Root Cause Analysis

Published in All Insurance Industry Insights on Monday, September 20, 2021

Root Cause Analysis (“RCA”) is simply defined as a process that helps you get a better understanding of an event’s primary cause.
Officially, it’s a fundamental, underlying, or system-related reason why something occurred that identifies one or more correctable system failures.1
Why is it important?  Utilizing a root cause analysis can help prevent similar events from happening again.  And that can reduce the chance of subsequent poor outcomes such as injury, damage, and downtime – A vital component to your business and personnel as part of a robust safety culture.
Incident investigation is a well-known activity following an event – In fact, it is required by certain regulatory standards such as OSHA’s Process Safety Management (PSM) and EPA’s Risk Management Program (RMP).  However, incorporating a root cause analysis into an incident investigation isn’t as common.  While incident investigation can identify an immediate cause, a root cause analysis can help pinpoint the underlying issues.  Another important aspect of this process is that it also helps focus the follow-up on systemic concerns (which account for the vast majority of root causes), rather than individual performance, fault, or blame.
There are many tools that can be used to conduct a root cause analysis.  Examples include: 2,3,4

  • Check Sheet
  • Column Chart
  • Correlation Chart
  • Fishbone Diagram
  • Five Whys?
  • Interrelationship Diagraph
  • Pareto Chart

My personal favorite is the “Five Whys?”.  This humble and unassuming technique can quickly get to the bottom of an issue by just asking the question “Why?”, five times in succession.  Applying this sequence to various critical categories can help identify what may be numerous root causes across several of these elements.  Once you have the root causes identified, you can then apply improvement methods to help prevent re-occurrence.
Apply to Critical Categories:

  • Equipment
  • Environment
  • Human Factors
  • Policies/Procedures
  • Leadership/Culture

Contact PDCM today for more information on root cause analysis and the various tools and techniques that support the process.


1 Zywave Risk Insights, “Root Cause Analysis During Incident Investigations”; 03/22/21
2 Langford International, Inc.  “Tool Time Choosing and Implementing Quality Improvement Tools”, Healthcare Version 12.0, Montana: Langford International, Inc.; 2007.
3 Langford International, Inc.; Pavelka’s Point Consulting, L.L.C.  “Tool Time Choosing and Implementing Quality Improvement Tools”, For Lean Version 1.0, Montana: Langford International, Inc.; 2012.
4 www.langfordlearning.com