Healthcare
Health and safety incident report
Capture what happened while it is still exact — time, place, severity and the action taken — without asking anybody to assign blame.
Why this survey gets sent
“By the time a report reaches me it has turned into a story. Two people remember two different times, nobody wrote down which door it was, and the only thing everyone agrees on is whose fault it was.”
An incident report is a record of facts, and facts decay within hours. The wording decides what you get: a box labelled “what happened” collects an account, and a box labelled “what went wrong” collects a defence. Ask for the sequence, the time, the place and the action taken, and leave the judgement to the review that follows.
What is in it
- Date, time and the exact location (required)
- Type of incident — including “near miss, nobody was hurt”
- How serious was the injury? — an ordered list
- Who was involved — name and role for each person
- What happened, in order, from just before to how it ended
- What was done immediately afterwards
- A photograph, if there is one
- Has a supervisor been told, and who is reporting
About 7 min to answer
Health and safety incident report
About 7 min
How to write this survey
Ask for the sequence, not the cause
The difference between a useful report and a useless one is a single line of wording. A box labelled “what happened?” collects an account; a box labelled “what went wrong?” collects a defence. Ask for the sequence explicitly: what was going on immediately before, then what happened, then how it ended. Chronology is easier to write for the person at the scene and much faster to read for the person reviewing it.
And do not ask for the cause here. Establishing a cause is the job of the review that follows, done by somebody who sees every report; the person standing at the scene sees one angle of it. Asking for a cause at that moment invites a guess, and a guess written into an official record is hard to withdraw later.
Time and place, exactly
Time and place are the two fields that spoil first. Take the date from a date picker rather than a text box, ask for the time written plainly as 14:30, and ask for a location precise enough that a stranger could walk to it: building, floor, room or corridor — not “round the back” and not “near the store room”.
The precision is not bureaucratic. Repeat incidents are found by grouping: three slips at the same entrance in three months means a floor that needs treating, and it never surfaces if the location was written three different ways. Where you have a fixed set of sites, make the location a closed list — a list is more accurate than any free text, and it costs the reporter less.
Severity is a closed, ordered list
Make severity an ordered list rather than a description: nobody was hurt, first aid on site, someone saw a doctor, someone was taken to hospital, a life-threatening injury or a death. An order lets the queue sort itself, so the reports that need escalating today appear at the top without anybody reading every word first.
Ask what was done immediately in a box of its own: first aid given, a machine stopped, an area closed off, a supervisor told. It is the part most often left out of a report, and it is the part that tells you whether the hazard is still there right now or has already been removed.
A near miss deserves the same report
Add “near miss — nobody was hurt” to the type list, and say in the intro that these are wanted just as much as injuries. Near misses are far more numerous, and they describe the same hazard before it has cost anybody anything: a site that records them gets a free warning, and a site that does not learns the same lesson at a much higher price.
Keep the report short enough to finish in five minutes. Every extra field costs you reports, and the dangerous failure in a safety system is not an incomplete report — it is the incident nobody filed at all because the page looked long to somebody who wanted to get back to work.
Neutral wording is what keeps the reports arriving
Neutral wording is not courtesy, it is the condition of the system working at all. Avoid words like “responsible”, “at fault” and “violation”; write “people involved” and “what happened”. Somebody who suspects that their report will become a disciplinary file will not write it, and you lose the first signal of a hazard that is still in the building.
Ask for the reporter's details at the end rather than the beginning, and say why they are being asked for: a name and a number so that whoever reviews the report can ask one follow-up question. If you want the reports to keep coming, make the name optional and accept an anonymous, partial report rather than no report at all.