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Keywords:

  • root cause analysis;
  • process improvement;
  • Six Sigma;
  • problem solving;
  • case study

The purpose of this article is to explore the dynamics of root cause analysis (RCA) and the applicability of the ‘5W + 1H’ (what, why, when where, who, how) technique, which is used by many managers in understanding a problem to define the root cause. The 5W + 1H methodology is insufficient in identifying the root cause because of the variations triggered by asking the question ‘why’. The article demonstrates that some extraordinary RCA was achieved by redefining the approach of the 5W + 1H’ methodology, as catastrophic failures were often the result of misinterpreting the ‘why’ question. Consequently, the article identifies a new domain that can be added to traditional RCA and Six Sigma projects. The article explores an alternative perspective to the problem definition in RCA. It provides a specific example and suggestions to help practitioners avoid expensive contingency plans, while conducting investigations to RCA using the refined 4W + 1H approach. Questioning the principles of RCA through a process reflective inquiry benefits both practitioners and academics. Copyright © 2012 John Wiley & Sons, Ltd.