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• What Is a Fishbone Diagram? | Templates & Examples

What Is a Fishbone Diagram? | Templates & Examples

Published on January 2, 2023 by Tegan George . Revised on January 29, 2024.

A fishbone diagram is a problem-solving approach that uses a fish-shaped diagram to model possible root causes of problems and troubleshoot possible solutions. It is also called an Ishikawa diagram, after its creator, Kaoru Ishikawa, as well as a herringbone diagram or cause-and-effect diagram.

Fishbone diagrams are often used in root cause analysis , to troubleshoot issues in quality management or product development. They are also used in the fields of nursing and healthcare, or as a brainstorming and mind-mapping technique many students find helpful.

Table of contents

How to make a fishbone diagram, fishbone diagram templates, fishbone diagram examples, advantages and disadvantages of fishbone diagrams, other interesting articles, frequently asked questions about fishbone diagrams.

A fishbone diagram is easy to draw, or you can use a template for an online version.

• Your fishbone diagram starts out with an issue or problem. This is the “head” of the fish, summarized in a few words or a small phrase.
• Next, draw a long arrow, which serves as the fish’s backbone.
• From here, you’ll draw the first “bones” directly from the backbone, in the shape of small diagonal lines going right-to-left. These represent the most likely or overarching causes of your problem.
• Branching off from each of these first bones, create smaller bones containing contributing information and necessary detail.
• When finished, your fishbone diagram should give you a wide-view idea of what the root causes of the issue you’re facing could be, allowing you to rank them or choose which could be most plausible.

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See an example

There are no built-in fishbone diagram templates in Microsoft programs, but we’ve made a few free ones for you to use that you can download below. Alternatively, you can make one yourself using the following steps:

• In a fresh document, go to Insert > Shapes
• Draw a long arrow from left to right, and add a text box on the right-hand side. These serve as the backbone and the head of the fish.
• Next, add lines jutting diagonally from the backbone. These serve as the ribs, or the contributing factors to the main problem.
• Next, add horizontal lines jutting from each central line. These serve as the potential causes of the problem.

Lastly, add text boxes to label each function.

You can try your hand at filling one in yourself using the various blank fishbone diagram templates below, in the following formats:

Fishbone diagram template Excel

Download our free Excel template below!

Fishbone diagram template Word

Download our free Word template below!

Fishbone diagram template PowerPoint

Download our free PowerPoint template below!

Fishbone diagrams are used in a variety of settings, both academic and professional. They are particularly popular in healthcare settings, particularly nursing, or in group brainstorm study sessions. In the business world, they are an often-used tool for quality assurance or human resources professionals.

Fishbone diagram example #1: Climate change

Let’s start with an everyday example: what are the main causes of climate change?

Fishbone diagram example #2: Healthcare and nursing

Fishbone diagrams are often used in nursing and healthcare to diagnose patients with unclear symptoms, or to streamline processes or fix ongoing problems. For example: why have surveys shown a decrease in patient satisfaction?

Fishbone diagram example #3: Quality assurance

QA professionals also use fishbone diagrams to troubleshoot usability issues, such as: why is the website down?

Fishbone diagram example #4: HR

Lastly, an HR example: why are employees leaving the company?

Fishbone diagrams come with advantages and disadvantages.

• Great tool for brainstorming and mind-mapping, either individually or in a group project.
• Can help identify causal relationships and clarify relationships between variables .
• Constant iteration of “why” questions really drills down to root problems and elegantly simplifies even complex issues.

Disadvantages

• Can lead to incorrect or inconsistent conclusions if the wrong assumptions are made about root causes or the wrong variables are prioritized.
• Fishbone diagrams are best suited to short phrases or simple ideas—they can get cluttered and confusing easily.
• Best used in the exploratory research phase, since they cannot provide true answers, only suggestions.

If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

Methodology

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

Fishbone diagrams have a few different names that are used interchangeably, including herringbone diagram, cause-and-effect diagram, and Ishikawa diagram.

These are all ways to refer to the same thing– a problem-solving approach that uses a fish-shaped diagram to model possible root causes of problems and troubleshoot solutions.

Fishbone diagrams (also called herringbone diagrams, cause-and-effect diagrams, and Ishikawa diagrams) are most popular in fields of quality management. They are also commonly used in nursing and healthcare, or as a brainstorming technique for students.

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Master the 7-Step Problem-Solving Process for Better Decision-Making

Discover the powerful 7-Step Problem-Solving Process to make better decisions and achieve better outcomes. Master the art of problem-solving in this comprehensive guide. Download the Free PowerPoint and PDF Template.

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Introduction.

The 7-Step Problem-Solving Process involves steps that guide you through the problem-solving process. The first step is to define the problem, followed by disaggregating the problem into smaller, more manageable parts. Next, you prioritize the features and create a work plan to address each. Then, you analyze each piece, synthesize the information, and communicate your findings to others.

In this article, we'll explore each step of the 7-Step Problem-Solving Process in detail so you can start mastering this valuable skill. At the end of the blog post, you can download the process's free PowerPoint and PDF templates .

Step 1: Define the Problem

One way to define the problem is to ask the right questions. Questions like "What is the problem?" and "What are the causes of the problem?" can help. Gathering data and information about the issue to assist in the definition process is also essential.

Step 2: Disaggregate

After defining the problem, the next step in the 7-step problem-solving process is to disaggregate the problem into smaller, more manageable parts. Disaggregation helps break down the problem into smaller pieces that can be analyzed individually. This step is crucial in understanding the root cause of the problem and identifying the most effective solutions.

Disaggregation helps in breaking down complex problems into smaller, more manageable parts. It helps understand the relationships between different factors contributing to the problem and identify the most critical factors that must be addressed. By disaggregating the problem, decision-makers can focus on the most vital areas, leading to more effective solutions.

Step 3: Prioritize

Once the issues have been prioritized, developing a plan of action to address them is essential. This involves identifying the resources required, setting timelines, and assigning responsibilities.

Step 4: Workplan

The work plan should include a list of tasks, deadlines, and responsibilities for each team member involved in the problem-solving process. Assigning tasks based on each team member's strengths and expertise ensures the work is completed efficiently and effectively.

Developing a work plan is a critical step in the problem-solving process. It provides a clear roadmap for solving the problem and ensures everyone involved is aligned and working towards the same goal.

Step 5: Analysis

Pareto analysis is another method that can be used during the analysis phase. This method involves identifying the 20% of causes responsible for 80% of the problems. By focusing on these critical causes, organizations can make significant improvements.

Step 6: Synthesize

Once the analysis phase is complete, it is time to synthesize the information gathered to arrive at a solution. During this step, the focus is on identifying the most viable solution that addresses the problem. This involves examining and combining the analysis results for a clear and concise conclusion.

During the synthesis phase, it is vital to remain open-minded and consider all potential solutions. Involving all stakeholders in the decision-making process is essential to ensure everyone's perspectives are considered.

Step 7: Communicate

In addition to the report, a presentation explaining the findings is essential. The presentation should be tailored to the audience and highlight the report's key points. Visual aids such as tables, graphs, and charts can make the presentation more engaging.

The 7-step problem-solving process is a powerful tool for helping individuals and organizations make better decisions. By following these steps, individuals can identify the root cause of a problem, prioritize potential solutions, and develop a clear plan of action. This process can be applied to various scenarios, from personal challenges to complex business problems.

By mastering the 7-step problem-solving process, individuals can become more effective decision-makers and problem-solvers. This process can help individuals and organizations save time and resources while improving outcomes. With practice, individuals can develop the skills to apply this process to a wide range of scenarios and make better decisions in all areas of life.

7-Step Problem-Solving Process PPT Template

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Mastering this process can improve decision-making and problem-solving capabilities, save time and resources, and improve outcomes in personal and professional contexts.

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How to conduct fishbone analysis (with example)

9 minutes read

What Fishbone Analysis is and why it is Useful

Fishbone analysis, also known as Ishikawa or cause-and-effect analysis, is a visual method used to identify and analyze the root causes of a problem or an effect. It is named after its creator, Kaoru Ishikawa, a Japanese quality control expert. The technique gets its name from the shape of the diagram, which resembles the skeleton of a fish, with the "head" representing the problem or effect and the "bones" branching off to indicate potential causes.

The primary purpose of fishbone analysis is to provide a structured approach to problem-solving and root cause identification. Here's why it is useful:

Systematic Approach: Fishbone analysis provides a systematic and organized way to explore the various factors that may contribute to a problem. It ensures that all possible causes are considered and evaluated.

Visual Representation: The visual nature of the fishbone diagram makes complex relationships and interdependencies easy to understand. It helps teams see the bigger picture and how different factors may be interconnected.

Team Collaboration: Fishbone analysis is often conducted in a collaborative setting, involving individuals from different departments or with various expertise. This collaboration fosters a shared understanding of the problem and encourages diverse perspectives.

Identification of Root Causes: By breaking down the problem into categories (commonly referred to as the 6Ms Manpower, Method, Machine, Material, Measurement, and Mother Nature), fishbone analysis aids in identifying the root causes rather than just addressing symptoms.

Prevention of Recurrence: Understanding and addressing the root causes of a problem can help prevent its recurrence. Fishbone analysis supports the development of effective solutions that target the source of the issue.

Decision Making: The insights gained from fishbone analysis empower teams to make informed decisions about the most appropriate actions to address the problem. It helps prioritize solutions based on their potential impact on root causes.

Continuous Improvement: Fishbone analysis is a key component of continuous improvement methodologies, such as Six Sigma and Total Quality Management. It fosters a culture of ongoing assessment and enhancement.

In short, fishbone analysis is a valuable tool for problem-solving and root cause analysis due to its systematic approach, visual representation, collaborative nature, and its effectiveness in identifying and addressing the underlying causes of an issue. It is widely used across various industries to improve processes, enhance quality, and drive continuous improvement initiatives.

Steps: Fishbone Analysis Process

The fishbone analysis process is a systematic and collaborative method designed to identify and analyze the root causes of a problem. This structured approach, also known as Ishikawa or cause-and-effect analysis, involves several key steps that guide teams through the process of understanding, visualizing, and addressing complex issues.

Step 1: Define the Problem

The first step in the fishbone analysis process is to clearly define the problem or effect that needs to be addressed. This step sets the stage for the entire analysis, ensuring that the team is focused on a specific issue and its associated challenges.

Step 2: Create the Fishbone Diagram

Once the problem is defined, the next step is to create the fishbone diagram. Draw a horizontal arrow pointing to the right, representing the problem. This arrow serves as the "spine" of the fishbone. Branch off from the spine with diagonal lines, creating the "bones" of the fishbone. Label each bone with one of the common categories of causes, often referred to as the 6Ms: Manpower, Method, Machine, Material, Measurement, and Mother Nature.

Step 3: Brainstorm Potential Causes

With the fishbone diagram in place, the team engages in a collaborative brainstorming session to identify potential causes within each category. This step encourages diverse perspectives and insights from team members with different expertise. As ideas are generated, they are added as branches or sub-bones extending from the main categories.

Step 4: Analyze and Categorize Causes

After the brainstorming session, the team reviews and analyzes the potential causes. Similar or related causes are grouped together, helping to identify patterns and connections. This process of categorization contributes to a more thorough understanding of the complex interactions contributing to the problem.

Step 5: Identify Root Causes

The analysis continues by probing deeper into the identified causes to determine the root causes—the fundamental factors that directly contribute to the problem. This step involves asking "why" multiple times to trace each cause back to its origin. The goal is to reach the underlying issues rather than addressing surface-level symptoms.

Step 6: Prioritize and Develop Solutions

Once the root causes are identified, the team prioritizes them based on their impact and feasibility for intervention. This step sets the foundation for developing effective solutions targeted at the core issues. It is essential to focus on preventive measures to avoid the recurrence of the problem.

Step 7: Implement and Monitor Solutions

The final step involves implementing the chosen solutions and monitoring their effectiveness. Continuous improvement is a key aspect of the fishbone analysis process, as it allows teams to refine their approach based on real-world outcomes and feedback.

The fishbone analysis process is a dynamic and iterative method that guides teams through a structured exploration of problems. By defining the problem, creating a fishbone diagram, brainstorming potential causes, analyzing and categorizing those causes, identifying root causes, and developing and implementing solutions, teams can gain valuable insights and foster a culture of continuous improvement within their organizations.

Application: Fishbone Analysis Sample

Let's delve into a practical example to illustrate the step-by-step process of conducting a fishbone analysis sample. Imagine a manufacturing company experiencing a consistent increase in product defects. The team decides to use fishbone analysis sample to identify and address the root causes of this quality issue.

The problem is clearly defined as an increase in product defects in the manufacturing process. The team aims to understand the factors contributing to this issue and work towards its resolution.

A horizontal arrow pointing to the right represents the problem—increased product defects. The main categories or "bones" branching off from the spine include Manpower, Method, Machine, Material, Measurement, and Mother Nature . Each category is crucial in understanding the potential causes related to the defects.

In a collaborative session, the team brainstorms potential causes within each category. For instance:

1. Under "Manpower," they identify issues like insufficient training or skill gaps.

2."Method" considerations might include outdated operating procedures or inadequate quality control processes.

3. In the "Machine" category, potential causes could involve equipment malfunctions or lack of maintenance.

4."Material" considerations might include poor-quality raw materials or inadequate supplier controls.

5."Measurement" issues might involve inaccurate testing tools or insufficient quality metrics.

6."Mother Nature" could encompass external factors like temperature or humidity affecting the production process.

After the brainstorming session, the team reviews and categorizes the potential causes. They discover that several issues relate to inadequate training (Manpower), outdated procedures (Method), and equipment malfunctions (Machine). These are grouped together to identify patterns and connections.

To identify root causes, the team probes deeper into the categorized issues. They ask "why" multiple times. For instance, if inadequate training is identified as a cause, the team might ask why the training is insufficient, leading them to discover issues with the training program or materials.

With the root causes identified, the team prioritizes them based on impact and feasibility. In our example, they might decide to implement a comprehensive training program for the workforce, update operating procedures, and schedule regular maintenance for equipment.

The chosen solutions are implemented, and the team monitors their effectiveness. They observe a decrease in product defects over time, validating the success of their intervention. Continuous monitoring ensures sustained improvement and allows the team to adapt their strategies if needed.

In this example, the fishbone analysis process guides the team from defining the problem to implementing effective solutions. The structured approach not only addresses the immediate issue of increased product defects but also sets the stage for ongoing quality improvement within the manufacturing process.

Tips for Conducting a Successful Fishbone Analysis

Conducting a successful fishbone analysis requires careful planning, effective collaboration, and a commitment to uncovering the root causes of a problem. Here are some tips to ensure a fruitful fishbone analysis:

1. Clearly Define the Problem

Begin by clearly defining the problem or issue you aim to address. A well-defined problem statement sets the stage for focused and effective analysis.

2. Assemble a Diverse Team

Form a cross-functional team with members from different departments or areas of expertise. Diverse perspectives contribute to a more comprehensive understanding of potential causes.

3. Use a Whiteboard or Fishbone Software

Utilize a whiteboard or specialized fishbone diagram software to visually represent the causes and effects. This enhances clarity and facilitates collaboration during the analysis.

4. Encourage Open and Honest Communication

Foster an open and honest environment where team members feel comfortable sharing their insights and perspectives. Encourage everyone to contribute ideas without fear of judgment.

5. Brainstorm Extensively

Conduct a thorough brainstorming session to identify potential causes within each category. Emphasize quantity over quality during the initial brainstorming phase, and later refine the list.

6. Categorize Causes Effectively

Carefully analyze and categorize the identified causes. Group similar or related causes together to identify patterns and connections, making it easier to pinpoint root causes.

7. Ask "Why" Multiple Times

When identifying root causes, use the "5 Whys" technique. Ask "why" multiple times to trace each cause back to its origin and uncover the underlying issues contributing to the problem.

8. Prioritize Root Causes

Prioritize the root causes based on their impact on the problem and feasibility for intervention. This helps in focusing efforts on the most critical issues.

9. Develop Actionable Solutions

Once the root causes are identified, develop actionable and targeted solutions. Ensure that the solutions address the core issues to prevent the recurrence of the problem.

10. Implement and Monitor

Implement the chosen solutions and closely monitor their effectiveness. Regularly review progress and adjust strategies as needed. Continuous improvement is a key aspect of the fishbone analysis process.

11. Document the Process

Document the entire fishbone analysis proc, including the identified causes, root causes, and implemented solutions. This documentation serves as a valuable reference for future analyses and improvements.

12. Seek Feedback and Learn

Encourage feedback from team members and stakeholders throughout the process. Learn from the analysis and use insights gained to refine future problem-solving approaches.

By following these tips, teams can conduct a successful fishbone analysis that not only identifies the root causes of a problem but also lays the groundwork for continuous improvement and enhanced problem-solving capabilities.

The Fishbone Analysis Process, with its structured steps, empowers teams to methodically investigate and address issues. In the practical application of Fishbone Analysis through the provided sample, in this case, we explored the nuances of dissecting a specific problem—offering a tangible example of how this method can be applied to various scenarios. Boardmix becomes the digital space where teams can collectively engage in the analysis, fostering collaboration and innovation. Boardmix's user-friendly interface and collaborative features align seamlessly with this process, facilitating real-time collaboration and enhancing the efficiency of problem resolution. Take action today, leverage the collaborative power of Boardmix, and elevate your approach to problem resolution.

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Strategic Planning Steps: Essential Process Explained

Ishikawa Diagram (Fishbone Diagram): A Comprehensive Guide to Effective Analysis

In the contemporary landscape of business and quality management, efficient problem-solving methodologies are regarded with paramount importance. Among these methodologies, the Ishikawa Diagram — also known as the Fishbone Diagram —stands out as a powerful tool for identifying, exploring, and visually displaying the roots of a particular problem. Named after its inventor, Kaoru Ishikawa, the diagram has found a multitude of uses in various fields ranging from manufacturing to education.

In this comprehensive guide, we will delve deep into the efficacy of the Ishikawa Diagram, examining its origins, structure, applications, and offering a step-by-step approach to craft and analyze this insightful tool.

Importance and Usage of the Ishikawa Diagram in Different Fields

The Ishikawa Diagram is celebrated for its ability to facilitate learning problem solving in a structured and collaborative manner. It prompts teams to look beyond superficial issues and investigate underlying causes of problems.

This quality has made it indispensable in domains like quality control, project management, healthcare, and any context where systematic analysis is key to improvement. Its simplicity and visual nature make it an engaging means of communication, able to enhance clarity and foster a collective understanding of complex issues. With its cross-industry relevance, the Ishikawa Diagram continues to evolve as a foundational element in the repertoire of analytical tools.

History and Origin of Ishikawa Diagram

Discussing the origin and development of the ishikawa diagram.

The Ishikawa Diagram was developed in the 1960s, an era marked by Japan's industrial revolution, where significant emphasis was put on quality control and manufacturing processes. This tool was initially embraced by the Kawasaki shipyards but soon proliferated beyond, to become a cornerstone of the total quality management movement. It empowered workers by giving them a voice to contribute to problem-solving endeavours.

Throughout its history, the Ishikawa Diagram has transcended its original context and has been modified and refined to suit a variety of disciplines, showcasing its versatility and adaptability.

Brief Biography of Kaoru Ishikawa, the Man Behind the Diagram

Kaoru Ishikawa, born in Tokyo in 1915, was not just an inventor but a visionary who transformed management practices. A prominent professor at the University of Tokyo, Ishikawa was dedicated to quality management processes and sought ways to involve all employees—from top management to the shop floor workers—in organizational problem-solving.

Apart from the Fishbone Diagram, which remains his most renowned contribution, Ishikawa also developed the concept of Quality Circles and advocated for the internal customer concept, which emphasizes the importance of each member of the process as a 'customer' to the preceding process step.

Understanding the Ishikawa Diagram

The structure of ishikawa diagram.

The Ishikawa Diagram's construction is metaphorically aligned with the anatomy of a fish. At its head is the problem statement, or the "effect", to be investigated. Extending from the 'spine' of the fish are the major categories of potential causes, often generalized as Methods, Materials, Machines, People, Measurements, and Environment. It's this skeletal structure that provides the framework upon which the specifics—the ‘bones’—of the potential causes are overlaid.

The intuitive nature of this layout promotes an organized and comprehensive dissection of issues at hand.

Key Elements and Components of the Diagram

Each branch or "bone" leading off from the main axis represents an avenue of inquiry, a category of potential causes. These categories can be further broken down into sub-branches, representing sub-causes, which provide a finer granularity of analysis.

It is this hierarchical decomposition that equips the Ishikawa Diagram with the ability to handle complex and multifaceted issues by visualizing the relationship between the effect and its causes in a structured and clear-cut manner.

The Concept and Principle of Cause and Effect in Relation to the Diagram

At its core, the Ishikawa Diagram is rooted in the cause-and-effect principle, illustrating that various factors and their interplay result in the final issue or 'effect.' Its intent is not simply to list possible reasons for a problem but to delve into the systemic and sometimes hidden connections that cause the observed effect.

Through this diagram, users systematically explore the potential causes, organized by major categories, to uncover the actual reason behind the problem.

Uses and Applications of Ishikawa Diagram

Discussing the role of ishikawa diagram in problem-solving.

Problem-solving is central to improvement initiatives across various sectors. When faced with a complex issue, it can be challenging to pinpoint exactly where things are going astray. The Ishikawa Diagram serves as a guide to systematically navigate through potential causes, ensuring a thorough examination rather than a hasty conclusion.

By analyzing the 'bones' that make up the 'fish,' teams can collectively identify root causes and not just symptoms, allowing for effective solutions rather than quick fixes.

Importance of Ishikawa Diagram in the Field of Quality Management

In quality management, the primary goal is to identify and rectify flaws to streamline processes and enhance the product or service. The Ishikawa Diagram aids this pursuit by laying out a roadmap to identify quality issues, leading to a deeper understanding of the process and thus, an improved quality outcome.

As processes become increasingly complex, the use of such a diagram ensures a methodical approach to maintaining high standards and fostering continual improvement within an organization.

Use of Ishikawa Diagram in Complexity Analysis and Decision-Making

One of the significant strengths of the Ishikawa Diagram is its ability to simplify complexity. By breaking down issues into smaller, more manageable parts, it aids decision-makers in comprehending and tackling complex problems. This tool enables a more thoughtful and data-driven decision-making process, where all possible factors are considered before any measures are implemented.

Step-by-Step Guide on How to Create an Ishikawa Diagram

Preparing to create the diagram.

Prior to engaging with the diagram, it is essential to have a clear understanding of the problem at hand. This involves gathering relevant information, ensuring accessibility to necessary resources, and assembling a team with diverse knowledge to contribute to the analysis. Identifying the scope and the boundaries of the problem is crucial; an Ishikawa Diagram is most effective when applied to a specific issue rather than an overwhelming or generalized one.

Define the Problem or the Effect

Defining the problem—also known as the "effect"—is the pivotal first step in creating your Ishikawa Diagram. This effect should be articulated as clearly and concisely as possible, setting the stage for the subsequent analysis. Once defined, this problem statement becomes the head of the fish, guiding every subsequent step in the exploration process.

Brainstorming Potential Causes

With the problem outlined, it's time for the team to employ collective brainstorming to identify all possible causes. This phase benefits from diversity of thought and open communication, as the team casts a wide net to capture every conceivable reason that might contribute to the problem. Multiple perspectives ensure that less obvious or unconventional causes are also taken into consideration.

Categorizing the Causes

After a myriad of potential causes have been gathered, they must be categorized. This involves sorting them into broader categories, such as the aforementioned Methods, Materials, Machines, People, Measurements, and Environment. These categories help in organizing thoughts and structuring the diagram, forming the main branches or 'bones' off which more detailed causes will hang.

Adding Causes and Sub-causes to the Diagram

The next step is to place each identified cause into its relevant category along the branches of the diagram. Within each category, causes are further broken down into finer details, forming sub-causes as necessary. This layered format is essential for a comprehensive and ordered analysis.

Analyzing and Interpreting the Diagram

Having constructed the Ishikawa Diagram, the final step is to analyze and interpret the findings. This process often uncovers patterns or reveals the most common categories that contribute to the problem. From here, teams can prioritize which causes to address first based on their potential impact and the resources available to create an action plan.

Advantages and Disadvantages of Ishikawa Diagram

Discussing the benefits of using ishikawa diagram.

The advantages of the Ishikawa Diagram are manifold. It promotes a thorough investigation of problems, avoiding superficial diagnoses. By visually mapping out the cause-and-effect relationships, it enhances collective understanding and fosters clearer communication among team members. Additionally, the diagram's structure encourages a democratic approach to problem-solving, where each team member can contribute perspectives and insights.

Exploring the Limitations and Challenges of Using the Diagram

Despite its benefits, the Ishikawa Diagram is not without its limitations. One challenge is the potential for the process to become unwieldy, especially when too many causes are identified without effective filtering or prioritization. Another limitation is the risk of drawing incorrect conclusions if the analysis is not sufficiently data-driven or if the team has inherent biases. Furthermore, the diagram alone cannot solve the problem—it is a tool, and its effectiveness depends on how it is used.

The Importance of a Balanced Approach While Using the Diagram

To mitigate the limitations of the Ishikawa Diagram, it is critical to adopt a balanced approach. This involves being systematic yet flexible, comprehensive yet focused, and data-driven while open to insights and experiences. Confirmatory data analysis and practical tests should follow the use of the diagram to validate the identified causes before taking corrective actions. Additionally, continuous learning and feedback loops can prevent the recurrence of past oversights.

Case Studies and Examples

Presenting real-life case studies where ishikawa diagram has been utilized effectively.

There are numerous real-world applications of Ishikawa Diagrams that illustrate their effectiveness. For example, in healthcare, hospitals have used the diagram to reduce patient wait times by identifying and addressing inefficiencies in their processes. In manufacturing, the diagram has been instrumental in diagnosing defects in production lines, leading to improvements in both quality and productivity.

Demonstrating the Process Through Examples

For instance, an automotive company may use an Ishikawa Diagram to dive into why a specific component is failing at a high rate. Through careful analysis, they might uncover that a combination of poorly trained staff (People), imprecise measurement tools (Measurement), and a suboptimal material (Material) is contributing to the defect. With these root causes identified, targeted interventions can be developed and implemented.

Recap of the Essential Points About Ishikawa Diagram

The Ishikawa Diagram is an exceptionally versatile tool that can dissect and clarify complex issues across industries effectively. It serves as a critical thinking instrument that structures problem analysis, facilitates communication, and promotes a culture of continuous improvement.

Emphasize the Importance of This Tool in Various Industries

The ongoing relevance of the Ishikawa Diagram in fields as diverse as healthcare, education, manufacturing, and beyond highlights its enduring value. For organizations striving for excellence, embracing such analytical frameworks is key to identifying problems at their core and crafting sustainable solutions.

Encourage More Research and Understanding About the Concept

Understanding how to properly leverage the Ishikawa Diagram can enhance one's analytical skills and elevate an organization's problem-solving abilities. It's a testimony to Kaoru Ishikawa’s legacy that his diagram remains a profound influence on modern-day quality management and decision-making processes. For professionals and organizations committed to optimal operations, mastery of the Ishikawa Diagram is a worthwhile pursuit— one that resonates with the enduring quest for knowledge and efficiency. As online certificate programs often include training in such analytical tools, they represent an accessible avenue for professionals to enhance their competency in deploying this powerful diagram.

The richness of the Ishikawa Diagram's potential is only as limited as the users' capacity to utilize it fully. With a blend of critical scrutiny and inventive application, this tool's utility remains an invaluable asset in the toolbox of problem solvers across the globe.

What are the primary functions and purposes of an Ishikawa Diagram in the context of problem-solving and root cause analysis?

The Ishikawa Diagram, also known as a Fishbone Diagram, offers a visual tool for root cause analysis. Dr. Kaoru Ishikawa, a Japanese quality control expert, developed this method. It is pivotal in problem-solving and analyzing complex issues. Users trace back from effects to potential causes systematically.

Core Functions of Ishikawa Diagrams

Facilitate brainstorming : This diagram serves as a brainstorming tool. It encourages collective problem-solving. Teams often use it to generate ideas around potential causes of a problem.

Categorize causes : The diagram has several branches that categorize causes. Common categories include Methods, Machines, People, Materials, Measurements, and Environment.

Visualize relationships : A clear visual layout shows cause-and-effect relationships. This feature promotes understanding of the interplay between different factors.

Focus discussion : By outlining causes, the diagram focuses team discussions. It directs attention to specific areas.

Foster a systematic approach : The structured nature of the diagram leads teams through a rigorous process. It ensures they consider all relevant aspects of an issue.

Purposes of Ishikawa Diagrams

Identify root causes : The primary purpose lies in identifying the fundamental causes. These are the underlying factors that contribute to a problem's occurrence.

Promote collaborative problem-solving : The Ishikawa Diagram brings teams together. It encourages collaboration and collective learning.

Support continuous improvement : When teams understand problems well, they can develop more effective solutions. This understanding supports an organizational culture of continuous improvement.

Ensure comprehensive examination : The layout ensures no stone remains unturned. Teams examine every possible contributing factor to a problem.

Enhance communication : The visual nature of the diagram enhances communication. It makes complex relationships between causes more understandable. It also provides a reference point for discussions.

In sum, Ishikawa Diagrams form a powerful arsenal in problem-solving. They ensure systematic, thorough analysis. They encourage team participation and pave the way for effective solutions. Their role in root cause analysis is indispensable for many organizations striving for excellence and continuous improvement.

How does the Ishikawa Diagram integrate with other data analysis tools and methodologies in enhancing organizational efficiency?

The ishikawa diagram in data analysis ecosystem.

The Ishikawa Diagram, or fishbone diagram, offers visual simplicity. It aids users in pinpointing root causes. Yet, its full potential emerges through integration. It complements other data analysis tools. These synergies enhance organizational efficiency.

Integration with Pareto Analysis

Ishikawa diagrams often pair with Pareto Analysis. Pareto prioritizes problems based on impact. Ishikawa defines these problems’ root causes. This combination streamlines problem-solving. It directs resources to areas with the greatest returns.

Link with Statistical Process Control

Next, consider Statistical Process Control (SPC). SPC uses statistical methods to monitor processes. The Ishikawa Diagram identifies variables for SPC charts. This helps maintain consistent quality.

Synergy with Failure Mode and Effect Analysis

Failure Mode and Effect Analysis (FMEA) assesses potential failure points. The Ishikawa Diagram adds depth here. It details the underlying causes of each failure mode. This strengthens preventive strategies.

Connection with Six Sigma

Six Sigma focuses on defect reduction. Ishikawa diagrams offer an early step in Six Sigma's DMAIC process (Define, Measure, Analyze, Improve, Control). They help in the 'Analyze' phase. Teams can them map out cause-and-effect relationships before seeking improvements.

Alignment with Lean Methodology

Lean methodology targets waste reduction. Ishikawa diagrams highlight the causes of waste. They aid in creating a targeted Lean intervention. This ensures efforts do not go to waste.

Using Ishikawa for Data-Driven Decisions

Organizations thrive on data-driven decisions. Ishikawa diagrams serve as a foundation for these. They set the stage for quantitative analysis. They ensure organizations do not rely on hunches.

Informed Hypotheses Development

Ishikawa diagrams facilitate informed hypotheses development. Analysts consider various factors. These guide subsequent data collection.

Streamlining Data Collection

Once hypotheses are set, efficient data collection follows. The Ishikawa Diagram informs relevant data to gather. This prevents extraneous data clogging the analysis.

Enhancing Cross-Functional Communication

Communication bridges successful integrations. The Ishikawa Diagram simplifies complex ideas. It brings clarity to cross-functional team discussions.

Driving Continuous Improvement

Continuous improvement stands at the heart of operational efficiency. Ishikawa diagrams offer a starting point for Kaizen events. Teams can identify and tackle inefficiencies on a regular basis.

The Ishikawa Diagram does not stand alone. It forms vital links within a network of methodologies. This improves decision-making processes. Teams identify root causes more effectively. Organizations gain in efficiency and effectiveness. Short, clear sentences convey this complex relationship. The integration enhances strategic and tactical business decisions. Ishikawa diagrams are more than a tool. They are a bridge to organizational excellence.

What are some of the common challenges faced when creating and interpreting Ishikawa Diagrams and how can these be effectively mitigated?

Understanding ishikawa diagrams.

Ishikawa diagrams, often known as fishbone diagrams, support root cause analysis in various industries. These tools help organizations ascertain possible causes of specific problems. Yet the creation and interpretation of Ishikawa diagrams involve several challenges.

Identifying Relevant Categories

One challenge involves determining relevant categories for potential causes. It requires a strong understanding of the process or problem at hand.

Mitigation Tips :

- Involve cross-functional teams in brainstorming sessions.

- Conduct thorough reviews of existing process documentation.

Categories must reflect all aspects that could influence the issue.

Ensuring Comprehensive Cause Analysis

An Ishikawa diagram must encompass all possible causes. A narrow focus compromises its effectiveness.

- Facilitate exhaustive cause-and-effect discussions.

- Ensure team members understand they must consider wide-ranging factors.

Comprehensive analysis reduces the risk of overlooking critical causes.

Avoiding Overcomplexity

Complex diagrams confuse more than clarify. Keeping diagrams straightforward aids comprehension.

- Focus on major cause categories initially.

- Drill down into sub-causes in successive diagrams if necessary.

This staged approach manages complexity effectively.

Maintaining Team Consensus

Reaching consensus among team members poses another challenge. Diverse perspectives can lead to conflict or confusion.

- Utilize neutral facilitators to guide discussions objectively.

- Establish clear rules for the cause-vetting process.

This helps maintain focus and ensures productive dialogue.

Validating Assumptions

Assumptions in Ishikawa diagrams may not always reflect reality. Validating these assumptions is a critical step for accurate diagrams.

- Pair causes with supporting data wherever possible.

- Revisit assumptions regularly to confirm their validity.

Data-driven validation strengthens the diagram's reliability.

Facilitating Effective Interpretation

Even well-constructed diagrams can be difficult to interpret. Misinterpretation can lead to incorrect conclusions.

- Provide training on Ishikawa diagram reading and interpretation.

- Create a legend or guide to explain symbols and layout conventions.

Clear interpretation guidance ensures accurate readings.

Supporting Decision Making

Ishikawa diagrams aim to inform decision-making. They must present information in a manner supportive of this goal.

- Prioritize identified causes based on impact and likelihood.

- Use the diagram as a starting point for further analysis or experimentation.

Prioritization helps target the most significant causes first.

The creation and interpretation of Ishikawa diagrams come with distinct challenges. Addressing these systematically enhances the effectiveness of the diagrams. It involves ensuring the relevance of categories, thoroughness in cause analysis, simplicity, consensus, assumption validation, proper interpretation, and decision-making support. When teams mitigate these challenges properly, Ishikawa diagrams serve as powerful tools for problem-solving and quality improvement efforts.

He is a content producer who specializes in blog content. He has a master's degree in business administration and he lives in the Netherlands.

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Fishbone Diagram

A fishbone diagram, also known as an Ishikawa diagram or cause and effect diagram, is a tool used to identify the root causes of a problem. It is named after Japanese quality control expert Kaoru Ishikawa, who developed the concept in the 1960s. Organizations across a variety of industries, including manufacturing, healthcare, and service use the fishbone diagram to identify and analyze the factors that contribute to a particular problem or issue.

Teams typically use a fishbone diagram to identify all of the possible causes of a specific problem or effect. You construct it by drawing a horizontal line with the problem or effect written at the end, and then drawing lines coming off of the central line to represent the different categories of causes. Teams typically label it with the major contributing factors, such as people, equipment, materials, environment, and methods.

Once a team determines the categories, the next step is to brainstorm and list out all of the potential causes within each category. You then draw the causes as branches off of the main lines, with each branch representing a specific cause.

Once a team has identified and listed all of the causes, the next step is to analyze the relationships between the causes to identify the root causes of the problem. You can do this through a variety of techniques, such as the 5 Whys method, which involves asking why the problem occurs repeatedly until the root cause is identified.

Once a team has identified the root causes, the next step is to develop and implement solutions to address those root causes. This can involve making changes to processes, equipment, training, or other factors that contribute to the problem.

The fishbone diagram is a valuable tool for identifying and addressing the root causes of a problem. By systematically analyzing the factors that contribute to a problem, organizations can develop effective solutions and improve the overall performance and quality of their processes.

Fishbone Diagram Example

When building a fishbone team members should be careful to include only the actual physical causes. It can be tempting to include items someone believes is happening or wishes were happening. Consequently, a fishbone can turn into a “wishbone” diagram.

Additional Resources on the Fishbone Diagram

• Ask Art: How Useful is Six Sigma and the Black Belts and Green Belts that Come with It?
• Jim Womack on how lean compares with Six Sigma, Re-engineering, TOC, TPM, etc., etc.
• Not Every Problem Is a “Nail” But Companies Typically Reach for the Same Old “Hammer”
• Why A3 Thinking is the Ideal Problem-Solving Method
• Developing Problem Solvers
• Fishbone Diagrams and Mind Maps

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Cause and Effect Diagram (Fishbone, Ishikawa): Ultimate Guide with Examples

Last Updated on January 8, 2024 by andrewshih

The Cause and Effect Diagram, also known as the Fishbone or Ishikawa Diagram, is a useful visual tool that aids in identifying and understanding the root causes of a problem. 

In this comprehensive guide, we will explore the intricacies of the Cause and Effect Diagram, providing a step-by-step procedure, a practical example, and resources for implementation.

What Is Cause And Effect Diagram

Cause and Effect Diagram is a graphical representation that illustrates the cause-and-effect relationships within a system or a specific problem. 

The diagram gets its name from its fishbone-like structure, where the problem statement is placed at the “head,” and various potential causes branch out like the “bones” of the fish.

By visually organizing potential causes into distinct categories, the diagram helps teams and individuals gain a clearer understanding of the relationships between different elements of a system, process, or situation.

When To Use A Fishbone Diagram

Here are some instances when using a Fishbone Diagram is particularly beneficial:

Complex Problem Solving

Quality improvement.

In industries that prioritize quality control, such as manufacturing or healthcare, a Fishbone Diagram is often used to investigate defects, errors, or deviations from standards. It helps teams explore and address the underlying causes affecting product or service quality.

Process Improvement

When analyzing and improving business processes, a Fishbone Diagram can be instrumental in identifying bottlenecks, inefficiencies, or breakdowns in the workflow. By categorizing potential causes, teams can streamline processes for increased efficiency.

Project Planning

Team collaboration.

When teams are working on a shared goal or project, a Fishbone Diagram encourages collaborative brainstorming sessions. It provides a visual platform for team members to contribute their insights and perspectives, fostering a collective understanding of the problem.

Customer Complaints

In customer-centric industries, a Fishbone Diagram can be deployed to investigate and address customer complaints. It helps identify the underlying causes of dissatisfaction and guides the development of strategies to enhance customer satisfaction.

Training and Development

In educational settings or corporate training programs, a Fishbone Diagram can be utilized to analyze challenges or obstacles hindering effective learning and development. It assists in identifying areas for improvement in training processes.

Strengths of Cause and Effect Diagrams

Visual representation.

One of the main strengths of cause and effect diagrams is their ability to provide a visual representation of complex issues. The diagram’s fishbone structure allows for a clear and organized display of potential causes and their relationships, making it easier for teams to understand and communicate.

Systematic Analysis

Cause and effect diagrams promote a systematic approach to problem-solving. By categorizing potential causes into major branches, teams can methodically explore and analyze each factor, leading to a comprehensive understanding of the root causes of a problem.

Collaborative Problem Solving

The creation of a cause and effect diagram often involves collaborative brainstorming sessions. This encourages team members to share their insights and perspectives, fostering a collaborative problem-solving environment that capitalizes on collective knowledge and expertise.

Identification of Multiple Causes

The diagram facilitates the identification of multiple causes contributing to a single problem. This multiperspective analysis helps ensure that the root causes are thoroughly explored, reducing the likelihood of overlooking critical factors.

Weaknesses of Cause and Effect Diagrams

Oversimplification.

One weakness of cause and effect diagrams is the potential for oversimplification. The structured nature of the diagram may not capture the complexity or interdependencies of certain issues, leading to a superficial understanding of the problem.

Subjectivity in Prioritization

Lack of quantitative data.

Cause and effect diagrams are primarily qualitative tools and do not inherently incorporate quantitative data. While they are effective in identifying potential causes, they may not provide a precise measurement of the impact or significance of each cause, requiring supplementary quantitative analysis.

How to Create Fishbone Diagram Step-by-Step

Creating a Cause and Effect Diagram involves systemically identifying and categorizing potential causes of a specific problem. Here are the steps to create a cause-and-effect diagram:

Step 1: Define the Problem Statement

Step 2: identify major categories (fishbone bones).

The next step is to create the main branches, or “bones,” of the fishbone diagram.

Teams using cause-effect diagrams often use additional mnemonic lists to ensure a thorough consideration of potential causes. For example, the manufacturing industry frequently utilizes 5Ms, and the service industry often uses 5Ps.

Step 3: Brainstorm Causes Within Each Category

Encourage open discussion and gather as many ideas as possible. There are several techniques that may be helpful during the storming process.

Step 4: Add Subcauses and Details

Continue this process until the team feels that the causes and sub-causes are sufficiently detailed. The team can continue to add additional sub-levels to sub-causes if necessary, although the diagram can become more difficult to visualize with multiple levels.

Step 5: Prioritize Causes

Step 6:  review, validate, and implement.

By following these steps, the team can utilize the Fishbone Diagram to systematically analyze complex problems, identify root causes, and drive effective solutions.

Tips for Creating a Cause and Effect Diagram

Tips for creating the diagram, tips for collaboration, cause and effect diagram examples, example 1: production delays in a manufacturing plant.

In this scenario, you are tasked with identifying the various factors contributing to production delays, allowing the team to identify root causes and implement targeted solutions.

Example 2: High Employee Turnover in a Company

In this scenario, you are tasked with identifying the root causes of high employee turnover and guiding the development of strategies to improve retention.

Problem Statement : High turnover rates lead to instability and decreased morale among employees.

While taking a deep dive and examining the potential causes of insufficient recruitment, the team identified poor job descriptions, limited recruitment channels, and a competitive job market.

Example 3: Customer Complaints in a Service Industry

In this scenario, you are tasked with understanding the causes of multifaceted customer complaints and helping the organization to enhance its service quality and address customer concerns effectively.

As the team continued to look into the cause of insufficient staffing, the team identified budget constraints, poor scheduling, and unexpected sickness as the causes.

Cause And Effect Diagram Complimentary Techniques

Affinity diagram.

Together, these tools provide a comprehensive approach to problem-solving, transitioning from idea generation and organization to in-depth cause-and-effect analysis.

5 Whys Analysis

Pareto chart.

How do I prioritize causes in a Fishbone Diagram?

Causes can be prioritized based on their significance or impact. This can be done through team discussion, voting, or using data such as the Pareto Principle to identify the most critical factors that require immediate attention.

Yes, a Fishbone Diagram can be a useful tool in the planning phase of a project. It helps anticipate potential challenges, risks, and issues, allowing teams to develop proactive strategies for successful project outcomes.

What is the difference between an affinity diagram and a fishbone diagram?

An affinity diagram is used for brainstorming and organizing ideas, providing a foundation for a Fishbone Diagram. The Fishbone Diagram then conducts a more detailed analysis of root causes within specific categories identified by the affinity diagram. They work together in a collaborative problem-solving process.

The Fishbone Diagram typically consists of six major elements or “bones.” These elements represent different categories under which potential causes of a problem are grouped. The six categories are People, Processes, Equipment, Materials, Environment, and Management . Each category helps organize and analyze potential causes systematically, providing a comprehensive view of the factors contributing to a specific issue.

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Cause and Effect Analysis

Identifying the likely causes of problems, (also known as cause and effect diagrams, fishbone diagrams, ishikawa diagrams, herringbone diagrams, and fishikawa diagrams.).

When you have a serious problem, it's important to explore all of the things that could cause it, before you start to think about a solution.

That way you can solve the problem completely, first time round, rather than just addressing part of it and having the problem run on and on.

Cause and Effect Analysis gives you a useful way of doing this. This diagram-based technique, which combines Brainstorming   with a type of Mind Map   , pushes you to consider all possible causes of a problem, rather than just the ones that are most obvious.

Click here   to view a transcript of this video.

About the Tool

Cause and Effect Analysis was devised by professor Kaoru Ishikawa, a pioneer of quality management, in the 1960s. The technique was then published in his 1990 book, " Introduction to Quality Control ."

The diagrams that you create with are known as Ishikawa Diagrams or Fishbone Diagrams (because a completed diagram can look like the skeleton of a fish).

Although it was originally developed as a quality control tool, you can use the technique just as well in other ways. For instance, you can use it to:

• Discover the root cause of a problem.
• Uncover bottlenecks   in your processes.
• Identify where and why a process isn't working.

How to Use the Tool

Follow these steps to solve a problem with Cause and Effect Analysis:

Step 1: Identify the Problem

First, write down the exact problem you face. Where appropriate , identify who is involved, what the problem is, and when and where it occurs.

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Then, write the problem in a box on the left-hand side of a large sheet of paper, and draw a line across the paper horizontally from the box. This arrangement, looking like the head and spine of a fish, gives you space to develop ideas.

In this simple example, a manager is having problems with an uncooperative branch office.

Figure 1 – Cause and Effect Analysis Example Step 1

(Click image to view full size.)

Some people prefer to write the problem on the right-hand side of the piece of paper, and develop ideas in the space to the left. Use whichever approach you feel most comfortable with.

It's important to define your problem correctly. CATWOE   can help you do this – this asks you to look at the problem from the perspective of Customers, Actors in the process, the Transformation process, the overall World view, the process Owner, and Environmental constraints.

By considering all of these, you can develop a comprehensive understanding of the problem.

Step 2: Work Out the Major Factors Involved

Next, identify the factors that may be part of the problem. These may be systems, equipment, materials, external forces, people involved with the problem, and so on.

Try to draw out as many of these as possible. As a starting point, you can use models such as the McKinsey 7S Framework   (which offers you Strategy, Structure, Systems, Shared values, Skills, Style and Staff as factors that you can consider) or the 4Ps of Marketing   (which offers Product, Place, Price, and Promotion as possible factors).

Brainstorm   any other factors that may affect the situation.

Then draw a line off the "spine" of the diagram for each factor, and label each line.

The manager identifies the following factors, and adds these to his diagram:

Figure 2 – Cause and Effect Analysis Example Step 2

Step 3: Identify Possible Causes

Now, for each of the factors you considered in step 2, brainstorm possible causes of the problem that may be related to the factor.

Show these possible causes as shorter lines coming off the "bones" of the diagram. Where a cause is large or complex, then it may be best to break it down into sub-causes. Show these as lines coming off each cause line.

For each of the factors he identified in step 2, the manager brainstorms possible causes of the problem, and adds these to his diagram, as shown in figure 3.

Figure 3 – Cause and Effect Analysis Example Step 3

Step 4: Analyze Your Diagram

By this stage you should have a diagram showing all of the possible causes of the problem that you can think of.

Depending on the complexity and importance of the problem, you can now investigate the most likely causes further. This may involve setting up investigations, carrying out surveys, and so on. These will be designed to test which of these possible causes is actually contributing to the problem.

The manager has now finished his analysis. If he hadn't looked at the problem this way, he might have dealt with it by assuming that people in the branch office were "being difficult."

Instead he thinks that the best approach is to arrange a meeting with the Branch Manager. This would allow him to brief the manager fully on the new strategy, and talk through any problems that she may be experiencing.

A useful way to use this technique with a team is to write all of the possible causes of the problem down on sticky notes. You can then group similar ones together on the diagram.

This approach is sometimes called CEDAC (Cause and Effect Diagram with Additional Cards) and was developed by Dr. Ryuji Fukuda, a Japanese expert on continuous improvement.

Professor Kaoru Ishikawa created Cause and Effect Analysis in the 1960s. The technique uses a diagram-based approach for thinking through all of the possible causes of a problem. This helps you to carry out a thorough analysis of the situation.

There are four steps to using the tool.

• Identify the problem.
• Work out the major factors involved.
• Identify possible causes.
• Analyze your diagram.

You'll find this method is particularly useful when you're trying to solve complicated problems.

This site teaches you the skills you need for a happy and successful career; and this is just one of many tools and resources that you'll find here at Mind Tools. Subscribe to our free newsletter , or join the Mind Tools Club and really supercharge your career!

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Comments (36)

• Over a month ago BillT wrote Hi AnotherFrancis, and Welcome to the Club! As with my response to Alex81, not everyone will find the example the most useful, as is the case with you. We appreciate your feedback. BillT Mind Tools Team
• Over a month ago AnotherFrancis wrote Nice article but, like Alex81, I didn't find the example to be very helpful.
• Over a month ago BillT wrote Hi Alex81, and Welcome to the Club! Thank you for your feedback on the Cause and Effect Analysis. I agree that not everyone may find the example the best way to demonstrate the resource. This diagram has also been known as the Ishikawa Diagram or Fishbone Diagram. You may find additional resources with better examples for you. Also, you may wish to post this in the Forums so that our members can provide their input into the topic. BillT Mind Tools Team

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Understanding Fishbone Analysis to Uncover and Solve Problems + Example

Learn how to use a Fishbone analysis and Fishbone diagram to uncover the root causes of a problem.

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In the dynamic landscape of small businesses, challenges come knocking regularly, and solutions aren’t always simple to come up with. In e-commerce, for example, a persistent problem emerges — abandoned shopping carts.

Picture a small startup doing pretty well when suddenly, one summer, customers fill baskets only to slip away before buying. If only the company knew what the root cause was so that next summer, they could avoid the same issue

There’s hope — the fishbone analysis — a method that dissects the intricacies of any business problem, including abandoned carts.

This guide covers the basics of conducting a fishbone analysis with your team to discern the best solutions to a problem. Plus, we’ll solve the issue of too many abandoned carts.

What’s a root cause analysis?

A  root cause analysis (RCA)  is the practice of assessing the underlying issues behind a problem. RCA helps define, measure, analyze, and control problems at their core.

There are several types of RCAs, including the Pareto chart, the 5 Whys and the fishbone analysis.

Pareto charts

A Pareto chart combines a bar graph with a line graph to highlight the frequency or impact of problems descending from left to right. It’s useful when you need to focus limited resources on addressing the most critical problems or improving the most important aspect of a process or system.

The 5 Whys is a simple RCA approach that prompts you to ask, “why did this happen?” about an issue five times. Each possible cause is drilled down on about five times until you reach the root. This RCA helps define the root cause of one problem in particular or can be combined with a fishbone diagram to find several root causes.

‎Fishbone analysis

A fishbone diagram visualizes the fishbone analysis in the shape of a fish skeleton by analyzing affinities (or categories) of a problem into many possible causes. The head is the problem statement — the large bones are the problem’s affinities, and the smaller bones are the possible root causes. Fishbone analysis is ideal for complex problems with many affinities and root causes.

What is a fishbone analysis?

Fishbone analysis is a visual discovery tool used to uncover problems by analyzing root causes. The fishbone analysis diagram highlights the root of any business problem — from manufacturing to local retail.

Fishbone diagrams help teams analyze complex issues and develop targeted solutions. Fishbone analysis is typically conducted with a group of subject matter experts. The diagram on a board fosters collaboration and structured problem-solving.

Also known as the Ishikawa diagram or cause-and-effect diagram, the fishbone analysis (and its diagram) was developed by  Dr. Kaoru Ishikawa , a Japanese quality control expert.

Fishbone analysis is an essential tool in  Six Sigma projects , where it’s used to identify and eliminate causes of defects and errors in an existing product or operation.

When to use a fishbone analysis

Using fishbone analysis and its diagrams are vital in these scenarios and many more like them:

• To investigate defects or quality issues in manufacturing processes.
• To identify factors affecting the development of a new product.
• To investigate workplace accidents or safety violations to prevent future occurrences.
• To investigate underlying causes of recurring customer complaints.
• To investigate root causes of software defects and glitches.

Use a fishbone analysis whenever you encounter a problem in your business with no visible solution. Problems can be business-oriented, production-oriented, and even customer-service-oriented. The fishbone's idea is to uncover any problem's root cause.

Anatomy of a fishbone analysis diagram

The fishbone analysis diagram looks like the bare bones of a fish. The head and spine represent a problem. The straight bones represent an affinity or category of causes, and the smaller bones represent the root causes.

The importance of a clear problem statement

The head of the fishbone represents the problem and must start with defining the problem you want to analyze. The more specific the definition, the better. Vague problem statements won’t inspire the team to brainstorm direct root causes. Here are two examples:

Vague problem statement:  Our sales are down

Detailed problem statement:  Our sales revenue in Region A declined by 15% compared to the same quarter last year, and this is the first year it has gone down instead of up.

‎Write the problem statement at the "head" of the fishbone and refer to it during the brainstorming session.

Selecting categories or affinities

In the visual fishbone diagram, a category or affinity is one of the prominent “bones” stemming from the spine. Each category must be an affinity of the problem statement; essentially, the things that can affect the problem and stem further into root causes.

Use at least four and no more than eight affinities for best results. If you have too many, it’ll get difficult to come up with the right solution, and if you have too few, some root causes might be missed.

Brainstorming root causes

Below or inside each categorical “bone”, start defining possible root causes. If, for example, the category is “website issues,” some root causes might be slow loading times, inefficient interface, and confusing navigation.

Brainstorming is easiest with a group;  meet with your team  to work on the fishbone analysis. Attempt to find up to five root causes per affinity. The idea is that from the root causes, you can come up with possible solutions.

Coming up with solutions

After the root causes are written down, you can start to analyze the solutions or actions to start solving the categorical issues one by one.

Try to add one or two solutions for each category and then rate them by importance and ease. When execution of the solutions begins, keep your fishbone diagram handy to see how the solutions help to address the original problem.

Types of fishbone analysis diagrams

There are three main types of fishbone analysis diagrams, and they all work as templates that can be applied to different industries.

6M fishbone analysis

The 6M fishbone analysis consists of six categories starting with the letter M you can analyze to find root causes. This analysis was created in the manufacturing industry but can also capture the root causes of other business problems.

‎Manpower (Workforce)

This category looks at the human elements involved in the process or problem, such as skills, training, knowledge, and workforce issues.

Methods refer to the processes and procedures for carrying out a task or operation. Problems related to inefficient or ineffective methods fall under this category.

Materials include all the physical resources used in a process, such as raw materials, components, and supplies. Problems in quality or availability are considered here.

Machinery can include equipment, machinery, tools, and technology, with machine performance, maintenance, or breakdown issues.

Measurement

Measurement involves metrics, data, and measurement systems. Problems related to inaccurate or inadequate measurement processes fall into this category.

Mother nature (Environment)

This category includes external factors beyond human control, such as weather, temperature, humidity, or other environmental conditions.

4S fishbone analysis

The 4S fishbone analysis uses fewer categories to analyze a problem. It works for any business problem in the service industry. That said, it can be used for any other industries as well.

Surroundings

This category refers to the physical environment in which a service is delivered or a process occurs, including the workspace layout, cleanliness, lighting, and overall atmosphere.

Suppliers encompass all the external entities and resources that provide inputs. This includes external vendors, subcontractors, or anyone who plays a role in supplying materials or information.

Systems relate to the processes and procedures that govern how work is done. It includes the systems used for scheduling, communication, documentation, and any software or technology systems.

Skills involve the responsible individuals' competencies, training, and capabilities.

8P fishbone analysis

The 8P fishbone is a larger example, typically used in enterprise scenarios where the problems have lots more categories than a small business might have.

This category covers aspects related to the product itself, such as its design, quality, features, and specifications.

Price considerations involve factors like the cost of the product or service, pricing strategies, and how price impacts customer perceptions.

Place refers to the distribution and location aspects of delivering a product or service, including distribution channels, accessibility, and geographic reach.

Promotion encompasses marketing and advertising efforts, including advertising channels, promotional materials, and messaging.

People are the individuals involved in the process, including employees, customers, and stakeholders. This category focuses on their roles, attitudes, and interactions.

Processes include the methods and procedures used to deliver a product or service. This category explores efficiency, workflow, and process design.

Physical evidence

Physical evidence refers to tangible elements that support the service or product, such as packaging, signage, or physical facilities.

Performance

Performance relates to how well a product or service meets the expectations and needs of customers. It considers quality, reliability, and customer satisfaction.

‎Fishbone analysis diagram example with custom categories | E-commerce business use case

Standard fishbone analysis diagrams are great, but a fishbone analysis with custom categories is ideal for small businesses. First, you write the problem statement; then, you select between four and eight categories of possible causes and build out the diagram.

In this example use case, the goal was to identify critical root causes behind the increase in abandoned carts and to formulate strategic solutions for increased customer satisfaction and retention during an upcoming summer season.

The team analyzed five custom categories and brainstormed between two and five root causes per category. They came up with solutions, some quickly and some that needed more work.

Take a look at their analysis. Below each category are the root causes and, below them, the chosen action. This analysis is only an example; you can go into much more detail on your own fishbone analysis.

Product pricing

Root Causes:

• Lack of seasonal discounts
• Price competitiveness
• Hidden costs

Proposed solution:  Offer more attractive summer discounts, bundle deals, and exclusive offers.

Customer behavior

• Customers put things in their carts and then forget
• Browsing behavior
• Seasonal buying patterns

Proposed solution:  Send better cart abandonment emails with personalized product recommendations to encourage the completion of purchases.

Website factors

• Slow page load time
• Complex checkout process
• Mobile responsiveness issues

Proposed solution:  Optimize speed by investing in content delivery networks and reducing unnecessary scripts on the product pages

Marketing and communication

• Ineffective email follow-ups
• Misaligned seasonal campaigns
• Insufficient retargeting ads

Proposed solution:  Join forces with the solution from customer behavior and develop a cart abandonment email sequence.

Customer service and support

• Inadequate product information
• Limited customer support availability
• Return policy concerns

Proposed solution:  Enhance product descriptions and create and upload high-quality images. Encourage user-generated content.

Competitive environment

• Competitors have more appealing loyalty programs
• Product variety
• Competitor promotions

Proposed solution:  Develop an enticing loyalty program that rewards repeat customers with exclusive perks.

Uncover any problem with a fishbone analysis

As you incorporate the fishbone analysis into your problem-solving toolkit, remember that small businesses' challenges aren’t insurmountable. With the right tools and strategies, you can unravel the root causes behind any problem.

Use Motion to help you  schedule  brainstorming sessions – it’ll use AI to find a time when everyone is available. Then, use Motion project management to assign, schedule, and track  all the tasks  related to the suggested solutions. Let Motion schedule what gets done first and assess whether the problem is solved completely or whether you need more work with your team.

Try Motion for free today  and start solving all your business’s problems efficiently.

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How to Use Fishbone Diagram for Problem Solving

Fishbone diagram is a problem-solving tool, used in literal terms like a fishbone. It is also known as a cause and effect diagram. The mechanism is to specifically identify the cause and effect of any business or project problem.

A fishbone diagram can help define potential reasons for an issue. This article will dive into understanding the core principles of the fishbone diagram problem solving as a tool.

In 1943 at Tokyo University, Kaoru Ishikawa created the "Fishbone Diagram." Fishbone diagrams can also be called diagrams of "cause and effect." The fishbone diagram problem solving tool is a perfect tool to dig through an issue when we try to assess the root cause and find a solution effectively.

It offers a mechanism for explicitly identifying the "effect" and then brings you to think about the potential triggers, based on typical manufacturing problems. The fishbone diagram problem solving is a basic model that makes it easy to grasp swift and efficient root causes to implement corrective behavior.

It reflects the question or impact at the fish's head or mouth. Possible contributing factors under separate causal groups are identified on the smaller "bones." A fishbone diagram can help define potential reasons for an issue that would otherwise not be discussed by encouraging the team to look through the definitions and discuss alternate reasons.

Source: EdrawMind

1.1 Why Use Fishbone Diagram for Problem Solving

The fishbone diagram makes you consider more when solving specific problems. During a brainstorming activity, various groups inspire thoughts from different areas.

The fishbone diagram brings order to the process of cause and effect . It's easy for participants to understand the main problems or issues and focus on the question across different potential triggers.

The fishbone diagram helps distinguish the causes and reasons for a problem and lets people intuitively figure out the solutions.

1.2 The Usage of Fishbone Diagram

The fishbone diagram problem solving method can be used when trying to fix problems or discover the root cause of an issue or problem, which helps you to see below the surface, and dive deeper into the real problem.

Here are several typical fishbone diagram problem solving applications:

• Manufacturing: ,nbsp;Uncover the root cause of a manufacturing problem by brainstorming and rating the likelihood and effect of all factors affecting the manufacturing cycle;
• Marketing or Product Marketing: ,nbsp;Identify the possible factors that may impede your company's popularity in the marketplace by investigating all the places that affect your product acceptance;
• Service: ,nbsp;Uncover the root cause of a business issue by brainstorming, and rate the probability and effect of all factors impacting the service delivery process.

There are 7 steps lead you to use fishbone diagram for problem solving:

• Explain the agenda behind the diagram

Let your team members know that the diagram can help you see different fields or possible areas that might lead to a solution to your current business problem.

• Draw diagrams

Draw the pattern or shape on your whiteboard, or use a software diagramming tool to ease accessibility. If you need remote attendants to do this exercise, you can quickly build it in EdrawMind and display your computer.

• Determine a simple statement on an issue

Write down statements at the top of your page or above where you will build the diagram., which means everyone has the same idea of the issue you are concerned with.

• Select what categories to use

Categories are discussed in more detail below. For example, you can add Policies, Methods, Personnel, and Software categories.

• Identify potential causes within each category of your problem

Team members may trigger brainstorming or contribute factors that fall into this category. You can either go by category or only come up with ideas and determine which type they fit.

• Go a step deeper to define sub-causes for any cause in the category

If you decide whether something can or will break down to smaller points, build divisions from the critical point.

Team members study the diagram to determine the most relevant focus points. If you are trying to take this a step forward and fix the root cause, it helps define where you're trying to benefit your initiative. You can't solve all the root factors at once, and some can get more significant payoff than others. Check the diagram for an evaluation of where the concentration of the team is best.

• Record results

You bring the work in. Capture, and log your work. You will need to return to it later, so you don't want to miss the importance of the exercise that you got.

There are several tips that should be considered when using the fishbone diagram for solving problems:

• Using the fishbone diagram tool to keep the team focused not on signs, but the problem's causes;
• Make sure you leave ample room in the diagram between the main groups to add minor specific pointers later;
• Try making team members write every cause on sticky notes while you're brainstorming causes, moving around the community asking each person about a particular reason. Continue to go through the loops, have more pointers before all suggestions have been eliminated;
• Encourage each person to join in the brainstorming exercise and voice their own opinions;
• Remember that the strategy of "five-whys" is often used in combination with the fishbone diagram.

While it takes time to create a fishbone diagram , it will help you and your team define the real causes and encourage you to strengthen the process and make permanent improvements.

Regardless, whether you are using the graphical or indented fishbone hierarchy, this process optimization method will significantly help you understand the factors involved in a process. The root causes of the event are the underlying process and system issues, which allowed the contribution. Hence fishbone diagram , the problem-solving tool, is extremely crucial when discussing strategies to deal with problems.

EdrawMind is an easy-to-use, flexible mind mapping tool designed to help you generate modern, fresh visuals and mind maps. By combining the bullet points into a mind map on a project, EdrawMind lets you organize the thoughts or concepts and create essential strategies.

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The Art of Effective Problem Solving: A Step-by-Step Guide

Whether we realise it or not, problem solving skills are an important part of our daily lives. From resolving a minor annoyance at home to tackling complex business challenges at work, our ability to solve problems has a significant impact on our success and happiness. However, not everyone is naturally gifted at problem-solving, and even those who are can always improve their skills. In this blog post, we will go over the art of effective problem-solving step by step.

Problem Solving Methodologies

Methodology of 8D (Eight Discipline) Problem Solving:

A3 Problem Solving Method:

The A3 problem solving technique is a visual, team-based problem-solving approach that is frequently used in Lean Six Sigma projects. The A3 report is a one-page document that clearly and concisely outlines the problem, root cause analysis, and proposed solution.

Subsequently, in the Lean Six Sigma framework, the 8D and A3 problem solving methodologies are two popular approaches to problem solving. Both methodologies provide a structured, team-based problem-solving approach that guides individuals through a comprehensive and systematic process of identifying, analysing, and resolving problems in an effective and efficient manner.

Step 1 – Define the Problem

By repeatedly asking “ why ,” you’ll eventually get to the bottom of the problem. This is an important step in the problem-solving process because it ensures that you’re dealing with the root cause rather than just the symptoms.

Step 2 – Gather Information and Brainstorm Ideas

Gathering information and brainstorming ideas is the next step in effective problem solving. This entails researching the problem and relevant information, collaborating with others, and coming up with a variety of potential solutions. This increases your chances of finding the best solution to the problem.

Next, work with others to gather a variety of perspectives. Brainstorming with others can be an excellent way to come up with new and creative ideas. Encourage everyone to share their thoughts and ideas when working in a group, and make an effort to actively listen to what others have to say. Be open to new and unconventional ideas and resist the urge to dismiss them too quickly.

Once you’ve compiled a list of potential solutions, it’s time to assess them and select the best one. This is the next step in the problem-solving process, which we’ll go over in greater detail in the following section.

Step 3 – Evaluate Options and Choose the Best Solution

Once you’ve compiled a list of potential solutions, it’s time to assess them and select the best one. This is the third step in effective problem solving, and it entails weighing the advantages and disadvantages of each solution, considering their feasibility and practicability, and selecting the solution that is most likely to solve the problem effectively.

You’ll be able to tell which solutions are likely to succeed and which aren’t by assessing their feasibility and practicability.

Step 4 – Implement and Monitor the Solution

When you’ve decided on the best solution, it’s time to put it into action. The fourth and final step in effective problem solving is to put the solution into action, monitor its progress, and make any necessary adjustments.

Finally, make any necessary modifications to the solution. This could entail changing the solution, altering the plan of action, or delegating different tasks. Be willing to make changes if they will improve the solution or help it solve the problem more effectively.

You can increase your chances of success in problem solving by following these steps and considering factors such as the pros and cons of each solution, their feasibility and practicability, and making any necessary adjustments. Furthermore, keep in mind that problem solving is an iterative process, and there may be times when you need to go back to the beginning and restart. Maintain your adaptability and try new solutions until you find the one that works best for you.

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What is a fishbone diagram—and what can it do for you?

Any bump in the design process can be a learning opportunity. Maybe an unexpected setback is delaying product development, or you're worried your next release may not get rave customer reviews. Whatever issue you’re facing, the fishbone diagram is a simple and effective brainstorming tool that can help you solve problems—and keep them from cropping up in the first place.

Read on to learn more about:

• What a fishbone diagram is
• How a fishbone diagram can help you solve problems
• 5 steps to create a fishbone diagram—and FigJam tools that make it easy

Create your fishbone diagram with FigJam

Get started with FigJam's free fishbone diagram template today.

What’s a fishbone diagram?

A fishbone diagram is also known as the cause-and-effect diagram, because it highlights the causes of a current or potential problem, or any other deviation from your team’s standard workflow.  Companies use fishbone diagrams to help streamline processes, boost customer satisfaction, and drive better business outcomes.

The diagram actually looks like a fish skeleton. A horizontal arrow represents the fish spine and points to the problem (or effect), which is the head of the fish. Shorter arrows act as the fish ribs, branching out to expose the problem’s causes.

How the fishbone method solves problems

The fishbone method of analysis helps teams go deep with their problem-solving, uncovering key factors teams can target and troubleshoot. When used effectively, a fishbone diagram can help you 1 :

• Easily identify and categorize the causes —big and small—of a particular problem in a highly visual way.
• Develop actionable solutions more quickly by providing a structured yet flexible approach to address problems.
• Promote a more effective work environment by fostering better collaboration and communication across teams.
• Continuously improve your product or process by documenting root causes to avoid repeating the same mistakes in the future.

5 steps to create a fishbone diagram

Build your own fishbone diagram in five steps 2 :

Step 1: Define the problem.

Create a clear, concise problem statement. This should address a known issue or one you’re trying to prevent, such as “customer satisfaction rate for our app has fallen 20%.” Use FigJam’s online whiteboard to brainstorm and agree on a problem statement. Or try FigJam’s fishbone diagram template .

Step 2: Label potential issues.

You can use the six labels in the classic fishbone diagram (see sidebar), or create your own set of categories to suit the product and problem facing your team. For example, Mazda chose styling, touch, cornering, driving, listening, and braking as key issues to address in developing the MX5 Miata sports car.

Step 3: Brainstorm all possible causes.

Ask why this problem occurred, and organize possible causes by category. For example, under the people category, you might list causes for a drop in customer satisfaction as staff burnout, lack of training, or employee turnover. Some causes may fit under more than one category.

Step 4: Add more detail to your fishbone analysis.

Keep asking why to further identify sub-causes that contribute to the problem. FigJam’s 5 whys template will help you dig deeper.

Step 5: Review each cause and develop action items.

Work with your team to create a list of action items that will help solve the problem. Invite your team to check the finished diagram, making sure no detail has been overlooked (see sidebar).

Creative examples of fishbone diagrams

Popularized in Japan’s manufacturing industry in the 1960s, the fishbone or Ishikawa diagram is now industry-standard in multiple fields. From healthcare and higher education to retail and high tech, fishbone diagrams  help teams improve and innovate.

For inspiration, consider these creative examples from a range of industries:

• Product defects fishbone diagram , Journal of Minerals and Materials Characterization and Engineering
• Carver County Public Health fishbone diagram , Minnesota Department of Health
• Cause and effect of blurry photos , Michigan State University Extension
• Bad coffee fishbone diagram , Kaizen Consulting Group

The classic 6-rib fishbone diagram

A typical fishbone diagram includes six ribs , each labeled with a potential issue to address. This could include:

• People. Evaluate everyone involved in the process, including their skill level, training, and performance.
• Machines. Examine equipment and any maintenance or upgrades required to solve a problem.
• Materials. Assess the raw and finished materials used. Do they meet expectations?
• Environment. Consider external factors such as bad weather or safety issues that can affect the development cycle.
• Method. Audit your team’s process—the number of steps, their complexity, and any potential bottlenecks.
• Measurement. Review the way your process is measured, controlled, and monitored.

Fishbone analysis pitfalls to avoid

The simplicity of a fishbone diagram makes it easy to use and understand, but it can also make it harder to prioritize tasks. Of all the causes identified in a fishbone diagram, a problem’s main causes aren’t necessarily ranked ahead of minor ones. It’s up to you and your team to prioritize issues that will have the most impact versus those that won’t.

Fishbone diagrams can sometimes reflect human biases, so you'll need to work to maintain objectivity. Gather input from key players across your company to ensure your fishbone analysis is valid and complete.

Bone up on your fishbone diagrams with FigJam

Problem-solving is a team sport. Work together to zero in on root causes using FigJam’s online collaborative whiteboard , then organize them with FigJam’s ready-made fishbone diagram template . If you’d rather make one from scratch, use FigJam’s free diagramming tools to:

• Produce an easy-to-understand visual that clearly shows cause-and-effect relationships.
• Collaborate in real time with key stakeholders to make sure the causes included are accurate and actionable.
• Construct a polished diagram that supports your brand and is presentation-ready.

Want to see an example of a fishbone diagram created in FigJam? Check out these inspiring fishbone diagrams shared by the Figma community .

Now you’ve got what you need to solve problems—and prevent them, too.

Go to next section

[1] https://6sigma.com/benefits-of-using-the-fishbone-diagram/

[2] https://www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/resources/job-aid-5-whys.pdf

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7 Steps to a Fishbone Diagram and to Identifying Those Causes

Often referred to as a cause and effect diagram, or Ishikawa, it is a simple root cause analysis tool that is used for brainstorming issues and causes of particular problems and can and often is used in conjunction with the 5 Whys tool.

In a fishbone diagram, the various causes are grouped into categories and the causes cascade from the main categories, flowing towards the effect, forming what resembles a fishbone appearance.

The prime remit is to brainstorm all the possibilities that could cause the problem and then drill down to the factor(s) that are causing this issue. Once found, eliminate them. It enables the team to focus on why the problem occurs, and not on the history or symptoms of the problem, or other topics that digress from the intent of the session. It also displays a real-time ‘snap-shot’ of the collective inputs of the team as it is updated.

How to Conduct a Fishbone Diagram

Draw the box on the right of a flip chart or large dry wipe board, and write the problem statement in the box. Be as clear and specific as you can about the problem.

Now draw the line going from left to right as the ‘Spine’, connecting to the problem statement.

Draw the ‘fishbones’ emanating from the spine. These represent the main cause categories.

Now label each Fishbone category. There are two options here. You can use the generic cause categories of People, Method, Machine, Material, Environment, which is easier to use for a group that is relatively new to this exercise, or you can brainstorm the major categories related to the specific problem.

Now brainstorm all the causes to the problem. You could use the approach of writing each cause on post it notes, going around the group asking each person for one cause. Continue going through the rounds, getting more causes, until all ideas are exhausted.

For each cause, agree in the group which category the issue should fall in. (An issue can fall in a number of categories) and continue this process until the group have run out of ideas.

• Next, get each individual in the team in turn, to put a tally mark against the top three causes they think affect the problem. You can use supporting data to help you decide, if it is available.
• Once completed, the facilitator adds up all the tallies for each cause and selects the top three with the highest scores. These three issues will now form the basis of additional investigation in order to find the root cause. The team may then investigate these causes further and use problem-solving techniques like 5 Whys to eliminate their occurrences.

An example Fishbone Diagram

The group in the example below, had a problem with excessive scrap. They then got a cross functional team together to understand possible reasons, listing each possible cause into categories.

The next step would be to pick the top three causes and delve deeper to find the true root causes.

A Few Tips Along the Way

1. Remember, as with any task-based activity, always close the session off with actions and owners – “Who is doing what by when?” This is important, as it keeps the teams focused on the project.

2. Hold people accountable and summarise the event, including the actions and deliverables to take away.

3. Have regular reviews with the team in between events, checking for status against the action plan, and work ways of getting tasks back on track if they are falling behind schedule. Keep on top of everything!

4. Leave every task and bit of information clear and concise, so the team understands what is expected of them.

5. As a part of Visual Management, why not create and place a number of large Problem solving boards around the shop floor or in the office. Get the teams to start identifying day to day issues, using QCPC charts and then running quick problem solving sessions, using fishbone diagrams and 5 whys together, 3 times a month for the highest turnbacks on these QCPC charts. You will systematically be embedding a problem solving and continuous improvement culture without even knowing it!

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How to build a fishbone diagram and get the most out of it

No business operates without problems along the way. But to solve them in time, you’ll need to be able to determine the cause quickly. That’s where using a fishbone diagram comes in.

A fishbone diagram , also known as the Ishikawa diagram or cause-and-effect diagram, is a tool you can use to visualize all of a problem’s potential causes, allowing you to discover the root causes and identify the best possible solution.

We put this guide together to show you how to make a fishbone diagram based on a fictional problem we’ll be investigating: why a software company’s customer churn is so high.

Let’s get started.

Step 1 – Define the problem

The first step to solving any problem – and the key to learning how to make a fishbone diagram – is correctly defining it. A clearly defined problem makes it easier to identify causes. It also encourages us to determine whether there’s even a problem to begin with.

In this case, the problem we’ve identified is that 40% of users cancel their subscriptions after the first month — which keeps us from reaching our goal of keeping cancellations below 20%. Now that we’ve identified our main problem, we can go ahead and add that to the fishbone diagram.

Problem definition tips:

• If you’re using the fishbone diagram to design a process or increase productivity, it’s just as important to correctly define your output. Your goals should be objective and achievable.
• Place the problem (the fish head) on one side of the diagram, and build the rest of the diagram (the fish bones) out to its left or right. The idea is that the “fish bones” indicate the impact of the causes.
• Place the causes with the biggest impact closer to the fish head and the causes with the smaller impact further away.

Step 2 – Decide on key categories of causes

Next, decide what areas of the problem are key to determining the actual cause. Going back to our example of investigating a high churn rate, here are three areas worth looking into:

• Subscription system

Once you start considering potential causes, you might find that most of them fall within one of these three categories. But you can always add more categories if needed. For example, If you think marketing impacted your retention figures, you could add that as a fourth area.

You can have as many areas as you need to. But to keep things simple, we recommend limiting yourself to no more than 10 — especially since we’re only learning how to make a fishbone diagram with this example.

Step 3 – Determine the actual causes of the problem

Now that you’ve defined the key areas to look into, let’s go through each one to determine all the individual influences that can affect our output. Look at each category and list every possible cause you can think of.

Looking at the subscription system, some possible causes include:

• We aren’t offering enough payment options
• The payment and registration systems are difficult to navigate
• Credit cards expire, voiding renewal
• The system doesn’t send out reminders for renewals.

When considering the user, potential causes include:

• Users don’t understand the full benefit of the software
• Users don’t know how to use all the functions
• Users experience delays when contacting support
• Users don’t use the software continuously, only requiring it for a few days at a time
• Users forget about the product.

When it comes to the software itself, potential causes may be:

• The software is unstable and crashes regularly
• The software is difficult to use
• Software installation requires multiple plugins to function well
• Key functionality requires additional subscriptions
• The software is insecure.

These are just a few potential causes. You should fill your fishbone diagram with as many different causes as you can come up with. Note that not every area of your diagram needs to have causes. Some might even have more causes than others.

Regardless, you now have a starting point to determine root causes. To keep going, investigate each cause to establish its actual effect on your output.

Tips to determine the actual cause:

• Run a brainstorming session or lay out a process map to generate better causes for your fishbone diagram
• Invite other team members in the process to make sure you’ve identified all the potential causes
• Some causes may have multiple sub-causes. Expand your fishbone diagram as needed to encompass all possible causes.

Step 4 – Using tools to plan the way forward

Remember, a fishbone diagram helps identify a problem’s causes. It doesn’t lead to solutions on its own. In fact, part of learning how to make a fishbone diagram is knowing what other tools you can use to identify causes more effectively.

Here are a few more tools to help you take your fishbone diagram to the next level:

Process Map

A process map is a flowchart of a specific system, showing all its inputs and outputs. It works best in areas like the manufacturing industry, where each product has a clearly defined process with multiple steps.

Process mapping involves looking at each step of the process one by one and listing all the potential influences. In an actual manufacturing environment, this may include being present on the production line and viewing the system, taking notes as you go through the process.

A process map is very effective at making sure you consider all the steps and influences involved in a system. In other words, it helps you clearly identify potential causes and add them to your fishbone diagram.

Brainstorming

Brainstorming is a fairly common tool in modern businesses. Instead of considering all the factors of a fishbone diagram by yourself, include others in the process. When working alone, it’s easy to overlook certain areas and completely miss others.

That’s why it’s worth making sure your  brainstorming session  takes the shape of a clearly-defined meeting. Have someone lead the session, taking note of any ideas team members offer up and leaving room for discussion. The goal is to end the brainstorming session with a list of causes to add to your fishbone diagram.

Once you’ve filled out your fishbone diagram, make sure everyone’s on the same page about how to follow up — whether it’s about delegating tasks or setting clear deadlines.

Tips for planning next steps:

• Not sure what causes to investigate? Collaborate with your team members on developing a cause-and-effect matrix. This way, you’ll get to rank causes by priority based on your team’s experience.
• Want to address a problem’s root cause and not just its symptom? Use our 5 Whys Template to take a closer look.
• How to make a fishbone diagram in a remote team

A fishbone diagram is more effective when multiple people get involved in creating it. But if your team works in remote and hybrid settings, you’ll need a tool designed to facilitate seamless collaboration.

Miro’s visual workspace is built for collaboration, making it easy to make a fishbone diagram together in real time — even if you aren’t in the same room. Seamlessly build diagrams using our intuitive, automated diagramming tools and our drag-and-drop, infinite canvas.

Not sure how to make a fishbone diagram from scratch? Save time using our free Fishbone Diagram Template . It’s fully customizable, allowing your team to add as much detail as you want and adjust its look and feel.

Tips for collaborating on a fishbone diagram in Miro:

• Invite your team to edit your board with you in real-time
• Invite stakeholders to view and comment on your Miro board for instant feedback
• Differentiate ideas by color-coding them
• Use frames to present your fishbone diagram and easily export it as a PDF or image
• Use sticky notes to add important context when building your fishbone diagram

Above all, avoid trying to build your fishbone diagram too quickly. Take the time to understand all the contributing factors, and make sure that anything you add to the fishbone diagram adds value.

• When to use a fishbone diagram?

Though fishbone diagrams were originally meant for problem-solving, they’re far more versatile — helping you break down any process or system into its contributing factors.

Here are a few use cases where knowing how to make a fishbone diagram comes in handy:

• To analyze a problem statement
• To brainstorm the causes of the problem (root cause analysis)
• To analyze a new design
• Process improvement
• Quality improvement

When in doubt, talk to your team to clarify the problem you’re investigating and how a fishbone diagram would help.

Miro is your team's visual platform to connect, collaborate, and create — together.

Join millions of users that collaborate from all over the planet using Miro.

• Step 1 – Define the problem
• Step 2 – Decide on key categories of causes
• Step 3 – Determine the actual causes of the problem
• Step 4 – Using tools to plan the way forward

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Fishbone Diagrams for Consequential Problem-Solving

Visualize Processes and Improve

The most successful businesses are not perfect. They are resilient. Every business encounters problems; most encounter them frequently. The ones that thrive are developing a problem-solving culture and arm employees with the tools to find and resolve the root causes of issues effectively. When employees are effective, empowered problem-solvers, obstacles turn into opportunities. One powerful problem-solving tool is the Fishbone Diagram.

What is a Fishbone Diagram?

A Fishbone Diagram also called an Ishikawa diagram or cause and effect diagram is a visual management tool used to document all the potential causes of a problem to uncover the root causes. The Fishbone Diagram helps users group these causes into categories and provides a structure to display them. When used effectively, it ensures that teams address the actual cause of the problem and don’t just implement a Band-aid solution.

The Fishbone Diagram is called such due to its resemblance to a fish’s skeleton. It was developed by Kaoru Ishikawa and became popular in the 1960s. It is used within many modern quality management methodologies, including Six Sigma and Lean Manufacturing. 

When to Use a Fishbone Diagram

Although we refer to the Fishbone Diagram as a structured problem-solving tool, it has other uses. It is helpful in breaking down the contributors to any process or system. Some ways to use it to test a problem statement, conduct root cause analysis, predict the results of a new process, streamline an existing process, improve quality outcomes, and uncover bottlenecks. 

How to Use a Fishbone Diagram

Step 1: Define the Problem

The first step in problem-solving, whether you use the Fishbone or not, is defining the problem correctly. Ideally, the problem statement will include an objective metric that can be used to determine success. For example, a problem statement such as, “The contact center abandon rate is too high,” will not be as helpful as a statement like, “The contact center abandon rate increased by 20% last month.”

In terms of the Diagram, the problem statement represents the “head” of the fish.

Keep in mind:

• If you are using a fishbone diagram to improve a process, instead of the problem, you will define your desired outcome in an objective and achievable way.
• Each of the “bones” in the diagram will represent a category of potential causes, but causes with the most significant impact should be closest to the “head.”

Step 2: Decide on Categories of Causes

The Fishbone tool forces you to think about the potential causes for the problem in several categories represented by the bones. The number will depend on the type and complexity of the problem. You can choose categories that make sense for your project, but in manufacturing, the 6 Ms are often used. They include:

• Man - the people involved in the process
• Methods - the Standard Work by which the process is performed
• Machines - the equipment and tools needed for the process
• Materials - the raw inputs, parts, consumables, and so forth
• Measurements - the data that is used to evaluate process results
• Mother Nature (Environment) - the conditions under which the process is performed.

Another commonly used structure is the McKinsey 7S Framework, which includes Strategy, Structure, Systems, Shared Values, Skills, Style, and Staff. Marketers may go with the 4Ps of Marketing; Product, Place, Price, and Promotion. Non-manufacturing process may include additional categories such as:

In our software call center abandon rate example, we’ll choose the categories of :

• Measurement
• Environment

Step 3: Brainstorm Potential Causes and Identify Roots

Now that the categories are defined, the team can go through each one and try to determine all the individual influences that can affect our results. Look at each type and list everything that falls within it. If a potential cause sounds more like a symptom than the root of the matter, the 5 Whys technique can be used to ensure that bottom-line reasons are included. If a source cause supersedes a potential cause, it can be removed from the diagram, or you can use strikethrough to preserve it while moving on to the fundamental problem. In this example, I’ve struck through “Low morale” as a potential cause because it is most likely a symptom of the lack of training and scheduling problems.

Step 4: Analyze the Diagram and Determine Next Steps

The Fishbone Diagram does not direct you to the solution, but it gives you an idea about where to look. By identifying potential causes in this manner, the team can assess the impact of each and brainstorm possible solutions. As in the case of our example, you’ll probably find more opportunities for improvement than you can tackle at once, but the exercise will put the team in a better position to decide what to do next. The Fishbone Diagram also becomes a good starting point for the next improvement cycle once your most critical root causes are addressed.

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The benefits of digital fishbone diagrams.

Back in the 1960s when the Fishbone Diagram was introduced, teams used paper to visualize their problem statement and possible causes. While that approach is acceptable for small groups working in the same space for a short period, it is not ideal for the way people work today.

That’s why KaiNexus has incorporated Fishbone Diagrams into our continuous improvement software platform. 

• The Fishbone Diagram is created and managed in the same platform you will use for implementing the changes once the analysis is complete.
• Information about your problem, the potential causes, and possible solutions are all collected for future review.
• Remote teams can be as effective as in-person ones.
• Roles and permissions can be applied to determine who can add access and edit Fishbones.
• Fishbone Diagrams can be used for Items, Projects, Improvements, Incidents, Tasks, and Charts. 
• Set up to 6 custom categories per diagram or reuse existing categories
• Highlight or strikethrough items

Using digital Fishbone Diagrams that are integrated with your improvement management software will help your team solve problems faster and accelerate the pace of positive change.

Fishbone Diagram Tips

The Fishbone diagram approach is not complicated, but you can do a few things to get the most out of it. We recommend:

• Use category names that are meaningful for your business. If “Methods” isn’t quite right, maybe “Procedures” is a better fit, for example.
• Don’t overload the categories. Create a new one if necessary. Likewise, don’t overcomplicate it; there’s no need to use six categories if four will do.
• Be careful not to add causes that are actually solutions.
• Prioritize your causes by keeping the most impactful ones closest to the “head”
• Use Fishbone Diagrams along with, not instead of, other problem-solving techniques such as The 5 Whys, A3s, process maps, and control charts.

KaiNexus is delighted to put one more digital improvement tool in the hands of our customers. If you’d like to know more about the impact of KaiNexus, one of our experts is available to help.

Want to learn more about KaiNexus Fishbone Diagrams?

Check out our fishbone video or support.kainexus.com for more information..

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Guide to understanding fishbone diagrams

What is a fishbone diagram?

A fishbone diagram is a visualization tool used in business to identify and investigate the many possible causes of a particular event, issue, or outcome. Fishbone diagrams are also known as cause and effect diagrams or Ishikawa diagrams , the latter named for the diagram's original creator, Japanese organizational theorist Kaoru Ishikawa.

Fishbone diagrams are a valuable tool for root cause analysis (RCA), as they provide a systematic framework for exploring all possible causes of a problem, not just the most obvious ones.

Fishbone diagram elements

As the name implies, fishbone diagrams are shaped like fish—or, rather, fish skeletons. The parts of the fish represent certain parts of the cause-and-effect scenario you're exploring.

• Head: The head of the fish is where you record the problem or outcome you're analyzing.
• Backbone: The straight line of the backbone simply provides a way to connect all the other bones to the head or main problem.
• Bones: The bones represent all the various causes that could be leading to the main problem. In most fishbone diagrams, there are a few main categories of causes with specific details branching off each.

Types of fishbone diagrams

There are a few main types of fishbone diagrams, each with unique features and ideal use cases. Review the different types, and choose which one is the best fit for your needs.

The simple fishbone

The most commonly used fishbone diagram is the simple fishbone. This type of diagram does not have predefined categories, so you are free to use whatever categories or labels make the most sense for your scenario. Simple fishbone diagrams can be used in any industry or function.

The 4S fishbone

On a 4S fishbone diagram, the four "bones" branching off from the spine are systems, surroundings, skills, and suppliers. The 4S fishbone is popular in the service industry and can be used to solve problems like poor customer feedback or high customer churn.

The 8P fishbone

The 8P method is a problem-solving method that classifies possible causes of a problem into eight groups: physical evidence, personnel, place, product (service), price, promotion, process, and productivity/quality. The 8P fishbone is commonly used to solve problems within the service industry, manufacturing, and administrative functions.

The man machines materials fishbone

The man machines materials fishbone is another fishbone diagram with predefined categories. This type of diagram is mostly used in manufacturing. It was developed to help people focus on various causes rather than automatically blaming an issue on human error.

Examples of when to use a fishbone diagram

Fishbone diagrams are a useful tool for problem-solving , especially for tricky problems and ones that could stem from various causes.

If you're still wondering when to use a fishbone diagram to support your problem-solving activities, read these fishbone diagram examples.

Product development

In product development projects, fishbone diagrams are useful for exploring market opportunities and identifying issues with current market offerings. To ensure your new products are truly filling a gap in the market, use a fishbone diagram to thoroughly explore your target customers' problems and the causes of those problems.

Troubleshooting processes

When a process or workflow isn't producing the desired outcomes, fishbone diagrams can help you diagnose the issues. When you do a deep dive into potential causes, it becomes easier to find the right solutions.

Root cause analysis

Fishbone diagrams provide a visual framework for root cause analysis and exploration. RCA methodology involves deeply investigating the underlying issues of problems that pop up, not just treating surface-level symptoms and putting out fires.

Benefits of fishbone diagrams

Fishbone diagrams help you visualize and explore the underlying causes of a particular problem. Top benefits of fishbone diagrams include:

Identifying potential causes of a problem

The main benefit of a fishbone diagram is its ability to help you identify potential causes of a problem. With the different types of fishbone diagrams available, there is a layout to fit any type of business problem in any industry. You can use a diagram with predefined categories or assign your own categories to fit your needs.

Revealing areas of weakness or bottlenecks in current processes

With a fishbone diagram, you can ensure no stone remains unturned as you study the problem. As you explore potential causes, the fishbone diagram will reveal any areas of weakness or bottlenecks in your current processes. You'll be able to address these issues, and any other root causes you uncover along the way.

Accelerating problem-solving

Most people are visual learners, and visual aids are proven to boost memory retention and recall. The visual format of the fishbone diagram accelerates the problem-solving process, helping you organize and categorize your thoughts and findings within a logical structure.

How to make a fishbone diagram

To get started making a fishbone diagram, follow these steps:

• Identify a problem to solve. The problem will form the "head" of your fishbone diagram. In addition to describing the problem, you can add information regarding where and when it occurred, if it was a specific event, who was involved, and the impact on your business.
• Choose the cause categories. Draw the "backbone" of your fishbone diagram and add lines branching from it to represent your cause categories. Refer to the types of fishbone diagrams section if you need ideas for cause categories to use.
• Brainstorm potential causes. Write the specific cause ideas as branches off their corresponding cause categories.
• Delve deeper. You may need to create further branches connected to your cause branches to explore the potential root cause(s) thoroughly. When collaborating with your team, include everyone's input and ideas.
• Agree on a root cause. Once you've finished your fishbone diagram, discuss and agree upon a root cause. There may be more than one.
• Discuss solutions. After using your fishbone diagram to find your root cause, take the time to devise solutions to prevent the same problem from recurring.

Why use MindManager to make fishbone diagrams

With a fishbone diagram software like MindManager , problem-solving and root cause analysis is changed forever—for the better. Features of MindManager include:

• User-friendly, intuitive interface
• Extensive image library—over 700 topic images, icons, and symbols to add to your fishbone diagrams
• Convenient file storage, retrieval, and sharing
• Powerful integrations with file storage apps like Box and OneDrive
• Google Docs integration via Zapier
• Numerous templates, tools, and features to facilitate brainstorming and strategic planning
• Google Chrome extension—MindManager Snap—to easily collect and import text, links, and images from the web
• Ability to add rich data—links, images, and documents—directly to your diagrams and charts

When you use MindManager as your fishbone diagram maker, you'll be able to quickly and easily record all the information you need, collaborate closely with your team, and gain a clearer perspective on the problem at hand and its potential causes.

Fishbone diagram templates

MindManager comes pre-installed with fishbone diagram templates. To use these templates:

• Open MindManager
• Click NEW in the navigation menu
• Select the template you want to use
• A preview screen will appear - check to see if you'd like to use your selected template
• Select 'Create Map'
• Customize the template for your specific project

Fishbone diagram FAQs

How is a fishbone diagram used for problem-solving.

Fishbone diagrams provide a visual framework for investigating the possible causes of a problem. They help you clearly sort ideas and explore various cause-and-effect connections within your business.

What is a fishbone diagram also known as?

There are many different names for the fishbone diagram. Some of the most common include:

• Cause and effect diagram
• Ishikawa diagram
• Fishikawa diagram
• Herringbone diagram

Conquer cause and effect with a fishbone diagram

Fishbone diagrams provide a way to visually organize and examine the potential causes relating to a particular problem. There are multiple types of fishbone diagrams, and they're popular across various industries and functions, including manufacturing, service-based industries, and business administration.

With a fishbone diagram, you can more easily identify the causes of a problem, reveal areas of weakness in current business processes, and accelerate your problem-solving activities.

Visualize more with MindManager

MindManager's fishbone diagram maker features a user-friendly interface, numerous premade templates, and an extensive library of images to support your diagram. To make a fishbone diagram, try MindManager today .

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7 Powerful Root Cause Analysis Tools and Techniques

By Sebastian Traeger

Updated: April 21, 2024

Reading Time: 5 minutes

1. The Ishikawa Fishbone Diagram (IFD)

2. pareto chart, 4. failure mode and effects analysis (fmea), 5. proact® rca method, 6. affinity diagram, 7. fault tree analysis (fta).

With over two decades in business – spanning strategy consulting, tech startups and executive leadership – I am committed to helping your organization thrive. At Reliability, we’re on a mission to help enhance strategic decision-making and operational excellence through the power of Root Cause Analysis, and I hope this article will be helpful!  Our goal is to help you better understand these root cause analysis techniques by offering insights and practical tips based on years of experience. Whether you’re new to doing RCAs or a seasoned pro, we trust this will be useful in your journey towards working hard and working smart.

Root Cause Analysis (RCA) shines as a pivotal process that helps organizations identify the underlying reasons for problems, failures, and inefficiencies. The goal is simple: find the cause, fix it, and prevent it from happening again. But the process can be complex, and that’s where various RCA techniques come into play. 

Let’s dive into seven widely utilized RCA techniques and explore how they can empower your team’s problem-solving efforts.

Named after Japanese quality control statistician Kaoru Ishikawa, the Fishbone Diagram is a visual tool designed for group discussions. It helps teams track back to the potential root causes of a problem by sorting and relating them in a structured way. The diagram resembles a fishbone, with the problem at the head and the causes branching off the spine like bones. This visualization aids in categorizing potential causes and studying their complex interrelationships.

The Pareto Chart, rooted in the Pareto Principle, is a visual tool that helps teams identify the most significant factors in a set of data. In most situations, 80% of problems can be traced back to about 20% of causes. By arranging bar heights from tallest to shortest, teams can prioritize the most significant factors and focus their improvement efforts where they can have the most impact.

The 5 Whys method is the epitome of simplicity in getting to the bottom of a problem. By repeatedly asking ‘why’ (typically five times), you can delve beneath the surface-level symptoms of a problem to unearth the root cause. This iterative interrogation is most effective when answers are grounded in factual evidence.

When prevention is better than cure, Failure Mode and Effects Analysis (FMEA) steps in. This systematic, proactive method helps teams identify where and how a process might fail. By predicting and examining potential process breakdowns and their impacts, teams can rectify issues before they turn into failures. FMEA is a three-step process that involves identifying potential failures, analyzing their effects, and prioritizing them based on severity, occurrence, and detection ratings.

The PROACT ® RCA technique is a robust process designed to drive significant business results. Notably used to identify and analyze ‘chronic failures,’ which can otherwise be overlooked, this method is defined by its name:

PReserving Evidence and Acquiring Data: Initial evidence collection step based on the 5-P’s – Parts, Position, People, Paper, and Paradigms.

Order Your Analysis Team and Assign Resources: Assembling an unbiased team to analyze a specific failure.

Analyze the Event: Reconstructing the event using a logic tree to identify Physical, Human, and Latent Root Causes.

Communicate Findings and Recommendations: Developing and implementing solutions to prevent root cause recurrence.

Track and Measure Impact for Bottom Line Results: Tracking the success of implemented recommendations and correlating the RCA’s effectiveness with ROI.

PROACT® RCA excels in mitigating risk, optimizing cost, and boosting performance, making it a valuable addition to any RCA toolkit.

The Affinity Diagram is a powerful tool for dealing with large amounts of data. It organizes a broad range of information into groups based on their natural relationships, creating a clear, visual representation of complex situations. It’s particularly beneficial for condensing feedback from brainstorming sessions into manageable categories, fostering a better understanding of the broader picture.

Fault Tree Analysis (FTA) is a top-down, deductive failure analysis that explores the causes of faults or problems. It involves graphically mapping multiple causal chains to track back to possible root causes, using a tree-like diagram. FTA is particularly useful in high-risk industries, such as aerospace and nuclear power, where preventing failure is crucial.

Each RCA technique provides a unique approach for viewing and understanding problems, helping you pinpoint the root cause more effectively. The key is to understand when and how to use each tool, which can significantly enhance your team’s problem-solving capabilities.

Power up your RCA analysis with our EasyRCA and revolutionize your problem-solving process. Start Your Free Trial.

In conclusion, the techniques presented offer a diverse set of tools to help organizations address problems and inefficiencies effectively. From visual representations like the Ishikawa Fishbone Diagram and Pareto Chart to more proactive approaches such as the 5 Whys and Failure Mode and Effects Analysis (FMEA), each technique provides a unique perspective on identifying and mitigating root causes.

The PROACT® RCA Method stands out for its comprehensive process, particularly suited for chronic failures. Additionally, the Affinity Diagram and Fault Tree Analysis (FTA) contribute valuable insights by organizing data and exploring causal chains, respectively. Leveraging these techniques strategically enhances a team’s problem-solving capabilities, enabling them to make informed decisions and drive continuous improvement.

I hope you found these 7 techniques insightful and actionable! Stay tuned for more thought-provoking articles as we continue to share our knowledge. Success is rooted in a thorough understanding and consistent application, and we hope this article was a step in unlocking the full potential of Root Cause Analysis for your organization. Reliability runs initiatives such as an online learning center focused on the proprietary PROACT® RCA methodology and EasyRCA.com software. For additional resources, visit our Reliability Resources .

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Quality Tools and Techniques (Fishbone Diagram, Pareto Chart, Process Map)

Definition/introduction.

In a dynamic and complex healthcare system, recognizing the role of quality in patient health outcomes and resource utilization is crucial. Various factors contribute to the gap between the ideal and existing states of healthcare delivery, including a lack of awareness of needs, resistance to new methods, and workforce shortages.

The establishment of the Joint Commission in 1951, Dr. Avedis Donabedian's structure-process-outcome framework for evaluating healthcare quality in 1966, the formation of the Agency for Healthcare Research and Quality (AHRQ) in 1989 and the Institute for Healthcare Improvement in 1991 are some of the historical milestones in the evolution of quality in healthcare. [1]  The Institute of Medicine (IOM) reports, the  To Err Is Human in 2000 and the  Crossing the Quality Chasm in 2001, have paved the way for establishing a culture of patient safety and healthcare quality. [2]  The IOM advocated for a redesign of the healthcare system to promote quality and safety by supporting front-line teams in identifying practices that hinder quality care and encouraging collective exploration to build a more robust healthcare system. [2]

The IOM defines quality as the measure of service offered to individuals and communities to achieve positive health outcomes [3] . Health care aims to deliver safe, timely, effective, efficient, equitable, and patient-centered (STEP) care supported by evidence-based medicine. [4]  A multidisciplinary team approach to quality improvement (QI) involves healthcare professionals, patients, and families, with each member playing a vital role in driving system-wide improvements and fostering organizational learning to improve health outcomes. [5]

QI in healthcare involves a wide range of tools and strategies. Common QI methodologies include the Model for Improvement, Plan-Do-Study-Act, Lean, and Six Sigma. [6] These methodologies employ diverse QI tools to identify root causes, address process issues, prioritize change opportunities, and anticipate potential barriers ( AHRQ. QI Toolkit ).

This article focuses on 3 tools used in QI—the Fishbone or Ishikawa Diagram, Pareto chart, and process mapping. These tools enable healthcare teams to identify and prioritize the root causes of the problem and decide on which aspects need to be acted on first.

Fishbone Diagram

The fishbone, also known as the cause-and-effect diagram, was introduced by Kaoru Ishikawa, who is often regarded as the father of Japanese quality for his contributions to quality management techniques [7] . This diagram is used in QI to visualize a root cause analysis (RCA) of a problem and ideate on potential actionable changes. In the diagram, the head of the fish, typically on the right side, represents the problem that occurred or the area needing improvement. Each branch, also called the bone of the diagram, corresponds to a major category of causes related to the effect ( CEC. Quality Improvement tools ). The teams brainstorm major causes and sub-causes by asking why the problem happened. These major causes can be categorized under the following (modifiable) headings—methods or systems, machine or equipment, manpower or people, materials, environment, and measurement (see  Image.  Fishbone Diagram).

The methods or systems category can include gaps in processes, training, or guidelines that lead to variability. The people or manpower category can relate to issues with human resources, cognitive errors, knowledge gaps, or biases, such as authority bias, for example, following orders simply because they were given by a doctor. Depending on the specific type of effect being analyzed in the RCA, heuristic errors can be categorized under a separate bone. The environment category focuses on what was happening at the time of the error or surrounding factors that may have facilitated its occurrence.

Thus, the fishbone diagram enables the stakeholders to identify major and minor contributors to a problem. From this comprehensive list, teams can develop successful process improvement initiatives and potential solutions through effective collaboration.  

Pareto Chart

Vilfredo Pareto originally introduced the Pareto principle based on his idea that 80% of the land was only owned by 20% of the Italian population ( CEC. Quality Improvement Tools ). In health care, teams can apply the Pareto principle to identify the "vital few" factors that can most efficiently improve the quality of care. After root causes have been identified and causes of the issue have been quantified, factors whose cumulative contributions constitute approximately 80% of the causes of issues are considered the lowest-hanging fruits or the biggest bang for the buck. Factors that have relatively minor effects are considered the "trivial many" and constitute the remaining 20% of the causes ( CEC. Quality Improvement Tools ). The most frequently used visual representation of the 80/20 rule is a Pareto chart [3] .

The Pareto chart consists of 2 components—a bar chart of the quantified causes ordered from most to least frequent and a line graph representing the cumulative percentage of contributions from different factors. To create a Pareto chart, first identify causes and then quantify the number of errors attributable to each cause. Pareto charts can be created in Excel using a table of causes and frequencies. The Pareto chart feature is categorized under Histogram Charts when inserting a chart.

The example Pareto chart (see  Image.  Pareto Chart) lists patient falls on a specific medical unit identified as the problem. The X-axis of the chart depicts the major categories of causes contributing to the problem. To determine which fall prevention strategies most efficiently promote patient safety, the bar graph is ordered left to right from most (vital few) to least (trivial many) frequent. The next step is to calculate the cumulative percentage curve or line graph, which is depicted by connecting the dots at the first, second, and third contribute percentages, and so on. The line graph is overlaid on the bar chart, with its axis on the right side of the graph. The 80/20 rule is applied by identifying the point where the cumulative percentage line graph intersects with 80% on the percentage axis. Factors that fall to the left of this point are the vital few or most impactful causes, whereas the factors to the right of the intersection are the trivial many. Working on the most frequent contributors to failure significantly impacts the given problem. [3]  The 80/20 rule helps optimize where QI efforts and resources are most efficiently expended, especially when garnering support for QI projects and allotting resources.

Process Map

Process mapping was introduced by Frank Gilbreth in the early 1900s ( NIH. Process Mapping ). Unlike written standard operating procedures that outline the ideal process, process maps provide a detailed, step-by-step depiction of the actual procedures, revealing potential duplications, delays, decision points, variations, and inefficiencies ( NIH. Process Mapping ). Process mapping in health care typically requires the perspectives of diverse stakeholders to identify different levels of interwoven and complex processes [8] . Other terms associated with process mapping include spaghetti diagrams (process maps with curved arrows instead of straight ones) and swim lanes (for complex processes with multiple parallel activities, such as discharge planning).

The process mapping begins by:

• Determining the scope by identifying clear start and endpoints of workflow
• Identifying and engaging stakeholders
• Mapping the process workflow as a team.

Formats are flexible and may include sticky notes, whiteboards, and electronic software, such as MS Visio, Smart Draw, and PowerPoint. Shapes in the process map can be used to visually differentiate process types. The shapes represent start and end points, actions performed, delays, and decision points. Shapes may vary, and legends should be provided to the team. These shapes are connected by arrows to depict the direction of the process flow. [9]

In the example process map, a simplified flowchart illustrates the process of documenting medication reconciliations for patients admitted to hospital medicine through the emergency department (see  Image.  Process Map). Steps in the process should be arranged in the correct order. Stakeholders, especially those on the front line, can help to determine accuracy and highlight any variations in the process. The draft process map should then be validated during a Gemba walk, which involves directly observing the actual workflow. Discrepancies and variations found can be corrected on the map.

The finalized current state process map can be used to develop targeted QI plans. Process mapping also plays a crucial role in RCA. A future state plan can be discussed with stakeholders and redrawn to optimize team workflow during the QI project design. [9]

Issues of Concern

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The effective use of QI principles by healthcare professionals is essential to achieve safe, evidence-based, patient-centered care. To implement successful QI programs, strong leadership across the organization is required to support frontline staff and offer training in QI methodologies to promote cultures of continuous learning. [5]  Some common challenges for QI project implementation include resistance to change, lack of training in QI methodologies, time constraints, low motivation, competing priorities, lack of teamwork or stakeholder engagement, ineffective leadership, and organizational support. [10]  

Complexity management and human factor training resources are key factors for team engagement. [11]  Various QI methods and tools exist. Choosing the right methods and tools for each QI project can accelerate goal achievement. Fishbone diagrams, Pareto charts, and process maps are valuable tools for helping define areas of action and craft SMART (specific, measurable, achievable, relevant, time-bound) aims for project design. Whichever QI tools are used, keeping patient safety and experience top of mind while reducing waste and increasing the value of care is important.

Clinical Significance

Medical errors pose a serious threat to public health in the United States. [12]  Healthcare organizations must regularly conduct QI programs and promote systems-based learning, which empowers employees to apply the principles of healthcare quality to promote patient safety. [13]  The introduction of the QI curriculum in early medical education and the promotion of safety culture in organizations improves healthcare efficiency and patient outcomes. [14]  John Kotter puts forth 8 principles to promote a patient safety culture:  [15]

• Establishing a sense of urgency in change initiation
• Building a powerful guiding coalition for goal alignment
• Creating a vision to direct the change effort
• Communicating the vision
• Team empowerment to act on the vision
• Generating short-term wins
• Consolidating improvements to produce positive changes
• Anchor new approaches in the organization's culture.

Effective change management involves a thorough understanding of the need for change and inclusive leadership. By fostering a collaborative approach, stakeholders can develop action plans that enhance healthcare efficiency and sustainability. [16]

Nursing, Allied Health, and Interprofessional Team Interventions

The application of QI principles in health care has significantly evolved over the past century. Proficiency in RCA methodologies enables healthcare teams to improve patient care and mitigate medical errors. Please see StatPearls' companion resource, " Root Cause Analysis and Medical Error Prevention ," for more information. Effective leadership establishes vision, aligns, motivates, and inspires teams to bring positive and sustainable changes. [15]  

Key steps for effective organizational performance include supportive QI leadership, collaborative teamwork, staff training in QI methodologies, patient and team feedback utilization, and success celebration ( AHRQ. Toolkit for Using AHRQ Quality Indicators ). Strong interprofessional networking, education, administrative support, and motivation are essential for developing robust healthcare teams and patient safety champions, who are pivotal in delivering safe, evidence-based, patient-centered care. [17]

Fishbone Diagram. This fishbone diagram illustrates the root causes of problems related to high physical therapy (PT) consult volume, represented as the head of the fish.  In this example, 5 cause categories or bones are identified—Systems, People, Environment, Materials, and Equipment. EHR, electronic health record.

Contributed by S Tagaram, MD

Process Map. This process map illustrates the medication reconciliation process in the emergency department (ED) for patients admitted to the hospitalist service.  The ovals here represent the start and end points of the process, rectangles denote the steps involved, and the diamond shape indicates a decision point. EMR, electronic medical record.

Pareto Chart. This Pareto chart for inpatient falls shows 5 causes. The left-side Y-axis displays the number of falls attributed to each cause. The right-side Y-axis shows the cumulative percentage contribution of these causes. The point where the orange line intersects with the horizontal solid blue 80% line indicates the most vital causes for the project. The vertical dotted blue line represents this transition from vital few to trivial many. In this example, the vital few could be either the first 2 or 3 causes on the left, depending on the resources allocated to the project, as the dotted line intersects the third cause (lack of mobility equipment). The 2 right-most causes (team communication and family attempt) contribute only 9% to the total. Efforts towards addressing these causes do not significantly impact the number of falls.

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