Doc Name: CHK-HSF-GRP Doc Type: Checklist

Doc Title: Incident Investigation Checklist Doc ID: <ID Number>

Status: Draft Effective Date: Page: 1 of 1

Incident Investigation Checklist

Establishing the Facts
This checklist of questions will assist investigators to establish the facts and may help to identify system design
weaknesses that contributed to the accident/incident.
WHO
was injured? was working with the injured? else was involved?
saw the accident had instructed and/or assigned the job Has information on circumstances or
to the injured? events prior to the accident/incident?
WHAT
is the injury? machinery/plant/equipment was in safe systems of work, permits to
use? work, isolation procedures were
there?
is the damage or loss? previous similar accidents or near training had been given?
misses (incidents) have occurred?
was the injured doing? action has been taken to prevent were the contributory causes of the
recurrence? accident/incident?
has the injured been instructed to did the injured and any witnesses see? communication system was in use?
do?
tools were being used? safety rules were violated
WHEN
did the accident/incident occur? did the injured start the job? did the supervisor last see the
injured?
did the damage become evident? was an explanation of the hazards was something observed to be
given? wrong?
WHY
did the injury occur? was the hazard not evaluated? were specific safety instructions not
given?
did communication fail? was personal protective equipment not was the injured where he was?
provided?
was training not given? was protective equipment not used? was the supervisor not consulted
when things started to go wrong?
were the unsafe conditions was there no system of work, permit to was the supervisor not there at the
permitted? work or isolation procedure operating? time?
WHERE
did the accident/incident occur? was the supervisor at the time? were the witnesses at the time?
did the damage occur?
HOW
did the injury occur? could the injury have been avoided? could better design help?

could the accident/incident have could the supervisor have prevented

been avoided? the accident/incident?
Note: care must be exercised in obtaining answers to some of these questions, as the investigator could be accused of
apportioning blame.
Determining Recommendations and Conclusions
This checklist may help the investigator when determining the recommendations to rectify system faults and what
conclusions can be drawn from the facts.
WHAT SYSTEMS FAILED?
how can we prevent failure or make how can we detect failure when it how can we control failure (minimise
it less likely? occurs? consequences)?
how can we detect approaching
failure?
WHAT DOES THE SYSTEM DO?
Why do we do this? what could we do instead? how else could we do it?
WHICH PERSONS FAILED?
what did they fail to do? how can we make failure less likely Note: Consider persons who failed to
supervise, train, check, design adequately
as well as persons who failed to close a
valve etc.
WHAT IS THE PURPOSE OF THE PERSON’S ACTION?
why do we do this?
WHAT COULD WE DO INSTEAD?
how else could we do it? who else could do it? when else could it be done?
WHAT SPECIFIC ITEMS IN THE SYSTEM TRIGGERED THE ACCIDENT/INCIDENT?
what does it do? what else could we do instead? how else could we do it?
why do we do this? what could we use instead?

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