Incident Management: What to Do and How to Prevent Them

Regardless of your workplace and industry, incidents happen. And that means at some point, every facility needs to understand incident management. If you’re a hospital employee health department, what happens when an employee comes to work with the flu? What about a nurse picking up an infectious disease from a patient? How about when sharps are improperly disposed of? What about missing medication or a gas leak? The list goes on, and there are different concerns for every industry.

There is no one-size-fits-all answer to incident management. Different types of incidents require a different approach. Knowing what constitutes an incident, what needs to be handled internally and what needs to be handled externally, the regulations that govern incident management, and best practices to stay on top of your tasks and your team is key to acing your incident management strategy.

Keep reading to find out:

• What are incidents?
• Who needs to know about incidents, internally and externally?
• What regulations do you need to know about when it comes to incidents?
• How do you manage the timeline after an incident?

What Is an Incident in Incident Management?

There are 340 million occupational accidents and 160 million work-related illnesses each year in the U.S. Slips, trips, falls, overexertion, bodily reaction, and contact with objects account for 84% of all non-fatal injuries involving time away from work. In 2020, 36,840 workplace injuries were caused by exposure to harmful substances or environments.

Realistically, is everything an incident? Is getting a paper cut and putting a band-aid on it an incident? Truthfully, the answer depends on your industry. There are some incidents that will be fine to handle internally, and some that must be reported to external governing bodies like the Occupational Safety and Health Administration (OSHA). Make sure you understand the regulations in your industry, so you don’t run into any non-compliance issues (we’ll cover the regulatory basics later on).

When it comes to incidents, generally, anything resulting in injury or illness for employees or visitors is considered an incident. That means most of those paper-cut injuries are technically incidents, though they rarely rise to the level of required reporting, especially externally. Depending on your setting, certain injuries and illnesses may be more common than others.

• Hospital settings are likely to see infectious diseases, sharps incidents, and increasingly, workplace violence
• Offices and retail businesses see cuts and bruises and common infectious illnesses, like the flu or COVID-19
• Gyms and exercise studios will often see minor sprains and strains, cuts and bruises, and cardiac incidents like heart attacks
• Manufacturing facilities will be more likely to encounter slips and falls and more serious injuries like limb loss
• Labs, or any other facility that commonly uses chemicals, will see chemical spills, burns, and even chemical or smoke inhalation injuries

Who Needs to Be Informed about Incidents?

Incidents are considered incidents because something caused pain or damage to a person (or workplace equipment, though as we’re talking about occupational health today, we’re going to skip over this half of incident management). That means the situation needs to be recorded, but how exactly that happens differs by workplace and by industry.

Most workplaces will have an internal reporting structure that must be accommodated when incidents occur. This might include filling out a form with information like the victim’s name, the details of the incident, any treatment offered at the time, and any follow-up care provided later. Check with your organization to find out the exact details of your process and structure.

For many incidents, filling out an internal report is all that’s required. To use the paper cut example above, cleaning the cut with soap and water and applying a Band-Aid are minor treatments that do not rise to the level needed to report externally. This is true of most cuts and scrapes, bruises, and often those common infectious diseases like the flu.

More severe incidents might require external reporting.

When to Report Incidents Externally

Workplace incidents can be a complex problem to navigate. From the immediate treatment to the reporting to the evaluation afterwards, incident management requires a good many steps that your occupational health department needs to be on top of.

If an incident results in employee (or contractor, visitor, etc.) injury, it should be externally reported. This is especially true if the employee requires time off of work. While the severity of injury can vary, there are some common ones that you should expect to need to report externally. These will vary by workplace, as we discussed earlier, but these typically include:

• Slips
• Falls
• Chemical exposure
• Loss of limb or organ
• Burns
• Cardiac incidents and infectious disease
• Death, including suicide

Who to Report Incidents to

When incidents need to be reported externally, there are a few different places they should be reported to.

1. OSHA: The one agency that probably comes to mind, OSHA needs to know about incidents that result in severe injury or loss of life. Any hospitalization, amputation, or loss of eye sustained in a workplace incident must be reported within 24 hours of discovery, and any death within 30 days of a workplace incident must be reported within 8 hours of discovery.
2. State boards and agencies: Get familiar with your state’s requirements, which may function in addition to OSHA’s reporting structure. States can vary widely in what they require. For example, Massachusetts has a Department of Industrial Accidents that must be informed of any employee disability lasting five full or partial calendar days. Texas employees have one year to apply for Workers’ Compensation, if their employer carries insurance. Insurance isn’t required for employers in Texas, however, so companies may need to prepare to face personal injury lawsuits after workplace incidents.
3. The Centers for Disease Control (CDC) and state Boards of Public Health: Infectious disease incidents don’t need to be reported to OSHA, but they should be reported for the benefit of public health. Your state’s specific requirements may vary, but the state board will report to the CDC if they deem the escalation necessary.

What Do You Do after an Incident Occurs?

Incident management requires a few steps, some of which we’ve covered a bit already.

Step One: Securing the Scene and Medical Response

When an incident occurs, ensuring safety as soon as possible is not just the first step, it’s critical. As any first aid course will tell you, the scene needs to be safe before you can do anything else. That means making sure first responders, medical staff you may have internally, and more can access the victim without putting themselves at risk. That might include limiting or cleaning up chemical spills, securing live wires, turning off machinery, or removing broken equipment. Call 9-1-1 for assistance as needed.

Once the scene is safe (and bear in mind, that might require first responders from the fire department or HAZMAT team), medical professionals, whether your internal team or first responders like emergency medical technicians (EMTs), can arrive to help the victim.

Step Two: Reporting

Once an incident has occurred, report the relevant details and information to the proper agencies and follow all internal reporting requirements.

Step Three: Evaluating the Incident

People are only human, so incidents are bound to happen at one point or another. But the facilities that manage incident response the best also do the best at understanding why incidents happen and taking steps to prevent them.

Of course, there are regulations, usually set by OSHA, for facility safety and processes that must be followed. Those will vary by industry, so make sure you know what’s required of yours. But your own internal policies should be constantly evolving with the realities of your work and your staff.

If an incident occurs, do an internal audit of the circumstances. Find out what happened in the lead-up and aftermath of the event, and make sure you review any footage if your facility has cameras. Use this information to review your current policies and processes. Update your policies as needed to reduce the risk of the same incident happening again.

What Tools Can You Use to Help with Incident Management?

An occupational health EHR will have multiple features that can help gather and process information so that reports present a detailed picture of problematic areas to target. Some reporting can allow users to see the most common types of injuries in an organization and the locations where these occur by pulling information from incident reports. These reporting tools make it easier to plan interventions that address an organization’s actual issues.

You could also choose to run reports on detailed incident listings, describing each recorded employee incident. You could view each illness, injury, and exposure by date to give you a more detailed view of your facility at any given time. Occupational medicine professionals can learn more information about:

• The nature of incidents
• Affected body parts
• Root causes
• Diagnoses
• Physicians who treated employees
• Injury severities

And the best EHRs will block out specific details, such as employee names or a doctor’s charting notes, to make them shareable without violating privacy.

How Does Incident Management Help?

Incident management is key in developing safer workplaces for all. Knowing how and why incidents happen makes it easier for us to update our regulations, processes, and policies to prevent those incidents from happening in the first place. When we do have to deal with incidents, incident management helps us do it quickly and safely to provide the best outcome possible.

You should know where and when you need to report incidents, whether to OSHA, your state health board, or just your own internal reporting structure. Understand the regulations that are in place to prevent incidents, and make sure you’re following them. Occupational health and safety departments are a great investment in quality incident management. With the right staff and tools, they can help you prepare your facility properly, they can assess victims, they can work on maintaining employee health and safety at work, they can perform return-to-work evaluations, and they can help you audit your processes in the aftermath of an incident.

FAQ: Incident Management

Here are some common questions about incident management and how to handle it.