INCIDENT CAUSE ANALYSIS METHOD (ICAM)

• Document No.

• Audit Title

• Client / Site

• Date & Time of incident

  Date

• Conducted on

  Date

• Prepared by

• Location
  Address

• Investigation Team

INCIDENT SUMMARY

• Collect information and evidence of the incident and report your findings here.

Items

• Item detail

• Photo evidence

  Media

TIMELINE

• List the activities and events leading up to the time of the incident, when the incident happened and what took place afterwards.

Activity

• Date & Time

  Date

• Activity

• What happened?

• Why did it happen?

• Actual Consequence

• Potential Consequence

• The contributing factors of this incident were analyzed using the Incident Cause Analysis Method (ICAM) process, an industrial safety initiative used to analyze serious incidents. ICAM is an analysis tool that sorts the findings of an investigation into a structural framework.
  
  An ICAM analysis clarifies why the incident happened and identifies all the factors that contribute to the event. The contributing factors are classified into four categories of the ICAM model which are: Absent or Failed Defences; Individual or Team Actions; Task or Environmental Conditions; Organisational Factors.

Absent or Failed Defences

• Enter defences here

Defence

• Absent or Failed?

  Task

  Environmental

• Organisational factor type

  Select Hardware Training Organisation Communication Incompatible goals Procedures Maintenance management Design Risk management Management if change Contractor management Organisational culture Vehicle management Management systems

  • Hardware
  • Training
  • Organisation
  • Communication
  • Incompatible goals
  • Procedures
  • Maintenance management
  • Design
  • Risk management
  • Management if change
  • Contractor management
  • Organisational culture
  • Vehicle management
  • Management systems

• Details of defence

Individual or Team Actions

• Enter Individual or Team Actions here

Actions

• Individual or Team?

  Team

  Individual

• Organisational factor type

  Select Hardware Training Organisation Communication Incompatible goals Procedures Maintenance management Design Risk management Management if change Contractor management Organisational culture Vehicle management Management systems

  • Hardware
  • Training
  • Organisation
  • Communication
  • Incompatible goals
  • Procedures
  • Maintenance management
  • Design
  • Risk management
  • Management if change
  • Contractor management
  • Organisational culture
  • Vehicle management
  • Management systems

• Details of Action

Task or Environment Conditions

• Enter Task or Environmental Conditions here

Conditions

• Task or Environmental

  Task

  Environmental

• Organisational factor type

  Select Hardware Training Organisation Communication Incompatible goals Procedures Maintenance management Design Risk management Management if change Contractor management Organisational culture Vehicle management Management systems

  • Hardware
  • Training
  • Organisation
  • Communication
  • Incompatible goals
  • Procedures
  • Maintenance management
  • Design
  • Risk management
  • Management if change
  • Contractor management
  • Organisational culture
  • Vehicle management
  • Management systems

• Details of Condition

Organisational Factors

• Enter Organisational Factors here

Factor

• Organisational factor type

  Select Hardware Training Organisation Communication Incompatible goals Procedures Maintenance management Design Risk management Management if change Contractor management Organisational culture Vehicle management Management systems

  • Hardware
  • Training
  • Organisation
  • Communication
  • Incompatible goals
  • Procedures
  • Maintenance management
  • Design
  • Risk management
  • Management if change
  • Contractor management
  • Organisational culture
  • Vehicle management
  • Management systems

• Details of Factor

Recommended Corrective Actions

• Enter Recommended Corrective Actions here

CAR

• CAR detail

Key Learnings

• Enter Lessons Learned here

Lesson

• Lesson

Sign off

• ICAM Report Author

  Sign