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UMA Incident Investigation Report

by Joshua Davis, from the Community

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Use this incident investigation report to document workplace injuries from initial details to closure. Capture general information, employee and witness statements, incident type, injury nature and affected body parts, and medical treatment. Conduct root cause analysis with the 5 Whys and record surface causes. Plan immediate, short term, long term, and system improvement actions with owners and due dates. Attach photos, sketches, interviews, and diagrams. Managers review follow up actions and confirm completion to close the report and return it to the safety team.

With SafetyCulture you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

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Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.