Root Cause Failure Analysis

Improving Reliability, Availability & Performance of Engineered SystemsBy

Dibyendu DeReliability Management Consultant Pvt. Ltd.

Agenda for Level 1 course

1. RCFA case studies 2. Energy Principle of RCFA 3. Not One; Not Two 4. Part & the Whole 5. Visible & the Invisible 6. FRETTLS technique 7. Developing Mindfulness of the Analyst

Is RCFA the right term to use?

May be it should be called "RCFU" - Root Cause Failure Understanding

Or

"URC" - Understanding Root Causes since there is never ever "one cause" for any failure

Or

"RCF" - Root Conditions for Failure - since number of conditions come together for a failure to happen.

Examples:

Why RCFA?

1. The only way to improve functioning of any complex system.

2. Great way to learn and teach

3. Easiest way to simultaneously eliminate multiple failures.

Examples:

RCFA Case Studies

Please wait....

Starts with Chapter 1 of the book Winning Anywhere the Power of See.. The "Sa" of Mr. Giri.

More case studies....

Principles of RCFA - Complexity

1. Energy flow2. Interactions3. Interdependence4. Entropy

Simple examples:

Not One; Not Two

Reading from the book... Winning Anywhere the Power of See...

Simple examples:

Part & the Whole

How does one see the whole?

Examples:

Visible & the Invisible

Axiom: What is visible is seldom the problem; what is invisible is the problem.

Cases...

FRETTLS Technique

F = Forces R = Reactions E = EnvironmentT = Temperature T = Time L = Lubrication S = Space, structure, speed, sync, substance, specifications, soil, .....

+

PLS3D Process

Examples:

Developing Mindfulness

1. Mindfulness training2. Games 3. Principles4. Design Awareness5. Journal6. Books7. Twitter & Facebook

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