Root cause analysis for team building
Early in my career we used a process that loosely resembled a root cause analysis after a severity 1 production outage. The intent of the process was to determine why the severity outage occurred and then fix the problem so it didn’t happen again. No one liked process and the documents we produced were rarely used to influence process improvement. It was a checkbox and an exercise to fill-in-the-blanks to say we completed it. I always thought the name post-mortem was bit odd as well and we were certainly dead to the process. Looking back, I see post-mortem efforts can be valuable if championed and executed correctly. But there is a better way. Twenty years later, we are learning to implement root cause analysis (RCA) into our recurring operational procedures. Like a post-mortem exercise, a RCA is typically done after an event has occurred with the intended benefit to prevent