The Curious Case of the Missing Bullet Holes

One piece of feedback we get time and time again is that the Sologic RCA methodology ‘takes over your thinking’ . What we hear from our students is that once they have encountered this systematic RCA method it’s close to impossible to ‘unlearn’.  

A particular area we focus on in our methodology is how to create effective cause and effect charts that help reveal hidden questions and missing information. This data is essential for an effective solution process.  

In today’s business world the case for systematic problem solving is well established, so it’s easy to forget that some of the best examples of this discipline are decades old.

One often shared example from WW2 is expertly retold in Matthew Syed’s outstanding 2015 book ‘Black Box Thinking’. Syed recounts that by 1943 the US military had an urgent problem to solve and they employed Abraham Wald, a brilliant young Hungarian mathematician to crack it.

The issue was that the US Air Force (USAF) was losing far too many aircraft to enemy fighters. They knew improved armouring was the answer but adding too much armour made their planes heavier and less manoeuvrable and dictated that they used more fuel, thereby limiting their range. Equally armouring the planes too little was also a big problem as this left them vulnerable to far fewer enemy hits. What Abraham Wald and his statistics team (SRG) were instructed to discover was the precise level and position of armour required.

In order to aid the team of mathematicians the military provided them with some data they thought might help them along. It went as follows: 

•    When US planes returned from raids over Europe a pattern was spotted. 
•    Far from being universally peppered across the aircraft there were far more bullet holes in the fuselage area and far less hits in and around the engine, cockpit and tail areas.

Immediately the military brass saw an opportunity for precise armouring; why not simply focus the reinforcements on the places that were recording the most hits, thereby effectively defending their brave pilots from attack?  So they asked Wald and his team exactly where to strengthen the armour.  The answer they got was not the one that they expected.

You see, Wald had realised that the officers had omitted some key data, they were only considering data from the planes that actually returned.  The armour, said Wald, doesn’t go where the bullet holes are. It goes where the bullet holes are not. Namely, around the cockpit and engines. 



The reason planes were coming back to base with fewer hits to the engine is that planes that got hit in the engine weren’t coming back at all!  Put starkly, the bullet holes revealed the parts of the aircraft that actually demanded the least amount of armour, not the most! 

As mathematician Jordan Ellenberg explains it in his 2014 New York Times Bestseller ‘How Not To Be Wrong’ if you were to visit the recovery room at a battlefield hospital, you’d see a many more people with bullet holes in their limbs than people with bullet holes in their chests. But that’s not because people don’t get shot in the chest; it’s because the people who get shot in the chest don’t typically make the recovery room.

For Wald and his team the critical information was delivered by way of an omission. Intrinsic to RCA culture is the methodical use of cause and effect charts, allowing us to uncover exactly these kinds of omissions. By applying solutions to previously hidden omissions, as well as the more obvious aspects of a problem our chances of reducing or even altogether preventing recurrence are vastly increased.  Once learnt, this is not easily forgotten. 

If you want to know more about how our Root Cause Analysis and Tactical Problem Solving methodology could help your organisation solve problems, reduce risk and improve performance please contact us.