Accident and Incident Reporting
Determining the Root Cause
All accidents and incidents, including near misses, must be reported and investigated as soon as possible. There are essentially two (2) major reasons for this. These are:-
1. To determine the true and accurate circumstances which led up to and contributed to the event?
2. To prevent the event occurring again, potentially with even greater repercussions.
The definition of an accident is an unplanned or undesired event that results in injury or illness to a person. This may also involve damage to plant, equipment and/or the environment.
The definition of an incident is an unplanned or undesired event that could have resulted in harm. It is often called a ‘near miss’ or ‘near hit’, e.g. a container of corrosive is dropped when being delivered but does not break or open.
The root cause is the true cause or causes of the event.
Identifying the root cause of an accident or incident may be a relatively complicated process. Several coincidental causes making up a chain of causation factors may be identified, none of which alone may have resulted in the accident. The basic concept of accident prevention is that accidents can have several causes, each of which must be identified and controlled.
In order for an investigation to uncover the root causes of accidents and incidents and, therefore, be of any benefit ‘who’, ‘what’, ‘when’, ‘why’, ‘where’ and ‘how’ questions need to be asked by employees of the Company.
For example: Who was injured? Who saw the accident? What is the injury? What tools were being used? When did the accident occur? When did the injured person start the task? Why did the injury occur? Why was training not given? Where did the accident occur? Where did the damage occur? How did the injury occur? How could the accident been avoided?
Checklist for Investigations
The Company shall investigate safety events using the standard checklist detailed below.
Note: In the table below, the term ‘event’ will be used to indicate ‘accident, incident or near miss’.
Personal
• What level of job training had been provided?
• How was competency assessed?
• What did the risk assessment identify in regard to areas of special need?
• What other factors may have impacted on work performance?
Management
• Who was supervising the task?
• What steps had the supervisor taken to ensure the task would be safely performed?
• What instructions had the supervisor given to those involved?
• What training had the supervisor received in giving out instructions to safely perform the work?
The safe work practice (Method Statement)
• When was a safe work practice written for this task?
• What information does it include?
• What information is missing from it?
• What evidence is available that the person(s) involved had been trained in the procedure?
• How was it being complied with?
• What personal protective equipment was available?
• How was it used?
• How often is a risk assessment conducted on this task?
Plant, equipment and substances
• What was the plant, equipment and other items or substances being used to produce?
• How were they being operated?
• How were plant and equipment failures dealt with?
• What type of exposure(s) was involved? (E.g. chemical, thermal, radiation, biological etc.)?
• When was the last time plant, equipment or other substances had a risk assessment?
• What controls were identified in this assessment?
• How often was equipment and plant maintained?
The workplace itself
What affect did the following have on the event?
• Noise
• Lighting
• Vibration
• Housekeeping
• Workplace layout and design
• Dust and fumes
• Flooring
Accident/Incident/Near Miss Notification Form
Companies shall report all safety incidents, accidents or near miss events so that they may be analysed and the risks of a repeat event mitigated.
Reporting to Statutory Authorities
Companies shall comply with all the statutory reporting requirements for [Country Dependant]. All reports to the relevant authorities will be signed by a senior manager before lodgement.
Accident Response Flow Chart
The flow chart shown in the sample text is an indication as to the steps to follow.
Companies should follow the steps noted below in reporting safety events:-
Review of Corrective Actions
Review corrective actions by taking the following steps:
1. Defining the scope of the activity that is to be assessed.
2. Identifying the risks.
3. Assessing the risks.
4. Controlling the risks.
5. Monitoring and reviewing the process.
Implement all controls using the following hierarchy of hazard control:
1. Eliminating the hazard.
2. Substituting the hazard.
3. Modifying the process.
4. Isolating the hazard.
5. Implementing engineering controls.
6. Using a combination of controls.
7. Using back up controls, such as personal protective equipment.
See that all corrective actions identified in an investigation are authorised with signed documentation.
- Allocate responsibility against each corrective action, to ensure everyone is aware of what is required of them. Any lack of response shall be tracked to the responsible person.
- Ensure any corrective actions have a time frame allocated to them for completion.
- Ensure all employees concerned have received sufficient training, or arrange for retraining, as deemed necessary by the findings of the investigation.
After implementing corrective actions, ensure they are evaluated at a future time. This is to ensure that the controls have not caused any further hazards, and that they are in fact appropriate to reducing the likelihood of a recurrence of the same event.
This Accident and Incident Reporting Article is an extract from our Health & Safety Management Manual available HERE for a special price of just £19.99. Suitable for all countries and organisations.
A UK Specific edition available.
