The Course of Action

The person given responsibility for achieving certain results must have the right (i.e. the authority) to decide how those results will be achieved otherwise, the responsibility for the results rests with those who stipulate the course of action. 

If you can t predict the course of action or sequence of steps you need to take, you can t write a procedure. You can t plan for unforeseen events and as the unexpected will happen sooner or later, it would be wasteful of resources to produce procedures for such hypothetical situations. If you do not use statistical techniques, for instance, it is a waste of time writing a procedure that will not be used even though the standard requires one. 

The following guidance notes pertaining to each situation and the alternative courses of action provided are not intended to be comprehensive and exhaustive. Many of the positive and negative aspects of any of the courses of action will be self-evident, and may arise out of group discussions. The notes are intended as guidance only. 

Analytical chemistry is a problem-solving science. Independent from the concrete analytical method, the course of action, called analytical process, is always very similar. The analytical process starts with the analytical question on the subject of investigation and forms a closed chain to the answer to the problem. Using a proper sampling technique a test sample is taken that is adequately prepared and then measured. The measured data are evaluated on the basis of a correct calibration and then interpreted with regard to the object under study. 

The scheme given in Fig. 2.1 represents normal analytical procedures in off-line analysis. It contains all the steps that must be considered in principle. However, there could be reasons to reduce the course of action. Not in all cases is the analyst able to take samples by himself or check the sampling procedure. Sometimes he or she must accept a situation in which he or she has to receive a given sample (e.g., in extreme cases, extraterrestrial samples, autopsy matter). 

Procedure notes, as well as a description of the course of action to be taken in the event that a test system becomes inoperable. 

The course of action to take when one or more doses have not been taken... 

Where a competent authority has objective grounds for considering that the sponsor or the investigator or any other person involved in the conduct of the trial no longer meets the obligations laid down, it shall forthwith inform him thereof, indicating the course of action which he must take to remedy this state of affairs. The competent authority concerned shall forthwith inform the Ethics Committee, the other competent authorities and the Commission of this course of action. 

In many cases of practical interest, analytical expressions which predict concentration changes for complex reaction schemes are difficult to obtain or clumsy to use. Often, an analytical expression is unobtainable. The courses of action which may be taken in such circumstances include (a) the use of numerical methods and (b) the application of approximations to the kinetics. These procedures may be used simultaneously. 

Engineers are often confronted with making choices between alternative equipment, designs, procedures, plans or methods. The courses of action require different amounts of capital and different operating expenses. Some basic concepts must be considered before attempting... 

Some 20 years later, Keck et al. (1989) noted that the course of action of neuroleptics, particularly the onset of their specific antipsychotic action, has still not been studied accurately enough. According to these authors there have been hardly any controlled studies in which clear distinction was made between the non-specific calming action and the antipsychotic effects of neuroleptics. 

The demonstration of the value of pharmaceuticals, such as psvchopharma-ceuticals, always involves a comparative analysis of alternative courses of action, such as the use of two psychopharmaceuticals or the use of a psychopharmaceutical and psychotherapy, or one of the courses of action can... 

There is also controversy over what to do if a patient does not respond to the first trial of an SSRI. If the reason for nonresponse is poor tolerability, then many clinicians try a second SSRI. Based on a recent survey, the course of action preferred by most psychiatrists is to switch to a drug with a different mechanism of action or a dual mechanism of action when a patient experiences inadequate efficacy from an adequate trial of an SSRI (135). 

When faced with a conflict, two major, related questions need to be answered Is this conflict important to me How do I know whether the situation is imperative to address Ury et al. (1988) gauge the answers to these questions in terms of transaction cost. The authors reason that in conflict, like in business, you want to minimize the costs. You need to consider the time cost, actual money cost, opportunity cost, and property cost and then determine the course of action that minimizes them. The answers also factor in satisfaction, long-term effects on relationships, and durability of a solution. For you, it may be helpful to analyze the person s relationship to you. Is this a significant relationship Will you have to deal with this person in the future Do you want things to work out In the case of a family member, boss, subordinate, or colleague, the answer is usually yes. With other scenarios such as a rude street vendor or casual acquaintance, the answer might be no. If this is your decision, there is no need to continue further. 

Vicarious rehearsal—The communication age allows some people—who are frequently farther away (by distance or relationship) from the threat—to participate vicariously in a crisis that they have no danger of experiencing and to try on the courses of action presented to them. In the most troublesome form, these worried well will heavily tax the recovery and response. 

This system did not elicit all symptoms but did take care to discover whether pregnancy could be a possibility. Observation showed evidence that she had a cold accompanying her symptoms. The course of action was clearly explained to the patient. The prompt No medication refers to the option of not giving medicine, just advice, but could also be adapted to use as a reminder to find out if she is taking any other medication prescribed or purchased. 

Subjective data are related to the identified problem and associated symptoms as described by the patient himself or herself (or in some cases by the caregivers of the patient). Objective data include observations made and information acquired by the health care practitioner that is determined to be relevant to the identified patient problems. The assessment refers to the practitioner s clinical opinion or judgment about the problem based on subjective and objective data, as well as the practitioner s previous experiences related to similar clinical problems and patients. The plan is the course of action deemed appropriate for each identified problem given the data available to the clinician. 

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