RCA and FEMA 9
Organizational Systems and Quality Leadership
Task 2; SAT1-1217
Organizational Systems and Quality Leadership Task 2; SAT1-1217
A. Root Cause Analysis
Root cause analysis (RCA) is a consistence procedure which is used for determining root causes of events or issues and an approach for reacting to them. Root cause analysis is pinned on the fundamental idea that efficient management needs more than just putting out fires for events which develop, but also finding ways to prevent them. RCA assists companies to avoid the likelihood of singling out one element to arrive at the expedient resolution. (Vanden & ABS Consulting, 2013). Additionally, root cause analysis helps enables organizations to avoid the idea of treating symptoms, and focus more on the underlying factors which result to an event or problem.
A1. RCA Steps
1. Identify what happened
At this stage, a team is supposed to state what transpired in an accurate and complete manner. Tools such as flowcharts may be applied here for the purpose of clarification of the information.
2. Determine what should have occurred
Here, the team determines what could have occurred in ideal situations. It is essential to develop a flowchart on the basis of given information and then compare it with flowchart developed in step 1.
3. Determine the causes
At this phase, the project team investigates the factors which contributed to the problem. During this process, the team looks for direct causes and contributory factors. A fishbone diagram can be applied this stage to investigate and display possible causes of a particular effect. (Kelly, Vottero, & Christie-McAuliffe, 2014).
4. Develop causal statements
The key purpose of causal statements is to connect the cause which was highlighted in step three to its effects and back to the main event which triggered RCA in first place. Causal statement helps to discuss how contributory elements contribute to adverse outcomes staff and patients. It has three sections namely; the cause, effect, and event.
5. Generate list of the recommended actions to curb the recurrence of the problem
Suggested actions refer to changes which the RCA team hopes will assist in preventing the event under review from recurring. Recommendations may fall under the following groups;
Improving or updating the software
Employing forcing functions which physically hinder users from making recurrent errors
Ensuring redundancy, for instance using backup systems or double checks
Establishing new policies
Simplifying the process
Training the staff
Applying cognitive aids, for example mnemonic devices
6. Prepare the summary and share it
This is a chance to engage the key players to facilitate the next steps in the process. For the purposes of clarity, the team can develop a flowchart.