5 WHY Incident Investigation

• Incident description

• Bechtel #

• Vessel / Location

• Conducted on

  Date

• Prepared by

• Document No.

1. INVESTIGATIVE TEAM MEMBERS

• Names of investigative team

2. IMPORTANT

• Have Bechtel been notified?

  yes

  no

• Time and Date

• Person notified

• INFORM BECHTEL

• Has a drug and alcohol test been arranged?

  yes

  no

• Time and date

• Person notified

• D&A TEST REQUIRED WITHIN 2Hrs

3. INCIDENT DETAILS

• Date and time of incident

  Date

• Vessel or Location of incident

• Incident

• Incident type

  Near Miss

  Personal Injury

  Environmental

  Equipment Damage / Process Loss

• Has the Medic been informed?

  yes

  no

• Inform the Medic

• Other - List

• Person(s) involved

• Plant / Equipment involved

• Injuries / Damage sustained

• Damages cost estimate

• Sequence of events

4. EVIDENCE

• Photographs

  Media

• Enter drawings?

Drawing

• Drawing

  Drawing

• Enter statements?

Statement

• Statement

• Signature

  Sign

5. 5 WHY

• 1. Why did the incident happen?

• Supporting data

• 2. Why did 1 happen?

• Supporting data

• 3. Why did 2 happen

• Supporting data

• 4. Why did 3 happen?

• Supporting data

• 5. (Optional) Why did 4 happen?

• Supporting data

6. ROOT CAUSE (What was the answer to the last question?)

• Enter root cause?

Root cause

• Root Cause

  Select Risk Assessment Procedure Design Quality Control Maintenance Human Factors Management Training Communication Environmental Other - List Below

  • Risk Assessment
  • Procedure
  • Design
  • Quality Control
  • Maintenance
  • Human Factors
  • Management
  • Training
  • Communication
  • Environmental
  • Other - List Below

7. RECOMMENDATIONS

• Enter recommendation?

Recommendation

• Recommendation