Root-Cause Analysis

Root-Cause Analysis

When you complain to your doctor that you have a sore throat, a fever, and a bad cough, you might be told to take medications for each of these symptoms. But the root cause is a virus. Medicines can't solve the problem. Your immune system has to hunt down and destroy the virus.

In the same way, many businesses treat symptoms of a problem rather than discovering the root cause. Imagine that your company is plagued with late shipments, incorrect address labels, and high turnover in the warehouse. These are symptoms of a problem with how shipments are handled. Instead of fixing each problem individually, you can find the root of all of them—perhaps outdated shipping software, mismanagement, or inadequate training. Eliminating the root cause fixes all of those chronic symptoms.

Root-Cause Analysis

Root-cause analysis is usually performed by a team that is investigating a complex negative event or a set of smaller, related problems. The team systematically searches for the causes of each problem, asking questions like the following:

  • What exactly is the problem? (Define its nature.)

  • How big is it? (Measure its magnitude.)

  • Where does it happen? (Pinpoint its location.)

  • When does it happen? (Track its timing.)

The following root-cause analysis studies the chronic problem of false intruder alarms in a workplace.

Root-Cause Analysis (Google Doc)

Problem: False Alarms at the Downtown Office

Date and Time Mechanical Causes Human Causes What Should Have Happened
at 01:33
Alarm triggered Employee returning from a concert stopped to pick up purse and forgot about alarm. No employee should access the office between 20:00 and 06:00.
at 14:26
Battery died in office detector, setting off alarm. The battery was not replaced on time. Maintenance should have replaced batteries in January.
at 06:07
Alarm triggered Employee seeking entry entered old alarm code. Any employee seeking entry should be well trained on alarm use.
at 01:39
Alarm triggered Employee seeking entry bungled alarm procedure. No employee should access the office between 20:00 and 06:00.
at 21:22
Alarm triggered Employee returned to office to make call and forgot code. No employee should access the office between 20:00 and 06:00.

Clearly, the root cause of most false alarms at this office is employee error. The errors usually occur during off hours, when employees unfamiliar with operating the alarm seek entry and use the wrong code, forget the code, or botch the procedure. You can eliminate the root cause by creating an official policy forbidding employee access during off hours, by designating specific employees to be "openers" and "closers," or by thoroughly training all employees in use of the alarm.

Performing a Root-Cause Analysis

Download a Root-Cause Analysis Sheet and fill it out.

  • At the top, write the problem that you want to investigate.

  • In the left-hand column, list dates and times when the problem has occurred.

  • In the middle columns, indicate any mechanical and human causes of the problem.

  • In the right-hand column, write down what should have happened instead.

  • Review your analysis, looking for causes that recur for multiple events.

  • Target a root cause and come up with a way to eliminate it, solving the chronic problem.

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