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2 Key Elements of a Near Miss Report [Free Form Templates]

A near miss report is an excellent business tool designed to document each near miss scenario. With this insightful document, you will be able to identify and document dozens of aspects that may result in a workplace incident.

Think of a simulated case scenario where an individual works for a contraction company. When executing his daily tasks where he is assigned to repairing a faulty power cable his safety belt snaps but luckily manages to grab the supporting bar and saves himself from crushing. However, he releases his tools of work which fall downwards only to miss hitting his colleague by an inch.

In this particular case, it was imminent that someone would have been seriously injured and probably nursing a broken rib. However, by a good chance, no one was injured. This leaves you completely shaken and probably out of breath.

What “that was really close!”

Dammit, “that would have been bad!”

Well, that was a near miss and it is a telltale sign of an impending accident.

Without any further ado, let’s dive straight in:

 

 

Part 1
What Is a Near Miss Report?

Near miss report is an essential document to record all incidences with a potential of causing damage to an organizations asset as well as workforce injury. Essentially, this document captures vital details of a specific incident like:

  • Name of the employee involved
  • A brief description of the exact occurrence
  • The location where it took place
  • A brief explanation of how it exactly happened

Although near misses do not result to any kind of injury or destruction of the company property these insightful reports form an integral part of the whole investigation process and highlight the key causes of an incident thus enabling you to put the necessary measures to avoid an accident from occurring.

Basically, a near-miss event is a prominent indicator of an impending workplace calamity. Basing your arguments from the insights of this document, you can be able to reduce the chances of the problem occurring.

Part 2
Why Do You Need a Near Miss Report? Importance of Near Miss Report

A near miss is a clear indication that an accident is imminent. This warning event should act as a trigger to a definitive cause of action on how to prevent the calamity from happening. To achieve this, a near miss report gathers vital data regarding the present work environments, workflows and structures analyses them and comes up with insightful suggestions on how to leverage on them.

 

Part 3
Detailed Guide on How To Create a Near Miss Report

Employee safety is paramount to the ultimate success of your enterprise. Therefore, putting all precautionary measures in an effort to avert an impending accident comes naturally for most experienced entrepreneurs.

ProsperForms — set up a form and start receiving submissions from your colleagues in minutes. 100+ forms available: reports, logs, requests, etc. or build your own. View and manage submissions on Timeline and Dashboard screens, generate PDF reports. Get Started
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To develop a superb near miss report, you will need to understand all its elements. Below here are some of the most essential elements of a typical document.

2 Key Elements of a Near Miss Report

1. Title page

Just like all other business documents a perfect near miss reports starts with an insightful title page that generally includes:

  • Date when the near miss occurred
  • Precise period when the event took place
  • Venue/place where it happened
  • Details of the individuals involved (inclusive of staff members and administrators)
  • Department

2. Description of the event

After stating all the specifics of the incident in regard the next step is offering a detailed and precise outline of the flow of events. Here some of the key elements to incorporate include:

  • Order of occurrences resulting in the near miss
  • An explicit description of what exactly were the relevant parties involved in when the near miss happened. For example, operating machines, lifting, walking, climbing and running)
  • Describe the setting surrounding the near miss
  • Tools employed amid the near miss
  • An insightful scrutiny of both the secondary and primary roots of the event
  • Possible courses of actions on how to correct the near miss

Part 4
Best Practices When Writing a Near Miss Report

Now you have all that you need to create an outstanding near miss report. Apparently, however, the game is not yet over. Featuring below are incredible tips which you must observe when designing this crucial workplace document.

  1. Informing newly on-boarded employees on the essence of instantly reporting near-miss incidences is a perfect approach in nurture a workplace safety conscious workforce.
  2. Consider offering incentives for every near miss event reported. Essentially this promotes prompt reporting, especially for highly hazardous areas.
  3. Gather feedback from an employee who provided the report about what can be improved to avoid the same situation in the future.
  4. If you update any processes or procedures as a result, let employees know how exactly. This creates a positive feedback loop and shows that their input is valued.

Near miss report perfectly outlines all the specifics of an event thus enabling you in precisely locating the main aspects that result to a particular occurrence. While this vital document is typically employed for precautionary purposes, a perfect near miss report allows you to identify impending accidents thus helping you prepare in advance and giving you a head-start to formulating actionable measures on how to avert the incident.

Part 5
Sample Form of a Near Miss Report

If you wish to broaden your understanding of how to create this document, below is a sample form of an excellent near miss report:

near miss report

Edit and use this template

ProsperForms — set up a form and start receiving submissions from your colleagues in minutes. 100+ forms available: reports, logs, requests, etc. or build your own. View and manage submissions on Timeline and Dashboard screens, generate PDF reports. Get Started
ZipRecruiter — post jobs to 100+ of the most visited job boards with one click. Get Started

 

incident near misses hazard alert immediate attention

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incident report

Edit and use this template

 

inspection round checklist

Edit and use this template

 

facility inspection round checklist

Edit and use this template

 

safety checklist

Edit and use this template

 

ProsperForms — set up a form and start receiving submissions from your colleagues in minutes. 100+ forms available: reports, logs, requests, etc. or build your own. View and manage submissions on Timeline and Dashboard screens, generate PDF reports. Get Started
ZipRecruiter — post jobs to 100+ of the most visited job boards with one click. Get Started
6s checklist

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fire risk assessment checklist

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security checklist

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workplace round checklist

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How to start:

Step 1: Create your account and create a new applet by selecting a customizable template.

Options:

  • Set the applet as “Team-wide” if you want all team members to view each other’s records.
  • Alternatively, you can allow each participant to view his/her own records only and stakeholders to view all entries.
  • Invite guests with limited permissions, if needed.
  • Set up reminders if you want your team members to receive automatic email reminders.
  • Configure who will add records by choosing the “Participants” tab.

Step 2: Users will click the “Open Submission Form” button to fill it out and submit it.

form template

 

Step 3: As soon as a new record is added, participants with “View” rights will receive an email notification and can view it in real time on the Timeline screen.

  • Click “Edit” to change status or other relevant attributes.
  • Employees can discuss records in real time — each record has its own section for live comments.
  • Add an unlimited number of attachments (documents, images, photos, videos, audio notes, files) to a record.
  • Export records or share them online.

Step 4: Get instant access to historical data and files with powerful search and filtering capabilities.

how to create project status report

Step 5: The dashboard screen allows you to save time when you want to check a high-level overview, with quick one-click retrieval of the relevant information.

project status report

 

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