Have you attended ESC's safety certification series? Have you ever wondered what's next?
• A structured form of problem solving
• Generally used after an undesired event has occurred
• Used to understand and control causes, and to prevent recurrence of the problem
Common RCA Techniques:
• 5 Why’s: a linear form of problem solving. The premise is that by asking why five times, the analyst will end up at the “root cause”. Why it’s ineffective: problems are non-liner, multiple things are happening at the same point in time and space. 5-Why’s is too simplistic to capture the whole picture. A good place to start to brainstorm a few causes, but not thorough enough to create a full understanding of the problem.
• Fishbone/Ishikawa Diagram: sometimes referred to as “cause & effect” diagrams, the Fishbone is a brainstorming tool where users try to come up with causes around a set of categories, usually Methods, Material, Manpower and Machinery or something similar. It too is a good tool to start brainstorming. Why it’s ineffective: does not show how causes relate to one another. You have no way of knowing which causes would be affected by certain solutions. Provides no framework to dig deeper into cause paths or even know where/when to stop. Teams vote on the “root cause”.
Apollo Root Cause Analysis:
• Based on true cause and effect logic. Consists of four simple steps: 1) Define the Problem, 2) Create the Cause & Effect chart, 3) Identify Solutions, and 4) Implement the Best Solutions. Start from the defined problem and look back in time, accounting for how causes relate to each other. All causes are backed by evidence and followed through to logical stopping points.
Benefits of Apollo RCA:
• Prevents analyses from stopping too soon
• Removes the “singular root cause” mentality by focusing on controlling numerous causes. This approach more greatly reduces the risk of the problem recurring.
• Highly marketable skill
• Provides quick return on training investment (ROI) – most students can more than pay for their entire on-site class of 25 students (~$12k) with the $ they save the company on their first RCA after class
• Comes with powerful software (RealityCharting) that helps students create better analyses and enables them to easily share results.
• Useful in any industry or discipline (safety, quality, IT, reliability etc.)
• Instructors also lead high-profile investigations in the field – bring these learnings into the classroom.
Root Cause Analysis for Practitioners
October 11-12, 2011
At the Evergreen Safety Training Center in Seattle