Incident Investigation Report Template
v2.4
Purpose. This template is used to write the investigation report for any injury, high potential incident, environmental event or significant near miss, using the incident cause analysis method.
1.Purpose
An investigation finds out what happened, why the controls failed and what will stop it happening again. This template gives every investigation the same structure so that findings can be compared across sites and actions can be tracked.
2.Investigation team
The site manager appoints an investigation leader who is trained in the incident cause analysis method and who was not involved in the event. The team must include a worker representative and, where relevant, a subject matter expert. High potential incidents require the HSE and Training Manager on the team.
3.Gathering the facts
Preserve the scene, take photographs and measurements, download plant data, collect the prestart, Take 5, job hazard analysis, permits and training records, and interview each person separately within 24 hours. Record facts, not opinions.
4.Analysis
Build a timeline, identify the absent or failed controls, and trace each one to its organisational cause: procedure, training, supervision, design, maintenance or management of change. Rate the actual and potential consequence using the risk matrix.
5.Actions
Write actions that fix the organisational causes, in order of the hierarchy of controls, each with an owner and a due date. Enter every action in the Hazard and Incident Register. Share the learnings at prestart across all sites.
6.Approval and reporting
The site manager approves the report. High potential incident reports must go to the General Manager Operations and, where required, to the regulator within the time the law allows.