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People: Is there any staff behaviors or characteristics that are contributing to the problem? Involves everyone in an open session: Using a chalkboard or other display to brainstorm allows everyone to contribute their ideas, no matter how big or small.
Generates lots of diverse ideas quickly: Because there are many bones, there is room for many ideas. Helps generate alternative approaches: Identifying multiple factors will lead to multiple possible solutions. One drawback to the fishbone diagram is that this tool cannot tell you how important or common a particular issue is. Once all of the possible causes are identified using a fishbone diagram, managers must determine which are the most important to address given limited resources.
To prioritize root causes according to risk, we consider frequency (on the x-axis) and severity (on the y-axis).


Cost-benefit is a measure of how difficult or costly it is to fix the problem (on the y-axis), as compared to the level of benefit or improvement that is expected (on the x-axis). Sometimes managers find it necessary to identify problems within larger processes or systems. Click on the image to the left for an illustration of how flow charting was used to assess Tanzania’s public health supply chain.
A Pareto chart and histogram are useful tools for quantifying the frequency of common causes of the problem. Histogram and Pareto analysis provides a useful representation of data that allows managers to prioritize. This web site has been developed with co-operation from the Yale School of Management's Case Workshop.
In the lean startup workshops, we've spent a lot of time discussing the technique of Five Whys.


The factors that rank highest in terms of frequency and severity ought to be the priority problems. This analysis also helps generate alternative approaches and provides a tool for showing progress.
The case is not intended to furnish primary data, serve as an endorsement of the organization in question, or illustrate either effective or ineffective management techniques or strategies. Insufficient staffing can be linked to two other factors: inadequate education and poor role definition among health care workers.



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