Root Cause Analysis

Essentially, this method of analysis takes you to the core of the problem. It is not a specifically defined methodology and, thus, can be accomplished in a number of ways including the following popular but simple technique of using "The Five Whys." This method of determining the root cause of a problem was originally developed by Sakichi Toyoda and was later incorporated into the manufacturing process in the Toyota Motor Corporation. The following example demonstrates the Five Whys in action to help solve a simple issue.

Problem: Our chest pain patients are being walked from triage to the ED.

• WHY? - We can't find a wheelchair.
• WHY? - They are never put back after use.
• WHY? - Staff hide the wheelchairs so they are available when their patients need transported.
• WHY? - There are never enough wheelchairs.
• WHY? - The current supply of wheelchairs has deteriorated and was taken out of service.

Solution: Budget for more wheelchairs

By drilling down five times, it is likely you may find a simple solution to a common problem by determining the root cause of the problem.

Other types of Root Cause Analysis include the FMEA (Failure Mode and Effects Analysis) and the Ishikawi, or Fishbone Diagram. FMEA is a powerful analytical tool that allows examination of steps within a process to anticipate what may go wrong so that preventive measures can be taken prior to the unwanted occurrence. The Ishikawi, or "Fishbone" Diagram, looks at a current process, and isolates the steps within the process, helping to look for methods of improvement.