Respond to two Colleagues Granth D1W5

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Week 5 Discussion – The Cause Mapping Method

Stephen E. Jarman

College of Business, Management, and Economics, Grantham University

MGT553 Performance Consulting Persuasive Communication and Influence

Rob Freeborough, PhD, MBA, SPHR

September 12, 2021

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Week 5 Discussion – The Cause Mapping Method

This paper explains how to use The Cause Mapping Method to analyze complex

problems for root-cause analysis and developing effective solutions. The following is fully cited

to Galley, 2007.

To analyze, document, communicate, and solve problems effectively, a cause-map builds

in three steps:

Step 1 – Problem

Step 2 – Analysis

Step 3 – Solutions

This example uses the sinking of the Titanic to explain how to use a cause map for root-cause

analysis of an issue.

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If you ask different people why the Titanic sank, it is normal to get different answers

because people see problems differently.

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In the cause mapping method, we lay out the cause-effect relationships of how the issue

actually occurred. The simple cause-effect relationship starts with the effect Titanic Sank and

was caused by Ship Hit Iceberg. The effect is on the left and the cause is on the right. We ask

‘why’ questions as we read across the page to the right, and time flows to the left.

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In this example of a cause-effect relationship, the Titanic sank because the steel plates on

the hull were bent. The steel plates on the hull were bent because the ship hit the iceberg. This

means that the steel plates bending on the hull were a cause of the Titanic sinking, but also were

an effect of the ship hitting the iceberg. That’s why you can ask why did the Titanic sink and

some people may say because the ship hit an iceberg and some people may say ‘no’ because the

steel plates on the hull were bent. They’re both telling the truth and this is much easier to

understand if the cause and effect relationships are laid out visually.

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This cause-and-effect relationship shows that the steel plates bending are caused by the

force of the ship hitting the iceberg and the strength of the steel. Even if the ship hit the iceberg,

if the steel is stronger, it reduces the bending on the plates. There are two causes of the steel

plates bending on the hull.

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If we continue to build the cause-and-effect relationships with the effect on the left and

the cause on the right, the effect of the Titanic sinking is the loss of over 1,500 lives. Fifteen

hundred lives was in effect caused by the Titanic having sank.

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The fatalities on the Titanic clearly impact the safety goal. The safety goal in any

organization is zero injuries. Anytime you deviate from zero injuries, the safety goal has been

impacted. So on the Titanic, this read box signifies the impact to the safety goal has occurred

because there were 1,500 fatalities.

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To clearly define a problem, there are really four questions need to be asked. The first

question, what’s the problem, is where many people may disagree because they literally see the

problem differently. We can accommodate those differences in this first question and move on

quickly to the timing – when did it happen – and the location – where did it happen. The fourth

question we want to ask is, how does this issue, regardless what you call the problem, how does

it impact the overall goals of the organization. And here, safety, with a goal of zero injuries was

clearly impacted because of the loss of life. The loss of the vessel is also one of the goals that’s

impacted. And then obviously the impact to the business.

The basic questions of defining a problem are what’s the problem, when did it happen, where did

it happen, and then how did it impact the overall goals of the organization – here, safety clearly

impacted the goals to the organization.

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The impact to the organization’s overall goals is determined in the problem definition and

it provides the starting point for the analysis step. Here, the impact to the safety goal and the

impact to the vessel are both shown as starting points in the analysis. The why questions begin

from there.

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As people add more information about the problem, it can be added in a very organized

way to the cause map. Someone may argue that the Titanic actually sank because water filled the

hull. This is true, the Titanic sank because water filled the hull can be added to the cause-and-

effect relationships. Water filled the hull because there’s an opening in the hull, and the opening

of the hull is because the steel plates had bent on the hull. As more detail is added to an

investigation, it doesn’t dilute or change what has already been established as fact in the

investigation.

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If we ask why the ship hit the iceberg, it is normal for some people to say the iceberg is

the cause of the ship hitting the iceberg because if the iceberg wouldn’t have been there, the ship

never could have hit it. This is a true statement, and it makes the iceberg one of the causes of the

ship hitting the iceberg. The same argument applies to the ship in the water. If we never would

have put the ship in water, it never would have hit the iceberg and that is true. But you still have

an iceberg and still have a ship in the water, and still not have hit the iceberg if the ship had just

turned in sufficient time. Some people may argue that the ship not turning sufficiently is the

cause of it hitting the iceberg. And in reality, it’s all three causes that are required to produce that

effect. The cause map easily shows that and accommodates those different points of view.

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Even more detail can be added to the cause map. The loss of 1,500 lives was because of the

people in the water. They either died of hyperthermia or they drowned. Because the Titanic sank,

there were not enough lifeboats, and the rescue ships arrived late. From a risk management

standpoint, the map says it is possible for the Titanic to sink and not lose anyone on the ship if

the lifeboats would have worked effectively and the rescue ships would have arrived earlier.

Both of those reduce the risk of loss of life.

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More detail can be added to the analysis, but in this example with this level of detail, we

can still talk about possible solutions. With not enough lifeboats, a solution is to install more

lifeboats. With rescue ships arrive late, we could have radios operated 24 hours a day on all ships

in the North Atlantic. With water filling the hull, we could improve the pump design and location

and we could change the design of the bulkheads to make those watertight. The strength of the

steel could be changed to be stronger. And the ship hitting the iceberg, we could establish an

iceberg surveillance program. And the ship not turning in a sufficient amount of time, we could

refine the communication process between the lookout in the bridge and the engine room. The

cause map shows different ways that the problem can be solved.

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Building a cause map effectively requires people to think in terms of cause-and-effect

and validate those cause-and-effect relationships with evidence. This can be done by thinking

through the problem. This is particularly helpful if people know how to do this with pencil and

paper to just write out the cause map. It can also be done on a dry erase board or chart paper in a

meeting. It can also be done electronically using tools like Microsoft Excel. And we show clients

how to do all three or four approaches in the workshops that we present.

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This slide shows an example of all three steps of cause mapping in Microsoft Excel. The

problem definition can be captured in one worksheet, the cause map can be captured in another

worksheet including all the boxes and connectors showing cause and effect relationships.

Evidence and solutions can also be added there. The third step is the action items can be tabled

on a separate worksheet. A thorough investigation is really about collecting and organizing all

the information to arrive at the best solutions.

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This is one of the tools our clients use to demonstrate the different levels of detail when

investigating an issue. It shows the Titanic incident at high-level of detail, the Titanic sank by

hitting and iceberg. It shows another level of detail that has 20 cause-and-effect relationships.

Then it shows another level of detail that has over a hundred cause-and-effect relationships.

Organizations that don’t know how to break a problem down specific cause-and-effect

relationships tend to just tell everyone “hey, don’t’ hit icebergs.” And it’s just not a sufficient

level of detail to get to specific solutions that ideally give the best leverage in preventing the

problem from recurring again.

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For more information about the cause mapping methodology, you are encouraged to

attend one of the public workshops which are held across North America on different dates and

locations. Information is available on the website below. Many workshops are presented at the

client’s workplace on specific issues. Templates are available upon request.

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References

Galley, M. 2007. Root-Cause Analysis – Titanic. ThinkReliabity.

http://www.youtube.com/watch?v=GOVeO5_0qD0