A worker on the night shift notices that a guard on a conveyor has been left loose after maintenance. She tells her supervisor. What happens in the next ten minutes decides whether she will report the next problem. If the supervisor thanks her, makes the area safe and asks how the guard came to be loose, the site learns something. If the first question is who left it that way, the site learns very little, and the worker learns to keep quiet.
That exchange rarely appears in audit evidence, yet it is where a management system either works or does not. Two developments in 2026 bring it into focus for organisations in Indonesia. The international revision of ISO 45001 has moved through its draft ballot with a clear emphasis on leadership, and the Ministry of Manpower (Kemnaker) has spent much of the year arguing that safety culture depends on leaders more than on documents. This article looks at what both mean for supervisors, safety walks and management review.
Background: why accidents are organisational
Industrial safety research has long described serious accidents as the product of conditions built into the organisation, with the final act of a worker as the last link. Reason (1997) called these latent conditions: staffing decisions, maintenance backlogs, procedures that do not fit the job, and production pressure that nobody intends but everyone feels. Human and organisational performance (HOP) builds on this view. Its core ideas, set out in practitioner works such as Conklin (2012) and the U.S. Department of Energy (2009) handbook, are that people make errors even when they are skilled and careful, that the work context shapes behaviour, and that the way leaders respond to failure determines whether the organisation learns from it.
Indonesian regulation reaches a similar point by a different route. Law No. 1 of 1970 places the duty for workplace safety on the pengurus, the person who manages the workplace. Government Regulation (PP) 50 of 2012 builds the SMK3 system around five stages: setting the OHS policy, planning, implementation, monitoring and evaluation, and review and improvement. Leadership commitment sits at the start of that cycle and management review at the end, and both are the responsibility of management.
ISO 45001:2018, adopted nationally as SNI ISO 45001:2018, is more explicit about culture. Clause 5.1 asks top management to develop, lead and promote a culture that supports the intended outcomes of the system, and to protect workers from reprisals when they report incidents, hazards, risks and opportunities. Clause 5.4 requires consultation and participation of non-managerial workers and asks the organisation to remove barriers to that participation. Clause 9.3 lists the inputs to management review, which include incidents, monitoring results and the outcome of worker consultation.
Local research has started to measure the leadership side of this picture. Millana et al. (2024), for example, studied 128 workers at a railway manufacturer and examined safety leadership through three dimensions, namely safety motivation, safety concern and safety policy, alongside safety compliance and safety participation as measures of behaviour. Studies of this kind treat leadership as a set of behaviours that a site can observe and improve.
Current issues: the ISO 45001 revision and Kemnaker's emphasis on culture
According to ISO/TC 283, the committee responsible for the standard, the Draft International Standard (DIS) for the revised ISO 45001 entered its ballot stage in June 2026. The ISO project page describes a 12-week ballot and now lists the project at stage 40.60, close of voting. At the time of writing, no public statement on the ballot outcome had been found, and ISO 45001:2018 remains the edition in force for certification. The content of the draft can still change before publication.
Commentary from certification bodies gives an idea of the direction. BSI describes the draft as giving more weight to top management owning health and safety outcomes, integrating OHS into governance and strategy, and showing commitment through behaviour and culture rather than through policies or delegated duties alone. BSI also notes a stronger focus in the performance evaluation clauses on going beyond lagging indicators and compliance checks, with more attention to well-being risks, management review and the use of performance data. These points come from a summary of the draft, so organisations should read them as an indication of direction and wait for the final text before changing their procedures.
In Indonesia, the same theme runs through statements from Kemnaker this year. In January 2026, RRI reported Minister of Manpower Yassierli as saying that most accidents attributed to human error stem from weaknesses in organisational and work systems, with only a minority caused by individual negligence. He argued that blaming workers misses the point. In May 2026, ANTARA reported the minister citing BPJS Ketenagakerjaan data of 319,224 work accident claims in 2025, and noting that only about 18,000 of roughly 450,000 companies apply SMK3. In June 2026, ANTARA quoted Deputy Minister Afriansyah Noor as saying that preventing accidents takes more than paperwork and basic compliance, and that safety culture has to be built into company values, daily behaviour and leadership.
Taken together, the international standard and the national regulator are moving towards the same question. An auditor or inspector will increasingly ask what leaders actually do, and what changed because of it, in addition to whether a policy has been signed.
Recommendations: making leadership visible in daily work
The steps below can be applied in an organisation with or without certification, and they fit within the existing requirements of PP 50/2012 and ISO 45001:2018.
Give safety walks a learning purpose
Many leadership safety walks turn into inspections. The manager looks for missing gloves, notes them and leaves. A walk focused on learning asks how the work is really done and what makes it hard. Useful questions include "What slows you down on this job?", "Where do you have to improvise?" and "What would you change if you could?" Fewer and longer walks tend to give better information than many short ones. Each walk should end with one or two things the leader will follow up personally, and the people visited should hear what happened to their input.
Prepare supervisors for the first response
The supervisor is usually the first person to hear about a near miss or a hazard. A short, practised response helps: thank the person, make the situation safe, ask what happened and what made sense at the time, and agree when they will hear back. Disciplinary questions can come later, through a defined process, and only where the facts justify them. Dekker (2016) describes a restorative approach to accountability, which asks who has been hurt, what they need and whose obligation it is to meet that need. The approach does not remove accountability. It moves the focus from punishment to repair and learning, and it makes clear to the workforce that honest reporting is safe.
Use learning teams for events and for normal work
A learning team is a small group of the people who do the work, facilitated so that they can describe how the job actually unfolds before anyone proposes a fix. Conklin (2012) argues for studying normal work before it fails, so the method suits recurring difficulties and near misses as well as incidents. The output is a list of conditions that make the work fragile and the controls that would make it more tolerant of error. Learning teams do not replace a formal investigation where regulation or severity require one, and they work best when the facilitator is not the line manager of the participants.
Strengthen management review
Clause 9.3 of ISO 45001:2018 already asks for a wide set of inputs. In practice, many reviews dwell on incident rates. A review can add evidence such as the time taken to close actions from reports, the share of reporters who received feedback, recurring themes from safety walks and learning teams, and the results of worker consultation. The outputs should be decisions with owners and resources. A review that ends with "continue monitoring" for every item has not done its job.
Measure what supports learning
Setting a target for the number of near-miss reports often produces low-quality reports. Targets for the speed and quality of the response, such as feedback to the reporter within an agreed time, tend to support honest reporting better. A low number of reports in a high-risk area deserves a conversation, because it may reflect fear or fatigue with the reporting process rather than safe work.
How Nusa Safety's services relate
Leaders and supervisors who want to practise these behaviours can take HSE Leadership for Line Management, which covers safety conversations, visible leadership and the supervisor's response to reports. For teams that need to examine events with a systems view, Incident Investigation and RCA trains investigators to look past the last action of the individual worker.
To understand where an organisation stands, a Safety Culture Maturity Assessment or a Safety Climate Survey (NOSACQ-50) can provide a baseline before and after a leadership programme. Organisations preparing for the revised standard can use an ISO Gap Assessment and Internal Audit to test how leadership, consultation and management review work in practice, and SMK3 and ISO 45001 Implementation to strengthen those processes.
On the digital side, Hazard Report is designed for reporting hazards and near misses from a phone, with an anonymous option and follow-up of each corrective action through to closure, which makes feedback to reporters visible. Observation Card records safety conversations without naming the people observed. SMK3 Manager keeps SMK3 evidence, action plans and P2K3 minutes in one place, which helps management review draw on current data. To discuss a specific site, please contact us.
Conclusion
The ISO 45001 revision is still a draft, and its final wording may change. The direction is already clear from the draft commentary and from Kemnaker's statements this year: leadership will be judged by what leaders do and by what changes as a result. For most organisations, the practical starting point is small and close to the work. Prepare supervisors for the first response to a report. Use safety walks and learning teams to understand normal work. Bring that learning into management review as evidence for decisions. A site that does these things well will be ready for the revised standard when it is published, and it will hear about the loose guard before it hurts someone.
This article is general information and does not constitute legal advice; for questions on how specific regulations apply to your organisation, please consult a qualified lawyer.
References
- ANTARA. (2026, May 22). Indonesia pushes stronger workplace safety to cut accidents. ANTARA News. https://en.antaranews.com/news/416747/indonesia-pushes-stronger-workplace-safety-to-cut-accidents
- ANTARA. (2026, June 24). Ministry pushes stronger OHS culture at workplaces. ANTARA News. https://en.antaranews.com/news/420257/ministry-pushes-stronger-ohs-culture-at-workplaces
- Badan Standardisasi Nasional. (2018). SNI ISO 45001:2018 Sistem manajemen keselamatan dan kesehatan kerja, persyaratan dengan panduan penggunaan. BSN.
- BSI. (n.d.). ISO 45001:2027 changes explained. BSI Group. https://www.bsigroup.com/en-GB/insights-and-media/insights/blogs/iso-45001-2027-changes-explained/
- Conklin, T. (2012). Pre-accident investigations: An introduction to organizational safety. Ashgate.
- Dekker, S. (2016). Just culture: Restoring trust and accountability in your organization (3rd ed.). CRC Press.
- Health and Safety Executive. (2013). Leading health and safety at work (INDG417 rev1). HSE Books. https://www.hse.gov.uk/pubns/indg417.htm
- International Organization for Standardization. (n.d.). ISO/DIS 45001 Occupational health and safety management systems, Requirements with guidance for use. https://www.iso.org/standard/45001/rev
- ISO/TC 283. (2026, June 18). ISO 45001 revision reaches Draft International Standard ballot stage. International Organization for Standardization. https://committee.iso.org/sites/tc283/home/news/content-left-area/news-and-updates/news.html
- Millana, M. C., Handoko, L., Rachman, F., & Anggraini, N. (2024). Pengaruh safety leadership terhadap safety behaviour di industri manufaktur perkeretaapian. Journal of Safety, Health, and Environment Engineering, 2(1). https://doi.org/10.35991/jshee.v2i1.4
- Peraturan Pemerintah Nomor 50 Tahun 2012 tentang Penerapan Sistem Manajemen Keselamatan dan Kesehatan Kerja.
- Reason, J. (1997). Managing the risks of organizational accidents. Ashgate.
- RRI. (2026, January 23). Govt pushes for OSH system strengthening in Indonesia. Radio Republik Indonesia. https://rri.co.id/en/national/2126517/govt-pushes-for-osh-system-strengthening-in-indonesia
- U.S. Department of Energy. (2009). Human performance improvement handbook (DOE-HDBK-1028-2009). U.S. Department of Energy.
- Undang-Undang Nomor 1 Tahun 1970 tentang Keselamatan Kerja.
