Advanced Safety Management, 3rd Edition

CHAPTER 19INCIDENT INVESTIGATION

Incident investigation in 45001 is addressed in Clause 10 Improvement. Within Clause 10, section 10.2 is titled Incident, nonconformity and corrective action. Duplication of the entirety of Clause 10 as in 45001 appears in Chapter 18.

In this chapter, the entirety of the requirements for incident investigation in Z10.0 is shown, followed by comment on the results of this author's research on incident investigation.

Expectations of management on incident investigation in Z10.0 are pretty much the same as the requirements in 45001.

9.2 INCIDENT INVESTIGATION IN Z10.0

The organization shall establish a process to report, investigate, analyze, document, and communicate incidents in order to learn from the event, improve the management system, and address OHSMS nonconformances and other factors that may be causing or contributing to the occurrence of incidents. The investigations shall be performed by personnel demonstrating competence in investigation procedures, conducted in a timely manner and include worker participation.

Organizations shall ensure that barriers to reporting are removed.

Note 1: The level of documentation should be appropriate to the actual or potential severity of the incident, potential impact, potential learning, or other opportunities for improvement. Lessons learned should be communicated to relevant workers and other interested parties.

Note 2: When appropriate, OHS Incident Investigations should be similar to other ...