Missouri State University - West Plains

Accident Reporting and Documentation Policy

Accident/Incident Report Form

Purpose

It is the policy of Missouri State University-West Plains (MSU-WP) that all accidents or incidents that result in personal injury and/or damage to University property or rise to the level of significant concern for the safety and security of the campus community shall be properly investigated and reported. Although accident/incident investigation is a reactive process, a comprehensive accident reporting and investigation process is a proactive measure that can effectively prevent or minimize future accidents/incidents. This operating procedure establishes a systematic process to ensure that accidents/incidents are properly reported and documented in a timely manner and that the appropriate corrective actions are taken.

Scope

This operating procedure applies to the investigation and reporting of all accidents/incidents that result in:

  • a work-related injury to any University employee (staff, faculty, student workers) or volunteers;
  • personal injury to non-University personnel while on or using University-owned property; or
  • damage to University-owned property; or
  • breach of campus safety and/or security.

Responsibilities

Department heads, managers and/or supervisors are responsible for:

  1. ensuring that all accidents/incidents are properly reported and investigated in accordance with this operating procedure; and
  2. ensuring that all corrective actions are promptly and completely carried out.

Employees are responsible for reporting any work-related accident resulting in injury to their manager/supervisor as soon as possible. All accidents/incidents must be reported by no later than the end of the employee’s regular work shift. (Note: Employees must also complete the appropriate Workers’ Compensation forms as soon as possible, normally within 24 hours of the incident pursuant to the Workers’ Compensation Section 7.5 of the Employee Handbook.)

Therefore, department heads, managers, supervisors and/or employees will immediately contact the Dean of Student Services or alternate staff person when issues within the scope of this policy develop. In the event the Dean of Student Services is not available, persons will contact 1) the Director of Business and Support Services or 2) the Coordinator of Student Life and Development. Depending on the circumstances, the Dean of Student Services (or alternate) will either request the preparation of an Accident/Incident Investigation Report or proceed directly to the scene themselves.

The Dean of Student Services will participate in accident investigations, either directly or by review of the report, as deemed appropriate to the occasion. The Dean of Student Services shall determine the level of participation that is warranted.

The Office of Human Resources is responsible for administering the Workers’ Compensation benefits program for work-related injuries or illnesses.

University General Counsel will review quarterly reports and identify any trends.

Notification Procedures

Victims (if possible) and witness(es) of all accidents/incidents are to contact the Dean of Student Services.

Investigation Guidelines

Once notified of an accident or incident, the Dean of Student Services (or alternate) will either request the preparation of an Accident/Incident Investigation Report or proceed directly to the scene to determine whether the situation should be handled within the University or referred to law enforcement or other agency for principal investigation.

Accident Scene – When possible, the accident scene should be preserved and disturbance of any physical evidence should be prevented until the principal investigator(s) arrive. Unless necessary to prevent further damage or injury, clean up or repair activities should commence only after all pertinent information has been collected.

Witnesses – The principal investigator(s) shall identify and record the names of all individuals who witnessed the incident. Each witness shall be requested to provide a written statement identifying the account of the accident/incident. Witnesses shall be instructed to forward their written statements to the Dean of Student Services. In addition, the victim of the accident/incident, if possible, shall be interviewed and provide a written statement.

Photographs – When feasible, the principal investigator(s) should obtain photographs and or measured diagrams of the accident scene. All photographs should be auto-dated by the camera.

Questioning Injured Employees and/or Witnesses – When questioning injured employees or witnesses, the investigator(s) shall stress that the purpose of the investigation is to identify facts and not to assign fault. At all times, the investigator(s) shall ensure that proper medical treatment and care of any injuries is given priority over questioning of the personnel involved.

Investigation Reporting – The investigator(s) shall prepare a report in the form as Exhibit A. Upon completion of the investigation, the investigator(s) will document the incident in a database.

Documentation

  • The Accident/Incident Investigation Report Form will be used to document the accident/incident. The Dean of Student Services (or alternate) will either originate or receive the report forms and then forward the original report to the Director of Business and Support Services and retain a copy for file. The Dean (or alternate) will request any witnesses to submit their accounts on the investigation report form to both the Office of Business and Support Services and the Dean of Student Services.
  • The Director of Business and Support Services will log the accident/incident into an Excel spreadsheet by providing the following information:
    • Date of accident
    • Name of injured party (if known)
    • Location of accident
    • Summary of accident
    • Cross reference ID to office records containing additional detailed information on the accident
    • Name of personnel who collected accident scene information
  • The Director of Business and Support Services will quarterly provide a listing to the University General Counsel of all accidents that were reported as occurring within the prior three months. Additionally, these offices will report any Major Accident (see definition above) to the University General Counsel and the Chancellor of the West Plains Campus within 24 hours.
  • University General Counsel will review the quarterly reports and attempt to identify any accident trends that prompt facility/grounds modifications to improve safety. If warranted, the University General Counsel will contact the appropriate entity for further review and, if appropriate, action.
    • Reports will be delivered to the University General Counsel on or near the following dates each year:
      • March 31
      • June 30
      • September 30
      • December 31