Conducting an Accident Investigation
Course 102
Safety Certified Supervisor Series

MODULE 7: WRITING THE REPORT

The Accident Report Form

• Section I. Background
• Section II. Description of the accident
• Section III. Findings
• Section IV. Recommendations
• Section V. Summary
• Section VI. Review and Follow-Up Actions
• Section VII. Attachment

Section IV. Recommendations (continued)

• Sample recommendations that correct primary surface causes
• Sample recommendations that correct secondary surface causes
• Sample recommendations that correct implementation and design root causes

These recommendations describe how to correct those common hazardous conditions and unsafe or inappropriate behaviors that eventually "set up" or produced the unique conditions and behaviors of the injury event. Correcting secondary surface causes is accomplished by improving the implementation of the safety management system. These recommendations will have a general positive impact throughout the work group or organization.

• Implement an effective education and training process covering machine guarding principles for all maintenance and affected employees Benefit: Affected employees will understand and be skilled in identifying and correcting machine guard hazards. Estimated investment: $500.00
• Implement improved employee orientation that includes education and training on hazard reporting procedures. Benefit: New employees will understand and gain skills in appropriate hazard reporting procedures. Estimated investment: $100
• Conduct supervisor/manager training on new policies. Management will better understand and
  gain skills in their responsibilities in response to hazard reports. Estimated investment: $200.