Safety – Incident investigation report sample

Incident investigation report sample

Incident investigation report sample - and what else you need to know

What is an incident investigation report?

An incident investigation report is a report which is created and completed when an incident takes place. The incident investigation report is the means by which the investigator objectively assess the incident including:

  • The events leading up to the accident
  • Facts of the incident itself
  • Information about what happened directly after the incident
  • Essential factors in the incident and possible/probably causes

Incident investigations can take place of major incidents or minor incidents, and the purpose of them is to mitigate the chance of (or ideally prevent) the chance that the same incident will occur again - at least not for the same reason.

The immediate supervisor or person responsible for the work area or tasks being performed is usually responsible for the investigation, and it is their job to be as objective and thorough as possible in the investigation.

The objective for the investigator is to find causes - not blame. The main purpose of an investigation is future prevention - not blame.

Here's an incident investigation report sample

In the sample below, the supervisor/manager Taylor Daniels is creating a report for a non-injury related incident involving Jane Peterson.

The purpose of this report is to uncover - even though no one was hurt - why there was a large unmarked gap between two platforms which could have resulted in serious injury.

Click on the button in the middle of the sample to expand the report to show all 3 pages.

Incident investigation report sample

Use and customise this incident investigation report sample for free.

So what needs to be in your incident investigation report?

What's in your incident investigation report will vary from company to company, project to project and potentially even incident to incident. We believe it's advantageous and good practice to keep a relatively standardised investigation report template which you use for all incidents. But if you don't find that practical, you can cut it down to size for certain incidents.

The main things you'll need your investigation report to cover are:

  • The project and job name - For record keeping and so everyone knows what they are talking about
  • The incident date and time - These details are incredibly important for understanding the conditions and circumstance for which the event took place, and whether they could be a factor in the incident itself
  • The incident classification - Classifying the incident enables safety teams to understand the frequency and severity of certain incidents including:
    • Lost time injuries
    • Medical treatment injuries
    • First aid
    • No treatment required (report only)
  • The name, company and contact number of the injured person/people
  • A description of what happened - This description should be as detailed as possible, accounting for as much as the person can accurately remember
  • Photos and videos of the incident - Pictures tell more than a thousands words when it comes to documenting incidents and serve as proof should the investigation go any further
  • Description of where the event happened with a location map or sketch
  • Description of why this happened - This section needs to be as objective as possible, focusing on causes and not blame
  • Description of the immediate actions taken - Understanding how the incident was responded to enables companies and teams to assess whether the response was adequate and what measure they can put in place next time to react more suitably
  • Select the relevant causes related to the surrounding environment and work practices
  • Notifications - Prompts to notify relevant government and industrial bodies, as well as to notify the police/ambulance/fire where applicable
  • Corrective actions - The corrective actions which should/will be taken in order to reduce the likelihood the same thing will happen again
  • Digital signature of the investigating officer 

And who needs to be involved in the investigation process and outcomes?

An incident investigation should be conducted by the supervisor or person in charge of the work activity taking place. The person involved in the incident should also be involved as they are a counterbalance to that account.

A health and safety representative and specific subject matter experts can also be involved where it's applicable.

But managing incident identifications, reports and investigations is hard and time-consuming

Hopefully you aren't managing too many incidents (otherwise it may be time to assess your operations). But managing incidents and investigations can be time-consuming and a bit of a logistical nightmare at the best of times.

If you are looking for a more integrated approach to managing your incidents, from hazard identification all the way through to incident investigation - then look at a designated safety management system or incident investigation app. A proper system can take care of forms, documentation, photos, workflows and analytics.

Incident investigation report template

Incident Investigation Report template

When any incident requires further investigation - use this template.
See the template →
Hazard incident report form

Hazard Incident Report form

Make reporting hazard incidents easy and keep your people and sites safer.
See the template →

See how you can easily streamline your systems and processes with Sitemate today

Over Lance Hodgson

Lance is VP of Marketing at Sitemate. His aim is to bring awareness to a brighter future for the Built World where industrial workers and companies work smarter.

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