QI Tools Root Cause Analysis - Iowa Department of Public Health

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• Why use a fishbone diagram?◦ To allow a team to identify, explore, andgraphically display – increasing detail – all ofthe possible causes related to a problem orcondition to discover its root cause(s).• What does it do?◦ Enable a team to focus on the content of theproblem versus the history of the problem orpersonal interests of the team.◦ Creates a snapshot of the collective knowledgeand consensus of a team around a problem◦ Focuses the team on causes, not symptoms.Fishbone Diagram
Fishbone Diagram
Page 1 and 2: QI ToolsRoot Cause AnalysisShaela M
Page 3 and 4: • Addressing the symptom instead
Page 5: • Fishbone Diagram• Cause and E
Page 9 and 10: Fishbone - Problem Statement
Page 11 and 12: Fishbone - Major Causes
Page 13 and 14: Fishbone - Sub-Causes
Page 15 and 16: Fishbone - Detailing 5 Why’s
Page 17 and 18: • The 5 Why’s may not lead to a
Page 19 and 20: Root Cause Analysis Rating Form
Page 21 and 22: Root Cause Analysis Rating Form

QI Tools Root Cause Analysis - Iowa Department of Public Health

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