Title Page

  • Work Group

  • Task Description

  • Location
  • Date

  • Prepared by (must include team members name and position titles)

HUMAN PERFORMANCE

  • Human Performance Error Traps

  • Human Performance Tools:
    • Verbalise Point and Touch (VPT)
    • Step-by-Step
    • 3 Part Communication
    • Show and Tell
    • Stop and Seek Out Help

  • Under what conditions should I / we STOP this task?

CRITICAL RISK MANAGEMENT

  • Are there any Critical Risks for this task?

  • Please select the icon from this list.

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  • Use the associated Critical Control Checklist/s (CCC) and incorporate all applicable controls into ‘Control Measures’ section for relevant task step/s.

  • Do I need any permits to complete the task?

  • Specify

  • Additional PPE Requirements

  • Specify

  • Please Note: Before undertaking the critical steps you identified in the task, you must stop and review the controls and error traps before you can start.

  • Detail Task Steps: Click "Add Task Step"

  • Task Step
  • Detail Task Steps

  • Existing and Potential HSE Hazards / what are my Human Performance Error Traps

  • Risk Before

  • Control Measures Required to Minimise the Risk / Human Performance Tools

  • Risk After

  • What Performance Mode am I / we in at this task step?

  • Isolation Points

  • All risks remain low or moderate after controls = Crew Leader or equivalent authorisation
    One or more risk remains high after controls = Superintendent or equivalent authorisation
    One or more risk remains critical after controls = Manager or equivalent authorisation

  • Authorised by (Name and Signature)

  • Position Title

  • I HAVE READ AND NOW UNDERSTAND THIS JSEA (Name and Signature)

POST TASK REVIEW

  • Review questions once task has been completed – If you answer any of the below questions, please send the JSEA to your leader for actions (share as learnings at shift start).

  • Any issues identified?

  • Any documents to be written or updated?

  • Any lessons learned?

  • Rio Tinto 5 x 5 HSEC Risk Matrix

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  • Likelihood Descriptors

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  • Economic Consequence types (Operational)

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  • Consequence

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  • Notify Natalie

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.