Incident Reporting and Documentation Policy

load the Incident Report Form

Purpose

It is the policy of Missouri State University-West Plains 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;
  • 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 6.5 of the Employee Handbook.) All injuries resulting in Emergency Medical Services (EMS) response, or treatment by medical personnel, shall be reported immediately to the associate vice-chancellor for business support services.

Therefore, department heads, managers, supervisors and/or employees will immediately contact the associate vice-chancellor for business support services or alternate staff person when issues within the scope of this policy develop. In the event the associate vice-chancellor for business support services is not available, persons will contact 1) the vice-chancellor of student services or 2) the director of student life and development. Depending on the circumstances, the associate vice-chancellor for business support services (or alternate) will either request the preparation of an Accident/Incident Investigation Report or proceed directly to the scene themselves.

The associate vice-chancellor for business support services will participate in accident investigations, either directly or by review of the report, as deemed appropriate to the occasion. The associate vice-chancellor for business support 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's General Counsel will review quarterly reports and identify any trends.

Definitions

Major Accident -- Any injury or illness-related accident that results in:

  1. Death;
  2. Amputations involving the loss of bone tissue;
  3. Loss of consciousness due to electrical shock, lack of oxygen or chemical exposure;
  4. Possible permanent functional impairment of a body part (excluding those resulting from a back strain);
  5. Admission to a hospital (other than 24-hour observation, hernia repair or back strain).

Notification Procedures

Victims (if possible) and witness(es) of all accidents/incidents are to contact the Associate Vice-Chancellor for Business Support Services.

If the incident involves a work-related injury, employees must notify their supervisor or designee immediately upon occurrence of an incident. In the event the employee is not able to report it (e.g., unconscious), any witness employed by the University must notify the office of human resources. (Refer to Section 6.5 of the Employee Handbook.) All injuries resulting in Emergency Medical Services (EMS) response, or treatment by medical personnel, shall be reported immediately to the associate vice-chancellor for business support services.

Investigation Guidelines

Once notified of an accident or incident, the associate vice-chancellor for business support 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 associate vice-chancellor for business support 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 associate vice-chancellor for business support services (or alternate) will either originate or receive the report forms and retain a copy for file. The associate vice-chancellor for business support services (or alternate) will request any witnesses to submit their accounts on the investigation report form to the associate vice-chancellor for business support services office.
  • The associate vice-chancellor for business 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 associate vice-chancellor for business support services will quarterly provide a listing to the University's 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's General Counsel and the chancellor of the West Plains campus within 24 hours.
  • University's 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's General Counsel will contact the appropriate entity for further review and, if appropriate, action.

Line of Authority:

Responsible administrator and office: associate vice-chancellor for business support services

Contact person in that office: associate vice-chancellor for business support services

Effective Date:

Chancellor approval: March 24, 2015