We’re reading incident reports the wrong way around!
Start with the solution, and work our way towards the front.
Incident report hits your desk. First thing you do is check to see who it was who was injured, when, where, and how it happened. Then you look at the investigation notes (if there actually are any) and look to see if the root cause was identified. It probably wasn’t. Then you go to the corrective action to see what is being put in place to prevent continuation or recurrence of the incident. It probably says something like, ‘take more care’, or ‘training’. Sure. Makes sense. Maybe.
But what if we started at the back and read the incident report in reverse?
How about we first go to the corrective action; the solution? From that, we should be able to get a pretty good idea of what problem is being solved. And by understanding the problem that is being solved, we should be able to predict what the incident was. If we can’t, then the corrective action doesn’t solve the problem, or we haven’t actually identified the problem that was the root cause of the incident.
A corrective action of ‘training’ tells us nothing. Training in what, for who?
But a corrective action of ‘training in dealing with violent and aggressive customers’, along with ‘source and implement the use of body cameras’, and ‘working two-up’ makes me think that there might have been an occupational violence incident. As I read through the incident and investigation reports I should be seeing what caused the occupational violence incident.
Similar would apply for a manual handling incident. Corrective action might read something like, ‘purchase height adjustable electric trolley for Records’, and ‘only fill archive boxes to max 10kg’, might make me think that there was an incident that involved lifting of an archive box that was perhaps too heavy for the staff member.
And ‘take more care’. That old chestnut. When I see that as a solution, I know straight away that the leader responsible hasn’t engaged their staff in identifying the solution, and/or they’ve been very laissez faire in their management of the incident. I’d be very surprised if a staff member recommended taking more care as a solution to a safety problem. A good leader would ask employees questions as to why they were distracted, rushing, fatigued or complacent. Then the solution would address that issue.
Give it a try. Read the proposed solution first, then see if it matches the identified problem. If it doesn’t, then either it’s a poor solution, or the problem hasn’t been properly identified. But best of all, it means that we are focusing on the solution first and foremost. We are future focused. Solutions minded.