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Leading verses Lagging HSE Reporting Tool

Instructions on using the Tool


1 The file is very easy to use, here are some of the basic steps:
F Open the file and save it to a place where you and your other team members on the project can access it;
F Open one file for each location / project that you want to track.
F On the tab called “programmers page” enter your company name, project name, month and Year (nothing else
F Go to the tab called main page;
F Click on the required date (1, 2, 3, etc.…) for the shift you are working (day or evening);
Start recording your results. The most successful users print the blank template at the beginning of shift and
F
make notes throughout the shift. This makes is easier to completed at the end of shift.

2 In your report:
F Grade each category (1, 2 or 3) the color will change automatically;
F Enter coaching notes, observations, etc.., into each of the categories;
Complete the middle section with notes you need to share, focus of the day, good things observed, training
F
for the following day, etc.… Also required in this section is:
F In your notes section, enter your Tool Box Topic for the following shift based on what was observed this shift;
In your notes section, add an excerpt or quote from the applicable regulations (we have to teach everyone,
F
everyday and it is a good exercise to keep you sharp with the regulations);
F In the notes section, add your brief, objective summary of the shifts events; and,
F General comments concerning any incidents (if appropriate).
F Enter any injuries if appropriate, and,
F Enter your initials.
Hit the save button, hit the save button, hit the save button, hit the save button - you know how many time
F
someone forgets this step.
Once you have completed the report, print it and review it with the leaders of the location / project before you
F email it to everyone – don’t ever blindside leadership with something they are not aware of. Only print the
actual shift report and share, not the entire excel file.

3 Notes on completing the report:


F This is a completely objective report, no emotion should be present and no names;
F Review it with the leaders, offer suggestions and options (we do not deal in absolutes);

© 2017 Greg Tilley. All Rights Reserved


Leading verses Lagging HSE Reporting Tool

Watch the language, this is not a tool for discipline – this is one safety professional communicating with
F operational professionals – don’t use words like “can’t”, “don’t”, “not allowed” however you are permitted to
quote regulations and code and present options on how to work with the rules;
F State a focus for the following day on what you observed from the report (should be their next tool box talk);
F Review everything objectively as we are here to coach our leaders;
F Strictly follow the grading / quality guidelines that are laid out;
F Feel free to make positive comments like “great job”, “let’s see that again tomorrow”, etc.…
F Always review with leaders and ensure they understand everything associated;
Never grade on rumors or hearsay, if you didn’t see it or do not have objective evidence to support it – it will
F not be graded;
Any score of yellow (2) or red (3) should have evidence presented with the report to support your
F observations;
F Allow room for improvement, even if in the green there still may be some areas for improvement; and,
F Ask questions about what you are seeing.

Important Notes (for the function of the excel file):


If there is no evening shift on your project, please enter the “number only” onto the evening page to
make the trending score work; and,
Never copy and paste scores from one sheet to another, it will break the excel links. (you can copy
and paste to text boxes only, not the grades).

Main Menu

© 2017 Greg Tilley. All Rights Reserved


Leading Verses Lagging HSE Reporting Tool

Quality and Gra


Categories

Hazard IDs and Near Misses

(Prod./ HSEQ) Meeting Quality &


Quantity

JHA / FLRA Procedures


Indicators

© 2017, Greg Tilley. All Rights Reserved.


Leading Verses Lagging HSE Reporting Tool

Leadership Field Presence

Leading Indicators
Sub -Contractor Performance

Inspections / NCRs / Corrective Actions

Equipment / Tools (General)

© 2017, Greg Tilley. All Rights Reserved.


Leading Verses Lagging HSE Reporting Tool

Housekeeping / PPE

Lagging Indicators
Incidents

Injury

Main Menu

© 2017, Greg Tilley. All Rights Reserved.


Leading Verses Lagging HSE Reporting Tool

Quality and Grading Matrix


1- Good 2 - Needs Improvement 3 - Requires Immediate Action

Hazard IDs and Near Misses are not


Hazard IDs and Near miss are being
being reported in a timely fashion Hazard IDs and Near Misses are being
created within the HSE NCR system in
(within same shift) in the HSE NCR noticed and not recorded in the HSE
a timely manner and issues are being
system and issues are not being NCR system.
dealt with.
address to enhance prevention.

Quantity – Less than 80% of expected


Quantity – Less than 60% of expected
Quantity – All expected Production / Production / HSEQ meetings are held.
Production / HSEQ meetings are not
HSE meetings are being held and This includes when job changes in the
being held.
HSEQ is addressed. field.
Quality – Less than 60% of the
Quality – All of the expected workforce Quality – Less than 80% of the
expected workforce is not attending and
is attending and the appropriate topics expected workforce is attending and the
the appropriate topics are not being
are being discussed by leadership in a appropriate topics are being discussed
discussed or leadership did poorly on
good and consistent manner. by leadership in a good and consistent
delivery.
manner.

All progressing the work have a JHA / FLRA is completed however not
completed JHA / FLRA on site with adequate enough for the task at hand /
workers and was reviewed / All jobs procedure is outdated and does not
No JHA / FLRA and / or no procedure in
have procedures adequate enough for reflect the work scope adequately
place for the task being completed.
the work being performed. JHA / FLRAs enough. Work or conditional changes
are reviewed and modified when work are not be accounted for in a modified
or conditions change. JHA.

© 2017, Greg Tilley. All Rights Reserved.


Leading Verses Lagging HSE Reporting Tool

Leaders are less than 80% visibly Leaders are less than 60% visibly
Leaders are visibly noticed throughout
noticed throughout the entire shift and noticed throughout the entire shift and
the entire shift, easily approachable and
are they seem distracted and not are they seem distracted and not
intervening when appropriate.
observed intervening when appropriate. observed intervening when appropriate.

Contractors are not totally meeting Contractors are not meeting


Contractors are meeting expectations
expectations and following the HSEQ expectations nor following all processes
and following all the HSEQ Plan.
Plan. Expectations to include however defined. Expectations to include
Expectations to include however not
not limited to: reporting incidents on however not limited to: reporting
limited to: reporting incidents on time;
time; intervening with all groups; incidents on time; intervening with all
intervening with all groups; minimizing
minimizing OI`s; attending meetings; groups; minimizing OI`s; attending
OI`s; attending meetings; submitting
submitting FLHAs, Inspections, field meetings; submitting FLHAs,
FLHAs, Inspections, etc.…
presence, etc... Inspections, field presence, etc...

Planned inspections are being delayed


All planned inspections are being Planned inspections are not taking
day after day, Leaders are not
completed, Leaders are participating place, Leaders are not meeting their
participating in all the inspections. All
and correcting issues, All non- obligations and non-conformances
non-conformances noticed are not
conformances noticed are being dealt noticed from the previous inspection are
being dealt with in a timely fashion,
with immediately. Everything observed not yet dealt with. Many items are not
Most everything is meeting local and
is meeting local and WSF policy. meeting local or WSF policy.
WSF policy.

Few pieces of equipment / tools


All pieces of equipment / tools Most but not all pieces of equipment /
inspected are in good working order,
inspected are in good working order, tools inspected are in good working
clean, free of debris, and have
clean, free of debris, and have order, clean, free of debris, and have
documented walk-around, inspections,
documented walk-around, inspections, documented walk-around, inspections,
preventative maintenance not being
Preventative Maintenance records are preventative maintenance is falling
followed or seriously off schedule, etc.
available and followed, etc.…. behind, etc.….
….

© 2017, Greg Tilley. All Rights Reserved.


Leading Verses Lagging HSE Reporting Tool

Quantity – Less than 80% of the work


Quantity – 100 % of the work areas are Quantity – Less than 60% of the work
areas are not controlling housekeeping
controlling housekeeping and everyone areas are not controlling housekeeping
and workers are not complying with
is wearing PPE. or workers are not wearing PPE.
PPE policies.
Quality – 100 % or better of the areas Quality – Less than 60% of the areas
Quality – Less than 80% of the areas
are not creating hazards with poor are creating hazards with poor cable
are creating hazards with poor cable
cable management, combustibles management, combustibles present,
management, combustibles present,
present, etc.… PPE compliance, etc.…
PPE compliance, etc.…

Incident or Near Miss Occurs (no Injury)


Serious Incident Occurs (no Injury).
Property Damage (Estimated <
Injury (Classified below);
$500.00);
No incidents, Environmental releases or Property Damage (Estimated >
Loss of Production (Estimated < 3
injuries has occurred on the shift. $500.00);
hours);
Hazard IDs and Near miss are being Loss of Production (more than 3 hours);
Environmental release of minor
created and issues are being dealt with. Environmental release of concern;
amounts;
Stop work Orders (Regulatory or client
Stop work order (Regulatory or Client
based).
based).

Medical Aid or Time Loss (Recordable


No injuries has occurred on the shift. First Aid
Injury).

Main Menu

© 2017, Greg Tilley. All Rights Reserved.


Leading Verses Lagging HSE Reporting Tool

© 2017, Greg Tilley. All Rights Reserved.


Programming Pa

Company Name

SSEM

Business Project /Area / Site

Enter Text Here

Month

May

Year

2017

Main Me
Main Me
Programming Page

Categories

Hazard IDs or Near Misses

Production Meetings

JHA / FLRA / Procedures

Leadership Field Prbesence

Sub-Contractor Performance

Inspections / NCRs / CAs

Equipment / Tools (General)

Housekeeping / PPE

Incidents

Injuries

Main Menu
Main Menu
```
SSEM

Day HSE Reports May


Instructions Page
Date

1 2 3 4 5
Quality and Grading
1 Matrix
6 7 8 9 10

1 Programmers Page
11 13 14 15
2

16 17 1 1 20 Safety Score
8 9
Trend Analysis
2 2
23 24 25
1 2
Indicator(s)
Trend Analysis
2
26 28 29 30
7

Injury Report
31
SSEM

Night HSE Reports May


nstructions Page
Date

1 2 3 4 5
ality and Grading
Matrix
6 7 8 9 10

ogrammers Page 1 1
11 12 15
3 4

Safety Score 1 1
18 19 20
6 7
Trend Analysis
2 2
21 22 25
3 4
Indicator(s)
Trend Analysis
2 2 2
27 30
6 8 9

Injury Report 3
1
Leading verses Lagging HSE Reporting Tool

May

1
Day Score 0.0
Hazard IDs or Near Misses 0
Production Meetings 0
JHA / FLRA / Procedures 0
Leadership Field Prbesence 0
Sub-Contractor Performance 0
Inspections / NCRs / CAs 0
Equipment / Tools (General) 0
Housekeeping / PPE 0
Incidents 0
Injuries 0

5.5
4.5
3.5

Trend Score
2.5
1.5
0.5
-0.5 1

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool 2.5

Trend S
1.5
0.5
-0.5 1

1
Night Score 0.0
Hazard IDs or Near Misses 0
Production Meetings 0
JHA / FLRA / Procedures 0
Leadership Field Prbesence 0
Sub-Contractor Performance 0
Inspections / NCRs / CAs 0
Equipment / Tools (General) 0
Housekeeping / PPE 0
Incidents 0
Injuries 0

5.5

4.5

3.5

Trend Score
2.5

1.5

0.5
© 2017 Greg Tilley. All Rights Reserved.
Leading verses Lagging HSE Reporting Tool
4.5

3.5

Trend Score
2.5

1.5

0.5

-0.5 1

Day Score 0.0


Evening Score 0.0
Total Score 0.0

5.5

4.5

3.5

Trend Score
2.5

1.5

0.5

-0.5 1 2

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Enter Text Here


Safety Score Trend Day
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Safety Score Trends Day


5.5
4.5
3.5
Trend Score

2.5
1.5
0.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Date
© 2017 Greg Tilley. All Rights Reserved.
2.5 Leading verses Lagging HSE Reporting Tool

Trend S
1.5
0.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Date

Safety Score Trend Night


2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Safety Score Trends Nights


5.5

4.5

3.5
Trend Score

2.5

1.5

0.5
© 2017 Greg Tilley. All Rights Reserved.
Leading verses Lagging HSE Reporting Tool
4.5

3.5

Trend Score
2.5

1.5

0.5

-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Date

Day and Evening Trend Combined


0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Safety Score Trends (Combined Day + Night)


5.5

4.5

3.5
Trend Score

2.5

1.5

0.5

-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Date

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Return to Main Menu

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

2017

29 30 31
0.0 0.0 0.0 Day Score
0 0 0 Hazard IDs or Near Misses
0 0 0 Production Meetings
0 0 0 JHA / FLRA / Procedures
0 0 0 Leadership Field Prbesence
0 0 0 Sub-Contractor Performance
0 0 0 Inspections / NCRs / CAs
0 0 0 Equipment / Tools (General)
0 0 0 Housekeeping / PPE
0 0 0 Incidents
0 0 0 Injuries

29 30 31

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

29 30 31

29 30 31
0.0 0.0 0.0 Night Score
0 0 0 Hazard IDs or Near Misses
0 0 0 Production Meetings
0 0 0 JHA / FLRA / Procedures
0 0 0 Leadership Field Prbesence
0 0 0 Sub-Contractor Performance
0 0 0 Inspections / NCRs / CAs
0 0 0 Equipment / Tools (General)
0 0 0 Housekeeping / PPE
0 0 0 Incidents
0 0 0 Injuries

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

29 30 31

0.0 0.0 0.0 Day Score


0.0 0.0 0.0 Evening Score
0.0 0.0 0.0 Total Score

9 30 31

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

May

Hazard IDs or Near Misses

JHA / FLRA / Procedures

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Sub-Contractor Performance

Equipment / Tools (General)

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Incidents
8
7
6
5
4
3
2
1
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Enter Text Here


Misses Production Meetings

ures Leadership Field Prbesence

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

ance Inspections / NCRs / CAs

neral) Housekeeping / PPE

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Injuries

8
7
6
5
Row 16 4 Row 17
Row 49 Row 50
3
2
1
0
3 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Return to Main Menu

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Leading verses Lagging HSE Reporting Tool

2017

etings

rbesence

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

s / CAs

PPE

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Row 17
Row 50

23 24 25 26 27 28 29 30 31

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

May

Date 1 2 3 4 5 6
First Aids (Day) 0 0 0 0 0 0
First Aids (Night) 0 0 0 0 0 0
First Aids (Total) 0 0 0 0 0 0
Medical Aids (Day) 0 0 0 0 0 0
Medical Aids (Night) 0 0 0 0 0 0
Medical Aids (Total) 0 0 0 0 0 0
Time Loss Injuries (Day) 0 0 0 0 0 0
Time Loss Injuries (Night) 0 0 0 0 0 0
Time Loss Injuries (Total) 0 0 0 0 0 0
Date 1 2 3 4 5 6

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

First Aids

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Leading verses Lagging HSE Reporting Tool

Enter Text Here

Injury Record
7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Date
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 First Aids (Day)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 First Aids (Night)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 First Aids (Total)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Aids (Day)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Aids (Night)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Medical Aids (Total)
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Time Loss Injuries (Da
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Time Loss Injuries (Ni
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Time Loss Injuries (To
7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Date

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

st Aids 0 Medical Injuries 0 Loss Time Injuries 0

Return to Main Menu


```

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

2017

First Aids (Day)


First Aids (Night)
First Aids (Total)
Medical Aids (Day)
Medical Aids (Night)
Medical Aids (Total)
Time Loss Injuries (Day)
Time Loss Injuries (Night)
Time Loss Injuries (Total)

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 1st
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0 0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 1st
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0 0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 2nd
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

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Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 2nd
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 3rd
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 3rd
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 4th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

SSEM
HSE Report May 4th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading verses Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 5th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 5th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 6th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 6th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 7th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 7th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 8th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 8th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 9th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 9th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 10th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 10th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 11th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 11th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 12th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 12th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 13th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 13th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 14th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 14th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 15th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 15th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 16th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 16th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 17th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 17th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 18th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 18th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 19th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 19th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 20th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 20th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 21st
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 21st
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 22nd
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 22nd
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 23rd
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 23rd
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 24th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 24th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 25th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 25th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 26th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 26th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 27th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 27th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 28th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 28th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 29th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 29th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 30th
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 30th
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 31st
Card Enter Text Here Day Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Today) (MTD)
(Today) (MTD) (Today) (MTD) initials

0 0 0

Safety Trends Day


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

SSEM
HSE Report May 31st
Card Enter Text Here Night Shift
Legend
1 Good All observations are to be recorded and all categories are to be graded. Any item(s) requiring "Action
Requried" are to be brought to the immediate attention of Manager responsible
2 Needs Improvement
3 Action Required Grade Observations / Specifics / Coaching Notes NCR # / Cor. Action / Status
Hazard IDs or Near
Misses

Production Meetings

JHA / FLRA /
Procedures

Leadership Field
LEADING

Prbesence

Sub-Contractor
Performance

Inspections / NCRs /
CAs

Equipment / Tools
(General)

Housekeeping / PPE
LAGGING

Incidents

Injuries

Use Caution High Risk


Score for Shift 0.0 Risk Increasing Immediate
Attention

© 2017 Greg Tilley. All Rights Reserved.


Leading and Lagging HSE Reporting Tool

Use Caution High Risk


Risk Increasing Immediate
Attention
HSE Advisor Notes / Worker Concerns / Items to be actioned / Production Meeting Topic

Enter Text Here Injury Record Reporter


Medical Medical Loss Time Loss Time HSE
First Aids First Aids
Injury Injury Injury Injury Advisor
(Night) (MTD)
(Night) (MTD) (Night) (MTD) initials

0 0 0

Safety Trends Evening


5.5
Trend Score

3.5
1.5
-0.5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Day

Return to Main Safety Score Indicator (s)


Menu Trend Analysis Trend Analysis

© 2017 Greg Tilley. All Rights Reserved.

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