Improving how organisations learn from incidents
Evaluating and strengthening incident investigation processes to support organisational learning and safety improvement.
The Challenge
The organisation sought to improve the way it learns from incidents to prevent future occurrences. The challenge was to assess and optimise the existing incident investigation and learning processes across different research domains, ensuring that the organisation systematically captures lessons from incidents and translates them into effective actions.
The Outcome
The maturity check revealed the need for standardised incident learning processes across all domains to ensure consistency in investigations and effective learning. Using structured methods like BowTie and Root Cause Analysis ensures findings are actionable. Proactive risk management through leading indicators, such as near-misses and safety culture assessments, helps identify risks early and take timely actions to prevent incidents. The review also emphasised the importance of implementing corrective actions quickly with clear action plans and ownership. Creating a centralised platform for sharing lessons learned across domains will speed up the adoption of best practices. Regular evaluation of implemented measures ensures continuous improvement and effectiveness.
ISO certified
