Root Cause Analysis

Start with a good problem statement!

One of the most difficult parts of the quality improvement process is the beginning – the problem statement. Getting a good problem statement is the key to root cause analysis and quality improvement. A bad problem statement can undermine any subsequent attempts to use the QI process.

A good problem statement describes in specific, concrete terms what the data has revealed. It describes the present undesirable situation while avoiding “hidden” solutions.

Criteria for a good problem statement

It states the effect. It states what, is wrong, not why, it is wrong. Avoid “lack of” statements. These always imply solutions.
It focuses on the gap between what is and what should be. The gap may be a change or deviation from the norm, standard or the customer’s expectation.
It is measurable. It says how often, how much, when,
It is stated in a positive manner. Do not state problems as questions. This may tend to imply that the answer to the question is the solution.
It focuses on the pain. The problem statement highlights how people are affected, the areas of discomfort, hurt or annoyance

Samples of problem statements

1. Simple, basic statements
“My car won’t start.”  “My bank statement doesn’t reconcile.”

2. Who, What When and Where statements
“Each page contains an average of 6 spelling errors.”  “The equipment overheats when it runs for 2 hours”  “The finance department missed its billing schedule 9 times in May.”  “This customer has been invoiced incorrectly for 3 months.”

All these statements are the effect of some problem. They focus on the gap between what is happening and what should be happening, have no implied solutions, focus on “the pain”, and are measurable.