Fishbone analysis
1 like1,697 views
The document explains the 5 Whys method for root cause analysis, which helps identify underlying causes of problems by repeatedly asking 'why' until the root cause is determined. It emphasizes the importance of collaborating with knowledgeable team members and using structured approaches like the PDCA cycle and Pareto analysis to prioritize and address issues effectively. The 5 Whys method, along with other analytical tools, is presented as essential for improving processes and making informed decisions to prevent future problems.
Fishbone analysis
- 1. Fish Bone Analysis MPA 208 Planning Workshop
- 3. Definition of 5 Whys Invented in the 1930’s by Toyota Founder Kiichiro Toyoda’s father Sakichi and made popular in the 1970s by the Toyota Production System, the 5 Whys strategy involves looking at any problem and asking: “Why?” and “What caused this problem?”
- 4. Understanding how to use the 5-Whys for Root Cause Analysis. The 5-Why method of root cause analysis requires you to question how the sequential causes of a failure event arose and identify the cause-effect failure path. ‘Why’ is asked to find each preceding trigger until we supposedly arrive at the root cause of the incident. Unfortunately it is easy to arrive at the wrong conclusion. A Why question can be answered with multiple answers, and unless there is evidence that indicates which answer is right, you will most likely have the wrong failure path. You can improve your odds of using the 5-Why method correctly if you adopt some simple rules and practices
- 5. The idea is simple. By asking the question "Why" you can separate the symptoms from the causes of a problem. This is critical as symptoms often mask the causes of problems. As with effective incident classification, basing actions on symptoms is worst possible practice. Using the technique effectively will define the root cause of any non-conformances and subsequently lead you to defining effective long term corrective actions. http://www.imsworld.org accessed Feb 14, 2014
- 6. 1. Assemble a team of people knowledgeable about the area of non- conformance. Include as many personnel as possible. 2. On a flip chart, presentation board, or even paper; write out a description of what you know about the problem. Try to document the Problem and describe it as completely as possible. Refine the definition with the team. Come to an agreement on the definition of the Problem at hand. 3. Have the team members ask “Why” the Problem as described could occur, and write the answer down underneath the Problem description. 4. If the answer provided from 3 (above) does not solve the Problem, you must repeat steps 3 and 4 until you do. 5. If the answer provided from 3 (above) seems likely to solve the Problem, make sure the team agrees and attempt a resolution using the answer. You may find that there are more than one root causes to the problem How to Use the 5 Whys ?
- 7. Non-Conformance Components are being delivered late to our customers. • Why 1 Why were we unable to meet the agreed-upon timeline or schedule for delivery? The job took much longer than we thought it would. • Why 2 Why did it take so much longer? Because we under estimated the complexity of the job.
- 8. • Why 3 Why did we underestimate the complexity of the job? Because we made a quick estimate of the time needed to complete it, and did not list the individual stages needed to complete the project. • Why 4 Why didn't we do this? Because we were running behind on other projects. • Why 5 and Root Cause Why are we running behind on other projects? We do not allow enough manufacturing/lead time when
- 11. Root Cause Analysis Root cause analysis is a combination of the art and science used to find the underlying reasons for a given effect. One of the most widely used root cause analysis tools is the 5 Whys. It is a simple, effective method of problem solving that can help teams identify and eliminate the root cause of a problem.
- 12. is an approach for identifying the underlying causes of why an incident occurred so that the most effective solutions can be identified and implemented. It's typically used when something goes badly, but can also be used when something goes well. Within an organization, problem solving, incident investigation and root cause analysis are all fundamentally connected by three basic questions: What's the problem? Why did it happen? and What will be done to prevent it
- 13. A Root Cause Analysis (RCA) is a process for identifying the basic or causal factors that underlie variations in outcomes. An RCA typically allows you to identify the “root” of the problem in a process, including how, where, and why a problem, adverse event, or trend exists. This analysis should focus on a process that has potential for redesign to reduce risk. The RCA is also a way of looking at unexpected events and outcomes to determine all of the underlying causes of the event and identify recommended changes that are likely to improve them. Through an RCA, you can make decisions and look for sustainable solutions based on data and facts. Remember that active failures are rarely root causes; rather, latent conditions over which we have control are often the root cause of a problem. An RCA focuses primarily on systems and processes, not individual performance.
- 14. • Determine the primary cause(s) and contributing factors. An RCA is generally broken down into the following steps: • Collect data • Analyze data • Develop and evaluate corrective actions, using PDSA cycle • Implement successful corrective actions
- 15. Plan-Do-Study-Act Cycle W Edwards Deming is most famous for Deming PDCA Cycle, otherwise known as the Shewhart cycle, or the Deming Wheel's “Plan-Do-Check- Act” (modified to “Plan-Do-Study-Act”). The PDSA cycle is a basic and scientific method for improvement. Once a team has mapped a process, set a goal, developed measures and a data collection plan and selected changes, the next step is to test those small changes using the PDSA cycle. It's a quick way to improve work processes that allows teams to rapidly test a change on a small scale. Risk taking is encouraged and failures are OK because the team learns from them. The PDSA cycle brings data, learning, and action together into one process. It should be noted that improvement often requires multiple PDSA cycles.
- 19. Paretho Using the 80:20 Rule to Prioritize Imagine that you've just stepped into a new role as head of department. Unsurprisingly, you've inherited a whole host of problems that need your attention. Ideally, you want to focus your attention on fixing the most important problems. But how do you decide which problems you need to deal with first? And are some problems caused by the same underlying issue? Pareto Analysis is a simple technique for prioritizing possible changes by identifying the problems that will be resolved by making these changes. By using this approach, you can prioritize the individual changes that will most improve the situation.
- 20. Pareto Analysis uses the Pareto Principle – also known as the "80/20 Rule" – which is the idea that 20% of causes generate 80% of results. With this tool, we're trying to find the 20% of work that will generate 80% of the results that doing all of the work would deliver. Note: The figures 80 and 20 are illustrative – the Pareto Principle illustrates the lack of symmetry that often appears between work put in and results achieved. For example, 13% of work could generate 87% of returns. Or 70% of problems could be resolved by dealing with 30% of the causes.
- 21. How to Use the Tool Step 1: Identify and List Problems – First, write a list of all of the problems that you need to resolve. Where possible, talk to clients and team members to get their input, and draw on surveys, helpdesk logs and suchlike, where these are available. Step 2: Identify the Root Cause of Each Problem – For each problem, identify its fundamental cause. (Techniques such as Brainstorming, the 5 Whys, Cause and Effect Analysis, and Root Cause Analysis will help with this.) Step 3: Score Problems – Now you need to score each problem. The scoring method you use depends on the sort of problem you're trying to solve. For example, if you're trying to improve profits, you might score problems on the basis of how much they are costing you. Alternatively, if you're trying to improve customer satisfaction, you might score them on the basis of the number of complaints eliminated by solving the problem.
- 22. Step 4: Group Problems Together By Root Cause – Next, group problems together by cause. For example, if three of your problems are caused by lack of staff, put these in the same group Step 5: Add up the Scores for Each Group – You can now add up the scores for each cause group. The group with the top score is your highest priority, and the group with the lowest score is your lowest priority. Step 6: Take Action – Now you need to deal with the causes of your problems, dealing with your top-priority problem or group of problems first. Keep in mind that low scoring problems may not be worth bothering with; solving these problems may cost you more than the solutions are worth. Note: While this approach is great for identifying the most important root cause to deal with, it doesn't take into account the cost of doing so. Where costs are significant, you'll need to use techniques such as Cost/Benefit Analysis, and use IRRs and NPVs to determine which changes you should implement