Health and Safety Incident Investigation

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1 Health and Safety Incident Investigation Version Number 3.0 Implementation Date 9/07/2012 Scope Department-wide Purpose The Department of Education, Training and Employment has a duty under the Work Health and Safety Act 2011 (Qld) to ensure as far as reasonably practicable the health and safety of its employees and others by identifying hazards, assessing the risks associated with those hazards and implementing control measures. To fulfil this duty, the Department of Education, Training and Employment is committed to investigating incidents. The main purpose of an investigation is to prevent the recurrence of an incident and to eliminate or minimise the risks associated with the incident. Health and safety investigations should be conducted to determine the cause of the incident and to recommend and implement corrective action. Investigations should not be conducted to apportion blame or liability. Importantly, the scope and complexity of any investigation should mirror the actual or potential seriousness of the incident. Clear communication of the investigation outcomes is integral to the investigation process. Overview This procedure provides guidance on the scope of a health and safety investigation to be conducted, the personnel responsible for appointing investigators, the time frames to commence an investigation and the responsibilities to report investigation outcomes. Responsibilities Assistant Directors-General/Executive Directors/Regional Directors/Institute Directors: establish and communicate a clear process to investigate health and safety incidents in line with departmental procedure where necessary, nominate a delegate to implement and manage the investigation process ensure the workplace has a pool of health and safety investigators through the identification and support for staff to complete the prescribed on-line health and safety incident investigation training upon notification of a Class A incident from a workplace that does not have a health and safety investigator immediately appoint a health and safety investigator to conduct an investigation allow sufficient time for the appointed investigator to conduct the investigation upon notification of a Class P incident from a workplace where the director/principal/faculty manager/officer in charge considers it is inappropriate for the workplace to conduct the Page 1 of 9

2 investigation appoint an investigator with the appropriate skill set to conduct an investigation review investigation reports as necessary and report outcomes in accordance with Health, Safety and Wellbeing Communication and Consultation. Directors/Principals/Faculty Managers/Officers in Charge: determine the classification of the incident in accordance with the classifications of Health and Safety Incidents: Class A incidents Serious injury fatality immediately inform the Assistant Director-General/ executive director/regional director/institute director or their delegate of the incident immediately appoint a health and safety investigator to conduct an investigation Serious injury Non fatality immediately appoint a health and safety investigator to conduct an investigation All other Class A incidents immediately appoint a health and safety investigator to conduct an investigation Class A incidents need to be reported immediately to Workplace Health & Safety Queensland on Class B incidents: appoint a health and safety investigator to conduct an investigation within 24 hours of being advised of the incident Class C incidents: determine whether the incident requires investigation. If the incident does require investigation appoint a health and safety investigator to conduct an investigation within three days of being advised of the incident. report all notifiable incidents definitions immediately in accordance with Health and Safety Incident Recording and Notification where a notifiable incident has occurred, ensure so far as is reasonably practicable, that the site where the incident occurred is not disturbed until an inspector appointed by the Department of Justice and Attorney General arrives at the site or any earlier time that an appointed inspector directs. seek assistance from a health and safety investigator to implement control measures to manage hazards, prevent access to the incident scene and to ensure the incident scene is free from current or future risk to prevent further injury provide resources and allow sufficient time for the appointed investigator to conduct the investigation communicate to relevant staff that the purpose of the investigation is to identify factors that caused the incident, and to recommend action to prevent future incidents of similar nature and not to apportion blame or liability ensure recommended corrective actions are implemented to manage risks report investigation outcomes and the implemented and/or proposed corrective actions following the process outlined in the Flowchart for Health and Safety Incident Investigation and Reporting. for Class P incidents: manage the incident in accordance with the principles of Managing Employee Complaints and Workplace Harassment, Sexual Harassment and Violence Where the incident cannot be resolved using the principles of Qld Government Directive: 08/10 - Managing employee complaints and Workplace Harassment, Sexual Harassment and Violence appoint an investigator with the appropriate skill set to conduct an investigation in circumstances where it is considered inappropriate for the workplace to conduct the investigation, refer the incident to the Assistant Director-General/executive director/regional director/institute director or their delegate Page 2 of 9

3 where the incident results in a WorkCover psychological injury notification, manage the notification in accordance with WorkCover Psychological Injury Claims fact sheet o in circumstances where it is considered inappropriate for the workplace to conduct the WorkCover investigation, refer the notification to the Assistant Director- General/executive director/regional director/institute director or their delegate ensure the injured person is aware of the professional counselling services available to all employees. Regional Senior Health and Safety Consultants/Health and Safety Coordinators/Managers: confirm all notifiable incidents have been reported in accordance with Health and Safety Incident Recording, Notification and Management assist and provide departmental advice to external investigators, e.g. Workplace Health and Safety Queensland provide advice regarding control measures to manage hazards prevent access to the incident scene and to ensure the incident scene is free from current or future risk to prevent further injury where necessary commence investigations into Class A incidents definitions immediately where appropriate, delegate the investigation of the Class A incident to a health and safety investigator provide advice and assistance with the investigation of health and safety incidents definitions when requested by a health and safety investigator see the Conducting a Health and Safety Investigation Guideline for assistance in conducting an investigation use the Health and Safety Incident Investigation Report template to record the outcomes of the investigation. Alternate report templates may be used, providing they capture, as a minimum, the information included in the Health and Safety Incident Investigation Report template if not already completed, upload documents and enter details pertaining to an investigation into the MyHR WHS Solution where available; alternatively, support staff to enter information into MyHR WHS Solution participate in and assist with the implementation of corrective action report investigation outcomes and the implemented and/or proposed corrective actions following the process outlined in the Flowchart for Health and Safety Incident Investigation and Reporting. Health and Safety Investigators: provide advice regarding control measures to manage hazards, prevent access to the incident scene and to ensure the incident scene is free from current or future risk to prevent further injury commence investigations into Class A incidents immediately commence investigations into Class B incidents within 24 hours commence investigations into Class C incidents within three days see the Conducting a Health and Safety Investigation Guideline for assistance in conducting an investigation seek assistance as necessary to conduct an investigation use the Health and Safety Incident Investigation Report template to record the outcomes of the investigation. Alternate report templates may be used by Health and Safety Investigators or external providers, providing the report template captures, as a minimum, the information included in the Health and Safety Incident Investigation Report template upload documents and enter details pertaining to an investigation into the MyHR WHS Solution where available report investigation outcomes and the implemented and/or proposed corrective actions following the process outlined in the Flowchart for Health and Safety Incident Investigation and Reporting Page 3 of 9

4 Staff Members: assist with investigations and provide all information as necessary assist with implementing control measures to manage hazards, prevent access to the incident scene and ensure safety to prevent further injury. Workplace Health and Safety Representatives: assist with investigations and provide information as necessary assist as necessary with the implementation of control measures to manage hazards, prevent access to the incident scene and ensure safety to prevent further injury participate as requested with the implementation of corrective action. Process Flowchart for Health & Safety Incident Investigation and Reporting Online Resources Conducting a Health and Safety Investigation Guideline Health and Safety Incident Investigation Report template Health and Safety Incident Investigation Online Training (available through the Learning Place) Review Date 1/01/2014 Definitions Health and Safety Definitions Cause: The producer of an effect supported by evidence. Class A Incidents: Serious injury or illness An injury or illness requiring the person to have immediate treatment as an in-patient in a hospital (i.e. admitted into hospital), or immediate treatment for care in addition to first aid for the amputation of any part of his or her body, or a serious head injury e.g. scalping, a penetrating injury to the skull, a fractured skull, loss of consciousness caused by a severe blow to the head, or a serious eye injury e.g. the loss of sight of an eye, a penetrating injury to the eye, a serious burn (e.g. requires medical treatment), or the separation of skin from an underlying tissue e.g. degloving or scalping, or a spinal injury e.g. a fracture of the spine with or without any limb weakness or paralysis. (Muscular injuries are not considered spinal injuries), or the loss of a bodily function e.g. a loss of consciousness, loss of movement of limb, loss of a sense (hearing/sight), loss of function of an internal organ, or serious lacerations e.g. one or more deep and or extensive cuts, tears or wounds to Page 4 of 9

5 the flesh or tissue. medical treatment within 48 hours of exposure to a substance, or any other injury or illness prescribed under a regulation e.g. any infection to which the carrying out of work is a significant contributing factor, including any infection that is reliably attributable to carrying out work or occupational zoonoses contracted in the course of work e.g. Hendra virus, Q fever, Anthrax as per section 699 of the Work Health and Safety Regulation Dangerous incident (includes electric shock) A dangerous incident is an incident that exposes a worker or any other person to a serious risk to a person s health or safety emanating from an immediate or imminent exposure to an uncontrolled escape, spillage or leakage of a substance, or an uncontrolled implosion, explosion or fire, or an uncontrolled escape of gas or steam, or an uncontrolled escape of a pressurised substance, or electric shock, or the fall or release from a height of any plant, substance or thing, or the collapse, overturning, failure or malfunction of, or damage to, any plant that is required to be authorised for use under a regulation, or the collapse or partial collapse of a structure, or the collapse or failure of an excavation or of any shoring supporting an excavation, or the inrush of water, mud or gas in workings, in an underground excavation or tunnel, or the interruption of the main system of ventilation in an underground excavation or tunnel, or any other event prescribed under a regulation, but does not include an incident of a prescribed kind (S37 Work Health and Safety Act 2011) Dangerous incidents and electric shock are notifiable incidents and by law must be reported immediately to Workplace Health & Safety Queensland on Serious electrical incident Section 11 of the Electrical Safety Act 2002 (Qld) an incident involving electrical equipment if, in the incident (a) a person is killed by electricity, or (b) a person receives a shock or injury from electricity, and is treated for the shock or injury by or under the supervision of a doctor, or (c) a person receives a shock or injury from electricity at high voltage, whether or not the person is treated for the shock or injury by or under the supervision of a doctor. Work caused illness An illness requiring the person to have immediate treatment as an in-patient in a hospital (i.e. admitted into hospital), or; immediate treatment for care in addition to first aid for the loss of a bodily function e.g. a loss of consciousness, loss of movement of limb, loss of a sense (hearing/sight), loss of function of an internal organ; or medical treatment within 48 hours of exposure to a substance, or any other injury or illness prescribed under a regulation e.g. any infection to which the carrying out of work is a significant contributing factor, including any infection that is reliably attributable to carrying out work or occupational zoonoses contracted in the course of work e.g. Hendra virus, Q fever, Anthrax as per section 699 of the Work Health and Safety Regulation Class P incidents: Page 5 of 9

6 Psychological incident Psychological incidents may lead to psychological injury and may be caused or aggravated by: potential traumatic event/s; conflict; workplace justice issues; or other related factor/s, e.g. bullying, harassment or discrimination. Psychological incidents that require immediate inpatient treatment are notifiable and need to be reported immediately to Workplace Health & Safety Queensland on Class B incidents: Bodily injury An injury that involves: the expectation the injured person will be absent from voluntary or paid work; the expectation a person, other than a voluntary or paid worker, will be incapacitated; the expectation a student will be absent from school; or external service providers such as Queensland Ambulance Service were engaged or transport to hospital was required. Near miss or potential event An incident that did not result in injury but had the potential to have resulted in a Class A, Class B or Class P incident. Class C incidents: Minor injury or incident An injury or incident: not classified as a Class A, Class B or Class P; or where there is the possibility that legal action may follow as a result of the injury or incident. Dangerous Incident (S37 Work Health and Safety Act 2011) Work Health and Safety Act 2011 (Qld) an incident that exposes a worker or any other person to a serious risk to a person s health or safety emanating from an immediate or imminent exposure to an uncontrolled escape, spillage or leakage of a substance, or an uncontrolled implosion, explosion or fire, or an uncontrolled escape of gas or steam, or an uncontrolled escape of a pressurised substance, or electric shock, or the fall or release from a height of any plant, substance or thing, or the collapse, overturning, failure or malfunction of, or damage to, any plant that is required to be authorised for use under a regulation, or the collapse or partial collapse of a structure, or the collapse or failure of an excavation or of any shoring supporting an excavation, or the inrush of water, mud or gas in workings, in an underground excavation or tunnel, or the interruption of the main system of ventilation in an underground excavation or tunnel, or any other event prescribed under a regulation, but does not include an incident of a prescribed kind. Hazard A source or a situation with a potential for harm in terms of human injury or ill-health, damage to property, damage to the environment, or a combination of these. Page 6 of 9

7 For example, the hazard is an uneven pathway. The risk is the likelihood that a person will slip/trip/fall because the uneven pathway forms a 'trip hazard'. Health and Safety Investigator The following are considered Health and Safety Investigators: Regional Senior Health and Safety Consultants TAFE Health and Safety Coordinators departmental employees who have successfully completed the DETE Health and Safety Incident Investigation workshop or online Health and Safety Incident Investigation course and who have been issued with a certificate of completion external providers engaged to conduct health and safety investigations. High risk plant The following items of plant are defined as high risk plant: air conditioning unit amusement device cooling tower escalator LP gas cylinder lift Immediately Investigations into a Class A incident should be commenced immediately upon appointment. This may be through a phone call by the appointed health and safety investigator to the person in charge of the workplace, to obtain details of the incident and provide advice regarding information to collect. It is understandable in many regional circumstances immediate attendance to the scene may not always be practicable. In these circumstances, it may be prudent to contact the person in charge of the workplace and request them to arrange for photographs to be taken and any witnesses identified. Incident An incident is any unplanned event resulting in, or having a potential for injury, ill-health, damage or other loss. Injury, illness or dangerous incident report form For specific information regarding the reporting of incidents, please refer to the Health and Safety incident recording and notification procedure guide. Investigator with appropriate skill set The investigation of a Class P incident requires the appointed investigator to have specific skills to ensure further psychological harm is not caused by the investigation process. This skill set includes but is not restricted to: having high level communication skills being able to take an understanding approach to the investigation being aware of the potential psychological ramifications of the investigation being able to develop strategies to progress and/or manage the investigation. In some circumstances, the investigation of Class P incidents may best be conducted by an investigator who is external to the workplace e.g. a regional investigator, external provider or staff member from a neighbouring school, TAFE or DETE workplace. Minor Student Incident (departmental definition for students) Any student incident (injury, illness) that is managed by the school (eg. first aid) but does not necessitate any contact with the parent/guardian/emergency contact. Page 7 of 9

8 Risk The likelihood that the harm will occur from exposure to a hazard. For example, the hazard is an uneven pathway. The risk is the likelihood that a person will slip/trip/fall because the uneven pathway forms a trip hazard'. Serious injury or illness An injury or illness requiring the person to have immediate treatment as an in-patient in a hospital (i.e. admitted into hospital), or immediate treatment for care in addition to first aid for the amputation of any part of his or her body, or a serious head injury e.g. scalping, a penetrating injury to the skull, a fractured skull, loss of consciousness caused by a severe blow to the head, or a serious eye injury e.g. the loss of sight of an eye, a penetrating injury to the eye, a serious burn (e.g. requires medical treatment), or the separation of skin from an underlying tissue e.g. degloving or scalping, or a spinal injury e.g. a fracture of the spine with or without any limb weakness or paralysis. (Muscular injuries are not considered spinal injuries), or the loss of a bodily function e.g. a loss of consciousness, loss of movement of limb, loss of a sense (hearing/sight), loss of function of an internal organ, or serious lacerations e.g. one or more deep and or extensive cuts, tears or wounds to the flesh or tissue. medical treatment within 48 hours of exposure to a substance, or any other injury or illness prescribed under a regulation e.g. any infection to which the carrying out of work is a significant contributing factor, including any infection that is reliably attributable to carrying out work or occupational zoonoses contracted in the course of work e.g. Hendra virus, Q fever, Anthrax as per section 699 of the Work Health and Safety Regulation Serious student incident (departmental definition for students) A student injury is considered 'serious' when: the above definition of a serious injury is met, and/or a parent/guardian/carer/emergency contact has been notified as a result of a health and safety incident, and/or external service providers, e.g. ambulance, are required to transport the student to hospital or there is a distinct possibility that legal action will follow. Workplace (legislative definition) A workplace is any place where work is, or is to be, performed by; (a) a worker, or (b) a person conducting a business or undertaking. Examples: 1. a vessel used for teaching members of the public to scuba dive 2. a vehicle supplied by an employer for use by a worker in the performance of work. Workplace health and safety event A workplace health and safety event which may include a health and safety incident, work related dangerous incident, serious injury or work caused illness. Authority Work Health and Safety Act 2011 (Qld) Work Health and Safety Regulation 2011 (Qld) Education (General Provisions) Act 2006 (Qld) Education (General Provisions) Regulations 2006 (Qld) Page 8 of 9

9 Related Policy Instruments Qld Government Directive: 08/10 - Managing employee complaints Health and Safety Incident Recording and Notification Workplace Harassment, Sexual Harassment and Violence Attachments Flowchart for Health and Safety Incident Investigation and Reporting Contact For further information, please contact: Regional Health and Safety Consultants: Organisational Health Health and Safety Team Telephone: (07) Uncontrolled Copy Disclaimer Uncontrolled copy. Refer to the Department of Education and Training Policy and Procedure Register at to ensure you have the most current version of this document. Page 9 of 9

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