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Change Management

Change Management refers to the overall strategy and comprehensive effort an organization undertakes to ensure that any modification to a process, product, document, or system is implemented effectively, safely, and without unintended adverse consequences, while maintaining compliance.

Change Management in a Quality System (QMS) Context

Change Management (often labeled as Change Controls in QMS software modules) is a fundamental component of maintaining quality and achieving continuous improvement.

A proper Change Management system addresses key principles found throughout quality standards like ISO 9001 and FDA regulations (21 CFR Part 820):

Risk Mitigation:

Integrating risk-based thinking is central to modern QMS approaches. Planning for changes requires assessing risks and opportunities. Changes must be planned and carried out in a planned manner.

Compliance:

Change management ensures that organizations continue to comply with regulatory requirements, such as FDA 21 CFR Part 820, EU MDR, and ISO 13485.

Continuous Improvement:

Change Management programs should be supported by long-term advantages and are used as a means of improving the organization’s overall performance. Changes to procedures identified through the Corrective and Preventive Action (CAPA) process must be implemented and communicated to ensure continuous improvement.

Software Integration:

Change control is often integrated with other QMS processes, such as document control, training management, and CAPA, and is often implemented through QMS software platforms.

AI chatbots are becoming more common in this space because they can track changes and inform stakeholders as needed.

Core Activities of the Change Management Process

The systematic process of managing change involves several critical, documented activities (often covered under "Change Controls" or "Design Changes"):

Identification and Documentation

Changes and modifications must be identified and documented. Records of changes must include a description of the change, identification of affected documents, the approval signature(s) and date, and the effective date. Changes to design documentation must be retained.

Review and Approval

Proposed changes must be reviewed and approved by authorized personnel before implementation. The review should generally be performed by the same function or organization that performed the original review, unless designated otherwise.

Verification and Validation

Changes to a design, process, method, or computer software must be validated or verified (where appropriate) before implementation.

  • For suppliers, manufacturers require written notification to evaluate the impact of the proposed change on the quality of the finished product or service before the supplier implements it.
  • In the case of Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/P), any change to a process must be verified or validated to ensure it does not create an adverse impact.

Preventing Obsolete Use (Document Control)

A crucial part of the process is ensuring that obsolete documents are promptly removed from all points of use or otherwise prevented from unintended use. The management system must ensure that the proper documentation is available at the proper revision level to the appropriate members of the organization.

Regulatory Requirements for Change Management

The nature of the change dictates regulatory requirements, particularly for medical devices:

Regulatory Frameworks Table

Regulatory Frameworks for Device Changes

Regulatory Framework Requirement for Change Triggering Change
FDA 510(k) (Premarket Notification) A new 510(k) submission is required if a legally marketed device is significantly changed or modified in design, components, manufacturing method, or intended use, such that the modification could significantly affect the safety or effectiveness of the device. Significant change in design, material, chemical composition, energy source, manufacturing process, or a major change in intended use.
FDA PMA (Premarket Approval) A PMA supplement must be submitted for approval before making a change that affects the safety or effectiveness of a high-risk Class III device. Changes affecting safety or effectiveness, such as changes in facility, sterilization, packaging, design, components, or principle of operation.
Special PMA Supplements Changes that enhance the safety of the device (e.g., strengthening a warning or precaution) may be implemented before FDA approval, provided a "Special PMA Supplement—Changes Being Effected" is submitted.
EU MDR (European Union) Any modification must be assessed in terms of safety and performance, and checked to ensure the intended use remains the same. If a change impacts the risk classification or intended purpose, a new conformity assessment may be required. Manufacturers must ensure that no significant changes are made to their devices that could void transitional eligibility.
IDE (Investigational Device Exemptions) Changes to an investigational plan typically require prior approval of a supplemental application. However, developmental changes or specific clinical protocol changes that do not significantly affect safety/validity may be implemented with a notice to the FDA within 5 working days.
UDI (Unique Device Identifier) A new device identifier must be assigned whenever a change is made to a device that results in a new version or model.

Organizational Challenges of Change Management

One of the most common challenges in implementing a QMS, which Change Management is central to, is resistance to change. Employees may equate a positive work environment with maintaining the status quo, and overcoming this resistance, especially among senior leaders, requires robust change management programs, good communication, and effective resourcing.

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