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Incident investigators' perspectives of incident investigations conducted in the Ghanaian mining industry

机译:事件调查人员在加纳采矿业进行事件调查的观点

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摘要

Incident investigation has been regarded as one of the means of improving safety performance. Limited published research exists that focuses on the context of practical investigation and the perspectives of investigators in the field. This research addresses this gap by evaluating how investigations are conducted in the Ghanaian Mining Industry. Forty-one investigators with diverse backgrounds were interviewed and the data collected was analysed through qualitative content analysis. Results of the study indicate that the blame culture is still evident, there is a lack of focus on controls and narrow dissemination of post-investigation findings. 49% of investigators had no knowledge of accident causation models and investigation methods. 37% of investigators had received no investigation training although they continue to investigate incidents. The frequently used data sources included interviewing victims/witnesses and evidence from the incident scene, while data from safety-related activities such as previous investigations and risk assessment were often under-utilised. An event tree showing opportunities to improve incident investigation and learning was developed to support the prioritisation of strategies for improving investigation practices. A framework has also been proposed to help incident investigators self-assess the maturity/effectiveness of their investigation practices.
机译:事件调查被认为是提高安全性能的手段之一。存在有限的发布研究,侧重于实际调查的背景和领域调查人员的观点。这项研究通过评估在加纳矿业行业的调查方式来解决这种差距。采访了四十一位具有不同背景的调查人员,通过定性内容分析分析收集的数据。研究结果表明,责任文化仍然明显,缺乏对控制后的控制和狭隘传播。 49%的调查人员没有了解事故导致模型和调查方法。 37%的调查人员未收到任何调查培训,尽管他们继续调查事件。常用的数据来源包括面试来自事件场景的受害者/证人和证据,而来自安全相关活动的数据,如先前的调查和风险评估,则经常被利用。制定了一个事件树,展示了改善事件调查和学习的机会,以支持改善调查做法的优先级。还提出了一个框架,帮助事件调查人员自我评估调查做法的到期/有效性。

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