TOOLKIT: Cause and Effect Diagram Institute for Healthcare Improvement ∙ ihi.org Instructions
- Write the effect you wish to influence in a box on the right-hand side of the page.
- Draw a horizontal line across the page to the left, starting at the box you just drew.
- Decide on five or six categories of causes for the effect. The standard categories in a classic cause and effect diagram are Materials, Methods, Equipment, Environment, and People.
- Draw diagonal lines above and below the horizontal line to create “fishbones,” and label each line at the end with one of the categories you have chosen. Draw a box around each label.
- For each category, generate a list of the causes that contribute to the effect. List the causes by drawing “branch bones.” As necessary, draw additional branch bones from the causes to show sub-causes. o Tip: Develop the causes by asking “Why?” until you have reached a useful level of detail — that is, when the cause is specific enough to be able to test a change and measure its effects.
- Write the effect you wish to influence in a box on the right-hand side of the page.
- Draw a horizontal line across the page to the left, starting at the box you just drew.
- Decide on five or six categories of causes for the effect. The standard categories in a classic cause and effect diagram are Materials, Methods, Equipment, Environment, and People.
- Draw diagonal lines above and below the horizontal line to create “fishbones,” and label each line at the end with one of the categories you have chosen. Draw a box around each label.
- For each category, generate a list of the causes that contribute to the effect. List the causes by drawing “branch bones.” As necessary, draw additional branch bones from the causes to show sub-causes. o Tip: Develop the causes by asking “Why?” until you have reached a useful level of detail — that is, when the cause is specific enough to be able to test a change and measure its effects.
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