fishbone problem solving tool

Guide: Fishbone Diagram

Author: Daniel Croft

What is a Fishbone Diagram?

The benefit of a Fishbone Diagram lies in its simplicity. It gives you a structured way to brainstorm and categorize the various factors affecting a specific issue. The diagram can get as detailed as you need it to be, allowing for sub-causes to branch off the main causes, offering even deeper insights.

The Components of a Fishbone Diagram

Bones : These are the categories of potential causes. They branch off the spine, leading towards the head.

Why Use a Fishbone Diagram?

The Fishbone Diagram is a flexible tool that can be used for a range of applications. Here’s why it’s so useful:

1. Easy Visualization:

2. team collaboration:, 3. root cause analysis:.

Identifying symptoms of a problem is one thing; uncovering the root cause is another. The Fishbone Diagram excels at this by forcing you to dig deep into various contributing factors. By isolating these causes, you’re better positioned to find a lasting solution.

How to Create a Fishbone Diagram: A Detailed Guide

Materials you’ll need:, step 1: identify the problem, step 2: determine the main categories.

Common categories often include:

Step 3: Brainstorm Causes

Step 4: dig deeper with sub-causes, step 5: analyze and take action.

After all the causes and sub-causes have been identified, it’s time to analyze the Fishbone Diagram as a team. Highlight or circle the causes that seem most likely to be contributing to the problem. These are the areas that will need immediate attention and action.

Examples and Case Studies: Understanding Fishbone Diagrams in Action

Case study: manufacturing unit with quality issues, step 1: identify the problem problem statement: “high number of defective products in the last quarter.”, step 2: main categories, step 4: dig deeper (5 whys), common mistakes and tips: how to make the most of your fishbone diagram, 1. overlooking minor causes.

While it’s easy to focus on the most glaring issues, minor causes can accumulate and have a significant impact.

2. Ignoring Data

Tip : Use metrics and KPIs to support or refute the causes you’ve identified. This adds credibility to your findings and helps you prioritize effectively.

3. Stopping at Symptoms

Fishbone Diagrams are a fantastic asset in the toolbox of anyone interested in continuous improvement. Whether you’re a seasoned professional or just getting started, this simple yet powerful tool can help you dissect complex problems and develop targeted solutions.

Q: What is the origin of the Fishbone Diagram?

Q: can fishbone diagrams be used for non-manufacturing problems, q: how many main categories should my fishbone diagram have.

A: The number of main categories can vary depending on the complexity of the problem. However, it’s generally advisable to have between 4-6 main categories for easier analysis and readability.

Q: Can I use software to create a Fishbone Diagram?

Q: how do i know which causes to prioritize after creating a fishbone diagram, daniel croft.

Hi im Daniel continuous improvement manager with a Black Belt in Lean Six Sigma and over 10 years of real-world experience across a range sectors, I have a passion for optimizing processes and creating a culture of efficiency. I wanted to create Learn Lean Siigma to be a platform dedicated to Lean Six Sigma and process improvement insights and provide all the guides, tools, techniques and templates I looked for in one place as someone new to the world of Lean Six Sigma and Continuous improvement.

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• What Is a Fishbone Diagram? | Templates & Examples

What Is a Fishbone Diagram? | Templates & Examples

Published on January 2, 2023 by Tegan George . Revised on January 29, 2024.

A fishbone diagram is a problem-solving approach that uses a fish-shaped diagram to model possible root causes of problems and troubleshoot possible solutions. It is also called an Ishikawa diagram, after its creator, Kaoru Ishikawa, as well as a herringbone diagram or cause-and-effect diagram.

Fishbone diagrams are often used in root cause analysis , to troubleshoot issues in quality management or product development. They are also used in the fields of nursing and healthcare, or as a brainstorming and mind-mapping technique many students find helpful.

Table of contents

How to make a fishbone diagram, fishbone diagram templates, fishbone diagram examples, advantages and disadvantages of fishbone diagrams, other interesting articles, frequently asked questions about fishbone diagrams.

A fishbone diagram is easy to draw, or you can use a template for an online version.

• Your fishbone diagram starts out with an issue or problem. This is the “head” of the fish, summarized in a few words or a small phrase.
• Next, draw a long arrow, which serves as the fish’s backbone.
• From here, you’ll draw the first “bones” directly from the backbone, in the shape of small diagonal lines going right-to-left. These represent the most likely or overarching causes of your problem.
• Branching off from each of these first bones, create smaller bones containing contributing information and necessary detail.
• When finished, your fishbone diagram should give you a wide-view idea of what the root causes of the issue you’re facing could be, allowing you to rank them or choose which could be most plausible.

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See an example

There are no built-in fishbone diagram templates in Microsoft programs, but we’ve made a few free ones for you to use that you can download below. Alternatively, you can make one yourself using the following steps:

• In a fresh document, go to Insert > Shapes
• Draw a long arrow from left to right, and add a text box on the right-hand side. These serve as the backbone and the head of the fish.
• Next, add lines jutting diagonally from the backbone. These serve as the ribs, or the contributing factors to the main problem.
• Next, add horizontal lines jutting from each central line. These serve as the potential causes of the problem.

Lastly, add text boxes to label each function.

You can try your hand at filling one in yourself using the various blank fishbone diagram templates below, in the following formats:

Fishbone diagram template Excel

Download our free Excel template below!

Fishbone diagram template Word

Download our free Word template below!

Fishbone diagram template PowerPoint

Download our free PowerPoint template below!

Fishbone diagrams are used in a variety of settings, both academic and professional. They are particularly popular in healthcare settings, particularly nursing, or in group brainstorm study sessions. In the business world, they are an often-used tool for quality assurance or human resources professionals.

Fishbone diagram example #1: Climate change

Let’s start with an everyday example: what are the main causes of climate change?

Fishbone diagram example #2: Healthcare and nursing

Fishbone diagrams are often used in nursing and healthcare to diagnose patients with unclear symptoms, or to streamline processes or fix ongoing problems. For example: why have surveys shown a decrease in patient satisfaction?

Fishbone diagram example #3: Quality assurance

QA professionals also use fishbone diagrams to troubleshoot usability issues, such as: why is the website down?

Fishbone diagram example #4: HR

Lastly, an HR example: why are employees leaving the company?

Fishbone diagrams come with advantages and disadvantages.

• Great tool for brainstorming and mind-mapping, either individually or in a group project.
• Can help identify causal relationships and clarify relationships between variables .
• Constant iteration of “why” questions really drills down to root problems and elegantly simplifies even complex issues.

Disadvantages

• Can lead to incorrect or inconsistent conclusions if the wrong assumptions are made about root causes or the wrong variables are prioritized.
• Fishbone diagrams are best suited to short phrases or simple ideas—they can get cluttered and confusing easily.
• Best used in the exploratory research phase, since they cannot provide true answers, only suggestions.

If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.

Methodology

• Sampling methods
• Simple random sampling
• Stratified sampling
• Cluster sampling
• Likert scales
• Reproducibility

 Statistics

• Null hypothesis
• Statistical power
• Probability distribution
• Effect size
• Poisson distribution

Research bias

• Optimism bias
• Cognitive bias
• Implicit bias
• Hawthorne effect
• Anchoring bias
• Explicit bias

Fishbone diagrams have a few different names that are used interchangeably, including herringbone diagram, cause-and-effect diagram, and Ishikawa diagram.

These are all ways to refer to the same thing– a problem-solving approach that uses a fish-shaped diagram to model possible root causes of problems and troubleshoot solutions.

Fishbone diagrams (also called herringbone diagrams, cause-and-effect diagrams, and Ishikawa diagrams) are most popular in fields of quality management. They are also commonly used in nursing and healthcare, or as a brainstorming technique for students.

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How to Use Fishbone Diagram for Problem Solving

Fishbone diagram is a problem-solving tool, used in literal terms like a fishbone. It is also known as a cause and effect diagram. The mechanism is to specifically identify the cause and effect of any business or project problem.

A fishbone diagram can help define potential reasons for an issue. This article will dive into understanding the core principles of the fishbone diagram problem solving as a tool.

In 1943 at Tokyo University, Kaoru Ishikawa created the "Fishbone Diagram." Fishbone diagrams can also be called diagrams of "cause and effect." The fishbone diagram problem solving tool is a perfect tool to dig through an issue when we try to assess the root cause and find a solution effectively.

It offers a mechanism for explicitly identifying the "effect" and then brings you to think about the potential triggers, based on typical manufacturing problems. The fishbone diagram problem solving is a basic model that makes it easy to grasp swift and efficient root causes to implement corrective behavior.

It reflects the question or impact at the fish's head or mouth. Possible contributing factors under separate causal groups are identified on the smaller "bones." A fishbone diagram can help define potential reasons for an issue that would otherwise not be discussed by encouraging the team to look through the definitions and discuss alternate reasons.

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1.1 Why Use Fishbone Diagram for Problem Solving

The fishbone diagram makes you consider more when solving specific problems. During a brainstorming activity, various groups inspire thoughts from different areas.

The fishbone diagram brings order to the process of cause and effect . It's easy for participants to understand the main problems or issues and focus on the question across different potential triggers.

The fishbone diagram helps distinguish the causes and reasons for a problem and lets people intuitively figure out the solutions.

1.2 The Usage of Fishbone Diagram

The fishbone diagram problem solving method can be used when trying to fix problems or discover the root cause of an issue or problem, which helps you to see below the surface, and dive deeper into the real problem.

Here are several typical fishbone diagram problem solving applications:

• Manufacturing: ,nbsp;Uncover the root cause of a manufacturing problem by brainstorming and rating the likelihood and effect of all factors affecting the manufacturing cycle;
• Marketing or Product Marketing: ,nbsp;Identify the possible factors that may impede your company's popularity in the marketplace by investigating all the places that affect your product acceptance;
• Service: ,nbsp;Uncover the root cause of a business issue by brainstorming, and rate the probability and effect of all factors impacting the service delivery process.

There are 7 steps lead you to use fishbone diagram for problem solving:

• Explain the agenda behind the diagram

Let your team members know that the diagram can help you see different fields or possible areas that might lead to a solution to your current business problem.

• Draw diagrams

Draw the pattern or shape on your whiteboard, or use a software diagramming tool to ease accessibility. If you need remote attendants to do this exercise, you can quickly build it in EdrawMind and display your computer.

• Determine a simple statement on an issue

Write down statements at the top of your page or above where you will build the diagram., which means everyone has the same idea of the issue you are concerned with.

• Select what categories to use

Categories are discussed in more detail below. For example, you can add Policies, Methods, Personnel, and Software categories.

• Identify potential causes within each category of your problem

Team members may trigger brainstorming or contribute factors that fall into this category. You can either go by category or only come up with ideas and determine which type they fit.

• Go a step deeper to define sub-causes for any cause in the category

If you decide whether something can or will break down to smaller points, build divisions from the critical point.

Team members study the diagram to determine the most relevant focus points. If you are trying to take this a step forward and fix the root cause, it helps define where you're trying to benefit your initiative. You can't solve all the root factors at once, and some can get more significant payoff than others. Check the diagram for an evaluation of where the concentration of the team is best.

• Record results

You bring the work in. Capture, and log your work. You will need to return to it later, so you don't want to miss the importance of the exercise that you got.

There are several tips that should be considered when using the fishbone diagram for solving problems:

• Using the fishbone diagram tool to keep the team focused not on signs, but the problem's causes;
• Make sure you leave ample room in the diagram between the main groups to add minor specific pointers later;
• Try making team members write every cause on sticky notes while you're brainstorming causes, moving around the community asking each person about a particular reason. Continue to go through the loops, have more pointers before all suggestions have been eliminated;
• Encourage each person to join in the brainstorming exercise and voice their own opinions;
• Remember that the strategy of "five-whys" is often used in combination with the fishbone diagram.

While it takes time to create a fishbone diagram , it will help you and your team define the real causes and encourage you to strengthen the process and make permanent improvements.

Regardless, whether you are using the graphical or indented fishbone hierarchy, this process optimization method will significantly help you understand the factors involved in a process. The root causes of the event are the underlying process and system issues, which allowed the contribution. Hence fishbone diagram , the problem-solving tool, is extremely crucial when discussing strategies to deal with problems.

EdrawMind is an easy-to-use, flexible mind mapping tool designed to help you generate modern, fresh visuals and mind maps. By combining the bullet points into a mind map on a project, EdrawMind lets you organize the thoughts or concepts and create essential strategies.

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Fishbone Diagrams for Consequential Problem-Solving

Visualize Processes and Improve

The most successful businesses are not perfect. They are resilient. Every business encounters problems; most encounter them frequently. The ones that thrive are developing a problem-solving culture and arm employees with the tools to find and resolve the root causes of issues effectively. When employees are effective, empowered problem-solvers, obstacles turn into opportunities. One powerful problem-solving tool is the Fishbone Diagram.

What is a Fishbone Diagram?

A Fishbone Diagram also called an Ishikawa diagram or cause and effect diagram is a visual management tool used to document all the potential causes of a problem to uncover the root causes. The Fishbone Diagram helps users group these causes into categories and provides a structure to display them. When used effectively, it ensures that teams address the actual cause of the problem and don’t just implement a Band-aid solution.

The Fishbone Diagram is called such due to its resemblance to a fish’s skeleton. It was developed by Kaoru Ishikawa and became popular in the 1960s. It is used within many modern quality management methodologies, including Six Sigma and Lean Manufacturing. 

When to Use a Fishbone Diagram

Although we refer to the Fishbone Diagram as a structured problem-solving tool, it has other uses. It is helpful in breaking down the contributors to any process or system. Some ways to use it to test a problem statement, conduct root cause analysis, predict the results of a new process, streamline an existing process, improve quality outcomes, and uncover bottlenecks. 

How to Use a Fishbone Diagram

Step 1: Define the Problem

The first step in problem-solving, whether you use the Fishbone or not, is defining the problem correctly. Ideally, the problem statement will include an objective metric that can be used to determine success. For example, a problem statement such as, “The contact center abandon rate is too high,” will not be as helpful as a statement like, “The contact center abandon rate increased by 20% last month.”

In terms of the Diagram, the problem statement represents the “head” of the fish.

Keep in mind:

• If you are using a fishbone diagram to improve a process, instead of the problem, you will define your desired outcome in an objective and achievable way.
• Each of the “bones” in the diagram will represent a category of potential causes, but causes with the most significant impact should be closest to the “head.”

Step 2: Decide on Categories of Causes

The Fishbone tool forces you to think about the potential causes for the problem in several categories represented by the bones. The number will depend on the type and complexity of the problem. You can choose categories that make sense for your project, but in manufacturing, the 6 Ms are often used. They include:

• Man - the people involved in the process
• Methods - the Standard Work by which the process is performed
• Machines - the equipment and tools needed for the process
• Materials - the raw inputs, parts, consumables, and so forth
• Measurements - the data that is used to evaluate process results
• Mother Nature (Environment) - the conditions under which the process is performed.

Another commonly used structure is the McKinsey 7S Framework, which includes Strategy, Structure, Systems, Shared Values, Skills, Style, and Staff. Marketers may go with the 4Ps of Marketing; Product, Place, Price, and Promotion. Non-manufacturing process may include additional categories such as:

In our software call center abandon rate example, we’ll choose the categories of :

• Measurement
• Environment

Step 3: Brainstorm Potential Causes and Identify Roots

Now that the categories are defined, the team can go through each one and try to determine all the individual influences that can affect our results. Look at each type and list everything that falls within it. If a potential cause sounds more like a symptom than the root of the matter, the 5 Whys technique can be used to ensure that bottom-line reasons are included. If a source cause supersedes a potential cause, it can be removed from the diagram, or you can use strikethrough to preserve it while moving on to the fundamental problem. In this example, I’ve struck through “Low morale” as a potential cause because it is most likely a symptom of the lack of training and scheduling problems.

Step 4: Analyze the Diagram and Determine Next Steps

The Fishbone Diagram does not direct you to the solution, but it gives you an idea about where to look. By identifying potential causes in this manner, the team can assess the impact of each and brainstorm possible solutions. As in the case of our example, you’ll probably find more opportunities for improvement than you can tackle at once, but the exercise will put the team in a better position to decide what to do next. The Fishbone Diagram also becomes a good starting point for the next improvement cycle once your most critical root causes are addressed.

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The benefits of digital fishbone diagrams.

Back in the 1960s when the Fishbone Diagram was introduced, teams used paper to visualize their problem statement and possible causes. While that approach is acceptable for small groups working in the same space for a short period, it is not ideal for the way people work today.

That’s why KaiNexus has incorporated Fishbone Diagrams into our continuous improvement software platform. 

• The Fishbone Diagram is created and managed in the same platform you will use for implementing the changes once the analysis is complete.
• Information about your problem, the potential causes, and possible solutions are all collected for future review.
• Remote teams can be as effective as in-person ones.
• Roles and permissions can be applied to determine who can add access and edit Fishbones.
• Fishbone Diagrams can be used for Items, Projects, Improvements, Incidents, Tasks, and Charts. 
• Set up to 6 custom categories per diagram or reuse existing categories
• Highlight or strikethrough items

Using digital Fishbone Diagrams that are integrated with your improvement management software will help your team solve problems faster and accelerate the pace of positive change.

Fishbone Diagram Tips

The Fishbone diagram approach is not complicated, but you can do a few things to get the most out of it. We recommend:

• Use category names that are meaningful for your business. If “Methods” isn’t quite right, maybe “Procedures” is a better fit, for example.
• Don’t overload the categories. Create a new one if necessary. Likewise, don’t overcomplicate it; there’s no need to use six categories if four will do.
• Be careful not to add causes that are actually solutions.
• Prioritize your causes by keeping the most impactful ones closest to the “head”
• Use Fishbone Diagrams along with, not instead of, other problem-solving techniques such as The 5 Whys, A3s, process maps, and control charts.

KaiNexus is delighted to put one more digital improvement tool in the hands of our customers. If you’d like to know more about the impact of KaiNexus, one of our experts is available to help.

Want to learn more about KaiNexus Fishbone Diagrams?

Check out our fishbone video or support.kainexus.com for more information..

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How to Use a Fishbone Diagram for Effective Problem-Solving

Learn how to use a fishbone diagram for effective problem-solving. This guide covers its benefits, tips for use, and real-world examples.

Learn how to use a fishbone diagram, a powerful visual tool that helps identify and solve complex problems. This article covers the history and uses of the fishbone diagram, as well as a step-by-step guide on how to create one. You’ll also discover the benefits of using fishbone diagrams, tips for effective problem-solving, and real-world examples from different industries. Whether you’re a business owner, manager, or team member, this article will provide you with the tools and knowledge to improve your problem-solving skills and make better decisions.

1. Introduction to Fishbone Diagram

The Fishbone Diagram, also known as the Ishikawa Diagram or Cause-and-Effect Diagram, was developed in the 1960s by Kaoru Ishikawa, a Japanese quality control expert. Ishikawa developed the diagram as a tool for identifying and analyzing the causes of defects in manufacturing processes.

The Fishbone Diagram has since been widely adopted in various industries for problem-solving and process improvement. Its success in identifying the root causes of problems has made it a valuable tool for quality management, as well as for innovation and product design.

In addition to manufacturing, the Fishbone Diagram has been applied to many other fields, such as healthcare, education, and business. Its versatility and simplicity make it an effective problem-solving tool that can be used by individuals and teams at all levels of an organization.

A Fishbone Diagram is a visual tool used to identify and analyze the potential causes of a problem or an effect. The diagram takes the form of a fish skeleton, with the “head” representing the problem or effect and the “bones” representing the potential causes. The bones are typically labeled with categories, such as people, process, equipment, materials, or environment, and each category is then broken down further to identify specific factors that could be contributing to the problem or effect. 

The resulting diagram provides a clear and organized way to understand the root causes of a problem, making it easier to develop effective solutions. Fishbone Diagrams can be created by hand, but they are also available as pre-made templates in presentation software such as MS PowerPoint, Apple Keynote, and Google Slides, making it easy to use them in business and academic settings.

2. How to create a Fishbone Diagram

To create a Fishbone Diagram, follow these steps:

• Identify the problem or the effect you want to analyze.
• Define the main cause of the problem or effect.
• Identify the major categories that contribute to the main cause.
• Break down each category into more detailed causes that contribute to it.
• Draw the Fishbone Diagram, with the main cause at the head of the fish and the major categories as the bones.

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3. The benefits of using Fishbone Diagrams:

Fishbone Diagrams offer several benefits, including:

• Better problem-solving and decision-making by identifying and analyzing the root causes of a problem or effect.
• Improved communication and collaboration among team members by providing a visual representation of the problem and its causes.
• Clear identification of causes and their relationships, can help to prioritize and address the most critical causes.
• Identification of potential solutions based on the analysis of the causes.

4. Tips for using Fishbone Diagrams:

To get the most out of Fishbone Diagrams, consider the following tips:

• Involve a diverse team of people with different backgrounds and perspectives.
• Keep an open mind and embrace different ideas and viewpoints.
• Prioritize the most critical causes and solutions, based on the analysis of the Fishbone Diagram.
• Review and revise the Fishbone Diagram as necessary, to ensure it accurately reflects the problem and its causes.

5. Real-world examples of Fishbone Diagrams:

Fishbone Diagrams can be used in many different industries and settings, including healthcare, manufacturing, and service industries. Here are a few examples:

• In healthcare, Fishbone Diagrams have been used to identify and address the root causes of medical errors and patient safety incidents.
• In manufacturing, Fishbone Diagrams have been used to analyze the causes of defects and inefficiencies in the production process.
• In service industries, Fishbone Diagrams have been used to identify and address the causes of customer complaints and service quality issues.

Fishbone Diagrams are a powerful tool for effective problem-solving and decision-making. By following the steps for creating a Fishbone Diagram and using the tips and examples provided, you can use this tool to identify and address the root causes of a problem or effect and make better decisions for your organization.

Whether you are just getting started with Fishbone Diagrams or looking to improve your problem-solving skills, PoweredTemplate has got you covered. Download free and premium presentation templates from PoweredTemplate that include Fishbone Diagrams that work in PowerPoint, Keynote, and Google Slides. These creative templates are designed to help you identify the root cause of complex problems and come up with effective solutions. With a range of customizable templates available, you’re sure to find one that fits your needs. 

Don’t wait any longer, start streamlining your problem-solving process with PoweredTemplate today!

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Fishbone Diagram by Kaoru Ishikawa explained

Fishbone Diagram: this article explains the Fishbone Diagram or Ishikawa Diagram by Kaoru Ishikawa in a practical way. After reading you will understand the basics of this powerful problem solving tool and Cause and Effect Analysis . This article also contains a downloadable and editable Fishbone Diagram template. Enjoy reading!

What is a Fishbone Diagram / Ishikawa Diagram?

Problems are the consequence of one or more root causes. By finding and removing the root causes, problems can be solved. Brainstorming sessions could identify possible root causes, but this is not a systematic manner.

By using a this diagram, it is possible to perform an extensive cause and effect diagram analysis and identify the root causes of problems. A frequently used alternative to this diagram is mind mapping.

This root cause analysis method was developed by Kaoru Ishikawa , a Japanese scientist, who discovered through his work at Kawasaki Heavy Industries , that a large number of contributing factors could influence a work process. Therefore, it is advised to use this method with the people who have the most knowledge about the work process. Include people like team members and managers.

To obtain insight into these factors, he designed a simple graphical tool, in which the potential root causes are represented in an orderly fashion.

As this root cause analysis model resembles a fishbone, the Ishikawa diagram is, also called the Cause and Effect Analysis . Actually, the diagram was intended for production processes and its accompanying quality control. Today, the Ishikawa diagram is also used in other sectors.

Create a Fishbone Diagram

The Fishbone Diagram makes a distinction between cause and result. On the right-hand side of this diagram, the head of the fish, the problems are identified and described and on the left-hand side the possible root causes are denominated. These root causes are subdivided into four categories. Subsequently, each category is branched into secondary causes.

Figure 1 – an example of a Fishbone Diagram

This concerns all causes that are created by human actions; is there good communication, do people understand their assignments, are the employees sufficiently involved, experienced and trained, etc.?

This concerns causes related to the functioning of machines, tools, installations and computers; have the correct machines been used, are the machines safe enough, do the machines meet the requirements, are they reliable, etc.?

There may be problems with the materials, raw materials and consumables and semi-finished products; what is the quality, how much do we need, are the materials resistant to external influences, how long will they last, etc.?

This category investigates whether possible causes can be found in the work method; are the work processes adequate; how are the cooperative arrangements organized, how do employees and departments communicate with each other, etc.?

Details of the Fishbone Diagram

The Fishbone Diagram takes shape by following a number of steps. It starts with a large piece of paper on which a fishbone is drawn.

From there the following steps come up for discussion:

• The problem, in which the analysis is to be performed, is written at the top of the paper.
• Each participant mentions one possible cause for the problem and states in which category the problem belongs. No comments may be made on each other’s causes. All the listed causes are included in the Fishbone Diagram.
• The participants also mention possible secondary causes. These secondary causes are entered as branches in the Fishbone Diagram.
• This process is continued until no more possible causes are mentioned.
• The diagram is critically studied by all participants. They will see whether the possible causes have been entered in the right category and / or whether certain causes are related or derived from other causes.
• There is a vote on the most likely causes. The causes with the most votes will be turned into a “top 3” of possible causes. These three causes are circled. The causes without a vote are deleted.
• The priority order is determined from the “top 3” causes. The possible cause with the highest priority will be investigated further and then dealt with. After this the second and third causes will be addressed.

The diagram is an excellent root cause analysis and problem solving tool that can be used in any sector. As sectors can differ tremendously from one another it is possible to extend or change the root cause categories.

A technical company many want to add an IT category to the category “machine”. An advertising agency can insert a “creativity” category. As long as the root causes of problems are identified, the fishbone diagram has achieved its objective.

Useful tips for success

• Make sure that there is consensus in the group about both the need and the characteristics of the cause statement before beginning the process of building the Fishbone Diagram.
• If appropriate, you can “graft” branches that do not contain a lot of information on to other branches. Likewise, you can split branches that have too much information into two or more branches as you go.
• Make parsimonious use of words while populating the Ishikawa diagram. Only use as many words as necessary to describe the cause or effect.

Fishbone Diagram template

Start with the cause and effect analysis and identify the causes of problems with this ready to use Fishbone Diagram template.

Download the Fishbone Diagram template

It’s Your Turn

What do you think? How do you apply the Fishbone Diagram? Do you recognize the practical explanation mentioned above or do you have additional information which you would like to share? What are your success factors for a set up?

Share your experience and knowledge in the comments box below.

More information

• Behnam, B., & Alvelos, H. (2011). Exploring the Potential of Quality Tools in Tire Retreading Industry: a Case Study . International Journal of Engineering Science and Technology (IJEST), 3(6), 5337- 5345.
• Ilie, G., & Ciocoiu, C. N. (2010). Application of Fishbone Diagram to Determine the Risk of an Event with Multiple Causes . Management Research and Practice, 2(1).
• Gupta, K., Sleezer, C.M. & Russ‐Eft, D.F. (2007). A Practical Guide to Needs Assessment . Pfeiffer.
• Ishikawa K. & Loftus, J.H. (1990). Introduction to quality control . Tokyo, Japan: 3A Corporation; 1990.

How to cite this article: Mulder, P. (2013). Fishbone Diagram (Ishikawa) . Retrieved [insert date] from Toolshero: https://www.toolshero.com/problem-solving/fishbone-diagram-ishikawa/

Original publication date: 07/19/2013 | Last update: 05/22/2024

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Patty Mulder

Patty Mulder is an Dutch expert on Management Skills, Personal Effectiveness and Business Communication. She is also a Content writer, Business Coach and Company Trainer and lives in the Netherlands (Europe). Note: all her articles are written in Dutch and we translated her articles to English!

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Blog Beginner Guides 15+ Fishbone Diagram Examples for Brainstorming Problem Causes

15+ Fishbone Diagram Examples for Brainstorming Problem Causes

Written by: Danesh Ramuthi Oct 13, 2023

The fishbone diagram, often referred to as the Ishikawa diagram or cause and effect diagram, is a powerful visualization tool that elucidates the intricate web of contributing factors behind a specific problem or issue. Characterized by its unique bone structure, it places the problem statement at the fish’s head, branching out to the various causes categorized into major segments.

The primary purpose of a fishbone diagram is to break down complex problems into understandable components, enabling team members to efficiently brainstorm and analyze causal relationships, making it indispensable in areas like quality management and root cause analysis.

Whether you’re aiming to delve deep into the causes of climate change or dissect the factors behind a the fishbone diagram provides a clear visual representation, highlighting the cause and effect relationship and underscoring the value of systematic problem solving.

For those eager to harness the potential of this great tool, Venngage offers a robust diagram maker . With customizable fishbone diagram templates , it empowers users to craft their diagrams effortlessly. These templates are meticulously designed to help you place ideas in the appropriate category, ensuring a comprehensive and organized cause and effect analysis.

Click to jump ahead:

Root cause fishbone diagram example

Cause and effect fishbone diagram example, ishikawa fishbone diagram example, medical fishbone diagram example, climate fishbone diagram example, project management fishbone diagram example, simple fishbone diagram example, how to use a fishbone diagram.

A root cause fishbone diagram, at its core, is a tool specifically tailored to identify, analyze and represent the underlying causes or root causes of a problem. Imagine a scenario where a manufacturing process has a recurring defect. 

In such a scenario, the problem statement or defect would be placed at the fish’s head. As one begins the fishbone analysis, the spine of the fish represents the main flow of the process, with smaller bones branching out. Each of these bones corresponds to a contributing factor or potential cause of the defect.

Utilizing the fishbone diagram for root cause analysis involves gathering team members for a brainstorming session. Here, the group would identify various major categories like “Machinery”, “Manpower”, “Materials”, “Methods”, etc. 

Under each of these categories, multiple factors are explored. For instance, under “Machinery”, potential causes could include outdated equipment, calibration errors or frequent breakdowns. The aim is to determine the root cause, or in some cases, multiple root causes, responsible for the defect. 

The visual representation afforded by the diagram aids in systematically breaking down the problem, ensuring no stone is left unturned.

One of the advantages of using a root cause fishbone diagram is its ability to pinpoint areas that might otherwise be overlooked. It offers a structured approach, helping teams avoid short-term fixes and instead address the deeper, underlying issues. However, it’s crucial to be aware of its disadvantages too. 

The success of the diagram heavily relies on the expertise and insights of the team members. If not all possible causes are considered, the analysis may be incomplete, leading to erroneous conclusions.

The cause and effect fishbone diagram is primarily used to map out the various causes contributing to a specific effect or outcome. For instance, consider a problem statement like “Decreased Sales in Quarter 3”. 

Placed at the head of the fish, this statement becomes the focal point of the analysis. The spine extends outwards, branching into multiple categories that could be influencing this decline.

Starting with a brainstorming session, team members can identify major categories such as “Marketing”, “Product Quality”, “External Factors”, and “Customer Service”. Under “Marketing”, for example, potential causes could be insufficient advertising, poor social media engagement, or ineffective promotional campaigns. 

The aim is to capture all the possible causes contributing to the decline in sales. Through the fishbone diagram’s structured format, teams can effectively map out the causal relationships, understanding how various factors interplay and lead to the overarching problem.

Using the cause and effect fishbone diagram offers a comprehensive overview, helping businesses or teams strategize effectively. They can prioritize areas that need urgent attention and develop strategies for improvement. 

However, like all tools, it has its disadvantages. It requires thoroughness and can become convoluted if too many minor issues are included. Thus, it’s essential to keep the diagram focused on significant, impactful causes to maintain its efficacy as a problem-solving tool.

The Ishikawa fishbone diagram or just fishbone diagram, named after its creator Kaoru Ishikawa, is a powerful visualization tool designed to map out causal relationships concerning a particular problem or issue. Its unique design, reminiscent of a fish’s skeletal structure, places the primary problem or effect at the fish’s head.

From this focal point, the “spine” of the fish extends, leading to branching “bones.” Each branch represents a category or a group of potential contributing factors that lead to the main problem. Often used in root cause analysis and quality management, the Ishikawa diagram breaks down complex issues by categorizing them into major areas such as “People”, “Processes”, “Environment” and more.

This structure allows for an organized exploration of potential causes, ensuring that various perspectives and elements related to the problem are considered.

By facilitating systematic identification and categorization of causes, the Ishikawa fishbone diagram becomes an essential tool in problem-solving and decision-making processes.

In the medical realm, the fishbone diagram finds a specialized application, offering clinicians a structured format to diagnose and understand patient conditions.

Given the critical nature of healthcare, pinpointing the root causes of medical symptoms or conditions becomes paramount. A medical fishbone diagram aids in this by visualizing potential causes related to a specific medical problem or symptom. Categories in a medical context might include “Laboratory Results”, “Patient History”, “Physical Examination Findings” and “Environmental Factors”.

Under each category, various factors or sub-causes can be listed. For instance, “Laboratory Results” could delve into specifics like electrolyte imbalances or abnormal blood cell counts.

The diagram’s visual representation ensures that healthcare professionals can comprehensively analyze patient conditions, considering multiple facets before determining a diagnosis or treatment plan. This systematic approach fosters enhanced patient care and promotes more accurate diagnostic processes.

Designed for meticulous cause and effect analysis, this fishbone diagram delves into the complex problems associated with climate change. Its visual representation, characteristic of the fish’s skeletal structure, places the overarching problem statement — for instance, “Global Warming” — at the fish’s head. From here, multiple categories branch out, representing major aspects such as “Anthropogenic Activities”, “Natural Causes” and “Economic Factors”. 

Each of these major categories further branches out to depict the specific factors contributing to the primary problem. 

The strength of the climate fishbone diagram lies in its ability to present a comprehensive overview, ensuring that all potential causes, whether they relate to deforestation, industrial emissions, or natural volcanic activities, are captured and analyzed. 

It serves as a visualization tool that aids researchers and decision-makers in crafting informed and effective strategies to combat climate-induced challenges.

In project management, where precision and systematic problem solving are paramount, the fishbone diagram finds significant utility. Project delays, cost overruns and unmet objectives often have multifaceted root causes. 

The project management fishbone diagram, an adaptation of the Ishikawa diagram, serves to identify, categorize and analyze these causes. 

Each category delineates into specific contributing factors, ensuring a thorough exploration of all potential issues. The visual format of the diagram aids team members during brainstorming sessions, facilitating the identification of challenges within the project lifecycle. 

By offering a clear visual representation of the cause and effect relationships inherent in project challenges, the project management fishbone diagram stands as an invaluable tool, helping teams to preemptively address issues, optimize processes and enhance overall project execution.

Related: How to Write a Comprehensive Project Management Plan [+ Examples]

For problems that may not be as intricate but still require structured analysis, a simple fishbone diagram becomes the tool of choice. Stripped of excessive categories and branches, the simple fishbone diagram focuses on presenting the main causes of a problem in a straightforward manner. 

Despite its simplicity, the core structure remains consistent: the primary issue or problem statement occupies the fish’s head, while a few major categories branch out from the central spine. This diagram’s strength lies in its accessibility; without delving into overly detailed branches, it offers a clear, concise visualization of the root causes and contributing factors. 

It’s particularly beneficial for quick brainstorming sessions or when introducing the concept of cause and effect analysis to those unfamiliar with the fishbone methodology. 

The simple fishbone diagram, while not exhaustive, provides a foundational framework, promoting structured thought and problem-solving in various contexts.

A fishbone diagram , also known as an Ishikawa or cause and effect diagram, provides a visual representation of potential causes leading to a particular problem or effect. 

It is a structured brainstorming tool that helps teams identify, explore and visually display the many potential causes related to a specific problem.

• Begin your fishbone diagram with the problem statement or the main effect you’re trying to understand. This is written on the right side and represents the fish’s head.
• Draw a horizontal line extending from the problem statement towards the left. This is the fish’s spine and serves as a foundation for the potential causes.
• Identify the major categories of causes. Common categories include “People”, “Processes”, “Equipment”, “Materials” and others, depending on the context. These are the primary bones branching off the central spine.
• Draw diagonal lines or “fishbones” branching off the spine for each major category.
• Under each major category, brainstorm and list down the potential contributing factors or sub-causes. These represent the smaller bones branching out from the primary bones.
• Connect these sub-causes to the respective major category lines using smaller diagonal lines.
• For causes that may have sub-components or more detailed breakdowns, further branch out from the main cause.
• Make sure to clearly label each cause and sub-cause for clarity.
• After the brainstorming session, analyze the diagram to determine the most likely root causes of the problem.
• Once complete, your fishbone diagram should offer a comprehensive visual overview of all the potential causes leading to the main problem. This structure enables teams to better understand the problem, prioritize potential causes and develop effective solutions or interventions.

Related: 10+ Types of Diagrams and How to Choose the Right One

We explored over 15 examples of fishbone diagrams to help you effectively brainstorm the causes of problems. 

This tool, with its visually intuitive structure, serves as a game-changer in analyzing root causes across various fields, from business challenges to technological snags. 

This article doesn’t just present examples but also educates readers on how to harness the power of the fishbone diagram to its fullest. 

For anyone inspired to create their own or seeking specialized templates, Venngage stands out as a go-to resource.

Explore Venngage’s diagram maker and discover an array of pre-designed fishbone diagram templates to kickstart your brainstorming sessions.

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What is a Fishbone Diagram

A fishbone diagram is a powerful problem-solving tool used in healthcare, engineering, and many other industries. Find out how you can use Lucidchart, Visio, and Excel to construct a fishbone diagram. Check out Lucidchart's free fishbone diagram examples and templates.

What is a fishbone diagram?

A fishbone diagram is also known as an Ishikawa diagram, herringbone diagram, or cause-and-effect diagram. This is because it describes the potential causes of a given problem or outcome. The diagram resembles an actual fish bone, with a long line running down the center pointing to the main outcome, also called the "problem statement". The other bones branch out from the middle bone and represent different categories of causes. In the template below, we've shown the six standard categories, Measurements, Materials, People, Machine, Methods, and Environment. However, feel free to swap these out for categories that best fit your problem.

Learn to use Lucidchart in 5 minutes

• Use our Fishbone Diagram Maker to create your first online chart from a template or blank canvas or import a document.
• Add text, shapes, and lines to customize your flowchart.
• Learn how to adjust styling and formatting within your flowchart.
• Locate what you need with Feature Find.
• Share your flowchart with your team to start collaborating.

What is a cause and effect analysis?

A cause and effect diagram is also known as a fishbone diagram due to its appearance. Cause and effect analysis can be used in a wide variety of industries, including engineering, marketing, and manufacturing. It was invented by Kaoru Ishikawa as a way to pinpoint contributing factors in business problems, especially in the field of industrial manufacturing. When conducting cause and effect analysis, teams start with a problem or challenge, then look at which roadblocks stand in the way of success.

Make a fishbone diagram in Lucidchart

You can make your own fishbone diagram with Lucidchart. To design the skeleton, simply use the line tool by clicking the "L" key. A crosshair will appear and let you draw a line. Easily add lines to the template below, and then drag out text boxes onto the lines to properly label them. Lucidchart also supports a variety of convenient features that make diagramming easy, like draggable resizing, pop-out context menus, and custom image upload. And once you’ve finished perfecting your diagram, you can share or publish it online.

How to create a fishbone diagram from a template or new document

It’s simple to create your own cause and effect analysis example by using Lucidchart. It’s professional diagramming software that runs seamlessly in your browser. This example shows the brainstorming process for a marketing team that’s trying to understand why website traffic has dipped. Open our editable template to start tackling your own business’s obstacles.

Get started in Lucidchart

• Register  for a Lucidchart account.
• Navigate to My Documents.
• Click Create > New Document.
• Explore and start with a fishbone diagram template or create a new document in Lucidchart.

Lucidchart has several fishbone diagram templates, covering various levels of complexity. Click the arrow next to “+Document” to open Lucidchart’s template library. To read about a template, simply click on it once—this will give you a closer look at the template and recommended uses. When you’ve found a template that suits your needs, select it and click “Create Document.” (To use the template below, click on the image.)

Determine your problem statement

5. The first thing you need for your fishbone diagram is a problem statement. Since fishbone diagrams are used to analyze cause-and-effect relationships, the problem statement is your final effect or result. Drag out a box from the toolbox in Lucidchart (it’s accessible from the left side of the screen), then double-click to label it accordingly. Depending on your industry and use case, the problem could be anything from “shipments arrive late” to “patient readmitted to the hospital.” Once you have the problem statement, draw a line out from it. Your line will be shorter or longer depending on how many categories you want to include.

List categories

6.  Next, you’ll add lines and corresponding boxes to show the categories of causes for your problem statement. It might be helpful here to think backwards. First, determine all the potential causes for a problem, and then group them into categories. The traditional categories for a fishbone diagram are the six M's:

• Measurements
• Mother Nature

If you’re not sure what to include, these categories are a great first step. You are also free to choose your own, more specific categories, depending on what best fits your diagram.

7. To add causes, draw new lines from the category lines and label them with text boxes. To draw a line without dragging it out from a shape, simply hold down the L key and crosshairs will appear. Click on any line again to angle it or rotate it. Remember to add as many causes as you can think of, even if some of them are less likely to occur than others. The more details you have, the easier it will be to analyze your problem.

Review your work

After you’ve completed the document, it’s time to review. Make sure your text is error-free and large enough to read. Did you include all relevant information, and is it organized under the right categories? Try sending a URL to a colleague and inviting them to comment or collaborate with you.

Compatible with Microsoft Visio

If you’re concerned about choosing Lucidchart over Visio, rest assured that our program is fully Visio-compatible. As the best  Visio alternative , you can open nearly any Visio file that’s sent to you with Lucidchart’s Visio import option, which is free for everyone. With a Pro account, you can also edit the document or export a Lucidchart document to .vdx format. You’ll never regret switching to Lucidchart: it’s more affordable, easier to use, and built for true collaboration.

How to add a fishbone diagram in Excel

1. Download the  MS Office Add-On  if you haven’t already

2. Use a template like the one below or create a new fishbone diagram in Lucidchart.Use this guide to learn  how to make a flowchart in Lucidchart  if you need help getting started.

3. Open your Excel sheet, go to your Lucidchart Add-In.

4. Select your diagram from your list of Lucidchart documents and insert it into your Excel sheet.

If you want to learn more about creating fishbones with Lucidchart, check out our  in-depth tutorial . If you’d like another free fishbone template, try our  fishbone example page . It’s easy to make these diagrams your own; simply drag and drop elements to rearrange them. Several types of images, including JPGs, PNGs, and SVGs, can be uploaded for even more customization.

Fishbone diagram for service industry example

Fishbone diagram

Fishbone diagram with sub-causes

Ishikawa diagram example

Cause-and-effect diagram example

Fishbone diagram worksheet

Helpful resources, fishbone diagram maker.

A thorough fishbone diagram can not only help your team collaborate to identify problems, but it can also help you save time and resources.

Make a Fishbone Diagram in Word

This step-by-step guide will explain how to make fishbone diagrams in Microsoft Word, both from scratch and using a Lucidchart template.

Make a Fishbone Diagram in Powerpoint

Use this guide to learn how to create fishbone diagrams in both PowerPoint and Lucidchart.

Follow the link to see the current Lucidchart pricing. You can try Lucidchart for free with 3 editable documents.

It’s easy to add, modify, and format lines in Lucidchart. Click and drag lines or use smart lines for a more streamlined experience.

Lucidchart makes it simple to add and format text anywhere in your diagram. Further manage your text by adding or uploading fonts and using our grammar tools.

Our template gallery offers over 900 templates and examples—with more being added weekly. These templates include network diagrams, Gantt charts, Kanban boards, simple and complex flowcharts, and more.

Click the link below to learn how to Install the lucidchart, Lucidspark, and Lucidscale add-ons for Google Docs, Sheets, and Slides.

Lucidchart is a visual workspace that combines diagramming, data visualization, and collaboration to accelerate understanding and drive innovation. Want to make a Fishbone diagram of your own? Try Lucidchart. It's quick, easy, and completely free.

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How to Make a Fishbone Diagram in Word

Follow this step-by-step guide to learn how to manually make a fishbone diagram in MS Word.

Fishbone Diagram

A fishbone diagram, also known as an Ishikawa diagram or cause and effect diagram, is a tool used to identify the root causes of a problem. It is named after Japanese quality control expert Kaoru Ishikawa, who developed the concept in the 1960s. Organizations across a variety of industries, including manufacturing, healthcare, and service use the fishbone diagram to identify and analyze the factors that contribute to a particular problem or issue.

Teams typically use a fishbone diagram to identify all of the possible causes of a specific problem or effect. You construct it by drawing a horizontal line with the problem or effect written at the end, and then drawing lines coming off of the central line to represent the different categories of causes. Teams typically label it with the major contributing factors, such as people, equipment, materials, environment, and methods.

Once a team determines the categories, the next step is to brainstorm and list out all of the potential causes within each category. You then draw the causes as branches off of the main lines, with each branch representing a specific cause.

Once a team has identified and listed all of the causes, the next step is to analyze the relationships between the causes to identify the root causes of the problem. You can do this through a variety of techniques, such as the 5 Whys method, which involves asking why the problem occurs repeatedly until the root cause is identified.

Once a team has identified the root causes, the next step is to develop and implement solutions to address those root causes. This can involve making changes to processes, equipment, training, or other factors that contribute to the problem.

The fishbone diagram is a valuable tool for identifying and addressing the root causes of a problem. By systematically analyzing the factors that contribute to a problem, organizations can develop effective solutions and improve the overall performance and quality of their processes.

Fishbone Diagram Example

When building a fishbone team members should be careful to include only the actual physical causes. It can be tempting to include items someone believes is happening or wishes were happening. Consequently, a fishbone can turn into a “wishbone” diagram.

Additional Resources on the Fishbone Diagram

• Ask Art: How Useful is Six Sigma and the Black Belts and Green Belts that Come with It?
• Jim Womack on how lean compares with Six Sigma, Re-engineering, TOC, TPM, etc., etc.
• Not Every Problem Is a “Nail” But Companies Typically Reach for the Same Old “Hammer”
• Why A3 Thinking is the Ideal Problem-Solving Method
• Developing Problem Solvers
• Fishbone Diagrams and Mind Maps

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Fishbone diagrams: How to use them for problem-solving

October 5, 2023 by MindManager Blog

When something goes wrong, it’s essential to understand the root cause in order to prevent it from occurring again.

However, life and business are both complex, making it difficult to identify at times the underlying causes which created the situation you’re facing now. That’s where and when a fishbone diagram can help!

In this article, we’ll dive into everything you need to know about fishbone diagrams and how to use them for problem-solving.

What is a fishbone diagram?

Fishbone diagrams (also called Ishikawa diagrams and cause-and-effect diagrams) are visualizations used to identify and illustrate the causes for a specific event. Potential causes are often brainstormed and then categorized in order to identify a problem’s root cause.

The diagram gets its name due to the branches radiating out from the main issue in a way that resembles a side view of a fish skeleton. However, the process can be applied to most mind map layouts.

Here’s a fishbone diagram example:

When to use fishbone diagrams

Fishbone diagrams help focus you and your team’s energy on the root cause of a problem instead of merely addressing and wasting time on the symptoms.

Here are a few common applications of Fishbone diagrams:

Manufacturing: Discover the root cause of a manufacturing issue by brainstorming and ranking the likelihood and impact of all the areas that influence the production process.

How to create a fishbone diagram in MindManager in 5 steps

Fishbone diagrams are quick to make in MindManager and the examples above are included as templates to make it even easier.

MindManager’s ease of capturing ideas during brainstorming makes it the ideal tool to capture and organize potential causes. The visual format allows you to see all the causes simultaneously, draw relationships between causes, and identify if the root cause is found multiple times within the diagram.

Here’s how to create a fishbone diagram:

• In MindManager, go to the File menu, select New and then click into the Problem-Solving folder. There you’ll find three templates for Fishbones, the manufacturing, service, and product analyses. Select a template.
• Enter the issue in the central topic.
• Next, either brainstorm potential causes and add them as floating topics initially and categorize them after the brainstorming session. Or, use each category as a guide for a mini-brainstorm session and enter the potential causes directly in the appropriate branch.
• Add more details to your causes as new subtopics or notes with the cause itself.
• Once all the potential causes have been identified, you can take the diagram a step further and rank each cause. One way to do this would be to use the Priority marker to rank the cause between 1 and 9. You can later filter the diagram and view specific priorities and hide the less important ones that will distract the focus of the team.

Key MindManager features for fishbone diagrams

There is no one single ‘right’ way to create, categorize, or rank items within a fishbone diagram.

With that said, here’s a list of ways to apply some of MindManager’s features to transform an ordinary diagram into a powerful application to visualize and empower your work.

• Use color (fonts, topic fill color) to categorize different causes.
• Change the font characteristics to emphasize different causes (e.g. bold, larger fonts, different font types, etc.).
• Use topic images to add greater context and enhance the visualizations.
• Write topic notes for more in-depth details related to each cause.
• Apply icons and tags to categorize causes.
• Hyperlink or add attachments to provide more details.
• Draw relationship lines between different connected causes throughout the diagram.
• Assign resources to any causes that you have identified. This may clarify who is responsible or accountable for that cause.
• Collapse branches for a quick overview or drill down into all the details.
• View the diagram through multiple lenses. For instance, you are not confined to the layout of the Fishbone diagram. Switch views to see the diagram as an outline, or dive in the Schedule, Icon or Tag views to see your content in groupings based on your assigned categories or due dates.
• Filter content to either show or hide topics that you have annotated with tags or icon markers. For instance, filter on all the top priority potential causes that need additional investigation.
• Share your diagram by either publishing it onto the web (and sharing a link) where anyone can open and view the Fishbone diagram interactively in their browser or export the diagram into a variety of different formats (e.g. Microsoft Word, HTML5, Microsoft Project, etc.).

Download MindManager today to get started on your fishbone diagram!

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The Role of Fishbone Diagram in Analyzing Cause and Effect

• 6 MINUTES READ

Also known as Ishikawa Diagram, Cause and Effect Diagram and Fishbone Analysis.

Variants include Tree Diagram.

A fishbone diagram is one of the various techniques available for conducting cause-and-effect analyses. It provides a structured way to identify and organize the potential causes contributing to a particular problem or effect. It allows the establishment and presentation of causal relationships in a straightforward and understandable format. The word fishbone comes from its visual representation that looks like the skeleton of a fish.

The fishbone diagram is one of the seven basic tools of quality and considered one of the fundamental tools in the domain of quality management. Its primary function lies in the identification of root causes underlying a specific effect in order to identify an appropriate solution that can be effective. This technique often used in Lean Six Sigma and other quality improvement methodologies to narrow down the area of analysis. The outcome of a fishbone analysis provides useful information for later problem-solving tools.

The fishbone analysis can also be effectively used in product and process design, as well as a cause prevention tool to prevent future problems and risks .

The first step in conducting a fishbone analysis is to clearly define the effect. This effect could be a quality issue, a technical complication, or simply not meeting a performance target. In the fishbone diagram, the effect is placed at the head of the fishbone while the causes are placed on the branches. For easier sharing and reference, it is important to categorize causes. Numerous categorization approaches are available, including the well-known “6 Ms” which will be discussed in further detail.

Combining the fishbone technique with the 5 whys technique gives the analysis an extra dimension. This allows to identify the hierarchy of causes including the possible root causes. Root causes typically represent those factors at the ends of the chains of causes that do not have any sub-causes. It is important to note that the main idea behind the fishbone analysis is to brainstorm all possible causes that may contribute to an effect, so be aware of brainstorming and adding causes which are actually solutions.

The 6 Ms Approach

The “6 Ms” is a widely adopted approach for categorizing potential causes and assigning labels to different branches on the fishbone diagram. This approach finds application in manufacturing, production, and service industries. The typical six categories it includes are Man, Method, Machine, Material, Environment, and Measurement.

Man – Anyone involved with the process and contributes to the effect including governance and support functions.

Method – How the process is performed and the specific requirements for doing it including policies, procedures and common practices.

Machine – The machinery, equipment and tools required to produce a product or deliver a service.

Material – All the materials needed to perform a process including raw materials, packaging, paperwork and information.

Environment – The conditions in which the process operates including the weather condition, geographical location and cultural aspects.

Measurement – The data and metrics that are used to evaluate the performance of the process.

There are many other categorization approaches that might be worth considering. For example, the “8 Ms” approach adds Management and Maintenance to the “6 Ms” categories. Alternatively, when the effect results from a documented or mapped process , the process steps themselves can form the basis for categorization. In such cases, the process input variables can be considered to be the potential causes.

It’s important to mention that the names used for categorizing causes can change depending on the situation or based on the user’s selection.

Conducting the Analysis and drawing the Fishbone

Fishbone analysis is a collaborative exercise, fostering the capture, categorization, and organization of the collective knowledge held by a team regarding a problem or process . By going through the steps of drawing the diagram with your team, everyone gains insight into the cause-and-effect, which makes the solution easier to find.

• With your team, clearly define the effect that you want to work on.
• Write the effect statement in a box at the center right of a large piece of paper.
• Draw a long horizontal line pointing to the box.
• Identify the cause categories using the 6 Ms or any other approach.
• Write them in boxes parallel to the horizontal line.
• Use brainstorming to log all possible causes under the appropriate categories. Start with the main causes then the secondary causes and so on.
• Update the chart as new potential causes become apparent.
• Highlight or assign numbers near to the key causes to show their relative importance.
• If necessary, collect data to confirm key causes are real.

Note: A cause-and-effect matrix can be used to prioritize the identified causes of a problem. Prioritizing and selecting the key causes will minimizes the need for more statistical analysis of inputs with limited impact on the final output.

Example – Manufacturing

The example shown here represents the output of a brainstorming session on the causes of the increased coolant consumption within a manufacturing plant. Note that this fishbone diagram is labeled using the “6 Ms” categorization approach.

Example – Non-Manufacturing

The example shown here is the output of a brainstorming session on the causes of the increased invoice errors within a particular company. It is important to note that only the main causes have been displayed in this diagram.

Example – Fishbone Combined with 5 Whys

A restaurant manager has noticed an increase in the number of customer complaints regarding the flavor of the coffee served. In response, his team has constructed a fishbone diagram, incorporating potential causes and their respective sub-causes for only two categories.

Another way of highlighting the structure of the possible causes is to use the why-why diagram .

There are many tools that can be used to identify and present a cause-and-effect relationship using the fishbone diagram. One of the simplest and most straightforward ways is using this fishbone diagram template .

Wrapping Up

The fishbone diagram is a valuable tool for conducting cause-and-effect analyses. It offers a structured approach to identify and organize potential problem causes. This tool is considered one of the fundamental tools in Lean Six Sigma and other quality improvement methodologies. Combining the fishbone diagram with the “5 Whys” adds depth to the analysis and helps revealing the main causes and potential root causes. The outcome of a fishbone analysis provides useful information for later problem-solving tools.

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Learning Objectives

After completing the lesson you will be able to:

1)  Define  root cause analysis (RCA)

2)  Demonstrate RCA using a Fishbone Diagram 

Case Study: “Why don’t we get paged sooner?”

At an HCI Clinic, providers are often delayed in how soon they see a patient during a new visit appointment. Typical delays (wait time) from check-in to provider page was 20 minutes. This 20-minute delay presented a cascade of problems for patients and care teams. For patients, it limited face-to-face time with a provider. For residents, the lack of time hindered care - building rapport with patients, potentially missing important details that help inform the care plan. The delay also caused resident job dissatisfaction. To identify all the moving parts in this complex (yet seemingly simple) problem, the team turned to the fishbone diagram as a useful tool to investigate the multiple causes of delay.

Health care’s problem solving toolkit

health care, we rely on evidence-based methods for solving problems. Root Cause Analysis (RCA) is a collective term that describes a wide range of approaches used to investigate a problem and its causes.

When we talk about a problem we often refer to its impact. We know how it impacts us personally, our system, patients, and/or customers. But our experience of the problem—it’s impact—doesn’t really tell us why it’s happening—the cause. If we don’t know the cause, we won’t be able to prevent it from happening again. Investigating a problem and its causes can result in long-term solutions, which is an essential part of our patient safety journey .

Fishbone Diagram

Fishbone thumb.

Download the Fishbone Diagram Quick Tips here .

Download a U of U Health PowerPoint Fishbone Diagram template here .

An easy to use tool for conducting a root cause analysis

What it is: The fishbone diagram Also referred to as “Ishikawa cause and effect” after Japanese founder and quality control expert Kaoru Ishikawa. is a tool to organize ideas and theories about what causes a problem or an event.

How it works: Teams work together to brainstorm and identify potential causes and group them into several categories to help highlight potential issues. Frequently used categories include people (or patients/providers/stakeholders), culture, method (or process), technology, equipment, supplies, etc. (customize categories as needed).

Follow Four Steps to Fishbone:

Fishbone steps4 01.

Three Tips for facilitating a fishbone

A successful fishbone diagram is led by a facilitator—one individual on the team who’s job is to remain impartial to the discussion, write down the identified causes on the fishbone diagram, and let the participant discussion flow freely.

Here are the top three tips for leading a successful fishbone:

#1: Help the team focus on identifying causes, not solutions.  It’s common for people to brainstorm solutions (how to fix), rather than causes (what to fix). Simply acknowledge any comments by writing them to the side (don’t disregard any comments, it’s demoralizing) and help everyone remember the difference between the two. For example, if the problem is delays at patient check-in, “add front desk personnel” offers a solution (how to fix). Whereas “front desk is short-staffed” focuses on a potential cause (what to fix).

#2: The cause is more important than the category.  People often get confused or stuck on what category a cause should go into. As a facilitator, remind the participants that listing the cause is more important than where it goes. For example, “front desk is short-staffed” could be placed under the category of People, but also Culture.

Sometimes a main category can become too big. A common one is to start with the “People” category, but by the time 10 causes are identified under that category, you may choose to split it, for example as: “Nurses” and “Doctors.”

#3: Keep brainstorming until the ideas run out.  People are often unsure of how many causes to identify. As long as the discussion keeps going, people are still brainstorming. When the silence starts to creep in, you have your first clue that perhaps you have enough to get started. 

As facilitator, you will write the statements as they come out during the discussion. If you have to paraphrase what was said (because of space requirements, complexity, etc.) confirm with the group that what you wrote was what was said.

See it applied

Returning to our introduction case study, the Oncology residents first mapped the process to identify where it was breaking down. They then brainstormed as a team and came up with the following categories and causes.

HCI Huntsman Clinic Check in to Provider Page Process Fishbone Diagram

fishbone full

Oncology team: Lindsay Burt, MD; Chris Baker, MD; Chris Weil, MD; Josh Gruhl, MD; Matthew arsons, MD; Ryan Hutten, MD; Ryan Kraus, MD; Timothy Griffith MD

Solving the age-old problems of health care doesn’t require more solutions. It requires better understanding of problems. The oncology residents found the fishbone a useful tool to illustrate how many variables contribute to a seemingly simple question: “why don’t we get paged sooner?” By breaking the problem into a series of categorized causes, the team identified overlap between workflows. Using this information, the team is now prioritizing causes from high-to-low effort to begin making improvements.

*Originally published Janurary 2021

Why do some organizations thrive during a crisis while others flounder? Iona Thraen, director of patient safety, joined forces with her ARUP Laboratory colleagues to learn how the world-renowned national reference lab adapted to the pandemic. Leaders created a culture of safety by putting innovation, learning, and patient-centered care at the heart of all their efforts.

Finding evidence to change the status quo isn’t easy; thinking about evidence in terms of how it persuades—whether subjective or objective—can make it easier. Plastic surgery resident Dino Maglić and his colleagues followed their guts and saved money by improving the laceration trays used to treat patients in the emergency department.

Every summer, senior value engineer Cindy Spangler stocks our offices with an abundance of tomatoes, zucchini, and squash. We asked her to share how improvement thinking influences her gardening. Turns out, there are parallels–learn from others, stick to your scope, and learn from the mistakes.

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Fishbone diagram templates

Uncover the root causes of any challenge with Miro's fishbone diagram templates. These templates guide your team through a structured brainstorming session, allowing you to map out all the potential factors contributing to an issue. With Miro's fishbone diagram examples to spark ideas, you'll be able to identify key areas for improvement and develop a shared understanding of the path forward.

Fishbone Diagram for Root Cause Analysis Template

Works best for:.

Fishbone Diagram

The Fishbone Diagram for Root Cause Analysis template helps identify and analyze the underlying causes of a problem. It visually breaks down issues into categories, such as people, processes, and equipment, to uncover root causes. Perfect for teams aiming to solve problems systematically, enhance processes, and prevent future occurrences. Ideal for brainstorming and collaborative analysis sessions.

Fishbone Diagram Template

Operations, Diagrams, Workflows

What is the best way to solve any problem your team faces? Go straight to the root. That means identifying the root causes of the problem, and fishbone diagrams are designed to help you do it best. Also known as the Ishikawa Diagram (named after Japanese quality control expert Kaoru Ishikawa), fishbone diagrams allow teams to visualize all possible causes of a problem, to explore and understand how they fit together holistically. Teams can also use fishbone diagrams as a starting point for thinking about what the root cause of a future problem might be.

Fishbone Diagram for Marketing

Optimizing marketing strategies requires identifying underlying issues. The Fishbone Diagram Marketing template helps you systematically explore factors affecting your campaigns. Categorize potential causes into areas such as market research, product positioning, promotional strategies, and distribution channels. This structured analysis enables your team to pinpoint and address issues, enhancing marketing effectiveness and achieving better results.

Fishbone Diagram for Healthcare

Ensuring high-quality care in healthcare settings requires a thorough understanding of root causes behind issues. The Fishbone Diagram for Healthcare template helps you analyze potential causes of problems in areas like patient care, staff performance, and administrative processes. This structured approach facilitates comprehensive analysis and collaborative problem-solving, ultimately leading to improved healthcare outcomes and patient satisfaction.

Fishbone Diagram for Process Improvement

Planning, Strategy

Process improvement is key to enhancing efficiency and productivity. The Fishbone Diagram for Process Improvement template helps you identify the root causes of process inefficiencies. Categorize potential causes into areas such as workflow, resources, technology, and personnel. This structured analysis enables your team to systematically explore and address issues, streamlining processes and boosting overall productivity.

Fishbone Diagram for Quality Control

Fishbone diagram

Maintaining high standards of quality is vital in any industry. The Fishbone Diagram for Quality Control template helps you identify and analyze the root causes of quality issues. Use it to categorize potential causes into areas such as materials, methods, manpower, and machinery. This structured approach ensures a thorough examination of all possible factors affecting quality, leading to more effective solutions and continuous improvement.

Identifying the root causes of marketing challenges is essential for effective strategy development. The Fishbone Diagram for Marketing template helps you systematically explore factors affecting your marketing efforts. Categorize potential causes into areas such as market research, product positioning, promotional strategies, and distribution channels. This structured analysis enables your team to pinpoint and address issues, optimizing marketing campaigns.

Fishbone Diagram for Manufacturing

In manufacturing, pinpointing the root causes of defects and inefficiencies is crucial. The Fishbone Diagram for Manufacturing template helps you systematically investigate issues related to production. Categorize potential causes into areas such as machinery, methods, materials, and manpower. This structured approach enables your team to collaboratively identify and address underlying problems, improving processes and enhancing manufacturing quality.

Fishbone Diagram for Service Improvement

The Basic Fishbone Diagram, also known as the Ishikawa or cause-and-effect diagram, is a powerful tool for identifying the root causes of problems. Use this template to systematically explore and document potential causes of an issue, categorizing them into key areas such as people, processes, equipment, and materials. This visual approach helps teams collaborate on problem-solving, ensuring all factors are considered and addressed effectively.

Cause and Effect Diagram Template

Diagramming

The Cause and Effect Diagram Template is a useful tool for analyzing complex relationships, identifying root causes of problems, and improving organizational processes. It can be customized to fit user's unique needs and provides a structured framework for analysis. Teams can use real-time collaborative analysis on the Miro platform to drive continuous improvement initiatives.

Crowd Sourced Cause and Effect

Fishbone Diagram, Problem solving

The Crowd Sourced Cause and Effect template leverages collective intelligence to identify root causes of problems. By involving multiple team members, you can gather diverse perspectives and uncover insights that might be overlooked. This collaborative approach ensures a comprehensive analysis and fosters team engagement.

Fishbone RCA

Problem solving, Strategy

Use the Fishbone RCA template to conduct a thorough root cause analysis (RCA) for any problem. This template helps you break down complex issues into manageable categories, enabling you to identify the underlying causes. It's an effective tool for improving processes, solving problems, and preventing future issues.

Fishbone Diagram by Hanna Havulinna

The Fishbone Diagram template, also known as the Ishikawa or Cause-and-Effect diagram, offers a visual tool for identifying and analyzing root causes of problems or issues. It provides a structured framework for categorizing potential causes into major categories such as people, process, environment, and equipment. This template enables teams to conduct root cause analysis systematically, facilitating problem-solving and decision-making. By promoting a structured approach to problem analysis, the Fishbone Diagram empowers teams to address issues effectively and implement corrective actions efficiently.

Fishbone Diagram by Dave Westgarth

Identify and solve problems effectively with the Fishbone Diagram by Dave Westgarth. This template helps you break down complex issues into root causes, enabling a thorough analysis and targeted solutions. Use it for quality control, process improvement, and troubleshooting in various industries. Ideal for teams focused on continuous improvement and problem-solving.

Fishbone Diagram for Product Development

Enhance your product development process with the Fishbone Diagram for Product Development. This template helps you identify potential issues and their root causes, ensuring a thorough analysis before product launch. Use it to streamline development, reduce risks, and improve product quality. Perfect for product managers and development teams aiming to deliver high-quality products efficiently.

Join thousands of teams collaborating and doing their best work on Miro.

About the fishbone diagram templates

Miro's fishbone diagram templates are a powerful tool for teams looking to dive deep into problem-solving. These templates, inspired by the Ishikawa or cause-and-effect diagram, offer a structured way to visualize all the potential causes of a particular issue. By laying out the various factors in a visual format, teams can collaboratively pinpoint the root causes of challenges and strategize on effective solutions.

Why you'll love our fishbone diagram examples

Our collection of fishbone diagram examples is designed to spark creativity and provide guidance on how to use this problem-solving method effectively. Each example serves as a springboard for your team to understand the breadth of possible causes for a problem and how they can interconnect. With these fishbone diagram examples, you'll find it easier to engage in productive discussions, ensuring that every voice is heard and every potential cause is considered.

How to use the fishbone diagram templates in Miro

Choose a fishbone diagram template from Miro's collection that best suits your team's needs.

Start by identifying the problem or effect and place it at the head of the fishbone.

Invite your team to join the board and collaborate in real time.

Brainstorm potential cause categories and use them as the "bones" off the main arrow. Common categories include Methods, Equipment, People, Materials, Environment, and Processes.

Under each category, add branches that represent specific causes within that category. Encourage your team to contribute their insights.

Use Miro's features to vote on the most likely causes or to group similar causes together.

Once all potential causes are identified, discuss and prioritize them to determine which ones to investigate further.

Develop an action plan based on your findings and assign tasks directly within Miro to ensure follow-through.

By following these steps, your team can harness the full potential of Miro's fishbone diagram templates to foster a collaborative environment, streamline the problem-solving process, and move forward with clarity and consensus.

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Using Fishbone Diagrams to Solve Problems

Fishbone diagrams may also be referred to as “Cause and Effect” diagrams, or Ishikawa diagrams , after their founder Kaoru Ishikawa. Whatever your preferred term, the fishbone diagram is a great tool for delving into a problem when we need to determine the root cause, and you are surrounded by the opinions of those around you. It provides a process to clearly define the “Effect” and then puts you to thinking about the possible causes, based on the categories of common problems in manufacturing.

Defining your “Effect”

The first step in using the fishbone diagram as a problem-solving tool is to clearly define your effect or outcome that you don’t like. This could be a quality issue, not meeting metrics or troubleshooting the introduction of a new process or product line. This becomes the “head” of the diagram. Use butchers paper or a whiteboard to sketch out out the fishbones template.

Defining an effect takes a little practice. Make sure it is brief and succinct. Use facts and numbers where possible. Spend a few minutes reflecting on your effect with the team; does everyone agree that the statement defines the problem as fully as possible?

Brainstorming the “Causes”

With your team, we want to add the bones to this diagram, brainstorming all of the possible influencing factors. Each idea needs to be put into a category or branch.

In manufacturing, it is accepted that there are 6 main branches that need investigation. These are often described as the “6M’s” but feel free to use the terms that best suit your company.

• People / Manpower: Everyone involved with the process across the value stream, including support functions
• Processes / Methods: This defines how the process is performed and the all requirements needed for doing it, including quality procedures, work orders / travellers / work instructions, drawings.
• Machines / Equipment: All machines and equipment, needed to accomplish the job, including tools
• Materials: Raw materials, purchased parts and subassemblies that feed into the end product
• Measurements: defines how have we determined that the outcome is wrong
• Environment: The conditions that influence the process including time, temperature, humidity or cleanliness

As the team suggests possible causes, determine which heading that idea belongs under, jotting it down clearly. Also add another branch, covering “why” that cause would influence the effect we are investigating. Continue until the team runs out of ideas.

If you find there are branches of the diagram that are missing, delve into that area further, asking questions; “Is it possible that the environment has affected our problem” too hot, too cold, too wet?

When you are out of ideas, take a break to clear everyone’s head. Here we change modes and needs a little time for our brains to shift gears. Now we don’t need any new ideas, we need to determine the top 2 or 3 possible causes that can be resolved and will have the most impact of the effect. You can use an A3 plan  to outline the current state, future state and the steps needed to achieve it.

If the top few causes are not clear, determine what further information is needed. While using a fishbone diagram does take time to develop, it will help you and your team to determine the real causes and allow you to improve your process and implement lasting change.

Related Content

Txm article: problem solving, txm article: learn about creating a culture of daily problem solving in this lean minute video, txm lean minute: learn simple techniques to finding the root cause in this lean minute video, purchase lean products including problem solving concern strips from our e-store.

Continuous improvement is at the heart of what we do at TXM. We have a proven track record of helping our customers achieve sustained superior operational performance. One of the tools we use to help our clients achieve this is the fishbone diagram. Also known as a Cause and Effect Diagram, the Fishbone Diagram is a valuable tool for identifying the root causes of problems. By identifying and addressing the root causes of problems, our clients are able to achieve significant improvements in their operations. If you are facing operational challenges, we encourage you to contact us to learn more about how we can help you using fishbone diagrams and other Lean tools. Continuous improvement is essential for achieving Operational Excellence, and TXM is here to help you every step of the way.

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Robert Chittenden is a Senior Lean Consultant at TXM Lean Solutions

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7 Powerful Root Cause Analysis Tools and Techniques

By Sebastian Traeger

Updated: April 21, 2024

Reading Time: 5 minutes

1. The Ishikawa Fishbone Diagram (IFD)

2. pareto chart, 4. failure mode and effects analysis (fmea), 5. proact® rca method, 6. affinity diagram, 7. fault tree analysis (fta).

With over two decades in business – spanning strategy consulting, tech startups and executive leadership – I am committed to helping your organization thrive. At Reliability, we’re on a mission to help enhance strategic decision-making and operational excellence through the power of Root Cause Analysis, and I hope this article will be helpful!  Our goal is to help you better understand these root cause analysis techniques by offering insights and practical tips based on years of experience. Whether you’re new to doing RCAs or a seasoned pro, we trust this will be useful in your journey towards working hard and working smart.

Root Cause Analysis (RCA) shines as a pivotal process that helps organizations identify the underlying reasons for problems, failures, and inefficiencies. The goal is simple: find the cause, fix it, and prevent it from happening again. But the process can be complex, and that’s where various RCA techniques come into play. 

Let’s dive into seven widely utilized RCA techniques and explore how they can empower your team’s problem-solving efforts.

Named after Japanese quality control statistician Kaoru Ishikawa, the Fishbone Diagram is a visual tool designed for group discussions. It helps teams track back to the potential root causes of a problem by sorting and relating them in a structured way. The diagram resembles a fishbone, with the problem at the head and the causes branching off the spine like bones. This visualization aids in categorizing potential causes and studying their complex interrelationships.

The Pareto Chart, rooted in the Pareto Principle, is a visual tool that helps teams identify the most significant factors in a set of data. In most situations, 80% of problems can be traced back to about 20% of causes. By arranging bar heights from tallest to shortest, teams can prioritize the most significant factors and focus their improvement efforts where they can have the most impact.

The 5 Whys method is the epitome of simplicity in getting to the bottom of a problem. By repeatedly asking ‘why’ (typically five times), you can delve beneath the surface-level symptoms of a problem to unearth the root cause. This iterative interrogation is most effective when answers are grounded in factual evidence.

When prevention is better than cure, Failure Mode and Effects Analysis (FMEA) steps in. This systematic, proactive method helps teams identify where and how a process might fail. By predicting and examining potential process breakdowns and their impacts, teams can rectify issues before they turn into failures. FMEA is a three-step process that involves identifying potential failures, analyzing their effects, and prioritizing them based on severity, occurrence, and detection ratings.

The PROACT ® RCA technique is a robust process designed to drive significant business results. Notably used to identify and analyze ‘chronic failures,’ which can otherwise be overlooked, this method is defined by its name:

PReserving Evidence and Acquiring Data: Initial evidence collection step based on the 5-P’s – Parts, Position, People, Paper, and Paradigms.

Order Your Analysis Team and Assign Resources: Assembling an unbiased team to analyze a specific failure.

Analyze the Event: Reconstructing the event using a logic tree to identify Physical, Human, and Latent Root Causes.

Communicate Findings and Recommendations: Developing and implementing solutions to prevent root cause recurrence.

Track and Measure Impact for Bottom Line Results: Tracking the success of implemented recommendations and correlating the RCA’s effectiveness with ROI.

PROACT® RCA excels in mitigating risk, optimizing cost, and boosting performance, making it a valuable addition to any RCA toolkit.

The Affinity Diagram is a powerful tool for dealing with large amounts of data. It organizes a broad range of information into groups based on their natural relationships, creating a clear, visual representation of complex situations. It’s particularly beneficial for condensing feedback from brainstorming sessions into manageable categories, fostering a better understanding of the broader picture.

Fault Tree Analysis (FTA) is a top-down, deductive failure analysis that explores the causes of faults or problems. It involves graphically mapping multiple causal chains to track back to possible root causes, using a tree-like diagram. FTA is particularly useful in high-risk industries, such as aerospace and nuclear power, where preventing failure is crucial.

Each RCA technique provides a unique approach for viewing and understanding problems, helping you pinpoint the root cause more effectively. The key is to understand when and how to use each tool, which can significantly enhance your team’s problem-solving capabilities.

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In conclusion, the techniques presented offer a diverse set of tools to help organizations address problems and inefficiencies effectively. From visual representations like the Ishikawa Fishbone Diagram and Pareto Chart to more proactive approaches such as the 5 Whys and Failure Mode and Effects Analysis (FMEA), each technique provides a unique perspective on identifying and mitigating root causes.

The PROACT® RCA Method stands out for its comprehensive process, particularly suited for chronic failures. Additionally, the Affinity Diagram and Fault Tree Analysis (FTA) contribute valuable insights by organizing data and exploring causal chains, respectively. Leveraging these techniques strategically enhances a team’s problem-solving capabilities, enabling them to make informed decisions and drive continuous improvement.

I hope you found these 7 techniques insightful and actionable! Stay tuned for more thought-provoking articles as we continue to share our knowledge. Success is rooted in a thorough understanding and consistent application, and we hope this article was a step in unlocking the full potential of Root Cause Analysis for your organization. Reliability runs initiatives such as an online learning center focused on the proprietary PROACT® RCA methodology and EasyRCA.com software. For additional resources, visit our Reliability Resources .

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Quality Tools and Techniques (Fishbone Diagram, Pareto Chart, Process Map)

Definition/introduction.

In a dynamic and complex healthcare system, recognizing the role of quality in patient health outcomes and resource utilization is crucial. Various factors contribute to the gap between the ideal and existing states of healthcare delivery, including a lack of awareness of needs, resistance to new methods, and workforce shortages.

The establishment of the Joint Commission in 1951, Dr. Avedis Donabedian's structure-process-outcome framework for evaluating healthcare quality in 1966, the formation of the Agency for Healthcare Research and Quality (AHRQ) in 1989 and the Institute for Healthcare Improvement in 1991 are some of the historical milestones in the evolution of quality in healthcare. [1]  The Institute of Medicine (IOM) reports, the  To Err Is Human in 2000 and the  Crossing the Quality Chasm in 2001, have paved the way for establishing a culture of patient safety and healthcare quality. [2]  The IOM advocated for a redesign of the healthcare system to promote quality and safety by supporting front-line teams in identifying practices that hinder quality care and encouraging collective exploration to build a more robust healthcare system. [2]

The IOM defines quality as the measure of service offered to individuals and communities to achieve positive health outcomes [3] . Health care aims to deliver safe, timely, effective, efficient, equitable, and patient-centered (STEP) care supported by evidence-based medicine. [4]  A multidisciplinary team approach to quality improvement (QI) involves healthcare professionals, patients, and families, with each member playing a vital role in driving system-wide improvements and fostering organizational learning to improve health outcomes. [5]

QI in healthcare involves a wide range of tools and strategies. Common QI methodologies include the Model for Improvement, Plan-Do-Study-Act, Lean, and Six Sigma. [6] These methodologies employ diverse QI tools to identify root causes, address process issues, prioritize change opportunities, and anticipate potential barriers ( AHRQ. QI Toolkit ).

This article focuses on 3 tools used in QI—the Fishbone or Ishikawa Diagram, Pareto chart, and process mapping. These tools enable healthcare teams to identify and prioritize the root causes of the problem and decide on which aspects need to be acted on first.

Fishbone Diagram

The fishbone, also known as the cause-and-effect diagram, was introduced by Kaoru Ishikawa, who is often regarded as the father of Japanese quality for his contributions to quality management techniques [7] . This diagram is used in QI to visualize a root cause analysis (RCA) of a problem and ideate on potential actionable changes. In the diagram, the head of the fish, typically on the right side, represents the problem that occurred or the area needing improvement. Each branch, also called the bone of the diagram, corresponds to a major category of causes related to the effect ( CEC. Quality Improvement tools ). The teams brainstorm major causes and sub-causes by asking why the problem happened. These major causes can be categorized under the following (modifiable) headings—methods or systems, machine or equipment, manpower or people, materials, environment, and measurement (see  Image.  Fishbone Diagram).

The methods or systems category can include gaps in processes, training, or guidelines that lead to variability. The people or manpower category can relate to issues with human resources, cognitive errors, knowledge gaps, or biases, such as authority bias, for example, following orders simply because they were given by a doctor. Depending on the specific type of effect being analyzed in the RCA, heuristic errors can be categorized under a separate bone. The environment category focuses on what was happening at the time of the error or surrounding factors that may have facilitated its occurrence.

Thus, the fishbone diagram enables the stakeholders to identify major and minor contributors to a problem. From this comprehensive list, teams can develop successful process improvement initiatives and potential solutions through effective collaboration.  

Pareto Chart

Vilfredo Pareto originally introduced the Pareto principle based on his idea that 80% of the land was only owned by 20% of the Italian population ( CEC. Quality Improvement Tools ). In health care, teams can apply the Pareto principle to identify the "vital few" factors that can most efficiently improve the quality of care. After root causes have been identified and causes of the issue have been quantified, factors whose cumulative contributions constitute approximately 80% of the causes of issues are considered the lowest-hanging fruits or the biggest bang for the buck. Factors that have relatively minor effects are considered the "trivial many" and constitute the remaining 20% of the causes ( CEC. Quality Improvement Tools ). The most frequently used visual representation of the 80/20 rule is a Pareto chart [3] .

The Pareto chart consists of 2 components—a bar chart of the quantified causes ordered from most to least frequent and a line graph representing the cumulative percentage of contributions from different factors. To create a Pareto chart, first identify causes and then quantify the number of errors attributable to each cause. Pareto charts can be created in Excel using a table of causes and frequencies. The Pareto chart feature is categorized under Histogram Charts when inserting a chart.

The example Pareto chart (see  Image.  Pareto Chart) lists patient falls on a specific medical unit identified as the problem. The X-axis of the chart depicts the major categories of causes contributing to the problem. To determine which fall prevention strategies most efficiently promote patient safety, the bar graph is ordered left to right from most (vital few) to least (trivial many) frequent. The next step is to calculate the cumulative percentage curve or line graph, which is depicted by connecting the dots at the first, second, and third contribute percentages, and so on. The line graph is overlaid on the bar chart, with its axis on the right side of the graph. The 80/20 rule is applied by identifying the point where the cumulative percentage line graph intersects with 80% on the percentage axis. Factors that fall to the left of this point are the vital few or most impactful causes, whereas the factors to the right of the intersection are the trivial many. Working on the most frequent contributors to failure significantly impacts the given problem. [3]  The 80/20 rule helps optimize where QI efforts and resources are most efficiently expended, especially when garnering support for QI projects and allotting resources.

Process Map

Process mapping was introduced by Frank Gilbreth in the early 1900s ( NIH. Process Mapping ). Unlike written standard operating procedures that outline the ideal process, process maps provide a detailed, step-by-step depiction of the actual procedures, revealing potential duplications, delays, decision points, variations, and inefficiencies ( NIH. Process Mapping ). Process mapping in health care typically requires the perspectives of diverse stakeholders to identify different levels of interwoven and complex processes [8] . Other terms associated with process mapping include spaghetti diagrams (process maps with curved arrows instead of straight ones) and swim lanes (for complex processes with multiple parallel activities, such as discharge planning).

The process mapping begins by:

• Determining the scope by identifying clear start and endpoints of workflow
• Identifying and engaging stakeholders
• Mapping the process workflow as a team.

Formats are flexible and may include sticky notes, whiteboards, and electronic software, such as MS Visio, Smart Draw, and PowerPoint. Shapes in the process map can be used to visually differentiate process types. The shapes represent start and end points, actions performed, delays, and decision points. Shapes may vary, and legends should be provided to the team. These shapes are connected by arrows to depict the direction of the process flow. [9]

In the example process map, a simplified flowchart illustrates the process of documenting medication reconciliations for patients admitted to hospital medicine through the emergency department (see  Image.  Process Map). Steps in the process should be arranged in the correct order. Stakeholders, especially those on the front line, can help to determine accuracy and highlight any variations in the process. The draft process map should then be validated during a Gemba walk, which involves directly observing the actual workflow. Discrepancies and variations found can be corrected on the map.

The finalized current state process map can be used to develop targeted QI plans. Process mapping also plays a crucial role in RCA. A future state plan can be discussed with stakeholders and redrawn to optimize team workflow during the QI project design. [9]

Issues of Concern

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The effective use of QI principles by healthcare professionals is essential to achieve safe, evidence-based, patient-centered care. To implement successful QI programs, strong leadership across the organization is required to support frontline staff and offer training in QI methodologies to promote cultures of continuous learning. [5]  Some common challenges for QI project implementation include resistance to change, lack of training in QI methodologies, time constraints, low motivation, competing priorities, lack of teamwork or stakeholder engagement, ineffective leadership, and organizational support. [10]  

Complexity management and human factor training resources are key factors for team engagement. [11]  Various QI methods and tools exist. Choosing the right methods and tools for each QI project can accelerate goal achievement. Fishbone diagrams, Pareto charts, and process maps are valuable tools for helping define areas of action and craft SMART (specific, measurable, achievable, relevant, time-bound) aims for project design. Whichever QI tools are used, keeping patient safety and experience top of mind while reducing waste and increasing the value of care is important.

Clinical Significance

Medical errors pose a serious threat to public health in the United States. [12]  Healthcare organizations must regularly conduct QI programs and promote systems-based learning, which empowers employees to apply the principles of healthcare quality to promote patient safety. [13]  The introduction of the QI curriculum in early medical education and the promotion of safety culture in organizations improves healthcare efficiency and patient outcomes. [14]  John Kotter puts forth 8 principles to promote a patient safety culture:  [15]

• Establishing a sense of urgency in change initiation
• Building a powerful guiding coalition for goal alignment
• Creating a vision to direct the change effort
• Communicating the vision
• Team empowerment to act on the vision
• Generating short-term wins
• Consolidating improvements to produce positive changes
• Anchor new approaches in the organization's culture.

Effective change management involves a thorough understanding of the need for change and inclusive leadership. By fostering a collaborative approach, stakeholders can develop action plans that enhance healthcare efficiency and sustainability. [16]

Nursing, Allied Health, and Interprofessional Team Interventions

The application of QI principles in health care has significantly evolved over the past century. Proficiency in RCA methodologies enables healthcare teams to improve patient care and mitigate medical errors. Please see StatPearls' companion resource, " Root Cause Analysis and Medical Error Prevention ," for more information. Effective leadership establishes vision, aligns, motivates, and inspires teams to bring positive and sustainable changes. [15]  

Key steps for effective organizational performance include supportive QI leadership, collaborative teamwork, staff training in QI methodologies, patient and team feedback utilization, and success celebration ( AHRQ. Toolkit for Using AHRQ Quality Indicators ). Strong interprofessional networking, education, administrative support, and motivation are essential for developing robust healthcare teams and patient safety champions, who are pivotal in delivering safe, evidence-based, patient-centered care. [17]

Fishbone Diagram. This fishbone diagram illustrates the root causes of problems related to high physical therapy (PT) consult volume, represented as the head of the fish.  In this example, 5 cause categories or bones are identified—Systems, People, Environment, Materials, and Equipment. EHR, electronic health record.

Contributed by S Tagaram, MD

Process Map. This process map illustrates the medication reconciliation process in the emergency department (ED) for patients admitted to the hospitalist service.  The ovals here represent the start and end points of the process, rectangles denote the steps involved, and the diamond shape indicates a decision point. EMR, electronic medical record.

Pareto Chart. This Pareto chart for inpatient falls shows 5 causes. The left-side Y-axis displays the number of falls attributed to each cause. The right-side Y-axis shows the cumulative percentage contribution of these causes. The point where the orange line intersects with the horizontal solid blue 80% line indicates the most vital causes for the project. The vertical dotted blue line represents this transition from vital few to trivial many. In this example, the vital few could be either the first 2 or 3 causes on the left, depending on the resources allocated to the project, as the dotted line intersects the third cause (lack of mobility equipment). The 2 right-most causes (team communication and family attempt) contribute only 9% to the total. Efforts towards addressing these causes do not significantly impact the number of falls.

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