Sample Template

Title: Incident Investigation / Date of Issue: March 2010
Approved by: / Review / Revise Date: March 2011
Location: all facilities

Purpose

To recognize and identify all immediate and root causes of the injury/incident and make the necessary recommendations to prevent the injury/ incident from recurring.

Scope

Review quarterly reports of the following injury/incident types to determine any additional investigative needs:

  • First aid
  • Health care
  • Near miss

The results of the review must be documented including corrective action (timeframe, responsibility, follow-up) that is required.

Definitions

Hazard / Any condition or practice or thing that has the potential for harming people, or damaging equipment, materials or the environment, but has yet to do so
Near Miss / An undesired event or unusual occurrence that is caused by one or more hazards in the workplace. Typical near-miss incidents occur when someone interacts with a hazard but does not require any medical intervention.
Incident / An undesired event that results in harm to people and/or damage to equipment, material or the environment.
First Aid Event / A non-life threatening injury that does not require a visit to a medical practitioner.
Health Care Incident / An incident resulting in a visit to a regulated health professional/health care providerfor the purpose of diagnosing and prescribing medical care as a result of an injury at work.

The following categories of injury/incidents may produce a loss to people, equipment, material and/or environment. Immediate investigation of the following is required:

Lost-time Incident / An incident resulting in time away from work beyond the regular scheduled shift
Critical Injury / As defined in the Ontario Regulation 834/90
Fatality / An injury that results in loss of life
Property Damage / An event where contact is made between two objects resulting in alteration of one or both of the objects
Occupational Illness / A condition that results from exposure in a workplace to a physical, chemical, biological or ergonomic agent to the extent that normal physiological mechanisms are affected and the health of the worker is impaired
Environmental Release / An accidental discharge of a physical, biological or chemical substance into the workplace and/or community
Fire/Explosion / An event where undesired combustion occurs.

Communication

The results of the injury/incident will be communicated to the employees in a number of ways:

  • Minutes of the JHSC meetings
  • Team meetings or other staff meetings
  • Postings on safety bulletin board or staff newsletters

The JHSC will assist in all areas with remedial actions and recommendations.

Notification requirement:

  • Critical and fatal injuries (under Critical injury regulation) require you contact the Ministry of Labour, JHSC/HS representative and trade union if any immediately and a written investigation report must be completed and sent within 48 hours to the Director.
  • If a person is disabled from performing his/her usual work or requires medical attention the employer shall within four days of occurrence, give written notice of the occurrence containing the prescribed information to the JHSC/HS Representative and Trade Union if any.
  • If an employer is advised that a worker has an occupational illness or a claim in respect of an occupational illness has been filed with WSIB the employer shall give in writing, within four days of being so advised, a report to a Director, to the JHSC/HS Representative and to the trade union in any.
  • Fire and Explosion (Ministry of Labour) (Immediately, if it results in an injury)
  • Chemical Releases (Ministry of Environment) (Immediately)
  • Lost time, Health Care, Modified work required as a result of first aid and only extending beyond 7 days. (Workplace Safety and Insurance Board) (Form 7 completed within 3 days of being advised of the injury and submitted to WSIB within 7 days)

Roles and Responsibilities

Manager/Supervisor

  • Ensure that the injured employee(s) receives appropriate medical care
  • Arrange transportation to a hospital, doctor’s office or employee’s home if necessary
  • Secure the scene of the incident (do not distrurb the scene in the event of a critical injury or fatality except to relieve human suffering or carry out an essential service)
  • Investigate the injury/incident and completes the Incident Investigation form within 24 hours of the injury/incident.
  • Contact a worker representative from the JHSC designated to investigate the injury/incident, to assist with the investigation if required
  • Notify appropriate internal and external personnel as soon as possible

Employees

  • Promptly report incident to supervisor.
  • Seek medical attention if required
  • Corporate with investigation

Worker designate of the JHSC

  • Investigate all critical injuries and fatalities
  • Conduct an investigation with the supervisor and assist in completion of the report if requested
  • Ensure that the reports are completed

Investigator

Collect Information

  • Interview workers involved
  • Interview witnesses
  • Interview outside experts, if applicable
  • Ensure the interviews are conducted as soon as reasonably possible.
  • Document all necessary information.

Scene assessment

  • Make observations, and use the scene assessment form to document the scene (site, equipment, material).
  • Use photographs/sketches/drawings etc.
  • Create a written narrative (objective) of what happened, include witness statements

Identify Contributing Factors;

  • Factors to consider are People, Equipment, Material, Environment and Process and include what role the factor played.

Write Report

  • Use the injury investigation report form to identify contributing factors through a review of items such as maintenance records, layout, training records, time of day, length of service in this - work area, etc. Consideration is given to lack of safety equipment, enforcement and/or the need for safety equipment.
  • Capture all the requirements contained in the investigation procedure. In some cases, additional forms or documentation may be needed. This might include Witness statements and / or scene assessment forms, police reports)
  • Distribute copies of the investigation report to appropriate personnel, (Health and Safety Co-coordinator, Administrator and JHSC/H&S representative).

Recommendations for corrective action

  • Responsibilities must be assigned for implementation of the recommended actions.
  • Recommendations are documented on the Corrective Action form.
  • The recommendations must focus on corrective actions(s) to all the contributing factors identified.

Recommendations should specify

  • What needs to be done
  • Why it needs to be done
  • When it should be completed

Recommendations are acted upon

  • Responsibility must be assigned to implement the recommendations
  • The actions must be recorded on the company standard form, it must include:
  • what has been done,
  • who has completed the actions, and
  • when the actions were completed.

Training

JHSC members and all supervisor / managers who are required to conduct investigations will receive formal incident investigation training. This training will occur within the first month of appointment to the JHSC or as a supervisor / manager.

Evaluation

This procedure will be reviewed on an annual basis or if an investigation identifies revisions are required.

The Incident Investigation Process will be evaluated by auditing the completion of Incident Reports for identifying contributing factors, corrective actions and follow up of corrective actions has being completed as outlined.

Acknowledge success/Make Improvements:

  • Make improvements
  • Acknowledge and congratulate all supervisors on completing comprehensive investigations and maintaining competency.

Forms / Records

OSACH Fast Fact –How to investigate an incident

First Aid,

Occupational Illness: Requirements to report to the Ministry of Labour,

References

Occupational Health and Safety Act (Section 51, 52)

Regulation 834/90: Definition of Critical Injury

Regulation 67/93: Healthcare and Residential Facilities