Assume Executive Responsibility

Chapter Four returns to the patient safety manifesto and continues with the committment Assume executive responsibility. This chapter focuses on what it looks like to accept responsibility on a personal and organizational level, whether in a clinical discipline, a department, a clinic, a single hospital, a large system of care, in the academic health sciences, or on a governing board. 

For leaders to assume responsibility, it is essential that they be grounded in the basic principles of safety science and have the courage to challenge the conventional wisdom that pervades the health care industry. These safety principles are as follows  

These principles stand in sharp contrast to the beliefs that permeate health care today  

Participate in external safety education programs, continuing medical education, conferences, etc. 

Hold detailed conversations with in-house experts on our realities of practice. 

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A well-designed QMS will include identified process owners with defined roles and responsibilities. Process owners require support from management, their customers, stakeholders, and quality assurance. Accountability and decision-making parameters will empower process owners to drive execution and improvements to their process, delivering the business results expected. Without these process owner attributes and support, minimal results will be achieved, and functional management will be burdened with and assume the responsibility for making decisions that should be in the hands of capable process owners. 

The construction management option of an independent C.M. does not seem to offer any advantages to either large projects or small ones. It is essentially the same as the first two options, executed through lump sum subcontracts, with the disadvantage that the Owner must retain a C.M. and still assume the responsibility instead of the contractor. On small enough projects, the Owner should act as its own C.M. and save construction management fees. 

Danckwerts ran the Editorial Board in a diffuse way and minutes are only available on the files of one meeting and even then the attendance was far from complete. The editors now meet regularly on a 3-yearly basis supplemented by informal contacts at technical meetings. The Executive Editor is responsible for overall organisation and maintains central records on activities but individual Editors continue to assume full responsibility for decisions on the meinuscripts sent to them. 

Since only 20 data records were collected from the system during the execution of the designed experiments conducted by Reece et al. (1989), we used their response surface models, deliberately contaminated with small Gaussian noise terms, to generate a total of 500 (x, z) pairs (assuming that the three variables, jCj, Xj, Xj, have independent and uniform... 

The order in which the summations over the responses (r) and substances (i) of concern are executed in the second and third steps above is arbitrary. However, these steps must be executed before the MAX and INTEGER functions are applied to the result. If the risk index for substances causing deterministic responses were based on calculations of health risk per se, rather than dose, the INTEGER function in Equation 6.5 would not be necessary, because the risk would be zero whenever a dose is below the threshold. Again, however, evaluation of the risk index for substances that cause deterministic responses based on dose is recommended when the dose-response relationship is assumed to have a threshold. The use of dose is supported by the observation that the dose-response relationship above the threshold generally is nonlinear. 

In the absence of systematic errors, the observed response, y, will be an unbiassed estimate of the true response, and the error term can be analyzed by statistical methods. In carefully executed synthesis experiments it is reasonable to assume that random errors occur independently of each other and that the observed variation of these random events are normally and independently distributed. A variation of the experimental conditions is considered to be significant if it produces a variation of the observed response outside the noise level given by the experimental error. Significant variations in this respect can then be analyzed by comparison to the error variation through known statistical distributions based on the normal distribution, e.g. the t distribution, the F distribution, and the %2 distribution. 

The role that the public has assumed - neither enshrined in the treaty documentation nor anticipated by the States Parties is another unique characteristic of the CWC. Here again, the Convention is evolutionary compared with earlier treaties and international agreements. Chemical weapons disposal has emerged as a vivid example of how local environmental justice concerns can intersect with global disarmament and nonproliferation efforts. With no formal inducement, the public has become a player in the execution of the CWC-mandated destruction of chemical weapons. What lessons can be learned from the public response and how... 

The contractor is legally bound to perform the work according to the contract. It has also assumed the professional responsibility and will be liable for failures stemming from the mechanical design and/or execution provided under the contract. It has a contractual right to take the necessary steps and incur reasonable expenses to protect its liability. 

The project execution plan and master project schedule developed by the Owner s Project Manager during the initial project stages (Chapter 9) set the basis and execution logic for the entire project and, normally, are all that is needed to execute small projects. However, in major projects, the responsibility for the actual execution is eventually turned over to an EPC contractor who must assume the planning and scheduling functions and issue an expanded execution plan and MPS in details commensurate with the size and complexity of the project. 

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