Jergi-6 004 Near Miss Reporting Process Rev-00

Jubail Export Refinery
General Instruction
JERGI 6.004
Near Miss Reporting Process
Revision Responsibility 31 October

00 JER Engineering 2008
General Instruction
JERGI xxxxxx
Rev. 00
Near Miss Reporting Process 31 October 2008
Revision Tracking
Revision Revision Date Scope of Revision
0 20 February 2009 Issued for Bid Packages.

First draft issued is based on Saudi Aramco GI-6.004 “Near Miss
00 31 October 2008 Reporting Process” issue date 02 December, 2006. Document was
modified to incorporate amendments and modifications.
This document is the property of Jubail Export Refinery and no parts of this document shall be reproduced by
any means without prior approval by the Company.
Page 2 of 9
General Instruction
JERGI xxxxxx
Rev. 00
Table of Contents
Section Contents Page
1 Scope 4
2 Conflicts, Deviations and Clarifications 4
3 References
4 Definitions
5 General Guidelines
6 Reporting Procedure
7 Communication and Follow-Up
8 Responsibilities
Appendix
1 Near Miss Report Form
Page 3 of 9
General Instruction
JERGI xxxxxx
Rev. 00
1 Scope
1.1 This General Instruction provides a process for reporting, investigating, analyzing,
and communicating near misses in Companyfacilities/operations. The objective is to
use near miss information to identify corrective actions and preventive measures to
reduce injuries and losses. Departments shall use this or a comparable process to
address near miss reporting in their operations.
2 Conflicts, Deviations and Clarifications

2.1 Any conflicts between this standard and other applicable Company Engineering
Standards (JERES), Material Specifications (JERMS), Standard Drawings (JERSD),
Engineering Procedures (JEREP), Company Forms or Industry standards,
specifications, Codes and forms shall be brought to the attention of Company
Representative by the Contractor for resolution.
Until the resolution is officially made by the Company Representative, the most
stringent requirement shall govern.
2.2 Where a licensor specification is more stringent than those of this standard, the
Licensor’s specific requirement shall apply.
2.3 Where applicable Codes or Standards are not called by this standard or its
requirements are not clear, it shall be brought to attention of Company
Representative by Contractor for resolution.
2.4 Direct all requests for deviations or clarifications in writing to the Company or its
Representative who shall follow internal Company procedure and provide final
resolution.
3 References
The selection of material and equipment, and the design, construction, maintenance,
and repair of equipment and facilities covered by this standard shall comply with the
latest edition of the references listed below as of the CUT-OFF DATE as specified
in the Contract unless otherwise noted.
Page 4 of 9
General Instruction
JERGI xxxxxx
Rev. 00
4 Definitions
4.1 Definitions presented in this Standard and other JER documents have precedence
over other definitions. Conflicts between various definitions shall be brought to the
attention of Company Representative by the Contractor for resolution.
Company: Jubail Export Refinery.
Company Representative: A designated person from the Company or an assigned

third party representative.
Company Inspector: A designated person or an agency responsible for conducting

inspection activities on behalf of the Company.
4.2 List of Definitions
A near miss is defined as an event which did not result in injury or loss, but which
had the potential for injury or loss if circumstances had been slightly different.
These may include:

− events where injury or property damage could have occurred but did not.
− events where a major safety system failed to perform as designed, e.g. fire pump
auto start malfunction.
− events where potential environmental damage could result.
Incidents which result in injury, property damage or product loss are typically
reported and investigated according to established procedures, such as GIs 6.001,
6.003, 6.005, and 6.029. Since investigations are generally required for such
incidents, near miss reports are not required, even if there was the potential for more
serious consequences. However a near miss report should be filled out for property
damage (or other) incidents if there was the potential for more serious consequences
and an investigation is not required by other instructions. Note that unsafe conditions
and unsafe acts in themselves are not near misses but may be part of a near miss
occurrence.
The Area Loss Prevention division can be contacted for advice on whether or not a
particular event should be reported as a near miss. In general, any near miss where
“someone could benefit by learning from the event” should be reported and
investigated as an opportunity to improve safety in the workplace.
Page 5 of 9
General Instruction
JERGI xxxxxx
Rev. 00
5 General Guidelines
5.1 Near misses should be openly reported, investigated, analyzed, and communicated
with the objective of sharing lessons learned and taking corrective action to prevent
recurrence and improve safety performance.
5.2 Departments should promote and publicize that near miss reporting is a positive
attribute to be encouraged and supported. Employees must be made aware that they
will not be punished or disciplined for reporting near misses.
6 Reporting Procedure
6.1 Any employee or contractor who believes a near miss has occurred should report the
incident to his supervisor as soon as possible. For contractors or maintenance
personnel the report should be made to the responsible Companysupervisor/foreman
in charge of the facility where the incident occurred. The initial report may be verbal,
in writing, or by e-mail.
6.2 The employee/contractor should fill in a Near Miss Report Form (Supplement 1)
with assistance from the supervisor if required. The supervisor should review and
sign the form and ensure it is routed to the division head.
6.3 Based on the potential seriousness of the near miss, the division head may determine
an additional level of investigation is necessary, such as an engineering review.
(Note: GI 6.003 can be used for guidance on the formation and conduct of
engineering reviews; however for near miss investigations, the selection of team
members and distribution of the report are not required to comply with GI 6.003).
7 Communication and Follow-Up

7.1 On a quarterly basis all departments should review, summarize, and openly
communicate information on near misses within their organization with the objective
of improving safety performance. This shall include trend analyses to identify areas
for improvements in processes, procedures, equipment, and other factors. These
summaries should be communicated to appropriate management, key personnel, and
a copy sent to the Area Loss Prevention division.
7.2 All recommendations from near misses should be tracked within the organization to
completion or resolution.
7.3 For near misses with the potential for serious consequences (e.g., serious
injury/fatality, property damage, product loss, environmental impact) or near misses
Page 6 of 9
General Instruction
JERGI xxxxxx
Rev. 00
with valuable lesson learning potential, both the Near Miss Report Form and the
investigation (if any) should be routed to the Area Loss Prevention division for wider
communication throughout the company as appropriate.
8 Responsibilities
8.1 Department managers
8.1.1 Ensure all aspects of the near miss program are complete, are maintained up to date,
and are implemented adequately.
8.1.2 Encourage and support open reporting where individuals do not fear any negative
consequences from reporting a near miss.
8.1.3 Ensure that corrective actions are properly implemented.
8.1.4 Highlight near misses at Safe Operations Committee (SOC) meetings and ensure that
lessons learned and improvements resulting from near miss reports are publicized
within the department.
8.1.5 Ensure quarterly (at a minimum) analyses and summaries of near misses are
prepared and communicated per paragraph 8.1.
8.1.6 Annually perform an internal review of the near miss program and make
improvements as necessary.
8.2 Division heads
8.2.1 Ensure all employees and contractors understand the intent of this General
Instruction and have been provided appropriate orientation on the organization’s near
miss program.
8.2.2 Upon being notified of a near miss, determine if additional investigation is required
and arrange for the investigation to be completed.
8.2.3 Ensure action items resulting from investigations are communicated to responsible
parties and are tracked to completion.
8.2.4 Forward copies of serious near miss reports and investigations to the Area Loss
Prevention division for wider communication throughout the company.
8.3 Unit operations foremen/supervisors
Page 7 of 9
General Instruction
JERGI xxxxxx
Rev. 00
8.3.1 Promote immediate reporting of all near misses, ensuring employees and contractors
that these are considered positive efforts.
8.3.2 Ensure all near misses are documented and forwarded to the facility division head
using the attached near miss report form.
8.3.3 Verify all action items resulting from investigations are implemented, and other
necessary follow-up action is completed.
8.4 All employees/contractors
8.4.1 Report any item that might be considered a near miss to their immediate supervision
or the facility supervisor (in the case of contractors).
8.4.2 Participate in the investigation and resolution of near misses as directed by their
supervision.
8.5 Loss Prevention Department
8.5.1 Disseminate appropriate information on serious near misses to a wider audience to

increase awareness and promote lessons learned.
Page 8 of 9
General Instruction
JERGI xxxxxx
Rev. 00
Appendix 1 - Near Miss Report Form
INCIDENT DETAILS
Date: Time: Location/Plant/Equipment
Dept: Org. Code Division/Unit
Near Miss Description (Explain what happened - use attachments if needed)
ESTIMATE OF LOSS POTENTIAL (What injuries or losses might have occurred.)

Injuries:
Property/Equipment Damage:
Environmental Damage:
Other:
ANALYSIS (Why did it happen (List unsafe acts, unsafe conditions, wrong procedures/equipment or
other factors.)
CORRECTIVE ACTION (What must be done to prevent recurrence - list recommendations)
REVIEWER INFORMATION
Reviewed By Supvr. or above (Name/Title/Badge): Date:
Distribution: Original - Department files 1 copy - Facility Division Head 1 copy Area Loss Prevention Division (for serious near misses only)
Page 9 of 9

Jergi-6 004 Near Miss Reporting Process Rev-00

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Jergi-6 004 Near Miss Reporting Process Rev-00

Uploaded by

Copyright:

Available Formats

Jubail Export Refinery

Revision Responsibility 31 October

Revision Revision Date Scope of Revision

0 20 February 2009 Issued for Bid Packages.

Section Contents Page

2 Conflicts, Deviations and Clarifications 4

7 Communication and Follow-Up

1 Near Miss Report Form

2 Conflicts, Deviations and Clarifications

Company: Jubail Export Refinery.

Company Representative: A designated person from the Company or an assigned

Company Inspector: A designated person or an agency responsible for conducting

4.2 List of Definitions

These may include:

7 Communication and Follow-Up

8.1.3 Ensure that corrective actions are properly implemented.

8.2 Division heads

8.3 Unit operations foremen/supervisors

8.4 All employees/contractors

8.5 Loss Prevention Department

8.5.1 Disseminate appropriate information on serious near misses to a wider audience to

Appendix 1 - Near Miss Report Form

ESTIMATE OF LOSS POTENTIAL (What injuries or losses might have occurred.)

CORRECTIVE ACTION (What must be done to prevent recurrence - list recommendations)

You might also like