Near‑miss reporting form & learning loop template
Simple, non-punitive near-miss form plus a short learning loop to convert reports into prioritized prevention actions.
Form fields:
- Date/time, location, brief description
- Immediate action taken
- Potential consequence rating
- Suggested prevention idea
Learning loop:
- Weekly review, triage to quick fixes vs investigations, owner assignment, feedback to reporter.
How to use: Deploy as a simple mobile/physical form and review weekly in safety huddles.
Discussion
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