RCA – Past, Present, and Future (a three-part series) Part 2

This is the second part in a three-part series.  If you haven't yet, read Part One.

In my blog about RCA Past, I focused exclusively on the two most popular historical RCA methods:  1) The 5-Whys, and 2) The Ishikawa Fishbone diagram.  I discussed the fact that both methods are attempts to methodically discover the preceding causes of any event and that both do so via different branches of logic. The 5-Whys employs conditional “if-then” logic and the Fishbone harnesses syllogistic logic (the logic of sets).  Both offer means of deducing causal predecessors with a degree of confidence.  

In follow up comments, it was pointed out to me that I omitted other methods that have been around for a long time such as Kepner Tregoe, MORT, and fault tree analysis.  I did not mean to imply that these were not historically important.  However, I did intend to focus on 5-Whys and Fishbone because they have propagated so much further in so many different disciplines and applications.

Now, let’s travel back three or four decades to the period of main-frame computers, pocket protectors, and ashtrays in the office.  Engineers at the DOE, NASA, and a variety of other organizations were working on problems of enormous complexity.  The failures were therefore equally complex.  But persistent failure was simply not an option, so they urgently developed, and utilized, what were at the time new ways of thinking to help manage this complexity.

Not surprisingly, they discovered deficiencies in these methods.  That’s because when we use something, we find out where it works as well as where it doesn’t.  Deficiency combined with practical application drives innovation and improvement.  And at that time, the field (if you could call it that) of root cause analysis was ripe for it.

Smart people like Mark Paradies, Dean Gano, Robert Nelms, William Corcoran, Charles Latino, and many others distinguished themselves first by being foot soldiers in the effort to solve complex problems using the available toolsets - and then by improving them once their deficiencies were exposed.  If the first round of structured problem solving models could be termed “RCA 1.0,” this next generation of innovators brought “RCA 2.0” to the world.  This led to many successful consulting companies, including Decision Systems (Taproot), Apollo, Reliability Center (Proact), Reason, and others.

Some of those that brought forth RCA 2.0 also forced RCA out of its initial isolation.  Naturally, a combination of causes was required for this to occur.  Probably the most obvious cause is that problems happen in every organization, not just nuclear power plants or rocket shops.  Hospitals have complex problems, as do chemical companies, utilities, and pharmaceutical companies.  Another cause was that RCA 2.0 innovators discovered they could develop a viable business model around teaching people their improved methods of RCA.  This provided a profit incentive to develop new markets.  I came into the business much later (in 2000) and remember an early conversation discussing what I did for a living.  After my explanation, the person (a lawyer) was amazed:  “You can make a living doing that?” she asked.  Indeed, I can (so far, anyway) – and I have the RCA 2.0 innovators to thank for it.

These RCA 2.0 consultancies were built on a simple business model.  It goes like this:

1. You (no matter who you are) have problems
2. Some of those problems are worth solving
3. Any structured root cause analysis process solves problems better than none
4. MY (insert your favorite) method of root cause analysis is better than the others

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