Office of the Saskatchewan Information and Privacy Commissioner. Guide to FOIP, Chapter 6, Protection of Privacy. Updated 27 February 2023. 277 Conducting Root Cause Analysis740 Root Cause Analysis is a useful process for understanding and solving a problem. It seeks to identify the origin of a problem by using a specific set of steps and tools to: • Determine what happened. • Determine why it happened. • Figure out what to do to reduce the likelihood that it will happen again. You can apply Root Cause Analysis to almost any situation. Determining how far to go in your investigation requires good judgement and common sense. It is important to recognize when a significant cause that can be changed is identified. Follow the steps and use the template when you want to conduct a comprehensive review of a significant problem and identify the events and factors that led to the root cause. Root Cause Analysis assumes that systems and events are interrelated; an action in one area often triggers an action in another. By tracing back these actions, you can discover where the problem started and how it grew into the symptom now being faced. There are three basis causes: i. Physical causes – something failed in some way (e.g., a car’s brakes stopped working). ii. Human causes – people did something wrong or did not do something that was needed. Human causes typically lead to physical causes (e.g., no one filled the brake fluid, which led to the brakes failing). iii. Organizational causes – a system, process, or policy that people use to make decisions (e.g., no one person was responsible for vehicle maintenance, and everyone assumed someone else had filled the brake fluid). 740 This section reproduced from Keith, Lori D., Pealow, James B., First Nations Health Managers: Human Resources, Programs and Support Services Toolbox, 2012. Ottawa: First Nations Health Managers Association at pp. 52 to 53.
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