A typical RCA template includes the following steps:
By using a Root Cause Analysis template, investigators can:
Here is a sample RCA template to help you get started:
Root Cause Analysis Template
Event Description: _
Initial Assessment: _
Root Cause Identification:
Root Cause | Impact on Event |
— | — |
- Human error | High |
- Equipment failure | Medium |
- Design flaw | Low |
Root Cause Classification:
Recommendations for Corrective Action: _
Implementation and Verification: ___
Remember to customize your RCA template according to the specific needs of your organization, industry, or type of analysis.
* **Description of the Problem**: * **Date When Problem Occurred**: * **Location**: * **Impact**:
* **Data Sources**: * **Relevant Metrics**: * **Stakeholders Involved**:
* **Time/Date**: * **Events Leading Up to the Problem**: * **Response Actions Taken**:
### 4.1. Immediate Causes
* List immediate causes identified.
### 4.2. Root Causes
* Identify root causes using techniques such as: * 5 Whys * Fishbone Diagram
* **Cause 1**: * Evidence: * Impact: * **Cause 2**: * Evidence: * Impact: * **(Add additional causes as necessary)**
* **Proposed Solution 1**: * **Proposed Solution 2**: * **Implementation Steps**: * **Responsible Parties**: * **Timeline for Implementation**:
* **Follow-Up Actions**: * **Monitoring Plan**: * **Review Date**:
* **What went well**: * **What could be improved**: * **Future Prevention Strategies**:
* Summary of findings and actions taken.