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Then gather relevant people and list major categories of potential causes.",{"name":69,"@type":60,"acceptedAnswer":70},"How do you develop causes to reach the root cause level?",{"text":71,"@type":63},"Discuss each major category and add ideas as sub-branches, breaking them into contributing factors. 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They are useful when there are multiple causes of a problem and help to ensure important potential factors are not ignored.  \nHow to  \nThis example shows the use of a Fishbone diagram to understand why there are so many overdue Asthma reviews.  \n1. Identify the problem. This becomes the head of the fish: High number overdue Asthma Reviews  \nHigh number of overdue Asthma Reviews  \n2. Gather the relevant people together and generate the major categories of potential causes. In the example shown these are Environment, Organisation, Clinicians and Patients. Other useful categories also include Equipment and Time. These form the spines of the fish.  \n3. Discuss each major category, adding the ideas generated as sub-branches. Each sub-branch may be further broken down into its contributing factors.  \n4. For every spine and sub-branch identified, ask yourself‘Why does this happen?’ and consider the question from different perspectives-such as patient, administrator, nurse, doctor, clinical commissioning group. This will produce the layers of causes that will help you to fully understand the root of the problem and its dependencies.  \nRoyal College of General Practitioners 30 Euston Square London NW1 2FB  \nTel 020 3188 7400 Fax 020 3188 7401 Email [info@rcgp.org.uk](info@rcgp.org.uk Web www.rcgp.org.uk)[ Web ](info@rcgp.org.uk Web www.rcgp.org.uk)[www.rcgp.org.uk](info@rcgp.org.uk Web www.rcgp.org.uk)  \nPatron: His Royal Highness the Duke of Edinburgh Registered charity number 223106  \n5. Use your completed Diagram to help you to generate ideas for improvement, which may then result in the development of a Driver Diagram to plan your improvements.  \nGPs forget to code the  \nreview  \nPrefer to manage their asthma exacerbations rather than self-care  \nPatients don’t understand the value of an annual review  \nRoyal College of General Practitioners 30 Euston Square London NW1 2FB  \nTel 020 3188 7400 Fax 020 3188 7401 Email [info@rcgp.org.uk](info@rcgp.org.uk Web www.rcgp.org.uk)[ Web ](info@rcgp.org.uk Web www.rcgp.org.uk)[www.rcgp.org.uk](info@rcgp.org.uk Web www.rcgp.org.uk)  \nPatron: His Royal Highness the Duke of Edinburgh Registered charity number 223106","cbCais7m2vVMwKCe","https://ap.wps.com/l/cbCais7m2vVMwKCe","pdf",165138,"English","# Diagnose\n## How to use a Fishbone diagram\n## Identify the problem\n## Gather major cause categories\n## Break down sub-branches and contributing factors\n## Ask “Why does this happen?” from different perspectives\n## Use the completed diagram for improvement ideas","[{\"question\":\"What is a Fishbone diagram used for?\",\"answer\":\"A Fishbone diagram is used to identify and display the root causes of a problem, especially when there are multiple causes and potential factors to consider.\"},{\"question\":\"How do you start building a Fishbone diagram?\",\"answer\":\"First, identify the problem and place it as the head of the fish. Then gather relevant people and list major categories of potential causes.\"},{\"question\":\"How do you develop causes to reach the root cause level?\",\"answer\":\"Discuss each major category and add ideas as sub-branches, breaking them into contributing factors. For each branch, repeatedly ask “Why does this happen?” from different perspectives until you understand the underlying causes and dependencies.\"}]","Fishbone Diagram - How to Use - Identify and Analyze Root Causes | PDF"]