of common equipment and devices used in these procedures and how to characterize new devices for safe use in patient treatments will be presented. This will be followed by a discussion of how to customize FMEA techniques and templates to one’s own clinic. Finally, cases of common failure modes for specific procedures (described previously) will be shown and recommended intervention methodologies and outcomes reviewed. Learning Objectives: Understand the general concept of failure mode and effect analysis Learn how to characterize new equipment for safety Be able to identify potential failure modes for specific procedures and learn mitigation techniques Be able to customize FMEA examples and templates for use in any clinic.« less

The role of microbiological testing in systems for assuring the safety of beef.

PubMed

Brown, M H; Gill, C O; Hollingsworth, J; Nickelson, R; Seward, S; Sheridan, J J; Stevenson, T; Sumner, J L; Theno, D M; Usborne, W R; Zink, D

2000-12-05

The use of microbiological testing in systems for assuring the safety of beef was considered at a meeting arranged by the International Livestock Educational Foundation as part of the International Livestock Congress, TX, USA, during February, 2000. The 11 invited participants from industry and government research organizations concurred in concluding that microbiological testing is necessary for the implementation and maintenance of effective Hazard Analysis Critical Control Point (HACCP) systems, which are the only means of assuring the microbiological safety of beef; that microbiological testing for HACCP purposes must involve the enumeration of indicator organisms rather than the detection of pathogens; that the efficacy of process control should be assessed against performance criteria and food safety objectives that refer to the numbers of indicator organisms in product; that sampling procedures should allow indicator organisms to be enumerated at very low numbers; and that food safety objectives and microbiological criteria are better related to variables, rather than attributes sampling plans.

Progress on the development of a master file of highway safety planning and evaluation data.

DOT National Transportation Integrated Search

1981-01-01

The National Highway Traffic Safety Administration requires each state to submit an annual Highway Safety Plan as a prerequisite for obtaining federal section 402 safety monies. The Highway Safety Plan serves as more than a mechanism for obtaining fu...

76 FR 17808 - Final Vehicle Safety Rulemaking and Research Priority Plan 2011-2013

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-31

... [Docket No. NHTSA-2009-0108] Final Vehicle Safety Rulemaking and Research Priority Plan 2011- 2013 AGENCY... availability. SUMMARY: This document announces the availability of the Final NHTSA Vehicle Safety and Fuel.... This Priority Plan is an update to the Final Vehicle Safety Rulemaking and Research Priority Plan 2009...

Probabilistic objective functions for margin-less IMRT planning

NASA Astrophysics Data System (ADS)

Bohoslavsky, Román; Witte, Marnix G.; Janssen, Tomas M.; van Herk, Marcel

2013-06-01

We present a method to implement probabilistic treatment planning of intensity-modulated radiation therapy using custom software plugins in a commercial treatment planning system. Our method avoids the definition of safety-margins by directly including the effect of geometrical uncertainties during optimization when objective functions are evaluated. Because the shape of the resulting dose distribution implicitly defines the robustness of the plan, the optimizer has much more flexibility than with a margin-based approach. We expect that this added flexibility helps to automatically strike a better balance between target coverage and dose reduction for surrounding healthy tissue, especially for cases where the planning target volume overlaps organs at risk. Prostate cancer treatment planning was chosen to develop our method, including a novel technique to include rotational uncertainties. Based on population statistics, translations and rotations are simulated independently following a marker-based IGRT correction strategy. The effects of random and systematic errors are incorporated by first blurring and then shifting the dose distribution with respect to the clinical target volume. For simplicity and efficiency, dose-shift invariance and a rigid-body approximation are assumed. Three prostate cases were replanned using our probabilistic objective functions. To compare clinical and probabilistic plans, an evaluation tool was used that explicitly incorporates geometric uncertainties using Monte-Carlo methods. The new plans achieved similar or better dose distributions than the original clinical plans in terms of expected target coverage and rectum wall sparing. Plan optimization times were only about a factor of two higher than in the original clinical system. In conclusion, we have developed a practical planning tool that enables margin-less probability-based treatment planning with acceptable planning times, achieving the first system that is feasible for clinical implementation.

NASA Engineering Excellence: A Case Study on Strengthening an Engineering Organization

NASA Technical Reports Server (NTRS)

Shivers, C. Herbert; Wessel, Vernon W.

2006-01-01

NASA implemented a system of technical authority following the Columbia Accident Investigation Board (CAE) report calling for independent technical authority to be exercised on the Space Shuttle Program activities via a virtual organization of personnel exercising specific technical authority responsibilities. After the current NASA Administrator reported for duty, and following the first of two planned "Shuttle Return to Flight" missions, the NASA Chief Engineer and the Administrator redirected the Independent Technical Authority to a program of Technical Excellence and Technical Authority exercised within the existing engineering organizations. This paper discusses the original implementation of technical authority and the transition to the new implementation of technical excellence, including specific measures aimed at improving safety of future Shuttle and space exploration flights.

Study Design and Evaluation of Risk Minimization Measures: A Review of Studies Submitted to the European Medicines Agency for Cardiovascular, Endocrinology, and Metabolic Drugs.

PubMed

Mazzaglia, Giampiero; Straus, Sabine M J; Arlett, Peter; da Silva, Daniela; Janssen, Heidi; Raine, June; Alteri, Enrica

2018-02-01

Studies measuring the effectiveness of risk minimization measures (RMMs) submitted by pharmaceutical companies to the European Medicines Agency are part of the post-authorization regulatory requirements and represent an important source of data covering a range of medicinal products and safety-related issues. Their objectives, design, and the associated regulatory outcomes were reviewed, and conclusions were drawn that may support future progress in risk minimization evaluation. Information was obtained from risk management plans, study protocols, clinical study reports, and assessment reports of 157 medicinal products authorized for cardiovascular, endocrinology, and metabolic indications. We selected observational studies measuring, as outcomes of interest, the relationship between the RMMs in place and (1) implementation measures, such as clinical knowledge or physicians` compliance to recommendations contained in the RMMs; and (2) occurrence or reduced severity of the adverse drug reactions for which the RMMs were required. Of 59 eligible studies (24 completed, 35 ongoing), 44 assessed implementation measures, whereas only 15 assessed safety outcomes (1 study as a single endpoint and 14 studies with other endpoints). Fifty-one studies used non-experimental designs and 25 studies employed electronic healthcare databases for analysis. Of the 24 completed studies, 17 were considered satisfactory and supported immediate regulatory decision making, 6 were considered inconclusive and required new evaluations, and 1 was terminated early because new safety restrictions were required, thereby necessitating a new evaluation. Compliance with agreed deadlines was considered acceptable in 21 of 24 completed studies; the average time for a submission was 37 months (standard deviation ± 17), with differences observed by type of data source employed. Three important gaps in the evaluation plans of RMMs were identified: lack of early feedback on implementation, limited evaluation of safety outcomes, and inability to provide information on the effectiveness from an integrated measurement of different elements of a set of risk minimization tools. More robust evidence is needed to advance regulatory science and support more rapid adjustment of risk minimization strategies as needed.

Improving efficiency and safety in external beam radiation therapy treatment delivery using a Kaizen approach.

PubMed

Kapur, Ajay; Adair, Nilda; O'Brien, Mildred; Naparstek, Nikoleta; Cangelosi, Thomas; Zuvic, Petrina; Joseph, Sherin; Meier, Jason; Bloom, Beatrice; Potters, Louis

Modern external beam radiation therapy treatment delivery processes potentially increase the number of tasks to be performed by therapists and thus opportunities for errors, yet the need to treat a large number of patients daily requires a balanced allocation of time per treatment slot. The goal of this work was to streamline the underlying workflow in such time-interval constrained processes to enhance both execution efficiency and active safety surveillance using a Kaizen approach. A Kaizen project was initiated by mapping the workflow within each treatment slot for 3 Varian TrueBeam linear accelerators. More than 90 steps were identified, and average execution times for each were measured. The time-consuming steps were stratified into a 2 × 2 matrix arranged by potential workflow improvement versus the level of corrective effort required. A work plan was created to launch initiatives with high potential for workflow improvement but modest effort to implement. Time spent on safety surveillance and average durations of treatment slots were used to assess corresponding workflow improvements. Three initiatives were implemented to mitigate unnecessary therapist motion, overprocessing of data, and wait time for data transfer defects, respectively. A fourth initiative was implemented to make the division of labor by treating therapists as well as peer review more explicit. The average duration of treatment slots reduced by 6.7% in the 9 months following implementation of the initiatives (P = .001). A reduction of 21% in duration of treatment slots was observed on 1 of the machines (P < .001). Time spent on safety reviews remained the same (20% of the allocated interval), but the peer review component increased. The Kaizen approach has the potential to improve operational efficiency and safety with quick turnaround in radiation therapy practice by addressing non-value-adding steps characteristic of individual department workflows. Higher effort opportunities are identified to guide continual downstream quality improvements. Copyright © 2017 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Real-time beam monitoring in scanned proton therapy

NASA Astrophysics Data System (ADS)

Klimpki, G.; Eichin, M.; Bula, C.; Rechsteiner, U.; Psoroulas, S.; Weber, D. C.; Lomax, A.; Meer, D.

2018-05-01

When treating cancerous tissues with protons beams, many centers make use of a step-and-shoot irradiation technique, in which the beam is steered to discrete grid points in the tumor volume. For safety reasons, the irradiation is supervised by an independent monitoring system validating cyclically that the correct amount of protons has been delivered to the correct position in the patient. Whenever unacceptable inaccuracies are detected, the irradiation can be interrupted to reinforce a high degree of radiation protection. At the Paul Scherrer Institute, we plan to irradiate tumors continuously. By giving up the idea of discrete grid points, we aim to be faster and more flexible in the irradiation. But the increase in speed and dynamics necessitates a highly responsive monitoring system to guarantee the same level of patient safety as for conventional step-and-shoot irradiations. Hence, we developed and implemented real-time monitoring of the proton beam current and position. As such, we read out diagnostic devices with 100 kHz and compare their signals against safety tolerances in an FPGA. In this paper, we report on necessary software and firmware enhancements of our control system and test their functionality based on three exemplary error scenarios. We demonstrate successful implementation of real-time beam monitoring and, consequently, compliance with international patient safety regulations.

International Research Reactor Decommissioning Project

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

Leopando, Leonardo; Warnecke, Ernst

2008-01-15

Many research reactors have been or will be shut down and are candidates for decommissioning. Most of the respective countries neither have a decommissioning policy nor the required expertise and funds to effectively implement a decommissioning project. The IAEA established the Research Reactor Decommissioning Demonstration Project (R{sup 2}D{sup 2}P) to help answer this need. It was agreed to involve the Philippine Research Reactor (PRR-1) as model reactor to demonstrate 'hands-on' experience as it is just starting the decommissioning process. Other facilities may be included in the project as they fit into the scope of R{sup 2}D{sup 2}P and complement tomore » the PRR-1 decommissioning activities. The key outcome of the R{sup 2}D{sup 2}P will be the decommissioning of the PRR-1 reactor. On the way to this final goal the preparation of safety related documents (i.e., decommissioning plan, environmental impact assessment, safety analysis report, health and safety plan, cost estimate, etc.) and the licensing process as well as the actual dismantling activities could provide a model to other countries involved in the project. It is expected that the R{sup 2}D{sup 2}P would initiate activities related to planning and funding of decommissioning activities in the participating countries if that has not yet been done.« less

Safety Assessment for a Surface Repository in the Chernobyl Exclusion Zone - Methodology for Assessing Disposal under Intervention Conditions - 13476

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

Haverkamp, B.; Krone, J.; Shybetskyi, I.

The Radioactive Waste Disposal Facility (RWDF) Buryakovka was constructed in 1986 as part of the intervention measures after the accident at Chernobyl NPP (ChNPP). Today, RWDF Buryakovka is still being operated but its maximum capacity is nearly reached. Plans for enlargement of the facility exist since more than 10 years but have not been implemented yet. In the framework of an European Commission Project DBE Technology GmbH prepared a safety analysis report of the facility in its current state (SAR) and a preliminary safety analysis report (PSAR) based on the planned enlargement. Due to its history RWDF Buryakovka does notmore » fully comply with today's best international practices and the latest Ukrainian regulations in this area. The most critical aspects are its inventory of long-lived radionuclides, and the non-existent multi-barrier waste confinement system. A significant part of the project was dedicated, therefore, to the development of a methodology for the safety assessment taking into consideration the facility's special situation and to reach an agreement with all stakeholders involved in the later review and approval procedure of the safety analysis reports. Main aspect of the agreed methodology was to analyze the safety, not strictly based on regulatory requirements but on the assessment of the actual situation of the facility including its location within the Exclusion Zone. For both safety analysis reports, SAR and PSAR, the assessment of the long-term safety led to results that were either within regulatory limits or within the limits allowing for a specific situational evaluation by the regulator. (authors)« less

Safety Priorities and Underestimations in Recreational Scuba Diving Operations: A European Study Supporting the Implementation of New Risk Management Programmes

PubMed Central

Lucrezi, Serena; Egi, Salih Murat; Pieri, Massimo; Burman, Francois; Ozyigit, Tamer; Cialoni, Danilo; Thomas, Guy; Marroni, Alessandro; Saayman, Melville

2018-01-01

Introduction: Scuba diving is an important marine tourism sector, but requires proper safety standards to reduce the risks and increase accessibility to its market. To achieve safety goals, safety awareness and positive safety attitudes in recreational scuba diving operations are essential. However, there is no published research exclusively focusing on scuba divers’ and dive centres’ perceptions toward safety. This study assessed safety perceptions in recreational scuba diving operations, with the aim to inform and enhance safety and risk management programmes within the scuba diving tourism industry. Materials and Methods: Two structured questionnaire surveys were prepared by the organisation Divers Alert Network and administered online to scuba diving operators in Italy and scuba divers in Europe, using a mixture of convenience and snowball sampling. Questions in the survey included experience and safety offered at the dive centre; the buddy system; equipment and accessories for safe diving activities; safety issues in the certification of new scuba divers; incidents/accidents; and attitudes toward safety. Results: 91 scuba diving centres and 3,766 scuba divers participated in the study. Scuba divers gave importance to safety and the responsiveness of service providers, here represented by the dive centres. However, they underestimated the importance of a personal emergency action/assistance plan and, partly, of the buddy system alongside other safety procedures. Scuba divers agreed that some risks, such as those associated with running out of gas, deserve attention. Dive centres gave importance to aspects such as training and emergency action/assistance plans. However, they were limitedly involved in safety campaigning. Dive centres’ perceptions of safety in part aligned with those of scuba divers, with some exceptions. Conclusion: Greater responsibility is required in raising awareness and educating scuba divers, through participation in prevention campaigns and training. The study supports the introduction of programmes aiming to create a culture of safety among dive centres and scuba divers. Two examples, which are described in this paper, include the Hazard Identification and Risk Assessment protocol for dive centres and scuba divers, and the Diving Safety Officer programme to create awareness, improve risk management, and mitigate health and safety risks. PMID:29628904

Safety Priorities and Underestimations in Recreational Scuba Diving Operations: A European Study Supporting the Implementation of New Risk Management Programmes.

PubMed

Lucrezi, Serena; Egi, Salih Murat; Pieri, Massimo; Burman, Francois; Ozyigit, Tamer; Cialoni, Danilo; Thomas, Guy; Marroni, Alessandro; Saayman, Melville

2018-01-01

Introduction: Scuba diving is an important marine tourism sector, but requires proper safety standards to reduce the risks and increase accessibility to its market. To achieve safety goals, safety awareness and positive safety attitudes in recreational scuba diving operations are essential. However, there is no published research exclusively focusing on scuba divers' and dive centres' perceptions toward safety. This study assessed safety perceptions in recreational scuba diving operations, with the aim to inform and enhance safety and risk management programmes within the scuba diving tourism industry. Materials and Methods: Two structured questionnaire surveys were prepared by the organisation Divers Alert Network and administered online to scuba diving operators in Italy and scuba divers in Europe, using a mixture of convenience and snowball sampling. Questions in the survey included experience and safety offered at the dive centre; the buddy system; equipment and accessories for safe diving activities; safety issues in the certification of new scuba divers; incidents/accidents; and attitudes toward safety. Results: 91 scuba diving centres and 3,766 scuba divers participated in the study. Scuba divers gave importance to safety and the responsiveness of service providers, here represented by the dive centres. However, they underestimated the importance of a personal emergency action/assistance plan and, partly, of the buddy system alongside other safety procedures. Scuba divers agreed that some risks, such as those associated with running out of gas, deserve attention. Dive centres gave importance to aspects such as training and emergency action/assistance plans. However, they were limitedly involved in safety campaigning. Dive centres' perceptions of safety in part aligned with those of scuba divers, with some exceptions. Conclusion: Greater responsibility is required in raising awareness and educating scuba divers, through participation in prevention campaigns and training. The study supports the introduction of programmes aiming to create a culture of safety among dive centres and scuba divers. Two examples, which are described in this paper, include the Hazard Identification and Risk Assessment protocol for dive centres and scuba divers, and the Diving Safety Officer programme to create awareness, improve risk management, and mitigate health and safety risks.

The evolving role and care management approaches of safety-net Medicaid managed care plans.

PubMed

Gusmano, Michael K; Sparer, Michael S; Brown, Lawrence D; Rowe, Catherine; Gray, Bradford

2002-12-01

This article provides new empirical data about the viability and the care management activities of Medicaid managed-care plans sponsored by provider organizations that serve Medicaid and other low-income populations. Using survey and case study methods, we studied these "safety-net" health plans in 1998 and 2000. Although the number of safety-net plans declined over this period, the surviving plans were larger and enjoying greater financial success than the plans we surveyed in 1998. We also found that, based on a partnership with providers, safety-net plans are moving toward more sophisticated efforts to manage the care of their enrollees. Our study suggests that, with supportive state policies, safety-net plans are capable of remaining viable. Contracting with safety-net plans may not be an efficient mechanism for enabling Medicaid recipients to "enter the mainstream of American health care," but it may provide states with an effective way to manage and coordinate the care of Medicaid recipients, while helping to maintain the health care safety-net for the uninsured.

Space-planning and structural solutions of low-rise buildings: Optimal selection methods

NASA Astrophysics Data System (ADS)

Gusakova, Natalya; Minaev, Nikolay; Filushina, Kristina; Dobrynina, Olga; Gusakov, Alexander

2017-11-01

The present study is devoted to elaboration of methodology used to select appropriately the space-planning and structural solutions in low-rise buildings. Objective of the study is working out the system of criteria influencing the selection of space-planning and structural solutions which are most suitable for low-rise buildings and structures. Application of the defined criteria in practice aim to enhance the efficiency of capital investments, energy and resource saving, create comfortable conditions for the population considering climatic zoning of the construction site. Developments of the project can be applied while implementing investment-construction projects of low-rise housing at different kinds of territories based on the local building materials. The system of criteria influencing the optimal selection of space-planning and structural solutions of low-rise buildings has been developed. Methodological basis has been also elaborated to assess optimal selection of space-planning and structural solutions of low-rise buildings satisfying the requirements of energy-efficiency, comfort and safety, and economical efficiency. Elaborated methodology enables to intensify the processes of low-rise construction development for different types of territories taking into account climatic zoning of the construction site. Stimulation of low-rise construction processes should be based on the system of approaches which are scientifically justified; thus it allows enhancing energy efficiency, comfort, safety and economical effectiveness of low-rise buildings.

Promoting Action on Research Implementation in Health Services framework applied to TeamSTEPPS implementation in small rural hospitals.

PubMed

Ward, Marcia M; Baloh, Jure; Zhu, Xi; Stewart, Greg L

A particularly useful model for examining implementation of quality improvement interventions in health care settings is the PARIHS (Promoting Action on Research Implementation in Health Services) framework developed by Kitson and colleagues. The PARIHS framework proposes three elements (evidence, context, and facilitation) that are related to successful implementation. An evidence-based program focused on quality enhancement in health care, termed TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety), has been widely promoted by the Agency for Healthcare Research and Quality, but research is needed to better understand its implementation. We apply the PARIHS framework in studying TeamSTEPPS implementation to identify elements that are most closely related to successful implementation. Quarterly interviews were conducted over a 9-month period in 13 small rural hospitals that implemented TeamSTEPPS. Interview quotes that were related to each of the PARIHS elements were identified using directed content analysis. Transcripts were also scored quantitatively, and bivariate regression analysis was employed to explore relationships between PARIHS elements and successful implementation related to planning activities. The current findings provide support for the PARIHS framework and identified two of the three PARIHS elements (context and facilitation) as important contributors to successful implementation. This study applies the PARIHS framework to TeamSTEPPS, a widely used quality initiative focused on improving health care quality and patient safety. By focusing on small rural hospitals that undertook this quality improvement activity of their own accord, our findings represent effectiveness research in an understudied segment of the health care delivery system. By identifying context and facilitation as the most important contributors to successful implementation, these analyses provide a focus for efficient and effective sustainment of TeamSTEPPS efforts.

Lessons from a Successful Implementation of a Computerized Provider Order Entry System

PubMed Central

Jacobs, Brian R.; Hallstrom, Craig K.; Hart, Kim Ward; Mahoney, Daniela; Lykowski, Gayle

2007-01-01

OBJECTIVES The electronic health record (EHR) can improve patient safety, care efficiency, cost effectiveness and regulatory compliance. Cincinnati Children's Hospital Medical Center (CCHMC) has successfully implemented an Integrating Clinical Information System (ICIS) that includes Computerized Provider Order Entry (CPOE). This review describes some of the unanticipated challenges and solutions identified during the implementation of ICIS. METHODS Data for this paper was derived from user-generated feedback within the ICIS. Feedback reports were reviewed and placed into categories based on root cause of the issue. Recurring issues or problems which led to potential or actual patient injury are included. RESULTS Nine distinct challenges were identified: 1) Deterioration in communication; 2) Excessive system alerts to users; 3) Unrecognized discontinuation of medications; 4) Unintended loss of orders; 5) Loss of orders during implementation; 6) Amplification of errors; 7) Unintentional generation of patient care orders by system analysts; 8) Persistence of specific patient care order instructions; 9) Verbal orders entered under the incorrect clinician. CONCLUSIONS Unanticipated challenges are expected when implementing EHRs. The implementation plan for any EHR should include methods to identify, evaluate and repair problems quickly. While continued challenges with this complex system are expected, we believe that the EHR will continue to facilitate improved patient care and safety. The lessons learned at CCHMC will permit other institutions to avoid some of these challenges and design robust processes to detect and respond to problems in a timely fashion to ensure implementation success. PMID:23055847

Practical Approaches for Achieving Integrated Behavioral Health Care in Primary Care Settings

PubMed Central

Ratzliff, Anna; Phillips, Kathryn E.; Sugarman, Jonathan R.; Unützer, Jürgen; Wagner, Edward H.

2016-01-01

Behavioral health problems are common, yet most patients do not receive effective treatment in primary care settings. Despite availability of effective models for integrating behavioral health care in primary care settings, uptake has been slow. The Behavioral Health Integration Implementation Guide provides practical guidance for adapting and implementing effective integrated behavioral health care into patient-centered medical homes. The authors gathered input from stakeholders involved in behavioral health integration efforts: safety net providers, subject matter experts in primary care and behavioral health, a behavioral health patient and peer specialist, and state and national policy makers. Stakeholder input informed development of the Behavioral Health Integration Implementation Guide and the GROW Pathway Planning Worksheet. The Behavioral Health Integration Implementation Guide is model neutral and allows organizations to take meaningful steps toward providing integrated care that achieves access and accountability. PMID:26698163

Practical Approaches for Achieving Integrated Behavioral Health Care in Primary Care Settings.

PubMed

Ratzliff, Anna; Phillips, Kathryn E; Sugarman, Jonathan R; Unützer, Jürgen; Wagner, Edward H

Behavioral health problems are common, yet most patients do not receive effective treatment in primary care settings. Despite availability of effective models for integrating behavioral health care in primary care settings, uptake has been slow. The Behavioral Health Integration Implementation Guide provides practical guidance for adapting and implementing effective integrated behavioral health care into patient-centered medical homes. The authors gathered input from stakeholders involved in behavioral health integration efforts: safety net providers, subject matter experts in primary care and behavioral health, a behavioral health patient and peer specialist, and state and national policy makers. Stakeholder input informed development of the Behavioral Health Integration Implementation Guide and the GROW Pathway Planning Worksheet. The Behavioral Health Integration Implementation Guide is model neutral and allows organizations to take meaningful steps toward providing integrated care that achieves access and accountability.

49 CFR 244.17 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file one original of a proposed Safety Integration Plan with the Associate Administrator for Safety, FRA, 1200 New...

49 CFR 244.17 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file one original of a proposed Safety Integration Plan with the Associate Administrator for Safety, FRA, 1200 New...

49 CFR 244.17 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file one original of a proposed Safety Integration Plan with the Associate Administrator for Safety, FRA, 1200 New...

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

PubMed

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

2017-04-01

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

Who knows the risk? A multilevel study of systematic variations in work-related safety knowledge in the European workforce.

PubMed

Dragano, Nico; Lunau, Thorsten; Eikemo, Terje A; Toch-Marquardt, Marlen; van der Wel, Kjetil A; Bambra, Clare

2015-08-01

Health and safety instructions are important components of occupational prevention. Albeit instruction is mandatory in most countries, research suggests that safety knowledge varies among the workforce. We analysed a large European sample to explore if all subgroups of employees are equally reached. In a comparative perspective, we also investigated if country-level determinants influence the variance of safety knowledge between countries. We used data on 24,534 employees from 27 countries who participated in the 2010 European Working Conditions Survey. Safety knowledge was measured as self-assessed quality of safety information. Country-level determinants were added from Eurostat databases (gross domestic product) and the European Survey of Enterprises on New and Emerging Risks (ESENER) study (% companies with A: safety plan or B: a labour inspectorate visit). Associations between knowledge, sociodemographic, occupational characteristics and macrodeterminants were studied with hierarchical regression models. In our sample, 10.1% reported a low degree of health and safety knowledge. Across all countries, younger workers, lower educated workers, production workers, private sector employees, those with less job experience or a temporary contract, or those who work in small businesses were more likely to report low levels of information. Moreover, low information prevalence varied by country. Countries with a high proportion of companies with a safety plan and recent labour inspectorate on-site visits had higher proportions of informed workers. A vast majority reported to be well informed about safety risks but systematic inequalities in the degree of knowledge between subgroups were evident. Further efforts on the workplace, the organisational and the political level are needed to universally implement existing occupational safety regulations. 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.

Quality improvement in neonatal digital radiography: implementing the basic quality improvement tools.

PubMed

Eslamy, Hedieh K; Newman, Beverley; Weinberger, Ed

2014-12-01

A quality improvement (QI) program may be implemented using the plan-do-study-act cycle (as a model for making improvements) and the basic QI tools (used to visually display and analyze variation in data). Managing radiation dose has come to the forefront as a safety goal for radiology departments. This is especially true in the pediatric population, which is more radiosensitive than the adult population. In this article, we use neonatal digital radiography to discuss developing a QI program with the principle goals of decreasing the radiation dose, decreasing variation in radiation dose, and optimizing image quality. Copyright © 2014 Elsevier Inc. All rights reserved.

Exploring how ward staff engage with the implementation of a patient safety intervention: a UK-based qualitative process evaluation.

PubMed

Sheard, Laura; Marsh, Claire; O'Hara, Jane; Armitage, Gerry; Wright, John; Lawton, Rebecca

2017-07-13

A patient safety intervention was tested in a 33-ward randomised controlled trial. No statistically significant difference between intervention and control wards was found. We conducted a process evaluation of the trial and our aim in this paper is to understand staff engagement across the 17 intervention wards. Large qualitative process evaluation of the implementation of a patient safety intervention. National Health Service staff based on 17 acute hospital wards located at five hospital sites in the North of England. We concentrate on three sources here: (1) analysis of taped discussion between ward staff during action planning meetings; (2) facilitators' field notes and (3) follow-up telephone interviews with staff focusing on whether action plans had been achieved. The analysis involved the use of pen portraits and adaptive theory. First, there were palpable differences in the ways that the 17 ward teams engaged with the key components of the intervention. Five main engagement typologies were evident across the life course of the study: consistent, partial, increasing, decreasing and disengaged. Second, the intensity of support for the intervention at the level of the organisation does not predict the strength of engagement at the level of the individual ward team. Third, the standardisation of facilitative processes provided by the research team does not ensure that implementation standardisation of the intervention occurs by ward staff. A dilution of the intervention occurred during the trial because wards engaged with Patient Reporting and Action for a Safe Environment (PRASE) in divergent ways, despite the standardisation of key components. Facilitative processes were not sufficiently adequate to enable intervention wards to successfully engage with PRASE components. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[The implementation of the week surgery in an orthopedic and urology ward and assessment of its impact].

PubMed

Mulloni, Giovanna; Petrucco, Stefania; De Marc, Raffaella; Nazzi, Cheti; Petri, Roberto; Guarrera, Giovanni Maria

2015-01-01

The implementation of the week surgery in an orthopedic and urology ward and the assessment of its impact. The week surgery (WS) is one of the models organized according the intensity of care that allows the improvement of the appropriateness of the hospital admissions. To describe the implementation and the impact of the WS on costs and levels of care. The WS was gradually implemented in an orthopedic and urology ward. The planning of the surgeries was modified, the wards where patients would have been transferred during the week-end where identified, the nurses were supported by expert nurses to learn new skills and clinical pathways were implemented. The periods January-June 2012 and 2013 were compared identifying a set of indicators according to the health technology assessment method. The nurses were able to take vacations according to schedule; the cost of outsourcing services were reduced (-4.953 Euros) as well as those of consumables. The nursing care could be guaranteed employing less (-5) full-time nurses; the global clinical performance of the ward did not vary. Unfortunately several urology patients could not be discharged during the week-ends. A good planning of the surgeries according to the patients' length of staying, together with interventions to increase the staff-skill mix, and the clinical pathways allowed an effective and efficient implementation of the WS model without jeopardizing patients' safety.

Runaway chemical reaction exposes community to highly toxic chemicals.

PubMed

Kaszniak, Mark; Vorderbrueggen, John

2008-11-15

The U.S. Chemical Safety and Hazard Investigation Board (CSB) conducted a comprehensive investigation of a runaway chemical reaction at MFG Chemical (MFG) in Dalton, Georgia on April 12, 2004 that resulted in the uncontrolled release of a large quantity of highly toxic and flammable allyl alcohol and allyl chloride into the community. Five people were hospitalized and 154 people required decontamination and treatment for exposure to the chemicals. This included police officers attempting to evacuate the community and ambulance personnel who responded to 911 calls from residents exposed to the chemicals. This paper presents the findings of the CSB report (U.S. Chemical Safety and Hazard Investigation Board (CSB), Investigation Report: Toxic Chemical Vapor Cloud Release, Report No. 2004-09-I-GA, Washington DC, April 2006) including a discussion on tolling practices; scale-up of batch reaction processes; Process Safety Management (PSM) and Risk Management Plan (RMP) implementation; emergency planning by the company, county and the city; and emergency response and mitigation actions taken during the incident. The reactive chemical testing and atmospheric dispersion modeling conducted by CSB after the incident and recommendations adopted by the Board are also discussed.

Site safety plan for Lawrence Livermore National Laboratory CERCLA investigations at site 300. Revision 2

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

Kilmer, J.

Various Department of Energy Orders incorporate by reference, health and safety regulations promulgated by the Occupational Safety and Health Administration (OSHA). One of the OSHA regulations, 29 CFR 1910.120, Hazardous Waste Operations and Emergency Response, requires that site safety plans are written for activities such as those covered by work plans for Site 300 environmental investigations. Based upon available data, this Site Safety Plan (Plan) for environmental restoration has been prepared specifically for the Lawrence Livermore National Laboratory Site 300, located approximately 15 miles east of Livermore, California. As additional facts, monitoring data, or analytical data on hazards are provided,more » this Plan may need to be modified. It is the responsibility of the Environmental Restoration Program and Division (ERD) Site Safety Officer (SSO), with the assistance of Hazards Control, to evaluate data which may impact health and safety during these activities and to modify the Plan as appropriate. This Plan is not `cast-in-concrete.` The SSO shall have the authority, with the concurrence of Hazards Control, to institute any change to maintain health and safety protection for workers at Site 300.« less

Incorporating bedside reporting into change-of-shift report.

PubMed

Laws, Dawn; Amato, Shelly

2010-01-01

Communication failures during shift reports are a leading cause of sentinel events in the United States. Providing adequate information during change-of-shift reporting is essential to promoting patient safety. In addition, patients want to be more involved in decisions regarding their plan of care. The purpose of the article is to discuss how a stroke rehabilitation unit was able to implement bedside change-of-shift reporting to meet both of these goals.

Current implementation and future plans on new code architecture, programming language and user interface

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

Brun, B.

1997-07-01

Computer technology has improved tremendously during the last years with larger media capacity, memory and more computational power. Visual computing with high-performance graphic interface and desktop computational power have changed the way engineers accomplish everyday tasks, development and safety studies analysis. The emergence of parallel computing will permit simulation over a larger domain. In addition, new development methods, languages and tools have appeared in the last several years.

Preoperative Planning in Orthopaedic Surgery. Current Practice and Evolving Applications.

PubMed

Atesok, Kivanc; Galos, David; Jazrawi, Laith M; Egol, Kenneth A

2015-12-01

Preoperative planning is an essential prerequisite for the success of orthopaedic procedures. Traditionally, the exercise has involved the written down, step by step "blueprint" of the surgical procedure. Preoperative planning of the technical aspects of the orthopaedic procedure has been performed on hardcopy radiographs using various methods such as copying the radiographic image on tracing papers to practice the planned interventions. This method has become less practical due to variability in radiographic magnification and increasing implementation of digital imaging systems. Advances in technology along with recognition of the importance of surgical safety protocols resulted in widespread changes in orthopaedic preoperative planning approaches. Nowadays, perioperative "briefings" have gained particular importance and novel planning methods have started to integrate into orthopaedic practice. These methods include using software that enables surgeons to perform preoperative planning on digital radiographs and to construct 3D digital models or prototypes of various orthopaedic pathologies from a patient's CT scans to practice preoperatively. Evidence-to-date suggests that preoperative planning and briefings are effective means of favorably influencing the outcomes of orthopaedic procedures.

PLANNING FOR SAFETY ON THE JOBSITE. SAFETY IN INDUSTRY--CONSTRUCTION INDUSTRY SERIES.

ERIC Educational Resources Information Center

OTTO, FRANCIS L.; VAN ATTA, F.A.

WORK INJURIES AND THEIR MONETARY LOSSES IN THE CONSTRUCTION INDUSTRY CAN BE EFFECTIVELY PREVENTED ONLY THROUGH AN AGGRESSIVE AND WELL-PLANNED SAFETY EFFORT. THIS BULLETIN DISCUSSES THE "HOW" OF PLANNING FOR SAFETY ON THE JOBSITE. IT WAS PREPARED IN THE DIVISION OF PROGRAMING AND RESEARCH, OFFICE OF OCCUPATIONAL SAFETY. CONTENTS INCLUDE (1) THE…

The three Rs of fire safety, emergency action, and fire prevention planning: promoting safety at the worksite.

PubMed

Thompson, Marcella R

2003-04-01

Fire safety is of paramount importance for everyone. In many workplaces, the occupational health nurse's scope of practice encompasses safety related activities. Included within this role is the responsibility for fire safety, emergency action, and fire prevention planning. The Three Rs of fire safety, emergency action, and fire prevention plans are rules, responsibilities, and resources. Myriad building and fire safety codes, regulations, and standards exist with which an employer must comply. An employer's responsibility for installing, testing, inspecting, and maintaining fire safety related equipment is extensive. Emergency action and fire prevention planning begins with conducting a detailed physical survey and preparing site maps. It includes making key policy decisions, writing procedures, and training employees in those procedures by practicing and executing site drills. The best resources available for emergency planning are the local fire department and the property insurer. Planning ahead means an efficient emergency response if disaster strikes. It saves lives, limits property damage, and preserves the environment.

Report on the oversight assessment of the operational readiness review of the Replacement Tritium Facility at Savannah River Site

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

Lee, B.T.

1993-03-01

This report presents the results of an oversight assessment (OA) conducted by the US Department of Energy's (DOE) Office of Environment, Safety and Health (EH) of operational readiness review (ORR) activities for the Replacement Tritium Facility (RTF) located at Savannah River Site (SRS). The EH OA of this facility took place concurrently with an ORR conducted by the DOE Office of Defense Programs (DP). The DP ORR was conducted from January 19 through February 5, 1993. The EH OA was performed in accordance with the protocol and procedures specified in EH Program for Oversight Assessment of Operational Readiness Evaluations formore » Startups and Restarts,'' dated September 15, 1992. The EH OA Team evaluated the DP ORR to determine whether it was thorough and demonstrated sufficient inquisitiveness to verify that the implementation of programs and procedures adequately ensures the protection of worker safety and health. The EH OA Team performed its evaluation of the DP ORR in the following technical areas: occupational safety, industrial hygiene, and respiratory protection; fire protection; and chemical safety. In the areas of fire protection and chemical safety, the EH OA Team conducted independent vertical-slice reviews to confirm DP ORR results. Within each technical area, the EH OA Team reviewed the DP ORR Plan, including the Criteria Review and Approach Documents (CRADs); the qualifications of individual DP ORR team members; the performance of planned DP ORR activities; and the results of the DP ORR.« less

Report on the oversight assessment of the operational readiness review of the Replacement Tritium Facility at Savannah River Site

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

Lee, B.T.

1993-03-01

This report presents the results of an oversight assessment (OA) conducted by the US Department of Energy`s (DOE) Office of Environment, Safety and Health (EH) of operational readiness review (ORR) activities for the Replacement Tritium Facility (RTF) located at Savannah River Site (SRS). The EH OA of this facility took place concurrently with an ORR conducted by the DOE Office of Defense Programs (DP). The DP ORR was conducted from January 19 through February 5, 1993. The EH OA was performed in accordance with the protocol and procedures specified in ``EH Program for Oversight Assessment of Operational Readiness Evaluations formore » Startups and Restarts,`` dated September 15, 1992. The EH OA Team evaluated the DP ORR to determine whether it was thorough and demonstrated sufficient inquisitiveness to verify that the implementation of programs and procedures adequately ensures the protection of worker safety and health. The EH OA Team performed its evaluation of the DP ORR in the following technical areas: occupational safety, industrial hygiene, and respiratory protection; fire protection; and chemical safety. In the areas of fire protection and chemical safety, the EH OA Team conducted independent vertical-slice reviews to confirm DP ORR results. Within each technical area, the EH OA Team reviewed the DP ORR Plan, including the Criteria Review and Approach Documents (CRADs); the qualifications of individual DP ORR team members; the performance of planned DP ORR activities; and the results of the DP ORR.« less

Ward round template: enhancing patient safety on ward rounds.

PubMed

Gilliland, Niall; Catherwood, Natalie; Chen, Shaouyn; Browne, Peter; Wilson, Jacob; Burden, Helena

2018-01-01

Concerns had been raised at clinical governance regarding the safety of our inpatient ward rounds with particular reference to: documentation of clinical observations and National Early Warning Score (NEWS), compliance with Trust guidance for venous thromboembolism (VTE) risk assessment, antibiotic stewardship, palliative care and treatment escalation plans (TEP). This quality improvement project was conceived to ensure these parameters were considered and documented during the ward round, thereby improving patient care and safety. These parameters were based on Trust patient safety guidance and CQUIN targets. The quality improvement technique of plan-do-study-act (PDSA) was used in this project. We retrospectively reviewed ward round entries to record baseline measurements, based on the above described parameters, prior to making any changes. Following this, the change applied was the introduction of a ward round template to include the highlighted important baseline parameters. Monthly PDSA cycles are performed, and baseline measurements are re-examined, then relevant changes were made to the ward round template. Documentation of baseline measurements was poor prior to introduction of the ward round template; this improved significantly following introduction of a standardised ward round template. Following three cycles, documentation of VTE risk assessments increased from 14% to 92%. Antibiotic stewardship documentation went from 0% to 100%. Use of the TEP form went from 29% to 78%. Following introduction of the ward round template, compliance improved significantly in all safety parameters. Important safety measures being discussed on ward rounds will lead to enhanced patient safety and will improve compliance to Trust guidance and comissioning for quality and innovation (CQUIN) targets. Ongoing change implementation will focus on improving compliance with usage of the template on all urology ward rounds.

Effectiveness of participatory training for the promotion of work-related health and safety among Korean farmers

PubMed Central

KIM, Jin-Seok; YOON, Seong-Yong; CHO, Seong-Yong; KIM, Sang-Kyu; CHUNG, In-Sung; SHIN, Hyeong-Soo

2017-01-01

This study was conducted to explore the effectiveness of participatory training for promoting farmer’s health and reducing agricultural work-related injuries. Candidates for this study included 595 farmers in 8 rural villages of South Korea. The one-day course participatory training was administered to 217 (36.5%) farmers and included an action-checklist, a good example presentation, and group discussion. The follow-up visit to participants’ houses and farms was performed after 1 to 3 months. A direct interview survey was administered pre- and post-trainings. The total number of proposed action plans for the improvement of working condition was 620. It was observed that 61.5% of action plans (72.2% of short term and 41.3% of long term plans) were completely implemented. In regards to health and safety indices, the proportion of current smokers was reduced from 29.8% to 25.3% in the group that underwent training. The pesticide intoxication was reduced from 16.1% to 4.8% in participants that underwent training. However, the agricultural injury rate was unchanged in both groups. This study reports significant beneficial effects of participatory training in the agriculture sector in Korea. PMID:28484146

Fast, Safe, Propellant-Efficient Spacecraft Motion Planning Under Clohessy-Wiltshire-Hill Dynamics

NASA Technical Reports Server (NTRS)

Starek, Joseph A.; Schmerling, Edward; Maher, Gabriel D.; Barbee, Brent W.; Pavone, Marco

2016-01-01

This paper presents a sampling-based motion planning algorithm for real-time and propellant-optimized autonomous spacecraft trajectory generation in near-circular orbits. Specifically, this paper leverages recent algorithmic advances in the field of robot motion planning to the problem of impulsively actuated, propellant- optimized rendezvous and proximity operations under the Clohessy-Wiltshire-Hill dynamics model. The approach calls upon a modified version of the FMT* algorithm to grow a set of feasible trajectories over a deterministic, low-dispersion set of sample points covering the free state space. To enforce safety, the tree is only grown over the subset of actively safe samples, from which there exists a feasible one-burn collision-avoidance maneuver that can safely circularize the spacecraft orbit along its coasting arc under a given set of potential thruster failures. Key features of the proposed algorithm include 1) theoretical guarantees in terms of trajectory safety and performance, 2) amenability to real-time implementation, and 3) generality, in the sense that a large class of constraints can be handled directly. As a result, the proposed algorithm offers the potential for widespread application, ranging from on-orbit satellite servicing to orbital debris removal and autonomous inspection missions.

Online Adaptive Radiation Therapy: Implementation of a New Process of Care

PubMed Central

Cao, Minsong; Kishan, Amar; Agazaryan, Nzhde; Thomas, David H; Shaverdian, Narek; Yang, Yingli; Ray, Suzette; Low, Daniel A; Raldow, Ann; Steinberg, Michael L.; Lee, Percy

2017-01-01

Onboard magnetic resonance imaging (MRI) guided radiotherapy is now clinically available in nine centers in the world. This technology has facilitated the clinical implementation of online adaptive radiotherapy (OART), or the ability to alter the daily treatment plan based on tumor and anatomical changes in real-time while the patient is on the treatment table. However, due to the time sensitive nature of OART, implementation in a large and busy clinic has many potential obstacles as well as patient-related safety considerations. In this work, we have described the implementation of this new process of care in the Department of Radiation Oncology at the University of California, Los Angeles (UCLA). We describe the rationale, the initial challenges such as treatment time considerations, technical issues during the process of re-contouring, re-optimization, quality assurance, as well as our current solutions to overcome these challenges. In addition, we describe the implementation of a coverage system with a physician of the day as well as online planners (physicists or dosimetrists) to oversee each OART treatment with patient-specific ‘hand-off’ directives from the patient’s treating physician. The purpose of this effort is to streamline the process without compromising treatment quality and patient safety. As more MRI-guided radiotherapy programs come online, we hope that our experience can facilitate successful adoption of OART in a way that maximally benefits the patient. PMID:29104835

Recommendations for safety planning, data collection, evaluation and reporting during drug, biologic and vaccine development: a report of the safety planning, evaluation, and reporting team.

PubMed

Crowe, Brenda J; Xia, H Amy; Berlin, Jesse A; Watson, Douglas J; Shi, Hongliang; Lin, Stephen L; Kuebler, Juergen; Schriver, Robert C; Santanello, Nancy C; Rochester, George; Porter, Jane B; Oster, Manfred; Mehrotra, Devan V; Li, Zhengqing; King, Eileen C; Harpur, Ernest S; Hall, David B

2009-10-01

The Safety Planning, Evaluation and Reporting Team (SPERT) was formed in 2006 by the Pharmaceutical Research and Manufacturers of America. SPERT's goal was to propose a pharmaceutical industry standard for safety planning, data collection, evaluation, and reporting, beginning with planning first-in-human studies and continuing through the planning of the post-product-approval period. SPERT's recommendations are based on our review of relevant literature and on consensus reached in our discussions. An important recommendation is that sponsors create a Program Safety Analysis Plan early in development. We also give recommendations for the planning of repeated, cumulative meta-analyses of the safety data obtained from the studies conducted within the development program. These include clear definitions of adverse events of special interest and standardization of many aspects of data collection and study design. We describe a 3-tier system for signal detection and analysis of adverse events and highlight proposals for reducing "false positive" safety findings. We recommend that sponsors review the aggregated safety data on a regular and ongoing basis throughout the development program, rather than waiting until the time of submission. We recognize that there may be other valid approaches. The proactive approach we advocate has the potential to benefit patients and health care providers by providing more comprehensive safety information at the time of new product marketing and beyond.

Use of Electronic Health Record Tools to Facilitate and Audit Infliximab Prescribing.

PubMed

Sharpless, Bethany R; Del Rosario, Fernando; Molle-Rios, Zarela; Hilmas, Elora

2018-01-01

The objective of this project was to assess a pediatric institution's use of infliximab and develop and evaluate electronic health record tools to improve safety and efficiency of infliximab ordering through auditing and improved communication. Best use of infliximab was defined through a literature review, analysis of baseline use of infliximab at our institution, and distribution and analysis of a national survey. Auditing and order communication were optimized through implementation of mandatory indications in the infliximab orderable and creation of an interactive flowsheet that collects discrete and free-text data. The value of the implemented electronic health record tools was assessed at the conclusion of the project. Baseline analysis determined that 93.8% of orders were dosed appropriately according to the findings of a literature review. After implementation of the flowsheet and indications, the time to perform an audit of use was reduced from 60 minutes to 5 minutes per month. Four months post implementation, data were entered by 60% of the pediatric gastroenterologists at our institution on 15.3% of all encounters for infliximab. Users were surveyed on the value of the tools, with 100% planning to continue using the workflow, and 82% stating the tools frequently improve the efficiency and safety of infliximab prescribing. Creation of a standard workflow by using an interactive flowsheet has improved auditing ability and facilitated the communication of important order information surrounding infliximab. Providers and pharmacists feel these tools improve the safety and efficiency of infliximab ordering, and auditing data reveal that the tools are being used.

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.

Establishment and implementation of common product assurance and safety requirements for the contractors of the Columbus programme

NASA Astrophysics Data System (ADS)

Wessels, H.; Stephan, H. J.

1991-08-01

When establishing the Columbus Product Assurance (PA)/safety requirements, the international environment of the Space Station Freedom program has to be taken into account. Considerations given to multiple ways of requirement definition and stages within the European Space Agency (ESA) Procedures, Specifications, and Standards (PSS-01) series of documents and the NASA Space Station requirements are discussed. A series of adaptations introduced by way of tailoring the basic ESA and NASA requirement sets to the Columbus program's needs are described. For the implementation of these tailored requirements, a scheme is developed, which recognizes the PA/safety approach within the European industries by way of various company handbooks and manuals. The changes introduced in the PSS-01 series and the applicable NASA Space Station requirements in recent years, has coincided with the establishment of Columbus PA/safety requirements. To achieve the necessary level of cooperation between ESA and the Columbus industries, a PA Working Group (PAWG) is established. The PAWG supervises the establishement of the Common PA/Safety Plan and the Standards to be used. Due to the high number of European industries participating in the Columbus program, a positive influence on the evolution of the industrial approaches in PA/safety can be expected. Cooperation in the PAWG has brought issues to light which are related to the ESA PSS-01 series and its requirements. Due to the rapid changes of recent years, basic company documentation has not followed the development, specifically as various recent ESA projects use different project specifc issues of the evolving PSS-01 documents.

Foodservice employees benefit from interventions targeting barriers to food safety.

PubMed

York, Valerie K; Brannon, Laura A; Shanklin, Carol W; Roberts, Kevin R; Howells, Amber D; Barrett, Elizabeth B

2009-09-01

The number of foodborne illnesses traced to improper food handling in restaurants indicates a need for research to improve food safety in these establishments. Therefore, this 2-year longitudinal study investigated the effectiveness of traditional ServSafe (National Restaurant Association Educational Foundation, Chicago, IL) food-safety training and a Theory of Planned Behavior intervention program targeting employees' perceived barriers and attitudes toward important food-safety behaviors. The effectiveness of the training and intervention was measured by knowledge scores and observed behavioral compliance rates related to food-safety practices. Employees were observed for handwashing, thermometer usage, and proper handling of work surfaces at baseline, after receiving ServSafe training, and again after exposure to the intervention targeting barriers and negative attitudes about food-safety practices. Repeated-measures analyses of variance indicated training improved handwashing knowledge, but the intervention was necessary to improve overall behavioral compliance and handwashing compliance. Results suggest that registered dietitians; dietetic technicians, registered; and foodservice managers should implement a combination of training and intervention to improve knowledge and compliance with food-safety behaviors, rather than relying on training alone. Challenges encountered while conducting this research are discussed, and recommendations are provided for researchers interested in conducting this type of research in the future.

WAG 2 remedial investigation and site investigation site-specific work plan/health and safety checklist for the soil and sediment task. Environmental Restoration Program

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

Holt, V.L.; Burgoa, B.B.

1993-12-01

This document is a site-specific work plan/health and safety checklist (WP/HSC) for a task of the Waste Area Grouping 2 Remedial Investigation and Site Investigation (WAG 2 RI&SI). Title 29 CFR Part 1910.120 requires that a health and safety program plan that includes site- and task-specific information be completed to ensure conformance with health- and safety-related requirements. To meet this requirement, the health and safety program plan for each WAG 2 RI&SI field task must include (1) the general health and safety program plan for all WAG 2 RI&SI field activities and (2) a WP/HSC for that particular field task.more » These two components, along with all applicable referenced procedures, must be kept together at the work site and distributed to field personnel as required. The general health and safety program plan is the Health and Safety Plan for the Remedial Investigation and Site Investigation of Waste Area Grouping 2 at the Oak Ridge National Laboratory, Oak Ridge, Tennessee (ORNL/ER-169). The WP/HSCs are being issued as supplements to ORNL/ER-169.« less

Improving patient safety in the radiation oncology setting through crew resource management.

PubMed

Sundararaman, Srinath; Babbo, Angela E; Brown, John A; Doss, Richard

2014-01-01

This paper demonstrates how the communication patterns and protocol rigors of a methodology called crew resource management (CRM) can be adapted to a radiation oncology environment to create a culture of patient safety. CRM training was introduced to our comprehensive radiation oncology department in the autumn of 2009. With 34 full-time equivalent staff, we see 100-125 patients daily on 2 hospital campuses. We were assisted by a consulting group with considerable experience in helping hospitals incorporate CRM principles and practices. Implementation steps included developing change initiative skills for key leaders, providing training in teamwork and communications, creating site-specific tools for safety and efficiency, and collecting data to document results. Our goals were to improve patient safety, teamwork, communication, and efficiency through the use of tools we developed that emphasized teamwork and communication, cross-checking, and routinizing specific protocols. Our CRM plan relies on the following 4 pillars: patient identification methods; "pause for the cause"; enabling all staff to halt treatment and question decisions; and daily morning meetings. We discuss some of the hurdles to change we encountered. Our safety record has improved. Our near-miss rate before CRM implementation averaged 11 per month; our near-miss rate currently averages 1.2 per month. In the 5 years prior to CRM implementation, we experienced 1 treatment deviation per year, although none rose to the level of "mis-administration." Since implementing CRM, our current patient treatment setup and delivery process has eliminated all treatment deviations. Our practices have identified situations where ambiguity or conflicting documentation could have resulted in inappropriate treatment or treatment inefficiencies. Our staff members have developed an extraordinary sense of teamwork combined with a high degree of personal responsibility to assure patient safety and have spoken up when they considered something potentially unsafe. We have increased our efficiency (and profitability); in 2012, our units of service were up 11.3% over 2009 levels with the same staffing level. The rigor and standardization introduced into our practice, combined with the increase in communication and teamwork have improved both safety and efficiency while improving both staff and patient satisfaction. CRM principles are highly adaptable and applicable to the radiation oncology setting. © 2014. Published by Elsevier Inc. All rights reserved.

Commonalities and Differences in Functional Safety Systems Between ISS Payloads and Industrial Applications

NASA Astrophysics Data System (ADS)

Malyshev, Mikhail; Kreimer, Johannes

2013-09-01

Safety analyses for electrical, electronic and/or programmable electronic (E/E/EP) safety-related systems used in payload applications on-board the International Space Station (ISS) are often based on failure modes, effects and criticality analysis (FMECA). For industrial applications of E/E/EP safety-related systems, comparable strategies exist and are defined in the IEC-61508 standard. This standard defines some quantitative criteria based on potential failure modes (for example, Safe Failure Fraction). These criteria can be calculated for an E/E/EP system or components to assess their compliance to requirements of a particular Safety Integrity Level (SIL). The standard defines several SILs depending on how much risk has to be mitigated by a safety-critical system. When a FMECA is available for an ISS payload or its subsystem, it may be possible to calculate the same or similar parameters as defined in the 61508 standard. One example of a payload that has a dedicated functional safety subsystem is the Electromagnetic Levitator (EML). This payload for the ISS is planned to be operated on-board starting 2014. The EML is a high-temperature materials processing facility. The dedicated subsystem "Hazard Control Electronics" (HCE) is implemented to ensure compliance to failure tolerance in limiting samples processing parameters to maintain generation of the potentially toxic by-products to safe limits in line with the requirements applied to the payloads by the ISS Program. The objective of this paper is to assess the implementation of the HCE in the EML against criteria for functional safety systems in the IEC-61508 standard and to evaluate commonalities and differences with respect to safety requirements levied on ISS Payloads. An attempt is made to assess a possibility of using commercially available components and systems certified for compliance to industrial functional safety standards in ISS payloads.

Improving client and nurse satisfaction through the utilization of bedside report.

PubMed

Vines, Mary M; Dupler, Alice E; Van Son, Catherine R; Guido, Ginny W

2014-01-01

Bedside reporting improves client safety and trust and facilitates nursing teamwork and accountability; however, many nurses do not consider it best practice when caring for their clients. A literature review was conducted to determine whether bedside report is an essential shift handover process that promotes both client and nursing satisfaction. Implications for nurses in professional development are discussed, and strategies for developing and implementing bedside report using Lewin's theory of planned change are provided.

48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... safety and health standards applicable to the work conditions of contractor and subcontractor employees...

48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... safety and health standards applicable to the work conditions of contractor and subcontractor employees...

48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... safety and health standards applicable to the work conditions of contractor and subcontractor employees...

48 CFR 952.223-71 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Provisions and Clauses 952.223-71 Integration of environment, safety, and health into work planning and..., safety, and health into work planning and execution. 952.223-71 Section 952.223-71 Federal Acquisition... safety and health standards applicable to the work conditions of contractor and subcontractor employees...

40 CFR 35.6055 - State-lead pre-remedial Cooperative Agreements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... safety plan. (i) Before beginning field work, the recipient must have a health and safety plan in place..., but must be made available to EPA upon request. (ii) The recipient's health and safety plan must comply with Occupational Safety and Health Administration (OSHA) 29 CFR 1910.120, entitled “Hazardous...

78 FR 61251 - The National Public Transportation Safety Plan, the Public Transportation Agency Safety Plan, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-03

... Transportation Agency Safety Plan, and the Public Transportation Safety Certification Training Program; Transit... systems are in a state of good repair, and provide increased transparency into agencies' budgetary... October 2001, mail received through the U.S. Postal Service may be subject to delays. Parties submitting...

78 FR 979 - Petition for Positive Train Control Safety Plan Approval and System Certification of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

...] Petition for Positive Train Control Safety Plan Approval and System Certification of the Electronic Train... the Federal Railroad Administration (FRA) for Positive Train Control (PTC) Safety Plan (PTCSP...-based train control system safety overlay designed to protect against the consequences of train-to-train...

12 CFR 30.4 - Filing of safety and soundness compliance plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... steps the bank will take to correct the deficiency and the time within which those steps will be taken. (c) Review of safety and soundness compliance plans. Within 30 days after receiving a safety and... AND SOUNDNESS STANDARDS § 30.4 Filing of safety and soundness compliance plan. (a) Schedule for filing...

Evaluation of the HACCP System in a University Canteen: Microbiological Monitoring and Internal Auditing as Verification Tools

PubMed Central

Osimani, Andrea; Aquilanti, Lucia; Tavoletti, Stefano; Clementi, Francesca

2013-01-01

Food safety is essential in mass catering. In Europe, Regulation (EC) No. 852/2004 requires food business operators to put in place, implement and maintain permanent procedures based on Hazard Analysis and Critical Control Point (HACCP) principles. Each HACCP plan is specifically implemented for the processing plant and processing methods and requires a systematic collection of data on the incidence, elimination, prevention, and reduction of risks. In this five-year-study, the effectiveness of the HACCP plan of a University canteen was verified through periodic internal auditing and microbiological monitoring of meals, small equipment, cooking tools, working surfaces, as well as hands and white coats of the canteen staff. The data obtained revealed no safety risks for the consumers, since Escherichia coli, Salmonella spp. and Listeria monocytogenes were never detected; however, a quite discontinuous microbiological quality of meals was revealed. The fluctuations in the microbial loads of mesophilic aerobes, coliforms, Staphylococcus aureus, Bacillus cereus, and sulphite-reducing clostridia were mainly ascribed to inadequate handling or processing procedures, thus suggesting the need for an enhancement of staff training activities and for a reorganization of tasks. Due to the wide variety of the fields covered by internal auditing, the full conformance to all the requirements was never achieved, though high scores, determined by assigning one point to each answer which matched with the requirements, were achieved in all the years. PMID:23594937

Evaluation of the HACCP system in a university canteen: microbiological monitoring and internal auditing as verification tools.

PubMed

Osimani, Andrea; Aquilanti, Lucia; Tavoletti, Stefano; Clementi, Francesca

2013-04-17

Food safety is essential in mass catering. In Europe, Regulation (EC) No. 852/2004 requires food business operators to put in place, implement and maintain permanent procedures based on Hazard Analysis and Critical Control Point (HACCP) principles. Each HACCP plan is specifically implemented for the processing plant and processing methods and requires a systematic collection of data on the incidence, elimination, prevention, and reduction of risks. In this five-year-study, the effectiveness of the HACCP plan of a University canteen was verified through periodic internal auditing and microbiological monitoring of meals, small equipment, cooking tools, working surfaces, as well as hands and white coats of the canteen staff. The data obtained revealed no safety risks for the consumers, since Escherichia coli, Salmonella spp. and Listeria monocytogenes were never detected; however, a quite discontinuous microbiological quality of meals was revealed. The fluctuations in the microbial loads of mesophilic aerobes, coliforms, Staphylococcus aureus, Bacillus cereus, and sulphite-reducing clostridia were mainly ascribed to inadequate handling or processing procedures, thus suggesting the need for an enhancement of staff training activities and for a reorganization of tasks. Due to the wide variety of the fields covered by internal auditing, the full conformance to all the requirements was never achieved, though high scores, determined by assigning one point to each answer which matched with the requirements, were achieved in all the years.

Quality of care: how good is good enough?

PubMed

Chassin, Mark R

2012-01-30

Israel has made impressive progress in improving performance on key measures of the quality of health care in the community in recent years. These achievements are all the more notable given Israel's modest overall spending on health care and because they have accrued to virtually the entire population of the country.Health care systems in most developed nations around the world find themselves in a similar position today with respect to health care quality. Despite significantly increased improvement efforts over the past decade, routine safety processes, such as hand hygiene and medication administration, fail routinely at rates of 30% to 50%. People with chronic diseases experience preventable episodes of acute illness that require hospitalization due to medication mix-ups and other failures of outpatient management. Patients continue to be harmed by preventable adverse events, such as surgery on the wrong part of the body and fires in operating theaters. Health care around the world is not nearly as safe as other industries, such as commercial aviation, that have mastered highly effective ways to manage serious hazards.Health care organizations will have to undertake three interrelated changes to get substantially closer to the superlative safety records of other industries: leadership commitment to zero major quality failures, widespread implementation of highly effective process improvement methods, and the adoption of all facets of a culture of safety. Each of these changes represents a major challenge to the way today's health care organizations plan and carry out their daily work. The Israeli health system is in an enviable position to implement these changes. Universal health insurance coverage, the enrolment of the entire population in a small number of health plans, and the widespread use of electronic health records provide advantages available to few other countries.Achieving and sustaining levels of safety comparable to, say, commercial aviation will be a long journey for health care--one we should begin promptly.This is a commentary on http://www.ijhpr.org/content/1/1/3/

Instrumentation and control upgrade plan for Browns Ferry nuclear plant

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

Belew, M.R.; Langley, D.T.; Torok, R.C.

1992-01-01

A comprehensive upgrade of the instrumentation and control (I C) systems at a power plant represents a formidable project for any utility. For a nuclear plant, the extra safety and reliability requirements along with regulatory constraints add further complications and cost. The need for the upgrade must, therefore, be very compelling, and the process must be well planned from the start. This paper describes the steps taken to initiate the I C upgrade process for Tennessee Valley Authority's (TVA's) Browns Ferry 2 nuclear plant. It explains the impetus for the upgrade, the expected benefits, and the process by which systemmore » upgrades will be selected and implemented.« less

Observations and lessons learnt from more than a decade of water safety planning in South-East Asia.

PubMed

Sutherland, David

2017-09-01

In many countries of the World Health Organization (WHO) South-East Asia Region, drinking water is not used directly from the tap and faecal contamination of water sources is prevalent. As reflected in Sustainable Development Goal 6, access to safer drinking water is one of the most successful ways of preventing disease. The WHO Water Safety Framework promotes the use of water safety plans (WSPs), which are structured tools that help identify and mitigate potential risks throughout a water-supply system, from the water source to the point of use. WSPs not only help prevent outbreaks of acute and chronic waterborne diseases but also improve water-supply management and performance. During the past 12 years, through the direct and indirect work of a water quality partnership supported by the Australian Government, more than 5000 urban and rural WSPs have been implemented in the region. An impact assessment based on pre- and post-WSP surveys suggests that WSPs have improved system operations and management, infrastructure and performance; leveraged donor funds; increased stakeholder communication and collaboration; increased testing of water quality; and increased monitoring of consumer satisfaction. These achievements, and their sustainability, are being achieved through national legislation and regulatory frameworks for water supply, including quality standards for drinking water; national training tools and extensive training of sector professionals and creation of WSP experts; model WSPs; WSP auditing systems; and the institution of longterm training and support. More than a decade of water safety planning using the WSP approach has shown that supplying safe drinking water at the tap throughout the WHO South-East Asia Region is a realistic goal.

[Post-marketing drug safety-risk management plan(RMP)].

PubMed

Ezaki, Asami; Hori, Akiko

2013-03-01

The Guidance for Risk Management Plan(RMP)was released by the Ministry of Health, Labour and Welfare in April 2012. The RMP consists of safety specifications, pharmacovigilance plans and risk minimization action plans. In this paper, we outline post-marketing drug safety operations in PMDA and the RMP, with examples of some anticancer drugs.

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

Noel, Camille E.; Gutti, VeeraRajesh; Bosch, Walter

Purpose: To quantify the potential impact of the Integrating the Healthcare Enterprise–Radiation Oncology Quality Assurance with Plan Veto (QAPV) on patient safety of external beam radiation therapy (RT) operations. Methods and Materials: An institutional database of events (errors and near-misses) was used to evaluate the ability of QAPV to prevent clinically observed events. We analyzed reported events that were related to Digital Imaging and Communications in Medicine RT plan parameter inconsistencies between the intended treatment (on the treatment planning system) and the delivered treatment (on the treatment machine). Critical Digital Imaging and Communications in Medicine RT plan parameters were identified.more » Each event was scored for importance using the Failure Mode and Effects Analysis methodology. Potential error occurrence (frequency) was derived according to the collected event data, along with the potential event severity, and the probability of detection with and without the theoretical implementation of the QAPV plan comparison check. Failure Mode and Effects Analysis Risk Priority Numbers (RPNs) with and without QAPV were compared to quantify the potential benefit of clinical implementation of QAPV. Results: The implementation of QAPV could reduce the RPN values for 15 of 22 (71%) of evaluated parameters, with an overall average reduction in RPN of 68 (range, 0-216). For the 6 high-risk parameters (>200), the average reduction in RPN value was 163 (range, 108-216). The RPN value reduction for the intermediate-risk (200 > RPN > 100) parameters was (0-140). With QAPV, the largest RPN value for “Beam Meterset” was reduced from 324 to 108. The maximum reduction in RPN value was for Beam Meterset (216, 66.7%), whereas the maximum percentage reduction was for Cumulative Meterset Weight (80, 88.9%). Conclusion: This analysis quantifies the value of the Integrating the Healthcare Enterprise–Radiation Oncology QAPV implementation in clinical workflow. We demonstrate that although QAPV does not provide a comprehensive solution for error prevention in RT, it can have a significant impact on a subset of the most severe clinically observed events.« less

Impact of the roll out of comprehensive emergency obstetric care on institutional birth rate in rural Nepal.

PubMed

Maru, Sheela; Bangura, Alex Harsha; Mehta, Pooja; Bista, Deepak; Borgatta, Lynn; Pande, Sami; Citrin, David; Khanal, Sumesh; Banstola, Amrit; Maru, Duncan

2017-03-04

Increasing institutional births rates and improving access to comprehensive emergency obstetric care are central strategies for reducing maternal and neonatal deaths globally. While some studies show women consider service availability when determining where to deliver, the dynamics of how and why institutional birth rates change as comprehensive emergency obstetric care availability increases are unclear. In this pre-post intervention study, we surveyed two exhaustive samples of postpartum women before and after comprehensive emergency obstetric care implementation at a hospital in rural Nepal. We developed a logistic regression model of institutional birth factors through manual backward selection of all significant covariates within and across periods. Qualitatively, we analyzed birth stories through immersion crystallization. Institutional birth rates increased after comprehensive emergency obstetric care implementation (from 30 to 77%, OR 7.7) at both hospital (OR 2.5) and low-level facilities (OR 4.6, p < 0.01 for all). The logistic regression indicated that comprehensive emergency obstetric care availability (OR 5.6), belief that the hospital is the safest birth location (OR 44.8), safety prioritization in decision-making (OR 7.7), and higher income (OR 1.1) predict institutional birth (p ≤ 0.01 for all). Qualitative analysis revealed comprehensive emergency obstetric care awareness, increased social expectation for institutional birth, and birth planning as important factors. Comprehensive emergency obstetric care expansion appears to have generated significant demand for institutional births through increased safety perceptions and birth planning. Increasing comprehensive emergency obstetric care availability increases birth safety, but it may also be a mechanism for increasing the institutional birth rate in areas of under-utilization.

An observational study of defensible space in the neighbourhood park

NASA Astrophysics Data System (ADS)

Marzukhi, M. A.; Afiq, M. A.; Zaki, S. Ahmad; Ling, O. H. L.

2018-02-01

The planning of neighborhood park is important to provide space for interaction, leisure, and recreation among residents in any neighbourhood area. However, on an almost daily basis, newspapers report inappropriate incidents such as snatch theft, robbery and street attack that occurred in the neighborhood park. These cases reflect the significance of physical planning and design of neighborhood park that directly affect the safety and comfort of the users. Thus, this study attempts to engage with the defensible space concept in ensuring the security elements be applied in the planning of the recreational area. This study adopts a qualitative method form of research that is retrofitted to an observational study. The observational study is significant for revealing the condition of a neighbourhood park in the ‘real-world,’ in which direct observation is conducted on Taman Tasik Puchong Perdana. The observer focused on four elements or variables of defensible space concept including the provision of facilities in the neighborhood park, territoriality, surveillance, image and milieu. The findings revealed that the planning of Taman Tasik Puchong Perdana does not deliberate the defensible space elements, which may contribute to the crime activities in the park. In these circumstances, the planning of neighbourhood park needs to include proposals for the implementation of defensible space in response to the challenges underpinned by crime problems. Besides, the awareness among the residents needs to be emphasized with the support from local authorities and other organizations to manage and sustain the safety environment in the neighborhood park.

49 CFR 244.19 - Disposition.

Code of Federal Regulations, 2014 CFR

2014-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.19 Disposition. (a) Standard of review. FRA reviews an applicant's Safety Integration Plan, and any amendments thereto, to determine whether it provides a...

49 CFR 244.19 - Disposition.

Code of Federal Regulations, 2011 CFR

2011-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.19 Disposition. (a) Standard of review. FRA reviews an applicant's Safety Integration Plan, and any amendments thereto, to determine whether it provides a...

49 CFR 244.19 - Disposition.

Code of Federal Regulations, 2013 CFR

2013-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.19 Disposition. (a) Standard of review. FRA reviews an applicant's Safety Integration Plan, and any amendments thereto, to determine whether it provides a...

49 CFR 244.19 - Disposition.

Code of Federal Regulations, 2012 CFR

2012-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.19 Disposition. (a) Standard of review. FRA reviews an applicant's Safety Integration Plan, and any amendments thereto, to determine whether it provides a...

49 CFR 244.19 - Disposition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.19 Disposition. (a) Standard of review. FRA reviews an applicant's Safety Integration Plan, and any amendments thereto, to determine whether it provides a...

Baltimore-Washington Parkway, Maryland : traffic safety plan

DOT National Transportation Integrated Search

2015-06-01

Over the past decade, a number of studies have documented the traffic safety issues on the National Park Services (NPS) portion of the Baltimore-Washington (B-W) Parkway. The Baltimore-Washington Parkway Traffic Safety Plan provides an action plan...

Clinical implementation and failure mode and effects analysis of HDR skin brachytherapy using Valencia and Leipzig surface applicators.

PubMed

Sayler, Elaine; Eldredge-Hindy, Harriet; Dinome, Jessie; Lockamy, Virginia; Harrison, Amy S

2015-01-01

The planning procedure for Valencia and Leipzig surface applicators (VLSAs) (Nucletron, Veenendaal, The Netherlands) differs substantially from CT-based planning; the unfamiliarity could lead to significant errors. This study applies failure modes and effects analysis (FMEA) to high-dose-rate (HDR) skin brachytherapy using VLSAs to ensure safety and quality. A multidisciplinary team created a protocol for HDR VLSA skin treatments and applied FMEA. Failure modes were identified and scored by severity, occurrence, and detectability. The clinical procedure was then revised to address high-scoring process nodes. Several key components were added to the protocol to minimize risk probability numbers. (1) Diagnosis, prescription, applicator selection, and setup are reviewed at weekly quality assurance rounds. Peer review reduces the likelihood of an inappropriate treatment regime. (2) A template for HDR skin treatments was established in the clinic's electronic medical record system to standardize treatment instructions. This reduces the chances of miscommunication between the physician and planner as well as increases the detectability of an error. (3) A screen check was implemented during the second check to increase detectability of an error. (4) To reduce error probability, the treatment plan worksheet was designed to display plan parameters in a format visually similar to the treatment console display, facilitating data entry and verification. (5) VLSAs are color coded and labeled to match the electronic medical record prescriptions, simplifying in-room selection and verification. Multidisciplinary planning and FMEA increased detectability and reduced error probability during VLSA HDR brachytherapy. This clinical model may be useful to institutions implementing similar procedures. Copyright © 2015 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Development of an implementation plan for the 6-PACK falls prevention programme as part of a randomised controlled trial: protocol for a series of preimplementation studies.

PubMed

Barker, Anna L; Morello, Renata T; Ayton, Darshini R; Hill, Keith D; Landgren, Fiona S; Brand, Caroline A

2016-12-01

Inhospital falls cause morbidity, staff burden and increased healthcare costs. It is unclear if the persistent problem of inhospital falls is due to the use of ineffective interventions or their suboptimal implementation. The 6-PACK programme appears to reduce fall injuries and a randomised controlled trial (RCT) was undertaken to confirm effects. This paper describes the protocol for the preimplementation studies that aimed to identify moderators of the effective use of the 6-PACK programme to inform the development of an implementation plan to be applied in the RCT. The 6-PACK project included five preimplementation studies: (1) a profile of safety climate; (2) review of current falls prevention practice; (3) epidemiology of inhospital falls; (4) acceptability of the 6-PACK programme; and (5) barriers and enablers to implementation of the 6-PACK programme. The Theoretical Domain Framework that includes 12 behaviour change domains informed the design of these studies that involved 540 staff and 8877 patients from 24 wards from six Australian hospitals. Qualitative and quantitative methods were applied with data collected via: structured bedside observation; daily nurse unit manager verbal report of falls; audit of medical records, incident reporting and hospital administrative data; surveys of ward nurses; focus groups with ward nurses; and key informant interviews with senior staff. Information on contextual, system, intervention, patient and provider level factors is critical to the development of an implementation plan. Information gained from these studies was used to develop a plan applied in the RCT that addressed the barriers and harnessed enablers. The RCT is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000332921. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

WE-H-BRC-04: Implement Lean Methodology to Make Our Current Process of CT Simulation to Treatment More Efficient

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

Boddu, S; Morrow, A; Krishnamurthy, N

Purpose: Our goal is to implement lean methodology to make our current process of CT simulation to treatment more efficient. Methods: In this study, we implemented lean methodology and tools and employed flowchart in excel for process-mapping. We formed a group of physicians, physicists, dosimetrists, therapists and a clinical physics assistant and huddled bi-weekly to map current value streams. We performed GEMBA walks and observed current processes from scheduling patient CT Simulations to treatment plan approval. From this, the entire workflow was categorized into processes, sub-processes, and tasks. For each process we gathered data on touch time, first time quality,more » undesirable effects (UDEs), and wait-times from relevant members of each task. UDEs were binned per frequency of their occurrence. We huddled to map future state and to find solutions to high frequency UDEs. We implemented visual controls, hard stops, and documented issues found during chart checks prior to treatment plan approval. Results: We have identified approximately 64 UDEs in our current workflow that could cause delays, re-work, compromise the quality and safety of patient treatments, or cause wait times between 1 – 6 days. While some UDEs are unavoidable, such as re-planning due to patient weight loss, eliminating avoidable UDEs is our goal. In 2015, we found 399 issues with patient treatment plans, of which 261, 95 and 43 were low, medium and high severity, respectively. We also mapped patient-specific QA processes for IMRT/Rapid Arc and SRS/SBRT, involving 10 and 18 steps, respectively. From these, 13 UDEs were found and 5 were addressed that solved 20% of issues. Conclusion: We have successfully implemented lean methodology and tools. We are further mapping treatment site specific workflows to identify bottlenecks, potential breakdowns and personnel allocation and employ tools like failure mode effects analysis to mitigate risk factors to make this process efficient.« less

Program on State Agency Remote Sensing Data Management (SARSDM). [missouri

NASA Technical Reports Server (NTRS)

Eastwood, L. F., Jr.; Gotway, E. O.

1978-01-01

A planning study for developing a Missouri natural resources information system (NRIS) that combines satellite-derived data and other information to assist in carrying out key state tasks was conducted. Four focal applications -- dam safety, ground water supply monitoring, municipal water supply monitoring, and Missouri River basin modeling were identified. Major contributions of the study are: (1) a systematic choice and analysis of a high priority application (water resources) for a Missouri, LANDSAT-based information system; (2) a system design and implementation plan, based on Missouri, but useful for many other states; (3) an analysis of system costs, component and personnel requirements, and scheduling; and (4) an assessment of deterrents to successful technological innovation of this type in state government, and a system management plan, based on this assessment, for overcoming these obstacles in Missouri.

48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and... danger to the environment or health and safety of employees or the public, the Contracting Officer may...

48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and... danger to the environment or health and safety of employees or the public, the Contracting Officer may...

48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and... danger to the environment or health and safety of employees or the public, the Contracting Officer may...

48 CFR 970.5223-1 - Integration of environment, safety, and health into work planning and execution.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Integration of environment, safety, and health into work planning and execution. As prescribed in 970.2303-3(b), insert the following clause: Integration of Environment, Safety, and Health Into Work Planning and... danger to the environment or health and safety of employees or the public, the Contracting Officer may...

Measurement Tools for Integrated Worker Health Protection and Promotion: Lessons Learned From the SafeWell Project.

PubMed

Pronk, Nicolaas P; McLellan, Deborah L; McGrail, Michael P; Olson, Shawn M; McKinney, Zeke J; Katz, Jeffrey N; Wagner, Gregory R; Sorensen, Glorian

2016-07-01

To describe (a) a conceptual approach, (b) measurement tools and data collection processes, (c) characteristics of an integrated feedback report and action plan, and (d) experiences of three companies with an integrated measurement approach to worker safety and health. Three companies implemented measurement tools designed to create an integrated view of health protection and promotion based on organizational- and individual-level assessments. Feedback and recommended actions were presented following assessments at baseline and 1-year follow-up. Measurement processes included group dialogue sessions, walk-through, online surveys, and focus groups. The approach and measurement tools generated actionable recommendations and documented changes in the physical (eg, safety hazards) and psychosocial (eg, health and safety culture) work environment between baseline and 1-year follow-up. The measurement tools studied were feasible, acceptable, and meaningful to companies in the SafeWell study.

Factors Influencing Attitude, Safety Behavior, and Knowledge regarding Household Waste Management in Guinea: A Cross-Sectional Study

PubMed Central

Mamady, Keita

2016-01-01

Waste indiscriminate disposal is recognized as an important cause of environmental pollution and is associated with health problems. Safe management and disposal of household waste are an important problem to the capital city of Guinea (Conakry). The objective of this study was to identify socioeconomic and demographic factors associated with practice, knowledge, and safety behavior of family members regarding household waste management and to produce a remedial action plan. I found that no education background, income, and female individuals were independently associated with indiscriminate waste disposal. Unplanned residential area was an additional factor associated with indiscriminate waste disposal. I also found that the community residents had poor knowledge and unsafe behavior in relation to waste management. The promotion of environmental information and public education and implementation of community action programs on disease prevention and health promotion will enhance environmental friendliness and safety of the community. PMID:27092183

Health, safety, and environmental management system operation in contracting companies: A case study.

PubMed

Nassiri, Parvin; Yarahmadi, Rasoul; Gholami, Pari Shafaei; Hamidi, Abdolamir; Mirkazemi, Roksana

2016-05-03

Systematic and cooperative interactions among parent industry and contractors are necessary for a successful health, safety, and environmental management system (HSE-MS). This study was conducted to evaluate the HSE-MS performance in contracting companies in one of the petrochemical industries in Iran during 2013. Managers of parent and contracting companies participated in this study. The data collection forms included 7 elements of an integrated HSE-MS (leadership and commitment; policy and strategic objectives; organization, resources, and documentation; evaluation and risk management; planning; implementation and monitoring; auditing and reviewing). The results showed that mean percentage of the total scores in seven elements of HSE-MS was 85.7% and 87.0% based on self-report and report of parent company, respectively. In conclusion, this study showed that HSE-MS was desirably functioning; however, improvement to ensure health and safety of workers is still required.

Ergonomics contributions to company strategies.

PubMed

Dul, Jan; Neumann, W Patrick

2009-07-01

Managers usually associate ergonomics with occupational health and safety and related legislation, not with business performance. In many companies, these decision makers seem not to be positively motivated to apply ergonomics for reasons of improving health and safety. In order to strengthen the position of ergonomics and ergonomists in the business and management world, we discuss company strategies and business goals to which ergonomics could contribute. Conceptual models are presented and examples are given to illustrate: (1) the present situation in which ergonomics is not part of regular planning and control cycles in organizations to ensure business performance; and (2) the desired situation in which ergonomics is an integrated part of strategy formulation and implementation. In order to realize the desired situation, considerable changes must take place within the ergonomics research, education and practice community by moving from a health ergonomics paradigm to a business ergonomics paradigm, without losing the health and safety goals.

Factors Influencing Attitude, Safety Behavior, and Knowledge regarding Household Waste Management in Guinea: A Cross-Sectional Study.

PubMed

Mamady, Keita

2016-01-01

Waste indiscriminate disposal is recognized as an important cause of environmental pollution and is associated with health problems. Safe management and disposal of household waste are an important problem to the capital city of Guinea (Conakry). The objective of this study was to identify socioeconomic and demographic factors associated with practice, knowledge, and safety behavior of family members regarding household waste management and to produce a remedial action plan. I found that no education background, income, and female individuals were independently associated with indiscriminate waste disposal. Unplanned residential area was an additional factor associated with indiscriminate waste disposal. I also found that the community residents had poor knowledge and unsafe behavior in relation to waste management. The promotion of environmental information and public education and implementation of community action programs on disease prevention and health promotion will enhance environmental friendliness and safety of the community.

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

SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

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

Zhou, Y; Tan, J; Jiang, S

Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this systemmore » for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.« less

Experience of domestic violence routine screening in Family Planning NSW clinics.

PubMed

Hunter, Tara; Botfield, Jessica R; Estoesta, Jane; Markham, Pippa; Robertson, Sarah; McGeechan, Kevin

2017-04-01

This study reviewed implementation of the Domestic Violence Routine Screening (DVRS) program at Family Planning NSW and outcomes of screening to determine the feasibility of routine screening in a family planning setting and the suitability of this program in the context of women's reproductive and sexual health. A retrospective review of medical records was undertaken of eligible women attending Family Planning NSW clinics between 1 January and 31 December 2015. Modified Poisson regression was used to estimate prevalence ratios and assess association between binary outcomes and client characteristics. Of 13440 eligible women, 5491 were screened (41%). Number of visits, clinic attended, age, employment status and disability were associated with completion of screening. In all, 220 women (4.0%) disclosed domestic violence. Factors associated with disclosure were clinic attended, age group, region of birth, employment status, education and disability. Women who disclosed domestic violence were more likely to have discussed issues related to sexually transmissible infections in their consultation. All women who disclosed were assessed for any safety concerns and offered a range of suitable referral options. Although routine screening may not be appropriate in all health settings, given associations between domestic violence and sexual and reproductive health, a DVRS program is considered appropriate in sexual and reproductive health clinics and appears to be feasible in a service such as Family Planning NSW. Consistent implementation of the program should continue at Family Planning NSW and be expanded to other family planning services in Australia to support identification and early intervention for women affected by domestic violence.

75 FR 13294 - National Boating Safety Advisory Council

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-19

... the strategic planning process and any new issues or factors that could impact, or contribute to, the...) Recreational Boating Safety Strategic Planning Subcommittee meeting. Saturday, April 17, 2010: (12) Recreational Boating Safety Strategic Planning Subcommittee meeting (Cont.). (13) Prevention through People...

NYC CV Pilot Deployment : Safety Management Plan : New York City.

DOT National Transportation Integrated Search

2016-04-22

This safety management plan identifies preliminary safety hazards associated with the New York City Connected Vehicle Pilot Deployment project. Each of the hazards is rated, and a plan for managing the risks through detailed design and deployment is ...

Field tests of a participatory ergonomics toolkit for Total Worker Health.

PubMed

Nobrega, Suzanne; Kernan, Laura; Plaku-Alakbarova, Bora; Robertson, Michelle; Warren, Nicholas; Henning, Robert

2017-04-01

Growing interest in Total Worker Health ® (TWH) programs to advance worker safety, health and well-being motivated development of a toolkit to guide their implementation. Iterative design of a program toolkit occurred in which participatory ergonomics (PE) served as the primary basis to plan integrated TWH interventions in four diverse organizations. The toolkit provided start-up guides for committee formation and training, and a structured PE process for generating integrated TWH interventions. Process data from program facilitators and participants throughout program implementation were used for iterative toolkit design. Program success depended on organizational commitment to regular design team meetings with a trained facilitator, the availability of subject matter experts on ergonomics and health to support the design process, and retraining whenever committee turnover occurred. A two committee structure (employee Design Team, management Steering Committee) provided advantages over a single, multilevel committee structure, and enhanced the planning, communication, and teamwork skills of participants. Copyright © 2016 Elsevier Ltd. All rights reserved.

Failure Mode and Effect Analysis (FMEA) may enhance implementation of clinical practice guidelines: An experience from the Middle East.

PubMed

Babiker, Amir; Amer, Yasser S; Osman, Mohamed E; Al-Eyadhy, Ayman; Fatani, Solafa; Mohamed, Sarar; Alnemri, Abdulrahman; Titi, Maher A; Shaikh, Farheen; Alswat, Khalid A; Wahabi, Hayfaa A; Al-Ansary, Lubna A

2018-02-01

Implementation of clinical practice guidelines (CPGs) has been shown to reduce variation in practice and improve health care quality and patients' safety. There is a limited experience of CPG implementation (CPGI) in the Middle East. The CPG program in our institution was launched in 2009. The Quality Management department conducted a Failure Mode and Effect Analysis (FMEA) for further improvement of CPGI. This is a prospective study of a qualitative/quantitative design. Our FMEA included (1) process review and recording of the steps and activities of CPGI; (2) hazard analysis by recording activity-related failure modes and their effects, identification of actions required, assigned severity, occurrence, and detection scores for each failure mode and calculated the risk priority number (RPN) by using an online interactive FMEA tool; (3) planning: RPNs were prioritized, recommendations, and further planning for new interventions were identified; and (4) monitoring: after reduction or elimination of the failure mode. The calculated RPN will be compared with subsequent analysis in post-implementation phase. The data were scrutinized from a feedback of quality team members using a FMEA framework to enhance the implementation of 29 adapted CPGs. The identified potential common failure modes with the highest RPN (≥ 80) included awareness/training activities, accessibility of CPGs, fewer advocates from clinical champions, and CPGs auditing. Actions included (1) organizing regular awareness activities, (2) making CPGs printed and electronic copies accessible, (3) encouraging senior practitioners to get involved in CPGI, and (4) enhancing CPGs auditing as part of the quality sustainability plan. In our experience, FMEA could be a useful tool to enhance CPGI. It helped us to identify potential barriers and prepare relevant solutions. © 2017 John Wiley & Sons, Ltd.

Identifying gaps, barriers, and solutions in implementing pressure ulcer prevention programs.

PubMed

Jankowski, Irene M; Nadzam, Deborah Morris

2011-06-01

Patients continue to suffer from pressure ulcers (PUs), despite implementation of evidence-based pressure ulcer (PU) prevention protocols. In 2009, Joint Commission Resources (JCR) and Hill-Rom created the Nurse Safety Scholar-in-Residence (nurse scholar) program to foster the professional development of expert nurse clinicians to become translators of evidence into practice. The first nurse scholar activity has focused on PU prevention. Four hospitals with established PU programs participated in the PU prevention implementation project. Each hospital's team completed an inventory of PU prevention program components and provided copies of accompanying documentation, along with prevalence and incidence data. Site visits to the four participating hospitals were arranged to provide opportunities for more in-depth analysis and support. Following the initial site visit, the project team at each hospital developed action plans for the top three barriers to PU program implementation. A series of conference calls was held between the site visits. Pressure Ulcer Program Gaps and Recommendations. The four hospitals shared common gaps in terms of limitations in staff education and training; lack of physician involvement; limited involvement of unlicensed nursing staff; lack of plan for communicating at-risk status; and limited quality improvement evaluations of bedside practices. Detailed recommendations were identified for addressing each of these gaps. these Recommendations for eliminating gaps have been implemented by the participating teams to drive improvement and to reduce hospital-acquired PU rates. The nurse scholars will continue to study implementation of best practices for PU prevention.

Autonomous Navigation by a Mobile Robot

NASA Technical Reports Server (NTRS)

Huntsberger, Terrance; Aghazarian, Hrand

2005-01-01

ROAMAN is a computer program for autonomous navigation of a mobile robot on a long (as much as hundreds of meters) traversal of terrain. Developed for use aboard a robotic vehicle (rover) exploring the surface of a remote planet, ROAMAN could also be adapted to similar use on terrestrial mobile robots. ROAMAN implements a combination of algorithms for (1) long-range path planning based on images acquired by mast-mounted, wide-baseline stereoscopic cameras, and (2) local path planning based on images acquired by body-mounted, narrow-baseline stereoscopic cameras. The long-range path-planning algorithm autonomously generates a series of waypoints that are passed to the local path-planning algorithm, which plans obstacle-avoiding legs between the waypoints. Both the long- and short-range algorithms use an occupancy-grid representation in computations to detect obstacles and plan paths. Maps that are maintained by the long- and short-range portions of the software are not shared because substantial localization errors can accumulate during any long traverse. ROAMAN is not guaranteed to generate an optimal shortest path, but does maintain the safety of the rover.

[An analysis of appeals against the ruling of the occupational physician's lodged to the Department of Prevention and Safety in the Working Environment--Health Prevention and Occupational Epidemiology Operative Unit within the A.S.P. Palermo (Palermo Health Authority), years 2008-2010].

PubMed

Marsala, M G L; Morici, M; Lacca, G; Curcurù, L; Eduardo, E Costagliola; Ilardo, S; Trapani, E; Caracausi, R; Firenze, A

2012-01-01

The purpose of this study is to analyze the appeals against a "suitability judgment for work" lodged to the U.O.S. "Health Prevention and Occupational Epidemiology Operative Unit" of Department of Prevention and Safety in the Working Environment within the ASP Palermo (U.O.S.), from 2008 to 2010. Studying the appeals gives an indirect view on the occupational physician activity and allows to monitor their actions, analysis aims at highlighting those issues around which any planning and implementation of coordination activities should be focused.

Environmental health monograph

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

Not Available

1974-05-01

Current environmental programs intended to reduce or mediate environmental health hazards in Berkeley, Charleston, and Dorchester Counties, South Carolina, are described. The following areas are considered: air pollution, noise abatement, pesticide control, accident prevention, food and milk sanitation, occupational health housing, water supply, sewerage, industrial waste, solid waste disposal, and vector control. The lack of adequate technically trained manpower or funds to implement minimum codes currently in force in the Trident Region is noted. The wide range of public and private agencies concerned with environmental health issues creates complexities in dealing with these issues. Conflicting codes and standards exist atmore » various government levels. The Trident Health District Office Air Pollution Control Program provides the following: ambient air quality surveillance; review of plans and specifications for proposed air pollution control facilities and equipment; and air monitoring. A list of safety - related courses offered by the Greater Charleston Safety Council is provided. A lack of readily available statistics concerning the various kinds of accidents and the frequency of their occurrence is noted. Concern is also expressed over the lack of personnel to inspect the growing food service industry. Local activities in the area of occupational health are reported to be less than minimal. The Charleston County Health Department has recently introduced a rural sanitation program. The county also issues permits for septic tank installation. The Regional Planning Council for the area aids municipalities and counties in planning for and implementing supply control and solid waste management in compliance with Federal and State laws. Mosquito abatement, rabies control, and rodent control activities in the area are described. Portions of this document are not fully legible. (GRA)« less

F14A System Safety Program Plan

DTIC Science & Technology

1981-09-03

by block number) Electromagnetic Pulse (EMP) Safety Plans Test Program EMP Testing F14 Aircraft Plans 20 ABSTRACT (Continue on reverse side if...compromising completion of the required experimental tasks. This document addresses the safety aspect of performing an Electromagnetic Pulse (EMP) test

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

PubMed

Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

2018-01-01

Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and surgeons in identifying the best practices to implement in the surgical care of TKA and THA patients.

A red-flag-based approach to risk management of EHR-related safety concerns.

PubMed

Sittig, Dean F; Singh, Hardeep

2013-01-01

Although electronic health records (EHRs) have a significant potential to improve patient safety, EHR-related safety concerns have begun to emerge. Based on 369 responses to a survey sent to the memberships of the American Society for Healthcare Risk Management and the American Health Lawyers Association and supplemented by our previous work in EHR-related patient safety, we identified the following common EHR-related safety concerns: (1) incorrect patient identification; (2) extended EHR unavailability (either planned or unplanned); (3) failure to heed a computer-generated warning or alert; (4) system-to-system interface errors; (5) failure to identify, find, or use the most recent patient data; (6) misunderstandings about time; (7) incorrect item selected from a list of items; and (8) open or incomplete orders. In this article, we present a "red-flag"-based approach that can be used by risk managers to identify potential EHR safety concerns in their institutions. An organization that routinely conducts EHR-related surveillance activities, such as the ones proposed here, can significantly reduce risks associated with EHR implementation and use. © 2013 American Society for Healthcare Risk Management of the American Hospital Association.

Engaging policy makers in road safety research in Malaysia: a theoretical and contextual analysis.

PubMed

Tran, Nhan T; Hyder, Adnan A; Kulanthayan, Subramaniam; Singh, Suret; Umar, R S Radin

2009-04-01

Road traffic injuries (RTIs) are a growing public health problem that must be addressed through evidence-based interventions including policy-level changes such as the enactment of legislation to mandate specific behaviors and practices. Policy makers need to be engaged in road safety research to ensure that road safety policies are grounded in scientific evidence. This paper examines the strategies used to engage policy makers and other stakeholder groups and discusses the challenges that result from a multi-disciplinary, inter-sectoral collaboration. A framework for engaging policy makers in research was developed and applied to describe an example of collective road safety research in Malaysia. Key components of this framework include readiness, assessment, planning, implementation/evaluation, and policy development/sustainability. The case study of a collaborative intervention trial for the prevention of motorcycle crashes and deaths in Malaysia serves as a model for policy engagement by road safety and injury researchers. The analytic description of this research process in Malaysia demonstrates that the framework, through its five stages, can be used as a tool to guide the integration of needed research evidence into policy for road safety and injury prevention.

A Qualitative Assessment of Current CCF Guidance Based on a Review of Safety System Digital Implementation Changes with Evolving Technology

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

Korsah, Kofi; Muhlheim, Michael David; Wood, Richard

The US Nuclear Regulatory Commission (NRC) is initiating a new rulemaking project to develop a digital system common-cause failure (CCF) rule. This rulemaking will review and modify or affirm the NRC's current digital system CCF policy as discussed in the Staff Requirements Memorandum to the Secretary of the Commission, Office of the NRC (SECY) 93-087, Policy, Technical, and Licensing Issues Pertaining to Evolutionary and Advanced Light Water Reactor (ALWR) Designs, and Branch Technical Position (BTP) 7-19, Guidance on Evaluation of Defense-in-Depth and Diversity in Digital Computer-Based Instrumentation and Control Systems, as well as Chapter 7, Instrumentation and Controls, in NRCmore » Regulatory Guide (NUREG)-0800, Standard Review Plan for Review of Safety Analysis Reports for Nuclear Power Plants (ML033580677). The Oak Ridge National Laboratory (ORNL) is providing technical support to the NRC staff on the CCF rulemaking, and this report is one of several providing the technical basis to inform NRC staff members. For the task described in this report, ORNL examined instrumentation and controls (I&C) technology implementations in nuclear power plants in the light of current CCF guidance. The intent was to assess whether the current position on CCF is adequate given the evolutions in digital safety system implementations and, if gaps in the guidance were found, to provide recommendations as to how these gaps could be closed.« less

78 FR 28776 - Approval and Promulgation of Implementation Plans; Georgia; State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... Section of this Federal Register, EPA is approving the State's implementation plan revision as a direct... Promulgation of Implementation Plans; Georgia; State Implementation Plan Miscellaneous Revisions AGENCY... State Implementation Plan (SIP) submitted by the Georgia Environmental Protection Division to EPA in...

MYPLAN -mobile phone application to manage crisis of persons at risk of suicide: study protocol for a randomized controlled trial.

PubMed

Andreasson, Kate; Krogh, Jesper; Bech, Per; Frandsen, Hanne; Buus, Niels; Stanley, Barbara; Kerkhof, Ad; Nordentoft, Merete; Erlangsen, Annette

2017-04-11

Persons with a past episode of self-harm or severe suicidal ideation are at elevated risk of self-harm as well as dying by suicide. It is well established that suicidal ideation fluctuates over time. Previous studies have shown that a personal safety plan can assist in providing support, when a person experiences suicide ideation, and help seeking professional assistance if needed. The aim of the trial is to determine whether a newly developed safety mobile app is more effective in reducing suicide ideation and other symptoms, compared to a safety plan on paper. The trial is designed as a two-arm, observer-blinded, parallel-group randomized clinical superiority trial, where participants will either receive: (1) Experimental intervention: the safety plan provided as the app MyPlan, or (2) Treatment as Usual: the safety plan in the original paper format. Based on a power calculation, a total of 546 participants, 273 in each arm will be included. They will be recruited from Danish Suicide Prevention Clinics. Both groups will receive standard psychosocial therapeutic care, up to 8-10 sessions of supportive psychotherapy. Primary outcome will be reduction in suicide ideation after 12 months. Follow-up interviews will be conducted at 3, 6, 9, and 12 months after date of inclusion. A safety plan is a mandatory part of the treatment in the Suicide Prevention Clinics in Demark. There are no studies investigating the effectiveness of a safety plan app compared to a safety plan on paper on reducing suicide ideation in patients with suicide ideation and suicidal behavior. The trial will gain new knowledge of whether modern technology can augment the effects of traditional personalized safety planning. ClinicalTrials.gov, NCT02877316 . Registered on 19 August 2016.

Making the message meaningful: a qualitative assessment of media promoting all-terrain vehicle safety.

PubMed

Brann, Maria; Mullins, Samantha Hope; Miller, Beverly K; Eoff, Shane; Graham, James; Aitken, Mary E

2012-08-01

Millions of all-terrain vehicles (ATV) are used around the world for recreation by both adults and youth. This increase in use has led to a substantial increase in the number of injuries and fatalities each year. Effective strategies for reducing this incidence are clearly needed; however, minimal research exists regarding effective educational interventions. This study was designed to assess rural ATV riders' preferences for and assessment of safety messages. 13 focus group discussions with youth and adult ATV riders were conducted. 88 formative research participants provided feedback on existing ATV safety materials, which was used to develop more useful ATV safety messages. 60 evaluative focus group participants critiqued the materials developed for this project. Existing ATV safety materials have limited effectiveness, in part because they may not address the content or design needs of the target population. ATV riders want educational and action-oriented safety messages that inform youth and adult riders about their responsibilities to learn, educate and implement safety behaviours (eg, appropriate-sized ATV, safety gear, solo riding, speed limits, riding locations). In addition, messages should be clear, realistic, visually appealing and easily accessible. Newly designed ATV safety materials using the acronym TRIPSS (training, ride off-road, impairment, plan ahead, safety gear, single rider) meet ATV riders' safety messaging needs. To reach a target population, it is crucial to include them in the development and assessment of safety messages. Germane to this particular study, ATV riders provided essential information for creating useful ATV safety materials.

Ferrocyanide Safety Program. Quarterly report for the period ending March 31, 1994

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

Meacham, J.E.; Cash, R.J.; Dukelow, G.T.

1994-04-01

Various high-level radioactive waste from defense operations has accumulated at the Hanford Site in underground storage tanks since the mid-1940s. During the 1950s, additional tank storage space was required to support the defense mission. To obtain this additional storage volume within a short time period, and to minimize the need for constructing additional storage tanks, Hanford Site scientists developed a process to scavenge {sup 137}Cs from tank waste liquids. In implementing this process, approximately 140 metric tons of ferrocyanide were added to waste that was later routed to some Hanford Site single-shell tanks. The reactive nature of ferrocyanide in themore » presence of an oxidizer has been known for decades, but the conditions under which the compound can undergo endothermic and exothermic reactions have not been thoroughly studied. Because the scavenging process precipitated ferrocyanide from solutions containing nitrate and nitrite, an intimate mixture of ferrocyanides and nitrates and/or nitrites is likely to exist in some regions of the ferrocyanide tanks. This quarterly report provides a status of the activities underway at the Hanford Site on the Ferrocyanide Safety Issue, as requested by the Defense Nuclear Facilities Safety Board (DNFSB) in their Recommendation 90-7. A revised Ferrocyanide Safety Program Plan addressing the total Ferrocyanide Safety Program, including the six parts of DNFSB Recommendation 90-7, was recently prepared and released in March 1994. Activities in the revised program plan are underway or have been completed, and the status of each is described in Section 4.0 of this report.« less

Awareness of Vision Zero among United States' road safety professionals.

PubMed

Evenson, Kelly R; LaJeunesse, Seth; Heiny, Stephen

2018-05-08

Vision Zero is a strategy to eliminate all fatalities and serious injuries from road traffic crashes, while increasing safe and equitable mobility for all. In 2015, the United States' Department of Transportation announced the official target of the federal government transportation safety policy was zero deaths. In 2017, we assessed the dissemination of Vision Zero in the United States. We conducted a web-based survey in 2017 among road safety professionals. Email invitations were sent using relevant membership directories and conference lists. We surveyed 192 road safety professionals, including planning/engineering (57.8%), public health (16.7%), and law enforcement/emergency medical services (EMS) (8.9%). Awareness of Vision Zero was higher among planning/engineering fields (97.3%) compared to law enforcement/EMS (76.5%) and public health (75.0%). Awareness was similar by number of years working in the field. Awareness was higher in the South (95.9%) and Northeast (95.0%) regions, followed by the West (90.8%) and Midwest (85.2%) Census regions. Among those that heard of Vision Zero (n = 174), 41.8% worked at a municipality with a Vision Zero campaign, while 41.2% did not. Among those working at a municipality with a Vision Zero campaign (n = 71), about half participated in the campaign (54.9%) while the other half did not (45.1%). With widespread dissemination of the Vision Zero strategy to road safety professionals, next steps include evaluating how Vision Zero is being adopted, implemented, and maintained in communities, as well as the awareness and acceptability by community members, and to identify the most promising policies and practices.

Environment, Safety, and Health Self-Assessment Report, Fiscal Year 2008

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

Chernowski, John

2009-02-27

Lawrence Berkeley National Laboratory's Environment, Safety, and Health (ES&H) Self-Assessment Program ensures that Integrated Safety Management (ISM) is implemented institutionally and by all divisions. The Self-Assessment Program, managed by the Office of Contract Assurance (OCA), provides for an internal evaluation of all ES&H programs and systems at LBNL. The functions of the program are to ensure that work is conducted safely, and with minimal negative impact to workers, the public, and the environment. The Self-Assessment Program is also the mechanism used to institute continuous improvements to the Laboratory's ES&H programs. The program is described in LBNL/PUB 5344, Environment, Safety, andmore » Health Self-Assessment Program and is composed of four distinct assessments: the Division Self-Assessment, the Management of Environment, Safety, and Health (MESH) review, ES&H Technical Assurance, and the Appendix B Self-Assessment. The Division Self-Assessment uses the five core functions and seven guiding principles of ISM as the basis of evaluation. Metrics are created to measure performance in fulfilling ISM core functions and guiding principles, as well as promoting compliance with applicable regulations. The five core functions of ISM are as follows: (1) Define the Scope of Work; (2) Identify and Analyze Hazards; (3) Control the Hazards; (4) Perform the Work; and (5) Feedback and Improvement. The seven guiding principles of ISM are as follows: (1) Line Management Responsibility for ES&H; (2) Clear Roles and Responsibilities; (3) Competence Commensurate with Responsibilities; (4) Balanced Priorities; (5) Identification of ES&H Standards and Requirements; (6) Hazard Controls Tailored to the Work Performed; and (7) Operations Authorization. Performance indicators are developed by consensus with OCA, representatives from each division, and Environment, Health, and Safety (EH&S) Division program managers. Line management of each division performs the Division Self-Assessment annually. The primary focus of the review is workplace safety. The MESH review is an evaluation of division management of ES&H in its research and operations, focusing on implementation and effectiveness of the division's ISM plan. It is a peer review performed by members of the LBNL Safety Review Committee (SRC), with staff support from OCA. Each division receives a MESH review every two to four years, depending on the results of the previous review. The ES&H Technical Assurance Program (TAP) provides the framework for systematic reviews of ES&H programs and processes. The intent of ES&H Technical Assurance assessments is to provide assurance that ES&H programs and processes comply with their guiding regulations, are effective, and are properly implemented by LBNL divisions. The Appendix B Performance Evaluation and Measurement Plan (PEMP) requires that LBNL sustain and enhance the effectiveness of integrated safety, health, and environmental protection through a strong and well-deployed system. Information required for Appendix B is provided by EH&S Division functional managers. The annual Appendix B report is submitted at the close of the fiscal year. This assessment is the Department of Energy's (DOE) primary mechanism for evaluating LBNL's contract performance in ISM.« less

[Implementation of a rational standard of hygiene for preparation of operating rooms].

PubMed

Bauer, M; Scheithauer, S; Moerer, O; Pütz, H; Sliwa, B; Schmidt, C E; Russo, S G; Waeschle, R M

2015-10-01

The assurance of high standards of care is a major requirement in German hospitals while cost reduction and efficient use of resources are mandatory. These requirements are particularly evident in the high-risk and cost-intensive operating theatre field with multiple process steps. The cleaning of operating rooms (OR) between surgical procedures is of major relevance for patient safety and requires time and human resources. The hygiene procedure plan for OR cleaning between operations at the university hospital in Göttingen was revised and optimized according to the plan-do-check-act principle due to not clearly defined specifications of responsibilities, use of resources, prolonged process times and increased staff engagement. The current status was evaluated in 2012 as part of the first step "plan". The subsequent step "do" included an expert symposium with external consultants, interdisciplinary consensus conferences with an actualization of the former hygiene procedure plan and the implementation process. All staff members involved were integrated into this management change process. The penetration rate of the training and information measures as well as the acceptance and compliance with the new hygiene procedure plan were reviewed within step "check". The rates of positive swabs and air sampling as well as of postoperative wound infections were analyzed for quality control and no evidence for a reduced effectiveness of the new hygiene plan was found. After the successful implementation of these measures the next improvement cycle ("act") was performed in 2014 which led to a simplification of the hygiene plan by reduction of the number of defined cleaning and disinfection programs for preparation of the OR. The reorganization measures described led to a comprehensive commitment of the hygiene procedure plan by distinct specifications for responsibilities, for the course of action and for the use of resources. Furthermore, a simplification of the plan, a rational staff assignment and reduced process times were accomplished. Finally, potential conflicts due to an insufficient evidence-based knowledge of personnel was reduced. This present project description can be used by other hospitals as a guideline for similar changes in management processes.

Using a Theory-Driven Approach to Manage the Relocation of an Intensive Care Unit: An Exemplar.

PubMed

Lin, Frances; Marshall, Andrea; Hervey, Lucy; Foster, Michelle; Hancock, Jane; Chaboyer, Wendy

Proactive planning and managing moving from old to newly built hospitals, and the relocation process of patients for complex specialized units such as intensive care units, are necessary for both patient safety and staff well-being. This article provides an exemplar for how theory can be used to facilitate a positive relocation experience. Using change management theory, a systematic approach to cocreate implementation strategy among researchers and clinicians was critical to the success of this project.

Academic-practice collaboration in nursing education: service-learning for injury prevention.

PubMed

Alexander, Gina K; Canclini, Sharon B; Krauser, Debbie L

2014-01-01

Teams of senior-level baccalaureate nursing students at a private, urban university complete a population-focused public health nursing practicum through service-learning partnerships. Recently, students collaborated with local service agencies for Safe Communities America, a program of the National Safety Council in affiliation with the World Health Organization. This article describes the student-led process of community assessment, followed by systematic planning, implementation, and evaluation of evidence-based interventions to advance prescription drug overdose/poisoning prevention efforts in the community.

Implementation Document for Recharge Trench Project for the North Boundary System Improvements IRS.

DTIC Science & Technology

1990-01-01

the claim is not determined to be in excess of the limits cat forth in Part VII or to the extent that the amount of the claim cannot reasonably be... Dermatitis may result from repeated skin contact with the liquid. 01/03/89 - 8048-138 L TASK SPECIFIC HEALTH AND SAFETY PLAN PAGE 9 REVISION 0 NORTH...an odor threshold of 200 ppm. Symptoms of overexposure include headache, vertigo, tremors, nausea, vomiting, dermatitis and eye irritation. SXylene has