WHS Incident Investigation Plan Template

The overall purpose of an incident investigation is to identify all of the factors that contributed to the injury, illness or fatality. The key outcome from an investigation is to prevent the same or similar incident from happening again. This can be achieved through consultation, research and analysis into the root causes of the incident and the development of a mitigation plan to eliminate or minimize the risks in the workplace.

When developing your incident investigation plan, you need to be clear about your objectives and have a firm understanding of your organisation’s existing incident investigation policy, procedures and processes including information gathering techniques and root cause analysis tools. Effective incident investigation plans ensure the purpose scope and objectives are relevant to the nature and scope of the incident that is being investigated. Objectives must be based on realistic and measurable objectives and include appropriate actions, timelines, schedules of tasks and responsibilities for investigation team members.

Your incident investigation plan will include the following elements:

· Incident investigation overview

· Incident investigation team overview

· Incident investigation strategy

· Consultation and communication strategy

· Risk management plan

· Time-line of events

· Mitigation strategy

· Reporting and monitoring requirements

Keep it up to date

Planning your incident investigation approach should be a well-planned, holistic and thorough process involving extensive research, consultation and communication with key witnesses and stakeholders. Throughout the implementation of your plan, you will need to revisit many of the ideas and strategies outlined in this document. By referring to your plan and updating it regularly, you will ensure that your incident investigation activities are heading in the right direction.

How to use this template

Prior to completing this incident investigation implementation plan template, consider the following:

1. Gather together your key business documents. Before you begin, gather together your key business documents. This includes business plans, budgets, and action plans. Having the right information on hand will mean you can be more accurate in your.

2. Take your time and consider your specific needs. Work through the template at your own pace. Start by deciding which sections are and set aside the sections that don’t apply. You can always go back to the other sections at a later date.

3. Decide on your audience. It’s also important to consider your audience when writing your. Will the plan be used internally? Or will you be sharing it with others? Deciding on the purpose of the plan can help you target your answers appropriately.

4. Use the [italicised text]. The italicised text is there to help guide you by providing some more detailed questions you may like to answer when preparing your responses. Of course, if a question does not apply to your circumstances it can be ignored.

5. Ask for some assistance. If you aren’t confident in completing the incident investigation plan template yourself, you can enlist the help of a WHS professional (or business adviser or accountant) to look through your plan and provide you with advice.

6. Review your work. Avoid mistakes by asking a number of impartial people to proofread your final plan..

7. Print. The [italicised text] is instructional and will disappear on “preview print” or “print”. To print a copy, select the Printer icon on the toolbar, or select File then Print on the main menu. FORMATTING WILL NEED TO BE COMPLETED

Incident Investigation Plan

Prepared: [Date prepared]

WHS Incident Investigation Plan Template 1

Keep it up to date 1

How to use this template 2

Table of Contents 4

Incident Investigation Overview 5

Duty holders: 5

Incident Investigation Objectives 5

Purpose statement: 5

Incident Investigation Team Overview 6

Incident Investigation Strategy 7

Task Schedule 9

Period 9

Consultation and Communication Strategy 11

Supporting documentation 12

Glossary 13

Incident Investigation Overview

Incident background:

[Provide a brief explanation of the background of the incident including key details, nature of incidents and losses suffered, parties involved and apparent or immediate causes.]

Duty holders:

[Who are the key duty holders under WHS law for implementing the incident investigation plan? List their names, titles and specific responsibilities.]]

Incident investigation framework:

[Explain the structure of the incident investigation system based on your organisation’s incident response and reporting policy and procedure. This may include a bullet lists, an illustration and/ or description.]

Incident Investigation Objectives

Purpose statement:

[What is the overall purpose of conducting the incident investigation? Ensure this statement is specific to the nature and scope of the incident event.]

Incident investigation objectives:

[What are the key objectives for the incident investigation plan? Write these based on as many aspects of the SMART model as possible. Ensure these goal statements are specific to the incident event and reflect integrity of the purpose statement.]

Incident investigation scope:

[Explain the extent and depth of activities that need to be completed to achieve the objectives. These activities may be listed as bullet points, using a flow chart or other illustration.]

Root cause analysis techniques:

[Explain the root cause analysis tools and techniques that are going to be used to discover the underlying causes of the incident.]

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WHS Incident Investigation Plan Template V:1 March2017

Incident Investigation Team Overview

[Explain the members of the incident investigation team, their overall purpose for being involved as well as their individual responsibilities.]

Name/ Title / Purpose / Responsibilities

Incident Investigation Strategy

[Using the following table, explain the activities that will be implemented to conduct the incident investigation. Use column 1 to list the name of the activity. In column 2, explain the task or area in the workplace where the activity will be implemented. In column 3, describe the details of each activity that must be completed. Use column 4 to list any resources that need to be acquired or purchased to complete the activity. Finally, use column 5 to list the responsible person/s for implementing the activity.]

Activity/ Method/ Tool / Task/ area / Description for use / Resources required / Responsible persons /

Task Schedule

[Using the Gantt Chart system, list all of the activities in order, that need to be achieved based on your incident investigation strategy. List these in the left hand column. Determine your period for the schedule, e.g. weekly, or monthly, based on the proposed completion date and group the cells in the second row. Draw a joined line identifying the time you believe is needed to complete each activity across the table. Consider any activities that can run simultaneously with others. Consider grouping tasks together for each hazard/risk using colour codes for simplified tracking]

Task /

Period

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5.
6.
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8.
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10.
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13.
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Estimated time-frame: ¾¾¾¾¾¾¾¾¾¾¾¾ Actual time-frame: ------

Consultation and Communication Strategy

[Your consultation and communication strategy must describe the key audience segments within your organisation and their information requirements, including incident investigation team members, workers as well as other internal and external parties who may require information throughout the process. Explain who is responsible for communications, timeframes and what methods will be used to communicate with key parties.]

Stakeholder / Information needs / Responsible persons / Communication methods / Time-frame for completion

Supporting documentation

[Attach any supporting documentation in relation to this incident investigation plan such as incident investigation framework, reports, recommendations or communication with key stakeholders. List all of your attachments here.]

Glossary

Consultation – Two-way communication between PCBUs and workers of WHS matters that aims to involve workers in decision making processes and develop engagement within the workforce

Corrective action – any reactive control used to fix a fault in the WHS system, environment, process or correct a human errors following an injury, illness or fatality

Hazard – a source of danger that has the potential to cause harm

Incident – Any unplanned event resulting in or having a potential for injury, ill health, damage or other loss

Mitigation strategy – a plan that aims to address a hazard or risk and contribute toward the prevention of similar incidents. These may include preventative and corrective actions

Notifiable incidents – the death of a person; a serious injury or illness of a person; or a dangerous incident

Preventative action – any pro-active control used to prevent injury, illness or a fatality

Risk – the effect of uncertainty on objectives

Risk assessment – the process of identifying, analysing and evaluating a risk to determine the likelihood and consequence of harm to people, property and the environment

Risk control – the process of either eliminating the risk, or using other methods such as isolation, engineering, administration or PPE to minimise the risk level

Risk identification – determining the sources of risk, cumulative effects of multiple hazards, consequences to the business, likely events as well as their causes and potential impacts to the business

Stakeholder – any person who has an influence on, or is influenced by the marketing activities of your business

Workplace fatalities – a work-related death. The victim may be a worker or other person such as a customer or visitor