From reactive to proactive

Bengoechea JA (2012) Infection systems biology from reactive to proactive (P4) medicine. Int Microbiol 15 55-60... 

Organisations still frequently rely on retrospective techniques such as incident reporting and complaints to drive safety management [21] and healthcare has been slow and sporadic in adopting predictive safety assessment techniques to detect medical error [22]. Twenty two percent of people in the UK believe, when asked, that they have been the victim of medical error [23]. Nevertheless continually striving to protect patients at vulnerable points in their lives is stiU clearly the right thing to do and a move from reactive to proactive risk reduction wiU surely pay dividends in the future. 

Meams, K. 2009. From reactive to proactive - Can LPls dehver Safety Science, 47, 491-2. 

When building HTS screening collections, it has long been the practice not only to proactively select molecules for inclusion but also to deselect compounds that have undesirable properties. Typical deselection criteria are in silico derived chemical reactivity descriptors designed to remove compounds that might give an inappropriate mode of action or result in toxic events [6]. Other properties derived from the molecular... 

A corrective action is initiated to correct the cause of an identified nonconformity and to prevent it or similar problems from reoccurring. It may include initial and follow-up actions (e.g., conducted after root cause analysis). Current quality system models and the cGMP regulations emphasize corrective actions and require that actions be documented. Under current quality system models, preventive actions include actions taken in response to quality data to address the cause of potential nonconformities to prevent their occurrence. An effective CAPA system therefore includes both reactive and proactive components. The effectiveness of corrective and preventive actions should be evaluated using objective criteria when possible and the evaluation documented. 

We talked about recruiting these employees from the perspectives of a selection committee and an industry recruiting committee. One of the common patterns that emerged is that the successful recruiting committees were proactive, they weren t reactive. That proactiveness seemed to help make those recruiting committees work. 

Maintenance tasks are either implemented proactively in order to prevent or minimize the chance of failure or reactively to correct a situation following failure. Preventive maintenance plans are derived from the EMEA process that will define the tasks and task frequencies required in order to maintain system reliability, consistency, and capability. Flaving applied the FMEA process in order to determine the maintenance strategy, it is essential that the system... 

Furthermore, the recognition of variations across the different scales of spatial and temporal dimensions would enable the identification of shifting therapeutic targets to address both of the individual and the time variances in personalized medicine (see Fig. 1). Accurate and robust biomarkers can also be useful for the stratification of diseases and classification of patient subgroups for more effective prevention and therapy. The prediction of drug responses would in turn help avoid adverse events for better clinical outcomes. In addition, the construction of dynamic disease predictive networks derived from the analyses of omics data would allow for the transition from reactive treatments to holistic and proactive care. With the transformation from disease-centered to human-based care, the systems and dynamical models would provide patient-centric information to enhance the participation of individuals, the goal of participatory medicine. 

The institution has in place rapid, useful, and intelligible feedback channels to communicate the lessons learned from both the reactive and proactive safety information systems. Throughout the institution the emphasis is on generalizing these lessons to the system at large rather than merely localizing failures and weaknesses. 

The shift from reactive corrective maintenance toward proactive predictive maintenance represents a significant move toward enhanced reliability. However, efforts designed to identify problems before failure are not sufficient to optimize reliability levels. Ultimately, for enhanced reliability, the root causes of maintenance problems have to be determined, in order to eliminate them. The high-est-priority use of root cause analysis (RCA) should be for chronic, recurring problems (often in the form of small events), since these usually consume the majority of maintenance resources. Isolated problems can also be analyzed by RCA. 

Full implementation of the DRMMP, however, requires continued technical assistance. Even if funding is available from cities to implement DRR projects, oftentimes, they lack the resources to manage and undertake DRR projects. It is a resource-intensive approach. The DRMMP only provides the roadmap for change in practice from a reactive to a more proactive approach. For the actual change to take place, the... 

The definition provided by Comfort, Boin and Demchack (2010, p. 9) to clarify these positions is a helpful one resilience is "the capacity of a social system. .. to proactively adapt to and recover from disturbances that are perceived within the system to fall outside the range of normal and expected disturhances". This hlends both the proactive and the reactive, as well as activities of adaptation and recovery. This definition is also deeply cultural, relative and incremental. It hinges on what is perceived as normal, expected and disturbing within a particular community - perceptions that can presumably change and evolve over time... 

This indicates that error management comprises two strategies proactive methods are applied to prevent errors occurring, and reactive strategies are used to learn lessons from incidents that have occurred and to apply these lessons to the development of preventive measures. Both proactive and reactive methods rely on an understanding of the courses of human error based on the theories and perspectives presented in this book. The tools and tech-... 

In the previous section I have described some researches which originated from me wishing to test certain alleged observations and various ideas which seemed questionable, and therefore that work has mainly a reactive character. In the present section I will outline some proactive researches, that is investigations which started with me at Keele and which initiated new lines of enquiry. It so happens that many of the researches of this type were concerned with the polymerisation of dioxacycloalkanes, the properties of oxonium ions, the polarography of carbenium and oxonium ions and various kinds of BIE, and they therefore fall outside the scope of this review but there were enough proactive researches on alkenes to make a story of steadily evolving ideas. 

As a result, the security paradigm has not necessarily changed, but instead has been adjusted—reasonable, necessary, and sensible accommodations have been and continue to be made. Because we cannot foresee all future intentional acts of terrorism, we must be prepared to shift from the proactive to reactive mode on short notice—in some cases, on very short notice. Accordingly, we must be prepared to respond to, react to, and mitigate what we can t prevent. 

Pharmacovigilance is evolving from being a largely reactive discipline, concentrating on the discovery of harm caused by marketed drugs, to a proactive study of their safety, effectiveness and associated risk factors in normal medical practice and use by patients. 

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