Learning

Root Cause Analysis
Purpose
The aim of the course is to introduce the investigation approach for safety, process or system based events, and provide details on various analysis techniques available to identify the root causes, whether equipment, human or organisational.
Who is this for?
Managers, supervisors and professionals who may be called upon to participate in the investigation and analysis of safety, process or system-based events.
Outline content
- Six steps for a successful investigation
- Root cause analysis techniques:
– Cause and effect diagram & change analysis
– Event and casual factor chart
– Failure modes and effects analysis (FMEA)
– Fault tree analysis
– Five Whys method
– Hazard-barrier-target analysis (Tripod)
– Job task analysis
– Management oversight and risk tree analysis (MORT)
– Human errors, violations, safety culture & organisational effectiveness
At the end of the course you should be able to:
- Plan an investigation and analysis
- Choose and apply the most appropriate root cause analysis technique for the adverse event
- Determine direct, contributing and root causes, and support conclusions logically with facts
- Determine organisational effectiveness and safety culture weaknesses that promoted or created vulnerability to the adverse event
- Explain key investigation results and support them in an oral briefing
In-house training
F2F (2 days)
What prior study is recommended?
Education, skills or experience equivalent to undergraduate level.
Related articles:
Incident investigation and analysis
Independent review and verification
Related consulting services:
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