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Root Cause Analysis (RCA)

[To download this presentation, visit: https://www.oeconsulting.com.sg/training-presentations]<br><br>This training presentation focuses on using the 5 whys and the cause and effect diagram for root cause analysis.

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Root Cause Analysis (RCA)

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  1. Root Cause Analysis Identify, Eliminate, Prevent © Operational Excellence Consulting. All rights reserved.

  2. NOTE: This is a PARTIAL PREVIEW. To download the complete presentation, please visit: https://www.oeconsulting.com.sg Learning Objectives 1. Understand the importance of identifying root causes in problem solving 2. Describe how to apply common Root Cause Analysis tools such as 5 Whys and Cause & Effect Diagram to identify root causes 3. Learn how to prioritize root causes with a Pareto Chart 4. Gain awareness of the pitfalls in root cause analysis 2 © Operational Excellence Consulting. All rights reserved.

  3. Outline 1. Key Concepts & Principles of Root Cause Analysis 2. Overview of a problem solving process 3. Root Cause Analysis using 5 Whys 4. Root Cause Analysis using Cause & Effect Diagram 5. Root cause prioritization using Pareto Chart 6. Pitfalls to avoid 3 © Operational Excellence Consulting. All rights reserved.

  4. “When we fail to grasp the systemic source of problems, we are left to ‘push on’ symptoms rather than eliminate underlying causes.” Peter Senge The Fifth Discipline © Operational Excellence Consulting. All rights reserved.

  5. What is Root Cause Analysis? § Root Cause Analysis (RCA) is a technique that helps guide people to discover and understand the initiating cause(s) of a problem, with the goal of determining missing or inadequately applied controls that will prevent recurrence 5 © Operational Excellence Consulting. All rights reserved.

  6. Root Cause – The “Evil at the Bottom” The highest-level cause of a problem is called the root cause § The root cause is the “evil at the bottom” that sets in motion the entire cause- and-effect chain causing the problem(s) Visible Problem Symptom First-level cause Higher-level cause Root Cause 6 © Operational Excellence Consulting. All rights reserved.

  7. Relationship of Problems, Symptoms and Causes PROBLEM (Don’t feel well) SYMPTOMS (Aches and fever) AS A RESULT OF THE PROBLEM ANALYSIS LEADS TO ROOT CAUSES (Infection) 7 © Operational Excellence Consulting. All rights reserved.

  8. Understanding Root Causes Symptoms § Result or outcome of the problem § What you see as a problem (Obvious) Aches and fever Symptoms Problem § Gap from goal or standard Don’t feel well Problem Root Causes § System below the surface, bringing about the problem (Not obvious) Infection Causes Causes Causes 8 © Operational Excellence Consulting. All rights reserved.

  9. Problem Symptoms versus Root Causes SYMPTOMS (Increased Cost, Poor Customer Service) PROBLEM (Reduced Productivity) AS A RESULT OF THE PROBLEM Quality Issue Causes ROOT CAUSES (Scrap & Rework) 9 © Operational Excellence Consulting. All rights reserved.

  10. Principles of Root Cause Analysis § Systems thinking approach § Prevention of recurrence § Pareto principle § Employee engagement § Continuous improvement 10 © Operational Excellence Consulting. All rights reserved.

  11. “The problems that exist in the world cannot be solved by the level of thinking that created them.” Albert Einstein © Operational Excellence Consulting. All rights reserved.

  12. What Is a Problem? A problem is a deviation from a standard, i.e., a difference between what should be happening and what is actually happening Standard – what should be happening Gap = Problem Current situation – what is actually happening 12 © Operational Excellence Consulting. All rights reserved.

  13. Problem Solving Funnel Big vague concern Breakdown Grasp the situation § Actual vs. standard § Actual vs. ideal Go See Point of cause § Time and place where events cause abnormality 5 Why Analysis Why? Root cause Countermeasures Source: Adapted from ‘Lean Production Simplified’, Pascal Dennis 13 13 © Operational Excellence Consulting. All rights reserved. © Operational Excellence Consulting. All rights reserved.

  14. PDCA Problem Solving Process 1 Select the Theme 2 Plan the Schedule 3 Grasp the Present Situation PLAN 4 Establish the Target Analyze the Cause & Identify Corrective Action 5 6 DO Implement Corrective Action 7 CHECK Evaluate the Result 8 ACT Standardize & Follow-up 14 14 © Operational Excellence Consulting. All rights reserved. © Operational Excellence Consulting. All rights reserved.

  15. What is a Root Cause? An event, condition or state that when removed, remediated or controlled, prevents recurrence of an undesirable behavior. 15 © Operational Excellence Consulting. All rights reserved.

  16. Dealing with Root Causes § Solutions must deal with root causes, not symptoms § Ask “Why?” five times to get to the root cause § Use the Cause and Effect Diagram 16 © Operational Excellence Consulting. All rights reserved.

  17. “Every defect is a treasure, if the company can uncover its cause and work to prevent it across the corporation.” Kiichiro Toyoda, Founder of Toyota © Operational Excellence Consulting. All rights reserved.

  18. 5 Whys Process Funnel The Problem: Tom is injured Because he had a fall Why is Tom injured? Because the floor was wet Why did he fall? Because there was a leaking valve Why was the floor wet? Because there was a seal failure Why was the valve leaking? Because it was not maintained Why did the seal fail? Root Cause 18 18 © Operational Excellence Consulting. All rights reserved. © Operational Excellence Consulting. All rights reserved.

  19. 5 Whys Analysis – Example 1 1stWhy Symptom: The machine stopped! 2ndWhy Causes: 1. The circuit overload tripped 3rdWhy 2. The shaft wore down and seized up 4thWhy 3. Metal cutting chips penetrated the area 5thWhy 4. Chips passed through the lubrication system 5. There was no strainer on the inlet pipe from the tank 19 © Operational Excellence Consulting. All rights reserved.

  20. 5 Whys Analysis – Example 3 WHY? KEEP ON ASKING WHY? LATE PACK CHANGE LATE ORDER FROM SUPPLIER WHY? TECHNICAL PROBLEM LATE DELIVERY FROM SUPPLIER MRP WHY? PARAMETER WRONG SCHEDULE ERROR SHORT LEAD TIME ORDER WHY? WHY? LATE DELIVERY TO CUSTOMER PRODUCTION PROBLEM WHY? PRINTING PROBLEM DOCUMENTATION ERROR WHY? WRONG SPECIFICATION QC HOLD WHY? PRODUCTION PROBLEM DAMAGED PACKS STORAGE/ HANDLING PROBLEM 20 © Operational Excellence Consulting. All rights reserved.

  21. 5 Whys Analysis – Example 4 Causes Problem Evidence Direct Indirect Root On-time delivery stands at 87%. Packaging delays creating a bottle-neck of finished product. Delivery of packaging product is frequently delayed from printer. Customers complaining about late deliveries. why #1 why #2 Films from art department are being held up waiting for confirmations. why #3 Need corporate approvals for correct usage of all company logo marks. Poor communication between corporate marketing and plants. why #5 why #4 21 © Operational Excellence Consulting. All rights reserved.

  22. Cause & Effect Diagram (Manufacturing) Causes Effect Manpower Methods Machines cause why Problem Statement Materials Measurements Mother Nature (Environment) 22 22 © Operational Excellence Consulting. All rights reserved. © Operational Excellence Consulting. All rights reserved.

  23. Manufacturing Example: Cause and effect diagram used in solving the problem of “High Scrap of Barcode Labels” MAN MACHINE Smear Improper training Illegible Torn Printwheel Dirty Machine Breakdown Handling High Scrap of Barcode Labels Worn Ribbon Wrinkled Ineffective adhesive Design of label Improper storage Damage Improper storage Size of label Wrong orientation Poor printing Process changes Process changes MATERIAL METHOD 23 © Operational Excellence Consulting. All rights reserved.

  24. Service Example: Cause and effect diagram used in solving the problem of “Late Payment of Invoices” Computer System Internal Mail System Cost-Reduction Program Older System One Pick-Up Daily Excess Demand Downtime Manual Sort Process Workspace Equipment New Maintenance Contractor Excess Demand Access Limitations Lost/Misplaced Mail Turnover Late Payment of Invoices Low Priority Inexperienced Staff Hiring Freeze Audit Recommendation for Tighter Control Turnover Centralized Payment Authorization Access Limitations Maximize Cash Manual Files Crowded Space Low Priority Branch Offices Forward Payments Weekly Reorganization of Purchase Org. Payment Delays Morale Missing Documentation Paycuts Productivity Deadlines Resigned Increased Workload No Limit Manager Overtime Reduced Missing Purchase Orders Legend Suspected root causes Finance Policy Staff Documentation 24 © Operational Excellence Consulting. All rights reserved.

  25. 5 Pareto Chart © Operational Excellence Consulting. All rights reserved.

  26. Pareto Chart – Data Collection Pizza Defects Pizza Defects - Ranked % of Total Category Frequency Category Frequency Cum % Wrong Toppings 29 Wrong Toppings 29 25% 25% Tastes Bad 10 Pizza Cold 25 21% 46% Forgot Breadsticks 7 Pizza Late 22 19% 64% Wrong Price Driver Had No Change 2 Wrong Crust 13 11% 75% 4 Tastes Bad 10 8% 84% Pizza Cold 25 Forgot Breadsticks Driver Had No Change 7 6% 90% Pizza Late 22 4 3% 93% Wrong Crust 13 Smashed in Box 3 3% 96% Smashed in Box 3 Wrong Price 2 2% 97% Driver Rude 1 Driver Rude 1 1% 98% All other 2 All other 2 2% 100% 26 © Operational Excellence Consulting. All rights reserved.

  27. Example: Pareto Chart Pareto Chart Pizza Defects 35 120% 30 100% 25 Cumulative Percent 80% Occurences 20 60% 15 40% 10 20% 5 - 0% Forgot Breadstic ks 7 90% 6% Driver Had No Change 4 93% 3% Wrong Toppings Pizza Cold Pizza Late Wrong Crust Tastes Bad Wrong Price Driver Rude Smashed in Box 3 96% 3% All other Quantity Cum % % of Total 29 25% 25% 25 46% 21% 22 64% 19% 13 75% 11% 10 84% 8% 2 1 2 97% 2% 98% 1% 100% 2% 27 © Operational Excellence Consulting. All rights reserved.

  28. About Operational Excellence Consulting © Operational Excellence Consulting. All rights reserved.

  29. About Operational Excellence Consulting § Operational Excellence Consulting is a management training and consulting firm that assists organizations in improving business performance and effectiveness. § One of our unique strengths is going beyond a tools-focused approach to seamlessly integrate people, processes, technology and continuous improvement initiatives to suit the specific needs and situations of our clients. § We provide corporate learning programs and management advisory services to assist our clients to achieve breakthrough in business performance and effectiveness. Our aim is to support our clients in designing, managing and executing lasting beneficial change. 29 © Operational Excellence Consulting. All rights reserved.

  30. END OF PRESENTATION For more of our training presentations, please visit: www.oeconsulting.com.sg © Operational Excellence Consulting. All rights reserved.

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