INCIDENT NOTIFICATION - Part 1

The reporting worker must fill out and complete the Incident Notification which is submitted to the Site Supervisor & a copy to the reporting worker. The Site Supervisor will review the information provided to determine if further investigation is required. 

INCIDENT INVESTIGATION - Part 2

The investigation is to be completed by the Site Supervisor and/or designee in cooperation with any additional persons (i.e. H&S Dept, H&S Committee, affected worker, etc.) to update and/or confirm initially reported information and close out or assign additional corrective action to prevent future loss. 

INCIDENT REVIEW - Part 3

The completed investigation is sent to the responsible Manager for review and additional comments and corrective actions as necessary. 

 *Please remember to take photos of the scene, equipment, damage, etc., and gather statements from affected workers whenever it is reasonably practicable to do so*

Incident Hazard Identification

Identify ALL factors that may have contributed to the incident.

You must submit the information in this section to your designated reporting person within 48 hours from the date of occurence OR from the date of first report.

Investigations should be completed as soon as reasonably practicable. Begin collecting information immediately.

Affected employee statement of events and factors that may have contributed to the incident:

 

Root Cause Analysis

For every incident, a root cause analysis helps us identify system deficienies that may have contributed to the event.

The responsible manager and/or HSE representative will review the information collected during the investgiation to determine the causal factors related to the incident.

 

A corrective action should be assigned to address each causal factor identfied during the investigation. 

Direct Causes (Worker Level)

Basic Causes (Supervisor Level)

Root Causes (Management Level)

The total risk factor (TRF), is based upon the severity, liklihood for recurrence and how often the situation arises.

On a scale of 3 - 12, with 12 being the highest risk factor and most serious.

3-5: A minor incident with low exposure and liklihood of recurrence, requires apporpriate corrective actions within a fixed time period.

6-8: An incident with medium risk, requires modification to processes and corrective action within a week

9-12: An incident with serious outcomes and liklihood of recurrents, requires immediate attention and corrective actions.  

IMPORTANT - In the event an incident is ongoing at the time of the investigation, be sure to maintain a record of corrective measures implemented, discussions with affected personnel and any other pertinent information as applicable to the event.