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Use an incident cause analysis method (ICAM) investigation template to address incidents

Use an incident cause analysis method (ICAM) investigation template to address incidents

This incident cause analysis method (ICAM) template is used to assist in the investigation of incidents, accidents and near misses in the field.

Use this template
or download pdf
Use an incident cause analysis method (ICAM) investigation template to address incidents

This incident cause analysis method (ICAM) template is used to assist in the investigation of incidents, accidents and near misses in the field.

Use this template
or download pdf

About the Use an incident cause analysis method (ICAM) investigation template to address incidents

Incident Cause Analysis Method (ICAM) Template is a tool that assists organizations with analyzing and understanding the causes of an incident. It helps to identify the root cause of the problem and assists organizations in making corrective and preventive actions. It also helps organizations to anticipate future incidents.

Conduct proper investigations with an incident cause analysis method (ICAM) template

The Incident Cause Analysis Method (ICAM) template is an effective problem-solving tool used by organizations to identify the root causes of an incident. It helps organizations to quickly analyze the incident, identify the root cause and develop corrective actions.

The ICAM template is used to identify the causal factors associated with an incident. It can be used to analyze any type of incident, such as an accident, medical error, or system failure. The template includes a series of questions that help to identify the cause of the incident. The questions are divided into categories and the template can be customized to your specific needs

The ICAM template is a valuable problem-solving tool that can help organizations to quickly identify the root cause of an incident and develop corrective actions. By using the template, organizations can improve their incident response process and improve their overall safety and performance.


Related categories

Preview of the template
Incident Details
Incident Summary
Collect information and evidence of the incident and report your findings here.
Item detail
Photo evidence
Timeline
List the activities and events leading up to the time of the incident, when the incident happened and what took place afterwards.
Date & Time
Activity
Analysis Overview
The basic cause of an incident is the mechanism of failure.
What happened?
The ICAM model analyses the contributing factors to determine why the incident happened.
Why did the incident happen?
Actual Consequences
Potential Consequences
ICAM Analysis
The contributing factors of this incident were analyzed using the Incident Cause Analysis Method (ICAM) process, an industrial safety initiative used to analyze serious incidents. ICAM is an analysis tool that sorts the findings of an investigation into a structural framework. An ICAM analysis clarifies why the incident happened and identifies all the factors that contribute to the event. The contributing factors are classified into four categories of the ICAM model which are: Absent or Failed Defences; Individual or Team Actions; Task or Environmental Conditions; Organisational Factors.
Absent or Failed Defences
The situations, systems, conditions, equipment, measures or human factors which normally prevent this type of incident from happening.
Absent or Failed?
Organisational factor type
Details of defence
Individual or Team Actions
The errors or violations made by people directly involved in the event.
Individual or Team?
Organisational factor type
Details of Action
Task or Environment Conditions
The "situational characteristics" which existed immediately prior to the incident, including the work situation, physical or social environment, or a person's mental, physical or emotional state.
Task or Environmental
Organisational factor type
Details of Condition
Organisational Factors
The latent system based factors present before the incident which may have contributed to the presence of specific adverse task or environmental conditions, individual or team actions, or absent or failed defences.
Organisational factor type
Details of Factor
Conclusion
Recommended Corrective Actions
What are we going to do about the incident? Use the Hierarchy of Control recommendations for corrective actions that will target prevention of recurrence and reduction of risk. The recommendations will address each identified absent or failed defence (risk controls) and Organisational factor (prevention and risk reduction strategies).
Enter recommended corrective actions here
CAR detail
Key Learnings
Enter Lessons Learned here
Lesson Learned
Sign off
Full name and signature of ICAM report author
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This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.