describe problem solving and root cause analysis

• Business Essentials
• Leadership & Management
• Credential of Leadership, Impact, and Management in Business (CLIMB)
• Entrepreneurship & Innovation
• Digital Transformation
• Finance & Accounting
• Business in Society
• For Organizations
• Support Portal
• Media Coverage
• Founding Donors
• Leadership Team

• Harvard Business School →
• HBS Online →
• Business Insights →

Business Insights

Harvard Business School Online's Business Insights Blog provides the career insights you need to achieve your goals and gain confidence in your business skills.

• Career Development
• Communication
• Decision-Making
• Earning Your MBA
• Negotiation
• News & Events
• Productivity
• Staff Spotlight
• Student Profiles
• Work-Life Balance
• AI Essentials for Business
• Alternative Investments
• Business Analytics
• Business Strategy
• Business and Climate Change
• Creating Brand Value
• Design Thinking and Innovation
• Digital Marketing Strategy
• Disruptive Strategy
• Economics for Managers
• Entrepreneurship Essentials
• Financial Accounting
• Global Business
• Launching Tech Ventures
• Leadership Principles
• Leadership, Ethics, and Corporate Accountability
• Leading Change and Organizational Renewal
• Leading with Finance
• Management Essentials
• Negotiation Mastery
• Organizational Leadership
• Power and Influence for Positive Impact
• Strategy Execution
• Sustainable Business Strategy
• Sustainable Investing
• Winning with Digital Platforms

Root Cause Analysis: What It Is & How to Perform One

• 07 Mar 2023

The problems that affect a company’s success don’t always result from not understanding how to solve them. In many cases, their root causes aren’t easily identified. That’s why root cause analysis is vital to organizational leadership .

According to research described in the Harvard Business Review , 85 percent of executives believe their organizations are bad at diagnosing problems, and 87 percent think that flaw carries significant costs. As a result, more businesses seek organizational leaders who avoid costly mistakes.

If you’re a leader who wants to problem-solve effectively, here’s an overview of root cause analysis and why it’s important in organizational leadership.

Access your free e-book today.

What Is Root Cause Analysis?

According to the online course Organizational Leadership —taught by Harvard Business School professors Joshua Margolis and Anthony Mayo— root cause analysis is the process of articulating problems’ causes to suggest specific solutions.

“Leaders must perform as beacons,” Margolis says in the course. “Namely, scanning and analyzing the landscape around the organization and identifying current and emerging trends, pressures, threats, and opportunities.”

By working with others to understand a problem’s root cause, you can generate a solution. If you’re interested in performing a root cause analysis for your organization, here are eight steps you must take.

8 Essential Steps of an Organizational Root Cause Analysis

1. identify performance or opportunity gaps.

The first step in a root cause analysis is identifying the most important performance or opportunity gaps facing your team, department, or organization. Performance gaps are the ways in which your organization falls short or fails to deliver on its capabilities; opportunity gaps reflect something new or innovative it can do to create value.

Finding those gaps requires leveraging the “leader as beacon” form of leadership.

“Leaders are called upon to illuminate what's going on outside and around the organization,” Margolis says in Organizational Leadership , “identifying both challenges and opportunities and how they inform the organization's future direction.”

Without those insights, you can’t reap the benefits an effective root cause analysis can produce because external forces—including industry trends, competitors, and the economy—can affect your company’s long-term success.

2. Create an Organizational Challenge Statement

The next step is writing an organizational challenge statement explaining what the gap is and why it’s important. The statement should be three to four sentences and encapsulate the challenge’s essence.

It’s crucial to explain where your organization falls short, what problems that poses, and why it matters. Describe the gap and why you must urgently address it.

A critical responsibility is deciding which gap requires the most attention, then focusing your analysis on it. Concentrating on too many problems at once can dilute positive results.

To prioritize issues, consider which are the most time-sensitive and mission-critical, followed by which can make stakeholders happy.

3. Analyze Findings with Colleagues

It's essential to work with colleagues to gain different perspectives on a problem and its root causes. This involves understanding the problem, gathering information, and developing a comprehensive analysis.

While this can be challenging when you’re a new organizational leader, using the double helix of leadership —the coevolutionary process of executing organizational leadership's responsibilities while developing the capabilities to perform them—can help foster collaboration.

Research shows diverse ideas improve high-level decision-making, which is why you should connect with colleagues with different opinions and expertise to enhance your root cause analysis’s outcome.

4. Formulate Value-Creating Activities

Next, determine what your company must do to address your organizational challenge statement. Establish three to five value-creating activities for your team, department, or organization to close the performance or opportunity gap you’ve identified.

This requires communicating organizational direction —a clear and compelling path forward that ensures stakeholders know and work toward the same goal.

“Setting direction is typically a reciprocal process,” Margolis says in Organizational Leadership . “You don't sit down and decide your direction, nor do you input your analysis of the external context into a formula and solve for a direction. Rather, setting direction is a back-and-forth process; you move between the value you'd like to create for customers, employees, investors, and your grasp of the context.”

5. Identify Necessary Behavior Changes

Once you’ve outlined activities that can provide value to your company, identify the behavior changes needed to address your organizational challenge statement.

“Your detective work throughout your root cause analysis exposes uncomfortable realities about employee competencies, organizational inefficiencies, departmental infighting, and unclear direction from leadership at multiple levels of the company,” Mayo says in Organizational Leadership .

Factors that can affect your company’s long-term success include:

• Ineffective communication skills
• Resistance to change
• Problematic workplace stereotypes

Not all root cause analyses reveal behaviors that must be eliminated. Sometimes you can identify behaviors to enhance or foster internally, such as:

• Collaboration
• Innovative thinking
• Creative problem-solving

6. Implement Behavior Changes

Although behaviors might be easy to pinpoint, putting them into practice can be challenging.

To ensure you implement the right changes, gauge whether they’ll have a positive or negative impact. According to Organizational Leadership , you should consider the following factors:

• Motivation: Do the people at your organization have a personal desire for and commitment to change?
• Competence: Do they have the skills and know-how to implement change effectively?
• Coordination: Are they willing to work collaboratively to enact change?

Based on your answers, decide what behavior changes are plausible for your root cause analysis.

7. Map Root Causes

The next step in your analysis is mapping the root causes you’ve identified to the components of organizational alignment. Doing so helps you determine which components to adjust or change to implement employee behavior changes successfully.

Three root cause categories unrelated to behavior changes are:

• Systems and structures: The formal organization component, including talent management, product development, and budget and accountability systems
• People: Individuals’ profiles and the workforce’s overall composition, including employees’ skills, experience, values, and attitudes
• Culture: The informal, intangible part of your organization, including the norms, values, attitudes, beliefs, preferences, common practices, and habits of its employees

8. Create an Action Plan

Using your findings from the previous steps, create an action plan for addressing your organizational problem’s root cause and consider your role in it.

To make the action plan achievable, ensure you:

• Identify the problem’s root cause
• Create measurable results
• Ensure clear communication among your team

“One useful way to assess your potential impact on the challenge is to understand your locus of control,” Mayo says in Organizational Leadership , “or the extent to which you can personally drive the needed change or improvement.”

The best way to illustrate your control is by using three concentric circles: the innermost circle being full control of resources, the middle circle representing your ability to influence but not control, and the outermost circle alluding to shifts outside both your influence and control.

Consider these circles when implementing your action plan to ensure your goals don’t overreach.

The Importance of Root Cause Analysis in Organizational Leadership

Root cause analysis is a critical organizational leadership skill for effectively addressing problems and driving change. It helps you understand shifting conditions around your company and confirm that your efforts are relevant and sustainable.

As a leader, you must not only effect change but understand why it’s needed. Taking an online course, such as Organizational Leadership , can enable you to gain that knowledge.

Using root cause analysis, you can identify the issues behind your organization’s problems, develop a plan to address them, and make impactful changes.

Are you preparing to transition to a new leadership role? Enroll in our online certificate course Organizational Leadership —one of our leadership and management courses —and learn how to perform an effective root cause analysis to ensure your company’s long-term success. To learn more about what it takes to be an effective leader, download our free leadership e-book .

About the Author

Root cause analysis (RCA) is the quality management process by which an organization searches for the root of a problem, issue or incident after it occurs.

Issues and mishaps are inevitable in any organization, even in the best of circumstances. While it could be tempting to simply address symptoms of the problem as they materialize, addressing symptoms is an inherently reactive process that all but guarantees a recurring—and often worsening—series of problems.

Ethical, proactive, well-run companies and organizations with a reactive approach will both encounter problems, but the former will experience fewer and recover faster because they prioritize root cause analyses.     

Root cause analysis helps organizations decipher the root cause of the problem, identify the appropriate corrective actions and develop a plan to prevent future occurrences. It aims to implement solutions to the underlying problem for more efficient operations overall.

Learn how next-generation detection devices shift asset management services from routine maintenance regimes to predictive, AI-powered processes.

Delve into our exclusive guide to the EU's CSRD

Organizations perform root cause analyses when a problem arises or an incident occurs, but there are any number of issues that need an RCA. Triggers for a root cause analysis fall into three broad categories.

When real-world materials or equipment fails in some way (for example, a desktop computer stops working or a component from a third-party vendor delivers substandard performance).

When people make mistakes or fail to complete required tasks (for example, an employee fails to perform regular maintenance on a piece of equipment, causing it to break down).

A breakdown in a system, process or policy people use to make decisions (for example, a company fails to train team members on cybersecurity protocols, leaving the company vulnerable to cyberattacks ).

Organizations can conduct root cause analyses for a range or reasons, from commonplace email service disruptions to catastrophic equipment failures. Regardless of the nature or scope of the issue, performing root cause analysis should include the same fundamental steps.

If you have decided to conduct a root cause analysis, your department or organization is likely experiencing some acute issue, or at least looking to make substantive improvements to a particular process. Therefore, the first step of the root cause analysis process should be identifying and defining the problem that you want to address. Without a clearly defined problem, it is impossible to correctly identify the root causes.

When the department has a clear idea of the problem, it’s time to draft a problem statement spelling out the issue for everyone who will help with the RCA.

Once the issue is identified and clearly articulated to all involved parties, leadership should create a project charter, which will assemble a team to complete the analysis. The team should include a facilitator to lead the team through the analysis and any team members with either personal or professional knowledge of the systems, processes and incidents that you will investigate.

Data collection is the foundation of the problem-solving process. It is vital, at this stage, to find every piece of information that can help you identify contributing factors and ultimately the root causes of the issue. This can include collecting photographs and incident reports, conducting interviews with affected parties and reviewing existing policies and procedures. Some questions that you may want to ask during data collection:

• When did the problem start and how long has it been going on?
• What symptoms has the team observed?
• What documentation does the organization or department must prove that an issue exists?
• How will the issue affect employees and other stakeholders?
• Who is harmed or otherwise affected by the existence of this problem?

This is the most important step in the RCA process. At this point, the team has collected all necessary information and starts to brainstorm for causal factors. Effective root cause analyses require openness to all potential underlying causes of an issue, so everyone on the RCA team should enter the brainstorming stage with an open mind. Avoid attempts to determine root causes until every possibility is identified and vetted; starting the incident investigation process with preconceived notions may bias the results and make it more difficult to determine the real root cause.

Once the RCA team has an exhaustive list of possible causes and contributing factors, it is time to determine the root causes of the issue. Analyze every possible cause and examine the actual impact of each one to figure out which possibilities are the most problematic, which ones have similarities and which ones can be altogether eliminated. Be prepared for the possibility that there are multiple root causes to the issue.

After the team narrows the list of possibilities, rank the remaining potential root causes by their impact and the likelihood they are the root cause of the problem. Leadership will examine and analyze each possibility and collaborate with the RCA team to determine the actual root causes.

Once the team settles on root causes and has laid out all the details of the issue, they must start brainstorming solutions. The solution should directly address the root causes, with consideration for the logistics of executing the solution and any potential obstacles the team may encounter along the way. These elements will comprise the action plan that will help the team address the current problem and prevent recurrences.

While all RCAs will include the same basic steps, there are myriad root cause analysis methods that can help an organization collect data efficiently and effectively. Typically, a company will select a method and use root cause analysis tools, such as analysis templates and software, to complete the process.

The 5 Whys approach is rooted in the idea that asking five “Why?” questions can get you to the root cause of anything. 5 Whys implores problem solvers to avoid assumptions and continue to ask “why” until they identify the root cause of a problem. In the case of a formalized organizational root cause analysis, a team may only need to ask three whys to find the root cause, but they may also need to ask 50 or 60. The purpose of 5 Whys is to push the team to ask as many questions as is necessary to find the correct answers.

A failure mode and effects analysis is one of the most rigorous approaches to root cause analysis. Similar to a risk analysis, FMEA identifies every possibility for system/process failure and examines the potential impact of each hypothetical failure. The organization then addresses every root cause that is likely to result in failure.

Pareto charts combine the features of bar charts and line charts to understand the frequency of the organization’s most common root causes. The chart displays root causes in descending order of frequency, starting with the most common and probable. The team then addresses the root cause whose solution provides the most significant benefit to the organization.

An impact analysis allows an organization to assess both the positive and negative potential impacts of each possible root cause.

Change analyses are helpful in situations where a system or process’s performance changed significantly. When conducting this type of RCA, the department looks at how the circumstances surrounding the issue or incident have changed over time. Examining changes in personal, information, infrastructure, or data, among other factors, can help the organization understand which factors caused the change in performance.

An event analysis is commonly used to identify the cause of major, single-event problem, like an oil spill or building collapse. Event analyses rely on quick (but thorough) evidence-gathering processes to recreate the sequence of events that that led to the incident. Once the timeline is established, the organization can more easily identify the causal and contributing factors.

Also known as a causal factor analysis, a causal factor tree analysis allows an organization to record and visually display—using a causal factor tree—every decision, event or action that led to a particular problem.

An Ishikawa diagram (or Fishbone diagram) is a cause-and-effect style diagram that visualizes the circumstances surrounding a problem. The diagram resembles a fish skeleton, with a long list of causes grouped into related subcategories.

DMAIC is an acronym for the Define, Measure, Analyze, Improve and Control process. This data-driven process improvement methodology serves as a part of an organization’s Six Sigma practices.

This RCA methodology proposes finding the root cause of an issue by moving through a four-step problem solving process. The process starts with situation analysis and continues with problem analysis and solution analysis, concluding with potential problem analysis.

An FTA allows an organization to visually map potential causal relationships and identify root causes using boolean logic.

Barrier analyses are based on the idea that proper barriers can prevent problems and incidents. This type of RCA, often used in risk management, examines how the absence of appropriate barriers led to an issue and makes suggestions for installing barriers that prevent the issue from reoccurring.

Companies that use the RCA process want to put an end to “firefighting” and treating the symptoms of a problem. Instead, they want to optimize business operations, reduce risk and provide a better customer experience. Investing in the root cause analysis process provides a framework for better overall decision-making and allows an organization to benefit from:

Continuous improvement : Root cause analysis is an iterative process, seeking not only to address acute issues, but also to improve the entire system over time, starting with the underlying cause. The iterative nature of root cause analysis empowers organizations to prioritize continuous process improvement.

Increased productivity : Preventing downtime, delays, worker attrition and other production issues within an organization saves employees time, freeing up bandwidth to focus on other critical tasks.

Reduced costs : When equipment breaks down or software bugs cause delays, organizations lose money and workers get frustrated. Root cause analysis helps eliminate the cost of continually fixing a recurring issue, resulting in a more financially efficient operation overall.

Better defect detection : When companies fail to address underlying issues, they can inadvertently affect the quality of the end product. Addressing persistent problems before they snowball protects the organization from revenue and reputational losses that are associated with product defects down the line.

Reduced risks : Improving business processes and systems keeps equipment running safely and helps workers avoid safety hazards in the workplace.

Intelligent asset management, monitoring, predictive maintenance and reliability in a single platform.

Enhance your application performance monitoring to provide the context you need to resolve incidents faster.

IBM research proposes an approach to detect abnormality and analyzes root causes using Spark log files.

Learn how IBM Instana provides precision hybrid cloud observability, metrics, traces and logs.

Downer and IBM are using smart preventative maintenance to keep passengers on Australia's light and heavy rail systems moving safely, reliably, comfortably and more sustainably.

Unlock the full potential of your enterprise assets with IBM Maximo Application Suite by unifying maintenance, inspection and reliability systems into one platform. It’s an integrated cloud-based solution that harnesses the power of AI, IoT and advanced analytics to maximize asset performance, extend asset lifecycles, minimize operational costs and reduce downtime.

Guide: Root Cause Analysis

Author: Daniel Croft

Daniel Croft is an experienced continuous improvement manager with a Lean Six Sigma Black Belt and a Bachelor's degree in Business Management. With more than ten years of experience applying his skills across various industries, Daniel specializes in optimizing processes and improving efficiency. His approach combines practical experience with a deep understanding of business fundamentals to drive meaningful change.

Root Cause Analysis (RCA) is a key tool in continuous improvement, acting as a systematic approach to identify and tackle the underlying issues behind problems. RCA aims not only to provide a temporary fix but to offer long-lasting solutions by addressing the root causes.

RCA, such as the Fishbone Diagram , the 5 Whys , and FMEA . Whether you’re looking to solve complex challenges or improve cost-efficiency, this guide will offer understanding of how to identify the root cause of problems with useful Lean Six Sigma tools.

What is Root Cause Analysis?

Root Cause Analysis, often referred to as RCA, is like being a detective for problems in your business or project. Imagine you have a leaking pipe in your house. You could keep mopping up the water every time it leaks, but that’s not really solving the issue. The right thing to do is find out why it’s leaking in the first place and fix that. RCA works the same way; it helps you find out the “why” behind a problem so you can fix it for good.

Structured Approach

When we say RCA is a “structured approach,” we mean it’s not just random guesswork. It’s a planned way to dig deep into a problem. You will follow certain steps and use specific tools to figure out what’s really going on. This makes sure you’re not just treating the “symptoms” of the problem, like mopping up water from a leak, but you’re finding out why the problem is happening in the first place.

Identify Underlying Reasons

The “underlying reasons” are the real culprits behind a problem. For example, if a machine in a factory keeps breaking down, simply repairing it each time isn’t enough. You need to find out why it’s breaking down. Is it old? Are people using it wrong? RCA helps you answer these kinds of questions.

Long-term Solutions

The coolest part about RCA is that it’s focused on long-term solutions. Once you know the root cause of a problem, you can create a fix that will (hopefully) make sure it never happens again. This is way better than just putting out fires all the time.

By understanding and using RCA, you’re not just stopping at “What is the problem?” You’re going the extra mile to ask, “Why did this problem happen?” and “How can we make sure it doesn’t happen again?” That’s a game-changer in making things better for the long run.

Importance of Root Cause Analysis

Understanding the “why” behind a problem isn’t just something that’s nice to do; it’s crucial for several reasons.

Problem Solving

Imagine you have a puzzle, but all the pieces are jumbled up. Trying to see the whole picture from this mess would be overwhelming, right? RCA is like sorting these puzzle pieces into groups; maybe by color or edge pieces versus middle pieces. When you break down a big, complex problem into smaller parts, it becomes much easier to solve. RCA helps you dissect a problem into its basic elements so you can tackle each one individually. This makes it easier to find out what’s really going wrong and fix it.

Cost-Efficiency

You know the saying, “Time is money”? Well, constantly fixing the same problem over and over again is like throwing both time and money down the drain. If you use RCA to get to the bottom of an issue and solve it at its root, that issue is less likely to come back. This means you spend less time, effort, and money on it in the future. For a business, this is a big deal because it means you can focus on growing and improving, rather than fixing the same old problems. This is where most businesses fail to progress as they spend the day to day activities fire fighting repreated problems.

Quality Improvement

Let’s say you run a bakery, and you notice that your chocolate chip cookies are coming out burnt too often. You could just toss the burnt cookies and make a new batch, but that doesn’t stop the next batch from burning too. If you use RCA to find out why they’re burning—maybe the oven temperature is wrong or the baking time is too long—you can fix that issue and make perfect cookies every time. This makes your customers happy and keeps them coming back. In the same way, RCA helps you improve the quality of your products or services by fixing the real issues, not just the symptoms. This leads to happier customers and better reviews, which are good for any business.

Types of Root Cause Analysis Methods

When it comes to finding the real reason behind a problem, one size doesn’t fit all. Different situations may require different approaches. That’s why there are several methods for conducting RCA. Let’s explore three of the most commonly used methods.

Fishbone Diagram (Ishikawa)

Imagine a fish. The head represents the problem you’re facing, and the bones branching off from the fish’s spine are the possible causes of the problem. This is what a Fishbone Diagram looks like. Also known as an Ishikawa Diagram or Cause and Effect Diagram, this method helps you visually break down a problem into different categories or “themes.”

For example, if you’re running a restaurant and customers are complaining about long wait times, you could use a Fishbone Diagram to categorize potential causes into themes like ‘Staffing,’ ‘Kitchen Efficiency,’ ‘Order Process,’ etc. Within each theme, you list out possible root causes. This helps you see the whole picture and makes it easier to identify where the real issue might be coming from.

You can learn more about the fishbone diagram process with our guide

Remember being a curious kid and asking “Why?” about everything? The 5 Whys method is pretty much the same. Start with the problem at hand and ask “Why did this happen?” Once you have an answer, ask “Why?” again, digging deeper. Keep asking “Why?” until you’ve asked it five times or until you reach a point where the root cause becomes clear.

For example, if a machine in a factory stops working, you could ask:

• Why did the machine stop? (Answer: The motor burned out.)
• Why did the motor burn out? (Answer: The motor was overloaded.)
• Why was the motor overloaded? (Answer: The machine was running at high capacity for too long.)
• Why was the machine running at high capacity for so long? (Answer: There was a backlog of orders.)
• Why was there a backlog of orders? (Root Cause: Poor planning and scheduling.)
• This helps you trace back the chain of events to find the root cause of the problem.

You can learn more about the 5 Whys process with our guide.

FMEA (Failure Modes and Effects Analysis)

FMEA is like looking into a crystal ball to see what could go wrong in the future. It’s a way to evaluate different ways a process or product could fail and to understand the impact of those failures. You list out all possible failure modes, how likely they are to happen, how bad the impact would be, and how well you could detect them before they cause problems. This helps you prioritize which potential issues need immediate attention.

Below is an example from a manufacturing business. The higher the RPN (risk priority number) the more important it is to address the issue.

You can learn more about the FMEA with our guide

Selecting an RCA method

If you are new to root cause analysis it can be difficult knowing which approach to use to solve your problem. This can be made simpler by considering the below

Is the problem simple and straightforward?

Use The 5 Whys Method

Is the problem complex with multiple factors?

Use Fishbone Diagram (Ishikawa)

Is a quantitative risk assessment needed?

Use FMEA (Failure Modes and Effects Analysis)

Use other specialized RCA techniques or hybrid methods

The Five-Step RCA Process

RCA isn’t something you can do haphazardly; it requires a structured approach to be effective. That’s where the Five-Step RCA Process comes in handy. It provides a roadmap to tackle your problem methodically. Let’s start by discussing the first step in detail.

Step 1: Define the Problem

Before you can find a solution to any problem, you need to know exactly what that problem is. You’d be surprised how often people jump to fixing things without clearly understanding what’s wrong in the first place. Defining the problem is like setting the GPS before going on a trip; it sets the direction for everything that follows. Here’s how to go about it:

Be Specific

Let’s say you’re running a coffee shop, and you notice that customers aren’t coming back. Simply saying, “Business is slow,” is too vague. A more specific problem statement would be, “Customer return rate has dropped by 20% in the last two months.”

Numbers don’t lie. Whenever possible, use data to define your problem. In the coffee shop example, you could look at sales records, customer surveys, or loyalty program participation to pinpoint the decline.

Consider the 5 Ws

• Who:  Who is affected by this problem? Is it just one department, the whole company, or maybe your customers?
• What:  What exactly is the issue? Try to describe it in one sentence.
• Where:  Where is this problem occurring? Is it in a specific location or across various places?
• When:  When did you first notice this problem? Is it a constant issue or does it happen only at certain times?
• Why:  At this stage, you may not know the root cause, but you might have some initial thoughts on why the problem might be occurring.

Write it Down

Once you’ve gathered all this information, write down your problem statement. This serves as a reference point for everyone involved in the RCA process, making sure everyone is on the same page.

After gathering all the relevant information, the problem statement for RCA could be:

“The rejection rate for Widget A produced on Line 3 has increased by 15% in Q2 2023 compared to Q1 2023, predominantly due to ‘Cracked Surface’ defects. This issue first became apparent at the beginning of Q2 and has been consistent since. Initial observations suggest it may be due to material quality or machine calibration issues.”

Step 2: Gather Data

Once you’ve clearly defined the problem, the next step is like being a detective gathering clues. You’ll need to collect all the relevant information that will help you get to the bottom of the issue. This stage is crucial because the quality of your Root Cause Analysis depends on the quality of your data. Here’s how to go about it:

Identify Data Sources

First, figure out where you can get the information you need. This could be anything from company records and employee interviews to customer surveys and machine logs. For example, if your problem is a decrease in product quality, you might look at manufacturing data, quality control reports, and customer feedback.

Types of Data to Collect

• Quantitative Data : These are numerical data that can be measured. Examples include sales figures, production rates, and customer satisfaction scores.
• Qualitative Data : These are descriptive data that can be observed but not measured. Examples include employee morale, customer comments, and the observable state of machinery or processes.

Timing Matters

When did the problem start? Was it gradual or sudden? Understanding the timeline can offer important insights into potential causes. Collect historical data if possible, as this will help you see trends and patterns.

Use Tools to Collect Data

Depending on your needs, various tools can help in data collection. Spreadsheets can be useful for tracking numbers and metrics. Surveys and questionnaires can capture customer or employee feedback. Advanced organizations may use specialized software for data collection and analysis.

Document Everything

Make sure to keep a record of all the data you collect. Organize the data in a way that’s easy to understand and analyze. Charts, graphs, or tables can be helpful here.

Verify Your Data

Before you move on to analyzing the data, make sure it’s accurate and reliable. Double-check your numbers, verify survey results, and confirm any observations. The last thing you want is to make important decisions based on faulty information.

Gathering data might seem like a time-consuming step, but it’s essential for a successful Root Cause Analysis. The more thorough you are at this stage, the easier it will be to identify the actual root cause of the problem later on.

Example Collected Data

Here’s a snapshot of what some of the collected data could look like:

Machine Logs (June 2023)

Quality Control Reports (June 2023)

Employee Interviews

• Operators have noticed the machine making unusual noises.
• Quality control staff report an increase in defects that look like cracks on the surface.

Step 3: Identify Possible Causes

After you’ve defined your problem and collected all the relevant data, it’s time to roll up your sleeves and dig into the “why” behind the issue. This step is like brainstorming, but more structured. You’re trying to come up with a list of all the things that could possibly be causing the problem you’ve identified. Here’s how to do it:

Choose a Method

As mentioned earlier, there are various methods you can use to identify possible causes. Two of the most common are the Fishbone Diagram and the 5 Whys. The choice depends on the nature of your problem.

• Fishbone Diagram: This is good for complex problems where multiple factors could be at play. The diagram allows you to visually organize potential causes into different categories, making it easier to focus your investigation.
• The 5 Whys: This method is more straightforward and works well for simpler problems. By repeatedly asking “Why?” you dig deeper into the issue until you identify possible root causes.

Involve the Right People

Don’t try to do this all on your own. Involve team members who are familiar with the problem area. They can offer valuable insights you might not have considered. If you’re dealing with a technical issue, for instance, having an engineer in the room can be incredibly helpful.

Generate a List of Possible Causes

Using your chosen method, start listing down all the potential causes. Be as comprehensive as possible. If you’re using a Fishbone Diagram, for instance, you’d list potential causes under each category or “bone” of the fish. For the 5 Whys, you’d document the chain of reasoning that leads you to potential root causes.

Use Your Data

Remember the data you collected in Step 2? Now’s the time to use it. Align your list of possible causes with the data to see which ones are most likely. For example, if one of your potential causes is “Poor Training,” but your data shows that all employees have completed mandatory training, then you might want to reconsider that cause.

Prioritize Causes

Not all causes are created equal. Some are more likely than others to be the root cause of your problem. Use your team’s expertise and the data you’ve collected to prioritize which causes to investigate further.

By the end of this step, you should have a well-organized list of possible causes for your problem, backed by data and expert input. This sets the stage for the next steps, where you’ll zero in on the actual root cause and figure out how to fix it.

Example of Identifying Possible causes

Following on with the same example, as this is a more complex issue with multiple factors, it makes sense to conduct the root cause analysis using the Fishbone method. Therefore, we need to ensure to include the right people—a cross-functional team. In this case, that would comprise production engineers who understand the machinery, quality control experts who have the data on defects, and machine operators who can provide firsthand experience and observations.

The next step is to collectively brainstorm and categorize potential causes for the increased rejection rate in Widget A. Utilizing the Fishbone Diagram, the team breaks down the problem into six major categories: Machine, Method, Material, Manpower, Environment, and Measurement.

Identifying the possible causes in our example

Following on with the same example, as this is a more complex issue with multiple factors, it makes sense to conduct the root cause analysis using the Fishbone method. Therefore, we need to ensure to include the right people—a cross-functional team. In this case, that would comprise production engineers who understand the machinery, quality control experts who have the data on defects, and machine operators who can provide firsthand experience and observations. The next step is to collectively brainstorm and categorize potential causes for the increased rejection rate in Widget A.  Utilizing the Fishbone Diagram, the team breaks down the problem into six major categories: Machine, Method, Material, Manpower, Environment, and Measurement.

Step 4: Determine the Root Cause

After identifying a list of possible causes, it’s time to put on your detective hat again and figure out which one is the real culprit—the root cause of your problem. 

This is a critical step, as identifying the wrong cause can lead you down a path of ineffective solutions. Here’s how to go about it:

Review Your List of Possible Causes

Start by revisiting the list you made in the previous step. This will serve as your “suspect list” in identifying the root cause. At this point, you’ve already done some initial prioritization, so you have an idea of which causes are most likely.

Analyze the Data

Remember the data you collected in Step 2? Now is the time to dive deep into it. Compare each possible cause against the data to see if it holds up. Look for patterns, correlations, or anomalies that might point to one cause over the others.

For example, if you’re dealing with a decrease in product quality and one of your possible causes is “Faulty Raw Materials,” you could look at inspection reports, batch numbers, and supplier records to see if there’s a correlation.

Conduct Tests or Experiments

Sometimes, analyzing existing data isn’t enough. You might need to conduct additional tests or experiments to validate or rule out possible causes. For instance, if you suspect a machine is malfunctioning and causing a problem, you might run it under controlled conditions to see if the issue repeats.

Use Logical Reasoning

Sometimes the root cause isn’t obvious, even with data and testing. In such cases, logical reasoning can help. You might use deductive reasoning to rule out unlikely causes or inductive reasoning to generalize from specific observations.

Involve Experts

If you’re stuck or the root cause isn’t clear, don’t hesitate to consult experts. These could be internal team members with specific expertise or external consultants who specialize in the problem area you’re investigating.

Confirm the Root Cause

Before you move on to finding a solution, make sure you’ve found the real root cause and not just a symptom of a deeper issue. Validate your findings by asking:

• Does this cause explain most or all of the problem?
• If we fix this, is it likely that the problem will be solved?
• Do most team members agree that this is the root cause?

Once you’ve determined the root cause, document it clearly. You’ll use this information in the next step to develop and implement a solution that addresses the issue at its core, ensuring it’s less likely to recur in the future.

Determining the Root Cause of our Example

Continuing with our example, the cross-functional team now shifts its focus to determining the root cause of the increased rejection rate for Widget A. Armed with their prioritized list of possible causes and the data gathered, they delve into the next step of the RCA process.

The team begins by revisiting the “suspect list” generated using the Fishbone Diagram. Machine-related factors, particularly temperature fluctuations, pressure inconsistencies, and cycle time variability, are at the top of this list, followed by material quality concerns. Analyze the Data Digging deeper into the data collected, the team finds that the temperature, pressure, and cycle time increases directly correlate with the spike in the ‘Cracked Surface’ defect type. They also note that the unusual noises observed by machine operators started to occur around the same time the defects increased. Conduct Tests or Experiments To validate these observations, the team decides to run the molding machine under controlled conditions, varying one parameter at a time while keeping the others constant. After a series of tests, they discover that an increase in temperature directly leads to the ‘Cracked Surface’ defects in the widgets. Use Logical Reasoning Using deductive reasoning, the team rules out other possible causes. For instance, since all operators have completed mandatory training and the material batches show no signs of contamination, these are less likely to be the root causes. Confirm the Root Cause After careful consideration and validation, the team reaches a consensus that the root cause of the problem is “Temperature Fluctuations in the Molding Machine.” This conclusion satisfies the criteria for root cause identification: It explains most, if not all, of the ‘Cracked Surface’ defects. Fixing this issue is likely to resolve the problem. Most team members agree that this is the root cause. The team documents this root cause clearly and prepares for the next step in the RCA process: developing and implementing a solution that will fix this issue at its core, thereby preventing its recurrence in the future.

Step 5: Implement and Monitor Solutions

Congratulations, you’ve identified the root cause! But your journey doesn’t end here. The whole point of Root Cause Analysis (RCA) is to not just find the root cause but to fix it so the problem doesn’t happen again. This is where Step 5 comes in, where you implement solutions and make sure they actually work. Here’s how to go about it:

Develop a Solution Plan

The first thing you need to do is come up with a plan for how you’re going to fix the root cause you’ve identified. This should include:

• What  needs to be done: The specific actions that will address the root cause.
• Who  will do it: The people responsible for each action.
• When  it will be done: A timeline for implementation.
• How  it will be done: The resources and methods needed to implement the solution.

Gain Approval and Support

Before you start making changes, make sure you have the necessary approvals. This might mean getting a budget approved or getting buy-in from key stakeholders. The more support you have, the smoother the implementation process will be.

Implement the Solution

Now it’s time to roll up your sleeves and get to work. Follow the plan you’ve developed, and start implementing the solution. This could involve anything from retraining staff and revising procedures to repairing equipment or introducing new technology.

Monitor Effectiveness

You can’t just implement a solution and walk away. You need to monitor how well it’s working. This means going back to the data you collected in Step 2 and continuing to track those metrics. Are they showing improvement? If not, you may need to revisit your solution or even go back to earlier steps in the RCA process.

Make Adjustments as Needed

Sometimes a solution that looks great on paper doesn’t work out as well in the real world. If you find that your solution isn’t as effective as you’d hoped, be prepared to make adjustments. This could mean tweaking your current solution or going back to the drawing board to identify a different root cause.

Document the Process

Don’t forget to document everything you’ve done, from the solutions you implemented to the results you achieved. This documentation can be invaluable for future problem-solving efforts and for creating a knowledge base that can help prevent similar problems in the future.

Implementing and monitoring solutions of our example

After identifying “Temperature Fluctuations in the Molding Machine” as the root cause, the team crafts a detailed solution plan: What Needs to Be Done : Overhaul the machine’s cooling system and recalibrate temperature settings. Who Will Do It : A dedicated team of production engineers and machine operators. When It Will Be Done : To be completed within a two-week timeframe. How It Will Be Done : Allocate necessary resources like new cooling components and software for recalibration.

Gain Approval and Support Before proceeding, the team prepares a budget proposal and secures approval from management. They also consult with the quality control team and machine operators to gain their buy-in, ensuring a smoother implementation process. Implement the Solution The team then sets out to execute the plan. The cooling system is overhauled, and the machine is recalibrated. A pilot run is conducted to ensure that the new settings are effective in maintaining consistent temperature levels. Monitor Effectiveness After implementing the changes, the team goes back to the data. They continue to monitor the same metrics—temperature, pressure, cycle time, and defect count. Initial results show a significant reduction in the ‘Cracked Surface’ defect type. The temperature fluctuations have notably decreased. Make Adjustments as Needed While the initial results are promising, the team remains vigilant. They agree to meet bi-weekly to review the data and make any necessary adjustments to the solution. So far, no further modifications are required. Document the Process The entire RCA process, from problem identification to solution implementation and monitoring, is meticulously documented. This documentation will serve as a valuable resource for future troubleshooting and continuous improvement initiatives. By diligently following this five-step RCA process, the team has not only identified the root cause of the problem but has also successfully implemented a solution to prevent its recurrence.

RCA is more than just a problem-solving method; it’s a strategic approach that dives deep into issues to eliminate them at their source. By following the Five-Step RCA Process, organizations can not only identify the real culprits behind their problems but also develop and implement long-lasting solutions. This guide walked you through each step in detail, from defining the problem to monitoring the effectiveness of your solutions. Remember, the quality of your RCA is as good as the effort and attention to detail you put into it. Whether you’re looking to improve product quality, enhance customer satisfaction, or increase cost-efficiency, a well-executed RCA can be a game-changing tool in your continuous improvement arsenal. It’s not just about fixing what’s broken; it’s about building something better for the long term.

• Williams, P.M., 2001, April. Techniques for root cause analysis . In  Baylor University Medical Center Proceedings  (Vol. 14, No. 2, pp. 154-157). Taylor & Francis.
• Gangidi, P., 2018. A systematic approach to root cause analysis using 3× 5 why’s technique.   International Journal of Lean Six Sigma ,  10 (1), pp.295-310.
• Wong, K.C., Woo, K.Z. and Woo, K.H., 2016. Ishikawa diagram.   Quality Improvement in Behavioral Health , pp.119-132.

Q: Why is Root Cause Analysis important?

A: Identifying and resolving the root cause of an issue is crucial for achieving sustainable improvements. Focusing only on symptoms can lead to temporary fixes that may mask the underlying problem. RCA helps you understand the systemic issues contributing to a problem, allowing you to put in place measures that result in lasting change.

Q: What are the common methods used for Root Cause Analysis?

A: Several methods are commonly used for Root Cause Analysis, including:

• 5 Whys : A simple technique that involves asking “why” multiple times until the root cause is identified.
• Fishbone Diagram (Ishikawa Diagram) : A visual tool used to categorize potential causes of a problem.
• Fault Tree Analysis : A graphical representation of various probable causes of an issue, arranged in a hierarchical manner.
• Pareto Analysis : Identifying the most significant factors contributing to a problem based on the Pareto principle.
• FMEA (Failure Modes and Effects Analysis) : A structured approach to identifying potential failure modes and their consequences.

Q: How do I start a Root Cause Analysis?

A: Initiating a Root Cause Analysis typically involves the following steps:

• Define the Problem : Clearly articulate what the issue is.
• Collect Data : Gather relevant information and evidence.
• Identify Possible Causes : List potential causes that could be contributing to the problem.
• Analyze : Use RCA methods like the 5 Whys or Fishbone Diagram to dig deeper.
• Identify Root Cause(s) : Through analysis, pinpoint the underlying cause(s).
• Develop and Implement Solutions : Create action plans to address the root cause(s).
• Review : Evaluate the effectiveness of the solutions and make adjustments as needed.

Q: Can Root Cause Analysis be applied to non-manufacturing sectors?

A: Absolutely, Root Cause Analysis is a versatile tool that can be applied in various sectors, including healthcare, IT, logistics, and even the public sector. The principles remain the same: identify the root cause to implement effective, long-term solutions.

Q: What are some common pitfalls to avoid in Root Cause Analysis?

A: Some common pitfalls to be aware of include:

• Rushing the Process : Skipping steps or rushing through them can lead to incorrect conclusions.
• Blaming Individuals : RCA should focus on systemic issues rather than blaming individual employees.
• Ignoring Data : Failing to consult data can result in assumptions that may not be accurate.
• Lack of Follow-Up : Without proper evaluation and adjustment, even good solutions may fail over time.

Daniel Croft

Daniel Croft is a seasoned continuous improvement manager with a Black Belt in Lean Six Sigma. With over 10 years of real-world application experience across diverse sectors, Daniel has a passion for optimizing processes and fostering a culture of efficiency. He's not just a practitioner but also an avid learner, constantly seeking to expand his knowledge. Outside of his professional life, Daniel has a keen Investing, statistics and knowledge-sharing, which led him to create the website www.learnleansigma.com, a platform dedicated to Lean Six Sigma and process improvement insights.

Free Lean Six Sigma Templates

Improve your Lean Six Sigma projects with our free templates. They're designed to make implementation and management easier, helping you achieve better results.

Was this helpful?

• Quality Management

Home » Free Resources » »

What is Root Cause Analysis? Process, Example & Everything You Need to Know

• Written by Contributing Writer
• Updated on March 7, 2023

Root cause analysis (RCA) is a problem-solving methodology used to identify the underlying cause of a problem, incident, or adverse event. Simply put, it is pinpointing the root of the problem to solve and prevent it from happening again.

When faced with a problem, we usually try to get to the bottom of it. For example, in the unfortunate event that we break our bones, we would be in immense pain. We might take measures to control the pain and blood loss. But our efforts don’t stop at simply having a painkiller and applying a bandage. We rush to the ER as soon as possible, get the necessary treatment to mend the broken bones, and make sure we are careful not to have such an accident.

What we did here is we analyzed the problem: the pain and took steps to fix the root cause, which is the broken bones. Here the pain is the symptom, and the fractured bone is the root cause.

Now that we are familiar with what it stands for let us dive deep into root cause analysis, or RCA, which is the systematic approach employed in various industries like healthcare, manufacturing, governmental organizations, aviation, etc. We also examine its definition, history, benefits, approaches, process, principles, tips, and how to learn more .

Defining RCA Analysis

Root cause analysis is a problem-solving process that seeks to identify the underlying cause of a problem or issue. It’s a systematic approach that goes beyond just identifying symptoms and aims to uncover the root cause of the problem. The objective is to prevent future occurrences of the situation by addressing its root cause.

RCA analysis involves collecting and analyzing data to identify a problem’s underlying cause. The process typically consists of a team of experts who use various tools and techniques to gather and analyze data. Once the root cause has been identified, the team develops a plan to address the root cause and prevent future occurrences of the problem.

Also Read: What Is Process Capability and Why It’s More Interesting Than It Sounds

History of Root Cause Analysis

The origins of root cause analysis can be traced back to the late 19th century when it was used in the manufacturing industry to improve production processes. In the 20th century, it was further developed and applied to a broader range of industries, including healthcare and aviation.

In the 1950s when manufacturers started to use it to understand industrial events. The primary goal of RCA is to determine the fundamental cause of a problem, which is referred to as the “root cause.”

One of the earliest adopters of RCA was Toyota, who employed the “5 whys” method, where the investigation of a breakdown or undesired event is conducted by asking “why” at least five times. This approach forces quality personnel to delve deeper and understand the underlying causes, layer by layer. Today, RCA is widely used in various industries to identify and eliminate problems, improve processes, and prevent recurrence.

RCA was first used in the healthcare industry to address adverse events and improve patient safety. The Institute of Healthcare Improvement (IHI) developed the RCA process in the late 1980s, and it quickly became a standard tool for improving patient safety and quality of care.

The Joint Commission, a US-based nonprofit that accredits healthcare organizations and programs, requires a root cause analysis (RCA) to be conducted whenever an accredited hospital experiences a specific type of adverse event. These are known as “sentinel” incidents, as they reveal a dangerous flaw in the care provided and prompt an immediate investigation and response.

RCA was developed in response to the growing number of plane crashes and incidents in the aviation industry. The National Transportation Safety Board (NTSB) was established in 1967. It has since been using RCA to investigate plane crashes and incidents to identify their root causes and prevent future occurrences.

Benefits of Root Cause Analysis

Before we go to explore how various industries and organizations benefit from implementing RCA, let us discuss the primary goals of root cause analysis.

The three main goals of RCA are:

• Identifying the root cause: The first goal is to discover the primary source of the problem or event. This is essential to understand the underlying causes and find practical solutions.
• Understanding the issues: The second goal of RCA is to fully comprehend the nature of the issues and develop a plan to fix, compensate, or learn from them. This requires a comprehensive analysis of the root cause and the factors contributing to it.
• Applying learnings: The third goal of RCA is to use the information gained from the analysis to prevent similar problems from occurring in the future. This includes making systemic changes to processes and systems and implementing measures to mitigate the risk of future adverse events.

Root cause analysis offers numerous benefits to organizations and industries. Some of the key benefits include:

• Improving quality: RCA helps organizations identify the root cause of problems and implement solutions to prevent future occurrences, improving quality and efficiency.
• Reducing risk: Organizations can reduce the risk of future incidents and adverse events by identifying the root cause of the problem and hence improving overall safety and security.
• Enhancing customer satisfaction: Organizations can better manage their product issues by addressing the root cause of problems. Thus organizations can improve customer satisfaction and trust.
• Improving organizational learning : RCA provides organizations with a systematic process for learning from problems and incidents, enabling them to improve their processes and procedures continuously.
• Increasing efficiency and productivity: Organizations can improve their processes and procedures by addressing the root cause of problems, leading to increased efficiency and productivity.

Also Read: Demystifying the Theory of Constraints

Top Approaches of Root Cause Analysis

There are several approaches to root cause analysis, each with its unique methodology and tools. Let’s discuss some of the most commonly-used types of root cause analysis.

The 5 Whys Root Cause Analysis

The 5 Whys root cause analysis approach is beneficial for solving simple problems or identifying root causes in a short amount of time. This simple yet effective approach involves asking “why” questions to identify the root cause of a problem. The process is repeated until the root cause is identified. For example, in a service industry setting, in case of a complaint, by asking “why” five times, the team could drill down layer by layer to understand the underlying causes of the problem, such as poor communication, inadequate training, or poor service quality.

Fishbone Diagram

The Fishbone Diagram is a visual tool that helps teams identify potential root causes of a problem. It is called so because it resembles a fishbone. The fishbone diagram organizes and categorizes possible causes, making it easier to identify the root cause. For example, a fishbone diagram could be used in a manufacturing setting to categorize and analyze the various factors contributing to a machine breakdown, such as equipment design, operator error, or poor maintenance.

Pareto Analysis

The Pareto Analysis approach uses statistical analysis to identify the most significant root causes of a problem. The Pareto principle states that 80 percent of issues are caused by 20 percent of root causes. Pareto analysis helps teams focus on the most critical root causes, reducing the time and resources required to address the problem. For example, in a healthcare setting, a Pareto analysis could determine that 20 percent of patient falls are caused by 80 percent of the root causes, such as slippery floors, poor lighting, or lack of staff supervision.

Fault Tree Analysis (FTA)

This type of root cause analysis is a graphical representation of the relationships between different system components and how they contribute to a problem or failure. FTA helps teams understand the interdependencies between various components and identify the root cause of a problem. For example, in an aviation setting, an FTA could be used to analyze the interdependencies between different components of a plane, such as the engines, fuel system, and control surfaces, and to identify the root cause of a crash.

Conducting Root Cause Analysis: Process

We can break the process of conducting RCA into the following steps:

• Define the problem: The first step is clearly defining the problem and understanding what needs to be addressed.
• Gather data: Once the problem is defined, the next step is to gather data. This involves collecting information about the problem, including date, time, and location, as well as any relevant documentation, reports, or other information.
• Form a team: The next step is forming a team of experts responsible for conducting the RCA. The team should include individuals with expertise in the problem area, as well as representatives from different departments or parts of the organization.
• Use a root cause analysis tool: The team should use a root cause analysis tool, such as a fishbone diagram, Pareto analysis, or fault tree analysis, to help identify potential root causes.
• Identify root causes: Once potential root causes have been identified, the team should use the data and information collected to validate and verify the root causes.
• Develop solutions: Once the root cause has been identified, the team should develop solutions to address the root cause and prevent future occurrences of the problem.
• Implement solutions: The final step is to implement the solutions and monitor their effectiveness to ensure that the problem has been fully resolved.

Also Read: Value Stream Mapping in Six Sigma

Root Cause Analysis Principles

Conducting RCA involves following several fundamental principles:

• Root cause focus: Root cause analysis focuses on discovering and correcting the root causes of a problem rather than just treating the symptoms.
• Short-term relief: While focusing on root causes is essential, it’s also important to provide short-term relief for the symptoms.
• Multiple root causes : Multiple root causes can contribute to a problem, so it’s important to identify all of them.
• No blame: The focus should be on understanding how and why a problem occurred rather than who was responsible.
• Evidence-based: Root cause claims should be supported by concrete cause-and-effect evidence.
• Actionable information: The results of the analysis should provide enough information to inform a corrective course of action.
• Future prevention: Consideration should be given to how the root cause can be prevented from recurring.

Tips for Root Cause Analysis

• Start with a clear definition of the problem: It is essential to have a crystal-clear understanding of the problem before starting the RCA process. This will help ensure that the team is focused on addressing the right issue and that the root cause is accurately identified.
• Gather all relevant data: Data is essential for a successful RCA. The team should gather as much relevant data as possible, including the date, time, and location of the problem, as well as all pertinent documentation, reports, or other information.
• Involve experts from different areas: Involving experts from different areas of the organization, such as operations, maintenance, and engineering, will help ensure that the root cause is accurately identified and that all potential root causes are considered.
• Use multiple tools and techniques: Different RCA tools and techniques, such as fishbone diagrams, Pareto analysis, and fault tree analysis, can provide different perspectives and insights into the root cause of a problem. The team should consider using multiple tools and techniques to ensure they completely understand the problem.
• Be thorough and systematic: RCA should be approached systematically, using a structured process and methodology to identify root causes. The team should be detailed and methodical in their approach to ensure that all potential root causes are considered and that the root cause is accurately identified.
• Focus on prevention: The goal of RCA is not just to identify the root cause of a problem but to prevent future occurrences. The team should focus on developing solutions that will prevent the problem from happening again in the future.

Also Read: Demystifying Kaizen Lean Six Sigma

Master Root Cause Analysis Skills to Become a Lean Six Sigma Expert

For a Lean Six Sigma expert, the ability to identify the underlying causes of problems and develop effective solutions for improving processes and outcomes is a prized skill. As such, you need to understand and know how to perform root cause analysis.

If you’re interested in becoming a Lean Six Sigma expert, an online Lean Six Sigma certification can provide you with the knowledge, skills, and tools you need to succeed in this role.

An online bootcamp like the one delivered by Simplilearn, in collaboration with the University of Massachusetts, covers the core concepts of Lean Six Sigma, including problem-solving methodologies, process improvement techniques, and statistical analysis tools. This IASSC-accredited program teaches how to identify and eliminate waste, reduce defects, and improve process efficiency across various industries.

With business mentoring from industry experts from KPMG, you’ll be able to tackle real-world business problems confidently. This fast-track program is perfect for quality professionals, business analysts, and executives looking to carve successful careers.

Ready to start your journey toward becoming a master in quality management? Enroll today!

You might also like to read:

Ultimate Guide to Six Sigma Control Charts

DMADV: Everything You Need to Know

Describing a SIPOC Diagram: Everything You Should Know About It

Process Mapping in Six Sigma: Here’s All You Need to Know

How to Use the DMAIC Model?

Leave a Comment Cancel Reply

Your email address will not be published. Required fields are marked *

Recommended Articles

Quality Management Breakdown: What is Measurement System Analysis?

What is measurement system analysis? This article covers its definition, importance, and fundamentals and dives into types, processes, and real-world applications.

What is Lean Project Management, and How Does It Work?

Explore the basics of Lean project management and how to implement Lean principles to achieve faster project cycles and superior outcomes.

Six Sigma Calculator: How to Use It?

The six sigma calculator helps us to calculate the defect, dpmo, dpo, dpu and the opportunities to improve upon the same

Failure Mode and Effects Analysis: A Complete Guide

Explore Failure Mode and Effects Analysis with our easy-to-understand guide. Learn what it is, why it’s useful, how to use it, and its key applications.

Six Sigma Certification Cost: Here’s A Comprehensive Guide

Explore the Costs of Six Sigma Certification. Discover the expenses involved in pursuing Six Sigma qualifications and the value it adds to your career. Get insights from UMass Amherst Bootcamp today.

Five Phases of Lean Six Sigma: A Complete Guide

Discover how the five phases of Lean Six Sigma can improve performance, efficiency, and quality.

Lean Six Sigma Certification

Learning Format

Online Bootcamp

Program benefits.

• Green and Black Belt exam training material included
• Aligned with IASSC-Lean Six Sigma
• Masterclasses from top faculty of UMass Amherst
• UMass Amherst Alumni Association membership

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

• Knowledge Base
• Starting the research process
• What Is Root Cause Analysis? | Definition & Examples

What Is Root Cause Analysis? | Definition & Examples

Published on January 6, 2023 by Tegan George . Revised on November 17, 2023.

Root cause analysis is a problem-solving approach that uses the analogy of roots and blooms to model cause-and-effect relationships. Rather than focusing on what’s above the surface, root cause analysis troubleshoots solutions to problems by analyzing what is causing them. Note Similarly to exploratory research , it’s important to remember that root cause analysis does not provide solutions to problems. Rather, it’s one method within a larger problem-solving landscape.

Root cause analysis is a form of quality management, often used in organizational management, quality control, and in healthcare fields like nursing. Root cause analysis can be a helpful study tool for students, too, when used for brainstorming or memorization exercises.

Table of contents

Root cause analysis template, the “5 whys” of root cause analysis, advantages and disadvantages of root cause analysis, other interesting articles, frequently asked questions.

It’s easy to draw root cause analysis charts by hand, on a whiteboard or a big piece of paper. Many people use fishbone diagrams as well, or you can download our template below.

Here's why students love Scribbr's proofreading services

Discover proofreading & editing

One of the most common ways to conduct root cause analysis is using the “5 Whys” method, popular in lean management. The 5 Whys are an interconnected method of analysis: after defining your problem, you ask “why?”  and answer as concisely as possible. The first “why” often leads to the second, which leads to the third, etc.

In short, you continue to ask “why” until the answer provided is no longer a contributor to the broader issue, but a possible solution to that issue. In other words, as you strategize, you’ll sense it’s time to stop when a provided answer has the potential to stop the whole problem from occurring, rather than only one aspect of that problem. This often takes 3-5 “whys” but can definitely stretch out for longer.

You can use this template to map out your whys.

Root cause analysis is a great way to organize your thoughts, but its simplicity leads to a few downsides.

• Great brainstorming tool for individual or group projects.
• Can help identify causal relationships and clarify relationships between variables .
• “5 whys” system can help simplify complex issues and drive possible solutions.

Disadvantages

• Can be overly simplistic, not leaving much room for nuance or variations.
• Path dependence can occur if the wrong question is asked, leading to incorrect conclusions.
• Cannot provide answers, only suggestions, so best used in the exploratory research phase .

If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

Methodology

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

There are several common tools used for root cause analysis , the most popular of which include fishbone diagrams , scatterplots, and the “5 whys.”

A fishbone diagram is a method that can be used to conduct root cause analysis.

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

George, T. (2023, November 17). What Is Root Cause Analysis? | Definition & Examples. Scribbr. Retrieved August 5, 2024, from https://www.scribbr.com/research-process/root-cause-analysis/

Is this article helpful?

Tegan George

Other students also liked, what is a fishbone diagram | templates & examples, how to write a problem statement | guide & examples, how to define a research problem | ideas & examples, what is your plagiarism score.

Advisory boards aren’t only for executives. Join the LogRocket Content Advisory Board today →

• Product Management
• Solve User-Reported Issues
• Find Issues Faster
• Optimize Conversion and Adoption

Better problem solving with root cause analysis (with template)

If you walk into your kitchen to find your favorite vase smashed on the floor, it might be safe to assume that the grinning cat nearby was the root cause of this problem. If only it was this simple in business and we could just say “the cat did it.” Product problems are often much more complex and connected to a variety of root causes.

If you think of a weed, the surface is only the problem you can immediately see. However, if you cut the weed from the ground level, it’s likely to grow back from the root. This is just like fixing product problems with a band-aid with little to no investigation of a root cause — it’s likely to return.

These types of problems need a more thorough root cause analysis (RCA) to determine how, and why the problem happened, and how to prevent it in the future.

What is root cause analysis?

Root cause analysis is a tool you can utilize when determining the true cause of a problem. You might have assumptions about what the cause of a problem might be or experience biases towards one as the main cause.

Performing a root cause analysis can help you determine what the underlying causes of a problem are to help address a more impactful and valuable solution:

What are the 4 steps in a root cause analysis?

When you’re trying to uncover the roots of a problem, it can be daunting to figure out where to start. The process to conduct a root cause analysis can be broken down into a few easy steps:

• Define the problem
• Identify and map the problem causes
• Identify the evidence that supports your causes
• Create a root cause analysis report and set up your action plan

1. Define the problem

A clear definition of the problem is the first step. Sometimes problems are easy to identify, like a broken link. More often, problems can be abstract and need clarification, like a decrease in overall purchases through a site or an increase in bugs reported.

Here are some more examples of problems:

• A 20 percent drop in customer purchases placed from the shopping cart page from the previous week
• 60 percent of customers on hold end up dropping their call and, as a result, the company has experienced a decrease in NPS scores
• A 40 percent increase of customer reported issues with using the folders feature in a CRM
• A 15 percent decrease in user engagement with a core feature on a social media site

It’s also critical to understand how to define a problem:

2. Identify and map the problem causes

Using tools like a fishbone analysis and the Five Whys framework can help you put together causes and start to categorize themes of the problem. When going through a Five Whys diagram, try to come up with a few alternate pathways and you might notice overlapping areas.

Each example of a Five Whys diagram is accurate, but only looking at one cause can prevent you from understanding the fuller picture. For example, there was more than one reason why the Fyre Festival failed and it’s important to identify overlapping themes to avoid leaning on only one cause:

In a product example, there might be numerous reasons why session times have decreased, or user reported bugs are up.

After evaluating the size, impact, general cause themes, and urgency of the problem, you’ll have a better understanding of how much effort will be needed for the analysis. The larger the problem on the surface, the more underlying causes you might find. Even simple problems can sometimes have numerous causes to consider and you need to determine how in-depth you need to dig to “unroot” the causes.

It’s also critical to check all your bases. Once you have evaluated and categorized the different potential causes to a problem, use the following as a checklist to ensure you’re covering all areas of where and how this problem happened. Be sure to identify any changes or recent events that might have occurred that could have impacted the problem.

• Demographics : is the problem happening to one specific demographic? Only happening to iPhone users? Users in a specific location?
• Time specific : when did the problem happen? Is it continuing to happen? Did the problem only occur during a specific time? You might discover that the problem is related to a time-specific cause, like a release or outage
• User journey : did anything change within the user journey? Map the workflow to determine if any new developments have occurred
• External factors : is this an issue with a third party integration? Did a competitor launch a successful new feature that might be taking business from you? Some of these external factors could be out of your control, but important to recognize
• Internal factors : how many feature releases happened during this time frame? Was there any product downtime or maintenance at that time?

3. Identify the evidence that supports your causes

Collecting evidence is a key part of a root cause analysis. Without evidence, your problem causes are based on assumptions and potentially harmful biases.

Start evaluating any data you might have available. Using session replay tools like LogRocket can help you collect evidence of the problem. Here are a couple of examples of the type of data that can be used to collect evidence:

• User count — number of users impacted by the problem
• Usage — daily, weekly, or monthly active users and a decrease or increase in session time
• Decrease or increase in events — for example, a decrease in users selecting the Add to cart button from a page or an increase in error pages
• Error tracking and user frustration — tools like LogRocket can help track where things are going wrong in your product and surface critical issues
• Qualitative evidence — run user interviews or user-submitted feedback with tools like Loom. Are multiple users running into the same roadblock? Are you seeing the same complaint from multiple users in feedback tickets?

4. Create a root cause analysis report and set up your action plan

Collect your evidence and root cause evaluation into an RCA template. Once you have your causes identified and your discovery efforts into one root cause analysis report, you can start creating a plan to address the problem and prevent it from happening in the future.

Over 200k developers and product managers use LogRocket to create better digital experiences

Collaborate with a team to brainstorm solutions and discuss which options might address multiple causes. Evaluate if you need both a short-term and long-term solution, depending on the level of effort and urgency required. As part of your analysis report, discuss how you can avoid this problem again in the future and any other risk mitigation plans.

Root cause analysis template

You can use this root cause analysis template on Google Sheets to organization your investigation, collect your evidence, and share with your team to determine next step solutions:

Root cause analysis example

Below is an RCA for Company B, a tax preparation product that experienced an increase in dropped customer calls.

Company B experienced an increase of 60 percent of customers on hold that ended up dropping their call. They also experienced an increase in NPS dissatisfaction and have concerns about losing customers.

After going through a root cause analysis, they discovered an 80 percent increase in user calls during tax season. This increase of call volume indicated much longer wait times to speak to a live agent.

After investigating some of the customer call reasons, they discovered that numerous customers had simple questions that could be answered quickly without too much support.

Company B gathered call logs that confirmed their suspicions. They brought the logs together that demonstrated the simplicity of repeated questions and gathered records of customers that dropped off after a certain amount of time on the phone.

Company B implemented a conversational AI chatbot that could answer generic questions and direct more complex questions to a live agent. Further, they implemented tooltips throughout the tax process flow to help users that appeared to be stuck.

Through the RCA process, you might discover that some parts of the user’s experience are confusing and create a plan to address minor UI challenges.

These solutions helped Company B improve their accessibility and scalability needs during an increase in call volume, without having to add more employee support. Going forward, Company B can plan to monitor call times and continuously evaluate customer service topics to determine where users might need further support and guidance in the future:

Common mistakes to avoid

There are a number of easy-to-fall-into traps when performing root cause analysis, including:

• Don’t rely on assumptions when determining root causes. Use evidence to support to disprove a cause
• Don’t limit your investigation. Go beyond one Five Why framework and be sure to exhaust all possibilities to avoid leaning on the first cause
• Don’t rely on the first idea — come up with multiple solutions to solve a problem
• Don’t work alone. Collaborating with a team will help you come up with a variety of potential solutions or new opportunities
• Don’t think this is a one-time thing. Prepare for the future and discuss risk management and mitigation if you expect this problem to happen again, especially with issues that might be related to factors out of your control. What’s the worst that can happen, and what can we do about it to make sure the problem is addressed quickly with minimal interruption?

Final thoughts

A root cause analysis can be a great tool to help you uncover the true causes of a problem and reduce any reliance on assumptions or biases. With the right investigation and evidence collection, you can learn more about how and why a problem happened and identify causes below the surface.

RCA can ensure your solutions address the root problem and help you better plan for the future.

Featured image source: IconScout

LogRocket generates product insights that lead to meaningful action

Get your teams on the same page — try LogRocket today.

Share this:

• Click to share on Twitter (Opens in new window)
• Click to share on Reddit (Opens in new window)
• Click to share on LinkedIn (Opens in new window)
• Click to share on Facebook (Opens in new window)
• #product strategy

Stop guessing about your digital experience with LogRocket

Recent posts:.

Strategies for managing delays in development sprints

You can maintain productivity and meet your deadlines with careful planning, open communication, and a commitment to improvement.

Leader Spotlight: The relational component of product management, with Michael Park

Michael Park talks about how he worked to adapt BombBomb’s product strategy as the pandemic revolutionized remote work.

A guide to product advertising

Product advertising involves you marketing a product or set of products instead of marketing the brand itself.

Leader Spotlight: Creating a ‘choose your own adventure’ experience, with Peter Sucher

Peter talks about how he works to enable Girl Scouts to express themselves and engage their customer base at the level they desire.

Leave a Reply Cancel reply

Lean Six Sigma Training Certification

• Facebook Instagram Twitter LinkedIn YouTube
• (877) 497-4462

How to do Root Cause Analysis? Everything You Need to Know

March 4th, 2024

Performing a root cause analysis is an invaluable problem-solving tool for any organization. At its core, root cause analysis (RCA) aims to uncover why issues arise by systematically evaluating contributing factors.

Once the underlying causes behind these problems are understood, teams can not only address the immediate symptoms but also take proactive preventative measures for the long term.  

Utilizing a data-driven methodology, root cause analysis gets to the bottom of quality, reliability, safety, and process inefficiencies.

By figuring out the true roots instead of just the obvious proximal causes, you diagnose the real reasons defects emerge, errors happen, failures occur or goals aren’t met.

The goal extends beyond resolving a one-time incident – it’s about fixing systemic gaps to avoid repeated future stumbles while continuously improving performance.

What is Root Cause Analysis?

Root cause analysis (RCA) refers to a set of approaches leveraged to uncover the underlying explanatory factors or root causes behind problems. Essentially, RCA provides a structured investigation process for identifying the true sources from which issues emerge in systems, products, workflows, or outcomes.

Whereas our instinct is often to address the most visible or proximate causes behind defects, errors, or negative events, root cause analysis deliberately digs deeper.

RCA diagnosis traces behind the symptoms to the source inputs, process weaknesses, and capability gaps giving rise to those surface-level problems.

This tracing back from consequence to cause requires analyzing the interconnected relationships within a system to find originating triggering points upstream where sustainable solutions can be targeted.

Goals of Performing Root Cause Analysis

There are three overarching goals fueling investments in root cause analysis initiatives:

Identify Underlying Problems

The foremost objective is to systematically diagnose the fundamental breakdowns or gaps responsible for the manifestation of issues.

As opposed to only compiling a list of contributing factors or observable indicators, RCA pursues the identification of the truly originating root deficiencies being tapped as the problem’s supply source.

Take Corrective Action  

The second purpose is to facilitate solution development targeting root causes for resolution.

Armed with insights linking specific deficiencies to negative outcomes, corrective interventions can be scoped to strategically address the problem’s inputs rather than applying superficial Band-Aids to outputs.

Investing in fixing root drivers substantially increases the soundness and sustainability of corrective actions taken.

Prevent the Recurrence of Issues

Lastly, the ultimate motivation is the prevention of issue recurrence through eliminating or controlling the root sources.

By remediating root causes and monitoring to confirm resolution, RCA strengthens system reliability and performance to avoid repeated failures manifesting in the future.

Hence required effort for rework decreases as problems stemming from the same unchecked root weaknesses cease to persist.

Steps for Conducting Root Cause Analysis

When executing a root cause analysis, there is an overall investigatory process containing key phases to follow for orderly problem diagnosis .

Walking through these main RCA steps lends structure to facilitate systematic root cause identification.

They provide foundational guidelines while deploying the specialized root cause analysis tools and methodologies covered later.

Define the Problem  

The first step when approaching any root cause analysis is to clearly articulate the problem you aim to address. This includes accurately describing the issue’s observable characteristics and quantifying the impacts witnessed thus far.

Define Specific Symptoms

Closely detail what is going awry to precisely scope the problem. Document factual indicators tied directly to performance shortfalls rather than vague hunches something is amiss. Quantify discrepancies between expected versus actuals. Capture failure modes . Outline errors committed or protocol breaches. Log quality defects surfacing. Probe to gather data-backed specifics.  

Understand Current Impacts

Quantify how these presenting symptoms translate into tangible setbacks. Connect observable indicators back to resulting consequences like goals underachieved, costs incurred, risks introduced, and other impacts.

Dimension the scope of influence including breadth across the customer base, affected product lines, or process phases. Demonstrate why solving this problem merits prioritization based on the depth of existing impacts.

Solid problem definition focusing on the analysis ultimately determines how effectively root causes will be found.

An accurate statement captures factual symptom patterns plus impact measurables tied to those reliability, quality, or performance defects witnessed.

That evidential grounding seeds direction for the data gathering and causal evaluation ahead.

Gather Information & Data

With a well-defined problem statement guiding the root cause analysis, attention next turns to gathering contextual input and evidence associated with the issue.

Create a Timeline of Events  

Work backward chronologically to chart out key events preceding and proceeding with observable defect occurrences . Capture operational data, process logs, related audit records, and other artifact sources to reconstruct event sequences.  

Consider perspectives like:

When exactly did defect indicators initially surface? Under what conditions or phase activity? After what system, input, or human touchpoint? Any correlative or high probability causal associations?

Seeking process flow understanding, catalog multi-tiered sequences of events, including upstream supplier activities, to identify potential propagation pathways giving rise to defects.

Document Contributing Factors

Beyond driving process factors and event chronologies, also gathers ancillary variables that likely influence or contribute to issue occurrence even if not as primary drivers. Consider documentation, insights from staff interviews, related incidents, past mitigation actions, and other clues that shed light.

Record as many hypothesized contributing factors as possible early on. This compilation supports connecting the dots during causal analysis without prematurely dismissing the potential relevance of surrounding variables.  

Through compiling events data and rounding out clues, these background informative sources feed into the causal analysis techniques to next diagnose just what latent weaknesses propagate or allow these problems to keep resurfacing.

Identify Causal Factors

With foundational information gathering completed, the next phase applies analytic techniques to start unraveling contributory causal linkages tied to the focal problem.

A diversity of root cause analysis tools can methodically assess hypotheses on factor interdependencies.

Use Analysis Tools Like 5 Whys and Fishbone Diagram

Structured brainstorming combined with visual mapping formats help investigates the likelihood of causal relationships across documented contributing variables and process flow events. For example:  

– The 5 Whys approach sequentially probes with “why” questions to follow explanatory chains probing closer to root causes.

– Fishbone diagrams visually organize causal factors under typical categorical influence dimensions like manpower, machinery, materials, methods, and more.

These analysis tools support rooting out key drivers versus ancillary variables amongst the stack of hypothesized factors initially compiled.  

Determine Relationships Between Factors  

Beyond naming factors, RCA analysis seeks to assess interrelationships – which elements potentially influence other elements either directly or in relayed sequences.

This mapping of connections across current state process steps, inputs, human decision points, and other variables constructs the pathway model of how certain vital few deficiencies propagate to enable the ultimate problem manifestation.

Solid analysis output accounts for factor likelihood and strength of relationships across the mapped flow.

Statistical, experiential, and consensus estimation techniques help qualify those key linkages for further root cause assessment.

Pinpoint the Root Cause(s)  

Having constructed a relationship model across contributing variables and process flow events, attention hones in on tracing the originating root causes behind the mapped issue. This diagnostic phase isolates the vital few originating causes to target for correction.

May Be Multiple Root Causes

Especially for complex problems, multiple root failure points may independently or jointly propagate deficiencies tied to the end observable defect. Isolate multiple contributing root causes rather than stopping at just one initial discovery.

Distinguish Between Causal Factors

When analyzing to pinpoint the deepest root sources, it is critical to differentiate causal factors from root causes.

Causal factors directly contribute to the problem but are not the underlying deficiencies enabling the causal chain.

True root causes originate upstream as the vital inputs or process weaknesses initiating the downstream consequence cascade.

Confirm root cause isolation by assessing if its resolution would eliminate the issue while simply addressing each causal factor alone would not resolve the problem long term.

This testing of whether fixed roots would break the failure sequence helps verify root cause validity for targeted corrective action ahead.

Implement Preventative Solutions

With verification of the root factors enabling the business problem’s occurrence, attention lastly turns to enacting changes to address exposed deficiencies for prevention.

Develop a Corrective Action Plan

Define a project plan oriented around enhancing control of the vital root inputs or strengthening process elements to minimize propagation likelihood going forward. Corrective actions directly target diagnosed deficiencies rather than applying generalized fixes.

Attach owners driving execution of enhancements like input specification improvements, adding process controls , capability development interventions, technology system changes, and more as tied to root issue resolutions.

Allocate Resources

Determine appropriate budget, staffing, infrastructure, and stakeholder access supports to facilitate execution against planned corrective initiatives. Resource design elements of the improvement plan for priority consideration.

Assign Responsibilities

Designate owners to carry through and sustain fixes critical for remediating diagnosed root weaknesses.

Assign subject matter experts tailored to focus areas like procurement, quality assurance, data analytics, applications, and more.

Maintain accountability via governance check-ins to validate containment of root factors enabling the original business problem faced.

Getting ahead of problems requires getting beyond just reactive firefighting. Root cause analysis provides an alternate mindset and procedural approach to transform from responsive defense to reliable prevention.

Leveraging the steps outlined transforms troubleshooting guesswork into solid problem diagnoses for impactful corrections that stick.

Tools for Root Cause Analysis

While the root cause analysis steps provide an overarching process, there are also many specific tools and techniques leveraged by practitioners to enable effective problem diagnosis .

These methodologies lend rigor and an evidence-based lens guiding productive analysis execution.

No one-size-fits-all tool exists as finding root causes encompasses a toolkit approach aligning techniques to problem complexity, organizational maturity , and analytics staff capabilities.

A variety of options cater better to deductive versus inductive analysis styles. Certain tools simplify tackling human versus process-driven deficiencies.

Below we will describe some of the most popular and impactful options as an introductory sampling of root cause analysis tooling available to drive actionable findings.

Looking across the techniques, common elements like visual mapping combined with iterative questioning enable unraveling factor connections. Statistics quantitatively point toward viral variables.

While no single method will perfectly fit every business environment, evaluating options against internal needs allows customizing an RCA toolbox for repeating success.

Let’s look at how to use 5W , fishbone diagram , fault tree , etc. to run a Root Cause Analysis.

5 Whys Technique

The 5 Whys approach represents one of the simplest root cause analysis tools, asking “why” iteratively to trigger deeper-dive brainstorming on contributory factors. By sequentially questioning “why” around five times, analysis can often get to root causes efficiently.

Ask “Why” Questions Iteratively

Start with the problem indicator as documented. Ask why it is occurring. For the explanation received, again ask why regarding that reason.

Continue asking why around five+ times until reaching a root originating cause rather than just symptoms or intermediate factors.

The key is not stopping at superficial responses. Use follow-on probing around systemic relationships to get beyond guesswork into sourcing vital causal inputs behind issues. Answer chains build an explanatory logic trail.

Fishbone Diagram

The fishbone diagram compiles a visual catalog of causal variables for organized analysis facilitating potential root cause identification.

As factors accumulate and interrelate in complex ways, this format supports assessment efficiency.  

Visually Map Causal Factors

Fishbone diagrams provide an intuitive visual roadmap of multiple categories of influencing factors like materials, machinery, staffing, and methods.

This organization into standard dimension groupings eases assessing angle applicability to the issue context. Breaking down by factor type combined with team discussion aids in root cause emergence.

Fault Tree Analysis

Fault Tree Analysis offers a structured deductive approach applying boolean logic for disciplined qualification of factor likelihood and interconnectedness to narrow resolving power onto root causes.

Deductive Root Cause Analysis

In a fault tree diagram, the undesired state requiring diagnosis sits at the top. Sub-branches then visually map how that state could logically occur based on combinations of certain lower-level events and conditions using “AND” and “OR” logical operators.

Walking through documented branches and assessing the likelihood of reaching originating root factors at the base of the tree provides evaluation rigor.

Fault tree branches knocked out via factor improbability allows deductively focusing in on the active root causes behind an issue.

Failure Mode & Effects Analysis (FMEA)

Failure Mode and Effects Analysis offers an anticipatory approach to risk analysis applied for early identification of vulnerabilities permitting problems before they emerge. It statistically quantifies criticality toward issues to guide control priorities.  

Predictive Identification of Failures

Potential failure modes are hypothesized along with estimating their likelihood to manifest and the severity of impact if occurring. A risk priority number mathematically combining probability and consequence severity indicates the highest priority vulnerabilities for proactive mitigation efforts.

FMEA analysis flows through these steps:

• Documenting process flows and system design specifications.
• Cataloging where and how failure could theoretically occur.
• Rating probability and severity estimates for each failure mode.
• Calculating weighted risk priorities steering mitigation targeting.
• Developing controls and contingency responses aligned to top risks.

Getting ahead of downstream issues, FMEA provides an alternate lens complementary to retrospectively investigating executed failures through other root cause analysis approaches.

It serves prevention needs rather than just diagnosis for organizations’ maturing quality system reliability and performance benchmarks.

Applications of Root Cause Analysis

While originally pioneered in industrial environments, root cause analysis has expanded across functions from product design through end-user support to unlock business performance, operational efficiency, and continuous improvement advances.

Root cause analysis seamlessly integrates into Lean Six Sigma cultures demonstrating infrastructure capabilities enabling reliable prevention. However, any organization in search of elevating standards, systematizing enhancements, or diagnosing tricky recurring issues can benefit from instituting RCA capabilities.

Manufacturing & Quality Control

Eliminating waste while improving quality, safety, and delivery benchmark attainment all require understanding vital causes behind unacceptable variation. RCA offers manufacturing analytics to optimize flow.

Reduce Defects & Waste

Learn why rejection and rework rates fail to meet control standards. Identify source impurities decreasing yield. Discover where bottleneck throughput lags emerge. Optimize prevention resources against diagnosed vital few equipment failure modes. Get to root design weaknesses prompting field failures.

RCA provides manufacturing analytics illuminating upstream process vulnerabilities and product robustness gaps that quality engineers can re-engineer to reduce downstream waste. The evidence-based insights fuel continuous improvement prioritization essential for operational excellence.

Software Development

IT leaders applying root cause analysis to diagnose tricky software defects optimize quality assurance. Pinpointing true error triggers versus symptoms provides effective resolutions by seasoned developers.

Bug Tracking and Resolution

Applying investigative questioning around runtime errors and customer-reported issues provides clarity to trace back through requirements, architecture, and code base vulnerabilities introducing those bugs. Similarly, managing outages and performance degradations benefits from RCA lifting the hood on dependencies and resource contention under the covers.

Business Process Improvement

Every business leverages processes crossing functional teams, underlying technology, and spanning external partners. Root cause analysis gifts a microscope to optimize flow efficiency, reliability, and experience.

Identify Process Inefficiencies

Document as-is workflow steps, decision points, and outputs. Measure improvement needs around cycle time, work transfers, rework loops, constraints impacting costs or service levels, and roadblocks frustrating customers. Construct current state process maps highlighting pain points.

Conduct RCA to diagnose root design, capability, and capacity gaps disadvantaging flow. Re-engineer based on evidence vs. assumptions alone.

From manufacturing shop floors to software quality assurance to overall business productivity, root cause analysis crosses functions to drive operational gains.

RCA provides insights to strengthen the weakest links recognized across integrated processes and systems that compromise broader performance.

Best Practices   

While the methods and tools empower root cause analysis execution, real-world success also depends on engagement, analysis, and implementation excellence.

Various best practices should be fostered around the people, process, and leadership elements involved with RCA.

Involve Cross-Functional Teams

Gathering a diversity of experts across functions touched by the problem to be diagnosed provides analytical breadth bolstering findings. Cross-functional collaboration harnesses different vantage points, experiences, and expertise to enrich RCA direction and outcome integrity.

Harness Different Perspectives

Multidisciplinary participation facilitates a well-rounded understanding of the current state, ideas on latent improvement opportunities, and balanced decision-making interpreting causes.

Consistent involvement across phases also strengthens buy-in critical for solution adoption success downstream.

With a breadth of lenses applied, creative identification of root causes overlooked otherwise comes to light.

Expanding beyond just technical leads or coaches facilitating RCA, hands-on participation across the various functions interfacing with the process or system under review will enhance analysis productivity and solution integrity.

Such collective ownership through the root cause journey propagates engagement critical for executing against recommended enhancements as well.

Create Blameless Culture

Effectiveness finding actual root causes relies on an environment promoting open transparency rather than fear of retribution. When people feel psychologically safe to share knowledge of vulnerabilities, higher quality analysis unfolds.

Encourage Transparency About Problems

Leaders must nurture a “blameless culture” where the focus stays on collective learning rather than targeting culpability.

Model inquisitive questioning, acknowledge contributions, and recognize success in uncovering insights. Establish RCA as an ongoing collaboration operating across functional boundaries.

Proactive sharing accelerates and enhances analysis, whereas environments allowing blame induce hiding failure observations essential for follow-on diagnostics.

Focus on True Root Causes

The end objective focuses on remediating deficiencies at originating sources instead of addressing symptoms alone. Repeatedly confirmed analysis dives deeper beyond the superficial factors initially evident.

Don’t Just Address Superficial Factors

Guard against analysis stagnation at intermediary contributors versus tracing further upstream toward vital root causes.

Leaders should constantly calibrate direction to pursue root factors that if remedied would prevent issue recurrence as the litmus test qualifying properly scoped RCA.

The core principles empowering successful root cause analysis encompass engagement models promoting transparency rather than fear while enabling deep analytic rigor refusing to settle on surface causes.

Adhering to these foundational practices pays dividends with more impactful insights and solution implementation.

Key Takeaways on How to do Root Cause Analysis

Root cause analysis provides a vital capability for any organization seeking to move beyond reactive firefighting toward reliable prevention.

While requiring investment and competency development, proficiency in paying RCA dividends emerges across operational efficiency, quality, customer experience, and financial performance outcomes.

RCA Helps Diagnose and Prevent Recurring Issues

Whether tackling sporadic issues or systemic defects, RCA gifts objective precision guiding corrective enhancements aligned to true underlying failure points.

The evidence-based analytical approaches uncover root causes that if remediated proactively contain issue recurrence likelihood.

The foundational overview shared introduces what , why , and how regarding root cause analysis. Several next milestone steps merit consideration for instituting RCA practices tailored to your organization’s needs.

Implement RCA Methodology Tailored to Your Needs

• Build Leadership Alignment: Confirm executive support to foster an engagement model and allocate resources enabling RCA productivity as a priority capability.
• Launch Training: Develop skilled practitioner depth across functions in RCA tools from visual mapping techniques like fishbone diagrams to statistical methods like FMEA while constructing an optimal toolkit mix.
• Standardize Governance: Define policies and collaborative forums providing oversight, best practice sharing, efficiency optimizations, and corrective action accountability across the RCA lifecycle.
• Start Small, Demonstrate Quick Wins: Pilot RCA diagnosis and solution implementation for an important business issue to showcase capability value realized.

Root cause analysis success requires work – from leadership, staff skill development, and process adoption. However, embracing RCA thinking and methods delivers a multiplier effect on operational gains to continue building competitive advantage.

Now is the time to get started or expand your RCA journey !

The root cause analysis is a very helpful process in understanding as well as finding solutions to the problem. These indispensable tools will help you conduct this process more efficiently.

Stop by and contact us at 6Sigma.us and find out how we can positively help you plan and change the culture and operations of your organization. We offer Six Sigma Green Belt and Six Sigma Black Belt   training programs, as well as a Master Black Belt program.

SixSigma.us offers both Live Virtual classes as well as Online Self-Paced training. Most option includes access to the same great Master Black Belt instructors that teach our World Class in-person sessions. Sign-up today!

Virtual Classroom Training Programs Self-Paced Online Training Programs

SixSigma.us Accreditation & Affiliations

Monthly Management Tips

• Be the first one to receive the latest updates and information from 6Sigma
• Get curated resources from industry-experts
• Gain an edge with complete guides and other exclusive materials
• Become a part of one of the largest Six Sigma community
• Unlock your path to become a Six Sigma professional

" * " indicates required fields

• Prompt Library
• DS/AI Trends
• Stats Tools
• Interview Questions
• Generative AI
• Machine Learning
• Deep Learning

Problem, Symptoms & Root Cause Analysis (RCA) Examples

Last updated: 30th Jan, 2024

Have you found yourself stuck in a cycle of solving the same or similar problems over and over again? Ever wondered why some solutions seem to only offer a temporary fix? Have you wondered if you have identified the correct problem or if you are trying to fix one of the symptoms? The key lies in your understanding of how we define problem statements, associated symptoms, root causes , and approach to problem-solving , which is fundamentally rooted in analytical thinking and critical thinking . What exactly is the difference between a problem and its symptoms ? And why is it crucial to conduct a root cause analysis to arrive at a lasting solution?

In both personal and professional spheres (workplace), the ability to identify correct problems and solve them is highly valued. Often, the issues we face are more complex than they first appear. Simply treating the visible symptoms of a problem rarely offers a lasting solution . This is where analytical thinking comes into play . Understanding the difference between a problem and its symptoms, and the role of root cause analysis in identifying and solving the actual problem, is a cornerstone of analytical thinking. This blog aims to throw light on these distinctions and demonstrate the importance of root cause analysis, empowering you to approach problems with a more analytical mindset for enduring solutions.

Table of Contents

What is a Problem?

In the context of problem-solving, a “ problem ” is a situation or condition that represents the obstruction for an entity (a person or a thing) to remain in or achieve the desirable or ideal state of being. Problems can also be referred to as “ challenges “. For example, a company aims to achieve a 20% increase in sales revenue by the end of the year. The problems or challenges that the company may face can be some of the following:

• Determining whether the product is not positioned correctly, and then coming up with the most apt product positioning in the manner that matches the needs of the customer
• Analyzing marketing strategy, identifying gaps, and coming up with a marketing strategy to reach out to potential customers matching the product positioning
• Create a potential customer pipeline from which X% can convert into the real ones
• Determine a sales strategy that can help make the sales to the potential customers.
• Determine the most apt communication channels for the potential customer to reach out and enquire
• Need for timely and cost-effective customer service

When the entity is moved to the ideal state (positive change) or most desirable condition, the problem stands resolved . The thing that takes the entity from an undesirable to a desirable state is called the solution .

Often, what we initially identify as a problem turns out to be merely a symptom of the underlying problem (or root cause). Symptoms of a problem can be understood as the indicators of the underlying “real problem”. Unlike symptoms , which are mere indicators or manifestations of the problem or real problem , the real problem itself is the root cause that leads to the observable symptoms. It is very important to discern between the symptom and the real problem. If not done well, there is a risk of solving the “ symptoms ” when you think that you are solving the problems.

Here is a problem vs symptom example . When you have a cough problem, it is important to differentiate between whether a cough is a problem and take medicines for it, or, if a cough is due to some lung problem and take the medicine to cure that lung-related problem.

Here is another example to understand problem vs symptoms . Let’s say, when a business is experiencing declining sales, one may call out the problem as “declining sales”. However, the “declining sales” is merely a symptom. The actual problem or the root cause can be traced to poor customer service based on the root cause scenario. It is the core issue that needs to be identified and resolved to bring about a positive change.

What are Symptoms? What’s the difference between Symptoms & Problems?

Symptoms of a problem are the observable effects or indicators that point towards an existing problem ; they are not the problem themselves. These are the signs that something is wrong, but they often don’t reveal the underlying cause. Understanding the distinction between symptoms and the actual problem is crucial because treating symptoms won’t eliminate the root issue.

The following are some of the problem vs symptom, or, symptom vs root cause examples :

• On the personal front, let’s consider recurring headaches. You might think the problem is the headache itself, but that is a symptom. The real problem or the root cause could be anything from dehydration to stress. Taking painkillers will temporarily relieve the headache but won’t resolve the underlying issue causing it.
• In a business setting, consider declining sales. At first glance, you might think the problem is the product or its pricing. However, declining sales are a symptom. The actual problem or the root cause could be poor customer service or ineffective marketing. Addressing only the symptom by slashing prices may bring a temporary boost in sales but won’t provide a long-term solution

By identifying and treating the root cause or actual problem rather than its symptoms , you can find a lasting solution that prevents the issue from recurring. This approach not only saves time and resources but also promotes better analytical thinking and decision-making.

The following are some of the key differences between symptoms and the problems or root cause :

• Symptoms when resolved can reappear after some time. Problems or root causes when resolved stay resolved.
• Symptoms are evident . They can be easily identified. Problems or root causes are difficult to unearth or determine. They can be deep-rooted .
• A problem can manifest in the form of many symptoms.

What is Root Cause Analysis (RCA)? Why is it needed?

Root Cause Analysis (RCA) is a structured approach for identifying the underlying causes of what is referred to as the problem (symptoms on the surface) . The goal is to find out what, how, and why something happened, thereby preventing recurrence. It’s like a detective’s investigation to find the “criminal” causing the symptoms, which in this context, are the undesired outcomes or challenges.

RCA is valuable because it helps you go beyond treating symptoms to find the real problem. It’s the difference between mopping up a water leak and fixing the pipe that’s leaking. By focusing on the root cause, you not only solve the immediate problem but also prevent similar issues in the future.

For instance, if a company is facing high employee attrition, addressing the symptoms might involve conducting exit interviews and providing compensation packages. However, a root cause analysis may reveal that the real issue is a toxic work culture or poor management. Addressing these root causes would lead to more effective and lasting solutions.

There are various methods for conducting RCA, and the choice often depends on the complexity of the problem and the resources available. Some popular techniques include:

• The 5 Whys : This method involves asking “Why?” repeatedly (usually five times) to drill down into the layers of a problem.
• Fishbone diagram : This visual tool allows you to categorize potential causes of a problem, helping to identify the root cause systematically.
• Analytical thinking : One can break down problems into sub-problems and continue this process until one reaches to most fundamental problems.
• First principles thinking : One can analyze a problem based on final, formal, material, and efficient causes and then repeat the process.

By understanding and applying these RCA techniques, you can develop a more analytical approach to problem-solving, thereby addressing issues at their core and preventing future recurrence.

Process for Arriving at the Root Cause of Symptoms / Problems

The following represents the process for arriving at the root cause of stated symptoms or problems:

• Distinguish Between Problem and Symptom : Your first task is to determine if what has been stated is the problem or merely a symptom of something deeper. For instance, experiencing a headache is generally a symptom, not the underlying problem itself.
• Identify the Underlying Problem : If what is stated is a problem, well and good. However, if you’ve identified a symptom, your next step is to discover what the problem could be. For example, if you’re dealing with headaches, the underlying issue may be something like ill-health.
• List All Observable Symptoms : Expand your perspective by identifying all the symptoms related to the issue at hand. This will give you a more comprehensive view and may provide additional clues about the root cause.
• Generate Cause Hypotheses for Stated Symptoms : Formulate hypotheses for what could be causing the symptoms for the identified problem. This step is essentially a diagnosis . Employ techniques like the “Five Whys” to dig deeper and identify potential underlying causes.
• Test Each Hypothesis to identify the real root cause : For each hypothesized cause, perform diagnostic tests to either validate or negate it. This could be in the form of data collection, interviews, or even controlled experiments. The aim is to gather evidence that either supports or refutes each hypothesis.
• Identify the Root Cause : After you’ve rigorously tested each hypothesis, you should be able to pinpoint one root cause that stands out as the most likely “actual problem” or “root cause” of the issues you’re observing.

Defining Problem Statement

The problem statement should consist of information related to the following:

• Ideal state: The ideal state outlines what the perfect scenario would look like once the problem is solved. This sets the vision and provides a clear goal for problem-solving efforts.
• What : Define the problem precisely. You can use root cause analysis to dig deep into the “What” aspect.
• Why : Identify why the problem is important.
• Where : Specify the areas or departments affected.
• When : Determine when the problem occurs or comes to notice.
• Who : Note who is impacted, either directly or indirectly.
• How : Describe the nature of the impact, be it financial, operational, or emotional.
• Outcome as a result of problem resolution : The outcome section elaborates on what success looks like, linking back to the ideal state. It can include quantitative and qualitative measures that indicate the problem has been solved.

Understanding the difference between a problem and its symptoms is the cornerstone of effective problem-solving. Many times, organizations or individuals get sidetracked by addressing symptoms without ever reaching the core issue. By employing a structured approach, like distinguishing between problems and symptoms, identifying all associated symptoms, formulating hypotheses for root causes , and rigorously testing these hypotheses, you set the stage for finding the actual root cause of the problem. This not only saves time and resources but also leads to long-lasting solutions.

From an analytical thinking standpoint, mastering this approach equips you with a crucial skill set. It helps you avoid the pitfalls of surface-level solutions and encourages a deeper understanding of challenges. So the next time you’re confronted with a “problem,” take a step back and consider: Is this the real issue, or is it just the tip of the iceberg? The answer to this question could be the first step toward effective and sustainable problem-solving.

Recent Posts

• Completion Model vs Chat Model: Python Examples - June 30, 2024
• LLM Hosting Strategy, Options & Cost: Examples - June 30, 2024
• Application Architecture for LLM Applications: Examples - June 25, 2024

Ajitesh Kumar

Leave a reply cancel reply.

Your email address will not be published. Required fields are marked *

• Search for:
• Excellence Awaits: IITs, NITs & IIITs Journey

ChatGPT Prompts (250+)

• Generate Design Ideas for App
• Expand Feature Set of App
• Create a User Journey Map for App
• Generate Visual Design Ideas for App
• Generate a List of Competitors for App
• Completion Model vs Chat Model: Python Examples
• LLM Hosting Strategy, Options & Cost: Examples
• Application Architecture for LLM Applications: Examples
• Python Pickle Security Issues / Risk
• Pricing Analytics in Banking: Strategies, Examples

Data Science / AI Trends

• • Prepend any arxiv.org link with talk2 to load the paper into a responsive chat application
• • Custom LLM and AI Agents (RAG) On Structured + Unstructured Data - AI Brain For Your Organization
• • Guides, papers, lecture, notebooks and resources for prompt engineering
• • Common tricks to make LLMs efficient and stable
• • Machine learning in finance

Free Online Tools

• Create Scatter Plots Online for your Excel Data
• Histogram / Frequency Distribution Creation Tool
• Online Pie Chart Maker Tool
• Z-test vs T-test Decision Tool
• Independent samples t-test calculator

Recent Comments

I found it very helpful. However the differences are not too understandable for me

Very Nice Explaination. Thankyiu very much,

in your case E respresent Member or Oraganization which include on e or more peers?

Such a informative post. Keep it up

Thank you....for your support. you given a good solution for me.

Root Cause Analysis: A Complete Guide With Example (2023)

Root Cause Analysis (RCA) is not just a structured method of problem-solving; it’s a vital component of organisational leadership. The goal of RCA is to fully understand what caused an issue, allowing for effective corrective actions.

One of the first steps in a successful RCA is identifying performance or opportunity gaps within an organisation. These gaps reflect ways in which an organisation falls short or fails to deliver on its capabilities. RCA helps in pinpointing these gaps, thereby allowing for more targeted solutions.

This article will take you through the benefits of RCA and the three basic types of root causes behind workplace incidents. We’ll then explore the two popular methodologies for RCA and how you can use the RCA methodology to identify them. 

Finally, we’ll share tools and best practices to help you implement a robust RCA framework so you can develop a comprehensive problem-solving process for safety and risk management in your organisation.

Read on to discover how RCA can revolutionise your approach to problem-solving and risk management.

The benefits of Root Cause Analysis (RCA)

Without a structured RCA framework for resolving incidents, organisations risk implementing superficial quick fixes that may address some of the symptoms but not the core problems.

An effective RCA methodology helps an organisation’s Health & Safety (H&S) team to identify the root causes of a reported incident in the workplace, which is essential to assign effective preventive or corrective actions . Implementing this framework have many benefits:

• Save time, money, and resources because they can identify and invest in the right preventive and corrective actions.
• Prevent the incident from recurring because they can correct the factors causing the issues.
• Prevent more damage or injury caused by a recurring incident.
• Prevent more downtime caused by a recurring incident.
• Boost productivity because they don’t have to revisit the same incident and spend extra time trying to solve the underlying issues.

The three basic types of root cause

There are three fundamental types of root causes:

• Environmental root cause These are causes related to external factors such as moisture levels, weather, or geography.
• Individual root cause These are causes related to an individual’s behaviour, personal choices, ability, or circumstance.
• Organisational root cause These are causes involving internal organisational structure or processes.

The two popular RCA frameworks

A study by Baylor University Medical Center Proceedings identified two popular RCA frameworks. We will cover each one with an example.

#1: The “5 Whys” Method

This is perhaps the most popular RCA technique because of its simplicity. The method is to ask why something happened at least five times. Here’s an example of how it works.

Incident: A construction worker fell and broke his arm.

• “Ask Why” #1: Why did he fall? Answer: He tripped on a wire
• “Ask Why” #2: Why was the wire on the ground? Answer: It was an extension wire needed to supply power to a tool on the other side.
• “Ask Why” #3: Why was the wire pulled across a thoroughfare? Answer: There was no power socket on the other side.  
• “Ask Why” #4: Why is there only one power socket in that area? Answer: There aren’t enough portable generators on the site.
• “Ask Why” #5: Why aren’t enough portable generators on the site? Answer: The application requesting the budget to rent a few more portable generators is pending approval.

Using this RCA technique, we’ve identified the actual root cause to be an organisational root cause. The solution for the organisation is to improve the process of approving budgets. 

Speeding up the process of approving budgets doesn’t just help prevent future similar incidents. It may also bring the added benefit of improving productivity when construction workers can quickly get what they need to perform their tasks.

Without using this RCA technique, one could have soon concluded that it was solely an environmental or individual root cause. Any corrective actions in these areas are likely to be ineffective or short-term.

#2: Causal Tree

A causal tree is used to evaluate other possible causes that contributed to the incident. This can help organisations identify other possible preventive or corrective actions. Here’s an example of how a causal tree could look like for the same incident example above:

Organisations can explore other possible root causes that need addressing using a causal tree. This RCA methodology is beneficial for identifying root causes across environmental, individual, and organisational categories. Another advantage of using the causal tree framework is that it allows organisations to implement short-term solutions to prevent incidents while they take more time to find answers to more prominent issues. For example, the construction company can implement the short-term solution of placing warning signs in front of extended wires on the ground. Meanwhile, the organisation will look into solving the other root causes identified, such as improving the budget approval process and hazard reporting training.

Common Mistakes to Avoid in Root Cause Analysis

Root Cause Analysis (RCA) can be highly effective in addressing workplace safety issues when done correctly. 

However, there are some common mistakes that organisations make when conducting RCA.

Mistake #1: Jumping to conclusions

One of the most common mistakes is jumping to conclusions without thoroughly examining the available information. This often leads to implementing quick fixes that do not address the root cause of the problem.

Tip: Ensure that you take the time to gather all relevant information and systematically work through the RCA process to identify the underlying cause.

Mistake #2: Focusing only on individual errors

Another mistake is solely blaming individuals for incidents without considering the broader organisational context. This can lead to a culture of blame and an unwillingness to report incidents in the future.

Tip: While it is essential to consider individual factors, also examine organisational root causes and environmental factors that may have contributed to the incident. This will help to create a more comprehensive understanding of the issue and lead to more effective solutions.

Mistake #3: Neglecting to involve the right people

One common mistake organisations make is neglecting to involve the right people in the RCA process. A successful RCA requires input from various stakeholders, including employees directly involved in the incident, supervisors, and management. Collaborative analysis helps in collecting a variety of viewpoints and promotes a sense of collective accountability for workplace safety.

Tip: Involving all pertinent stakeholders in the RCA process is crucial, as it aids in collecting a variety of viewpoints and promotes a sense of collective accountability for workplace safety.

Mistake #4: Inadequate documentation

Poor documentation of the RCA process and its outcomes can lead to a lack of accountability and hinder the implementation of corrective actions.

Tip: Document every step of the RCA process, including the incident description, investigation, root cause identification, and proposed corrective actions. This will help ensure that all stakeholders are aware of their responsibilities and can track the progress of the implemented solutions.

Mistake #5: Failing to follow up on corrective actions

Implementing corrective actions is only one part of the RCA process. Organisations sometimes fail to follow up on these actions, which can lead to a recurrence of the incident or issue.

Tip: Establish a system to monitor the progress of corrective actions and evaluate their effectiveness. Regularly review the implemented solutions and make any necessary adjustments to ensure that the root cause is fully addressed and the risk of recurrence is minimised.

How to implement a robust RCA framework 

To enhance workplace safety, it is crucial to establish a strong RCA framework within your organisation.

These are the following steps to implement such a framework:

• Train the H&S team on how to use the different types of RCA frameworks.
• Make it easy for employees to report incidents and other events like near misses.
• Update the new employee training, health and safety training, and SOP guides on submitting incident reports and conducting RCA.
• Conduct regular health and safety training sessions.
• Creating an action plan: outline the steps to be taken, the stakeholders involved, and the timeline for implementation

The importance of high-quality incident and hazard reports 

The effectiveness of any Root Cause Analysis (RCA) relies heavily on the input data’s accuracy and quality. Therefore, it is imperative to have a reliable incident reporting system in place to ensure the provision of high-quality input data.

Here are the characteristics of a high-quality incident report:

• Records the incident’s time, date, and location.
• Is honest, clear, and concise.
• Provides accurate information that doesn’t leave out important facts.
• Provide as much context as possible.
• It is written in a first-person, objective observation of what happened, not what they think might have happened.

To write an accurate incident report, employees should be encouraged to start writing the report as soon as possible. 

Delaying writing the report can lead to inaccurate reports or reports without enough detail because the memory gets fuzzy. Whenever possible or relevant, employees should also attach photos for additional context.

To help you navigate the complexities of incident reporting, we strongly recommend downloading our free checklist and comprehensive guide .

Best practices to improve incident reporting and RCA

One of the best practices to improve the quality of incident reports is digitalising the incident reporting process. 

Here’s an example of how Vatix’s incident reporting systems can improve the quality of workplace incident reports and RCA.

• Higher quality incident reports Our mobile platform makes it easy for employees to report an incident from anywhere without the friction of filling out and submitting a paper form. Facilitating on-the-spot reporting for employees minimises the likelihood of postponing or neglecting to report incidents or other events. Faster reporting of incidents also improves the quality of the report. Employees are more likely to record details with better descriptions and upload photos directly from their mobile devices, improving the data needed for an effective RCA.
• Customise incident types to an organisation’s specific needs Our incident reporting software allows organisations to customise the types of incidents employees can report. These templates eliminate the need to print out, distribute, and file multiple forms.
• Easily customise the incident reporting template to capture relevant information. With our incident reporting software, organisations can customise the incident reporting forms to ensure employees submit all required and relevant information. 
• Real-time reporting and location tracking for faster response Paper-based incident reporting causes a lot of delays and it can take hours before supervisors or managers can view the incident reports. With real-time mobile incident reporting, employees can submit incidents on-the-spot and the H&S team will be alerted with a location so they can respond to the incident within minutes. In some cases, faster response time with location tagging can be the difference between life and death.
• Easy to get more context at a glance Unlike manual paper-and-pen incident reporting forms, employees can easily add photographs to the incident report directly from their mobile. The incident reporting app also logs the location and provides visual maps for additional context at a glance.

Improve workplace health & safety processes

By combining mobile incident reporting with an effective RCA strategy, organisations can respond to incidents faster and more effectively to create a positive safety culture, leading to increased productivity and decreased risk of accidents and injuries. Talk to our sales here to learn more about how you can customise our mobile incident reporting software to fit your business and improve workplace safety.

Latest posts

COSHH Legislation: Essential Guidelines for Workplace Safety

The Complete Guide to Mandatory Occurrence Reporting

8 Common Workplace Injuries & How to Prevent Them

Elevate safety & operations with vatix.

ManWinWin BLOG

Root cause analysis: identifying and solving problems.

Learn what Root Cause Analysis (RCA) is, explore effective techniques and access templates to systematically identify and address the underlying causes of issues in your organization.

Unlock the full potential of your organization with our comprehensive guide on Root Cause Analysis (RCA) .

Learn the essential techniques like the 5 whys and fishbone diagram , discover best practices for implementation, and access ready-to-use templates., start identifying and solving the underlying causes of your most persistent problems, ensuring long-term success and continuous improvement..

Table of contents

1. introduction to root cause analysis (rca), 2. popular techniques for root cause analysis, 3. implementing root cause analysis in your organization, 4. root cause analysis tools and templates, manwinwin plays a crucial role in the context of root cause analysis (rca), introduction.

Root Cause Analysis (RCA) is a critical methodology for identifying and addressing the fundamental causes of problems within an organization. This comprehensive guide will delve into the core aspects of RCA, starting with an introduction to its definition, importance, key principles, and objectives. By understanding these foundational elements, organizations can better appreciate the value of RCA in improving operational efficiency, quality, and safety. Following this, we will explore popular techniques for conducting RCA, including the 5 Whys and Fishbone Diagram, providing step-by-step instructions to help you effectively apply these methods in real-world scenarios.

Implementing Root Cause Analysis in your organization requires a systematic approach and awareness of best practices to avoid common pitfalls. This guide outlines practical steps for conducting RCA, ensuring thorough investigation and resolution of issues. Additionally, we will discuss various RCA tools and software that can enhance the process, along with access to downloadable RCA templates for immediate use. These resources will equip your team with the necessary tools to perform thorough root cause analyses, ultimately leading to sustained improvements and problem prevention.

Root Cause Analysis (RCA) is a systematic process used to identify the underlying causes of problems or incidents in order to prevent their recurrence. Rather than just addressing the symptoms of an issue, RCA aims to discover the root cause, thereby providing long-term solutions. This method is essential in various industries, including manufacturing, healthcare, and IT, where complex systems and processes often lead to repeated problems if not properly addressed.

The importance of RCA lies in its ability to improve overall efficiency, quality, and safety within an organization. By understanding and eliminating the root causes of issues, companies can reduce downtime, minimize costs associated with recurring problems, and enhance customer satisfaction. RCA promotes a proactive rather than reactive approach to problem-solving, leading to continuous improvement and operational excellence.

Key Principles and Objectives

• Systematic Approach: RCA involves a structured method to dissect and analyze problems, ensuring all potential causes are considered and examined.
• Focus on Root Causes: The primary goal is to identify the fundamental reasons behind an issue, rather than merely addressing the immediate symptoms.
• Evidence-Based: RCA relies on data and factual information to uncover the root cause, avoiding assumptions and conjecture.
• Involvement of Stakeholders: Effective RCA engages all relevant parties, from frontline employees to management, to gather diverse perspectives and insights.

The main objectives of conducting an RCA are:

• Identify and Eliminate Root Causes: Discover the true origin of a problem to ensure it is resolved permanently.
• Prevent Recurrence: Implement solutions that prevent the issue from happening again, leading to more stable and reliable operations.
• Improve Processes and Systems: Enhance overall processes by identifying weaknesses and implementing corrective actions.
• Enhance Safety and Compliance: Ensure that safety standards and regulatory requirements are met by addressing underlying issues that could lead to violations or hazards.

ManWinWin Software is the result of 40+ years of experience and know-how

We have helped companies around the world to improve their maintenance.

Microsoft Partner

Christian Schilling

Project Manager

Init dubai fze.

Several techniques are widely used in Root Cause Analysis, each offering a unique approach to identifying the root causes of problems. Here are two of the most popular methods:

5 Whys Method: The 5 Whys technique involves asking “why” repeatedly (typically five times) to drill down into the cause of a problem. This method helps to peel away the layers of symptoms and uncover the underlying issue.

Fishbone Diagram (Ishikawa Diagram): The Fishbone Diagram, also known as the Ishikawa Diagram, is a visual tool that helps identify, explore, and display possible causes of a specific problem. It categorizes causes into major areas (e.g., People, Processes, Materials, Equipment) and then further breaks them down into sub-causes.

Step-by-Step Guide on Using the 5 Whys Method

The 5 Whys method is straightforward but highly effective in pinpointing the root cause of a problem. Here’s a step-by-step guide on how to use it:

#1 Assemble a Team Gather a team of individuals familiar with the problem. Their diverse perspectives will provide a comprehensive view of the issue.

#2 Define the Problem Clearly articulate the problem you are trying to solve. Be as specific as possible to ensure everyone understands the issue at hand.

#3 Ask the First Why Ask, “Why did this problem occur?” Record the answer provided by the team. This answer should address the immediate cause of the problem.

#4 Ask Why Again Take the answer from the first why and ask, “Why did this happen?” Continue to document the responses. Each answer should lead to another layer of causality.

#5 Repeat the Process Continue this process, typically five times, until you reach the root cause. The number five is a guideline; sometimes fewer or more questions are needed to reach the true root cause.

#6 Identify Corrective Actions Once the root cause is identified, discuss and implement appropriate corrective actions to address and prevent the problem from recurring.

#7 Review and Monitor After implementing the corrective actions, monitor their effectiveness. Ensure the problem has been resolved and the root cause has been adequately addressed.

Example of the 5 Whys in Action:

Problem: The customer received a damaged product.

Why was the product damaged? Because it was improperly packaged.

Why was it improperly packaged? Because the packaging materials were insufficient.

Why were the packaging materials insufficient? Because the supplier delivered substandard materials.

Why did the supplier deliver substandard materials? Because the supplier changed their materials without notice.

Why did the supplier change their materials without notice? Because our contract does not specify material quality standards.

In this example, the root cause is the lack of specified material quality standards in the supplier contract. The corrective action would involve updating the contract to include these standards, preventing future occurrences of this problem.

Welcome to ManWinWin Software

Maximize efficiency and streamline your maintenance processes with ManWinWin Software, the most experienced maintenance management software provider. Our advanced solutions, backed by years of expertise, optimize workflows and drive operational excellence.

Discover how our trusted software can revolutionize your maintenance operations today.

Implementing Root Cause Analysis (RCA) in your organization involves a structured approach to ensure thorough investigation and resolution of problems. Here are the practical steps to follow:

Define the Problem: Clearly identify and articulate the problem or incident that needs analysis. Ensure that the problem statement is specific, measurable, and understood by all team members.

Assemble the RCA Team: Form a team of individuals with diverse knowledge and perspectives related to the problem. Include members from different departments if necessary to get a holistic view.

Collect Data: Gather all relevant data and evidence related to the problem. This can include incident reports, process logs, interviews with involved personnel, and any other pertinent information.

Identify Possible Causes: Use brainstorming sessions and techniques like the Fishbone Diagram to list all potential causes of the problem. Encourage open communication and avoid premature judgments.

Analyze Causes: Apply techniques such as the 5 Whys to drill down into each potential cause and identify the root cause. Ensure that the analysis is data-driven and factual.

Develop and Implement Solutions: Once the root cause is identified, brainstorm possible solutions. Choose the most effective and feasible solutions, and develop an action plan for implementation. Assign responsibilities and deadlines.

Monitor and Review: After implementing the solutions, monitor their effectiveness over time. Verify that the problem is resolved and that the corrective actions are preventing recurrence. Adjust the solutions if necessary.

Document the Process: Keep detailed records of the RCA process, findings, decisions made, and actions taken. This documentation will be valuable for future reference and continuous improvement.

Best Practices

• Foster a Blame-Free Culture: Encourage a culture where team members feel safe to speak up and share their insights without fear of blame or retribution. Focus on the problem, not on assigning fault.
• Use a Structured Approach: Adhere to a systematic and structured method for RCA. This ensures consistency and thoroughness in identifying and addressing root causes.
• Involve the Right People: Ensure that the RCA team includes individuals with relevant knowledge and experience. Their input is crucial for accurately identifying causes and developing effective solutions.
• Prioritize Communication: Maintain open and clear communication throughout the RCA process. Ensure that all team members are informed and aligned with the objectives and progress of the analysis.
• Integrate RCA into Organizational Processes: Embed RCA into your organization’s standard operating procedures. This promotes a proactive approach to problem-solving and continuous improvement.

Common Pitfalls to Avoid:

• Jumping to Conclusions: Avoid rushing to solutions without thoroughly analyzing the root causes. Premature conclusions can lead to ineffective fixes and recurrence of problems.
• Superficial Analysis: Do not stop the analysis at the first identified cause. Often, the true root cause lies deeper, and superficial analysis can miss critical underlying issues.
• Lack of Data and Evidence: Ensure that your analysis is based on accurate and comprehensive data. Decisions based on assumptions or incomplete information can lead to incorrect conclusions.
• Neglecting Follow-Up: Implementing solutions is only part of the process. Regularly review and monitor the effectiveness of the solutions to ensure they are addressing the root cause and preventing recurrence.
• Inadequate Documentation: Failing to document the RCA process and findings can result in loss of valuable knowledge. Proper documentation helps in tracking progress, sharing insights, and training new team members.

By following these practical steps and adhering to best practices while avoiding common pitfalls, your organization can effectively implement Root Cause Analysis, leading to more robust problem-solving and continuous improvement.

Join ManWinWin Software, the world’s most experienced company in CMMS!

Choose a better way to manage your maintenance, watch or book a demo, use manwinwin free version.

Free forever industrial maintenance management software up to 100 Assets. Start today!

Effective Root Cause Analysis (RCA) often requires the use of various tools and software to streamline the process, enhance accuracy, and facilitate collaboration. Here are some of the most useful RCA tools and software:

Fishbone Diagram (Ishikawa Diagram)

• Purpose: Helps identify, organize, and visually display potential causes of a problem.
• iCategorizes causes into major areas such as People, Processes, Materials, Equipment, and Environment.

5 Whys Analysis Tool

• Purpose: Assists in drilling down to the root cause by repeatedly asking “Why?”.
• Features: Simple, effective, and often integrated into other RCA software for easy use.

Pareto Analysis (80/20 Rule)

• Purpose: Helps prioritize causes based on their impact, allowing focus on the most significant ones.
• Features: Uses charts to show the most common causes of problems and their cumulative effect.

Failure Mode and Effects Analysis (FMEA)

• Purpose: Identifies potential failure modes within a system, assesses their impact, and prioritizes them for action.
• Features: Systematic, quantitative analysis of risks and failures.

Root Cause Analysis Software

• TapRooT®: Comprehensive RCA software that helps investigate, analyze, and fix root causes. It includes incident tracking, audit management, and corrective action tracking.
• Minitab®: Statistical software that includes tools for quality improvement and RCA. It helps in data analysis, visualization, and identification of root causes.
• SmartDraw®: Diagramming software that offers templates for Fishbone Diagrams, flowcharts, and other RCA tools, making it easy to create professional diagrams.

Collaborative Tools

• Microsoft Teams / Slack: Platforms that facilitate team collaboration, document sharing, and communication during the RCA process.
• Google Workspace: Provides tools like Google Docs and Sheets for collaborative documentation and data analysis.

Access to Downloadable RCA Templates for Immediate Use

To streamline the Root Cause Analysis process, having access to ready-made templates can be extremely helpful. Here are links to downloadable RCA templates that you can use immediately:

Fishbone Diagram Template Link: ASQ Fishbone Diagram Template Description: American Society for Quality (ASQ) provides a comprehensive Fishbone Diagram template that helps in identifying potential causes of a problem and organizing them visually.

5 Whys Worksheet Link: Lean Enterprise Institute 5 Whys Template Description: Lean Enterprise Institute offers a structured worksheet for conducting the 5 Whys analysis to get to the root cause of issues.

Pareto Chart Template Link: Vertex42 Pareto Chart Template Description: Vertex42 provides an Excel template for creating Pareto charts to prioritize causes based on their frequency and impact.

FMEA Template Link: American Society for Quality (ASQ) FMEA Template Description: ASQ offers a detailed template for conducting Failure Mode and Effects Analysis, allowing for systematic risk assessment.

Root Cause Analysis Report Template Link: Smartsheet RCA Report Template Description: Smartsheet provides a comprehensive RCA report template that includes sections for documenting the analysis process, findings, and corrective actions.

Discover ManWinWin services in maintenance management consulting

Implementation

Training is the component that consolidates and sustains the solution on the client.

Audit & Diagnosis

Evaluation and systematization of the client’s case. Before and after implementation.

Standard procedures

Simple, not bureaucratic and permanently accessible documents.

Want to know how the world’s most experienced CMMS maintenance management software can help you?

Computerized Maintenance Management System (CMMS) software like ManWinWin plays a crucial role in the context of Root Cause Analysis (RCA). CMMS platforms like ManWinWin help organizations streamline their maintenance operations by managing work orders, scheduling preventive maintenance tasks, tracking equipment history, and more.

In RCA, CMMS software serves as a valuable repository of maintenance data and historical records, which are essential for conducting thorough analyses. By leveraging data stored in CMMS platforms, maintenance teams can identify patterns, trends, and recurring issues, aiding in the identification of root causes.

CMMS software facilitates the implementation of corrective actions by allowing maintenance teams to track the effectiveness of solutions over time. Integration with RCA methodologies enables organizations to not only address immediate problems but also prevent their recurrence, leading to improved asset reliability, reduced downtime, and enhanced operational efficiency.

ManWinWin, specifically, offers features that align with RCA processes, making it a valuable tool for organizations seeking to implement effective root cause analyses within their maintenance strategies.

🤖 Meet OnCall AI, our observability copilot that makes troubleshooting easy. Read announcement.

What is Root Cause Analysis: Techniques and Processes

Read this article to understand how to answer the question, what is root cause analysis? Learn about its principles and real-world applications, along with the popular frameworks used to perform root cause analysis.

Root Cause Analysis (commonly abbreviated as RCA) is a process used to identify the underlying cause of a problem, focusing on the fundamental issue(s) instead of only addressing the downstream symptoms. While potentially more difficult in the short-term, RCA produces solutions which tackle the root of the problem, saving a lot of time down the road.

In the contexts of IT infrastructures, microservices, observability, and monitoring , RCA can be applied to systematically track down the root cause of issues or failures in complex technology systems. When performance problems, errors, or outages occur, developers can leverage RCA to analyze log, metric, and trace data to help determine the exact cause.

This article will explore the principles, techniques, and real-world applications of root cause analysis in depth.

Key Takeaways

RCA is used by organizations to uncover the root cause of their problems and identify the best solution.

Integrating RCA is influential across industries, improving quality, efficiency, and safety. These industries include business, manufacturing, engineering, and more.

Organizations can collect data using multiple techniques, including fishbone diagrams, failure mode, effects analysis, and change or event analysis.

Key RCA Principles

Here are five principles which are important to consider when performing RCA:

Focus on Causes, Not Symptoms

Explore connections between Root Causes

Perform fact-based Analysis

Execute a non-punitive approach

Derive actionable solutions

Let's break down each one:

Symptoms are the immediate issues observed by users, while root causes are the underlying factors which lead to them occurring. Addressing symptoms alone can provide temporary relief, but identifying and resolving root causes leads to lasting solutions.

By focusing on root causes, organizations can tackle problems effectively and swiftly identify improvement areas. This approach not only prevents future breakdowns but also ensures more reliable and efficient operations.

Additionally, understanding and addressing root causes can enhance system resilience, reduce downtime, and optimize resource utilization. This approach helps in building a more robust infrastructure, capable of withstanding and quickly recovering from present and future issues.

Multiple Root Causes

Organizational problems often stem from multiple interrelated root causes. A thorough root cause analysis (RCA) can not only identify and examine these individually, but also uncover how they are connected, providing a comprehensive understanding of the underlying issue. This approach also explores contributing factors, enabling more effective and holistic solutions.

Organizations often use methods like the "Five Whys" or fishbone diagrams to dissect problems into multiple root causes. This systematic approach ensures that all aspects of the issue are addressed.

Fact-based Analysis

Relying solely on assumptions or intuition can lead to successful fixes, but more often than not leads to impractical and ineffective solutions. Therefore, gathering and analyzing data through evidence-based investigations is crucial for accurately understanding organizational problems. Additionally, ensuring data reliability and accuracy is essential for both supporting any findings and ultimately making informed decisions.

Organizations can collect data through various methods such as interviews, observations, document reviews, and case studies. This fact-based approach ensures that conclusions are grounded in solid evidence, leading to more effective and credible solutions.

Non-punitive Approach

In addressing issues, it is essential to encourage openness and focus on the how/why, not the who. A blame-free environment motivate employees to communicate information freely, leading to a more accurate and comprehensive understanding of the problem. Additionally, most issues are systematic in nature, caused by improper build frameworks or testing mechanisms, meaning no one individual is entirely culpable.

It is also essential to emphasize a clear objective amongst team members and improve processes rather than just assigning blame. This system can foster cooperation and contribute to the fast discovery of issues arising within the organization.

Actionable Solutions

Ensure that the analysis leads to practical solutions to prevent the recurrence of the problems. These solutions should identify root causes effectively and be practical to implement. More concretely, they should be:

Monitoring and follow-ups are also necessary to sustain improvements. These actionable mechanisms can ensure that the generated solutions are practical and working as intended, allowing essential adjustments.

The section below shows how organizations implement the fundamental principles of RCA in their operations.

Common Techniques and Methods in RCA

Fishbone diagram (ishikawa).

The Fishbone Diagram, also known as Ishikawa Diagram, is a cause-and-effect style diagram that provides context around an issue's root cause. It is particularly prominent in identifying the multiple causes that contributed to a problem.

The diagram resembles a fish structure, with the effect or problem analyzed in the fish's head. The fish's skeletal structure represents the combinations of causes which led to the issue, where each individual cause is represented as a specific bone in the skeleton. Some potential categories of causes are listed below:

Workforce : Factors related to the individual people involved.

Method : Procedures and processes followed.

Machines : Equipment and root cause analysis tools utilized.

Mission : The goal and objective.

Materials : Materials and substances used in the process.

Promotion : Marketing efforts.

Suppliers : Product providers.

Measurements : Measurement and data collection methods.

Management : Approaches and organization of materials.

Environment : The surrounding conditions and external factors.

Using the Fishbone diagram, team members first brainstorm within each present category and identify potential causes of the problem. This collaborative approach promotes in-depth understanding and ensures that all factors are overlooked.

Failure Mode and Effective Analysis

Failure Mode and Effective Analysis (FMEA) is a rigid approach to root cause analysis. Like a risk analysis, FMEA identifies every possibility for system and process failure and examines the potential impact of each hypothetical failure. The organization then addresses every root cause that is likely to fail. There are four steps in FMEA include:

Identify potential failures and defects

Determine the potential severity and consequences of each

Create systems for failure detection

Predict the likelihood of occurrence

Successful use of FMEA requires using data and insights gained from previous experiences with similar products and systems. The object is to identify failure modes and failure effects. A failure mode is a system's potential or actual defects or errors. A failure effect describes how a failure mode will impact customers or end users.

Change/Event Analysis

Change (or Event) analysis is another method which can change systems and performance processes within the organization. When conducting this type of RCA approach, head departments examine how the circumstances relating to the issue or incident have changed, including examining changes in personal information, data, and infrastructure.

Instead of focusing on the specific day or time the problem occurred, this approach focuses on a more extended period and explores its historical context. To implement change analysis, organizations usually follow these steps:

Listing down all possible causes of an event that causes occurrences of changes

Categorizing each change or event according to the organization's influence can be external or internal.

Examining events segmenting whether it's an unrelated factor, correlated factor, or a possible cause.

Analyzing how to replicate or remedy the cause.

Now that you have learned the techniques used in RCA, follow along as we outline the specific steps taken to implement it into your processes.

You can use distributed tracing to analyze changes or events . This process covers application requests from the front to the back end, enabling real-time visibility across an infrastructure or environment.

Step-by-step Guide to Conducting RCA – How To Do Root Cause Analysis

Conducting a thorough Root Cause Analysis (RCA) requires a systematic and structured approach. Here’s a step-by-step guide to effectively performing RCA:

Step 1: Preparation and Definition

Understanding the problem in detail is crucial as it sets the foundation for the entire analysis process. This step involves gathering initial information about the symptoms and the context in which the problem occurred. Gather a diverse team within your organization with experience in the relevant within the organization so you can clearly describe the issues and their impact.

When your department clearly understands the problem, you can begin drafting a problem statement that spells out the issue for everyone who will help with the RCA.

Step 2: Data Collection

This process includes collecting various data sources. This includes telemetry data like logs and metrics, along with testimonies like witness accounts. Methods for collecting data can include:

Interviews: Talking to individuals involved or affected by the issue.

Observations: Directly observing the processes and activities where the problem occurred.

Document Reviews: Examining relevant documents, records, and reports.

Case Studies: Reviewing similar past incidents to draw parallels and insights.

Some questions that should be considered when collecting data include the following:

When did the problem start, and how long has it happened?

What symptoms has the team observed?

What documentation must the organization or department use to prove that an issue exists?

How did the issue affect the stakeholders and other employees?

Who was affected or harmed by the existence of this problem?

Step 3: Analysis

Use RCA techniques like the five whys or the fishbone diagram to map out the context around the issue based on the data collected, to better understand the situation.

Developing a practical root cause analysis process requires being open to all potential underlying issues and causes. Therefore, everyone on the RCA team should enter the brainstorming and analysis stage with an open mind.

Searching for the root cause of issues takes time due to noise and chaotic log data. You can go around this RCA roadblock by using third-party tools. For instance, Edge Delta structures every log data into patterns , allowing teams to observe entire environments and immediately get the data needed from noisy datasets. This feature detects new behaviors and provides solutions to problems as they occur.

Step 4: Developing Solutions

Once the organization's team members and stakeholders have determined the root causes and can fill out all the details of the issue, they can start brainstorming for solutions. They must formulate actionable solutions based on the identified root causes.

It is also crucial to consider the logistics and factors of executing the solution and any potential obstacles the team may encounter. Ensure solutions are practical, sustainable, and prevent recurrence. These elements comprise the action plan to help the team solve the current problem and prevent recurrences.

Step 5: Implementation and Follow-up

The final RCA step is to implement the solutions necessary to solve the problem within the organization. Develop a plan or a timeline for implementing the solution and inform the team involved about proactive quality management.

Once you have successfully implemented your solution, monitoring its effectiveness is necessary. Ensure that your solution solves the problem and avoids problems along the way. Monitoring feedback and new data in the long run is also helpful.

Root Cause Analysis (RCA) is a powerful approach that allows organizations to identify the source of a problem. With an effective RCA process, teams can implement suitable lasting solutions to significantly improve their performance.

Organizations can harness RCA's potential using Failure Mode, Event Analysis, and Fishbone analysis. They should also adhere to methods and best practices such as setting clear objectives, gathering diverse teams, standardizing processes, and encouraging a blame-free culture, which can help integrate RCA to avoid recurring problems.

FAQs on Root Cause Analysis

What is the meaning of root cause analysis.

Root cause analysis is a technique for discovering the root causes of problems within an industry and identifying appropriate solutions.

What are the 5 steps of root cause analysis?

The five steps of root cause analysis involve defining the problem, log collection , identifying the root causes, prioritizing the causes, and implementing solutions.

What is the meaning of root cause analysis in ITIL?

Root Cause Analysis in ITIL (Information Technology Infrastructure Library) systematically exposes the underlying issues behind IT service disruptions.

What are the 5 Whys root cause analysis?

The 5 Whys in root cause analysis are deeply rooted in the idea that asking five "Why?" questions can help organizations identify the root cause of underlying problems.

BusinessMap

SixsigmaDaily

SafetyCulture

HarvardBusinessOnline

Filed Under

• Troubleshooting

Related Posts

How to reduce mean time to resolution (mttr) - best strategies and tips, introducing oncall ai: the copilot that makes troubleshooting easy, stay in touch.

Sign up for our newsletter to be the first to know about new articles.

• RCA 101 – 5-Why Analysis (Free Training)
• RCA201 – Basic Failure Analysis
• RCA 301 – PROACT® RCA Certification
• RCA401 – RCA Train The Trainer
• Other Trainings
• 5 Whys Root Cause Analysis Template
• RCA Template
• Chronic Failure Calculator

Root Cause Analysis with 5 Whys Technique (With Examples)

By Sebastian Traeger

Updated: April 23, 2024

Reading Time: 7 minutes

What Is the 5 Whys Technique?

Example of the 5 whys technique, how to conduct a 5 whys analysis in 5 steps, when to use a 5 whys analysis, using 5 whys template, tips for mastering the 5 whys technique, frequently asked questions about 5 whys.

With over two decades in business – spanning strategy consulting, tech startups and executive leadership – I am committed to helping your organization thrive.

At Reliability, we’re on a mission to help enhance strategic decision-making and operational excellence through the power of Root Cause Analysis, and I hope this article will be helpful! 

Our goal is to help you better understand 5 whys techniques by offering insights and practical tips based on years of experience. Whether you’re new to doing RCAs or a seasoned pro, we trust this will be useful in your journey towards working hard and working smart.

The 5 Whys Technique is like peeling an onion – it helps you uncover the underlying reasons behind a problem, layer by layer. By repeatedly asking “why” at least five times, this method digs deep to reveal the root cause of an issue. It’s a simple yet powerful problem-solving approach that aims to get to the heart of the matter rather than just addressing surface-level symptoms.

5 Whys Technique: A method that involves iteratively asking “why” five times to unveil the fundamental cause of a problem.

In essence, the 5 Whys Technique is not just about fixing what’s broken on the surface; it’s about understanding and addressing the deeper issues that lead to problems in the first place.

The 5 Whys Technique is like a detective, uncovering the truth behind recurring problems. Let’s take a look at how this method works in two different scenarios.

Case Study: Manufacturing Defects

Imagine a company that keeps encountering the same manufacturing defects despite various attempts to fix them. By using the 5 Whys Technique, they discovered that the defects were not caused by faulty machinery, as previously assumed, but rather by human error due to unclear operating instructions. This realization led to improved training procedures and clear work guidelines, ultimately eliminating the defects.

Application in Service Industry

Now, consider a service industry struggling with frequent customer complaints and service failures. Through the 5 Whys Technique, it was revealed that these issues stemmed from inadequate staffing levels during peak hours. By addressing this root cause, such as hiring additional staff or adjusting schedules, the service quality can significantly improve, leading to higher customer satisfaction.

These examples illustrate how the 5 Whys Technique can be applied across different sectors to identify and address underlying issues effectively.

Step 1: Identify the Problem

Before diving into a 5 Whys analysis, it’s crucial to clearly identify the problem or issue at hand . This step sets the stage for the entire process and ensures that the focus remains on addressing the right concern. Take the time to gather relevant data, observe patterns, and consult with team members or stakeholders to gain a comprehensive understanding of the problem.

Step 2: Ask ‘Why’ Five Times

Once the problem is clearly defined, it’s time to start peeling back the layers. The process involves asking “why” five times, not necessarily limited to five questions but enough to delve deeper into the underlying causes of the problem . Each “why” serves as a gateway to uncovering additional factors contributing to the issue. This iterative approach helps in identifying not just one cause, but multiple interconnected elements that may be at play.

By consistently probing deeper with each “why,” you can reveal hidden complexities and nuances that may have been overlooked initially. This method allows for a more thorough understanding of the situation, paving the way for effective solutions that address root causes rather than surface-level symptoms.

This structured approach encourages critical thinking and enables teams to move beyond quick fixes towards sustainable improvements.

The 5 Whys Technique is a versatile problem-solving approach that can be applied in various scenarios to uncover root causes and drive continuous improvement. Here are two key situations where the 5 Whys Analysis can be particularly beneficial:

Recurring Issues

• The 5 Whys Technique is especially useful when dealing with recurring issues. Whether it’s a manufacturing defect that keeps resurfacing or a persistent customer complaint in the service industry, this method helps identify the underlying reasons behind these repetitive problems. By repeatedly asking “why,” it becomes possible to trace the issue back to its root cause, allowing for targeted solutions that prevent reoccurrence.

Process Improvement

• Organizations constantly strive to enhance their processes and workflows for increased efficiency and quality. When seeking to improve existing procedures, the 5 Whys Technique serves as a valuable tool. By systematically analyzing the factors contributing to inefficiencies or bottlenecks, teams can gain insights into how processes can be optimized at their core. This method enables organizations to make informed decisions about process improvements based on a deep understanding of the underlying issues.

In both cases, the 5 Whys Analysis offers a structured yet flexible approach to delve into complex problems, making it an indispensable tool for driving meaningful change and progress within organizations.

When it comes to conducting a 5 Whys analysis, utilizing a structured template can greatly facilitate the process and ensure a comprehensive investigation into the root cause identification. Using RCA software such as EasyRCA can benefit the team by streamlining your 5-why process. Here’s how organizations can benefit from using a template:

Benefits of Using a Template

• Streamlined Process: A well-designed 5 Whys template provides a clear framework for conducting the analysis, guiding teams through the iterative questioning process. This streamlines the investigation, making it easier to navigate and ensuring that no crucial aspects are overlooked.
• Thorough Investigation: By following a predefined template, teams are prompted to explore various facets of the problem systematically. This ensures that all relevant factors are considered, leading to a more thorough and insightful investigation into the underlying causes.
• Consistent Approach: Templates offer a standardized approach to conducting 5 Whys analyses within an organization. This consistency promotes uniformity in problem-solving methods across different teams or departments, enhancing overall efficiency and effectiveness.

Customizing the Template

Organizations have the flexibility to customize 5 Whys templates according to their specific needs and industry requirements. This adaptability allows for tailoring the template to address unique challenges and incorporate industry-specific considerations. Customization may include:

• Adding Industry-Specific Prompts: Tailoring the template by incorporating prompts or questions relevant to particular industries or types of issues being analyzed.
• Incorporating Visual Aids: Enhancing the template with visual aids such as flow charts or diagrams can help teams better understand and communicate complex causal relationships.
• Iterative Refinement: Regularly reviewing and refining the template based on feedback and evolving organizational needs ensures that it remains aligned with current processes and challenges.

Customizing the template empowers organizations to harness the full potential of the 5 Whys Technique in addressing diverse problems while aligning with their unique operational contexts.

Encouraging Open Communication

In mastering the 5 Whys Technique as a problem-solving method, creating an environment that fosters open communication is paramount. When team members feel comfortable expressing their perspectives and insights, it leads to a more comprehensive exploration of the underlying causes of a problem. Encouraging open communication allows for diverse viewpoints to be considered, providing a holistic understanding of the issue at hand.

By promoting an atmosphere where individuals are empowered to voice their observations and concerns, the 5 Whys analysis can benefit from a rich tapestry of ideas and experiences. This inclusive approach not only enhances the depth of the analysis but also cultivates a sense of ownership and collective responsibility for addressing root causes within the team or organization.

Continuous Improvement Mindset

A key aspect of mastering the 5 Whys Technique is embracing a continuous improvement mindset. Rather than viewing problems as isolated incidents, this approach encourages teams to see them as opportunities for growth and development. By instilling a culture of continuous improvement, organizations can leverage the insights gained from 5 Whys analyzes to drive positive change across various aspects of their operations.

Fostering a mindset focused on continuous improvement entails actively seeking feedback, evaluating processes, and implementing iterative enhancements based on the findings. It involves an ongoing commitment to learning from past experiences and leveraging that knowledge to proactively address potential issues before they escalate. Embracing this mindset ensures that the 5 Whys Technique becomes ingrained in the organizational ethos, leading to sustained progress and resilience in problem-solving efforts.

As we wrap up our exploration of the 5 Whys Technique, let’s address some common questions that may arise regarding this powerful problem-solving method.

What is the primary goal of the 5 Whys Technique?

The primary goal of the 5 Whys Technique is to uncover the root cause of a problem by iteratively asking “why” at least five times. This approach aims to move beyond surface-level symptoms and address the underlying issues that lead to recurring problems.

Is the 5 Whys Technique limited to specific industries or sectors?

No, the 5 Whys Technique is versatile and can be applied across various industries and sectors. Whether it’s manufacturing, healthcare, service, or technology, this method offers a structured yet flexible approach to identifying root causes and driving continuous improvement.

How does the 5 Whys Technique contribute to continuous improvement?

By delving into the fundamental reasons behind problems, the 5 Whys Technique provides organizations with valuable insights for driving continuous improvement. It not only helps in resolving immediate issues but also fosters a culture of ongoing enhancement and development within an organization.

Can the 5 Whys Technique be used for complex problems with multiple contributing factors?

Yes, while initially designed as a simple and straightforward method, the 5 Whys Technique can certainly be applied to complex problems with multiple interconnected factors. By systematically probing deeper into each layer of causality, this technique enables a comprehensive understanding of intricate issues.

I hope you found this guide to 5 whys technique insightful and actionable! Stay tuned for more thought-provoking articles as we continue to share our knowledge. Success is rooted in a thorough understanding and consistent application, and we hope this article was a step in unlocking the full potential of Root Cause Analysis for your organization.

Reliability runs initiatives such as an online learning center focused on the proprietary PROACT® RCA methodology and EasyRCA.com software. For additional resources, visit Reliability Resources .

• Root Cause Analysis /

Recent Posts

Post-Incident Analysis for Enhanced Reliability

How To Conduct Incident Analysis?

The Role of Artificial Intelligence in Reliability Engineering

Ultimate Guide to Swiss Cheese Model and Its Applications

Root Cause Analysis Software

Our RCA software mobilizes your team to complete standardized RCA’s while giving you the enterprise-wide data you need to increase asset performance and keep your team safe.

Root Cause Analysis Training

[email protected]

Tel: 1 (800) 457-0645

Share article with friends:

Root Cause Analysis, Ishikawa Diagrams and the 5 Whys

Published: June 11, 2018 by Matthew Barsalou

Root cause analysis (RCA) is a way of identifying the underlying source of a process or product failure so that the right solution can be identified. RCA can progress more quickly and effectively by pairing an Ishikawa diagram with the scientific method in the form of the well-known plan-do-check-act (PDCA) cycle to empirically investigate the failure. Often, failure investigations begin with brainstorming possible causes and listing them in an Ishikawa diagram. This is not necessarily wrong, but often the ideas listed do not clearly contribute to the failure under investigation.

Write a Problem Statement

Once a problem-solving team has been formed, the first step in an RCA is to create a problem statement. Although critical for starting an RCA, the problem statement is often overlooked, too simple or not well thought out. The problem statement should include all of the factual details available at the start of the investigation including:

• What product failed
• The failure observations
• The number of failed units
• The customer’s description of the failure

The customer’s description does not need to be correct; it should reflect the customer’s words and be clear that it is a quote and not an observation. For example, a problem statement may start as, “Customer X reports Product A does not work.” The rest of the problem statement would then clarify what “does not work” means in technical terms based upon the available data or evidence. A good problem statement would be: “Customer X reports 2 shafts with part numbers 54635v4 found in customer’s assembly department with length 14.5 +/-2 mm measuring 14.12 mm and 14.11 mm.”

Create an Ishikawa Diagram

An Ishikawa (or fishbone ) diagram should be created once the problem statement is written and data has been collected. An Ishikawa diagram should be viewed as a graphical depiction of hypotheses that could explain the failure under investigation. It serves to quickly communicate these hypotheses to team members, customers and management. Hypotheses that have been investigated can also be marked on the Ishikawa diagram to quickly show that they are not the cause of the failure (Figure 1).

How Did the Failure Happen?

Elements in the Ishikawa diagram should be able to explain how the failure happened. For example, “lighting” is a typical example under “environment”; however, it is seldom clear how lighting could lead to the failure. Instead, the result of bad lighting should be listed and then empirically investigated. In this example, lighting could cause an employee to make a mistake resulting in a part not properly installed. Therefore, the part not properly installed would be listed in the Ishikawa diagram. Simply investigating the lighting could take time and resources away from the investigation so the first step would be to see if a part is installed.

Causes of a part not being installed can be listed as sub-branches, but the priority should be on determining if the part was installed or not. If a part is not correctly installed, then use the 5 Whys on that part of the Ishikawa diagram for investigation. The lighting may be a contributing cause, but it should not be the first one investigated. The Ishikawa diagram should be expanded each time 5 Whys is used. For example, the branch may end up as: material → part not installed → employee skipped operation → work environment too dark → poor lighting → light bulbs burned out.

In this example, the use of 5 Whys led to the true cause of the failure – the light bulbs burned out. Had the 5 Whys not been used, then the employee may have been retrained, but the same employee or somebody else may have made the same or a different mistake due to the poor lighting. Each time a cause is identified, the 5 Whys should be used to dig deeper to find the true underling cause of the failure. Failing to use the 5 Whys risks a recurrence of the failure – the corrective action may only address symptoms of the failure.

Other Potential Causes

Potential causes that do not directly explain the failure, but theoretically could have caused it, can be listed in the Ishikawa. This ensures they will not be forgotten; however, better explanations should be prioritized for investigation. Tracking and monitoring investigation are related actions can be facilitated by copying the Ishikawa items into a spreadsheet such as the one shown in Figure 2.

Here, each hypothesis from the Ishikawa diagram is prioritized and the highest priority hypotheses are assigned actions, a person to carry them out and a due date. This makes it easier for the team leader to track actions and see the results of completed actions. Such a tracking list can also be used to communication the team’s progress to management and customers. New insights may be gained as the investigation progresses. For example, somebody checking the length of a part may have observed damage. This damage could then be entered into an updated Ishikawa diagram and then transferred to the tracking list.

The Scientific Method

The scientific method should be used when investigating the failure. According to biophysicist John R. Platt’s Strong Inference , the scientific method consists of:

• Devising alternative hypotheses
• Devising a crucial experiment (or several of them) with alternative possible outcomes, each of which will, as nearly is possible, exclude one or more of the hypotheses
• Carrying out the experiment so as to get a clean result
• Recycling the procedure, making sub-hypotheses or sequential hypotheses to refine the possibilities that remain and so on

Each item in the Ishikawa diagrams should be viewed as a hypothesis that could explain the cause of the failure under investigation. A good hypothesis should be simple, general, avoid making too many assumptions and should be able to make refutable predictions. A simpler hypothesis is more likely to be correct. In general, it is best to look for the cause closest to the problem and then work back from there using the 5 Whys. The ability to make predictions is essential for testing the hypothesis ; a hypothesis that can’t be tested should not be trusted as there is no way to be sure that it is correct. As Dutch psychologist and chess master Adriaan de Groot said, “Where prediction is impossible, there is no knowledge.”

Integrate the Scientific Method

The scientific method can be integrated into RCA by using cycles of PDCA . The planning phases consist of describing the problem, collecting data and forming a hypothesis.

• P : Whether freshly formed or taken from an Ishikawa diagram, the hypothesis should make some form of prediction (or plan ), such as “measurement deviation” predicting “parts will be measured out of specification.”
• D : The next step is do – where the hypothesis is evaluated. This could be as simple as measuring a part or as elaborate as designing a new type of test method.
• C : The check phase is where the results are evaluated and conclusions are formed.
• A : Act is where the conclusions are acted upon. A hypothesis may be rejected or modified based on new evidence or the results of the testing, or a plan may be created to confirm a supported hypothesis.

If the hypothesis is not supported, then the next one in the prioritized tracking list should be selected and evaluated.

Using Ishikawa diagrams and the scientific method can serve as a standalone methodology for RCA or be used as part of any RCA process that uses Ishikawa diagrams. This approach is completely compatible with methodologies such as 8D and A3 reports.

• de Groot, Adriaan D. 1969. M ethodology: Foundations of Inference and Research in the Behavioral Sciences . The Hague: Mouten.
• Platt, John R. 1964. “Strong Inference.” Science 146, no. 3642: 347-353.
• Quine, W.V. and J.S. Ullian. 1978. The Web of Belief . (10th ed.), New York: Random House.

About the Author

Matthew Barsalou

3 Root Cause Analysis Templates (and Examples)

By Status.net Editorial Team on May 8, 2023 — 7 minutes to read

Root Cause Analysis (RCA) is a powerful tool used by organizations and professionals to identify, understand, and address the core issues behind recurring problems. By analyzing and addressing the root cause of a problem, you can ensure that the issue will not repeat itself, enhancing your organization’s overall performance, safety, and efficiency. This article will give you an overview of root cause analysis templates and examples to help you adopt this approach for your own processes.

To launch a successful root cause analysis, you need to start by defining the problem clearly. This ensures that your team remains focused on addressing the correct underlying issue. Next, explore various strategies to identify the root cause of your problem. This may involve brainstorming, data analysis, or consultations with experts. Once the root causes have been identified, you can develop targeted solutions to eliminate them and prevent future occurrences.

Related: Root Cause Analysis (RCA) Methods for Effective Problem Solving

5 Whys: How to Uncover Root Causes [Examples]

Root Cause Analysis Template

Five whys technique.

To apply the Five Whys Technique in root cause analysis, begin by stating the problem and then, ask “why” the problem occurred. Keep asking “why” until identifying the root cause. This method works best when working with simpler, specific problems. As an example, consider the following problem and its subsequent analysis:

• Problem: Production is delayed.
• Why? There’s a machine breakdown.
• Why? The machine’s belt is damaged.
• Why? The belt has worn out due to extended use.
• Why? Maintenance and replacement schedules were not followed. (Root cause)

Learn more: 5 Whys: How to Uncover Root Causes [Examples]

Fishbone Diagram

A Fishbone Diagram, also known as an Ishikawa Diagram or Cause and Effect Diagram, is a visual tool used to identify and organize possible causes for a specific problem. To create a Fishbone Diagram, follow these steps:

• Write down the problem statement at the head of your diagram.
• Identify main categories of potential causes (e.g., people, processes, environment, equipment).
• Add these categories as “ribs” branching off the main “spine” of the fishbone.
• Brainstorm specific potential causes under each category.
• Analyze and prioritize the identified causes to determine the root cause(s).

As a simple example, suppose the problem is “late product deliveries.” Categories could include:

• People: staff shortages, lack of training
• Processes: inefficient processes, lack of communication
• Environment: disruptions due to weather, shipping provider issues
• Equipment: outdated equipment, vehicle breakdowns

Learn more: Fishbone Diagram (Components, Factors, Examples) and Ishikawa Diagram: Examples and Applications

Pareto Analysis

Pareto Analysis is a decision-making tool that helps prioritize the most significant causes contributing to a problem. It’s based on the 80/20 rule, which states that about 80% of the effects come from 20% of the causes. To perform a Pareto Analysis:

• List all possible causes of the problem.
• Assign values (e.g., frequency, cost, or time) to each cause.
• Rank the causes in descending order based on the assigned values.
• Calculate the cumulative percentage for each cause.
• Create a Pareto chart with causes on the x-axis and assigned values on the y-axis, and draw a line representing the cumulative percentage.
• Identify the causes contributing to 80% of the problem (starting from the highest value) to address and fix the problem.

When using a Pareto Analysis in root cause analysis, focus on the top contributing causes to solve the most significant aspects of the problem. This technique is especially valuable when dealing with complex problems or when resources are limited.

Related: What is Poka-Yoke? [Examples, Principles, Methods]

Root Cause Analysis Examples

• Example 1: Manufacturing Defects Problem Statement: The production line of a manufacturing company is experiencing a high number of defects in their products.

Root Cause Analysis:

• The first step is to gather data and identify the problem. The data shows that the defects are occurring in a specific area of the production line.
• The team then conducts a brainstorming session to identify possible causes of the problem. They identify that the machine used in that area may be malfunctioning.
• The team then conducts further investigation and finds that the machine is not being maintained properly and is causing the defects.
• The team then develops a plan to fix the machine and improve maintenance procedures to prevent similar issues in the future.
• Example 2: Employee Turnover Problem Statement: A company is experiencing high employee turnover rates.
• The first step is to gather data and identify the problem. The data shows that the highest turnover rates are in a specific department.
• The team then conducts a survey to identify the reasons why employees are leaving. The survey results show that employees are leaving due to lack of growth opportunities and poor management.
• The team then conducts further investigation and finds that the department has not had any promotions or job rotations in the past year, and the manager has received multiple complaints from employees.
• The team then develops a plan to provide growth opportunities for employees and address the management issues to improve employee retention.
• Example 3: Customer Complaints Problem Statement: A company is receiving an increasing number of customer complaints.
• The first step is to gather data and identify the problem. The data shows that the majority of complaints are related to a specific product.
• The team then conducts a survey to identify the reasons for the complaints. The survey results show that customers are experiencing issues with the product’s durability and performance.
• The team then conducts further investigation and finds that the product was recently redesigned to reduce costs, but the changes resulted in lower quality.
• The team then develops a plan to improve the product’s quality and durability to address the customer complaints and prevent similar issues in the future.
• The team also decides to conduct regular quality checks and involve customers in the product development process to ensure their needs are met.

These examples show how root cause analysis can be used to identify the underlying cause of a problem and develop a plan to address it. It involves gathering data, conducting investigations, and using problem-solving techniques to identify the root cause and develop solutions. By addressing the root cause of a problem, organizations can prevent similar issues from occurring in the future.

Guidelines for Effective Root Cause Analysis

Gathering information.

To perform a successful root cause analysis, begin by gathering information about the problem. Collect data from diverse sources, including employees, documents, and other relevant records. Organize this information systematically to gain a clear understanding of the issue at hand. Key steps in gathering information:

• Identify the problem and clarify its scope
• Gather data from relevant sources (e.g., documents, personnel, external experts)
• Organize data systematically for easy analysis

Identifying Possible Causes

After gathering information, work to identify possible causes of the problem. This step requires examining the data closely and using analytical methods, such as brainstorming, fishbone diagrams, and flowcharts.

Consider multiple probable causes for the issue rather than focusing on a single explanation. These potential causes can be refined and ranked by probability and impact later in the analysis process. Some tips for identifying possible causes:

• Use various analytical techniques (brainstorming, fishbone diagrams, flowcharts)
• Consider multiple causes and don’t focus on one explanation
• Keep an open mind and avoid jumping to conclusions

Evaluating Data

Once the possible causes have been identified, the next step is to evaluate the data to pinpoint the root cause of the problem. Assess the impact and probability of each potential cause, then determine the most likely root cause(s).

Investigate the relationships between causes and the problem to understand the underlying mechanisms that need to be addressed. This step may require further data collection or revisiting previously gathered information. Key aspects of evaluating data:

• Assess the impact and probability of each possible cause
• Determine the most likely root cause(s)
• Investigate relationships between causes and problem to understand underlying mechanisms

Benefits of Root Cause Analysis

Continuous improvement.

Root cause analysis (RCA) encourages continuous improvement in your organization by identifying the underlying causes of problems and implementing solutions. When you conduct RCA, you build a foundation for long-term improvement that goes beyond simple fixes.

Preventive Action

Another benefit of root cause analysis is its focus on preventive action. When you identify and address the root causes of problems, you can prevent similar issues from occurring in the future. This proactive approach helps your organization improve its performance and reduce the likelihood of encountering the same issues again. Not only does this save time and effort, but it also fosters a culture of problem-solving and accountability.

Cost Savings

Finally, root cause analysis can lead to significant cost savings for your organization. By identifying and resolving the root causes of problems, you can avoid the expenses associated with repeated failures, downtime, and operational inefficiencies. Moreover, a well-executed RCA provides valuable insights that inform better decision-making and resource allocation. As a result, your organization can operate more efficiently, ultimately cutting costs and improving its bottom line.

See also: Root Cause Analysis (RCA) Methods for Effective Problem Solving

Fishbone Diagram (Components, Factors, Examples)

Ishikawa Diagram: Examples and Applications

What is Poka-Yoke? [Examples, Principles, Methods]

• Root Cause Analysis (RCA) Methods for Effective Problem Solving
• Steering Committee: Complete Guide with Examples & Templates
• 30 Employee Feedback Examples (Positive & Negative)

How to Perform Real Root Cause Analysis & Problem Solve

A root cause is defined as a factor that caused a nonconformance and should be permanently eliminated through process improvement. The root cause is the core issue—the highest-level cause—that sets in motion the entire cause-and-effect reaction that ultimately leads to the problem(s).

Most of the clients we work with cite the ability to problem solve effectively as one of their major issues and skill gaps.

Root cause analysis or problem-solving is defined as a collective term that describes a wide range of approaches, tools, and techniques used to uncover the causes of problems. Some problem-solving approaches are geared more toward identifying true root causes than others, some are more general problem-solving techniques, and others simply offer support for the core activity of root cause analysis.

Finding and developing effective solutions to problems is the best way to ensure that problems, once solved, stay solved. The root-cause tools presented will help people dig beyond the typical initial answers and get to the true cause of a problem.

Join DVIRC’s Director of Continuous Improvement, Alan Shell to learn how to perform true root cause analysis and embed these tools into your everyday processes.

How to Perform Real Root Cause Analysis & Problem Solve Waitlist

Who should attend:.

Continuous Improvement leaders, team members, and department leaders.

Cancellation Policy

Cancellations must be received up to 5 business days prior to program start date. Cancellations must be submitted via email to [email protected].

By using this site you agree to our use of cookies. Please refer to our privacy policy for more information.   Close

7 Powerful Problem-Solving Root Cause Analysis Tools

The first step to solving a problem is to define the problem precisely. It is the heart of problem-solving.

Root cause analysis is the second important element of problem-solving in quality management. The reason is if you don't know what the problem is, you can never solve the exact problem that is hurting the quality.

Manufacturers have a variety of problem-solving tools at hand. However, they need to know when to use which tool in a manner that is appropriate for the situation. In this article, we discuss 7 tools including:

• The Ishikawa Fishbone Diagram (IFD)
• Pareto Chart
• Failure Mode and Effects Analysis (FMEA)
• Scatter Diagram
• Affinity Diagram
• Fault Tree Analysis (FTA)

1. The Ishikawa Fishbone Diagram IFD

The model introduced by Ishikawa (also known as the fishbone diagram) is considered one of the most robust methods for conducting root cause analysis. This model uses the assessment of the 6Ms as a methodology for identifying the true or most probable root cause to determine corrective and preventive actions. The 6Ms include:

• Measurement,
• Mother Nature- i.e., Environment

Related Training: Fishbone Diagramming

2. Pareto Chart

The Pareto Chart is a series of bars whose heights reflect the frequency or impact of problems. On the Chart, bars are arranged in descending order of height from left to right, which means the categories represented by the tall bars on the left are relatively more frequent than those on the right.

Related Training: EFFECTIVE INVESTIGATIONS AND CORRECTIVE ACTIONS (CAPA) Establishing and resolving the root causes of deviations, problems and failures

This model uses the 5 Why by asking why 5 times to find the root cause of the problem. It generally takes five iterations of the questioning process to arrive at the root cause of the problem and that's why this model got its name as 5 Whys. But it is perfectly fine for a facilitator to ask less or more questions depending on the needs.

Related training: Accident/Incident Investigation and Root Cause Analysis

4. Failure Mode and Effects Analysis (FMEA)

FMEA is a technique used to identify process and product problems before they occur. It focuses on how and when a system will fail, not if it will fail. In this model, each failure mode is assessed for:

• Severity (S)
• Occurrence (O)
• Detection (D)

A combination of the three scores produces a risk priority number (RPN). The RPN is then provided a ranking system to prioritize which problem must gain more attention first.

Related Training: Failure Mode Effects Analysis

5. Scatter Diagram

A scatter diagram also known as a scatter plot is a graph in which the values of two variables are plotted along two axes, the pattern of the resulting points revealing any correlation present.

To use scatter plots in root cause analysis, an independent variable or suspected cause is plotted on the x-axis and the dependent variable (the effect) is plotted on the y-axis. If the pattern reflects a clear curve or line, it means they are correlated. If required, more sophisticated correlation analyses can be continued.

Related Training: Excel Charting Basics - Produce Professional-Looking Excel Charts

6. Affinity Diagram

Also known as KJ Diagram, this model is used to represent the structure of big and complex factors that impact a problem or a situation. It divides these factors into small classifications according to their similarity to assist in identifying the major causes of the problem.

7. Fault Tree Analysis (FTA)

The Fault Tree Analysis uses Boolean logic to arrive at the cause of a problem. It begins with a defined problem and works backward to identify what factors contributed to the problem using a graphical representation called the Fault Tree. It takes a top-down approach starting with the problem and evaluating the factors that caused the problem.

Finding the root cause isn't an easy because there is not always one root cause. You may have to repeat your experiment several times to arrive at it to eliminate the encountered problem. Using a scientific approach to solving problem works. So, its important to learn the several problem-solving tools and techniques at your fingertips so you can use the ones appropriate for different situations.

ComplianceOnline Trainings on Root Cause Analysis

P&PC, SPC/6Sigma, Failure Investigation, Root Cause Analysis, PDCA, DMAIC, A3 This webinar will define what are the US FDA's expectation for Production and Process Control / Product Realization, the use of statistical tehniques, 6 sigma, SPC, for establishing, controlling , and verifying the acceptability of process capability and product characteristics, product acceptance or validation and other studies. Non-conformance, OOS, deviations Failure Investigations, and Root Cause Analysis, PDCA, DMAIC, and similar project drivers to improvement, A# and similar dash boards.

Accident/Incident Investigation and Root Cause Analysis If a major workplace injury or illness occurred, what would you do? How would you properly investigate it? What could be done to prevent it from happening again? A properly executed accident/incident investigation drives to the root causes of the workplace accident to prevent a repeat occurrence. A good accident/incident investigation process includes identifying the investigation team, establishing/reviewing written procedures, identifying root causes and tracking of all safety hazards found to completion.

Root Cause Analysis - The Heart of Corrective Action This presentation will explain the importance of root cause analysis and how it fits into an effective corrective and preventive action system. It will cover where else in your quality management system root cause analysis can be used and will give examples of some of the techniques for doing an effective root cause analysis. Attendees will learn how root cause analysis can be used in process control.

Addressing Non-Conformances using Root Cause Analysis (RCA) RCA assumes that systems and events are interrelated. An action in one area triggers an action in another, and another, and so on. By tracing back these actions, you can discover where the issue started and how it grew into the problem you're now facing.

Risk Management Under ISO 14971 ISO 14971:2019 is the definitive standard for risk management for medical devices and IVDs. The standard lays out a comprehensive approach to managing risks in the life sciences. The course will discuss practical approaches to complying with the standard.

Introduction to Root Cause Investigation for CAPA If you have reoccurring problems showing up in your quality systems, your CAPA system is not effective and you have not performed an in-depth root cause analysis to be able to detect through proper problem solving tools and quality data sources, the true root cause of your problem. Unless you can get to the true root cause of a failure, nonconformity, defect or other undesirable situation, your CAPA system will not be successful.

Root Cause Analysis and CAPA Controls for a Compliant Quality System In this CAPA webinar, learn various regulations governing Corrective and Preventive Actions (CAPA) and how organization should collect information, analyze information, identify, investigate product and quality problems, and take appropriate and effective corrective and/or preventive action to prevent their recurrence.

How to Design and Implement a Dynamic Control Plan This webinar training will discuss how to design a dynamic control plan that combines FMEA and the control plan by extending the FMEA to encompass the elements of the control plan and create a living document that helps to drive continual improvement.

An Easy to Implement Integrated Risk Management Approach Compliant with ISO 14971 This integrated risk management training for medical devices will discuss how to incorporate risk management as per ISO 14971 guidelines in all phases of medical device development. It will highlight the documentation needed to support the decisions made as part of the risk management process.

The Use and Mis-use of FMEA in Medical Device Risk Management The presentation will discuss the proper use of FMEA in risk management and how to recognize and avoid the traps associated with this tool in order to have a more efficient risk management process. Most medical device manufacturers use FMEA as a part of their risk management system. Most medical device manufacturers use FMEA as a part of their risk management system.

Root Cause Analysis for CAPA Management (Shutting Down the Alligator Farm) Emphasis will be placed on realizing system interactions and cultural environment that often lies at the root of the problem and prevents true root cause analysis. This webinar will benefit any organization that wants to improve the effectiveness of their CAPA and failure investigation processes.

Root Cause Analysis for Corrective and Preventive Action (CAPA) The Quality Systems Regulation (21 CFR 820) and the Quality Management Standard for Medical Devices (ISO 13485:2003), require medical device companies to establish and maintain procedures for implementing corrective and preventive action (CAPA) as an integral part of the quality system.

Strategies for an Effective Root Cause Analysis and CAPA Program This webinar will provide valuable assistance to all regulated companies, a CAPA program is a requirement across the Medical Device, Diagnostic, Pharmaceutical, and Biologics fields. This session will discuss the importance, requirements, and elements of a root cause-based CAPA program, as well as detailing the most effective ways to determine root cause and describing the uses of CAPA data.

Legal Disclaimer

This piece of content and any of its enclosures, attachments or appendices, references are created to provide solely for information purpose. ComplianceOnline has made all effort to provide accurate information concerning the subject matter covered. This content is created from interpretation, and understanding of relevant and applicable information and it is not all inclusive. It can be best used in conjunction with your professional judgment and discretion.

However, this piece of content and any other ancillary items disseminated in connection with same are not necessarily prepared by a person licensed to practice law in a particular jurisdiction. This piece of content is not a substitute for the advice of an attorney. If you require legal or other expert advice, you should seek the services of a competent attorney or other professional.

ComplianceOnline necessarily is not, cannot and will not be liable for any claims, damages, or regulatory legal proceedings initiated as a consequence of you using whole or any part of the content present in this document. If any action, claim for damages, or regulatory proceedings is commenced against ComplianceOnline as a consequence of your use of this document, then and in that event, you agree to indemnify ComplianceOnline for such claims, and for any attorney's fees expended by ComplianceOnline in connection with defense of same.

Root Cause Analysis – The 5 Whys Technique

This elementary and often effective approach to problem-solving promotes deep thinking through questioning, and can be adapted quickly and applied to most problems. For example, asking “Why?” may be a favorite technique of your three-year-old child in driving you crazy, but it could teach you a valuable problem-solving technique.

“If you don’t ask the right questions, you don’t get the right answers. A question asked in the right way often points to its answer. Asking questions is the ABC of diagnosis. Only the inquiring mind solves problems.” – Edward Hodnett

The “5 Whys” is a simple problem-solving technique that helps you to get to the root of a problem quickly, which was originally developed by Sakichi Toyota. It was used within the Toyota Motor Corporation during the evolution of its manufacturing methodologies. It is a critical component of problem-solving training, delivered as part of the induction into the Toyota Production System.

How to Conduct 5 Whys Analysis?

When you’re looking to solve a problem, start at the result and work backward (toward the root cause), continually asking: “Why?” You’ll need to repeat this over and over until the root cause of the problem becomes apparent.

The 5 Whys strategy involves looking at any problem and asking: “Why?” and “What caused this problem?” Very often, the answer to the first “why” will prompt another “why” and the answer to the second “why” will prompt another and so on; hence the name the 5 Whys strategy.

The 5 Whys exercise is vastly improved when applied by a team and there are five basic steps to conducting it:

• Write down the specific problem. Writing the issue helps you formalize the problem and describe it completely. It also helps a team focus on the same problem.
• Ask “Why” the problem happens and write the answer down below the problem.
• If the answer you just provided doesn’t identify the root cause of the problem that you wrote down in Step 1, ask “Why” again and write that answer down.
• Loopback to step 3 until the team is in agreement that the problem’s root cause is identified. Again, this may take fewer or more times than five Whys.
• After settling on the most probable root cause of the problem and obtaining confirmation of the logic behind the analysis, develop appropriate corrective actions to remove the root cause from the system.

Edit this Diagram

5 Whys Example

The vehicle will not start. (The problem)

• Why? – The battery is dead. (First why)
• Why? – The alternator is not functioning. (Second why)
• Why? – The alternator belt has broken. (Third why)
• Why? – The alternator belt was well beyond its useful service life and not replaced. (Fourth why)
• Why? – The vehicle was not maintained according to the recommended service schedule. (Fifth why, a root cause)

Note: A 5 Whys analysis sometime could be taken further to a sixth, seventh, or higher level, but five iterations of asking why are generally sufficient to get to a root cause.

5-Whys Criticisms

Here are each of the criticisms as listed on the Wikipedia:

• Stopping at symptoms, not the root cause
• Limited by the investigator’s knowledge.
• Not asking the right Why questions.
• Not repeatable – Different people build different 5 Whys.
• The tendency to isolate a single root cause

©2024 by Visual Paradigm. All rights reserved.

• Terms of Service
• Privacy Policy
• Security Overview

• Nimble Work Management

Work Management

Get Started

SwiftKanban

Nimble Retro

Collaborative OKRs

• Project Work Management
• Cloud Migration
• Customer Support
• Professional Services
• Training and Consulting
• Success Stories
• Newsletters
• News & Events

_____________________

Hybrid Agile

Integrations

AKT/ AKC Access

• Marketing Manage Marketing Projects with Ease
• HR Effortless HR Project Management
• Sales Optimize & Manage Sales
• Project/Work Management Create, Manage & Monitor Tasks
• Cloud Migration Effectively Manage you Cloud Migrations
• Success Stories What our Customers say about us
• Learn Comprehensive Guide to Agile, PM & Work Management
• Webinars Product & Thought Leadership Webinars
• Newsletters Nimble Newsletter Archive
• News & Events Latest Happenings at NimbleWork
• Videos Product Overview Videos & Tutorials
• Try Nimble for Free

5 Whys: The Power of Root Cause Analysis in Project Management

• Updated on August 5, 2024

Project management involves navigating complexities and overcoming challenges to ensure project success. Among the various tools available, the 5 Whys technique stands out for its simplicity and effectiveness in root cause analysis. By asking “why” five times, project managers can delve into the underlying causes of problems, fostering a culture of continuous improvement and proactive management.

The 5 Whys technique goes beyond surface-level solutions, encouraging teams to explore beyond the obvious. Each successive “why” peels back layers, revealing hidden connections and insights crucial for sustainable problem-solving. This depth of analysis is often underestimated but essential for effective project management.

Implementing the 5 Whys technique promotes a culture of inquiry and critical thinking within teams. It encourages collaborative problem-solving, as team members work together to understand root causes. This cultural shift, often overlooked, is vital for long-term success. Empowered teams are more engaged and invested in project outcomes.

The benefits of the 5 Whys extend beyond immediate problem resolution. By addressing root causes, project managers prevent future issues, leading to more predictable outcomes and efficient resource use. This proactive approach enhances communication and supports better risk management. The 5 Whys technique aligns with adaptive project management principles, driving meaningful and lasting improvements.

Source: citoolkit.com

1. Understanding the 5 Whys Technique

A. origin and evolution.

The 5 Whys technique traces its origins back to Sakichi Toyoda, the founder of Toyota Industries, and it has been a cornerstone of the Toyota Production System since the 1930s. Initially developed to enhance manufacturing processes, its simplicity and effectiveness soon led to widespread adoption across various industries. The technique has since evolved, finding relevance in areas such as quality control, healthcare, and notably, project management.

B. Core Principles

At its core, the 5 Whys technique is built on the principle of iterative inquiry. By asking “why” multiple times—typically five, but sometimes more or fewer depending on the complexity of the issue—teams can move past surface-level symptoms to uncover the true root cause of a problem. The key principles include:

1. Simplicity: The technique requires no special tools or complex methodologies, making it accessible and easy to implement.

2. Focus: By concentrating on a single issue, the 5 Whys helps teams maintain clarity and avoid getting sidetracked.

3. Collaboration: Engaging the entire team in the inquiry process fosters diverse perspectives and more comprehensive solutions.

4. Documentation: Recording each step of the inquiry ensures that the reasoning behind decisions is transparent and can be revisited if needed.

2. Implementing 5 Whys in Project Management

When to use 5 whys.

The 5 Whys technique is particularly useful in project management for addressing:

1. Recurring Problems: Issues that resurface periodically often indicate an underlying root cause that hasn’t been adequately addressed.

2. Complex Issues: Problems with multiple layers or contributing factors benefit from the structured inquiry that the 5 Whys provide.

3. Team Dynamics: Situations where team alignment and collaboration are crucial for problem resolution.

Step-by-Step Implementation Guide

1. Identify the Problem: Clearly define the issue at hand. Be specific to ensure the inquiry process is focused.

2. Assemble the Team: Include stakeholders and team members who are familiar with the problem and can contribute diverse insights.

3. Ask the First “Why”: Start with the initial problem statement and ask why it is occurring. Record the answer.

4. Ask Subsequent “Whys”: For each answer provided, ask why it is happening. Continue this process until you reach the root cause, typically after five iterations.

5. Develop Solutions: Once the root cause is identified, brainstorm and implement solutions to address it. Ensure the solutions are sustainable and prevent recurrence.

6. Review and Document: Document the process, findings, and implemented solutions. Review the outcomes to ensure the problem has been resolved.

Common Pitfalls and Solutions

1. Superficial Answers: Avoid settling for answers that only address symptoms. Push for deeper understanding.

2. Lack of Collaboration: Ensure all relevant team members are involved to gain a comprehensive view of the problem.

3. Inadequate Documentation: Thoroughly document each step to maintain transparency and facilitate future reviews.

4. Stopping Too Early: Sometimes, more than five iterations are necessary to uncover the true root cause. Be flexible and persistent.

By following these steps, project managers can effectively implement the 5 Whys technique to enhance problem-solving, improve team communication, and drive continuous improvement in their projects.

NimbleRetro – 5Whys

3. Benefits of 5 Whys for Project Managers

Enhanced problem-solving capabilities.

The 5 Whys technique empowers project managers to tackle problems at their core rather than addressing superficial symptoms. This methodical approach ensures comprehensive solutions, minimizing the chances of recurrence. The key benefits include:

1. In-depth Analysis: By delving deeper into issues, project managers can uncover hidden causes that might otherwise be overlooked.

2. Holistic Solutions: Addressing root causes leads to more robust and long-lasting solutions.

3. Prevention of Future Issues: Understanding the root cause helps prevent similar problems from arising in the future.

Improved Team Communication

The collaborative nature of the 5 Whys technique fosters open communication among team members. This enhanced communication translates into better project outcomes:

1. Shared Understanding: Team members gain a collective understanding of issues and their causes.

2. Enhanced Collaboration: Engaging the entire team in problem-solving promotes diverse perspectives and solutions.

3. Increased Transparency: Documenting each step of the inquiry process ensures that all team members are on the same page.

Efficient Resource Allocation

By identifying the root causes of issues, project managers can allocate resources more efficiently:

1. Targeted Interventions: Resources can be directed towards addressing the root cause rather than merely mitigating symptoms.

2. Cost Savings: Preventing issues from recurring reduces the need for repeated resource allocation.

3. Optimized Effort: Teams can focus their efforts on solutions that provide the most significant impact.

Proactive Risk Management

The 5 Whys technique supports proactive risk management by identifying potential problems before they escalate:

1. Early Detection: Uncovering root causes early in the project lifecycle helps prevent larger issues.

2. Risk Mitigation: Addressing root causes reduces the likelihood of risks materializing.

3. Continuous Improvement: The iterative nature of the 5 Whys promotes ongoing risk assessment and management.

4. 5 Whys vs. Other Root Cause Analysis Methods

Comparison of techniques.

Several root cause analysis methods are available, each with its strengths and weaknesses. Comparing these techniques can help project managers choose the most suitable approach:

1. Fishbone Diagram (Ishikawa): Visual tool that helps categorize potential causes but can become complex with numerous factors.

2. Failure Mode and Effects Analysis (FMEA): Systematic approach for identifying and prioritizing potential failure modes, useful for complex projects but time-consuming.

3. Fault Tree Analysis (FTA): Graphical representation of fault paths, effective for technical issues but requires specialized knowledge.

Choosing the Right Method

Selecting the appropriate root cause analysis method depends on various factors:

1. Complexity of the Problem: Simpler issues might benefit from the 5 Whys, while more complex problems may require FMEA or FTA.

2. Available Resources: The 5 Whys technique is resource-efficient, requiring minimal training and tools.

3. Team Expertise: Consider the team’s familiarity with different methods and their ability to implement them effectively.

4. Project Scope: Larger projects with higher stakes might benefit from more detailed analyses like FMEA.

5. Advanced Applications of 5 Whys

Integration with other project management tools.

The 5 Whys technique can be seamlessly integrated with other project management tools to enhance its effectiveness:

1. Kanban Boards: Use the 5 Whys to investigate bottlenecks and improve workflow efficiency.

2. Gantt Charts: Apply the technique to identify and address delays in the project timeline.

3. Risk Registers: Incorporate 5 Whys analysis to uncover the root causes of identified risks and develop mitigation strategies.

The “5 Whys Plus” Approach

Expanding on the traditional 5 Whys technique, the “5 Whys Plus” approach includes additional steps to ensure comprehensive solutions:

1. Validation: Verify that the identified root cause is accurate and that the proposed solutions are effective.

2. Implementation: Develop and execute an action plan to address the root cause.

3. Review: Continuously monitor the implemented solutions to ensure they are working as intended.

Quantitative 5 Whys Analysis

While the 5 Whys technique is typically qualitative, it can be enhanced with quantitative data to provide more robust insights:

1. Data Collection: Gather relevant data to support each “why” and provide evidence for the identified causes.

2. Statistical Analysis: Use statistical methods to analyze the data and validate the root cause.

3. Metrics: Develop metrics to measure the effectiveness of the implemented solutions and track improvements over time.

6. Conclusion: Importance of 5 Whys in Project Management

The 5 Whys technique is a powerful tool for project managers, offering a simple yet effective method for root cause analysis. By fostering a culture of inquiry, enhancing problem-solving capabilities, and promoting continuous improvement, the 5 Whys technique helps project managers navigate challenges, optimize resources, and deliver successful projects consistently. Integrating this technique with other project management tools and methodologies can further amplify its benefits, making it an indispensable part of a project manager’s toolkit.

7. Additional Resources: NimbleWork’s Retrospective Tool for 5 Whys Implementation

To support project managers in implementing the 5 Whys technique, NimbleRetro offers a comprehensive retrospective tool. This tool facilitates the 5 Whys process, enabling teams to document each step, collaborate effectively, and track the outcomes of their root cause analysis efforts. By leveraging Nimble’s retrospective tool, project managers can enhance their problem-solving capabilities and drive continuous improvement in their projects.

Share the Knowledge

Simplifying Project Management!

Explore Nimble! Take a FREE 30 Day Trial

Other popular posts on Nimble!

Overcoming Agile Challenges with Pragmatic Agile

Pragmatic Agile emerges as a nuanced approach that respects the core principles of Agile while addressing its common pitfalls. Agile’s appeal lies in its promise of continuous delivery and adaptability, yet these strengths can also become its weaknesses if not properly managed.

Key Voices in the Pragmatic Agile Movement

“Pragmatists” in the Agile community advocate for adapting Agile principles and practices to the specific context and needs of an organization, rather than adhering strictly to a single methodology. They often emphasize practicality and flexibility, focusing on what works best in real-world situations.

What is Pragmatic Agile? A Succinct Description

Pragmatic Agile is an approach to Agile that emphasizes practical, flexible, and context-specific application of Agile principles.

How to Crack the Code of Integrating Project Management with Existing Business Tools?

Have you ever felt like your organization has untapped potential, hidden behind a maze of disconnected software systems and siloed data? The secret to unlocking this

We are on a Mission to # HumanizeWork

Join 150,000+ Pioneers, Leaders & Mavericks receiving our updates!

• Stay ahead with the latest trends on Project and Work Management
• Be notified about Thought Leader Webinars & Talks
• Get to know about our Product Updates

Subscribe To Our Newsletter

• No translations available for this page

See Nimble Agile in Action!

• Get your questions answered by our product experts
• Explore real-world case studies of successful Nimble implementations
• Discover how Nimble can be tailored to your specific needs

Information

• Author Services

Initiatives

You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader.

All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess .

Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications.

Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers.

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Original Submission Date Received: .

• Active Journals
• Find a Journal
• Proceedings Series
• For Authors
• For Reviewers
• For Editors
• For Librarians
• For Publishers
• For Societies
• For Conference Organizers
• Open Access Policy
• Institutional Open Access Program
• Special Issues Guidelines
• Editorial Process
• Research and Publication Ethics
• Article Processing Charges
• Testimonials
• Preprints.org
• SciProfiles
• Encyclopedia

Article Menu

• Subscribe SciFeed
• Recommended Articles
• Author Biographies
• Google Scholar
• on Google Scholar
• Table of Contents

Find support for a specific problem in the support section of our website.

Please let us know what you think of our products and services.

Visit our dedicated information section to learn more about MDPI.

JSmol Viewer

A diagnostic case study for manufacturing gas-phase chemical sensors.

1. Introduction

2. materials and methods, 2.1. system overview of the device, 2.2. case presentation—device components, 2.2.1. performance of the gas chromatography columns, 2.2.2. proportional valves, 2.2.3. sorbent trap, 2.2.4. heated transfer lines, 2.2.5. flow sensors, 2.2.6. pressure regulator, 2.2.7. ionization source, 2.2.8. differential mobility spectrometer, 3.1. device failure modes, 3.1.1. failure mode a: gain resistor, 3.1.2. failure mode b: sorbent trap, 3.1.3. failure mode c: feedback controlled system failure resulting from the inherent inaccuracies of flow sensors and the hysteresis of the proportional control valve, 3.1.4. failure mode d: leaks, 3.1.5. failure mode e: dms chip failure, 3.2. management and outcome, 4. discussion, 4.1. symptom: low signal, 4.2. symptom: elution time shifts, 4.3. symptom: loss of signal, 4.4. symptom: peak shape/width variation, 5. conclusions, supplementary materials, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.

• Fabianowski, W.; Maziejuk, M.; Szyposzyńska, M.; Wiśnik-Sawka, M. Detection and identification of vocs using differential ion mobility spectrometry (Dms). Molecules 2021 , 27 , 234. [ Google Scholar ] [ CrossRef ]
• Frausto-Vicencio, I.; Moreno, A.; Goldsmith, H.; Hsu, Y.-K.; Hopkins, F.M. Characterizing the performance of a compact btex gc-pid for near-real time analysis and field deployment. Sensors 2021 , 21 , 2095. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Guntner, A.T.; Abegg, S.; Konigstein, K.; Gerber, P.A.; Schmidt-Trucksass, A.; Pratsinis, S.E. Breath sensors for health monitoring. ACS Sens. 2019 , 4 , 268–280. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Camara, M.; Gharbi, N.; Lenouvel, A.; Behr, M.; Guignard, C.; Orlewski, P.; Evers, D. Detection and quantification of natural contaminants of wine by gas chromatography–differential ion mobility spectrometry (GC-DMS). J. Agric. Food Chem. 2013 , 61 , 1036–1043. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Buryakov, I.; Krylov, E.; Nazarov, E.; Rasulev, U.K. A new method of separation of multi-atomic ions by mobility at atmospheric pressure using a high-frequency amplitude-asymmetric strong electric field. Int. J. Mass Spectrom. Ion Process. 1993 , 128 , 143–148. [ Google Scholar ] [ CrossRef ]
• Bílek, J.; Maršolek, P.; Bílek, O.; Buček, P. Field test of mini photoionization detector-based sensors—Monitoring of volatile organic pollutants in ambient air. Environments 2022 , 9 , 49. [ Google Scholar ] [ CrossRef ]
• Huang, X.; Yang, S.; Li, W.; Nidetz, R.; Sharma, R.; Sivakumar, A.D.; Thota, C.; Zhu, H.; Wu, W.; Jeong, S.-Y. Microfluidic integration of μPID on μcolumn for ultracompact micro-gas chromatography. Sens. Actuators B Chem. 2024 , 410 , 135717. [ Google Scholar ] [ CrossRef ]
• Agbroko, S.O.; Covington, J. A novel, low-cost, portable PID sensor for the detection of volatile organic compounds. Sens. Actuators B Chem. 2018 , 275 , 10–15. [ Google Scholar ] [ CrossRef ]
• Tereshkov, M.; Dontsova, T.; Saruhan, B.; Krüger, S. Metal Oxide-Based Sensors for Ecological Monitoring: Progress and Perspectives. Chemosensors 2024 , 12 , 42. [ Google Scholar ] [ CrossRef ]
• Li, Y.; Zhang, B.; Li, J.; Duan, Z.; Yang, Y.; Yuan, Z.; Jiang, Y.; Tai, H. Pd-decorated ZnO hexagonal microdiscs for NH 3 sensor. Chemosensors 2024 , 12 , 43. [ Google Scholar ] [ CrossRef ]
• Zhang, Y.; Jiang, P.; Cao, W.; Li, X.; Lai, J. High-sensitivity ethylene gas sensor based on NDIR and dual-channel lock-in amplifier. Optik 2020 , 223 , 165630. [ Google Scholar ] [ CrossRef ]
• Xu, M.; Peng, B.; Zhu, X.; Guo, Y. Multi-gas detection system based on non-dispersive infrared (NDIR) spectral technology. Sensors 2022 , 22 , 836. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Fung, S.; Contreras, R.P.; Fung, A.G.; Gibson, P.; LeVasseur, M.K.; McCartney, M.M.; Koch, D.T.; Chakraborty, P.; Chew, B.S.; Rajapakse, M.Y. Portable chemical detection platform for on-site monitoring of odorant levels in natural gas. J. Chromatogr. A 2023 , 1705 , 464151. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Yeap, D.; Hichwa, P.T.; Rajapakse, M.Y.; Peirano, D.J.; McCartney, M.M.; Kenyon, N.J.; Davis, C.E. Machine vision methods, natural language processing, and machine learning algorithms for automated dispersion plot analysis and chemical identification from complex mixtures. Anal. Chem. 2019 , 91 , 10509–10517. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Peirano, D.J.; Pasamontes, A.; Davis, C.E. Supervised semi-automated data analysis software for gas chromatography/differential mobility spectrometry (GC/DMS) metabolomics applications. Int. J. Ion Mobil. Spectrom. 2016 , 19 , 155–166. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Chakraborty, P.; Rajapakse, M.Y.; McCartney, M.M.; Kenyon, N.J.; Davis, C.E. Machine learning and signal processing assisted differential mobility spectrometry (DMS) data analysis for chemical identification. Anal. Methods 2022 , 14 , 3315–3322. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Chromatotech. energyMEDOR. Available online: https://chromatotec.com/solutions/auto-gc-866-analyzers-range/sulfur-compounds/energymedor/ (accessed on 23 July 2024).
• Miller, R.A.; Nazarov, E.G.; Eiceman, G.A.; King, A.T. A MEMS radio-frequency ion mobility spectrometer for chemical vapor detection. Sens. Actuators A Phys. 2001 , 91 , 301–312. [ Google Scholar ] [ CrossRef ]
• Moretti, P.; Vezzani, S.; Garrone, E.; Castello, G. Evaluation and prediction of the shape of gas chromatographic peaks. J. Chromatogr. A 2004 , 1038 , 171–181. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Gough, D.V.; Bahaghighat, H.D.; Synovec, R.E. Column selection approach to achieve a high peak capacity in comprehensive three-dimensional gas chromatography. Talanta 2019 , 195 , 822–829. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Wilson, R.B.; Siegler, W.C.; Hoggard, J.C.; Fitz, B.D.; Nadeau, J.S.; Synovec, R.E. Achieving high peak capacity production for gas chromatography and comprehensive two-dimensional gas chromatography by minimizing off-column peak broadening. J. Chromatogr. A 2011 , 1218 , 3130–3139. [ Google Scholar ] [ CrossRef ] [ PubMed ]

Click here to enlarge figure

Share and Cite

Contreras, R.P.; Koch, D.T.; Gibson, P.; McCartney, M.M.; Chew, B.S.; Chakraborty, P.; Chevy, D.A.; Honeycutt, R.; Haun, J.; Griffin, T.; et al. A Diagnostic Case Study for Manufacturing Gas-Phase Chemical Sensors. Chemosensors 2024 , 12 , 155. https://doi.org/10.3390/chemosensors12080155

Contreras RP, Koch DT, Gibson P, McCartney MM, Chew BS, Chakraborty P, Chevy DA, Honeycutt R, Haun J, Griffin T, et al. A Diagnostic Case Study for Manufacturing Gas-Phase Chemical Sensors. Chemosensors . 2024; 12(8):155. https://doi.org/10.3390/chemosensors12080155

Contreras, Raquel Pimentel, Dylan T. Koch, Patrick Gibson, Mitchell M. McCartney, Bradley S. Chew, Pranay Chakraborty, Daniel A. Chevy, Reid Honeycutt, Joseph Haun, Thomas Griffin, and et al. 2024. "A Diagnostic Case Study for Manufacturing Gas-Phase Chemical Sensors" Chemosensors 12, no. 8: 155. https://doi.org/10.3390/chemosensors12080155

Article Metrics

Article access statistics, supplementary material.

ZIP-Document (ZIP, 317 KiB)

Further Information

Mdpi initiatives, follow mdpi.

Subscribe to receive issue release notifications and newsletters from MDPI journals