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  • How do you use the 5 Whys method?

    The method is remarkably simple: when a problem occurs, you drill down to its root cause by asking "Why?" five times. Then, when a counter-measure becomes apparent, you follow it through to prevent the issue from recurring.
  • How do you document the 5 Whys?

    Follow these steps:

    1Write down the problem.2Ask: “Why is this problem occurring?”3Generate a concise reason the problem exists. If there is more than one, write them all down.4For each reason, ask “Why is that occurring?” and document the responses.5Keep asking “Why?” until you reach the root or source cause.
  • The 5 Whys Problem Solving technique is a simple process to follow to solve any problem by repeatedly asking the question “Why” (five times is a good rule of thumb), to peel away the layers of symptoms that can lead to the root cause of a problem. This strategy relates to the principle of systematic problem solving.

Using five whys to

review a simple problem Online library of Quality,

Service Improvement

and Redesign toolsNHS England and NHS Improvement

Using five whys to review a simple problem

Quality, Service Improvement and Redesign Tools: Root cause analysis using five whys

What is it?

By repeatedly asking the question 'why?" (use five as a rule of thumb), you can conduct a very superficial review of a simple problem.. It is a very basic tool and can be completed without statistical analysis but is not suitable as a key technique to identify causal factors in a 'systems-based" patient safety incident investigation arising from a complex system.

How to use it

1.Write down the simple problem. This helps you to formalise the issue and describe it

accurately. It also helps a team focus on the same problem.

2. Identify why the problem most commonly occurs then, write the answer down. Loop

back and ask 'why" again until the team agrees that they have identified a key reason for the issue . This may take fewer or more than five 'whys?" The cause and effect (fishbone) diagramcan help explore other potential reasons for a basic failure or problem. Once you have established inputs on a cause and effect diagram you can use the five whys technique to drill down to identify some of the basic reasons behind a problem or superficial 'symptoms", but it is important to avoid assumptions.

Examples

An example of using five whys might be:

The patient was late in theatre, it caused a delay. Why?

There was a long wait for a trolley. Why?

A replacement trolley had to be found. Why?

The original trolley"s safety rail was worn and had eventually broken. Why?

It had not been regularly checked for wear. Why?

One basic underlying reason may be that there is no equipment maintenance schedule. Setting up a proper maintenance schedule may help ensure that patients are not late due to faulty equipment.

What next?

You will need to communicate outcomes to others to help ensure the problem is better understood.

Additional resources

Bicheno, J (2008) The Lean Toolbox: The Essential Guide to Lean Transformation, PICSIE

Books: 4th edition

Liker, J (2004) The Toyota Way Fieldbook: A Practical Guide for Implementing Toyota"s

4Ps, McGraw-Hill

Mannon, M and Collins, D (2015) Quality Management in a Lean Health Care

Environment, Business Expert Press, New York

Background

Five whys was devised by Toyota as they developed their manufacturing methodologies. It forms a critical component of their problem solving training and is part of the induction into the Toyota production system. It is used in the 'analyse" phase of Six Sigma (define, measure, analyse, improve, control). Quality, Service Improvement and Redesign Tools: Root cause analysis using five whysquotesdbs_dbs12.pdfusesText_18
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