accident

Accident / Incident Investigation Rev. 4-09 Page 1 of 8ACCIDENT.DOCLeadership Objectives:∙Determine the root causes of accidents/incidents to prevent reoccurrence.∙Demonstrate leadership concern for the health and safety of employees.-The Leadership shall review the scene of significant accidents/incidents.- A written report of all lost work day cases shall be forwarded to the Divisional Manufacturing Director and Divisional Safety Manager (See attached “Accident-Near MissCommunications” letter dated October 18, 2004).-The Leadership shall review the report of all injury/illness and near-miss incidents in the Plant Safety Review Board meeting.Who is responsible for conducting accident/incident investigation?∙The Leadership is responsible to assure that the incident investigation process is followed.∙The Leadership will participate in investigations of serious incidents.∙The Supervisor has the responsibility to promptly investigate incidents.∙Local Joint Health and Safety Committee is responsible to participate and support the needs of an investigation.Rev. 4-09 Page 2 of 8ACCIDENT.DOC(continued)Follow an Accident/Incident Investigation Process.∙Supervisors shall promptly investigate incidents, while the Local Health & Safety Committee will provide technical support of the process.∙Determine depth of investigation.- A comprehensive (large scale) investigation may be required.∙Notify Proper Personnel(See attached Accident Reporting Procedure.)∙The Supervisor shall make a preliminary review of the incident before the end of the shift.∙Affected employees and witnesses shall be interviewed.∙All facts shall be documented.- Review safe job procedures.- Review previous safety observation tours.∙Determine possible immediate, short term and long term corrective action.∙Implement a corrective action plan.- Update safe job procedures.∙ A written report is required which summarizes the facts of the incident.- Safety Incident Report (See Common Core Element 3# Injury/Illness Tracking, Analysis & Resolution- Delphi Equipment Incident Report (Required for Catastrophic Trailer Failure Incidents forcommunication of incidents to Delphi PC&L, trailer mfg. and responsible carrier)∙Communicate information across the company as appropriate (See Common Core Elements #2 Awareness & Communication, #3 # Injury/Illness Tracking, Analysis & Resolution and attached letter).Rev. 4-09 Page 3 of 8ACCIDENT.DOCRev. 4-09Page 4 of 8ACCIDENT.DOCACCIDENT REPORTING PROCEDUREGENERAL PROCEDURES:∙ Medical & Emergency Attention Given.∙ Bloodborne Pathogens Procedures Followed. ∙ Accident Scene Secured.∙ VME (within 8 hrs.) Serious Near Miss or Serious Injuries to __________________________.∙ Email Accident Report (See Attached) to Manufacturing Director ____________________________; copies to Divisional Safety Manager ______________within 24 hours on all lost time cases or near misses which under slightly different circumstances could have been a lost time case.∙In case of Accidents/Incidents involving Tractor Trailer Processes/Failures, submit report to Delphi Logistics as well.ADDITIONAL PROCEDURES--SERIOUS ACCIDENT∙ Identify Onsite Coordinator for Fatality/Serious Accident Investigation. ∙ Identify Onsite Coordinator for Communications with Family.∙ OSHA (or state OSHA) Notified or your local governmental requirements.* Within 8 hours (fatality) or the in-patient hospitalization of 3 or more employees as a result of a work-related incident.∙Local Joint Health & Safety Personnel Delphi Representative _____________________________ Union Representative _____________________________NOTIFICATIONS:Management (notify appropriate members):∙ ∙ ∙ ∙ ∙ ∙Medical :∙ ∙ ∙Union Contacts :∙Rev. 4-09Page 5 of 8ACCIDENT.DOCrevised October 18, 2004 Page 1 of 2 To: MTT Members, Delphi Divisional Safety Managers, Delphi Personnel DirectorsFrom: Karl L. Bossung Re: Accident - Near Miss CommunicationsIn an effort to achieve our ultimate goal of an injury/illness free workplace, it is extremely important to ensure that communication of serious accidents and near miss incidents are forwarded to each Delphi location then disseminated throughout the workplace.In order to achieve this objective, the following process has been developed for communicating serious accidents and near miss incidents for every Delphi facility worldwide.∙ When a serious accident or near miss occurs at any Delphi facility, a short VME message from that facility must becommunicated to your Divisional Manufacturing Manager and Divisional Safety Manager. This VME message must be sent by the facility within 8 hours of the incident occurring. This verbal message must be followed by a brief written Safety Bulletin within 24 hours of the incident, to the same aforementioned persons (e-mail is the preferred method for distributing the written Safety Bulletin). It will be the responsibility of the Division to immediately forward this VME and written Safety Bulletin to the Delphi Corporate Director of Health and Safety (248)813-8080 (e-mail:karl.bossung@). The VME and written Safety Bulletin must contain at least the following information:∙ Location∙ Date of Incident∙ Description of Operation/Work ∙ Description of Incident∙ Injury Status as it is currently known ∙ Immediate Corrective Action∙ Location Contact Name and Phone Number∙ Recommended Target Group at other Delphi Worldwide facilities for Immediate SafetyContactRev. 4-09 Page 6 of 8 ACCIDENT.DOC Page 2 of 2∙This brief written notification will be used to communicate the facts associated with the incident and serve as a emergency safety talk to the recommended target group at each Delphi facility worldwide. After further investigation is completed and short and long term recommendations are finalized, a more thorough written Safety Bulletin (with attached visual aids such as sketches, pictures, video, etc.) must be completed by the location and sent to the Division who in turn will forward to the Delphi Corporate Director of Health and Safety for distribution. This more thorough Safety Bulletin should be completed within 14 days of the incident date.∙It will be the responsibility of the Delphi Corporate Director of Health and Safety to forward both the VME and written information to the Divisional Safety Managers throughout Delphi.∙Each Divisional Safety Manager will be responsible to immediately forward this information to each of their locations worldwide.∙Each Plant/Facility/Operations Manager will be responsible to disseminate this information immediately throughout their respective organization and that the Recommended Target Group identified by the incident site is given a special Safety Contact by their supervisors relative to the accident/near miss and also the safe method of performing their job.∙Each Delphi Division will be responsible to conduct internal audits to ensure that the information has been disseminated throughout their locations and to the proper target audience. When conducting such audits, at least half the locations surveyed must be from International Operations.∙The Delphi Corporate Director of Health and Safety will also conduct random audits to ensure that this process is being followed. Results of the audits will be reviewed by the Delphi Strategy Board.cc: J. T. Battenberg IIID. RunkleM. WeberD. LogozzoDivision Name ___________ Array Array__________ PlantSAFETY INCIDENT REPORT(Please Print or Type)Describe the Incident:Detail the Contributing Factors: (e.g.: 5 Why’s, Root Cause Analysis, etc.)1.2.3.4.5.Date of Latest Safety Contact: Subject: Given by:How Long has this Person been Performing this Task: Are Written/Standard Procedures Developed for this Task: Yes [ ] No [ ]Latest Date these Procedures were Reviewed with this Person: By Whom:If Recordable, Describe the Reason:If a Lost Workday Case, Describe the Reason:If a Lost Workday Case , Is Suitable Alternate Work Assignment Available: Yes [ ] No [ ] Has Alternate Work Assignment been Offered: Yes [ ] No [ ]Alternatives and corrective actions should be based upon the prevent or significantly reduce the chance of the incident Hierarchy is defined by 5 levels of safety controls. The “Elimination / Substitution” and “Engineering” controls are by rely much less on human behavior, are more difficult to defeat, implement the top 2 levels (Elimination / Substitution and controls.Disposition, Notes and Comments on this Incident:Prepared by: Dept: Title:Date: Supervisor’s Signature:Date: Safety Supervisor’s Signature: Date:Business Unit Manager: Date: ______ Plant Manager:Date:。