Root Cause Analysis, Second Edition: The Core of Problem Solving and Corrective Action

This best-seller can help anyone whose role is to try to find specific causes for failures. It provides detailed steps for solving problems, focusing more heavily on the analytical process involved in finding the actual causes of problems. It does this using figures, diagrams, and tools useful for helping to make our thinking visible. This increases our ability to see what is truly significant and to better identify errors in our thinking. In the sections on finding root causes, this second edition now includes: more examples on the use of multi-vari charts; how thought experiments can help guide data interpretation; how to enhance the value of the data collection process; cautions for analyzing data; and what to do if one can't find the causes. In its guidance on solution identification, biomimicry and TRIZ have been added as potential solution identification techniques. In addition, the appendices have been revised to include: an expanded breakdown of the 7 M's, which includes more than 50 specific possible causes; forms for tracking causes and solutions, which can help maintain alignment of actions; techniques for how to enhance the interview process; and example responses to problem situations that the reader can analyze for appropriateness. Title page CIP data Contents List of Figures and Tables Preface to the Second Edition Preface to the First Edition Chapter 1_Getting Better Root Cause Analysis The Problem The Impact Approaches to Root Cause Analysis Existing Problem-Solving Models A Proposed Model Chapter 2_Multiple Causes and Types of Action Initial Problem Response The Diagnosis Actions to Prevent Future Problems The Need for Filters Chapter 3_Step 1: Define the Problem Selecting the Right Problem Scoping the Problem Appropriately The Problem Statement Chapter 4_Step 2: Understand the Process Setting Process BoundariesFlowcharting the Process Why Process is So Important Additional Values of the Flowchart Chapter 5_Step 3: Identify Possible Causes Using the Flowchart for Causes Using a Logic Tree for Causes Using Brainstorming and the Cause-and-Effect Diagram for Causes Using Barrier Analysis for Causes Using Change Analysis for Causes Eliminating Possible Causes Sources for Possible Causes Chapter 6_Step 4: Collect the Data A Basic Concept Types of Data Using Existing Versus New Data Where to Collect Data Special Tests Sample Size and Time Frame Data Collection Tools for Both Low- and High-Frequency ProblemsAdditional Tools for High-Frequency Problems Enhancing Data Collection Value Organizing the Data Collection Process Chapter 7_Step 5: Analyze the Data Tools for Low-Frequency Data Additional Tools for High-Frequency Data Questioning the Data Data Analyses Summaries Analyzing Variation Cautions on Data Analysis Where to Go Next? Can't Find the Cause? Chapter 8_Identify and Select Solutions Step 6: Identify Possible Solutions Step 7: Select Solution(s) to Be Implemented Chapter 9_Implement, Evaluate, and InstitutionalizeStep 8: Implement the Solution(s) Step 9: Evaluate the Effect(s) Step 10: Institutionalize the Change Chapter 10_Organizational Issues Cognitive Biases Emotional Barriers Resistance to Change Organizational Culture Project Ownership Coaching/Facilitation Skills Other Issues Chapter 11_Human Error and Incident Analysis Human Error Incident Analysis Chapter 12_Improving Corrective Action Critical Thinking Buddhism Stoic Philosophy Summary of Root Cause Analysis Appendix A_Example Projects A Need for Focus How Would They Know?How Proficient is That? Getting the Shaft Back Got it in the Bag! Appendix B_Root Cause Analysis Process Guides Generic Process Thinking SIPOC Analysis Form Data Collection and Analysis Tools Do It2 Root Cause Analysis Guide Do It2 Problem-Solving Worksheet Checklist for Reviewing the Corrective Action Process Expanded List of Seven Ms Forms for Tracking Causes and Solutions Appendix C_Enhancing the Interview Basic Interview Problems and Process Types of Interviews and Questions Leveraging How Memory Works The Importance of Time and Reflection