What initiatives have made the most positive impact?

Though ISM should have made the most significant positive impact it hasn't due to lack of enforcement and politics. It was designed as a tool to insure management properly supported ship's maintenance. However, those who certify are paid by the very companies they purport to regulate. This conflict of interest negates the positive effects initially intended and simply results in an increased work load on a shrinking ship's crew. I know of one ISM certified company whose 'critical equipment' check list does not even require a check for a functioning bilge pumping system and yet ABS approves that ISM program every year. It's joke.