Title Page

  • REGISTRATION DATE

  • LOCATION
  • REPORT NUMBER

  • DEPARTMENT

  • PROJECT TYPES

PROJECT INITIAL INFORMATION

  • In this section, Facilitator select the project types along with project area. Discuss with the champion or leader about the problem statement and background. Find sufficient baseline data as the benchmarks for target establishment.

  • PROJECT AREA

  • TITLE

  • BACKGROUND & CURRENT STATE

  • BASELINE

TARGET ESTABLISHMENT & TEAM FORMATION

  • In this section, Facilitator arrange meeting with the executive sponsor, champion and leader to set the target objective and team formation.

  • TARGET OBJECTIVE

  • EXEC. SPONSOR

  • CHAMPION

  • LEADER

  • MEMBER

  • FACILITATOR

  • TEAM DOCUMENTATION

PROJECT PROCESS STRUCTURE

    ANALYSIS AND COUNTERMEASURE
  • In this section, Facilitator guide the project team to analyze the root cause as well as its relevant countermeasure.

  • POTENTIAL CAUSE OR ROOT CAUSE

  • CONTINGENCY, CORRECTIVE OR PREVENTIVE ACTION

IMPROVEMENT ITEMS

  • In this section, Facilitator review and provide tangible or intangible benefit information.

  • BENEFITS OF PROJECT

  • TANGIBLE

  • BREAKEVEN ANALYSIS MODEL

  • COST:BENEFIT RATIO

  • ESTIMATED ANNUAL SAVING (IN MILLION IDR)

  • PROCEEED!

  • INTANGIBLE

  • RELATE TO BENEFITS

  • STANDARDIZATION

  • PROCEEED!

  • DOCUMENTATION
  • In this section, Facilitator documented any evidence comparison such as flow process, description, data, graph, etc. Ideally it compares before and after project.

  • BEFORE VS AFTER

PROJECT MONITORING

  • DATE OF COMPLETION BY PROCESS STRUCTURE:

  • PROJECT SUSTAINABILITY
  • In this section, Facilitator controlled and monitored the closed project regularly to ensure the sustainability.

  • AUDIT AT:

  • STATUS:

  • FINAL PROJECT VALIDATION
  • In this section, Facilitator escalate the project sustainability result to validator for project acknowledgement.

  • FINAL PROJECT VALIDATION:

  • MONITORED BY:

  • VALIDATED BY:

  • FOLLOW-UP ACTION & RE-VALIDATION

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.