It is an unfortunate circumstance when a worker gets hurt on the job. It is even worse if no attempt is made to learn from the incident and to correct the cause(s) that led to the incident and worker injury. If the causes are not corrected, more workers could be injured in a similar way.
Owners and employers should investigate all incidents and near-misses.
Near-misses are incidents that cause no visible injury or damage but that could have caused serious injuries or property damage under slightly different circumstances. They should be investigated because they point to conditions or work practices that must be changed to prevent future incidents.
Everyone in the business has a role to play in an incident investigation. Workers must report incidents to their supervisors. The owner, employer or supervisor needs to investigate promptly. If possible, one employer representative and one worker representative should participate in the investigation. After the investigation is complete, an investigation report must be prepared.
The purpose of conducting an incident investigation is to:
determine the causes of the incident
identify any unsafe conditions, acts or procedures that contributed to the incident
find out why those unsafe conditions existed and/or unsafe actions were taken
find ways to prevent similar incidents.
Interview witnesses and the people involved in the incident – even if the person was not present at the time of the incident. For example, it may be appropriate to interview a supervisor who gave instructions at the start of the shift or a trainer who instructed the workers involved, months earlier.
unsafe or defective equipment
lack of skill
unsafe environment or conditions
lack of physical ability; e.g., strength
poor housekeeping
lack of maintenance
physical hazards
poor design
poor planning
fatigue, stress
poor instruction
poor supervision
unsafe work practices
unusual or unfamiliar work conditions.
Once the causes are identified and corrective actions to prevent recurrence determined, the investigation report can be completed. However, there are still a few more things that need to be done:
Results should be shared with affected employees.
The recommended corrective actions have to be implemented.
Follow up should be done to ensure the corrective actions are working as planned.
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