Assignment 9.2: Defining the Problem

Assignment 9.2: Defining the Problem

Value: 20 points

Introduction

Typically root cause analysis is performed after an adverse event; however, it is also a tool to analyze microsystem data related to the organization and a larger system.  Through this analysis, gaps can be identified, for example between benchmarks and internal data, and drilled down even further through a RCA.  RCAs can provide the team direction to determine what additional data and information is needed, which is essential to propel the team towards improving the delivery of care.

Many tools to define the problem exist:

• Cause and Effect Diagram (known as Ishikawa or fishbone diagram): A problem analysis tool to identify all possible causes of a problem. The visual is used to stimulate brainstorming and discussion among stakeholders.
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  • Read a description and instructions in the Cause and Effect Diagram (PDF)
• Links to an external site..
• Read the American Society for Quality

• • Links to an external site. information on the Fishbone diagram.
  • View the Cause and Effect video:

• 5 Whys: By iteratively asking “why” helps create a clearer picture of the problem and strategically identify the real cause(s) of the problem.
• 
  • Read a description and instructions in the 5 Whys (PDF)
• Links to an external site..
• Read the American Society for Quality

• • Links to an external site. information on the 5 Whys.
  • View the 5 Whys video:

• Failure Mode and Effects Analysis (FMEA): This tool can be used as a prospective analysis or retrospective method with root cause analysis. FMEA focuses on known or potential problems/errors with a goal to prevent errors by identifying all the steps and the potential problems with each step.

• • Read a description and instructions in the Failure Modes and Effects Analysis (PDF)
• Links to an external site..
• Read the American Society for Quality

• • Links to an external site. information on the Failure Modes and Effects Analysis model.
  • View the Failure Modes and Effects Analysis video:

• Pareto Charts: Based on the Pareto principle that 80% of output in a situation is due to 20% of the input.
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  • Read a description and instructions in the Pareto Chart (PDF)
• Links to an external site..
• Read the American Society for Quality

• • Links to an external site. information on the Pareto Chart.
  • View the Pareto Chart video:

• Scatter Plot Diagram: A useful tool to determine if there is correlation between two variables. A positive or negative correlation does not necessarily mean cause-and-effect, nor can strength of the variables be determined. The diagram only observes relationships between variables.
• 
  • Read a description and instructions in the Scatter Plot (PDF)

• • Links to an external site..
  • View the Scatter Plot video:

Links to an external site.

Assignment Guidelines

Watch the videos for a description of each tool. Also, see Table 4.3 (p. 70) in your textbook for more QI tools and their uses.

Select one of the tools above to help define your problem.  Download and complete the worksheet for the tool you selected, or complete your own template.

Submit the RCA tool worksheet for your QI project.

Submission

Submit your assignment [and review full grading criteria] on the Assignment 9.2: Defining the Problem Assignment page.

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