Incident Investigation
Location: ..............................................................................
Date: ................................................... Time: ......................
Injured Person's Details:
Name/Home Address/Phone Number/Age/Sex/Job
Title/Employment Location and Status/ Nature of Injury/Brief
Circumstances of What Happened
Other Persons Interviewed
Name/Home Address/Phone Number/Job Title/Employment
Location and Status/Details or Statement obtained.
Causes of Incident
Action to Prevent Recurrence
|
Action required |
Person Responsible |
Target Completion Date |
Actual Completion Date |
| |
|
|
|
Investigator
Name: ................................ Job Title: ..................................
Contact Details:.................... Date Investigation Completed:....
CHECKLIST - ACCIDENT INVESTIGATION (incl. DANGEROUS OCCURRENCES)
|
1 |
Do you have a (written) system for investigating incidents (accidents, dangerous occurrences etc.)? |
YES/NO |
|
2 |
Are relevant personnel instructed or trained in the investigation of incidents? |
YES/NO |
|
3 |
Do investigators have access to an 'Investigation Kit' to aid investigations (e.g. camera, tape measure, forms etc.)? |
YES/NO |
|
4 |
Do you link incident investigation to remedial work action plans? |
YES/NO |
|
5 |
Do you know how much such incidents cost your business/sector of industry? |
YES/NO |
|
6 |
Do you monitor, and aim to reduce, losses arising from accidents and dangerous occurrences? |
YES/NO |
|
7 |
Do you encourage 'near miss' reporting? |
YES/NO |
N.B. Some of the above questions may be more relevant to larger business.
REFERENCES/FURTHER DETAILS
Publications
1. The cost of accidents at work (HS(G)96)
2. Successful health and safety management (HS(G)65)
3. Health Risk Management: a practical guide for managers in small and medium- sized enterprises (HS(G)137
4. Managing Health and Safety 5 steps to success indg 275
5. You can do it. The what, why and how of improving health and safety at work.- 'a self help guide' (HSE) ISBN 07176 0726 7
6. HSE Books:
7. HSE website accidents:
8. The real costs of accidents at work indg 355