Topics Map > Near-Miss or Unsafe Act
Topics Map > Employee Handbook > Risk Management
Risk Management - Injury & Incident Reporting - Report a Near-Miss or Unsafe Act
Extension employees should submit all near-miss/unsafe act reports using an Extension-specific SharePoint workflow.
Guidance for Submitting
Submit a report if there is an incident that:
- Did not result in property damage;
- Did not result in personal injury;
But, given a slight shift in time or position, a high-risk injury/incident could have occurred.
Instructions for Submitting a Near-Miss/Unsafe Act to Risk Management
*Make sure that you have initiated the Extension Phone Tree as part of the High-Risk Injury/Incident Response workflow.
1) Complete the Near-Miss Report
- Download the Near-Miss Report to your local computer. Complete the report.
- Note: If you have printed copies that you have filled out by hand, you can scan them into PDFs.
2) Submit the Report Form through SharePoint
- Go to the Extension Injury/Accident Reporting SharePoint Site.
- Click the "Draft Report" button to prepare your report for submission. Save it. You may save and edit it as needed.
- Complete these fields for your submission:
- Record Title: Append [First Name] [Last Name] [Date] to the template document name
- E.g. Near-Miss-Report - Nathaniel Shay 2019.11.04
- Incident Type: Select whether it is a non-employee injury/incident, near-miss, or vehicle accident report.
- Description: Include a brief description of why you are submitting the report.
- Incident Date: Date the incident documented in the report occurred.
- 4-H Accident?: Select whether the incident was 4-H related (Yes/No).
- Upham Woods Accident?: Select whether the incident was Upham Woods related (Yes/No).
- Volunteer Related: Select whether the incident involved a volunteer (Yes/No).
- Immediate Supervisor: Your immediate supervisor's email.
- Institute Director: Your institute director's email.
- Attach Completed Report: Upload the completed report as an attachment.
- When you are ready to submit, click on the "My Reports" button. Find your Report.
- Click "Send to Risk Management".
- Click "Run Flow."
Help with Near-Miss/Unsafe Act Report
- If you have any questions related to the report form, please contact the Office of Risk Management (608) 262-0379.
- If you have any questions related to the Extension SharePoint Workflow, please contact the Extension Help Desk (all tickets will be routed through DoIT Help Desk).