What happens at your practice when an employee is injured? What happens if an accident damages your equipment and you can't treat your patients until the damage is fixed?

Accidents can have obvious negative impacts on the practice, such as injury or death, damage to equipment, lawsuits, loss of productivity, and low morale; however, you can utilize these incidents to create improvements in safety programs, procedures, and equipment. How? Design and execute a safety program that includes unbiased, prompt, and accurate accident investigations. The purpose of accident investigation is to determine measures that can prevent similar accidents in the future.

Accident reporting facilitates insurance, state, and OSHA reporting requirements, such as processing a workers' compensation claim or documenting recordable injuries. It goes beyond accident reporting and identifies the cause(s) of an accident to prevent future incidents.

Basic elements of accident investigating
Immediately provide first aid to injured employees and eliminate or control hazards to others. Then preserve the scene, document the conditions, and interview witnesses. All accidents and near misses provide an opportunity for you to discover new ways to improve safety conditions. The best practice is to investigate all accidents and near misses, even if they do not result in an injury.

Institute a systematic method to investigate accidents at your practice. Avoid the temptation to quickly assign a cause before uncovering all of the relevant facts.

Use this 5-step process to investigate accidents:

  1. Investigate the facts
  2. Review the facts to find the root cause
  3. Implement corrective measures
  4. Document findings and actions
  5. Follow up

Try to avoid finding fault with employees for unsafe behaviors. An employee may have committed an unsafe act that can be perceived as a fault, but it is important to investigate the facts and understand why the behavior occurred.

Perform a root cause analysis
It's easy to focus on the direct or obvious cause of the accident; however, the first domino that started the chain of events is the real underlying reason for the accident. To uncover this reason, conduct a root cause analysis.

Consider these three levels when you review the facts:

  • Direct cause--the immediate, and typically the most obvious, cause of the accident
  • Indirect cause--Unsafe acts or conditions that we can see that often result in accidents but are not necessarily the root cause
  • Root cause--the underlying reason for the accident that we can't see until a thorough investigation identifies the underlying reason

How do I find the root cause? Keep asking "Why"
Example: A new employee sustained a lower back injury.
Why? The employee tried to lift a large bag of dog food. (Direct cause)
Why? The employee was unable to lift the bag from a low shelf up to a cart.
Why? The employee lifted the large back of dog food alone. (Indirect cause)
Why? The employee was unaware about asking for help.
Why? The practice did not teach the new employee how to properly lift heavy items. (Root cause)

Correct actions and make changes
The hazard control process to implement corrective actions should include the affected employee(s). The changes may involve these controls:

  1. Eliminate the hazard
  2. Substitute a less hazardous material or technique
  3. Use engineering controls (slip resistant coatings or mats in wet areas, lift tables)
  4. Use administrative controls (periodic inspections, job procedures, pre-hire screenings)
  5. Personal Protective Equipment (PPE)
  6. Training (orientation, safety meetings, reviewing losses)

Document your findings of the accident investigation process in an accident investigation report so that the data can be used in future investigations, employee training, and other safety performance improvements at your practice. Your documentation should include direct, indirect, and root causes, as well as recommendations to prevent reoccurrence. The documentation should also include the short- and long-term controls that were implemented to control hazards.

When you incorporate these concepts into your incident investigation protocol you will be more equipped to identify systematic failures and to implement change that will result in sustained improvement in your loss-prevention programs.

Questions? Need information about risk management and business insurance?
If you would like to learn how the AAHA Business Insurance Program can help you, or if you would like a free policy review, contact HUB by phone at 866-380-AAHA (2242) or by email at [email protected].

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