All modern manufacturing facilities are using principles that “all accidents are preventable” but sometime incidents or even accidents are still can happen.

It is important to gather as much data and analyze it to prevent recurrence.

Investigation Report

Let’s review first part – [ Incident Reporting ] A. To be completed by the COMMUNICATOR AT THE TIME OF INCIDENT.

Safety 4M Analysis

All fields in first part (A) of report are self explanatory. Let review “Incident / Accident Description and Evaluations sections.

Description

Detailed the area / part of equipment, what happened, with who and how – attach diagram or picture where applicable in the “Attachment” sheet only.

Evaluations

All sections of evaluations must be filled in order to get Hazard Rating Number (HRN), which will suggest future course of actions.

Degree of Possible Harm

  • 0.1 —> Scratch or bruise;
  • 0.5 —> Laceration or mild ill health effect;
  • 1 —> Break of a minor bone, or minor temporary occupational illness;
  • 2 —> Break of a major bone, or minor permanent occupational illness;
  • 4 —> Loss of one limb, one eye, or serious temporary occupational illness;
  • 8 —> Loss of limbs, eyes, or serious permanent occupational illness;
  • 15 —> Fatality.

Likelihood of Occurrence

  • 0 —> Impossible cannot happen;
  • 0.1 —> Almost impossible possible in extreme circumstances;
  • 0.5 —> Highly unlikely though conceivable;
  • 1 —> Unlikely but could occur;
  • 2 —> Possible but unusual;
  • 5 —> Even chance could happen;
  • 8 —> Probable not surprised;
  • 10 —> Likely to be expected;
  • 15 —> Certain no doubt.

Frequency of Exposure

  • 0.1 —> Infrequently;
  • 0.2 —> Annually;
  • 1 —> Monthly;
  • 1.5 —> Weekly;
  • 2.5 —> Daily;
  • 4 —> Hourly;
  • 5 —> Constantly.

Number of Personnel

  • 1 —> 1-2 persons;
  • 2 —> 3-7 persons;
  • 4 —> 8-15 persons;
  • 8 —> 16-50 persons;
  • 12 —-> >50 persons.

Hazard Rating Number (HRN)

HRN = DPH * Likelihood * FOE * NOP

  • HRN range 1-3, risk is minimal – No need to make any changes;
  • HRN range 3-9, risk is still low- review existing measures;
  • HRN range 10-15, risk is medium – control measures needs to be reviewed;
  • HRN range 16-20, risk is HIGH – future activity could be stopped;
  • HRN higher then 25,  EXTREME risk – not recommend to restart activity.

Investigation Part using Cap-Do Cycle

5W2H phenomenon tool

Start 1st stage of investigation by determining phenomenon using 5W2H analysis. After it’s done, use 2nd stage to find root cause by using hybrid of RCA and 4M Analysis.

4M Analysis in Lean Six Sigma

Finally, after finding single of multiple causes, proceed to stage 3 and create action plan of countermeasure with assignment of responsible person and completion timeframe.

Investigation action plan

Last section is used to verify and close Incident Report

Health and Safety report closure

If your company requires above mentioned template, do not hesitate to contact us.

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