C ity  O f  P hiladelphia A ccident,  I njury &  I llness Report   City of Philadelphia  Office of Finance Risk Mgmt. Divi...
Today’s Goals <ul><li>Introduce the COPA II form </li></ul><ul><li>Provide training on how to properly complete the COPA I...
COPA II – Information/Specifics & Fundamental Cause
Department’s Top 3 Causes & Goals <ul><li>Overexertion </li></ul><ul><li>Motor Vehicle Accident </li></ul><ul><li>Fall Sam...
City of Philadelphia Policy <ul><ul><li>Obtain referral slip from supervisor </li></ul></ul><ul><ul><li>Obtain copy of enc...
City of Philadelphia Policy cont. <ul><li>Departments are to: </li></ul><ul><ul><li>Immediately report all injuries to the...
Getting Started with COPA II <ul><ul><ul><li>Immediate supervisor  is responsible for completing the COPA II report w/ inp...
The Report <ul><li>Part I –  Identification </li></ul><ul><li>Part II –  Description </li></ul><ul><li>Part III – Motor Ve...
Part I: Identification
Indentification Information <ul><li>Obtain the employee’s current information </li></ul><ul><li>No nicknames or abbreviati...
Incident Type <ul><li>Injury </li></ul><ul><ul><li>any wound or damage to the body resulting from an event in the work env...
Indentificaion Information <ul><ul><li>Job Title vs. Job title at time of injury </li></ul></ul><ul><ul><li>Work Assignmen...
Location of Incident <ul><li>Location (Inside) </li></ul><ul><ul><li>Address </li></ul></ul><ul><ul><li>Location in Buildi...
Example: Part 1
Part II: Description of Incident
Accident Type/Section 30
Body Part Effected <ul><li>Section 31: List body part(s) injured </li></ul>
Incident & Treatment Description <ul><li>Section 32: Give detailed description of the incident </li></ul><ul><ul><li>Inter...
Example: Part 2
Part III: Motor Vehicle Accidents/Crash
Motor Vehicle Accident/Crash <ul><li>D.C. Number </li></ul><ul><ul><li>Get this from Police Report </li></ul></ul><ul><li>...
Part IV: Signatures & Date
<ul><li>Required: </li></ul><ul><ul><li>Employee </li></ul></ul><ul><ul><li>Immediate supervisor on duty </li></ul></ul><u...
Part V: Fundamental Cause & Corrective Action
Fundamental Cause & Corrective Action <ul><li>Left column has four main categories for fundamental causes </li></ul><ul><u...
Example: Part 5
Identify Possible Corrective Actions: “Correcting the Root Cause” <ul><li>Possible Corrective Actions (right column): </li...
Corrective Actions – Do’s & Don’ts <ul><li>Example: </li></ul><ul><li>A worker, parks a large truck on the road side to st...
Example: Part 5
Fundamental Cause & Corrective Action <ul><li>The last section is the date corrective actions were implemented </li></ul><...
Fundamental Causes? (Give the letters) What are the Correction Action?
QUESTIONS?
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Copaii train the supervisor module 09.27.10

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Copaii train the supervisor module 09.27.10

  1. 1. C ity O f P hiladelphia A ccident, I njury & I llness Report City of Philadelphia Office of Finance Risk Mgmt. Division COPA II
  2. 2. Today’s Goals <ul><li>Introduce the COPA II form </li></ul><ul><li>Provide training on how to properly complete the COPA II form </li></ul><ul><li>Demonstrate the importance of properly & completely completing the COPA II </li></ul>
  3. 3. COPA II – Information/Specifics & Fundamental Cause
  4. 4. Department’s Top 3 Causes & Goals <ul><li>Overexertion </li></ul><ul><li>Motor Vehicle Accident </li></ul><ul><li>Fall Same Level </li></ul>
  5. 5. City of Philadelphia Policy <ul><ul><li>Obtain referral slip from supervisor </li></ul></ul><ul><ul><li>Obtain copy of encounter form from the CMP </li></ul></ul><ul><ul><li>Not provide private insurance to the CMP </li></ul></ul><ul><ul><li>Other responsibilities & procedures in SMILE Guide </li></ul></ul><ul><li>Employees must (Covered in SMILE Guide): </li></ul><ul><ul><li>Report the injury/illness to their immediate supervisor at time of injury </li></ul></ul>
  6. 6. City of Philadelphia Policy cont. <ul><li>Departments are to: </li></ul><ul><ul><li>Immediately report all injuries to the City’s Third Party Administrator (CSI) </li></ul></ul><ul><ul><ul><li>1-866-IOD-Claims or 1-866-463-2524 </li></ul></ul></ul><ul><ul><li>Complete and submit injury report (COPA II) to Departmental Safety Office within 48 hrs. </li></ul></ul><ul><ul><ul><li>Phone #: 1-866-463-2524 </li></ul></ul></ul><ul><ul><ul><li>Fax #: 215-587-1270 </li></ul></ul></ul><ul><ul><ul><li>Address: P.O. Box 58579 </li></ul></ul></ul><ul><ul><ul><li>Philadelphia, PA 19102 </li></ul></ul></ul>
  7. 7. Getting Started with COPA II <ul><ul><ul><li>Immediate supervisor is responsible for completing the COPA II report w/ input from injured employee </li></ul></ul></ul><ul><ul><ul><li>Complete COPA II immediately after incident </li></ul></ul></ul><ul><ul><ul><li>Review & complete all areas of the report </li></ul></ul></ul>
  8. 8. The Report <ul><li>Part I – Identification </li></ul><ul><li>Part II – Description </li></ul><ul><li>Part III – Motor Vehicle Accident/Crash </li></ul><ul><li>Part IV – Signatures </li></ul><ul><li>Part V – Fundamental Causes & Corrective </li></ul><ul><ul><li>Action </li></ul></ul>COPA II is divided into 5 parts:
  9. 9. Part I: Identification
  10. 10. Indentification Information <ul><li>Obtain the employee’s current information </li></ul><ul><li>No nicknames or abbreviations </li></ul><ul><li>Get CURRENT address , job title, etc </li></ul><ul><li>Get CURRENT contact information </li></ul><ul><li>Verify payroll number </li></ul>
  11. 11. Incident Type <ul><li>Injury </li></ul><ul><ul><li>any wound or damage to the body resulting from an event in the work environment </li></ul></ul><ul><li>Illness </li></ul><ul><ul><li>Adverse reactions resulting from an exposure to a substance or environmental condition </li></ul></ul><ul><ul><li>both acute & chronic illness </li></ul></ul><ul><li>Near Miss </li></ul><ul><ul><li>A “near miss” is an event that could have resulted in an injury. </li></ul></ul>
  12. 12. Indentificaion Information <ul><ul><li>Job Title vs. Job title at time of injury </li></ul></ul><ul><ul><li>Work Assignment </li></ul></ul><ul><ul><ul><li>Routine, Non-routine, Emergency </li></ul></ul></ul><ul><li>Immediate Supervisor vs. Immediate Supervisor at the time of the injury </li></ul><ul><li>Witness Info </li></ul><ul><ul><li>Get full names & job titles for all witnesses </li></ul></ul><ul><ul><li>Get contact information for all witnesses </li></ul></ul>
  13. 13. Location of Incident <ul><li>Location (Inside) </li></ul><ul><ul><li>Address </li></ul></ul><ul><ul><li>Location in Building </li></ul></ul><ul><li>Where (Outside) </li></ul><ul><ul><li>Closest address or intersection </li></ul></ul><ul><ul><li>Normal work area or type </li></ul></ul>
  14. 14. Example: Part 1
  15. 15. Part II: Description of Incident
  16. 16. Accident Type/Section 30
  17. 17. Body Part Effected <ul><li>Section 31: List body part(s) injured </li></ul>
  18. 18. Incident & Treatment Description <ul><li>Section 32: Give detailed description of the incident </li></ul><ul><ul><li>Interview the employee & witnesses </li></ul></ul><ul><li>Section 33: Provide information on medical treatment </li></ul><ul><ul><li>First Aid: give type </li></ul></ul><ul><ul><li>CMP or Other: Date & Site </li></ul></ul>
  19. 19. Example: Part 2
  20. 20. Part III: Motor Vehicle Accidents/Crash
  21. 21. Motor Vehicle Accident/Crash <ul><li>D.C. Number </li></ul><ul><ul><li>Get this from Police Report </li></ul></ul><ul><li>A.I.D. Number </li></ul><ul><ul><li>Get from Police Dept is A.I.D. is involved </li></ul></ul><ul><li>Vehicle Property Number </li></ul><ul><ul><li>Vehicle property # may be the only info available when initially completing this form. </li></ul></ul><ul><li>Don’t forget! Complete the City’s Accident Report form in addition to COPA II </li></ul>
  22. 22. Part IV: Signatures & Date
  23. 23. <ul><li>Required: </li></ul><ul><ul><li>Employee </li></ul></ul><ul><ul><li>Immediate supervisor on duty </li></ul></ul><ul><ul><li>Unit Supervisor </li></ul></ul><ul><ul><li>Dept. Safety Officer </li></ul></ul><ul><li>Optional: </li></ul><ul><ul><li>DC 47 Release </li></ul></ul><ul><ul><ul><li>DC 47 Members Only </li></ul></ul></ul>Signatures
  24. 24. Part V: Fundamental Cause & Corrective Action
  25. 25. Fundamental Cause & Corrective Action <ul><li>Left column has four main categories for fundamental causes </li></ul><ul><ul><li>You can choose multiple entries from each category </li></ul></ul><ul><li>Identify factors that contributed to incident </li></ul><ul><ul><li>Think about the incident & its root causes </li></ul></ul>
  26. 26. Example: Part 5
  27. 27. Identify Possible Corrective Actions: “Correcting the Root Cause” <ul><li>Possible Corrective Actions (right column): </li></ul><ul><li>Provides guidance to eliminating or reducing the hazards identified as the “Root Cause” </li></ul><ul><li>Address all “Root Causes” identified & list in Section 47. </li></ul>
  28. 28. Corrective Actions – Do’s & Don’ts <ul><li>Example: </li></ul><ul><li>A worker, parks a large truck on the road side to start the job. As he exits the truck, he steps on the curb and twists his ankle. </li></ul><ul><li>Don’t Recommend: </li></ul><ul><li>“ Be more aware of your surrounding” </li></ul><ul><li>“ Watch where you’re going” </li></ul><ul><li>“ be more careful” </li></ul><ul><li>Do Recommend: </li></ul><ul><li>Train the employee on proper lifting technique. </li></ul><ul><li>Provide a cart for transporting file boxes. </li></ul>
  29. 29. Example: Part 5
  30. 30. Fundamental Cause & Corrective Action <ul><li>The last section is the date corrective actions were implemented </li></ul><ul><li>Don’t wait until corrective actions are implemented before submitting COPA II </li></ul><ul><ul><li>If necessary, resubmit after implementation of corrective actions </li></ul></ul>
  31. 31. Fundamental Causes? (Give the letters) What are the Correction Action?
  32. 32. QUESTIONS?

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