CITY AND COUNTY OF DENVER CR&CF RISK UNIT Accident / Incident Investigation Standard

Transcription

1 CITY AND COUNTY OF DENVER CR&CF RISK UNIT Accident / Incident Investigation Standard 1.0 Introduction The purpose of this Standard is to ensure that all accidents and incidents that result in a workplace injury or illness are thoroughly investigated to identify causal factors, and to ensure that corrective actions are taken to prevent a reoccurrence. The procedure is this Standard provides guidance for completing the investigation and the Supervisor's Report of Accident or Incident. If a motor vehicle is involved in the injury please review Step 4 below. 2.0 Definitions Employee Work Injury OUCH Line Report Supervisor's Report of Accident Or Incident This is a document that is filled out by the OUCH line RN whenever the employee calls to report an on-the-job injury or illness. The form is available to the employee from the designated medical provider/clinic. A copy of the OUCH Line Injury Report is sent to Risk Management, and becomes a permanent document in the workers' compensation file. An investigation report that is to be completed by the supervisor concerning details of a workplace accident or incident involving an employee or member of the public. 3.0 Procedure An investigation shall be performed by the supervisor each time an accident or incident occurs in the workplace involving an injury to an employee or a member of the public, motor vehicle damage or damage to City property. The investigation results shall be documented on the Supervisor's Report of Accident or Incident. When conducting an investigation into an accident or incident, the first-line supervisor has the primary responsibility to begin the process that is outlined in the following steps: 3.1 Agency / Department Head Responsibilities Ensure agency/department supervisors have adequate training in the incident/accident investigation process. Ensure Supervisor Reports of Incident/Accident are provided to the Risk Management Office within 5 days of the incident. 3.2 Supervisor s Responsibilities Step 1 Upon receipt of information that an accident/injury has occurred or an OUCH Line Injury Report received, the supervisor shall review the report and ensure that all sections are satisfactorily completed. Pay special attention to the Accident/Incident Investigation Standard Page 1 of 9

2 sections that instruct the employee to "describe accident" and to "describe nature of injury and all parts of the body affected." Step 2 Conduct an Accident Investigation: Investigations are conducted to document the facts of an accident or incident, correct unsafe acts and conditions, and to determine if a safety violation occurred. The following steps provide guidance on how to conduct an investigation: a. Collect Facts Written statements from individuals involved Written statements from witnesses Interviews with individuals involved and witnesses Photographs of the scene and equipment involved Sketches of the accident scene Review of maintenance records Review of training records Written hazard analysis b. Analyze the Facts Facts should be analyzed to determine primary cause c. Develop Corrective Actions Address the causal factors to ensure that there is not a reoccurrence. Include additional training, procurement of equipment, development of written procedures, etc. Step 3 Supervisors shall obtain the Supervisor's Report of Accident or Incident (Attachment One) from the DOT Website under forms, from their department safety office or from Risk Management and complete each section in full and provide to the Risk Management Office within 5 days of the incident. Below are some completion guidelines: Section 1 - Complete each box with the required information about the injured party. Section 2 - Complete each box with contact information about yourself. Section 3 - Describe the accident based on your investigation. Your investigation should methodically analyze circumstances surrounding the occurrence and you should ask yourself the following questions: What was the person doing when the accident occurred? Accident/Incident Investigation Standard Page 2 of 9

3 Was the location or environmental condition a contributing factor? Was a hazardous condition of equipment, tools or materials a contributing factor? Was a management action or lack of action a contributing factor? Was the injured person or another person the contributing factor? Why did the accident occur? How could the accident have been prevented? Section 4 - Identify the type of accident. Section 5 - Identify the cause of the accident/incident. Many times there are multiple causes associated with a claim. You should select the primary cause of the injury or accident. Once the primary cause has been selected, click on the drop down box and pick the associated cause (electronic form only). Section 6 - List witness information and summarize witness statements concerning the injury or accident. Section 7 Corrective Actions must be implemented in order to prevent the incident from happening again. Check the date for completion and the corrective action(s) that will be taken to prevent a reoccurrence. Section 8 - Determine whether or not there was a safety violation. In accordance with the Colorado Revised Statutes a safety violation occurs when either (or both) of the following is true: The injury was caused by the willful failure of the employee to use safety devices provided by the employer The injury resulted from the employee's willful failure to obey any reasonable rule adopted by the employer for the safety of the employee Section 9 Answer the question for drug/alcohol test administered. Step 4 In the event of a motor vehicle accident, a Vehicle & Property Damage Report (Attachment Two) must also be completed. This report contains three sections that are to be completed by the employee/driver involved in the accident, the supervisor, and safety officer respectfully. 3.3 Safety Professional / Representative Investigation Department or Agency Safety Professionals / Representative will ensure the quality of the Supervisor s Report by reviewing before it is sent to Risk Management within 5 days of the incident. They are also to be available to assist throughout the injury or illness investigation process, and must be included in the process for accidents of a serious nature that include one or more of the following circumstances: A traumatic accident or acute illness that requires the injured party to be transported from the scene by ambulance Accident/Incident Investigation Standard Page 3 of 9

4 An injury or illness that requires hospitalization When the accident results in a fatality When it is suspected that drugs or alcohol use contributed to the accident When the accident results in disabling damage to any vehicle or any equipment ("disabling damage" is defined in Section 4.0 (c) of this Standard) When the injury includes bone fractures or the resulting medical treatment includes the application of sutures Note: Management may choose to assign a Safety Professional / Representative the supervisor s responsibility for completing the Supervisor s Report of Accident / Incident. 3.4 Risk Management Office Responsibilities Upon receipt of an OUCH Line Work Injury Report, the Claims adjustor shall check to see whether or not a Supervisor's Report of Accident or Incident has been submitted. If a Supervisor's Report of Accident or Incident has been submitted, then the document shall be included in the permanent workers' compensation file. If a Supervisor's Report of Accident or Incident has not been submitted, then the Risk Management Office shall contact the supervisor by , or other means and inform him/her that he/she is responsible for completing the form and submitting it to the Risk Management Office within five calendar days following notification of a workplace injury or illness. Information on the form will be used by the adjustor to help determine whether or not the City is accepting liability for the injury or illness, and whether or not an adjustment for a safety rule violation should be taken. Information collected will be used by the Risk Management Office to identify injury trends and areas of concern for accident prevention efforts. 4.0 Post Accident Alcohol and Drug Testing Alcohol and drug testing requirements are established by Executive Order Number 94. In accordance with this Order, post accident testing shall take place as follows: a) The supervisor shall ensure that driver-employee is tested for alcohol and drugs when the accident: 1. May have been the fault of the employee and the accident involves a fatality. 2. May have been the fault of the employee and any individual was injured severely enough to receive medical treatment immediately away from the scene of the accident. 3. May have been the fault of the employee and the accident resulted in disabling damage to any vehicle or any equipment. 4. There is reasonable suspicion to test the employee. Accident/Incident Investigation Standard Page 4 of 9

5 b) Post-accident alcohol and drug testing shall be administered within two (2) hours following the accident. Supervisors who do not test employees within the established time frame may be subject to discipline, up to and including dismissal. c) "Disabling damage" for a vehicle accident is defined as damage that precludes the departure of the vehicle from the scene of the accident in its usual manner. Vehicle damage that can be remedied temporarily at the scene without special tools or parts, i.e., replacing a tire with the spare, taping over a headlight, or tying down the hood of a car is not considered disabling. d) "Disabling damage" for a workplace accident is defined as precluding the use of the equipment for its usual operation. Damage to equipment that can be remedied temporarily at the scene without special tools or parts is not considered disabling. e) If the supervisor does not initiate alcohol testing within eight (8) hours of the accident or drug testing within thirty-two (32) hours of the accident, the supervisor shall cease attempts to administer the tests and shall state in writing for the record the reasons for not administering the tests. Supervisors who do not test employees within the established time frames may be subject to discipline, up to and including dismissal. Accident/Incident Investigation Standard Page 5 of 9

6 Attachment One Accident/Incident Investigation Standard Page 6 of 9

7 Accident/Incident Investigation Standard Page 7 of 9

8 Attachment Two Accident/Incident Investigation Standard Page 8 of 9

9 Accident/Incident Investigation Standard Page 9 of 9