The Process for Conducting an RCA

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There are many potential causes of any disparity, so it’s important to gather diverse perspectives and input as you conduct your RCA. You’ll put together a team that will meet over the course of several weeks or months to discuss and organize identified causes.

Who will be involved in the RCA process?

Build a core team that includes multiple perspectives. This might include:

  • Patient representatives or CAB members: Patients have answers! Clinic staff may be too close to the problem or unwilling to recognize the root causes. Whenever possible, conduct focus groups or surveys with patients and involve CAB members in the root cause analysis process. Community groups that serve the priority population are another valuable resource. Click here to see tips for getting feedback from patients and for conducting focus groups (hyperlink).
  • An equity champion: ADD TEXT
  • A QI specialist: It can be useful to integrate the RCA team with your organization’s existing QI team. QI experts often have experience conducting a Root Cause Analysis and may offer helpful tips on doing it efficiently and effectively.
  • A leadership figure: It’s important to involve leadership, as they may have the influence to affect change once the root causes are identified. They also may be familiar with the policy-level causes of a disparity.
  • A front line provider and/or staff member: Frontline providers and staff, including administrative and support staff will be familiar with day-to-day details. Including their perspective is key to developing an accurate analysis.

How to engage participants in the RCA process

Ideally, your RCA team will gather information from different stakeholders, compile everyone’s input, and report back to see if any key information is missing.

It’s important to remember that the issues implicated in your RCA can be challenging to discuss because they are sensitive. You may be asking some tough questions about race. Some useful tips for facilitating these discussions include:

  • Asking open-ended questions. If your questions are too specific, you may limit the responses of your participants and you are likely to miss important factors.
  • Giving participants the opportunity to consider the topic outside of meeting with your team. They may have more time to develop ideas and discuss them with their peers.
  • Providing opportunities for anonymous feedback, or to provide feedback outside of the group.

Further resources for discussing sensitive topics is available here (hyperlink).

The important final step of any RCA is to make sure that the results are disseminated—throughout the organization.

Think carefully as a team about the best way to share this information and who should be the person(s) to share it. Remember that it’s always a delicate matter to call out problems and identify areas for improvement. Strategize so that your message is heard.