A new approach to serious injury and fatality prevention

Since the advent of Heinrich's Injury Pyramid in 1931, it has been generally accepted that there is a predictive relationship between the frequency and types of non-injury, minor injuries and the serious, life-altering or threatening injuries, at the top of the triangle. The safety triangle theorizes that for every major injury there are 29 minor injuries and 300 non-injury incidents. Though this triangle is considered a gold standard, many safety professionals realize that all non-injury or minor incidents are not equal and some have more potential to result in a serious injury or fatality (SIF).

A recent report by the Campbell Institute, Serious Injury and Fatality Prevention: Perspectives and Practices recommends a redesign or enhancement of the model. The new SIF prevention model would look at all incidents - namely, precursors to accidents, recordable injuries, lost-time injuries and fatalities - and seek out those with serious injury and fatalities potential. It encourages organizations to focus on the process factors that lead to SIF, rather than human error, which will always occur. They should focus on repairing gaps in their safety management system, workplace culture, and changing or modifying work processes that eliminate human error.

For example, a workplace with a production problem may ignore or even condone shortcuts and speed, which can lead to bad decisions by workers. A forklift operator may drive too fast and not wear a seatbelt, which can lead to a serious accident. While there can be a tendency to blame the worker, the production demands were the proximate cause and the precursor to the event. According to the author of the paper, Joy Inouye, a key to lowering the fatalities in the workforce lies in an organization's ability to look inward. "Instead of blaming the worker for not putting on his seatbelt, start to look at those organizational factors that contributed to that." The report includes examples of companies that have successfully revamped strategies for identifying risk factors.

Trends in injury patterns validate the need for a shift in thinking. While employers have done a good job in reducing the total recordable incident rate, there has been a disturbing increase in the number of workplace fatalities and catastrophic injuries. Diving deeper into near misses and smaller, less serious incidents could help prevent on-the-job deaths or catastrophic injuries. By identifying potential precursors to such events and educating employees about those precursors, companies can focus on eliminating the potential for such incidents to occur.

The report recognizes that isolating incidents with the potential for SIF requires serious groundwork. It suggests next steps like organizing a think-tank that defines "serious injury", "precursor" and "potential." To determine whether an incident is a potential SIF or not, it may make sense to define and use a Severity Scale that can be consistently understood by anyone, one that is tied to potential outcomes. For example, most severe could be an injury that would lead to the death of an individual, and the least severe could be first aid and immediate return to work. Including specific injury examples can be helpful.

Implementation raises the bar of safety management and requires a proactive, rather than reactive approach. It will take careful planning - both around the processes used and the responsibilities assigned.

What employers can do

• Review and evaluate your near miss reporting system
  • Do workers fear the consequences of reporting something they may be blamed for or is there a culture of trust and all workers participate in reporting?
  • Is near miss training part of new hire orientation?
  • Are supervisors and management onboard and do they foster a reporting culture?
  • Is reporting simple and straightforward?
  • Does the report provide a solid log of what leads up to the incident?
  • Is the definition of near miss clear?
  • Is there a thorough investigation that identifies the root cause?
  • Are corrective actions taken and employees notified?
• Have supervisors explain to employees why the company is focusing on the smaller incidents and near-misses, and how a minor incident can turn major. Explain the importance of looking at potential rather than actual outcomes for minor incidents.
• Think-outside-the box. A recent article in Risk and Insurance described how Wente Family Estates vineyards teamed up with the criminology department at Holy Names University in Oakland to take a look at workers' comp data to analyze injuries and near misses, pinpointing problem areas and gathering insight on how to prevent future losses. The idea was based on a partnership between United Airlines and the University of New Haven that used interns from the criminology department as part of a data visualization project, leading to a 23 percent reduction in employee injuries and a 29 percent reduction in aircraft damage on the ground.