Knowella

Serious Potential Incident Report Template

The organisation with an excellent recordable rate and a fatality is not an anomaly. Research consistently finds only weak correlation between high-frequency low-severity incidents and serious injury events, because they have different causes. This report exists to capture the events that had the potential to kill someone, whatever they actually cost.

KnowSafeRecordSAF-009Pinned in navigation39 fields across 5 sectionsFull researchSee the form

Reviewed by Siddarth SinghCSPLast reviewed 16 August 2026

Basis
ICMM, ICAM level 4
Workspace
KnowSafe
Form type
Record
Captures
Potential, not outcome
Different causes
From routine incidents

The short version

  • Campbell Institute and related research finds weak correlation between recordable injury frequency and serious injury and fatality events. A low recordable rate does not indicate that SIF exposures are controlled.
  • SIF-potential incidents have different root causes and precursors from other incidents, which is why classifying by potential rather than outcome changes what the organisation learns.
  • Only a small proportion of recordable injuries carry SIF potential, while many more SIF-potential exposures are found through observations and inspections than through injuries.
  • The classification decision must be made at the point of reporting, because after an investigation concludes that nobody was hurt, the incentive to grade it seriously disappears.
  • The useful focus is process factors and control failures rather than human error, which will always be present and is rarely the actionable finding.
  • High-energy hazards are the practical filter: where the energy present could kill, the event has SIF potential regardless of what happened.

What this is

What is a serious potential incident?

What is a serious potential incident?

An event which, under slightly different circumstances, would have resulted in a fatality or life-altering injury. It is classified by what could have happened rather than by what did, and it includes events with no injury and no damage at all.

What is a SIF precursor?

A condition or circumstance that, if left uncorrected, could lead to a serious injury or fatality. Precursors are typically the absence or failure of a control against a high-energy hazard, and research indicates they are found far more often through observation and inspection than through injury reporting.

Scope

When is a serious potential incident report required?

This record captures events by potential severity. It sits alongside rather than inside the general incident process.

Use this template when

  • Any event where the credible worst outcome was death or life-altering injury, regardless of actual outcome
  • Control failures against high-energy hazards: falls from height, uncontrolled energy, vehicle interaction, engulfment, electrical contact
  • Near misses that would routinely be logged and closed but carried serious potential
  • Observations and inspection findings identifying an absent or defeated control against a high-energy hazard
  • Any event that would have been serious but for position, timing or luck

Do not use it for

  • The general incident report, which records what happened and covers the full range of outcomes
  • Root cause analysis, which follows this and requires a method proportionate to the potential
  • Regulatory reporting determinations, which follow their own criteria based on actual outcome
  • Insurance and claims records, which are driven by actual cost
  • The corrective action record, which tracks the actions this generates

Compliance mapping

Which ICMM requirements does this satisfy?

SIF classification is a management practice rather than a regulatory requirement, sitting within incident investigation obligations.

ClauseRequirementWhere it lands
ISO 45001 cl.10.2Incident investigation to determine underlying causes and the need for corrective actionThe event
ISO 45001 cl.6.1.2Hazard identification proactive and reactive, drawing on incidents and near missesFollow up
ISO 45001 cl.9.1Monitoring and measurement with indicators appropriate to what is being managedEscalation
29 CFR 1904.39Reporting of fatalities and severe injuries within defined timescales, based on actual outcomeEscalation
ICMM guidanceSignificant potential incident classification and critical control verification in miningEvent
ICAM methodologyInvestigation method addressing absent or failed defences, individual and organisational factorsFollow up
ISO 45001 cl.8.1.2Hierarchy of controls, applied to the control failures this report identifiesFollow up
RIDDOR (GB)Reportable dangerous occurrences, defined by event type rather than by injury outcomeEscalation

What it does not cover

  • The general incident report, which records the event and its actual outcome.
  • Root cause analysis, which follows and should use a method proportionate to the potential rather than the outcome.
  • Regulatory reporting, which is determined by actual outcome or by defined dangerous occurrence categories.
  • Critical control verification, which checks that controls against fatal risks are present and effective.
  • The corrective action record, tracking the actions arising to verified closure.

How to complete it

How to complete a serious potential incident report, step by step

Classify at the point of report, describe the control that failed, and investigate to the potential rather than the outcome.

Classify by potential, at the point of reporting

Ask what the credible worst outcome was, not what happened. This has to be decided when the event is reported, because once an investigation establishes that nobody was hurt and nothing was damaged, the pressure to grade it seriously evaporates and the event becomes a routine near miss.

Use high energy as the filter

Falls from height, uncontrolled or stored energy, vehicle and pedestrian interaction, suspended loads, engulfment, electrical contact, confined space atmosphere. Where the energy present is sufficient to kill and a control was absent, defeated or failed, the event has serious potential whatever the outcome. This gives a consistent test rather than a judgement about how close it felt.

Describe which control failed, not who erred

The research is explicit that focusing on process factors rather than human error produces the useful findings, because human error will always occur. The question is which control was supposed to prevent this, and whether it was absent, inadequate, defeated or simply not applied that day.

Investigate to the potential

An event with fatal potential and no injury warrants the investigation depth of a serious injury, not the depth its actual cost suggests. This is the single most consequential decision in the process, and the one most frequently reversed by resourcing pressure once it is clear nobody was hurt.

What auditors find

Most common serious potential incident report findings

Findings here concentrate on classification and on what happens after it.

FindingClauseWhat fixes it
Events classified by actual outcome rather than potential.ISO 45001 cl.10.2Classify by credible worst outcome at the point of reporting.
Serious potential events investigated at the depth their actual cost suggested.ISO 45001 cl.10.2Investigate to the potential; that is the entire purpose of the classification.
Low recordable rate presented as evidence that fatal risk is controlled.ISO 45001 cl.9.1Report SIF-potential separately; the correlation between the two is weak.
Findings expressed as human error rather than control failure.ISO 45001 cl.8.1.2Identify the control that should have prevented it; error is a starting point, not a cause.
Observations and inspections not used as a source of SIF precursors.ISO 45001 cl.6.1.2Most SIF-potential exposure is found by looking, not by waiting for events.
No definition of what counts as serious potential, so classification is inconsistent.ISO 45001 cl.10.2Define it with a high-energy filter and worked examples; calibrate the people classifying.
Classification downgraded during investigation once no injury was confirmed.ISO 45001 cl.10.2Lock the classification at report; downgrading defeats the mechanism.
Actions from serious potential events tracked alongside minor ones with no priority.ISO 45001 cl.10.2Separate the queue; these actions address fatal exposure.
Contractor events excluded from the classification process.ISO 45001 cl.8.1.4Include them; contractor work frequently carries the higher-energy exposures.
No verification that the control identified as failed was subsequently effective.ISO 45001 cl.10.2Verify at the point of work later; closure on paper is not effectiveness.

Case in point

Case in point: the year the numbers improved

Research summarised by the Campbell Institute found that the traditional assumption, that reducing high-frequency low-severity incidents would reduce fatalities proportionately, does not hold. The correlation is weak, because most recordable injuries involve different hazard profiles, exposures and failure modes from the events that kill people.

The practical consequence is a pattern that recurs across industries: an organisation reduces its recordable rate substantially over several years, reports steady improvement, and experiences a fatality with no warning visible in the safety data. Nothing in the reporting was wrong. It was measuring a different thing.

Work reported through industry groups has found that only a small proportion of recordable injuries carry SIF potential, while considerably more SIF-potential exposures are identified through observations and inspections than through injuries at all.

The template

The template, field by field

The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.

39fields
5 sections
Reference
SAF-009
Archetype
Record
Record ID
CASE-2026-000
Scoring
Maximum potential loss
Direction
High is bad
Singleton
No
Basis
ICMM, ICAM level 4
Links
Forces level 4 RCA, bowtie review
Tags
Incident, Critical risk
Sections
5
Fields
39
Follow up fields
6
Repeating sections
0
Links out
8
Field typesOwn ID, generated on saveCase thread and parentPick list from a registryLinked to another templateFollow up, dashed outlineScored

Event

11 fields
Text

Case ID*

Generated on save

Auto sequence. Format CASE-2026-00000.

The record's own ID. Other templates point at this value.

Single Choice

Status*

Scored

Drives who this goes to next.

  • Planned2 pts
  • In progress2 pts
  • Complete3 pts
  • Deferred0 pts
  • Open0 pts
  • Closed3 pts
  • Overdue0 pts
Info

Purpose

This record exists for events that could have killed or seriously injured somebody, whatever actually happened. It forces the deepest level of investigation and senior attention. Raising one is never criticised.

Date & Time

Date and Time of Event*

Date & Time

Date Reported*

Pick List

Raised By*

From FDN-003 Worker NameFilter: Site matches, Status is Active
Text

Person ID*

Linked

Format PER-0000.

Links to FDN-003 Person ID

Text

Case ID 2

OptionalThread key

Enter the original incident or near miss reference where one already exists.

Thread key. Every record in this chain carries this value

Single Choice

Parent Type

Optional

What kind of record this follows.

IncidentNear missFindingAuditInspectionRisk assessmentComplaintEquipment failureNonconformanceManagement of change
Text

Parent ID

OptionalThread key

The reference of that record.

Immediate predecessor record

Date & Time

Raised Date*

Where

4 fields
Pick List

Site*

From FDN-001 Site NameFilter: Status is Active
Text

Site ID*

Linked

Format SITE-000.

Links to FDN-001 Site ID

Single Choice

Area*

The area within the site.

Cutting roomBoning hallPackingChill storeFreezerPasteurisingFillingCulture roomDespatchYardWorkshopPlant roomOffices
Location

Exact Location

Optional

Drop a pin for anything hard to find.

The event

9 fields
Text

Description*

Single Choice

Actual Outcome*

Often nothing at all. That is the point.

Nothing happenedMinor damageFirst aidMedical treatmentLost time
Single Choice

Maximum Potential Loss*

Scored
  • Minor4 pts
  • Moderate3 pts
  • Serious2 pts
  • Fatal or catastrophic0 pts
Single Choice

Which Fatal Risk*

Which of the small number of things that can kill people here was in play.

Mobile equipmentWorking at heightEnergy isolationConfined spaceAmmonia releaseMachine entanglementFire or explosionElectricalLifting operations
Pick List

Critical Control

OptionalFrom FDN-011 Control NameFilter: Site matches
Text

Control ID

OptionalLinked

Format CCTRL-000.

Links to FDN-011 Control ID

Single Choice

Control Failed Or Absent*

Scored
  • Control worked3 pts
  • Control present but weak1 pt
  • Control bypassed0 pts
  • Control absent0 pts
Text

Control Failure Report ID

OptionalLinkedShows if Control Failed Or Absent not equals Control worked

Links to SAF-082 Report ID

Text

Barrier Detail*

Which barriers held, which did not, and why.

Escalation

7 fields
Single Choice

Investigation Level*

Scored

Level 4 by default for anything recorded here.

  • None required3 pts
  • Quick debrief2 pts
  • 5 Why2 pts
  • Full RCA1 pt
  • Cross functional RCA0 pts
Users

Executive Sponsor*

Text

RCA ID

OptionalLinked

Links to FDN-013 RCA ID

Single Choice

Bowtie Review Required*

YesNo
Text

Bowtie ID

OptionalLinkedShows if Bowtie Review Required equals Yes

Links to SAF-062 Bowtie ID

Single Choice

Stand Down Called

Optional
YesNo
Text

Stand Down Record ID

OptionalLinkedShows if Stand Down Called equals Yes

Links to SAF-130 Stand Down ID

Follow up

8 fields
Single Choice

Action Required*

Scored

Raise the action record, then enter its reference here.

  • No2 pts
  • Yes0 pts
Single Choice

Priority

OptionalScoredShows if Action Required equals Yes
  • High0 pts
  • Medium1 pt
  • Low3 pts
Text

CAPA ID

OptionalLinkedShows if Action Required equals Yes

Format CAPA-2026-00000.

Links to FDN-014 CAPA ID

Users

Action Owner

OptionalShows if Action Required equals Yes
Users

Site Manager*

Signature

Signature*

Users

Executive Sponsor*

Signature

Second Signature*

SAF-009 · record IDs look like CASE-2026-000 · Forces level 4 RCA, bowtie review

Open in Knowella

Run it with agents

From a document you fill in to a programme that runs itself

The report captures potential rather than outcome. What fails is the classification that drifted downward and the investigation sized to the actual cost.

KnowSafe

Classifies at the point of report using a high-energy filter, locks the grading, and drives investigation depth from potential rather than outcome.

Ella
Ella

Brings observations and inspection findings into the same classification, since that is where most SIF-potential exposure is actually found.

KnowContractor

Includes contractor events and exposures, which frequently carry the higher-energy work and sit outside site reporting.

KnowMaintain

Connects failed controls to the assets and work orders that restore them, and verifies effectiveness at the point of work rather than on paper.

This template lives in KnowSafe — safety and compliance. Incidents, hazards, permits, inspections and the critical controls behind them.

Meet KnowSafe→

Glossary

Serious Potential Incident Report definitions and key terms

SIF
Serious injury and fatality: death, permanent disability, or injury severe enough to permanently alter quality of life.
SIF potential
An event or condition that under slightly different circumstances would have produced a serious injury or fatality.
Precursor
A condition that, uncorrected, could lead to a SIF event, typically an absent or failed control against a high-energy hazard.
High-energy hazard
An energy source sufficient to cause death or life-altering injury: height, motion, electrical, thermal, chemical, pressure or gravity.
Critical control
A control whose failure would substantially increase the likelihood of a fatal event, warranting explicit verification.
ICAM
Incident Cause Analysis Method, addressing absent or failed defences alongside individual, task, environmental and organisational factors.
Recordable rate
A frequency measure of recordable injuries, which correlates weakly with fatal risk exposure.
Classification at report
Deciding potential severity when the event is reported, before the actual outcome influences the judgement.

FAQ

Frequently asked questions about serious potential incident report

Why not just use the near miss process?+

Because a general near miss process treats all events alike and volume buries the important ones. Research indicates SIF-potential incidents have different root causes and precursors from other incidents, so grouping them together means the analysis is dominated by events with a different failure profile. Separating them is what makes the pattern visible.

Does a falling injury rate mean fatal risk is falling?+

Not reliably. Campbell Institute and related research found weak correlation between high-frequency low-severity incidents and SIF events, because they involve different hazards, exposures and failure modes. Organisations routinely reduce recordable rates over years while their exposure to high-energy hazards is unchanged, and the reporting shows improvement throughout.

How do we decide what counts as serious potential?+

Use a high-energy filter rather than a judgement about how close it felt. Where the energy present, height, motion, electrical, thermal, pressure, was sufficient to kill, and a control was absent, defeated or failed, the event has serious potential regardless of outcome. That gives a consistent test that different people apply the same way.

Where do most SIF-potential exposures come from?+

Observation and inspection rather than incident reporting. Industry work has found that only a small proportion of recordable injuries carry SIF potential, while many more SIF-potential exposures are found by looking at work. An organisation relying on events to reveal fatal risk is watching the least productive source.

Why classify at the point of reporting?+

Because the classification will drift downward otherwise. Once an investigation confirms that nobody was hurt and nothing was damaged, the pressure to treat an event as serious disappears, and it becomes a routine near miss closed with a toolbox talk. Locking the classification at report is what preserves the investigation depth the potential warrants.

Keep going

Related templates and programmes

Siddarth Singh

Written and reviewed by

Siddarth Singh

Founder & Chief Executive Officer, Knowella

Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.

  • Certified Safety Professional (CSP), Board of Certified Safety Professionals
  • MBA, University of Chicago Booth School of Business
  • MS and BS, The Ohio State University, Industrial and Systems Engineering
  • Six Sigma Black Belt
Verify with BCSP →

Sources and last review. Reviewed 16 August 2026 against:

This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.

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