APPROACHES TO ROOT CAUSE ANALYSIS

APPROACHES TO ROOT CAUSE ANALYSIS

There are many methodologies, approaches, and techniques for conducting root cause analysis, including:

1. Events and causal factor analysis: Widely used for major, single-event problems, such as a refinery explosion, this process uses evidence gathered quickly and methodically to establish a timeline for the activities leading up to the accident. Once the timeline has been established, the causal and contributing factors can be identified.
2. Change analysis: This approach is applicable to situations where a system’s performance has shifted significantly. It explores changes made in people, equipment, information, and more that may have contributed to the change in performance.
3. Barrier analysis: This technique focuses on what controls are in place in the process to either prevent or detect a problem, and which might have failed.
4. Management oversight and risk tree analysis: One aspect of this approach is the use of a tree diagram to look at what occurred and why it might have occurred.
5. Kepner-Tregoe Problem Solving and Decision Making: This model provides four distinct phases for resolving problems:
   1. Situation analysis
   2. Problem analysis
   3. Solution analysis
   4. Potential problem analysis

Root Cause Analysis Diagram

CONDUCTING ROOT CAUSE ANALYSIS

When carrying out root cause analysis methods and processes, it’s important to note:

• While many root cause analysis tools can be used by a single person, the outcome generally is better when a group of people work together to find the problem causes.
• Those ultimately responsible for removing the identified root cause(s) should be prominent members of the analysis team that sets out to uncover them.

A typical design of a root cause analysis in an organization might follow these steps:

1. A decision is made to form a small team to conduct the root cause analysis.
2. Team members are selected from the business process/area of the organization that experiences the problem. The team might be supplemented by:
   • A line manager with decision authority to implement solutions
   • An internal customer from the process with problems
   • A quality improvement expert in the case where the other team members have little experience with this kind of work
3. The analysis lasts about two months. During the analysis, equal emphasis is placed on defining and understanding the problem, brainstorming its possible causes, analyzing causes and effects, and devising a solution to the problem.
4. During the analysis period, the team meets at least weekly, sometimes two or three times a week. The meetings are always kept short, at maximum two hours, and since they are meant to be creative in nature, the agenda is quite loose.
5. One person in the team is assigned the role of making sure the analysis progresses, or tasks are assigned to various members of the team.
6. Once the solution has been designed and the decision to implement has been taken, it can take anywhere from a day to several months before the change is complete, depending on what is involved in the implementation process.