What's So Fishy About The Fishbone Diagram?

A fishbone diagram is the go-to tool in Performance Improvement to identify potential causes of a problem. During brainstorming, teams can systematically identify all of the causes contributing to a problem or an effect. Each identified cause is then placed on a line attached to a category on the fishbone. A service related fishbone (such as in healthcare) typically contains four categories:

  • Plant/Technology

  • Procedures

  • Policies

  • People

Using the “5 Whys” technique is helpful when constructing a fishbone. The purpose is to determine the root cause of a problem. Example: Let’s say that the problem (effect) is non-compliance with isolation policy.

1. Why? There are no gowns in the caddy.

2. Why? No one restocked the caddy.

3. Why? No one noticed the caddy was low on gowns and needed restocking.

4. Why? No one looked to see if the gown stock was getting low.

5. Why? Because there is no standard procedure for checking gown stock.

Potential Solution: Add checking gown stock to the shift checklist.

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