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Limited research on root cause analysis exists in educational leadership. Accurately diagnosing and detailing root causes—the why—of organizational failure, as is relatively common in other fields, could improve principals' ability to devise situationally- and contextually-responsive solutions in their improvement plans. In this study, the authors analyze school improvement plans to provide insight into how principals use root cause analysis to identify their and their school's failures as a way to respond strategically with goals and action steps.

In this exploratory qualitative study, the authors develop coding schemes and leverage an existing rubric of school improvement plan quality to assess what principals identify as root causes for 216 priorities across 111 school improvement plans.

The overall quality of root causes submitted by principals was low, typically between “beginning” and “developing” stages. The majority of root causes aligned with priorities and desired outcomes, but fewer than one-third had a systems focus. Moreover, less than half of root causes suggested that school leaders played a part in the organizational failures. The vast majority of plans instead identified teachers as the root cause, foundational fault or “why” of the problem.

An increased understanding of root cause analysis conceptualization and development seems necessary if improvement planning is to be a strategic response to a school's most serious organizational challenges. The predominant approach to school improvement planning has focused almost exclusively on how to succeed or become better with little investment in identifying root causes of organizational decline or failure. This initial study of root cause quality in school improvement planning is a key first step in critically thinking about how improvement is to be achieved when failure is unconceived.

The international energy agency states that the world’s primary energy needs are expected to grow to 55 per cent until 2030. Therefore, oil and gas industry as the main energy source will be more crucial where building or advancing new capacities is required. Because the reports highlight the delay as a recurring problem, thereby, more in-depth investigation to find out the main contributing causes is needed.

Root cause analysis (RCA) was applied to identify, rank, analysis and categorize the main sources of this problem.

Based on RCA procedure; Pareto analysis showed that 84.7 per cent of the delay is because: the radar chart indicated no difference in perception of the participants regarding the importance of the root causes, correlation analysis suggested strong relationship among the participants and the cause-and-effect diagram emphasized more on operational, human and equipment categories, which in total account for 51.86 per cent of the delay.

The risk planners of large-scale projects can consider these root causes as the main items to analysis, monitor and control, as they are vitally important for project success.

The purpose of this paper is to go a step further from the traditional 5 Whys technique by adding three more legs during the root cause analysis stage – occurrence, human and systemic issues that contribute toward the problem, hence the term 3 × 5 Whys. Performing individual 5 Whys for these three components enables to identify deeper root cause(s) that may spawn across multiple groups within an organization.

Cause-and-effect analysis used during traditional root cause investigations within an 8D or Lean six sigma project is used as a theoretical foundation. Examples from different industries are presented showing the 3 × 5 Why’s framework and advantages it brings to the organization along with identifying shortcomings and suggestions to make it more effective.

If properly used this integrated methodology will reveal higher order systemic causes (e.g. policies or management decisions) stemming from lower lever symptoms (e.g. defective parts, procedural errors). Effective execution of this methodology can provide tremendous results in defect reduction, yield improvement, operational efficiency improvement and logistics management type of projects. Resolving higher level sources of problems allows an organization to evolve itself and maintain a competitive edge in the market.

Adopting this quality management technique in start-up companies entails some challenges and other implications have been discussed with SWOT analysis.

Examples from various sectors using 3 × 5 Why approach have been presented that show that this methodology provides deeper insight into root causes which could be affecting multiple groups in an organization. Using this technique effectively is found to be beneficial to resolve issues in operations management, logistics, supply chain, purchasing, warehouse operations, manufacturing, etc.

This methodology has a human component which often results in some sort of resistance as not all working professionals think alike when it comes to accountability and ownership of issues. This may hinder root cause analysis and subsequent corrective actions implementation.

This study is unique in its in-depth real-world case studies demonstrating the need for taking a deep dive approach to root cause analysis by understanding specific, system and human components responsible for causing the failure mode.

The application of lean and quality improvement methods is very common in process improvement projects at organisational levels. The purpose of this research is to assess the adoption of Lean Six Sigma™ approaches for addressing a complex process-related issue in the coal industry.

The sticky coal problem was investigated from the perspective of process-related issues. Issues were addressed using a blended Lean value stream of supply chain interfaces and waste minimisation through the Six Sigma™ DMAIC problem-solving approach, taking into consideration cross-organisational processes.

It was found that the tendency to “solve the problem” at the receiving location without communication to the upstream was, and is still, a common practice that led to the main problem of downstream issues. The application of DMAIC Six Sigma™ helped to address the broader problem. The overall operations were improved significantly, showing the reduction of sticky coal/wagon hang-up in the downstream coal handling terminal.

The Lean Six Sigma approaches were adopted using DMAIC across cross-organisational supply chain processes. However, blending Lean and Six Sigma methods needs to be empirically tested across other sectors.

The proposed methodology, using a framework of Lean Six Sigma approaches, could be used to guide practitioners in addressing similar complex and recurring issues in the manufacturing sector.

This research introduces a novel approach to process analysis, selection and contextualised improvement using a combination of Lean Six Sigma™ tools, techniques and methodologies sustained within a supply chain with certified ISO 9001 quality management systems.

In implementing Six Sigma and/or Lean Six Sigma, a practitioner often faces a dilemma of how to select the subset of root causes from a superset of all possible potential causes, popularly known as root cause analysis (RCA). Generally one resorts to the cause and effect diagram for this purpose. However, the practice adopted for identification of root causes is in many situations quite arbitrary and lacks a systematic, structured approach based on the rigorous data driven statistical analysis. This paper aims at developing a methodology for validation of potential causes to root causes to aid practitioners.

Discussion has been made on various methods for identification and validation of potential causes to root causes with the help of a few real life examples for effective Lean Six Sigma implementation.

The cause and effect diagram is the frequently adopted method for identifying potential causes out of a host of methods available for such identification. The method of validation depends on the practitioners’ knowledge on the relationship between cause and effect and controllability of the causes.

The roadmap thus evolved for the validation of root causes will be of great value to the practitioners as it is expected to help them understand the ground reality in an unambiguous manner resulting in a superior strategy for cause validation and corrective actions.

The purpose of this paper is to examine out‐of‐stock (OOS) challenges in the independent grocery sector with a special emphasis on in‐store root causes. The analysis aims to assess the extent and root causes for OOS in the independently controlled retail sector and provide a comparison of these results with the centrally controlled chain sector in Denmark. The paper also seeks to examine the practices and challenges of store ordering and store replenishment processes in the independent sector and identify practical implications for store management and other members of the grocery channels.

The research design includes two studies. Study‐I surveys and compares the extent and root causes of OOS of 42 stores from eight chains in the two sectors. Study‐II identifies, based on qualitative interviews with 17 store managers/owners of independent stores, specific insights on store operations.

The quantitative study shows that the OOS rates in the independent sector are significantly higher than in the centrally organized sector. Furthermore, the independent grocery sector faces OOS challenges in more categories than the centrally controlled sector. The study also reveals a very large variation in the performance of independent stores. Contrary to the centrally controlled chain store sector, the major root cause for OOS in the independent sector is found in the store ordering process. The qualitative study shows that the main discriminating issues between stores with a low and a high OOS rate are: store management emphasis and commitment to OOS issues; the resulting priority and managerial guidance in store ordering and store replenishment tasks; the stability of staff and the proper planning for replenishment peaks; the store size and resulting space conditions; and the use of appropriate decision heuristics and use of inventory in store ordering.

The findings have practical implications for store management as it reveals practices to pursue and to avoid. Also, it is argued that the findings have implications for the other members of the grocery channels.

Empirically, this paper explores two issues not being dealt with in depth in previous research, i.e. the OOS challenge in the independent sector and the emphasis on store operations.

Some manufacturing and service organizations have made efforts to work on continuous improvement in the form of Kaizen, lean thinking, Six Sigma, etc. The elimination of problems and waste (MUDA for the Japanese) plays a fundamental role in the reduction of operational costs and quality rejections of finished products both internally in the organization and in the supply chain. Some of these efforts use quality control tools to remedy it. Kaoru Ishikawa proposes seven basic quality tools. In this group of quality tools is the cause-and-effect diagram (CED), also known as “The Fishbone” and “Ishikawa diagram”. Exploring this questioning can shed light on the first indications to ratify the arguments of Ishikawa and Deming, that the main problems of companies are found in their processes and perhaps, in a deep way, in some of these cornerstone root causes that have to do with the way organizations are managed. The purpose of this study is to investigate cornerstone root causes through the application of CEDs in 40 Mexican companies that began an effort to improve some of their organizational processes.

An exploratory qualitative study was conducted. As a research strategy, the case study method was applied. Using theoretical sampling, the Ishikawa diagrams of 40 companies were analyzed, and 24 semi-structured interviews in depth were conducted.

The results of this research confirm the main research question: Are there cornerstone root causes that give way to one or several problems or effects of problems in organizations regardless of their sector? In other words, there were at least seven typical patterns that show the first signs of cornerstones root causes in organizations.

The method itself is a limitation; 40 case studies are not enough to generalize the results. In addition, the research was conducted only in a single Latin American country; in some cities of Mexico. However, 60 per cent of these companies are multinationals.

This paper is fundamental to delve into the cornerstones causes that give rise to the problems of organizations of the twenty-first century. The authors understand that these are the first indications, and that they cannot be considered a conclusion of these causes. However, this first theoretical sampling presents a first light on the subject.

The study contributes to the limited existing literature on total quality management and Kaizen in quality control tools and subsequently disseminates this information to provide impetus, guidance and support toward improving the problems of the organizations of twenty-first century.

Argues that root cause analysis as it is often used is grounded on tools which are weak and confusing. Illustrates this discussion on root cause analysis with examples. Reviews policy and risk in the light of the discussion. Counsels avoidance of the “mythological absolute” of root cause analysis.

The purpose of this paper is to evaluate the common themes leading or contributing to clinical incidents in a UK teaching hospital.

A root‐cause analysis was conducted on patient safety incidents. Commonly occurring root causes and contributing factors were collected and correlated with incident timing and severity.

In total, 65 root‐cause analyses were reviewed, highlighting 202 factors implicated in the clinical incidents and 69 categories were identified. The 14 most commonly occurring causes (encountered in four incidents or more) were examined as a key‐root or contributory cause. Incident timing was also analysed; common factors were encountered more frequently during out‐hours – occurring as contributory rather than a key‐root cause.

In total, 14 commonly occurring factors were identified to direct interventions that could prevent many clinical incidents. From these, an “Organisational Safety Checklist” was developed to involve departmental level clinicians to monitor practice.

This study demonstrates that comprehensively investigating incidents highlights common factors that can be addressed at a local level. Resilience against clinical incidents is low during out‐of‐hours periods, where factors such as lower staffing levels and poor service provision allows problems to escalate and become clinical incidents, which adds to the literature regarding out‐of‐hours care provision and should prove useful to those organising hospital services at departmental and management levels.

This paper attempts to develop a hybrid cause and effect diagram (CED) and interpretative structural model (ISM) for root cause analysis in quality management. The proposed model overcomes the weakness of the CED in reliably articulating hierarchical cause–effect Relationships.

A focus group discussion (FGD) among quality experts in the case company to establish relationships between the determined causes.

The hybridization of the CED and ISM allowed the causes to be ordered more clearly to determine potential root causes as well as presenting these causes more comprehensively.

The paper has been one of the very few attempts to improve the CED approach. As such, this paper employs the ability of the ISM to order concepts in a hierarchical structure, which is useful in determining root causes.