Why Conduct Incident Investigations?
When investigating a worksite incident, it is essential to record all findings accurately and thoroughly. This includes documenting the accident scene, identifying any possible witnesses, and interviewing involved parties to verify facts. All of these steps will help employers and workers understand what happened and identify potential hazards in order to prevent future incidents from occurring.
Who should do the investigating?
It is equally important to involve managers and employees in the incident investigation. Managers can provide oversight of the process, as well as draw on their experience to identify potential contributing factors from when the incident occurred. Employees also bring valuable insight – for instance, workers may be able to identify specific unsafe practices or conditions that led up to the incident.
Six steps for successful incident investigation:
The 7 steps of investigation includes:
STEP 1 – IMMEDIATE ACTION
Once the area is safe, first aid and medical care has been given for the people involved and the scene has been preserved, a thorough investigation will begin. Evidence will be collected from multiple sources which may include CCTV tapes, photographs of the scene or other physical evidence such as samples. This evidence must be carefully documented and stored securely in accordance to local laws and regulations.
STEP 2 – PLAN THE INVESTIGATION
It is important to develop a clear plan for investigating any incident. The plan should consider the resources required, who will be involved, and how long it is expected to take. Depending on the severity or complexity of the incident, an investigation team may be necessary in order to ensure that all aspects of the case are thoroughly examined.
An accident investigation is important for any workplace incident, not only for human error but for equipment and management systems errors as well. With a proper investigation, a safety committee will need to involved or established as well as a single investigator.
STEP 3 – DATA COLLECTION
The investigation of any incident requires a thorough analysis of all available information. This might include interviewing witnesses or victims and an injured worker, reviewing documents related to the event, examining equipment or machinery that was involved in the incident and studying the incident scene.
The data collected from these sources can provide invaluable insights into what happened during the incident and help investigators determine the cause. To collect data, comb over every sequence of events and gather information regarding human errors as well as equipment errors. Weather conditions should be documented as well along with safety problems, property damage, serious injury, witness statements, near misses, work environment, other incidents, and other relevant information that will be helpful to the investigation team.
STEP 4 – DATA ANALYSIS
The root cause of an incident is typically the result of multiple failures, decisions, and processes that have been allowed to exist in an organization’s environment. To properly recognize the root cause requires a thorough investigation into the systemic factors at play.
The direct causes are more obvious, but it’s important not to overlook their connections to underlying influences. By looking closely at both direct and underlying causes, it becomes possible to identify where improvement can be made and prevent similar incidents from occurring in the future. In order to understand the data, you’ll need to review records such as inspection reports as well as review all injuries recorded, the me
STEP 5 – CORRECTIVE ACTIONS
Root cause analysis also helps organizations to recognize any potential areas for improvement, ensuring that similar incidents do not happen again in the future. By understanding and addressing the root causes of an incident, organizations can gain greater visibility into their processes and ensure long-term success.
Additionally, significant cost savings can be achieved through effective root cause analysis as it provides a valuable opportunity to review existing processes and address any deficiencies before they become costly later on. Ultimately, when used correctly, root cause analysis can help an organization get ahead of problems before they occur and reduce risks associated with them and other hazards.
Corrective actions might include personal protective equipment changes or updates due to equipment failure. Doing a ‘quick fix’ would be an example of what not to do as a corrective action. Cutting corners can cause repeat incidents and come with serious consequences.
STEP 6 – REPORTING
Once the investigation is concluded and all outstanding issues are closed out, it is important to communicate the findings so that lessons can be shared. In order to do this, organizations should use formal incident investigation reports, alerts, presentations and meeting topics.
Regular safety inspections, regular maintenance, implement corrective actions and a safety program, being sure to follow up with organizational requirements on safety and training both management and employees on safety in incidents are crucial when reporting and maintaining reporting.
Why look for the root cause?
Root Cause Analysis can be used to help organizations recognize and rectify the underlying causes of problems they may be facing. The first step in this process is to identify the negative events that are occurring and determine if any patterns or trends exist among them.
What are the steps involved in investigating an incident?
- Secure the area
- Plan the investigation
- Collect all information
- Analyze collected data
- Find the root cause
- Execute corrective actions
- Document and share the results
What should I know when making the analysis and recommendations?
If your analysis is just another step of managing incidents. Be sure to allocate the appropriate resources and time to complete a full analysis in these situations:
- When issues occur or can be expected to occur more than once
- When an outage has or can affect many users
- When the system isn’t functioning as designed
What is OSHA Process Safety Management Management of Change?
MOC’s (Management of Change) establish and implement written procedures to manage changes made to process chemicals, technology, equipment, procedures and facilities. OSHA’s Process Safety Management (PSM) standard requires companies to perform MOC’s when changes are made that could affect how safely a process runs.
This procedure should outline all points involved in making changes to the process, such as reviewing safety concerns, assessing risks, identifying potential hazards, selecting appropriate control measures, monitoring results, and updating records.
Which are the three types of MOC?
The three most common types of MOC are administrative, organizational, and technical.
What are the steps of MOC process?
8 Steps to a MOC Process
- Identify Proposed Changes.
- Risk Assessment.
- Determine if Hazards/Risks Can Be Controlled.
- Evaluate Making a Change.
- Implement Change If Safe.
- Pre-Startup Safety Review (PSSR)
- Train Workers on Change.
- Execute and Monitor Change.