rcfa steps.pdf

7/27/2019 RCFA Steps.pdf

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ROOTCAUSE FAILURE ANALYSIS

M aintenance Excel l ence

RSARSA20042004

Building RCFA As Part Of A

Structured System

Building RCFA As Part Of ABuilding RCFA As Part Of A

Structured SystemStructured System

Module 7

Module 7Module 7



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RSARSA20042004

STEP 1 : EDUCATE ALL PEOPLE ON RCFA ITSELFSTEP 1 : EDUCATE ALL PEOPLE ON RCFA ITSELF

•• Start by educate our maintenance andStart by educate our maintenance and

technical people on RCFAtechnical people on RCFA

HOW TO MAKE RCFA AS PART OF OUR SYSTEM

HOW TO MAKE RCFA AS PART OF OUR SYSTEMHOW TO MAKE RCFA AS PART OF OUR SYSTEM

•• Management to set expectations as toManagement to set expectations as to

why their people are trained on RCFAwhy their people are trained on RCFA

••

Conduct management presentation andConduct management presentation andoverview on the basics of RCFA andoverview on the basics of RCFA and

when it should be appliedwhen it should be applied

Root-cause-failure-analysis shouldn't

be over -applied. Abide by the 80-20 rule:

20 percent of problems cause 80 % of

losses. For this, set up a spreadsheetdetailing failures encountered and the

total annual losses associated w/ each.

rank those problems from largest to

smallest annual loss.



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RSARSA20042004

STEP 2 : ANALYZE FAILURE MODES TO UNDERGO RCFASTEP 2 : ANALYZE FAILURE MODES TO UNDERGO RCFA



•• Assign someone to summarize most common and frequent failuresAssign someone to summarize most common and frequent failures

encountered and rank its severity according to its consequenceencountered and rank its severity according to its consequences & costs & cost

•• This is important so as to understandThis is important so as to understand w/cw/c failures will undergo a thoroughfailures will undergo a thorough

Root Cause Failure AnalysisRoot Cause Failure Analysis•• Once the failure modes had beenOnce the failure modes had been

summarized, prioritize high risksummarized, prioritize high risk

failures and thosefailures and those w/cw/c are chronicare chronic

in naturein nature

•• Assign a common RCFA Facilitator Assign a common RCFA Facilitator

and RCFA third party consultant toand RCFA third party consultant to

guide in the initial process of theguide in the initial process of the

RCFA AnalysisRCFA Analysis

•• It is also vital and important toIt is also vital and important to

collect as much data as possiblecollect as much data as possible

regarding the failure for later regarding the failure for later veriveri--

ficationfication of every single hypothesisof every single hypothesis



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RSARSA20042004

STEP 3 : CONDUCT THE RCFA ANALYSISSTEP 3 : CONDUCT THE RCFA ANALYSIS



•• Once the teams had been identified, allowOnce the teams had been identified, allow

them to proceed with the RCFA Analysisthem to proceed with the RCFA Analysis

and determine the Physical, Human andand determine the Physical, Human and

the Latent Cause of the problemthe Latent Cause of the problem

• Analysis processes that stop at the iden-

tification of physical root causes or to thecomponent level always lack depth. Ana-

lyses that focus on people that make bad

decisions are often called “witch hunting”

expeditions. True Root Cause Analysis

will seek to understand why good people

make bad decisions. Why did the personwho made the decision think it was the

right thing to do at the time?

• All RCFA efforts must steer away from

blaming people in the first place and thismust be clear to all people



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M aintenance Excel l ence RSARSA20042004

STEP 4 : RECOMMENDATION OF THE IMPROVEMENT PLANSTEP 4 : RECOMMENDATION OF THE IMPROVEMENT PLAN



• Management commitment should be clear

at the beginning of any RCFA initiative.

teams will lost motivation and enthusiasm

if their recommendations will fall on deaf

ears. Management should review and have

the recommendations approved by the teamwho performed the analysis

• When performing true RCA, getting to the

causes is the easy part, getting somethingdone to eliminate the causes is a whole

different story.

• The most important thing that people must understand is that it does not

matter who did something, what matters is why. If we do not address theWHY a failure is likely to recur. Therefore, if we have verified beyond a

doubt that a latent root exists, then it is a fact. All facts must be addressed

with recommendations.



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STEP 5 : IMPLEMENTATION OF THE IMPROVEMENT PLANSTEP 5 : IMPLEMENTATION OF THE IMPROVEMENT PLAN



•• Once the recommendation had been approved plan for theOnce the recommendation had been approved plan for the implementaimplementa--

tiontion of the improvement and countermeasureof the improvement and countermeasure

•• Countermeasure should be two folds, toCountermeasure should be two folds, to

address the Physical roots and both theaddress the Physical roots and both the

Human and Latent Cause of the problemHuman and Latent Cause of the problem

•• Management should understand that unlessManagement should understand that unless

the problems would resurface unless latentthe problems would resurface unless latent

cause of the problem is being addressed.cause of the problem is being addressed.

We must understand that blaming oneWe must understand that blaming one anoano--

ther ther have no room in the RCFA Analysis,have no room in the RCFA Analysis,

what is important is the how & why and notwhat is important is the how & why and not

the who caused the problemthe who caused the problem



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STEP 6 : TRACK RESULT & MEASURE KEY INDICATORS ON RCFASTEP 6 : TRACK RESULT & MEASURE KEY INDICATORS ON RCFA

HOW TO MAKE RCFA AS PART OF OUR SYSTEMHOW TO MAKE RCFA AS PART OF OUR SYSTEMHOW TO MAKE RCFA AS PART OF OUR SYSTEM

• ROI is only one measure of effectiveness. However, our Root Cause

Analysis efforts should be further measured as to how they contribute

to the Key Performance Indicators (KPI’s) of the corporation. It is vital

to demonstrate this linkage as it will make the attainment of these goals

dependent on the task of Root Cause Analysis. This further helps to

justify the existence of the Root Cause Analysis effort.

• Measurement will allow us to learn from the things that go wrong and

focus our efforts on improving it. We are what we measure and if wemeasure what is important then our efforts will definitely be rewarded.



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STEP 7 : SHARE RCFA LESSONS LEARNED & CELEBRATE SUCCESSSTEP 7 : SHARE RCFA LESSONS LEARNED & CELEBRATE SUCCESS

HOW TO MAKE RCFA AS PART OF OUR SYSTEMHOW TO MAKE RCFA AS PART OF OUR SYSTEMHOW TO MAKE RCFA AS PART OF OUR SYSTEM

• The greatest benefit any corporation

can get from their Root Cause Analysisefforts is to raise the knowledge, skill

and awareness of their employees to

issues identified in a RCFA. This is

because we do not want other peopleto make the same triggering

• People who performed well would

want to be recognized. Its Human

Nature. Providing inexpensive and

simple recognition will provide

both benefits to the team and the

company, remember that the com-pany benefited from the improve-

ments done by the RCFA team



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ACKNOWLEDGMENTACKNOWLEDGMENT

This is to thank the following people that have continuously provided meknowledge and inspiration in driving my passion on reliability & maintenance . . .This is to thank the following people that have continuously provided meknowledge and inspiration in driving my passion on reliability & maintenance . . .

RCFA Consultants and RooticiansRCFA Consultants andRCFA Consultants and RooticiansRooticiansBob Nelms of Failsafe Network, Vee Narayan author of Risk Analysis, Dr.

William Corcoran – Saving Lives, Robert Latino of Reliability Center Inc.,

Terry Herrmann, Michael Mulligan

Bob Nelms of Failsafe Network, Vee Narayan author of Risk AnalysBob Nelms of Failsafe Network, Vee Narayan author of Risk Analysis, Dr.is, Dr.William CorcoranWilliam Corcoran – – Saving Lives, Robert Latino of Reliability Center Inc.,Saving Lives, Robert Latino of Reliability Center Inc.,

Terry Herrmann, Michael MulliganTerry Herrmann, Michael Mulligan

My Friends from ReliabilityMy Friends from ReliabilityMy Friends from Reliability

And most of all to our dear God Almighty for providingme this opportunity to share this brief presentation . . .

And May God Bless Us All

And most of all to our dear God Almighty for providingAnd most of all to our dear God Almighty for providingme this opportunity to share this brief presentation . . .me this opportunity to share this brief presentation . . .

And May God Bless Us AllAnd May God Bless Us All

Terrence O Hanlon, Steve Turner of PM Optimization, Daryl Mather , author of Maintenance Scorecards, Sam Pickens, Bryan Weir CMMS Consultant , Joe

Peterson – Maintenance Editor, Rui Assis Weibull Specialist, Dave Thompson

Terrence O Hanlon, Steve Turner of PM Optimization, DarylTerrence O Hanlon, Steve Turner of PM Optimization, Daryl Mather Mather , author of , author of

Maintenance Scorecards, Sam Pickens, Bryan Weir CMMS ConsultanMaintenance Scorecards, Sam Pickens, Bryan Weir CMMS Consultant , Joet , Joe

PetersonPeterson – – Maintenance Editor,Maintenance Editor, RuiRui AssisAssis WeibullWeibull Specialist, Dave ThompsonSpecialist, Dave Thompson

MaramingMaraming SalamatSalamat Po !Po !

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