Observation template for the 5 safety behaviour patterns

Proactiveness Yes No

“What if” questions is asked in the risk assessment process

Thorough risk assessment is carried out whenever needed

Thinks ahead prior to carrying out a task

Takes in all relevant conditions in the surroundings
Considers what conditions can change during carrying out the work
Continuous improvement approach is part of the natural way of thinking
Attention towards unsafe conditions are ensured
Constant awareness towards possible hazards and unforeseen situations
are ensured

Supports good house keeping

Uses the necessary time needed to find the best possible solution
Respects barriers, safety guards, and signs

Reports important findings e.g. near misses

Involvement Yes No

Acknowledges roles and responsibilities with regard to safety

Participates actively in problem solving processes

Involves other relevant people in problem solving processes
Takes safety initiatives

Intervene when he experiences hazards or poor safety behaviour

Shows appreciation to good safety behaviour
Asks questions to reports, procedures or the like
Presents arguments, solutions and ideas for safety improvements

Discusses safety issues with colleagues

Assertiveness

Express feelings, thoughts, and considerations in a constructive manner

Respects and encourages others to speak up
Gives feedback to colleagues
Asks questions to clarify concerns
Ensures common understanding of the task prior to doing it

Points out what needs to be improved

Confidently raise safety concerns to managers

Confidently raise safety concerns to colleagues

Stops any job that is perceived dangerous

Corrects other colleagues’ inadequate safety behaviour in a
constructive way

Visible

Is a good role model in safety matters

Shows support towards the company’s safety policies and goals
Communicates safety initiatives and efforts on a daily basis

Clearly shows positive attitude towards safety in general

Talks to colleagues about safety
Refers to safety procedures when relevant
Praises colleagues when observing good safety work and initiatives
Takes actively part in safety campaigns

Uses the personal protective equipment

Knowledge based acts

Knows how to do a qualified observation round

Knows all important procedures

Knows vital safety and prevention principles
Knows were to find relevant knowledge

Carries out a thorough risk assessment

Uses time to equip himself with new valuable knowledge
Uses the equipment and tools correctly

Uses the correct personal protection equipment

Overall overview of the safety behaviours observations

After the observation fill in the chart here to get an

overall overview of the person’s strengths and focus areas
to be developed

Overall development

plan Strengths:

Focus areas to develop:

Knowledge
Proactiveness Involvement Assertiveness Visibility
based