17 May 2018
The importance of understanding 'cause' when a safety event occurs
Investigations close the feedback loop to a risk review. They provide the reason for change and are part of an effective safety management system.
A safety event, be it a near miss or one where an injury of some kind occurs, is what the military would call a 'combat indicator' that something has gone wrong and that something worse could happen if we do nothing. When an event happens it indicates that either a risk has not been identified or controls have failed. While every event does not require investigation, an organisaiton with an effective safety management system needs to set thresholds on what it will investigate and must undertake investigations when these thresholds are met.
The purpose of a safety investigation is to establish 'cause' not blame. Establishing cause allows us to understand why something went wrong and to review our controls so that they can be improved. It is also a way of identifying what went right. So investigations provide us with the opportunity to learn and they support a positive culture by reinforcing to workers that an organisation takes safety seriously and does not seek to blame but to improve.
Where we do not investigate we lose the opportunity to improve and we increase the potential for a potentially more serious event to happen. Aside from the obvious, investigations allow an organisation to better understand the use and expenditure of resources and provides the opportunity to further avoid unnecessary cost. This alone should be good reason to undertake investigations - why waste precious resources when you dont need to.
As stated earlier, not every event needs investigation. If you havent determined what you will investigate, perhaps you should.
Hauraki Health and Safety can provide you with safety investigation support using the internationally proven ICAMS process. If yo need our help give us a call.
Number of Quad Bike Serious Harm Notifications from Jan 2009 to 31 Nov 2017 – 547