Incident classification systems

The severity of pelvic pain and the incidence of infertility are not related to the localization of the lesions or to the stage of the disease (Gruppo Ital-iano per lo Studio dell Endometriosi 2001), as categorized according to the revised American Fertility Society (r-AFS) guidelines (American Fertility Society 1985). In fact, the r-AFS classification system is inadequate to express the severity of the symptomatology because it does not reflect the disease in terms of cellular mass or activity. 

Broaden the application to cover reactive hazards resulting from process-specific conditions and combinations of chemicals. Additionally, broaden coverage of hazards from self-reactive chemicals. In expanding PSM coverage, use objective criteria. Consider criteria such as the North American Industry Classification System (NAICS), a reactive hazard classification system (e.g., based on heat of reaction or toxic gas evolution), incident history, or catastrophic potential. 

Management of change Material safety data sheet Management systems verification National Association of Chemical Distributors North American Industry Classification System National Fire Incident Reporting System National Fire Protection Association National Institute of Standards and Technology National Oceanic and Atmospheric Administration National Response Center (USCG)... 

AVhen developing an incident investigation management system, it is important to define common terms and classifications. Several incident categories can be used to develop a classification system. Classification has two main purposes ... 

From many companies perspectives, classification by severity is the most common classification system used to establish when to investigate an incident and who should be on a team. The main disadvantage with using severity alone to establish team membership is that it does not consider the potential loss from the occurrence, such as that with a high potential incident. In addition, the complexity of the system involved should also be used to determine team composition as more complex systems might require a larger team to understand the data. 

Regardless, the classification system should achieve a specific outcome and add value. To achieve this goal, companies should consider developing a classification scheme that helps establish the proper team composition based on the complexity, nature, and severity of the occurrence. Chapter 7 describes considerations for building a team based on classification of an incident. The chapter defines terms such as minor incidents, limited impact incidents, significant incidents, high-potential incidents (HIPO), and catastrophic incidents. 

Many companies recognize this and have a system in place to match their resources to the type of incident. Classifying the nature of the incident is one of the first steps. An example of one approach to incident classification follows. 

Dose-Response Assessment. Determining the relationship between the dose of a hazardous substance and the probability of a specific response is called dose-response assessment.6 This aspect of risk assessment is needed to extrapolate from responses observed in experiments or incidents involving high doses to the much lower potential doses relevant to waste disposal and other routine exposure situations. Dose-response assessment is a major issue in establishing the foundations of a risk-based waste classification system, and it is discussed in detail in Section 3.2. 

Development of a comprehensive and risk-based hazardous waste classification system requires assumptions about the measure or measures of response (adverse health effects) from exposure to radionuclides and hazardous chemicals that should be used in classifying waste. Possible measures of response discussed in Section 3.2.3 include fatalities, incidence, or some combination of the two, such as total detriment (ICRP, 1991). The following sections discuss the measures of response from exposure to hazardous subtances that... 

The definition and classification system for disasters and major incidents based on common and unique features of disasters (onset, duration, effect, and reactive period). 

Carcinogenicity has been used by the World Health Organization as an index for classifying mycotoxins [32]. However, the carcinogenic effects of very few mycotoxins have been established or even directly correlated. Therefore, this method of classifying mycotoxins may not be applicable at the present time. But as the carcinogenic risk of more mycotoxins is established based on ongoing research to identify the associations between human or animal consumption of contaminated food and the incidence of associated mycotoxicosis, this classification system may become very relevant. 

Traditionally, ampicillin has been considered the drug of choice for the treatment of acute exacerbations of chronic bronchitis. Unfortunately, the need for multiple repeat daily doses (four times daily), increased incidence of gastrointestinal side effects, and the increasing incidence of penicillin-resistant /3-lactamase-producing strains of bacteria (see Tables 106-2 and 106-4) have limited the usefulness of this safe and very cost-effective antibiotic. As stated earlier, the proposed classification system outlined in Table 106-2 offers first-and second-line treatment options for acute exacerbations of chronic bronchitis that are directed by the baseline clinical status of the patient. These treatment recommendations can be used to initiate therapy in patients with class I through IV disease. 

SSI incidence depends on both procedure- and patient-related factors. Traditionally, the risk for SSIs has been stratified by surgical procedure in a classification system developed by the National... 

Much effort is also devoted in healthcare to defining the incidents that should be reported and devising classification systems to capture them. Such classifications can be useful in providing broad brush descriptions of the major types of incidents. However, Billings cautions us that the real meaning of the incidents is apparent only in the narrative and will never be captured by classification alone. To make real sense of an incident, you must have the story and, furthermore, the story must be interpreted by someone who knows the work and knows the context. The implication of this is that if healthcare incident reports are to be of real value, they need to be reviewed by clinicians and, ideally, also by people who can tease out the human factors and... 

Rundman, W.B., WiUiamson, J.A.H., Deakin, A. etal. (2006) An integrated framework lor safety, quality and risk management an information and incident management system based on a universal patient safety classification. Quality and Safety in Health Care, 15(suppl 1), i82-i90. 

A cause factor designated as having a relationship to an incideuL A causal factor or several causal factors can be assigned to an incident based on a predetermined causal classification system. See also Causal Factor (CF). 

An injury that terminates fatally and is causally related to an incident. Death resulting from work injuries is assigned a time charge of 6000 days each according to the ANSI Z16.2 Standard. See also Occupational Injury and Illness Classification System (OIICS). 

An index computed by multiplying the disabling injury frequency rate by the disabling injury severity rate and dividing the product by 1000 DII = (DIFR x DISR)/1000. This measure reflects both frequency and severity, yielding a combined index of total disabling injury (ANSI Z16.2). See also Incidence Rate Occupational Injury and Illness Classification System (OIICS). 

A general category of items such as might appear in an incident causal classification system to permit the grouping of relatively infrequent dissimilar items. 

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