BACKGROUND:

Note any contextual or background information necessary to fully understand the issue.
Indicate how this problem affects the company’s goals or is related to its values.

CURRENT CONDITION:

Insert a diagram that illustrates how the current process works.
Label the diagram so that anyone knowledgeable about the process can understand.
Note the major problems (we like to put them in storm bursts to set them apart)
Include quantified measures of the extent of the problem – graphical representations are best!

ROOT CAUSE ANALYSIS:

List the main problem(s)
Ask appropriate “why?” questions until you reach the root cause. A rule-of-thumb: you haven’t reached the root cause until you’ve asked “why?” at least 5 times!
List the answers to each why question

Problem
 first immediate cause
 cause for the first immediate cause
 deeper cause to the preceding cause
 etc.

TARGET CONDITION:

Insert a diagram that illustrates how the proposed process will work, with labels.
Note or list the countermeasure(s) that will address the root cause(s) identified.
Predict the expected improvement in the measure of interest (specifically and quantitatively)

IMPLEMENTATION PLAN:

List the actions which must be done in order to realize the Target Condition, along with the individual responsible for the action and a due date.
Add other items, such as cost, that are relevant to the implementation.

Action
Responsibility
Deadline
Action 1
D. Smith
Oct. 1
Action 2
N. Jones
Nov. 5
Action 3
M. Jordan
Nov. 28
Etc.

COST: no expenditures required

FOLLOW-UP:

Plan
Actual

Note the plan to measure the effectiveness of the proposed change.

Indicate when it will be measured, and by whom.

Leave blank initially

After follow-up, record the