Appendix B - Causal Factor Worksheets

After an appropriate root cause model has been used to identify the direct cause, the root cause, and any

applicable contributing cause, these findings can be related to the ORPS cause categories by using one or

more of the worksheets in this appendix. Each of the seven major cause worksheets has a matrix to list

the applicable subcategory cause for each finding. (The same subcategory cause may be listed for up to

four similar findings under columns I through IV). The Worksheet Summary can be used to list, from the

individual worksheets, the one direct cause, the one root cause, and up to three contributing causes, their

descriptions, and the corrective actions for electronic entry.

Worksheet Instructions:

Check each worksheet as applicable or nonapplicable.

List subcategory cause information on each applicable worksheet.

List the applicable subcategory cause for the root cause, the contributing causes,

and the direct cause by placing an R, C, or D in the appropriate box. (The same

cause may be listed for up to four similar findings; for example, four different

failed parts).

Under cause description, reference each cause with the code and Roman numeral

from the matrix and describe each cause (explain how it was related to the

occurrence).

Under recommended corrective actions, list the action intended to correct each

cause to prevent recurrence.

Transfer the direct, the root, and up to three contributing causes and the corrective

actions to the Worksheet Summary. When there are more than three contributing causes,

select those that result in the greatest and most widespread improvement when corrected.

(Note that even though only three contributing causes may be reported, corrective actions

should be made for all identified causes). Use the ORPS PC software to transmit the

results to the ORPS database.

Refer to Appendix C for an example of how to use the worksheets.

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