ORGSYS5.docx A. Root cause analysis (RCA) is a system used to determine the root cause o

ORGSYS5.docx  A.  Root cause analysis (RCA) is a system used to determine the root cause of an adverse event. The system also determines ways to effectively handle the event. The general purpose of conducting a root cause analysis is identify what led to an event so that a similar event can be prevented in the future.  A1. The six steps used to conduct an RCA as defined by IHI are as follows.  1.First, the problem needs to be identified. Team members discuss the details of what happened that led to the event in question.  2.Secondly, the team works together to identify what should have happened. The team members discuss what wouldve happened in an ideal situation.  3.Third, team members to determine why the event happened. The team discusses factors that may have directly or indirectly caused the event to occur. It is recommended that five “whys” are asked to determine a concise cause of the event.  4.Fourth, the team works together to formulate a causal statement. This statement addresses the cause and effect of the event that led to a root cause analysis.  5.Fifth, the team creates a list of actions that will be helpful in reducing the likelihood of repeating the event. The actions will hopefully prevent the event from occurring in the future.  6.Lastly, the team generates of summary of the root cause analysis and shares it with others. Flow charts can be used to help clarify and describe information regarding the event.