Contoh Form Rca (simple).docx

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Form : ROOT CAUSE ANALYSIS Analisis terhadap KTD: Tim RCA Ketua Anggota Diskripsisingkatkejadian: ( Ringkasan Kasus ) Faktor yang menjadipencetus (trigger): ( Identifikasi faktor pencetus ). Kronologikejadian: ( Urutan Kejadian di ceritrakan)

Faktor-faktor yang terkait dengan kejadian: a. Faktor-faktor yang terkaitlangsung: b. Faktor-faktor yang menunjang terjadinya kejadian:

Analisisakarmasalah : (gambarkan diagram tulangikan/pohonmasalah)----five why

Rencanasolusi: ( rekomendasi pemecahan akar masalah )

ImplementasidanTindak lanjut: ( Action Plan----- PDCA ) Pelaporan: ( Lap.Hasil RCA )

Contoh Form Rca (simple).docx

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