Root Cause Analysis & Environmental Assessments. Karin Hoelzer, DVM, Ph.D. November 9, 2017
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1 Root Cause Analysis & Environmental Assessments Karin Hoelzer, DVM, Ph.D. November 9, 2017
2 Outline of today s presentation What is RCA & why is it needed? Pew s RCA initiative Some lessons learned about RCA
3 Outline of today s presentation What is RCA & why is it needed? Pew s RCA initiative Some lessons learned about RCA
4 Why root cause analysis (RCA) is needed? It is our view that complex systems almost always fail in complex ways, and we believe it would be wrong to reduce the complexities and weaknesses associated with these systems to some simple explanation. Too often, accident investigations blame a failure only on the last step in a complex process, when a more comprehensive understanding of that process could reveal that earlier steps might be equally or even more culpable. Columbia Space Shuttle Accident Investigation Board, 2003
5 RCA: explain why disaster strikes & how to prevent it 1986: Space Shuttle Challenger disaster Live on CNN
6 From Challengerto Columbia: root causes reoccur Challenger investigation Root causes identified Physical causes NASA history NASA culture Corrective actions suggested Seventeen years in-between System returned to status quo Columbia investigation Root causes reoccurred
7 The goals of RCA: prevent disaster reoccurrence Root causes are RCA focus RCA approach Causal influences Caused event or Increased impact Controllable Manageable Within control Usually > 1 RC Learn from past Why system failed Events Interactions Root causes Prevent repeat Systematic Comprehensive Physical factors Human factors Organization Other
8 Systems theory: attributes of complex systems consist of multiple interdependent parts have set points shaped by these interactions changes require deep knowledge of interactions system is prone to return to set points
9 Understanding accidents: Swisscheese model Basic premises Humans are fallible Errors happen Understand why Adapt conditions Understanding is key to prevention James Reason, 2000 Complex systems have many safety barriers Every safety barrier has weaknesses Accidents happen when holes align Need to understand near misses
10 Outline of today s presentation What is RCA & why is it needed? Pew s RCA initiative Some lessons learned about RCA
11 Why is root cause analysis a priority for Pew? Foundation of a prevention-based food system Not always done; ineffectively shared; lost opportunities Improvements require collaborative approach Alignment among FDA, CDC, FSIS, state & local; industry
12 Root cause analysis project approach Research Other models (e.g., NTSB, CSB, NuReg) RCA best practices Convenings RCA value; obstacles; definitions Communicating RCA findings RCA best practices Outreach Conference presentations (IAFP, InFORM) Publication in trade magazine (upcoming)
13 Pew s work on RCA: Goals and objectives RCA description Best practices Learning from RCA definition current practice challenges value other models success stories obstacles recommendations pilot project
14 Pew s work on RCA: Goals and objectives RCA description Best practices Learning from RCA definition current practice challenges value other models success stories obstacles recommendations pilot project
15 Outline of today s presentation What is RCA & why is it needed? Pew s RCA initiative Some lessons learned about RCA
16 Pew s work on RCA: Learning from other models RCA in other high-risk industries Transportation, chemical, nuclear industries Occupational safety; consumer product safety Recreational scuba diving 3 Key research questions How are RCAs conducted? (When, why & how) How are key findings disseminated & used? What is working & what is not?
17 Key finding: Not every investigation is a RCA Three distinct but related types of investigations: Predictive (before operations) What can go wrong & how to prevent it? Based on risk assessment, fault tree analysis, etc. Site licensing, standard setting, regulations, etc. Operational (during operations) Are safety measures implemented & adhered to? Based on inspection, surveys, etc. Investigational (after accident) What went wrong & why? What actually worked? Based on root cause analysis
18 RCA: learning from past to prevent future retrospective prospective Root cause analysis Inspection - What went wrong and why? - How to prevent reoccurrence? - What could create future problems? - Is operation in compliance? - How to restore compliance? - How to prevent future issues?
19 Key finding: Not every event requires a RCA New & catastrophic RCA Recommend changes Accident or incident Monitor Trend analysis Known factor Training & outreach Minimize occurrence Rules & regulation Recommend changes
20 Key finding: Effective RCAs reconstruct events Before the accident What was the general situation before the event? What specific events led up to the event? During the accident What went wrong and why? What went right? After the accident How well did the post-event response work? What has been learned and what changes have been made?
21 Key finding: Effective RCAs consider 4 types of factors Structures Systems Impacts. Performance Decision-making Communication. Physical Operation Policies Structures Culture. Organization External Weather Post response Regulations.
22 Key finding: Properties of effective RCAs Timely investigation Frequent stakeholder communications Comprehensive & systematic Appropriate technical expertise available Unbiased & transparent Conclusions based on & driven by evidence Clearly & concisely reported
23 Conclusion: RCA valuable for foodborne outbreaks Systems-based approach for prevention Key in prevention-based food system Understand why outbreak happened Find weaknesses in food system Identify how to prevent reoccurrence Other high-risk industries rely on RCA Opportunities to learn from them
24 Thank you for your time & attention To continue the discussion beyond today please contact: Karin Hoelzer, DVM, PhD Senior Officer, Health Programs The Pew Charitable Trusts 901 E Street, NW, Washington, DC p: e: khoelzer@pewtrusts.org Source: New Yorker, 12/06/2004
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