Current Reality Trees An Action Learning Tool for Root Cause Analysis

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Current Reality TreesAn Action Learning Tool for
Root Cause Analysis
Henry Mosley Strategic Leadership Seminar for
Population and Reproductive Health
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The Critical Question for the Action Learning
Organization

• Why is there a difference between the desired
  future and the current reality?

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What is a Current Reality Tree?

• The Current Reality Tree is a systems analysis
  tool that can help uncover the fundamental
  underlying forces that are sustaining the current
  system, and therefore are constraining the usual
  programmatic efforts to reach the desired future.

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Who Creates a Current Reality Tree?

• Developing a current reality tree must be an
  action-learning team process with members coming
  from diverse backgrounds who can bring a broad
  insight into the problem from the household,
  community and government perspectives.

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What Information is Necessary?

• Building current reality trees requires that the
  team initially agree on
• a clear picture the desired future and,
• a detailed description of the current situation,
  highlighting the recognizable practices, values
  and resources related to the issue of concern

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How Are Current Reality Trees Created?

• The process of creating the tree involves asking
  questions and engaging in deep reflection in
  order to get deep down to the underlying or root
  causes that are sustaining the current
  situation.
• Some of these roots will be core problems
  that must be dealt with in order to produce the
  sustainable changes necessary to reach the future
  we want

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Steps to Creating a Reality Tree
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Step 1. Identify the Action Learning Team

• For Root Cause Analysis to work, the action
  learning team must have a diverse membership that
  can answer Yes to the following questions
• Do we have intuitive knowledge about the
  situation?
• Can we recognize and understand the deeper
  patterns and interactions in our system?

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Step 2. Specify the Problem

• The problem the team will be asked to address
  must be
• Familiar - to the team
• Important significant for the team
• Urgent solutions will be acted on soon
• Feasible not overly complex
• No existing solution not a technical problem
  requires adaptive/generative learning
• Provides a learning opportunity
• And the team must have authority for solutions
  and action

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Step 3 Select the Key Question
The Key Question begins with Why ? This is
the issue around which you will build your
Reality Tree. Examples Why are there so many
unintended pregnancies? Why are women not
using safe delivery services? Why do women fear
modern contraception? Why is the HIV rate so
high among adolescent girls?
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Step 4 Create a List of Undesirable Effects
(UDEs)
Refer to your description of the Current
Situation and make a list of the reasons or
answers to your Key Question. These will
involve the practices, values and resources you
have identified at the household, community and
government levels. These will mostly be
negative factors that are related to the gap
between your vision of the desired future and the
current reality.
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Step 4 Create a List of Undesirable Effects
(UDEs) continued

• These reasons will be called Undesirable
  Effects (UDEs).
• They are negative or bad conditions and are
  therefore undesirable.
• They are also effects because for the most part
  they are caused by something else.

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Step 5 Connect Your UDEs in a Logical Order of
Cause and Effect

• Each UDE should be considered both as a statement
  (or answer to a question) and as a pointer to a
  deeper question
• The UDEs therefore, identify various elements in
  a complex system of cause and effect relationships

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Step 5 Connect Your UDEs in a Logical Order of
Cause and Effect

• The task of the team is to make the logical
  connections among the UDEs, gaining a deeper
  understanding until they finally get down to some
  root causes.
• By this process a Current Reality Tree is
  created

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What Does a Reality Tree Look Like?
Key Question WHY is happening?
Undesirable Effect - UDE
Undesirable Effect - UDE
Undesirable Effect - UDE
Undesirable Effect - UDE
Undesirable Effect - UDE
Undesirable Effect - UDE
Undesirable Effect - UDE
Undesirable Effect - UDE
Root Cause
Root Cause and CORE PPROBLEM
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Step 5 Connect Your UDEs in a Logical Order of
Cause and Effect

• Write each of your UDEs on a Post-it note (or
  index card).
• Now look for relationships among the UDEs.
• Decide if one may be the cause of another.
• Then arrange these two vertically with the
  cause below the effect.

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Example
Why dont pregnant women use government health
clinics for maternity care?
Service quality is poor
Clinic supervision is infrequent
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Step 6 Identify Intervening Steps That May Be a
Part of Your Original Pair
Ask yourself Is this the true cause of this
effect, or are there intervening steps
missing?

• These may be
• UDEs already in your list.
• New causes (UDEs) not in your original list.
• UDEs that have been placed in in the wrong
  sequence.

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Example
Original
Revised
Service quality is poor
Service quality is poor
Staff performance is poor
Clinic facilities are disorganized
Clinic supervision is infrequent
Staff training is inadequate
Clinic supervision is infrequent
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Step 7 Repeat This Process With Remaining UDEs
From Your Original Group

• Connect all possible remaining UDEs together.
• Connect the remaining UDEs to the first pair or
  to other clusters where possible.
• Look for multiple causes for a single UDE.

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Step 8 Review and Trace
If you are lucky you will have connected all of
your UDEs. What is more likely is that you have
groupings of unconnected branches in your
Current Reality Tree.
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Example
Why dont pregnant women use government health
clinics for maternity care?
Service quality is poor
People prefer traditional birth attendants
Staff performance is poor
Clinic facilities disorganized
Traditional TBAs are readily available
Staff training is inadequate
Clinic supervision is infrequent
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Step 8 Review and Trace continued

• Now your objective is to trace the cause and
  effect chain deeper in each branch until you
  reach an end point or Root Cause.
• Choose a single branch and start asking deeper
  questions
• At the lowest UDE always ask why does this
  exist? The answer will be the next lower UDE.

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Step 8 Review and Trace continued
To speed up the connection process look for
lateral or intermediate connections. These are
connections that can join two groups of branches
together.
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Step 9 Pruning your Tree

• Look at your original UDE list one more time.
  Have they all been used?
• Prune any entities not required to connect all
  the UDEs.
• Look for unrelated UDEs or Facts of Life.
  Since these are not in the causal chain, they
  will not be dealt with in this analysis.

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Step 10 Identify Root Causes and the Core Problem

• Locate all Root Causes (entities with arrows
  coming out but with none going in).
• Determine if any Root Cause accounts for more
  than 70 of the UDEs if so then that can be
  considered as your Core Problem.

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Example
Service quality is poor
People prefer traditional healers
Staff performance is poor
Clinic facilities are disorganized
Traditional healers are readily available
Staff training is inadequate
Clinic supervision is infrequent
There is no community involvement in health
Root cause and Core problem
Government priorities are always changing
Root cause
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The Strategic Objective Is Directed to
Tackling the Core Problem
Sphere of Influence
Sphere of Control
Leaders recognize that their sphere of
influence for change is far greater than their
sphere of control.