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Get to the root of matters with an incident investigation report

Inicdent investigations are a necessary part of businesses where workers are placed in risky situations, or when there are complaints filed by one employee against another. Use these report forms to easily collect and organize all the necessary information

What is an incident investigation report?

An incident investigation report is a detailed account of a given incident and its causes. As soon as a formal complaint is filed or an incident occurs, investigators use an incident investigation form to record the facts, analyze the evidence and formulate a conclusion regarding said incident. The investigation should be impartial and objective.

Incident investigation reports help decision-makers decide on corrective actions. They also ensure cases are investigated on time, thoroughly, and accurately.

Investigation report being written up on a black typewriter

Essential elements of any incident investigation report

Every company should have an incident investigation report template ready to use when accidents or incidents occur. This makes documenting and collecting information easier and facilitates the exchange of information between relevant parties.

Your incident investigation checklist should contain:

  1. The type of incident
  2. Date and location of the incident
  3. Any affected work
  4. The person(s) affected
  5. A brief summary
  6. Property (all information collected, such as witness statements etc.)
  7. Supporting evidence (e.g. photos, documents)
  8. Additional information (e.g. legal regulations, effects on the company, reference to comparable incidents)
  9. Conclusion
  10. Proposals for further action/measures
  11. Name of the investigator or investigators
  12. The investigator’s signature
  13. Date of recording

Depending on the sector and the purpose of the investigation, a report may include other elements. Adapt your template according to your business’ needs.

3 steps of every incident investigation report

An investigation report checklist is a step-by-step method of determining facts by properly documenting the event. To make sure you collect all the relevant data, follow three steps each time you prepare a report.

Step 1: Start with what you know

Investigators record information via conversations with the persons involved (interviewee or accused) and the details of complaints. It’s especially important that you record the time, date, and location of the person making the statement.

Step 2: Analyze collected data

Analyze available evidence to decide whose version of event is correct. Use resources such as film footage, email records, documents or papers, or physical objects to reach your conclusion, and document investigative statements. Part of a successful analysis is being able to distinguish between relevant and irrelevant facts.

Step 3: Formulate conclusions

Every incident investigation report closes by offering a conclusion. You need to indicate whether claims or complaints are well-founded, unfounded, or inconclusive.

Main categories of incident investigation report

There are four main types of event you will investigate. Those are near misses, injury and lost time, exposure incidents, and sentinel event. One you’ve decided which type of investigation you’ll conduct, proceed to file initial, progress, special, and final reports. Each category of incident is different and involves different people.

  1. Near Misses: Near misses are exactly what they sound like— incidents with potentially major consequences which, due to circumstantial events (such as timing, location, happy accidents, etc.), didn’t occur.
  2. Injury: Any event that ended in injury requires investigation. Injuries can result from multiple factors, such as:

  3. Exposure: these incident investigation reports cover any injury resulting from exposure to harmful substances, chemicals, gases, or weather, such as:

    • Asbestos
    • Cleaning products
    • Pesticides
    • Fertilizers
    • Lead
    • Carbon monoxide
    • Radiation
    • Poisonous insects, plants, or animals
    • Heat stroke

  4. Sentinel events: Sentinel events result in loss of life or permanent, debilitating injury. These might be:

    • Vehicle collisions
    • Chemical, toxic substance, or radiation exposure
    • Fire and explosions

It’s not uncommon for an incident to fall under multiple of these categories. The four main types of incident categorize events according to the severity of consequences. Near misses have no result, sentinel events lead to death or permanent injury, and injury and exposure events produce more mild consequences.

Regardless of which incident category you’re dealing with, file reports in four stages.

  1. Initial investigation report: Write an initial report directly after an incident or accident occurs. It’s best practice to file this report within a few hours of an incident so that everyone can remember what happened. This is where you document names, contact information, events that led up to the accident, eyewitnesses, and any other relevant information.
  2. Progress investigation report: Progress reports are updates that cover victims’ medical statuses, necesary worker’s compensation, whether a substitute worker needs to be hired, and more
  3. Special investigation report: A special investigation report is filed when new or similar events develop after the primary event
  4. Final investigation report: Final investigation reports summarize workplace accidents. They include any corrective measures, total costs of incidents, and the investigator’s signature.

It’s important to note that sometimes the initial report is synonymous with the final report. It depends on the nature of the incident, whether related events occur, and whether any follow-up actions need to be taken. Near miss reports in particular are usually complete after an initial investigation, which will outline necessary corrective actions.

What’s the difference between a workplace accident and an incident?

The difference between an accident and an incident is that incidents is an event that transpires by accident or malicious intent, and include sexual harassment claims or dangerous work conditions while an accident explicitly results in physical consequences like injury or death. Near misses are considered incidents. while injury, exposure, and sentinel events are considered accidents.

Incident investigation report example

Location
105 Peterson St, Soldiers Grove, WI, 54655
Suite #105 in the supply closet

Job Number
10000256314

Date of Accident
1-1-2015

Date Reported
1-1-2015

Was the injured person a contractor?
Yes   No

Type of incident

Please describe the nature of the incident.

Occupational Hazard that required the first aid treatment

Injury

What type of injury was sustained?
Concussion

What body part was injured?
Head

Was follow-up treatment necessary?
Yes   No

Person(s) involved

Employee’s Name
John Smith

Date of Birth
1-1-1960

Employee’s Address
107 Peterson St, Soldiers Grove, WI, 54655

Social Security Number
583-15-XXXX

Healthcare Number
000-00-0000-A

Description

Describe in detail the events leading up to the event.

Employee, John Smith, was tasked with retrieving more printer paper from the supply cabinet after the printer ran out. The printer paper is located on the top shelf in a box that weighs approximately 20 pounds. John Smith’s shorter-than-average height meant that he had to reach for the box of paper. However, that meant he would have to support a load of 20 pounds over his head. His arms gave out and the box of printer paper fell on his head, knocking him out. His colleague, Matt Dowley, was with him at the time and immediately called for first aid. John Smith was transported to the hospital to receive further care.

Witnesses

Name
Matt Dowley

Phone Number
(262)-185-2369

Analysis

What immediate causes, failures to act, and conditions contributed directly to the incident?

The main factor that led to the incident was the fact that a box weighing over twenty pounds was located on a high shelf. There was also no step ladder available for getting office supplies from the higher shelves.

What basic causes are the contributing factors? (job factors, personal factors)

John Smith didn’t ask for help from his colleague, Matt Dowley, nor did he offer his help.

Prevention

What actions are recommended to prevent a recurrence of this incident? When? And by whom?

It is recommended that heavy boxes are to be placed on the bottom shelves in the supply cabinet and that a ladder will be provided so that any employee regardless of their height can reach the higher shelves. It is also recommended that lifting an object over twenty pounds becomes a two-person assist.

Potential frequency

Frequent   Probable  Occasional   Remote   Improbable

Severity

Catastrophic   Critical   Moderate   Minor

Cost

Estimated:
$500

Actual:
$358.34

Conclusion

Further Comments:
It is my advice that we have the boxes of printer paper stored next to the printer in a further attempt to reduce the risk of muscle strains and other injuries from transporting the boxes from the supply room.

Investigated by:
Rebecca Windslow

A magnify glass, notebook, and pencil ready for a investigation

 

Workflow automation sofware for incident investigation reporting

Documenting evidence with pen and paper and manually writing investigation reports is time-consuming and tedious. It’s must faster and more accurate to use workflow automation software like Lumiform and produce standardized digital incident investigation reports.

Thanks to a combination of desktop software and a mobile app, you can gather information in real-time and easily store collected data. Streamline communication with team members and management by assigning and tracking tasks and solve incidents up to four times faster. Lumiform improves your incident investigation process by:

Employees conducting an investigation of a workplace accident

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