Incident Report Form NZ (Free Template for Workplaces)

Simple incident report (short incident investigation) template

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Full incident report (complex incident investigation) template

When an incident arises the effort applied to investigating what happened, why and what lessons can be learnt from it will vary according to the nature of the incident. Most incidents are minor thus the “investigation” tends to be cursory and not apply a great deal of science. This approach may be totally appropriate, but not for more serious events which have more significant actual or potential consequences.

When it comes to incident investigation ICAM is the qualification most frequently cited in NZ. This is not because ICAM is particularly earth shattering or unique, rather it is about all there is in NZ if looking for an Incident Investigation qualification. Around the world there are a host of models – from a 4-step model (like ICAM) right through to 9 steps. Take your pick, but the reality is they are all pretty much the same. What they do is provide a structure to use in conducting an investigation – which is better than nothing.

A standard Incident investigation template is provided HERE.

The real issue is not what template to use but how the investigation is conducted. At the risk of adding the model collage, the Winsland experience is it boils down to the following;

1. Collect facts
2. Photographs aid understanding – take them
3. A timeline provides a good visual overview of what happened.
4. The investigation is as good as the data which is where interviewing enters the picture. In terms of interviews;
   1. They must be timely – as time passes memories fade, stories shared etc.
   1. Its ok to probe – don’t just record the conversation. You are looking for Root Cause thus revert to childhood and keep asking why, ask what the person was thinking, how they felt about what happened. Get their view on why things happened and follow up to verify.
   1. It needs to be safe. If it is not OK to make genuine mistakes in the organisation people may feel threatened shape their answers accordingly. Take this into account. Verify wherever possible.
   1. Don’t rely on others, to interview – managers tend to weed out or fail to see things an independent person would not.

• Analyse facts
• identify both direct causes (obvious) – ask;
  • What were the things that lead to the incident occurring?
  • what things designed to stop this happening failed and why?
• Root Cause Analysis (RCA) yet another grand sounding term which really means you should look at the whole picture for things that allowed what happened to occur. This will include (PEEPO);
  • People,
  • Environmental,
  • Equipment,
  • Procedures
  • Organisational 
• Remember use the Five Whys – don’t just accept “that is the way it is””, rather ask “why is it that way?
• Maybe group findings under headings in the form of a Fishbone diagram (people love a picture) and it gives some order

• Develop corrective actions
• Identify the priorities
• Ask those involved for ideas
• Take expert advice where required

• Reporting
• Write up a formal incident report for internal consumption.

It may be appropriate to share this with those who were involved in the incident to identify errors, assist with ownership and encourage people to contribute honestly.

• Write up any safety alerts – to communicate lessons learnt to a workforce

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Winsland support for incident investigation

More serious events—especially those involving lost time injuries or system failures—require a full investigation by trained professionals. Independent investigators remove the internal barriers and provide assurance that root causes are identified. This is where Winsland incident investigation support comes in.

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Managing incidents through the Winsland health and safety APP

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Useful links

Sitewise – useful templates for incident investigation and reporting

ACC – details of ACC incident reporting of health and safety incidents