Safe Systems institutional management

One important foundation stone is to get the key institutions within road transport (road builders, traffic managers, vehicle makers, transport planners, etc.) to develop generative safety cultures internally. While Safe System thinking requires institutions such as road and traffic authorities to accept a level of accountability far greater than ever applied historically, this still falls fundamentally short of the generative safety cultures that can be found in the industrial field. 

The objective of this research was therefore to develop a master plan for the safe management of end-of-life mercury containing lamps for the entire country. It encompasses detailed analysis of the complete system of logistics (collection, transportation, and safe disposal of end-of-life CFLs/FTLs), financing models, institutional mechanisms, policy framework, and issue of public awareness. 

Safe Automation and ANSI/ISA 84.01-1996 served as significant technical references for the first international standard, IEC 61511, issued by the International Electrotechnical Commission (IEC). In the United States, IEC 61511 was accepted by ISA as ISA 84.00.01-2004, replacing the 1996 standard. In 2004, the European Committee for Electrotechnical Standardization (CENELEC) and the American National Standards Institute (ANSI) recognized IEC 61511 as a consensus standard for the process industry. IEC 61511 covers the complete process safety management life cycle. With its adoption, this standard serves as the primary driving force behind the work processes followed to achieve and maintain safe operation using safety instrumented systems. 

American Association of Retired Persons American Health Care Association American Hospital Association American Medical Association American Nurses Association American Pharmaceutical Association American Society of Health-System Pharmaeists American Society for Healthcare Risk Management Department of Veterans Affairs Food and Drug Administration Generic Pharmaceutical Industry Association Institute for Safe Medication Practices... 

It was reported by the Institute for Safe Medication Practices (ISMP) in 2000 that fewer than 5 percent of physicians were writing prescriptions electronically. In a 2000 white paper entitled, A Call to Action Eliminate Handwritten Prescriptions within 3 Years, ISMP recommended the use of electronic prescribing by clinician order entry to reduce medication errors (ISMP, 2000). CPOE can help to reduce errors in the delivery and transcribing of orders to the pharmacy where the orders are filled. Order management can be used to control inventory and alert pharmacy staff (and even the patient) of the status of a prescription. For example, some national chain pharmacies have the capability of alerting the patient by phone or e-mail if a prescription is ready or if other action needs to be taken before the prescription can be picked up. The system should also be able to report results, such as the number of prescriptions filled, the revenue generated over a specified time, and medication error reports. 

The P T committee s primary function is to maintain a drug formulary. Pedersen et al. (2001) showed that 97.5% of hospifals reporfed fhaf formulary development and management was a primary function of a P T committee. However, key elements of managing the formularies are developing and implementing policies that assure safe and effective medication therapy within institutions. These elements were also reported as primary fxmctions by 97.1% of the hospitals surveyed. The following section reviews fhe formulary system and its management. 

A good guideline for what elements a safety management system should contain is the American National Standards Institute (ANSI), ANSI/AIHA ZlO-2005 American National Standard Occupational Health and Safety Management Systems. A similar standard exists for the construction and demolition industry ANSI/ASSE AlO.38-2000 (R2007) Basic Elements of an Employer s Program to Provide a Safe and Healthful Work Environment. 

Medication Errors Reporting System. This system was developed by the Institute for Safe Medication Practice (ISMP) in 1975 and is a voluntary medication error reporting system. The system receives reports from frontline practitioners and shares its information with the pharmaceutical companies and the FDA, and is managed by U.S. Pharmacopoeia (USP). 

The institution recognizes the critical dependence of a safety management system on the trust of the workforce, particularly in regard to reporting systems. (A safe culture—that is, an informed culture—is the product of a reporting culture that, in turn, can only arise from a just culture.)... 

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