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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
MSB/SHE/SOP/03 02 27 FEB 2020 1 of 7

OBJECTIVE
This procedure establishes the methods and responsibilities for accident/incident reporting and
investigation when an accident/incident occurs to employees within the hospital, site office or commuting
accident.

SCOPE
This procedure shall be followed whenever there is an accident/incident and abnormality in hospital,
Medivest premises or commuting accident. It is applicable to all incidents; including near miss, occupational
poisoning, disease & dangerous occurrences and accidents that are related to occupational safety and
health, including all shifts, personnel working in, vendor and visitor.

REFERENCE
 Occupational Safety & Health Act and Regulations 1994
 Factory and Machinery Act 1967
 Safety and Health (Notification of Accident, Dangerous Occurrence, Occupational Poisoning &
Occupational Disease) Regulation 2004 (NADOPOD)

INPUT
Notification of accident / incident occurred within hospital area, Medivest premises and commuting accident.

OUTPUT
Preliminary and After Investigation reporting form.

DEFINITION
 Accident Undesirable event giving rises to death, ill health, injury or other loss.
 Activity Daily work / job which utilize material or output that have hazards on
occupational safety and health
 DOSH Department of Occupational Safety and Health
 Hazard Source, situation or act with a potential for harm in terms of human injury or
ill health, or a combination of this
 Ill health Identifiable, adverse physical or mental condition arising from and made
worse by a work activity and work-related activity
 Incident Work related event(s) in which an injury or ill health (regardless of severity)
or fatality occurred, or could be have occurred
Note: An incident where no ill health, injury or other loss occurs is also
referred to as “near miss”. The term “incident” includes “near miss”
 JKKP Jabatan Keselamatan dan Kesihatan Pekerjaan
 MMS Medivest Management System
 OSH Occupational Safety and Health
 PPE Personal Protective Equipment
 Risk Combination of the likelihood of an occurrence of a hazardous event or
exposure(s) and severity of injury or ill health that can be caused by the event
or exposure(s).
 SHE Safety, Health and Environment
 SH-EPMC Safety and Health & Environmental Performance Monitoring Committee
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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
MSB/SHE/SOP/03 02 27 FEB 2020 2 of 7

RESPONSIBILITY
 Head of Department (HOD)
 Facility Manager (FM) / Plant Manager (PM)
 Head of Services (HOS)
 Safety and Health Officer (SHO)
 Safety, Health, Environment Executive (SHEE)
 SHE Coordinator (SC)
 Safety and Health Committee

PROCESS DESCRIPTION
1. Whenever any accident/incident arising out of or in connection with work which caused any person
either:
No Cause from accident / incident Description
a. Death or serious bodily injury as The employer shall notify the nearest Department of
specified in First Schedule of Occupational Safety and Health office by the
NADOPOD, which prevents the person quickest means available; and within 7 days send a
from following his normal occupation report thereof in an approved form.
for more than four calendar days, or
where a dangerous occurrence, as
specified in Second Schedule of
NADOPOD, takes place in any place of
work,
b. Bodily injury to any person which The employer shall, within 7 days, send a report
prevents the person from following his thereof in an approved form to the Department of
normal occupation for more than four Occupational Safety and Health office.
calendar days
c. Suffered an injury or condition which The employer shall inform the DOSH in writing of the
causes death within one year of the death as soon as it comes to his knowledge. Where
date of that accident a person at work suffers or likely to suffer from one
of the occupational poisonings or occupational
diseases specified in column 1 of Third Schedule of
NADOPOD and the work involves one of the
activities specified in the corresponding entry in
column 2 of that schedule the employer shall within
7 days, send a report thereof to the nearest
Department of Occupational Safety and Health office
in an approved form.

2. Type of incident / accident that might happen in our premises and need to be report is:
 Incident / Accident that cause Fatality
 Incident / Accident that cause Major and Minor Injury
 Near Miss and Property Damages (Minor or Major)
 Occupational Accident and Illness (Needle Prick Injury, Carpal Tunnel Syndrome, etc.)
 Commuting accident
 Disruption in electrical, water, lifts and others supply that might affect services in the hospital
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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
MSB/SHE/SOP/03 02 27 FEB 2020 3 of 7

 Spillage or release of any hazardous gases

 Harassment or fight
 Robbers or break-ins
3. If any incident/accident happens, Head of Services (HOS) to complete Accident/Incident Report
(Preliminary) MMS Form 2010 within 24 hours after incident. All report must be submitted to:
 Copy 1: Head of Department (Safety, Health & Environment).
 Copy 2: Senior Manager (HR&A) - Related to MSB Staff and Insurance Only.
 Copy 3: Safety and Health Officer (Regional NS/M/SJ)
 Copy 4: Head of Department of related incidents / accidents
 Copy 5: Ministry of Health / Hospital, DOSH/ DOE/ ST (For Electrical) etc
4. Safety and Health Committee shall investigates the incident/accident occurred. Accident / Incident that
needs to be investigate is:
 Incident / Accident happens and cause major injury
 Major Property Damages
 Needle Prick Injury
5. For investigation, Safety and Health Committee is recommend to use Fishbone tool for Root Cause
Analysis for why the accident / incident had happen.

The fishbone tool shall carry out the steps listed below:
i. The safety and health committee needs to agree on the problem statement (also referred to as the
accident / incident). This is written at the mouth of the “fish”. Be as clear and specific about the
problem.
Example: Problem statement – Hand Injury cause from hit the mop squeezer, Slip and Fall at the
toilet, Finger Injury cause from cutting activity, etc.
ii. Safety and Health Committee to agree on the major categories of causes of the problem (written
as branches from the main arrow). Major categories often include (not limited to): equipment or
supply factors, environmental factors, rules/policy/procedures factors and people/staff factors, etc.
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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
MSB/SHE/SOP/03 02 27 FEB 2020 4 of 7

iii. Safety and Health Committee needs to discuss all the possible causes of problem. Do use the
concept of 1 H (How) and 4 W (When, Who, What, Why) during facilitates and writes the causal
factor as a branch from the appropriate category (places it on the fishbone diagram).
6. For major incident/accident, Facility Manager/Plant Manager / Chairman of SH-EPMC shall inform SHO
and safety and health committee members to investigate. Safety and Health Committee:
a) The safety committee member is to conduct an investigation immediately or as soon as it is safe to
do so, a statement from the victim may be collected at a later date if necessary.
b) Visit the scene of the incident and ensure that the area involved is not unnecessarily disturbed until
the investigation is completed. Interview the person(s) involved, witnesses and all other relevant
personnel (e.g.: suppliers of equipment, substances etc.)
c) The accident site should be made safe before normal activity may be resumed.
d) Collect evidence (e.g.: details of spill chemicals, parts of failed equipment, etc.) and review
documentation including relevant policies, work procedures, maintenance regimes etc. If necessary,
draw a diagram of the accident scene, including measurements of distances and dimensions and
where appropriate, take photographs.
e) The safety committee members must identify all the contributing factors (cause of problem) so that
a decision can be made on which conditions and circumstances contributed to the accident.
f) To studies on the trends of accident/incident reported at the workplace, to conduct Hazard
Identification, Risk Assessment & Risk Control (if required) and make recommendations on the ways
of eliminating or minimizing the risk to safety or health at the workplace. The effectiveness of the
action taken shall be reported and reviewed during the Safety & Health Committee meeting.
 The Accident/Incident Report (After Investigation) MMS Form 2020 must be send within 7 days
to the recipient of Copy 1 until Copy 7 as above.
 Safety and Health Officer shall:
i. Review the Accident/Incident Reports and carry out analysis and recommend practical
changes if required
ii. Submit the Accident/Incident Report to Department of Occupational Safety & Health
whenever any accident/incident happened as per NADOPOD requirement for related form
such as:
 JKKP 6 – Pemberitahuan mengenai kemalangan / kejadian berbahaya
 JKKP 7 – Pemberitahuan mengenai keracunan pekerjaan / penyakit pekerjaan
 JKKP 9 – Data kemalangan
 JKKP 10 – Data keracunan dan penyakit pekerjaan
iii. Ensure Vendor's to submit the accident/incident Report to Department of Occupational
Safety & Health whenever any accident/incident happened as per NADOPOD requirement
iv. For any Fatality or Major Accident, the site of the accident must not be altered, unless to
make the area safe. Safety and Health Officer / Executive or DOSH personnel and Police
will direct the investigation, with the assistance of the Company's Safety and Health
Committee.
 SHEE / SHO / SC to keep Accident/ Incident Report and any related document of
accident / incident (e.g. JKKP 6 / JKKP 7, Medical certificate, etc.) in SHE file.
g) Whenever any accident arising out of or in connection with work which caused any person either
death or serious bodily injury (which prevents the person from following his / her normal occupation
for more than four calendar days or where a dangerous occurrence (takes place in any place of
work), SHE Department shall:
i. immediately notify the nearest Department of Occupational Safety and Health office by the
quickest medium available; and
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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
MSB/SHE/SOP/03 02 27 FEB 2020 5 of 7

ii. Within 7 days send a report thereof in an approved form (JKKP 6).
h) For once a year, SHE Department need to submit JKKP 8 – Daftar kemalangan, kejadian berbahaya,
keracunan pekerjaan & penyakit pekerjaan to Department of Occupational Safety and Health
(DOSH) before 31st January.

RECORDS

Title of Records Reference No. Location Retention Period

Accident/Incident Report (Preliminary) MMS Form 2010 All premises 5 years
Accident/Incident Report (After
MMS Form 2020 All premises 5 years
Investigation)
Notification of Accident / Dangerous
- Premises related 5 years
Occurrence (JKKP 6)
Notification of Occupational Poisoning
- Premises related 5 years
and Occupational Disease (JKKP 7)
Summary of Accident / Dangerous
Occurrence, Occupational Poisoning - SHE Corporate 5 years
and Occupational Disease (JKKP 8)
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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
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PROCESS FLOW FOR ACCIDENT / INCIDENT REPORTING AND INVESTIGATION

Records /
Activity Responsibility Reference
Documents

Start

If any incident/accident happens, Head of Services (HOS) to  HOS  Notification of

complete Accident/Incident Report (Preliminary) MMS Form Accident,
2010 within 24 hours after incident Dangerous
Occurrence,
Poisoning and
Send report to: Occupational
Safety and Health Committee shall Copy 1: S. Manager SHE
 Safety and Disease
investigate the incident / accident Copy 2: Manager FMS
Copy 3: Executive SHE Health (NADOPOD)
Copy 4: S. Manager HR&A Committee
Copy 5: Safety & Health Officer
Copy 6: Plant Manager
For major incident/accident, FM / Copy 7: MOH, HOS, DOSH,
DOE, ST Etc.
Plant Manager / SH-EPMC  Facility  Notification of
Chairman shall call SHO and Manager / Accident,
safety committee members to Plant Manager Dangerous
investigate (use fishbone method) / SH-EPMC Occurrence,
The Accident/Incident Chairman Poisoning and
Report (After Occupational
SHO to carry out investigation for
Investigation). Report Disease
major incident / accident
must be complete within 7 (NADOPOD)
working days.  SHO / SHE

SHO/ SHEE shall review the

result effectiveness and make Submit
related
sure the root cause, corrective
JKKP form:
and preventive action before
recommending for improvement. JKKP 6,  Notification of
7,9,10
(NADOPOD)  SHO /SHE / Accident,
Record to be kept and maintained if required SC Dangerous
Occurrence,
Poisoning and
For once a year, SHE Department need to submit JKKP 8 – Occupational
Daftar kemalangan, kejadian berbahaya, keracunan pekerjaan  SHO / SHE Disease
& penyakit pekerjaan to Department of Occupational Safety (NADOPOD)
and Health (DOSH) before 31st January.

End
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MEDIVEST MANAGEMENT SYSTEM PROCEDURE

SAFETY, HEALTH AND ENVIRONMENT

ACCIDENT/ INCIDENT REPORTING AND INVESTIGATION

Commercial in Confidence
Document Reference Revision Number Effective Date Page Number
MSB/SHE/SOP/03 02 27 FEB 2020 7 of 7

ATTACHMENT
 Table 6 – Kod Kejadian Berbahaya
 Table 9 – Kod Kemalangan
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