Incident Report Form

It is important to develop a strong culture of incident reporting, no matter how minor, as all reported incidents should be used as valuable lessons in how to prevent a recurrence.An investigation should concentrate on identifying what actions or events led to the incident, and to identify strategies to ensure that the incident is addressed and controlled. Outcomes of investigations will strengthen the safety systems and methods of work within a company.

Information to be completed on an Incident Report Form is:

• What was the Incident/near miss?
• Where there any injuries? (Note: Any injuries require an Incident Report Form to be completed)
• Was there any damage to property or plant?
• What caused the incident? (List what factors you feel led to the incident. Possible causes are, lack of training, ineffective guarding, poor systems of work, miscommunication, poor housekeeping, lack of maintenance, or inexperience.)
• What actions will be taken to eliminate future repeats of the incident? Look at adopting the “Hierarchy of Control” method to decide what action to take to prevent the incident happening again
• Management comments.

Management must ensure that the incident:

• has been discussed with all parties involved
• has been controlled to a level acceptable by all parties involved
• has not created any new issues
• can be considered as controlled and able to be signed off as closed

Below is an example of HSSE world Incident Report form to be used for reporting any type of incident working at work site including juries, LTI, property damage ,vehicle incident , fire and more

To learn and read more about Accident incident investigation CLICK HERE

watch the video of how to use the incident report form