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    Who is Responsible for Investigating

    the Incident / Accident?

    The Supervisor has the

    Ultimate Responsibility!!!

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    Why Should a Supervisor Have to

    Investigate?

    Supervisors Expertise:

    Employeesknowledge of the employees under

    them.

    Managingevaluates and supervises the

    employees conduct. Equipmentknowledge of the equipment used

    within their work area.

    Environmentknowledge of the work area(s).

    Methodsknowledge of work procedures.

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    Definitions and References

    EmergencyA serious situation or occurrence that

    happens unexpectedly and demands immediate

    action.

    Accident1.a. An unexpected, undesirable event.

    1.b. An unforeseen incident. InjuryDamage or harm.

    IncidentAn occurrence or event that interrupts

    normal procedure or precipitates a crisis.

    * definitions come from the third edition of the American Heritage College

    Dictionary copyright 1997

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    Investigating the Incident / Accident

    Step 1Preparation

    Step 2 - Initial Response and Reporting

    Step 3Identify the Causes (Root Cause

    Analysis) Step 4 - Results

    Step 5Corrective Actions

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    Investigating the Incident / Accident

    Step 1Preparation

    Are you prepared to conduct an

    incident / accident investigation?

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    Step 1Preparation

    Supplies and Equipment for the Investigation

    Come prepared with the following in the field:

    Pen and extra paper

    PP-HR Incident / Accident Investigation Checklist

    (available online athttp://www.busfin.uga.edu/forms/)

    Camera

    Caution Tape

    Witnessto verify conditions

    http://www.busfin.uga.edu/forms/http://www.busfin.uga.edu/forms/
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    Step 1Preparation

    Important Paperwork

    Do you have the following in your workplace?:

    Written Emergency Response Procedures.

    Written Standard Operating Procedures (SOP) forthe work assignment.

    Written Incident / Accident Investigation StandardOperating Procedures (SOP).

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    Step 1Preparation

    Forms

    Do you have access to the following documents?:

    Supervisors Gu ide to the WorkersCompensat ion Process-http://www.hr.uga.edu/work_comp_guidelines.html

    UGA Human ResourcesWorkers Compensat ionFirst Report of Injury-https://jobapp.humanres.uga.edu/EMPCOMP/first_report.pdf

    UGA Human Resources Workers Compensat ionPanel of Physicians-http://www.busfin.uga.edu/benefits/workers_comp_panel.pdf

    http://www.hr.uga.edu/work_comp_guidelines.htmlhttps://jobapp.humanres.uga.edu/EMPCOMP/first_report.pdfhttps://jobapp.humanres.uga.edu/EMPCOMP/first_report.pdfhttp://www.busfin.uga.edu/benefits/workers_comp_panel.pdfhttp://www.busfin.uga.edu/benefits/workers_comp_panel.pdfhttp://www.busfin.uga.edu/benefits/workers_comp_panel.pdfhttp://www.busfin.uga.edu/benefits/workers_comp_panel.pdfhttps://jobapp.humanres.uga.edu/EMPCOMP/first_report.pdfhttps://jobapp.humanres.uga.edu/EMPCOMP/first_report.pdfhttp://www.hr.uga.edu/work_comp_guidelines.html
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    Step 1Preparation

    Forms continued

    Do you have access to the following forms?:

    UGA Human Resources Workers Comp Wage

    Statement-

    http://www.busfin.uga.edu/forms/workers_comp_wage_statement.pdf

    Fam ily Medical Leave Act (FMLA) information

    http://www.hr.uga.edu/fmla/fmla_intro.html

    http://www.busfin.uga.edu/forms/workers_comp_wage_statement.pdfhttp://www.busfin.uga.edu/forms/workers_comp_wage_statement.pdfhttp://www.hr.uga.edu/fmla/fmla_intro.htmlhttp://www.hr.uga.edu/fmla/fmla_intro.htmlhttp://www.busfin.uga.edu/forms/workers_comp_wage_statement.pdfhttp://www.busfin.uga.edu/forms/workers_comp_wage_statement.pdf
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    Investigating the Incident / Accident

    Step 2 -Initial Responseand Reporting

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    Four Groups for Initial Response and Reporting:

    Emergency Reporting

    First Aid and Medical Care

    Incident / Accident Reporting

    Isolation of Area and Lock-out / Tag-out

    Step 2 - Initial Response and

    Reporting

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    Step 2 - Initial Response and

    Reporting

    Emergency Reporting

    Was an emergency reported to the University of

    Georgia (UGA) Public Safety Department at 706-

    542-2200? Make sure to immediately report

    criminal or suspicious activity to UGA Public Safety

    as well.

    Who reported it?

    What was reported?

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    Step 2 -Initial Response and

    Reporting

    First Aid and Medical Care

    Was first aid administered and who administered it?

    What assistance did they provide?

    What was the nature of the injury?

    When (date & time) and where was first aidadministered?

    Was the accident/injured person taken to thehospital? Specify the hospital or clinic.

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    Step 2 - Initial Response and

    Reporting

    Incident / Accident Reporting

    Has the incident been properly reported?

    Was the UGA Physical Plant DepartmentHuman

    Resources (PPD HR) office contacted at 706-542-

    1141?

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    Step 2 - Initial Response and

    Reporting

    Incident / Accident Reporting continued

    If necessary, have the following forms beencompleted?:

    1.) UGA Incident/Accident Report (*different from

    Accident/Incident investigation checklist form).

    Supervisor must submit to Physical Plant HRwithin 24 hours of incident/accident.

    Submit report for all incidents and accidents

    2.) Workers Compensation First Report of Injuryor Occupational Disease ( Physical Plant HR

    will complete)

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    Incident / Accident Reporting continued

    3.) Workers Compensation Payment Election

    Form (Physical Plant HR will complete)

    4.) Authorization and Consent to Release

    Medical Information ( Physical Plant HR willcomplete)

    Was Workmans Compensation (Amerisys)contacted at 1-877-656-7475 for injuries requiringmedical treatment?

    Step 2 - Initial Response and

    Reporting

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    Isolation of Area and Lock-out / Tag-out

    Was the area isolated after the accident / incident to

    prevent further injury? How was the area isolated?

    Was the area roped or taped off to prevent access?

    Were any barricades put in place?

    Step 2 - Initial Response and

    Reporting

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    Isolation of Area and Lock-out / Tag-out continued

    Were any warning signs put in place?

    Was machinery or equipment locked-out and

    tagged out after the accident / incident?

    Step 2 - Initial Response and

    Reporting

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    Five Major Groups of Accident / Incident Causes:

    Man

    Material

    Method

    Management Environment

    Step 3Identify the Causes

    (Root Cause Analysis)

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    MethodManagement

    Environment

    ManMaterial

    cause 1

    cause 2

    cause 1

    cause 2

    cause 1

    cause 2

    cause 1

    cause 2

    cause 1

    cause 2

    Fishbone Diagram Applied to the Five Groups

    Results

    Step 3Identify the Causes

    (Root Cause Analysis)

    S 3 Id if h C

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    Man (Personnel)

    * this includes the injured and co-workers at the scene.

    What was the level of experience of personnel?

    Did personnel have proper training?

    Were personnel able to meet the jobs physicalrequirements?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Man (Personnel) continued

    * this includes the injured and co-workers at the scene.

    Did personnel have any health concerns that may

    have contributed?

    Is there a history of on the job injuries with theemployee?

    Was exhaustion or fatigue a factor?

    Was stress (work or personnel) or substance abuse

    a contributing factor for the injury?

    Does the incident appear to be legitimate?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Man (Personnel) continued

    * this includes the injured and co-workers at the scene.

    Was someone in an area they should not have been?

    Was the work identified?

    Were hazards identified in the work area?

    Was there a breakdown in communication?

    Was horseplay, negligence, or criminal activity present?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Material (equipment, raw material or other)

    Did the equipment or raw material fail?

    What was the cause of the failure?

    - design flaw, maintenance, improper use or

    installation, etc Had the equipment been altered or repaired?

    Did the equipment have proper protection in place?

    - belt guards, cab role over bars, etc

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Material (equipment, raw material or other)continued

    Was appropriate Personal Protective Equipmentcorrectly used?

    Did hazardous materials contribute to the accident /

    incident?- chemical, biological, and radiological

    Could contact with these substances have beenprevented or minimized?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Method (Work Procedure) Were enough personnel assigned to the task?

    Were personnel properly trained?

    Were safe work practices and procedures beingused?

    Did conditions change to make the currentprocedure in place unsafe?

    Procedure

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Method (Work Procedure)continued Did time constraints alter the procedure in place?

    Were the right tools, equipment, materials, andpersonal protective equipment available for thetask?

    Were tools, equipment, materials, and personalprotective equipment used correctly?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Method (Work Procedure)continued Was the speed at which the work was done a

    concern?

    Was the task at hand evaluated for hazards?

    Were warning signs (i.e. Men at Work, Danger, etc.)

    posted if necessary in visible locations?

    AuthorizedPersonnel Only

    Danger

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Management Did the manager (supervisor) have proper training

    or knowledge for the work being done?

    Did the management communicate safety rules topersonnel (including the injured)?

    Were written work and safety procedures in placeand available?

    Were safety policies enforced with consistency?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Management continued Was there appropriate oversight of work

    operations?

    Were safety complaints acted on? What was done?

    Did management ensure proper training of

    personnel?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Management continued Did management identify hazards to employees?

    Did management make sure proper equipment andmaterials were available?

    Did management understand their authority at a job

    site?

    Step 3Identify the Causes

    (Root Cause Analysis)

    St 3 Id tif th C

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    Environment Where and what time did the accident / incident

    occur?

    What was the topography (slope of the landscape)if relevant?

    Were there any obstacles in the work area?

    Step 3Identify the Causes

    (Root Cause Analysis)

    Step 3 Identify the Causes

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    Environment continued Was housekeeping a contributing factor?

    Were noise, vibration and other distractionspresent?

    Were hazardous conditions present?

    - dust, gaseous or fumes, etc

    Step 3Identify the Causes

    (Root Cause Analysis)

    Step 3 Identify the Causes

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    Environment continued What was the light conditions at the work area?

    What was the weather at the time of the accident /incident?

    Was it hot or cold in the actual work area? (i.e.

    outside, in freezer, culture room)

    Step 3Identify the Causes

    (Root Cause Analysis)

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    Step 4Results

    What do the results of the investigation point to as theroot cause? Which one of the following is it?:

    Man

    Material

    Method

    Management

    Environment

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    Step 5Corrective Actions

    What are you going to do to address the particular identifiedcause(s)? Document any corrective action or changes inprocedure.

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