Root Cause Analysis Template

I propose this simplified Root Cause Analysis worksheet to clients seeking structure for their 5-Why approach.  it is a beginner’s tool, but it does an excellent job of asking a series of high-level questions to help identify direct causes, root cause(s), and contributing factors and how each identified opportunity gets a corrective action to lessen the probability of a recurrence.

 

PURPOSE:

A Root Cause Analysis assists in developing a quality improvement plan for specific service delivery areas.

 

WHAT IS A ROOT CAUSE?

Root causes:

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