Root Cause Analysis (RCA) – Death of an Acronym?

Most of us have lived through decades of acronyms where they were a revelation when introduced, but lost their innovativeness when “copycats” came out of the woodwork and made them faster and less expensive (i.e. – TPM, RCM, Six Sigma, etc.). Of course, by doing this, those that were not interested in the methodologies themselves (just the popular acronym receiving accolades in high visibility trade magazines and journals) hopped on and invested in the “black market brands” seeking quicker results with less investment.

Think about it. Reliability Engineering was borne in the aerospace and military industries. Back then, Reliability Engineering concepts were a revelation. When these concepts were bridged into the manufacturing industry, no one knew what Reliability was, but everyone wanted it.

This is true of healthcare in the USA today. It is this author’s experience and observation in healthcare in the USA, that they are 15 – 20 years behind industry in terms of administrative infrastructure related to Reliability. As Reliability has become “old hat” in manufacturing, healthcare is just now getting the concept of “High Reliability Organizations”.

In an industry that needs Reliability the most, why are they one of the last to adopt such established technologies. Of course, their perception of what Reliability is, is drastically different than that of a Reliability Engineer in manufacturing. Is this evolutionary process any different today than say 100 years ago? Probably not.

Root Cause Analysis (RCA) is a term that many of the noted RCA providers today say originated in the day of the philosopher’s such as Socrates and Plato. Since that time these concepts were shaped and fine-tuned in the aerospace industry to progress the science of flight. Now they are in manufacturing and there are as many providers as there are industries. Everyone considers the process they use to solve problems as Root Cause Analysis (RCA). The problem with this is that many such processes were developed to provide quick and inexpensive answers to problems, but not necessarily the correct answers. Many advocate doing RCA alone and their processes do not require data to prove their assumptions. How many prosecutors’ cases would hold up in court using hearsay as their primary evidence?

Therefore RCA as it stands today, ranges from trial-and-error approaches to “CSI” type of investigations. If one were to bid out an open-RCA project, the bids would likely vary tenfold (10X) between the highest and lowest bidders for this reason. The term RCA has just lost its significance and has become a commodity. While different “brands” of RCA exist on the market, they are all mostly viewed as the same, regardless of their methodology’s uniqueness and innovativeness. While it is like comparing apples and oranges in the eyes of the vendors, to the purchasers it is often apples with apples comparisons.

What most do not realize is that RCA is a thought process. It is not forms, charts, graphs, trees or software. These “tools” are only used to express the thought process. The facilitation of the RCA thought process is what makes it work or not. Guiding teams through a learning experience designed to help them uncover the answers that are within them. I have never worked in an organization that did not have the knowledge internally to solve their own problems. They just need a structured thought process to help them think it through. This is the reality of RCA, not all the bells and whistles associated with the tools. The tools are worthless if the methodology is not valid (and I am a tools provider)!