Example RCA Report and Chart Templates

RCA program champions and facilitators often ask us for RCA report and chart templates or forms. Because every organization, situation and problem is unique, our clients are most successful at truly solving and preventing problems when they view root cause analysis as a knowledge-based process, rather than a software- or template-based process. Further, valuable solutions come from people through their ideas and process knowledge, and through the new information uncovered by the questions that are generated and answered when creating the cause and effect chart. So we offer the following example reports and charts to inspire their ability to thoroughly pinpoint causes, organize them in an accurate and logical fashion, and identify and prioritize effective solutions.

Because the example reports and charts posted on this page are based on real client situations, and because the investigations we perform for our clients are highly confidential, these examples are anonymous, and -- when needed – have been altered slightly to protect confidentiality and anonymity. To create these, we employed the Sologic® RCA method and Causelink® RCA software.

Unplanned Shutdown of Plastics Production Line

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Multiple Leaks in Newly Installed Pipeline

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Unplanned downtime, lost profit: Slurry Pump Seal Leakage

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Pipeline weld non-conformance

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Clinical Healthcare

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Dust Explosion

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Near-Miss Asphalt Drop

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Loss of Productivity - Virus Software

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Healthcare Crisis

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

IT - Customer Complaints

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Manufacturing Non-Conformance

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Project Management: Delivered Late, Over Budget, Profit Lost

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Shipments Missed - Supply Chain Problems

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart

Customer Perception of Quality Problem

PDF icon Summary Report
PDF icon Full Report with Cause Details on Chart


Contact us if you would like to see an example problem in your industry or if you have a unique problem that you would like to share.