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Fish Bone Diagram

Fishbone Diagrams


A fishbone diagram is also called cause and effect diagram/Ishikawa diagram/Herringbone diagram/ Fishikawa diagram. This diagram is created by Dr. Karoru Ishikawa which is mainly used for product design or quality defect prevention to identify potential factors causing an overall effect.

When to use fishbone diagram:

A fishbone diagram is used in Brain Storming session to focus on conversation. Once the group has brainstormed all the possible causes for a problem, the facilitator helps the group to to rate the potential cause according to their level of importance. It is also used in the “analyze’’ phase of Six Sigma’s DMAIC (Define, Measure, Analyze, Improve, Control) approach to problem solving.

How does the fishbone diagram looks:

This design of fishbone diagram looks like a skeleton of of a fish. It typically works right to left with each large “bone” of the fish branching out to include smaller bones containing more details.

Fishbone diagram works on:

  1. Method
  2. Material
  3. Man
  4. Machine
  5. Environment

How to create fishbone diagram:

  • Create head, which lists the problem or issues that needs to be studied.
  • Create a backbone of fish (Straight line which goes to head)
  • Identify at least four “Causes” that create the effect and connect these causes with arrows to spine. This create first bone of fish.
  • Brainstorm around each “Causes “to document those things which leads to the cause. Use 5 Why or other questioning process such as the 4P’s (Polies, Procedure, People and Plant) to keep the conversation focused
  • Continue breaking down each cause until the root causes is identified.

How does the fish bone diagram looks:

Fishbone diagram

Five important point you need to understand before dealing into root cause analysis using fishbone diagram in Healthcare industry

  1. Being open towards the root cause analysis help you to identify the actual root cause and the relationship with it to the effect in turn to identify an effective solution.
  2. Discuss the causes in detailed way help the organization to identify modern solutions which you have not considered earlier
  3. Having a moderator helps to avoid digressive discussions and to bring the group together to identify action items.
  4. It is advisable to appoint a group moderator or facilitator while doing the brain storming session.
  5. More number of Healthcare professional are using fishbone diagram to analyze their problems.
  6. Visual diagram always gives an edge in analyzing clinical problems.



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