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Not only is technology going through its revolutions faster, but the institutions and organisations which exploit that technology are also in the process of almost constant reshaping. This accelerating change is a double-edged sword for safety. On the one hand, it offers the opportunity for improvement, but on the other it threatens the tried and trusted measures which have produced high safety levels in the past. Trial and error as a learning method is not acceptable in high risk technologies. We must not only get things right first time, but adapt the management of safety to the dynamic of constant change. This book explores that dilemma by studying how organisations manage safety and what is crucial for a good safety management system, how to harness change directly to safety improvement and how to adapt safety management systems to change imposed from the outside.