The company for our pipe line management of change (MOC) case study has over 2,000 employees, multiple business units, areas, and facilities crossing several provincial and local jurisdictions.

They do have an existing MOC process, which was good on paper, but not in practice.

During an external regulatory audit numerous shortcomings were identified that required addressing. Upon further investigation, it was identified that a majority of prior incidents were attributed to lack of an effective MOC process. Leadership created a mandate to improve the MOC process to address the shortcomings. This project would be done in 3 phases extending over three years.


  • MOC process was ineffective.
  • Too many changes being introduced across all areas resulting in increased risk exposure.
  • Different definitions of what MOC should include resulting in inconsistent practices
  • Some parts of the business avoided using the MOC process.
  • Risk was not properly managed.


  • Reduce the number of changes.
  • Establish a consistent and sustainable. program (system, processes, technology).
  • Establish metrics to monitor and improve process over time.
  • Establish continuous improvement process.


  • Define the scope and desired outcomes for each phase of the project.
  • Establish a cross-functional team and use an iterative process.
  • Start with Asset MOCs first, to be followed later by procedures, organizational and regulatory changes.
  • Leverage technology that supports best practices, risk-based strategies, and adaptive workflows.


  • Project:Phase 1 – 12 months
  • 3 months to develop new process
  • 6 months to configure, implement, and refine application
  • 3 months to train and roll-out phased across areas
  • Process Improvement:
  • Simplified process using stage-gate approach and removing bottlenecks.
  • introduced missing best practices: replacement in kind (RIK), risk screening, PHAs, PSSRs, etc.
  • Streamlined approval process from 18 to 3 approvals based on risk.
  • Increased engagement of affected stakeholders and clarified roles using RACI model.
  • Implemented logic to identify who needed to be involved, and what work needed to be performed based on the assets being changed.
  • Identified key performance indicators to monitor and control risk.
  • Outcomes:
  • Each area follows the same process independent of the type of change.
  • Risk is assessed for each change and monitored across all areas.
  • MOCs are better aligned with both corporate and area priorities.
  • Overall risk is visible and used as a leading indicator to drive further risk reduction.

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About the Author

Jon Knight

Jon Knight leads the NASP Team’s media creation department. He has been involved with workplace safety training since 2017 with a focus on course creation. He also provides video production and voiceovers for NASP content.
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