Here is a root cause technique written many years ago. The key is to
ask why? why? why?
Technique: Root Cause Analysis
A technique used to identify the conditions that initiate the occurrence
of an undesired activity or state. Once the root causes are identified,
steps to eliminate them can be determined. The result of this technique
can be summarized using fishbone diagrams. The key to applying the
technique in Enterprise Engineering projects is to take problems expressed
by the customers (not perceived problems) and determine if the statement
sounds like an effect, a problem, or a cause. Remedies should be aimed at
the root causes and not the problems nor the effects.
Root Cause Analysis will provide the identification of all true causes,
not symptoms and an illustration of the interplay between causes/chain of
related causes.
Applications:
To display characteristics of a given situation or problem.
To brainstorm or identify potential causes, areas for further
investigation, and/or solutions.
To depict what needs to be in place to enable a given outcome or result
(see Ishikawa Diagramming, positive Ishikawa).
To help cross-functional organizational units understand interaction
relationships.
Procedures:
1. Review all candidate problems.
2. Remove duplications.
3. Reprint problems.
4. Review each item in the consolidated problem list and ask: "...is
this a cause or does this sound like an effect?...", then continue to
explore the chain of causes by asking: "why...why...why?..." to separate
out problems from symptoms.
5. Exhaust the list of possibilities to discover additional causes and
effects.
6. Circle or highlight the most probable causes being careful not to
include symptoms.
7. Discuss and prioritize for analysis/solution generation.
8. Validate against team mates, raw notes, gut hunches, and other
information collected and available to the team.
Cross References:
Determine Customer Satisfiers
Analyze Process
Instructions:
To start the Root Cause Analysis review all candidate problems from the
consolidated lists obtained during the interview process. Remove
duplication and combine like problem statements to synthesize the list
into a manageable size. (Assign original problem numbers for tracking.)
Reprint the problem statements, cut them into individual strips and tape
to a flip chart or board for review. Construct an overall problem, main
effect or customer satisfier statement.
Review each item in the consolidated problem list using brainstorming and
facilitation and ask: "...is this a cause or does this sound like an
effect? Focusing on causes, trace the chain of causes by asking the
questions "why, why, why..." until a root set of causes are determined.
Insure that causes are separated from their effects and that problems are
separated from symptoms. A helpful way of determining if something is a
cause or effect is to say the phrase, "CAUSE 1, therefore, PROBLEM
STATEMENT, therefore, EFFECT". If that phrase makes sense then you are on
the right track. Or, ask "How Come?" which will lead to a root cause, and
"So What?" which will lead to the effect of the problem.
There are three types of graphic representations that can be used to
display the results of a Root Cause Analysis. The Cause and Effect
Diagram is shown in Figure 1 below. (An alternative cause effect
representation is the mind map.) A more popular diagramming technique is
the Ishikawa diagram shown in Figure 2 (see Ishikawa Diagramming).
Reference:
1. Kazuo Ozeki. Tetsuichi Asaka, Handbook of Quality Tools, The Japanese
Approach. Productivity Press, 1990.
I hope this helps this dialog.
Cheers
Bill Hobler
[Host's Note: There is no figure included. Thanks, Bill, for posting this.
...Rick]
--"William J. Hobler, Jr" <bhobler@worldnet.att.net>
Learning-org -- Hosted by Rick Karash <rkarash@karash.com> Public Dialog on Learning Organizations -- <http://www.learning-org.com>