Many companies will be familiar with the terms Total Quality Management (TQM), or Total Production System (TPS). They began initially to describe a Japanese-style management for quality improvement. TQM (and its variants) represent a philosophy of a broad and systemic approach to managing organizational quality which sets the context for a quality management system (QMS). It extends beyond the quality of products and services to the quality of all issues within an organization.
When it comes to safety efforts the evolution towards using safety management systems (SMS) has become standard practice for industries that include aerospace, chemical industry, and now a matter of priority for others such as the pipeline industry in the US.
However, in recent years, major incidents have made it clear that there is still a necessity for companies to improve their safety capabilities through the application of systematic and proactive approaches:
"not as a stand-alone activity that is separate from the main activities and processes of the organization, but as an integrated part of total performance management" 
Building on the success of TQM, in 1998, Geoetsh (1998), introduced the concept of Total Safety Management (TSM) as a performance-oriented approach. The fundamentals of this approach include: a strategic approach to safety, emphasis on performance assessment, employee empowerment, reliance upon robust methods of risk analysis, and continual improvement. More specific organizational processes have been proposed since by various organizations.
Integration of safety with quality, environment and productivity have also been proposed by means of:
Strategic and cultural integration in order to enhance learning, continuous performance, stakeholder involvement and participative management.
Coordination of common business processes between safety, quality, environment.
Correspondence of different standards (ex. ISO 9001, 14000, 31000, etc.) with cross-references and possibly a common information system.
However, while there is utility in these approaches they do not get to the heart of the matter which is a need for a systematic methodology that is risk-based, performance-oriented with a focus on continuous improvement.
TOSCA Approach to TSM
A European project under the name of TOSCA (Total Operations Management of Safety Critical Activities) has proposed the following five principles for TSM based on effective risk management (RM) principles derived from ISO 31000:
RM should be part of all decision making and organizational processes and provide a capability for creating value for business;
RM should be based on best available risk information to create a common operational picture about risks;
Participative risk management must ensure that all the needs of stakeholders are taken into account while their knowledge about risks is brought into play;
Knowledge management should be part of risk management so that all knowledge about risks is managed effectively and all RM techniques are better integrated; Performance monitoring and operational feedback is necessary for making
RM dynamic, iterative, and responsive to change. At the same time, this will facilitate continual improvement of the organization
Each of these principles are defined and elaborated in their proposed methodology. However, it is the second principle that I believe communicates where the fundamental paradigm shift needs to occur.
It is common for safety management systems to focus their attention on correcting safety problems to return to normal operations. This is the same focus that quality has in the use of corrective and preventive actions (CAPA) processes. As I have discussed in previous blog posts, this is known as feed-back control which is reactive in nature. There is no predictive or anticipatory capabilities to foresee future states or events.
This is why a feed-forward process is needed using a model-driven control. It is the model that provides predictive capabilities that can help to address the effects of uncertainty before they happen.
It is important to note that performance indicators can now be measured not in terms of outcomes (lagging indicators) but instead as antecedents (leading indicators) so that changes are made before undesired outcomes are produced.
Adopting Total Safety Management (TSM) will require that existing safety management systems change from reactive to proactive behaviors. Effective risk management is at the core of this change and it is here that continuous improvement is needed.
More information about TSM can be found in the following reference materials:
 Total Safety Management: Principles, processes and methods, 2016, T. Kontogiannis, M.C. Leva & N. Balfe
 Total Safety Management: What are the Main Areas of Concern int he Integration of Best Available Methods and Tools, 2014, Maria Chiara Leva, Nora Balfe, Tom Kontogiannis, Emmanuel Plot, Micaela De Michela
 TOSCA (Total Operations Management for Safety Critical Activities) project