Workplace Near Miss Reporting

A workplace near miss (or high potential) incident can be described as an event that had the potential to but, did not cause the death or injury to a person or damage to property, plant or equipment.

This workplace near miss report form has provisions to describe what happened and the processes involved in the near miss incident. You can also indicate in the report what could have potentially happened if circumstances developed into a more serious occurrence.

Note: Near miss reporting helps management predict and prevent the occurrence of incidents.

Why a Near Miss Matters and How to Report Them?

A near miss is an unplanned event that did not result in injury, illness, or damage but, the event had the potential to do so. Near misses are often thought of as ‘lucky’ events or ‘close calls.’ But while they may seem innocuous, near misses can be quite dangerous. That’s because a near miss is an indication that something went wrong and if that something isn’t corrected, it could easily lead to an actual incident, injuries or even fatalities.

A near miss matters because:

• They provide an opportunity for hazard identification and to improve health and safety management before someone gets hurt.
• They can be an indicator of safety issues or high-risk health and safety problems.
• They can help prevent a notifiable incident occurring and improve safety.

When reporting a near miss be sure to:

• Report the event as soon as possible to people who have the authority to take corrective actions.
• Include as many details as possible in the reporting system used.
• Be prepared to follow up to ensure corrective actions are taken and are effective.

Note: Reporting near misses is very important as it provides an opportunity to learn and improve before someone gets hurt and will reduce incident rates.

Why Subscribe and Download this Workplace Near Miss Report?

This workplace near miss report can be used to document and report a near miss event, that may have the potential to cause the death or injury to a person, or damage to property, plant or equipment.

With this workplace near miss report you will be able to:

• Very easily edit and customize the template to create your own workplace near miss report.
• Apply your own style, format and brand to the workplace near miss report.
• Use it in any industry or sector regardless of size or type of organization.

Availability and Use of this Workplace Near Miss Report

• This workplace near miss report is accessible to you right now by clicking the ‘Become a Member Now’ button.
• The flowchart will be delivered to you in fully editable Microsoft Word format for immediate and full use in your business.
• There are no membership auto-renewals, contracts or ongoing costs.

If you can find HSEQ documents that are of better value than what your Membership offers, we will REFUND YOU double the cost of your membership.

You may also need:

• Incident Register
• Incident Report Form
• Safety Assessment Form
• Safety Improvement Request
• Health and Safety Performance Report
• Nonconformity and Corrective Action Procedure