Accident Investigation Revised

8/6/2019 Accident Investigation Revised

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Why Investigate Accidents?Why Investigate Accidents?

j Prevent a recurrence with correctiveaction

j Determine the causej Document your companys version of

the incident

j Completion of OSHA-required reporting


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Investigation is 4 Step ProcessInvestigation is 4 Step Process

j Control the Scene

j Gather Data

j Analyze Data

j Write Report


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Who Investigates?Who Investigates?

j Minor accident Supervisor

Safety committee memberj Major accident

Supervisor Safety committee member Safety manager


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Investigators QualificationsInvestigators Qualifications

j Accident investigation trainingj Understanding of the importance

of investigationj Ability to communicate details


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When to Investigate?When to Investigate?j Immediately after

incident Witness memories

fade Equipment and clues

are moved

j F inish investigationquickly.


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Investigation KitInvestigation Kit

j Camera and filmj Report forms, clipboard, pens

j Barricade tapej F lashlightj Tape measurej Tape recorderj Work gloves


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Accident Investigation GoalsAccident Investigation Goals

j Preparing the investigation teamj Conducting the investigation


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The Accident OccursThe Accident Occurs

j Employee immediately reports theaccident to a supervisor

j Supervisor treats the injury or assessesneed for outside medical treatmentj Leave the accident scene intactj

Contact the accident investigation team


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Control the SceneControl the Scene

j Provide medical care for injured F irst Aid

On Scene Evaluation Transport for Medical Care

j Control existing hazards Prevent further injuries Get more help if needed

j Preserve evidence


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Beginning the InvestigationBeginning the Investigationj Gather investigation

team and kitj Report to the scene

j Look at the bigpicture

j Record initialobservations

j Take pictures


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Gather DataGather Data

j Photos of accident scenej Drawings & sketches & measurements

j Data Persons involved Date, time, location

Activities at time of accident Equipment involved List of witnesses


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Data Analysis ListData Analysis List

j Accident Titlej Date, Time, Location

j Persons involvedj Witnessesj Work & Environmental Conditions at

time of accidentj Immediate actions taken at scene


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Whats Involved?Whats Involved?

j Who wasinjured?

j Medication,drugs,or alcohol?

j Was employee

ill?j Double shift or

rotating shifts?


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What Was Involved?What Was Involved?

j Machine, tool, or equipmentj Chemicals

j Environmental conditionsj Production schedule


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j Date and time?j Normal shift?j Employee coming

off a vacation?

Time of IncidentTime of Incident


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Incident LocationIncident Location

j Work areaj On, under, in, near

j Off-site addressj Doing normal job duties


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Incident ActivitiesIncident Activities

j Motion conducted at time of incidentj Repetitive motions?

j Type of material being handled


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Unsafe ActsUnsafe Acts

j List all unsafe acts involved in the accidentj Examples of unsafe acts

Unauthorized operation of equipment Running - Horse Play Not following procedures By-passing safety devices Not using protective equipment Under influence of drugs or alcohol Taking short-cuts


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Unsafe conditionsUnsafe conditions

j List all unsafe conditions involved in theaccident

j Examples of unsafe conditions Ergonomic Hazards Environmental hazards Inadequate housekeeping

Blocked walkways Improper or damaged PPE Inadequate machine guarding


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Incident DescriptionIncident Description

j Details so readercan clearly picturethe incident

j Specific bodyparts affected

j Specific motionsof injured employee

just before, during, andafter incident


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Information InterviewsInformation Interviews

j Gather just the facts make no judgments or statements

j

Conduct interviews one on onej Be friendly but professionalj Conduct interviews near the scene in

privatej Interview all supervisors


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WitnessesWitnesses

j Who witnessed the incident?j Was a supervisor or lead person nearby?

j Where were other employees?j Why didnt anyone witness the incident?


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Ask all witnessAsk all witness

j Name, address, phone numberj What did you see

j What did you hearj Where were you standing/sittingj What do you think caused the accident

j Was there anything different today


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Ask SupervisorsAsk Supervisors

j What is normal procedure foractivities involved in the accident

j

What type of training personsinvolved in accident have had.j What, if anything was different todayj

What they think caused the accidentj What could have prevented the

accident


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Analyze DataAnalyze Data

j Gather all photos, drawings, interviewmaterial and other information collectedat the scene.

j Determine a clear picture of whathappened

j F ormally document sequence of events


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Causal F actorsCausal F actors

j Try not to accept single cause theoryj Identify underlying causes

j Primary causej Secondary causes


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What controls failed?What controls failed?

j List the specific engineering,administrative and training controls thatfailed and how these failures contributed tothe accident.


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What controls worked?What controls worked?

j List any controls that prevented amore serious accident orminimized collateral damage orinjuries.


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DetermineDetermine

j What was not normal before theaccident

j

Where the abnormality occurredj When it was first notedj How it occurred.


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Change AnalysisChange Analysisj 1. Define the problem (What happened?).j 2. Establish the norm (What should have

happened?).j 3. Identify, locate, and describe the change

(What, where, when, to what extent).j 4. Specify what was and what was not affected.j 5. Identify the distinctive features of the

change.j 6. List the possible causes.j 7. Select the most likely causes.


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Report CausesReport Causes

j Analysis of the Accident HOW &WHY

j

a. Direct causes (energy sources;hazardous materials)j b. Indirect causes (unsafe acts and

conditions)j c. Basic causes (management policies;

personal or environmental factors)


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PreventionPrevention

j What needs to change or be improved toprevent similar accidents in the future? Engineering Controls Administrative Controls Training Controls


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Completed ReportCompleted Reportj Signed by

investigationmembers

j Signed byinjured employee

j F orwarded to

claims management


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Send & F ile ReportSend & F ile Report

j After developing a formal report,forward it for review & action.

j F ile a copy of the report and all raw data,photos, interview notes, etc. in a singlefile


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SummarySummaryj Investigate accidents immediatelyj Determine who was involved and

who witnessed itj Ascertain what items or equipment

were involvedj Record detailed descriptionj Determine causal factorsj Conduct corrective actions


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1. It is best to interview witnesses all together inorder to save time. True or F alse

2. Name two environmental factors that may beinvolved in an accident ________________,

________________.

3. Define a minor accident according toinvestigation procedures: __________________________________.

4. The main reason for investigating accidents is

to fix the blame somewhere. True or F alse5. Employees need to report injuries only if they

think they need to see a doctor. True or F alse


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6. Prior to arriving at the accident scene, oneteam member should have taken the

__________________.7. Describe at least 2 factors to investigate about

the injured employee: ______________, _____________.

8. How could the time of the accident beconsidered a causal factor?_______________.

9. Describing the general accident location

is adequate for the report. True or F alse10. Describe at least 2 factors to investigate

when equipment is involved: ____________, _____________.

Accident Investigation Revised

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