Ooops!! I could have had a...

I enjoy doing meaningful, robust investigations that really get to the root of the matter. They allow me to be involved in improving whatever process is impacted. This is something I find a great deal of satisfaction in.

The other day, I asked for feedback on a presentation I was giving for approval of an investigation I am working on. The investigation was not one of the type I had done before, was exceptionally high profile and had a very compressed time line for the level of effort and detail that would be required. I was given some reference numbers, in our database, of similar investigations I could review, and perhaps use as a template for my investigation.

Well, I did just that and started digging in. However, I was so zoned on completing the investigation, that I missed one of the key fundamentals I usually adhere to; I failed to utilize Fault Tree Analysis as a means of getting to Root Cause. I am not a disciple of Fault Tree Analysis. I AM A ZEALOT!! And yet, I failed to do what I am normally quite disciplined about doing.

Back to my feedback on the presentation: I was asked, "Where is your Fault Tree Analysis?" After trying to justify myself, I gave up and capitulated to what I knew was the truth; I had buried my nose so deep in the template, that I failed to do a thorough investigation.

I was forced (by my own behaviors) to rework my work (terribly painful on a personal level) and build my Fault Tree. The end result of the investigation was no different, but the Fault Tree provided substance to what I had done with the template and made it easy for the approvers to see my conclusion and how I had gotten there. In the end, I was glad I had to rework my work. (That's kind of a catchy phrase!)

I've now put together a little checklist for me to follow, so that when I am steeped in a big investigation, I won't slap my forehead with the heel of my palm and say, "Oooops!! I could have had a...

...Fault Tree!