Book companion resource · Template

Root Cause Analysis Template (RCA Form)

Letter & A4. Print-ready. Free, no email required.

Using the template

Find the cause, prove it, then close the loop.

A root cause analysis template is a form that takes a team from one repeat failure to the cause behind it, and then to the actions that stop it. This one works in four moves: pick the right tool, map and rank the causes, prove the root cause, and track every action until it is checked at 60 days and again at 6 months.

The two-page RCA form below, printable as a PDF in Letter and A4.
A Fishbone table with the six standard categories and a ranking table for evidence.
An actions table that sorts every fix into PM, CBM, SOP or design.
A 60-day and 6-month verification, so the analysis does not die in a folder.

Pick the tool before you fill the form.

5 Whys: The story is short and linear: one event, and you can walk it backwards in your head. Use the 5 whys template and copy the root cause into section 6.
Fishbone: Several causes came together, and you need a team to map them across categories before chasing any one. That is what sections 5 to 7 of this form are for.
FMEA: The asset has not failed yet, or it was modified, and you want to catalog the risks first. That is engineering work, and it needs its own form.

Still unsure? The RCA Picker Flowchart decides in three questions.

A filled example: pump P-207.

Example from Fix the System, Chapter 13. The book follows a maintenance manager, Ray, through his first round of RCAs.

The failure. The seal on cooling-water pump P-207 kept failing. Six close-outs in a row said a version of the same thing: replaced seal, tested OK. The watch list put it in the top three by downstream cost.

The tool. More than one thing was in the story, so it got a Fishbone. The session ran 75 minutes with two rotating-equipment technicians (day and night shift), the production supervisor for the loop, an operator who had run that loop for nine years, and a facilitator. It produced 17 causes across the six categories.

The top three causes, ranked:

The operating setpoint had drifted 12% above design over three years, after a change made during a process upset was never reversed.
The seal material was wrong for the fluid temperature at peak demand.
The startup procedure had no dwell time for the seal faces to reach temperature.

The actions, one per channel: re-document the setpoint and add a deviation alert (CBM). Specify a different seal material and keep two in stock (design). Add the dwell step through the SOP change board (SOP).

The result in the story: no seal failure for the next 16 months. Then the alert fired, an operator caught the drift, and the setpoint was corrected before any damage. About 11 hours of analysis, against roughly $24,000 in parts, labor and downtime that the seal failures would have cost over those 16 months at the old rate.

Most RCAs fail after the meeting.

The session feels like the work. It is not. The work is the evidence in the weeks after, and the actions that land as work orders. If an action has no work order, no owner and no date, it will not happen.

Two numbers tell you whether your RCA program works. The book gives working bands for both:

RCA completion rate: the share of flagged repeat failures with a finished RCA and its actions closed or assigned. Aim for 90% or higher. Below 70% means analyses are opened and quietly abandoned.
Recurrence rate: the share of assets with a finished RCA where the same failure came back within two quarters. Aim for under 15%. Above 25% means the causes are wrong, or the actions never closed.

Questions planners ask

Is 5 whys the same as root cause analysis?: No. 5 whys is one RCA tool, the fastest one. It fits a single failure with a straight line of causes. When several conditions came together, a 5 whys follows one branch and misses the rest. That is when you run a Fishbone with a team, and this form is built for it.
Which failures should get an RCA?: Repeats first. Flag an asset when it has three or more failures under the same code in 12 months, when a technician marks a recurrence at close-out, or when it fails in less than half its expected interval. Each flagged asset gets a tool, an owner and a due date that same week.
Who should be in the room?: The technician who has done the repair most often, the operator who runs the asset, the planner, the area supervisor, and a reliability engineer if you have one. For a Fishbone, five to seven people. The maintenance manager facilitates but does not dominate.
How long does an RCA take?: A 5 whys takes about 20 minutes. A Fishbone session runs 60 to 90 minutes, then two to three weeks of evidence gathering. In the P-207 example the whole analysis took about 11 hours across three weeks. An FMEA on one asset takes three to six hours over two or three meetings.

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The PDF is the blank form. This web guide is excluded from printing so it does not add pages to the form.

One form for one repeat failure. Pick the tool, find the cause, prove it, then close every action. Built from the RCA method in Fix the System, Chapters 13 and 16.

Companion to: Fix the System, Chapters 13 and 16.

Who uses it: the RCA owner. Usually the planner for a Fishbone session, the technician who did the repair for a 5 Whys.

When: the same week the asset lands on your repeat-failure watch list.

Filed where: the asset's CMMS record, with the session notes and the work orders it opens.

1. Header

RCA ID: ____________ Date opened: ____________

Asset tag: ____________ Asset description: _____________________

Failure code: ____________ Work orders for the failures: ____________

RCA owner: ____________________ Facilitator: ____________________

2. The failure

One sentence. Specific equipment. Specific symptom.

_______________________________________________________________

Occurrences in the last 12 months (dates): _______________________________

Why this failure gets an RCA (check all that apply):

Three or more failures under the same failure code in the last 12 months.
A technician flagged it as a recurrence at work order close-out.
It failed in less than half of the expected time between failures for this asset class.
It was costly, unexpected or safety-adjacent.

3. Pick the tool

Pick by the problem, not by the tool you know.

5 Whys. One event, one straight line of causes you can walk backwards in your head. About 20 minutes. Use the 5 Whys worksheet and copy the root cause into section 6.
Fishbone. Several conditions came together. A team of five to seven, a 60 to 90 minute session, then two to three weeks of evidence. Use section 5.
FMEA. The asset is new or modified and has not failed yet. Engineering-led. This form does not fit; start an FMEA instead.

4. The team

Check that each role is in the room.

Technician who has done the repair most often
Operator who runs the asset
Planner who schedules the work
Reliability engineer, if the plant has one
Area supervisor

Names: _______________________________________________

5. Causes (Fishbone)

Write the failure at the head. For each category ask what actually contributed, in your observation. Not what could have. Collect first, rank later.

Category	What actually contributed
People
Method
Machine
Material
Measurement
Environment

Rank and investigate

Rank by confidence and impact. The top three to five become investigation targets. Each one gets evidence, an owner and a due date.

Cause	Evidence to collect (inspection, history, test, interview)	Owner	Due	Confirmed?
1.
2.
3.
4.
5.

6. Root cause and the confirmation test

Confirmed root cause(s), one sentence each:

Root cause 1: _______________________________________________________

Root cause 2: _______________________________________________________

Root cause 3: _______________________________________________________

If we fix these, does the failure stop on this asset, and on similar assets with similar conditions?

Yes. Continue to section 7.
No, or not sure. The analysis is not done. Keep investigating.

Answers that mean you have not found the root: "operator error", "part failure", "wear and tear", "we don't know".

7. Corrective actions

Every root cause gets at least one action, opened as a work order or a change request, with an owner and a date.

Action	Channel (PM, CBM, SOP, Design)	WO or change #	Owner	Due
1.
2.
3.
4.
5.

Channel key: PM, a PM task added or changed. CBM, a sensor, threshold or alert. SOP, an operating or maintenance procedure, or training. Design, a spec, material or part change.

Similar assets with the same conditions (open a tracking work order for each):

_________________________________________________________
_________________________________________________________

8. Verification

60-day check (date: ____________): actions implemented ______ of ______. Blocked actions and why: _______________________

6-month check (date: ____________): has the failure recurred on this asset? ☐ No ☐ Yes

If yes, one of three things is true:

The root cause was right, but an action never closed. Audit the work orders.
The root cause was right, but the change did not hold. Redesign the action.
The root cause was wrong. Reopen the analysis.

9. Sign-off

RCA owner: ____________________ Date: ____________

Facilitator: ____________________ Date: ____________

Area supervisor: ____________________ Date: ____________

File location

This form attached to the CMMS record for asset tag ____________.
Every action in section 7 opened and referenced on this form.
60-day and 6-month checks scheduled with an owner.

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