IMPORTANCE OF FISH BONE DIAGRAM IN MANAGEMENT OF HEALTHCARE ORGANISATION

The Fishbone Diagram is a team brainstorming tool used to identify potential root causes to problems. Because of its function it may be referred to as a cause-and-effect diagram. 

In a typical Fishbone diagram, the effect is usually a problem to be resolved, and is placed at the "fish head". The causes of the effect are then laid out along the "bones", and classified into different types along the branches. Further causes can be laid out alongside further side branches.

Objective

The main goal of the Fishbone diagram is to illustrate in a graphical way the relationship between a given outcome and all the factors that influence this outcome.

The main objectives of this tool are:

• Determining the root causes of a problem.

• Focusing on a specific issue without resorting to complaints and irrelevant discussion.

• Identifying areas where there is a lack of data.

Field of application

The Fishbone diagram could be applied when it is wanted to:

• Focus attention on one specific issue or problem.

• Focus the team on the causes, not the symptoms.

• Organize and display graphically the various theories about what the root causes of a problem may be.

• Show the relationship of various factors influencing a problem. 

• Reveal important relationships among various variables and possible causes.

• Provide additional insight into process behaviors. 

Benefits

• Helps determine root causes

• Encourages group participation

• Uses an orderly, easy-to-read format to diagram cause and effect relationships

• Indicates possible causes of variation

• Increases knowledge of the process process by helping everyone to learn more about the factors at work and how they relate

Prerequisites

• A problem is composed of a limited number of causes, which are in turn composed of sub causes.

• Distinguish these causes and sub causes is a useful step to deal with the problem. 

In healthcare sector it is important that the management use this tool effectively to understand the day to day operational issues as these are multifactorial in nature and need attention to avoid any operational setbacks.

Analysis helps you identify causes that warrant further investigation. Since Cause-and-Effect Diagrams identify only Possible Causes, you may want to use a Pareto Chart to help your team determine the cause to focus on first.

• Look at the “balance” of your diagram, checking for comparable levels of detail for most of the categories.

A thick cluster of items in one area may indicate a need for further study.

A main category having only a few specific causes may indicate a need for further identification of causes.

If several major branches have only a few subbranches, you may need to combine them under a single category

• Look for causes that appear repeatedly. These may represent root causes.

• Look for what you can measure in each cause so you can quantify the effects of any changes you make. 

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