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Sample Follow-up Checklist Incident Investigation Guideline Investigator Name: Event Assessed: Date of Assessment: Investigation Follow-up Checklist

Follow-up Issues
1. 2. 3. Are the incident investigation follow-up expectations clearly stated in the incident investigation policy statement? Are the incident investigation follow-up expectations and requirements included in key performance indicators? Does the incident investigation management system include: Strongly encouraging near miss reporting and investigation? Requirements for formal periodic status reports of recommendations? Requirements for documentation of a formal plan for sharing lessons learned? Provisions for multiple versions of the report, where needed? Provisions for modifications of original recommendations? Are appropriate levels of upper management aware of and involved in monitoring the implementation or resolution of recommendations and resultant action plans? Have audit protocols been established that include examination of effective implementation of: Investigation follow-up measures? Recommendations? Are incident investigation follow-up expectations included in training and competency systems?

Addressed? Yes No




(See Chapter 14)

2003 AIChE - CCPS