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BT Assessments
Root Cause Assessment
Root Cause Assessment — Free Assessment
Assessment Form
Contact Name
(Required)
First
Last
Company Name
(Required)
Contact Email
(Required)
Problem Definition
Is the problem clearly defined with a specific, measurable impact statement agreed on by all stakeholders?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Is the scope of the problem bounded — identifying what is and is not part of the issue?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Recurrence History
Has this problem recurred after previous attempts to resolve it?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Is the frequency and pattern of recurrence tracked over time?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Causal Analysis Discipline
Has the team worked through at least five levels of ‘why’ to reach a structural root cause rather than a symptom?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Has the identified root cause been validated with data rather than assumption?
(Required)
Not at all
Basic / Partial
Mostly
Fully
People Factors
Are accountability gaps or unclear ownership a contributing factor to this problem?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Do the individuals closest to this problem have the skills and authority needed to resolve it?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Process Factors
Is the absence of a documented, followed process a contributing factor to this problem?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Are the process steps that lead to this problem consistently executed in the same way by all staff?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Technology Factors
Is the absence, misconfiguration, or failure of a system a contributing factor to this problem?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Would this problem be prevented or significantly mitigated by a technology change?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Data Factors
Is the absence or inaccuracy of data a contributing factor to decisions that lead to this problem?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Do the people who need to act on this problem have access to the right data at the right time?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Governance Factors
Is unclear ownership, authority, or policy a contributing factor to this problem?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Would this problem be prevented by a clear policy or decision right that currently does not exist?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Culture Factors
Are incentives or behavioral norms working against the outcome needed to resolve this problem?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Is there a cultural norm of escalating this issue rather than empowering the team to resolve it?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Prior Fix Analysis
Did prior fixes address symptoms rather than the structural root cause?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Were prior fixes implemented with sufficient change management and adoption support?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Systemic vs. Isolated
Is this problem isolated to one team, system, or process, or does it reflect a systemic organizational issue?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Are similar problems occurring in other parts of the organization from the same root cause?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Resolution Readiness
Is there executive sponsorship to implement a structural fix rather than another symptomatic patch?
(Required)
Not at all
Basic / Partial
Mostly
Fully
Does the organization have the capability and capacity to execute a root-level remediation?
(Required)
Not at all
Basic / Partial
Mostly
Fully
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