Continuous Improvement Toolkit
Fishbone Diagram
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The Continuous Improvement Map
Managing Selecting & Decision Making Planning & Project Management*
Risk PDPC Break-even Analysis Importance Urgency Matrix Daily Planning PERT/CPM
FMEA RAID Log* Quality Function Deployment Cost Benefit Analysis MOST RACI Matrix Activity Networks
Risk Analysis* Payoff Matrix Delphi Method TPN Analysis SWOT Analysis Stakeholder Analysis
Fault Tree Analysis Decision Tree Pick Chart Voting Four Field Matrix Project Charter Improvement Roadmaps
Traffic Light Assessment Critical-to X Force Field Analysis Portfolio Matrix
PDCA Policy Deployment Gantt Charts
Kano Decision Balance Sheet Paired Comparison
Lean Measures OEE DMAIC Kaizen Events Control Planning
Cost of Quality* Pugh Matrix Prioritization Matrix
Process Yield A3 Thinking Standard Work Document control
Project KPIs KPIs Pareto Analysis Matrix Diagram
Understanding
Best Practices Implementing
Capability Indices
Descriptive Statistics Chi-Square Nonparametric
Cause & Effect TPM Automation Solutions***
Gap Analysis*
Probability Distributions Hypothesis Mistake Proofing Health & Safety
ANOVA DOE
Bottleneck Analysis
Histograms Normal Distribution Multivariate Multi-vari Studies Simulation Just in Time 5S
Reliability MSA Graphical Methods Scatter Plots Correlation Regression Quick Changeover Visual Management
Understanding Run Charts 5 Whys Product Family Matrix Flow Pull
Root Cause Analysis Data Mining
Performance**
Control Charts Fishbone Diagram Relations Mapping SIPOC* Spaghetti** Process Redesign
Benchmarking***
Data collection planner* Sampling How-How Diagram*** Tree Diagram* Waste Analysis** Value Stream Mapping**
Check Sheets** Interviews Brainstorming SCAMPER*** Attribute Analysis Value Analysis** Process Mapping
Questionnaires Focus Groups Affinity Diagrams Morphological Analysis Flow Process Charts** Time Value Map**
Data Observations Mind Mapping* Lateral Thinking Flowcharting IDEF0 Service Blueprints
Collection Suggestion Systems Five Ws Group Creativity Designing & Analyzing Processes
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Fishbone Diagram
A fishbone diagram provides a structured way to identify
and organize the potential causes of a problem
It allows to establish and present the cause-and-effect in an easy and
understandable format
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Fishbone Diagram
It is called this way because of its shape that looks like a
skeleton of a fish
It is also called a cause-and-effect diagram and an Ishikawa diagram
after the man who created it
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Fishbone Diagram
It is used to identify the sources of variation within a
process which causes a problem to occur
This brings attention to the primary factors affecting the quality of a
product or service
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Fishbone Diagram
Helps to identify the root causes of a problem or effect in
order to identify appropriate solutions
Effect
Often used in Lean Six Sigma and other quality improvement approaches
to narrow down the area of analysis
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Fishbone Diagram
The outcome of a fishbone diagram will provide further
information to later problem-solving tools
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Fishbone Diagram
Often used during brainstorming sessions to identify the
causes of an undesirable effect of a problem
By going through the steps of drawing the diagram with your team,
everyone gains insight into the cause-and-effect, which makes the
solution easier to find later
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Fishbone Diagram
Benefits
Provides a clarity about Allows to capture,
A teamwork exercise that
the causes of an effect categorize and organize
helps to organize people's
and how to avoid it in people’s knowledge of a
knowledge of a process
future. process.
Identifies the potential
factors that may cause Can be used in product Can be used to identify
an effect to prevent and process design to the causes of risks.
future problems (cause plan new processes.
prevention).
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Fishbone Diagram
The first step in conducting the fishbone analysis is to clearly
define the effect which may be desirable or undesirable
This could be a quality issue, a technical issue, or not meeting a
performance target
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Fishbone Diagram
The effect will become the head of the fishbone diagram
Effect
Should be brief. Use numbers where possible
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Fishbone Diagram
The causes will be placed in the branches of the chart
Cause
Category Effect
Each cause needs to be put into a category for easier sharing and reference
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Fishbone Diagram
Allows to identify the hierarchy of causes including the
possible root causes
Lines are used to
connect the series of
linked causes
Sub cause
Potential
cause
Root causes are normally those at the ends of chains of causes that do
not have any sub causes
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Fishbone Diagram
5 why’s are often used to dig deeper and go beyond
symptoms
Effect
2 3
Potential cause 1
Category
Combining the fishbone with the 5 whys gives the analysis an extra dimension
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Fishbone Diagram
Potential causes in a fishbone diagram are normally
grouped into categories for easier sharing and reference
These categories are used to label the different branches on the
fishbone diagram
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Fishbone Diagram
There are different approaches of constructing a
fishbone diagram indicated by the branch labels
4 8
6
There is no right or wrong way to do that
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Fishbone Diagram
4 Ms – one of the most basic forms to group the potential
causes of a problem or effect
Man Method
Machine 4 Material
These categories typically include Man Method, Machine and Material
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Fishbone Diagram
6 Ms – the most common way to categorize potential
causes of a problem or effect
Man Method
Machine
Material
6 Measurement
Environment
Commonly used in manufacturing and production environments as
well as service environments
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Fishbone Diagram
6 Ms
Man – anyone involved with the process and contributes
to the effect Including governance and support functions
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Fishbone Diagram
6 Ms
Method – how the process is performed and the specific
requirements for doing it
Rules and Work Common
Procedures
policies instructions practices
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Fishbone Diagram
6 Ms
Machine – the machinery, equipment and tools required
to perform the process
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Fishbone Diagram
6 Ms
Material – all the materials needed to perform a process
Raw materials Parts Packaging Information Paperwork
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Fishbone Diagram
6 Ms
Environment – the conditions in which the process
operates
Location Time Temperature Culture
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Fishbone Diagram
6 Ms
Measurement – the data and metrics that are used to
evaluate the performance of the process
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Fishbone Diagram
Different names may be used for the same category
depending on the situation and on the user's choice
Man – Men – Manpower – People – Labor
Machine – Machinery – Equipment – Tools – Systems
Measurement – Metrics – Inspection
Method – Process – Procedure
Environment – Mother Nature – Milieu
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Fishbone Diagram
8 Ms – adds Management and Maintenance to the 6 M
categories
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Fishbone Diagram
When the effect results from a mapped or documented process,
the process steps can be used as the basis for categorization
Employee Dept. Manager Controller Payroll Officer
10 20 30 40
Prepare expense Approve Approve Pay
report and Sign and Sign employee
Approve
and sign The process input
variables (design factors)
can be the potential
Pay Prepare causes
employee expense report
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Fishbone Diagram
When you are working on an affinity diagram, you can use
the titles of the affinity groups as the basis for categorization
Economic Social Cultural
Economic
The items within each
affinity group can be the
potential causes
Social Cultural
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Fishbone Diagram
You may also create subcategories of a main category
and include it in new branches
Man Man Man
Training Kaizens Suggestions
Measurement Material Method
Remember to avoid writing real names of persons under the
“Man” category
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Fishbone Diagram
You may even rename or create your own branches that
best suit your project
Mind Body
Soul Heart
Fishbone analysis can also be used in our personal lives to create ideas
about the certain personal issues and how to avoid them
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Fishbone Diagram
Typical Fishbone Diagrams for Manufacturing and Non-
manufacturing Processes
Manpower Environment Machine
Manufacturing
Material Measurement Method
People Environment Equipment
Administration
and Services
Policies and Procedures
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Fishbone Diagram
Now that we have identified the categories, it time to add to
the diagram the possible causes of the effect
Material
Using water
from the tap Not fresh coffee beans
Low water quality Beans roasted
some time ago Coffee not
tasting
Cleaning SOP Current Long roasting
not followed settings period good
Unclean coffee maker
Over roasting
Machine
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Fishbone Diagram
How to Conduct a Fishbone Analysis
With your team, clearly define the effect that you want to work on
Write the effect statement in a box at the center right of a large piece of paper (or on a
wall) and draw a long horizontal line pointing to the box
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Fishbone Diagram
How to Conduct a Fishbone Analysis
Identify the cause categories using the 6 Ms or any other approach
Write them in boxes parallel to the horizontal line
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Fishbone Diagram
How to Conduct a Fishbone Analysis
Use brainstorming to log all possible causes under the appropriate
categories
Start with the main causes and the secondary causes and so on
Use 5 whys to get to the root causes
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Fishbone Diagram
How to Conduct a Fishbone Analysis
Take time to ensure the appropriateness of the recorded information
Update the chart as new potential causes become apparent
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Fishbone Diagram
How to Conduct a Fishbone Analysis
Highlight or assign numbers near to the key causes to show their
relative importance
Draw links between causes that are related
4
2 5
3
1
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Fishbone Diagram
How to Conduct a Fishbone Analysis
If necessary, collect data to confirm key causes are real
Plan and implement actions to address the key causes
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Fishbone Diagram
Example – Increased Invoice Errors
Environment Equipment Method
Poor ergonomics Cumbersome process
Inadequate printers
Noisy office Incompatible system Manual data entry
System not integrated
Increased
Poor paper quality Low morale
Invoice Errors
Increased workload
Delayed paper supply Poor audit system
Poor technical support
Material Measure Man
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Fishbone Diagram
Example – Increased Coolant Consumption
Environment Machine Method
Materials in trench Machine breakdown Adding WBLF to the tank
Adjusting concentration settings
Machine leakage Blocked hoses
Evaporation in summer
High Coolant
Consumption
WBLF measured for all lines Lack of training
Biocide level
Absenteeism
Rounding
Delayed measurement
Antifoam level Poor shift communication
Material Measure Man
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Fishbone Diagram
Further Information
Be aware of adding causes which are actually solutions
The main idea behind the fishbone diagram is to brainstorm all possible
causes that may contribute to a problem, and not brainstorm solutions
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Fishbone Diagram
Further Information
A cause-and-effect matrix can be used to prioritize the
causes of the problem
Prioritizing and selecting the key causes will minimizes the need for more
statistical analysis of inputs that are unlikely to have an impact on the output
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Fishbone Diagram
Further Information
Another way of highlighting the structure of the possible
causes is to use the tree diagram
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Fishbone Diagram
Further Information
The measure of success for a fishbone diagrams is not
quality of ideas but quantity of ideas
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Fishbone Diagram
Further Information
A fishbone diagram can also be used to structure the
thoughts of a team
Sometimes it is useful to change the effect statement into the ideal
situation and ask the team to brainstorm what produces this ideal situation
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Fishbone Diagram
Further Information
Sometimes it is useful to brainstorm out the ideas first
then organize them by category later
People sometimes tend to focus more on the categories than the
content and this slow down and restricts their thinking
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Fishbone Diagram
Further Information
One of the seven basic tools of quality
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