Appendix B Survey Small Med Example

Appendix B:

Small & Medium sized employers Survey Example

Form Approved

OMB Control Number: 1290-0043

Expiration Date: March 31, 2025

Leading Indicator Survey Questions Small and Medium Sized Employees

The survey created for these questions is intended to assess the use of safety and health metrics, with special emphasis on the acceptance and use of “leading indicators.” Answers to this survey are not intended for OSHA policy or rulemaking efforts. For the purpose of these surveys, the following definitions apply:

Leading Indicator or Metric: For purposes of this document, leading indicators are proactive, preventive, and predictive measures that provide information about the effective performance of your safety and health activities. They measure events leading up to injuries, illnesses, and other incidents and reveal potential problems in your safety and health program. In contrast, lagging indicators measure the occurrence and frequency of events that occurred in the past, such as the number or rate of injuries, illnesses, and fatalities.

Examples of leading indicators can include:

• Risk assessments

• Job safety observations

• Inspections

• EHS training

• Leadership safety engagement

• Corrective actions completed

• Employee safety perception surveys

Lagging or Trailing Indicator or Metric: Lagging indicators on the other hand alert you to a failure in an area of your safety and health program or to the existence of a hazard, leading indicators allow you to take preventive action to address that failure or hazard before it turns into an incident. A good program uses leading indicators to drive change and lagging indicators to measure effectiveness.

Examples of lagging indicators can include:

• OSHA Total Recordable Incident Rate (TRIR)

• OSHA Days Away, Restricted and Transferred (DART) rates

• Property damage

• Workers’ compensation costs

• Liability/litigation costs

Business Impact Measures: Trailing or outcome measures that focus on the business impacts of safety and health programs and initiatives (e.g., safety and health contributions to key business strategies). For more information one can refer to OSHA’s , Using Leading Indicators to Improve Safety and Health Outcomes.

Examples of business impact measures can include:

• Productivity

• Reputational risk

• Business continuity

• Workforce morale

• Financial health

Public reporting burden for this collection of information is estimated to average 15 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Occupational Safety and Health Administration, U.S. Department of Labor, 200 Constitution Ave NW., Suite N3621, Washington, DC 20210-4537 and reference the OMB Control Number 1290-0043.

The following questions are designed to collect information on the indicators that are in place at your worksite. Lagging indicators include the traditional safety metrics (OSHA rates) that indicate, for example, compliance with OSHA standards and regulations. These are the bottom-line numbers that can evaluate the overall effectiveness of safety at your facility. The drawback with lagging indicators to measure site safety success is that they only tell one events that have already occurred. The lagging indicator does address successes in preventing injuries, incidents, and accidents. This is where leading indicators come into play and should be used in conjunction with lagging indicators as a part of a site’s metrics. A leading indicator in contrast is a measure one utilizes that ideally would precede a future event and would be used to drive and measure activities your site may carry out to prevent and control injury and illness.

Survey Questions

Name:

Job Title:

Company:

Phone: Email:

Industry:

Number of Employees

As appropriate for each of the questions in this survey please address if your response is site based or it reflects on the entire corporation.

1. What business or industry are you in (i.e., healthcare, manufacturing, construction, and so forth)?

2. Who is filling out this survey – safety and health professional or another company manager?

3. What is your annual average for the number of employees?

4. What percent of your employees are full time company employees?

5. What percent of your employees are contractors?

6. What percent of your employees are temporary employees?

7. What leading indicators do you collect?

Check All That Apply

	Musculoskeletal Disorders
	Employee/Leadership Engagements
	Corrective Actions (Quality/Closures)
	Risk Assessment/ Inspections of hazards with potentially serious consequences
	Incidents (Near-miss or Close Calls)
	Violations/Penalties (or 3rd Party Audits)
	Safety and Health Program Participation
	Safety and Health-Related Training Rate
	Incident Reporting Process
	Company Safety Plan Audits, Exercises and drills
	Other Leading Indicators not listed (please specify)

8. Of these, indicate which leading indicators are most important in your workplace?

Check All That Apply Number in order of importance.

	Musculoskeletal Disorders
	Employee/Leadership Engagements
	Corrective Actions (Quality/Closures)
	Risk Assessment/ Inspections of hazards with potentially serious consequences
	Incidents (Near-miss or Close Calls)
	Violations/Penalties (or 3rd Party Audits)
	Safety and Health Program Participation
	Safety and Health-Related Training Rate
	Incident Reporting Process
	Company Safety Plan Audits, Exercises, and drills
	Other Leading Indicators not listed (please specify)

9. Why were the indicators in question 7 chosen?

Briefly comment on all that apply.

Musculoskeletal Disorders
Employee/Leadership Engagements
Corrective Actions (Quality/Closures)
Risk Assessment/ Inspections of Hazards with potentially Serious Consequences
Incidents (Near-miss or Close Calls)
Violations/Penalties (or 3rd Party Audits)
Safety Program Participation
Safety and Health-Related Training Rate
Incident Reporting Process
Company Safety Plan Audits, Exercises, and drills
Other Leading Indicators not listed

10. How do you track the leading indicators you identified in Question 7 above?

Briefly comment on all that apply.

Musculoskeletal Disorders
Employee/Leadership Engagements
Corrective Actions (Quality/Closures)
Risk Assessment/ Inspections of Hazards with Potentially serious Consequences
Incidents (Near-miss or Close Calls)
Violations/Penalties (or 3rd Party Audits)
Safety Program Participation
Safety and Health-Related Training Rate
Incident Reporting Process
Company Safety Plan Audits, Exercises, and drills
Other Leading Indicators not listed

11. What lagging indicators do you collect?

12. Do you link your leading indicators to outcome data such as OSHA Days Away, Restricted or Transferred (DART) or Total Case Incident Rate (TCIR) rates to evaluate results?

a. Yes

b. No

13. Which metrics, if any, (leading, lagging, business impact) do you report to senior management?

Check All That Apply

☐ leading ☐ lagging ☐ business	Musculoskeletal Disorders
☐ leading ☐ lagging ☐ business	Employee/Leadership Engagements
☐ leading ☐ lagging ☐ business	Corrective Actions (Quality/Closures)
☐ leading ☐ lagging ☐ business	Risk Assessment/ Inspections of hazards with potentially serious consequences
☐ leading ☐ lagging ☐ business	Incidents (Near-miss or Close Calls)
☐ leading ☐ lagging ☐ business	Violations/Penalties (or 3rd Party Audits)
☐ leading ☐ lagging ☐ business	Safety and Health Program Participation
☐ leading ☐ lagging ☐ business	Safety and Health-Related Training Rate
☐ leading ☐ lagging ☐ business	Incident Reporting Process
☐ leading ☐ lagging ☐ business	Company Safety Plan Audits, Exercises, and drills
☐ leading ☐ lagging ☐ business	Other Leading Indicators not listed

14. Do you validate the lagging/outcome metrics?

a. Yes

b. No

Response:

15. If yes, how is that done?

Current Use:

16. What leading indicators are, or could be, commonly used in your industry?

Future Use:

Response:

17. What barriers and challenges, if any, have you encountered to using leading indicators?

18. How could employers be encouraged to use leading indicators in addition to lagging indicators to improve safety management? Example?

Response:

19. Any additional comments regarding the use of leading indicators?

Response:

20. Any additional comments on the use of metrics generally?

Response:

21. Are your leading indicators of safety and health reported to, or reviewed by the Board of Directors, or a BoD governance committee?

Response:

Response:

21. Have the leading indicators you've selected overtaken OSHA Recordable injury statistics as having more meaning for your organization than OSHA lagging indicators? 

21. If you have any leading indicators tracking, data, or forms you would be willing to share, please email NSC at [TBD]

 

8