Practical Problem Solving Facilitator’s Guide

Fishbone Diagram & Five Why Explained Learn exactly what the fishbone diagram and 5 Why analysis are and how to leverage them.

A step by step guide to presenting Gemba Academy’s 5S course to lean learners in all positions. This guide includes key points, discussion items, quiz questions and answers, and helpful tips. Using Gemba Academy’s online learning content, any facilitator can teach teams of people to solve their problems quickly and efficiently.

August 2017 Fishbone Diagram & Five Why Explained

Preparation and Lesson Plan Use this page to prepare for each training session.

Resources • Gemba Academy videos • Online quizzes

Prepare for a Successful Training Session • Watch videos and complete quizzes on your own at least one day before the training session. • Read this guide thoroughly and become familiar with the course content before presenting to others. • Prepare a suitable training room for your participants. • Prepare a computer with internet access and a projector or large screen. Test all equipment before the training session. • Have your Gemba Academy username and password ready.

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• Choose your quiz style. The most popular option is to use the online interactive quiz, answering questions as a group with open discussion. Another option is to print the PDF version and have participants complete the quizzes individually.

Training Session Outline • Step 1: Introduce the session topic and content to the participants. • Step 2: Play a video. • Step 3: Lead a group discussion using this guide. Review key points, ask prepared questions and have participants fill in Choose Your Quiz the blanks in their workbooks. Style • Step 4: Take the quiz and review responses. • Step 5: Apply what has been learned in your workplace.

When questions come up, encourage other participants to answer. Responding to questions with “What does the team think?” goes a long way to build engagement.

Helpful Tip

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Step 1: Session Overview • Introduce the training topic. • These videos explain what the Fishbone Diagram and Five Why analysis are and how they can be used to analyze root causes.

• Explain what to expect during this session. In this session we will: • Watch “Fishbone Diagram Explained” (10:25) • Watch “Five Why Explained” (7:58) • Discuss what we learned from the video using the workbook • Review the content with a quiz and talk about the results

Step 2: Play “Fishbone Diagram Explained”

Step 3: Review Key Points

History of the Fishbone • The fishbone diagram was first developed by Kaoru Ishikawa (1915-1989) in the 1960’s. • The diagram is also called the “Ishikawa diagram” or “cause-and-effect diagram” • He identified this diagram as one of the 7 Tools, along with the , the , the , the , the Flow chart, and the Scatter diagram.

How to Create a Fishbone Diagram • There are a number of ways to create a fishbone diagram. Here, we’ll be presenting Gemba Academy’s preferred method, but we encourage you to find a method that works for your company. • First, gather your cross-functional team into the same room and gather all the supplies you need. • Don’t use sofware to create the diagram right away. Instead, use some butcher’s paper or a whiteboard on the wall, and have some markers and post-it notes ready. Once you’ve completed the diagram, you can save a digital version to your computers. • When you’re ready to start, write the main problem or problem statement on the right side of the diagram, enclosed by a box. • Draw a horizontal arrow extending from the box. This is the “spine” of the “fish”. • Draw the major cause categories coming off of the “spine”. Try starting with the 4M’s + 2. • If you’re dealing with a more service-related problem, try the 6 P’s: People, Process, Policies, Procedure, Price, and Product.

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• Develop a list of factors that could be causing or contributing to the problem. • Try the Nominal Group Technique: everyone has 5 minutes to write down as many problems as they want, they read their problems out loud, and the team decides where on the diagram they should go. • Once the initial brainstorming is complete, use the Nominal Group Technique to deal with any additional ideas that arise. Do it as many times as you need, until the team is out of ideas. • Afer you finish placing your ideas on the chart, go through each cause and ask “why does this happen?” several times. • Select the root causes you initially wish to focus on. Group similar root causes together and address their level of importance, urgency, and potential for expansion. • You might try N/3: give team members a number of votes equal to the number of root causes divided by 3, and have them vote on root causes to address. You may need to do several rounds of N/3 in order to reach a manageable list. • Once you have decided what root causes to focus on, draw starbursts or kaizen burst symbols around the root causes the team has elected to address.

Step 4: Quiz

1. The Fishbone Diagram was first developed by Mr. ______. Shigeo Shingo Taiichi Ohno Kaoru Ishikawa W. Edwards Deming

2. We should always use sofware to draw fishbone diagrams for the first time. True False

3. Using Post-it notes (sticky notes) is a good way to facilitate the brainstorming sessions that are part of the fishbone creation process. True False

4. If there were 15 root causes identified, how many votes would each team member receive afer N/3 was done? Please write the number below. ___Five_____

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5. The fishbone diagram is a ______tool, meaning we’ll continue to update it as we learn more and make improvements. dynamic static

Step 5: Play “5 Why Explained”

Step 6: Review Key Points

What is Five Why? • Five Why analysis is a problem solving method used to explore the cause and effect relationships of a particular problem. • Sakichi Toyoda, one of the founders of the Toyota Motor Corporation, is credited as the first person to practice 5 Why. • By repeating “why?” a number of times, the nature of the problem as well as its countermeasure becomes clear.

How to do Five Why 1. Write down the problem statement. 2. Ask why the problem exists. Keep answers short and to the point. 3. Continue asking why on the same point of cause until the root cause is identified. Don’t keep asking why on 5 different problems. • We don’t necessarily have to ask “why” 5 times exactly.

5 Why Examples • While 5 Why is not a difficult concept, it does require some practice. • In this example, the problem is that the milk is spoiled. 1. Why is the milk spoiled? We didn’t drink all the cartons before the expiration date. 2. Why didn’t we drink the milk? We had too many cartons in the fridge. 3. Why did we have too many cartons? We bought more cartons than we needed at the store. 4. Why did we buy more cartons than we needed? There was a sale on milk, and we tried to save money. • Please refer to the video for the additional examples.

So…? • Once you have completed your initial 5 Why analysis, check the cause and effect logic of your result by working backwards and asking “so?” • For example, drawing on the multi-branch example in the video:

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• There are leaks. So… • it gets dirty. So… • we have to clean up. So… • the process is not running. So… • we have lost time. So… • we’re losing production opportunities. So… • we’re not able to make enough parts per hour. • If your analysis has multiple branches, make sure to check each path.

Typical Errors to Avoid • Asking “why” about five different causes instead of drilling down on the same point of cause. • Stopping at just 5 whys when more may be needed, especially with multiple paths. • Not checking for logical cause-and-effect relationships by asking “so?” may cause errors. • Not verifying that our assessment is accurate by going and seeing for ourselves.

Step 7: Quiz

1. The 5 Why is a problem solving method used to explore the cause and ______relationship of a particular problem. defective effect exploration analysis

2. Which of the following is NOT part of the 5 Why process? Ask why the problem exists Continue asking why on the same point of cause until a root cause is identified Continue asking why on different points of cause until a root cause is identified Write down the problem

3. 5 Why analysis may result in multiple paths being created. True False

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4. What single word can be asked/used to verify the cause and effect relationship of a 5 Why Analysis makes sense? Why Huh So Who

5. Which of the following are typical errors committed during 5 Why analysis? Select all that apply. Not asking “so” to check the analysis makes sense. Involving others. Stopping at 5 whys when more may be needed. Not creating multiple paths when more may be needed.

Step 8: Reflection Give your participants 10-15 minutes to fill out the reflection questions at the end of their workbooks. When they’ve finished, have a short discussion with them. Now that you know how to use tools like 5 Why and the Fishbone, go ahead and analyze the problem you’ve selected. Be sure to investigate multiple causes (if there are any) and use “so…” to check that your paths are logical. Spend 5-10 minutes discussing.

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