A productive accident investigation focuses on identifying flaws in the process leading up to the incident and the safety procedures that were meant to prevent it from occurring. The goal is to implement the knowledge you gain to prevent another incident from occurring in the future.
First, notify emergency responders, attend to injuries and damage, and inform all appropriate personnel (and the workers’ family members).
Be sure to secure the site so proper investigation can take place. You may have to shut down any work in progress and block access to materials and equipment that may have been involved in the incident. Avoid tampering with evidence and exposing workers to additional hazards as much as possible. Then, determine the depth of investigation the particular incident warrants.
Next, you will need to gather as much data about the incident as possible. It’s critical that this process begins before witnesses forget details and before continuing on with regular work duties compromises any evidence.
Question witnesses and have them complete and sign statements about what they saw. These findings should be documented, even if they say they didn’t see the incident, because that note will be useful if stories change down the road. The purpose of questioning is to collect as much information as possible about exactly what occurred.
Gather any documentation from equipment logs to photos and diagrams of the accident scene. As the investigator looks over what’s collected, it’s important to identify any gaps in the information and attempt to fill those gaps with further investigation.
Typically, it isn’t practical to keep the site of the incident secure while the investigation proceeds. Once the investigator feels they have obtained all of the information that’s available (and preserve any evidence items), the site can be cleared to continue regular operation.
Analysis & Documentation
The investigator should then have access to all of the available data and be prepared to determine what happened and how. It’s best to organize all of the events by listing them in chronological order, providing a step-by-step recounting of the incident; and then organized logically, to show how specific aspects related to others. This makes it much easier to determine everything that the investigator knows, along with any unknown aspects, to determine a probable cause.
Documentation is a key component to any safety program, and is particularly important when investigating accidents. Collect all the facts so that everyone is working from the same information and can refer back to it. A report becomes extremely beneficial if litigation becomes necessary, since that generally occurs many months or even years after the actual incident. Be sure there is a clear summary of what happened, the investigator’s conclusions, and all of the backup documentation (photos, witness statements, etc.)
Investigation value lies in preventing future incidents, emphasizing why sharing the report’s findings and recommendations with all workers is crucial. The better everyone understands the conditions contributing to the incident, the less likely those situations will be repeated.
Sharing these results encourages workers to make the right choices in the future. Note that if litigation is pending and details could create additional exposure, it’s best to have legal counsel review any information before it’s released.
Implement the investigator’s recommendations and make necessary changes to processes and procedures to prevent repeat incidents. Regular follow-ups are a must, ensuring that the correct steps are being taken. That way, the time and energy that have been invested into the accident investigation will have been worthwhile.
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