The objective of this process is to understand the behaviour of the system in the context of a specific event to share good practice or identify improvements.
This process applies to any event within the organisation report by an employee. This includes events that are covered by the mandatory occurrence scheme or any other voluntary report of an incident or other event that could support lesson learning and continuous improvement.
This process is triggered by the receipt of a mandatory occurrence or voluntary safety information report. This process can also be triggered by a specific request for investigation of an event that was not reported using formal process.
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The following tools are examples of commercial products that support the implementation of this process.
The following material is publicly available and provides generic guidance to this process.