Root Cause Analysis Honsha Associates Agenda www.honsha.org 1.Lean: What is it? 2.Root Cause Analysis – a PDCA approach 1. What is RCA? A Toyota perspective 2. Why use it? There are other methods. 3. When to use it? First things first. 4. Where is adequate to use it? It doesn’t fit everywhere 5. How to use it? POC, 5Whys, Trystorming, 3.Q&A APICS SGV PDM 22 June, 2011 Root Cause Analysis Samuel Obara 1 of 14
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Root Cause Analysis
Honsha Associates
Agenda
www.honsha.org
1.Lean: What is it?
2.Root Cause Analysis – a PDCA approach
1. What is RCA? A Toyota perspective
2. Why use it? There are other methods.
3. When to use it? First things first.
4. Where is adequate to use it? It doesn’t fit everywhere
5. How to use it? POC, 5Whys, Trystorming,
3.Q&A
APICS SGV PDM 22 June, 2011Root Cause AnalysisSamuel Obara
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Why Do We Need a Tool?
4
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Why Do We Need Correct Tools?
5
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What if we do find the Correct Tool but Don’t use it Correctly?
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So using the Correct Tool in the Correct way is Important!!!
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To achieve quality results!!!
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Missing the Purpose
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Do You Know the Purpose?
You can’t meet the goal if you don’t know the purpose.
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“There is nothing
so useless as doing efficiently
that which should not be
done at all”
Peter F. Drucker
The Most Studied Company in The World
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PURPOSEOur first step
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Lead Time
“The only thing we are doing is reducing the lead time line”Taiichi Ohno
Order Processing shipping delivery receive $
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If you keep lowering the water level, you will keep getting more problems.
A B
Stop lowering the water level Keep lowering the water level
No immediate problems Urgent problems
Loss of competitiveness Solve problems
? ?Market?
Competition?
Life cycle?
Etc…
What?
How?
When?
Where?
Who?
Etc…
Lower the water level and problems will appear
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1 2 3 4
signstamp
copy
A
file
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Lowering the water level
How does “waste elimination” cause
problems to appear?
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Waste – 8”
8” 1”
Waste – 1”
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stampsi
gn
stamp sig
n
stamp
3 4 1 2
3 4 1 2
copy
file
A
Honsha Associates
Six way intersection in Lisbon, Portugal
Too many accidents:
13 accidents in one year.
Problems of today are
solutions from the past.
Problem
Result: 16 accidents in one year
Solution
Increased
number of
traffic lights
and signs
Honsha Associates 21
Why are we afraid of
problems?
• They keep coming back
• They are time consuming
• They reveal incompetence
• They lower the morale
• They …
• We don’t have an effective method to solve them.
• We don’t have a solution so the problem will not come back.
• We don’t have a scientific method.
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The Japanese eat very little fat
The French eat a lot of fat
They suffer fewer heart attacks than the British or the Americans.
The Japanese drink very little red wine
The Italians drink excessive amounts of red wine
They suffer fewer heart attacks than the British or the Americans.
CONCLUSION: The Root Cause of Heart Attacks
The Real Root Cause of Heart Attacks
FACT: England and the US have the highest rates of heart attacks
Eat and drink what you like. It’s speaking English that kills you.”
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The Scientific Method
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Root Cause Analysis
CAUSES EFFECT
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Root Cause Analysis
Causes
Effect
Categories
Facts
Assumptions
Root Cause
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www.honsha.orgCourtesy of NUMMI - TLO
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Before the root
cause, there is
the point of
cause
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The Problem, The Cause, The Root Cause
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WHY is the computer not working?
Because it is not plugged in.
SOLUTION: Plug it in!!
The quick and easy solution.
(so easy and quick that we don’t mind repeating it all the time…)
Root Cause
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Honsha Associates
WHY is the computer not working?
Because it is not plugged in.
WHY is it not plugged in?
Because the cable has been pulled out of the outlet
WHY was the cable pulled out of the outlet?
Because something got hooked on to the cable and pulled it out.
WHY things get hooked on to the cable?
Because the cable lies on the floor and gets in the way.
WHY does the cable lies on the floor and gets in the way?
Because it is too long.
WHY is the cable too long?
Uh?... I don’t know…
SOLUTION a: Shorten the length of the cable
SOLUTION b: Tape the cable on the wall
SOLUTION c: Bring the computer next to the outlet
SOLUTION: Plug it in!!
Root Cause- the 5 Whys Technique
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Source: Memory Jogger II
Honsha Associates
Source: Memory Jogger II
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Source: Memory Jogger II
Honsha Associates
Source: Memory Jogger II
Honsha Associates
Source: Memory Jogger II
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Source: Memory Jogger II
Honsha Associates
Source: Memory Jogger II
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Waste: 8” Waste: 1”
How will you deal with your next problem?
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Addressing the Root Cause
Honsha Associates
Workshops and Certifications
1. Understanding Key Lean Principles
2. Lean Problem Solving – the Essence of PDCA
3. Lean Leadership and Awareness
4. Kaizen Teian
5. Building and sustaining a lean culture
6. Value Stream Map and Management
7. 5S and Visual Workplace
8. Standardized Work
9. Error Proofing – Pokayoke Method
10. Kanban and Just in Time
11. Lean Assessment Techniques
12. A3 Thinking – Management level
13. Policy Deployment – Hoshin Kanri
14. Lean Business Administration: Lean in Service and Knowledge Work
15. Skills for Lean Coaches: Advanced Level
Upon approval, you become a
registered certified agent at
Honsha.ORG website.
Honsha Associates
Thank you!
www.honsha.org
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