Near Miss Reporting Template

Near miss reporting helps identify possible hazards before they cause safety events, and is also a safety compliance area of focus for many industries, including construction and other industrial verticals. The compliance requirements for near miss reporting are regulated by local governing bodies and agencies e.g the OSHA (Occupational Safety and Health Administration) in North America and HSE (Health and Safety Executive) in many other regions.

These regulations and 'rules' are designed to ensure that companies record close calls properly, properly investigate their causes, and then take the necessary actions to mitigate the chance that these close calls turn into incidents.

To meet your near miss reporting format requirements, you'll want to include a number of key sections in your report format, whether you run the report via Word, Excel, PDF or a proper digital document:

1. Incident Description: The employee reporting the near miss must provide a clear and detailed account of the near miss. Basic near miss information like the time and date of the incident must always be recorded, so they should be required fields in your form.

2. Equipment/Materials Involved: Many near misses occur in or around equipment and materials, as they pose inherent safety risk. Cleary documenting exactly what was involved in the near miss helps to identify if faulty equipment or improper use played a role, and then leads into follow on rectifications.

3. People Involved/Witnesses: The main employee reporting the near miss should also document any other employees or people in the workplace who witnessed the near miss incase there is an investigation down the track. In some cases, it is best to avoid using names to maintain privacy and promote a blame-free culture.

4. Hazards/Unsafe Conditions: Have a section for the employee or worker to try identify and describe any potential hazards or unsafe conditions that contributed to the near miss. This person will be great for identifying current conditions or specific circumstances, and ideally this section of the form can also be completed by the safety manager or person investigating the issue, as they will likely be able to take a deeper look at the conditions.

5. Root Cause Analysis: Define the underlying causes or reason for the near miss. This is best setup in the near miss report template to be a dropdown or multi-select field, so that people know the options and to keep your data standardised.

6. Corrective Actions/Recommendations: Propose improvements that could help prevent more near misses, and prevent the near miss escalating into an accident or injury. These actions could include updating procedures, providing additional training, or improving equipment or workspaces.

7. Follow-Up Actions: Include any immediate actions taken after the near miss to mitigate risks, as well as plans for monitoring and reviewing the effectiveness of the corrective measures.

By following this structured approach in your near miss report format, your employees will be able to easily document near misses properly, and your company will get accurate and reliable safety data.