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Root cause analysis basics

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Root cause analysis (RCA) is the discipline of asking "why" until you reach a cause you can actually eliminate. Skip this and you fix symptoms forever.

Two techniques worth knowing

  • 5 Whys - iteratively ask "why did that happen" until you reach an underlying cause. Usually takes 3-7 rounds, not always exactly five.
  • Fishbone (Ishikawa) diagram - map possible causes across categories (People, Process, Equipment, Materials, Environment, Measurement). Structured brainstorming for messier problems.

Signs you've found a real root cause

  • The cause is under your team's control to change.
  • Fixing it prevents recurrence, not just this instance.
  • It's a systemic condition, not a person's mistake.
  • You can articulate it in one sentence.

Signs you haven't

  • The "cause" is that someone made a mistake. (People make mistakes when systems allow them to.)
  • The fix is training or awareness posters. (Real root causes rarely respond to information.)
  • You could imagine the same thing happening again next month.

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