Sample Investigation Improvement Checklist Incident Investigation Guideline INVESTIGATION IMPROVEMENT CHECKLIST

Instructions: Review each classification statement to determine if it is TRUE or FALSE for the incident investigation finding in question. Any statement that is answered with FALSE presents a causal path and an associated management system improvement opportunity.

Category
DESIGN

Circle
T/F

Defining Statements
The current design used the correct specifications and was built so that it was adequate for the intended service. (This includes design logic, hardware, installation accuracy, arrangement, & ergonomic factors.) The control system(s) for the equipment or activity in question performed in accordance with the design logic, programming, or other instructions. (This deals with the actual control operation or execution. It would not include control logic that is in the design category.) The administrative procedures were:

PROCESS CONTROLS

T/F

ADMIN PROCEDURES

T/F T/F T/F T/F

available (you had them) adequate (they were usable) accurate (they were correct)

approved and enforced (you really meant it) These are the procedures covering broad organizational needs such as management of change, design and installation expectations (including avoiding headknockers and logical labeling), procurement (including approving substitutions and vendor equivalents), implementation (including defining training requirements and administrative support systems), safety (including specifying appropriate protective gear), environmental compliance, housekeeping standards, and emergency response. The operational procedures were: available (you had them) adequate (they were usable) accurate (they were correct) approved and enforced. (you really meant it) available (you had them) adequate (they were usable) accurate (they were correct)

OPERATION PROCEDURES

T/F T/F T/F T/F

MAINTENANCE PROCEDURES

The maintenance procedures were: T/ F T/F T/F T/F

approved and enforced. (you really meant it) (The focus of this category is the actual maintenance tools, techniques, and standards for work that go beyond the traditional scope of normal inspection and preventive maintenance activities.) Training was:

TRAINING T/F T/F

available, timely (initially and in reviews) adequate and verified to be effective to achieve functional and compliance requirements.

2003 AIChE - CCPS

Sample Investigation Improvement Checklist Incident Investigation Guideline Category

INSPECTION & PM

Circle
T/F

Defining Statements
Inspection and preventive maintenance were in accordance with applicable procedures, manufacturers or experiencebased recommendations and governing standards, and were adequate for the service conditions. The equipment, parts, and materials as initially procured were as specified, were not defective, and met or exceeded the applicable specifications. (If you had gotten what you thought you were getting, the equipment or material involved would not be an issue.) Personnel were fit for duty required. (Includes physical/mental/emotional states and addresses preexisting physical conditions, substance abuse, and other related concerns.) Personnel actions, activities, and decisions were in accordance with procedures, training, and expected workplace standards. External items including weather and external third party actions/events were not creating out-of-design conditions. The incident has been satisfactorily classified in one or more of the above categories

EQUIP & MATERIALS

T/F

PERSONNEL FITNESS

T/F

HUMAN ACTIONS

T/F

EXTERNAL OTHER

T/F T/F

2003 AIChE - CCPS