Incident And Accident Reporting And Investigation
Incident and Accident Reportingand InvestigationMarch 13, 2017
Outline Purpose Definitions General Reporting Guidance Electronic Submission of Forms Specific Reporting Requirements Summary
Purpose Ensure compliance with State of Louisiana Office of RiskManagement (ORM) requirements for incident and accidentreporting and investigation. Determine the root cause of incidents and accidents so that actionmay be taken to reduce the likelihood of re-occurrence. Note that hyperlinks are used in this training. Use them to accessmore detailed information.
DefinitionsAn Incident is an unplanned or “near-miss” event that could havecaused personal injury or property damage.An Accident is an undesired event that results in personal injury orproperty damage. Even “minor” injuries (cuts or sprains) areconsidered accidents.A Motor Vehicle Accident is any incident in which the vehicle comesinto any contact with another vehicle, person, object, or animal thatresults in death, personal injury, or property damage, regardless of:who was injured, what was damaged or to what extent, where itoccurred, or who was responsible.
General Reporting Guidance Report all incidents and accidents, no matter how minor. Performing a rootcause analysis on a “near miss” or an accident can provide valuableinformation that could prevent a future accident. The state directs the use of three forms for reporting:oooDA 2000, Employee Post Incident or Accident Analysis - - foremployees.DA 3000, Visitor /Client Post Incident or Accident Analysis - - forvisitors, contractors and students.DA 2041, Louisiana State Driver Safety Program Accident Report - for employee vehicle accidents while driving on official business. Submit reporting forms within five calendar days. The exception is forvehicle accidents; they must be reported within 48 hours. The supervisor should complete the reporting forms. However, due to timeconstraints on reporting motor vehicle accidents, the DA 2041 can besubmitted by the employee or the supervisor.
General Reporting Guidance Submit forms electronically via the Incident and AccidentReporting web page. University Police does not need to be contacted unless the accidentinvolves Emergency Medical Service response. For vehicleaccidents, contact University Police if the accident involves anLSUHSC-owned vehicle, occurred on LSUHSC grounds, or involvedan injury or death. Report any incident or accident involving recombinant DNA to theBiological Safety Officer immediately. If necessary, this will allowLSUHSC to report the incident or accident to the National Institutesof Health within their prescribed timeline. If an accident involves serious injury, death, or significant propertydamage, the supervisor shall notify senior leadership.
Electronic Submission of FormsThe next five slides describe how to access theEnvironmental Health and Safety (EHS) website so that you can submit the appropriateincident or accident report electronically.
Electronic Submission of FormsAccess the EHS website from the Health Sciences Centerhome page www.lsuhsc.edu.Click MyLSUHSCClick Facilities
Electronic Submission of FormsClick Environmental Health and Safety
Electronic Submission of Forms- Once at the EHS website, click Incident and Accident Reporting.
Electronic Submission of Forms- On Incident and Accident Reporting page, click on the desired form.
Electronic Submission of Forms- Fill out forms completely, including the electronic signature.- Once finished, click on “Save & E-mail” icon at bottom of form.
Electronic Submission of Forms- Then, you will be asked to save a copy of this file.- Next, your Adobe program may ask tocontinue or allow to send this e-mail. Selectyes and an email will be generated.- Click send and your email willbe sent to the proper individuals.
Specific Reporting RequirementsThe next six slides provide information onreporting and submitting the incident and accidentreports for: Employees Students Visitors or Contractors Vehicle Accidents
Employee Reporting Seek immediate medical attention if required. Note that UniversityPolice does not need to be contacted unless the accident involvesEmergency Medical Service (EMS) response. Report the incident or accident to your supervisor. The supervisor will complete and submit the DA 2000 form withinfive calendar days. If the accident results in medical expenses, the supervisorcompletes and submits the Office of Workers’ CompensationDA 1973 form. For more information see Workers’Compensation page. Note: Completion of the DA 2000 is required even if a DA 1973 isalso submitted.
Root Cause Analysis A basic failure of many accident investigations is that theyidentify and correct only the immediate causes, or symptoms ofan accident. “Human error” is often listed as the cause of theaccident, when in fact the underlying cause is often morecomplex, such as lack of proper training or lack of standardoperating procedures. Accordingly, completion of the root cause analysis portion of theDA 2000 form is critical. Determining the true root cause andtaking corrective action will help prevent a re-occurrence.
Student Reporting Seek immediate medical attention if required. If the event occurs in the classroom or lab, the instructor willcomplete and submit the DA 3000 form within five calendar days. If the event occurs outside the classroom or lab, notify UniversityPolice. University Police will then respond and complete andsubmit the DA 3000 form. Although a Root Cause Analysis is not required for incidents andaccidents involving students, the responsible party shouldinvestigate and take appropriate action.
Visitor and Contractor Reporting The escort or sponsor should assist in obtaining medicalassistance if required. Notify University Police. University Police will then respondand complete and submit the DA 3000 form.
Reporting Vehicle Accidents Call the local Police to report the accident and obtain a traffic accidentreport when available. If the accident involves an LSUHSC-ownedvehicle, occurred on LSUHSC grounds, or involved an injury or death,notify University Police at 568-8999 or 568-8270. Complete and submit an on-line fillable DA 2041 form within 48hours, weekends included (e.g., if the accident occurs at 4:00 P.M. ona Friday, you must submit the DA 2041 by 4:00 P.M. on Sunday).Alternatively, to expedite submittal if the DA 2041 form has beencompleted by hand, it may be scanned and emailed toDA2041@lsuhsc.edu and6410StateofLouisiana@sedgwickcms.com.
Reporting Vehicle Accidents Include a copy of the local police traffic accident report with theDA 2041 submission. However, if the local police traffic accidentreport is not immediately available, submit the DA 2041 without itand follow-up later when received. Due to the time constraintson reporting, the DA 2041 can be submitted by either theemployee or the supervisor. To facilitate timely completion of the DA 2041, keep a hardcopyof the Vehicle Accident Reporting Quick Guide in your vehicle. Completion of the DA 2000 form is not required for vehicleaccidents.
Summary Report all incidents and accidents no matter how minor. Performinga root cause analysis on a “near miss” can provide valuableinformation that could prevent a future accident. Use the proper form depending on who was involved in the incidentor accident. For incidents and accidents involving employees, thereporting forms should be completed by the supervisor. Submit the forms electronically via the EHS web site within fivecalendar days. The exception is for vehicle accidents; they must bereported within 48 hours. University Police does not need to be contacted unless the accidentinvolves Emergency Medical Service (EMS) response. For vehicleaccidents, contact University Police if the accident involves anLSUHSC-owned vehicle, occurred on LSUHSC grounds, or involvedan injury or death.
Questions See the “Incident and Accident Reporting and InvestigationPolicy” for more information. For questions or assistance, contact Jim Davis, Safety Officer, atjdavis3@lsuhsc.edu or 504-568-4952.
cause analysis on a "near miss" or an accident can provide valuable information that could prevent a future accident. The state directs the use of three forms for reporting: o DA 2000, Employee Post Incident or Accident Analysis - - for employees. o DA 3000, Visitor /Client Post Incident or Accident Analysis - - for
Key terms in incident reporting in NHSN Required Incidents reporting . Coming Up Next Optional Incident reporting Incident case studies . 20 . So far, the key terms in incident reporting and required Incidents reporting have been covered. Next, optional Incidents repor\൴ing as well as incident case studies will be discussed.
accident reporting and investigation of each accident and incident (near-miss); and periodic review of the program to keep it up to date. The direct cause of an accident usually results from one or more previous unsafe actions or conditions. A good accident investigation program discovers the events leading up to an incident or accident.
immediate feedback to the individual reporting the incident. 3.2 The Trust's Accident/Incident Reporting Policy applies to all staff and all departments within the Trust. 3.3 In accordance with the requirements of the National Reporting and Learning System (NRLS) reportable incidents will be forwarded to the NRLS, Care Quality
Policy Number: BQIS 460 0301 008 Incident Reporting/Review 6 Contact Information for Incident Reporting & Management Questions regarding incident management/reporting can be directed to the BQIS Incident Reporting Department through e-mail BDDSIncidentReports@fssa.
RBC Insurance Accident Claim351.17 RBC Insurance Accident Claim188.37 Pilot Insurance Accident Claim259.95 State Farm Accident Claim182.16 State Farm Insurance Accident Claim178.70 Pafco Accident Claim115.46 Royal & Sunnaliance Accident Claim98.19
AND INVESTIGATION PLAN Accident/incident Reporting It is necessary to report every accident to your supervisor and the IGB Safety Coordinator in order to learn the cause and adopt proper methods to prevent any similar accident. The IGB . University Office of Risk Management: 217-333-3113. .
Incident Management Process Map 1. Incident Management Process Map 1. Incident Management Description and Goals 9. Incident Management Description and Goals 9. Description 9. Description 9. Goals 9. Goals 9. Incident Management RACI Information 10. Incident Management RACI Information 10. Incident Management Associated Artifacts Information 24
2 General tips for the online map update Since maps can become out of date they are updated on a regular basis. The following options are available for carrying out updates in the multimedia system:
