Easy Incident & Accident Investigations

1. Easy Incident & Accident Investigations Presented by Joe Angyus, CSP October 7, 2009

2. Three Common Myths • Accidents, by definition, “just happen” • Many accidents are caused by “stupidity” • No accidents = safe workplace

3. Establish an investigation process • Determine what to investigate; • Who will investigate; and • Write policy on investigation procedure “Those designated simply have to take the time, understanding that, in the long run, inadequate investigations will cost them even more time” • Frank Bird, Jr., Practical Loss Control Leadership

4. Employees who: Fear Have concern Want to avoid Misunderstand Won’t report! But when employees: Buy in Perceive importance See the value Believe in end goal They’re more likely to report! Reporting incidents

5. Phases of Investigation • Initial actions at the scene • Gather information (Four P’s) • Analyze all significant causes • Develop and take corrective actions • Write the report • Review the findings and recommendations • Follow up to verify effectiveness of the actions

6. Initial actions at the scene • Take control • Ensure first aid, call emergency services • Control secondary incidents • Identify sources of evidence • Preserve evidence • Determine loss potential • Notify personnel

7. Gathering Information • Interviewing witnesses (people) • Photos, sketches, or maps (positions) • Equipment exam (parts) • Material failure analysis • Records check (paper)

8. Write a good description • Description should contain: • What was the injured attempting to do? • What went wrong? • What was the outcome (loss)? • Be thorough, but keep it simple!

9. Writing a good description • What was the injured attempting to do? The injured was attempting to replace a defective air valve by using a 12 ft. step ladder.

10. Writing a good description 2. What went wrong? Since it wasleaning unsecured against the air receiver tank, the ladder slipped outward as the injured climbed to access the valve.

11. Writing a good description 3. What was the outcome (loss)? The injured fell 7 ft. to the floor beneath the tank, striking against hydraulic lines causing a fractured left collarbone and significant bruising to his right arm and shoulder.

12. Analyze significant causes • Start with the event (loss) • Work backwards by asking “why” • Identify the unsafe acts/conditions • Don’t stop at “symptoms” • Determine system failures

13. At the scene With the people involved By the frontline leader Examples: Re-instruct the injured Replace the tool Take immediate corrective actions

14. Identify and correct system deficiencies Types of system deficiencies could include: Standards for tools and equipment selection, use and inspection Training program Employee observation Management controls Take long-term corrective actions

15. Review the findings and recommendations • Management’s role in investigation process: • Demonstrates importance • Verify problems solved • Determine who else needs to know • Identify why the safety program didn’t adequately control the hazard

16. Follow up to verify action effectiveness • Evaluate how systems are working after actions taken • Circle back with injured employee

17. ? ? ? If you have further questions, please contact: Joe Angyus ~ joe_angyus@toc.org 800-733-8621 Questions?