The Problem With Root Cause Analysis

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Article Critique

In their study, Peerally, Carr, Warring, and Dixon-Woods (2017) approach the problem of patient safety which, according to the authors, remained a topic of interest since 1990 (para.1). Healthcare experts tried to learn from industries that included high risk (such as aviation, nuclear power, etc.). The evaluation of these industries’ practices brought one important practice that was implemented ever since it had been adopted. This practice is root cause analysis (or RCA). Authors claim that RCA is not a single technique but rather a number of interconnected practices that have a goal of evaluating possible risks and eliminating their aftermaths (Peerally et al. 2017, para. 1). RCA includes a significant number of approaches and tools that were taken from a variety of different industries and practices. These include taking into account the human factor and effectively learning from the safety science.

The authors state that, although broadly applied in the healthcare practice, RCA remains underdeveloped, which results in inefficient implementation of this practice. If RCA methods were researched and developed more, they would become an asset capable of dealing with a number of obstacles that the modern healthcare system faces. Therefore, the need to further broaden methods involved in RCA and research the problem of risk prevention in healthcare is an important topic that requires proper discussion and evaluation. In their article, the authors determine which challenging trends are prevalent in usage of RCA in modern healthcare and offer their opinions on how these issues may be resolved and what improvements the RCA system may require (Peerally et al. 2017, para. 1). If this study is considered successful and scientifically valuable, the RCA specialists may drastically improve the quality of RCA services which will lead to providing the patients with highly risk-free treatment.

Research Methods Evaluation

To deepen the understanding of RCA topic and provide corresponding argumentation, the authors used a significant number of scientific literature. The total number of sources used in completing this study is sixty-seven. It is evident that the research is supported by a considerable number of relevant materials. The sources’ publication dates vary from 1999 to 2016. Therefore, one may argue that the authors tried to include as many sources from different points in RCA research timeline as possible. Assuming that the RCA practice did not occur immediately after healthcare experts suggested learning from various high-risk industries, the implementation of RCA started in the late 90s. Thus, the authors included different sources that cover the topic in different periods of RCA’s development and research state.

Since this research is published in a peer-reviewed journal in 2017, its relevancy is out of the question. In fact, modern healthcare practice has to deal with a significant number of risks that occur when treating any patient. This is especially relevant to highly complicated cases and surgical procedures. All of these require healthcare practitioners to pay utmost attention to every aspect of patients’ safety. If all of the risks are successfully precluded, the treatment may become much easier as well as much more effective. These factors contribute to the relevancy of researching the RCA implementation topic, which, in turn, ensures that the study itself is highly relevant. Moreover, there are publications included in the source material for this study that were published less than two years ago which points out that this research was created with high relevancy in mind.

The type of research is determined by the fact that the authors compile the source material to provide coverage and evaluation of the topic suggesting possible improvements and solutions to challenges. Thereby, this study is of a basic research type which has a goal of compiling theoretical base which is then analyzed. The data analysis will then lead to a number of conclusions which are aimed at improving the understanding of a certain topic.

The sample material used in the study is presented by the materials that were analyzed in the process of performing the research. The authors attempted to cover as many aspects of RCA implementation as possible including quality of RCA investigations, political influences, evaluation of the prevailing risk control tools, quality of feedback, incidents analysis, and others. The sample tends to be taken unbiased with particular attention towards precision of the coverage that each source provides. Thus, in the context of this research, the included materials are most appropriate. Furthermore, the authors suggest that the RCA “is a promising approach with considerable face validity as a way of producing learning from things that have gone wrong” (Peerally et al. 2017, para. 14). They also note that, although highly viable, the RCA practices lack refinement and perfection. The RCA methods were unsuccessfully implemented in order to provide significant benefits to the quality of healthcare services. The authors provide eight reasons as to why the RCA functioning remained less efficient than required.

Article Structure and Possible Improvements

The design of this study assumes collecting credible data from various scientific publications regarding RCA practices. The data samples are then compiled and analyzed to uncover the problematic nature of the current RCA implementation. The collected data indeed demonstrates that the current RCA usage does not function properly resulting in much less effectiveness of this practice. Moreover, across the decades in which RCA was used, other problems started emerging which led to further negative effects. Data analysis uncovered specific connections between RCA methods of risk assessment and the output data recovered from analyzing each individual event. However problematic this may seem, it also points out that the methodology of this study is robust and well-chosen. The authors succeeded in creating a proper design which allowed them better sampling and analyzing data.

Moreover, the narrative of this article is highly comprehensible, and the study itself is structured very well. This makes it easier for the research consumer to evaluate and use it to deepen their knowledge. There seems to be no reason in improving the current state of the research. The only possible improvement would be to further increase the depth of the research by covering other various topics contributing to the RCA implementation. There is, of course, a possibility of further researching the topic. Moreover, the outcomes of this study may be used by healthcare practitioners to apply them to their practice which will serve as verification of the eight problems of RCA implementation. Furthermore, the practitioners themselves may contribute to this undoubtedly important research by providing expert opinions on it. This will not only deepen the research but also give it more scientific value.

The results of this study, as stated by the authors, may be applied to increase the effectiveness of RCA usage which will lead to improving the healthcare system as a whole. The RCA specialists must, therefore, pay attention to the reasoning that authors bring to light. However, there are certain factors that do not depend on how well the RCA specialists are carrying out their duties. Nevertheless, those aspects of RCA must also be noticed because they may improve healthcare on another levels and in other fields. Therefore, the main application of the results of this study is to provide guidelines for RCA specialists that will contribute to risk assessment procedures making them far more effective, while requiring fewer resources that must be spent to improve the overall quality of RCA.


To summarize, the article by Peerally et al. (2017) is a profound and thought through research which provides a significant coverage of the RCA implementation topic. The authors analyzed a high number of scientific sources which ensured the relevancy and depth of their study. They then proceeded to formulate their reasoning for the poor quality of RCA practices in the modern healthcare system. According to authors, there are currently eight important problems that RCA implementation has to deal with. These issues prevent healthcare system from being clearly evaluated from the risk factors standpoint. All in all, this is an excellent piece that may be further improved and used to improve the healthcare quality across the globe successfully. The article is clearly structured, narrated, and provides a solid reasoning behind the author’s assumptions. All of the evidence is supported by facts and scientific publications. Furthermore, the authors explicitly state why the topic is so important and what practical usage its discussion will bring.


Peerally, M. F., Carr, S., Waring, J., & Dixon-Woods, M. (2017). The problem with root cause analysis, BMJ Quality & Safety, 26(5), 417-422.

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"The Problem With Root Cause Analysis." NursingBird, 27 Dec. 2021,


NursingBird. (2021) 'The Problem With Root Cause Analysis'. 27 December.


NursingBird. 2021. "The Problem With Root Cause Analysis." December 27, 2021.

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NursingBird. "The Problem With Root Cause Analysis." December 27, 2021.