Accident Incident Reporting and Investigation Program

Policy

Accidents, injuries, near misses, and incidents involving University employees, students, or visitors shall be reported in accordance with this policy. All workers have a right to report work-related injuries or illnesses free from retaliation.

Proper, accurate, and timely reporting plays a critical role in the investigation which allows for the following:

  • Identification of the hazard;
  • Determination of the cause;
  • Development of a corrective action plan to prevent additional accidents, incidents, or injuries; and
  • Implementation of proper safeguards to prevent recurrences.

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Authority and Responsibility

Employees or students performing work are responsible for:

  • Immediately reporting any unsafe conditions or accidents/injuries including near misses outside of research and/or teaching laboratories to their supervisor, or Human Resources (HR) representative and Environmental Health and Safety (EHS);
  • Immediately reporting any unsafe conditions or accidents/injuries including near misses inside research and/or teaching laboratories to their principle investigator (PI), laboratory safety specialist, Teaching Assistant (TA), and the Office of Research Safety (ORS);
  • Participating in a root cause analysis investigation with EHS, ORS, and/or laboratory safety specialist for accidents/injuries, as deemed necessary; and
  • Completing the required documentation detailed in this policy for all injuries.

Supervisors, teaching assistants (TAs), or Human Resources (HR) Representatives are responsible for:

  • Ensuring any unsafe conditions or accidents/injuries including near misses outside of research and/or teaching laboratories have been reported by the employee or student performing work to EHS and if not reporting them;
  • Ensuring any unsafe conditions or accidents/injuries including near misses inside research and/or teaching laboratories have been reported by the employee or student performing work to ORS and laboratory safety specialist and if not already reported, reporting them;
  • Immediately notifying EHS of any incidents involving death, hospitalization, amputation, or eye losses;
  • Completing and submitting the required accident/injury documentation detailed in this policy for all injuries;
  • Assisting with the implementation of a corrective action plan to rectify any unsafe condition; and
  • Assisting with the implementation of a corrective action plan resulting from the root cause analysis investigation for accidents/injuries.

Environmental Health and Safety (EHS) is responsible for:

  • Responding to and investigating all unsafe conditions outside of research and/or teaching laboratories;
  • Responding to and conducting a root cause analysis investigation of accidents/injuries including near misses involving non-research and/or teaching related laboratory employees or students performing non-research related work, as deemed necessary;
  • Developing a corrective action plan to rectify any unsafe condition;
  • Developing a corrective action plan including identification of a responsible party including identifying those responsible for addressing the scope of the action item as a result of an accident/injury root cause analysis investigation;
  • Assisting departments with the implementation of corrective action plans;
  • Issuing a root cause analysis investigation report including timeline and pictures to Risk Management, ORS, and Human Resources Leave Management; and
  • Notifying the Occupational Health and Safety Administration (OSHA), as deemed necessary.

Office of Research Safety (ORS) and Laboratory Safety Specialists are responsible for:

  • Responding to and investigating all unsafe conditions inside of research and/or teaching laboratories;
  • Responding to and conducting a root cause analysis investigation of accidents/injuries including near misses involving research and/or teaching related laboratory employees or students performing research related work, as deemed necessary;
  • Notifying EHS immediately of any fatalities, inpatient hospitalizations, amputations, or eye losses;
  • Developing a corrective action plan to rectify any unsafe condition;
  • Developing a corrective action plan including identification of a responsible party including identifying those responsible for addressing the scope of the action item as a result of an accident/injury root cause analysis investigation;
  • Assisting departments with the implementation of corrective action plans; and
  • Issuing a root cause analysis investigation report including timeline and pictures to Risk Management, ORS, and Human Resources Leave Management.

Facilities Services – Capital Project and Delivery is responsible for:

  • Reporting all contractor related injuries via email to Risk Management at cwalters@uchicago.edu;
  • Reporting any incident causing or creating an unsafe condition during construction/renovation in University buildings to Risk Management and Environmental Health and Safety; and
  • Contacting Risk Management at 773.702.1951 for any contractor taken from the site by ambulance.

Risk Management is responsible for:

  • Responding to and conducting an investigation of accidents/injuries including near misses involving the general student population and visitors, upon notice;
  • Requesting and/or developing a corrective action plan to rectify any unsafe condition identifying the urgency of the corrective action;
  • Requesting a corrective action plan including identifying those responsible for addressing the scope as a result of an investigation into an accident/injury root cause analysis;
  • Assisting departments with the implementation of corrective action plans; and
  • Ensuring those responsible have completed the scope as agreed.

Human Resources – Leave Administration is responsible for:

  • Processing accident/injury reports;
  • Identifying those accidents that may need further response to prevent injury to others, when applicable;
  • Receiving and forwarding medical bills to the third party claims administrator for payment; and
  • Establishing a claim with the third party administrator for work related injuries.

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Procedure

Emergency Medical Attention

For incidents occurring:

  • On campus, contact University of Chicago Police at extension 123 or 773.702.8181 to arrange for on-scene medical assistance; or
  • Off campus, dial 911 to arrange for on-scene medical assistance.

General Medical Attention for University Employees

If you are a University of Chicago employee and you are injured on the job during your employment:

  1. Report the accident or injury to your Supervisor or Human Resources representative immediately;
  2. Your supervisor or Human Resources representative will complete a Request for Evaluation and Treatment – Work Related Illness or Injury WC Form 100 (Form 100);
  3. Take the original copy of the Form 100 and seek medical treatment at the nearest Emergency Room;
  4. Your Supervisor will complete the Supervisor’s First Report – Workers’ Compensation Claim of Injury/Illness;
  5. Your Supervisor or Human Resources will provide you with an Employee Statement of Injury or Illness -Workers’ Compensation, Accrual Use Option Form, Workers’ Compensation Rights and Responsibilities statement, and an Authorization to Release Protected Health Informaiton for your completion to complete;
  6. Scan and email the aforementioned forms to leaveadministration@uchicago.edu or fax to 773.834.4847;
  7. Always use the “buddy” system when obtaining medical attention by having someone escort the injured individual to receive medical treatment; and
  8. If you or another employee cannot escort yourself to the University of Chicago Occupational Medicine clinic or Adult Emergency Room due to the extent of your injury, dial 123 or 773.702.8181 (University of Chicago Police Department) and request an ambulance.

UNIVERSITY OF CHICAGO OCCUPATIONAL MEDICINE (UCOM)
Location: University of Chicago Medicine, 5841South Maryland Avenue, D136
Phone Number: 773.702.6757
Hours: 7:15 a.m. – 4:30 p.m. M-F

ADULT EMERGENCY ROOM
Location: Bernard Mitchell Hospital, 901 East 58th Street
Phone Number: 773.702.6250
Hours: Open 24 hours

Note: There are other forms you may be required to complete during or following your medical evaluation and treatment.

General Medical Attention for Off-Site University Employees Located in Illinois

If you are a University of Chicago employee, but work at a satellite location in Illinois and are injured on the job during your employment:

  1. Report the accident or injury to your Supervisor or Human Resources representative immediately;
  2. Supervisor or Human Resources representative will complete a Request for Evaluation and Treatment - Work Related Illness or Injury WC Form 100 and the Supervisor’s First Report – Workers’ Compensation Claim of Injury/Illness;
  3. Your Supervisor or Human Resources will provide you an Employee Statement of Injury or Illness - Workers’ Compensation, Accrual Use Option Form, Workers’ Compensation Rights and Responsibilities statement, and Authorization to Release Protected Health Information for your completion to complete;
  4. Scan and email the aforementioned forms to leaveadministration@uchicago.edu or fax to 773.834.4847;
  5. Always use the “buddy” system when obtaining medical attention by having someone escort the injured individual to receive medical treatment;
  6. If you or another employee cannot escort yourself to the nearest emergency room due to the extent of your injury, contact the local emergency care provider and request an ambulance;
  7. Inform the emergency room that it is a work related accident and you are an employee at the University of Chicago so the facility directly bills the University of Chicago; and
  8. If you are billed directly for any reason, forward these bills to Human Resources – Leave Administration.

General Medical Attention for Off-Site University Employees Located in Illinois

If you are a University of Chicago employee, but work at a satellite location outside of Illinois and are injured on the job during your employment:

  1. Seek medical treatment as you would for any medical or injury condition (There are no designated providers outside of Illinois); and
  2. Contact the Office of Risk Management to advise them of a work related injury by calling 773.702.1951

General Medical Attention for Students

Student Injury/Illness Reporting Flow Chart shall be used to guide students/student workers to the right department for medical assistance. If you are a University of Chicago student and are injured while performing work, follow the procedures above for “General Medical Attention for University Employees”. If you are a student and are injured or become ill for any other reason:

  1. Seek first aid or medical treatment immediately at one of the following depending on the time or nature of the accident or injury;
  2. Always use the “buddy” system when obtaining medical attention by having someone escort the injured individual to receive medical treatment; and
  3. If you or another student cannot escort yourself to the Student Care Center (SCC) or Mitchell Emergency Room due to the extent of your injury, dial 123 or 773.02.8181 (University Police) and request an ambulance.

STUDENT HEALTH SERVICES (SHS)
Location: Albert Merritt Billings, 5841 South Maryland Avenue, Suite R100
Phone Number: 773.702.4156
Hours: 8 a.m. – 5 p.m. M-F

Note: The SHS is an appointment-based clinic: you must call and schedule an appointment to be seen.  No walk-ins will be accepted.

ADULT EMERGENCY ROOM
Location: Bernard Mitchell Hospital, 901 East 58th Street
Phone Number: 773.702.6250
Hours: Open 24 hours

Non-University Personnel

Report all accidents/incidents involving non-university personnel to the University of Chicago Police Department at 773.702.8181 and Risk Management at 773.702.3693.

Supervisor’s Follow-up

If there is any suspicion of injury or illness, make sure the employee follows the procedures for employees injured on the job. If medical treatment is not required, send the original copies of all the three forms to Human Resources – Leave Administration. All forms are available on the Human Resources website under Leaves of Absence and Workers’ Compensation.

Investigate the accident or incident to determine the cause and initiate any necessary corrective action to rectify the problem. Report your findings to Environmental Health and Safety. If you need assistance conducting this investigation, contact Environmental Health and Safety. HR Absence Management shall forward copies of all WC Form 100’s to Environmental Health and Safety for follow-up investigation, as deemed necessary by Risk Management. All corrective actions identified during the investigation shall be the responsibility of the supervisor and associated department.

If an injury or illness involving a student consists of a chemical exposure, needle stick, bloodborne pathogen exposure, or any other safety issue, the Student Care Center shall report the injury/illness to Environmental Health and Safety by completing the Student Injury/Illness Assessment Form. A safety representative shall evaluate if further investigation is necessary.

Reviewed: April 2017

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