Fishbone diagram

- Do you have a repeating problem in your business? One you thought was fixed? I'm sure you work hard to address the root cause. But often, we find there's more than one. That's when a fishbone diagram comes in handy. A fishbone diagram is a visual method that helps teams identify many possible root causes to a problem. And it's called a fishbone diagram, because it looks like the bones of a fish. Using this method, the problem is stated at the head, and the causes are written on the spine that attaches to the backbone. We refer to these as categories of causes, and it's up to you to figure out which ones are contributing to the root causes of the problem in your specific case. Let's say you work for a group of urgent care clinics, where patients are repeatedly suffering because of incorrect diagnosis, and you need to find the root causes so you can help address the problem. First, gather a team of people from different areas that are involved in the process of diagnosing a patient. Then, write the problem at the head of the fish and behind it draw a horizontal line. And with your team, go step by step and look for issues contributing to the problem. On your fishbone, write the categories of the factors you observe that are affecting the diagnosis of a patient. In our case, the categories the team added to the spines were communication, patient records, lab testing equipment and physicians. Now, drill deeper in each category to establish subcauses and write them on each spine. For communication, they asked, "What specifically "about communication contributed to the misdiagnosis?" The team added, "Information from test results are delayed." And "There are misunderstandings at handoffs." For the next category ask, "What specifically about the lab equipment contributed "to the misdiagnosis?" The team added, "Equipment is not available, "and the equipment is not calibrated." For each category, always ask, "What else?" Until everyone on the team is satisfied, you've covered all potential root causes. Now that you have a list of many potential root causes, here are a few ways you can choose which ones to work on first. You can use pareto analysis to help determine which cause or causes are the most likely to have the biggest impact. Or, you can debate with your team members and reach a consensus of the most likely direct causes. However, if you have no data to drive an objective discussion, go and visit the process. Again, to observe directly, so you can validate your opinions and assumptions. Using these methods, you'll probably find one or two direct causes for which you'll want to go deeper by doing a 5Y analysis on those. So as you can see, the fishbone diagram is a very effective tool to help identify the root causes of your problem.