CP - Planned Task Observation Checklist

• Planned task to be observed:

• Conducted on

  Date

• Team Leader:

• Team Member 2.

• Team Member 3.

IDENTIFY PROCEDURE TO BE OBSERVED

Identify procedure you will observe

• Does the procedure align with a high risk activity ?

  Yes

  No

  N/A

• Do you have any new or inexperienced team members ?

  Yes

  No

  N/A

• Are there work instructions that are associated with incident trends or repeat incidents ?

  Yes

  No

  N/A

Review Procedure

• Do you understand the task requirements ?

  Yes

  No

  N/A

• Do you understand all the potential hazards ?

  Yes

  No

  N/A

• Check that suitable controls have been identified

  Yes

  No

  N/A

• Can the job be done safer or more productive ?

  Yes

  No

  N/A

Prepare observation materials

• Have you highlighted sections of the procedure to focus on ?

  Yes

  No

  N/A

• Have you made notes on the procedure ?

  Yes

  No

  N/A

• Have you prepared a list of questions to check knowledge ?

  Yes

  No

  N/A

• Have you added a check column against procedural steps ?

  Yes

  No

  N/A

Inform personnel

• Explain that you will be conducting a PTO ?

  Yes

  No

  N/A

• Explain why you are doing this ?

  Yes

  No

  N/A

• Describe the process you will follow ?

  Yes

  No

  N/A

• If possible, arrange time ?

  Yes

  No

  N/A

OBSERVE WORK PRACTICES

Check personnel's understanding of the procedure

• Check they understand the procedure for the task ?

  Yes

  No

  N/A

• Check they understand the associated risks of the task ?

  Yes

  No

  N/A

• Do they understand the controls associated with the task ?

  Yes

  No

  N/A

Check work practices and behaviours against procedure

• Observe work practices against the procedure.

  Yes

  No

  N/A

• Reinforce positive behaviours.

  Yes

  No

  N/A

• Identify deviations from procedure and coach when safe to do so.

  Yes

  No

  N/A

REVIEW OBSERVED PRACTICE AGAINST PROCEDURE

Observation Discussed

• Have you identified any gaps between the procedure and the practice observed ?

  Yes

  No

  N/A

Identify Opportunities

• Are there opportunities to improve the risk controls that are in place ?

  Yes

  No

  N/A

• Are there opportunities to improve the procedure ?

  Yes

  No

  N/A

ACTION FINDINGS & PROVIDE FEEDBACK

Provide feedback

• Thank them for their participation.

  Yes

  No

  N/A

• Reinforce the positives aspect of the task.

  Yes

  No

  N/A

• Identify and explain aspects of the task they are not doing correctly and coach them in the correct way.

  Yes

  No

  N/A

• Explain actions to participant and enter in data management system

  Yes

  No

  N/A

• Select date

  Date

Person being observed ? Sign off

• Person being observed 1. Name and Signature

  Sign

• Person being observed 2. Name and Signature

  Sign

• Person being observed 3. Name and Signature

  Sign

• Person being observed 4. Name and Signature

  Sign

Coach?

• Coach. Name and Signature

  Sign

• # of attempts

  Select 1 2 3 4 5 6 7 8 9 10

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10

• Competent/Not yet Competent?

  Yes

  No

  N/A

Person Being Observed 1 up Manager

• Person being Observed 1 up Manager. Name and Signature

  Sign