What is accident?
An unfortunate incident that happens unexpectedly and unintentionally, typically resulting in damage or injury.
An accident or a mishap is an incidental and unplanned event or circumstance, often with lack of intention or necessity. It usually implies a generally negative outcome which might have been avoided or prevented had circumstances leading up to the accident been recognized, and acted upon, prior to its occurrence.
A solid accident and incident investigation process is a critical component of an effective safety program. After all, if you complete a thorough investigation and determine why an accident or incident occurred, you have the information and knowledge for preventing a future occurrence. The way to successfully accomplish this critical task is by drilling down to the root cause.
Engaging in a methodical, systematic, and comprehensive root cause analysis is a proven method for achieving success. When properly structured, implemented, and followed, it is one of the most effective and efficient methods for performing investigations.
- Equipment failure
- Procedure failure
- People failure
- How did it failed?
- Hope the inspection was not carried out?
- If carried out, no seriousness was maintained by the observer?
- If it was then why the observation was not reported?
It is far better to learn from incidents, from the events that did not result in loss but could have, if the circumstances would have been different. For that, you also need a risk classification system, to assess what could have happened, just in case …..
By the way …. a risk classification system could also be used when evaluating deviations noted during inspections or behavior observations. If fact, the substandard acts or conditions observed could result in loss …. if the circumstances would have been different.
Determining the potential risk is the objective of risk classification. The outcome of the risk classification process helps to determine:
- which levels of management should be involved
- which investigation methods should be used
- whether a team approach should be used to contribute to investigation and analysis; possibly including (external) expertise
- the management level of the team chairperson
- selecting remedial actions and deciding budget provisions
- Know what happened – register facts for communication and cause analysis
- Know why it happened – carry out cause analysis
- Know why the consequences were what they were – evaluate post event actions
- Know what to do – so it won’t happen again
- Carry out remedial actions – make sure they will be done well and on time; assign responsibilities
- Let others know – communicate and report so they will learn as well
An organisation can “learn” by storing the information in a database so it can be retrieved at a future date …. if someone remembers to check the database. Better, the reasons why the accidents occurred should be translated into safe work methods, procedures and into the management system. It then becomes part of the organisations “memory” or, if you want “the way we work”.